• 제목/요약/키워드: evaluation practice

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Continuous Transarterial Infusion Chemotherapy with Gemcitabine and 5-Fluorouracil for Advanced Pancreatic Carcinoma

  • Hong, Guo-Bin;Zhou, Jing-Xing;Sun, Hua-Bin;Li, Chun-Yang;Song, Li-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2669-2673
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    • 2012
  • Purpose: Pancreatic carcinoma is one of the most malignant tumors of the alimentary system, with relatively high incidence rates. The purpose of this study was to assess the efficacy and safety of two regimens for advanced pancreatic carcinoma: continuous transarterial infusion versus systemic venous chemotherapy with gemcitabine and 5-fluorouracil. Methods: Of the 48 patients with advanced pancreatic carcinoma receiving chemotherapy with gemcitabine and 5-fluorouracil, 24 received the selective transarterial infusion, and 24 the systemic chemotherapy. For the continuous transarterial infusion group (experimental group), all patients received gemcitabine 1000 mg/$m^2$, given by 30-minute transarterial infusion, on day 1 of a 4-week cycle for 2 cycles, and a dose of 600 mg/$m^2$ 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. For the systemic venous group (control group), gemcitabine and 5-fluorouracil were infused through a peripheral vein, a dose of 1000 mg/$m^2$ gemcitabine being administrated over 30 min on days 1 and 8 of a 4-week cycle for 2 cycles, and a dose of 600 mg/$m^2$ 5-fluorouracil was infused on days 1~5 of a 4-week cycle for 2 cycles. The effectiveness and safety were evaluated after 2 cyclesaccording to WHO criteria. Results:The objective effective rate in transarterial group was 33.3% versus 25% in the systemic group, the difference not being significant (P=0.626). Clinical benefit rates(CBR) in the transarterial and systemic groups were 83.3% and 58.3%, respectively (P=0.014). The means and medians for survival time in transarterial group were higher than those of the systemic group (P < 0.005). at the same time, the adverse effects did not significantly differ between the two groups (P > 0.05). Conclusion: Continuous transarterial infusion chemotherapy with gemcitabine and 5-fluorouracil could improve clinical benefit rate and survival time of patients with advanced pancreatic carcinoma, compared with systemic venous chemotherapy. Since adverse effects were limited in the transarterial group, the regimen of continuous transarterial infusion chemotherapy can be used more extensively in clinical practice. A CT and MRI conventional sequence can be used for efficacy evaluation after chemotherapy in pancreatic carcinoma.

Review of fungicide resistance problems in Korea (국내 살균제 저항성 문제의 현황과 전망)

  • Kim, Choong-Hoe
    • The Korean Journal of Pesticide Science
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    • v.4 no.2
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    • pp.1-10
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    • 2000
  • Fungicide resistance study in Korea is still in its infancy, and most of those resistance studies are largely limited to newness of the detected resistant strains. In future, detection of fungicide-resistant strains has to be based on sensitivity distribution of pathogen populations to certain fungicides, and standard levels of certain fungicides for resistance should be determined under the basis of this data. Most of the early research on fungicide resistance in Korea has overlooked this point, and resulted in inconsistency and confusion for monitoring sensitivity shift of pathogen population among individual researchers. Fungicide resistance detected in vitro tests has to be documented in field trials by examining control efficacy against resistant and wild-type pathogen populations. Resistance detection in wife has to be correlated with lower activity in practice. Using this process, fungicide resistance will have a practical meaning. Fitness evaluation of resistant strains for survival is, in particular, of importance to determine the future stability of the resistance in the pathogen population. In fields, sensitivity change of pathogen populations should be carefully monitored with and without fungicide selection pressures to establish long-term management strategies against fungicide resistance. It is becoming an urgent task to provide information through research for designing and implementing successful counter-measures against fungicide resistance problems in Korea.

