Purposes: The purpose of this study is to analyze nurses' perception on the clinical career ladder system which was introduced to enhance the nursing capabilities in general hospital. Methods: Research data has been collected for approximately 30 days since March 28, 2017 from 171 nurses who had been involved in the clinical career ladder system, 177 nurses who had not participated, and a total of 348. Finding: The study results showed that nurses' perception on the cost effectiveness of clinical career ladder system is significantly different depending on the sex, age, program experience, personal stage in the clinical career ladder system and the individual's health condition. In addition, the nurses' willingness to pay for the clinical career ladder system was significantly associated with their department and the needs for the system. With adjusted age, gender, position, education and marital status, nursing competency was 8.71(95% Confidence Interval; 4.79 to 12.63) in the presence of system experience, but the perception on clinical career ladder system was 4.34(95% Confidence Interval; -6.84 to -1.84). Practical Implications: Based on the study results, we expect that more hospitals introduce the clinical career ladder system and also use these study results as basic data for securing excellent nurses.
Yu, Byunghyuk;Park, Ji Yeon;Park, Ki Bum;Kwon, Oh Kyoung;Lee, Seung Soo;Chung, Ho Young
Journal of Gastric Cancer
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v.20
no.3
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pp.328-336
/
2020
Purpose: The standard treatment for stage IB gastric cancer is curative surgery alone, but some patients show poor survival with disease recurrence after curative surgery. The aim of this study was to identify prognostic factors of recurrence and long-term survival in patients with stage IB gastric cancer after surgery. Materials and Methods: We retrospectively reviewed data from 253 patients with stage IB gastric cancer who underwent gastrectomy between 2011 and 2016 at Kyungpook National University Chilgok Hospital and analyzed the clinicopathological characteristics associated with recurrence and survival. Results: Fourteen patients experienced recurrence with a mean follow-up of 54.1 months. Two of these patients had locoregional recurrence and 12 patients had systemic recurrence. The median interval between the operation day and the day of recurrence was 11 months (range 4-56 months). Multivariate analysis revealed that lymphatic vessel invasion (LVI) (hazard ratio [HR], 3.851; 95% confidence interval [CI], 1.264-11.732) and the elderly (age≥65) (HR, 3.850; 95% CI, 1.157-12.809) were independent risk factors for recurrence after surgery. The LVI (HR, 3.630; 95% CI, 1.105-11.923) was the independent prognostic factors for disease-specific survival (DSS). The 5-year DSS rates were 96.8% in patients who did not have LVI, and 89.3% in patients who had LVI. Conclusions: This study shows that LVI was associated with recurrence and poor survival in patients with stage IB gastric cancer after curative gastrectomy. Patients diagnosed with LVI require careful attention for systemic recurrence during the follow-up period.
Spikelet number per unit area(SPN) is a major determinant of rice yield. Nitrogen nutrition status and biomass during reproductive stage determine the SPN. To formulate a model for estimating SPN, the 93 field experiment data collected from widely different regions with different japonica varieties in Korea and Japan were analyzed for the upper boundary lines of SPN responses to nitrogen nutrition index(NNI), shoot dry weight and shoot nitrogen content at panicle initiation and heading stage. The boundary lines of SPN showed asymptotic responses to all the above parameters(X) and were well fitted to the exponential function of $f(X)=alphacdot{1-etacdotexp(gamma;cdot;X)}$. Excluding the constant, from the boundary line equation, the values of the equation range from 0 to 1 and represent the indices of parameters expressing the degree of influence on SPN. In addition to those indices, the index of shoot dry weight increase during reproductive stage was calculated by directly dividing the shoot dry weight increase by the maximum value ($800 extrm{g/m}^{-2}$) of dry weight increase as it showed linear relationship with SPN. Four indices selected by forward stepwise regression at the stay level of 0.05 were those for NNI ($I_{NNI}_P$) at panicle initiation, NNI($I_{NNI}_h$) and shoot dry weight($I_{DW}_h$) at heading stage, and dry weight increase($I_{DW}$) between those two stages. The following model was obtained: SPN=48683ㆍ $I_{DWH}$$^{0.482}$ㆍ $I_{NNIp}$$^{0.387}$ㆍ $I_{NNIH}$$^{0.318}$ㆍ $I_{DW}$$^{0.35}$). This model accounted for about 89% of the variation of spikelet number. In conclusion this model could be used for estimating the spikelet number of japonica rice with some confidence in widely different regions and thus, integrated into a rice growth model as a component model for spikelet number estimation.n.n.
