Objectives: This study aims to determine the healthcare workers’ (HCWs) attitudes, perceptions, and practices regarding Antimicrobial Stewardship (AMS) at the Philippine Children's Medical Center (PCMC). Materials and Methods: This cross-sectional study employed a validated online survey. Results: The study included 288 healthcare workers, predominantly female (77.35% ) and aged 31-40 years (47.74%), with physicians being the largest professional group (57.14%). HCWs had positive attitudes toward AMS. They perceived moderate to high antimicrobial resistance (AMR) levels in different contexts but believed the hospital had lower AMR levels than the country. HCWs agreed that AMR impacts antimicrobial choices, patient outcomes, and safety. Contributors to AMR were prescribing inappropriate antimicrobials, unnecessary prescriptions, poor patient adherence, and inadequate infection control measures. HCWs, except medical technologists, were aware of the Antimicrobial Stewardship Program (ASP) and its interventions. Only nurses and pharmacists were aware of the hospital policies against AMR. Barriers to AMS implementation include inadequate training in antimicrobial use, lack of infectious disease/ microbiology services, lack of electronic medication management services, and personnel shortages. HCWs had high self-reported AMS practices, but a practice gap in single-dose surgical antibiotic prophylaxis was identified, with low physician adherence (50.6%). Conclusion This study revealed positive attitudes and high self-reported AMS practices among HCWs. They also perceived moderate to high AMR in different contexts but believed that the hospital has lower AMR levels than the country. Addressing the identified barriers to implementation and practice gaps is crucial for achieving antimicrobial stewardship goals.
Antimicrobial Stewardship ; Viperidae ; Health Personnel

PURPOSE: Though web-based tests have many advantages, they do not become the main test form in medical education because of their many technical or operational limitations. We have developed a new web-based test system to overcome these limitations and, ultimately, to replace conventional paper and pencil tests. METHODS: We developed a web-based test system using a windows 2000 server, mySQL, visual basic 6.0 and ASP script as developing tools. We applied this system to formal examinations. The system was modified and optimized based on users' demands and problems identified during testing. RESULTS: Since web-based testing was first administered in 2003 to the third-year students during their clinical practice examinations, it has been used in 51 examinations at the College of Medicine in Chungbuk National University. In 2004, it was used in more than a half of the regular examinations at our medical college. At the beginning, lecturers were reluctant to adopt a new test system because of unfamiliarity and fear of additional workload. Shortly, however, they found that they were able to handle the multimedia contents more easily and obtain much information from results analysis without additional work. Examinees also favored web-based tests in presenting multimedia data but had some difficulties in focusing on the test. Overall, examinees' preference for web.based tests was comparable to conventional tests. According to user demand, we improved this test system by verifying question formats and making test analysis. CONCLUSION: Web-based tests can replace paper and pencil tests in medical education. Improvement of this testing system is expected with serious and continuous concerns from examiners.
Chungcheongbuk-do ; Education, Medical* ; Humans ; Multimedia ; Viperidae

PURPOSE: The standardized patient (SP) is a person carefully trained to represent a real patient case for consistent and accurate use in student performance evaluation and/or training, has added a very important dimension in OSCE. The purpose of this study is compared a well-trained professional SP (PSP) and a amateur SP (ASP) in OSCE. METHODS: We surveyed 378 students apprentices and staffs involving OSCE of Daegu-Kyungbuk Consortium and analysed the validity between the PSP and ASP after OSCE. RESULTS: Of 92 total stations in which students were evaluated by staff evaluator, SP were used in 47 stations (48%). Of the 47 stations, professional SP 7 stations (16%). The questionnaires were made to know the effectiveness and realistics of SP. The results were different between station used PSP and ASP. Moreover, it was significantly different between the staffs and the students. The SP can offer advantages such as availability, adaptability and effectivity. If trained well, they also can provide positive effects to the students and the staffs. The PSP provides efficient and reliable opportunity to assess clinical skills in a safe situation without any harm to the real patients. CONCLUSION: It is suggested that the use of SP is stimulating and challenging way of evaluating the OSCE. Also, It appeared to be financially and availably feasible if it commonly owned in the boundary of the land such Daegu-Kyungbuk Consortium.
Clinical Competence ; Humans ; Viperidae ; Surveys and Questionnaires

