• Title/Summary/Keyword: Weekly management

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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.

Effects of Acceptance and Commitment Therapy on Stress, Anxiety, and Acceptance of Reserve Officers Training Corps: A pilot study (수용전념치료가 학군사관 후보생의 스트레스, 불안 및 수용에 미치는 효과에 대한 예비연구)

  • On, An-Kook;Son, ChongNak
    • Journal of Digital Convergence
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    • v.15 no.10
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    • pp.261-268
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    • 2017
  • The study is designed to explore the effects of the Acceptance-Commitment Therapy (ACT) on Reserve Officer's Training Corps (ROTC)' stress, anxiety, and acceptance. Among the total of 82 ROTC, total of 12 participants whom showed over-average scores for stress and anxiety and agreed to participate in study were selected. The ACT group received twice-weekly, approximately 90 minute, total of 8 sessions of ACT program Both groups filled out Perceived Stress Scale, State-Trait Anxiety Inventory, and Acceptance and Action Questionnaire each before, at the end of, and 4 weeks after the program. The result showed that the group that participated in ACT program showed significant decrease in stress and anxiety, and although the overall acceptance behavior showed no significant change, the Acceptance - a subfactor of the scale - showed significant increase. This study suggest empirical evidence to prove that the ACT is effective in reducing stess and anxiety of ROTC. However, the study has only few ROTC participants and thus has limitations. Therefore it is crucial that future studies are conducted addressing this issue.

Clinical Efficacy of Individual Cognitive Behavioral Therapy for Patients with Primary or Secondary Insomnia (일차성 및 이차성 불면증 환자에서의 개별 인지행동치료의 임상적 효능)

  • Shin, Youn-Mi;Cha, Bo-Seok;Lim, Chae-Mi;Shin, Hong-Beom
    • Sleep Medicine and Psychophysiology
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    • v.17 no.1
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    • pp.34-40
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    • 2010
  • Objectives: This study aimed to evaluate the clinical efficacy of individual cognitive behavioral therapy (CBT) for Patients with Primary or Secondary Insomnia. Methods: Participants were recruited from a primary care sleep clinic from January 2008 to June 2009. The study sample included 64 outpatients with primary insomnia (n=30) and secondary insomnia (n=34) according to the criteria of DSM-IV. Participants completed sleep diaries, Dysfunctional Beliefs and Attitudes about Sleep Scale-16 (DBAS), State-Trait Anxiety Inventory (STAI) before CBT and shortly after completion of CBT. CBT was provided in 7 weekly, 40-50-minute individual therapy sessions. Results: Both groups of patients with primary and secondary insomnia showed significant improvement in the DBAS and sleep parameters including sleep onset latency, total sleep time, and sleep efficiency. Repeated-measures ANOVA of the DBAS and sleep parameters showed no significant group-by-time interactions between patients with primary and secondary insomnia, suggesting the efficacy of CBT for patients with secondary insomnia was equivalent to that of CBT for patients with primary insomnia. Conclusion: This study suggests that CBT is effective for the management of primary and secondary insomnia in a primary care setting.

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An Emotional Self-Regulation Program for Obese Children: Pilot Study Using Mixed Methods (비만아동을 위한 정서적 자기조절 프로그램의 개발 및 효과: 혼합방법론의 적용)

  • Kim, Hee-Soon;Ma, Yu-Mi;Park, Ji-Young;Kim, Seung-Hyun
    • Child Health Nursing Research
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    • v.19 no.3
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    • pp.187-197
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    • 2013
  • Purpose: The purpose of the study was to develop an emotional self-regulation program for obese children and to examine the program's effectiveness on depression, eating habits, and body mass index. Methods: The emotional self-regulation program was developed from theory-based strategies and a pre-post pilot study was conducted with 46 children (19: intervention, 27: control). The program included 6 weekly group sessions over 2 months. The embedded experimental model of concurrent mixed methods was used to better understand research outcomes by converging both quantitative and qualitative data. Anthropometric measurements and surveys were performed before and after the intervention. Three focus group interviews were conducted with all participants after intervention to explore their experiences. Results: The intervention group displayed decreased depression levels in the quantitative outcomes. The participants also expressed positive outcomes such as improvements in confidence, impulse management, intimacy, happiness, and losing weight. Conclusion: These findings suggest that emotional self-regulation skills are crucial factors for obese children not only to manage their emotional problems but also to control their weight. Further research is needed with a larger sample size and randomized controlled trials.

