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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.

A Study of Drawing Policy Schemes to Establish Marine Clusters - Focused on Shipping Port Logistics Policy - (해양클러스터 구축을 위한 정책 방안 도출에 관한 연구 - 해운항만물류정책을 중심으로 -)

  • Gim, Jingoo;Jo, Jinhaeng;Paik, Jongsil
    • Journal of Korea Port Economic Association
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    • v.29 no.2
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    • pp.173-194
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    • 2013
  • This paper aims at drawing policy schemes to establish marine clusters so as to enhance Korea's global port competitiveness and applying them to its national management for the advancement of national economy through policy suggestions. The research method is an integrated approach(IA) that comprises SWOT Method with strategic approaches, HFP Model enhanced by KJ Method and descriptive deductions. Strategic schemes established for the SPLC are followed by the group of geographical proximity, integration of ICT, expansion of the interchange of ICT & opportunities of ET, integration of ICT services with marine technologies, supply of integrated services in the SPLC and implementation of organizational policies. In order to make a specific implementation of strategic establishment schemes of the SPLC, we need to select a promotion entity. It is advised to establish the joint organization of the public sector and the private sector, which is considered most desirable. In practice, it is to be followed by promoting support schemes of the organizational policy on the level of national management. In order to reinforce this study, further compensative and proactive researches on the offshore sector with marine clusters are required in terms of the development of the high value added 'blue' ocean.

Developing Competency Based Integrated Curriculum for Fostering Sports Marketer in Sports Industry (스포츠마케터 인재양성을 위한 역량기반 융합형 교육과정 개발)

  • Kim, Jin-Se;Ahn, Jai-Han;Kim, Mi-Suk
    • Journal of Digital Convergence
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    • v.16 no.6
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    • pp.449-462
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    • 2018
  • The purpose of this study is to develop a competency-based convergence curriculum for the development of sports marketers, sports talent in the sports industry. For this purpose, we conducted literature analysis, in-depth interviews and job analysis to derive necessary capabilities to become sports marketers, draw up a capability profile, and then developed a capability model through expert verification. Sports marketers ' capacity models were divided into sport marketing / PR and sports events by type of experience, with six common basic competencies including sports mind and 12 professional competencies including sponsorships. Sports marketers education courses developed based on capacity models are composed of understanding of sports industry, sports marketing communication, sports law, understanding of sports facility, sports facilities management, sports sponsorship, sports media, sports licensing, sports agent, sports event planning, sports event management, make a proposal, sports event field practice. The developed training courses for sports marketers will be used in colleges and private education institutions related to the sports industry, contributing to fostering and expanding sports industry talent.

The Economic Comparision through LCC Analysis on each Graded Alternatives for Green Remodeling of Public Building (공공건축물의 그린리모델링 수준별 LCC (Life Cycle Cost) 분석을 통한 경제성 비교)

  • Kim, Jaemoon;Lee, Junghyuk;Lee, Duhwan
    • Korean Journal of Construction Engineering and Management
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    • v.19 no.2
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    • pp.38-49
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    • 2018
  • Since the ratification of the Paris Agreement (COP21), the government is continuously strengthening policies for the reduction of greenhouse gas of the construction industry in accordance with the growing importance of reducing greenhouse gas and obligation of the government. Especially, the government emphasizes the need to improve the energy performance of old public buildings. Since 2014, the government is running a pilot project in which the government supports the construction cost of the green remodeling project of old public buildings and it is intended to develop the best practice of green remodeling and activate the green remodeling in the private sector. In this study, we analyzed the economical efficiency of the old public buildings by each level through green remodeling and conducted building related investigation and equipment measurement to plan the alternatives of the corresponding buildings. The improvement plan is a green remodeling plan that integrates alternatives. Five improvement plans were developed for each level to analyze the economic feasibility of each plan. As for the analysis method, the first energy demand amount calculation and the LCC analysis were performed through ECO2. In the LCC aspect, the improved 3/4 plan (middle level plan) was the most excellent and results were obtained in the order of the highest cost plan followed by the lowest cost plan. As a result, it is expected that it can be utilized as a basic data for future green remodeling performance plan and economic feasibility analysis in the future.

