Purpose: There is controversy regarding the cosmetic outcome after accelerated partial breast radiation (APBR). We report the cosmetic outcome from a single-arm prospective clinical trial of APBR delivered using intensity-modulated radiation therapy (IMRT) in elderly patients with stage I breast cancer (BC), using a novel fractionation schedule. Materials and Methods: Forty-two patients aged ${\geq}65$, with Stage I BC who underwent breast-conserving surgery were enrolled in a phase I/II study evaluating a 2-week course of APBR. Thirty eligible patients received 40 Gy in 4 Gy daily fractions. Cosmetic outcome was assessed subjectively by physician/patient and objectively by using a computer program (BCCT.core) before APBR, during, and after completion of the treatment. Results: The median age was 72 years, the median tumor size was 0.8 cm, and the median follow-up was 50.5 months. The 5-year locoregional control in this cohort was 97% and overall survival 87%. At the last follow-up, patients and physicians rated cosmesis as 'excellent' or 'good' in 100% and 91 %, respectively. The BCCT.core program scored the cosmesis as 'excellent' or 'good' in 87% of the patients at baseline and 81% at the last follow-up. The median $V_{50}$ (20 Gy) of the whole breast volume (WBV) was 37.2%, with the median WBV $V_{100}$ (40 Gy) of 10.9%. Conclusion: An excellent rate of tumor control was observed in this prospective trial. By using multiple assessment techniques, we are showing acceptable cosmesis, supporting the use of IMRT planned APBR with daily schedule in elderly patients with early stage BC.
The purpose of this study was to explore effects of acceptance-commitment therapy on assertiveness and interpersonal anxiety of university students with interpersonal anxiety. Twelve students are selected of three hundred thirty students who completed an assertiveness sacle and a social anxiety scale, and finally six students were assigned to an experiment group and the others to a control group. ACT program consisting of 8 sessions twice a week approximately 120minutes is provided for experiment group, on the other hand, nothing is provided for control group. All participants completed an assertiveness sacle, a social anxiety scale at pre-test, post-test, and 6 weeks follow-up periods. In the experimental group, the assertiveness score was improved after ACT program but not in the control group. The improvement observed in the experimental group was maintained until the follow-up test. In the anxiety test, the experimental group showed a larger decrease than the control group, and the difference was also found in the follow-up test. Finally, the implications and limitations of this study, along with suggestions for future study were discussed.
Lee, Seung Hwan;Han, Sang Yun;Lee, Soo Jin;Chae, Han;Lim, Jung Hwa
Journal of Oriental Neuropsychiatry
/
v.33
no.1
/
pp.33-48
/
2022
Objectives: Academic stress poses a significant risk for the mental health of medical students, and a feasible group intervention program for managing academic stress is required. The purpose of this study was to examine the clinical effectiveness of emotional freedom techniques (EFT) on the mental health of Korean medical students. Methods: The class of first-year medical school students (n=36) participated in an after-school EFT group intervention program comprising six sessions (15 minutes/session, three weeks) to analyze its clinical effectiveness as a single-group test-retest clinical study. The changes in the Perceived Stress Scale (PSS), Test Anxiety Inventory (TAI), Positive and Negative Affect Schedule (PANAS), and State-Trait Anxiety Inventory (STAI) scores were examined using a paired t-test and Cohen's D at post-EFT and two-week follow-up. Results: There were significant curtailments at post-EFT and follow-up measures in TAI-Total (t=2.704 and t=3.289), TAI-Worry (t=2.297 and t=2.454), TAI-Emotionality (t=2.763 and t=3.654), PSS-Negative Perspective (t=2.659 and t=3.877), and PANAS-Negative Affect (t=2.885 and t=3.259) subscales, however not in PSS-Positive Perspective (t=-1.279 and t=-1.101) and PANAS-Positive Affect (t=0.194 and t=-0.122) subscales. The trait anxiety (t=2.227) was significantly mitigated in the post-EFT measure and the state anxiety (t=2.30) in the follow-up measure. Conclusions: The EFT group intervention alleviated test stress, negative affect, and anxiety in the Korean medical students. This study contributes to an understanding of academic stress and EFT intervention in the competitive environment of medical education.
