Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 44
Filtrar
1.
Exp Psychol ; 69(2): 83-103, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35929473

RESUMO

The current study compared emotion perception in two cultures where display rules for emotion expression deviate. In Experiment 1, participants from America and Korea played a repeated prisoner's dilemma game with a counterpart, who was, in actuality, a programmed defector. Emotion expressions were exchanged via emoticons at the end of every round. After winning more points by defecting, the counterpart sent either a matching emoticon (a joyful face) or a mismatching emoticon (a regretful face). The results showed that Americans in the matching condition were more likely to defect, or to punish, compared to those in the mismatching condition, suggesting that more weight was given to their counterpart's joyful expression. This difference was smaller for Koreans, suggesting a higher disregard for the outward expression. In a second, supplementary experiment, we found that Korean participants were more likely to cooperate in the mismatching or regretful condition, when they thought their counterpart was a Westerner. Overall, our data suggest that emotion perception rules abide by the display rules of one's culture but are also influenced by the counterpart's culture.


Assuntos
Comportamento Cooperativo , Dilema do Prisioneiro , Emoções , Humanos , Percepção
2.
PLoS One ; 15(12): e0243378, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33290422

RESUMO

Due to the recent emphasis on the importance of interprofessional education (IPE) in healthcare fields, interest in IPE introduction is increasing in South Korea. The purpose of this study was to examine the differences in perceptions of medical, nursing, and pharmacy students regarding IPE. Also, the study aimed at identifying the priority rankings of educational needs by analyzing the differences between students' perceptions of the importance level and the present level for each interprofessional competency. A cross-sectional study was carried out using a survey. A total of 1,500 questionnaires were distributed, of which 1,084 were returned (response rate, 72.3%). The participants were 559 medical, 393 nursing, and 96 pharmacy students. The questionnaire comprised items on the students' perception of IPE and their interprofessional competency. The questionnaire comprised 12 items on their IPE perception and 9 items on their interprofessional competency. These items were developed by examining the content validity by medical educational specialists and conducting a factor analysis for verification. Data were analyzed using the t-test and ANOVA, and Borich's formula was used to calculate the rank of educational needs.89.6% did not know the meaning of IPE. The difference in students' perception of IPE was not significant by grade. Further, the level of IPE perception was higher for female than male students and for students who knew the meaning of IPE than those who did not. The nursing students' perception of the importance, preference, and effectiveness of IPE was the highest, whereas medical students' perception was the lowest. All students perceived their present level to be lower than the importance level for each interprofessional competency. Interprofessional communication skills (6.791) were highly necessary for students. These results will serve as baseline information for developing IPE programs in South Korea.


Assuntos
Educação Médica , Educação Interprofissional , Relações Interprofissionais , Aprendizagem , Adolescente , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Currículo , Tomada de Decisões , Feminino , Humanos , Masculino , República da Coreia , Instituições Acadêmicas , Software , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
3.
Psychon Bull Rev ; 27(5): 1014-1024, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32557262

RESUMO

Previous research has shown that mental representations of actions can influence performance on relevant tasks or dimensions even when there is no overt execution of the action. In this study, we examined whether cognitive processes prior to the physical execution of an action can elicit attentional bias towards irrelevant tasks or dimensions of that action. Participants performed two independent tasks-an action task and a search task-where they were instructed to plan an action and execute the action following the visual search task. We found that the same features of the object were prioritized in the subsequent search task when participants had planned an action response on the object in comparison to when they had not. This effect occurred even when the feature was irrelevant to the tasks or required action. Furthermore, the effect of action planning without physical response was found to be comparable to the effect of physical response. These results suggest that planning of a simple action can induce attentional bias to irrelevant features of objects even without physical action.


