• Title/Summary/Keyword: multiple-group analysis

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Clinical Outcome of Turkish Metastatic Breast Cancer Patients with Currently Available Treatment Modalities - Single Center Experience

  • Cabuk, Devrim;Basaran, Gul;Teomete, Mehmet;Dane, Faysal;Korkmaz, Taner;Seber, Selcuk;Telli, Ferhat;Yumuk, Perran Fulden;Turhal, Serdar
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.117-122
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    • 2014
  • Background: Breast cancer is the most common malignancy and the second leading cause of cancer-related death among women in the developed countries. Despite advances in screening, improved local therapies and adjuvant systemic treatments, median survival of metastatic breast cancer patients (MBC) is in the range of 2-3 years at most. We aimed to investigate whether the prognostic factors and therapeutic responses of our Turkish patients are similar to those in the literature. Materials and Methods: We reviewed the medical records of MBC patients who had been treated in our institution between 1999-2009 and analyzed their clinicopathological features and survival outcomes retrospectively Results: A hundred and sixty patients were included. Median age was 47 (23-82), median follow up was 24 (2-186) months. At the time of diagnosis 59% of patients were under the age of 50 and 46% were postmenopausal. The majority (37%) had multiple sites of metastases. Forty percent received endocrine therapy and 40% chemotherapy as first line metastatic treatment. Thirty (20%) patients were treated with molecular targeting agents like trastuzumab, lapatinib and sunitinib, frequently combined with a chemotherapy agent. Five-year overall survival (OS) was 32% and median OS was 38 months for the whole group. Five year progression free survival (PFS) was 10% and median PFS was 10 months. Menopausal status, hormone receptor expression and disease free status had a significant impact on overall survival in the multivariate analysis (p 0.018, p 0.018 and p:0.003, respectively). Conclusions: All our patients were treated with the modern oncologic therapies recommended by the international guidelines. From our data, MBC patients live up to 3-4 years, indicating that further improvement beyond that requires development of new treatment modalities. The survival outcomes of our patients were consistent with the data reported in the literature.

The Effects of Interpersonal Relationships on Job Satisfaction of Home-visiting Care Helpers (방문 요양보호사의 대인관계가 직무만족에 미치는 영향)

  • Na, Mi-Jeong;Mo, Seon-Hee
    • The Journal of the Korea Contents Association
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    • v.15 no.4
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    • pp.234-245
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    • 2015
  • This study was to investigate the effects of interpersonal relationships on job satisfaction of home-visiting care helpers and the category of interpersonal relationships was subdivided into elderly clients, guardians, colleagues and directors considering the person-to-person nature of home-visiting care helper's job characteristics. A group of 336 care helpers who engaged in home-visiting care service providing facilities in Daejeon City was selected as a research subject, and the data were analyzed with SPSS 22.0 program using reliability, frequency, correlation and hierarchical multiple regression. The results for the final analysis revealed that the effect of socio-demographic features was not significant while, among characteristics of job performances, work priority, turnover experience, and career choice reasons turned out to have significant impacts on job satisfaction. In particular, interpersonal relationships except the one with guardians were found to be the most influential variables and the effects of those relationships on job satisfaction were significant. The influencing power was stronger in relationships with director, elderly clients, and colleagues in order, and the job satisfaction level was higher as they were in better relationships with director, elderly clients, and colleagues. The results of this research shows that it is necessary to set an atmosphere where harmonious interpersonal relationships can be formed inside and outside of facilities in order to improve job satisfaction of home-visiting care helpers.

Association with Self-Perception for Obesity and Mental Health among Korean Adolescent (한국청소년에서 자가비만인식도와 정신건강과의 관련성)

