• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4289-4294
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• 2016

Background: Studies have shown that a return to spirituality is a major coping response in cancer patients so that therapists can adopt a holistic approach by addressing spirituality in their patient care. The present study was conducted to develop a guideline in the spiritual field for healthcare providers who serve cancer patients in Iran. Materials and Methods: Relevant statements were extracted from scientific documents that through study questions were reviewed and modified by a consensus panel. Results: The statements were arranged in six areas, including spiritual needs assessment, spiritual care candidates, the main components of spiritual care, spiritual care providers, the settings of spiritual care and the resources and facilities for spiritual care. Conclusions: In addition to the development and preparation of these guidelines, health policy-makers should also seek to motivate and train health service providers to offer these services and facilitate their provision and help with widespread implementation.

• Journal of radiological science and technology
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• v.8 no.2
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• pp.29-45
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• 1985

Computed Tomography Scanner (CT) is highly expensive in operation as well as purchasing. That reason may cause not only to increase the burden of patients but also to waste the capital resources leading to financial difficulties. However the numbers of CT installed throughout the country is increasing, because of efficiency in medical care, patient's concern, competitions among the hospitals within the same area. In the non-Metropolitan area the scanners were expected to be less utilized and less profitable. Nine hospitals equipped with the CT were studied on the utilization of that equipment during the period from November 1984 to February 1985 in non-Metropolitan area and break-even point in one hospital was analyzed for estimating profitabilities. The results were as follows ; 1. Among those nine hospitals, four hospitals had less than 400 beds, which is one of the restrictive minimum standards on the installation of Whole-body Computed Tomography Scanner. 2. The operating time during the normal operation period was longer than those of any other studies, but the accumulated down time was also longer than those of any other studies. The average number of scanning per week for each CT was 45, while the estimated number of for the break-even point was 56.7 cases. 3. When the downtime was excluded in calculating the average operation would be much closer to the cases for the break-even point. Therefore the break-down of the equipment was to be a main cause of the low profitability. 4. The average scanning rate for head area was 33.6%, however three of the nine hospitals showed about 20%. 5. If scanning ratio for the body parts excepting head was increased, the number of scanning for the break-even point would be diminished. 6. The small size hospital especially located near the Metropolitan area showed largest loss in the CT operation. In purchasing the highly expensive equipments in hospitals, demand should be taken into account and planning is recommended.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.30-39
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• 2018

Background: Clinical Pharmacy Practice Experience (CPPE) is an important curriculum that offers students patient-centered disease prevention and treatment with evidence-based optimal pharmacotherapy for better clinical outcomes. However, few studies have evaluated the perception of pharmacy students regarding CPPE in tertiary and secondary hospitals. This study aimed to evaluate the perception of pharmacy students regarding the learning program of CPPE. Methods: The survey questionnaire consisted of 15 self-administered questions regarding pharmacy practices, barriers, and improvement of practical training. Fourteen institutional pharmacies located in seven regions responded to a survey questionnaire from March 1 to June 30, 2017. The participants were pharmacy students doing clerkship in a hospital setting. Results: The response rate was 73.6%. Thirty-five participants (22.4%) had used a hospital library, but 121 (77.6%) had never used the library for drug information resources. Eighty-one (50.0%) responded that clinical knowledge and drug information was the most beneficial practice. Thirty-seven (31.1%) respondents in the tertiary hospitals and 19 (46.3%) in the secondary hospitals answered that they were filling prescriptions during the daily break. On the other hand, 72 respondents (60.5%) in the tertiary hospitals and 17 (41.5%) in the secondary hospitals did literature research to prepare for presentation. Conclusion: More students in secondary hospitals continue to fill prescriptions during the daily break, as compared to those in tertiary hospitals. Therefore, the authors suggest self-directed learning to improve clinical performance and each institution considers offering onsite or online library service to improve evidence-based CPPE for pharmacy school students.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.9 no.6
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• pp.151-158
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• 2010

In line with the requirement of appropriate protocol support for such mission-critical wireless sensor network (WSN) applications as patient monitoring, we investigate the framework for designing medium access control (MAC) schemes. The data traffic in medical systems comes with inherent traffic heterogeneity as well as strict requirement of reliability according to the varied extents of devise-wise criticality in separate cases. This implies that the quality-of-Service (QoS) issues are very distinctly delicate requiring specialized consideration. Besides, there are features in such systems that can be exploited during the design of a MAC scheme. In a monitoring or routine surveillance application, there are degrees of regularity or predictability in traffic as coordinated from a node of central control. The coordinator thus takes on the role of marshaling the resources in a neighborhood of nodes deployed mostly for upstream traffic; in a collision-free scheme, it schedules the time slots for each superframe based on the QoS specifications. In this preliminary study, we identify the key artifacts of such a MAC scheme. We also present basic performance issues like the impact of superframe length on delay incurred, energy efficiency achieved in the network operation as obtained in a typical simulation setup based on this framework.

