Green Cross Research Articles

Effect of the Green Cross method on patient safety culture in a postanaesthesia care unit: a longitudinal quasi-experimental study

BackgroundHospitals should adopt multiple methods to monitor incidents for a comprehensive review of the types of incidents that occur. Contrary to traditional incident reporting systems, the Green Cross (GC) method...

New records of two alien plants, Carex annectens and C. gravida (Cyperaceae) in Korea

In Korea, two alien plants were newly found, and we describe their morphological characteristics and habitats with photographs. One, a member of Cyperaceae, Carex annectens, was found in roadside forests from Gyeongsangnam-do. This species can be distinguished from C. gravida by having inflorescences, usually branched, with more than 15 spikes and pistillate scale yellow or brown. The other is C. gravida, which was found along roadsides of open habitats from Chungcheongnam-do and Gyeonggi-do. This species can be distinguished from C. muehlenbergii Schkuhr ex Willd. var. enervis Boott by having proximal leaf sheaths longitudinally green-and-white striped and with prominent green cross veins. These species grow on roadsides, suggesting that they were likely to have been introduced when green sites were installed and during road construction. Their introduction into Japan has been reported, but the associated ecological risk is unknown. Therefore, we need continuous population monitoring for these new invasive species in Korea.

Voyage charterparty arrangement for river tramp shipping: Green and traditional vessels comparison

Voyage charterparty arrangement (VCA) for river shipping is a common agreement between a shipowner and a charterer regarding the transportation of specific cargoes from one port to another via a tramp vessel. Optimizing VCA with the essential terms such as laytime and sailing speed of the vessel, is a crucial task for both parties to reduce potential disputes and achieve win-win outcomes. This paper models the problem from two perspectives: the VCA negotiation stage and execution stage. Firstly, according to the given probability distribution of port time, the theoretically optimal laytime is obtained by using textbook formulation of newsvendor problems (NVP). On this basis, considering the concerns about the inaccuracy of the given probability distribution and the adjustment measures taken by charterers and shipowners in reality, an integrated adjustment model is constructed to determine the optimal laytime in the VCA negotiation stage. Secondly, taking into account the vessel's uncertain lock crossing time, an operations coordination model with information sharing of the berth plan is established to obtain the optimal sailing speed under a certain confidence level in the VCA execution stage. Finally, a case study of chartering tramp vessels on the Yangtze River validates the applicability and effectiveness of the models proposed in this paper, and some important management insights are derived. The results show that establishing lower optimal speed limits and relatively shorter laytime when signing a contract with the shipowner of green river vessels is reasonable for the charterer. By notifying the shipowner of the berth plan after the green river vessel crosses through the lock, the charterer can avoid higher demurrage costs due to speeding-up. Operations coordination would be mutually beneficial without abusing the contract terms. Compared to traditional river vessels, it's more reasonable to reduce the benefits allocated to charterers from the deceleration of green river vessels by shipowners.

Learning from patient safety incidents: The Green Cross method.

Hospitals can improve how they learn from patient safety incidents. The Green Cross method, a proactive reporting and learning method, is one strategy to meet this challenge. In it, nurses play a key role. However, describing its impact on learning from the users' perspective is important. This study aimed to describe nurses' experiences of learning from patient safety incidents before and 3 months after implementing the Green Cross method in a postanaesthesia care unit. A qualitative study with an inductive descriptive design with focus group interviews was conducted before and 3 months after implementing the Green Cross method to assess its impact. The data were analysed using qualitative content analysis. The study was conducted in a postanaesthesia care unit in a Norwegian hospital trust. Before implementing the Green Cross method, participants indicated limited openness and learning, including the subcategories 'Lack of openness hampers learning', 'Adverse events were taken seriously' and 'Insufficient visible improvements'. After implementing the Green Cross method, participants indicated the emergence of a learning environment, including the subcategories 'Transparency increases learning', 'Increased patient safety awareness' and 'Committed to quality improvements'. Implementing the Green Cross method in a postanaesthesia care unit positively impacted openness and nurses' patient safety awareness, which is crucial for learning and improving quality. The Green Cross method could be useful for organizational learning and facilitating learning from patient safety incidents through transparency, discussion and involvement of nursing staff.

