• Title/Summary/Keyword: Long Term Response

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Screening for Patients with Non-small Cell Lung Cancer Who Could Survive Long Term Chemotherapy

  • Wu, Xue-Yan;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.647-652
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    • 2015
  • Background: Lung cancer was one of the most common cancers in both men and women all over the world. In this study, we aimed to clarify who could survive after long term chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Methods: We enrolled 186 patients with stage IV NSCLC after long term chemotherapy from Jun 2006 to Nov 2014 diagnosed in Jiangsu Cancer Hospital. Multiple variables like age, gender, smoking, histology of adenocarcinoma and squamous-cell cancer, number of metastatic sites, metastatic sites (e.g. lung, brain, bone, liver and pleura), hemoglobin, lymphocyte rate (LYR), Change of LYR during multiple therapies, hypertension, diabetes, chronic bronchitis, treatments (e.g.radiotherapy and targeted therapy) were selected. For consideration of factors influencing survival and response for patients with advanced NSCLC, logistic regression analysis and Cox regression analysis were used in an attempt to develop a screening module for patients with elevated survival after long term chemotherapy become possible. Results: Of the total of 186 patients enrolled, 69 survived less than 1 year (short-term group), 45 one to two years, and 72 longer than 3 years (long-term group). For logistic regression analysis, the short-term group was taken as control group and the long-term group as the case group. We found that age, histology of adenocarcinoma, metastatic site (e.g. lung and liver), treatments (e.g. targeted therapy and radiotherapy), LYR, a decreasing tendency of LYR and chronic bronchitis were individually associated with overall survival by Cox regression analysis. A multivariable Cox regression model showed that metastatic site (e.g. lung and liver), histology of adenocarcinoma, treatments (e.g. targeted therapy and radiotherapy) and chronic bronchitis were associated with overall survival. Thus metastatic site (e.g. lung and liver) and chronic bronchitis may be important risk factors for patients with advanced NSCLC. Gender, metastatic site (e.g. lung and liver), LYR and the decreasing tendency of LYR were significantly associated with long-term survival in the individual-variable logistic regression model (P<0.05). On multivariate logistic regression analysis, gender, metastatic site (e.g. lung and liver) and the decreasing tendency of LYR associated with long-term survival. Conclusions: In conclusion, female patients with stage IV adenocarcinoma of NSCLC who had decreasing tendency of LYR during the course therapy and had accepted multiple therapies e.g. more than third-line chemotherapy, radiotherapy and/or targeted therapy might be expected to live longer.

Factors related to Family Caregiver Satisfaction with the Institutional care services under the Public Long-Term Care Insurance system (노인장기요양보험 시설서비스에 대한 가족수발자 만족도 영향 요인)

  • Kwon, Jin-Hee;Han, Eun-Jeong;Lee, Jung-Suk
    • Health Policy and Management
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    • v.19 no.4
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    • pp.78-97
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    • 2009
  • This study examined the factors related to family caregiver satisfaction with institutional care services for beneficiaries under the Public Long-Term Care Insurance(PLTCI) system. Determining what contributes to family caregiver satisfaction is a critical step toward implementing effective quality improvement strategies. A national cross-sectional descriptive survey was conducted from November to December 2008, using proportionate quota sampling based on the location and level of Long-Term Care of the beneficiaries. Total 1,745 family caregivers wrote informed consents and 733 (response rate 42%) completed questionnaires, which included caregiver characteristics, organizational resources, primary objective and subjective stressors, perceived quality of services, and family caregiver satisfaction. Family caregivers were satisfied overall with institutional care. In multiple regression analysis, there was a statistically significant difference in degree of family caregiver satisfaction according to caregiver characteristics(relationship to beneficiary), primary objective stressors (insurance type of beneficiary), perceived quality of services(respect to family caregivers' idea, ADL support, expertness of staff, careful concern of staff, fulfillment of client's requests, and safety of institution's environment). In public long-term care, satisfaction efforts are in an early stage of development. This study is meaningful as the first attempt to measure family caregiver satisfaction with institutional care for beneficiaries under the PLTCI system, and to identify factors affecting the satisfaction. Among the identified factors, the policy makers, the insurer, and the providers need to pay attention to perceived quality of services, in particular, to improve customer satisfaction. Our findings can provide quality care improvement initiatives in the public long-term care setting.

