Evidence-based care and the curriculum.

An evidence-based (EB) approach has been a significant driver in reforming healthcare over the past two decades. This change has extended across a broad range of health professions, including oral healthcare. A key element in achieving an EB approach to oral healthcare is educating our practitioners, both current and future. This involves providing opportunities integrated within simulated and actual clinical settings for practitioners to learn and apply the principles and processes of evidence-based oral healthcare (EBOHC). Therefore, the focus of this discussion will be on ways in which EBOHC and associated research activities can be implemented into curricula, with the aim of improving patient care. This paper will initially define the scope of EBOHC and research, what these involve, why they are important, and issues that we need to manage when implementing EBOHC. This will be followed by a discussion of factors that enable successful implementation of EBOHC and research into curricula. The paper concludes with suggestions on the future of EBOHC and research in curricula. Key recommendations related to curricula include strengthening of the culture of a scientific approach to education and oral healthcare provision; complete integration of EBOHC into the curriculum at all levels; and faculty development to implement EBOHC based on their needs and evidence of effective approaches. Key recommendations to support implementation and maintenance of EBOHC include recognition and funding for high-quality systematic reviews and development of associated methodologies relevant for global environments; building global capacity of EBOHC researchers; research into improving translation of effective interventions into education and healthcare practice, including patient-reported outcomes, safety and harms, understanding and incorporation of patient values into EB decision-making, economic evaluation research specific to oral healthcare and effective methods for changing practitioner (faculty) behaviours; and extend access to synthesized research in 'user friendly' formats and languages tailored to meet users' needs. Realizing these recommendations may help to improve access to effective healthcare as a basic human right.

Environmental assessment of water, sediment and plants in the Mankyeong River, ROK.

This study was carried out to evaluate water quality, sediment and plant vegetation in eight tributaries of the Mankyeong River for enhancement of natural purification. Among the tributaries, the Iksancheon water had the highest concentration of BOD, T-N and NH4-N due to inflow of swine wastes from the livestock district. The Yucheon water had the highest level of electrical conductivity and SO4(2-) due to inflow of mis-treated wastewater from industrial districts. The Tabcheon had generally similar concentrations of nitrogen and phosphate to that of the upstream of the Mankyeong River: agricultural activity along the Tabcheon appeared to have little negative influence to the water quality. Among various sediments, concentration of organic matter, nitrogen and phosphate were high in the Iksancheon and the Yucheon due to the livestock wastes and industrial wastes. There were 282 species of plants during summer with 43 aquatic plants, 57 hydrophytes, 178 waterside plants and 4 terrestrial plants. Some plant resources were recommended due to much absorption of nitrogen and phosphate for enhancement of natural purification. C. demersum and H. verticillata were recommended in the submerged aquatic plants, H. dubia, N. indica and N. subinteperrimum in the floating leaf aquatic plants, P. communis, Z. latifolia and T. orientalis in the emerged aquatic plants, C. scutata and P. distichum in the waterside plants.

Agricultural recycling of the by-product concentrate of livestock wastewater treatment plant processed with VSEP RO and bio-ceramic SBR.

One of the problems in a reverse osmosis process for livestock wastewater treatment is disposal of the by-product concentrate. The agricultural recycling of the concentrate is more cost saving than a further treatment. Application of the concentrate reduces the chemical fertilizer amendment. The agricultural recycling of the concentrate from the Kimhae livestock wastewater treatment plant, processed with the VSEP RO and bio-ceramic SBR, was studied. The concentrate includes non-biodegradable humic ubstance and residual inorganic ions (NH4+, NO3-, PO4(3-), K+, etc.). The contents of N, P and K were 1,650, 382 and 2,059 mg L(-1), respectively. The total acidity of humic acids extracted from the concentrate was 5.17 cmol(+) g(-1), composed of 2.38 cmol(+) g(-1) of carboxylic group and 2.79 cmol(+) g(-1) of phenolic hydroxyl group. Coliforms and E. coli were not detected in the concentrate. The yield of rice plant with the concentrate applied to it resulted in similar production to that with chemical fertilizer applied. The water extractable nitrate content of the concentrate-applied land did not exceed that of chemical fertilizer applied, at soil depths of 30 and 60 cm. The percolated amount of nitrate into the water table in arable land with the concentrate applied showed a similar level to that treated with the chemical fertilizer.

The possible cost effectiveness of peripheral blood stem cell mobilization with cyclophosphamide and the late addition of G-CSF.

The purpose of this study was to develop a cost-effective protocol for the mobilization of peripheral blood stem cells (PBSC) in patients with malignancy. Thirty consecutive patients were randomized to mobilize PBSC with the late addition of a standard 250 microg dose of G-CSF (Neutrogen) from day 8 or early addition of the same dose of G-CSF from day 2, following cyclophosphamide (CY) 4 g/m2. The median yield of CD34+ cells from evaluated patients was 7.87 x 10(6)/kg (range, 2.06-27.25), collected in a median of four apheresis (range, 2-9). Target CD34 + cell doses > or = 2.0 x 10(6)/kg were achieved in all patients able to be evaluated. There were no statistically significant differences in CD34+ cell yields or toxicities. Overall engraftment occurred with median days to neutrophils > or = 0.5 x 10(9)/L or platelets > 20 x 10(9)/L of 11 and 17 days, respectively. However, the duration of G-CSF administration was markedly shorter in the late use of G-CSF group than in the early use of G-CSF group, with a median of 9 days compared with 15 days (p<0.001). PBSC harvesting after priming with CY plus delayed use of G-CSF made it a safe and cost-effective procedure.