• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7409-7414
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• 2013

Background: Delay in diagnosis of breast cancer is associated with a poorer survival and a pivotal contribution to this delayed diagnosis comes from patient delay in presenting at a clinic. Reasons involved must be evaluated in order to decrease this reducible delay. Objectives: i) To evaluate the reasons for patient delay in diagnosis of breast cancer; ii) to investigate any association with other variables. Materials and Methods: A 6 month cross sectional study (from July 2012 to Dec 2012), was carried out in Surgical and Oncology Units of Civil Hospital, Karachi. A total of 100 females diagnosed with breast cancer of any histological type were interviewed after informed consent and relevant data were collected. Due ethical clearance was obtained. Results: Mean age was $47.5{\pm}12.1$ years with a range from 25-77 years. Mean duration of delay was $5.13{\pm}4.8$ months, from shortest 1 month to longest 36 months. Duration of delay was observed to be no delay (<1 month) in 28%, short delay (1-3 months) in 30% and long delay (>3 months) in 42% of patients. Considering the symptoms as "harmless" (39%) was the most frequent reason of delay followed by "temporary" (20%) and the "use of traditional methods" (12%). Most common reason for later approaches was an increase in the size of the lump (41%). Statistically significant association (p-value <0.05) of longer patient delay was obtained with being single, being illiterate, painless breast lump as the first symptom, negative family history of breast cancer and vague attribution of the symptoms. Conclusions: Significant delay in approach to health care facility was observed in our study due to variable reasons given by women. Sufficient awareness regarding breast cancer, its symptoms and favorable effects of a timely diagnosis on prognosis must be imparted to our general population.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4715-4718
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• 2015

Background: Patient delay can contribute to a poor outcome in the management of head and neck cancers (HNC). The main objective of the present study was to investigate the factors associated with patient delay in our population. Materials and Methods: Patients with cancers of the head and neck attending a regional cancer center of North East India were consecutively interviewed during the period from June 2014 to November 2014. The participation of patients was voluntary. The questionnaire included information on age, gender, residential status, educational qualification, monthly family income, any family history of cancer, and history of prior awareness on cancer from television (TV) program and awareness program. Results: Of 311 (n) patients, with an age range of 14-88 years (mean 55.4 years), 81.7% were males and 18.3% females (M:F=4.4). The overall median delay was 90 days (range=7 days-365 days), in illiterate patients the median delay was 90 days and 60 days in literate patients (P=0.002), the median delay in patients who had watched cancer awareness program on TV was 60 days and in patients who were unaware about cancer information from TV program had a median delay of 90 days (p=0.00021) and delay of <10 weeks was seen in 139 (44.6%) patients, a delay of 10-20 weeks in 98 (31.5%) patients, and a delay of 20-30 weeks in 63 (20.2%) patients. Conclusions: Education and awareness had a significant impact in reduction of median patient delay in our HNC cases.

• Clinical and Experimental Pediatrics
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• v.60 no.9
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• pp.282-289
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• 2017

Purpose: Recent advancements in molecular techniques have greatly contributed to the discovery of genetic causes of unexplained developmental delay. Here, we describe the results of array comparative genomic hybridization (CGH) and the clinical features of 27 patients with global developmental delay. Methods: We included 27 children who fulfilled the following criteria: Korean children under 6 years with global developmental delay; children who had at least one or more physical or neurological problem other than global developmental delay; and patients in whom both array CGH and G-banded karyotyping tests were performed. Results: Fifteen male and 12 female patients with a mean age of $29.3{\pm}17.6months$ were included. The most common physical and neurological abnormalities were facial dysmorphism (n=16), epilepsy (n=7), and hypotonia (n=7). Pathogenic copy number variation results were observed in 4 patients (14.8%): 18.73 Mb dup(2)(p24.2p25.3) and 1.62 Mb del(20p13) (patient 1); 22.31 Mb dup(2) (p22.3p25.1) and 4.01 Mb dup(2)(p21p22.1) (patient 2); 12.08 Mb del(4)(q22.1q24) (patient 3); and 1.19 Mb del(1)(q21.1) (patient 4). One patient (3.7%) displayed a variant of uncertain significance. Four patients (14.8%) displayed discordance between G-banded karyotyping and array CGH results. Among patients with normal array CGH results, 4 (16%) revealed brain anomalies such as schizencephaly and hydranencephaly. One patient was diagnosed with Rett syndrome and one with $M{\ddot{o}}bius$ syndrome. Conclusion: As chromosomal microarray can elucidate the cause of previously unexplained developmental delay, it should be considered as a first-tier cytogenetic diagnostic test for children with unexplained developmental delay.

