Purpose: There is controversy regarding the cosmetic outcome after accelerated partial breast radiation (APBR). We report the cosmetic outcome from a single-arm prospective clinical trial of APBR delivered using intensity-modulated radiation therapy (IMRT) in elderly patients with stage I breast cancer (BC), using a novel fractionation schedule. Materials and Methods: Forty-two patients aged ${\geq}65$, with Stage I BC who underwent breast-conserving surgery were enrolled in a phase I/II study evaluating a 2-week course of APBR. Thirty eligible patients received 40 Gy in 4 Gy daily fractions. Cosmetic outcome was assessed subjectively by physician/patient and objectively by using a computer program (BCCT.core) before APBR, during, and after completion of the treatment. Results: The median age was 72 years, the median tumor size was 0.8 cm, and the median follow-up was 50.5 months. The 5-year locoregional control in this cohort was 97% and overall survival 87%. At the last follow-up, patients and physicians rated cosmesis as 'excellent' or 'good' in 100% and 91 %, respectively. The BCCT.core program scored the cosmesis as 'excellent' or 'good' in 87% of the patients at baseline and 81% at the last follow-up. The median $V_{50}$ (20 Gy) of the whole breast volume (WBV) was 37.2%, with the median WBV $V_{100}$ (40 Gy) of 10.9%. Conclusion: An excellent rate of tumor control was observed in this prospective trial. By using multiple assessment techniques, we are showing acceptable cosmesis, supporting the use of IMRT planned APBR with daily schedule in elderly patients with early stage BC.
Background: Clinical manifestations of diabetic peripheral neuropathy (DPN) vary along the course of nerve damage. Nerve conduction studies (NCS) have been suggested as a way to confirm diagnoses of DPN, but the results have limited utility for evaluating clinical phenotypes. The current perception threshold (CPT) is a complementary method for diagnosing DPN and assessing DPN symptoms. We compared NCS variables according to clinical phenotypes determined by CPT measurements. Methods: We retrospectively enrolled patients with type 2 diabetes mellitus who underwent both NCS and CPT tests using a neurometer. CPT grades were used to determine the clinical phenotypes of DPN: normoesthesia (0 to 1.66), hyperesthesia (1.67 to 6.62), and hypoesthesia/anesthesia (6.63 to 12.0). The Michigan Neuropathy Screening Instrument (MNSI) was used to determine a subjective symptom score. DPN was diagnosed based on both patient symptoms (MNSI score ${\geq}3$) and abnormal NCS results. Results: A total of 202 patients (117 men and 85 women) were included in the final analysis. The average age was 62.6 years, and 71 patients (35.1%) were diagnosed with DPN. The CPT variables correlated with MNSI scores and NCS variables in patients with diabetes. Linear regression analyses indicated that hypoesthesia was associated with significantly lower summed velocities and sural amplitudes and velocities, and higher summed latencies, than normoesthesia. Sural amplitude was significantly lower in patients with hyperesthesia than in patients with normoesthesia. Conclusion: NCS variables differed among patients with diabetes according to clinical phenotypes based on CPT and decreased sural nerve velocities was associated with hyperesthesia.
ISO 15489:2001 addresses the principles and requirements with which organizations, both public and private, should comply on the management of their records to ensure that adequate records are created, captured and managed. The standard defines the characteristics that a record should have through records management system as follows: authenticity, reliability, integrity, and usability. Authenticity means that records can be proven to be what it purports to be, to have been created or sent by the person purported to have created or sent it, and to have been created or sent at the time purported. Reliability means that the contents of the records can be trusted as a full and accurate representation of the transactions, activities or facts to which they attest and can be depended upon in the course of subsequent transactions or activities. Integrity refers to ensuring that a record is complete and unaltered. Usability means that records can be located, retrieved, presented and interpreted. In order to have these characteristics, a record should be persistently linked to the metadata necessary to document a transaction. Metadata is "data describing context, content and structure of records and their management through time." Metadata ensure the creation and maintenance of authentic, reliable and usable records and the protection of the integrity of those records. It could be implemented by creating and capturing records management metadata in systems that create and manage records. There have been some projects and standard initiatives to identify a core set of records management metadata. Included are the Australian Recordkeeping Metadata Standard and the British Metadata Standard which is part of the Requirements for Electronic Records Management System. Recently ISO/TS 23081-1 is published to implement metadata requirements within the framework of ISO 15489. Public records management system in Korea is ruled by the Act on the Management of Archives by Public Agencies and Administrative Records Management Regulation. This article evaluates records and their descriptive elements captured and maintained by the records management system in Korea on the basis of the international metadata standards.