The experience and reflections of GC labs as an independent clinical laboratory to the COVID-19 pandemic in South Korea

BackgroundAmid the COVID-19 pandemic, extensive testing was undertaken by independent clinical laboratories (ICLs), yet limited research exists on this matter. Drawing from Green Cross Laboratories (GC Labs)' pandemic response experience, this study seeks to offer insights for preparation for the next pandemic.MethodsThis retrospective study analyzed the outcomes of SARS-CoV-2 real-time reverse transcription polymerase chain reaction (SARS-CoV-2 rRT PCR) tests administered by GC Labs for COVID-19 diagnosis, upon request by different organizations, between February 2020 and April 2022. The distribution of institutions that requested the tests, the type of tests, and the positive rate were analyzed. We investigated resource allocation details.ResultsICLs were responsible for conducting 85.6% of all tests carried out under South Korea’s COVID-19 testing policy during the pandemic. The availability of free testing regardless of symptoms led to a significant increase in the use of pooled tests, which accounted for more than 80% of all tests conducted after August 2021. The gender and age distribution of COVID-19 cases nationwide and GC Labs’ positive cases were similar. When we analyzed the positive rate by requesting organizations during the COVID-19 pandemic, despite an overall nationwide positivity rate of 35%, high-risk facilities exhibited a positivity rate of less than 5% by maintaining preemptive testing. The most notable increase in resources during the pandemic was seen in human resource input.ConclusionsSouth Korea's ICLs were able to conduct large volumes of testing during the COVID-19 pandemic because of their logistics and computer systems, scalable testing space, and trained testing personnel. They also had the flexibility to bring in additional resources to expand testing capacity because they are specialized testing organizations. Hence, ICLs could execute the pooled test that the government had introduced for extensive general population screening. The preemptive periodic testing of high-risk populations kept the positive rate much lower than in the general population. This study's findings will aid in refining mass testing-based policies for the next pandemic.

Vacuum-assisted caesarean delivery assessment of maternal & fetal outcome

: The baby is delivered via incisions made in the mother's abdomen and uterus during a Caesarean delivery, sometimes known as a C-section. Whether medically necessary or elective, caesarean sections have increased sharply in recent decades all throughout the world, exceeding the WHO-recommended 10-15% rate. Every effort should be taken to give cesarean sections to women in need rather than aiming to achieve a target rate, according to a 2015 WHO statement. Therefore, we must investigate the strategies that can improve CD's maternal and neonatal health condition. This study compares the outcomes for the mother and the newborn in the vacuum-assisted CD and manual CD groups.: A progressive study was conducted at Lucknow's Green cross Hospital between June 2012 and April 2018. 500 pregnant ladies took part in this study as participants. This research was approved by the institutional human ethical committee. 250 caesarean sections were performed as part of this cohort study, each with vacuum assistance utilizing a soft cup vacuum extractor on the fetal scalp and manual removal of the skull as usual with fundal compression as support. Due to the absence of uterine activity and amniotic fluid, all of the patients underwent preplanned caesarean sections. The study's findings showed that manual extraction Caesarean birth is inferior to vacuum-assisted Caesarean delivery. Additionally, it was noted that Vacuum Assisted Caesarean Delivery resulted in less uterine incision extension, estimated blood loss, and maternal discomfort. : There was no difference between Vacuum and Manual Extraction caesarean deliveries in terms of Apgar Score, the requirement for infant resuscitation, or admission to the NICU.

Green Cross method in a postanaesthesia care unit: a qualitative study of the healthcare professionals’ experiences after 3 years, including the COVID-19 pandemic period

ObjectivesUnsafe medical care causes morbidity and mortality among the hospital patients. In a postanaesthesia care unit (PACU), increasing patient safety is a joint effort between different professions. The Green Cross...

