Nurse Practitioner Preceptorship Model

Shirley Strachan-Jackman 한국간호과학회 2009 한국간호과학회 학술대회 Vol.2009 No.10

Appraising the Value of Medical Device Innovation in South Korea: Multi-Criteria Decision Analysis Application for Reimbursement Coverage Decision-Making

이상수,최현숙,Liesl Strachan 한국보건의료기술평가학회 2015 보건의료기술평가 Vol.3 No.2

Since the year 2000, the reimbursement coverage and pricing rule for medical devices in South Ko- rea has been evolving gradually with the introduction of the ‘Value Appraisal Standard (VAS)’ sys- tem in March 2006 to recognize the premium value of innovative medical devices. Nevertheless, the VAS system has been criticized due to the lack of objectivity and its insufficient operability. Over the last decade, the quest for a more comprehensive, structured and transparent reimbursement coverage decision-making process has prompted research into alternative decision-making frameworks. In this regard, multi-criteria decision analysis (MCDA) arose and has gained more attention as an ap- proach to support healthcare decision-making involving multiple and conflicting criteria. In 2014 the task force initiated by both Ministry of Health and Welfare and Health Insurance Review and As- sessment Service and composed of various stakeholder representatives was formed to improve the re- imbursement coverage and pricing rule by leveraging international practices from foreign countries and to develop the most feasible pricing rule in the current healthcare policy environment. The task force studied the principles, processes and practices for reimbursement coverage and pricing of medi- cal devices in other countries and also deliberated MCDA for improved and fair recognition of the value of innovative medical devices. The consensus for the improved reimbursement coverage and pricing rule with MCDA was reached among the stakeholders and placed into official regulation effec- tive in January 2015. The MCDA application is expected to contribute to better innovation value rec- ognition and also transparent and reasonable operation in the decision-making process.

Response of Ecosystem Carbon and Water Vapor Exchanges in Evolving Nocturnal Low-Level Jets

Hong, Jin-Kyu,Mathieu, Nathalie,Strachan, Ian B.,Pattey, Elizabeth,Leclerc, Monique Y. Korean Society for Atmospheric Environment 2012 Asian Journal of Atmospheric Environment (AJAE) Vol.6 No.3

The nocturnal low-level jet makes a significant impact on carbon and water exchanges and turbulent mixing processes in the atmospheric boundary layer. This study reports a case study of nocturnal surface fluxes such as $CO_2$ and water vapor in the surface layer observed at a flat and homogeneous site in the presence of low-level jets (LLJs). In particular, it documents the temporal evolution of the overlying jets and the coincident response of surface fluxes. The present study highlights several factors linking the evolution of low-level jets to surface fluxes: 1) wavelet analysis shows that turbulent fluxes have similar time scales with temporal scale of LLJ evolution; 2) turbulent mixing is enhanced during the transition period of low-level jets; and 3) $CO_2$, water vapor and heat show dissimilarity from momentum during the period. We also found that LLJ activity is related not only to turbulent motions but also to the divergence of mean flow. An examination of scalar profiles and turbulence data reveal that LLJs transport $CO_2$ and water vapor by advection in the stable boundary layer, suggesting that surface fluxes obtained from the micrometeorological method such as nocturnal boundary layer budget technique should carefully interpreted in the presence of LLJs.

Endometrial ablation and resection versus hysterectomy for heavy menstrual bleeding: an updated systematic review and meta-analysis of effectiveness and complications

Clare Deehan,Iliana Georganta,Anna Strachan,Marysia Thomson,Miriam McDonald,Kerrie McNulty,Elizabeth Anderson,Alyaa Mostafa 대한산부인과학회 2023 Obstetrics & Gynecology Science Vol.66 No.5

To evaluate the clinical efficacy, safety, and cost-effectiveness of endometrial ablation or resection (E:A/R) compared to hysterectomy for the treatment of heavy menstrual bleeding. Literature search was conducted, and randomized control trials (RCTs) comparing (E:A/R) versus hysterectomy were reviewed. The search was last updated in November 2022. Twelve RCTs with 2,028 women (hysterectomy: n=977 vs. [E:A/R]: n=1,051) were included in the analyzis. The meta-analysis revealed that the hysterectomy group showed improved patient-reported and objective bleeding symptoms more than those of the (E:A/R) group, with risk ratios of (mean difference [MD], 0.75; 95% confidence intervals [CI], 0.71 to 0.79) and (MD, 44.00; 95% CI, 36.09 to 51.91), respectively. Patient satisfaction was higher post-hysterectomy than (E:A/R) at 2 years of follow-up, but this effect was absent with long-term follow-up. (E:A/R) is considered an alternative to hysterectomy as a surgical management for heavy menstrual bleeding. Although both procedures are highly effective, safe, and improve the quality of life, hysterectomy is significantly superior at improving bleeding symptoms and patient satisfaction for up to 2 years. However, it is associated with longer operating and recovery times and a higher rate of postoperative complications. The initial cost of (E:A/R) is less than the cost of hysterectomy, but further surgical requirements are common; therefore, there is no difference in the cost for long-term follow-up.

