• 제목/요약/키워드: safety-care-activity

검색결과 119건 처리시간 0.029초

Efficacy and Safety of Sorafenib for Advanced Non-Small Cell Lung Cancer: a Meta-analysis of Randomized Controlled Trials

  • Wang, Wei-Lan;Tang, Zhi-Hui;Xie, Ting-Ting;Xiao, Bing-Kun;Zhang, Xin-Yu;Guo, Dai-Hong;Wang, Dong-Xiao;Pei, Fei;Si, Hai-Yan;Zhu, Man
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5691-5696
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    • 2014
  • Background: Many clinical trials have been conducted to evaluate sorafenib for the treatment of advanced NSCLC, but the results for efficacy have been inconsistent. The aim of this study was to evaluate the efficacy and safety of sorafenib in patients with advanced NSCLC in more detail by meta-analysis. Methods: This meta-analysis of randomized controlled trials (RCTs) was performed after searching PubMed, EMBASE, ASCO Abstracts, ESMO Abstracts, and the proceedings of major conferences for relevant clinical trials. Two reviewers independently assessed the quality of the trials. Outcomes analysis were disease control rate (DCR), progression- free survival (PFS), overall survival (OS) with 95% confidence intervals (CI) and major toxicity. Subgroup analysis was conducted according to sorafenib monotherapy, in combination with chemotherapy or EGFR-TKI to investigate the preferred therapy strategy. Results: Results reported from 6 RCTs involving 2, 748 patients were included in the analysis. Compared to sorafenib-free group, SBT was not associated with higher DCR (RR 1.31 (0.96- 1.79), p=0.09), PFS (HR 0.82 (0.66-1.02), p=0.07) and OS (HR 1.01 (0.92-1.12), p=0.77). In terms of subgroup results, sorafenib monotherapy was associated with significant superior DCR and longer PFS, but failed to show advantage with regard to OS. Grade 3 or greater sorafenib-related adverse events included fatigue, hypertension, diarrhea, oral mucositis, rash and HFSR. Conclusions: SBT was revealed to yield no improvement in DCR, PFS and OS. However, sorafenib as monotherapy showed some activity in NSCLC. Further evaluation may be considered in subsets of patients who may benefit from this treatment. Sorafenib combined inhibition therapy should be limited unless the choice of platinum-doublet regimen, administration sequence or identification of predictive biomarkers are considered to receive better anti-tumor activity and prevention of resistance mechanisms.

일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정 (Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital)

  • 김경운
    • 간호행정학회지
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    • 제6권3호
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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PDCA 모형에 기초한 QI활동 평가틀 개발 및 사례분석 (Development of QI Activity Evaluation Framework Based on PDCA and Case Study on Quality Improvement Activities)

  • 박연화;이명하;정석희
    • 간호행정학회지
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    • 제18권2호
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    • pp.222-233
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    • 2012
  • Purpose: This study was conducted to develop an evaluation framework for QI activity in medical institutions and to analyze QI activity cases by applying the developed evaluation framework. Method: A four-phase process was employed to develop the evaluation framework, and a descriptive survey was used for the QI case study. Data were collected in April, 2010 by examining 157 QI activity cases presented at conferences and published in Journal of Korean Society of Quality Assurance in Health Care over the past three years. Developed QI activity evaluation instruments were used for data collection. Data were analyzed using the SPSS 18.0 for Windows program. Result: A QI Activity Evaluation Framework was developed. This framework consisted of 45 items. The department with the highest level of QI participation was the nursing department. The most frequent QI activity theme was patient safety. QI activity levels in Korean medical institutions are relatively equalized without significant differences according to institution characteristics. Conclusions: From the quality aspect of QI activity, more systematic and scientific approaches are required to upgrade QI activity. This study could provide methodological guidelines for QI activity and be useful in setting goals and directions for QI activity in medical institutions in Korea.

Safety Assessment of Foods Produced Using Recombinant DNA Techniques

  • Toyoda, Masatake
    • Toxicological Research
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    • 제17권
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    • pp.167-171
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    • 2001
  • The introduction of genetically modified crops has raised concerns regarding safety issues over the insertion of foreign genes into plant genomes using recombinant DNA technology. Since 1991 in Japan, 29 foods and 6 food additives have been evaluated, based on the "Guideline for Safety Assessment", before these foods were marketed. The MHW, however, decided that safety assessment of such foods and food additives should be legally imposed. because soon such foods and food additives are expected to circulate globally and a new system for assessing safety of such foods and food additives at a pre-market stage is necessary, in order to avoid the distribution of any genetically modified foods that have had no safety assessment. The MHW published relevant announcements to amend existing regulations on 1 May 2000. "Standards for safety assessment of seed plant" is established based on a concept of substantial equivalence, and applicable to the products which are regarded as equivalent to the existing products used as foods and food additives. The characterization of the food products entails consideration of the molecular characterization. phenotypic and compositional characteristics, key nutrients and toxicants, and toxicity and allergenicity of the introduced proteins, and if there are indications of unintended effects of the modification, whether further safety testing (animal studies etc.) is needed should be considered. Safety and wholesomeness studies with whole foods should be care fully designed in order to avoid nutritional imbalances causing artifacts and uninterpretable results as was the case of Dr. Pusztaiis report. A case study of genetically modified soybeans (glyphosate-tolerant soybeans) on the immune system of rats and mice is shown. Chemical compositions were also compared with those of the non-GM soybeans. The studies failed to detect any differences in immuno-toxic activity.muno-toxic activity.