Assuntos
Viés de Atenção/fisiologia , Atividade Motora/fisiologia , Percepção Visual/fisiologia , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
4.
Korean J Med Educ ; 32(2): 131-142, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32486622

RESUMO

PURPOSE: This study is to develop an interprofessional education (IPE) program for medical, nursing, and pharmacy students and to analyze the effectiveness. METHODS: Subjects consisted of 116 students (41 medical, 46 nursing, and 29 pharmacy students) enrolled in their final year. Subjects were randomly assigned to either the intervention group or the control group, with 58 in each group. A pretest-posttest control group design was used. The program was operated for a single day, and consisted of small-group activities and role-play. We utilized the following tools: Perceptions towards Interprofessional Education (PIPE), Self-Efficacy for Interprofessional Experiential Learning (SEIEL), and Perception towards Interprofessional Competency (PIC). We used t-test and analysis of covariance for analysis. RESULTS: The PIPE tool revealed that the scores of the intervention group were significantly higher than those of the control group (p=0.000). The result was the same when the scores were categorized into the groups medical students (p=0.001), nursing students (p=0.000), and pharmacy students (p=0.005). The SEIEL study also indicated the intervention group scored significantly higher than the control group (p=0.000). However, pharmacy students did not reveal significant (p=0.983). The intervention group scored significantly higher than the control group in the PIC. A concluding survey of the intervention group indicated that most students were satisfied with the IPE program. CONCLUSION: We hope this study will provide useful information for designing and improving IPE programs in other universities.


Assuntos
Currículo , Práticas Interdisciplinares , Educação Interprofissional , Competência Profissional , Estudantes de Medicina , Estudantes de Enfermagem , Estudantes de Farmácia , Atitude , Comportamento do Consumidor , Educação Médica , Educação em Enfermagem , Educação em Farmácia , Feminino , Humanos , Masculino , Enfermeiras e Enfermeiros , Farmacêuticos , Médicos , Aprendizagem Baseada em Problemas , Autoeficácia , Inquéritos e Questionários , Universidades
5.
Korean J Med Educ ; 32(1): 23-33, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32130848

RESUMO

PURPOSE: This study will compare differences in perception of interprofessional education (IPE) in the faculty of medicine, nursing, and pharmacy. It will also analyze differences in the level of importance of IPE competences and the present competence levels of their students perceived by the faculty. METHODS: The study included 115 participants from the faculty of medicine, 31 from nursing, and 23 from pharmacy. The surveys contained 21 questions on their perceptions of IPE, and perception on the nine competences of IPE. The results were analyzed using analysis of variance and χ2 analysis, and the Borich coefficient was calculated to identify the educational order of priority from the competence levels of their student of IPE. RESULTS: Participants of 14.8% responded that they were aware of IPE, 95.8% responded that they did not have experience in IPE, and 95.8% responded that IPE was necessary. Among the subfactors of perception of IPE, the faculty of medicine had significantly lower perceptions of the importance, effectiveness, and support of IPE (p<0.001). The present competence levels of their students were significantly lower (p<0.001) than the level of importance of IPE competences perceived by the faculty, and its perception was at its lowest in the faculty of medicine. The needs assessment of the IPE program was in the order of communication skills (10.210), conflict-solving skills (10.114), problem-solving skills (9.319), empathy skills (9.110), and collaborative leadership (8.624) among the nine competences. CONCLUSION: This study will contribute to providing basic data needed to develop faculty development programs on IPE and IPE programs for their students.


Assuntos
Atitude do Pessoal de Saúde , Docentes/psicologia , Educação Interprofissional , Competência Profissional , Adulto , Currículo , Feminino , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , República da Coreia , Inquéritos e Questionários
6.
Artigo em Inglês | MEDLINE | ID: mdl-31167383

RESUMO

Despite a rapid increase in both the number of long-term care facilities (LTCFs) and their residents in recent years, the concept of pharmacist-involved medication management is relatively new in South Korea. The objective of this study was to identify the perspectives of non-pharmacy professionals regarding the development of pharmacist-involved medication management in LTCFs. Employing a snowball sampling strategy, this study relied on semi-structured, one-on-one, in-depth interviews with twelve non-pharmacy professionals in LTCFs. The inductive thematic analysis and the constant comparative method were employed for the analysis. Participants revealed the need for pharmacist-involved medication management systems in LTCFs at the intrinsic and environmental levels. Through pharmacist-involved medication management, participants desired "medication review/reconciliation" and "pharmaceutical education/counseling". The barriers to be overcome included "the authorization of pharmacists' roles", "the financial stability of LTCFs", "role awareness among coworkers", and "the professional development of pharmacists". In this study, we advanced our understanding of non-pharmacy professionals' perceptions of pharmacist-involved medication management in LTCFs. The results of this study can be applied in other Asian countries where the development of pharmacist-involved medication management for the institutionalized elderly is relatively new.


