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Objective To evaluate the efficacy of accelerated partial breast irradiation ( APBI ) and whole breast irradiation ( WBI ) with simultaneous integrated boost ( SIB ) from the perspective of economics, and provide a reference for postoperative adjuvant therapy mode selection for early-stage breast cancer after breast-conserving surgery. Methods A total of 355 early-stage breast cancer patients who underwent APBI or WBI-SIB after breast-conserving surgery were evaluated on efficacy and cost-effectiveness, of which 177 patients received APBI, and 178 patients received WBI-SIB. Survival analysis was done according to treatment received. NCI-CTC 3.0 was used to score the toxicities. Breast aesthetic outcome were evaluated with Harris standards. Results Median follow-up was 42 months ( 5.8 -92.7 months) . The 3-year locoregional recurrence free survival( LRFS) rates in APBI group and WBI-SIB group were 98.2％ and 97.6％, distant metastasis free survival( DMFS) were 94.3％ and 93.7％, disease-free survival ( DFS) were 93.1％ and 91.6％, and overall survival 95.5％ and 94.3％, respectively, without statistically significant differences(P>0.05). Compared with WBI-SIB group, the acute reaction rates in APBI group decreased from 5. 6％ to 3.4％(χ2 =6.044, P <0. 05), and late reactions from 5.6％ to 2.3％ (χ2 =6.149, P<0. 05), while the cosmetic outcome improved from 88.8％ to 93.8％(χ2 =5.22, P<0. 05). Moreover, the processing average time was shortened by 26.5 d (χ2 =40.76, P<0. 05). Conclusions After breast-conserving surgery, the efficacy of APBI showed no difference from WBI-SIB with respect to 3-year local control, disease-free survival, and overall survival, but displayed a significantly better toxicity profile and cost-effectiveness ratio for early breast cancer patients. It can be used as a good radiotherapy model after breast-conserving surgery in early-stage breast cancer.
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Objetivo: Conocer la reproducibilidad del Índice de Bienestar General (WHO-5 WBI) en estudiantes adolescentes de noveno grado de Cartagena (Colombia). Método: Participaron en el estudio 157 estudiantes adolescentes, con una media para la edad de 15,1 años (DE = 1,1), el 56,1 % eran varones. WHO-5 WBI se compone de cinco ítems que cuantifican estado de ánimo triste, reducción del interés por las actividades relevantes y nivel de energía durante las dos últimas semanas. Se calcularon los coeficientes de alfa de Cronbach y omega de McDonald como indicadores de consistencia interna, y la correlación de Pearson (r) y el coeficiente de correlación intraclase(CCI) como estimadores de la estabilidad. Resultados: WHO-5 WBI mostró aceptable consistencia interna en la primera y segunda aplicación, con valores de alfa de Cronbach de 0,668 y 0,697 y omega de McDonald de 0,671 y 0,686, respectivamente. Igualmente, WHO-5 WBI presentó alta estabilidad a cuatro semanas con coeficiente de Pearson (r = 0,612; p<0,001) y el CCI 0,613 (IC95 % 0,505-0,702). Conclusiones: WHO-5 WBI presenta aceptable reproducibilidad, estabilidad, a cuatro semanas en estudiantes adolescentes. Se necesita conocer el desempeño de esta escala frente al mejor criterio de referencia, una entrevista clínica estructurada.
Objective: To know the reproducibility of results of the WHO-5 WBI among nine-grade adolescent students in Cartagena (Colombia). Method: A total of 157 students participated in the research with mean age of 15.1 (SD = 1.1), 56.1 % were boys. WHO-5 WBI consists of five items that quantify depressed mood, decreased interest in activities and energy lost during the last two weeks. It was calculated Cronbach alpha and omega McDonald coefficients as indicators of internal consistency; and Pearson correlation coefficient (r) and intraclass correlation coefficient (ICC) as estimators of the stability. Results: WHO-5 WBI showed acceptable internal consistency in the first and second application, Cronbach's alpha of 0.668 and 0.697, respectively, and omega of McDonald and 0.686 0.671, respectively. Similarly, WHO-5 WBI showed high stability over four weeks with Pearson coefficient (r = 0.612, P <0.001) and ICC 0.613 (95% CI 0.505-0.702). Conclusions: The WHO-5 WBI presents acceptable reproducibility over four-weeks among adolescent students. It is needed to know the psychometric performance of the WHO-5 WBI using the best gold standard.
