• Title/Summary/Keyword: Risk program

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Detection of Circulating Tumor Cells in Breast Cancer Patients: Prognostic Predictive Role

  • Turker, Ibrahim;Uyeturk, Ummugul;Sonmez, Ozlem Uysal;Oksuzoglu, Berna;Helvaci, Kaan;Arslan, Ulku Yalcintas;Budakoglu, Burcin;Alkis, Necati;Aksoy, Sercan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1601-1607
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    • 2013
  • A determination of circulating tumor cell (CTC) effectiveness for prediction of progression-free survival (PFS) and overall survival (OS) was conducted as an adjunct to standard treatment of care in breast cancer management. Between November 2008 and March 2009, 22 metastatic and 12 early stage breast carcinoma patients, admitted to Ankara Oncology Training and Research Hospital, were included in this prospective trial. Patients' characteristics, treatment schedules and survival data were evaluated. CTC was detected twice by CellSearch method before and 9-12 weeks after the initiation of chemotherapy. A cut-off value equal or greater than 5 cells per 7.5 ml blood sample was considered positive. All patients were female. Median ages were 48.0 (range: 29-65) and 52.5 (range: 35-66) in early stage and metastatic subgroups, respectively. CTC was positive in 3 (13.6%) patients before chemotherapy and 6 (27.3%) patients during chemotherapy in the metastatic subgroup whereas positive in only one patient in the early stage subgroup before and during chemotherapy. The median follow-up was 22.0 (range: 21-23) and 19.0 (range: 5-23) months in the early stage and metastatic groups, respectively. In the metastatic group, both median PFS and OS were significantly shorter in any time CTC positive patients compared to CTC negative patients (PFS: 4.0 vs 14.0 months, Log-Rank p=0.013; and OS: 8.0 months vs. 20.5 months, Log-Rank p<0.001). OS was affected from multiple visceral metastatic sites (p=0.055) and higher grade (p=0.044) besides CTC positivity (log rank p<0.001). Radiological response of chemotherapy was also correlated with better survival (p<0.001). As a result, CTC positivity was confirmed as a prospective marker even in a small patient population, in this single center study. Measurement of CTC by CellSearch method in metastatic breast carcinoma cases may allow indications of early risk of relapse or death with even as few as two measurements during a chemotherapy program, but this finding should be confirmed with prospective trials in larger study populations.

Protection of Diversity through the Control of the Delimitation of the Audience Share in German Television (독일에서의 시청점유율제한을 통한 다양성 보호 연구)

  • Shim, Young-Sub
    • Korean journal of communication and information
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    • v.51
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    • pp.117-135
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    • 2010
  • The regulation of media concentration which is provided in the German Interstate Treaty on Broadcasting (RStV) is part of the rules forming the "positive broadcasting order" required by German Constitutional Law. This control ensures that the diversity of viewpoints can be articulated to the public. Broadcasting must operate independently from the state and from particular social groups if it is to be a genuine service to the public. One risk of economic competition in the media is a tendency towards the concentration of business enterprises. Moreover, economic competition is no guarantee for journalistic diversity. The aim of balanced diversity in the broadcasting sector can only be pursued by creating conditions under which different voices obtain the chance to be heard in an equitable manner. Within the framework of the meaning of section 26, it shall be assumed that there is a predominant impact on public opinion if the programs attributable to one company reach an annual audience share of 30 percent. The same shall apply if the company reaches an audience share of 25 percent and holds a dominant position in a related media-market or an overall assessment of its activities in television. The restriction of audience shares has limits such as that the audience shares of news programs and education and entertainment programs are pooled. Therefore, there is a vagueness about the productivity of different program branches.