To effectively secure and execute the national budget, it is very important to estimate the reasonable construction cost of each process in the construction of public facilities and works. The construction cost is generally estimated at the time when the design of the targeted structures has been completed. Without detailed sectional drawings and with only simple information on bridge structures in the planning stage or in the early design stage. it would be very difficult to predict the approximate construction cost. In this study, a more efficient and appropriate approximate construction cost estimation model in the planning stage and in the early design stage is presented and verified as reliable by analyzing the construction cost data of 61 existing steel box girder bridges from previous studies. The results of this study show that when the construction cost that was predicted using the construction cost estimation model in the design stage was compared with the cost from the conventional standards, the suggested model in this study produced results with a very high confidence level.
Teke, Fatma;Yoney, Adnan;Teke, Memik;Inal, Ali;Urakci, Zuhat;Eren, Bekir;Zincircioglu, Seyit Burhanedtin;Buyukpolat, Muhammed Yakup;Ozer, Ali;Isikdogan, Abdurrahman;Unsal, Mustafa
Asian Pacific Journal of Cancer Prevention
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v.15
no.6
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pp.2815-2819
/
2014
Background: The aim of this study was to evaluate the prognosis of patients with stage IA-IIB cervical carcinoma and to investigate a possible correlation of histology with prognosis. Materials and Methods: Two hundred fifty one patients with adenocarcinoma and squamous cell carcinoma (SCC) histology for FIGO (International Federation of Gynecology and Obstetrics) stage IA-IIB uterine cervical carcinomas at the Radiation Oncology Clinic of GH Okmeydan Training and Research Hospital between January 1996 and December 2006 were selected, analyzed retrospectively and evaluated in terms of general characteristics and survival. Disease-free survival (DFS) and overall survival (OS) was calculated using the Kaplan-Meier method and differences were compared with the log-rank test. Multivariate analysis using a Cox-proportional hazards model was used to adjust for prognostic factors and to estimate hazard ratio (HR) with 95% confidence interval (CI). Results: There was no differences between the two tumour types in age, stage, pelvic nodal metastasis, parametrial invasion, surgical margin status, DSI, LVSI, maximal tumor diameter, grade, and treatment modalities. 5-year OS and DFS were 73% and 77%, versus 64% and 69%, for SCC and adenocarcinoma, respectively (p> 0.05). Multivariate analysis revealed independent prognostic factors including pelvic nodal metastasis and resection margin status for OS (p=0.008, p=0.002, respectively). Conclusions: Prognosis of FIGO stage IA-IIB cervical cancer patients was found to be the same for those with adenocarcinoma and SCC.
Sharma, Kanika;Ahlawat, Parveen;Gairola, Munish;Tandon, Sarthak;Sachdeva, Nishtha;Sharief, Muhammed Ismail
Radiation Oncology Journal
/
v.37
no.2
/
pp.73-81
/
2019
Purpose: There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC. Materials and Methods: It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated. Results: The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3-102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS. Conclusion: Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.
PURPOSE. This study evaluated marginal fit of glass infiltrated alumina cores fabricated using two techniques and their marginal stability after firing cycles of veneering porcelain. MATERIALS AND METHODS. Fifteen standardized all-ceramic crowns were fabricated on a metal die using each technique: slip cast technique of VITA In-Ceram sprint Alumina (Group A as control) and plastic foil matrix technique of Turkom-Cera fused alumina core system (Group B). Copings were compared between groups and within groups at coping stage and after firing each layer of veneering porcelain. A device was used to standardize seating of copings on the metal die and positioning of the specimens under the microscope after each stage of fabrication. The specimens were not cemented and marginal gap was measured using an image analyzing software (Imagepro Express) on the photographs captured under an optical microscope. Two tailed unpaired 't test' was used to compare marginal gaps in two groups and one way ANOVA was used to analyze marginal distortion within each group at 95% confidence interval. RESULTS. The marginal gap was smaller at the coping stage in group B ($60+30{\mu}M$) than group A ($81+21{\mu}M$) with statistical significance. After firing of veneering porcelain the difference was insignificant. At the final stage, both groups exhibited lower mean marginal gaps than at the initial coping stage with the difference of $11.75{\mu}M$ for group A and $11.94{\mu}M$ for group B, but it was statistically insignificant due to high value of standard deviation. CONCLUSION. Within the limitations of this study, it was concluded that both techniques produced copings with comparable and acceptable marginal fit and marginal stability on firing veneering porcelain.