Purpose: In recent years, efforts to improve the dental curriculum in South Korea have focused on a shift to outcome-based dental education based on core competencies in dentistry. So far, the field has seen various studies on the development of competencies, performance evaluation, and the importance of outcome-based education, but few studies have documented the development of such an education model. Therefore, this study develops an OBE curriculum for dentistry education and describes the development procedures and then finally this study intends to share our experience to other dental schools. Methods: This study introduces the development procedure and details of an outcome-based education model for dental education and presents the five stages of an outcome-based education model. In this study, 3 educational experts and 2 dental professor composed the TFT and developed the research method according to the ADDIE model. Step 1 is to conduct quantitative / qualitative research analysis through some survey and interview, Step 2 is to do a survey to revise competency, Step 3 is to develop a materials through consensus and participation of our professors of the dental school, Step 4 is to do some workshops, Step 5 is to prepare and conduct a outcome evaluation. Results: Step 1 is a required process for developing an educational model: the Job Analysis & Need Analysis stage. Step 2 is the Development of Outcome and Competency stage, which involves revising the competencies that are the basis of the curriculum. Step 3 is developing competency descriptions, competency levels, and evaluation criteria?the Development of Outcomes and Evaluation Standards. Step 4 is the Development of Milestones for Curriculum and Instructional Strategy, which examines the curriculum's problems and analyzes the improvements of each course. Step 5 is the Evaluating Outcomes stage, conducted based on the competencies specified by the target dental school. Conclustion: The model presented here can serve as a foundation for outcome-based education in other dental schools.
The purpose of this study is to conduct an in-depth interview on 5 middle aged women who have attempted suicide in the past and to explore their suicide attempts and the vivid empirical value of life after the attempt. The collected data were analyzed using Giorgi's phenomenological approach. The data analysis resulted in 21 sub categories and 7 essential categories. Study participants experienced an-'selected death at the end of a cliff', 'standing on the border of life and death', 'life became clear after escaping delusion', 'working toward life once again', 're-evaluating their past life and discovering new possibilities', 'experiencing the vividness of life here', 'spiritual growth and deeper insight'. Such results offer a discussion on existence toward self-completion, and hold significance in that it increased our in depth understanding and recognition beyond the narrow perceptions of individuals who attempt suicide.
Jabur, Roberto de Oliveira;Goncalves, Ramon Cesar Godoy;Faria, Kethleen Wiechetek;Semczik, Izabelle Millene;Ramacciato, Juliana Cama;Bortoluzzi, Marcelo Carlos
Journal of Dental Anesthesia and Pain Medicine
/
v.21
no.2
/
pp.155-165
/
2021
Background: This study aimed to assess the course of anxiety and pain during lower third molar (LTMo) surgery and explore the role of mobile and single-channel electroencephalography under clinical and surgical conditions. Methods: The State-Trait Anxiety Inventory (STAI), Corah's Dental Anxiety Scale (DAS), and Interval Scale of Anxiety Response (ISAR) were used. The patient self-rated anxiety (PSA), the pain felt during and after surgery, EEG, heart rate (HR), and blood pressure (BP) were assessed. Results: The Attention (ATT) and Meditation (MED) algorithms and indicators evaluated in this study showed several associations. ATT showed interactions and an association with STAI-S, pain during surgery, PSA level, HR, and surgical duration. MED showed an interaction and association with DAS, STAI-S, and pain due to anesthesia. Preclinical anxiety parameters may influence clinical perceptions and biological parameters during LTMo surgeries. High STAI-Trait and PSA scores were associated with postoperative pain, whereas high STAI-State scores were associated with more pain during anesthesia and surgery, as well as DAS, which was also associated with patient interference during surgery due to anxiety. Conclusions: The findings suggest that single-channel EEG is promising for evaluating brain responses associated with systemic reactions related to anxiety, surgical stress, and pain during oral surgery.
