Breast cancer is the most common cancer among women in Malaysia. Therefore, it is highly important for the public to be educated on breast cancer and to know the steps to detect it early on. Healthcare providers are in the prime position to provide such education to the public due to their high knowledge regarding health and their roles in healthcare. The present systematic review involved studies conducted in recent years to analyze the knowledge, attitudes and behavior of Malaysian healthcare providers regarding breast cancer, in attempts to obtain an overall picture of how well equipped our healthcare providers are to provide optimal breast cancer education, and to see their perceptions and actual involvement in said education. The systematic review was conducted via a primary search of various databases and journal websites, and a secondary search of references used by eligible studies. Criteria for eligibility included being published from the year 2008 till present, being conducted in Malaysia, and being written in the English language. A total of two studies were eligible for this review. Findings show that Malaysian future and current healthcare providers have moderate knowledge on breast cancer, have a positive towards involvement of breast cancer education, but have poor actual involvement.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.14
no.2
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pp.15-28
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2019
Objectives : This study aimed to systematically and comprehensively review controlled clinical trials on the effectiveness and safety of Chuna Manual Therapy for stroke. Methods : By October 7, 2019, three core databases and three domestic databases were searched. Seven major academic journals on the related field were also hand-searched. Methodological quality of the included studies was evaluated using the Cochrane risk of bias tool. Meta-analysis was conducted and the quality of its evidence was assessed using the GRADE methodology. Results : Five articles met the eligibility criteria. The results of most of included studies were in favor of Chuna Manual Therapy. No study described any adverse events during or after the clinical trials. Meta-analysis of three eligible studies showed that the pre- and post-treatment scores on the Modified Barthel Index (mean difference 8.00, 95% confidence interval 0.26 to 15.74) and Berg Balance Scale (mean difference 3.57, 95% confidence interval 0.64 to 6.51) of the Chuna-treated group were significantly different, but only marginally higher than those of the non-treatment group. Thus, the level of evidence gathered from these studies was assessed to be low. Conclusions : Based on current available evidence, any confirmative conclusions cannot be made on the effectiveness and safety of Chuna Manual Therapy for stroke because of the small sample size, low methodological quality, presence of statistical heterogeneity, and missing safety information. More rigorously designed large-scale multi-center studies are needed to establish more specific and credible evidence to support or oppose the use of Chuna Manual Therapy for stroke.
Background: The Ministry of Public Health (MOPH) in Lebanon provides cancer drugs free of charge for uninsured patients who account for more than half the total case-load. Other categories of cancer care are subsidized under more stringent eligibility criteria. MOPH's large database offers an excellent opportunity to analyze the cost of cancer treatment in Lebanon. Materials and Methods: Using utilization and spending data accumulated at MOPH during 2008-2013, the cost to the public budget of cancer drugs was assessed per case and per drug type. Results: The average annual cost of cancer drugs was 6,475$ per patient. Total cancer drug costs were highest for breast cancer, followed by chronic myeloid leukemia (CML), colorectal cancer, lung cancer, and Non-Hodgkin's lymphoma (NHL), which together represented 74% of total MOPH cancer drug expenditure. The annual average cancer drug cost per case was highest for CML ($31,037), followed by NHL ($11,566). Trastuzumab represented 26% and Imatinib 15% of total MOPH cancer drug expenditure over six years. Conclusions: Sustained increase in cancer drug cost threatens the sustainability of MOPH coverage, so crucial for socially vulnerable citizens. To enhance the bargaining position with pharmaceutical firms for drug cost containment in a small market like Lebanon, drug price comparisons with neighboring countries which have already obtained lower prices may succeed in lowering drug costs.
Han, Sanghyun;Park, Bumsoo;Lim, Jeong-Wook;Youm, Jin-Young;Choi, Seoung-Won;Kim, Dae Hwan;Ahn, Dong Ki
Journal of Korean Neurosurgical Society
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v.63
no.6
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pp.673-680
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2020
The demineralized bone matrix (DBM) as the bone graft material to increase the fusion rate was widely used in spinal fusion. The current study aimed to compare the fusion rate of DBM to the fusion rate of autograft in lumbar spine fusion via meta-analysis of published literature. After systematic search, comparative studies were selected according to eligibility criteria. Checklist (risk of bias assessment tool for non-randomized study) was used to evaluate the risk of bias of the included nonrandomized controlled studies. The corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze the fusion rate of posterolateral lumbar fusion and lumbar interbody fusion. Eight studies were finally included in this meta-analysis. These eight studies included 581 patients. Among them, 337 patients underwent spinal fusion surgery using DBM (DBM group) and 204 patients underwent spinal fusion surgery with mainly autologous bone and without using DBM (control group). There was no significant differences of fusion rate between the two groups in posterolateral fusion analysis (risk ratio [RR], 1.03; 95% CI, 0.90-1.17; p=0.66) and interbody fusion analysis (RR, 1.13; 95% CI, 0.91-1.39; p=0.27). Based on the available evidence, the use of DBM with autograft in posterolateral lumbar spine fusion and lumbar interbody fusion showed a slightly higher fusion rate than that of autograft alone; however, there was no statistically different between two groups.
