Purpose: To compare the dosimetrical and radiobiological parameters among various volumetric modulated arc therapy (VMAT) techniques using restricted and continuous arc beams for left-sided breast cancer. Materials and Methods: Ten patients with left-sided breast cancer without regional nodes were retrospectively selected and prescribed the dose of 42.6 Gy in 16 fractions on the planning target volume (PTV). For each patient, three plans were generated using the $Eclipse^{TM}$ system (Varian Medical System, Palo Alto, CA) with one partial arc 1pVMAT, two partial arcs 2pVMAT, and two tangential arcs 2tVMAT. All plans were calculated through anisotropic analytic algorithm and photon optimizer with 6 MV photon beam of $VitalBEAM^{TM}$. The same dose objectives for each plan were used to achieve a fair comparison during optimization. Results: For PTV, dosimetrical parameters such as Homogeneity index, conformity index, and conformal number were superior in 2pVMAT than those in both techniques. $V_{95%}$, which indicates PTV coverage, was 91.86%, 96.60%, and 96.65% for 1pVMAT, 2pVMAT, and 2tVMAT, respectively. In most organs at risk (OARs), 2pVMAT significantly reduced the delivered doses compared with the other techniques, excluding the doses to contralateral lung. For the analysis of radiobiological parameters, a significant difference in normal tissue complication probability was observed in ipsilateral lung while no difference was observed in the other OARs. Conclusions: Our study showed that 2pVMAT had better plan quality and normal tissue sparing than 1pVMAT and 2tVMAT but not for all parameters. Therefore, 2pVMAT could be considered the priority choice for the treatment planning for left breast cancer.
This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea(diseases of the respiratory system, injury and poisoning & certain other consequences of external causes). And it was understood that most of residents within a distance of 40 minute by the public transportation were using. And mostly were under the age of 9 or over 60, and the provision of medical features such as the degree of consultation and operational functions were inadequate. When we classify inpatient treatment cost for each resource application as the medical cost being the center of patient care function, the equipment and human resource application sector are constituted over half. Accordingly, the following suggestions are made as plans to strengthen the competitiveness for the growth of general hospitals located in the provincial areas on the basis of analytical results. First, it is necessary to have the characterization matching to the age and disease groups with a high frequency. Second, it is necessary to increase the degree of hospital resource utilization according to the characterization. Third, it is necessary to concentrate on public relations. The above suggestion, as a method for securing image improvement and competitive power as a general hospital, and through expansion of social function that a regional general hospital needs to secure not only as an individual institution but also as a general hospital, it can be seen that a general improvement of image as a regional general hospital is possible.
The Journal of Korean Academic Society of Nursing Education
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v.2
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pp.32-55
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1996
It was enacted 'Emergency Medical Act' in January, 1994 beginning the emergency medical service system from 1982, and while it was established the emergency medical department in junior college providing the detailed agenda about emergency medical technician and the regulation relative to the application of a law on the emergency medical act in 1995, the fire school and the National Medical Center are enforced the curriculum. It is very important subject faced for the construction of emergency medical system to produce a number of emergency medical technicians to be sufficient to the role of emergency aid. In this study it is analysed the training curriculum for the emergency medical technician and presented the improvement plans. 1. Though it needs the qualification level of first and second class in the selection process, the more important thing needs the detailed qualification level by term of one's service and the skills of business accomplishment. 2. In the examination management, (1) written examination is composed of the questions to understand how much faithfully they carry out the practical business as the emergency medical technicians, (2) it is added practical examination as the item to appraise the situation disposal ability. 3. It is necessary to prescribe the activity in the medical institution and ambulance arrangement through the development of 'Business Treatment Guide'. 4. For the regional balanced disposition of emergency medical personnel it is selected balanceably the educational institution by eight medical service areas, and considering the characteristics of region it is necessary to manage, in the practical business training course, another special course such as the mountains medical aid and sea medical aid. 5. In the period of education the first class needs the practical business training period of a certain period after passing examination, and the second class needs the extension of the period. 6. As the problems to improve in the curriculum [1] in the first class course (1) intensification of practical educaiton (2) reinforcement of curriculum (3) the development of standardized curriculum etc., [2] in the second class course (1) varieties of curriculum (2) intensification of basic first aid treatment education.