A Critical Review on the Critical Communication Studies in Korea (한국의 비판언론학에 대한 비판적 성찰: 문화연구와 정치경제학을 중심으로)

  • Cho, Hang-Je
    • Korean journal of communication and information
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    • v.43
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    • pp.7-46
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    • 2008
  • The purpose of this essay explores a critical review of the Korean critical communication studies focused on the problematic of cultural studies and political economy in 2000s. The findings are as follows; The 'consumer turn' or 'audience turn' in new revisionism modelling John Fiske's cultural studies has been interpreted not to complement but to substitute the necessary criticism of the post-authoritarian media establishment of Korea at that time, arising identity crisis of Korean cultural studies as one of the critical camp. On other side, however, some political economy studies close to the unilinear theses of orthodox marxism has been appraised to neglect the complex process and structure of media and cultural production as well. While the press war between the market-dominant dailies and some progressive dailies has given rise to a whole debate as expected in consolidating period of Korean emerging democracy, the conjucturalism as modelled by Hall's 'authoritarian populism' failed to initiate a new theo tical practice in Korea. Finally, this review essay propose the some new research issues that would converge cultural studies and political economy, modernism and postmodernism; citizenship vs 'cultural citizenship'(valuing the private identity and gender) or Habermasian public sphere vs 'cultural public sphere', the culture of production, (modern)citizen/(postmodern)consumer(recently debated in English media policy), 'differentiation' in capitalist production and 'difference' in consumer sovereignty, 21c future vision of public service broadcasting as one of the 20c institutions.

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Effects of incorporation of 2.5 and 5 wt% TiO2 nanotubes on fracture toughness, flexural strength, and microhardness of denture base poly methyl methacrylate (PMMA)

  • Naji, Sahar Abdulrazzaq;Behroozibakhsh, Marjan;Kashi, Tahereh Sadat Jafarzadeh;Eslami, Hossein;Masaeli, Reza;Mahgoli, Hosseinali;Tahriri, Mohammadreza;Lahiji, Mehrsima Ghavvami;Rakhshan, Vahid
    • The Journal of Advanced Prosthodontics
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    • v.10 no.2
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    • pp.113-121
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    • 2018
  • PURPOSE. The aim of this preliminary study was to investigate, for the first time, the effects of addition of titania nanotubes ($n-TiO_2$) to poly methyl methacrylate (PMMA) on mechanical properties of PMMA denture base. MATERIALS AND METHODS. $TiO_2$ nanotubes were prepared using alkaline hydrothermal process. Obtained nanotubes were assessed using FESEM-EDX, XRD, and FT-IR. For 3 experiments of this study (fracture toughness, three-point bending flexural strength, and Vickers microhardness), 135 specimens were prepared according to ISO 20795-1:2013 (n of each experiment=45). For each experiment, PMMA was mixed with 0% (control), 2.5 wt%, and 5 wt% nanotubes. From each $TiO_2$:PMMA ratio, 15 specimens were fabricated for each experiment. Effects of $n-TiO_2$ addition on 3 mechanical properties were assessed using Pearson, ANOVA, and Tukey tests. RESULTS. SEM images of $n-TiO_2$ exhibited the presence of elongated tubular structures. The XRD pattern of synthesized $n-TiO_2$ represented the anatase crystal phase of $TiO_2$. Moderate to very strong significant positive correlations were observed between the concentration of $n-TiO_2$ and each of the 3 physicomechanical properties of PMMA (Pearson's P value ${\leq}.001$, correlation coefficient ranging between 0.5 and 0.9). Flexural strength and hardness values of specimens modified with both 2.5 and 5 wt% $n-TiO_2$ were significantly higher than those of control ($P{\leq}.001$). Fracture toughness of samples reinforced with 5 wt% $n-TiO_2$ (but not those of 2.5% $n-TiO_2$) was higher than control (P=.002). CONCLUSION. Titania nanotubes were successfully introduced for the first time as a means of enhancing the hardness, flexural strength, and fracture toughness of denture base PMMA.

