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The Changes of Confidence, Accuracy and Knowledge of Medical Professionals after the Education for Survival Prediction in Terminally Ill Cancer Patients (말기암환자에 대한 여명 예측교육 후의 의료인의 자신감과 정확도 및 지식의 변화)

  • Park, Jun-Seok;Baek, Na-Young;Suh, Sang-Yeon;Kim, Yu-Il;Jeong, Hwee-Soo;Oh, Sang-Woo;Sung, Nak-Jin;Ahn, Hong-Yup;Seo, Ah-Ram;Lee, Yong-Joo
    • Journal of Hospice and Palliative Care
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    • v.15 no.3
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    • pp.155-161
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    • 2012
  • Purpose: In this study, we evaluated the effects of training for survival prediction of terminally ill patients in terms of medical professionals' confidence, accuracy and knowledge of survival prediction. Methods: Twenty-nine participants completed a self-administered questionnaire where they scored their confidence, accuracy and knowledge of survival prediction before and after the training session. The training was provided in July 2009 at a university hospital located in Gyeonggi province, Republic of Korea. The participants were instructed by a professor of family medicine specialized in hospice palliative medicine to predict survival of a case using the palliative prognostic score and objective prognostic score. The training was provided in the form of a PowerPoint presentation for 40 minutes. Results: Participants' confidence in survival prediction significantly increased from $4.00{\pm}1.73$ ($mean{\pm}SD$) (0~10, visual analogue scale) to $5.83{\pm}1.71$ after the training (P<0.001). Before training, participant's level of confidence significantly correlated with their age (P=0.04). The training significantly improved the correlation between the confidence level and the number of terminal cancer patients whom they have experienced (P=0.005 before training, P=0.017 after training). Participant's accuracy in survival prediction also significantly improved from 14 of 29 (48%) to 27 of 29 (93.1%) (P<0.001). The change in knowledge of survival prediction was too small to be statistically analyzed. Conclusion: After training, the confidence and accuracy scores significantly improved. Further study with a greater number of participants is needed to generalize this finding.

Studies on Feed Intake and Nutrient Utilization of Sheep under Two Housing Systems in a Semi-arid Region of India

  • Bhatta, Raghavendra;Swain, N.;Verma, D.L.;Singh, N.P.
    • Asian-Australasian Journal of Animal Sciences
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    • v.17 no.6
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    • pp.814-819
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    • 2004
  • An investigation was carried out to study the effect of two housing systems on feed intake and nutrient utilization of sheep in a semi-arid region of India. Two types of housing managements were adopted. The first was a shed- 20'${\times}$10' structure with all the four sides of 6' chain link fencing with central height of 10'. The roof was covered with asbestos sheets, with mud floorings. The second was an open corral- 20'${\times}$10' open space with all the four sides covered with 6' chain link fencing. Thirty-four (32 ewes and 2 rams) sheep were grazed together on a 35 ha plot of native range. All the sheep were grazed as a flock from 08:00 to 17:00 h during the yearlong study. The flock was divided into two groups (16 ewes+1 ram) in the evening and housed according to two housing systems (Shed and Open Corral). Three digestion trials were conducted during three defined seasons of monsoon, winter and summer seasons to determine the effect of housing on nutrient intake and utilization. Blood samples were collected in three seasons for the estimation of hemoglobin and glucose. Dry and wet bulb temperatures were recorded at 06:00 A.M. and 09:00 P.M. using suitable thermometers both inside the shed and in the open corral and temperature humidity index (THI) was calculated. There was significant (p<0.05) difference in the THI between shed and open corral in all the seasons, indicating that the shed was always warmer compared to open corral. The daily dry matter intake (DMI, g/d) was 965, 615 and 982 in sheep housed under shed and 971, 625 and 1,001 in those housed in open corral during monsoon, winter and summer season, respectively. These differences were however non-significant (p>0.05). The digestibility of DM was 45.92, 45.13 and 50.30 in sheep housed under shed and 43.64, 45.02 and 55.02 in sheep housed in open corral during monsoon, winter and summer seasons, respectively. There was no significant (p>0.05) difference in the digestibility of nutrients in sheep maintained under shed and in open corral. Blood Hb concentration was 13.97, 14.13 and 13.15 in sheep housed under shed and 15.27, 13.63 and 14.82 in those kept in open corral, whereas blood glucose concentration was 59.67, 59.70 and 52.33 in sheep under shed and 61.00, 61.00 and 57.83 in open corral, during monsoon, winter and summer, respectively. There was also no significant effect of housing on the body weight changes, wool yield and survivability in ewes. Although housing had no significant effect on nutrient intake, their utilization and blood parameters, there was significant effect on the physiological responses and energy expenditure of sheep maintained under the two housing systems (Bhatta et al., 2004). It can be concluded from this study that the housing systems didn't have any significant effect on the nutrient intake and utilization of native breed like Malpura, which were well adapted to the hot semi-arid conditions of India. However, while deciding provisions for housing of different breeds of sheep (both crossbred and native) parameters like physiological responses, energy expenditure, health conditions and overall economics of the systems should be taken into consideration.