The Diagnostic Yield of Exome Sequencing in Predominantly Antibody Deficient Patients Followed in Private Practice Allergy/Immunology Clinics

RationalePredominantly Antibody Deficiencies (PAD) account for most inborn errors of immunity (IEI) followed in private practice Allergy/Immunology clinics. While the genetic revolution has provided significant insights to understand the molecular basis of many IEI disorders, genetic testing in PAD has yielded a molecular diagnosis in only 15–30% of patients. These numbers may however be inflated due to selection bias inherent in these studies being performed in academic referral clinics where more complicated patients tend to be referred. The diagnostic yield and utility of broad-based genetic testing is largely unknown in the private practice setting. MethodsTen Consortium of Independent Immunology Clinics (CIIC) sites that provide care for more than 4,000 IEI patients (most with PAD) participated. Providers at each clinic proposed patients for inclusion using a questionnaire that included clinical and lab data that were reviewed by a 5-member enrollment committee. Patients were scored based on several factors including family history, early age of onset, autoimmune features, etc. and stratified as follows: P1 (5–17 points), P2 (3–4 points), P3 (1–2 points), and P4 (No points). P1, P2, and P3 patients were enrolled and samples sent for exome sequencing, lymphocyte subset analysis, and B cell immunophenotyping. ResultsOf 226 patients screened, 198 were selected for enrollment, and 137 submitted samples (48 P1, 58 P2, and 31 P3). Sixty percent were female, mean age 50.7 years (range 8–87), 57.6% had B cell abnormalities (low B cells, low memory B cells, low switched memory B cells, etc.), and 34.8% had Tor NK cell abnormalities (low numbers, reversed CD4/CD8 ratio, etc.). Causative pathogenic variants were identified in 8% of the exomes and highly suspicious VUS were identified in another 5%, predominantly in patients with a P1 priority score. ConclusionWe show that the diagnostic yield of broad-based genetic testing in PAD patients followed in private practice Allergy/Immunology clinics is somewhat lower than that reported in academic referral clinics. Diagnostic yield can, however, be improved by scoring clinical and laboratory features to stratify patients prior to testing.Acknowledgement: Supported by grants from Green Cross Corporation, Shire/Takeda, Pharming Group N.V., and Soleo Health.

Diagnostic performance of GENEDIA W and ActiveXpress+ COVID-19 antigens tests among symptomatic individuals in Peru and The United Kingdom.

In order to generate independent performance data regarding accuracy of COVID-19 antigen-based rapid diagnostic tests (Ag-RDTs), prospective diagnostic evaluation studies across multiple sites are required to evaluate their performance in different clinical settings. This report describes the clinical evaluation the GENEDIA W COVID-19 Ag Device (Green Cross Medical Science Corp., Chungbuk, Korea) and the ActiveXpress+ COVID-19 Complete Testing Kit (Edinburgh Genetics Ltd, UK), in two testing sites Peru and the United Kingdom. Nasopharyngeal swabs collected from 456 symptomatic patients at primary points of care in Lima, Peru and 610 symptomatic participants at a COVID-19 Drive-Through testing site in Liverpool, England were analyzed by Ag-RDT and compared to RT-PCR. Analytical evaluation of both Ag-RDTs was assessed using serial dilutions of direct culture supernatant of a clinical SARS-CoV-2 isolate from the B.1.1.7 lineage. For GENEDIA brand, the values of overall sensitivity and specificity were 60.4% [95% CI 52.4-67.9%], and 99.2% [95% CI 97.6-99.7%] respectively; and for Active Xpress+ the overall values of sensitivity and specificity were 66.2% [95% CI 54.0-76.5%], and 99.6% [95% CI 97.9-99.9%] respectively. The analytical limit of detection was determined at 5.0 x 102 pfu/ml what equals to approximately 1.0 x 104 gcn/ml for both Ag-RDTs. The UK cohort had lower median Ct values compared to that of Peru during both evaluations. When split by Ct, both Ag-RDTs had optimum sensitivities at Ct<20 (in Peru; 95% [95% CI 76.4-99.1%] and 100.0% [95% CI 74.1-100.0%] and in the UK; 59.2% [95% CI 44.2-73.0%] and 100.0% [95% CI 15.8-100.0%], for the GENDIA and the ActiveXpress+, respectively). Whilst the overall clinical sensitivity of the Genedia did not meet WHO minimum performance requirements for rapid immunoassays in either cohort, the ActiveXpress+ did so for the small UK cohort. This study illustrates comparative performance of Ag-RDTs across two global settings and considers the different approaches in evaluation methods.

