To verify the correlations between the clinical outcomes and physical factors of short-course chemoradiotherapy (SCRT) and long-course chemoradiotherapy (LCRT) with delayed surgery in patients with rectal cancer. Seventy-two patients with rectal cancer were enrolled in this study. Nineteen patients were treated with SCRT (25 Gy, 5 fractions) by intensity-modulated radiation therapy (IMRT), and 53 patients were treated with LCRT (50.4 Gy, 28 fractions) by three-dimensional conformal radiation therapy (3DCRT). Various physical factors for the target and organs at risk (OARs) were calculated to compare the clinical outcomes. The organ equivalent dose (OED) and lifetime attributable risk (LAR) of bowels and bladders were similar between the SCRT and LCRT groups, whereas the values of femurs were higher in the LCRT group. The equivalent uniform dose and normal tissue complication probability were higher in the LCRT than the SCRT group for most organs. Treatment complications, including anastomotic leakage, bowel adhesion, and hematologic toxicity, were not significantly different between SCRT and LCRT groups. CIs were $0.84{\pm}0.2$ and $0.61{\pm}0.1$ for SCRT and LCRT, respectively. The CVIs were $1.07{\pm}0.0$ and $1.10{\pm}0.1$, and the HIs were $0.09{\pm}0.0$ and $0.11{\pm}0.1$ for SCRT and LCRT, respectively. The sphincter-saving rates were 89.5% and 94.3% for SCRT and LCRT, respectively. The complete pathologic remission rates were 21.1% and 13.2%, and the down-staging rates were 47.4% and 26.4% for SCRT and LCRT, respectively. SCRT with IMRT is comparable to conventional LCRT in both physical indexes and clinical outcome. The preoperative SCRT, compensated by IMRT, is an effective and safe modality.
Yu, Jesang;Choi, Ji Hoon;Ma, Sun Young;Jeung, Taesig
Progress in Medical Physics
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v.26
no.3
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pp.137-142
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2015
We retrospectively analyzed the outcomes in patients who underwent reirradiation for brain metastasis. Twenty-three patients with brain metastases who were initially treated with palliative brain radiotherapy and were retreated with a second course of brain RT between June 2008 and December 2012. WBRT, 3DCRT and SRS were used for brain metastasis. The median dose of the first course of WBRT was 30 Gy (range, 23.4~30 Gy). The dose of the first course 3DCRT for lesion was 30 Gy in 3 Gy per fraction. The median dose of the first course of SRS was 16 Gy in 1 fraction (range, 12~24 Gy). The median dose of the second course of WBRT was 27.5 (range, 12~30 Gy). The median dose of the second course of 3DCRT for lesion was 30 Gy (range, 25~30 Gy). The dose of the second course of SRS was 16 Gy in 1 fraction. The second course of WBRT was administered on radiographic disease progression with symptom in all patients. With median follow-up of 25 months, overall symptom resolution rates were 47.8%. Rate of palliative efficacy was 82.6% including stable disease. The median survival time after initiation of reirradiation was 3.2 months. Median value of KPS prior to reirradiation was 30. Median value of KPS after reirradiation was 60. Reirradiation of brain metastasis maybe feasible and effective in select patients with a good performance status $KPS{\geq}60$ (: ECOG 0~2) prior to reirradiation.
Purpose: An emerging trend in Asian higher education is English-medium instruction (EMI), which uses English as the primary instructional language. EMI prepares domestic students for international leadership; however, students report difficulty in learning, and educators have raised questions concerning the effectiveness of EMI. The flipped learning model (FLM), in which lecture and homework activities for a course are reversed, was applied to an English-medium course offered by a college of nursing in Korea. The aims of this study were to: 1) revise an existing English-medium nursing course using the FLM; 2) explore students' learning experiences and their acceptance of the FLM; and 3) identify key factors in the success of FLM. Methods: We used a descriptive, cross-sectional, mixed-methods design and the participants were students at one nursing school in Korea. A series of course development meetings with faculties from the nursing school and the center for teaching and learning were used to develop the course format and content. We conducted course evaluations using the Flipped Course Evaluation Questionnaire with open-ended questions and focus group interviews. Results: Students (N=75) in a 15-week nursing course responded to a survey after completing the course. Among them, seven students participated in one of two focus groups. Overall, students accepted and favored the flipped learning strategy, and indicated that the method enhanced lecture content and their understanding of it. Factors associated with effective instruction included structured monitoring systems and motivational environments. Conclusion: The FLM requires sufficient preparation to facilitate student motivation and maximize learning outcomes.
