• Child Health Nursing Research
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• v.30 no.2
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• pp.142-153
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• 2024

Purpose: This study aimed to describe the process of developing a validated pediatric nursing simulation scenario template using the real-time Delphi method. Methods: A panel of 13 pediatric nursing experts participated in a real-time Delphi survey conducted over two rounds. Initially, 83 items were included in the questionnaire focusing on the structure and content of the simulation scenario template. Data analysis involved calculating the content validity ratio (CVR) and the coefficient of variation to assess item validity and stability. Results: Through iterative rounds of the Delphi survey, a consensus was reached among the experts, resulting in the development of a pediatric nursing simulation scenario template comprising 41 items across nine parts. The CVR values ranged from 0.85 to 1.0, indicating a high consensus among experts regarding the inclusion of all items in the template. Conclusion: This study presents a novel approach for developing a pediatric nursing simulation scenario template using real-time Delphi methods. The real-time Delphi method facilitated the development of a comprehensive and scientifically grounded pediatric nursing simulation scenario template. Our template aligns with the International Nursing Association for Clinical Simulation and Learning standards, and provides valuable guidance for educators in designing effective simulation scenarios, contributing to enhanced learning outcomes and better preparation for pediatric clinical practice. However, consideration of cultural and contextual adaptations is necessary, and further research should explore alternative consensus criteria.

• Physical Therapy Rehabilitation Science
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• v.13 no.2
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• pp.240-249
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• 2024

Objective: The objective of this study is to evaluate various research that have examined dynamic knee valgus and to pinpoint a straightforward, clinically practical 2D assessment method for dynamic knee valgus that is user-friendly. Design: A literature review Methods: This literature review was conducted in Pubmed, MEDLINE^® and Google Scholar with the following key words: Knee valgus angle, Knee valgus evaluation, Knee valgus assessment, Dynamic knee valgus. After removing duplicate studies, 53 articles were initially chosen using this method, with 17 studies ultimately meeting the selection criteria. Results: Based on the comprehensive review of various studies, the Single Leg Squat (SLS) was identified as the most popular test method, followed by the Single Leg Landing (SLL) as the next most common test method. The Frontal Plane Projection Angle (FPPA) method was the most representative method for measuring dynamic knee valgus (DKV) during these tests. SLS was found in a total of 10 studies, while SLL was found in 7 studies. Conclusions: The most commonly proposed test for assessing DKV is measuring the SLS using the FPPA method. However, when applied to individuals without knee pathology, the discriminative power of this method may be limited. This suggests the need for further research to explore alternative methods for assessing DKV in this population.

• Clinical Endoscopy
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• v.57 no.4
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• pp.501-507
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• 2024

Background/Aims: Polyps greater than 30 mm are classified as "giants". Their endoscopic removal represents a technical challenge. The choice of the endoscopic removal technique is important because it provides a resection sample for precise histopathological staging. This is pivotal for diagnostic, prognostic, and management purposes. Methods: From a retrospective analysis, we obtained a sample of 38 giant polyps. Eighteen polypectomies were performed using the epinephrine volume reduction (EVR) method, nine polypectomies utilized endo-looping or clipping methods, and 11 patients underwent surgery. Results: We obtained en bloc resection with the EVR method in all cases; histology confirmed the correct indication for endoscopic resection in all cases. Moreover, no early or delayed complications were observed, and no patient required hospitalization. Using endo-looping or clipping methods, we observed advanced histology in 1/9 (11.1%) cases, while another patient (1/9, 11.1%) had delayed bleeding. Among patients who underwent surgery, 5/11 (45.5%) were deemed overtreated and three had post-surgical complications. Conclusions: We propose EVR as an alternative technique for giant polyp resection due to its safety, effectiveness, cost-efficiency, and the advantage of avoiding the need to postpone polypectomy to a later time. Further prospective studies might help improve this experience and enhance the technique.