Purpose: The purpose of this study was to identify the factors influencing quality of life of married immigrant women in Korea. Methods: The participants included 508 married immigrant women who met the eligibility criteria and agreed to participate in the study. Participants were evaluated for subjective assessment of married immigrant-related constructs using a self-report questionnaire, for self-esteem, self-efficacy, and quality of life (QOL). The analysis was done using SPSS for Windows, version 10.1, and included stepwise regression. Results: The major findings were as follows; 1) There were significant relationships between marital satisfaction (r=.39, $p$=.001), violence by the husband during the couple's arguments (r=-.24, $p$<.001), satisfaction with life in Korea (r=.39, $p$<.001), self-esteem (r=.16, $p$<.001), self-efficacy (r=.51, $p$<.001) and quality of life. 2) Marital satisfaction, self-efficacy, education level and satisfaction life with in Korea were significant factors, which explained 53% of the variance in quality of life (F=43.97, $p$<.001). Multiple regression analysis revealed that a powerful predictor of QOL for married immigrant women was self-efficacy. Conclusion: Developing nursing interventions to enhance self-efficacy toward improvement of QOL among married immigrant women is recommended.
Purpose: This study was done to examine actor and partner effect of dementia knowledge, self-efficacy and depression on dementia preventive behavior in elderly couples. Methods: Participants were 115 couples aged 60 years or over who met eligibility criteria. All measures were self-administered. Data were analyzed using SPSS 18.0 and AMOS 18.0 program. Results: Dementia knowledge in elderly couples showed actor and partner effect on dementia preventive behavior. Self-efficacy in the wife did not have direct effects on dementia preventive behavior, but showed indirect effects through dementia knowledge. Self-efficacy in the husband showed direct effects on dementia preventive behavior and indirect effects through dementia knowledge. Wife's depression had direct actor effect on dementia preventive behavior and indirect effect through self-efficacy and dementia knowledge. Husband's depression did not have direct actor effect on dementia preventive behavior, but indirect effect through self-efficacy and dementia knowledge. Effect size of wives' dementia knowledge, self-efficacy and depression on dementia preventive behavior was larger than that of husbands'. Dementia preventive behavior, dementia knowledge and depression had a mutual effect. Conclusion: Results indicate that to promote dementia preventive activity in elderly couples, programs should be conducted for both of the couple, but focused differently for wife and husband.
Background : In-home physical therapy program as a result of a study of the need for in-home physical therapy, most patients were needed. This study of patients who received physical therapy were surveyed, and patients need physical therapy for what I have found that factors. The purpose of this study is the in-home physical therapy program for patients to determine that how much needs were investigated. Methods : In this study, 469 people were involved with the patients who received physiotherapy. Surveys were returned to the questionnaire. The collected data was analyzed by Chi-square and one-way ANOVA. Results : The need for in-home physical therapy to 31 to 60 years suggests that the highest. In this paper, the female respondents was higher, the damaged parts Many times patients with musculoskeletal injuries, duration of treatment was 3-1 months there. 469 people need physical therapy visits of respondents that respondents were 423 people. qualification standards of physical therapy visits and asked questions of the state or local government public agencies or public health wad the highest with 40.3%, eligibility criteria for physical therapy visits a physical therapist trained in the regular 43.3%, per visit, treatment 10,000won 43.5% less than the cost of investigation into the health insurance coverage and should apply to questions about whether the response was 50.1%. Conclusion : Further, the study of in-home physical therapy services were the patient's perspective. This information, visit the home physical therapy program will contribute to the legalization.
Forte, Antonio Jorge;Boczar, Daniel;Kassis, Salam;Huayllani, Maria T.;McLaughlin, Sarah A.