Regional Distribution and Practice Pattern of Pediatric Dental Clinics in Korea (한국에서 소아전문 치과의원의 지역분포 및 진료패턴)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.1
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    • pp.44-52
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    • 2020
  • The number of pediatric dental clinics has been increasing due to the development of dentistry and changes in public awareness of professional dental care for children. The purpose of this study was to investigate the present status of pediatric dental clinics in Korea in several respects, including regional distribution. There were 343 pediatric dental clinics (1.91%) among 17,917 dental clinics in Korea. 248 out of 343 private practitioners were board certified pediatric dentists. Of 248 board certified pediatric dentists, 25 displayed the specialty in their clinics' name. Gyeonggi occupied largest share of the total pediatric dental clinics in Korea, followed by Seoul and Busan. Gangnam-gu occupied largest share of the total pediatric dental clinics in Seoul. Out of all pediatric dental clinics in Korea, 78.7% was run by only one dentist. 90.9% of pediatric dental clinics didn't do night clinic on weekdays and 26.5% was open until after 15:00 on Saturday.

Clinicopathological Profile of Head and Neck Cancers in the Western Development Region, Nepal: A 4-Year Snapshot

  • Lasrado, Savita;Prabhu, Prashanth;Kakria, Anjali;Kanchan, Tanuj;Pant, Sadip;Sathian, Brijesh;Gangadharan, P.;Binu, V.S.;Arathisenthil, S.V.;Jeergal, Prabhakar A.;Luis, Neil A.;Menezes, Ritesh G.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6059-6062
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    • 2012
  • Regional cancer epidemiology is an important basis for determining the priorities for cancer control in different countries worldwide. There is no reliable information about the pattern of head and neck cancer in western Nepal and hence an attempt was here made to evaluate the situation based on hospital data, which provide the only source in the western region of Nepal. A clinicopathological analysis of head and neck cancers treated between 2003 and 2006 in Manipal Teaching Hospital affiliated to Manipal College of Medical Sciences, Pokhara, Western Development Region, Nepal was performed. A total of 105 head and neck cancer cases were identified with a male to female ratio of 1.8:1. The median ages of male and female patients were 62 and 64 years, respectively. Ninety-seven (92.4%) of the cancer patients were suffering from carcinoma, three (2.9%) had blastoma, three (2.9%) had sarcoma, and two (1.9%) had lymphoma. The majority (61.9%) of carcinoma cases were squamous cell carcinoma followed by anaplastic carcinoma (7.2%). Of the carcinoma cases, the most common site of primary lesion was larynx (19.6%), followed by the thyroid (14.4%), the tongue and hypopharynx with 10.3% cases each. Comparative analysis among males and females did not reveal any sex difference in type of head and neck cancers. The head and neck cancer pattern revealed by the present study provides valuable leads to cancer epidemiology in western Nepal and useful information for health planning and cancer control, and future research in western Nepal.

The Recent Practice of Evaluation of Government-sponsored Research Institutes(GRIs) in Korea : From Retrospective to Forward-looking perspective (이공계 정부출연(연) 기관평가모형개발 및 적용사례 연구)

