Diagnosis-related group (DRG) system is patient classification system designed to produce limited number of classes which are relatively similar in terms of resource consumption and clinical characteristics. The aim of this study was to assess the level of knowledge, attitude and practice (KAP) of Turkish health care providers toward DRG system implemented in Turkey.A total of 238 healthcare providers were randomly selected from two urbanand one rural hospital in Turkey.A questionnaire was used for data collection; contacting 32 items (10 items about knowledge, 12 items about attitude and 10 items about the practice) and its validity and reliability were confirmed. Data analysis was performed using chi-square and multivariate logistic regression.In this study,only one third of healthcare providers showed good knowledge (35.7%) and good practice (37.4%) about DRG system,compared to 54.2% of them showed good attitude.There was significant difference between age, gender, occupation groups and whether the respondents have attended a workshop for DRG system in terms of KAP (p > 0.05).These results indicated the need for further actions to implement DRG system in terms of creation of suitable environment and increasing awareness among healthcare providers, especially male, medical doctors, nurses, elderly, and those who have never attended a workshop, in addition to regular review to ensure the program would reach its targets.

Cervical cancer is the seventh most common cancer among women in Iraq. This study aimed to assess the factors influencing Pap smear practice among married primary school teachers in Diyala City, Iraq. A total of 222 teachers (aged 20 years to 63 years) residing in Diyala City were enrolled in a cross sectional study from 1st August till 30th September 2012. The sampling method was a self-administered survey using a multistage sampling technique. The prevalence of Pap smear practice was very low (12.6%). Relatives and friends were the main source of information about the Pap smear test for more than one third (41.9%) of the respondents. However, the medical doctor’s advice was the most important reason for undergoing a Pap smear test in more than two third (60.7%) of respondents. Only 32.4% of the teachers have good knowledge about cervical cancer and Pap smear test, but 76.1% of them showed a positive attitude toward learning about cervical cancer and Pap smear. Based on multiple logistic regression analysis results only the husband’s encouragement (p= 0.003, prevalence odds ratio [POR] = 0.256, 95%CI 0.10-0.63) was significantly associated with Pap smear practice. A more effective educational program is needed to educate Iraqi women about cervical cancer and screening tests, including Pap smear.
Papanicolaou Test

This study aimed to assess the concurrent validity of the Malay version of the Perceived Stress Scale (PSS-10) PSS-10 item. Methods: A crosssectional study was conducted among all students in a medical faculty in Malaysia. The questionnaire included three parts; socio-demographic correlates, PSS-10 and the validated Malay version of Depression Anxiety and Stress Scale-21 item (DASS-21). Spearman's correlation coefficient was used in the analysis. Stress subscale of DASS -21 correlated positively with the total score of PSS-10 (r= +0.50, p<0.001), positively with the negative subscale of PSS-10 (r=+0.36, p<0.001) and negatively with the positive subscale of PSS-10 (perceived coping) (r= -0.33, p<0.001). Conclusion: The Malay Version of PSS-10 has fair correlation with the stress subscale of DASS-21. This confirmed the concurrent validity of this scale, which further strengthened the previous evidence that the Malay version of PSS-10 was a valid tool to measure stress in Malaysian university students. ASEAN Journal of Psychiatry, Vol. 15 (1): January – June 2014: 8-13.
Stress, Psychological ; Students, Medical

Streptococcus pneumoniae (pneumococcus) is the most common cause of community-acquired pneumonia, meningitis, and bacteremia in children and adults, including the elderly, and is responsible for high rates of morbidity and mortality worldwide. Aim of this paper to review published articles on incidence of pneumococcal meningitis in children less than 5 years of age in Malaysia, Singapore and Thailand, and compare the incidence of pneumococcal meningitis among the children in the three courtiers. Literature searches were conducted using google scholar, PubMed, the World Health Organization (WHO) website of the Weekly Epidemiological Record, and the countries’ Ministry of Health (MOH) website, and were limited to articles written in English. All relevant publications/abstracts published/presented during the period December 2000 through March 2014. Searches were conducted from April 1, 2014, till July 11, 2014 using various combinations of the following search terms “ Pneumococcal diseases” OR “meningococcal” OR “pneumococcal meningitis” OR “meningococcus”. A total of five articles and abstracts described the incidence of pneumococcal meningitis among children 5 years old. These five documents include two conference abstracts from Malaysia, one published paper from Singapore and two published papers from Thailand. The Malaysian, Singaporean and Thai pneumococcal meningitis incidence rate was 3.8-8.6, 2.3 and 0.10-1.8 per 100,000 children respectively. Our review confirmed that the incidence rate of pneumococcal meningitis was vary among the countries. The highest incidence rate of pneumococcal meningitis was found in Malaysia followed by Singapore and Thailand.
Meningitis, Pneumococcal ; Child

There is high expectation from the population on part of the healthcare providers. These include; skilful and timely medication administration; and knowledge, honesty, listening skills, availability and professional attitude. The aim of this paper is to evaluate the expectation of population with regards to the healthcare providers in Turkey. A cross- sectional study was conducted in Turkey, including both rural and urban population, carried out from October 2011 till January 2012. A total of 540 household heads were selected using multistage random sampling technique. Data was collected using modified self-administered 16-items QUOTE (Quality of Care Through the Patients’ Eyes) questionnaire. The questionnaire measures communication/ accessibility, organizational skills and professional skills. The response rate was (77.1%) and data was analyzed by using SPSS version 16.0. All the aspects measured using QUOTE questionnaire were found to be important by the majority of respondents, but with varying degrees of priority. The quality aspects related to the professional skills of physicians was ranked first followed by communication/ accessibility and last but not the least is the organizational skills of health care providers. This study explored the Turkish people priorities and expectations regarding healthcare providers. The public priorities and expectation were different across population. This may reflect the need to understand people’s expectations before providing the services to avoid complaints that may occur after the services have been rendered.

Health system reform has been a major concern for different countries. The aim of this research was to develop a reliable and valid questionnaire suitable to assess the consequences of health reform process from people’s perspective. An extensive literature review used to extract a set of statements as possible indicators for health system reform. Expert panel used to determine the content validity rate (CVR) and the content validity index (CVI). The first version produced in Turkish language and pre-piloted with 20 heads of household. Qualified committee used to translate the Turkish version to English version. Group of eighteen academics and graduate students recruited to tests both versions for parallel test validity. The construct validity of the questionnaire was determined using principal components analysis with Varimax rotation method (PCA). Internal consistency and questionnaire’s reliability were calculated by Cronbach’s alpha and the test–retest reliability test. A 17- items questionnaire was developed through the qualitative phase. The Bartlett’s test was significant (p < 0.001), and the KMO value (0.842) showed that using principal component analysis (PCA) was suitable. Eigenvalues equal or higher than 1 were considered significant and chosen for interpretation. By PCA, 4 factors were extracted (accessibility, attitude and preference, quality of care and availability of resources) that jointly accounted for 85.2% of observed variance. The Cronbach’s alpha coefficient showed excellent internal consistency (alpha=0.97), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (Intra-class coefficient = 0.96). The findings showed that the designed questionnaire was valid and reliable and can be used easily to assess the consequences of health reform process by comparing the situation before and after the reform from people’s perspective.