This study aimed to develop a new convergence course applying project-based learning (PBL) and collaborative teaching methods and identify its educational effects. The course development proceeded as follows: First, three instructors collaborated to define course goals, plan objectives, content, and methods, and create a syllabus for a PBL-based fashion studio course. Roles were divided to maximize expertise: one instructor focused on fashion design, another on three-dimensional cutting, and the third on flat cutting, and digital techniques. Second, the classes were conducted and feedback on student progress was shared, enhancing class quality and engagement. Third, teaching effectiveness was assessed through learner evaluation questionnaires, reflection journals, and performance assessments. Lastly, based on the results from these evaluations, positive aspects of the course were reviewed, and ways to modify it and enhance course quality for continuous improvement were explored. The results showed high satisfaction with the learning effects on major competencies, indicating that students not only effectively learned major skills but also improved their communication and teamwork. The students perceived the teaching methods positively allowing them to be more active in class. Instructors noted that the course produced higher-quality design and production outcomes compared to previous courses. Overall, the course applying PBL and collaborative teaching methods was found to improve educational quality and effectiveness, making it a valuable approach for learner-centered education.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.23
no.1
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pp.3-7
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2012
Objectives : The early onset of mood symptoms in bipolar disorder has been associated with poor outcomes in many studies. However, aspects of the clinical course of bipolar disorder in children and adolescents are controversial. The goal of this article is to review the clinical characteristics and longitudinal course of children and adolescents with bipolar disorders. Methods : Searches were conducted in MedLine, PsycINFO, KISS, and RISS using the terms phenomenology, clinical course, outcome, BPD, pediatric, children and adolescents. Twenty-one reports were selected : either original articles reporting symptoms and clinical characteristics of subjects (ages 5-18 years), or published articles in reviewed journals about bipolar disorder in children and adolescents. Results : Approximately 70% of subjects with bipolar disorder recovered from their index episode, and 50% had at least 1 syndromal recurrence, particularly depressive episodes. For 60% of the follow-up time, subjects had syndromal or subsyndromal symptoms with numerous changes in symptoms and shifts of polarity. Approximately 20% of BP-II subjects converted BP-I. Conclusion : Bipolar disorders in children and adolescents are characterized by episodic illness with subsyndromal and syndromal episodes with mainly depressive and mixed symptoms and rapid mood changes. Extensive follow-up time is needed to evaluate the continuity of bipolar disorder symptoms from childhood to adulthood.
To get an appropriate and meaningful performance assessment outcomes and to provide the base of essential elementary educational evaluations, we had tried to establish achievement standards, assessment standards and had developed appropriate assessment tools in 「Intelligent Life」 course of the elementary school in this study. The following things were taken into account to establish achievement standards, assessment standards and to develop assessment tools. First, managing deeply not only cognitive domain but also the basic inquiry skills and affective domain, all-round educational properties of integrated courses were likely to come out. Second, evaluating instructional processes as well as instructional results, we had developed assessment standards in elementary 2nd grade's 「Intelligent Life」 course. Third, developing assessment standards on the basis of the 7th Curriculum, we had examined both text book and teacher's guide to promote effectiveness of field application. The type of an assessment tools had been developed variously, considering the characteristics of the elementary lower grades and properties of elementary 2nd grade's 「Intelligent Life」 course. We had developed assessment tools to observe and evaluate practical achievement levels, placing great importance on the types of an assessment tools including observing, narrative of inquiry, report, etc. As a result of investigation of elementary teachers' understandings of the developed achievement standards, assessment standards, and an assessment tools, were revealed in the affirmative on the whole.