• Health Policy and Management
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• v.13 no.4
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• pp.115-130
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• 2003

Reperfusion delay in patients with acute myocardial infarction leads to increased morbidity and mortality. We sought to measure the rates of reperfusion delay and to identify factors associated with reperfusion delay after arrival to hospitals. We included 360 patients who had acute myocardial infarction with ST-elevation or left bundle branch block on electrocardiogram and received reperfusion therapy from the three participating academic medical centers from 1997 to 2000. Through retrospective chart review, we collected data about time to reperfusion therapy, patient and hospital factors potentially associated with reperfusion delay. Factors independently associated with reperfusion delay were determined by logistic regression analysis. Median door­to­needle time was 60.0 minutes, and median door­to­balloon time was 102.5 minutes. According to recommendation of the American College of Cardiology/American Heart Association Guidelines, 226 out of 264(85.6％) of thrombolytic patients and 43 out of 96(44.8％) percutaneous transluminal coronary angioplasty(PTCA) patients experienced reperfusion delay. The significant factors associated with delay were type of reperfusion therapy, patient factors including hypertension and delayed symptom onset to presentation(>4 hours), and hospital factors including nocturnal presentation(6pm∼8am), weekend, and an individual hospital. A significant proportion of patients experienced reperfusion delay. The identified predictors of reperfusion delay may help design a hospital system to reduce the delay in reperfusion therapy

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9427-9432
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• 2014

Background: Delayed presentation of symptomatic breast cancer is a public health issue in Iran, making a major contribution to low survival. Despite the importance of this problem, current knowledge is insufficient to inform interventions to shorten patient delay. The aim of this study was to explore factors influencing patient delay in Iranian women with self-discovered breast cancer symptom. Materials and Methods: This qualitative study was conducted during 2012-2013. Purposeful sampling was used to recruit 20 Iranian women with self-discovered symptoms of breast cancer who attended the Cancer Institute of Tehran University of Medical Sciences, Tehran, Iran. Data were collected through semi-structured in-depth audiotaped interviews, which were transcribed and analyzed using conventional content analysis with MAXqda software version 10. Findings: Content analysis of the data revealed four main themes related to the delay in seeking medical help including: 1) attributing symptoms to the benign conditions; 2) conditional health behavior; 3) inhibiting emotional expression; and 4) barriers to access to health care systems. Conclusions: These results suggest that patient delay is influenced by complex and multiple factors. Effective intervention to reduce patient delay for breast cancer should be developed by focusing on improvement of women's medical knowledge, managing patients' emotional expression and reform of the referral system.

• Journal of Nutrition and Health
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• v.26 no.4
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• pp.443-454
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• 1993

The purposes of this study were to analyze the work patterns of selected hospital foodservices by Work Sampling methodology, and to investigate the relationship among operational factors affecting productivity. The hospitals were classified into 3 groups by the percentage of patient meals, and the percentage of special patient diet, and the menu items of patients meals. The groups clustered were characterized by productivity. Work Sampling methodology was utilized to analyze the work patterns of hospitals with selected 3 hospitals to investigate the productivity the productivity and labor times used in each work functions. Productivity index analyzed by Work Sampling were 10.36 min/meal, 10.95 min/meal, and 12.19 min/meal, respectively X, Y, Z hospital. Z hospital was significantly different from time used in direct work function and delay. Direct work function time was the highest, delay the lowest in Z hospital. The relation between the results of Work Sampling and the productivities of 3 groups showed not by delay but direct work function in the classification used in this study.