This study was carried out to identify the effects of an art therapy program based on reality therapy on the weight control, body image, and self-esteem of college students. The program was developed by the authors. The design was a pretest-post test control group design. The subjects were college students attending M college : 8 in experimental group A, 6 in experimental group 2, who wanted to control their body weight and 16 in the control group who didn't attend the program those in the experimental group attended the program once (group A) or twice (group B) per week meeting a total of six times. The data were analyzed by quantity method (SPSS 10.0 program) and quality method(process analysis). The results were as follows : 1. The average obesity index of pre-test, post-test, and a follow-up test decreased from 8.9% to 6.1%, 3.7%. And the rate of decrease both pre-post and post-follow up were statistically significant 2. The average obesity index of group A decreased from 9.6% to 6.3%, 4.1% and the rate of decrease between pre and post were statistically significant. But the rate of decrease between post and follow-up were statistically not significant 3. The average obesity index of group B decreased from 7.8% to 5.8%, 3.1% and the rate of decrease between pre and post were not significant statistically. But the rate of decrease between post and follow-up were statistically significant 4. The average scores of pre and post body image increased and were statistically significant : group A from 129.0 to 153.5, group B from 127.7 to 155.2. 5. The average scores of pre and post semantic differential method increased and were statistically significant: group A from 38.1 to 44.1, group B from 38.0 to 45.0. 6. The average scores of pre and post self-esteem increased: group A increased from 37.3 to 40.3 and were statistically significant, group B increased from 36.5 to 39.5 but was statistically insignificant 7. The average scores of pre and post obesity rate, body image, semantic differential method and self-esteem in the control group were not statistically significant 8. The pre and post scores of body image(p=.001), semantic differential method(p=.001) and self-esteem(p=.039) between experimental and control group were statistically significant. 9. In Duncan multiple comparison, it was not statistically significant between group A and B, but statistically significant between group A and the control group, group B and the control group in obesity index, body image, semantic differential method. There was no statistically significance among the three groups in self esteem 10. In Duncan multiple comparison, group A gained higher scores than group B in obesity index(-1.2%), and self esteem(0. 3). Group B gained higher scores than group A in body image(3. 0), and semantic differential method(1. 0). So it is difficult to conclude whether group A or B is more effective. In conclusion, the art therapy program based on reality therapy was effective in weight the control program of college students: obesity was decreased, the scores of body image and semantic differential method and self-esteem were increased. The scores of group A were increased more than group Band were statistically significant, The time interval was a very important factor in this program. The recommendation is : the validity of this program has to be tested through various subjects and in various areas. And also this program has to be tested in other topics.
Purpose: This study aimed to develop an emotive role-play program for nursing students focusing on high-risk pregnancy and analyze its effects on communication skills, clinical performance, and emotional intelligence. Methods: A quasi-experimental nonequivalent comparison group design was adopted with 83 nursing students (experimental group, 45; comparison group, 38) who participated voluntarily in an extracurricular program. The preliminary survey was conducted on November 3 and November 4, 2020, and the follow-up survey was conducted on November 12, 2020, for the comparison group and on November 27, 2020, for the experimental group. A program that included five role-play scenarios related to induced labor, preeclampsia, premature rupture of membranes, preterm labor, and infertility was developed by a group of experts and presented to the experimental group over 11 total hours across 3 days. Each student participated in a role-play scenario as a patient, family member, or nurse and observed three other scenarios. The comparison group received a workbook after the follow-up evaluation. The independent t-test was performed to analyze changes in communication skills, clinical performance, and emotional intelligence. Results: Communication skills (t=1.84, p=.035) and clinical performance (t=2.75, p=.004) significantly increased in the experimental group compared to the comparison group. A significant difference was not observed between the experimental and comparison groups for emotional intelligence (t=1.36, p=.088). Conclusion: The emotive role-play program concerning high-risk pregnancy was effective in improving nursing students' communication skills and clinical performance and can be used in nursing education related to high-risk pregnancy and childbirth.
Saffari, Mohsen;Sanaeinasab, Hormoz;Jafarzadeh, Hassan;Sepandi, Mojtaba;O'Garo, Keisha-Gaye N.;Koenig, Harold G.;Pakpour, Amir H.
Journal of Preventive Medicine and Public Health
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v.53
no.4
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pp.275-284
/
2020
Objectives: Police officers may be at a greater risk for cardiovascular disease (CVD) than the general population due to their highstress occupation. This study evaluated how an educational program based on the health belief model (HBM) may protect police officers from developing CVD. Methods: In this single-group experimental study, 58 police officers in Iran participated in a 5-week intervention based on HBM principles. Outcomes included changes in scores on an HBM scale, time spent on moderate to vigorous physical activity (International Physical Activity Questionnaire), body mass index (BMI), blood lipid profile, blood glucose, and blood pressure. The intervention consisted of 5 HBM-based educational sessions. Follow-up was conducted at 3 months post-intervention. The paired t-test was used to examine differences between baseline and follow-up scores. Results: All aspects of the HBM scale improved between baseline and follow-up (p<0.05), except the cues to action subscale. Self-efficacy and preventive behaviors improved the most. BMI decreased from 26.7±2.9 kg/㎡ at baseline to 25.8±2.4 kg/㎡ at follow-up. All components of the lipid profile, including triglycerides, cholesterol, high-density lipoprotein, and low-density lipoprotein, showed significant improvements post-intervention. Blood glucose and blood pressure also decreased, but not significantly. Nearly 25% of participants who were not physically active at baseline increased their physical activity above or beyond the healthy threshold. Conclusions: A relatively brief educational intervention based on HBM principles led to a significant improvement in CVD risk factors among police officers. Further research is needed to corroborate the effectiveness of this intervention.
