• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• Research in Community and Public Health Nursing
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• v.15 no.2
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• pp.255-265
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• 2004

Purpose: The purpose of this study was to investigate the effects of group art therapy on old adults' powerlessness, loneliness. depression and self-image (for 55-year old or older people). Method: An experimental group of 10 persons were given group art therapy for 1 hour per week for 8 weeks. Results: The result of this study showed that group art therapy is effective in decreasing older adults' powerlessness (p<0.05) and their loneliness and depression (p<0.05). However, there was no significant difference in the score of loneliness (p>0.05). A tree test was executed to analyze self-image change. and the result of the tree test showed a significant change in the tree shape. which mean a significant positive change in self-image. Conclusions: The scores of older adults' powerlessness, loneliness and depression were lowered by the group art therapy. Therefore it is thought that group art therapy program was an effective intervention for improving older adults' quality of life. Thus, this study suggests to apply group art therapy as a supportive nursing intervention in order to manage powerlessness, loneliness, depression and self-image in old low-income adults.

• Journal of Music and Human Behavior
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• v.15 no.2
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• pp.41-67
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• 2018

The purpose of this case study was to examine how a supportive songwriting program could facilitate resilience for adolescents with school maladjustment. Participants included four middle school students with adaptive difficulties. The participants received eight 50-minute sessions of a supportive songwriting program. The program consisted of singing and discussing selected songs, followed by the participants creating their own lyrics about their current adaptation issues. The Resilience Scale for Adolescents was completed by each participant before and after the intervention, and the participants' lyrics were analyzed for how the factors of resilience were reflected in their lyrics. The results showed that all participants' scores on the resilience scale increased. It was also found that the factor on the resilience scale that increased the most for each participant was related to the issues expressed in their lyrics. The results suggest that the process of writing songs can be effective in eliciting adolescents' school related issues and accessing their positive resources, which can lead to behavioral and psychological improvements.

• Women's Health Nursing
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• v.21 no.3
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• pp.197-206
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• 2015

Purpose: The purpose of this study was to examine the effects of light therapy on sleep disturbance and depression in climacteric women with menopausal symptoms. Methods: The research design was a nonequivalent control group pre test-post test design. Data were collected from September 29, 2013 to November 11, 2013. Participants included 17 climacteric women in an artificial light therapy group, 17 climacteric women in a sun light therapy group and 16 climacteric women in a control group. Measures consisted of the sleep disturbance, depression, melatonin, and serotonin. Results: There was a statistically significant difference of Korean Sleep Scale A (F=53.87, p<.001), and melatonin (F=31.19, p<.001) among three groups. There was a statistically significant difference of Self-Rating Depression Scale (F=121.86, p<.001), and serotonin (F=102.37, p<.001) among three groups. Conclusion: Artificial and sun light therapy can be applied as a supportive nursing intervention to subjects with sleep disturbance and depression in climacteric women with menopausal symptoms. Artificial and sun light therapy is expected to be a complementary alternative intervention for health management of the subjects with sleep disturbance and depression in climacteric women with menopausal symptoms.

• Korean Journal of Social Welfare
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• v.66 no.3
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• pp.29-53
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• 2014

This research is to study the economical, psychsocial, physical pains of the elderly mens living alone and the process being out of the isolated life. From this, we expect to propose a supportive program to help the living alone of the elderly mens. Six of the elderly mens living alone joined this research and the hermeneutical grounded theory methodology was applied to interpret it. Data were collected by the depth interview and various written records and they were analyzed by Rennie(2007)'s methodology. We could construct 13 categories by analyzing and categorizing meaningful units of the data. The core theme of the living alone experience was presented as "Accepting self-existence forgotten in the swamp of isolation and preparing for the blessed death." Based upon the research outcomes, we suggested a social supportive program considering the elderly men's characters and a way to improve the accessibility to the therapy system for the elderly mens living alone and the need for a meaning therapy.

