• Title/Summary/Keyword: Clinical Evaluation Tool

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Comparative evaluation of ultrasonography with clinical respiratory score in diagnosis and prognosis of respiratory diseases in weaned dairy buffalo and cattle calves

  • Hussein, Hussein Awad;Binici, Cagri;Staufenbiel, Rudolf
    • Journal of Animal Science and Technology
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    • v.60 no.12
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    • pp.29.1-29.11
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    • 2018
  • Background: Respiratory troubles have economic impacts in countries where livestock industry is an important segment of the agricultural sector, as well as these problems may cause significant economic losses for bovine producers. Various practical methods are used to assess diseases that affect the bovine respiratory system. Ultrasonography is a noninvasive tool that has been used frequently in diagnosis of various animal diseases. The present study was designed to establish whether thoracic ultrasonography is a diagnostic tool for detection of respiratory troubles in weaned buffalo and cattle calves, as well as to assess its prognostic value in comparison with clinical respiratory scores. Thirty five (15 buffalo and 20 cattle) calves were included. Twelve (6 buffalo and 6 cattle) clinically healthy calves were enrolled as controls. Results: Based on physical examinations, clinical respiratory scores (CRS), ultrasound lung scores (ULS) and postmortem findings, animals were classified into 4 groups as pulmonary emphysema (n = 8), interstitial pulmonary syndrome (n = 7), bronchopneumonia (n = 12), and pleurisy (n = 8). The mean values of CRS and ULS were significantly higher in diseased calves (P < 0.01). In calves with pulmonary emphysema and interstitial syndrome, thoracic ultrasonography revealed numerous comet-tail artifacts, which varied in numbers and imaging features. Furthermore, variable degrees of pulmonary consolidation with alveolograms and bronchograms were noticed in bronchopneumonic calves. In addition, thick irregular or fragmented pleura with pleural effusions and fibrin shreds were imaged in calves with pleurisy. A weak correlation was calculated between CRS and ULS (r = 0.55, P < 0.01). Hematologically, the counts of white blood cells, activities of aspartate aminotransferase and partial tensions of carbon dioxide were significantly increased in all diseased groups. Serum concentrations of total globulins were higher in claves with bronchopneumonia (P < 0.05). The partial tension of oxygen was decreased in all diseased calves (P < 0.05). Conclusions: Thoracic ultrasonography is a diagnostic tool for various lung troubles and assessment the grade and severity of pulmonary diseases, as well as it can be used as a follow-up tool for evaluating the prognosis of respiratory troubles and monitoring the efficacy of therapies.

Validation of the Korean Version of the Undergraduate Clinical Education Environment Measure (한국형 임상실습 교육환경 평가척도 타당화)

  • Chun, Kyunghee;Park, Young Soon;Oak, Ji Won
    • Korean Medical Education Review
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    • v.23 no.1
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    • pp.37-45
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    • 2021
  • In light of the need for a tool to evaluate the clinical practice education environment as perceived by medical and nursing students, this study is was conducted to develop and validate the Korean version of the Undergraduate Clinical Education Environment Measure (K-UCEEM) as a measurement tool for managing the clinical practice education climate and quality of education. For validation, the UCEEM consisting of 25 items developed by Pia Strand in 2013 was adapted according to standard translation procedures. The K-UCEEM questionnaire was administered to 73 medical students and 135 nursing students who participated in clinical practice at one medical institution. Exploratory factor analysis and confirmatory factor analysis were conducted to confirm the validity of the instrument's structure. In order to determine referential validity, the relationships among stresses in clinical practice were examined, and differences in factor scores were compared by gender and college. It was confirmed that the scale of 24 items and five factors showed a moderate model fitness index. The reliability of the factors ranged from 0.786 to 0.867. In addition, all five factors were found to have negative correlations with the clinical practice stress sub-factor, and there were statistically significant differences by gender and college. Through this study, the validity and reliability of the K-UCEEM were verified. In the future, it is expected that further verification of the scale, as well as evaluation and improvement of the clinical practice education environment based on this scale, will occur.

Current Status of Clinical Practice Education in Maternity Nursing in Korea - four-year course nursing schools centered - (모성간호학 실습교육의 현황 - 4년제 간호대학(학과)를 중심으로 -)

  • Kim, Il-Ok;Park, Chai-Soon
    • Women's Health Nursing
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    • v.12 no.1
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    • pp.12-21
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    • 2006
  • Purpose: This study was performed to provide data for improvement in clinical practice education through analyzing the status of clinical practice education in maternity nursing in four year course nursing schools in Korea. Method: Analyzed subjects were 43 schools out of 53 four year course nursing schools in Korea. Result: Credits in theory and clinical practice are on the decline. The relationship between goals and areas of clinical practice was not sufficient. The department was not efficient in meeting the demands between theory and practice. The number of students in a group according to clinical areas were thoughtfully assigned, and clinical practice was performed based on real situations. Instructors for clinical practice used practice lecturers, part-time lecturers, preceptors, and assistant instructors including faculty. Methods of practice education and evaluation were varied. Conclusion: A suitable philosophy and goals of clinical practice education maternity nursing should be established at this point in time. Furthermore, a study should be performed to analyze the relationship between goals and contents of clinical practice for maternity nursing. In addition, a standardized tool should be developed to evaluate clinical practice.