  • Hwang, In-Cheol;Lee, Kyoung-Shik;Park, Dong-Kyun;Jung, Eun-Young;Choi, Chung-Hyun;Cho, Seong-Jin;Bae, Seung-Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.2
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    • pp.112-119
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    • 2011
  • Objectives : Obesity has been linked to various psychological problems as well as medical complications, especially among adolescents. Previous studies have suggested an association between body weight and depression or self-esteem ; however, there has been little evidence on self-perception of weight and mental health. The aim of this study was to examine the association of perceptional weight status with mental health in Korean adolescents. Methods : This study was based on data obtained from the third Korean National Health and Nutritional Examination Survey (2005). The study sample consisted of 583 adolescents (268 boys, 315 girls) aged 12-18 years, who had completed the health survey, the health examination, and the nutritional survey. Participants were divided into two groups based on the actual or perceptional weight status: non-obese and obese. Questionnaires for stress, depressive mood, and suicidal thoughts were utilized as mental health indicators. Results : The agreement between actual and perceptional weight status was moderate (k value, 0.585 ; p<0.01). The influencing factors for the discrepancy between actual and perceptional weight status were body mass index of subjects and their parents' education. The obese group was likely to have higher stress levels and more experience of depressive mood or suicidal ideation in regard to both actual and perceptional weight status. A multiple logistic regression analysis revealed that girls who had perceived themselves as obese were more likely to have an experience of depressive mood than other girls (unadjusted OR, 4.98 ; adjusted OR, 5.15). Conclusion : An experience of depressive mood was significantly associated with the perception of weight status and not actual weight status in Korean female adolescents.

A Study of Factors Related to Job Satisfaction Affecting Service Year: A Dental Hygienist in Seoul (근속연수에 영향을 미치는 직무만족요인에 관한 연구: 서울지역 치과위생사를 중심으로)

  • Kim, Hyo-Jung;Kim, Yun-Ji;Kim, Myoung-Hee
    • Journal of dental hygiene science
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    • v.14 no.4
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    • pp.510-515
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    • 2014
  • Despite the high demand for dental care professionals, high turnover of dental hygienists have been reported, especially among workers in the dental clinics. This study aimed to examine job satisfaction factors affecting dental hygienist's service year in Seoul using cross-sectional data. The questionnaire survey was conducted from August 26, 2013 to September 13, 2013. Data were collected from 296 employees of dental clinics and hospitals located in Seoul. Logistic regression analysis was applied for parameter estimates, using PASW Statistics 18.0 and R software version 3.0.3. The Cronbach's ${\alpha}$ for the total job satisfaction factors was 0.922. In descriptive statistics, the group (that less than four years of working and over four years of working) had a statistically significant difference in age, religion, experience of turnover and autonomous factor among job satisfaction factors. In multiple logistic regression model, autonomy in job satisfaction was an important factor to predict the length of service in dental hygienist (odds ratio, 2.65; 95% confidence interval, 1.06~6.60). Autonomous factor was a significant predictor of length of service for dental hygienist. This study encourages future investigations of the role of job satisfaction of service year using better analytical frameworks.

Prediction Model for Reduced Bone mass in Women using Individual Characteristics & Life Style Factors (여성의 개인적 특성과 생활양식요인을 이용한 골량감소 예측모형)

  • Lee, Eun-Nam;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.83-109
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    • 1998
  • This study was carried out to identify the Important modifiable risk factors for reduced bone mass and to construct prediction model which can classify women with either low or high bone mass. Through the literature review, individual characteristics such as age, body weight, height, education level, family history, age of menarche, postmenopausal period, gravity, parity, menopausal status, and breast feeding period were identified and factors of life style such as past milk consumption, past physical activity, present daily activity, present calcium intake, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of reduced bone mass in women. Four hundred and eighty women aged between 28 and 76 who had given measurement bone mineral density by dual energy x-ray absortiometry in lumbar vertebrae and femur from July to October, 1997 at 4 general hospitals in Seoul and Pusan were selected for this study. Women were excluded if they had a history of any chronic illness such as rheumatoid arthritis, diabetes mellitus, hyperthroidism, & gastrointestinal disorder and any medication such as calcium supplements, calcitonin, estrogen, thyroxine, antacids, & corticosteroids known affect bone. As a result of these exclusion criteria, four hundred and seventeen women were used for analysis. Multiple logistic regression model was developed for estimating the likelihood of the presence or absence of reduced bone mass. A SAS procedure was used to estimate risk factor coefficient. The results are as follows For lumbar spine, the variables significant were age, body weight, menopause status, daily activity, past milk consumption, and past physical activity(p<0.01), while for femoral Ward's triangle, age, body weight, level of education, past milk consumption, past physical activity(p<0.001). Past physical activity, present daily activity and past milk consumption are the most powerful modifiable predictors in vertebrae and femur among the predictors. When the model performance was evaluated by comparing the observed outcome with predicted outcome, the model correctly identified 74.1% of persons with reduced bone mass and 84.5% of persons with normal bone mass in the lumbar vertebrae and 82.9% of persons with reduced bone mass and 75.0% of persons with normal bone mass in the femoral Ward's triangle. On the basis of these results, a number of recommendations for the management of reduced bone mass may be made : First, those woman who are classified as high risk group of the reduced bone mass in the prediction model should examine the bone mineral density to further examine the usefulness of this model. Second, the optimal amount of milk consumption and a regular weight bearing exercise in childhood, adolescence, and early adult should be ensured.

