• Title/Summary/Keyword: choice criteria

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A Study on Prescription and Management of Medicines by School-Nurses (양호교사(養護敎師)의 투약(投藥) 및 의약품관리(醫藥品管理) 실태(實態))

  • Kim, Jung Hee;Park, Jae Yong;Cha, Byung Jun
    • Journal of the Korean Society of School Health
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    • v.11 no.2
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    • pp.297-307
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    • 1998
  • The purpose of this paper is to understand the prescription and management of medicines by school-nurses. A survey was mailed to 199 school-nurses in elementary and secondary schools in Pusan from February 10 to March 31, 1997. It was shown that 97.0% of the schools have visiting school-doctors and only 29.6% have visiting school-pharmacists. 36.7% of the respondents don't know the amount of this annual health-related budget. Concerning the annual budget of purchasing medicines, 50.4% of the elementary schools spend 210,000 won to 400,000 won and 45.0% of the secondary schools spend more than 610,000 won. 56.3% of the respondents said the budget was enough, but 5% said it was not. 70.9% of the schools purchase medicines twice a year. The average number of students visiting the nurse in a year are 1,892 in elementary schools, 1.6 times per student and 2,471 in secondary schools, 1.7 times per student, respectively. The annual average number of students who were prescribed medicine a year are 1,804 in elementary schools, 1.5 times per student, 2,372 in secondary schools, 1.7 times per student. The percentage of students who are prescribed internal medicines was 45.5% in elementary, schools and 61.3% in secondary schools, respectively. To the preralence sicknesses, the wound was the most common, accounting for 42.7% in elementary and 22.6% in secondary schools. Next was abdominal pain, indigestion, and headaches in elementary schools; and colds, indigestion, and abdominal pain in secondary schools, respectively. To the dirersity of medicines prescribed: internal medicines 29 for abdominal pain, 25 for indigestion, 8 for physiological pain, 13 for headaches, 30 for colds, and 10 for eye disease; external medicines 2 for skin disease, 10 for toothaches and 31 for other sicknesses. 42.7% of the respondents said the schools have enough medicines, but 7.6% said that schools need more. 50.8% of the respondents said they get information on medicines from TV advertisements or medicine-related books, 16.6% get information from visiting pharmacists. More experienced nurse-teachers are likely to get information from visiting pharmacists, but 37.5% of the respondents who have less then four year experience in school get information through other nurse-teachers before deciding to buy medicines. To the choice of medicines: 83.9% of the respondents said that they choose safe medicines with less side-effects. 40.7% responded that they write down the prescription history daily, but 6.1% said they do this only once in two or three months. To the confidence in prescriptions, 37.7% of the respondents said they are sure of the effectiveness of the medicines they prescribe. To what extent the nurse-teachers prescribe, 50.3% said they prescribe to the level of anagelics, and 21.1% prescribe to anti-histamines and antibiotics. 80.4% said that the details of illnesses and medicines to be prescribed in school should be regulated by a school health-care law. To the problems in prescription, 79.9% of the respondents worry about abuse by students who want prescriptions but have no serious illnesses, 57.8% worrg about the lack of information on medicines and dosage. And 55.8% said they can't tell the difference between medicines whose brands are different, but bare the same ingredients. The conclusion of this study is that a health education program is necessary to prevent the misuse or abuse by students and a continuing education program for school-nurses is needed to solve the problems related to the purchasing and prescription of medicines. The criteria of the prescription of medicines also should be regulated by a school health-care law or management acts.

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"Legal Study on Boundary between Airspace and Outer Space" (영공(領空)과 우주공간(宇宙空間)의 한계(限界)에 관한 법적(法的) 고찰(考察))