• Korea Journal of Hospital Management
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• v.15 no.3
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• pp.143-169
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• 2010

This is a case study of Seoul St. Mary's Hospital applying a real-time enterprise (RTE) strategy to improve customer satisfaction and operational efficiency with the main process of medical institutions. The hospital is applying an RTE strategy to get real-time information on occurrences at each contact point of the main process of the medical institution from reservation to discharge through dashboard and to resolve issues through rapid decision-making. The RTE strategy of the hospital has some summaries: First, the hospital has linked a hospital management strategy to the RTE strategy to build a patient-centered treatment process. Second, the hospital has operated a control tower for change management and implementation monitoring in the process of implementing the RTE strategy. Third, the hospital has built systematic RTE-based environment as an application program in which the nU System is linked to Business Processor Renovation (BPR) promoted from 2006 on. Fourth, the hospital is applying a strategy to improve efficiency in operating the hospital by increasing customer satisfaction, removing inefficiency and variability, and managing medical resources efficiently through the RTE strategy. Fifth, it has established an information-sharing system through authority management for each user in terms of RTE information. Sixth, it has supplemented limitations of short-term information of the RTE strategy by linking the key performance index to the cost information system in order to improve performance of the RTE strategy. Seventh, it has improved customer satisfaction and achieved higher performance in improving operational efficiency, as compared with rival hospitals, through the RTE strategy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6001-6006
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• 2015

Background: Pancreatic cancer is the fourth leading cause of cancer related death with median survival ranging from 3 to 6 months for metastatic disease. Palliative chemotherapy has been the backbone of treatment in advanced stage and has evolved over time. Data pertaining to the disease are scarce from our part of the world where treatment poses a significant challenge due to lack of resources. Materials and Methods: A retrospective chart review was performed for all patients presenting with stage IV pancreatic carcinoma at a tertiary care hospital in Karachi, Pakistan between January 2008 and December 2012. Data were collected using a pre-designed, coded questionnaire looking at patient characteristics, treatment given and outcome. Results: 101 patients were found to be eligible. Mean age was $56.7{\pm}12.8years$, the male to female ratio was 2:1 and most patients had a good performance status. More than half of the tumors were located in the head (57%, n=58) and almost all were adenocarcinomas (95%, n=96). Some 58% (n=59) received first line chemotherapy of which 49% (n=29) received gemcitabine-based regimens and 39% (n=23) received FOLFIRINOX. The median progression free survival for gemcitabine based treatment was 2.9 months (IQR=1.6-5.6) as opposed to 7.3 months (IQR=4.5-9.2) for FOLFIRINOX (P=0.02). Median overall survival was 4.9 months (IQR=2.3-9.5) for first line gemcitabine based treatment and 10.5 months (IQR=7.0-13.2) for first line FOLFIRINOX therapy (P=0.002). Patients on FOLFIRINOX had better survival across all subgroups. Inpatient admissions and dose reductions were more frequent with FOLFIRINOX but the difference between the two regimens was not statistically significant. FOLFIRINOX could be successfully administered as outpatient therapy to a number of patients. Conclusions: FOLFIRINOX remains a suitable first line option in patients with metastatic pancreatic cancer with good performance status even in a resource-poor country where diagnostic and supportive care facilities may be less than optimal and cost is a limitation.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.377-380
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• 2015