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Prognostic Model in Patients with Early-stage Squamous Cell Carcinoma of the Uterine Cervix: A Combination of Invasive Margin Pathological Characteristics and Lymphovascular Space Invasion

  • Khunamornpong, Surapan;Lekawanvijit, Suree;Settakorn, Jongkolnee;Sukpan, Kornkanok;Suprasert, Prapaporn;Siriaunkgul, Sumalee
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6935-6940
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    • 2013
  • Background: This study aimed to develop a prognostic model in patients with early-stage cervical squamous cell carcinoma based on clinicopathological features, including invasive margin characteristics. Materials and Methods: Clinicopathological features and outcomes of 190 patients with FIGO stage IB-IIA cervical squamous cell carcinoma treated by surgery were collected and analyzed for factors associated with tumor recurrence. In addition to well-recognized pathological risk factors, the pathological characteristics of invasive margin (type of invasive pattern and degree of stromal desmoplasia and peritumoral inflammatory reaction) were also included in the analysis. Multiple scoring models were made by matching different clinicopathological variables and/or different weighting of the score for each variable. The model with the best performance in the prediction of recurrence and decreased survival was selected. Results: The model with the best performance was composed of a combined score of invasive pattern, lymphovascular space invasion (LVSI), and degree of inflammatory reaction and stromal desmoplasia (total score =10). Compared to those with score ${\leq}8$, the patients with score 9-10 had a significantly higher recurrence rate in the overall group (p<0.001) and the subgroup without adjuvant therapy (p<0.001), while the significance was marginal in the subgroup with adjuvant therapy (p=0.069). In addition, the patients with score 9-10 had a higher rate of tumor recurrence at distant sites (p=0.007). The disease-free survival was significantly lower in the patients with score 9-10 than those with score ${\leq}8$ among the overall patients (p<0.001), in the subgroup without adjuvant therapy (p<0.001), and the subgroup with adjuvant therapy (p=0.047). Conclusions: In this study, a prognostic model based on a combination of pathological characteristics of invasive margin and LVSI proved to be predictive of tumor recurrence and decreased disease-free survival in patients with early-stage cervical squamous cell carcinoma.

A Study on the Satisfaction and Achievement of Learning by Female Learner's Characteristics in Internet Education Program (여성 학습자의 특성에 따른 인터넷교육 프로그램 만족도와 학업성취도에 관한 연구)