Understanding Utilization and Seroprevalence of Syphilis Tests in Local Clinics and Hospitals in Korea

Diagnosis of syphilis, a sexually transmitted infection, can be based on clinical information and various combinations of results of both non-treponemal and treponemal assays. Because understanding a patient population is helpful for test utilization in the clinical laboratory, we aimed to investigate the results of syphilis serology tests requested from local clinics in Korea. We retrospectively evaluated the syphilis serology test results of serum Rapid Plasma Reagin (RPR), Treponema pallidum latex agglutination (TPLA), RPR titer, and fluorescent treponemal antibody absorption (FTA-ABS) IgG, and IgM tests performed in Korean adults in the laboratory information system of Green Cross Laboratories. We investigated the patterns of syphilis serology test results and possible interpretation according to combinations of syphilis serology based on a traditional testing algorithm. During the one-year study period, 33,746 RPR tests were performed in Korean adults (7,622 men and 26,124 women) with a median age of 35.1 years (interquartile range 30.8 - 43.4 years). Among these RPR tests, 317 (0.9%) showed RPR+ results and were performed simultaneous with TPLA tests. Among these 317 patients, 187 (59.0%) had RPR+/TPLA+ results. Among 130 patients with RPR+/TPLA- results, FTA-ABS IgG and IgM were only tested in 15 (11.5%): 14 were IgG-/IgM-, and one who underwent only the IgM test showed a negative result (probably a biological false positive of RPR). Among 187 RPR+/TPLA+ patients, 60 (2.1%) had RPR titer ≥ 1:8, and 10 were FTA-ABS IgM+ (including weak reactive results probably due to current infection or rare biological false-positive). Among 121 patients with RPR+/TPLA+/RPR titer ≤ 1:4, 30 were tested for FTA-ABS IgG and/or IgM: the two FTA-ABS IgM+ (including weak reactive) patients had an RPR titer of 1:4. This study will help to understand patient populations and test utilization for syphilis serology test interpretation in clinical laboratories in Korea. Further studies are needed to investigate the clinical impact of test utilization of syphilis serology in Korea.

Big-Data-Based Text Mining and Social Network Analysis of Landscape Response to Future Environmental Change

Climate change impacts the urban environment and landscape changes worldwide. To understand how South Korean citizens perceive these changes and what they expect for the future landscape, this study analyzed urban residents’ perceptions through text mining. Data related to the keywords “future landscape”, “future environment”, “well-being”, and “climate change” were collected from July 2020 to July 2021 from the Korean search engines Naver, Daum, and Google using the tool TEXTOM. Keywords, importance, and related words were derived through word frequency, TF-IDF, and N-gram analysis. CONCOR analysis was used to derive the meaning and relevance of the words. In “future landscape”, results showed a high frequency of the words “complex”, “apartment”, “future value”, and “sale”, and the connection strength was higher between “complex”, “landscape”, and “future value”. In “future environment”, “eco-friendly” showed the highest word frequency, and the words “New Deal”, “hydrogen” and “mobility” showed a high frequency and correlation. For “well-being”, “Green Cross” (a well-being-related company) showed the highest frequency, and the connection strength between satisfaction indexes was high. For “climate change”, “response” showed the highest frequency, and the connection strength between “carbon-neutral”, “UN-convention”, and “plan-establishment” was high. These results showed that South Koreans associate landscaping with the value of apartment complexes, that they expect solutions to mitigate climate change impacts with green and eco-friendly strategies, and lastly that well-being-related companies are receiving a great deal of public attention. Thus, it is expected that the results will help plan effective landscaping approaches to respond to environmental changes.