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A Study of Stress, Stress Coping Style and Health Symptoms in 6th Grade Elementary School Children (초등학교 아동의 스트레스 생활사건과 대처방식, 건강문제에 관한 연구)

  • Cho Nam Jin;Park In Sook
    • Child Health Nursing Research
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    • v.4 no.2
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    • pp.193-206
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    • 1998
  • The purpose of this study was to examine the stressors and stress coping styles of 6th grade el ementary school children and to explore the relationship between stressful life events and health symptoms and the effects of coping style which is theoretically considered to mediate the relationship between stress and health symptoms. The study subjects consisted of 329 in 6th grade elementary school children in Cheong-Ju city. Of the 329 subjects, 171 were boys and 158 were girls. For this study, three kinds of questionnaires were adopted as follows ; 1) Feel Bad Scale (FBS) by Lewis et al., 2) lazarus-Folkman's Way of coping questionnaire 3) Hee Sun Shin's Health Symptom questionnaire (HSQ) The researcher visited the school and collected data in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done for 10 days (from 5th to 15th of July 1997) . The data were analyzed by descriptive statistics, correlation analysis, multiple regression analysis using the SAS statistical program. The results of this study were as follows : 1. The mean score for the FBS was 211.37(range : 77-427), The most severe stressors perceived by children were parental divorce and other's smash or steal of my things. The most frequently experienced stressful life events were conflict with siblings and being scolded for other's fault. 2. The most frequently used stress coping style was the active coping (M=17.85), followed by passive (M=13.64) and magical one (M=13.42). 3. The mean score for the HSQ was 23.30(range : 0-72) The most frequently complained health symptoms were headache and having much worry about everything. 4. There was a significant relationship between stressful life events and health symptoms (r=.60, p<.001). Also, stressful life events were positively related with passive coping(r=.27, p<.001) and magical coping (r=.38, p<.001). Health symptoms were positively correlated with passive coping(r=.33, p<.001) and magical coping (r=.41, p<.001). 5. Stepwise multiple regression analysis revealed that the most powerful predictor was the variable of stressful life events. Health concerns, magical coping style, passive coping style and active coping style accounted for 49.15% of the variance in health symptoms. This study revealed that stressful life events correlated with health symptoms in 6th grade elementary school children and passive coping and magical coping had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress.

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Korean Nurses Knowledge Concerning Vaginal Birth After Cesarean(VBAC) and its Educational Material (제왕절개 기왕력이 있는 질 분만(VBAC)에 관한 간호사의 인식정도와 교육안)

  • Park Sang-Ju;Choi Kyung-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.267-284
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    • 1999
  • The purpose of this study are 1. Evaluate the degree of knowledge of Vaginal Birth After Cesarean(VBAC) of Korean nurses. 2. To gather and develop educational material for VBAC. The sample was surveyed Korean Nurses knowledge about VBAC, from November 1998 through March 1999. For the data analysis, the SPSS computer program percentage and frequency were used for descriptive statistics. The x2 and the t-test were used to compare the results of the two sample groups. Open questions asked in the survey were sorted out by content, then displayed in chart form. For the education material, the Internet was the main source of information. Information on the Internet was provided by professional doctors and prenatal educational nurses. The results of the survey are as follows: 1. Out of 97 Nurses 15.3% answered that cesarean deliveries do not need to be performed after previous cesarean sections : however. 46.4% answered that cesarean sections must be performed after previous cesarean sections. 2. Of the nurses surveyed 14% had no knowledge or had never heard of VBAC. 3 Nurses did not have questions from patients concerning VBAC was 34.7%. This led to the conclusion that patients either do not have knowledge about VBAC or patients have no interest in the trial of labor. 4, Nurses indicated that their information about VBAC originated from other people's experiences (31%), Nursing School (25%), Media information (9%), and through literature review (6%). This data led to the conclusion that the knowledge about VBAC may not be extensive enough to counsel and guide patients who are willing to endure the trial of labor. 5. Nurses preferred hospital education programs to develop their knowledge concerning VBAC. Based upon survey, the conclusion was made that General Nurses and Maternity Nurses did not have knowledge about VBAC success rates and the possibility of a trial of labor. In order for nurses to help patients make decisions concerning VBAC, nurses have to gam more knowledge through hospital educational programs. Further more, the study suggests that through hospital educational programs, the possibility and importance of VBAC must be emphasized to nurses who work in maternity areas. Second, through prenatal educational programs, the possibility and importance of VBAC must be explained and emphasized to patients who had previous cesarean sections. Third, the clinical pathways of VBAC need to be developed. Fourth, each hospital needs to develop multi-disciplinary teams, consis-ting of obstetricians, risk management/quality management, staff registered nurses, and the director for perinatal services. This team can review cesarean section rates and help to increase the practice of VBAC.