The purpose of this study is to explore the effects of ACT on smartphone addiction level, self-control, and anxiety of college students with smartphone addiction. 320 college students who lived in Chonbuk completed SAPS-A. 42 students who gained more than 40 points score by SAPS-A completed SCRS, STAI, and AAQ-16 as pre-treatment. Final 18 participants were randomly assigned to 9 in the ACT group and 9 in control group. ACT program was administered for 8 sessions, follow-up study was conducted at the end of treatment and at 4 weeks follow-up periods. The results of this study were as follows: Smartphone addiction and anxiety levels of ACT group were significantly reduced and maintained until the follow-up. Self-control and Acceptance-action levels were significantly increased and maintained until the follow-up. It has been confirmed that ACT had an effect on smartphone addiction treatment, anxiety decrease and self-control ability improving, therefore, based on this result, further research will be needed to apply the ACT on smartphone addiction treatment in families, school, local community, etc.
Egbe, Alexander C.;Nguyen, Khanh;Mittnacht, Alexander J.C.;Joashi, Umesh
Journal of Chest Surgery
/
v.47
no.3
/
pp.211-219
/
2014
Background: Our objectives were to review our institutional early and midterm experience with primary tetralogy of Fallot (TOF) repair, and identify predictors of intensive care unit (ICU) morbidity. Methods: We analyzed perioperative and midterm follow-up data for all cases of primary TOF repair from 2001 to 2012. The primary endpoint was early mortality and morbidity, and the secondary endpoint was survival and functional status at follow-up. Results: Ninety-seven patients underwent primary repair. The median age was 4.9 months (range, 1 to 9 months), and the median weight was 5.3 kg (range, 3.1 to 9.8 kg). There was no early surgical mortality. The incidence of junctional ectopic tachycardia and persistent complete heart block was 2% and 1%, respectively. The median length of ICU stay was 6 days (range, 2 to 21 days), and the median duration of mechanical ventilation was 19 hours (range, 0 to 136 hours). By multiple regression analysis, age and weight were independent predictors of the length of ICU stay, while the surgical era was an independent predictor of the duration of mechanical ventilation. At the 8-year follow-up, freedom from death and re-intervention was 97% and 90%, respectively. Conclusion: Primary TOF repair is a safe procedure with low mortality and morbidity in a medium-sized program with outcomes comparable to national standards. Age and weight at the time of surgery remain significant predictors of morbidity.
Jin Hoo Seok;Jong Hyun Kim;Taek Hyun Kwon;Joonho Byun;Won Ki Yoon
Journal of Cerebrovascular and Endovascular Neurosurgery
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v.25
no.1
/
pp.28-35
/
2023
Objective: The purpose of this study was to evaluate the effectiveness of middle meningeal artery embolization (MMAE) in elderly high-risk patients with symptomatic chronic subdural hematoma (CSDH) in terms of reduction in hematoma volume and recurrence rate. Methods: We retrospectively reviewed data prospectively collected from nine patients who underwent 13 MMAE for CSDH between June 2017 and May 2022. The volume of the subdural hematoma was measured using a computer-aided volumetric analysis program. Hematoma volume changes during the follow-up period were analyzed and clinical outcomes were evaluated. Results: The mean follow-up period was 160 days (range, 46-311 days). All procedures were technically successful and there were no procedure-related complications. Of the 13 MMAE, 84% (11 out of 13 hemispheres) showed mean 88% of reduction on follow-up volumetric study with eight cases of complete resolution. There was one refractory case with MMAE which had been performed multiple burr-hole trephinations, for which treatment was completed by craniotomy and meticulous resection of multiple pseudomembranes. There was no recurrent case during the follow-up period, except for refractory case. Conclusions: MMAE for CSDH in selected high-risk elderly patients and relapsed patients might be effective. Despite the small cohort, our findings showed a high rate of complete resolution with no complications. Further prospective randomized trials are warranted to evaluate its usefulness as a primary treatment option for CSDH.
The Journal of Korean Academic Society of Nursing Education
/
v.20
no.2
/
pp.321-331
/
2014
Purpose: The purpose of this study was to investigate the effects of case management service for hypertensive elderly patients through the customized visiting home health care program. Method: Non-equivalent control group pretest-posttest design was employed. Data were collected from April 2007 to January 2009. Among a total of fifty subjects, 25 subjects were belonged to the case management group and the others were belonged to the general management group. Results: 1) In experimental group, significant increasing rate of number of people within normal blood pressure by time, but no significant increasing rate of number of people within normal blood neutral fat, total cholesterol, HDL, & LDL. 2) In experimental group, the score of knowledge about disease and healthy life practice were increased on 8 week period but decreased on follow up period. Number of people within normal blood HDL and mean score of healthy life practice were significantly higher than control group on follow up period. Conclusion: Case management service was effective on controlling blood pressure but partly effective on blood lipid, knowledge about disease, and healthy life practice in hypertensive patients. Further study is needed to conduct a periodic re-evaluation of the effect of case management and to verify an optimal interval to provide the case management service.
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