No abstract available.
Income ; Urease

Aging is associated with increased risk of frailty and malnutrition. However, food insecurity has rarely been highlighted in the elderly population, especially among the low income group. Thus, a cross-sectional study was conducted to determine the association between nutritional status, food insecurity and frailty among elderly in low income residences in Klang Valley. A total of 72 elderly individuals aged 60 years and above was selected (mean age 66 ± 6 years) through convenient sampling. Participants were interviewed to obtain information on socio-demographic, health status, food insecurity and cognitive status. Anthropometrics parameters and frailty assessments was measured using standard criteria. Results showed that 75.0% of the participants had abdominal obesity. Nearly half of the participants were overweight (41.7%), followed by normal (43.0%) and underweight (15.3%). With respect to food insecurity, most of them reported that they had enough food (93.1%). There were significant correlation (p < 0.05) between food insecurity with height (r = -0.263, p = 0.026). Most of the participants were pre-frail (58.3%), frail (27.8%) and followed by non-frail (13.9%). Calcium intake is inversely associated with frailty (t = -2.62, p = 0.011). In conclusion, food insecurity was not a problem, however, half of the subjects were overweight and pre-frail. Three out four subjects had abdominal obesity. There is a need to investigate further the pathogenesis of fat frail in this low income elderly population and formulate effective intervention strategies.
Aged ; Income

ASEAN Neurology Association (ASNA) consists of 9 member countries, Brunei, Indonesia, Lao, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam. Among them 2 countries are considered lower middle income, 4 as upper middle income, and 3 as high income by World Bank criteria. The life expectancy is above 75 years in Brunei and Singapore, below 60 years in Lao and Myanmar. There are a total of 1,871 neurologists in ASNA member countries which has a total of 540 million populations. This constitutes 2.2% of the world neurologists, although ASNA member countries accounts for 8.3% of the world population. Myanmar and Lao in particular, has lowest ratio of neurologist, with one neurologist serving 5 million populations in Myanmar, and 2 million populations in Lao.
Myanmar ; member ; Neurology ; Income ; Neurologist

BACKGROUND: Worldwide trends in health risks, lifestyle behaviors, health perceptions, and health-seeking patterns suggest alarming disparities among individuals from low- and middle-income countries. Such international comparisons are particularly troubling for older individuals (≥60 years). OBJECTIVES: This study aims to compare health risks, lifestyle behaviors, health perceptions, and health-seeking patterns between younger (<60) and older (≥60) Filipinos from rural communities in the Philippines. METHODS: A comparative cross-sectional study was employed with 863 younger and 427 older Filipinos. Data were analyzed using frequencies, chi-squares, and T-tests. RESULTS: Older participants were more likely to be single/widowed, ≤ high school education and had higher rates of hypertension, high cholesterol, diabetes, and depression. They reported poorer health status and went to the village health center when sick. Furthermore, they were less likely to drink alcohol and see a physician. CONCLUSION There were significant differences in modifiable health risks and lifestyle behaviors and differences in health perceptions between younger and older cohorts of Filipinos living in rural areas in the Philippines. Our findings suggest the need to design separate health promotion interventions that target older and younger Filipinos' unique needs from rural communities.
Low-Middle-Income Countries ; Aging ; Cross-sectional ; Population Health ; Philippines

BACKGROUND: We conducted this study to investigate the financial burden of terminal cancer patient's family and to identify factors influencing their economic burden. METHODS: We approached 187 family members supporting their famly member with terminal cancer who was enrolled in four hospice and palliative care program. We constructed a questionnaire examining the impact of illness on their family. With multiple logistic analysis, we examined the patients' and family members' demographic and the patients' clinical factors associated with the burden caused by terminal cancer. RESULTS: The majority of families reported the loss of savings (54%), the need to make major life changes in order to care for the patient (50%), the loss of incomes (34%), the inability to function normally because of the stress of the illness (27%). Many families had to move to a less expensive home (18%), delay medical care for other family members (12%), or change educational plans for other family members (13%). Families that cared for patients who wanted to be cared for at institution (odds ratio: 2.72, 95% confidential interval: 1.19~6.19), patients with liver cancer (3.61, 1.53~8.57), and families who were poor caregivers (2.97, 1.24~7.10), or primary caregiver was a spouse (3.57, 1.47~8.68) were more likely to lose savings. Families that were in 'new couple' in family life cycle stages (3.91, 1.04~14.63), 'birth of the first child' (8.34, 2.74~25.32), and 'the adolescent family or the launching family' (10.56, 4.07~27.33), were more likely to lose savings than 'the empty family or the aging family'. CONCLUSION: Many families reported severe caregiving and economic burdens. Social and financial support need to be given to families with predictors of high economic burdens.
Adolescent ; Aging ; Caregivers ; Climacteric ; Financial Support ; Hospices ; Humans ; Income ; Liver Neoplasms ; Palliative Care ; Spouses ; Surveys and Questionnaires

