Displaying publications 61 - 80 of 290 in total

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  1. Jamal AA, Aldawsari ST, Almufawez KA, Barri RM, Zakaria N, Tharkar S
    Int J Med Inform, 2020 09;141:104202.
    PMID: 32506051 DOI: 10.1016/j.ijmedinf.2020.104202
    BACKGROUND: The use of social media is widespread globally. It provides a quicker and faster means of efficient exchange of communications. The use of Twitter Applications to seek mental health advice is becoming popular.

    OBJECTIVES: This study aims to identify the determinants associated with Twitter use in psychiatric consultations and to assess the level of satisfaction in using the microblogging platform. In addition, the level of e-health literacy is also assessed among users.

    METHODS: The target population included Twitter users seeking psychiatric consultation. A leading psychiatrist's twitter account with 4.5 million followers was selected and consent obtained. A validated Patient Satisfaction Questionnaire was adopted to assess the level of satisfaction in Twitter use and e-health literacy. The questionnaire was tagged to the chosen Twitter account and reminders were sent until the sample size was reached. Data was analysed using SPSS version 22.0. The analysis included descriptive statistics tabulation, multi-response analysis, and cross-tabulation for satisfaction variables and the chi-square test was used to measure association between different variables.

    RESULTS: The study obtained 155 completed response sheets, of which 52 were Twitter users seeking psychiatric advice while the rest sought general health advice. Most of the study participants were females (71.6 %). Women, single status and income range between 4000-9000 Saudi riyal were found to be significantly associated with Twitter use for psychiatric consultation. Generally, most of the participants were satisfied with Twitter in seeking psychiatric consultation that reduced financial disbursement. Furthermore, concerns were expressed regarding the waiting period, word limitations and issues of privacy. The e-health literacy was higher among the participants.

    CONCLUSION: Psychiatric consultations via Twitter is more popular among women. By addressing privacy issues and reducing response time, Twitter may be used as a major platform to deliver mental health services to the population.

    Matched MeSH terms: Referral and Consultation
  2. Yusoff J, Ismail A, Abd Manaf MR, Ismail F, Abdullah N, Muhammad R, et al.
    Health Qual Life Outcomes, 2022 Jan 29;20(1):15.
    PMID: 35093066 DOI: 10.1186/s12955-022-01921-1
    BACKGROUND: Quality of life (QoL) is one of the treatment outcome measures in patients with breast cancer. In this study, we measured the QoL of women with breast cancer at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and identified the associated factors.

    METHODOLOGY: This cross-sectional study was conducted from October 2017 to December 2017 and involved female patients with breast cancer. The QoL scores and domains were determined using the EuroQol EQ-5D-5L, and were presented as the utility value and visual analog scores, respectively.

    RESULTS: We recruited a total of 173 women, aged 33-87 years. The median VA score was 80.00 (interquartile range [IQR] 70.00-90.00); the median utility value was 0.78 (interquartile range [IQR] 0.65-1.00. Women who did not take traditional medicine had a higher utility index score of 0.092 (95% CI 0.014-0.171), and women with household income of RM3000-5000 had a higher utility index score of 0.096 (95% CI 0.011-0.180).

    CONCLUSION: Traditional medicine consumption and household income were significantly associated with lower QoL. The pain/discomfort domain was the worst affected QoL domain and was related to traditional medicine use and household income. Addressing pain management in patients with breast cancer and the other factors contributing to lower QoL may improve the QoL of breast cancer survivors in the future.

    Matched MeSH terms: Referral and Consultation
  3. Liew SC, Tan MP, Breen E, Krishnan K, Sivarajah I, Raviendran N, et al.
    BMC Med Educ, 2023 Oct 25;23(1):796.
    PMID: 37880711 DOI: 10.1186/s12909-023-04777-1
    BACKGROUND: Virtual consultation is a synchronous mode of telemedicine provided remotely via information and communication technology. The projected growth of digitalization in healthcare delivery, however, necessitates medical student training in virtual consultation (VC) to ensure safe and effective patient care. This study describes the implementation and preliminary evaluation of a competency-based VC training module for undergraduate medical students.