A noise-based high-resolution time-reversal method for acoustic defect localization in water pipes.

Pressurized water supply pipeline systems (PWSPS) are quintessential to human development and sustenance, but suffer a multitude of unresolved defects (i.e., leaks, blockages, etc.) due to aging and inaccessibility. In this paper, the ubiquitous high-frequency background noise in PWSPS is harnessed to introduce a high-resolution, passive defect detection technique. The relation between the acoustic Green's and cross correlation functions for a pressurized water pipe is derived for the case of high frequency waves, i.e., acoustic wavelengths smaller than the pipe diameter. This relation is subsequently used to formulate a time-reversal technique for localizing anomalies such as small variations in pipe wall impedance and through-wall defects (i.e., leaks). It is shown that the derived relationship between the cross correlation and acoustic Green's functions enables very accurate defect detection and localization by measuring the background noise at two locations along a pipe. This is an important result given that (i) there is limited access to buried PWSPS to conduct high-frequency active defect detection, and (ii) traditional methods to actively probe pipes (e.g., valve maneuverer) are low-resolution (tens to hundreds of meters) and often result in pipe overloading and fatigue.

Saturday, June 18, 20227:40 AM - 5:00 PMPO22 Presentation Time: 7:40 AM: A Novel Algorithm for Automatic Interstitial Needle Tracking on PETRA MRI for HDR Brachytherapy

<h3>Purpose</h3> Current practice for interstitial high-dose-rate (HDR) brachytherapy treatment planning involves manual tracking of needle positions on CT images. Recently, PETRA MRI showed the potential to detect empty interstitial gynecological brachytherapy needles owing to low needle signal, intermediate tissue contrast and high spatial resolution. We aimed to develop an algorithm for automatic interstitial needle tracking on PETRA images by employing their negative contrast against surrounding tissue. <h3>Materials and Methods</h3> Fourteen ProGuide Sharp Needles 6Fx294mm were implanted in an endometrial adenocarcinoma patient using a Syed-Neblett template. One of the needles lay in the obturator center, and six inside the obturator slots. The patient underwent standard CT imaging with copper-filled needles. After marker removal, 3D PETRA images of the patient's pelvis (TR\TE 3.32\0.07 ms, voxel size 0.9 mm³ isotropic, 416 slices) were acquired on a 3T Siemens Vida MR scanner. PETRA MR images were analyzed for interstitial needle detection using custom code in MATLAB R2022a. A rectangular part of all axial slices where needles may be contained (slices 149-310) was selected. For each slice part, corner points were extracted from the original part and from its sharpened gradient magnitude image by detecting Harris features. Points found within Euclidean distance (ED) of 3 pixels on both images were matched, and the pixel with minimum signal intensity closest to each such point on the original part was selected. Minimum intensity points lying within 2 pixels ED between subsequent slices were considered as possible catheter coordinates. Such points appearing on at least 10 continuous slices were designated as true catheters, and their positions were compared to those visible on CT. <h3>Results</h3> Figure 1a) displays the selected MR image parts for two example slices. Pixels with detected Harris features and their closest signal minima are marked by red and green crosses, respectively, in b). Pixels accepted as needle positions are shown as magenta crosses in c). Matching CT image parts with bright marker-filled needles are displayed in d). Empty interstitial catheters on PETRA images corresponded to local minima of signal intensity, located near Harris features. The assumption of needle position continuity within an allowed distance along subsequent slices helped avoid spurious signal minima, while following needle position variations caused by different deflection angles. Needles guided through the obturator grooves and the central needle were detected only after they became detached from the obturator (ex. figure left). All 14 needles were tracked along their visible length inside tissue (ex. figure right). Visual comparison to CT images confirmed interstitial catheter detection on MRI. Selecting a range of slices and zooming on a part of each slice for analysis reduced computational time and output data size. <h3>Conclusions</h3> Automated detection of interstitial needles is feasible on PETRA MR images and may facilitate MR-only treatment planning in interstitial HDR brachytherapy. The newly developed algorithm was able to track all needles inside tissue based on their signal intensity characteristics, without requiring manual seed position placement.

