• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2841-2846
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• 2014

Background: When dealing with breast cancer, early detection is closely associated with determining and closely monitoring high risk groups. The aim of this study was to determine the preventable risk factors that are specific for our country, and to understand which risk factors were most predominant. Materials and Methods: The study was planned as a case-control design. Women diagnosed with breast cancer who visited the Surgery, Obstetrics and Gynaecology, and Radiation Oncology outpatient clinics of the Izmir Dokuz Eylul University (DEU) School of Medicine were accepted as the case group. Then a control group matched for age was established among females who visited the outpatient clinics on the same days. A questionnaire prepared by the researchers was implemented using a face-to-face interview technique. The Mann-Whitney U test was used in the comparisons of the group averages, and the Pearson chi-square test in the comparisons between groups. In order to determine the dominant risk factors, binary logistical regression test was implemented. Results: A total of 138 patients, 69 cases and 69 controls, were included in the study. A significant difference can be detected between the groups in terms of BMI, smoking, breast cancer prevalence among first degree family members, presence of breast cancer among distant family members, existence of other types of cancers among family members and the age of onset of menopause (p<0.05). Logistical regression analysis revealed that the presence of breast cancer among first degree relatives increased the risk of developing breast cancer 5.7 times. Conclusions: Although some results of this study are compatible with findings in the literature, some are not. In order to determine unique risk factors, there is a clear need for large-scale studies.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7693-7699
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• 2013

Aims: A main reason for increasing incidence of cervical cancer worldwide is the lack of regular cervical cancer screening. Coverage and uptake remain major challenges and it is crucial to determine the perceived susceptibility to cervical cancer, as well as the benefits of, and barriers to, cervical cancer screening among women. Materials and Methods: A cross-sectional survey was conducted among 369 women attending an outpatient centre in Malaysia and data were collected by administering a self-report questionnaire. Results: The majority of the participants (265, 71.8%) showed good level of perception of their susceptibility to cervical cancer. Almost all responded positively to four statements about the perceived benefits of cervical cancer screening (agree, 23.1% or strongly agree, 52.5%), whereas negative responses were received from most of the participants (agree, 29.9%or strongly agree, 14.6 %) about the eleven statements on perceived barriers. Significant associations were observed between age and perceived susceptibility($x^2$=9.030, p=0.029); between employment status (p<0.001) as well as ethnicity and perceived benefits (p<0.05 [P=0.003]); and between education and perceived barriers to cervical cancer screening (p<0.001). Conclusions: Perceived susceptibility, including knowledge levels and personal risk assessment, should be emphasized through education and awareness campaigns to improve uptake of cervical cancer screening in Malaysia.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4825-4830
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• 2016

Background: In developed countries, awareness of cervical cancer screening is well documented. In contrast, in Oman as a developing country, public responses regarding cervical screening are unclear. This study aimed to assess the level of awareness about cervical cancer and Papanicolau (Pap) smear testing and to establish any correlations between knowledge and demographic factors among Omani women. Methods: In this cross-sectional survey, participants were divided into three groups: patients who attended the Outpatient Gynecology Department in Sultan Qaboos University Hospital (SQUH), Oman, female staff from SQUH, College of Medicine and College of Nursing at Sultan Qaboos University (SQU) and graduating female students at SQU. Data collection was through interview-based and online self-administered questionnaires. Cumulative scoring was used for data analysis. Results: There were 204 outpatients, 133 staff and 157 students. Outpatients (79.4%), staff (97.7%) and students (75.2%) had heard of cervical cancer. Nevertheless, their specific knowledge, regarding signs and symptoms, risk factors and Pap smear, was low at 38.7%, 35.3% and 7.6% among outpatients, staff and students, respectively. Some 39.9% of the married outpatients had adequate overall knowledge as compared to none of the single women. Educational level was found to be significantly associated with outpatient knowledge with the highest awareness levels among postgraduates and medical university graduates (61.5%). Conclusion: Specific knowledge of cervical cancer, its risk factors and cervical Pap smear is generally poor among Omani women. This lack of knowledge may be one of the contributing factors for the high incidence of cervical cancer in Oman relative to that in developed countries.