    METHODS: A newly developed six-week VC module was implemented online through asynchronous microlearning and synchronous simulation-based experiential learning modalities. Clinical students in years 4 and 5 and fresh graduates, who had not started pre-registration house officer or residency programmes, were invited to participate. Training outcomes using checklist-based video-recorded assessments of VC encounters between medical students and simulated patients were compared. Each video was independently assessed by two facilitators trained in VC teaching and assessment, using a direct observed virtual consultation skills checklist derived from established VC competencies. The participants completed course evaluations electronically as additional outcome measures.

    RESULTS: Fifty-two clinical phase medical students and alumni completed both the instructional and practical phases of this module. Altogether, 45 (95.7%) students found the module beneficial, and 46 (95.9%) reported increased self-efficacy for conducting VC. In total, 46 (95.9%) students would recommend the course to others. Post-test results showed a significant increase in the students' abilities to conduct a VC (t-test = 16.33, p 

    Matched MeSH terms: Referral and Consultation
  4. Hassan R, Siregar JA, A Rahman Mohd NA
    Malays J Med Sci, 2014 Mar;21(2):54-62.
    PMID: 24876808 MyJurnal
    Telemedicine in neurosurgery or teleneurosurgery has been widely used for transmission of clinical data and images throughout the country since its implementation in 2006. The impact is a reduction of patient number that need to be reviewed in the level III hospitals and an increment in the number of patients that are kept in level II hospitals for observation by the primary team. This translates to reduction of unnecessary transfer of patients and subsequently cost benefits for patients and medical providers. The main aim is to determine the amount of reduction in unnecessary transfer by the implementation of teleneurosurgery in the management of referrals to neurosurgical department in Hospital Sultanah Amninah Johor Bahru (HSAJB). Other factors associated with transfer decision are also evaluated.
    Matched MeSH terms: Referral and Consultation
  5. Sidek MSM, Siregar JA, Ghani ARI, Idris Z
    Malays J Med Sci, 2018 Mar;25(2):95-104.
    PMID: 30918459 DOI: 10.21315/mjms2018.25.2.10
    Background: With teleneurosurgery, more patients with head injury are managed in the primary hospital under the care of general surgical unit. Growing concerns regarding the safety and outcome of these patients are valid and need to be addressed.

    Method: This study is to evaluate the outcome of patients with mild head injury which were managed in non-neurosurgical centres with the help of teleneurosurgery. The study recruits samples from five primary hospitals utilising teleneurosurgery for neurosurgical consultations in managing mild head injury cases in Johor state. Two main outcomes were noted; favourable and unfavourable, with a follow up review of the Glasgow Outcome Scale (GOS) at 3 and 6 months.

    Results: Total of 359 samples were recruited with a total of 11 (3.06%) patients have an unfavourable. no significant difference in GOS at 3 and 6 months for patient in the unfavourable group (P = 0.368).

    Conclusion: In this study we have found no significant factors affecting the outcome of mild head injury patients managed in non-neurosurgical centres in Johor state using the help of teleneurosurgery.

