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This paper delves into the challenges of achieving inclusion within science-advice institutions, particularly focusing on the International Council for the Exploration of the Sea (ICES). It explores the normative and practical implications of broadening the epistemic space to incorporate diverse ways of knowing in uncertain contexts. Traditional science-advice often relies on strict quantification and institutionalized expertise, limiting the recognition of alternative perspectives. The study proposes an alternative view rooted in post-normal science, advocating for the adoption of an extended peer community model. Despite ICES's efforts to enhance stakeholder engagement through its Stakeholder Engagement Strategy, gaps remain in effectively valuing epistemic diversity. By analyzing a historical case involving the revision of fishing quotas for Northeast Atlantic mackerel, the paper illustrates the limitations of strict quantification in addressing complex and uncertain problems. It recommends a participatory approach informed by post-normal science principles and incorporates the concept of "epistemic injustice" in Miranda Fricker's work (Fricker, 2003, 2007) to the discussion to underscore the ethical imperative of inclusive decision-making. Ultimately, the paper advocates for post-normal science approaches to better address contemporary challenges in science-advice institutions when the problem is deeply uncertain and complex. • Post-normal science approach advocated for inclusive decision-making in science-advice institutions. • Extended peer community model proposed to incorporate diverse ways of knowing in uncertain contexts. • ICES's efforts to enhance stakeholder engagement highlighted, but gaps in valuing epistemic diversity remain. • Introduction of Fricker's concept "epistemic injustice" to frame the ethical imperative of inclusive decision-making. • Case study illustrates limitations of strict quantification in addressing complex, uncertain problems. [ABSTRACT FROM AUTHOR]

Background: Carbapenem resistance among gram-negative bacilli is an emerging threat worldwide. The objective of this study was to identify risk factors for the acquisition of carbapenem-resistant Escherichia coli (CRE). Methods: We conducted a matched case-control study comprising 57 cases of acquisition of CRE and 114 controls (1:2 matched) selected from patients with a culture of carbapenem-susceptible E coli between January 2006 and December 2010 at a 2000-bed tertiary care center in South Korea. Results: On univariate analysis, previous use of carbapenem (P < .01), fluoroquinolone (P < .01), and glycopeptide (P < .01), as well as length of hospital stay (P < .05), were significantly associated with CRE acquisition. On multivariate analysis, previous use of carbapenem (odds ratio [OR], 4.56; 95% confidence interval [CI] 1.44-14.46; P = .01) and previous use of fluoroquinolone (OR, 2.81; 95% CI, 1.14-6.99; P = .03) were independent risk factors. Conclusions: At this institute, the antibiotic selective pressure of carbapenems and fluoroquinolones was shown to be an important risk factor for the acquisition of CRE. [Copyright &y& Elsevier]

Background: Gastric polyps are found frequently in various colonic polyposis syndromes. Genetic alterations of several genes occur in gastric adenomas and colorectal adenomas. However, it is unknown whether patients with gastric adenomas are at higher risk for colorectal adenomas. Objective: To investigate the prevalence rate of colorectal adenoma in patients with gastric adenomas and to determine the association between the presence of gastric adenomas and synchronous colorectal adenomas. Design: A retrospective, cross-sectional, case-control study. Setting: Single center: Center for Health Promotion of Samsung Medical Center. Patients: This study involved 87 patients with gastric adenomas and 174 sex-matched and age-matched controls among 19,019 participants who underwent EGD and colonoscopy simultaneously or within 6 months of each other from January 2001 to December 2008 at the Center for Health Promotion of Samsung Medical Center. Intervention: EGD and colonoscopy. Main Outcome Measurements: The prevalence rate of colorectal adenoma in patients with gastric adenomas. Results: The 87 gastric adenoma patients included 72 men and 15 women. Colorectal adenomas were identified in 42 (48.3%) of 87 cases and in 58 (33.3%) of 174 controls (P = .022). The prevalence of colorectal adenoma was significantly higher in the gastric adenoma group than in the control group. The mean size and number of colorectal adenomas were not significantly different between the two groups. The majority of colorectal adenomas were located in distal colonic segments in the gastric adenoma group in contrast with proximal colonic segments in the control group. Multivariate logistic regression analysis revealed that independent risk factors for colorectal adenoma were the presence of gastric adenomas (odds ratio [OR], .915; 95% confidence interval [CI], 1.044-3.513) and increasing age over 55 years (OR, 2.943; 95% CI, 1.558-5.560). Limitations: Lack of data on previous colorectal adenomas and possible confounding factors such as hyperlipidemia or diabetes mellitus. Conclusion: The risk of colorectal adenoma increases significantly in patients with gastric adenomas and in patients over age 55. A screening colonoscopy may be necessary for patients with gastric adenomas to detect colorectal adenomas. [Copyright &y& Elsevier]

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infections are a concern across the worldwide. Methods: Antibiotic stewardship and hand hygiene programs were reinforced in a 2,000-bed tertiary hospital in South Korea where the methicillin resistance rate of Staphylococcus aureus is about 65%. The computerized prescription restriction was implemented in August 2008. “Hand hygiene program,” consistent with World Health Organization guideline, was reinforced in December 2008. We assessed the effect of the infection control programs on the incidence of MRSA bloodstream infection (BSI) from January 2006 through November 2011. Results: Incidence of MRSA BSI was reduced from 0.171 per 1,000 patient-days in 2009 to 0.116 per 1,000 patient-days in 2011 (P = .009). Monthly mean antibiotic consumption decreased from 690.54 ± 28.33 defined daily dose per 1,000 patients-days in 2008 to 652.47 ± 20.77 (P = .015) in 2011. The rates of performance in hand hygiene increased from 43% in 2008 to 83% in 2011 (P = .043). Conclusion: Although we did not implement all components of “MRSA bundle,” efforts to reinforce antibiotic stewardship and hand hygiene program for 3 years had beneficial effects on the decrease in MRSA BSI in this institute with high rate of MRSA. [Copyright &y& Elsevier]