• Clinical and Experimental Pediatrics
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• v.59 no.1
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• pp.30-34
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• 2016

Purpose: Although Bednar's aphthae are common and regress spontaneously, these lesions may lead to feeding intolerance and are often misdiagnosed, rendering examinations useless. This study sheds new light on the clinical features of Bednar's aphthae. Methods: Sixteen neonates and infants were newly diagnosed with Bednar's aphthae via routine health check-ups in an outpatient clinic. Medical records were retrospectively reviewed, and the following parameters were analyzed; sex, gestational age, birth weight, mode of delivery, and perinatal problems. A physical examination was carried out during the next outpatient visit to examine the healing process and check for the existence of scars or complications. Results: Initial presentation included changes in feeding habits (n=10), longer feeding time, reduced intake, and increased irritability. In 6 patients, Bednar's aphthae were discovered incidentally, without prior symptoms. Feeding posture and method of feeding are important causes of Bednar's aphthae. Eleven patients were fed in a horizontal position, whereas 5 patients were fed in a semiseated position. Fifteen patients were bottle-fed, whereas 1 patient was exclusively breastfed. After correcting the feeding position, the ulcerative lesions disappeared within 1 month of diagnosis. During the follow-up period, lesions did not recur in any of the patients. Conclusion: This study suggests that Bednar's aphthae are caused by mechanical pressure. A diagnosis of Bednar's aphthae should be considered when lesions are found on the palate of infants and when symptoms seem to be feeding related. Proper education of parents can both treat Bednar's aphthae and easily prevent its recurrence.

• Quality Improvement in Health Care
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• v.7 no.2
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• pp.180-188
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• 2000

Objectives : The purpose of this study was to evaluate the reliability of questionnaire according to item arrangement on patient satisfaction questionnaire. Methods : We developed the two types of questionnaire with different item arrangement. In the first type (A), questions were arranged according to medical service dimensions. Questions in the second type (B) were arranged according to medical process. Both questionnaires were composed of six dimensions: physical environments, process, competence, courtesy, information giving, understanding patients. Measurements were performed on a 5-score Likert scale. In an outpatients and inpatient survey, total 777 patients answered the type A (outpatients: 257, inpatients: 128) or Type B (outpatients: 257, inpatients: 135). In order to compare the internal consistency of two types. Cronbach's ${\alpha}$ were calculated. Multiple regression analysis was also performed to know which type of questionnaire explain more of the overall satisfaction. Results : In outpatient survey, type A questionnaire showed higher internal consistency than B except physical environments dimension. Also in inpatient survey, type A had higer internal consistency than B in four dimensions(process, competence, courtesy, understanding patients). In the results of multiple regression analysis, type A questionnaire ($R^2$=0.53) explained more of the variation in overall satisfaction then B questionnaire ($R^2$=0.43) in outpatient survey. In inpatient survey, type B questionnaire ($R^2$=0.40) explained, more of the variation in overall satisfaction than type A questionnaire ($R^2$=0.33).But the difference of R was not significant in inpatient survey. Conclusion : The results of this study support that type A questionnaire has higer reliability in assessment of consumer satisfaction than type B.

• Journal of Acupuncture Research
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• v.34 no.4
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• pp.190-196
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• 2017

Background: The purpose of this study was to investigate the efficacy of muscle energy techniques (MET) of upper trapezius and sternocleidomastoid muscles on Bell's palsy. Methods: In this retrospective study, we screened the medical records of patients with Bell's palsy who had received inpatient and outpatient treatment at the Department of Acupuncture & Moxibustion, Korean Medicine Hospital Dong-Eui University between November 28, 2016 and April 30, 2017. A total of 34 out of 93 Bell's palsy patients met the inclusion criteria. The 34 patients were divided into two groups: Group A patients had undergone Korean-Western combination treatment and MET of upper trapezius and sternocleidomastoid muscles; Group B patients had undergone Korean-Western combination treatment only. MET of upper trapezius and sternocleidomastoid muscles had been performed three times a week during the inpatient period, and two to three times a week during the outpatient period. Yanagihara scores had been assessed at the first visit, and 1, 2, 3, and 4 weeks after the first visit. Results: Group A Yanagihara scores were significantly improved during each interval from the first visit to 4 weeks later. Group B Yanagihara scores were also significantly improved except during the first week. During every period, the improvements observed in Yanagihara score were significantly higher in Group A than in Group B. Conclusion: These results suggest that MET of upper trapezius and sternocleidomastoid muscles may be effective treatment for Bell's palsy.