A Microcomputer-Based Data Acquisition System (Microcomputer를 이용(利用)한 Data Acquisition System에 관(關)한 연구(硏究))

  • Kim, Ki Dae;Kim, Soung Rai
    • Journal of Biosystems Engineering
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    • v.7 no.2
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    • pp.18-29
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    • 1983
  • A low cost and versatile data acquisition system for the field and laboratory use was developed by using a single board microcomputer. Data acquisition system based on a Z80 microprocessor was built, tested and modified to obtain the present functional system. The microcomputer developed consists of 6 kB ROM, 5 kB RAM, 6-seven segment LED display, 16-Hex. key and 8 command key board. And it interfaces with an 8 channel, 12 bits A/D converter, a microprinter, EPROM programmer for 2716, and RS232C interface to transfer data between the system and HP3000 mini-computer manufactured by Hewlett Packard Co., A software package was also developed, tested, and modified for the system. This package included drivers for the AID converter, LED display, key board, microprinter, EPROM programmer, and RS232c interface. All of these programs were written in 280 assembler language and converted to machine codes using a cross assembler by HP3000 computer to the system during modifying stage by data transferring unit of this system, then the machine language wrote to the EPROM by this EPROM programmer. The results are summarized as follows: 1. Measuring program developed was able to control the measuring intervals, No. of channels used, and No. of data, where the maximum measuring speed was 58.8 microsec. 2. Calibration of the system was performed with triangle wave generated by a function generator. The results of calibration agreed well to the test results. 3. The measured data was able to be written into EPROM, then the EPROM data was compared with original data. It took only 75 sec. for the developed program to write the data of 2 kB the EPROM. 4. For the slow speed measurements, microprinter instead of EPROM programmer proved to be useful. It took about 15 min. for microprinter to write the data of 2 kB. 5. Modified data transferring unit was very effective in communicating between the system and HP3000 computer. The required time for data transferring was only 1~2 min. 6. By using DC/DC converting devices such as 78-series, 79-series. and TL497 IC, this system was modified to convert the only one input power sources to the various powers. The available power sources of the system was DC 7~25 V and 1.8 A.

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Development of Abdominal Compression Belt and Evaluation of the Efficiency for the Reduction of Respiratory Motion in SBRT (체부 정위방사선치료 시 호흡운동 감소를 위한 복부 압박기구 개발 및 유용성 평가)