    Matched MeSH terms: Referral and Consultation
  6. Memon AH, Rahman IA
    ScientificWorldJournal, 2014;2014:165158.
    PMID: 24693227 DOI: 10.1155/2014/165158
    This study uncovered inhibiting factors to cost performance in large construction projects of Malaysia. Questionnaire survey was conducted among clients and consultants involved in large construction projects. In the questionnaire, a total of 35 inhibiting factors grouped in 7 categories were presented to the respondents for rating significant level of each factor. A total of 300 questionnaire forms were distributed. Only 144 completed sets were received and analysed using advanced multivariate statistical software of Structural Equation Modelling (SmartPLS v2). The analysis involved three iteration processes where several of the factors were deleted in order to make the model acceptable. The result of the analysis found that R(2) value of the model is 0.422 which indicates that the developed model has a substantial impact on cost performance. Based on the final form of the model, contractor's site management category is the most prominent in exhibiting effect on cost performance of large construction projects. This finding is validated using advanced techniques of power analysis. This vigorous multivariate analysis has explicitly found the significant category which consists of several causative factors to poor cost performance in large construction projects. This will benefit all parties involved in construction projects for controlling cost overrun.
    Matched MeSH terms: Referral and Consultation/economics*
  7. Hassan A, Ibrahim F
    J Digit Imaging, 2011 Apr;24(2):308-13.
    PMID: 20386951 DOI: 10.1007/s10278-010-9283-8
    This paper presents the development of kidney TeleUltrasound consultation system. The TeleUltrasound system provides an innovative design that aids the acquisition, archiving, and dissemination of medical data and information over the internet as its backbone. The system provides data sharing to allow remote collaboration, viewing, consultation, and diagnosis of medical data. The design is layered upon a standard known as Digital Imaging and Communication in Medicine (DICOM). The DICOM standard defines protocols for exchanging medical images and their associated data. The TeleUltrasound system is an integrated solution for retrieving, processing, and archiving images and providing data storage management using Structured Query Language (SQL) database. Creating a web-based interface is an additional advantage to achieve global accessibility of experts that will widely open the opportunity of greater examination and multiple consultations. This system is equipped with a high level of data security and its performance has been tested with white, black, and gray box techniques. And the result was satisfactory. The overall system has been evaluated by several radiologists in Malaysia, United Arab Emirates, and Sudan, the result is shown within this paper.
    Matched MeSH terms: Referral and Consultation*
  8. Loke KH, Woon TH
    Med J Malaysia, 1983 Mar;38(1):51-6.
    PMID: 6633337
    Psychiatric consultation in schools is not a new concept in the Western Countries but it is so in Malaysia owing to the lack ofa sufficient number of trained psychiatrists available locally. The aim of consultation is to help the school authorities to understand and to solve emotional and behaviourial problems of school children. The authors have begun a study project, on a voluntary basis, on the psychiatric problems of the school children of a secondary school in Kuala Lumpur. This was possible with the cooperation between the Department of Education, Kuala Lumpur, the Department of Social Welfare, Federal Territory and the Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur. The authors used two methods to gather data, namely through individual evaluation of the referred students (a total of 23 students having been interviewed) and through the holding of group therapy sessions with the consultee as the cotherapist. The authors found that minor behaviourial problems such as inattentiveness, talking, eating and sleeping in the classrooms constituted the majority of the reasons for referral. This was followed by problems concerned with poor academic performance, including the quality of class work. Major problems such as theft, extortion and gangsterism and personal emotional problems such as interpersonal relationship problems, boyfriend/girfriend problems and sexual problems were also encountered. Female pupils appeared to be more forthcoming in discussing their problems. The project has resulted in the school gradually adopting the guidance rather than the purely disclplinary concept in understanding the pupils' problems and their maladjustment behaviour in many cases. Joint efforts by psychiatrists, psychologists, professional social workers and school health personnel should be invested in this important area of school education.
    Matched MeSH terms: Referral and Consultation*
  9. Bentsen BG
    Scand J Prim Health Care, 1986 Feb;4(1):43-50.
    PMID: 3961309 DOI: 10.3109/02813438609013970
    "Health for all by year 2000" was the subject of the WHO Conference at Alma-Ata in 1978. It was evident that good primary care was a requirement to reach this goal. However, knowledge about this was scanty, and the instrument, an acceptable classification for analyses of primary care, was lacking. Since 1978 a WHO Working Party on Classifications of Primary Care has been working on a Reason for Encounter Classification. A RFEC test form was produced. In 1983 a feasibility study was conducted in nine countries: Australia, Barbados, Brazil, Hungary, Malaysia, The Netherlands, Norway, the Philippines, and the USA. The results of this were changing the original proposal very much. In addition, the WONCA/WHO Classification of Health Problems in Primary Care was included in the final version. In 1984 this final version was accepted by WONCA Classification Committee. This is called ICPC = The International Classification of Primary Care. ICPC is biaxial with the chapters of organ/organ systems along the one axis, in addition of three chapters: General, Mental, and Social problems. The other axis comprises seven components: Complaints, Process and Diagnosis. An alphanumeric code is used. The feasibility study of RFEC comprised ten test sites, and 138 primary care professionals recorded a total of 100 452 reasons for encounter. The English version of the RFEC was translated into five other languages, and these versions were used during the study. ICPC is a comprehensive, simple and practicable classification which can be used in medical records and in different areas of primary care research.
    Matched MeSH terms: Referral and Consultation/trends
  10. Teoh JI, Kinzie JD, Tan ES
    Int J Soc Psychiatry, 1973;18(4):301-7.
    PMID: 4720845
    Matched MeSH terms: Referral and Consultation*
  11. Syed A, Mohd Don Z, Ng CJ, Lee YK, Khoo EM, Lee PY, et al.
    BMJ Open, 2017 05 09;7(5):e014260.
    PMID: 28490553 DOI: 10.1136/bmjopen-2016-014260
    OBJECTIVE: To investigate whether the use of apatient decision aid (PDA) for insulin initiation fulfils its purpose of facilitating patient-centred decision-making through identifying how doctors and patients interact when using the PDA during primary care consultations.
    DESIGN: Conversation analysis of seven single cases of audio-recorded/video-recorded consultations between doctors and patients with type 2 diabetes, using a PDA on starting insulin.
    SETTING: Primary care in three healthcare settings: (1) one private clinic; (2) two public community clinics and (3) one primary care clinic in a public university hospital, in Negeri Sembilan and the Klang Valley in Malaysia.
    PARTICIPANTS: Clinicians and seven patients with type 2 diabetes to whom insulin had been recommended. Purposive sampling was used to select a sample high in variance across healthcare settings, participant demographics and perspectives on insulin.
    PRIMARY OUTCOME MEASURES: Interaction between doctors and patients in a clinical consultation involving the use of a PDA about starting insulin.
    RESULTS: Doctors brought the PDA into the conversation mainly by asking information-focused 'yes/no' questions, and used the PDA for information exchange only if patients said they had not read it. While their contributions were limited by doctors' questions, some patients disclosed issues or concerns. Although doctors' PDA-related questions acted as a presequence to deliberation on starting insulin, their interactional practices raised questions on whether patients were informed and their preferences prioritised.
    CONCLUSIONS: Interactional practices can hinder effective PDA implementation, with habits from ordinary conversation potentially influencing doctors' practices and complicating their implementation of patient-centred decision-making. Effective interaction should therefore be emphasised in the design and delivery of PDAs and in training clinicians to use them.
    Matched MeSH terms: Referral and Consultation*
  12. Russell V, Clarke M, Loo CE, Bharathy A, Vasudevan U, Byrne E, et al.
    Acad Psychiatry, 2019 Apr;43(2):157-166.
    PMID: 30069698 DOI: 10.1007/s40596-018-0960-0
    OBJECTIVE: The study's objective was to determine the educational value of participation in a consultation/liaison psychiatry service to primary care clinics, from the perspective of Malaysian medical undergraduates.