Mitigating Tannery Pollution in Sub-Saharan Africa and South Asia

The global leather market is worth more than $270 billion annually, and provides an important and accessible source of manufacturing exports for countries in the Global South. Leather is the source for a range of apparel items, including handbags, belts, shoes, wallets, gloves, and various other products, such as furniture, car seats, and luggage. Behind all leather goods is the tannery industry, with much of the raw materials processing located in the Global South (Lund-Thomsen, 2009, Journal of Business Ethics, vol. 90, p. 57). Unlike most synthetic fibers, which are derived from plastics and associated with the petrochemical industry, leather has the potential for a comparatively lighter footprint because it is based on natural and renewable materials not associated with the carbon emissions of fossil fuels. However, leather has suffered from various concerns, including animal rights and toxic effluents. It is ranked as the fourth most dangerous global industry to human health, with many tanneries in the Global South lacking basic protection for the workers and leaching toxic chromium into rivers (Green Cross and Pure Earth, 2016, World’s worst pollution problems: The toxics beneath our feet). This article explores the prospects for reducing the environmental footprint of tanneries in the Global South, focusing on the Sustainable Manufacturing and Environmental Pollution (SMEP) program, a series of projects in South Asia (SA) and Sub-Saharan Africa (SSA) that explore ways to reduce manufacturing pollution. The article lays out a series of technical and managerial interventions that would vastly reduce the negative impacts on human health and the natural environment.

Application of “Iron Salt + Air” Catalytic Oxidation System in Green Cross Coupling Reaction&lt;/b&gt;&lt;b&gt;: Recommendation for an Undergraduate Research-Training Program

Application of “Iron Salt + Air” Catalytic Oxidation System in Green Cross Coupling Reaction&lt;/b&gt;&lt;b&gt;: Recommendation for an Undergraduate Research-Training Program

A Comparative Study on South Korean Bio-pharmaceutical Company Internationalization Strategies: Uppsala Model and Born Global Perspectives

Purpose This study aims to draw implications from the nation’s leading bio-pharmaceutical companies by comparing their international strategies. In particular, this study adopts two theories related to internationalization, the uppsala model and the born global perspective, considering that there are differences in business models and international strategies among the bio-pharmaceutical companies. Design/Methodology/Approach Academic papers, websites, and newspaper articles were used to collect information on the status of international entry of companies, and to analyze basic information. Next, interviews with three bio-pharmaceutical industry experts were conducted to verify this and confirm additional content. Interviewees were selected with actual and industrial research experience. Findings We found that GC Green Cross and Hanmi Pharmaceutical, which are expanding their business to biomedicine based on chemical synthetic drugs, are explained by the Uppsala model, while Celltrion and Samsung Biologics’ international strategy focused on biomedicine comes from a born global perspective. Research Implications By systematically analyzing South Korean bio-pharmaceutical company international strategies, this study found that each company has various international market entry modes depending on product characteristics and CEO’s intention. Furthermore, it was suggested that a differentiated international strategy by region and country is necessary. In a practical sense, besides, this study suggests South Korean bio-pharmaceutical companies need a step-by-step international market entry strategy in the future

Pluronic F-68 Reduces the Endothelial Adherence and Improves the Rheology of Liganded Sickle Erythrocytes