Background: Cancer incidence rates are increasing particularly in developing countries. It is crucial for policy makers to know basic cancer epidemiology in each region to design comprehensive prevention plans. There have hitherto been no population-based data available for cancer in Khuzestan province. The present report is a first from the regional population-based cancer registry for the period of 2002-2009. Materials and Methods: Data were collected retrospectively reviewing all new cancer patients whom were registered in Khuzestan province cancer registry during an 8-year period (2002-2009). All cases were coded based on the ICD-O-3 coding system and collected data were computerized using SPSS (Chicago, IL) software, version 11.5. The age standardized incidence rates (ASRs) per 100,000 person-year for all cancers were computed using the indirect method of standardization to the world population. Results: During the 8-year study period, 16,801 new cancer cases were registered. Based on the computed ASRs, the five most frequent malignancies in females were breast (26.4 per 100,000), skin (13.6), colorectal (5.72), stomach (4.31) and bladder(4.07) and in males, the five most frequent were skin (16.0 per 100,000), bladder (10.7),prostate (7.64), stomach (7.17), and colorectal (6.32).The ASR for all malignancies in women was 92.5 per 100,000, and that for men was 87.4. Conclusions: The observed patterns from the analysis of Khuzestan cancer registry data will lead to better understanding of the epidemiology of various malignancies in this part ofthe country and consequently provide a useful guide for authorities to make efficacious decisions and policies about a cancer control program for south-west Iran.
Due to the 3 years and 4 months of corona, many things have changed throughout society, such as social activities, free movement, and lifestyle. One of them is the increasing public interest and demand for walking tours. Public awareness of health and leisure activities has increased due to lifestyle changes, aging, and urbanization following the spread of infectious diseases such as COVID-19, and demand for walking tour services is also increasing. As of 2019, nationwide About 560 'Walking Trails' of 1,849 courses were created, with a total length of 18,000 km. In this study, in a situation where social interest and necessity for walking tours are increasing, studies related to walking tours are reviewed, and sustainable management plans for walking tours are proposed. To this end, the concept and research trends of walking tours were examined through literature related to walking tours, and in-depth interviews were conducted with a total of 17 people, 8 visitors and 9 officials, with Ansan Daebudo Haesol-gil as the target. Visitors In-depth interviews with 180 contents were coded, and 147 effective contents were divided into 20 subcategories and organized into 7 upper categories. In-depth interviews with 101 stakeholders were individually coded, 96 effective contents were divided into 14 subcategories, and organized into 5 upper categories. After that, it was reviewed based on the contents organized through qualitative content analysis, and the Five implications were derived. The significance of this study is that the study was conducted on specific Haesol-gil in the suburbs of the metropolitan area. The limitation of this study was that more detailed investigations and considerations were not conducted on the positive and negative effects of walking tours on the Daebudo area. As a follow-up study, academic arrangements and case studies on regional regeneration through walking tours are required.
The purposes of this study was to confirm the current issues of workforce policy of dental auxiliary personnel in Korea. The literature review and data collection were conducted in terms of the auxiliary personnel supply, regional distribution, legal works, working environment. Despite the rapid increase in the number of dental hygienists, the number of active dental hygienists is less than half of the total, and the dental clinics still experience the shortage. Considering the dental hygienist's work, the available dental auxiliary personnel for the dental assistance is limited. The proportion of dental hygienists is concentrated in large cities, and the ratio of dental clinics composed of only dental hygienists is high. Thus, it is essential to look for a plan to solve the disparity. The criterion for judging the legality of the works is ambiguous because a large portion of dental hygienist's work is not specified in the Medical Technicians Act. The job life is also shortened, and occupational profession and satisfaction are lowered. Thus, job burnout is accelerating. The difference between the legal works and the practiced works of dental hygienist and the conflict between the personnel might be due to the lack of utilization plans for the dental personnel at the government level. Therefore, the government should establish the roles of dental hygienist in accordance with the demands of the dental health service, institutionalize the necessary policies accordingly, and make efforts to establish plans to improve the relevant laws and utilize the manpower appropriately.