    METHODS: A mixed method design was used. Fourth-year medical students participated in a consultation/liaison psychiatry service to two government-operated primary care clinics. Each student attended two half-day consultations to the clinics during the psychiatry clinical clerkship. Students joined in discussions with primary care clinicians, performed supervised clinical assessments, and administered a depression screening instrument. The learning experience was evaluated through four focus groups, each with 9-10 participants, held throughout the academic year. An end-of-year, anonymous, online questionnaire survey was administered to the entire class. Thematic analysis of focus group transcripts was performed and quantitative statistics were calculated (Stata version 13).

    RESULTS: Focus group themes included the following: (a) active learning opportunities in primary care psychiatry consultation had perceived added educational value, (b) students benefited from contact with patients with previously undiagnosed common mental disorders, and (c) students' primary care experience raised their awareness of societal and professional responsibilities. Of the class of 113 students, 93 (82%) responded to the questionnaire. The survey responses reflected the qualitative themes, with 79 respondents (85%) stating that the learning experience met or exceeded their expectations.

    CONCLUSIONS: Academic psychiatry has been criticized for its overreliance on secondary care settings in undergraduate clinical teaching. Our findings suggest that supervised clinical placements in primary care are feasible and provide added educational value as a routine component of the undergraduate psychiatry clinical clerkship.

    Matched MeSH terms: Referral and Consultation*
  13. Poudel RR, Kumar VS, Tiwari V, Subramani S, Khan SA
    J Orthop Surg (Hong Kong), 2019 2 13;27(1):2309499019825598.
    PMID: 30744526 DOI: 10.1177/2309499019825598
    PURPOSE: Ensuring compliance to treatment protocol, especially regular visit to treating facility, is an important aspect of clubfoot management. However, the factors affecting compliance to follow-up schedule are myriad.