A perfluorochemical blood substitute emulsified with Pluronic F-68 has been shown to improve the filterability of deoxygenated sickle red cells. We questioned whether some of the effect was independent of oxygen loading and studied the influence of Fluosol DA (Green Cross, Osaka, Japan) and Pluronic on the rheology and adhesion of sickle red cells saturated with oxygen and carbon monoxide. A 5-vol/vol% concentration of Fluosol or equivalent concentration of Pluronic was equally effective at improving the filtration of washed sickle cells through 5-micron-diameter pores at wall shear stresses approximating 1,000 dyne/cm2. The same concentration of Pluronic reduced the extensional static rigidity of irreversibly sickled cells (ISC) by 25% and also abolished the adherence of gravity-sedimented sickle cells to endothelial monolayers in the presence of saline or plasma. The inhibition of adherence was not reversible by washing and was accomplished with equal ease by isolated treatment of sickle cells or endothelium. Pluronic had no effect on the rheology or adhesion of normal adult red cells. Neither Fluosol nor Pluronic changed sickle or normal cell shape, mean cell volume, mean cell density, or cell density distribution. A lubricating effect of Pluronic on cell surfaces could explain all of the rheological observations and offers another direction of inquiry in the search for therapy for sickle cell disease.

Nurses’ experience of incident reporting culture before and after implementing the Green Cross method: A quality improvement project

BackgroundAdverse events are a leading cause of death worldwide, although many are considered preventable. Incident reporting is a prerequisite for preventing adverse events; however, underreporting is common. The Green Cross method is an alternative incident reporting process that includes a daily team meeting to discuss incidents and work on improvements. ObjectivesThe aim of this quality improvement project was to improve the culture of incident reporting by implementing the Green Cross method and to evaluate the improvement by describing nurses’ experience with the culture of incident reporting. MethodsThe project included a three-month implementation of the method in a postanesthesia care unit, which was evaluated by focus group interviews (n = 22 nurses) and analysed by qualitative content analysis. FindingsFour focus group interviews were conducted before implementation (n = 19 nurses) and four after implementation (n = 16 nurses). Before implementation, Theme 1, “Incident reporting with potential for improvement”, was constructed, describing a culture wherein nurses expressed motivation to report incidents but barriers, such as finding the system complicated and experiencing emotional obstacles towards reporting, prevented them. After implementation, Theme 2, “Increased focus on transparency”, was constructed, describing a culture wherein nurses perceived an increased rate of incident reporting but still encountered barriers, such as finding reporting uncomfortable and demanding, experiencing a threatened working environment, and still wanting visible improvement. ConclusionThe nurses in the postanesthesia care unit experienced the Green Cross method as a useful patient safety initiative for improving the rate of incident reporting, but barriers to reporting still existed.

The comparison of seroconversion rates among different varicella vaccines administered Turkish children; MAV/06 and vOka

ABSTRACT Varicella is a vaccine-preventable disease, and the incidence of varicella has declined since the introduction of varicella vaccine campaigns. A wild type of varicella zoster virus (VZV) was isolated from a 33-month-old child with varicella in Korea in 1989, a different strain (MAV/06). A live-attenuated varicella vaccine containing strain (MAV/06), Suduvax®, was developed in South Korea in 1994. Turkey introduced the varicella vaccine containing the MAV/06 strain (Varicella Vaccine-GCC, Green Cross, South Korea) in January 2019. Therefore, we aimed to compare the seroconversion rates among MAV/06 vaccine- and vOka-administered children. We prospectively collected blood samples from 98 received vOKA and 98 received MAV/06 children 6 weeks after administration, and seroconversion rates were determined by an indirect fluorescence assay (Anti-VZV IIFT IgG, Euroimmun, Germany). Seroconversion rate was significantly higher in vOka group than MAV/06 group (82.7% vs. 64.3%; p = .004). Of the children vaccinated with vOka strain, 17 children did not develop antibodies, 12 were weakly positive, and the remaining 69 children were strongly positive. Of the children who were administered MAV/06 strain, 35 were negative, 20 were weakly positive, and 43 were strongly positive. In conclusion, this study demonstrated that MAV/06 varicella vaccine had lower seroconversion rates and the strong seropositive cases were less common than vOka-administered children. Larger and prospective studies are needed.

