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A Study on the Efficiency of Clinical Practice for Nursing Education in the Junior College of Nursing in Korea (전문대학 간호과의 임상 실험 효율화를 위한 연구)

  • Lee, Kun-Ja;Kim, Myung-Soon;Yang, Young Hee
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.77-108
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    • 1989
  • The purpose of this study was to find out the present condition of clinical practice and to develop a scheme on the efficiency of clinical practice for nursing education in junior college of nursing in korea. This study was conducted by 2 sections. Ist section was to find out the present condition of clinical practice to 42 directors of nursing collegd and data were collected July 8 to September 30, 1988. 2nd section wat to develop a scheme on the efficiency of clinical practice for nursing education and subjects were nursing professors 258: and clinical nurses 223 in 42 junior nursing colleges their clinical settings in korea. So total subjects were 481. Data were collected july 8, 1988 to June 30, 1988 and were analysed to get the mean, standand deviation, frequency, percentage, t-test, x-test used by SPSS - pc. Major findings were as follows: 1. The present condition of clinical education in junior college of nursing in Korea. 1) 32 colleges (76.2%) were managed by a-yeas system. 2) 25 colleges (59.5%) were performed by individual practice for each subject. 3) 4 weeks interval between class education and clinical education was a major type among total colleges(36.6%, J5 colleges) 4) 30 colleges (71.4%) provided clinical education for all subjects that should be practiced. Nursing administration wes not practiced in 5 colleges (41.9%) among the remainder(12 colleges). The main cause that all practice subjects were not practiced was the lack or absence of suitable clinical settings(8 colleges. 66.7%) 5) 18 colleges (42.9%) responded that a clinical educator was, subject-charged professor. 6) 12 colleges (29.3%) responded that a clinical instructor was in charge of 6~10 students. 7) The evaluation ration ratio(professor to head nurse) by each evaluator was mostly 50% to 50 % and 60% to 40%, respectively 11 colleges(27.5%) The most common evaluation methods were evaluation by head nures, report, presence, conference (11 colleges, 27.5%) 8) The field carrier of professor was mostly 2 years (79 persons, 20.7%) and mean was 3.2 years. The education carrier of a professor was mostly over than 6 years (261 persons, 66.4%) and mean was 9.2 years. The charge hours per-week of a professor were mostly 16-18 hours (16 persons, 131.8%) 9) 34 colleges (82.9%) approved that clinical practice hour was class hour and 18 colleges (43.9 %) counted that 2 hours of clinical education equaled 1 hour of class education. 2. A study 'on the efficiency of clinical practice for nursing education. L) general characteristics of subjects were as follows: kung-sang province (145 persons, 30.5%), 30-34 years (190 persons, 39.8%), graduated degree (245 persons, 51.5%), 6-10 years of carrier (199 persons, 41.4%) were the majority. 2) suitable clinical setting was responded the systematic ward with responsible clinical educator by 210 persons(43.8%) The response by working field of subjects showed a significant difference (p< 0.01) 3) 259 subjects (54.0%) responded that the desirable qualfication of clinical instructor was 3-5 years of clinical experience with master degree or higher. 4) The mean score of desirable quality degree of clinical instructor was 3.43 professors, score (3.54) was significantly higher than clinical nurses' (3.28) (p<0.01) 412 subjects (86.0%) responded that the insufficient guality of instructor was improved by continuing to seek more new information in reference. 5) 196 subjects (41.4%) responded that desirable qualification of head nurse was more than 2 years of head position among 5 years of clinical experience. The response by working' field of subjects showed a significant difference (p<0.05) 6) The mean score of desirable quality degree of head nurse was 3.18 Clinical nurses' score(3.38) was significantly higher than professors' (3.01) (p<0.01) 419 subjects (87.8%) responded that the insufficient of head nurse was improved by continuing relationship with instructor and being responsible from planing of clinical education. 7) The mean score of performance level of the desirable clinical education guide incollege was 2.91 Professors' score (2.96) was significantly higher than clinical nurses' (2.84) (p<0.01) 340 subjects (71.1%) responded that the possible resolution for poor performance was the more specified syllabus of clinical education and the satisfiable orientation for students. 8) The mean score of performance level of the desirable clinical education guide in hospital was 3.03 9) 141 subjects (29.6%) responded that the desirable clinical evaluator was the group of professor, head nurse, staff nurse. Response by working field of subjects was a significant difference (p< 0.05) 10) The mean score of performance level of the evaluation content needed in clinical education was 3.50 Clinical nurses' score (3.56) was significantly higher than professors' (3.45) (p<0.01) 11) 433 subjects (90.2%) responded that6 desirable evaluation method for clinical education was the presence. 12) The mean score of performance level about how personal difference among clinical educators was minimized was 2.89 and response by working field of subjects was not significant. The cause of poor performance was too much workload at clinical settings and too many students st colleges by 386 subjects (81.1%).

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Favorable Outcome in Elderly Asian Patients with Metastatic Renal Cell Carcinoma Treated with Everolimus: The Osaka Urologic Oncology Group

  • Inamoto, Teruo;Azuma, Haruhito;Nonomura, Norio;Nakatani, Tatsuya;Matsuda, Tadashi;Nozawa, Masahiro;Ueda, Takeshi;Kinoshita, Hidefumi;Nishimura, Kazuo;Kanayama, Hiro-Omi;Miki, Tsuneharu;Tomita, Yoshihiko;Yoshioka, Toshiaki;Tsujihata, Masao;Uemura, Hirotsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1811-1815
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    • 2014
  • Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.

