Purpose: This study evaluated whether combination therapy is more effective than monotherapy in elderly patients with metastatic or recurrent gastric cancer (MRGC) as first-line chemotherapy. Materials and Methods: Elderly (≥ 70 years) chemo-naïve patients with MRGC were allocated to receive either combination therapy (group A: 5-fluorouracil [5-FU]/oxaliplatin, capecitabine/oxaliplatin, capecitabine/cisplatin, or S-1/cisplatin) or monotherapy (group B: 5-FU, capecitabine, or S-1). In group A, starting doses were 80% of standard doses, and they could be escalated to 100% at the discretion of the investigator. Primary endpoint was to confirm superior overall survival (OS) of combination therapy vs. monotherapy. Results: After 111 of the planned 238 patients were randomized, enrollment was terminated due to poor accrual. In the full-analysis population (group A [n=53] and group B [n=51]), median OS of combination therapy vs. monotherapy was 11.5 vs. 7.5 months (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.56 to 1.30; p=0.231). Median progression-free survival (PFS) was 5.6 vs. 3.7 months (HR, 0.53; 95% CI, 0.34 to 0.83; p=0.005). In subgroup analyses, patients aged 70-74 years tended to have superior OS with combination therapy (15.9 vs. 7.2 months, p=0.056). Treatment-related adverse events (TRAEs) occurred more frequently in group A vs. group B. However, among severe TRAEs (≥ grade 3), there were no TRAEs with a frequency difference of > 5%. Conclusion Combination therapy was associated with numerically improved OS, although statistically insignificant, and a significant PFS benefit compared with monotherapy. Although combination therapy showed more frequent TRAEs, there was no difference in the frequency of severe TRAEs.

Purpose: The purpose of this study was to understand the effects of infection control fatigue and social support on burnout among nurses during the Coronavirus Disease 2019 (COVID-19) pandemic. Methods: This study is a descriptive survey study designed to confirm the effects of nurses' infection control fatigue and social support on burnout among nurses during the COVID-19 pandemic. The collected data were analyzed using frequency, percentage, mean, standard devia analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheffé test, Pearson’s correlation coefficient, and stepwise multiple regression analysis using SPSS Statistics 26.0. Results: An analysis of the correlations between fatigue from infection control, social support, and burnout showed a positive correlation between burnout and fatigue from infection control (r=.39, p<.001), and a negative correlation between burnout and social support (r=-.29, p<.001). Conflict and lack of support due to uncertain circumstances (β=.51, p<.001), support from supervisor's (β=-.22, p<.001), and experience of infection management education during the previous 1year (β=-.15, p=.007) were identified as the factors that influenced burnout among nurses, and explained 39.0% of the variance in burnout. Conclusion The results of this study demonstrate that fatigue from infection control and social support influence burnout levels among nurses, which suggests the need to establish a new kind of work culture. Additionally, the findings call for the development and implementation of interventional programs that can reduce fatigue from infection control and increase social support for nurses.

Purpose: This study was conducted to assess the factors affecting turnover intention of the nurses working in neonatal intensive care units, including the extent of fatigue, work stresses, and work overload related to infection control. Methods: This was a descriptive correlational study to test factors affecting the turnover intention of the nurses working in neonatal intensive care units. Data was analyzed utilizing descriptive statistics, t-test, One-way ANOVA, Pearsons’ Correlation Coefficient, and multiple regressions by using the IBM SPSS Statistics 23.0 Program(IBM Corp., Armonk, NY). Results: The turnover intention of nurses had a positive correlation with the extent of fatigue (r=.54, p<.001), work stress (r=.40, p<.001), and with the work overload (r=.43, p<.001) related to infection control. In addition, factors affecting the turnover intention of nurses included the extent of fatigue (β=.52, p<.001) related to infection control and the number of pediatric patients assigned to each nurse (β=.26, p=.001) and the variances explained by the regression model was 37.0%. Conclusion It is necessary to establish and implement strategies to lower the extent of fatigue related to infection control by reducing the nurses’ workload. Securing additional nurses to ensure an appropriate number of pediatric patients assigned to each nurse, and providing efficient management and available resources to reduce the turnover intention of nurses working in neonatal intensive care units are suggested.