  • Choi, Wan-Sik
    • The Korean Journal of Air & Space Law and Policy
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    • v.2
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    • pp.31-67
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    • 1990
  • One of the first issues which arose in the evolution of air law was the determination of the vertical limits of airspace over private property. In 1959 the UN in its Ad Hoc Committee on the Peaceful Uses of Outer Space, started to give attention to the question of the meaning of the term "outer space". Discussions in the United Nations regarding the delimitation issue were often divided between those in favour of a functional approach ("functionalists"), and those seeking the delineation of a boundary ("spatialists"). The functionalists, backed initially by both major space powers, which viewed any boundary as possibly restricting their access to space(Whether for peaceful or military purposes), won the first rounds, starting with the 1959 Report of the Ad Hoc Committee on the Peaceful Uses of Outer Space which did not consider that the topic called for priority consideration. In 1966, however, the spatialists, were able to place the issue on the agenda of the Outer Sapce Committee pursuant to Resolution 2222 (xxx1). However, the spatialists were not able to present a common position since there existed a variety of propositions for delineation of a boundary. Over the years, the funtionalists have seemed to be losing ground. As the element of location is a decisive factor for the choice of the legal regime to be applied, a purely functional approach to the regulation of activities in the space above the Earth does not offer a solution. It is therefore to be welcomed that there is clear evidence of a growing recognition of the defect inherent to such an approach and that a spatial approach to the problem is gaining support both by a growing number of States as well as by publicists. The search for a solution of the problem of demarcating the two different legal regimes governing the space above the Earth has undoubtedly been facilitated, and a number of countries, among them Argentina, Belgium, France, Italy and Mexico have already advocated the acceptance of the lower boundary of outer space at a height of 100km. The adoption of the principle of sovereignty at that height does not mean that States would not be allowed to take protective measures against space activities above that height which constitute a threat to their security. A parallel can be drawn with the defence of the State's security on the high seas. Measures taken by States in their own protection on the high seas outside the territorial waters-provided that they are proportionate to the danger-are not considered to infringe the principle of international law. The most important issue in this context relates to the problem of a right of passage for space craft through foreign air space in order to reach outer space. In the reports to former ILA Conferences an explanation was given of the reasons why no customary rule of freedom of passage for aircraft through foreign territorial air space could as yet be said to exist. It was suggested, however, that though the essential elements for the creation of a rule of customary international law allowing such passage were still lacking, developments apperaed to point to a steady growth of a feeling of necessity for such a rule. A definite treaty solution of the demarcation problem would require further study which should be carried out by the UN Outer Space Committee in close co-operation with other interested international organizations, including ICAO. If a limit between air space and outer space were established, air space would automatically come under the regime of the Chicago Convention alone. The use of the word "recognize" in Art. I of chicago convention is an acknowledgement of sovereignty over airspace existing as a general principle of law, the binding force of which exists independently of the Convention. Further it is important to note that the Aricle recognizes this sovereignty, as existing for every state, holding it immaterial whether the state is or is not a contracting state. The functional criteria having been created by reference to either the nature of activity or the nature of the space object, the next hurdle would be to provide methods of verification. With regard to the question of international verification the establishment of an International Satelite Monitoring Agency is required. The path towards the successful delimitation of outer space from territorial space is doubtless narrow and stony but the establishment of a precise legal framework, consonant with the basic principles of international law, for the future activities of states in outer space will, it is still believed, remove a source of potentially dangerous conflicts between states, and furthermore afford some safeguard of the rights and interests of non-space powers which otherwise are likely to be eroded by incipient customs based on at present almost complete freedom of action of the space powers.

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Modified FOLFOX-6 Chemotherapy for Recurrent or Inoperable Gastric Cancer Patients (진행성 위암 환자예시의 FOLFOX 6 항암치료)

  • Jee, Sung-Bae;Han, Jae-Hyun;Huh, Hoon;Song, Kyo-Young;Chin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Kim, Seung-Nam;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.8 no.1
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    • pp.40-46
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    • 2008
  • Purpose: We wanted to evaluate the efficacy and toxicity of modified FOLFOX-6 chemotherapy for treating recurrent or inoperable gastric cancer patients. Materials and Methods: From April 2006 to August 2007, 35 patients with recurrent gastric cancer after curative resection and 43 patients with inoperable gastric cancer underwent chemotherapy, and the results were retrospectively investigated. Results: 78 patients were assessable for response and toxicity, and they underwent an average of 7.1 cycles of chemotherapy. The response was evaluated according to the RECIST criteria. 11 partial responses (14.1%), 35 cases of stable disease (44.9%), and 32 cases of progressive disease (41%) were observed. The median time to progression was 6 months, and the average overall survival was 13 months. CTCAE grade 1 or 2 anemia (52.6%) was the most prevalent toxicity. Other common toxicities included thrombocytopenia (17.9%) and peripheral neuropathy (30.8%). There were 13 changes in the chemotherapy regimen to S1-cisplatin due to disease progression, but only an average of 1.76 cycles of S1-cisplatin were delivered due to severe toxicities and poor compliance. Conclusion: Acceptable efficacy and toxicity were seen as 59% of the patients showed non-progression, and no grade 3 or 4 toxicities were observed. In conclusion, the modified FOLFOX-6 chemotherapy is considered to be the proper 1st-line choice as a palliative treatment for recurrent or inoperable gastric cancer patients.