Assuntos
Assistência de Longa Duração/organização & administração , Conduta do Tratamento Medicamentoso/organização & administração , Farmacêuticos/organização & administração , Papel Profissional , Idoso , Atitude do Pessoal de Saúde , Aconselhamento , Instalações de Saúde , Humanos , Entrevistas como Assunto , Assistência de Longa Duração/normas , Conduta do Tratamento Medicamentoso/normas , Farmacêuticos/normas , Pesquisa Qualitativa , República da Coreia
7.
Basic Clin Pharmacol Toxicol ; 125(2): 108-116, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30924261

RESUMO

The aim of this cohort study was to compare the effectiveness of statin regimens for primary prevention among seniors aged ≥ 75 years. Seniors aged 75-100 years for whom statin therapies for primary prevention were newly initiated between 1 January 2009 and 31 December 2011, and who continued the same statin regimen during the first year after the index date were identified using the claims data from the South Korean National Health Insurance Database. A propensity score matching and multivariable Cox proportional hazards model were developed to evaluate adjusted ischaemic cardiovascular-cerebrovascular event (CCE) risk and all-cause mortality risk for all patients, as well as for subgroups. A total of 5629 older patients aged 75-100 years were included in the study population. Compared to moderate-intensity statin therapy, low-intensity statin therapy was significantly associated with increased risk of ischaemic CCEs, while high-intensity statin therapy was associated with reduced risk of ischaemic CCEs; however, compared to moderate-intensity statin therapy, both low-intensity and high-intensity statin therapies were associated with increased risk of all-cause mortality. For the 4689 older patients who regularly received moderate-intensity statin therapy including 10 mg atorvastatin, 20 mg atorvastatin, 10 mg rosuvastatin or 20 mg simvastatin for primary prevention, multivariable regression adjusting for potential covariates revealed no significant difference in ischaemic CCEs or all-cause mortality between the moderate-intensity statin users and 10 mg atorvastatin users both before and after propensity scoring matching. No significant heterogeneity was detected in the patient subgroups. The results of this study based on real-world data can supply evidence-based reasons for choice of statin regimen for the primary prevention of CCEs in older people aged ≥ 75 years.


Assuntos
Doenças Cardiovasculares/epidemiologia , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Prevenção Primária/métodos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/prevenção & controle , Bases de Dados Factuais/estatística & dados numéricos , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Masculino , Programas Nacionais de Saúde/estatística & dados numéricos , Prevenção Primária/estatística & dados numéricos , Pontuação de Propensão , República da Coreia/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento
8.
Cells ; 8(2)2019 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-30813369

RESUMO

Sulforaphane (SFN), a potent nuclear factor erythroid 2-related factor 2 (Nrf2) activator, is present in the species of the Brassicaceae, especially in broccoli sprouts. In this study, the effects of SFN against microglial activation and inflammation, and the potential mechanisms involved, were analyzed. As mitogen-activated protein kinase (MAPK) signaling plays a key role in microglial activation and inflammation, we focused on the role of SFN in regulating the MAPK signaling regulation of the inflammatory and anti-inflammatory cascades in lipopolysaccharide (LPS)-activated microglia. The anti-inflammatory and immunomodulatory effects of SFN were explored by evaluating the expression and secretion of inflammatory proteins, cytokines, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and activator protein-1 (AP-1) under pre- and post-treatment conditions. Under the SFN pre- and post-treatment conditions, the MAPK phosphorylation levels were significantly reduced in both acutely and chronically activated microglial cells. SFN also reduced the c-Jun N-terminal kinase (JNK) phosphorylation levels, which subsequently reduced NF-κB and AP-1 signaling. As a result, the expression of the inflammatory mediators (iNOS, COX-2, NO, and PGE2) and proinflammatory cytokines (TNF-α, IL-6, and IL-1ß) was decreased. At the same time, SFN increased the expression of Nrf2 and heme oxygenase-1 (HO-1) as well as the production of the anti-inflammatory cytokines IL-10 and IL-4. In conclusion, this study demonstrated that SFN exerts an anti-neuroinflammatory effect on microglia through JNK/AP-1/NF-κB pathway inhibition and Nrf2/HO-1 pathway activation.