Background: There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. Our objectives were to determine the frequency of breast cancer patients with delayed presentation, the reasons of delay and its association with different socio-demographic variables in our North Pakistan setting. Materials and Methods: We interviewed 315 histologically confirmed breast cancer patients. Delay was defined as more than 3 months from appearance of symptoms to consultation with a doctor. Questions were asked from each patient which could reflect their understanding about the disease and which could be the likely reasons for their delayed presentation. Results: 39.0 % (n=123) of patients presented late and out of those, 40.7% wasted time using alternative medicines; 25.2 % did not having enough resources; 17.1 % presented late due to painless lump; 10.6% felt shyness and 6.5% presented late due to other reasons. Higher age, negative family history, < 8 school years of education and low to middle socio-economic status were significantly associated with delayed presentation (p< 0.05). Education and socioeconomic status were two independent variables related to the delayed presentation after adjustment for others (OR of 2.26, 2.29 and 95%CI was 1.25-4.10, 1.06-4.94 respectively). Conclusions: Significant numbers of women with breast cancer in North Pakistan experience presentation delay due to their misconceptions about the disease. Coordinated efforts with public health departments are needed to educate the focused groups and removing the barriers identified in the study. Long term impact will be reduced overall burden of the disease in the region.

• 대한핵의학회:학술대회논문집
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• 2002.05a
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• pp.17-24
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• 2002

Recurrence of colorectal cancer after apparently curative resection remains common, with reported relapse rates of up to 40%. Because complete resection of solitary metastases or local recurrence may improve long-term survival, surgical management of such cases has become increasingly aggressive but has led to only modest survival benefit. The limitations of current approaches based on structural imaging are well documented, with over half of the patients who are thought suitable for curative surgery being found to have unresectable disease at operation. Therefore, better preoperative assessment is crucial. The increasing use of FDG-PET as an oncologic staging investigation has significantly improved the assessment of patients with suspected colorectal cancer recurrence. Several studios show that substantial and largely appropriate changes in patient management occur, often soaring patients the significant morbidity and mortality associated with aggressive but futile therapies while also saving scarce community resources. Nevertheless, the clinical relevance of these findings has still been questioned. The utility of PET in routine clinical practice will likely depend on its ability to provide incremental information compared with CT in selected patients rather than to serve as a replacement for CT. In conclusion, in patients with suspected recurrent or metastatic colorectal carcinoma, FDG-PET should be performed (1) when there is rising carcinoembryonic antigen levels in the absence of a known source, (2) to increase the specificity of structural imaging when there is an equivocal lesion, and (3) as a screening method for the entire body in the preoperative staging before curative resection of recurrent disease.

• Korean Medical Education Review
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• v.17 no.3
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• pp.110-121
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• 2015

Competency-based medical education (CBME) is an outcome-oriented curriculum model for medical education that organizes learning activities and assessment methods according to defined competencies as the learning outcomes of a given curriculum. CBME emerged to address the accountability of medical education in response to growing concerns about the patient safety in North America in the 1970s, and the number of medical schools adopting CBME has dramatically increased since 1990. In Korea, CBME has been under consideration as an alternative curriculum model to reform medical education since 2006. The purpose of this paper is three-fold: (1) to review the literature on CBME to identify the challenges and benefits reported in North America, (2) to summarize the process and experiences of planning and implementing CBME at Inje University College of Medicine, and finally (3) to provide recommendations for Korean medical schools to be better prepared for the successful adoption of CBME. In conclusion, one of the key factors for successful CBME implementation in Korea is how well an individual school can modify the current curriculum and rearrange the existing resources in a way that will enhance students' competencies while maximizing the strengths of the school's existing curriculum.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.165-169
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• 2014

Purpose: Trauma is one of the most common and lethal causes of death in Korea, especially in people under the age of 40. However, a considerable percentage of trauma patients are lost each year due to the scarce resources of the trauma system. The purpose of this study was to determine the recognition of trauma and trauma system. Methods: From April 8th to 22nd, 2014, visitors and in-patients in our medical center were interviewed and surveyed with a questionnaire, which included 28 questions regarding the trauma system, such as the most common cause of death, the locations of trauma centers, the importance of trauma centers, and consent for supporting trauma centers financially. Results: The majority of the respondents recognized trauma as a common cause of death; this was particularly true for people younger than 40. Most respondents' expectancy for the optimal time for trauma patient transport was high, recognizing that major trauma patients should receive urgent care. The respondents felt that trauma centers are important and needed, just as much as police stations and libraries are. Among 178 respondents, 140 (80.5%) were willing to financially support the trauma system. Conclusion: The respondents were aware of the seriousness of trauma and generally agreed on the need for trauma centers. In order to meet the needs and the demands of the people, and to reduce preventable death rate, the trauma system should be improved not only in quality but also in quantity with better and more facilities and manpower, with the aid of publicity from trauma organizations and funding from the government.