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A Comparative Study on Total Payment of Mental and Behavioral Disorders Patients Admitted through the Emergency Room: Focusing on Main & Sub Sick (응급실 경유 정신 및 행동장애 입원환자들의 총진료비 비교 : 주상병과 부상병 환자 중심으로)

  • Choi, Hyun-Sik;Lee, Hyun-Sook
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.562-569
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    • 2014
  • The purpose of this study was to investigate the determinants of total payment for mental and behavioral disorders patients admitted through the emergency room. Study data was selected from the Korean National Health Insurance sample data in 2009. This data was consisted of 753 inpatients who are 331 inpatients with only main sick(F31-F39) and 422 inpatients with main sick codes(F31-F39) and sub sick(F00-F99) admitted through the emergency room. SPSS v.18 was used for the statistical analysis such as descriptive analysis, t-test, ANOVA, and multiple regression analysis. In multiple regression analysis, significant variables affecting total payment of main sick patients were gender(p<.01), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). Also, main sick patients with sub sick were gender(p<.01), age(p<.001), treatment result(p<.001), path of the emergency room(p<.001), and length of stay(p<.001). These findings implied that it is necessary to build short, middle, and longterm program and system for high risk mental and behavioral disorders groups.

The Effects of Korean and Korean-Chinese's Psychological Characteristics and Entrepreneur's Motive on Entrepreneurial Intention (한국과 중국동포의 심리적 특성과 창업동기가 창업의지에 미치는 영향)

  • Park, Kyung Seok;Ha, Kyu Soo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.2
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    • pp.61-70
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    • 2014
  • Entrepreneurship provides working opportunities to not only an entrepreneur himself but also many other people on the way its process. Boosting entrepreneurship, therefore, seems the most effective way for activating one's economy as well as creating jobs. This study examines factors that influence on entrepreneurial intention of Korean and Korean-Chinese's who will eventually be the potential entrepreneurs. This model tests various theoretical research hypotheses relating to individual psychological characteristics, and entrepreneurial motivation and entrepreneurial intention. Valid 247 questionnaires have been collected within about one month of 2013. Statistical processing of the data collected from this survey to take advantage of the statistical package SPSS 18.0 program through a process of data coding in the following ways: by frequency analysis, factor analysis, regression analysis. The result of hypothesis testing are as follows. The result of analysis shows that risk-taking propensity and desire for self-achievement is not a significant factor to entrepreneurial intention in both countries. But entrepreneurial self-efficiency and entrepreneurial motivation positively influence entrepreneurial intention both of the Korean and Korean-Chinese. At the last, the study examines moderate effect, that is, whether social support influences on entrepreneurial intention as a moderate variable. it is confirmed that the social support does play a positive role to entrepreneurial intention. Beside, discussion is made on the implications of the study for academicians and practitioners, the limitations of the study, and some directions for future studies.

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The Potential Driving Behavior Analysis of Novice Driver using a Driving Simulator (차량시뮬레이터를 이용한 초보운전자의 잠재적 운전행동 분석)

