• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.6141-6147
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• 2015

Background: Cancer is a leading cause of death worldwide. A large proportion of cancer deaths are preventable through early detection but there are a range of social, emotional, cultural and financial dimensions that hinder the effectiveness of cancer prevention and treatment efforts. Cancer stigma is one such barrier and is increasingly recognized as an important factor influencing health awareness and promotion, and hence, disease prevention and control. The impact and extent of stigma on the cancer early detection and care continuum is poorly understood in India. Objectives: To evaluate cancer awareness and stigma from multiple stakeholder perspectives in North India, including men and women from the general population, health care professionals and educators, and cancer survivors. Materials and Methods: A qualitative study was conducted with in-depth interviews (IDIs) and focus group discussions (FGDs) among 39 individuals over a period of 3 months in 2014. Three groups of participants were chosen purposively - 1) men and women who attended cancer screening camps held by the Indian Cancer Society, Delhi; 2) health care providers and 3) cancer survivors. Results: Most participants were unaware of what cancers are in general, their causes and ways of prevention. Attitudes of families towards cancer patients were observed to be positive and caring. Nevertheless, stigma and its impact emerged as a cross cutting theme across all groups. Cost of treatment, lack of awarenes and beliefs in alternate medicines were identified as some of the major barriers to seeking care. Conclusions: This study suggests a need for spreading awareness, knowledge about cancers and assessing associated impact among the people. Also Future research is recommended to help eradicate stigma from the society and reduce cancer-related stigma in the Indian context.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3533-3540
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• 2016

Background: Cigarette smoking is one of the leading global causes of premature and preventable death. In Brunei Darussalam, smoking-related diseases have been a primary cause of mortality for the past three decades. Despite the increasing efforts that have been made in recent years to reduce the consumption of tobacco products in Brunei, the prevalence of adolescent smoking cigarette, however has risen alarmingly, from 8.9% in 2013 to 11.4% in 2014, with a higher prevalence found in males (17.8%) than in females (4.8%). In response to the need for more effective smoking prevention programmes in Brunei, this study sought to explore factors that influence Bruneian male adolescents to start and continue smoking. Materials and Methods: A qualitative study using focus group discussions (FGDs) as the data collection method was conducted from October to November 2015. A total of 43 studentss, comprising 31 smokers and 12 non-smokers, aged 13-17 years, from two government secondary schools in Bandar Seri Begawan, participated in six FGDs. Discussions were recorded and translated. Transcripts were entered into NVivo10, before thematic analysis was conducted. Results: We identified three themes under the core construct of 'factors influencing smoking initiation' ('family as teachers', 'overt pressure from peers' and 'perceived smoking has many advantages') and three themes under the core construct of 'factors influencing smoking continuation' ('craving and addiction', 'smoking as a 'social activity' and 'easy accessibility of cigarettes'). Conclusions: Based on the findings, it is recommended that future prevention activities should be embedded in a comprehensive approach, involving all stakeholders within a community, and should be focused towards bringing a change in smoking and parenting behavior of parents, social norms within the culture towards all population levels, and at strengthening the existing non-smoking policies in schools and other public places where young people congregate.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5611-5615
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• 2014

Context: Tobacco is the single largest cause of preventable death among adults globally, as it is in India. Despite this alarming situation, there is very minimal inclusion of tobacco in formal education systems, including the medical discipline, in India. Aims: The present study analyzed the extent of integration of tobacco control related content in Masters of Public Health (MPH) curricula of various institutes in India. Materials and Methods: This cross-sectional study was conducted during January 2011 to May 2011 in all colleges of the country offering a MPH course. The colleges were enlisted using various internet search engines (Google Scholar, Pubmed, Medline), other published literature and snowball technique. A 50 items semi-structured questionnaire was designed, posted and e-mailed (followed by hard copy) to the Person-In-Charge of the MPH program. Statistical Analysis: Descriptive statistics were used to profile the tobacco control content in respective institutions. All data entry and analysis was conducted using SPSS (version 16) for windows. Results: The duration of the MPH course was two years in all institutes and had accreditation with some affiliated body. Tobacco related diseases were covered under 'non communicable diseases' section by every institute. However, a mere 41.4% of institute's had faculty who had received specialized training in tobacco control. More coverage was given to health risks and effects of smoking as compared to cessation interventions (5 A's), symptoms of withdrawal and pharmacological treatments. Only 25% of institutes were in process of introducing tobacco courses into their curricula. Lack of expertise and administrative barriers were cited as perceived major problems in inclusion of tobacco control in MPH curricula. Conclusions: It can be concluded that tobacco control is not receiving adequate attention in public health curricula in India. There is a need for coordinated efforts in the area of tobacco control so as to reduce morbidity and mortality from tobacco induced diseases.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제18권3호
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• pp.570-590
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• 2024

