Background: The aim of the study was to evaluate the vaginal dose and toxicity in patients of cervical cancer treated with image guided brachytherapy at our institute. Materials and Methods: Thirty-five patients treated with image based brachytherapy for cervical cancer were included. Vaginal contouring was done on MRI at brachytherapy and with CT scans of subsequent brachytherapy fractions. Dose volume parameters (DVH) were reported in accordance with the GEC-ESTRO guidelines. These were correlated with vaginal toxicity (assessed by CTCAE version 3) and quality of sexual life assessed at one year of completion of treatment. Results: Vaginal shortness was observed in 22 out of 30 (62.8%) patients, Nine (25.7%) had vaginal dryness and in 10 (28.5%) patients, there was contact bleeding. No association could be demonstrated between the dose volume parameters and vaginal toxicity in the present study. Conclusions: The lack of association between dose volume parameters of vagina with vaginal morbidity may be due to uncertainties involved in the delineation of vaginal wall and dosimetry. Future research is required to accurately define vaginal dose distribution to study its correlation with vaginal morbidity. Vaginal morbidity needs to be documented in order to improve the sexual outcome in these patients.
Purpose: This study aimed to improve the quality of prehospital emergency care for elderly patients by determining current prehospital care status based on run sheets and level of knowledge, and prehospital care confidence toward the elderly through questionnaires answered by 119 emergency medical technicians (EMTs). Methods: This study was conducted with 4,946 elderly patients who were transferred to the hospital by 119 ambulances in D city from March 1, 2013 to February 28, 2014. This study was a descriptive study of 119 run sheets. The questionnaire was completed by 160 EMTs working in D city. All data were analyzed by using SPSS 21.0. Results: 74.2% was due to disease among the 4,946 elderly patients who were transferred by 119 ambulances, and a rest was due to injury. The mean knowledge score of the 119 EMTs regarding elderly patients was low. Their confidence on prehospital care of the elderly patients statistically significantly differed according to career at hospital and education. Conclusion: Theoretical knowledge, education on prehospital care of the elderly, and repeated technical prehospital care education and training accompanied by feedback assessment by 119 EMTs are needed.
Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.
Journal of the Korea society of information convergence
/
v.6
no.2
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pp.61-66
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2013
In this study, the accounting information systems and Satisfaction with computerized accounting education study. As the control variable, computer usage time and computer experience were used. To sum up the analysis result, Details of the quality of accounting information system, quality system quality, information quality, service quality, satisfaction of computerized accounting education was analyzed significant effect. Used to control variable, computer usage time. Computer usage time of the control variable in the system quality, information quality and significant impact on satisfaction. Computer experience of the control variable in the system quality, information quality and significant impact on satisfaction.
Objective : The purpose of our study is to compare and analyze the standards for the 2nd cycle of Evaluation and Accreditation system on institute of Korean Medicine Education & Evaluation (2nd IKMEE standards) and WHO guidelines for quality assurance of Traditional Medicine Education in the Western Pacific Region (WHO/WPRO guidelines) around the global standards of World Federation for Medical Education for basic medical education (WFME standard) to identify the shortcomings and improvements of 2nd IKMEE standards. Method : Each article of 2015 revised WFME standard was translated and summarized with focus on its core content. The next step was to review and analyze the corresponding contents of 2nd IKMEE standards in 2016 and the WHO/WPRO guidelines in 2005 for each item, focusing on the WFME standards. Results : All items in the fields of 3. assessment of students and 7. program evaluation in the WFME domain were absent from the 2nd IKMEE standards, and almost none of the WHO/WPRO guidelines. Most items in 1. the mission and outcomes domain, except for some items in the 1.1 mission field, the items of 2.6~2.8 fields in 2. education program domain, the items of 4. student domain except for the items of 4.3 student counseling and support field, and almost all items about quality development in WFME standards did not have a corresponding item in both the 2nd IKMEE standards and the WHO/WPRO standards. Conclusion : 1. The WFME standards are applicable to the criteria development of IKMEE standards. Several items of the WFME standards may need to be modified to apply the educational characteristics of Korean medicine, but consensus or further study is required. 2. Both the 2nd IKMEE standards and the WHO/WPRO standards are very insufficient to meet the WFME standards. In particular, 3. assessment of students and 7. program evaluation in the WFME domain were not in the 2nd IKMEE standards. This standard needs to be supplemented.