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Evaluation of Current Coding Practices in 3 University Hospitals (3개 대학병원의 주 진단 코딩사례 평가)

  • Seo, Sun Won;Kim, Kwang Hwan;Pu, Yoo Kyung;Suh, Jin Sook;Seo, Jeong-Don;Park, Woo-Sung;Yoon, Seok Jun;Lee, Young Sung;Lee, Moo-Sik;Chung, Hee-Ung
    • Quality Improvement in Health Care
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    • v.9 no.1
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    • pp.52-64
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    • 2002
  • Background : Coding of principal diagnosis is essential component for producing reliable health statistics. We performed this study to evaluate the current practice of principal diagnoses determination and coding, and to give some basic data to improve coding of principal diagnosis. Method : Nineteen medical record administrators (MRAs) of 3 university hospitals participated in coding principal Dx. from August 1, 2001 to August 31, 2001. From each hospital, 10 medical records of patients with high frequency disease were selected randomly. Each 10 medical records were grouped into three (A. B, C). Then, these 30 medical records were given to each MRAs for coding. At the same time questionnaire was given to each of them. Questions were to prove how they decide and code the principal diagnosis among many current diagnoses; how they decide and code the principal diagnosis when they see irrelevant diagnosis recorded as the principal diagnosis in medical record, when only tentative diagnoses were recorded without final diagnosis, and when different diagnoses were recorded in different sheets of same record. Agreement of coding among 3 hospitals were compared and survey results were analysed with SAS 6.12. Results : Agreement of coding was found in medical records 5-6 of each 10 medical records. Causes of disagreement were as follows. Difference of clinician's opinion from each hospital; mixed use of guideline from KCD-3 and guideline from DRG; difference in 4th digit classification according to the absence of pathology report in the medical record; difference of abbreviations among hospitals. 57.9% of MRAs selected the principal diagnosis recorded by physician, 42.1% of MRAs decided principal diagnosis after consulting to KCD-3 guideline. When there were difficulties in determining the principal diagnosis, 42.1% of MRAs decided principal diagnosis after discussion with the physician, 26.3% after discussion with fellow MRAs. Conclusion : There were differences in codings among hospitals. To minimize the difference, we suggest the development of disease-specific guidelines for coding in addition to the current general guideline such as KCD-3. To do this, Coding Clinic which can produce guidelines is needed.

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A Study on Patients' Satisfaction and Service Utilization in the DRG Based Payment System - Patients who Experienced Cesarean Section Before and After the Demonstration Program - (DRG 지불제도에서 환자의 의료서비스 만족도와 제공량에 관한 연구 - 시범사업 전.후 제왕절개 분만 경험 산모를 대상으로 -)

  • Kim, Ji Sook;Park, Hayoung
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.190-202
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    • 2000
  • Background : The objectives of this study were to examine patients' satisfaction with the DRG based payment method and its association with their awareness of the method, to examine patient reported changes in doctors' caring attitude, level of their out-of-pocket payments, providers' acceptance of patients' request for additional services after the program, and to examine changes in service utilization recorded in medical records. Method : One hundred-four patients who had cesarean sections before and after the demonstration program at two hospitals located in Seoul participated in the study. Patients were surveyed before discharges when their charges were finalized. Their medical records were reviewed as well to collect data for service utilization during hospital stays. The association between patients' satisfaction with the payment method and their awareness of the method was analyzed by ${\chi}^2$-test, and the significance of changes in providers' acceptance of patients' request for additional services and service utilization after the program were examined by ${\chi}^2$-test and t-test, respectively. Results : A large proportion of patients did not know of the DRG based payment method at the time of survey and a significantly larger proportion of patients who came to the hospitals with the knowledge satisfied with the method. About the same proportion of patients reported improvement and deterioration in doctors' caring attitude compare to the previous hospitalizations and a similar result was found concerning out-of-pocket payments. Providers' acceptance of patients' request for medication, PCA and painless delivery decreased significantly after the program whereas the acceptance for additional hospital days and laboratory and radiology tests did not. Length of stay, the numbers of days on antibiotics and antianemic medication, and the number of blood tests decreased significantly after the program, however, decreases in the rate of antianemic medication and the number of urine analyses were not statistically significant. Re-operation, in-hospital death, and complications were not observed before and after the program. Conclusion : The study findings indicated a need for better patient education and publicity about the newly introduced payment method to improve their satisfaction with the system. Other study findings concerning service utilization and quality of care indicators were consistent with the government funded evaluation studies.