Food-Health indicators have been developed and utilized internationally in the 'Food' domain of environment and health indicators. In Korea, however, Food Safety Health Indicators which are in the introductory stage had been developed separately from Environmental Health Indicators. The aim of the current study is to suggest feasible applications of the domestic Food Safety Health Indicators as a case study. We introduced 3 possible applications which are as follows: 1) production of two types of Integrated Food Safety Health Index; 2) conduction of correlation analysis between the Integrated Food Safety Health Index and Food Safety Health Indicators; 3) conduction of regression analysis to evaluate the relationship between the Integrated Food Safety Health Index and socioeconomic status. As a result, we provided the calculated Integrated Food Safety Health Index I and Integrated Food Safety Health Index II, which represents the regional food safety level in relative and absolute terms, respectively. Integrated Food Safety Health Index I was significantly correlated with the outbreaks of food-borne diseases (caused by Campylobacter jejuni, Bacillus cereus, Salmonella spp. and unknown cause) and incidence of E.coli infections. Integrated Food Safety Health Index II significantly decreased as the proportion of foreigners and women increased, and increased as the population density increased. Utilization of such Integrated Food Safety Health Indicators may be helpful in understanding the overall domestic food safety level and identifying the indicators which must be considered with priorities to enhance the food safety levels regionally and domestically. Furthermore, analyzing the association between Integrated Food Safety Health Index and factors other than food safety could be useful in conducting risk management and identifying susceptible populations. Food Safety Health Indicators can be useful in other applications, and may serve as a supporting material in establishing or modifying policy plans to enhance food safety. Therefore, keen interests by researchers accompanied by further studies on food safety health indicators are needed.
Journal of the Korea Academia-Industrial cooperation Society
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v.22
no.3
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pp.422-428
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2021
This study surveyed residents and public officials for the projects to make smart-city plans of Geumsan-gun. First, domestic and foreign cases related to smart city projects were reviewed. The local status of Geumsan-gun was investigated regarding various aspects of the natural, social, urban environment, and smart-city facilities. The survey results were as follows. Overall, more than half of the survey respondents said they were satisfied with their housing quality. Several problems in their areas, such as inefficient welfare system, shortage of parking space, and industrial infrastructure, were reported. On the other hand, tourism and leisure facilities, health care support systems, industries to boost the economy, and the job market were also important issues. The problem was that the regional problems mentioned above were not in line with their preferences for smart-city services. The implications of the survey results could be summed up as follows. The groupware surveys of Geumsan-gun should be used as survey tools, whereas IT survey tools (Google, Survey Monkey, etc.) should be used for locals. In particular, a survey targeting residents should ask plain and compact questions taking advantage of local gatherings. It is also important to have a pilot-survey with relevant public officials and select related projects and regional issues. The survey of local residents and public officials is a prerequisite for promoting smart city projects. The smart city project shall reflect the needs of residents while solving community problems by considering the survey results and local conditions.
Cancer registries help to establish and maintain cancer incidence reporting system, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.
Journal of the Economic Geographical Society of Korea
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v.26
no.4
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pp.375-390
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2023
This study examined the genesis process and competitiveness determinants of overseas bio-industrial clusters. The bio industry is a promising new industry that major countries around the world are paying attention to because it can be applied to various industries and can create high added value by combining artificial intelligence and information and communication technology. In addition, the importance of clusters is emphasized in that it requires connection and cooperation with various stakeholders. However, compared to this importance and interest, related research in Korea is somewhat insufficient. In particular, overseas case studies are also overly biased toward a few leading clusters, and tend to produce policies and development plans that do not correspond to domestic local conditions. To alleviate this problem, this study looked at the birth and growth process of the BioHealth Capital Region in the United States, Cambridge Cluster in the United Kingdom, and Medicon Valley in Denmark and Sweden. Through this, we aim to enrich related case studies that were lacking, identify the determinants of competitiveness of each cluster, and present implications for the creation and development of domestic bio industry clusters.
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