• Korean Journal of Cognitive Science
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• v.26 no.2
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• pp.167-207
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• 2015

This study focused on the awareness and coping methods of psychological trauma and human suffering in the contemporary era after the development of posttraumatic stress disorder(PTSD) including the situations in the Korean society, and proposed principles for an alternative paradigm of trauma recovery. Trauma is defined as an 'external' stress causing chronic suffering mediated by memory, and the American Psychiatric Association approved PTSD in the Diagnostic and Statistical Manual of Mental Disorders in 1980. The development of PTSD empowered moral legitimacy to the victims, opened a successful way to treatment, and accomplished explosive amount of research in the area of neurobiology and cognitive neuroscience. However, this also narrowed the understanding of human suffering, and the importance of an alternative coping method which overcomes the limitations of technical intervention became overlooked. Moreover, the Korean society has an underlying mechanism of replacing the matter of trauma to a problem of an individual. This is shown among the historical context of splitting and denial, and among medicalized bureaucracy. Trauma should be acknowledged as a social suffering, and searching for an alternative paradigm is in need. This study suggested the following principles; seeking for truth and justice, survivor as the agent of recovery emphasizing the responsibility of the community, ecological adaptations of recent bio-psychological achievements, and finally putting emphasis on continuous discussions about the definition of recovery.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2547-2554
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• 2014

Background: To evaluate the perception of cancer patients toward treatment services and influencing factors and to inquire about the use of complementary alternative medicine (CAM). Materials and Methods: Information was obtained through pre-tested structured questionnaires completed by cancer patients during treatment at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Results: Of 242 patients, 137 (64.6%) accepted to enter this study. Most were Saudi (n=93, 68%), female (n=80, 58%), educated at university (n=71, 52%), married (n=97, 72%) and with breast cancer (n=36, 26%). One-hundred (73%) patients were satisfied with the services provided; 61% were Saudi. Ninety-four (68%) respondents were satisfied with the explanation of their cancer. Twenty-eight (21.6%) patients received CAM, of them 54.0% received herbal followed by rakia (21.0%), nutritional supplements/vitamins (7.0%) and Zamam water (18.0%), with significant differences among them (p =0.004). Seven (5%) patients believed this therapy could be used alone; 34 (25%) patients believed it could be used with other treatments, regardless of whether they themselves used this therapy. Fifty-three (53%) satisfied patients felt they received enough support; 31 (58%) patients received support from family and friends; 22 (41.6%) patients received support from the health-care team. Patients who received information about their disease from their physicians and those who felt they had enough support were more satisfied. The patients who took alternative treatment were older age, mostly female and highly educated but values did not reach significance. Conclusions: We stress enhancing the educational and supportive aspects of cancer-patient services to improve their treatment satisfaction and emphasize the need for increasing the educational and awareness programs offered to these patients.

• Asian-Australasian Journal of Animal Sciences
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• v.30 no.5
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• pp.749-754
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• 2017

Objective: The objective of the present study was to investigate the effects of farrowing month (FM), parity and sex on the growth performance of Berkshire swine raised in alternative production systems. Methods: A total of 40 farrowing records from 27 sows and 1,258 body weight (BW) records from 274 piglets collected over a two-year period were used for the analysis. The BWs were recorded at birth, weaning (28 d), 56, 84, 112, and 140 days. Any BW not recorded on schedule was recalculated to conform the days of age among corresponding BW records, using growth curves drawn with polynomial functions whose power was determined by the number of existing observations for each individual. Results: The mean parity (${\pm}$standard deviation) of the sows was $3.42{\pm}2.14$. The sows that farrowed in June had the lowest number of total born with an average of $6.25{\pm}2.22$ piglets per sow. However, the lowest average number of piglets weaned at day 28 was found in sows that farrowed in May, as well as the highest number recorded for the stillborn piglets with an average of 2.67 piglets per sow. Moreover, the smallest increase in weight from birth to weaning occurred in piglets that were farrowed in May, which also corresponds with the average daily gain (ADG) of 0.29 kg and the last recorded weight measurement on day 140 of $41.69{\pm}1.45kg$. Contrastingly, the highest growth rate was found among pigs farrowed in June, with the largest increase in weight of 7.55 kg from birth to weaning, the highest ADG of 0.51 kg from birth to 140 day of age and the highest BW of $74.70{\pm}1.86kg$ recorded on day 140. Conclusion: Pigs farrowed in June also had the least number of piglets that died between birth and weaning. The zone of thermal comfort found in sows reared in indoor confinement systems did not improve the reproductive performance of the sows reared in an outdoor, alternative production system, while the growth performance of the piglets was improved when the ambient temperature was consistently hot or consistently cold.

