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The Factors Influencing the Organizational Silence of Social Workers
No full text본 연구는 사회복지사의 조직침묵에 영향을 미치는 요인을 발견하기 위한 연구이다. 조직침묵은 조직 구성원들이 특정사안에 대해 집합적으로 침묵하는 현상으로 구성원의 직무만족도와 업무태도 그리고 이직의도에 부정적인 영향을 미치는 요인이다. 사회복지분야에서의 조직침묵에 대한 연구는 이제 시작되고 있지만 특정 분야와 지역에 집중된 표본선정의 문제를 가지고 있다. 이러한 문제점을 극복하기 위하여 2019년 한국사회복지사협회의 사회복지사 통계연감 자료 중 전국의 민간기관에 근무하는 2,846명의 자료를 분석하였으며, SPSS Win 27.0 프로그램을 사용하여 기술통계와 상관관계 분석 그리고 다중회귀분석을 실시하였다. 연구결과 사회인구학적 특성으로는 연령과 직위가 조직침묵에 영향을 미치는 것으로 나타나고 있으며, 직무 및 조직특성으로 직무동기 중 내재적 동기와 외재적 동기, 개인-조직 적합성, 시설내 의사소통, 직무자율성, 조직문화와 비윤리적 행위가 영향을 미치는 것으로 나타났다. 한편 외재적 동기와 조직문화 그리고 조직의 비윤리적 행위는 조직침묵을 증가시키는 것으로 나타났다. 사회복지사의 조직침묵을 감소시키기 위해서는 건강한 의사소통을 통한 조직문화의 형성과 직무자율성 향상과 비윤리적 행위 등의 감소 등과 같은 다양한 대책이 필요함을 보여준다.
This study aims to discover the factors influencing the organizational silence of social workers. Organizational silence is a phenomenon in which members of the organization collectively remain silent on specific issues and is a factor that negatively affects members job satisfaction, job attitudes, and turnover intention. The study of social professionals' organizational silence is only getting started, but its sample selection is limited to certain regions and fields of expertise. To overcome these limitation, data from the 2019 Social Workers Statistical Yearbook of the Korea Association of Social Workers was used, and 2,846 employees of private institutions nationwide provided responses, which were analyzed. For data analysis, descriptive statistics, correlation analysis, and multiple regression analysis were performed using SPSS Win 27.0. As a result of analyzing the factors affecting organizational silence, in social demographic characteristics age and position status affect organizational silence. In job and organizational characteristics, intrinsic and extrinsic job motivations, individual-organizational suitability, communication in facilities, job autonomy, organizational culture and unethical behavior influence organizational silence. Extrinsic motivation, organizational culture and unethical behavior increase organizational silence. It shows that to reduce the organizational silence of social workers, various measures such as the formation of an organizational culture through healthy communication, improvement of job autonomy, and reduction of unethical behavior are needed
Initial case series experience with robotic-assisted transanal minimally invasive surgery performed with da Vinci single-port system for the excision of rectal cancer
No full textBackground: Transanal minimally invasive surgery (TAMIS) is widely used for rectal lesion excision. Robot-assisted TA TAMIS (R-TAMIS) may improve surgical ergonomics. The introduction of the da Vinci Single-Port (SP) robot, designed for endoluminal surgery, has brought new possibilities. Our primary objective herein was to assess the technical and oncological feasibility and efficacy of Single-port robotic TAMIS (SPR-TAMIS) in rectal cancer excision. The secondary objective was to analyze the perioperative outcomes.
Materials and methods: We included 14 consecutive patients with rectal cancer who underwent SPR-TAMIS between April 2021 and February 2023. Patient data, surgical details, and clinical outcome data were collected to assess the safety and feasibility of SPR-TAMIS.
Results: The median participant age was 72 years, and full-thickness excision was performed without specimen fragmentation in all cases. The median tumor diameter was 2.7 cm, positioned between 10 cm proximally and 7 cm distally from the anal verge. Negative margins were achieved in 93% of cases, with one case requiring further resection. The median operative time was 175 min, and the median hospital stay was 5 days. No intraoperative conversion from SPR-TAMIS to laparoscopic or conventional transanal excision was required. No mortalities or major postoperative complications occurred; however, one patient (7.1%) experienced minor morbidity manifesting as wound dehiscence (Clavien-Dindo grade I). No recurrence was observed during the 24-month follow-up.