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Evaluation of Cancer Treatment Using FDG-PET (FDG-PET을 이용한 암 치료 효과의 평가)

  • Ryu, Jin-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.64-73
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    • 2002
  • FDG-PET has potential as an effective, non-invasive tool to measure tumor response to anticancer therapy. The changes in tumor FDG uptake may provide an early, sensitive guide to the clinical and subclinical response of tumors to cancer treatment, as well as functional assessment of residual viable tumor. This may allow the evaluation of subclinical response to anticancer drugs in early clinical trials and improvements in patients management. However, monitoring tumor responses with FDG-PET is still in its infancy. The methods of measurement of FDG uptake are currently diverse and timing with respect to anti cancer therapy variable. Therefore, there is a need for larger-scale trials along with standardized methodology and a collection of reproducibility data. The recent guideline from the European group seems to be the most comprehensive. In future, the combination of morphological and metabolic images may improve the quantitative nature of these measurements by relating tumor viability to total tumor mass. More data on sensitivity and specificity of FDG-PET technique are needed along with continued advancement of PET methodology.

The Epidemiology of Delays in a Teaching Hospital (부적절 재원의 이유)

  • Kim, Yoon;Lee, Kun-Sei;Kim, Chang-Yup;Kim, Yong-Ik;Shin, Young-Soo;Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.4 s.44
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    • pp.650-660
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    • 1993
  • This study aims to describe the causes of medically unnecessary hospital stay at a teaching tertiary hospital, using modified version of Delay Tool in which the causes of delay are divided into slx major categories : delay related to test scheduling, test results, surgery, medical staff, patient/family, and administration. For the analysis of hospital stay, 6,479 inpatient-days were reviewed in two medical and four surgical departments for one month. Initially inappropriate hospital stays were identified using Appropriateness Evaluation Protocol (AEP), and causes of delay listed in Delay Tool were assigned to each of them. In both medical and surgical services, the most important cause of delay was related to medical staffs, ranging from 3.6% to 51.6% of total inpatient days. Next important category was delay related to test scheduling in medical services ($4.7{\sim}9.2%$), and delay related to surgery in surgical services ($7.3{\sim}15.0%$). Among subcategories of delay related to medical staffs, delay due to conservative care was the most important cause of inappropriate hospital stay ($2.9{\sim}6.4%$). Each clinical departments had different distribution among delay categories, which could not be fully justified by their clinical charateristics. The Delay Tool would be helpful in exploring factors related to the inefficient use of hospital beds. As a measurement tool of inappropriate hospital stay, however, the Delay Tool should be refined in the definitions of categories and its contents.

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Evaluation of the Effects of Feedback and Remediation after Formative Assessment in the Introduction to Clinical Medicine (임상실습 입문교육에서 형성평가 후 되먹임 및 재시험의 효과)

  • Lee, Yong Jig;Choi, Son Hwan
    • Korean Medical Education Review
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    • v.18 no.1
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    • pp.38-43
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    • 2016
  • The authors investigated the effect of feedback and remediation after formative assessment (FRFA) by comparing the FRFA score and that of summative assessment (SA) in a course on clinical skills. In March 2015, 33 subjects underwent evaluation of their ability to perform a complex clinical skill using a real-time ready-made mobile assessment form tool, and through e-mail they were supplied with their feedback and final score (the pass group earned 2 points; the intermediate group earned 1 point; the nonpass group earned 0 points) followed by their self-reflection. The nonpass group underwent a re-test and e-mail feedback again until they passed the test, given the ease of performance. In December 2015, the 33 subjects took a 10-item SA, and one of the 10 items addressed a similar clinical skill. The difference between the first score on the FRFA and the score on the SA was evaluated statistically (p=0.05) through data analysis, variance distribution, correlation analysis, and linear regression analysis using SPSS software ver. 16. The increase from the score on the SA to that on the FRFA was statistically significant ($4.5{\pm}9.29$) in the pass group and the intermediate group, and was $29.7{\pm}11.49$ in the nonpass group of the formative evaluation (p<0.001). Using an FRFA could decrease the range in the standard deviation of the score and increase the minimum score among the subjects.