Assuntos
Anti-Inflamatórios/farmacologia , Heme Oxigenase-1/metabolismo , Isotiocianatos/farmacologia , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Microglia/patologia , Fator 2 Relacionado a NF-E2/metabolismo , NF-kappa B/metabolismo , Fator de Transcrição AP-1/metabolismo , Animais , Linhagem Celular , Ciclo-Oxigenase 2/metabolismo , Citocinas/metabolismo , Ativação Enzimática/efeitos dos fármacos , Lipopolissacarídeos , Camundongos , Microglia/efeitos dos fármacos , Modelos Biológicos , Óxido Nítrico Sintase Tipo II/metabolismo , Nitritos/metabolismo , Fosforilação/efeitos dos fármacos , Sulfóxidos
9.
Int J Clin Pharmacol Ther ; 57(5): 249-258, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30738496

RESUMO

BACKGROUND: The associations between colorectal cancer (CRC) progression and changes in N-glycan expression suggest the potential for new biomarkers and targeted cancer therapies. This study was performed to analyze N-glycans and to compare their expression profiles in tumor and corresponding adjacent non-tumor (control) tissues in stage I and IV CRC patients to examine N-glycans as potential prognostic markers. MATERIALS AND METHODS: Six adult CRC patients, including 3 in stage I and 3 in stage IV who underwent curative surgery were enrolled in this study. The tumor and control tissue samples were collected during surgery. Tissue samples were analyzed using liquid chromatography-tandem mass spectrometry as well as database searching. RESULTS: In this study, 76 N-glycans from 12 tissues of 6 CRC patients were profiled. There were 6 high mannose, 3 mannose, 1 core, 14 hybrid, 30 hybrid/complex, and 22 complex type N-glycans. There were 44 N-glycans in stage I control, 29 in stage I tumor, 43 in stage IV control, and 54 in stage IV tumor. Tumor- and stage-specific N-glycans were also identified. The relative abundance of N-glycans varied across the divided group. CONCLUSION: N-glycans presented only in stage I tumor from the biopsy sample for the diagnosis of CRC or in stage I control obtained during the surgery showed potential as biomarkers to predict CRC prognosis. Further high-throughput glycomic study should be performed with a larger sample size.
.


Assuntos
Neoplasias Colorretais/metabolismo , Polissacarídeos/metabolismo , Adulto , Biomarcadores Tumorais/metabolismo , Progressão da Doença , Humanos , Prognóstico
10.
Int Clin Psychopharmacol ; 34(1): 9-17, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30096056

RESUMO

It has been reported that selective serotonin reuptake inhibitors (SSRIs) might induce major adverse cardiovascular events (MACE), but the association between the use of SSRIs and MACE has not been elucidated as yet. Therefore, the aim of this study was to evaluate the association between the use of SSRIs and MACE in depressed patients with previous cardiovascular events. Two researchers independently selected randomized-controlled studies (RCTs) according to the predefined inclusion criteria and evaluated the quality of articles. A quantitative analysis was carried out to estimate pooled risk ratios (RRs) for the association between the use of SSRIs and MACE. Ten RCTs were selected in the final analysis. The use of SSRIs in depressed patients with previous cardiovascular events significantly decreased the risk of MACE [RR: 0.74; 95% confidence interval (CI): 0.55-0.99]. The risk of myocardial infarction was also reduced significantly (RR: 0.59, 95% CI: 0.37-0.93), associations with stroke and all-cause-death (cardiac or other causes): risk of stroke (RR: 0.88, 95% CI: 0.35-2.25) or all-cause death (RR: 0.83; 95% CI: 0.66-1.05). This meta-analysis suggests that the use of SSRIs decreased the risk of MACE by significantly reducing the risk of myocardial infraction in patients with depression and previous cardiovascular events.