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A Study on the Impact of Corporate Publicity on Social Responsibility Perception and Brand Attitude (기업의 공공성이 사회적 책임 인식과 브랜드 태도에 미치는 영향 연구)

  • Kang, Soyoung
    • The Journal of the Korea Contents Association
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    • v.20 no.7
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    • pp.379-391
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    • 2020
  • The growth paradigm that has led Korea for the last few decades is now reaching its critical point. Rather than focusing on the outcomes created by severe competitions of individual companies, a growth based on win-win system and solidarity focusing on public interests is more called for. In this background, I would like to examine the concept of corporate publicness and what factors consist of it. The study aims to verify a causal relationship that corporate publicness affects the corporation's social responsibility and consumers' favorability and credulity toward the company, and looks for the possibility that corporate publicness is recognized as a corporation's substantive competitiveness and an important management activity for its sustainability. The results of the study shows that corporate publicness is composed of 5 dimensions: sincerity, activeness, pursuit of public interest, harmony, and community spirit. Then the study statistically verifies that corporate publicness significantly has a positive impact on the overall evaluation results of a corporation's social responsibility. Lastly, the study confirms that corporate publicness and socially responsible activity of a company have a positive influence overall on the attitude toward the corporate brand. Based on these results, an implication is drawn that strengthening corporate publicness and its practice in action should be emphasized for a corporation to keep making outstanding performances in a sustainable way.

Evaluation of National School Foodservice Management : Labor Control Menu Management , and Maintenance of Equipments and Facilities (전국 초등학교 급식 관리 실태조사)

  • 정현주
    • Journal of Nutrition and Health
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    • v.30 no.6
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    • pp.704-714
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    • 1997
  • The purpose of this survey was to investigate the operation and the environment of foodservice in elementary schools nationwide. A questionnaire about foodservice management to practice and foodservice operation was mailed to dietitians of each school . Of the 1, 416 schools that participated in this survey, 388 schools were selected for analysis. The main results of this study are as follows. More schools in small cities . Education levels of dietitians were significantly different from area to area. Mean total length of employment for dietitians at school foodservice was 4.7 years and varied significantly by area and the type of foodservice system. Foodservice has been operated for 2-5 years in most of schools. Schools in large cities served more people than those in small cities and rural areas. Also , schools adapting conventional foodservice system served more people than those adapting commissary or joint management system. Foodservice expense also veried significantly by area and foodservice systems. Mean foodservice expense per meal were significantly higher in schools adapting commissary system than those adapting other systems. Most schools employed dietitians, cooks, and assistant cooks, but not engineers not drivers. Mothers of students were working voluntarily. The degree of participation by mothers in cooking , serving , and cleaning was higher in schools of small cities and rural areas than those in large cities, in schools adapting commissary or joint management system than those adapting conventional system. Education and training ranked as personnel management had one of the hardest tasks. Education and training of employees were also difficult for dietitians, especially in commissary or joint management systems. Percentage of schools having separate lunchroom was higher in small cities rural areas than in large cities, in joint management or commissary system than conventional system. Most difficult matters in serving was the portion control. Over 40% of schools did not use standard recipes. Menu cycles were shorter in schools in small cities and rural areas which adapted the joint management system than area other schools. Except refrigerators, thermos , display racks, sterilizers, sinks, worktables, and table, all other equipment were insufficient in most of schools. More than half of the schools didn't have rice cookers, flatware racks, and distributing carts which are stated plainly in detailed enforcement regulations for school foodservice. Cooking equipments were described as the most needed by dietians. According to the results of this survey, many and urgent problems need to be addressed improve the quality of school foodservice . Lunchroom setups, effective personnel management and expenses, recipes standardization, serving size control and regular checking and repairing of equipments are all problems to be addressed.