Objectives: The purpose of this study was to develop operation management evaluation standards for efficient operation of practical courses conducted on campus and to verify validity and reliability. Methods: The draft evaluation criteria of this study were derived based on the CIPP program evaluation model, in order to verify the validity of the content, the Delphi survey was conducted targeting 30 dental hygiene professors and clinical field dental hygienists who had been in charge of practical education for more than 5 years. Main survey was conducted with 252 professors and clinical field dental hygienists in charge of practical education. Results: Through exploratory factor analysis, a total of 36 questions were confirmed with 7 factors. As a result of verifying the internal consistency of the final evaluation criteria, the degree of internal fit of the items in the entire domain was 0.914. Conclusions: According to the above results, the validity and reliability of the evaluation criteria for evaluating the operation and management of in-school clinical practice were verified to be appropriate, and it is thought that it can be used in follow-up studies related to the operation and management of the practice course in the future.
Journal of Korea Entertainment Industry Association
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v.14
no.5
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pp.159-170
/
2020
Despite evidence that early childhood teachers play a critical role in guiding children through their child assessment, most beginning teachers in the survival stage face the greatest difficulties in this area. Using the intentional and purposeful tools of action research, this collaborative action study supports a beginning teacher in reflecting upon her perceptions of the 'child assessment' of young children and devising and evaluating good guidance practices. During the course of the study, the participating teacher became engaged in more reflective teaching which prompted her to perceive the "child assessment" of the children from different perspectives. As her understanding of the importance of making her curriculum and classroom climate more engaging and meaningful deepened and she reconceptualized her notion of child assessment, the teacher witnessed positive changes in her students' behaviors which, in turn, increased her sense of efficacy. These very positive, empowering results are strong recommendation for using collaborative action research especially in the novice years of teaching for it provides the teacher with a life-long transformative tool for professional development.
This study is a follow-up paper on "Development of flipped learning class model for nail beauty education" published by Seol (2022). This model was conducted from March to June 2022 for 70 students taking the "Nail color design 1" course. After 15 weeks of class, a survey of the students' perceptions of flipped learning and their self-evaluation of goal achievement was conducted, which was composed of questionnaires using a 5-step Likert scale. 15 questions were designed to evaluate the students' satisfaction with their experience and class operations; 4 questions to evaluate whether the class goal had been reached through flipped learning; and 9 questions to evaluate the students' perceptions of flipped learning. As a result of applying this model to theoretical and practical nail beauty classes, it was confirmed that flipped learning helped students better understand the content and had a positive effect on learning, while the subject's educational goals were also achieved. By evaluating the students' perceptions of flipped learning, we may conclude that they experienced learning satisfaction and perceived the approach positively. Moreover, they have expressed a desire for additional flipped learning. This study is thus meaningful in confirming the procedure's effectiveness by applying the flipped classroom model to theoretical and practical subjects with a focus on the nail beauty field, and showing how it achieved students' positive perceptions and educational goals.
The epidemiology of pancreatic neuroendocrine neoplasms (PNENs) in Asia has been clarified through epidemiological studies, including one conducted in Japan, and subsequently another in South Korea. As endoscopic ultrasonography (EUS) has become more widely accessible, endoscopic ultrasound-fine needle aspiration (EUS-FNA) has been performed in pancreatic tumors for which the clinical course was only monitored previously. This has enabled accurate diagnosis of pancreatic tumors based on the 2010 WHO classification; as a result, the number of patients with an accurate diagnosis has increased. Although surgery has been the standard therapy for PNENs, new treatment options have become available in Japan for the treatment of advanced or inoperable PNENs; of particular note is the recent introduction of molecular target drugs (such as everolimus and sunitinib) and streptozocin. Treatment for progressive PNENs needs to be selected for each patient with consideration of the performance status, degree of tumor differentiation, tumor mass, and proliferation rate. Somatostatin receptor (SSTR)-2 is expressed in many patients with neuroendocrine tumor. Somatostatin receptor scintigraphy (SRS), which can visualize SSTR-2 expression, has been approved in Japan. The SRS will be a useful diagnostic tool for locating neuroendocrine neoplasms, detecting distant metastasis, and evaluating therapy outcomes. In this manuscript, we review the latest diagnostic methods and treatments for PNENs.
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