• The Journal of Industrial Distribution & Business
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• v.12 no.8
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• pp.33-39
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• 2021

Purpose: The influence of age on time preference is not identified in the usual cross-sectional analysis. This study aims to test whether age affects time preference after controlling for the effects of individual heterogeneity including cohort effects. Research design, data and methodology: Drawing on a nationally representative panel dataset of Indonesians, we estimate the effects of age on time preference after controlling for unobserved individual heterogeneity as well as potential cohort effects. We measure time preference exploiting information on two sets of multiple price lists: one for a one-year delay, and the other for a five-year delay. Results: When we controlled for time-invariant individual characteristics, including birth cohort effects in a fixed effects model, the older men and women were more patient in a linear fashion, particularly when the delay was longer. To highlight the importance of controlling for individual fixed effects, we repeated the specification without controlling for individual fixed effects in OLS or censored maximum likelihood regression; we found no relation between age and impatience in men or women and for a one or five-year delay. Conclusions: The older men and women are more patient, and time preferences are correlated with unobserved individual heterogeneity.

• Journal of the Korean Society of Radiology
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• v.15 no.2
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• pp.93-100
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• 2021

The purpose of this study is to find out the factors that affect the patient's exposure dose during the abdominal CT scan using the bolus tracking technique, and reducing the radiation exposure to the patient during the abdominal CT scan using the bolus tracking technique by adjusting the delay time according to the corresponding factor. The experiment was divided into two parts, and the first experiment was conducted with 300 patients There were 188 males and 112 females, and their average age was 58±12.18(19~85). In the second experiment, 150 subjects (100 males and 50 females) who were undergoing their follow-up examination among the first experiment subjects, and the difference in dose before and after was compared by applying the delay time according to the influencing factor. As a result of the first experiment, there was a relationship between the arrival time of the contrast media and the heart rate, and it was found that the arrival time decreased as the heart rate increased for both men and women. As a result of the second experiment, the average dose of CTDIvol and DLP before/after applying the delay time according to the heart rate decreased 4.98 mGy and 5.33 mGy·cm in the male group, and 3.54 mGy and 3.88 mGy·cm in the female group. By applying proper delay time according to the patient's heart rate during abdominal CT scan with the bolus tracking technique, the radiation exposure dose of the patient can be reduced.

• Journal of the Korean Dietetic Association
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• v.7 no.1
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• pp.38-49
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• 2001

This study was designed to analyze the dietetic practitioner's job in the over 600-ed hospitals in korea and to assess their labor time spent and staffing need indices. The actual time spent and expected labor time spent on dietitians' activities were investigated and the proper dietic staffing needs in the hospitals was also calculated. A job analysis questionnaires were developed and mailed to 20 hospitals. Completed questionnaires were received form 12 hospitals for a response rate of 60%. The followings are summary of the results. 1. The jobs dietitians at the hospitals were classified into the following 7 areas, direct patient care, indirect patient care, therapeutic patient care, education & counseling, meeting & research, delay & movement, and administration & food services. 2. The actual time spent on dietetic practice was 48.6 hours and expected labor time spent was 99.2 hours, Therefore, the proper time required to conduct classified jobs was 2.1 times higher than the time spent. Especially, the time required for performing clinical nutrition services including direct patient care, indirect patient care, therapeutic patient care was significantly higher than the time needed. 3. The average times required for the direct patient care was 1334.6min, for the indirect patient care was 796.3min, for the therapeutic patient care was 1634.5min, for the education & counseling was 265.2min, for the meeting & research was 366.7min, for the delay & movement was 327.3min, and for the administration & food services was 1170min. The staffing need indices was 12.3. As a conclusion, the standardized job descriptions for the dietitian to carry out their job at the hospital should be established. And the clinical dietitians as nutrition professionals have to be recruited to provide systematically hospitalized patients with medical nutrition therapy at each hospital.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.2
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• pp.707-712
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• 2013

In patients with acute myocardial infarction (AMI), the delay from symptom onset to hospital arrival has a critical effect on morbidity and mortality. This study examined to find out the determinants of the prehospital delay in patients with AMI. The study sample consisted of 597 patients hospitalized with AMI between Jan and Dec 2009. Demographic, medical history, and clinical data were abstracted from the hospital medical records of patients with confirmed AMI, the prehospital delay was categorized as less than or greater than 6 hours. Older age, low socioeconomic status(medical aid), and low use of Emergency medical system were associated with delays in seeking emergency care for Acute myocardial infarction. Education programs to improve patient knowledge of acute coronary syndrome symptoms and promote patient responsiveness with regard to seeking medical care should be used to reduce the prehospital delay time, especially in the low socioeconomic group.