  • Hwang, Seon-Bung;Kim, Il-Hwan;Kim, Woong;Im, Hyeong-Seo;Gang, Jin-Mook;Jeong, Seong-Min;Kim, Gi-Hwan;Lee, Ah-Ram;Cho, Yu-Ra
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.13-19
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    • 2011
  • Purpose: It's essential to minimize the tumor motion and identify the exact location of the lesions to achieve the improvement in radiation therapy efficiency during SBRT. In this study, we made the established compression belt to reduce respiratory motion and evaluated the usefulness of clinical application in SBRT. Materials and Methods: We analyzed the merits and demerits of the established compression belt to reduce the respiratory motion and improved the reproducibility and precision in use. To evaluate the usefulness of improved compression belt for respiratory motion reduction in SBRT, firstly, we reviewed the spiral CT images acquired in inspiration and expiration states of 8 lung cancer cases, respectively, and analyzed the three dimensional tumor motion related to respiration. To evaluate isodose distribution, secondly, we also made the special phantom using EBT2 film (Gafchronic, ISP, USA) and we prepared the robot (Cartesian Robot-2 Axis, FARARCM4H, Samsung Mechatronics, Korea) to reproduce three dimensional tumor motion. And analysis was made for isodose curves and two dimensional isodose profiles with reproducibility of respiratory motion on the basis of CT images. Results: A respiratory motion reduction compression belt (Velcro type) that has convenient use and good reproducibility was developed. The moving differences of three dimensional tumor motion of lung cancer cases analyzed by CT images were mean 3.2 mm, 4.3 mm and 13 mm each in LR, AP and CC directions. The result of characteristic change in dose distribution using the phantom and rectangular coordinates robot showed that the distortion of isodose has great differences, mean length was 4.2 mm; the differences were 8.0% and 16.8% each for cranio-caudal and 8.1% and 10.9% each for left-right directions in underdose below the prescribed dose. Conclusion: In this study, we could develop the convenient and efficient compression belt that can make the organs' motion minimize. With this compression belt, we confirmed that underdose due to respiration can be coped with when CTV-PTV margins of mean 6 mm would be used. And we conclude that the respiratory motion reduction compression belt we developed can be used for clinical effective aids along with the gating system.

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Design of Truck Escape Ramps (자동차 긴급 피난 차선의 계획 설계)

  • 구본충
    • Journal of the Korean Professional Engineers Association
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    • v.28 no.4
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    • pp.54-75
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    • 1995
  • This synthesis has been prepared from a review of literature on Truck Escape Ramps technology and a survey of current practice by state department of transportation. Their locations have been determined usually from a combination of accident experience and en-gineering judgement, but new tools are emerging that can identify needs and sites without waiting for catastrophic accidents to happen. The Grade Severity Rating Systems holds promise in this regard. Design Procedures for truck excape ramps continue to evolve. Gravel arrester beds are clearly the preferred choice across the country Rounded aggregate, uniformly graded in the approximate size range of 13 to 18mm. Tech-nical publications typically have dassified TER types as paved gravity, sandpile, and ar-rester bed ramps. The design speed for vehicle entry into the ramp in critical to the deter-mination of ramp length. An escape ramp should be designed for a minimum entry speed of 130km/hr, a 145km/hr design being preferred. The ramps should be straight and their angle to the roadway align-ment should be as possible. The grade of truck escape ramps show the adjustment of ramp design to local topography, such as the tradeoff of ramp length against earthwork requirements. A width of 9 to 12m would more safety acommodate two or more outof con-trol vehicles. Reguarding comments on the most effective material, most respondents cited their own specification or referred to single graded, rounded pea gravel. The consensus essentially Is that single graded, well -rounded gravel is the most desirable material for use in arrester beds. The arrester beds should be constructed with a minimum aggregate depth of 30cm. Successful ramps have used depths between 30 and 90cm.

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A Study on the Development of a Measuring Instrument for Korean Nursing Student' Evaluation of the Effect of Simulation Education. (시뮬레이션 교육의 효과 평가를 위한 한국형 간호학생 팀워크 측정도구개발)

  • Nam, Ho-Hee;Song, Hyun-Young;Lee, Bo-Ram
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.3
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    • pp.381-390
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    • 2017
  • The aim of this study is to develop a teamwork self-assessment tool for Korean nursing students (K-self assessment of teamwork) to evaluate the effects of simulation education, and to test the validity of the tool. As the research method, data were collected from 185 third- and fourth-year nursing students who had completed emergency simulation practice courses while attending nursing schools at two universities in K region. The collected data were analyzed using such statistical programs as SPSS/WIN 22.0 and AMOS 17.0. A test of the construct validity was conducted using confirmatory factor analysis and explanatory factor analysis. To test the criterion validity of the K-self assessment of teamwork, its correlation with the Mayo High Performance Teamwork Scale (MHPTS) was analyzed using Pearson's correlation coefficients. In addition, of the reliability items, the internal consistency was tested using Chronbach's ${\alpha}$. The results of the study are as follows: The construct validity was demonstrated through the confirmatory factor analysis and explanatory factor analysis. As regards the test of reliability, there was one item for which the reliability of its validity was increased to .937 when a (single/particular) question was removed. However, in the end, no questions were removed, because the correlation coefficient between the questions and the total score was greater than .4. The overall reliability of the K-self assessment tool of teamwork was found to be .934, confirming its reliability. The translated version of the K-self assessment of teamwork developed in this study was also demonstrated to be applicable to domestic settings, in which the teamwork of nursing students can be assessed during simulation education. The results of the use of this tool in the future will be used to assess the effects of simulation education at nursing colleges, and will become the basis of various types of educational programs aimed at improving teamwork in emergency situations.