Kim, Sun-Bae;Ann, Dong-Yeal;Lee, Nam-Soo;Choi, Zoo-Ill;Oh, Kyung-Ghn;Park, Inn-Soo;Park, Hee-Jin
The Korean Journal of Emergency Medical Services
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v.9
no.2
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pp.183-206
/
2005
Nowadays, the whole world is putting in the knowledge information society by the internet which is connecting the global network. The internet enable us to see the life of the other people in real time. Most of health care professional obtain and update their new knowledge and skills through continuing education. EMTs who works five or ten shifts per day are not easy to attend continuing education session usually offered during their off-times. One of solutions to this problem would be to develop a education program which does not limit time and place. There has been increasing interest in the use of computers in medical education, but all designated facilities and teachers have no sufficient preparations for the education and training of EMT. There has been less attention to the rationale for the use and selection of applications. This article discusses an approach to the selection of medical informatics applications for the undergraduate medical curriculum. The aim of this study is to develop and evaluate a web-based continuing education program, to help EMT improve their knowledge of transfusion therapy and medical law, and to enhance their ability to contribute to the quality of patient care. The program generally was well received by EMTs. The program is a useful adjunct to the existing continuing education program. It also could be used in EMT student education and other health sciences.
Yildiz, Ali Naci;Bilir, Nazmi;Camur, Derya;Caman, Ozge Karadag
Safety and Health at Work
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v.3
no.2
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pp.123-129
/
2012
Objectives: The study was conducted with the aim of evaluating applied occupational health teaching for final-year medical students at Hacettepe University, Faculty of Medicine. Methods: The study included all sixth grade medical students (n=293) during one academic year. Pre- and post-training tests were used to assess the magnitude of change in knowledge and attitude of students on occupational health, whereas the opinion of students on several aspects of the quality of teaching sessions were assessed by using post-training questionnaires. Results: Post-training tests revealed that the level of knowledge on all aspects of occupational health increased among medical students. An evaluation of the teaching sessions showed favorable results for the overall quality of the sessions: 81.3% of the students stated that the sessions were well organized, 81.7% remarked the workplace/factory visit was a valuable experience, and 91.0% stated feeling more competent on occupational health issues. Conclusion: There was a greater increase in students' knowledge on technical precautions than their knowledge on issues related to medical practice in the workplace. Visiting a workplace was found to contribute to the overall aim of knowledge and attitude change on occupational health issues. The scope of undergraduate medical education should be extended by improving occupational health education with respect to educational content, duration, and methods.
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.
Duman, Evrim;Yildirim, Mustafa;Kaya, Vildan;Ozturk, Duriye;Inal, Aysun;Akarsu, Zeynep;Gunduz, Seyda;Yildiz, Mustafa
Asian Pacific Journal of Cancer Prevention
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v.16
no.15
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pp.6779-6782
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2015
Background: Chemoradiotherapy is an important treatment modality for lung cancers. The aim of this study was to investigate alterations in, as well as the interrelationship between, lung function and quality of life of patients receiving chemoradiotherapy due to locally advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) limited to the thorax. Materials and Methods: The study included patients receiving definitive chemoradiotherapy for lung carcinoma. The respiratory function of the patients was assessed by measuring forced expiratory volume in 1 s per unit (FEV1) and forced expiratory volume in 1s per unit of vital capacity (FEV1/VC) before, in the middle of and after treatment. During the study, EORTC QLQ C30 and LC13 questionnaires developed by the Committee of the European Organization for Research and Treatment of Cancer (EORTC) were employed to evaluate the quality of life on the same day as respiratory function tests (RFT). Findings: The study included 23 patients in total: 19 (82.6%) diagnosed with NSCLC and 4 (17.4%) with SCLC. The average percentage FEV1 was $55.6{\pm}21.8%$ in the pre-treatment period, $56.2{\pm}19.2%$ in the middle of treatment and $60.4{\pm}22%$ at the end of treatment. The improvement in functional scores, symptom scores and general health scores during treatment was not statistically significant (P= 0.568, P= 0.734, P= 0.680, P=0.757 respectively). Conclusions: Although this study showed an improvement in respiratory function and quality of life of patients during treatment with thoracic chemoradiotherapy, no statistically significant results were obtained. While evaluating the effectiveness of treatments for lung carcinoma, the effects of treatment on respiratory function and quality of life should be considered.
In light of changes in today's medical environment, whether to dismantle the 50-year-old internship training system in the Republic of Korea is under debate. Although the question remains open, discussions on such issues have drawn attention to the quality of the clinical clerkship and student career advisory programs in medical colleges. The purpose of this study is to analyze the experiential clerkship and career exploration issues. Ensuring excellence of the clerkship and career advisory sessions is an essential responsibility of educational institutions regardless of whether the intern training system is dismantled. Important objectives of the experimental clerkship include reinforcing prerequisites established by law, introducing a student practice license, developing a standardized clinical assessment and student portfolio requirement, and publishing a guidebook for clinical directors. For career exploration, it is necessary to broaden participants' experiences of specialties and to manage the variety of student career guidance programs. It is imperative for the Korean Association of Medical Colleges, in collaboration with medical colleges, to play a leading role in focusing more attention and effort on such issues.
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