  • 이철원;현재호
    • Proceedings of the Technology Innovation Conference
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    • 1998.06a
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    • pp.131-163
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    • 1998
  • The interest in the evaluation of government-sponsored research institutes (GRIs) has increased markedly in Korea in 1990s; this is mainly because of the increasing needs 1) to improve the quality of R&D at GRIs, and 2) to reorient the GRIs' strategic position in Korean national innovation systems due to the enhancement of R&D capabilities of private companies and universities during last decade. As a first attempt to diagnose the managerial and strategic issues of GRIs, a Multi-Ministerial Evaluation Committee was established as an ad hoc task force under the Prime Minister's Office in 1991. According to the recommendations of the committee, the Ministry of Science and Technology (MOST) to which most of GRIs were affiliated, made it a rule to evaluate the annual performance of GRIs since 1992. This paper examines the recent experience of MOST's evaluation of Government-sponsored Research Institute in Korea. After several years'efforts of Science & Technology Policy Institute(STEPI) to build prospective evaluation systenL MOST decided to apply two supplementary approaches for the evaluation of GRIs; one is summative annual evaluation and the other is formative 3-year evaluation. The annual evaluation system that is designed as a temporary measure is to monitor and to guide the self-evaluation activities of GRIs. In the process of annual evaluation, MOST tries to minimize its direct involvement, and allows each GRI to develop self-evaluation system that is most appropriate for the unique characteristics of the institute. If there exist urgent issues under scrutiny, however, it can be incorporated and examined by a group of external experts as special issues in the annual evaluation system. The aim of 3-year evaluation is both to examine the past performance of each GRI and to investigate whether the strategic role of each GRI is viable in the future. Its major focus, however, lies not on auditing past performance but on strengthening future strategic position of each GRI. The MOST designates a group of evaluation experts with appropriate knowledge and competence as members of the General Evaluation Committee for one year. With the help of STEPI, a specialized research institute for R&D evaluation, the General Evaluation Committee develops methodology and procedures for the actual evaluation of GRIs. Based on the evaluation reports and recommendations from the General Evaluation Committee, the MOST develops various policy measures for strengthening GRIs.

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A Study on Teaching Competence and Attitudes of School Nurses for Health Education (학교보건수업에 대한 양호교사의 태도 및 교수능력의 인식도에 관한 조사연구 -서울시 중학교 양호교사를 중심으로-)

  • Kim, Jae Hee
    • Journal of the Korean Society of School Health
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    • v.10 no.1
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    • pp.41-50
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    • 1997
  • The purpose of this study is to provide fundamental data supporting facilitation of a formal health education performed by school nurses as health educators. To evaluate the teacher expertise of school nurses as health educators, this study analyzed the present status of health education and the recognition of self-confidence in teaching ability of school nurses. Self addressing questionnaire were mailed out to 340 secondary school nurses in Seoul and out of them 244 nurses (71.8%) responded to the survey. Analysis of the data was made using t-test and ANOVA in SAS program. The major results are as follows : 1. The total health instruction performance rate was 84.6% (204). Regular health instruction was carried out by 66 nurses and the rest of the 155 subjects gave irregular instruction on health education. 2. Regular health education classes was offered as a part of physical education class hour by 89.4% of the respondents whereas only 10.6% of them had formal health education classes. The survey showed that irregular health education classes were mainly held in physical education class hours (70.3%) and 14.8% had opportunities for additional classes on health education. 3. The average class for regular health education was 5 hours per week but for irregular health education classes were only one hour per semester (32.9%). 4. Among the 11 categories of health education, education on drug abuse and body structure and function and physical development occupied 95.6%, 69.6% respectably while physical training, family health, social health occupied 10.8%, 12.7%. 5. Health education was given much more at public schools (88.2%) than at private schools. 6. 232 (95.0%) school nurses agreed with the necessity of formalizing health education classes and 227 (93.1%) wanted to change their status from school nurses to formal health teachers. 7. There is a tendency to change the status from school nurse to formal health teacher, and the necessity of having a formal curriculum on health education while less recognized by the older and longer-careered nurses was more recognized by those nurses with higher education. 8. The lack of administrative support (79.5%), work burden (77.9%), and lack of teaching competency (22.1%) were the greatest problems. 9. Education on drug abuse was stressed the most whereas physical training was most neglected. 10. There is a tendency that older and longer-careered school nurses thought less positively of their status, and then 98 (81.1%) school nurses acknowledged themselves as professional teachers. 11. 176 (72.5%) school nurses agreed with the necessity of continuing education : health knowledge and teaching skills for formal health teachers. 12. 179 (73.8%) school nurses had a positive attitude and undergraduate preparation and the practice of professional health teachers. 13. The school nurses had self-confidence in their teaching competence, teaching strategies and knowledge in all 11 health education areas.

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