The relationship between condyle position, morphology and chin deviation in skeletal Class III patients with facial asymmetry using cone-beam CT (안면비대칭을 동반한 골격성 III급 부정교합자에서 하악 과두의, 위치 형태와 이부 편위의 관계: cone-beam CT를 이용한 연구)

  • Lee, Bo-Ram;Kang, Dae-Keun;Son, Woo-Sung;Park, Soo-Byung;Kim, Seong-Sik;Kim, Yong-Il;Lee, Kyung-Min
    • The korean journal of orthodontics
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    • v.41 no.2
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    • pp.87-97
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    • 2011
  • Objective: Facial asymmetry is usually evaluated from the difference in length and angulation of the maxilla and mandible. However, asymmetric position or shape of the condyle can also affect the expression of asymmetry. The purpose of this study was to evaluate the correlation between condylar asymmetry and chin point deviation in facial asymmetry. Methods: Cone-beam CT images of fifty adult skeletal Class III patients were studied. Thirty patients who had more than 4 mm menton deviation were categorized in the asymmetric group. Twenty patients with less than 4 mm menton deviation were assigned to the symmetric group. Anteroposterior and transverse condyle positions were evaluated from the cranial base. The greatest mediolateral diameter (GMD) of the condyle in the axial plane and angulation to the coronal plane were measured. The height and volume of the condyles were evaluated. Results: The symmetric group had no statistical difference between both condyles in position, angulation, GMD, height and volume. In the asymmetric group, the non-deviated side condyle was larger in GMD, height and volume than the deviated side. There was no statistical difference in condyle position and angulation. The GMD, height difference and condylar volume ratio (non-deviated/deviated) were positively correlated with chin deviation. From the linear regression analysis, condylar volume ratio was a significant factor affecting chin deviation. Conclusions: These findings suggests that the non-deviated side condyle is larger than the deviated side. In addition, condylar asymmetry can affect the expression of facial asymmetry.

Antioxidant Activity and Inhibition Activity against α-Glucosidase and PTP1B of Chrysanthemum indicum L. Extract and Fractions (감국(Chrysanthemum indicum L.) 추출물과 분획물의 항산화 및 α-Glucosidase와 PTP1B 저해 활성)

  • Hwang, Sung-Woo;Cha, Ji-Yun;Lee, Hoon-Yeon;Kim, Bo-Ram;Park, Min;Lee, Bo-Ri;Moon, Kwang- Hyun;Lee, Jeong-Ho;Kim, Dae-Geun;Kim, Wook;Jeong, Kyoung-Ok;Lee, Young-Mi
    • Journal of the East Asian Society of Dietary Life
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    • v.27 no.2
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    • pp.235-242
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    • 2017
  • In this study, we evaluated the polyphenol content, flavonoid content, antioxidant and biological of 70% EtOH extract and its fractions (dichloromethane, ethyl acetate and water) of the plant Chrysanthemum indicum L. (CI) belonging to family chrysanthemum. antioxidant activity was determined 1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS), and superoxide scavenging activity. The biological activity tests included measurement of ${\alpha}$-glucosidase and PTP1B. The results show that content of polyphenol and flavonoid in 70% EtOH of CI 30.20 mg and 31.58 mg, respectively. Among the different samples, ethyl acetate (EA) fraction showed the highest level of polyphenol (87.87 mg) and flavonoid (65.12 mg). The DPPH, ABTS and superoxide dismutase(SOD) antioxidant assay of EA fraction showed 93.84%, 93.38% and 84.68% inhibition respectively. The EA fraction also showed the highest antioxidant activity compared to 70% EtOH extract and other fractions. EA fraction ($20{\mu}g/mL$) showed the highest 30.29% and 99.24%, respectively compared to other samples. The results of this study show that the EA fraction contained more antioxidant and antidiabetic components than 70% EtOH extract and other fractions. In conclusion, we believe that CI may be useful natural antioxidant and functional material.

