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Violence is present in all work environments. Standing on the frontline of the health care system, nurses are at greatest risk of being abused in the hospital setting. A recent study was conducted to determine the prevalence and nature of workplace violence against nurses, how nurses deal with such aggression, and to identify the risk factors related to violence in the hospital environment. Details are published in the February 2006 issue of Hong Kong Medical Journal.
Based on the returned questionnaire from 420 nurses, more than 70% reported abuse of any kind, including verbal abuse (73%), bullying (45%), physical abuse (18%), and sexual harassment (12%). Over 80% of nurses experiencing verbal abuse tended to confide in friends, family members, or colleagues; however, about 40% ignored the incident. Working in male wards and in certain specialties such as the Accident and Emergency Department, Community Nursing Service, and the Orthopaedics and Traumatology Department are risk factors for workplace violence included.
Findings of this study revealed that nurses are at high risk of workplace violence. Although most violence is verbal abuse, physical abuse and sexual harassment are not uncommon. Further large-scale studies should be conducted to more closely examine the problem.
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Acute lymphoblastic leukaemia (ALL) is the most common childhood malignancy. Although it is highly responsive to chemotherapy with satisfactory induction remission rates in many cases, relapse is often the major cause of treatment failure. The February 2006 issue of Hong Kong Medical Journal includes a study showing the outcome of children with ALL who were treated using a protocol including one or two delayed intensifications. Chemotherapy was modified from a German Berlin-Frankfurt-Muenster 95 (BFM95) protocol that included a delayed intensification similar to the induction phase repeated 5 months after diagnosis. High-risk patients were given double delayed intensification.
A total of 171 newly diagnosed patients (1997-2002) with a median age at diagnosis of 5.6 years were recruited in this study (HKALL97). The induction remission rate was 95%. Compared with a similar study in 1993 (HKALL93), a significant decrease in the relapse rate at 4 years (37% vs 16%) and a growth in the 4-year overall survival (82% vs 87%) were seen. Besides, the difference of event-free survival (survive without relapse) was most remarkable that the rate increased from 65% to 79%.
The results revealed that a more intensive delayed consolidation phase improved the outcome for children with ALL by reducing relapses at 4 years. The early treatment complications were manageable and non-leukaemia mortality during remission remained low.
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