Health-Related Quality of Life and Satisfaction of Children with Severe Hemophilia a Treated with Turoctocog Alfa Pegol (N8-GP)

Introduction:Hemophilia A is an inherited bleeding disorder characterized by deficiency of factor VIII resulting in recurrent and spontaneous musculoskeletal bleeding. Treatment-related challenges including development of inhibitors to FVIII, venous access problems, and pain at infusion site can impact a patient's quality of life and may subsequently affect patient satisfaction with treatment. Recent advances have extended the half-life of factor replacement therapy which can allow less frequent dosing. The health-related quality of life (HRQOL) and satisfaction with treatment are reported in children with severe hemophilia A who were treated with turoctocog alfa pegol, a novel recombinant FVIII product.Methods: Children with severe hemophilia A aged 0-12 years who participated in the single-arm phase III pathfinder™5 trial were included in this analysis. In the main phase of the trial, 68 children were treated using 60 IU/kg turoctocog alfa pegol IV twice weekly for 26 weeks. HRQOL was assessed by children and their parents using age-specific versions of the Hemophilia-Quality of Life questionnaire (HAEMO-QOL-I for ages 4-7 and HAEMO-QOL-II for ages 8-12). Satisfaction was assessed by parents using the Hemophilia Satisfaction questionnaire (HEMO-SAT). HAEMO-QOL and HEMO-SAT scores range from 0 to 100, with a lower score reflecting a better QOL or higher treatment satisfaction. Changes in the HAEMO-QOL and HEMO-SAT scores from baseline to the end of the main phase of the trial were assessed only for those individuals who completed the questionnaires at both time points.Results: Sixty-eight children participated in the trial (20 aged 0-3 years, 23 aged 4-7 years, 25 aged 8-12 years). Table 1 presents the change in scores of the individuals who completed the questionnaires at both time points in each age group. As reported by the children aged 4-7 and their parents, the mean HAEMO-QOL-I total score decreased (reflecting an improvement for the group) from baseline to end of the trial (29.6 to 22.3 for children; 31.2 to 20.5 for parents). Change in individual scores (N=7 children; N=14 for parents), reflected improvement of HRQOL in 6 out of the 8 domains and in the total score (mean change -14.0±13.9) for the children and in 7 out of the 8 domains and in the total score (mean change -11.5±12.8) for the parents. As reported by the children aged 8-12 and their parents, the mean HAEMO-QOL-II total score decreased (reflecting an improvement for the group) from baseline to end of the trial (21.7 to 17.9 for children; 29.2 to 20.4 for parents). Changes in individual scores (N=21 for children; N=21 for parents), reflected improvement of HRQOL in 8 out of the 10 domains and in the total score (mean change -3.6±9.2) for the children and in 9 out of the 10 domains and in the total score (mean change -8.6±10.0) for the parents. Parents reported low scores in all domains of the HEMO-SAT at both baseline (N=19 for aged 0-3 years, N=20 for aged 4-7 years, N=22 for aged 8-12 years) and end of main phase (N=16 for aged 0-3 years, N=18 for aged 4-7 years, N=21 for aged 8-12 years) indicating that they maintained a high level of satisfaction during the initial 26 weeks of treatment with turoctocog alfa pegol.Conclusions: Overall, children with severe hemophilia A who were treated with turoctocog alfa pegol consistently reported improvement in HRQOL and maintained a high level of satisfaction by the end of the 26-week main phase of the trial. [Display omitted] DisclosuresKearney:Bioverativ: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Grifols: Research Funding; Bayer: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Pham:Novo Nordisk: Consultancy. Adalsteinsson:Novo Nordisk: Employment. Landorph:Novo Nordisk: Employment. Raffini:CSL Behring: Consultancy; Genetech: Consultancy; Green Cross Inc: Consultancy; Bayer: Consultancy.