Purpose: This study was conducted to assess the factors affecting turnover intention of the nurses working in neonatal intensive care units, including the extent of fatigue, work stresses, and work overload related to infection control. Methods: This was a descriptive correlational study to test factors affecting the turnover intention of the nurses working in neonatal intensive care units. Data was analyzed utilizing descriptive statistics, t-test, One-way ANOVA, Pearsons’ Correlation Coefficient, and multiple regressions by using the IBM SPSS Statistics 23.0 Program(IBM Corp., Armonk, NY). Results: The turnover intention of nurses had a positive correlation with the extent of fatigue (r=.54, p<.001), work stress (r=.40, p<.001), and with the work overload (r=.43, p<.001) related to infection control. In addition, factors affecting the turnover intention of nurses included the extent of fatigue (β=.52, p<.001) related to infection control and the number of pediatric patients assigned to each nurse (β=.26, p=.001) and the variances explained by the regression model was 37.0%. Conclusion It is necessary to establish and implement strategies to lower the extent of fatigue related to infection control by reducing the nurses’ workload. Securing additional nurses to ensure an appropriate number of pediatric patients assigned to each nurse, and providing efficient management and available resources to reduce the turnover intention of nurses working in neonatal intensive care units are suggested.

The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into ‘dental hygiene job relevance’, ‘dental hygiene competency relevance’, ‘timeliness’, and ‘value discrimination of educational goal setting’ to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.
Cross-Sectional Studies ; Data Collection ; Dental Hygienists ; Discrimination (Psychology) ; Education ; Expert Testimony ; Humans ; Hygiene ; Learning* ; Medical Assistance ; Oral Health* ; Oral Hygiene* ; Social Security

Bovine tuberculosis is a chronic contagious disease responsible for major agricultural economic losses. Abattoir monitoring and trace-back systems are an appropriate method to control bovine tuberculosis, particularly in beef cattle. In the present study, a trace-back system was applied to bovine tuberculosis cases in Korean native Hanwoo beef cattle. Bovine tuberculosis was detected in three index beef cattle during abattoir monitoring in Jeonbuk Province, Korea, and the original herds were traced back from each index cow. All cattle in each original herd were subjected to tuberculin skin test. The positive rates in the tuberculin skin test were 64.6% (62 of 96), 4.8% (2 of 42), and 8.1% (3 of 37) at farms A, B, and C, respectively. On post-mortem examination of 56 tuberculin-positive cattle, 62% had granulomatous lesions, and Mycobacterium bovis was cultured from 40 (71.4%) of the cattle. Molecular typing by spoligotyping and the mycobacterial interspersed repetitive unit-variable-number tandem repeat assay revealed the genotype of the M. bovis strains from the index cattle were same as the M. bovis genotype in each original herd. The results suggest that tracing back from index cattle to the original herd is an effective method to control bovine tuberculosis in beef cattle.
Abattoirs ; Agriculture ; Animals ; Autopsy ; Cattle ; Disease Outbreaks ; Genotype ; Jeollabuk-do ; Korea ; Methods ; Molecular Typing ; Mycobacterium bovis ; Red Meat ; Skin Tests ; Tandem Repeat Sequences ; Tuberculin ; Tuberculosis, Bovine