Assuntos
Doenças Cardiovasculares/epidemiologia , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Humanos , Infarto do Miocárdio/epidemiologia , Razão de Chances , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/epidemiologia
11.
Basic Clin Pharmacol Toxicol ; 124(6): 691-703, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30511436

RESUMO

This meta-analysis was conducted to derive an integrated conclusion about the influence of glutathione S-transferase (GST) genetic polymorphisms on busulfan pharmacokinetic (PK) parameters and veno-occlusive disease (VOD). Studies which analysed the effect of GST genetic polymorphisms on area under the curve (AUC), clearance (CL) or VOD were searched for and selected. A pooled analysis was conducted using Comprehensive Meta-Analysis programme. Nineteen studies were included in this meta-analysis. GSTA1*B and GSTM1 null genotypes significantly decreased CLIV of busulfan (standardized difference in means (SDM) = -1.103; P = 0.019 and SDM = -0.418; P = 0.002, respectively). GSTA1*B significantly increased AUCIV of busulfan (SDM = 0.832; P = 0.046), whereas GSTM1 did not (SDM = 0.155; P = 0.478). The PK parameters of oral busulfan did not differ according to GST genotype. GSTA1, GSTM1 and GSTP1 were not significantly associated with VOD occurrence. GSTA1 and GSTM1 genotypes affected CLIV of busulfan, but only GSTA1 affected AUCIV . There was no significant difference in the PK parameters of oral busulfan (CLPO and AUCPO ) and VOD when only GST genotypes were considered.


Assuntos
Bussulfano/efeitos adversos , Bussulfano/farmacocinética , Glutationa Transferase/genética , Hepatopatia Veno-Oclusiva/etiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Transplante de Células-Tronco Hematopoéticas , Humanos , Lactente , Pessoa de Meia-Idade , Polimorfismo Genético , Adulto Jovem
12.
Ther Clin Risk Manag ; 14: 2119-2126, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30498355

RESUMO

PURPOSE: Liver transplantation is the treatment of choice for patients with end-stage liver disease. Due to the between- and within-individual pharmacokinetic variability in tacrolimus, used to prevent rejection after transplantation, it is difficult to predict the dose needed achieve the target levels in the blood. This study aimed to construct a population pharmacokinetic model of tacrolimus dosage prediction for therapeutic drug monitoring in clinical settings for Korean adult patients receiving living donor liver transplantation (LDLT). METHODS: A total of 58 Korean adult patients receiving LDLT with tacrolimus administration were enrolled. Demographic, clinical, and CYP3A5*1/*3 polymorphism data were collected. Population pharmacokinetic modeling of tacrolimus during the first 14 days after transplantation was performed using NONMEM program. Parameters were estimated by the first-order conditional estimation with interaction method. The internal validation of the final model was assessed by the bootstrap and visual predictive check methods using 500 samples from the original data. RESULTS: One-compartmental model was selected as a base model. After the stepwise covariate model building process, postoperative day (POD) and combinational CYP3A5 genotype of the recipient and donor were incorporated into clearance (CL/F). The estimated typical values of CL/F and volume of distribution (V/F) were 6.33 L/h and 465 L, respectively. The final model was CL/F =6.33× POD0.257×2.314 (if CYP3A5 expresser recipient grafted from CYP3A5 expresser donor) ×1.523 (if CYP3A5 expresser recipient grafted from CYP3A5 nonexpresser donor) and V/F =465× POD0.322. CONCLUSION: A population pharmacokinetic model for tacrolimus was established successfully in Korean adult patients receiving LDLT. This model is expected to contribute to improving patient outcomes by optimizing tacrolimus dose adjustment for liver transplant patients.