Breast cancer ranks among the most prevalent forms of malignancy and foremost cause of death by cancer worldwide. It is not preventable. Early and precise detection is the only remedy for lowering the rate of mortality and improving the probability of survival for victims. In contrast to present procedures, thermography aids in the early diagnosis of cancer and thereby saves lives. But the accuracy experiences detrimental impact by low sensitivity for small and deep tumours and the subjectivity by physicians in interpreting the images. Employing deep learning approaches for cancer detection can enhance the efficacy. This study explored the utilization of thermography in early identification of breast cancer with the use of a publicly released dataset known as the DMR-IR dataset. For this purpose, we employed a novel approach that entails the utilization of a pre-trained MobileNetV2 model and fine tuning it through transfer learning techniques. We created three models using MobileNetV2: one was a baseline transfer learning model with weights trained from ImageNet dataset, the second was a fine-tuned model with an adaptive learning rate, and the third utilized early stopping with callbacks during fine-tuning. The results showed that the proposed methods achieved average accuracy rates of 85.15%, 95.19%, and 98.69%, respectively, with various performance indicators such as precision, sensitivity and specificity also being investigated.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.6-15
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• 2010

Purpose: Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center. Methods: Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggido. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer. Results: Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%). Conclusion: Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.

• 생명과학회지
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• 제33권12호
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• pp.1046-1051
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• 2023

본 연구의 목적은 개인의 흡연여부와 다양한 사회경제적 변수 간 영향관계가 성별과 장애여부에 따라 구분된 하위집단에서 차별적으로 나타나는지를 확인하는데 있다. 특히 본 연구는 일반인의 흡연 여부가 아니라 장애인을 대상으로 흡연의 여부가 장애인의 건강에 미치는 영향을 분석한 연구로 연구의 의의가 있다고 볼 수 있다. 본 연구에서는 장애인의 흡연율과 흡연 요인을 분석하는데 목적이 있다. WHO에 따르면 담배로 인한 사망자는 매년 600만명에 이른다. 담배는 심혈관질환, 폐질환, 암 등 비전염성질환과 조기 사망에 매우 강한 인과관계를 갖는 것으로 알려져 있다. UN이 제시한 지속가능 발전목표(Sustainable Development Goals, 이하 SDGs)는 건강한 삶의 보장과 모든 세대의 복지 증진(Ensure healthy lives and promote well-being for all at all ages)을 위해 WHO의 담배규제기본협약(Framework Convention on Tobacco Control)을 이행할 것을 요구하고 있다. 이것은 흡연의 모든 과정에서 발생하는 다양한 위협요인이 흡연자뿐만 아니라 경제, 사회, 환경 등 다양한 영역에서 다차원적으로 작용하는 위협하기 때문이다. 본 연구목적의 달성을 위해 본 연구는 2013년 국민건강영양조사를 활용하여 흡연과 선행연구에서 확인된 흡연 영향요인 간 인과관계를 확인하였다. 본 연구를 위하여 특히 성별과 장애여부에 따라 구분된 4개의 하위집단을 독립적 모형으로 하여 분석하였으며 흡연여부를 종속변수로 하는 로지스틱회귀분석을 활용하였다. 본 연구 분석결과 독립변수의 영향력 여부는 성별과 장애유무에 따라 구분된 각 집단별로 뚜렷한 차이를 나타내는 것이 확인되었다. 상대적으로 비장애집단에서 독립변수의 영향이 유의한 반면 장애집단에서는 유의성이 상실되는 경향을 보였으며 이 같은 경향은 특히 장애여성집단에서 더욱 명백하게 확인되었다. 분석결과를 기반으로 장애집단의 특성을 고려하지 않은 기존의 선행연구가 가진 설명의 한계를 확인하였으며 장애의 물리적·심리적 특수성을 충분히 고려한 연구모형을 통해 흡연과의 상관관계를 재분석해야 함을 함의로 제시하였다. 추후 장애인의 건강한 삶의 질을 개선하기 위하여 건강증진 영향들을 분석한 이후 건강증진에 기여할 수 있는 대표적인 변인들을 고려하여 적용하는 다양한 연구들이 수행되어져야 할 것으로 여겨진다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.6883-6888
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• 2015

Background: Tobacco smoking is a major cause of preventable disease and death worldwide. Kreteks are clove-flavored cigarettes made from a combination of tobacco and ground-clove mixed with a sauce, smoked widely in Indonesia. Because health and social consequences of kretek smoking are potentially as great as those of traditional cigarettes, this study examines the prevalence of kretek smoking in Indonesia and associated risk factors. Materials and Methods: The study used nationally representative Indonesia Global Adult Tobacco Survey data. Multiple logistic regression analysis was employed to identify correlates of kretek smoking. Results: One-third of Indonesian adults smoked tobacco of which about 90.0% smoked kreteks. Prevalence of kretek smoking among men (60.9%) was more than 25 times the rate among women (2.3%). Overall, the highest prevalence of kretek use was in the age group 45-54 years (36.5%), followed by 34-44 (35.1%), 25-34 (34.2 %), and 55-64 years (32.8%). By wealth index, prevalence of kreteks smoking among those in the middle index was almost 50% above the rate for the wealthiest group (36.4% vs 24.8% respectively). Logistic regression results showed that being male, being older, having less education, and being less wealthy were significant predictors of kretek smoking, while urban vs rural residence was not. Conclusions: Kretek smoking is common in Indonesia and is entrenched in the sociocultural fabric of the country. However, potential consequences of kretek smoking, particularly as risks for noncommunicable diseases, underscore the importance of a comprehensive approach to tobacco control as outlined in the World Health Organization's MPOWER strategies.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8265-8270
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• 2014