• Oral Biology Research
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• v.42 no.4
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• pp.228-234
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• 2018

The aim of this study was to determine the condition of supportive periodontal therapy (SPT) in implant patients and the effect of SPT on implant long-term survival. Implants placed at the Dept. of Periodontology, Chonnam National University Dental Hospital over a 5-year period, were traced for up to 8 years. Patients who had visited the hospital at least once a year were defined as regular SPT, and patients who were treated by active periodontal therapy were defined as patients with periodontitis. Kaplan-Meier survival analysis was performed based on the observation periods, and the effect of SPT and history of periodontitis on implant survival assessed by chisquare test. A total of 183 patients (age: 21-91, 98 males and 85 females), and 508 implants were used for this study. Three hundred eight implants were under SPT and 87 implants was under regular SPT. For the patients with periodontitis 136 implants were placed. The 5-year survival rate was 94.8%. The overall survival rate in patients who received SPT was 97.1% and 91.0% for those who did not (p=0.004). The survival rate in patients who received regular SPT was 97.7%, and 96.8% for patients received irregular SPT. The survival rate was 93.4% in patients with periodontitis and 95.2% in patients without periodontitis. Among patients with periodontitis, the survival rate was 100.0% in patients who received regular SPT and 89.2% for irregular SPT (p=0.012). These results suggest that regular SPT improves implant survival rate and is more effective in patients with periodontitis.

• Korean Journal of Social Welfare Studies
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• v.42 no.1
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• pp.83-115
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• 2011

This research is to study the psychological, emotional, physical pains of the spouses of gambling addicts and the recovery process from the suffering. From this, we expect to propose a supportive program to help the recovery. Nine of the spouses of gambling addicts joined this research and the hermeneutical grounded theory methodology was applied to interpret it. Data were collected by the depth interview and various written records and they were analyzed by Rennie(2007)'s methodology. We could construct 20 categories by analyzing and categorizing meaningful units of the data. The core theme of the recovery experience was presented as "Stopping rolling the Sysyphus's boulder, and returning to the routine peace." Based upon the research outcomes, we suggested a supportive program considering male and female differences and a way to improve the accessibility to the therapy system for the spouses of gambling addicts and the need for a meaning therapy.

• Journal of Oriental Neuropsychiatry
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• v.35 no.3
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• pp.291-302
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• 2024

Objectives: To report result of Korean medicine treatment for post-traumatic stress disorder caused by a traffic accident. Methods: The patient was diagnosed with left talus fracture due to a traffic accident that occurred 10 days before visiting our hospital. The patient complained symptoms such as re-experiencing, intrusiveness, insomnia, and anxiety. We diagnosed him with post-traumatic stress disorder and applied Korean medicine treatment including Samulanshin-tang-gami pharmacopuncture, other acupuncture, herbal medicine, and supportive therapy. PCL-5, EQ-5D, and NRS were used as an evaluation tool. The patient's quality of sleep was also evaluated. Results: At 8 weeks after starting treatment, the patient's PCL-5, EQ-5D, and NRS PCL-5 scores all decreased, with PCL-5 score decreased from 51 to 20, mean NRS score decreased from 7 to 4.667, and EQ-5D score decreased from 54444 to 22223. The overall sleep quality of the patient increased. Conclusions: Korean medicine therapy including Samulanshin-tang-gami pharmacopuncture, other acupuncture, herbal medicine, and supportive therapy might be useful for alleviating symptoms of post-traumatic stress disorder caused by a traffic accident.

• Tuberculosis and Respiratory Diseases
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• v.78 no.1
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• pp.36-40
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• 2015

Malignant pleural mesothelioma (MPM) is an aggressive, treatment-resistant, and generally fatal disease. A 68-year-old male who was diagnosed with MPM at another hospital came to our hospital with dyspnea. We advised him to take combination chemotherapy but he refused to take the treatment. That was because he had already received chemotherapy with supportive care at another hospital but his condition worsened. Thus, we recommended photodynamic therapy (PDT) to deal with the dyspnea and MPM. After PDT, the dyspnea improved and the patient then decided to take the combination chemotherapy. Our patient received chemotherapy using pemetrexed/cisplatin. Afterwards, he received a single PDT treatment and then later took chemotherapy using gemcitabine/cisplatin. The patient showed a survival time of 27 months, which is longer than median survival time in advanced MPM patients. Further research and clinical trials are needed to demonstrate any synergistic effect between the combination chemotherapy and PDT.

• The Korean Journal of Nuclear Medicine
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• v.11 no.1
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• pp.71-75
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• 1977

A case is reported of aplastic anemia occuring during Methimazole therapy. Since this seems to be a kind of self-limiting disease having considerably rapid recovery, much more detailed supportive therapy is considered to be crucial rather than any other corticosteroid or the androgen therapy.