• Journal of the Korea Safety Management & Science
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• v.17 no.2
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• pp.107-115
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• 2015

The study targeted Japanese employees who have visited hospital for spinal disorder. The study analyzed work environment and pain relief methods of work-related back pain patients, and the relationship between back pain and other body parts. The purpose of this study was to provide draw up measures for patients with back pain and to provide basic data for the sustainable prevention program. The study result of back pain, in other words, employees suffering from lumbago, had disparity between occupations; the highest number of patients were made up of 16-years or above long-serving employees, and below 5-years of short-serving employees. There were more patients complaining of chronic lumbago than acute lumbago, and patients recognized poor posture as the primary cause of lumbago. Furthermore, 99.5% of spinal disorder patients complain back pain, 23.2% use only alternative therapy, and 15.2% visit clinic and hospital with alternative therapy. Patients showed pain reduction and high satisfaction after using alternative therapy. The study targeted Japanese employees where complement therapy is more generalized than that of Korea, and thus there should be multilateral management programs provided in Korea as well.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.3
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• pp.217-226
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• 2022

Background: Intraosseous anesthesia is the process by which an anesthetic solution, after penetration of the cortical bone, is directly injected into the spongiosa of the alveolar bone supporting the tooth. This study aimed to compare the effectiveness of the traditional inferior alveolar nerve block (IANB) and computerized intraosseous anesthesia in the surgical extraction of impacted lower third molars, compare their side effects systemically by monitoring heart rate, and assess patients' a posteriori preference of one technique over the other. Methods: Thirty-nine patients with bilaterally impacted third molars participated in this study. Each patient in the sample was both a case and control, where the conventional technique was randomly assigned to one side (group 1) and the alternative method to the contralateral side (group 2). Results: The traditional technique was faster in execution than anesthesia delivered via electronic syringe, which took 3 min to be administered. However, it was necessary to wait for an average of 6 ± 4 min from the execution to achieve the onset of IANB, while the latency of intraosseous anesthesia was zero. Vincent's sign and lingual nerve anesthesia occurred in 100% of cases in group 1. In group 2, Vincent's sign was recorded in 13% of cases and lingual anesthesia in four cases. The average duration of the perceived anesthetic effect was 192 ± 68 min in group 1 and 127 ± 75 min in group 2 (P < 0.001). The difference between the heart rate of group 1 and group 2 was statistically significant. During infiltration in group 1, heartbeat frequency increased by 5 ± 13 beats per minute, while in group 2, it increased by 22 ± 10 beats per minute (P < 0.001). No postoperative complications were reported for either technique. Patients showed a preference of 67% for the alternative technique and 20% for the traditional, and 13% of patients were indifferent. Conclusion: The results identified intraosseous anesthesia as a valid alternative to conventional anesthesia in impacted lower third molar extraction.

• Journal of the Korea Safety Management & Science
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• v.12 no.2
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• pp.55-64
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• 2010

This study tried to focus on nontraditional job that has not been studied in terms of the subjects associated with MSDs(Musculoskeletal Disorders). Specifically, dental procedure was the job to be analyzed in this study. An alternative method as well as a traditional method for viewing teeth while performing simulated dental procedures. Four graduated students did both methods(direct view and indirect view) as the subjects in this study. The method based on indirect view used a video camera and monitor to view the teeth. The experiment was conducted five times for each subject. The major findings in this study were as follows; 1) Job speed was increased with the repetitions for both methods, 2) Difference of Neck flexion between direct and indirect methods was statistically siginificant(Neck flexion for indirect method was dramatically decreased), 3) Difference of job speed between direct and indirect methods was statistically significant(Job speed for direct method was faster than that of indirect method), 4) Difference of error rate between direct and indirect methods was statistically significant(error rate for direct method was lower than that of indirect method), 5) Even though indirect method did not provide better performance in terms of job speed and error rate yet, it seemed to need a trade-off between two methods in the future since indirect method provided better working postures than that of direct method.