• Title/Summary/Keyword: Tertiary education

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Role of a Risk of Malignancy Index in Clinical Approaches to Adnexal Masses

  • Simsek, Hakki Sencer;Tokmak, Aytekin;Ozgu, Emre;Doganay, Melike;Danisman, Nuri;Erkaya, Salim;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7793-7797
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    • 2014
  • Objective: The aim of this study was to evaluate predictive role of risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Methods: This retrospective study was conducted with a total of 569 patients with adnexal masses/ovarian cysts managed surgically at our clinic between January 2006 and January 2012. Obtained data from patient files were age, gravidity, parity, menopause status, ultrasound findings and CA125 levels. For all patients ultrasound scans were performed. For the assessment of risk of malignancy index (RMI) Jacobs' model was used. Histopathologic results of all patients were recorded postoperatively. Malignancy status of the surgically removed adnexal mass was the gold standard. Results: Of the total masses, 245 (43.1%) were malignant, 316 (55.5%) were benign and 8 (1.4%) were borderline. The mean age of benign cases was lower than malign cases ($35.2{\pm}10.9$ versus $50.8{\pm}13.4$, p<0.001). Four hundred and five of them (71.2%) were in premenopausal period. Malignant tumors were more frequent in postmenopausal women (81% versus 29%, p<0.001). All ultrasound parameters of RMI were statistically significantly favorable for malignant masses. In our study ROC curve analysis for RMI provided maximum Youden index at level of 163.85. When we based on cutoff level for RMI as 163.85 sensitivity, specificity, PPV, NPV was calculated 74.7%, 96.2%, 94% and 82.6%, respectively. Conclusions: RMI was found to be a significant marker in preoperative evaluation and management of patients with an adnexal mass, and was useful for referring patients to tertiary care centers. Although utilization of RMI provides increased diagnostic accuracy in preoperative evaluation of patient with an adnexal mass, new diagnostic tools with higher sensitivity and specificity are needed to discriminate ovarian cancer from benign masses.

Clinical Nutrition Service at Medical Centers in Seoul (서울지역 의료기관의 임상영양서비스 현황조사)

  • Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.17 no.2
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    • pp.176-189
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    • 2011
  • The purpose of this study was to investigate the status of clinical nutrition services at various medical centers in Seoul, Korea. A questionnaire was distributed to the departments of nutrition at 44 hospitals in Seoul on July 2009. Nutritional screening carried out at a rate of 59.1% at the medical centers, and a significant difference was found according to the type of center, from 100% in tertiary hospitals to 18.8% in normal hospitals. On annual average, the numbers of inpatients, inpatients for malnutritional screening, inpatients with malnutrition, and inpatients for malnutrition management were 15,169.5, 10,870.9, 2,224.8, and 1,546.2, respectively. On average the group nutrition education was done 36.1 times/year for diabetes, 8.2 times/year for cancer, and 1.9 times/year for renal disease, and the numbers of participants 423.1, 95.1, and 31.5, respectively. On average the individual nutrition education of inpatients with diabetes was done 135.4 times/year for ordered-type, and 119.3 times/year for unordered-type, 106.2 times/year for paid-type, and 148.5 times/year for unpaid-type. The mean fee for education and counseling was the highest for peritoneal dialysis (73,090.9 won) but the lowest for heart disease (23,609.1 won). On average the individual nutrition education of outpatients with diabetes was done 234.6 times/year for ordered-type, and 2.5 times/year for unordered-type, 204.4 times/year for paid-type, and 32.7 times/year for unpaid-type. The mean fee for education and counseling was also the highest for peritoneal dialysis (63,500.0 won) but the lowest for heart disease (21,336.4 won). To implement more effective clinical nutrition service, a national medical insurance imbursement policy should be urgently instituted such that diseases left as unpaid are covered by health insurance, including all nutrition-related disease.

A Survey of Blood Glucose Testing, Medication, Diet, and Exercise Adherence in Korean Patients with Type2 Diabetes (당뇨병환자의 자가혈당검사, 약물, 식이 및 운동 치료지시이행)

  • Kim Hee-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.181-186
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    • 2003
  • Purpose: The purpose of this study was to investigate the adherence to diabetes control recommendations (blood glucose testing, medication, diet, exercise) in patients with type 2 diabetes at home and to analyse the correlation between adherence and blood glucose level. Method: Participants, numbering 214, were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. The data were collected by a self report adherence questionnaire. Glycosylated haemoglobin (HbA1c) was determined by the high-performance liquid chromatography technique and fasting blood glucose was analyzed by the glucose oxidase method. Result: Medication adherence was higher than diet or exercise adherence. The frequency of blood glucose testing was lower for middle school graduates than college graduates. Diet adherence was significantly lower for participants who were obese, who did not have a spouse, and who had hyperglycemia. Medication and diet adherence were negatively correlated with HbA1c. Conclusion: A diet education program should be developed for patients with type 2 diabetes who are obese, who do not have a spouse, and who have hyperglycemia.

