Purpose: This mixed method study aimed to investigate patients' level of anxiety and their experience of this before undergoing esophagogastroduodenoscopy (EGD). Methods: A total of 125 patients answered a questionnaire assessing their pre-EGD level of anxiety, and a total of 17 patients participated in individual interviews regarding their experience of EGD-related anxiety. The SPSS Software program was used for survey data analysis and content analysis was used for qualitative data. Results: The mean anxiety score was 40.00±9.86 and the factors related to anxiety levels were being female (p<.001) and being a relatively young age (20-30 years old, p=.004). There were no significant differences shown in level of anxiety according to the purpose EGD was performed for: screening, diagnosis, or disease follow-up. In the qualitative analysis, however, patients who underwent a follow-up procedure as a result of stomach cancer exhibited more complicated feelings of anxiety and helplessness than others. For those who underwent EGD for diagnostic reasons, they worried about the test results and were concerned about possible life changes after diagnosis. Those for whom EGD was performed for screening purposes expressed concern only in the event of EGD complications. Conclusion: This study explored the nature of pre-EGD anxiety according to the purpose of the procedure. Nurses and doctors should be aware that patients undergoing EGD may have different levels and experiences of pre-procedure anxiety.
Although financial information is a great influence upon determining of the group which use them, detection of management fraud and earning manipulation is a difficult task using normal audit procedures and corporate credit evaluation processes, due to the shortage of knowledge concerning the characteristics of management fraud, and the limitation of time and cost. These limitations suggest the need of systemic process for !he effective risk of earning manipulation for credit evaluators, external auditors, financial analysts, and regulators. Moot researches on management fraud have examined how various characteristics of the company's management features affect the occurrence of corporate fraud. This study examines financial characteristics of companies engaged in fraudulent financial reporting and suggests a model and system for detecting GAAP violations to improve reliability of accounting information and transparency of their management. Since the detection of management fraud has limited proven theory, this study used the detecting method of outlier(upper, and lower bound) financial ratio, as a real-field application. The strength of outlier detecting method is its use of easiness and understandability. In the suggested model, 14 variables of the 7 useful variable categories among the 76 financial ratio variables are examined through the distribution analysis as possible indicators of fraudulent financial statements accounts. The developed model from these variables show a 80.82% of hit ratio for the holdout sample. This model was developed as a financial outlier detecting system for a financial institution. External auditors, financial analysts, regulators, and other users of financial statements might use this model to pre-screen potential earnings manipulators in the credit evaluation system. Especially, this model will be helpful for the loan evaluators of financial institutes to decide more objective and effective credit ratings and to improve the quality of financial statements.
Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.
Background 'For many years, the Papanicolaou smear has been used to detect pre-malignant and malignant disease of the cervix. Although cervical cytology screening programmes have result in the reduction of cervical cancer incidence and mortality, Pap smear have been subjected to intense scrutiny and criticism in recent years. So cervicography is introduced. Cervicography is an adjunct method of cervical cancer screening intended to complement Papanicolaou smear. Cervicography involve obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the efficacy of Papanicolaou smear and cervicography in cervical cancer screening. Materials & Methods : This study population was of 74 women, who visited department of obstetrics & Gynecology, Korea association of Health Promotion Chung-nam branch from January, 20O2 to October, 2003. All patients were taken Pap smear before cervicography, and then two cervicography was obtained with applying5% acetic acid. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen. Results : 1. The sensitivity and the specificity of Papanicolaou smear was 92.1% and 72.7%respectively.2. The sensitivity and the specificity of cervicography was 88.9% and 54.5% respectively. The false negative rate, and false positive rate of Papanicolaou smear were 7.9%, 27.2% respectively. The false negative rate, and false positive rate of cervicography were 11.1%,45.5% respectively. Conclusions . Papanicolaou smear is a useful method and an important tool for detecting cervical cancer. However when Papanicolaou smear and Cervicograpy is used together, the sensitivity is higher than for Papanicolaou smear used alone.