Multifunctional services and space composition in small elderly care facilities - Analysis of pioneering care facilities in Japan (takurosho) - (소규모 고령자 복지시설에서의 서비스 다기능화와 공간구성 - 일본의 선진사례 택로소를 중심으로 -)

  • Kim, Sung-Ryong;Takemiya, Kenji
    • Journal of the Korean Institute of Rural Architecture
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    • v.18 no.3
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    • pp.9-16
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    • 2016
  • This study aimed to clarify the multifunctional services and space composition in the process of developing a multifunctional long-term care program in small elderly care facilities in Japan. We collected data about multifunctional long-term care at small facilities from the Community Life Support Center (CLC), a Japanese non-profit corporation, and conducted an interview survey of the members of the CLC's secretariat in 2014. Furthermore, we selected 3 Japanese pioneering care facilities (known as takurosho), and conducted interview surveys and data collection to clarify in detail the space composition and process of development of multifunctional long-term care at small facilities. Four distinct results were found. First, the facilities had gradually increased non-institutional services, including visitation, overnight stays, and long-term stays, to fit the needs of users and their families. Secondly, in the 1990s, they could offer both non-institutional and institutional services at the same facility, but after the long-term care insurance system began in 2000, non-institutional long-term stay services were not allowed. Third, the facilities had built extensions or extra rooms in response to increases in multifunctional services and users. These rooms had common characteristics, with sitting rooms at the center of the facility. Lastly, the maximum number of service users at each of the 3 facilities was limited to 15, to maintain a small scale. However, as the size of facilities was increased through building extensions or remodeling, the overall amount of area available to users increased.

Effects of 4% Hypertonic Saline Solution Mouthwash on Oral Health of Elders in Long Term Care Facilities (4% 고농도 식염수를 이용한 구강함수가 요양시설 입소노인의 구강건강에 미치는 효과)

  • Kim, Ju Ok;Kim, Nam Cho
    • Journal of Korean Academy of Nursing
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    • v.44 no.1
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    • pp.13-20
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    • 2014
  • Purpose: This study was done to examine the effects of 4% hypertonic saline solution mouthwash and tooth brushing education on the oral health of elders living in long term care facilities. Methods: In this quasi-experimental study, the participants were assigned to a 2% experimental group (n=20), a 4% experimental group (n=20), and a control group (n=20). Data were analyzed using ANOVA, repeated measures ANOVA, Fisher exact test, Chi-square test, Kruskal-Wallis test and multiple response analysis with the SAS program. Results: Regular tooth brushing and use of 4% hypertonic saline solution mouthwash by elders provided better oral health by decreasing xerostomia, oral tongue plaque, halitosis, and the number of oral bacteria. Conclusion: The results indicate that regular tooth brushing with continuous 4% hypertonic saline solution mouth washing education promotes oral health for elders in long term care facilities, thus the dental care described in this study is recommended for elders in long term facilities.

Exercise induced Right Ventricular Fibrosis is Associated with Myocardial Damage and Inflammation

  • Rao, Zhijian;Wang, Shiqiang;Bunner, Wyatt Paul;Chang, Yun;Shi, Rengfei
    • Korean Circulation Journal
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    • v.48 no.11
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    • pp.1014-1024
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    • 2018
  • Background and Objectives: Intense exercise (IE) induced myocardial fibrosis (MF) showed contradictory findings in human studies, making the relationship between IE and the development of MF unclear. This study aims to demonstrate exercise induced MF is associated with cardiac damage, and inflammation is essential to the development of exercise induced MF. Methods: Sprague-Dawley rats were submitted to daily 60-minutes treadmill exercise sessions at vigorous or moderate intensity, with 8-, 12-, and 16-week durations; time-matched sedentary rats served as controls. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum cardiac troponin I (cTnI) concentration. After completion of the exercise protocol rats were euthanized. Biventricular morphology, ultrastructure, and collagen deposition were then examined. Protein expression of interleukin $(IL)-1{\beta}$ and monocyte chemotactic protein (MCP)-1 was evaluated in both ventricles. Results: After IE, right but not left ventricle (LV) MF occurred. Serum cTnI levels increased and right ventricular damage was observed at the ultrastructure level in rats that were subjected to long-term IE. Leukocyte infiltration into the right ventricle (RV) rather than LV was observed after long-term IE. Long-term IE also increased protein expression of proinflammation factors including $IL-1{\beta}$ and MCP-1 in the RV. Conclusions: Right ventricular damage induced by long-term IE is pathological and the following inflammatory response is essential to the development of exercise induced MF.

Long-term management of Graves disease: a narrative review

  • Hyo-Jeong Kim
    • Journal of Yeungnam Medical Science
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    • v.40 no.1
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    • pp.12-22
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    • 2023
  • Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient's drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.

Dynamic deflection monitoring method for long-span cable-stayed bridge based on bi-directional long short-term memory neural network

  • Yi-Fan Li;Wen-Yu He;Wei-Xin Ren;Gang Liu;Hai-Peng Sun
    • Smart Structures and Systems
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    • v.32 no.5
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    • pp.297-308
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    • 2023
  • Dynamic deflection is important for evaluating the performance of a long-span cable-stayed bridge, and its continuous measurement is still cumbersome. This study proposes a dynamic deflection monitoring method for cable-stayed bridge based on Bi-directional Long Short-term Memory (BiLSTM) neural network taking advantages of the characteristics of spatial variation of cable acceleration response (CAR) and main girder deflection response (MGDR). Firstly, the relationship between the spatial and temporal variation of the CAR and the MGDR is described based on the geometric deformation of the bridge. Then a data-driven relational model based on BiLSTM neural network is established using CAR and MGDR data, and it is further used to monitor the MGDR via measuring the CAR. Finally, numerical simulations and field test are conducted to verify the proposed method. The root mean squared error (RMSE) of the numerical simulations are less than 4 while the RMSE of the field test is 1.5782, which indicate that it provides a cost-effective and convenient method for real-time deflection monitoring of cable-stayed bridges.