Archives of Plastic Surgery
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v.47
no.4
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pp.305-309
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2020
Breast cancer treatment-related lymphedema (BCRL) is a common comorbidity in breast cancer survivors. Although magnetic resonance imaging (MRI) is widely used to evaluate therapeutic response of patients with various medical conditions, it is not routinely used to evaluate lymphedema patients. We conducted a systematic review of the literature to identify studies on the use of MRI to evaluate therapy for BCRL. We hypothesized that MRI could provide information otherwise not possible through other examinations. On October 21, 2019, we conducted a systematic review on the PubMed/MEDLINE and Scopus databases, without time frame or language limitations, to identify studies on the use of MRI to evaluate therapy for BCRL. We excluded studies that investigated other applications of MRI, such as lymphedema diagnosis and surgical planning. Of 63 potential articles identified with the search, three case series fulfilled the eligibility criteria. In total, 53 patients with BCRL were included and quantitatively evaluated with MRI before and after manual lymphatic drainage. Authors used MRI or MR lymphagiography to investigate factors such as lymphatic vessel cross-sectional area, tissue water relaxation time (T2), and chemical exchange saturation transfer. The only study that compared MRI measurement with standard examinations reported that MRI added information to the therapy evaluation. MRI seems to be a promising tool for quantitative measurement of therapeutic response in patients with BCRL. However, the identified studies focused on only manual lymphatic drainage and were limited by the small numbers of patients. More studies are necessary to shed light on the topic.
Yoon, Han Gyul;Noh, Jae Myoung;Ahn, Yong Chan;Oh, Dongryul;Pyo, Hongryull;Kim, Haeyoung
Radiation Oncology Journal
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v.37
no.3
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pp.185-192
/
2019
Purpose: The effectiveness of thoracic radiation therapy (TRT) in extensive-stage small cell lung cancer (ES-SCLC) patients is increasingly reported, but there is no definite consensus on its application. The aim of this study was to identify factors associated with better outcomes of TRT among patients with ES-SCLC, focusing on whether a higher TRT dose could improve treatment outcome. Materials and Methods: The medical records of 85 patients with ES-SCLC who received TRT between January 2008 and June 2017 were retrospectively reviewed. Eligibility criteria were a biological effective dose with α/β = 10 (BED) higher than 30 Gy10 and completion of planned radiotherapy. Results: During a median follow-up of 5.3 months, 68 patients (80.0%) experienced disease progression. In univariate analysis, a BED >50 Gy10 was a significant prognostic factor for overall survival (OS; 40.8% vs. 12.5%, p = 0.006), progression-free survival (PFS; 15.9% vs. 9.6%, p = 0.004), and intrathoracic PFS (IT-PFS; 39.3% vs. 20.5%, p = 0.004) at 1 year. In multivariate analysis, a BED >50 Gy10 remained a significant prognostic factor for OS (hazard ratio [HR] = 0.502; 95% confidence interval [CI], 0.287-0.876; p = 0.015), PFS (HR = 0.453; 95% CI, 0.265-0.773; p = 0.004), and IT-PFS (HR = 0.331; 95% CI, 0.171-0.641; p = 0.001). Response to the last chemotherapy was also associated with better OS in both univariate and multivariate analysis. Conclusion: A TRT dose of BED >50 Gy10 may be beneficial for patients with ES-SCLC. Further studies are needed to select patients who will most benefit from high-dose TRT.
Kim, Jihye;Yu, Hana;Ku, Boncho;Kim, Hyunho;Kim, Jongyeol;Jeon, Youngju
Journal of Physiology & Pathology in Korean Medicine
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v.28
no.6
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pp.662-667
/
2014
The purpose of this clinical study is to develop structured clinical trial protocol and guideline for improvement of safety, useful and effective of pulse diagnosis devices. As a first step, papers on pulse diagnosis and pulse diagnosis devices from 2001 and 2013 were systematically reviewed. In the next step, we have collected the opinions from the specialists, companies, and statistician in pulse diagnosis to evaluate the current condition, the state and problem of domestic clinical trial cases of pulse diagnosis device. And we have to created protocol and case report form (CRF) in regards to site condition and characteristics of pulse diagnosis devices, and showed the guideline of eligibility criteria, operation process, investigation items, evaluation items and so on. This clinical protocol will become a basic information for a researcher in designing or performing a clinical study of pulse diagnosis devices, and be used as a useful material during acquisition of good clinical data. Furthermore, we hope to enhance the invigoration of pulse diagnosis clinical trials and the performance improvement of pulse diagnosis devices.
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