Nilaweera, Riw;Perera, S.;Paranagama, N.;Anushyanthan, As
Asian Pacific Journal of Cancer Prevention
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제13권4호
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pp.1193-1196
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2012
Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but they are largely preventable. There are limited data on knowledge and practices on screening methods of breast and cervical cancers among female health care workers in Sri Lanka, in spite of having an organized screening programme islandwide. A cross-sectional survey was conducted among 219 female health care workers including public health midwives (68.9%) selected from 6 districts in Sri Lanka using convenient sampling methods. A self-administered questionnaire was used as a pre-test in a capacity building training programme to collect the data. The mean (SD) duration of work experience of the respondents was 12 years and 52.5% were aged over 35 years. Most (76.7%) were married, and afamily history of cancer was reported by 24.2%. Over 98% knew about self breast examination. Even though 84.1% practiced it, only 47.9% practiced it on a monthly basis. Clinical breast examination and mammography were known by 94.1% and 64.3% respectively. Only 19.2% had undergone a clinical braest examination within one year and 3.6% had ever undergone a mamography. Only 76.3% knew that a Pap smear detects precancerous stage of cervical cancer. Among 169 married workers, 73.4% had never had a Pap smear and only 17.2% had got it done within the preceding 5 years. Among the reasons for not doing a pap smear within 5 years, 47.0% belived it as not nescessary, 17.3% due to fear/dislike, 23.2% as not having symptoms, 3% had not known about it and 3% not known about availability of services. The study findings suggest that the knowledge and practices on breast and cervical cancer screening methods among female health care workers need to be improved. Considering the role that health care workers play in communicating health behaviors to the general public, strengthening health education interventions for this group of females is essential.
Purpose: The important things in space plan of a screening center are improving the spatial awareness by space systemization and minimizing the examination time for customers, and reducing the required time of screening work and maximizing the capacity for the screening center. Therefore, we tried to solve the problem of improving spatial awareness and reducing the examination time by using the pedestrian based discrete event simulation at the minimum cost. Methods: We have analyzed the drawbacks and the supplement points by comparing the floor plan at the time of opening and the current floor plan. Based on the analysis, we propose an improved plan which changes the location of the examination rooms and the number of services, and we also verify the improved plan based on simulation analyses. Results: 1) Through the analyses, we derived the drawbacks of the floor plan at the time of opening, and we realized that the current floor plan reflects the drawbacks. 2) The major reasons of the long examination time are the human traffic jam and the occurrence of queues due to unreasonable allocation of services. 3) Through the discrete event simulation analyses, it was possible to specify the place of the queues manually so as to use the given space fairly. 4) Using the discrete event simulation, it was possible to reduce the examination time and to improve the spatial awareness effectively at the minimum cost. Implications: Although the proposed simulation methodology in this paper is an analysis of the existing screening center, we expect that the proposed methodology will be used to develop a more efficient architectural design process by pre-applying the method to the course of designing a screening center and finding the suitability of the proposed method with the matched number of services.
As intellectual terror threats increase, we feel the limit in coping with those threats and the things we do are placing traditional X-ray machines & ETD and increasing aviation security staffs. In fact, even if air transportation system is the fast and most efficient transportation methods, it is true that there are many inconveniences to endure due to terror threats. In the name of security, even if we make a lot of efforts and time to screen both good-natured passengers, baggage, cargo and suspicious passengers, it is impossible to screen perfectly and it is not an efficient methods. Therefore, we introduce profiling system that reduce the effort to screen good-natured passengers but focus on screening dangerous passengers and baggages. Profiling system strengthens aviation security, using the concept "Selection & Concentration". Israel started to introduce manual profiling system in aviation security, which is interviewing suspicious passengers and it has been used in crime investigation since 1960. And it has been upgraded and diversified to CAPPS(Computer Assisted Passenger Screening Program) and SPOT(Screening Passenger by Observation). So, this theses is to study on the concept & kind of profiling and profiling methods adopted in airlines. Also it presents the method of introduction of profiling system in Korea and the necessity of making law on it.