  • Lee, Sang-Ro;Kim, Joong-Hyo;Lee, Nam-Yong;Park, Young-Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.33 no.4
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    • pp.1591-1601
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    • 2013
  • In this study, It is conducted for novice drivers about driving behavior and psychological characteristics analysis to reduce traffic accident risk and provide the basic data of education program development. Therefore, this study classified by the category-specific characteristics and hazard prediction through survey of the novice driver and unpredictable behavior and psychological characteristics were studied. The novice and general characteristics and driving behavior with vehicle simulators, comparison and analysis of the novice driver traffic safety education basic research direction based on the statistical results. Prediction the results of this study, the Hazard of the driver, speeding, traffic violation, information providing omission, abrupt change, the number of accidents in all areas novice driver is high compared to the general driver. In addition, Novice driver showed a statistically significant level of Hazard compared to the general driver target novice drivers and the general ability to predict Hazard of violation, abrupt change, and a number of traffic accidents were omitted level of speeding and other information providing level drivers all showed similar results. Vehicle simulator. The experimental results showed that novice drivers compared to drivers poorly overall driving performance. It showed a notable difference in the number of collisions, especially novice drivers compared to drivers in complex road traffic conditions due to a lack of driving experience and learning ability are considered.

Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
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    • v.5 no.1
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    • pp.133-145
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    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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Cumulative Probability of Prostate Cancer Detection Using the International Prostate Symptom Score in a Prostate-specific Antigen-based Population Screening Program in Japan

  • Kitagawa, Yasuhide;Urata, Satoko;Narimoto, Kazutaka;Nakagawa, Tomomi;Izumi, Kouji;Kadono, Yoshifumi;Konaka, Hiroyuki;Mizokami, Atsushi;Namiki, Mikio
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7079-7083
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    • 2014
  • The International Prostate Symptom Score (IPSS) is often used as an interview sheet for assessing lower urinary tract symptoms (LUTS) at the time of prostate-specific antigen (PSA) testing during population-based screening for prostate cancer. However, the relationship between prostate cancer detection and LUTS status remains controversial. To elucidate this relationship, the cumulative probability of prostate cancer detection using IPSS in biopsy samples from patients categorized by serum PSA levels was investigated. The clinical characteristics of prostate cancer detected using IPSS during screening were also investigated. A total of 1,739 men aged 54-75 years with elevated serum PSA levels who completed the IPSS questionnaire during the initial population screening in Kanazawa City, Japan and underwent systematic transrectal ultrasonography-guided prostate biopsy between 2000 and 2013 were enrolled in the present study. Of the 1,739 men, 544 (31.3%) were diagnosed with prostate cancer during the observation period. The probability of cancer detection at 3 years in the entire study population was 27.4% and 32.7% for men with $IPSS{\leq}7$ and those with $IPSS{\geq}8$, respectively; there was no statistically significant difference between groups. In men with serum PSA levels of 6.1 to 12.0ng/mL at initial screening, the probability of cancer detection was significantly higher in men with $IPSS{\leq}7$ than in those with $IPSS{\geq}8$. There were no significant differences in clinical characteristics between groups of patients stratified by IPSS. These findings indicate that the use of IPSS for LUTS status evaluation may be useful for prostate cancer detection in the limited range of serum PSA levels.

Network Moderating Effects between Social Entrepreneurship and Organizational Performance: Focus on Jeju areas Social Enterprise Workers (사회적기업가 정신과 조직성과간의 네트워크 조절효과: 제주지역 사회적기업 근로자를 대상으로)

  • Kang, MoonSil;Kim, YoonSook
    • Journal of Service Research and Studies
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    • v.6 no.4
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    • pp.15-34
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    • 2016
  • The purpose of this study is to examine the effects of social entrepreneurship on organizational performance and to identify network moderating effects on social entrepreneurship and organizational performance. Data collected from 189 employees working in social enterprises were analyzed by using SPSS 18.0 program. Results are as follows: First, innovativeness, proactiveness, and social value orientation which were sub-factors of social entrepreneurship had positive effects on social performance. Second, proactiveness, risk-taking, and social value orientation which were sub-factors of social entrepreneurship had positive effects on economic performance. Third, the network significantly moderated the effects on innovativeness, proactiveness, social value orientation which were sub-factors of social entrepreneurship, and social performance. Fourth, the network significantly moderated the effects on proactiveness which was a sub-factor of social entrepreneurship, and economic performance. These results exhibited that the social entrepreneurship was effective to increase the organizational performance by activating the network and proposed a useful approach for further studies as an investigation method.