  • Lim, Kwang Myung;Kim, Sung Soo
    • Journal of Agricultural Extension & Community Development
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    • v.8 no.1
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    • pp.25-40
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    • 2001
  • The purposes of the study were to identify satisfaction and achievement of learning by female learner's characteristics, and to suggest measures to improve quality of education in internet education programs. In order to determine the educational effectiveness associated with the characteristics of learners, this study attempted to employ two way approaches by observing the degree of achievement for learning, which represents an instructor-oriented approach, and the degree of satisfaction for education, which represents a learner-oriented approach to enhance the quality of internet education for female learners. As an approach to evaluate the educational effectiveness, the degree of achievement in learning(Tyler's classical approach), and the degree of satisfaction for education (Scriven's consumer-oriented evaluation model) were utilized. A survey form was developed by the researcher after reviewing the various tools originated from Boshier, Cross, Gagne and Choi, and distributed to a panel of judges that examined the content validity of the instrument. The sample for the study consisted of 160 female learners from three universities in Seoul and capital area, and the survey form was used to collect data for this study. The SPSS WIN program was used in analyzing the data and a series of statistical tests were conducted including frequency, percentile, t-test, ANOVA, correlation, multiple regression, and factor analysis. The statistical significance level was 0.05. The following conclusion were drawn from this study of female internet education. First, it was evident that female internet learners tend to utilize information from internet, and this can be interpreted as participants' positive attitude, and voluntary participation. Second, educational facilities and services should be improved in the future, because the level of satisfaction was low in these areas compared to curriculum and educational methodology. Third, the participating factors influenced by the level of satisfaction for education of learner characteristics were the 'formation of inter-personal relationship and willingness to change' and the 'needs for education on internet', thus appeared that both social and educational needs influenced the level of satisfaction for education. Fourth, the degree of achievement in learning was higher in the order of 1) attitude 2) function 3) knowledge, thus, attitude change was the most important in achievement of learning. Fifth, the individual background that influenced the level of achievement in learning were age and educational experience. As for the individual level of achievement for learning, the younger and more educated group were more satisfied.

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A Study on the Relationship of Serum Vitamin D Levels with Insulin Resistance in Premenopausal Women (폐경 전 여성에서 혈청 비타민 D 농도와 인슐린 저항성에 관한 연구)

  • Lee, Ji-Hye;Hong, Jun-Hwa;Kim, Hyun-Jin;Park, Kang-Seo;Lee, Jae-Min;Kim, Byung-Joon;Ahn, Kyu-Jeung;Jeong, Bi-O;Kim, Sung-Hwan;Lee, Seong-Kyu
    • Journal of the East Asian Society of Dietary Life
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    • v.19 no.5
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    • pp.713-722
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    • 2009
  • Vitamin D levels have been reported to be associated with diabetes, obesity and metabolic syndrome. There have been studies on the nutritional status of vitamin D in postmenopausal women at Seoul and premenopausal women at Busan, and these studies showed that nearly no relationship between serum vitamin D levels and the obesity index existed. However, there have been no studies that examined about the relationship between serum vitamin D levels and insulin resistance in Korea. In this study, we investigated serum vitamin D levels and the relationship between serum vitamin D levels and insulin resistance (homeostasis model assessment of insulin resistance), obesity index (body mass index, percentage of body fat and waist circumference) in 180 premenopausal women (non-obese women 87.8%, obese women 12.2%) in spring (March~April), fall (September~October) and winter (January~February) at Daejeon. Serum vitamin D levels were lower in winter than in spring-fall, after adjusting for age and the obesity index. The frequency of vitamin D inadequacy (serum vitamin D levels were $\leq$ 20 ng/mL) was 45.5% in winter and, 23.5% in spring-fall, and which showed that vitamin D inadequacy was higher in winter than in spring-fall. Multiple regression analysis showed that serum vitamin D levels had no relationship with the obesity index or insulin resistance. There was no difference in the obesity index or insulin resistance between the vitamin D inadequacy and normal group, and there was no relationship between serum vitamin D levels and the obesity index or insulin resistance in non-obese and obese premenopausal women, respectively. In conclusion, serum vitamin D levels in premenopausal women at Daejeon were lower in winter than in spring-fall, and the frequency of vitamin D inadequacy was higher in winter than in spring-fall. Serum vitamin D levels had no relationship with the obesity index or insulin resistance in premenopausal women, most of whom were not obese.