A study to Find Factors of the Box Office Record in Korean Popular Music : by Control Effects of Management Companies and Distribution Companies (대중음악 흥행결정요인이 국내대중음악 흥행성과에 미치는 영향 : 기획사와 유통사의 조절효과를 중심으로)

  • Kim, Yang Sug;Lee, Sang Houck
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.10 no.1
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    • pp.23-31
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    • 2015
  • The purpose of this study is to find the factors of the box office record in Korean popular music. For this purpose, 1.239 musics were selected in the Gaon digital weekly album chart from second week July 2013 to first week July 2014. The result can be summarized as follows: First, entertainment of music company, distribution of music company, singer, OST(Original Sound Track), television show, SNS and high ranking in the first week of its release are the factors of the box office record in Korean popular music. Second, entertainment of a large number of music production company is more effective than the others, but there is no difference in the case of distribution music company. Third, musics of singers who have large number of music ranked Gaon digital chart and appearance of television show program are effective in the box office record in Korean popular music. Fourth, SNS are great factors to promote Korean popular music. Fifth, it is important to rank high position in the first week of its release.

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A study on the state of customized visiting oral health programs (맞춤형 방문구강보건사업 현황조사)

  • Jung, Jae-Yeon
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.4
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    • pp.606-619
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    • 2009
  • Objectives : This study was to examine the state of customized visiting oral health programs in a bid to help facilitate the unified operation of the programs and the development of required guidelines. Methods : The subjects in this study were 49 dental hygienists who were professionals responsible for customized visiting health care programs across the nation. Results : 1. Regarding the form of employment of the dental hygienists were investigated many contract and daily workers. 2. As to the possession of equipment necessary for visiting oral health programs, denture cleaners(12.2%) were most widely possessed in some regions, followed by mobile scalers(10.2%) and mobile suctions(8.2%). In terms of expendable devices and materials, dental mirrors, pincettes and explorers were the most widely possessed dental checkup devices, and the most widely possessed oral hygiene supplies were toothbrushes, interdental brushes and denture cleaners. Those devices and materials were in more possession than the other types of devices and materials. The most widely possessed equipment for educational purpose was laptop computers, followed by beam projectors and screens. The most widely possessed teaching materials were dentiform, followed by CD-ROMs. 3. Those whom they visited the most for oral health care service were elderly people, followed by the disabled and patients with chronic diseases. The dental hygienists who went out to visit those people outnumbered the others who stayed at public health centers. Concerning the types of visiting oral health care service, the most prevalent service provided to the elderly included denture cleaning/management, oral massage and preventive treatment against dental caries. The most dominant service provided to the disabled involved education of the oral health care act, preventive treatment against dental caries and toothbrushing by professionals. The most common service offered to patients with chronic diseases was education of the oral health care act and oral health education. The dental hygienists paid a visit to a mean of 5.8 households a day. The average weekly number of households cared by the dental hygienists was 27.3. It took a mean of 37.1 minutes for them to take care of each household. 4. As for satisfaction level with the implementation of the visiting oral health programs, they expressed the greatest satisfaction at teamwork with professionals($3.56{\pm}0.94$), followed by the professionalism of their work($3.21{\pm}0.94$) and workload($3.08{\pm}0.94$). Their satisfaction level with the work conditions required for creative job performance($2.75{\pm}0.98$) and partnership with other institutions($2.64{\pm}1.03$) was below 3.0. In regard to the impact of their characteristics, marital status made a statistically significant difference to satisfaction level with workload. The unmarried dental hygienists were more pleased with their workload than the married ones(p<0.05). 5. As to needs for education for professionalism improvement, they asked for education about visiting oral health care skills the most, followed by education about oral health care for patients with chronic diseases, education of planning/evaluation and education of oral health care for the disabled. Conclusions : The top priority for the vitalization of the programs was the procurement of budget, followed by the procurement of equipment and educational media and the procurement of human resources.