13.
Ther Clin Risk Manag ; 14: 1813-1829, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30319263

RESUMO

PURPOSE: Diabetes is a chronic lifelong condition, and adherence to medications and self-monitoring of blood glucose are challenging for diabetic patients. The dramatic increase in the prevalence of diabetes is largely due to the incidence of type 2 diabetes in low- and middle-income countries (LMIc) besides high-income countries (HIc). We aimed to evaluate whether pharmacist care (PC) service model in LMIc and HIc could improve clinical outcomes in diabetic patients by performing a meta-analysis. METHODS: PubMed, Embase, and ProQuest Dissertations Unlimited Published Literature database were searched to find publications pertaining to pharmacist-led intervention in patients with diabetes. The inclusion criteria were as follows: 1) randomized controlled trials, 2) confirmed diabetic patients (type 1 or type 2), 3) pharmaceutical care intervention by clinical pharmacist or/and multidisciplinary team, and 4) reporting HbA1c at baseline and end of study or the mean change in these values. RESULTS: A total of 37 articles were included in the meta-analysis. The overall result was significant and in favor of PC intervention on HbA1c change (standard difference in mean values [SDM]: 0.379, 95% CI: 0.208-0.550, P<0.001). The stratified meta-analysis showed that PC was significant in both HIc (n=20; SDM: 0.351, 95% CI: 0.207-0.495) and LMIc (n=15; SDM: 0.426, 95% CI: 0.071-0.780). More than 6 months is needed to obtain adequate effects on clinical diabetes parameters. CONCLUSION: Our study presented that an adequate duration of pharmacist-led pharmaceutical care was effective in improving HbA1c in patients with diabetes in both LMIc and HIc.

14.
Sci Rep ; 8(1): 14921, 2018 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-30297729

RESUMO

In this study, pharmacophore based 3D QSAR models for human acetylcholinesterase (AChE) inhibitors were generated, with good significance, statistical values (r2training = 0.73) and predictability (q2training = 0.67). It was further validated by three methods (Fischer's test, decoy set and Güner-Henry scoring method) to show that the models can be used to predict the biological activities of compounds without costly and time-consuming synthesis. The criteria for virtual screening were also validated by testing the selective AChE inhibitors. Virtual screening experiments and subsequent in vitro evaluation of promising hits revealed a novel and selective AChE inhibitor. Thus, the findings reported herein may provide a new strategy for the discovery of selective AChE inhibitors. The IC50 value of compounds 5c and 6a presented selective inhibition of AChE without inhibiting butyrylcholinesterase (BChE) at uM level. Molecular docking studies were performed to explain the potent AChE inhibition of the target compounds studies to explain high affinity.


Assuntos
Acetilcolinesterase/metabolismo , Inibidores da Colinesterase/química , Inibidores da Colinesterase/farmacologia , Desenho Assistido por Computador , Desenho de Fármacos , Butirilcolinesterase/metabolismo , Descoberta de Drogas , Humanos , Simulação de Acoplamento Molecular , Relação Quantitativa Estrutura-Atividade
15.
PLoS One ; 13(9): e0201705, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30265678

RESUMO

Our goal was to help prevent drug-related morbidity and mortality by developing a collaborative multidisciplinary team care (MTC) service model using a service design framework that addressed the unmet needs and perspectives of diverse stakeholders. Our service model was based on a "4D" framework that included Discover, Define, Design, and Develop phases. In the "discover" phase, we conducted desk research and field research of stakeholders to identify the unmet needs in existing patient care services. We used service design tools, including service safaris, user shadowing, and customer journey maps to identify pain and opportunity points in the current services. We also performed focus group discussions and in-depth interviews with stakeholders to explore the needs for improved services. In the "define" phase, we generated the service concept by mind mapping and brainstorming about the needs of stakeholders. The service concept was defined to be a Patient-oriented, Collaborative, Advanced, Renovated, and Excellent (P-CARE) service. We named the service "DrugTEAM" (Drug Therapy Evaluation And Management). In the "design" phase, we designed and refined four prototypes based on results from validation tests for their application towards following services: 1) medication reconciliation, 2) medication evaluation and management, 3) evidence-based drug information, and 4) pharmaceutical care transition services. During the "develop" phase, we implemented four services in a longitudinal chronic care model, considering the time spent by patients for each inpatient and outpatient setting. In conclusion, this is a study to develop a collaborative MTC service model using service design framework, focused on managing the unmet needs of patients and healthcare providers. As a result of implementing this service model, we expect to strengthen the professional relationship between pharmacists and stakeholders to ultimately create better patient outcomes.