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Exercise Self-Efficacy as a Mediator between Goal-Setting and Physical Activity: Developing the Workplace as a Setting for Promoting Physical Activity

  • Iwasaki, Yoshie;Honda, Sumihisa;Kaneko, Shuji;Kurishima, Kazuhiro;Honda, Ayumi;Kakinuma, Ayumu;Jahng, Doosub
    • Safety and Health at Work
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    • 제8권1호
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    • pp.94-98
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    • 2017
  • Background: Physical activity (PA) is ranked as a leading health indicator and the workplace is a key setting to promote PA. The purpose of this study was to examine how goal-setting and exercise self-efficacy (SE) during a health promotion program influenced PA level among Japanese workers. Methods: Using a cross-sectional study design, we surveyed 281 employees. The short version of the International Physical Activity Questionnaire was used to assess PA level. Exercise SE was assessed using a partially modified version of Oka's exercise SE scale. Personal goals were assessed as the total numbers of "yes" responses to five items regarding "details of personal goals to perform PA". A mediational model was used to examine whether exercise SE mediates between the number of personal goals and PA level. Results: The mean age of the participants was 46.3 years, 76.2% were men, and the most common occupational category was software engineer (30.6%). The average PA level per week exceeded the recommended level in 127 participants (45.2%). One hundred and eighty-four participants (65.5%) set some form of concrete personal goal to perform PA. The relationship between the number of personal goals and PA level was mediated by exercise SE. Conclusion: Our study showed that exercise SE mediates goal-setting and increases PA. The results suggest that the components of PA promotion programs should be tailored to enhance participants' confidence in performing PA.

경남지역 일부 산업간호사의 보건관리 업무 및 관련요인에 관한 연구 (A Study on Health Care Activities of Some Industrial Nurses and their Related Factors in Kyungnam Area)

  • 김영숙
    • 한국직업건강간호학회지
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    • 제4권호
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    • pp.48-57
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    • 1995
  • The purpose of this study was to assess the performance of the role and function of some industrial nurses and to characterize the factors affecting the performance of their activities. Thus the results could be used to suggest the direction in the performance of industrials nurses' activities effectively. During a period from January 10 to March 31, 1994, the data were collected from 87 industrial nurses, who were working as health managers in the plants, in Ulsan city and the vicinity in Kyungnam province, using a structured questionnaire. The results were as follows : 1. The general characteristics of industrial nurses in this study were 82.8% being 30 years old or less, 60.9%, being not married, and 93.1% having eduction levels above junior college. 2. With respect to general work conditions, 94.3% were working in a separate room provided for health care division, 40.2% working under the safety and health department, and 98.9% working as common-level staffs. And 60.9% were working less than 44 hours a week, 70.1% had work experiences less than 5 years, and 50.6% had annual incomes ranging 10 to 14 million wons. 3. As work conditions related to health care activities, 49.4% performed the activities not related to health care as always or occasionally, and 87.4% answered that occupational physicians were appointed in their plant and among them, however, only 6.9% worked on full-time basis and 52.8% perform little activities as occupational physicians. For a decision related to health care activity, 69.0% discussed the problems with the supervisors, and 19.5% made decisions by themselves. 4. As for attitude and perception to their activities as health managers, 66.7% moderately recognized the importance of health manager in the workplace, with 63.2% being satisfied their wages and treatment from the company, 57.5% being satisfied with their job positions and 51.7% having positive attitudes as being health managers. 5. The degree of performance at least in one of health related activities were very high in activities such as general medical care(100%), general health examination(98.0%) and specific health examination(100%), and relatively high in health education(72%), new employee health examination(60.9%), document handling(79.3%) and activity for work environment(70.1%). However, the performance rate was very low in preparing protective equipment (20.8%). 6. The levels of activities related to health care were significantly high when making decisions by themselves, when occupational physicians not being full-time, and when satisfying their job positions, and, on the other hand, significantly decreased as work hours increased. 7. In addition to some kinds of periodic education asked by all of the nurses, 89.7% wanted a specialized licensing system for industrial nurse, and 97.4% wanted to apply for the license test. As a conclusion, it is suggested that industrial nurses should be given more authority and placed in more self-controlled system to perform health care and other activities more efficiently, and the role and function of the occupational physician should be clearly distinguished from that of the industrial nurse as a health manager to avoid an unnecessary overlapping.