Studies on electrocardiogram of the normal Korean native cattle I. Standard limb leads (정상적(正常的)인 한우(韓牛)의 심전도(心電圖)에 관(關)한 연구(硏究) I. 표준지유도(標準肢誘導))

  • Choi, In-hyuk;Jung, In-sung;Kim, Nam-soo;Suh, Doo-seok
    • Korean Journal of Veterinary Research
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    • v.33 no.4
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    • pp.719-734
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    • 1993
  • The electrocardiographic(ECG) parameters on the standard limb leads in the normal Korean native cattle have been measured with a 3 channel Electrocardiograph built in a computed analysis. The study was conducted on the animals 98 heads of mean age of 17.7 months. Conduction parameters, waves, intervals and segments have been recorded. The recordings were analyzed as to shape and amplitude of the P and T waves and the components of the QRS complex. Heart rate was recorded by the Electrocardiogram which were a mean of $80.4{\pm}11.6beats/min$. And the younger had a higher heart rate than the older one. Average conduction times in the RP, the QRS complex and the QTc interval recorded $166.7{\pm}23.1msec.$, $79.7{\pm}8.8msec.$ and $395.5{\pm}30.4msec.$, in the P and T wave duration recorded $70.1{\pm}13.5msec.$ and $97.6{\pm}16.9msec.$, and in the PR and ST segment duration recorded $97.9{\pm}23.5msec.$ and $173.9{\pm}40.3msec.$, respectively. The wave forms in each lead observed various types. The amplitudes of wave type showed the highest frequency in each lead that were analyzed as follow : 1. In P wave, amplitudes of the positive type showed the frequency of 65.3%, 82.7% and 52.0% in leads I, II and III that were $103.1{\pm}47.8{\mu}V$, $115.2{\pm}37.3{\mu}V$ and $67.4{\pm}26.9{\mu}V$, and it showed the frequency of 54.1% and 85.7% in the leads aVL and aVF that were $63.7{\pm}23.0{\mu}V$, $88.0{\pm}83.6{\mu}V$, respectively. Average amplitude of the negative type showed the frequency of 78.6% in lead aVR which was $99.3{\pm}38.0{\mu}V$. 2. Average amplitude of the QRS complex were from $362.8{\pm}177.7{\mu}V$ to $532.8{\pm}253.9{\mu}V$(mean of $449.1{\pm}57.2{\mu}V$) that in all leads except lead I were manifested the Low-Voltage QRS complex(below 0.5mV). Average amplitudes of each wave type in the QRS complex aere $-50.2.4{\pm}258.2{\mu}V$ and $-428.6{\pm}195.1{\mu}V$ in the QS groups type that showed a frequency of 66.3%, 70.4% in the leads I and aVL, were $451.1{\pm}20.4.0{\mu}V$, $387.6{\pm}175.8{\mu}V$ and $299.3{\pm}146.5{\mu}V$ in the R groups type that showed a frequency of 48.0%, 53.1% and 34.7% in the leads III, aVR and aVF, and were $-307.5{\pm}180.3{\mu}V$, $201.4{\pm}77.2{\mu}V$ in the QR wave type which showed a frequency of 39.8% in lead II, respectively. 3. In T wave, amplitude of the positive type showed the frequency of 50.0%, 82.7%, 51.0% and 57.1% in leads II, III aVR and aVF which were $214.9{\pm}115.6{\mu}V$, $188.5{\pm}119.3{\mu}V$, $191.0{\pm}93.7{\mu}V$ and $165.7{\pm}91.9{\mu}V$, and the negative type showed a frequecny of 66.3% and 72.5% in leads I and aVL. that were $221.3{\pm}112.5{\mu}V$, $-173.6{\pm}86.7{\mu}V$, respectively. 4. Amplitude of ST segment in leads I, II and III were a mean of $-12.2{\pm}37.2{\mu}V$, $17.5{\pm}42.6{\mu}V$ and $28.3{\pm}40.4{\mu}V$, in leads aVR, aVL and aVF were $-3.9{\pm}32.5{\mu}V$, $-15.9{\pm}35.6{\mu}V$ and $26.2{\pm}37.5{\mu}V$, respectively.

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Development and Assessment Individual Maximum Permissible Dose Method of I-131 Therapy in High Risk Patients with Differentiated Papillary Thyroid Cancer (물리학 선량법을 이용한 갑상선암의 개인별 최대안전용량 I-131 치료법 개발과 유용성 평가)

  • Kim, Jeong-Chul;Yoon, Jung-Han;Bom, Hee-Seung;JaeGal, Young-Jong;Song, Ho-Chun;Min, Jung-Joon;Jeong, Heong;Kim, Seong-Min;Heo, Young-Jun;Li, Ming-Hao;Park, Young-Kyu;Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.110-119
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    • 2003
  • Purpose: Radioiodine (I-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. Materials and Methods: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age $50{\pm}11$ years) of papillary thyroid cancer. Among them 43 patients were treated with ${\Leq}7.4GBq$, while 15 patients with ${\geq}9.25GBq$. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up I-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. Results: MPD measured by CF method using tracer and therapeutic doses were $13.3{\pm}1.9\;and\;13.8{\pm}2.1GBq$, respectively (p=0.20). They showed a significant correlation (r=0.8, p<0.0001). Exposed doses to blood measured by CF and biological methods were $1.54{\pm}0.03\;and\;1.78{\pm}0.03Gy$ (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-dose group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). Conclusion: Measurement of MPD using CF method is reliable, and the high-dose I-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.