    METHODS: A cross-sectional study was undertaken among caregivers of clubfoot patients from a tertiary referral clubfoot clinic in a developing country. Hospital records were reviewed to collect demographic data and subjects were classified as either "regular" or "irregular" if they missed ≤3 and >3 scheduled hospital visits, respectively. Various factors that could affect compliance such as family size, number of children, literacy of caregiver, occupation of breadwinner, and time taken to travel to hospital were studied. Caregivers were probed regarding the reason for their irregularity.

    RESULTS: A total of 238 patients were included, of which 138 formed the "regular" group and the rest 100 formed the "irregular" group. Patients in the regular group were significantly younger (mean age 43.8 months) compared to the irregular group (59.8 months; p = 0.001). The mean follow-up period in the regular group was 28.1 months and in the irregular group was 33.8 months. On univariate analysis, age, duration of follow-up, and transport duration were found to be significant between the two groups. However, multivariate analysis revealed that female children with clubfoot are more likely to be irregular as compared to males ( p = 0.038).

    CONCLUSION: In a developing country setting, higher age and being a female child are associated with irregularity to hospital visit protocol. At clubfoot clinics, identifying these children and counseling their caregivers might improve compliance.

    Matched MeSH terms: Referral and Consultation*
  14. Chan YM, Goh KL
    Gastrointest Endosc, 2004 Apr;59(4):517-24.
    PMID: 15044888
    BACKGROUND: The appropriateness has become an important issue as the use of EGD becomes more widespread. No study of the appropriateness of EGD has been performed in the Asia-Pacific region. This study examined the appropriateness of EGD in a large Asian hospital by using the American Society for Gastrointestinal Endoscopy 2000 guidelines. A secondary aim was to correlate appropriateness with the presence of positive findings at EGD.

    METHODS: A cross-sectional study was conducted of consecutive diagnostic EGDs performed at a university-affiliated, teaching hospital, which has an open-access endoscopy system for doctors who work in the hospital. The main indication(s) for EGD was recorded and assessed as appropriate or inappropriate by using American Society for Gastrointestinal Endoscopy criteria. EGD findings were recorded and classified as positive or negative. Referrals were categorized as being from endoscopists, primary care physicians, and others.

    RESULTS: Of 1076 referrals for EGD, 88.3% were deemed appropriate. The group with the highest rate of appropriate referral was endoscopists (90.2%), followed by primary care physicians (89.6%) and "others" (81.9%). The rate of appropriate referrals was significantly higher for endoscopists and primary care physicians compared with "others" (respectively, p=0.001 and p=0.022). The most common appropriate indication was "upper abdominal distress that persists despite an appropriate trial of therapy" (35.4%). The most common inappropriate indication was "dyspepsia in patients aged 45 years or below without adequate empirical medical treatment" (48.4%); 42.2% with an appropriate indication had positive findings compared with only 25.6% of those with inappropriate indications (p=0.006). On multivariate analysis, the following were identified as independent predictive factors for positive findings at EGD: male gender (p=0.005), age over 45 years (p=0.011), smoking (p=0.005), none/primary education (p<0.001), and secondary education (p=0.026).

    CONCLUSIONS: The proportion of patients referred for open-access EGD with an appropriate indication(s) was high for all doctor groups in a large university-affiliated medical center in Asia. EGDs performed for appropriate indications had a higher yield of positive findings. Independent predictive factors of positive findings were male gender, age over 45 years, lower education level, and referral by an endoscopist.

    Matched MeSH terms: Referral and Consultation/statistics & numerical data
  15. Flaherty GT, Chen B, Avalos G
    J Travel Med, 2017 Sep 01;24(6).
    PMID: 28922821 DOI: 10.1093/jtm/tax059
    The purpose of this study was to examine the principal travel health priorities of travellers. The most frequently selected travel health concerns were accessing medical care abroad, dying abroad, insect bites, malaria, personal safety and travel security threats. The travel health risks of least concern were culture shock, fear of flying, jet lag and sexually transmitted infections. This study is the first to develop a hierarchy of self-declared travel health risk priorities among travellers.
    Matched MeSH terms: Referral and Consultation*
  16. Koh KC, Islam M, Chan WK, Lee WY, Ho YW, Alsagoff SAH, et al.
    Med J Malaysia, 2017 08;72(4):209-214.
    PMID: 28889131
    INTRODUCTION: In Malaysia, the prevalence of missed opportunities for HIV-testing is unknown. Missed opportunities have been linked to late diagnosis of HIV and poorer outcome for patients. We describe missed opportunities for earlier HIV-testing in newly-HIV-diagnosed patients.