BACKGROUND/AIMS: We evaluated the status of antibiotic stewardship programs (ASPs) for physicians. This survey was a follow-up study of data from 2006 and was performed with some new questions about ASPs. METHODS: The online survey collected information on infectious diseases from doctors in 84 hospitals. The questions included some about ASPs. The data were analyzed and compared with a previous report. RESULTS: Responses came from 40 hospitals. ASPs existed in 87.5% of these (95.5% in 2006), and a computerized preauthorization system was the most common method (85.0%, 59.1% in 2006). An antimicrobial management team existed in 33 hospitals (82.5%), and the preauthorization systems were mainly implemented by infectious disease doctors (72.5%). Incentives to set up ASPs existed in only 12.5% of hospitals (2.3% in 2006). CONCLUSIONS: Computerized preauthorization ASP systems are relatively more common. To improve the uptake of ASPs in each hospital a team approach from the medical institutions is required, along with the cooperation and willingness of those involved.
Anti-Bacterial Agents ; Communicable Diseases ; Follow-Up Studies ; Motivation ; Viperidae

Recently, Wireless internet market has reached to the induction and growth stage by rapid development of Mobile service by fusion of Internet and wireless technology of communications. This paper improved the problem of a result report system of the donation of blood inspection which is delivered to the mail currently. We can confirm the result of the blood inspection to the execution. The user uses cellular phone taking the security of the individual into account. We used ASP language with WML and developed in this paper, Database used MS-SQL2000 Servr and Web server used a host server which offers Mnuri.
Cellular Phone ; Internet ; Postal Service ; Viperidae ; Wireless Technology

One of the major clinical issues encountered after lumbar spinal fusion is the development of adjacent segment pathology (ASP) caused by increased mechanical stress at adjacent segments, and resulting in various radiographic changes and clinical symptoms. This condition may require surgical intervention. The incidence of ASP varies with both the definition and methodology adopted in individual studies; various risk factors for this condition have been identified, although a significant controversy still exists regarding their significance. Motion-preserving devices have been developed, and some studies have shown their efficacy of preventing ASP. Surgeons should be aware of the risk factors of ASP when planning a surgery, and accordingly counsel their patients preoperatively.
Humans ; Incidence ; Pathology* ; Risk Factors ; Spinal Fusion* ; Stress, Mechanical ; Viperidae

Although it has been known that seminal plasma (SP) modulates immune responses, the morphologic and functional effects of SP on mast cells have not been well documented. The purpose of this study was to determine the morphologic and functional effects of SP from the azoospermic (ASP), oligozoospermic (OSP) and normozoospermic (NSP) men on rat peritoneal mast cells (RPMC). By inverted microscopy, degranulation of RPMC occurred by treatment of OSP, NSP or compound 48/80. Treatment of RPMC with OSP and NSP resulted in increase in size and decrease in surface folds and bulged granules from the cell surface indicating that degranulating processes took place. Irregular cell surface with few microvilli and large degranulation channels filled with altered granules of various sizes were observed in OSP or NSP-treated RMPC. The degranulation index (DI) of RPMC treated with HBSS was 8.8+/-5.0. SP-induced DI was 11.9+/-6.2, 57.1+/-16.9 and 61.9+/-15.8, in ASP, OSP and NSP, respectively. The DI of RPMC treated with compound 48/80 (1 microgram/ml) was 83.5+/-21.4. These results indicated that the OSP, NSP but not ASP, induced the degranulation of RPMC. OSP and NSP induced histamine release (HR) from RPMC (4.5x105 cells). The HR of RPMC treated with HBSS was 1,030+/-196.6ng/ml, whereas ASP, OSP and NSP-induced HR was 1,010+/-204.7, 2,794+/-453.3 and 2,899 +/-366.7 ng/ml, respectively. The HR of RPMC treated with compound 48/80 was 6,300+/-476.2 ng/ml. Intracellular calcium level(ICL) of RPMC was also increased by OSP and NSP. The ICL of RPMC treated with HBSS was 6.1+/-1.0 pmole. ASP, OSP and NSP-induced ICL was 9.0+/-1.1, 81.2+/-18.5 and 76.6+/-18.0 pmole, respectively. The ICL of RPMC treated with compound 48/80 was 102.9+/-22.2 pmole. From the above results, it is suggested that OSP and NSP contain some factors to degranulate RPMC by the increase of intracellular calcium level.
Animals ; Calcium ; Histamine Release* ; Histamine* ; Humans ; Male ; Mast Cells* ; Microscopy ; Microvilli ; Rats* ; Semen* ; Viperidae

Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumor of uncertain origin, and it has a strong propensity for metastasis to the lungs, bones and brain. We report upon an unusual case of ASPS, presenting as multiple lung nodules with no other detectable primary site, in a 44-year-old man. A fine needle aspiration of the nodules yielded scattered, discohesive cells, each containing an eccentrically displaced nucleus and prominent nucleolus, on a granular background. Tumor cells with numerous bared nuclei, and occasional sheets of epithelioid cells were also found. Under the cytological diagnosis of an unclassified epithelioid malignant tumor, resection of the lung nodules was performed. The histologic findings were consistent with ASPS, showing positive TFE3-nuclear immunoreactivity. There is limited literature concerning cytological findings associated with pulmonary ASPS: especially in cases where the primary site is unknown. Here, we present a cytological review of pulmonary ASPS, investigating the significance of TFE3 staining in the diagnosis of ASPS.
Adult ; Biopsy, Fine-Needle ; Brain ; Epithelioid Cells ; Humans ; Lung ; Neoplasm Metastasis ; Sarcoma, Alveolar Soft Part ; Viperidae

Database system construction using raw data in nursing research would be useful resource because of keeping and accumulating source data. The purpose was to provide with the effect of keeping and managing data through the development and maintenance of bank construction program done on the web. The structure of database was made on the basis of research format such as author, study purpose, study method and period. In addition it was made to be e-mail address of author and study field. Also it was attached data files, questionnaire and variables. This database system was connected with web using ODBC and ASP technolgy on the Microsoft Windows 2000. It was available to connect by membership to prevent from releasing source data without permission. Data provider and its user could communicate with each other on the web. Through this source data banksystem construction it was able not only to share specific information on research data with others but also to do research process more efficiently and to share information of quantitative study. It may be concluded that this databank system contributed to develop nursing research.
Information Storage and Retrieval ; Electronic Mail ; Nursing Research* ; Nursing* ; Surveys and Questionnaires ; Viperidae

PURPOSE: To evaluate the clinical results of anterior stromal puncture (ASP) using neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for refractory recurrent corneal erosion (RCE). METHODS: Ten eyes of eight patients with RCE showing poor response to conservative therapy who were treated with Nd:YAG laser ASP and followed up for at least 4 months were studied. The cause and duration of erosions, times, and total energy of the laser were recorded. The preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure, complications, and recurrence were reviewed. RESULTS: The mean follow-up time was 9.6 months. The laser energy setting was 0.2 or 0.3 mJ per shot. The average total laser energy was 6.2 mJ. Two of 10 eyes received another Nd:YAG laser treatment. All 10 eyes were successfully treated and had no recurrence after the operation during follow-up. Postoperative BCVAs were equal to or better than the preoperative BCVAs. No significant complications except faint corneal haze were observed. CONCLUSIONS: Nd:YAG laser ASP is an effective and safe procedure to treat refractory RCE in short-term follow-up.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Punctures* ; Recurrence ; Viperidae ; Visual Acuity