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SMALL SCALE DAIRYING IN THREE FARMING SYSTEMS IN EAST JAVA I. FARMER'S INCOME AND HOUSEHOLD CHARACTERISTICS

  • Widodo, M.W.;de Jong, R.;Udo, H.M.J.
    • Asian-Australasian Journal of Animal Sciences
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    • v.7 no.1
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    • pp.19-29
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    • 1994
  • The annual income (gross margin) in 1989/90 of a sample of 274 farmers in seven milk cooperatives was analyzed in the sugar cane, cassava, and horticulture areas in East Java. On average dairying contributed 42%, crops 29% and off-farm revenue 29%. Dairy income was highest in the cassava area, where it compensated for the low crop income, and lowest in the sugar cane area. Farm area and average milk yield per day per cow correlated positively with farmer's income, whereas crop income increase significantly with farm area and with the number of cows. The level of total cost per cow had a negative impact on dairy and with the number of cows. The level of total cost per cow had a negative impact on dairy and on total income. Government officials and other professionals engaged in dairying had a significantly higher total income than those with their main occupation in dairying, cropping or working as farm labourers. Uneducated farmers obtained a significantly larger income through crops, whereas farmers with tertiary education obtained more income through off-farm work, This study suggests that more attention must be paid to the actual use of labour and the improvement of the dairy output/cost ratio.

Factors Affecting Activity-Based Costing Adoption in Autonomous Public Universities in Vietnam

  • HOANG, Thi Bich Ngoc;PHAM, Duc Hieu;NGUYEN, Thi Minh Giang;NGUYEN, Thi Thanh Phuong
    • The Journal of Asian Finance, Economics and Business
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    • v.7 no.12
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    • pp.877-884
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    • 2020
  • The main aim of the present study is to investigate the factors that are considered affecting the adoption of Activity-Based Costing (ABC) in the autonomous public universities in Vietnam. A quantitative research was carried out. The data was collected through an online questionnaire survey between June 2020 and September 2020 addressed to the target respondents comprising 168 managers and accountants from 23 autonomous public universities in Vietnam, which participated in the resolution project No. 77/NQ-CP of the Vietnamese government on the pilot renovation of operational mechanisms of public tertiary education institutions during the period of four years, from 2014 to 2017. The findings resulted from hypothesis testing by a binary regression analysis based on the SPSS 20.0 software show that training, competition, support of top manager, and university size are the four main factors that positively affect the adoption of Activity-Based Costing (ABC) in studied universities. On the other hand, no statistically significant impact was found on two other variables, namely the variety of services provided and the usefulness of cost information factors. From the research results, discussions and policy recommendations have been presented to promote the adoption of Activity-Based Costing (ABC) in Vietnamese autonomous public universities in the coming time.

Reliability and Validity Tests of Patient Classification System Based on Nursing Intensity (간호강도에 의한 환자분류도구의 신뢰도 및 타당도 검증)

  • Park, Jung-Ho;Kim, Eun-Hye
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.5-16
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    • 2007
  • Purpose: This study is to verify the validity and reliability of classified items and criteria of the patient classification system(PCS) based on Park's definition of nursing intensity. Methods: An expert group of 8 persons verified the content validity of the tools. The 1817 inpatients at a tertiary hospital in Seoul, Korea were classified into 4 groups according to two tools for verifying concurrent validity and interraters' reliability. These verifications were performed from September to October, 2004. Results: Nursing domains of the tools have been divided into 12 items: hygiene, nutrition, elimination, exercise & activity, education & counseling, emotional support, communication & consciousness, treatment & examination, medication, measurement & observation, coordination of multidisciplinary team, admission & discharge & transfer management. Content validity was verified by the content validity index(above 0.75 in all 12 areas). Interraters' reliability was no significant difference in the results of the patient classification between the two raters(A group 93.75%. B group 88.24%). Concurrent validity was also verified by the agreement of two tools(73.7%). Conclusion: These results showed that the reliability and validity of the PCS based on the nursing intensity were verified. These will use an data for nursing productivity in the future.