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Effects of Neonatal Exposure of Di (n-butyl) Phthalate and Flutamide on Male Reproduction in Rats

  • Kim, Tae-Sung;Kim, Hyung-Sik;Shin, Jae-Ho;Lee, Su-Jung;Moon, Hyun-Ju;Kang, Il-Hyun;Kim, In-Young;Seok, Ji-Hyun;Oh, Ji-Young;Han, Soon-Young
    • Proceedings of the Korean Society of Embryo Transfer Conference
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    • 2002.11a
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    • pp.109-109
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    • 2002
  • In recent reports, the multiple reproductive defects such as cryptorchidism, hypospadias, epididymal cysts, low sperm counts, and testicular cancers are increased in humans, and these changes were doubted by the chemicals with estrogenic or antiandrogenic activities in our environment. To compare the effects of neonatal exposure of di (n-butyl) phthalate and flutamide on the development of reproductive organs and to identify the specific mechanisms of these abnormalities related to the male reproducton, Sprague-Dawley neonate male rats were injected subcutaneously during 5-14 days after birth with corn oil (control), flutamide (0.05, 0.1, and 0.5 mg/animal) and DBP (5, 10, and 20 mg/animal). Animals were killed at 31 (immature) and 42 (pubertal) days of age respectively and blood was collected from abdominal aorta for serum testosterone analysis. Testes, epididymides, seminal vesicles, ventral prostate, levator ani plus bulbocavernosus muscle (LABC), cowpers glands and glans penis were weighed. Expression of steroid hormone receptors (AR and ER) was examined in the testes and ventral prostate. At 31 days of age, ventral prostate, seminal vesicles, LABC, and cowpers glands significantly decreased in the flutamide (0.5 mg/animal) and DBP (20 mg/animal), but serum testosterone levels were not changed. Flutamide slightly delayed the testes descent at the high dose (0.5 mg/animal), but DBP did not show any significant effect on the testes descent at all doses. DBP and flutamide decreased the expression of AR protein in the testes but did not affect the expression of ERa and ER protein in the testes. At 42 days of age, ventral prostate, seminal vesicles, and cowpers glands weights were still significantly decreased at the high dose of flutamide (0.5 mg/animal) and DBP (20 mg/animal), but the weights of testes and epididymides were not different. Serum testosterone decreased significantly in DBP treated animals and slightly, not significantly, in flutamide group. While DBP still significantly decreased the expression of AR protein in testis, flutamide recovered from downregulation of AR protein and did not affect the expression of ERa and ER protein in the testes. Based on these results, flutamide and DBP have shown several similar patterns in reproductive abnormalitis, but some marked differences which may be caused by different acting mechanism.

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A Study on Depression, Self-esteem and Health Practice of Female Workers in Small Workplace (소규모 사업장 여성근로자의 우울, 자아존중감과 건강실천행위)

  • Han Su Jeong
    • Journal of Korean Public Health Nursing
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    • v.16 no.2
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    • pp.454-468
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    • 2002
  • Historically, women's health needs have been viewed primarily as reproductive, and all other health needs have been dealth with without considering their responses to disease and treatment(Strickland & Giger, 1994). It has mostly been through the efforts of women's group, especially health care team, that more recognition has been given to the overall health of women worker in recent years. The purpose of this study was to examine the depression, self-esteem and health practice in order to identify health care strategies to improve health promotion among women workers in small workplace. The consisted of 94 women workers who work at small manufacturing industry. The data were collected from January to February, 2002. The instruments for this study was Rogenburgs self-esteem scale, Zung s depression self-reporting scale and Breslow & Enstrom s health habits scale. The analysis of data were performed with frequency, percentage, t-test, ANOVA. $\chi^2$ test, pearson correlation and multiple regression using SPSS Win 10.1 program. 1. The average depression score was 1.87 which is relatively low and the average self-esteem score was 2.75 which is relatively moderate. The total mean score for health practice was 4. 10(range 0-7) which is relatively high moderately. 2. Health practice had not a statistically significant correlation with depression and self-esteem, but the depression had a statistically significant correlation with self-esteem(r=-.401, p=.000). 3. There was not a significant difference In depression, self-esteem and health practice according to the general characteristics 4. There was a significant difference in sub category of health practice according to the status of living with family and status of marriage. As far as the health practice of women workers living with family practiced better health than women workers no living with family concerning breakfast(p=.03) and as far as the health practice of women workers no living with family practiced better health than women workers living with family concerning sleeping time(p=.04). There was a significant difference in breakfast(p=.04), smoking(p=.00), and BMI(p=.05) according to the status of marriage. 5. The major factor was age and explained for $7\%$ of health practice. The repeated study should be carried out to figure out the health practice and its related factors of female workers at small manufacturing industry.

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