This study analyzed the current situation and problems of two-way referral between wound healing department of general hospitals and community health service centers through stipulated interview with physicians in general hospitals and community health service centers, and patients visiting these organizations from March 2011 to April. It was found that the current two-way referral process for wound repair were facing a series of problems, including hospitals-transfer difficulty, incomplete two-way referral policy and undefined practice protocol, information-sharing obstacle between general hospitals and community health service centers. The critical countermeasures for overcoming these obstacles in two-way referral of wound ailments shall include construction of further linkage mechanism among all levels of hospitals, establishment of the drug-obtaining mechanism, establishment of an explicit two-way referral process of wound repair, and establishment of a database of diagnosis and treatment information of patients that can be accessed by doctors of different levels of hospitals, etc.
Community Health Planning ; Community-Institutional Relations ; Hospitals, Special ; Humans ; Referral and Consultation ; Wound Healing

INTRODUCTIONColorectal cancer is now the cancer with the highest incidence in Singapore. However, the overall mortality rate is still about 50% because the majority of the patients present at a late stage of disease. A charity event of screening colonoscopy was offered to the public in conjunction with the 185th anniversary of Singapore General Hospital. The aim of this event was to raise awareness about early detection of colorectal cancer and the safety of colonoscopy.

MATERIALS AND METHODSWe conducted a one-off free screening event for colorectal cancer using colonoscopy. Four hundred and ninety individuals responded to a multimedia advertisement for the event. Of these, 220 individuals were selected for the screening based on National Guidelines for colorectal cancer screening and financial status.

RESULTSOne hundred and fifty-two individuals turned up for the colonoscopy. The median age was 55 years (range, 22 to 82), with 84 males. Significant pathology was found in 33% of the individuals (n = 51). Colorectal polyps were detected in 34 individuals (22%). A total of 45 polyps were removed, with 20 hyperplastic polyps and 25 adenomas. Eight out of 25 adenomas were located proximal to the splenic flexure. Rectal cancer was diagnosed in 1 individual (0.6%). One individual had a large dysplastic rectosigmoid ulcer and refused further intervention. There were no significant complications from any of the colonoscopies.

CONCLUSIONSColonoscopy is an invaluable screening modality as it has a high pick-up rate for colorectal polyp and cancer in an asymptomatic population. It is also proven to be safe in our study. It has the added advantage over flexible sigmoidoscopy of detecting a significant number of proximal lesions. Also, therapeutic polypectomy can be performed in the same setting.

Charities ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; prevention & control ; Community-Institutional Relations ; Hospitals, General ; Humans ; Mass Screening ; Singapore

OBJECTIVES: The objectives of this study were to determine the demographic as well as clinical profile of patients participating in the breast cancer community outreach program and determine if the Breast Cancer Community Outreach Program can successfully find breast cancer cases in the community.

METHODS: In 2001, a breast cancer community outreach program was organized by the Vicente Sotto Memorial Center - Breast Center. The program components included breast cancer lay forum, breast self-examination (BSE) classes and breast clinic. Twenty seven breast cancer community outreach program were conducted in a span of 8 years.

RESULTS: There were 1719 participants with a mean age of 32.5 years. The most common reason for consultation was breast check-up (79.6%), majority had normal breast examination findings (75.9%) and breast cancer was also identified in only 19 out of 1719 (1.1%). Most of these were early breast cancer.

CONCLUSION: The Breast Cancer Community Outreach Program was not only vital in providing an-site breast cancer cases among women consulting at the community breast clinic.

Human ; Breast Self-examination ; Community-institutional Relations ; Breast ; Breast Neoplasms ; Ambulatory Care Facilities