The 34 potently pig pheromonal odorants (1-32, 5755 & 7113) through structure-based virtual screening and ligand-based virtual screening method were selected and their ADMET and pharmacokinetics characters were evaluated and discussed quantitatively. The pheromonal odorants were projected on the following pre-calculated models, Caco-2 cell permeability, blood-brain barrier permeation, hERG inhibition and volume-distribution. From the results of in silico study, it is found that an optimal compound (31) either penetrating or have a little ($P_{caco2}$=-8.143) for Caco-2 cell permeability, moderate penetrating ability ($P_{BBB}$=0.082) for blood-brain barrier permeation, the low QT prolongation ($P_{hERG}$=1.137) for the hERG $K^+$ channel inhibition, and low distribution into tissues ($P_{VD}$=-5.468) for volume-distribution. Therefore, it is predicted that the compound (31) a topical application may be preferable from these based foundings.
Bhattacharjee, Biplab;Simon, Rose Mary;Gangadharaiah, Chaithra;Karunakar, Prashantha
Journal of Microbiology and Biotechnology
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제23권6호
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pp.779-784
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2013
Leptospirosis is a worldwide zoonosis of global concern caused by Leptospira interrogans. The availability of ligand libraries has facilitated the search for novel drug targets using chemogenomics approaches, compared with the traditional method of drug discovery, which is time consuming and yields few leads with little intracellular information for guiding target selection. Recent subtractive genomics studies have revealed the putative drug targets in peptidoglycan biosynthesis pathways in Leptospira interrogans. Aligand library for the murD ligase enzyme in the peptidoglycan pathway has also been identified. Our approach in this research involves screening of the pre-existing ligand library of murD with related protein family members in the putative drug target assembly in the peptidoglycan biosynthesis pathway. A chemogenomics approach has been implemented here, which involves screening of known ligands of a protein family having analogous domain architecture for identification of leads for existing druggable protein family members. By means of this approach, one murC and one murF inhibitor were identified, providing a platform for developing an anti-leptospirosis drug targeting the peptidoglycan biosynthesis pathway. Given that the peptidoglycan biosynthesis pathway is exclusive to bacteria, the in silico identified mur ligase inhibitors are expected to be broad-spectrum Gram-negative inhibitors if synthesized and tested in in vitro and in vivo assays.
Iron deficiency anemia is a worldwide public health problem relevant to unsound nutritional practice. While the prevalence of iron deficiency anemia is very common among pregnant women, appropriate nutritional service programs to improve the iron status are lacking in Korea. In an attempt to develop a nutritional screening tool to separate the high-risk subjects of iron deficiency, we carried out a nutritional survey for 115 Korean pregnant women whose gestational age ranged from 13 to 24 weeks. Each subject was interviewed with questionnaires for general characteristics and dietary habits. Food intake was measured by 24-hour recap method and 2 day record. Fasting blood was drawn for measuring hemoglobin and serum ferritin. It appeared that half of the pregnant women belonged to the anemia group and had insufficient dietary habits to provide adequate amounts of dietary iron. The first gravida and the working women had better hematological iron indicators than the second or more gravida and the housewives. It also appeared that women who had bigger family size and lower BMI in pre-pregnancy had poorer iron status. Among the food consumption habits, fruit dependent dietary habit was related to poor iron status. Sufficiently consumed green leafy vegetable and appropriate amount of food before morning sickness were positive factors of iron stares. Our results indicated that parity, BMI, current job, family size, food habits including consumption of fruits, green & yellow vegetables, and food habits before the onset of morning sickness are significant factors to contribute the Fe deficiency anemia during pregnancy.
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