Assuntos
Atenção à Saúde , Monitoramento de Medicamentos , Modelos Teóricos , Feminino , Humanos , Masculino
16.
Support Care Cancer ; 26(8): 2737-2742, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29488017

RESUMO

PURPOSE: Network analysis was conducted to systematically analyze the relationship between causative drugs and types of drug-related problems (DRPs) in hospitalized patients with hematologic malignancies. METHODS: A total of 1187 DRPs identified in hematology wards between 2013 and 2015 were analyzed. DRPs were classified into 11 sub-domains for problems and 35 sub-domains for causes according to Pharmaceutical Care Network Europe classification. Causative drugs were classified by Anatomical Therapeutic Chemical code. Network analytic tool was used to represent the relationship between drugs, causes, and problems. In-degree centrality (CD-in) was calculated to identify major causes of DRPs. RESULTS: The following drugs accounted for more than 5% of DRP, including antibacterials (J01, 26.5%), drugs for acid-related disorders (A02, 11.5%), antiemetics (A04, 9.7%), antifungals (J02, 8.8%), and antineoplastic agents (L01, 7.0%). Inappropriate combinations (C1.3, CD-in of 161) of drugs for acid-related disorders, antifungals, and antineoplastic agents were major causes of DRPs and induced non-optimal effects of drug treatment (P1.2). Inappropriate dose adjustments (C3.6, CD-in of 151) of antibacterials lowered effects (P1.2) and increased side effects (P2.1). Missing necessary synergistic or preventive drugs, especially antiemetics, (C1.8, CD-in of 54) resulted in untreated indication (P1.4). CONCLUSIONS: DRPs were mainly related to medications for supportive care. More attention should be paid to interactions of drugs used for acid-related disorders, dose adjustment of antibacterials, and omission of antiemetics in hospitalized patients with hematologic malignancy.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Neoplasias Hematológicas/complicações , Hospitalização/tendências , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Feminino , Neoplasias Hematológicas/patologia , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Metanálise em Rede , Estudos Retrospectivos
17.
Int J Clin Pharmacol Ther ; 56(4): 177-183, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29319496

RESUMO

OBJECTIVE: This study aimed to investigate the factors affecting the geographic differences in antibiotic prescription rates in pediatric upper respiratory tract infections (URI) patients in South Korea. MATERIALS AND METHODS: We performed a nationwide cross-sectional study using 228 administrative districts of Korea, which are the unit of analysis. Prescription rate of antibiotics, the outcome variable, was measured as the proportion of antibiotic prescription days out of total visit days for the treatment of acute URIs using National Health Insurance Service (NHIS) claims data for 2012. Multivariate regression analysis was performed to identify factors affecting geographic variation in antibiotic prescription rates. RESULTS: The socioeconomic status of the district, as measured by the amount of local property tax payable and the proportion of individuals with higher level of education, were negatively correlated with prescription rate. The degree of competition in the hospital market within a district was positively associated with it. Patients living in areas with better access to family medicine physicians and those living in rural areas were less likely to use antibiotics to treat URIs. CONCLUSION: Our findings indicate the importance of considering demand factors as well as supply factors when developing intervention strategies for antibiotic overuse.
.