The purpose of this study was to examine beliefs, self-efficacy and eating behaviors by the stages of change in vegetable consumption among college students (n = 297). A survey was conducted to examine study variables, and subjects were categorized into three groups based on the stages of change: precontemplation/contemplation stage (PC/C), preparation stage (P), action/maintenance stage (A/M). Subjects had 3.7 servings of vegetables a day, and vegetable consumption was significantly different by stages of change (p < 0.001). The A/M group showed higher score on beliefs regarding vegetable consumption (p < 0.001) than the other groups, and perceived benefits of vegetable consumption (e.g. cancer prevention) more strongly (p < 0.05). The PC/C group felt more barriers than the A/M group, such as disliking cooking methods, texture of vegetables (p < 0.001), bad taste and bad experience of eating vegetables (p < 0.05). Self-efficacy score was 27.2, with decreasing self-efficacy from A/M to P, PC/C (p < 0.001). The A/M group showed more confidence in nine behaviors such as "eating vegetables during meals" and "replacing menu at home with more vegetable dishes" (p < 0.001) than the other groups. The A/M group had more desirable eating behaviors (e.g, having a variety of foods, eating regularly, consumption of food groups). This study suggests that target population for education and educational strategies be different based on the stages of change. For those in the PC/C stage, education might focus on reducing barriers and increasing self-efficacy. For those in the A/M stage, it is necessary to use strategies to maintain and reinforce behaviors for enough vegetable consumption.
Background: This meta-analysis aimed to evaluate the incidence of tumor recurrence, postoperative myasthenia gravis, postoperative complications, and overall survival after limited versus total thymectomy for Masaoka stage I and II thymoma. Methods: A systematic search of the literature was conducted using the PubMed, Embase, MEDLINE, and Cochrane databases to identify relevant studies that compared limited and total thymectomy in Masaoka stage I-II patients. The quality of the included observational studies was assessed using the Newcastle-Ottawa Scale. The results of the meta-analysis were expressed as log-transformed odds ratios (log ORs), with 95% confidence intervals (CIs). Results: Seven observational studies with a total of 2,310 patients were included in the meta-analysis. There was an overall non-significant difference in favor of total thymectomy in terms of tumor recurrence (pooled log OR, 0.40; 95% CI, -0.07 to 0.87; p=0.10; I2=0%) and postoperative myasthenia gravis (pooled log OR, 0.12; 95% CI, -1.08 to 1.32; p=0.85; I2=22.6%). However, an overall non-significant difference was found in favor of limited thymectomy with respect to postoperative complications (pooled log OR, -0.21; 95% CI, -1.08 to 0.66; p=0.64; I2=36.1%) and overall survival (pooled log OR, -0.01; 95% CI, -0.68 to 0.66; p=0.98; I2=47.8%). Conclusion: Based on the results of this systematic review and meta-analysis, limited thymectomy as a treatment for stage I and II thymoma shows similar oncologic outcomes to total thymectomy.
Objective: The objective of this study was to determine the five-year survival among patients with cervical cancer treated in Hospital Universiti Sains Malaysia. Methods: One hundred and twenty cervical cancer patients diagnosed between $1^{st}$ July 1995 and $30^{th}$ June 2007 were identified. Data were obtained from medical records. The survival probability was determined using the Kaplan-Meier method and the log-rank test was applied to compare the survival distribution between groups. Results: The overall five-year survival was 39.7% [95%CI (Confidence Interval): 30.7, 51.3] with a median survival time of 40.8 (95%CI: 34.0, 62.0) months. The log-rank test showed that there were survival differences between the groups for the following variables: stage at diagnosis (p=0.005); and primary treatment (p=0.0242). Patients who were diagnosed at the latest stage (III-IV) were found to have the lowest survival, 18.4% (95%CI: 6.75, 50.1), compared to stage I and II where the five-year survival was 54.7% (95%CI: 38.7, 77.2) and 40.8% (95%CI: 27.7, 60.3), respectively. The five-year survival was higher in patients who received surgery [52.6% (95%CI: 37.5, 73.6)] as a primary treatment compared to the non-surgical group [33.3% (95%CI: 22.9, 48.4)]. Conclusion: The five-year survival of cervical cancer patients in this study was low. The survival of those diagnosed at an advanced stage was low compared to early stages. In addition, those who underwent surgery had higher survival than those who had no surgery for primary treatment.
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