    METHODS: Cross sectional study. Adult patients diagnosed with HIV infection and had at least one medical encounter in a primary healthcare setting during three years prior to diagnosis were included. We collected data on sociodemographic characteristics, patient characteristics at diagnosis, HIV-related conditions and whether they were subjected to risk assessment and offered HIV testing during the three years prior to HIV diagnosis.

    RESULTS: 65 newly HIV-diagnosed patients (male: 92.3%; Malays: 52.4%; single: 66.7%; heterosexual: 41%; homosexual 24.6%; CD4 <350 at diagnosis: 63%). 93.8% were unaware of their HIV status at diagnosis. Up to 56.9% had presented with HIV-related conditions at a primary healthcare facility during the three years prior to diagnosis. Slightly more than half were had risk assessment done and only 33.8% were offered HIV-testing.

    CONCLUSIONS: Missed opportunities for HIV-testing was unacceptably high with insufficient risk assessment and offering of HIV-testing. Risk assessment must be promoted and primary care physicians must be trained to recognize HIV-related conditions that will prompt them to offer HIVtesting.

    Matched MeSH terms: Referral and Consultation/statistics & numerical data
  17. Ng YK, Mohamed Shah N, Loong LS, Pee LT, Chong WW
    PLoS One, 2021;16(10):e0258249.
    PMID: 34618863 DOI: 10.1371/journal.pone.0258249
    BACKGROUND: Patient-centred care (PCC) has been suggested to provide benefits such as improved patient-healthcare provider communication and better disease self-management to patients. The practice of PCC should involve all healthcare professionals, including pharmacists who are well-positioned in providing pharmaceutical care to patients. However, a better understanding of the factors that can affect the practice of PCC in pharmacists' consultations is needed.

    OBJECTIVE: To explore the perceptions of Malaysian hospital pharmacists and patients on the barriers and facilitators of a PCC approach in pharmacist consultations.

    DESIGN: This study employed a qualitative, explorative semi-structured interview design.

    SETTING AND PARTICIPANTS: Interviews were conducted with 17 patients and 18 pharmacists from three tertiary hospitals in Malaysia. The interviews were audiotaped and transcribed verbatim. Emerging themes were developed through a constant comparative approach and thematic analysis.

    RESULTS: Three themes were identified in this study: (i) patient-related factors (knowledge, role expectations, and sociocultural characteristics), (ii) pharmacist-related factors (personalities and communication), and (iii) healthcare institutional and system-related factors (resources, continuity of care, and interprofessional collaboration). Pharmacists and patients mentioned that factors such as patients' knowledge and attitudes and pharmacists' personality traits and communication styles can affect patients' engagement in the consultation. Long waiting time and insufficient manpower were perceived as barriers to the practice of PCC. Continuity of care and interprofessional collaboration were viewed as crucial in providing supportive and tailored care to patients.

    CONCLUSION: The study findings outlined the potential factors of PCC that may influence its implementation in pharmacist consultations. Strategic approaches can be undertaken by policymakers, healthcare institutions, and pharmacists themselves to address the identified barriers to more fully support the implementation of PCC in the pharmacy setting.

    Matched MeSH terms: Referral and Consultation*
  18. Gil Cuesta J, van Loenhout JAF, de Lara Banquesio ML, Mustaffa M, Guha-Sapir D
    Disaster Med Public Health Prep, 2020 02;14(1):34-38.
    PMID: 31679549 DOI: 10.1017/dmp.2019.99
    INTRODUCTION AND OBJECTIVES: Typhoon Haiyan partially destroyed the Ormoc District Hospital in the Philippines. A field hospital was established to replace its outpatient department for 5 weeks. We investigated the reasons for medical consultation in the field hospital.

    METHODS: We described the consultations by sex, age, week, and diagnosis according to the Surveillance in Post-Extreme Emergencies and Disasters system. We compared the number and proportion of upper respiratory tract infections (URTIs) with a control season in 2014.