Standardization of the Method of Measuring Average Glandular Dose (AGD) and Evaluation of the Breast Composition and Thickness for AGD (평균 유선선량 측정방법의 표준화 및 유방 두께, 실질양상과의 상관관계 분석)

  • Park, Hye-Suk;Kim, Hee-Joung;Lee, Chang-Lae;Cho, Hyo-Min;Yu, A-Ram
    • Progress in Medical Physics
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    • v.20 no.1
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    • pp.21-29
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    • 2009
  • Breast cancer is the most common form of cancer among korean woman. Therefore, the early detection activities of breast cancer such as breast self-examinations, clinical breast examinations, mammography are important. A yearly mammography examination has been recommended for women aged 40 and older for the early detection of breast cancer in asymptomatic periods. However, the glandular tissue of breast is the most radiation-sensitive tissue, and the determination of average glandular dose (AGD) forms an important part of the quality control of the mammographic systems. Because of the difficulty of estimating AGD directly, it is often estimated from the measurements of the incident air kerma and by applying the appropriate conversion factors. The primary objective of this study was to standardize the method of measuring AGD. The secondary objective was to evaluate the relationships between AGD per various composition and thickness of the breast using Monte Carlo simulations. As a result, we standardized the method of measuring AGD according to International Atomic Energy Agency (IAEA) guidelines (CoP: an international code of practice). Overall, AGD for mammographic practice in Korea was less than 3.0 mGy recommended by the Korea Food and Drug Adminstration (KFDA) protocol, and Korean Institute for Accreditation of Medical Image (KIAMI). The measured and simulated AGD for a given condition were calculated as 1.7 and 1.6 mGy, respectively. For the AGDs obtained, there was no significant difference between them. The simulated AGD was dependent on the fraction of glandular tissue of the breast. The AGD increases with increasing of the breast glandularity due to increasing absorption of low energy photons. The AGD also increases as a function of breast thickness. In conclusion, the results of this study could be used as a baseline to establish a reference level of radiation dose in mammography.

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Petrological study and Provenance estimation on the stone materials from the Jeolla Usuyeong Rampart, the Republic of Korea (전라우수영 성곽 부재에 대한 암석학적 연구 및 산지추정)

  • Park, Sang Gu;Kim, Sung Tae;Kim, Jun Hyeok;Kim, Seon Hyang;Baek, Ye ram;Kim, Jae Hwan;Jwa, Yong-Joo
    • Journal of the Korean earth science society
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    • v.39 no.3
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    • pp.250-259
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    • 2018
  • We investigated the petrological features of the stone materials used in the Jeolla Usuyeong rampart and estimated their provenance through the geological survey. The Jeolla Usuyeong was designated as a historic site (No. 535) on 2016. Since the remaining rampart is less than 15%, it is necessary to make conservation on it. In this study, we discriminated the stone materials used for the rampart according to their petrographic characteristics and estimated the volume proportion of each stone by the rock type. Also, we measured the whole-rock magnetic susceptibility. The petrographic features of the stones in the rampart were compared with those in the vicinity by their mineral composition and texture. The stone materials of the rampart mainly consist of the tuff, lapilli tuff, and lapilli stone. Among these three kinds of rocks, lapilli tuff is quantitatively the most abundant (60.3%), the next is tuff (34.7%), and lapilli stone (2.5%) shows the least amount. The whole-rock magnetic susceptibility of the tuffaceous rocks can be divided by the value of $1.0{\times}10^{-3}$ SI unit. Also, the compressive strength of tuff exhibits about 156 MPa, which is adequate to reuse for the repairing work. Petrological comparisons between stone materials and outcrop rocks distributed around the Hwawon peninsula leads to a conclusion that the stone materials of the rampart are likely to have been delivered from the Dongoeri and Sindeok-ri. Judging from the results of the comparison on the frequency of use and physical properties among the tuffaceous rocks, tuff is considered to suitable for restoring the rampart.