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Visceral fat and body weight are reduced in overweight adults by the supplementation of Doenjang, a fermented soybean paste

  • Cha, Youn-Soo;Yang, Ji-Ae;Back, Hyang-Im;Kim, Soo-Ran;Kim, Min-Gul;Jung, Su-Jin;Song, Won O;Chae, Soo-Wan
    • Nutrition Research and Practice
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    • v.6 no.6
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    • pp.520-526
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    • 2012
  • Various forms of fermented soybean products are well documented for their health benefits. The efficacy of anti-obesogenic effect of Doenjang, one of the most commonly used seasonings in Korean cuisine, has been reported only in animal models; thus, an evaluation of Doenjang needs to be conducted in human studies. We aimed to test the hypothesis that Doenjang supplementation reduces body weight and changes body composition in overweight adults. A total of 51 overweight adults participated in this study. A group of males with BMI ${\geq}23kg/m^2$ and waist to hip ratio (WHR) ${\geq}$ 0.90, and a group of females with BMI ${\geq}23kg/m^2$ and WHR ${\geq}$ 0.85 were randomly assigned to either a Doenjang supplement (9.9 g dry/day) group or a placebo group for a 12-week randomized, double-blind and placebo-controlled study. Anthropometric parameters, abdominal fat distribution by computerized tomography (CT) and blood components were measured before and after the intervention period. After the 12-week study, the Doenjang supplementation group had significant reductions in body weight (kg), body fat mass (kg) and body fat (%) compared to the placebo group, the supplementation of Doenjang resulted in a significant reduction in visceral fat ($cm^2$), although no changes were observed in total and subcutaneous fat are as ($cm^2$), serum lipid profiles and dietary intakes. The present study demonstrated that daily supplementation of 9.9 g dry/day of Doenjang for 12 weeks reduces body weight and visceral fat in overweight adults.

Basic Knowledge Level of Nurses on the Administration of Medication (투약에 관한 간호원의 기초지식 정도)

  • 한윤복;이인자;김명자;노유자
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.12-22
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    • 1976
  • Amongst varieties of clinical nursing role, the administration of medication is often highlighted as of prime importance. In order to attain data for the improvement of teaching strategies of medication, diagnostic evaluation of the knowledge level is a necessity. This study was performed from August through December 1975. 449 registered nurses, randomly sampled from general hospitals:16 of Seoul and 7 of Taegu and Pusan, were tested through 54 test questionaries based on 4 practical dimensions of administration of medication. Results are as follows ; 1. Status of respondents: Length of clinical experiences; the average length revealed to be 2 years and 7 months, 72% revealed to have had less than 3 years of experience; 38.6%-less than 1 year, 19 .2%-over 1 year and less than 2 years, and 14, 2%-over 2 years and less than 3 years. Type of Nursing education received ; 9.4% revealed to have graduated technical high school of nursing, 67.5o/o the 3 year diploma school and 21, 7% the baccalaureate degree program. The knowledge Level; Degree of self-satisfaction on knowledge level revealed that;27, 4% responded to "more or less satisfied", 48.8% "more or less un-satisfied" and 19.8% to "not satisfied". The average level of basic knowledge revealed to be moderate by 66.95 points. The level of knowledge of 4 questionnaire categories revealed that; drug action category by average of 66.5 points, methodology category by 65.4 Points, safety measure category by 71.4 points and terminology and concepts category by 64.6 points, Questionnaire items which revealed high points are of;6 of drug action category, 4 of methodology, 4 of safety measure, and 3 of terminology. The items of low points are: 8 of drug action, 3 of methodology, 3 of safety measure and 5 of terminolology categories. 3. The type of nursing education revealed to have no significant influence on the level of knowledge on the administration of medication. 4. The length of clinical experience revealed to have no significant influence on the level of knowledge. 5. 75. l% responded that the actual practice of medication modes are "similar" to that included in the fundamentals of nursing course. 6. In-service education on medication; 54.0% revealed to have some incidental in-service education on medication while 34.0% receive programmed in- service education. 61.8% revealed to have expressed the need of systemic In-service education as one of the means for improvement of medication. 32.7% revealed to obtain information concerning medicine by reading commercial publications on drug package, while only 20.9% by reading specific information channel.