    RESULTS: We included 6785 consultations, 55.9% from women. The majority of consultations were communicable diseases (88.2%) followed by noncommunicable (7.1%) and injuries (5.6%). Males suffered more often from injuries than women (66.0% vs 34.0%). Consultations due to injuries decreased from 10.0% in the first to 2.9% in the last week. The most frequent diagnosis over the study period was acute respiratory infections (ARIs) (73.1%), of which 83.0% were children. The number of daily URTIs was higher than in a similar 2014 period.

    CONCLUSIONS: ARI was the most prevalent diagnosis. We recommend ARI treatments being fully accessible after such a disaster. During the first week, injury prevention should focus on adult men. Studies after natural disasters should include control periods to better understand disease distribution, ultimately improving the prioritization in disasters.

    Matched MeSH terms: Referral and Consultation/trends*; Referral and Consultation/statistics & numerical data
  19. Tata MD, Gurunathan R, Palayan K
    Ann Gastroenterol, 2014;27(1):34-41.
    PMID: 24714557
    BACKGROUND: Gastric cancer is notably one of the leading causes of cancer-related death in the world. In Malaysia, these patients present in the advanced stage, thus narrowing the treatment options and making the surgery nearly impossible for successful curative resection. Failure to identify high-risk patients and delay in diagnostic endoscope procedure contributed to the delay in diagnosis. The aim of the study was to develop and validate a scoring system (MARK's Quadrant) which can identify symptomatic patients who are at risk for gastric cancer.

    METHODS: A 3-phase approach was undertaken: Phase 1: development of the weighted scoring system; Phase 2: estimating positive predicting value of MARK's Quadrant; and Phase 3: a) testing the validity of MARK's Quadrant in an open-access endoscope system; and b) comparing its usefulness compared to conventional referral system.

    RESULTS: In phases 1 and 2, MARK's Quadrant with weighted symptoms was developed. The sensitivity of MARK's Quadrant is 88% and the specificity is 45.5% to detect cancerous and precancerous lesions of gastric. This was confirmed by the prospective data from phase 3 of this study where the diagnostic yield of MARK's Quadrant to detect any pathological lesion was 95.2%. This score has a high accuracy efficiency of 75%, hence comparing to routine referral system it has an odds ratio (95%CI) of 10.98 (4.63-26.00), 6.71 (4.46-10.09) and 0.95 (0.06-0.15) (P<0.001 respectively) for cancer, precancerous lesion and benign lesion diagnosis respectively.

    CONCLUSION: MARK's Quadrant is a useful tool to detect early gastric cancer among symptomatic patients in a low incidence region.

    Matched MeSH terms: Referral and Consultation
  20. Woo M, Ng Kh
    Biomed Imaging Interv J, 2008 Jan;4(1):e13.
    PMID: 21614306 MyJurnal DOI: 10.2349/biij.4.1.e13
    Medical physics is a relatively small professional community, usually with a scarcity of expertise that could greatly benefit students entering the field. However, the reach of the profession can span great geographical distances, making the training of students a difficult task. In addition to the requirement of training new students, the evolving field of medical physics, with its many emerging advanced techniques and technologies, could benefit greatly from ongoing continuing education as well as consultation with experts.Many continuing education courses and workshops are constantly being offered, including many web-based study courses and virtual libraries. However, one mode of education and communication that has not been widely used is the real-time interactive process. Video-based conferencing systems do exist, but these usually require a substantial amount of effort and cost to set up.The authors have been working on promoting the ever-expanding capability of the Internet to facilitate the education of medical physics to students entering the field. A pilot project has been carried out for six years and reported previously. The project is a collaboration between the Department of Medical Physics at the Toronto Odette Cancer Centre in Canada and the Department of Biomedical Imaging at the University of Malaya in Malaysia. Since 2001, medical physics graduate students at the University of Malaya have been taught by lecturers from Toronto every year, using the Internet as the main tool of communication.The pilot study explored the different methods that can be used to provide real-time interactive remote education, and delivered traditional classroom lectures as well as hands-on workshops.Another similar project was started in 2007 to offer real-time teaching to a class of medical physics students at Wuhan University in Hubei, China. There are new challenges as well as new opportunities associated with this project. By building an inventory of tools and experiences, the intent is to broaden the real-time teleteaching method to serve a wide community so that future students entering the field can have efficient access to high-quality education that will benefit the profession in the long term.
    Matched MeSH terms: Referral and Consultation
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