Background: Smoking tobacco is considered as a leading cause of preventable death, mostly in developing countries like India. One of the primary goals of international tobacco control is to educate smokers about the risks associated with tobacco consumption. Tobacco warning labels (TWLs) on cigarette packages are one of the most common statutory means to communicate health risks of smoking to smokers, with the hope that once educated, they will be more likely to quit the habit. Materials and Methods: The present survey was conducted to assess the effectiveness of TWLs in communicating health risks of tobacco usage among 263 adult smokers working as bus drivers in Karnataka State Road Transport Corporation (KSRTC), Mangalore, India. Information was collected on demographic details, exposure and response to health warnings on tobacco products, intention to quit and nicotine dependency. Results: The majority (79.5%) of the respondents revealed negative intentions towards quitting smoking. Nearly half of the participants had a 'low' nicotine dependency (47.5%) and 98.1% of the respondents had often noticed warning labels on tobacco packages. These health warnings made 71.5% of the respondents think about quitting smoking. Respondents who noticed advertisement or pictures about dangers of smoking had better knowledge, with respect to lung cancer and impotence as a consequence of tobacco. A higher exposure to warning labels was significantly associated with lower nicotine dependency levels of smokers among the present study population. A significantly higher number of respondents who noticed advertisement or pictures about the dangers of smoking thought about the risks of smoking and were more inclined to think about quitting smoking. As exposure increased, an increase in the knowledge and response of participants was also observed. Conclusions: Exposure to tobacco warning labels helps to educate smokers about health risks of tobacco smoking. It may be possible to promote oral health among bus drivers by developing strategies to educate them about these risk factors.

• 대한간호학회지
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• 제2권1호
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• pp.141-157
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• 1971

The peripheral infection is one of the major causes of maternal death, and although it is preventable through an effective prenatal as well as postnatal care its morbidity is increasing due to bacterial resistant to an effective antibiotics. The primary purpose of this study was to investigate the peripheral morbidity of 949 parturients who were admitted to the Obstetrics and Gynecologic department of Ewha Woman's University Hospital from January 1971 to September 1971. Among the 949 parturients, especially 40 normal parturients were selected (20, control soup was given complete aseptic care during labor and delivery and post delivery: 20, compare group was given the ordinary care practiced during labor and delivery and maternal ward of Ewha Woman's University Hospital) for bacteriologic test on vaginal flora twice, on admission and on complete cervical dilatation of each parturient. The results obtained from this study were as follows; 1. Majority of parturients age were 21 to 35 years old(90.83%), and educational level of 949 parturients was above high school. A large number of parturients socioeconomic level (according to their husbands' job) were moderate. 2, Among the 949 parturients, multipara (55.9%) were a little more than primipara (44. 1%) and 38.84% of parturients had experienced aborition. 3. In deliverty types, normal deliveries (804 cases) were more than cesarean section deliveries (145 cases) The peripheral morbidity after normal deliveries was 0.5%, and cesarean section deliveries, 23.45%. 4. Among 949 parturients incidence of hemorrhage eases (500cc or more bleeding) showed the higher peripheral morbidity (24.86%) than other cases (bleeding less than 500cc, 7.83%). 5. The majority of parturients (81.03%) had teen taking antenatal care, but most of them were taken irregular antenatal care. On the other hand, on admission, the parturients with complication were 30.32%, and their peripheral morbidity showed much higher (7.02%) than those with no complication (2.71%). 6. The incidence of peripheral morbidity in premature ruptured membrane was higher (10.91%) than normal parturienta (1.73%). 7. In the result of aseptic care during labor and delivery and post delivery, the number of cultured bacteria was legs in control group than Compare group (in control group, on admission 17, on complete cervical dilatation 12: in compare group, on admission 21 on complete cervical dilatation 21) . The most common bacteria were Staphylococcus (control group 14 on admission, compare group 16 on admission), and next Streptococcus, E- Coil, Bacillus Subtilis, in order. Also in control group the number. of colony were reduced (43%) more than in Compare group. Transient temperature elevation from 37℃ to 37.4℃ were noted in compare group (50%) than in control group (30%), and there was no one indicated above 38℃. In conclusion, the aseptic care is the test way of preventing peripheral infection as well as decreasing the puerperal morbidity. Therefore the most important nursing care is the aseptic care for each parturient during labor and delivery and peat delivery and also all the instruments must be cleaned and sterilized.