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The purpose of this study was to evaluate the effects of Web-based nutrition education program for junior and senior high school students. Three materials, which were printed materials on Group I, WBI (Web-Based Instruction) leaflet on Group II and the web-based nutrition education program developed in the antecedent research, were applied for 564 students in 3 junior high school and 4 senior high school in Seoul during 4 weeks. Pre-test was done from October 21 to October 26, 2002 and post-test was done from November 25 to December 13, 2002. The statistical data analysis was completed using SPSS WIN (ver. 11.0) for descriptive analysis, t-test and ANOVA. According to the evaluation of effectiveness for web-based nutrition education program, nutrition knowledge, food attitude, food habit and nutrient intake were not significantly improved but positively. And on the evaluation of effectiveness for nutrition education program by materials, WBI was more effective educational materials than WBI leaflet and printed materials. Consequently nutrition knowledge, food attitude, food habit and nutrient intake were improved positively but not significantly using WBI, which was due to the instructional period of the only 4 weeks. Therefore long-term instruction should be required for effective nutrition program, as well as more WBI nutrition education program for high school students would need to be developed in the near future in that WBI was effective material on nutrition education.
Subject(s)
Humans , Data Interpretation, Statistical , Education , Feeding Behavior , SeoulABSTRACT
The purposes of this study were to: a) develop the quality assessment tool of Web-based Instruction (WBI) for nutrition education, b) evaluate the operated WBI (NutriZone) by this tool, and c) do the feasibility study about quality assessment tool for WBI by establishing the instruction and operating strategies. The developed quality assessment tool of WBI for nutrition education was divided into three categories of instructional design, contents and support & operation. And a total of forty items were measured by Likert 5 point scale, computed as one point per item, and amounted to forty points in all. As a result of evaluation, NutriZone got 21.79 out of 40 points and fulfillment rate of 54.5%. The IPA (Importance-Performance Analysis) was applied to establish the instruction and operating strategies, and nine items characterized as attractiveness, multimedia, and learner-initiative were in 'Doing Great, Keep It Up', and so it was regarded as program designed with concern in WBI's characteristics unlike the conventional face-to-face education. But twelve items such as 'Errors on switch to other screens are few.', 'Ready correction leads to be out of systemic error.', 'Highlight marks and moving pictures were used in sign of importance.' and etc. that got high importance and low performance needed to be focused in instructional strategy.
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Education , Feasibility Studies , MultimediaABSTRACT
For the purpose of developing 'Web-Based Nutritional Education Program', this study did instructional analysis, analysis of entry behaviors and learner characteristics to select instructional contents for nutritional education program for junior/senior high school students. Survey questionnaires were distributed from October 21, 2002 to October 26, 2002 to a total of 564 junior/senior high school students in Seoul. The total number of questionnaires collected and used in our study was 479, which is 84.9% of the total questionnaires distributed. As a result of the curriculum analysis of 'Techonolgy-Home economics', subjects related with 'food and nutrition' in the 7th educational course study result, lessons including the contents of food and nutrition were 'nutrition and meal of adolescent' in 7th grade, 'family meal management' in 9th grade and 'practice of home life' in 10th grade. According to the curriculum analysis, 'nutrition' and 'food' were chosen for the superior subjects of nutrition education program and four subordinate subjects per superior one were developed. Then, entry behaviors and learner characteristics were analyzed: life characteristics, internet usage, anthropometrics data and nutritional knowledge. Students were interested in using computer and preferred passive activity to dynamic activity. According to the analysis of internet usage, WBI for students should composed active parts such as game, moving image, immediate reply and follow-up by e-mail, bulletin board and community activity. Students' BMI were in normal range but they were lacked nutritional knowledge. We wrote performance objectives that were specific behavior skills to be learned, the conditions under which they must be performed and the criteria for successful performance. The next step for developing the WBI nutrition education program would be based on the results mentioned above.