A Study on Corporate Support for Employment of Retirees in Gyeongsangnam-do Employment Crisis

  • Jang, Yumi
    • International Journal of Advanced Culture Technology
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    • v.10 no.3
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    • pp.33-38
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    • 2022
  • Gyeongsangnam-do needed an employment stability response policy to induce re-employment of job seekers who retired due to large-scale unemployment and job instability following the employment crisis, and stable settlement and long-term employment after new employment.This study is to confirm the effective corporate support policy as an employment promotion strategy through new recruitment of the employment crisis in Gyeongsangnam-do. A total of 380 companies in Gyeongsangnam-do were targeted for the survey through online surveys and in-person surveys. As a result of the study, as a measure to improve working conditions through financial support for long-term employment stability, first, support for youth-middle-age asset formation of SME workers is required, and second, support for old-age income guarantee for SME workers was proposed. Third, direct corporate subsidies are continuously needed for job promotion and job stability of Gyeongsangnam-do companies.

A Study on Facilites Safety of Long-Term Care Facilities for Elderly :Focused on the Factual Survey of Seoul Metropolitan Area (장기요양시설의 노인보호를 위한 시설안전에 관한 연구 : 수도권 시설안전 실태조사를 중심으로)

  • Moon, Yongpil
    • The Journal of the Korea Contents Association
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    • v.20 no.10
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    • pp.308-325
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    • 2020
  • This study examines factual facilites safety of long-term care facilities for eldery, for improvement of Korean policy. So, This study reviewed policies of facilites safety of long-term care facilities on main OECD countries. We analyzed factual survey of facilites safety of long-term care facilities in Seoul metropolitan area. The results of the study were as follows: First, There were differences of law and rule of facilites safety of long-term care facilities in comparison with those of social welfare facilities, child day-care center, hospital. Second, it was the result of location condition analysis. Long-term care facilities in the Seoul metropolitan area were located on more than six floors of buildings. The location conditions of private facilities are weak compared to those of corporations and local governments. Third, there were the result of internal structure of facilities. Overall, the placement status was insufficient. For instance, there are smokeproof masks/fireproof blankets, smoke windows(fire safety windows), smoke smothering. In addition, there were places where legal essential installation structures were insufficient. Private facilities were generally insufficient in facility structures compared to those of local governments and welfare corporations. Fourth, there were the result of safety management. It was confirmed that private facilities were insufficient compared to local government facilities. For instance, there are safety management analysis, response manuals, fire preparedness training, etc. Finally, implications and future directions policies of facilites safety of long-term care facilities were discussed based on the finding of the study.

Efficacy of the Disappearance of Lateral Spread Response before and after Microvascular Decompression for Predicting the Long-Term Results of Hemifacial Spasm Over Two Years

  • Kang, Min-Cheol;Choi, Yu-Seok;Choi, Hak-Ki;Lee, Sang-Hoon;Ghang, Chang-Gu;Kim, Chang-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.372-376
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    • 2012
  • Objective : The purpose of this large prospective study is to assess the association between the disappearance of the lateral spread response (LSR) before and after microvascular decompression (MVD) and clinical long term results over two years following hemifacial spasm (HFS) treatment. Methods : Continuous intra-operative monitoring during MVD was performed in 244 consecutive patients with HFS. Patients with persistent LSR after decompression (n=22, 9.0%), without LSR from the start of the surgery (n=4, 1.7%), and with re-operation (n=15, 6.1%) and follow-up loss (n=4, 1.7%) were excluded. For the statistical analysis, patients were categorized into two groups according to the disappearance of their LSR before or after MVD. Results : Intra-operatively, the LSR was checked during facial electromyogram monitoring in 199 (81.5%) of the 244 patients. The mean follow-up duration was $40.9{\pm}6.9$ months (range 25-51 months) in all the patients. Among them, the LSR disappeared after the decompression (Group A) in 128 (64.3%) patients; but in the remaining 71 (35.6%) patients, the LSR disappeared before the decompression (Group B). In the post-operative follow-up visits over more than one year, there were significant differences between the clinical outcomes of the two groups (p<0.05). Conclusion : It was observed that the long-term clinical outcomes of the intra-operative LSR disappearance before and after MVD were correlated. Thus, this factor may be considered a prognostic factor of HFS after MVD.