• The Journal of Society for e-Business Studies
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• v.22 no.1
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• pp.37-49
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• 2017

In order to maximize the efficiency and the quality of care in a hospital, hospitals in general operate by appointments. Patient no-shows or missed appointments waste the time of staffs who prepare for appointments, deprive patients of needed care, and increase burden on clinic capacity. The purpose of this study is to examine the importance and significance of factors that affect patient no-shows. The actual data of 50,000 outpatient appointments is compiled and analyzed from a VAMC in the United States with aims to identify the factors that contribute to outpatient no-shows and to draw meaningful implications. Random forest along with logistic regression analysis identify the factors affecting no-shows; appointment leadtime, show-up rate, travel distance, no-show rate in previous period, patient age, severity, complexity of disease, chronic pain, depression, drug dependence. The appointment leadtime, show-up rate, travel distance and previous no-show rate can be improved by enhancing SMS pre-notification and by improving afterwards telephone counseling. For other factors, it needs to study on the service differentiation with the characteristics of each patient group.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.3
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• pp.141-150
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• 2013

Objectives : The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. Methods : We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. Results : Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. Conclusion : Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.

• Journal of Home Health Care Nursing
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• v.10 no.2
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• pp.123-131
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• 2003

This study was to compare the functional status. complication and readmission rates. and client satisfaction with nursing care of home-based care and hospital-based care for clients with Coronary Artery Bypass Graft. Raw data were collected by interviewing and reviewing charts of 41 clients with Coronary Artery Bypass Graft between June 2001 and July 2002 at an university hospital located in Seoul. Korea. Out of 41 clients. 15 were in home care group and 26 were in hospitalization group. The baseline characteristics of the groups were almost identical. Mean age was 61.7 and 75.6% of clients being male. For home care group. the data collection was made at discharge and at termination of home care. and for hospitalization group. at discharge and at the first visit of outpatient department. Complication and readmission rates were investigated at one month after operation. Collected data were then analysed by conducting Chi-square test. Wilcoxon rank sum test. and Wilcoxon signed ranks test with SPSS program. The level of significance was .05. The results of the study are summarized as follows: 1. Postoperative length of stay of the home care group was shorter than that of hospitalization group by 1. 14 days(8.45 days vs. 9.59 days). On average. 1.8 home visits per client were observed. 2. The functional status (Barthel Index) at the termination of home care was significantly increased from that at discharge. For hospitalization group. a significant increase was observed between the functional status at the discharge and that at the first visit of outpatient department. The differencies in incremental of the scores. between the groups. were however not significant. 3. Complication and readmission rates; no statistically significant difference between the groups was observed. 4. The client satisfaction with nursing care (CSS) at termination of home care was significantly higher than that at hospital discharge. In conclusion. the outcomes of the analysis suggest that the home care benefits clients with Coronary Artery Bypass Graft. Client satisfaction with nursing care rises at termination of home care as compare to that measured at hospital discharge. Meanwhile. there was no significant differences in functional status. and complication and readmission rates. Further. home care reduced the length of stay in hospital.

• The Journal of the Korea Contents Association
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• v.14 no.10
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• pp.10-19
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• 2014

In recent, hospital information systems are widely used to electronically record, manage and share the data collected in hospitals. Such systems have contributed greatly to improving the work efficiency in modern hospitals, however, the collected data concerning the patients should be appropriately processed and reused to provide the healthcare service providers with decision supports. Especially, this paper proposes the patient flow monitoring system for the operations management of the outpatient department for patients with chronic diseases, and discusses the related issues. The proposed system visualizes the standard process model extracted from the patient history data and various performance measures, and this enables the managers to evaluate and enhance the operations of the outpatient clinic. In this paper, the patient flow monitoring system is applied to the rheumatology clinic, and the prototype system optimized for I-pad is illustrated.