• Title/Summary/Keyword: Hospital Clinical Training

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May the Neutrophil/Lymphocyte Ratio Be a Predictor in the Differentiation of Different Thyroid Disorders?

  • Kocer, Derya;Karakukcu, Cigdem;Karaman, Hatice;Gokay, Ferhat;Bayram, Fahri
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3875-3879
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    • 2015
  • Background: The neutrophil/lymphocyte ratio (NLR) is a simple index of systemic inflammatory response, and has been shown to be a prognostic indicator in some types of cancer. Inflammation has been implicated in the initiation and progression of thyroid cancer. The aim of this study was to examine the relationship of NLR with papillary thyroid cancer (PTC) and different benign thyroid pathologies like multinodular goiter (MNG) and lymphocytic thyroiditis (LT). Materials and Methods: We retrospectively evaluated the neutrophil, lymphocyte counts and NLR calculated from these parameters of 232 patients with histologically confirmed as multinodular goiter (group MNG) (n=70), lymphocytic thyroiditis (group LT) (n=97), LT with PTC (group LT-PTC) (n=25) and PTC (group PTC) (n=40). The optimal cut-off value for NLR was determined. Results: NLR level was significantly higher in groups LT-PTC and PTC as compared to groups MNG and LT (p<0.05). NLR of LT subgroups according to TSH levels were not different (p>0.05). When we grouped the patients as benign and malignant according to PTC presence, the optimum NLR cut-off point obtained from ROC analysis was 1.91 (sensitivity 89.0% and specificity 54.5%). Conclusions: Since NLR was significantly elevated in group LT-PTC and group PTC, NLR value may give an opinion as a potential marker in differentiation of benign and malign thyroid disorders. For this purpose a cut-off value of 1.91 for NLR may be accepted.

When Are Circular Lesions Square? A National Clinical Education Skin Lesion Audit and Study

  • Miranda, Benjamin H.;Herman, Katie A.;Malahias, Marco;Juma, Ali
    • Archives of Plastic Surgery
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    • v.41 no.5
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    • pp.500-504
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    • 2014
  • Background Skin cancer is the most prevalent cancer by organ type and referral accuracy is vital for diagnosis and management. The British Association of Dermatologists (BAD) and literature highlight the importance of accurate skin lesion examination, diagnosis and educationally-relevant studies. Methods We undertook a review of the relevant literature, a national audit of skin lesion description standards and a study of speciality training influences on these descriptions. Questionnaires (n=200), with pictures of a circular and an oval lesion, were distributed to UK dermatology/plastic surgery consultants and speciality trainees (ST), general practitioners (GP), and medical students (MS). The following variables were analysed against a pre-defined 95% inclusion accuracy standard: site, shape, size, skin/colour, and presence of associated scars. Results There were 250 lesion descriptions provided by 125 consultants, STs, GPs, and MSs. Inclusion accuracy was greatest for consultants over STs (80% vs. 68%; P<0.001), GPs (57%) and MSs (46%) (P<0.0001), for STs over GPs (P<0.010) and MSs (P<0.0001) and for GPs over MSs (P<0.010), all falling below audit standard. Size description accuracy sub-analysis according to circular/oval dimensions was as follows: consultants (94%), GPs (80%), STs (73%), MSs (37%), with the most common error implying a quadrilateral shape (66%). Addressing BAD guidelines and published requirements for more empirical performance data to improve teaching methods, we performed a national audit and studied skin lesion descriptions. To improve diagnostic and referral accuracy for patients, healthcare professionals must strive towards accuracy (a circle is not a square). Conclusions We provide supportive evidence that increased speciality training improves this process and propose that greater focus is placed on such training early on during medical training, and maintained throughout clinical practice.

Predictive factors associated with successful response to utrasound guided genicular radiofrequency ablation

  • Kose, Selin Guven;Kose, Halil Cihan;Celikel, Feyza;Akkaya, Omer Taylan
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.447-457
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    • 2022
  • Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.

Associations between Adiponectin and Two Different Cancers: Breast and Colon

  • Gulcelik, Mehmet Ali;Colakoglu, Kadri;Dincer, Halil;Dogan, Lutfi;Yenidogan, Erdinc;Gulcelik, Nese Ersoz
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.395-398
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    • 2012
  • Objectives: Breast and colon cancer are neoplasms well known to be related to obesity. Adiponectin, a protein that increases in obesity, seems to be involved in the relationship but clinical data are limited. Methods: In this study, we therefore evaluated the serum adiponectin levels in 87 breast and 27 colon cancer patients and assessed the relation with BMI, menopausal status, receptor status and stage of disease. Results: Serum adiponectin levels were lower in cancer cases ($8583{\pm}2095$ ng/ml for breast cancer, $9513{\pm}2276$ for colon cancer) than in controls ($13905{\pm}3263$). Conclusion: A low serum adiponectin level may be associated with both breast and colon cancer, and that this association is not statistically significant for either receptor or menopausal status in breast cancer groups.

Investigation of Infection Control Management in Occupational Therapy and Clinical Practice Students (작업치료(학)과 임상실습 학생들의 감염관리 인식 및 실태조사)

  • Won, Junghee;Chang, Moonyoung
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.3
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    • pp.95-107
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    • 2019
  • Objective : The aim of this study was to investigate the infection management awareness and infection prevention management status of students who participated in occupational therapy and clinical practice. Methods : The study was carried out from June 27th to August 4th, 2017, to survey the awareness and practice of infection control in 11 practice institutes among 193 students who had experience in 8 universities. Results : A total of 93.3 % of the respondents said that they needed education about infectious diseases, but 53.3 % of them did not receive infection prevention education at school or in clinical trial institutes. Hygienic practices for infection prevention and infection control practices related to handwashing were high, but the use of protective equipment was poor in the observation of swallowing disorder treatment. It is also important to educate students who have been trained in infection control. However, infection prevention training at universities and training centers is insufficient suggesting the importance of future infection education. Conclusion : Infection control education to prevent infection is necessary not only for clinicians but also for students participating in on-the-job training. Effective efforts are also needed in universities and clinical practice institutes so that infectious disease prevention education can be implemented. This study provides basic data for infection control education in universities and practice educational institute that perform clinical training and occupational therapy.

Do Radiology Residents Perform Well in Preliminary Reporting of Emergency MRIs of Spine?

  • Lee, Joon Woo;Lee, Guen Young;CHONG, Le Roy;Kang, Heung Sik
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.1
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    • pp.10-17
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    • 2018
  • Purpose: To evaluate interpretation errors involving spine MRIs by residents in their second to fourth year of training, classified as minor, intermediate and major discrepancies, as well as the types of commonly discordant lesions with or without clinical significance. Materials and Methods: A staff radiologist evaluated both preliminary and final reports of 582 spine MRIs performed in the emergency room from March 2011 to February 2013, involving (1) the incidence of report discrepancy, classified as minor if there was sufficient description of the main MR findings without ancillary or incidental lesions not influencing the main diagnosis, treatment, or patients' clinical course; intermediate if the correct diagnosis was made with insufficient or inadequate explanation, potentially influencing treatment or clinical course; and major if the discrepancy affected the main diagnosis; and (2) the common causes of discrepancy. We analyzed the differences in the incidence of discrepancy with respect to the training years of residents, age and sex of patients. Results: Interpretation discrepancy occurred in 229 of the 582 cases (229/582, 39.3%), including 146 minor (146/582, 25.1%), 40 intermediate (40/582, 6.9%), and 43 major cases (43/582, 7.4%). The common causes of major discrepancy were: over-diagnosis of fracture (n = 10), missed cord lesion (n = 9), missed signal abnormalities associated with diffuse marrow (n = 5), and failure to provide differential diagnosis of focal abnormal marrow signal intensity (n = 5). No significant difference was found in the incidence of minor, intermediate, and major discrepancies according to the levels of residency, patients' age or sex. Conclusion: A 7.4% rate of major discrepancies was found in preliminary reporting of emergency MRIs of spine interpreted by radiology residents, probably related to a relative lack of clinical experience, indicating the need for additional training, especially involving spine trauma, spinal cord and bone marrow lesions.

The Effect of Pre-training about Role Behavior on Communication and Evaluation or Clinical Skills (역할행동 사전교육이 의사소통, 진료기술의 평가에 미치는 영향)

  • Kim, Kyung-Soo;Kim, Cheon-Jung;Jeong, Seo-Yun;Kim, Kyeong-Ok
    • Journal of Oriental Neuropsychiatry
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    • v.29 no.4
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    • pp.223-230
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    • 2018
  • Objectives: The objective of this study was to clarify the effect of pre-training about role-behavior on the evaluation of communication and clinical skills in clinical training using role-playing. Methods: This study used data of 116, 4th grader students from Korean Medicak College of Dongshin University in 2016 and 2017. The data was divided into two groups: those who did pre-training about role-behaviors and those who did not. After performing their role-playing, they were asked to fill out questionnaires about 2 categories-communication and evaluation skills-, composed of 10 items each. Results: 1. Through pre-education, communication skills required the form and content of questions and the practice of communicating with patients. 2. Through pre-education, there was the need to practice listening for medical history, diagnosis skills and establishing relationships with patients. 3. Pre-training of communication skills and clinical skills helps to expose the shortcomings of clinical practice. Conclusions: In conclusion, pre-training about role-behaviors can help improve communication skills and clinical skills in clerkship using role-playing.

Current Status of Biological Nursing Science Education for Clinical Nurses in General Hospital (종합병원 임상간호사 실무교육에서의 기초간호학 교육현황)

  • Jeong, Jae Sim;Hwang, Young Hui;Kim, Yongbum;Ryu, Jae Geum;Kim, Mi Kyung;Choi, So-Eun;Park, Myung Sook;Lee, Hyangkyu;Lee, Kyung-Sook;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.20 no.1
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    • pp.47-53
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    • 2018
  • Purpose: The purpose of this study was to investigate the extent and the nature of biological nursing science education for clinical nurses in general hospital. Methods: Five advanced general hospitals located in Seoul and Gyeonggi province were conveniently sampled. Contents of education for nurses conducted by the hospital nursing department from January 1 to December 31 of 2015 were collected. Contents of education included biological nursing science and the scope of inclusion and time of assignment were analyzed. Results: A total of 271 cases of nursing education data were collected and 223 cases were analyzed after excluding 48 cases whose contents were not confirmed. Biological nursing science was included in the contents of education for 117 cases (52.5%), but not for 106 cases (47.5%). Regarding the frequency of the biological nursing science education contents, 'pathophysiology'was the most frequently included (n= 286), followed by 'structure and function of the human body' (n= 191), 'mechanisms and effects of drugs' (n= 114) and 'clinical microbiology' (n= 43). Conclusion: Results of this study confirmed that the education for clinical nurses included a lot of biological nursing science related contents. These results can be used as basis for the development of curriculum and training course for nurses.

The Effectiveness of Assertive Training on the State Anxiety and Assertive Behavior of Nursing Students Experiencing Clinical Practice Training (주장훈련이 임상실습시 간호학생이 느끼는 불안과 주장행동에 미치는 효과)

  • Yang, Jin-Ju
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.1
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    • pp.54-67
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    • 2001
  • This study was tried to investigate the effectiveness of assertive training on the state anxiety and assertive behavior which nursing students had experienced during clinical practice training from April 29, to June 5, 2000. Subjects for this study were thirty-six nursing students of practicing in a general hospital. Eighteen nursing students were assigned for the experimental group and trained by assertive training program during 4 weeks and eighteen nursing students were assigned for the control group. The assertive training program was composed of cognitive, behavioral and emotional assertive training. Post- test assessment was administrated to all subjects on a week later after the last session. The data were analyzed with SPSS PC programs. The results of this study were summarized as follows: 1) There were no significant differences between the experimental group and the control group on post- intervention comparisons of the state anxiety score (p=0.230), but in the experimental group, the anxiety score more decreased after the assertive training than that in the control group with significant differences(p=0.019). 2) There were no significant differences between the experimental group and the control group on post- intervention comparisons of assertive behavior (p=0.530). However, after the assertive training, the experimental group became more assertive than the control group with no significant differences(p=0.721). 3) The hypothesis that the more the assertive behavior, the less the state anxiety experienced by nursing students of clinical practice training was supported(r=-0.397, p=0.017). On the basis of this study results, the assertive training is effective for the reduction of the state anxiety experienced by nursing students of clinical practice training.

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A Study on Causes of Stress Experienced by Part Students of Dental Hygiene Department During Clinical Training (일부 치위생과 학생들의 임상실습 시 경험하는 스트레스 요인에 관한 조사)

  • Lee, Jung-Hwa;Jeon, Eun-Sook
    • Journal of dental hygiene science
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    • v.9 no.1
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    • pp.137-143
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    • 2009
  • The purpose of this study was to survey the cause factor and degree of stress experienced by second and third grade students of dental hygiene department in Gyeong-nam province and Ulsan Metropolitan city who were finished two weeks public health center training and four weeks dental hospital and local dental clinical training. It was to provide basic data and improve the problem of clinical training program. 1. In respect of their motives of choosing the hygiene department, 64.8% in second grade and 62.2% in third grade of those respondents cite guarantee of getting a job as main reason. In respect of the satisfaction for major field, 29.6% of second grade and 73.3% of third grade respondents were satisfied. 2. In the satisfaction for clinical training in public health center, 46.3% of second grade and 46.7% of third grade respondents were satisfied. In the satisfaction for clinical training in local dental clinic and hospital, 50.9% of second grade and 66.7% of third grade respondents were satisfied. 3. In the respect of major factor to feel stress in clinical training in public health center, the relation of school practice program and clinical training in public health center, 50.5% of respondents was felt stress because of the difference between school practice program and field condition was exist. 4. In the respect of major factor to feel stress in local dental clinic and hospital training, the relation of school practice program and clinical practice in public health center, 54.5% of respondents were felt stress. 62.1% of respondents were felt stress because of the difference between knowledge and practice. 58.1% of respondents were felt stress because of the difference between school practice program and field condition was exist. 50.5% of respondents were felt stress because of the lack of knowledge in related fields. As the above results, it is necessary to develop clinical practice program that is to increase satisfaction and provide motivation in oder to reduce the stress during clinical training.

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