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Humans , Curriculum , Education , Electronic Mail , Follow-Up Studies , Internet , Meals , Reference Values , SeoulABSTRACT
For the purpose of developing 'Web-Based Nutritional Education Program', this study analyzed nutritional problems of junior/senior high school students and set appropriate instructional goals for nutritional education program. Survey questionnaires were distributed from October 21,2002 to October 26, 2002 to a total of 564 students at three junior high schools and five senior high schools located in Seoul. The total number of questionnaires collected and used in our study was 479, which is 84.9% of the total questionnaires distributed. According to the survey results, three student groups (male and female students at junior high schools and female students at senior high schools) had lower than an ideal body weight. In case of their Basal Metabolic Indices (BMI), the female students and junior high school students showed a tendency to be underweight, while the other three student groups were within the normal range. The result of the survey showed that all four groups of students showed a deficiency in nutrient intake of calories, calcium and thiamin when compared with Korean RDA. Particularly, in the case of the female students at senior high schools, the deficiency of iron intake was a problem. The survey about food attitudes and food habits of the students showed that the senior high school students had more problems when compared with their junior high school counterparts (p < .001). Therefore, the instructional goals of nutritional education program were set as follows: 1) To improve the level of understanding and the perception of junior and senior high school students about the importance of a dietary lifestyle. 2) To change food attitudes and nutritional knowledge related to individual dietary 1ifestyle, so as to maintain good health through the enhancement of the students' physical activities. We found out that it is critically important to factor in the existing problems of food attitudes and food habits, as well as nutrient intake among junior and senor high school students when setting objectives for nutritional education programs.
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Female , Humans , Calcium , Education , Feeding Behavior , Ideal Body Weight , Iron , Life Style , Motor Activity , Reference Values , Seoul , ThinnessABSTRACT
The purpose of this study was to develop, through the integration of instructional theory, a Courseware and to investigate the effectiveness of a web-based computer assisted instruction(WBI) program for preventing drug abuse, a serious problem for youth problem. During the first stage of this study done "Drug Abuse Prevention" Courseware was developed based on, Gagn & Brigg's instructional design theory, Keller's ARCS theory and the CAI model of Hannafin & Peck. For the second stage, the courseware was used to provide education for students adolescents in drug abuse prevention. This study used an quasi-experimental, one-group pretest-posttest design with a convenience sample of 36 male high school students who were at one high school located in Seoul. Data were collected using self-reported questionnaires which included a learning achievement tool, the Keller's IMMS (Instructional Material Motivation Survey), on attitudes to drug use, and on responses to the WBI instruction. Prior to the experiment, the "drug abuse prevention" learning method and the procedures of the study were explained to the students, and then the learning achievement of the subjects was measured as a pretest. The students were then given 2 weeks WBI utilizing the courseware. A post-test which included the pre-test learning achievement questionnaire and a survey of learning motivation and attitudes toward drug were given two weeks after the education was completed. The data analysis was done using SPSS/PC. Paired t-test was used to analyze the differences between the pre-test and post-test scores for learning achievement. The results of the analysis are as follows: There were significant differences in learning achievement between the pre-test and post-test(t=-18.62, p=0.000). The hypothesis, that learning achievement will be higher, after the class has used the courseware, than before was supported. The scores for learning motivation and attitudes toward drugs were also higher than the results of existing studies. In conclusion, this study suggests that WBI is an effective learning method in the prevention of drug abuse for adolescents as it can be used for self-learning and repeated learning as assisted instruction. Recommendation would be given that further research needs to be develped in the courseware by cognitive learning style and by multimedia courseware and virtual reality system.