OBJECTIVE: The aim of this paper was to develop efficient and practical health promotion strategies in the workplace by investigating both the present status of health promotion and the barriers to its practice. METHODS: A questionnaire was administered to 20% of industrial workers in the workplaces which receives the health care agency enterprise or are supported by a grant from the national treasury, K University Hospital in Gyeong-Gi province, and C University Hospital in Seoul. RESULTS: According to the questionnaire survey, 51.3% workers were practicing health promotion activities and smoking cessation was the most common method among them. Regarding the factors that prompt workers to commence health promotion activities, TV or the mass media had a 33.4% effect, followed by a 22.1% effect for an abnormal finding at regular health screening. The most necessary health promotion activity in the workplace was exercise (41.9%), followed by stress management. When asked about their expectations of the health promotion program, 84.8% of the respondents answered that they expected it to be significantly or somewhat effective. Factors affecting the health promotion activities of workers were worker's health status and job control. CONCLUSIONS: This study demonstrated that workers evaluate health promotion activities positively and that some workers are unable to participate in these activities despite their willingness to do so due to the barrier of circumstances. To encourage worker's participation, the government and employers should remove barriers.
Community-Institutional Relations ; Data Collection ; Delivery of Health Care ; Financing, Organized ; Health Promotion* ; Mass Media ; Mass Screening ; Occupational Health ; Questionnaires ; Seoul ; Smoking Cessation

PURPOSE: We examined the effects of a community outreach program for maternal health in Tigray, Ethiopia, on women's knowledge about pregnancy, childbirth, postpartum care, and family planning, and assessed their participation in antenatal care, postpartum checkups, institutional childbirth, and contraceptive use. METHODS: We recruited Ethiopian women of reproductive age (15 to 49 years) in Tigray, Ethiopia. Two villages in Tigray, Kihen and Mesanu, which have similar population sizes and living environments, were chosen as the intervention and comparison groups, respectively. A two-group pretest-posttest design with cluster sampling was employed. We conducted self-report questionnaire surveys using face-to-face interviews. The 2.5-year community outreach program was developed based on Rogers' diffusion of innovation theory. It consisted of mass media use and health education for lay women in the community, along with training of health care providers, including nurses, midwives, and health extension workers, in maternal health care. RESULTS: The intervention group showed significant increases in knowledge and behaviors regarding maternal health and family planning compared to the comparison group (p < .001). In particular, there was a dramatic increase from 10.8% to 93.5% in the institutional birth rate in the intervention group. CONCLUSION: The community outreach program and health care professional training effectively improved knowledge and behaviors regarding maternal health in Ethiopian women. Mass media and interpersonal communication channels for health education may be useful health interventions in developing countries.
Birth Rate ; Community-Institutional Relations* ; Delivery of Health Care ; Developing Countries ; Diffusion of Innovation ; Ethiopia* ; Family Planning Services* ; Female ; Health Education ; Health Personnel ; Humans ; Mass Media ; Maternal Health* ; Midwifery ; Parturition ; Population Density ; Postnatal Care ; Pregnancy

PURPOSE: With the continuous spread of the AIDS virus and other sexually transmitted diseases (STDs) throughout Asia, it has become imperative for HIV/AIDS prevention outreach programs to stress the need for using prophylactics as one form of protection. This is particularly true for commercial sex workers. This pilot study was conducted to investigate the rate of condom use among the commercial sex workers in Korea and reasons why they frequently do not wear condoms during sexual intercourse. METHODS: Fifty female commercial sex workers who worked in the Yong San area were recruited while outreach was performed and forty eight responses were analyzed due to two incomplete questionnaires. The data were collected on June 28, 2004 as part of an outreach program for condom use promotion. RESULTS: The subjects ranged in age from 21 to 45 years. Nearly half of the subjects (47.9%) did not consistently use condoms. The major reason for not using protection was clients'reluctances for using condoms. When condoms were used, the subjects preferred lubricant-rich and less painful condom during intercourse. CONCLUSION: Due to the inconsistent use of condoms, it is clear that many commercial sex workers and clients are susceptible to sexually transmitted diseases. Therefore, it is important to not only educate commercial sex workers, but also to educate their pimps and clientele about the importance of condom use. In general, it is recommended that practical strategies and a policy for condom use promotion be developed.
Adult ; Community-Institutional Relations ; Condoms/*utilization ; Cross-Sectional Studies ; Decision Making ; Female ; HIV Infections/epidemiology/prevention & control ; *Health Knowledge, Attitudes, Practice ; Health Policy ; Health Promotion ; Health Services Needs and Demand ; Humans ; Korea/epidemiology ; Middle Aged ; Pilot Projects ; Prostitution/*psychology/statistics & numerical data ; Questionnaires ; Risk-Taking ; Safe Sex/ethnology/*psychology/statistics & numerical data ; Sex Education ; Sexual Partners/psychology ; Sexually Transmitted Diseases/epidemiology/prevention & control ; Time Factors