Clinicopathologic Characteristics of Breast Cancer in Jamaica

Chin, Sheray Nicole,Green, Cheryl,Strachan, Georgiana Gordon,Wharfe, Gilian Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.7

Breast cancer is the most common cancer in Jamaican women. This study assessed the clinicopathologic features of cases in a hospital-based specialist clinic in Kingston, Jamaica. A retrospective chart review was performed for the 2-year study period and relevant clinical and surgico-pathologic data were recorded and analyzed. Median age of the 121 breast cancer patients was 52 years (range 22-84, IQR 20) and there was 1 case of male breast cancer. Most patients (65%) were referred from the surgical service after definitive breast cancer surgery, 20% were referred for pre-operative systemic therapy, and 15% had a diagnosis of metastatic disease. The surgico-pathologic group comprised 78 women who were referred for adjuvant therapy. The majority had presented with a palpable breast lump (91%), with median tumour size 3.5cm (range 0.4-13, IQR 4). Most tumours were node positive (56%). Approximately one-third of patients had stage III disease (33%). Most women presented with large palpable tumours and had lymph node involvement confirmed on surgicopathological evaluation, indicative of limited early breast cancer detection. A national screening mammography programme is recommended for detection of earlier lesions. Pre-operative systemic therapy should be considered as an option for eligible patients.

Response of Ecosystem Carbon and Water Vapor Exchanges in Evolving Nocturnal Low-Level Jets

홍진규,Nathalie Mathieu,Ian B. Strachan,Elizabeth Patte,Monique Y. Leclerc 한국대기환경학회 2012 Asian Journal of Atmospheric Environment (AJAE) Vol.6 No.3

The nocturnal low-level jet makes a significant impact on carbon and water exchanges and turbulent mixing processes in the atmospheric boundary layer. This study reports a case study of nocturnal surface fluxes such as CO2 and water vapor in the surface layer observed at a flat and homogeneous site in the presence of low-level jets (LLJs). In particular, it documents the temporal evolution of the overlying jets and the coincident response of surface fluxes. The present study highlights several factors linking the evolution of low-level jets to surface fluxes: 1) wavelet analysis shows that turbulent fluxes have similar time scales with temporal scale of LLJ evolution; 2)turbulent mixing is enhanced during the transition period of low-level jets; and 3) CO2, water vapor and heat show dissimilarity from momentum during the period. We also found that LLJ activity is related not only to turbulent motions but also to the divergence of mean flow. An examination of scalar profiles and turbulence data reveal that LLJs transport CO2 and water vapor by advection in the stable boundary layer,suggesting that surface fluxes obtained from the micrometeorological method such as nocturnal boundary layer budget technique should carefully interpreted in the presence of LLJs.

Locally Advanced Breast Cancer in Jamaica: Prevalence, Disease Characteristics and Response to Preoperative Therapy

Chin, Sheray Nicole,Green, Cheryl May Antoinette,Gordon-Strachan, Georgiana Marie,Wharfe, Gilian Helen Frances Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.7

Breast cancer is the most common cancer in Jamaican women. Locally advanced breast cancer (LABC) is associated with aggressive biology and poor prognosis, and has a predilection for African-American women. In this retrospective review, we assessed the prevalence of LABC as a breast cancer presentation in a population of mainly Afro-centric ethnicity, and determined disease characteristics and response to pre-operative chemotherapy. LABC was prevalent (20%), and had a low pathological response rate to pre-operative chemotherapy, with a high risk of disease recurrence. Increased utilization of breast cancer screening may help detect cancer at less advanced stages, and optimizing pre-operative chemotherapy is recommended to improve response rates and ultimately survival.

Administrative Claims Datasets in South Korea and Japan: A Comparative Assessment Based on Extensive Practical Experience

Haine Lee,Younghyun Kang,Ji-Hyun Lee,Jae-Eun Myung,Liesl Strachan,Yoko Ishiguro,Sang-Soo Lee 한국보건의료기술평가학회 2020 보건의료기술평가 Vol.8 No.1

The administrative claims datasets refer to the data that occurs when healthcare providers claim ser- vices and items of care rendered to patients from payers. The purpose of this study is to review and compare the characteristics and differences of the administrative claims data in South Korea and Ja- pan. We compared the differences of claims data and examined the utilization of the data based on the hands-on experience of analyzing the data in both countries. The structure of claims data of both countries are comparable since they originated from similar health insurance systems in general. However, there also exist some differences: 1) institution in charge of managing claims data, 2) data access, and 3) data component. First, while the claims data in South Korea are only constructed and operated by National Health Insurance Service and Health Insurance Review and Assessment Ser- vice, those in Japan are constructed not only Ministry of Health, Labor and Welfare but also local governments, academic societies or private entities. Second, in Japan, only government officials or academic societies members can have access to the claims data while other stakeholders can access data that are constructed by private entities but not nationally representative. However, private sector is allowed to access the claims data with public Institutional Review Boards in South Korea. Lastly, unlike Korea, the Diagnosis Procedure Combination database in Japan has a unique characteristic that contains important clinical outcomes and can be analyzed together with claims data. Generating robust research using real-world datasets such as claims, clinical and Electronic Medical Records data is emerging. Based on the review of this study, to enable researchers to perform extensive re- search projects, policies on the use and management of medical big data need to be developed and strengthened.