BACKGROUND: The authors have developed a Digital image chart(DIC) and digital Radiotherapy Record System (DRRS). We have evaluated the DIC and DRRS for reliability, usefulness, ease of use, and efficiency. METHOD AND MATERIALS: The basic design o f the DIC and DRRS was to build an digital image database of radiation therapy patient records for a more efficient and timely flow of critical image in formation throughout the department. This system is a subunit of comprehensive radiation oncology managemert system (C-ROMS) and composed of a picture archiving and communication system (PACS), radiotherapy information database, and a radiotherapy imaging database. The DIC and DRRS were programmed using Delphi under a Windows 95 environment and is capable of displaying the digital images of patients identification photos, simulation films, radiotherapy setup, diagnostic radiology image... Gross lesion photos, and radiotherapy planning isodose charts with beam arrangements. Twenty-three clients in the department are connected by Ethernet (10 Mbps) to the central image server (Sun Ultra-sparc 1 workstation). RESULTS: From the introduction of this system in February 1998 through December 1999, we have accumulated a total of 15,732 individual images for 2,556 patients. We can organize radiation therapy in; paperless environment in 120 patients with breast cancer. Using this system, we have succeeded in the prompt, accurate, and simultaneous access to patient care information from multiple locations throughout the department. This coordination has resulted in improved operational efficiency within the department. CONCLUSION: The authors believe that the DIC and DRRS has contributed to the improvement of radiation oncology department efficacy as well as to time and resource savings by providing necessary visual information throughout the department conveniently and simultaneously. As a result, we can also achieve the paperless and filmless practice of radiation oncology with this system.
Breast Neoplasms ; Dacarbazine ; Hospital Information Systems ; Humans ; Income ; Patient Care ; Radiation Oncology* ; Radiotherapy*

Purpose: Herein is reported our initial experience of the CyberKnife to show its safety and feasibility as a treatment modality for non-metastatic prostate cancer. Materials and Methods: Twenty patients, with biopsy-proven prostate cancers, were recruited into a phase I clinical trial using the CyberKnife. The distribution of clinical risks, as assessed using the ASTRO criteria, was as follows: low (4), intermediate (5) and high (11). The mean age and follow up of the patients were 71.4 years and 15 months, respectively. The patients received 7.5-9Gy of radiation in a single fraction for 4-5 days. The total radiation dose to the prostate was 34-37.5Gy, which approximates to 86.4Gy in 2Gy fractions. The rectal and bladder acute toxicities were graded using the criteria of the Radiation Therapy Oncology Group (RTOG). The results of acute toxicities were compared to those of the historical control, which had been treated with conventional four field box techniques (received median dose 70.2Gy). The prostate-specific antigen (PSA)- based short-term efficacy was described. Results: The acute rectal toxicity scores were 0, 1 and 2 in 13, 5, and 2 patients, respectively. The acute bladder toxicity scores were 0, 1 and 2 in 16, 3 and 1 patient, respectively. No grade 3 or 4 acute toxicity was noted. These figures contrast sharply with those found for the historical control. All toxicities spontaneously subsided within 3 months after treatment. Continuous PSA reduction was noted in all patients, and no PSA failure was noted during the follow up period. Conclusions: Our data show the feasibility of the CyberKnife in terms of its efficacy and acute toxicity. Moreover, the capability of using a hypo-fractionation schedule lead to marked improvement in patient convenience, with substantial resource savings.
Appointments and Schedules ; Follow-Up Studies ; Humans ; Income ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Urinary Bladder