Conclusions: In our early experience, SPR-TAMIS is a safe and feasible surgery for selected early stage rectal cancers, offering enhanced visualization and stable maneuverability transanally. This platform may have potential advantages for the excision of larger or more proximal lesions
Differences in spatiotemporal dynamics for processing specific semantic categories: An EEG study
No full textSemantic processing is an essential mechanism in human language comprehension and has profound implications for speech brain-computer interface technologies. Despite recent advances in brain imaging techniques and data analysis algorithms, the mechanisms underlying human brain semantic representations remain a topic of debate, specifically whether this occurs through the activation of selectively separated cortical regions or via a network of distributed and overlapping regions. This study investigates spatiotemporal neural representation during the perception of semantic words related to faces, numbers, and animals using electroencephalography. Source‐level analysis focuses on contrasting neural responses to different semantic categories. Critical intervals used in the source contrast analysis are defined using the peak duration of global field power. Effective connectivity, determined through a causality analysis of brain regions activated for semantic processing, is explored. The findings reveal the necessity of a distributed network of regions for processing specific semantic categories and provide evidence suggesting the existence of a neural substrate for semantic representations
The Real-World Tidal Volume Variability is Associated with Treatment Outcomes in the Acute Respiratory Distress Syndrome : A Retrospective Cohort Study
No full textBackground: Excessive spontaneous breathing during mechanical ventilation can lead to patient self-inflicted lung injury. However, clinical data linking spontaneous breathing to treatment outcomes is insufficient. We aimed to evaluate the effect of tidal volume variability on ventilator-free days in mechanically ventilated patients with acute respiratory distress syndrome (ARDS) using high-resolution tidal volume data stored through the patient monitor. Methods: In this single-center, retrospective cohort study, adult ARDS patients who received mechanical ventilation in our medical intensive care unit between April 2018 and July 2019 were included. Study patients’ expiratory tidal volume data during the first 7 days of mechanical ventilation was collected every 2 seconds by the patient monitors. The included patients were dichotomized within each tidal volume stratum into high and low tidal volume variability groups based on the standard deviation of tidal volume values normalized by predicted body weight. The primary outcome was ventilator-free days. Results: A total of 108 ARDS patients were categorized into the high and low tidal volume variability groups (each 54 patients). The baseline characteristics of the two groups were comparable except for the height (165 ± 8 cm vs 162 ± 7 cm; P = 0.02). The ventilator-free days were significantly fewer in the high tidal volume variability group (0 [IQR, 0–16] days vs. 10 [IQR, 0–21] days; mean difference, -4.5 [95% CI, -8.3–-0.7] days; P = 0.01). After adjusting for age, sex, body mass index, APACHE II score, and baseline PaO2/FiO2 ratio, high tidal volume variability was significantly associated with zero ventilator-free days (odds ratio, 3.74; 95% CI, [1.55–9.06]; P = 0.003). Conclusion: Based on the high-resolution tidal volume data acquired from the patient monitor, high tidal volume variability during the first 7 days of mechanical ventilation in ARDS patients was associated with fewer ventilator-free days. Keywords: tidal volume variability; spontaneous breathing; patient self-inflicted lung injury; mechanical ventilation; ARDSDocto
Preventing fraud victimisation against older adults: Towards a holistic model for protection
No full textThe prevention of fraud against older adults and other age groups, has been the subject of limited research with very few systematic attempts to map different tools and strategies that are used. This paper using the UK and South Korea as a starting point, but other countries too, maps some of the most common tools and strategies used to prevent frauds that target older adults. It develops the first comprehensive typology of strategies built upon the degree to which they embrace modern technology. It shows much of the prevention used is low tech, but high-tech solutions rooted in the fourth industrial revolution technologies are emerging and growing. The paper draws these different strategies and tools together to offer a holistic model for the prevention of fraud against older adults for further debate and utilisation by professionals
Prognostic Impact of Inflammation-Based Factors in Patients with Esophageal Squamous Cell Carcinoma Achieving Pathological Complete Response After Neoadjuvant Chemoradiotherapy Followed by Surgery
No full textBackground: Patients achieving pathological complete response (pCR) post-neoadjuvant chemoradiotherapy (nCRT) and surgery for locally advanced esophageal squamous cell carcinoma (ESCC) have a favorable prognosis. However, recurrence occurs in approximately 20-30% of all patients, with few studies evaluating their prognostic factors. We identified these prognostic factors, including inflammation-based markers, in patients with ESCC showing pCR after nCRT and surgery.
Patients and methods: Patients with ESCC undergoing esophagectomy post-nCRT (January 2007-August 2017) were studied. Survival analysis evaluated 5-year overall (OS) and recurrence-free survival (RFS). Risk factors, including inflammation factors, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (PLR), were analyzed using Cox-proportional hazards model.
Results: Overall, 123patients participated herein. After a median follow-up duration of 67 months (44-86 months), 17 patients (12.3%) had recurrent disease. The 5-year OS and RFS rates were 71.6% and 68.0%, respectively. In the multivariable analysis, older age (
≥
60 years) [hazard ratio (HR) 3.228, 95% confidence interval (CI) 1.478-7.048, p = 0.003], higher pretreatment T stage (≥ T3; HR 2.563, 95% CI 1.335-4.922, p = 0.005), nonapplication of induction chemotherapy (HR 2.389, 95% CI 1.184-4.824, p = 0.015), and higher post-nCRT PLR (≥ 184.2; HR 2.896, 95% CI 1.547-5.420, p = 0.001) were poor independent prognostic factors for 5-year RFS. The patient group with three to four identified factors with poor outcomes exhibited a 5-year RFS rate of 46.2%.