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Differences in Prevalence and Risk Factors of the Metabolic Syndrome by Gender in Type 2 Diabetic Patients (제 2형 당뇨병환자 성별 대사증후군 유병률과 위험요인 차이)

  • Kim, Hee-Seung;Jung, Sun-Ha
    • Korean Journal of Adult Nursing
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    • v.18 no.1
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    • pp.3-9
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    • 2006
  • Purpose: The purpose of this study was to assess the difference between prevalence and risk factors of the metabolic syndrome(MS) by gender in type2 diabetic patients. Method: 108 participants(males 69, females 39) were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. MS was defined by a third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adult Treatment Panel III)(ATP III), and abdominal obesity was determined by Asia-Pacific criteria in waist circumference. Results: The prevalence of MS by definition of NCEP-ATP III and the Asia-Pacific criteria in waist circumference was 39.3% in males and 66.7% in females type2 diabetic patients. The abdominal obesity prevalence was seen in 44.9% of males and in 79.5% of females patients. The prevalence of low HDL-cholesterolemia in serum was 26.2% in male, 52.8% in female type2 diabetic patients. Conclusion: These results show that nurses should focus on female diabetic patients for preventing MS.

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Green ICT framework to reduce carbon footprints in universities

  • Uddin, Mueen;Okai, Safiya;Saba, Tanzila
    • Advances in Energy Research
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    • v.5 no.1
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    • pp.1-12
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    • 2017
  • The world today has reached a certain level where it is impossible to get the quality education at the tertiary level without the use of Information and Communication Technology (ICT). ICT has made life better, communication easier and faster, teaching and learning more practical through computers and other technology based learning tools. However, despite these benefits ICT has equally contributed immensely to environmental problems. Therefore there is the need to use ICT resources efficiently in universities for environmental sustainability so as to save both the university environment and the world at large from the effects of global warming. This paper evaluates the carbon footprints from the use of ICT devices and comes up with a proposed green ICT framework to reduce the carbon footprints in universities. The framework contains techniques and approaches to achieve greenness in the data center, personal computers (PCs) and monitors, and printing in order to make ICT more environmentally friendly, cheaper, safer and ultimately more efficient. Concerned experts in their respective departments at Asia Pacific University of Technology and Innovation (APU) Malaysia evaluated the proposed framework. It was found to be effective for achieving efficiency, reducing energy consumption and carbon emissions.

Analysis of Metabolic Syndrome Risk Factors among the Menopausal Women in Her Fifties (50대 폐경 여성의 대사증후군 위험인자 분석)

  • Shim, Hye-Sun;Kim, Hee-Seung;Kim, Joo-Hyun
    • Journal of Korean Biological Nursing Science
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    • v.12 no.1
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    • pp.58-62
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    • 2010
  • Purpose: The purpose of this study was to assess the difference of metabolic syndrome (MS) risk factors according to the MS diagnosis in the age of fifties women. Methods: Forty-two subjects (non metabolic syndrome 30, metabolic syndrome 12) were recruited from the health promotion center of a tertiary care hospital in an urban city. MS was defined by third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) (ATP III), and abdominal obesity was determined by Asia-Pacific criteria in waist circumference. Results: The prevalence of MS by definition of NCEP-ATP III and Asia-Pacific criteria in waist circumference was 28.6% in the age of fifties women. The educational level and the median HDL-cholesterol were significantly lower in the MS patient group than in the Non-MS group. The median of weight, triglyceride, and fasting glucose were significantly higher in the MS patient group than in the Non-MS group. Conclusion: These results indicate that the nursing care should be focused on weight, triglyceride, HDL-cholesterol, and fasting glucose of the MS patients in the fifties women.

Development of Patient Classification System based on Nursing Intensity in Stroke Unit (뇌졸중 전문치료실의 간호강도에 근거한 환자분류도구 개발)

  • Kim, Eunjung;Kim, Heejung;Kim, Miyoung
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.5
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    • pp.545-557
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    • 2014
  • Purpose: The purpose of this study was to develop a patient classification system based on nursing care intensity for patients with acute stroke-related symptoms and verify its validity and reliability. Methods: Data were collected between November, 2013 and February, 2014. The verification for content validity of the patient classification system was conducted by a group of seven professionals. Both interrater reliability and concurrent validity were verified at stroke units in tertiary hospitals. Results: The intensive nursing care for acute stroke patients consisted of 14 classified domains and 56 classified contents by adding 'neurological assessment and observation' and 'respiratory care': 'hygiene', 'nutrition', 'elimination', 'mobility and exercise', 'education or counselling', 'emotional support', 'communication', 'treatment and examination', 'medication', 'assessment and observation', 'neurological assessment and observation', 'respiratory care', 'coordination between departments', and 'discharge or transfer care'. Each domain was classified into four levels such as Class I, Class II, Class III, and Class IV. Conclusion: The results show that this patient classification system has satisfactory validity for content and concurrent and verified reliability and can be used to accurately estimate the demand for nursing care for patients in stroke units.