Purpose: Anorectal malformations are often associated with other anomalies, reporting frequency with 40-70%. Gastrointestinal anomalies have been known to be relatively less common than associated anomalies of other organ system. This study was performed to assess a distinctive feature of cases associated with esophageal atresia. Methods: Clinical data (from January 2000 through December 2011) on the 196 subjects with anorectal malformations, managed in our Hospital, were reviewed. Total 14 neonates were identified with accompanying esophageal atresia and retrospective analysis was conducted. Results: The incidence was 7.1% and there were 8 male and 6 female subjects. Only 2 cases were associated with esophageal atresia without tracheoesophageal fistula. Although variable cases of anorectal malformation in female subjects, almost cases were anorectal malformations with rectourethral fistula in male. Other associated anomalies were identified in all cases, with more than 3 anomalies in 10 cases. There were 4 VACTERL (Vertebral abnormalities, Anal atresia, Cardiac anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal and Limb anomalies) associations accounting for 28.6%, but could not identify chromosomal anomaly. Most cases were managed with staged procedure, usually primary repair of esophageal atresia and diverting colostomy. Overall mortality rate was 21.4%, mainly caused by heart problems. Conclusion: This study shows that early diagnosis and rational surgical approach with multidisciplinary plan are mandatory in managing anorectal malformations with esophageal atresia, when considering a high frequency of associated anomaly and a relative high mortality.
Sen, Seyhan;Barlas, GulSen;YakiStiran, Selcuk;Derin, ilknur G.;Serifi, Berna A.;Ozlu, Ahmet;Braeckman, lutgart;laan, Gert van der;Dijk, Frank van
Safety and Health at Work
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v.10
no.4
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pp.420-427
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2019
Introduction: To prevent and manage the societal and economic burden of occupational diseases (ODs), countries should develop strong prevention policies, health surveillance and registry systems. This study aims to contribute to the improvement of OD surveillance at national level as well as to identify priority actions in Turkey. Methods: The history and current status of occupational health studies were considered from the perspective of OD surveillance. Interpretative research was done through literature review on occupational health at national, regional and international level. Analyses were focused on countries' experiences in policy development and practice, roles and responsibilities of institutions, multidisciplinary and intersectoral collaboration. OD surveillance models of Turkey, Belgium and the Netherlands were examined through exchange visits. Face-to-face interviews were conducted to explore the peculiarities of legislative and institutional structures, the best and worst practices, and approach principles. Results: Some countries are more focused on exploring OD trends through effective and cost-efficient researches, with particular attention to new and emerging ODs. Other countries try to reach every single case of OD for compensation and rehabilitation. Each practice has advantages and shortcomings, but they are not mutually exclusive, and thus an effective combination is possible. Conclusion: Effective surveillance and registry approaches play a key role in the prevention of ODs. A well-designed system enables monitoring and assessment of OD prevalence and trends, and adoption of preventive measures while improving the effectiveness of redressing and compensation. A robust surveillance does not only provide protection of workers' health but also advances prevention of economic losses.
Concurrent chemo-radiation (CRT) has been established as the standard of care for non-metastatic loco-regionally advanced nasopharyngeal carcinoma (NPC) but recently the addition of induction chemotherapy in the already established regimen has presented an attractive multidisciplinary approach. This retrospective study was carried out to evaluate the efficacy of induction chemotherapy (IC) followed by CRT for the management of loco-regionally advanced NPC. Between July 2005 and September 2010, 99 patients were treated with cisplatin based IC followed by CRT. Induction chemotherapy included a 2 drug combination; intravenous gemcitabine $1000mg/m^2$ on day 1 and 8 and cisplatin $75mg/m^2$ on day 1 only. Radiotherapy (RT) was given as a phase treatment to a total dose of 70 Gy in 35 fractions. Concurrent cisplatin ($75mg/m^2$) was administered to all patients on days 1, 22 and 43. All patients were evaluated for tumor response and adverse effects after IC and 6 weeks after the completion of the treatment protocol. Statistical analysis was performed using SPSS version 17 and Kaplan Meier estimates were applied to project survival. Median follow-up duration was 20 months. The 5-year overall survival (OS), loco regional control (LRC) and relapse free survival (RFS) rates were 71%, 73% and 50%respectively. Acute grade 4 toxicity related to induction chemotherapy and concurrent chemo-radiation was 4% and 2% respectively, with only 3 toxicity-related hospital admissions. We conclude that induction gemcitabine and cisplatin followed by chemo-radiation is a safe and effective regimen in management of nasopharyngeal carcinoma, meriting further investigation in randomized clinical trials.