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An Ethnographic Study about Taegyo Practice in Korea (태교 실천에 대한 일상생활 기술적 연구)

  • 김현옥
    • Journal of Korean Academy of Nursing
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    • v.27 no.2
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    • pp.411-422
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    • 1997
  • The purpose of this study is twofold : (i) to investigate how much effort the married couples are making for the good health of both the pregnant woman and her unborn child from the time of their marriage to and during the period of conception : and (ii) to comprehensive investigate socio-cultural back-grounds which affect prenatal effort. Result of this study provide a basis for the prenatal care program which will be appropriate to our culture. This study has been done by the ethnographic research method. The subjects of this study are 53 people in all consisting of 33 pregnant women and 20 husbands. In order to investigate socio-cultural factors which influence Taegyo, producers of Taegyo music were interviewed. In addition the researcher surveyed the markets of Taegyo music, participated in special courses of prenatal education, analyzed the content of the books and periodicals dealing with Taegyo, and collected the concept of Taegyo distributed by the mass media. The full-fledged study continued for eight months from February to August.1996. The data were analyzed as soon as they were collected. Spradly's(1979, 1980) developmental, sequential method of domain analysis. taxonomic analysis, componential analysis, and theme analysis in this order was adopted as the procedure of analyzing the data. To obtain the exactness of study, Sandelowski's (1986) four criteria, that is, Credibility, Fittingness, Auditability, and Confirmability were applied to all stages of data collection, data analysis, the interpretation of the result, and the description of the result. The following are the result : 1. The couples' Taegyo at the stage of preconception was related to their physical, psychological, spiritual conditions under which a healthy baby will be born. Specific methods they prefer are : "the choice of one's spouse." "physical check-up," "physical good health, " "praying, " and so on. 2. When the marriod couple have sex in order to conceive, their Taegyo was related to the imposition of their physical, psychological, and environmental conditions. Specific methods they prefer are : "having sex at specific time, " "having sex in nice place." "to purify their minds while having sex," and so on. 3. The married couples' Taegyo while they are in pregnancy was related to the imposition of their physical. psychological, emotionmental. environmental, social and spiritual conditions. Specific methods they prefer are : "listening to music. " "reading," "looking at beautiful things only," "to avoid looking at or listening to bad things." "to eat food in good shape, " "to avoid drugs," "eating Korean herbal medicine." "sexual abstinence," "to avoid dangerous places," "to keep emotional tranquility," "moderate exercises and rest." "leading a pure life." "praying." "being aware of their words and behavior." "for the couple to keep a good relationship." "interaction with their unborn child," "to support Taegyo for pregnant women," and so on. 4. The married couple put Taegyo into practice on the basis of the following principles : the principle of respecting an unborn child, the principle of forming a good disposition. the principle of top-down parental love, the principle of synergy between a pregnant woman and her unborn child, the principle of expecting a good child, the principle of forming a good habit, and the principle of acquiring a parental role. 5. The practice of Taegyo is influenced by such factors as the married couple, the supporting system, and the mass media. As the husband -and-wife factor, their information of Taegyo, the degree of importance is assigned to their characters, their time to spare, their healthiness, the age of pregnant woman, their conception plan, their religion, their belief of the Taegyo effects, and the birth of a baby in this order. The factor of the supporting system consists of her husband's support, her family support, and her neighbor's support. The mass media factors include the broadcasting media, books specialized in Taegyo, periodicals for pregnant women, booklets for advertizing powdered milk, Taegyo music of record manufacturing companies, and the teaching materials for gifted children. Among these the mass media is especially taking advantage of Taegyo as its main source of economic profits are leading the public behavior pattern to a prodigal one. Taegyo is a self-control behavior which requires practice for the following : the physical and psychological good health of the pregnant woman and her unborn child, the development of the unborn child's good character, the development of the unborn child's intelligence and talents, the expectation of the unborn child's good features. shape a good habit, the expectation of the unborn child's bright future, and the learning of a parental role, the expectation of male birth. Above all it is a type of our good cultural tradition which pursues a value higher than the one that the prenatal care does. The principles of pregnancy care inherent in the habit of Taegyo will provide us a guideline for the development of the prenatal care.

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The Short Term Efficacy of Entecavir Therapy in Chronic Hepatitis B (만성 B형 간염 환자에서 엔테카비어의 단기 치료 효과)

  • Kim, Hyun;Chae, Hee-Bok;Jeon, Won-Joong;Park, Seon-Mee;Youn, Sei-Jin;Eun, Jong-Ryul;Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.31-40
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    • 2008
  • Background/Aims : Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. Materials and Methods : Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = $5\;log_{10}\;copies/ml$. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. Results : Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < $5\;log_{10}\;copies/ml$ or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log10 copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. Conclusions : Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.

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