Diagnosis delay of breast cancer and its associated factors in Malaysian women

<p>Abstract</p> <p>Background</p> <p>Breast cancer is the leading cause of cancer mortality among women in Malaysia. Delayed diagnosis is preventable and has major effects on patients' prognosis and survival. The objectives of our study were to identify the magnitude of delayed diagnosis and its associated factors in women with breast cancer in Malaysia.</p> <p>Methods</p> <p>This study had a cross-sectional design. Respondents had histologically confirmed breast cancer and were registered at five medical centres between 2005 and 2007. All breast cancer patients who attended hospital clinics at the East Coast were included. Patients at Kuala Lumpur hospitals were selected by systematic sampling. A standardised questionnaire was developed to interview respondents. We measured the time from the first recognition of symptoms to the first general practitioners' consultation and to the histological diagnosis of breast cancer. Diagnosis delay was defined when there was more than 6 months from the recognition of symptoms to the histological diagnosis. Multiple logistic regression was used for analysis.</p> <p>Results</p> <p>In total, 328 respondents were included. The mean (standard deviation) age was 47.9 (9.4) years. Most respondents were of Malay ethnicity, were married housewives with a median family income of RM1500 a month. Most respondents had ductal carcinoma (89.3%) and the stage distribution was as follows: 5.2% stage I, 38.7% stage II, 44.8% stage III and 11.3% stage IV. The median time to consultation was 2 months and the median time to diagnosis was 5.5 months. The frequency of diagnosis delay of more than 3 months was 72.6% and delay of more than 6 months occurred in 45.5% of the cases. The factors associated with diagnosis delay included the use of alternative therapy (odds ratio (OR) 1.77; 95% confidence interval (CI): 1.06, 2.94), breast ulcer (OR 5.71; 95% CI: 1.59, 20.47), palpable axillary lymph nodes (OR 2.19; 95% CI: 1.23, 3.90), false-negative diagnostic test (OR 5.32; 95% CI: 2.32, 12.21), non-cancer interpretation (OR 1.68; 95% CI: 1.01, 2.78) and negative attitude toward treatment (OR 2.09; 95% CI: 1.15, 3.82).</p> <p>Conclusions</p> <p>Delays in consultation and diagnosis are serious problems in Malaysia. Diagnosis delay was influenced by complex interactions between many factors. Breast awareness and education are required to promote early detection, diagnosis and treatment before the tumours enlarge and metastasis.</p

Magnetohydrodynamics flow past a moving vertical thin needle in a nanofluid with stability analysis

In this study, we intend to present the dynamics of a system based on the model of convective heat and mass transfer in magnetohydrodynamics (MHD) flow past a moving vertical thin needle in nanofluid. The problem is formulated in mathematical form by using Buongiorno’s model with the modified boundary condition. The transformed boundary layer ordinary differential equations are solved numerically using the bvp4c function in MATLAB software. The effects of the involved parameters, including, Brownian motion, thermophoresis, magnetic field, mixed convection, needle size and velocity ratio parameter on the flow, heat and mass transfer coefficients are analyzed. The numerical results obtained for the skin friction coefficients, local Nusselt number and local Sherwood number, as well as the velocity, temperature and concentration profiles are graphically presented and have been discussed in detail. The study reveals that the dual solutions appear when the needle and the buoyancy forces oppose the direction of the fluid motion, and the range of the dual solutions existing depends largely on the needle size and magnetic parameter. The presence of the magnetic field in this model reduces the coefficient of the skin friction and heat transfer, while it increases the coefficient of the mass transfer on the needle surface. A stability analysis has been performed to identify which of the solutions obtained are linearly stable and physically relevant. It is noticed that the upper branch solutions are stable, while the lower branch solutions are not

Customer Awareness and Behavior Intention Towards the Use of Halal Logo on Restaurants

The trend of eating out leads the food service industry to the needs of managing customers and making sure that all their needs and preferences can be fulfilled. The certification and recognition of establishment also becomes the in thing in hospitality industry, which includes the certification of halal, HACCP, and ISO. Establishment with certification is useful as a marketing strategy to attract more customers. This study discusses the level of customer awareness of towards the halal logo used in some restaurants which is carried out to give evidence to restaurant operators regarding the importance of attaching the genuine halal logo in their restaurant. From the findings, it is showed that customers are do aware of the use of halal logo on restaurants. It is also a factor in choosing a restaurant. It is concluded that halal logo is one of the main factors for customers in choosing restaurants which in return can be a main strategy to attract and retain more customers in the future, not only for the local customer but also to foreigners

The processes of change scale: A confirmatory study of the malay language version

Background: Processes of change (POC) comprise one of the psychological constructs in the Transtheoretical Model. The objective of this study is to test the validity and reliability of the Malay version of the POC scale among university students by using a confirmatory approach. Method: A cross-sectional study design with a convenience sampling method using a self-administered questionnaire was carried out. University undergraduate students were approached to fill in the questionnaire, which consisted of demographic information and a POC scale. The POC scale consisted of 30 items and two main factors (i.e., cognitive and behavioural). The POC scale was translated into the Malay language using a standard procedure of forward and backward translation. Confirmatory factor analysis (CFA) was performed, and composite reliability was computed using Mplus version 8. Results: A total of 620 respondents with a mean age of 20 years (standard deviation = 1.15) completed the questionnaire. Most of the participants were female (74.7%) and Malay (78.2%). The initial CFA model of the POC scale did not exhibit fit based on several fit indices (comparative fit index (CFI) = 0.880, Tucker Lewis index (TLI) = 0.867, standardised root mean square residual (SRMR) = 0.075 and root mean square error of approximation (RMSEA) = 0.058). Several re-specifications of the model were conducted and the modification included adding correlation between the items’ residuals. The final model for the Malay version of the POC scale showed acceptable values of model fit indices (CFI = 0.922, TLI = 0.911, SRMR = 0.064 and RMSEA = 0.048). The composite reliability of both the cognitive and behavioural processes was acceptable at 0.856 and 0.752, respectively. Conclusion: The final model presented acceptable values of the goodness of fit indices, indicating that the scale is fit and acceptable to be adopted for future study