Objective: Giant invasive pituitary adenoma looks histologically benign, but these tumors have an aggressive clinical course. The authors review 10 cases and discuss the results obtained and the strategy to use for the management of giant invasive pituitary adenoma. Methods: Out of a series of 155 pituitary adenomas treated surgically between 1994 and 2002, ten patients with giant invasive pituitary adenoma were selected and their clinical problems, radiologic findings, extent and invasiveness, hormonal and histologic findings and surgical results were analyzed retrospectively. Results: There were 4 male and 6 female patients, with an average age of 47 years and an average follow-up period of 42 months. The average size of tumor was 50.7mm. These tumors revealed severe invasions into surrounding structures. 8 patients underwent transsphenoidal approach(TSA) operations, 1 patient with transcranial operation and 1 patient with combined TSA and transcranial operation. In all cases, subtotal resection was performed. The histologic findings were 2 prolactinomas and 3 hormonal non-function adenomas. The therapies administered after surgical removal consisted of conventional fractionated radiotherapy (2 patients), treatment with dopamine agonists to control hyperprolactinemia (2 patients), and treatment with hormone replacement (2 patients). Conclusion: Giant invasive pituitary adenomas are characterized by different forms of expansion and invasiveness and variable clinical problems. Because of their aggressive expansion and invasiveness, there are many different strategies which can be considered for their management. The authors obtain good results by choosing conservative surgical removal and multidisciplinary treatments with serial radiological and hormonal follow-up.
Purpose: The purpose of this paper was to explore the meaning of parent participation (PP), to clarify the concept of PP as a benefit to children and their families, and to increase understanding of PP in pediatric nursing practice. Methods: Walker and Avant's approach to concept analysis was used. A search of multidisciplinary literature published between 1994 and 2012 was undertaken using the keyword, 'parent participation' combined with hospitalized children. Attributes, antecedents and consequences were inductively derived from the citations analyzed (n=30). Results: PP was identified as having three attributes: Negotiation, Performing caring activity, Providing individualized care. Antecedents of PP were 'Parents & pediatric nurses' attitudes', 'Children's age', 'Children's conditions'. Consequences of PP were 'Effective partnership', 'Mutual empowerment'. Conclusion: Parent participation as defined by the results of this study should contribute a foundation for theory development in pediatric nursing practice.
According to Ferber (1988), philosophy of science considerations are particularly important for an area like consumer research that seeks to be interdisciplinary. The fact that the topic is studied by so many disciplines with different research traditions immediately raises the question of how one evaluates the (often conflicting) knowledge claims of its various practitioners. Closely related to this is the issue of whether it is even possible to study the topic in a truly interdisciplinary manner or whether a multidisciplinary approach is worth trying. In fact, this issue has triggered heated debates on positivism and relativism in consumer research and a significant number of consumer researchers, though majority of them still resorts to the traditional positivist paradigm, has rejected the tenets of positivism and has turned instead to relativism as the emergent paradigm for knowledge generation. The purpose of this paper is to elaborate on the possibility of eclecticism between positivism and relativism in consumer research. However, self-justifying system of each research camp let any comparison or attempt to reconcile regress to the questioning of philosophical assumption, "Objective reality does exist?", which can not be resolved. As Kuhn (1970) noted, philosophy of science may be chosen for reasons that are ultimately personal and subjective. Therefore, the possibility of eclecticism may be reserved. Rather, complementarity of each research practice can be suggested to make consumer research achieve holistic disciplinary status. Both camps can get nowhere by challenging respective philosophical underpinnings but can advance knowledge on substantive and methodological domains by complementing each other.
Purpose: This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. Methods: We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Results: Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. Conclusion: As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.
Housing can be defined as the vessel containing human life and each country has considerably different form and culture of it. This study aims to understand the society's common cultural values of house selection, decision making, an various housing issues. Consequently, applying a multidisciplinary approach, this project seeks to explore the correlations between people and housing, and between society and housing, to better understand the thought and culture of the housing residents. In order for doing it, adopting cultural value of housing as a tool, a comparative cultural study of housing values in East Asia starting from Korea and China will be conducted. Through such a comparative cultural study, it will be ultimately possible to grasp the locality and uniqueness of specific cultures with more clarity. A survey using questionnaire was conducted on 126 Korean Students and 145 Chinese students who are studying at K University in Seoul on a random sampling basis. The results of survey are as follow. Both Korean and Chinese college students gave higher values on neighborhood environment, convenience of transportation, privacy and safety, and to be given a higher value. On the other hand, they gave lower values on the symbolism of social status. Korean university college students gave higher considerations in the list of , , and than Chinese. Chinese college students gave higher consideration in the list of , and than Koreans. Even though this study has some limitations in generalizing the findings, we can understand the identity of Koreans and Chinese through the comparative study.
The purpose of the study is to explore the relationship among learning motive, job creativity, major satisfaction and school satisfaction of enrolled students in 2 vocational schools in Seoul. Hypotheses based on the relevant literature are tested. Job creativity was found to be positively influenced by learning motives and autonomy. Intrinsic learning motive and autonomy affect student's major satisfaction, but extrinsic learning motive was found to have negative effects on major satisfaction as autonomy trait was irrelevant to school satisfaction. Vocational college programs offer mainly technical and on-the-job training unlike general colleges. Thus, students are psychologically sensitive to school programs and multidisciplinary approach is needed.
Journal of the Korean Academy of Esthetic Dentistry
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v.23
no.1
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pp.27-33
/
2014
The patient was a 26-year old female who was not satisfied with the aesthetic approach of her maxillary incisors. The treatment goal throughout the process was to manage the risk and recreate the original and youthful appearance of the smile. The biomechanical risk was managed by providing coverage of the exposed dentin and rebuilding the eroded structures with minimal tooth reduction throughout the treatment. Functional risk and prognosis for this patient were both improved by achieving acceptable function. The patient was satisfied with the full-ceramic restorations and the symmetry, harmony gingival architecture.
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