Blood utilization review has recently been used to minimize inappropriate transfusion, reduce post transfusion infections and improve the quality of transfusion practices. Ajou University Hospital is a 906 bed tertiary care teaching institution. Since March, 1995, the concurrent review of blood transfusion requests using institutional blood transfusion criteria has been initiated. To evaluate the effectiveness of the transfusion review, the units of blood components transfused per patient(total number of units of blood components transfused/total number of patients discharged) and inappropriate transfusion ratio of blood components(total number of units of blood components inappropriately transfused/total number of units of blood components transfused) were compared during the concurrent review for 9 months and pre-concurrent review for 9 months, respectively. The possible savings of blood components realized by the review were also extrapolated. The results were as follows : 1. The unit transfused per patient for pre-review and during review were 0.675 (9,080/ 13,422) and 0.654(12,123/18,546) for packed RBC(PRBC); 0.417 (5,602/ 13,422) and 0.296 (5,444/18,546) for fresh frozen plasma(FFP); 0.372(5,007/13,422) and 0.424(7,868/18,546) for platelet con-centrates(PC), respectively. 2. The inappropriate transfusion ratio of blood components for pre-review and during review were 0.039 and 0.009 for PRBC; 0.321 and 0.064 for FFP; 0.143 and 0.008 for PC, respectively. These differences were statistically significant(p=0.000). 3. The PRBC and FFP anticipated to have been saved by this review was 519 units and 2,992 units annually, respectively. 4. However, 2,621 units of PC were used additionaly during this review due to increased number of oncology patients and better hemostatic therapy practiced during the same period. In conclusion, the concurrent review of transfusion requests was very effective tool to educate residents in clinical departments the transfusion medicine and improve utilization of blood and its components.
Blood Platelets ; Blood Transfusion* ; Concurrent Review* ; Humans ; Income ; Tertiary Healthcare ; Transfusion Medicine ; Utilization Review

PURPOSE: Patient motion during magnetic resonance (MR) imaging is one of the major problems due to its long scan time. Entropy based post-processing motion correction techniques have been shown to correct motion artifact effectively. One of main limitations of these techniques however is its long processing time. In this study, we propose several methods to reduce this long processing time effectively. MATERIALS AND METHODS: To reduce the long processing time, we used the separability property of two dimensional Fourier transform (2-D FT). Also, a computationally light metric (sum of all image pixel intensity) was used instead of the entropy criterion. Finally, partial Fourier reconstruction, in particular the projection onto convex set (POCS) method, was combined thereby reducing the size of the data which should be processed and corrected. RESULTS: Time savings of each proposed method are presented with different data size of brain images. In vivo data were processed using the proposed method and showed similar image quality. The total processing time was reduced to 15% in two dimensional images and 30% in the three dimensional images. CONCLUSION: The proposed methods can be useful in reducing image motion artifacts when only post-processing motion correction algorithms are available. The proposed methods can also be combined with parallel imaging technique to further reduce the processing times.
Artifacts ; Brain ; Entropy ; Fourier Analysis ; Humans ; Income ; Light ; Magnetic Resonance Spectroscopy

OBJECTIVEIn order to figure out how and to what degree the social and economic development and control strategy influencing the epidemics of tuberculosis and to provide reference for tuberculosis prevention and control in China.

METHODSBased on the data from the nationwide random surveys on tuberculosis in 1979, 1984/1985, 1990 and 2000 and the indexes on social and economic development of China, correlation coefficient was used to analyze the relationship of three factors including (1) the change of epidemic situation of tuberculosis from 1979 to 2000; (2) the level of social and economic development; (3) the implementation of Health V Project.

RESULTSThe prevalence rate of smear positive tuberculosis was significantly correlated to per capita net income of rural population, consumption level of city population, per capita GDP, density of population, and proportion of rural population. Among which the correlation with per capita net in come of rural population, consumption level of city population, per capita GDP, or density of population showed negative, correlation but the proportion of rural population showed positive. The range of GDP increase was similar in both areas with or without the implementation of Health V Project from 1990 to 2000 (77.2% and 77.8%). However, the ranges of the decline of prevalence rate were quite different (44.4% and 12.3%) in the two areas. In the western part of China, the range of GDP increase was similar in the areas with or without the implementation of Health V Project. However, the prevalence rate declined in the area that implementing the project but increased in other areas without the project.

CONCLUSIONThe level of social and economic development had influenced the prevalence rate of tuberculosis, but the implementation of tuberculosis control project played an important role in the reduction of tuberculosis prevalence rate from 1979 to 2000 in China.

China ; epidemiology ; Female ; Humans ; Income ; statistics & numerical data ; Male ; Prevalence ; Rural Population ; Socioeconomic Factors ; Tuberculosis ; epidemiology