BACKGROUND/OBJECTIVE: Competent renal dietitians are crucial for better patient compliance and clinical outcomes, specifically in critical settings. The aim of this study was to develop and evaluate an evidence-based course in renal dietetics for dietitians working in health care systems where dietetic specialization is absent. SUBJECTS/METHODS: Fifteen licensed dietitians working with hemodialysis patients in Lebanon were randomly recruited to participate in the course. The latter was developed by the study's primary investigator, according to evidence-based practice guidelines, and focused on all aspects of renal nutrition. Total course duration was 28 hours spread over a 2 month period. Dietitians' knowledge in renal nutrition was tested pre- and post-training through a 23-item questionnaire; the total score was expressed in percentage (< 60% score indicated insufficient knowledge). Paired-samples t test was used for statistical analysis. RESULTS: Overall knowledge of the dietitians significantly improved post-training and reached satisfactory levels (pre: $38.75{\pm}17.20%$, post: $62.08{\pm}21.85%$). Sub-analysis of the change in the knowledge showed significant and satisfactory improvement only in 3 topics: 1) correct body weight use in calculations, 2) energy estimation method and 3) phosphorus management. Knowledge in the fluid management significantly improved but did not achieve a satisfactory level. CONCLUSION: The course significantly improved dietitians' knowledge in renal nutrition. If adopted as part of the continuing education of dietitians in countries that lack dietetic specializations, it may serve the first step towards improving health care practice.
Sung Wook Chang;Dong Hun Kim;Dae Sung Ma;Ye Rim Chang
Journal of Trauma and Injury
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v.36
no.1
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pp.3-7
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2023
Purpose: As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes. Methods: Patients who were managed at a regional trauma center in Dankook University Hospital from August 2016 to February 2018 were included and were grouped as precourse (August 2016-August 2017, n=9) and postcourse (September 2017- February 2018, n=9). Variables regarding injury, parameters regarding REBOA procedure, morbidity, and mortality were prospectively collected and reviewed for comparison between the groups. Results: Demographics and REBOA variables did not differ between groups. The time required from arterial puncture to balloon inflation was significantly shortened from 9.0 to 5.0 minutes (P=0.003). There were no complications associated with REBOA after the course. Mortality did not show any statistical difference before and after the course. Conclusions: The endovascular training for REBOA pilot course, which uses a modified form of flipped learning, realistic simulation of ultrasound-guided catheter insertion and balloon manipulation, and competence assessment, significantly improved procedural performance during resuscitation of trauma patients.
The Journal of Korean Academic Society of Nursing Education
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v.23
no.1
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pp.76-85
/
2017
Purpose: The aim of this study was to explore the effects of imagery training on outcomes of clinical competence, voluntary practice time and basic nursing skills performance during a core basic nursing skills course. Methods: The design was a pre-post test design with two groups consisting of 88 nursing 3rd-year students. Clinical competence was assessed with a pre-post test, and basic nursing skills' performance and voluntary practice time were assessed at the post-test point. Data were collected from March, 2016 to June, 2016. Results: The pre-post differences of all subcategories of clinical competence were significantly improved in the experimental group (p<.05). but the control group did not show significant differences in the teaching/coordinating and professional development areas (p>.05). The experimental group practiced 1.33 hours more than the control group in voluntary practice. The two groups showed no significant difference in basic nursing skills' performance (p>.05). Conclusion: Imagery training during a core basic nursing skills course showed positive effects on nursing students' clinical competence improvement and increase of voluntary practice time.
Journal of the Korea Society of Computer and Information
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v.18
no.8
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pp.141-148
/
2013
Traditional face-to-face university education has shifted its course to combine the advantages of both online and offline education in a blended-learning approach. However, there is still much that is unknown about the actual effect of blended learning, particularly it's learning outcomes in terms of cost effectiveness. This study qualitatively examines the costs and the learning outcomes of blended learning at an on-line college and off-line university. Online college level English pedagogy courses and blended with offline operations at an online university were studied across two semesters in terms of the quality of education, and both direct and indirect cost savings. Other causes for various learning outcomes and cost implications are proposed and validated.
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