Relationships between upper extremity performance and unified Parkinson's disease rating scale-motor exam

  • Hwang, Wonjeong;Hwang, Sujin;Lee, Kyoungsuk;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.2 no.2
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    • pp.99-103
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    • 2013
  • Objective: Clinical measures that quantify upper extremity function are needed for the accurate evaluation of patients and to plan an intervention strategy. The purpose of this study was to examine the relationship between the Unified Parkinson's Disease Rating Scale (UPDRS)-Motor Exam and upper extremity performance as a quantifying clinical tool of upper extremity function in persons with Parkinson's disease. Design: Cross-sectional study. Methods: Thirty-two idiopathic Parkinson's Disease persons participated in this study. To investigate the relationship between the UPDRS-motor exam, Box and Block test (BBT), and Action Research Arm Test (ARAT) by two physical therapists. The examination took up to 1 hour, and the participants were invited to rest between each clinical measure in order to minimize the effects of fatigue. Clinical measures were assessed while the subjects were in the "on" phase of their medication cycle, generally 1-3 hour after taking their anti-Parkinson's medications. Results: In more affected side, the UPDRS-motor exam was significantly negative correlated with the BBT (p<0.05) but it was not significantly correlated with the ARAT. In less affected side, only positively correlation was significantly shown between BBT and ARAT (p<0.05). On the other hand, between BBT and ARAT were not significantly correlated with the UPDRS-motor exam. Conclusions: The UPDRS-motor exam is effective tool which was significantly correlated with manual dexterity in more affected upper extremity. But The UPDRS-motor exam is not effective tool in less affected upper extremity.

A Case Report of Intervention Strategy applied ICF Tool about Floor to Stand and Stand to Floor for Stroke Patient (ICF Tool을 적용한 뇌졸중 환자의 바닥에 앉고 일어서기에 대한 중재전략의 증례)

  • Yun, Tae-Won;Kim, Tae-Yoon
    • Journal of Korean Physical Therapy Science
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    • v.18 no.1
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    • pp.33-49
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    • 2011
  • The process of physical therapy uses a problem-solving approach to enhance a patients's functioning status. The International Classification of Functioning, Disability and Health(ICF) is the common concept for the functioning in the world. Physical therapists require the ability to identify problems, formulate hypothesis, and plan intervention strategies through clinical reasoning. In the clinical process, physical therapists need to use standard and common languages in speech and in documentation. The purpose of this study was to suggest the process of making strategy for efficient intervention, examining and evaluating the functional problem of the person with stroke using ICF tools. For the first step in this process model, therapists could list the information relating to functional problems used by the ICF Core set and then could identify the interaction among the problems using the ICF assessment sheet. For the next step, therapist is needed to make the hypothesis and hypothesis testing, and then set a primary functional goals and therapeutic goals in detail after prioritizing the problems to be managed based on the problem list. Finally, after setting the identified problems as the purpose of intervention through the hypothesis testing, therapist could do some intervention after making a plan to solve these problems, and find out the outcomes using the ICF evaluation display. This report illustrates how to apply the process based on ICF concept into physical therapy practice. Making a decision for the most efficient intervention requires that therapists use the clinical reasoning process based on ICF concept.

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Endoscopic Ultrasound Staging of Upper Gastrointestinal Malignancies

  • Saadany, Sherif El;Mayah, Wael;Kalla, Ferial El;Atta, Tawfik
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2361-2367
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    • 2016
  • Since 1980, endoscopic ultrasound (EUS) has been used as an important tool for the evaluation of malignant diseases in hollow viscus and bilio-pancreas, as well as sub-epithelial tumors. The high-resolution capacity and low penetration depth of EUS make it possible to obtain highly detailed images of the gastrointestinal wall and immediate surroundings to a depth of 4-5 cm. Thus, over the past 35 years, EUS succeeded to modify management in significant number of cases and is now considered a gold standard tool for many gastrointestinal diseases, especially in the pancreatico-biliary tract, and adjuvant needle insertion now allows access to remote lesions that were difficult to reach in the past. With the growing spectrum of indications, tissue sampling for diagnostic purposes has become common. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in staging of upper gastrointestinal malignancies, especially esophageal, gastric and ampullary tumors.

PET and PET/CT in Clinical Cardiology (심장 PET과 PET/CT의 임상적 이용)

  • Won, Kyoung-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.124-132
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    • 2005
  • Cardiac PET emerged as a powerful tool that allowed in vivo quantification of physiologic processes including myocardial perfusion and metabolism, as well as neuronal and receptor function for more than 25 years. Wow PET imaging has been playing an important role in the clinical evaluation of patients with known or suspected ischemic heart disease. This important clinical role is expected to grow with the availability of PET/CT scanner that allow a true integration of structure and function. The objective of this review is to provide an update on the current and future role of PET in clinical cardiology with a special eye on the great opportunities now offered by PET/CT.