Numerical solution of third-order Robin boundary value problems using diagonally multistep block method

This numerical study exclusively focused on developing a diagonally multistep block method of order five (2DDM5) to get the approximate solution of the third-order Robin boundary value problems directly. The mathematical derivation of the developed 2DDM5 method is by approximating the integrand function with Lagrange interpolation polynomial. The proposed direct integrator scheme was applied to compute numerical solution at two-point concurrently. Shooting technique adapted with the Newtons divided difference interpolation method was implemented throughout the proposed algorithm. The theoretical characteristics of the developed method including the order, consistency, zero-stable and convergence are discussed. The method are tested on four Robin boundary value problems. The numerical results signify that the computational performances of the proposed method is competitive in terms of accuracy and efficiency than the existing method

Stagnation-point flow and heat transfer over an exponentially stretching/shrinking cylinder

The stagnation-point boundary-layer flow and heat transfer over an exponentially stretching/shrinking cylinder is studied. The governing partial differential equations in cylindrical form are first transformed into ordinary differential equations which are then solved numerically using a shooting method. Results for the skin friction coefficient, local Nusselt number, velocity and temperature profiles are presented and discussed in detail. The effects of the stretching/shrinking parameter ɛ and the curvature parameter γ on the fluid flow and heat transfer characteristics are also examined. It is found that the solutions for a shrinking cylinder are non-unique and that the surface shear stress and the heat transfer rate at the surface increase as the curvature parameter increases

A similarity solution for the flow and heat transfer over a moving permeable flat plate in an external free stream : case of strong injection

The previous work of Bachok et al. (Heat Mass Transf. 47:1643–1649, 2011) on the forced convection heat transfer on an isothermal moving surface in an external free stream is extended to the case when fluid injection through the surface, characterized by the parameter γ, is large. The asymptotic solution derived in this limit shows that the boundary layer has a double region structure, with an inviscid inner region of thickness O(γ) and an outer shear layer. Some further aspects of the original problem not treated in Bachok et al. (Heat Mass Transf. 47:1643–1649, 2011) are discussed as well as the analogous problem for a constant surface heat flux, where relatively small injection rates are seen to give rise to large increases in the surface temperature

Nanofluid slip flow over a stretching cylinder with schmidt and péclet number effects

A mathematical model is presented for three-dimensional unsteady boundary layer slip flow of Newtonian nanofluids containing gyrotactic microorganisms over a stretching cylinder. Both hydrodynamic and thermal slips are included. By applying suitable similarity transformations, the governing equations are transformed into a set of nonlinear ordinary differential equations with appropriate boundary conditions. The transformed nonlinear ordinary differential boundary value problem is then solved using the Runge-Kutta-Fehlberg fourth-fifth order numerical method in Maple 18 symbolic software. The effects of the controlling parameters on the dimensionless velocity, temperature, nanoparticle volume fractions and microorganism motile density functions have been illustrated graphically. Comparisons of the present paper with the existing published results indicate good agreement and supports the validity and the accuracy of our numerical computations. Increasing bioconvection Schmidt number is observed to depress motile micro-organism density function. Increasing thermal slip parameter leads to a decrease in temperature. Thermal slip also exerts a strong influence on nano-particle concentration. The flow is accelerated with positive unsteadiness parameter (accelerating cylinder) and temperature and micro-organism density function are also increased. However nano-particle concentration is reduced with positive unsteadiness parameter. Increasing hydrodynamic slip is observed to boost temperatures and micro-organism density whereas it decelerates the flow and reduces nano-particle concentrations. The study is relevant to nano-biopolymer manufacturing processes

Mixed convection boundary layer flow over a moving vertical flat plate in an external fluid flow with viscous dissipation effect

The steady boundary layer flow of a viscous and incompressible fluid over a moving vertical flat plate in an external moving fluid with viscous dissipation is theoretically investigated. Using appropriate similarity variables, the governing system of partial differential equations is transformed into a system of ordinary (similarity) differential equations, which is then solved numerically using a Maple software. Results for the skin friction or shear stress coefficient, local Nusselt number, velocity and temperature profiles are presented for different values of the governing parameters. It is found that the set of the similarity equations has unique solutions, dual solutions or no solutions, depending on the values of the mixed convection parameter, the velocity ratio parameter and the Eckert number. The Eckert number significantly affects the surface shear stress as well as the heat transfer rate at the surface

Boundary layer flow of nanofluid over an exponentially stretching surface

The steady boundary layer flow of nanofluid over an exponential stretching surface is investigated analytically. The transport equations include the effects of Brownian motion parameter and thermophoresis parameter. The highly nonlinear coupled partial differential equations are simplified with the help of suitable similarity transformations. The reduced equations are then solved analytically with the help of homotopy analysis method (HAM). The convergence of HAM solutions are obtained by plotting h-curve. The expressions for velocity, temperature and nanoparticle volume fraction are computed for some values of the parameters namely, suction injection parameter α, Lewis number Le, the Brownian motion parameter Nb and thermophoresis parameter Nt