BACKGROUND: Microvascular decompression with retromastoid craniotomy carries an especially high risk of postoperative nausea and vomiting. In this study, we compare the antiemetic efficacy of ramosetron and ondansetron in patients undergoing microvascular decompression with retromastoid craniotomy. METHODS: Using balanced anesthesia with sevoflurane and remifentanil infusion, ondansetron 8 mg (group O, n = 31) or ramosetron 0.3 mg (group R, n = 31) was administered at the dural closure. The incidence and severity of postoperative nausea and vomiting, required rescue medications and the incidence of side effects were measured at post-anesthetic care unit, 6, 24 and 48 hours postoperatively. Independent t-tests and the chi-square test or Fisher's exact test were used for statistical analyses. RESULTS: There were no differences in the demographic data between groups, except for a slightly longer anesthetic duration of group R (P = 0.01). The overall postoperative 48 hour incidences of nausea and vomiting were 93.6 and 61.3% (group O), and 87.1 and 51.6% (group R), respectively. Patients in group R showed a less severe degree of nausea (P = 0.02) and a lower incidence of dizziness (P = 0.04) between 6 and 24 hours. CONCLUSIONS: The preventive efficacy of ramosetron when used for postoperative nausea and vomiting was similar to that of ondansetron up to 48 hours after surgery in patients undergoing microvascular decompression with retromastoid craniotomy. A larger randomized controlled trial is needed to confirm our findings.
Antiemetics* ; Balanced Anesthesia ; Chi-Square Distribution ; Craniotomy* ; Dizziness ; Humans ; Incidence ; Microvascular Decompression Surgery* ; Nausea ; Ondansetron* ; Postoperative Nausea and Vomiting ; Vomiting

PURPOSE: This study was done to apply failure mode & effect analysis (FMEA) to chemotherapy in order to reduce prescribing, dispensing and administering errors related to treatment and provide patients with a safe medical environment. METHODS: A one group pre-post test design was used to verify the effects using the tool for FMEA in chemotherapy. RESULTS: There was a statistically significant decrease in prescribing errors from 11.47% to 3.18%; administering errors decreased but they were not statistically significant. In a addition, there was no change in dispensing errors. CONCLUSION: The results show that FMEA removed risk factors that might occur during the process of chemotherapy and that it was an effective tool for prevention of negligent accident occurring in actual patients.
Drug Therapy* ; Evaluation Studies as Topic ; Humans ; Nursing* ; Patient Safety* ; Risk Factors

We cloned the full-length cDNA of O Manisa, the virus for vaccinating against foot-and-mouth disease. The antigenic properties of the virus recovered from the cDNA were similar to those of the parental virus. Pathogenesis did not appear in the pigs, dairy goats or suckling mice, but neutralizing antibodies were raised 5-6 days after the virus challenge. The utilization of O Manisa as a safe vaccine strain will increase if recombinant viruses can be manipulated by inserting or removing a marker gene for differential serology or replacing the protective gene from another serotype.
Animals ; Antibodies, Neutralizing ; Clone Cells* ; Cloning, Molecular ; DNA, Complementary* ; Foot-and-Mouth Disease ; Foot-and-Mouth Disease Virus* ; Goats ; Humans ; Mice ; Parents ; Swine ; Virulence*

In this study, trends in the sales of antimicrobials for use in livestock facilities and fisheries from 2003 to 2012 were investigated with regard to antimicrobial group, antimicrobial usage, and animal species. The overall amount of antimicrobials sold each year from 2003 to 2007 was 1,500 tons, after which they decreased, with the lowest sales being 936 tons in 2012. The total volume of antimicrobials used for feed additives decreased markedly by 94% from 2003 to 2012, which was mainly attributed to banning of feed additives. However, antimicrobial consumption through self prescription by farmers for disease prevention and treatment increased by 25% from 2003 to 2012. The largest volume of antimicrobials sold was for use in pigs (48~57%), followed by poultry (18~24%), fisheries (11~25%), and cattle (5~8%). Tetracycline was the highest selling antimicrobial, followed by penicillins and sulfonamides, although the overall sale of all three antimicrobials gradually decreased over the study period. This study demonstrated that the total consumption of antimicrobials has gradually decreased since 2008. Nevertheless, usage by nonprofessionals increased, which can ultimately cause emergence and spread of antimicrobial resistance. Thus, early establishment of veterinary prescription guidelines for prudent use of antimicrobials is urgently needed in Korea.
Animals ; Cattle ; Commerce* ; Fisheries* ; Korea ; Livestock* ; Penicillins ; Poultry ; Prescriptions ; Sulfonamides ; Swine ; Tetracycline