Work engagement as a mediator between organizational commitment and job satisfaction among community health-care workers in China: a cross-sectional study.

The purpose of this study was to explore levels of organizational commitment, job satisfaction and work engagement among community health-care workers in China, and to examine spatial relationships of variables. Data were collected by Organizational Commitment Scale, Job Satisfaction Scale and Utrecht Work Engagement Scale from 1404 community health-care workers in Guangzhou and Shenzhen cities. Structural equation model was used to analyze relationships among three variables. Medium levels of organizational commitment, job satisfaction and work engagement were found among community health-care workers. Organizational commitment was positively correlated to work engagement (r = 0.564) and job satisfaction (r = 0.550). The path analysis indicated that total effect (ß = 0.598) of organizational commitment on job satisfaction (R2 = 0.52) consisted of a direct effect (ß = 0.264) and an indirect effect (ß = 0.334), which was mediated positively by work engagement. Improvement in work engagement may lead to higher level of job satisfaction and organizational commitment.

Triple intrathecal therapy without cranial irradiation for central nervous system preventive therapy in childhood acute lymphoblastic leukemia.

BACKGROUND: To evaluate the treatment results of central nervous system preventive therapy (CNSP) with triple intrathecal therapy (TIT) alone in children with acute lymphoblastic leukemia (ALL). METHODS: We retrospectively studied a cohort of 59 patients with median follow-up time 50.6 months (range: 27-80 months) at a single institution in Taiwan. Patients with ALL were classified in risk groups at diagnosis. TPOG-ALL-93 protocols and TPOG-ALL-2002 protocols were used. Both protocols were for multicenter studies in Taiwan and contained protocols for standard-risk (SR), high-risk (HR), and very-high-risk (VHR) patients. In this study, we used TIT alone for CNSP. In all ALL patients, methotrexate, hydrocortisone, and cytarabine were given at age-dependent doses. RESULTS: As of October 2006, patients had a 3-year event-free survival and an overall survival 89.4 +/- 4.1% (S.E.) and 93.1 +/- 3.3%, respectively. Under TIT no patients had complications such as seizure, encephalitis, or infection, and no morbidities like those caused by cranial irradiation. In this study, we used TIT alone for CNSP and had no CNS relapse. CONCLUSIONS: In the context of effective systemic therapy, TIT alone appears to be effective CNSP for most patients with ALL.

The development of a novel protocol for the treatment of de novo childhood acute myeloid leukemia in a single institution in Taiwan.

From November 1, 1995 to July 31, 2004, 49 children with de novo acute myeloid leukemia (AML) were treated at our institution. One patient who was treated by a different protocol was excluded. In total, 48 patients with de novo AML were enrolled in this study. Forty-two patients with AML other than acute promyelocytic leukemia (non-APL) were treated consecutively with 2 novel protocols: Mackay Memorial Hospital (MMH)-AML-96, designed as a pilot phase, and Taiwan Pediatric Oncology Group (TPOG)-AML-97A, on the basis of MMH-AML-96 with minor modifications. Six patients with APL were treated consecutively with 2 protocols, TPOG-APL-97 and APL-2001. As of July 31, 2006, the remission rates were 79%, 92%, and 98% after 1, 2, and 3 courses of induction therapy, respectively. The 5-year overall survival was 64%+/-6.9% (SE), and the 5-year event-free survival was 60%+/-7.1%; for non-APL AML, the rates were 62%+/-7.5% and 59%+/-7.6%; for APL, 83+/-15.2 and 67+/-19.3%. Among the factors analyzed, a complete remission achieved after 1 course of induction therapy, lactate dehydrogenase <500 IU/L at diagnosis, patients without invasive fungal infection during chemotherapy, and male sex were associated with a favorable outcome.