Conclusions: Significant prognostic factors include higher post-nCRT PLR, older age, higher clinical T stage, and nonapplication of induction chemotherapy. Identifying higher recurrence risk patients is crucial for tailored follow-up and treatment
A Systematic Study of the Temperature Dependence of the Dielectric Function of GaSe Uniaxial Crystals from 27 to 300 K
No full textWe report the temperature dependences of the dielectric function ε = ε1 + iε2 and critical point (CP) energies of the uniaxial crystal GaSe in the spectral energy region from 0.74 to 6.42 eV and at temperatures from 27 to 300 K using spectroscopic ellipsometry. The fundamental bandgap and strong exciton effect near 2.1 eV are detected only in the c-direction, which is perpendicular to the cleavage plane of the crystal. The temperature dependences of the CP energies were determined by fitting the data to the phenomenological expression that incorporates the Bose-Einstein statistical factor and the temperature coefficient to describe the electron-phonon interaction. To determine the origin of this anisotropy, we perform first-principles calculations using the mBJ method for bandgap correction. The results clearly demonstrate that the anisotropic dielectric characteristics can be directly attributed to the inherent anisotropy of p orbitals. More specifically, this prominent excitonic feature and fundamental bandgap are derived from the band-to-band transition between s and pz orbitals at the Γ-point
Epidemiology and Disease Burden of Respiratory Syncytial Virus Infection in Adults
No full textRespiratory syncytial virus (RSV) constitutes a significant cause of respiratory illness and mortality among older adults, a demographic that is expanding with considerable impact on healthcare systems worldwide. The actual burden of RSV in this population may still be underestimated, owing to factors such as low awareness and suboptimal diagnostic sensitivity in adults, the lack of robust RSV surveillance systems, and the infrequent use of diagnostic testing. Recent advancements in respiratory virus detection have spurred further exploration into appropriate preventive and therapeutic strategies. The recent approval of two vaccines highlights the critical need for the precise estimation of the RSV disease burden to optimize the effectiveness and cost-efficiency of immunization programs. This narrative review aimed to summarize the existing knowledge of the RSV burden in adults with a particular focus on older adults, incorporating data from Korea. Overall, current estimates indicate that the annual RSV attack rate in the general adult population ranges from 1 - 7%, increasing to approximately 4 - 10% among elderly and high-risk groups. The in-hospital mortality rate can be estimated to be around 7 - 10%, rising up to 40% among intensive care unit-admitted patients. To elucidate RSV's disease burden, further continuing research, including population-based studies, is necessary
Tests of the Null of Cointegration Using Integrated and Modified OLS Residuals
No full textThis study develops a KPSS (Kwiatkowski et al., 1992)-type cointegration test utilizing residuals from integrated and modified ordinary least squares (IMOLS) estimation. The test statistic, denoted by KPSSFb has a pivotal null limit distribution under fixed-b assumption. The proposed test demonstrates reasonable performance in terms of size and power when the Andrews’ AR(1) plug in data-dependent (DD) bandwidth is employed and fixed-b critical values are used. Additionally, two modified IMOLS residuals are proposed to obtain alternative data-dependent bandwidths. In the simulation experiment, these bandwidths deliver improved power properties for the proposed test
Trastuzumab deruxtecan versus trastuzumab emtansine in HER2-positive metastatic breast cancer: long-term survival analysis of the DESTINY-Breast03 trial
No full textTrastuzumab deruxtecan (T-DXd) demonstrated significantly improved efficacy over trastuzumab emtansine (T-DM1) in DESTINY-Breast03 (median follow-up, 28 months). We report updated efficacy and safety analyses, including secondary and exploratory efficacy endpoints (median follow-up, 41 months) of DESTINY-Breast03. Patients with advanced HER2-positive metastatic breast cancer previously treated with taxane and trastuzumab were randomized to T-DXd (5.4 mg per kg (261 patients)) or T-DM1 (3.6 mg per kg (263 patients)). The primary endpoint was progression-free survival (PFS) by blinded independent central review and was previously reported. The key secondary endpoint was overall survival (OS). Other secondary endpoints included objective response rate, duration of response and PFS (all by investigator assessment) and safety. At data cutoff, 20 November 2023, median PFS by investigator assessment was 29.0 versus 7.2 months (hazard ratio (HR), 0.30; 95% confidence interval (CI), 0.24-0.38), the 36-month PFS rate was 45.7% versus 12.4% and median OS was 52.6 versus 42.7 months (HR, 0.73; 95% CI, 0.56-0.94) with T-DXd versus T-DM1, respectively. Treatment-emergent adverse events were consistent with the previous analyses. No new instances of grade ≥3 interstitial lung disease or pneumonitis occurred (all grade rate, 16.7% (T-DXd) versus 3.4% (T-DM1)). With longer follow-up, T-DXd continued to demonstrate superior efficacy over T-DM1 with a manageable safety profile. ClinicalTrials.gov registration: NCT03529110