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Feasibility Study of Deep Inspiration Breath-Hold Based Volumetric Modulated Arc Therapy for Locally Advanced Left Sided Breast Cancer Patients

  • Swamy, Shanmugam Thirumalai;Radha, Chandrasekaran Anu;Kathirvel, Murugesan;Arun, Gandhi;Subramanian, Shanmuga
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.9033-9038
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    • 2014
  • Background: The purpose of this study was to assess the feasibility of deep inspiration breath-hold (DIBH) based volumetric modulated arc therapy (VMAT) for locally advanced left sided breast cancer patients undergoing radical mastectomy. DIBH immobilizes the tumor bed providing dosimetric benefits over free breathing (FB). Materials and Methods: Ten left sided post mastectomy patients were immobilized in a supine position with both the arms lifted above the head on a hemi-body vaclock. Two thermoplastic masks were prepared for each patient, one for normal free breathing and a second made with breath-hold to maintain reproducibility. DIBH CT scans were performed in the prospective mode of the Varian real time position management (RPM) system. The planning target volume (PTV) included the left chest wall and supraclavicular nodes and PTV prescription dose was 5000cGy in 25 fractions. DIBH-3DCRT planning was performed with the single iso-centre technique using a 6MV photon beam and the field-in-field technique. VMAT plans for FB and DIBH contained two partial arcs ($179^{\circ}-300^{\circ}CCW/CW$). Dose volume histograms of PTV and OAR's were analyzed for DIBH-VMAT, FB-VMAT and DIBH-3DCRT. In DIBH mode daily orthogonal ($0^{\circ}$ and $90^{\circ}$) KV images were taken to determine the setup variability and weekly twice CBCT to verify gating threshold level reproducibility. Results: DIBH-VMAT reduced the lung and heart dose compared to FB-VMAT, while maintaining similar PTV coverage. The mean heart $V_{30Gy}$ was $2.3%{\pm}2.7$, $5.1%{\pm}3.2$ and $3.3%{\pm}7.2$ and for left lung $V_{20Gy}$ was $18.57%{\pm}2.9$, $21.7%{\pm}3.9$ and $23.5%{\pm}5.1$ for DIBH-VMAT, FB-VMAT and DIBH-3DCRT respectively. Conclusions: DIBH-VMAT significantly reduced the heart and lung dose for left side chest wall patients compared to FB-VMAT. PTV conformity index, homogeneity index, ipsilateral lung dose and heart dose were better for DIBH-VMAT compared to DIBH-3DCRT. However, contralateral lung and breast volumes exposed to low doses were increased with DIBH-VMAT.

Analysis and Investigation for the Status of Radiation Therapy QA in Korea (국내 방사선치료기기의 품질관리 현황조사 및 분석)

  • Lee, Sang-Hoon;Kim, Ju-Ree;Cho, Sam-Ju;Cho, Kwang-Hwan;Lim, Chun-Il;Kim, Hyeog-Ju;Huh, Hyun-Do;Shin, Dong-Oh;Kwon, Soo-Il;Choi, Jin-Ho
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.223-231
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    • 2010
  • We have taken surveys about total 72 departments of radiation oncology which is performing the treatment with linear accelerator and brachytherapy unit in Korea. The survey was included the research about the linear accelerator, brachytherapy, Also, we surveyed the various performance (QA period, manpower, time) of quality control for understanding of efficiency. The survey results show that the QA test of daily and weekly are almost same comparing to USA and Europe but the QA performance of monthly and yearly in Korea are 15.5 which is less than USA and Europe recommended QA item number of 17 to 21. The manpower and QA time in Korea also lower than 50% of USA and Europe recommended because the manpower and QA time limitation in Korea. It will be expected that the manual of quality management in each clinic could be appropriately established when combining the present results with previously published AAPM TG-40 and other protocols.