Assuntos
Antibacterianos/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , Doença Aguda , Criança , Pré-Escolar , Estudos Transversais , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Padrões de Prática Médica , Classe Social
18.
Int J Clin Pharmacol Ther ; 56(1): 12-23, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29154750

RESUMO

OBJECTIVE: The distribution of counterfeit or falsified drugs is increasing worldwide. This can contribute to the high burden of disease and cost to society and is of global concern with the worldwide circulation of pharmaceuticals. The preparation and implementation of good distribution practice should be one of the most important aspects of ensuring safe drug circulation and administration. This research aimed to compare and analyze good distribution practice guidelines from advanced countries and international organizations, and to evaluate the status of the current good distribution practice guidelines in the world. MATERIALS AND METHODS: Advanced pharmaceutical countries and international organizations, such as the World Health Organization, European Union, Pharmaceutical Inspection Co-operation Scheme, United States of America, Canada, and Australia, which have stable good distribution practice guidelines and public confidence, were included in the analysis. RESULTS: The World Health Organization and European Union guidelines are models for standardized good distribution practice for nations worldwide. The United States of America has a combination of four different series of distribution practices which have a unique structure and detailed content compared to those of other countries. The Canadian guidelines focus on temperature control during storage and transportation. The Australian guidelines apply to both classes of medicinal products and medical devices and need separate standardization. CONCLUSION: Transparent information about the Internet chain, international cooperation regarding counterfeiting, a high-standard qualification of sellers and customers, and technology to track and trace the whole life cycle of drugs should be the main focus of future good distribution practice guidelines worldwide.
.


Assuntos
Qualidade de Produtos para o Consumidor , Saúde Global , Preparações Farmacêuticas/normas , Medicamentos Falsificados , Guias como Assunto , Legislação de Medicamentos , Preparações Farmacêuticas/provisão & distribuição , Organização Mundial da Saúde
19.
Conscious Cogn ; 55: 214-222, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28892738

RESUMO

Implicit working memory (WM) has been known to operate non-consciously and unintentionally. The current study investigated whether implicit WM is a discrete mechanism from explicit WM in terms of cognitive resource. To induce cognitive resource competition, we used a conjunction search task (Experiment 1) and imposed spatial WM load (Experiment 2a and 2b). Each trial was composed of a set of five consecutive search displays. The location of the first four displays appeared as per pre-determined patterns, but the fifth display could follow the same pattern or not. If implicit WM can extract the moving pattern of stimuli, response times for the fifth target would be faster when it followed the pattern compared to when it did not. Our results showed implicit WM can operate when participants are searching for the conjunction target and even while maintaining spatial WM information. These results suggest that implicit WM is independent from explicit spatial WM.


Assuntos
Memória de Curto Prazo/fisiologia , Reconhecimento Visual de Modelos/fisiologia , Desempenho Psicomotor/fisiologia , Percepção Espacial/fisiologia , Memória Espacial/fisiologia , Adulto , Humanos , Adulto Jovem
20.
Patient Prefer Adherence ; 11: 1381-1388, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28860721

RESUMO

PURPOSE: To assess the degree of satisfaction and expressed needs of pharmaceutical care services in patients with chronic diseases and explore the factors related to the needs from patients' perspectives for the further development of pharmaceutical care service models. PATIENTS AND METHODS: A cross-sectional survey of 220 patients (mean age ± SD: 61.3±13.1, male:female: 104:116) was conducted. The questionnaire was structured to measure patients' degree of satisfaction and expressed needs using a 5-point Likert scale. Additionally, preferred duration, methods of service delivery, and willingness to pay were surveyed. Responses were analyzed using an ordinal regression method to predict factors that were related to pharmaceutical care services. RESULTS: Sixty-seven patients had experienced pharmaceutical care services. Their satisfaction levels were high in all categories; however, there were no significant differences between categories. The levels of expressed needs were similar among categories without significant differences. The preferred delivery method was a face-to-face conversation combined with being provided with written information (53.2%). The preferred duration was ≤10 min (70.5%). About 48% of the patients showed willingness to pay for the service. Education level and region influenced patients' needs. CONCLUSION: The satisfaction and needs of pharmaceutical care services was very positive; however, noticing only a third of patients experienced pharmaceutical care services, this may indicate a lack of awareness and less appreciation of pharmacists by patients. Details concerning patients' awareness and the value of pharmaceutical care services require further investigation.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA