• Title/Summary/Keyword: Medical model

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Evaluation of the Trends of Stomach Cancer Incidence in Districts of Iran from 2000-2010: Application of a Random Effects Markov Model

  • Zayeri, Farid;mansouri, Anita;Sheidaei, Ali;Rahimzadeh, Shadi;Rezaei, Nazila;Modirian, Mitra;khademioureh, Sara;Baghestani, Ahmad Reza;Farzadfar, Farshad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.661-665
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    • 2016
  • Background: Stomach cancer is the fifth most common cancer and the third leading cause of death among cancers throughout the world. Therefore, stomach cancer outcomes can affect health systems at the national and international levels. Although stomach cancer mortality and incidence rates have decreased in developed countries, these indicators have a raising trend in East Asian developing countries, particularity in Iran. In this study, we aimed to determine the time trend of age-standardized rates of stomach cancer in different districts of Iran from 2000 to 2010. Materials and Methods: Cases of cancer were registered using a pathology-based system during 2000-2007 and with a population-based system since 2008 in Iran. In this study, we collected information about the incidence of stomach cancer during a 10 year period for 31 provinces and 376 districts, with a total of 49,917 cases. We employed two statistical approaches (a random effects and a random effects Markov model) for modeling the incidence of stomach cancer in different districts of Iran during the studied period. Results: The random effects model showed that the incidence rate of stomach cancer among males and females had an increasing trend and it increased by 2.38 and 0.87 persons every year, respectively. However, after adjusting for previous responses, the random effects Markov model showed an increasing rate of 1.53 and 0.75 for males and females, respectively. Conclusions: This study revealed that there are significant differences between different areas of Iran in terms of age-standardized incidence rates of stomach cancer. Our study suggests that a random effects Markov model can adjust for effects of previous responses.

Measures of Spatial Accessibility to Emergence Medical Services with a Modified Three-Step Floating Catchment Area Model : A Case Study of the Chungnam Province (수정 3SFCA 모형을 활용한 응급의료서비스 접근성 분석: 충청남도를 사례로)

  • Park, Jeong Hwan;Woo, Hyun Jee;Kim, Young Hoon
    • Journal of the Korean association of regional geographers
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    • v.23 no.2
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    • pp.388-402
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    • 2017
  • This paper presents an enhancement of the two-step floating catchment area (2SFCA) method for measuring spatial accessibility between three age groups, addressing the problem of uniform access within the catchment by applying multiple impedance function to account for distance decay and by applying weights to different age groups to account for medical service preference. The enhancement is provided to be another special care of the gravity model. When applying this modified three-step floating catchment area to measure the spatial access to emergency medical services in a study area, Chungnam province in South Korea, we find that it reveals the variation of spatial accessibility patterns between cities and rural areas and delineates more spatially explicit medical service shortage areas in southern Chungnam areas, especially remoted local rural areas. Finally, this method may be used to help the health and medical service divisions and the state departments improve designation of medical shortage areas. From the discussions, it is easy to implement in planning spatial policies of medical service and straightforward to be used as a basic, but core element for health and medical strategies in the province.

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Estimated Risk of Radiation Induced Contra Lateral Breast Cancer Following Chest Wall Irradiation by Conformal Wedge Field and Forward Intensity Modulated Radiotherapy Technique for Post-Mastectomy Breast Cancer Patients

  • Athiyaman, Hemalatha;M, Athiyaman;Chougule, Arun;Kumar, HS
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5107-5111
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    • 2016
  • Background: Epidemiological studies have indicated an increasing incidence of radiation induced secondary cancer (SC) in breast cancer patients after radiotherapy (RT), most commonly in the contra-lateral breast (CLB). The present study was conducted to estimate the SC risk in the CLB following 3D conformal radiotherapy techniques (3DCRT) including wedge field and forward intensity modulated radiotherapy (fIMRT) based on the organ equivalent dose (OED). Material and Methods: RT plans treating the chest wall with conformal wedge field and fIMRT plans were created for 30 breast cancer patients. The risks of radiation induced cancer were estimated for the CLB using dose-response models: a linear model, a linear-plateau model and a bell-shaped model with full dose response accounting for fractionated RT on the basis of OED. Results: The plans were found to be ranked quite differently according to the choice of model; calculations based on a linear dose response model fIMRT predict statistically significant lower risk compared to the enhanced dynamic wedge (EDW) technique (p-0.0089) and a non-significant difference between fIMRT and physical wedge (PW) techniques (p-0.054). The widely used plateau dose response model based estimation showed significantly lower SC risk associated with fIMRT technique compared to both wedge field techniques (fIMRT vs EDW p-0.013, fIMRT vs PW p-0.04). The full dose response model showed a non-significant difference between all three techniques in the view of second CLB cancer. Finally the bell shaped model predicted interestingly that PW is associated with significantly higher risk compared to both fIMRT and EDW techniques (fIMRT vs PW p-0.0003, EDW vs PW p-0.0032). Conclusion: In conclusion, the SC risk estimations of the CLB revealed that there is a clear relation between risk associated with wedge field and fIMRT technique depending on the choice of model selected for risk comparison.

A MODEL FOR PROTECTIVE BEHAVIOR AGAINST THE HARMFUL EFFECTS OF RADIATION FOR RADIOLOGICAL TECHNOLOGISTS IN MEDICAL CENTERS

  • Han, Eun-Ok;Moon, In-Ok
    • Journal of Radiation Protection and Research
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    • v.34 no.3
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    • pp.95-101
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    • 2009
  • Protective behavior of radiological technologists against radiation exposure is important to achieve reduction of the patient doses without compromising medical achievements. This study attempts to provide a basic model for the sophisticated intervention strategy that increases the level of the protective behavior of the technologists. The model was applied to real situations in Korea to demonstrate its utility. The results of this study are summarized as follows: First, the protective environment showed the highest relationship in the factors considered, r=0.637 (p<0.01). Secondly, the important factors were protective environment in environment characteristics, expectation for the protective behavior 0.228 (p<0.001), self-efficacy 0.142 (p<0.001), and attitude for the protective behavior 0.178 (p<0.001) in personal characteristics, and daily patient -0.112 (p<0.001) and number of the participation in the education session for the protective behavior 0.074 (p<0.05). Thirdly, the final protective behavior model by a path analysis method had direct influence on the attitude 0.171 (p<0.01) and environment 0.405 (p<0.01) for the protective behavior, self efficacy 0.122 (p<0.01), expectation for the protective behavior 0.16 (p<0.01), and self-efficacy in the specialty of projects 0.154 (p<0.01). The acceptance of the model determined by the absolute fit index (GFI), 0.969, and by the incremental fit index (CFI), 0.943, showed very significant levels. Value of $x^2$/df that is a factor applied to verify the acceptance of the model was 37, which implies that the result can be accepted in the desirable range. In addition, the parsimonious fit index configured by AGFI (0.890) and TLI (0.852) was also considered as a scale that accepts the model in practical applications. In case of the establishment of some specific intervention strategies based on the protective behavior model against harmful radiation effects proposed in this study, the strategy will provide an effective way to prevent medical harmful radiation effects that could cause severe injuries to people.

A Prospective Model of Behavior of Physical and Occupational Therapists of The Confidentiality of Patient Medical records by Structural Equation Model (구조모형방정식을 이용한 물리치료사와 작업치료사의 환자의료정보 보호행동 예측모형 개발)

  • Lee, I.H.;Park, H.J.;Yun, K.I.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.4 no.1
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    • pp.71-80
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    • 2010
  • This study developed the perspective model of behavior of physical therapists(PTs) and occupational therapists(OTs) who are dealing with confidential patient medical information in hospitals. Theory of planned Behavior(TpB) model, expanded models 1 and 2 that add habit, social pressure, and work convenience concept to TpB are tested for the validity in explaining the preposing factors that affect the behavior of PTs and OTs in ensuring the confidentiality of patient medical records. Data were collected by administrating a survey to the 120 PTs and OTs in A city. Of the 120 questionaries distributed, 110 were responded resulting 91.6% of response rate. There were not significantly different among the group classified by age, 'clinical career, gender, work family, and education level were analysis using with Independent t test and one-way ANOVA. The relationships on the concepts suggested in the models were analysed by applying the Structured Equations Modeling methods. The results of Structured Equations analysis showed that expanded model 2 was more effective model than TpB model and expanded model 1.

Quantitative Ultrasound for Osteoporosis Screening in Postmenopausal Women (폐경 후 여성에서 골다공증의 조기검진도구로서 골초음파의 유용성)

  • Shin, Hee-Young;Jung, Eun-Kyung;Rhee, Jung-Ae;Choi, Jin-Su;Shin, Min-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.4
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    • pp.408-416
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    • 2001
  • Objectives : To evaluate the diagnostic value of quantitative ultrasound (QUS) in the prediction of osteoporosis as defined by dual energy x-ray absorptiometry (DEXA) in postmenopausal women. Methods : Questionnaires and height and weight measurements were used in the investigation of 176 postmenopausal women. QUS measurements were taken on the right calcaneus while bone mineral density (BMD) measurements of the lumbar spine and femoral neck were made with DEXA. The areas under the curves (AUC) of the speed of sound (SOS) for osteoporosis in the lumbar spine and femoral neck were obtained through receiver operating characteristic (ROC) analysis and evaluated. A comparison was made, for osteoporosis in the lumbar spine and femoral neck, between the AUCs of the logistic model with clinical risk factors and SOS. Results : Pearson's correlation coefficients of SOS and lumbar spine BMD, and of SOS and femoral neck BMD were 0.26 and 0.37. The AUC for the logistic model in its discrimination for lumbar spine osteoporosis was 0.764, and for SOS 0.605. The AUCs for the logistic model in its discrimination for femoral neck osteoporosis and for SOS were 0.890 and 0.892, respectively. Conclusions : These results suggest that the diagnostic value of QUS as a screening tool for osteoporosis is moderate for the femoral neck, but merely low for the lumbar spine and that the predictability provided by SOS is no better than that by the sole use of clinical risk factors in postmenopausal women.

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Analysis of paramedic students' needs for the major theme of emergency medical technology Using Borich need assessment and The Locus for focus model

  • Ahn, Hee-Jeong;Shim, Gyu-Sik;Lee, Hyo-Ju;Han, Song-Yi
    • Journal of the Korea Society of Computer and Information
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    • v.27 no.12
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    • pp.251-258
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    • 2022
  • This study aims to provide basic data for reinforcing the learning competency of paramedic students by analyzing the performance, importance, and demand for the major curriculum of them. The participants of the study was 217 students from the Department of Emergency medical technology from 3 universities in Chungnam, and the survey data collection period was from December 13 to December 24, 2021. As a result of the study, 'Education for Ambulance management', 'Education for maintaining professionalism after graduation', 'Education for In-hospital patient monitoring' are highly required by Borich need, and 'Education for medical oder from a doctor, Education for han dover to In-hospital medical staff', 'Education for non-traumatic emergency patient treatment', 'Education for In-hospital patient monitoring', and 'Education for In-hospital medical assistance' are the top priority areas of the LF model. It is judged that it is necessary to reinforce the curriculum corresponding to in order to strengthen the learning capabilities of paramedic students.

Research of Database Model of Kim-YoungHun's Medical Chart (청강 김영훈 진료기록 데이터베이스모형 개발연구)

  • Cha, Wung-Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.2
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    • pp.279-291
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    • 2006
  • Cheong-Gang Medical Chart is 60 years worth of diagnosis records kept by Oriental Medicine Doctor Kim Young Hoon [金永勳, 號 晴崗 1882-1974], who held practice in Seoul's Jong-ro from 1915 till 1974. Kim Young Hoon's eldest son, Kim Ki Su (金琦洙) donated the medical records exceeding a thousand volumes to KyungHee University, and researches are being made presently. The author of Cheong-Gang Medical Chart, Kim Young Hoon, was a medical scholar who studied the essence of the traditional medicine of his time. He was handed down the quintessence of traditional medicine by keeping in touch with the prominent oriental doctors in Seoul at that time, and he constantly applied it to his practice and made records of it. Consequently, his diagnosis charts contain a whole new form of prescriptions, treatment skills, and processes of clinical application that have never been seen before in the texts of Korean Medicine. The writer has written a paper on the present condition of Cheong-Gang Medical Chart, which was published in the Journal of Korean Oriental Medicine in 2004. This manuscript reports the results of the test studies made to develop an efficient database model as a prior step to organizing the medical records into a data bank.

A Case Study on Electronic Commerce for Medical Fields in e-Marketplace of EZmedicom (이지메디컴의 e-마켓플레이스를 통한 의료전자상거래 시스템 사례연구)

  • Kim, Jong-Uk;Park, Sang-Cheol;Seo, Jeong-Wook
    • Journal of Information Technology Services
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    • v.6 no.3
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    • pp.141-162
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    • 2007
  • In this study, we conduct a case analysis on EZmedicom which is one of the leading companies in e-Marketplace for medical fields. By examining major business models of EZmedicom, we provide the success factors in launching the electronic commerce to the potential companies which are interested in participating in e-marketplace for medical fields. Especially, we deduct the solution, logistics field, and electronic group-purchasing as its major business model. Based on these factors, we also propose the MDvan solution which is one of the electronic purchase and supply system, Ezlogis that is the system supporting logistics parts in medical fields, VMI(vendor management inventory), standardization of item code and the linkage of SCM as its critical success factors of EZmedicom. The findings of this study suggest practical and managerial implications for e-Marketplace implementation in the medical field and further research.

An Empirical Study on the Efficient Hospital Service Operation Management for the Reduction of Medical Errors (의료과오를 줄이기 위한 효율적인 병원서비스운영에 대한 실증적 연구)

  • Lee, Don-Hee;Choi, Kang-Hwa
    • Journal of Korean Society for Quality Management
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    • v.38 no.4
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    • pp.491-503
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    • 2010
  • This paper presents a research model, which identifies a relationship between medical error reduction, efficiency of organizational systems, and employee satisfaction with organizational support. The proposed model was tested through hypotheses, based on data collected from 210 respondents from the medical staff of large -sized (i.e., more than 500 beds) residential hospitals in cities of South Korea. The results of the study showed that medical error reduction is associated with corrective system and employee satisfaction with organizational support. Therefore, it is very important that organizations improve their employees' satisfaction by providing sufficient support (e.g., information support and sharing, work guide book, etc.) for their work. In addition, in organizational systems, the corrective system has positive relationship with medical error reduction. In terms of corrective procedures, leaders or managers can make improvements by providing and supporting a friendly work environment where errors may be reported without blame and discussed in order to be corrected.