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Role of Concomitant Chemoradiation in Locally Advanced Head and Neck Cancers

  • Lasrado, Savita;Moras, Kuldeep;Pinto, George Jawahar Oliver;Bhat, Mahesh;Hegde, Sanath;Sathian, Brijesh;Luis, Neil Aaron
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4147-4152
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    • 2014
  • Standard therapy for advanced head and neck cancer consists of a combination of surgery and radiation. However, survival of this patient population has not improved during the past 20 years. Many different multimodality treatment schedules have been proposed, and chemotherapy is often used with the intent of organ preservation. The present study was intended to establish the efficacy of concomitant chemoradiation with a single agent carboplatin in advanced head and neck cancers.The objectives were to investigate the feasibility of concomitant administration of carboplatin, monitor acute toxicity during radiotherapy, and determine subacute side effects, such as wound healing following surgery after chemoradiotherapy. A prospective study was conducted wherein a total of 40 patients with stage III and IV squamous cell carcinomas of oral cavity, oropharynx, hypopharynx and larynx were enrolled. All patients were treated with external beam radiotherapy and weekly carboplatin area under curve (AUC of 5). Radiotherapy was given in single daily fractions of 1.8-2 grays (Gy) to a total dose of 66-72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Neck dissection was recommended for all patients with neck disease showing less than a complete response after chemoradiation. A total of 40 patients were enrolled of whom 32 were males and 8 were females. Highest incidence of cancer was seen in the 5th-6th decades of life with a median age of 47.7 years. Oropharyngeal tumours constituted a maximum of 21 patients followed by hypopharynx in 10, larynx in 7 and oral cavity in 2. 80% of the patients had a neck node on presentation of which 40% had N2-N3 nodal status. TNM staging revealed that 58% of patients were in stage III and 43% in stage IV. Evaluation of acute toxicity revealed that 50% had grade II mucositis, 25% grade III mucositis, 2.5% grade IV mucositis. 50% of patients had grade I skin reactions, 65% of patients had grade I thrombocytopenia, and 24% of patients had grade I anaemia. After completion of treatment 65% of patients had complete response at the primary and regional sites, and 35% of patients had a partial response of whom 23% underwent neck dissection and 5% of them underwent salvage surgery at the primary site. At the end of one year there were six deaths and four recurrences and 70% were free of disease. Concurrent chemoradiation with carboplatin provided good locoregional control for locally advanced head and neck cancers. This regimen, although toxic, is tolerable with appropriate supportive intervention. Primary site conservation is possible in many patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancers.

Analyzing the effects of artificial intelligence (AI) education program based on design thinking process (디자인씽킹 프로세스 기반의 인공지능(AI) 교육 프로그램 적용 효과분석)

  • Lee, Sunghye
    • The Journal of Korean Association of Computer Education
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    • v.23 no.4
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    • pp.49-59
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    • 2020
  • At the beginning of the discussion of AI education in K-12 education, the study was conducted to develop and apply an AI education program based on Design Thinking and analyze the effects of the AI education programs. In the AI education program, students explored and defined the AI problems they were interested in, gathered the necessary data to build an AI model, and then developed a project using scratch. In order to analyze the effectiveness of the AI education program, the change of learner's perception of the value of AI and the change of AI efficacy were analyzed. The overall perception of the AI project was also analyzed. As a result, AI efficacy was significantly increased through the experience of carrying out the project according to the Design Thinking process. In addition, the efficacy of solving problems with AI was influenced by the level of use of programming languages. The learner's overall perception of the AI project was positive, and the perceptions of each stage of the AI project (AI problem understanding and problem exploration, practice, problem definition, problem solving idea implementation, evaluation and presentation) was also positive. This positive perception was higher among students with high level of programming language use. Based on these results, the implications for AI education were suggested.