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요양시설과 재가의 요양보호사 직무비교 (Comparison of Frequency and Difficulty of Care Helper Jobs in Long Term Care Facilities and Client Homes)

  • 황은희;정덕유;김미정;김건희;신수진
    • 한국보건간호학회지
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    • 제26권1호
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    • pp.101-112
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    • 2012
  • Purpose: The purposes of this study were to identify differences of duties, tasks, and task elements of care helpers between long term care (LTC) facilities and client's home (CH), and to provide data for the development of educational programs and policies. Methods: This study was a descriptive investigation; the subjects of the study were 418 care helpers. Duties, tasks, and task elements were measured using the framework proposed by Shin et al. (2012). Data were analyzed by t-test using PASW 18.0. Results: All of the jobs were statistically significant differences between LTC and CH. Dietary assistance and Daily work assistance were more frequently in CH, and the frequency of other tasks was higher in LTC than CH. Tasks with higher-reported difficulty by those who worked in LTC were as follows: personal hygiene, position change and movement, exercise and activity assistance, safety care, communication assistance, dietary assistance, environment management, daily work assistance, emergency prevention, early detection and speedy reporting, and dementia patient care. Conclusion: These findings suggest that training for care helpers of each facility type will be differentiated. Tasks and task elements reported by care helpers were modified and added to the standard textbook.

여성근로자의 노동시장 및 작업환경 특성 연구 - 성인지적 비교분석으로 통해 본 - (A Study on Characteristics of Labor Force Participation Rate and Work Environment of Female Workers)

  • 이관형
    • 한국안전학회지
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    • 제28권5호
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    • pp.78-82
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    • 2013
  • The purpose of this study is to review the labor force partitpation rate and work environment characteristics of female workers to provide basic information for establishment and implementation of effective policies related to accident prevention and workers health protection for female workers. It was analyzed employment status, work environment and injuries and illnesses based on economic activity census results, compensation of industrial injury and the second working condition survey. According to economic activity census results, female labor force participation rate has been steadily increased, whereas male labor force participation rate has been decreased since 1970. Industrial accident rate has been declined in male workers but that in female workers has been steadily increased even though male workers were higher accident rate than female workers. It was evaluated that female workers are vulnerable to industrial injuries and illnesses in the aspect of their working environment and employment status. Also, Substantial differences between female and male workers in occupational exposure patterns, occupational disease and occupational environments were observed. Therefore it was recommended that special care programs for female workers such as a specialized monitoring and management program should be introduced in the near future.

Prevalence of MSDs and Postural Risk Assessment in Floor Mopping Activity Through Subjective and Objective Measures

  • Naik, Gouri;Khan, Mohammed Rajik
    • Safety and Health at Work
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    • 제11권1호
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    • pp.80-87
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    • 2020
  • Background: Residential and commercial cleaning is a part of our daily routine to maintain sanitation around the environment. Health care of professionals involved in such cleaning activities has become a major concern all over the world. The present study investigates the risk of musculoskeletal disorders in professional cleaners involved in floor mopping tasks. Methods: A cross-sectional study was performed on 132 mopping professionals using a modified Nordic questionnaire. The Pearson correlation test was implemented to study the association of perceived pain with work experience. The muscle strain and postural risk were evaluated by means of three-channel electromyography and real-time motion capture respectively of 15 professionals during floor mopping. Results: Regarding musculoskeletal injuries, risk was reported majorly in the right hand, lower back, left wrist, right shoulder, left biceps, and right wrist of the workers. Work experience had a low negative association with MSDs in the left wrist, right wrist, right elbow, lower back, and right lower arm (p < 0.01). Surface EMG showed occurrence of higher muscle activity in upper trapezius and biceps brachii (BB) muscles of the dominant hand and flexor carpi radialis and BB muscles of the nondominant hand positioned at the upper and lower portion of the mop rod, respectively. Conclusion: Ergonomic mediations should be executed to lessen the observed risk of musculoskeletal injuries in this professional group of workers.

인지장애 노인의 환경에 대한 연구 (A Study on the Environments for Older People with Cognitive Impairments)

  • 문창호
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제5권9호
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    • pp.107-116
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    • 1999
  • The purpose of this study is to present reference materials for the planning and research of related environments by introducing the theoretical background and samples of the environments for older people with cognitive impairments. Major contents of the study include cognitive impairments and residential facility of older people, model environments for special care unit, therapeutic dimensions of environments, outdoor garden, activity calendar, and site-visits of the sample facilities. Some results of the study could be summarized as follows ; 1) Special care unit for the people with cognitive impairments has been required and developed. 2) Weiss Institute, Corrine Dolan Alzheimer Center, and Wood Place in Oakmont were analyzed as model environments. 3) Therapeutic dimensions such as safety & security, awareness & orientation, opportunities for socialization, regulated sensory stimulation, provisions for privacy, ties to the healthy & familiar, and autonomy & control were proposed. 4) The advantages of outdoor garden for the people with cognitive impairments were explained. 5) Activity calendar for a facility was introduced and recognized as a essential guide for environment planning. 6) Sample facilities showed small size households and various ideas of environments for the older people with cognitive impairments.

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