Work Characteristics and Health Status of Shift Workers based on the Results of the Fifth Korean Working Conditions Survey (교대근로자의 업무특성과 건강상태에 대한 연구: 제5차 근로환경조사를 중심으로)

  • Baek, Kyunghee;Ha, Kwonchul
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.29 no.4
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    • pp.550-561
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    • 2019
  • Objectives: The purpose of this study is to provide basic data for the improvement of the working environment for health prevention and related countermeasures for shift workers. This study was conducted based on the Fifth Korean Working Conditions Survey (KWCS), which analyzed the health effects of shift work forces and compared them with preceding studies. Methods: By analyzing secondary rates using raw data from the 5th KWCS, 4,870 (9.7%) of the 50,184 total study subjects were divided into shift work and 45,314 (90.3%) non-shift work groups based on the response to shift status. Variables that could affect work health issues were identified and corrected. A cross-analysis was conducted to examine demographic characteristics (gender, age, and education level) of the workers and occupation characteristics (monthly net earnings, employment type, occupation, working period up to now, workplace scale, type of work system, and weekly working hours). In order to find the work health issue ratio between the shift and non-shift work groups, logistic regression was analyzed and the association with health problems according to shift type by gender was looked at through cross-analysis. Results: According to the surveys conducted from the 1st KWCS (2006) to the 5th KWCS (2017), the proportion of shift workers continued to increase. Also, muscular pains in the lower limbs (hips, legs, knees, feet, etc.) (OR=1.135, 95%CI 1.031-1.251), headaches, eyestrain (OR=1.580, 95% CI 1.428-1.748), anxiety (OR=1.715, 95% CI 1.402-2.099), difficulty falling asleep (OR=1.391), and other problems (OR=7.392) were reported. In addition, back pain, muscular pains in shoulders, neck and/or upper limbs, muscular pains in lower limbs (hips, legs, knees, feet, etc.), headaches, eyestrain, depression, anxiety, overall fatigue resulted in significant results for both male and female shift workers. Depression and anxiety were higher in female shift/circulation compared to males. Conclusions: The social nets for the health and safety of shift workers should be explored in a variety of ways, including management and supervision of shift sites, attempts to reorganize and improve the shift system, development of workers' health recovery programs, promotion, systematic treatment, and compensation systems.

Analysis of the Relationship Between Freight Index and Shipping Company's Stock Price Index (해운선사 주가와 해상 운임지수의 영향관계 분석)

  • Kim, Hyung-Ho;Sung, Ki-Deok;Jeon, Jun-woo;Yeo, Gi-Tae
    • Journal of Digital Convergence
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    • v.14 no.6
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    • pp.157-165
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    • 2016
  • The purpose of this study was to analyze the effect of the shipping industry real economy index on the stock prices of domestic shipping companies. The parameters used in this analysis were the stock price of H Company in South Korea and shipping industry real economy indices including BDI, CCFI and HRCI. The period analysis was from 2012 to 2015. The weekly data for four years of the stock price index of shipping companies, BDI, CCFI, and HRCI were used. The effects of CCFI and HRCI on the stock price index of domestic shipping companies were analyzed using the VAR model, and the effects of BDI on the stock price index of domestic shipping companies were analyzed using the VECM model. The VAR model analysis results showed that CCFI and HRCI had negative effects on the stock price index, and the VECM model analysis results showed that BDI also had a negative effect on the stock price index.