METHOD: The primary data source of the study consists of excerpts of verbal expressions within the familial context. The provenance of the locational data can be traced to a familial unit with a cultural legacy deeply embedded in Javanese customs. The data were collected using observation and participation methodologies, employing advanced techniques of recording and note taking. The data were categorized and characterized to identify the various data types and formats. The tabulated results of classification and typification are presented to triangulate theory through expert validation and justification of theories. The method of contextual analysis was utilized to conduct the data analysis that relies on the pragmatic context.
RESULTS: The study's findings indicate the following: The Javanese language encompasses various modes of pseudo-directive utterances, such as commanding, ordering, suggesting, insinuating, and recommending. In addition, the Javanese language encompasses pseudo-directive pragmatics such as warning, prohibiting, reminding, suggesting, and commanding.
CONCLUSION: This research will significantly assist in formulating a pragmatic framework that considers cultural factors, as other linguistic phenomena in various regional languages remain unresolved.
MATERIALS & METHODS: Data for subdistricts in Malaysia and radiotherapy services were extracted from Department of Statistics Malaysia and Directory of Radiotherapy Centres (DIRAC). Data from DIRAC were validated by direct communication with centres. Locations of radiotherapy centres, distance and travel time to the nearest radiotherapy were estimated using web mapping service, Google Map.
RESULTS: The average distance and travel time from Malaysian population to the closest radiotherapy centre were 82.5km and 83.4mins, respectively. The average distance and travel were not homogenous; East Malaysia (228.1km, 236.1mins), Central (14.4km, 20.1mins), East Coast (124.2km, 108.8mins), Northern (42.9km, 42.8mins) and Southern (36.0km, 39.8mins). The MV/million population for the country is 2.47, East Malaysia (1.76), Central (4.19), East Coast (0.54), Northern (2.40), Southern (2.36). About 25% of the population needs to travel >100 km to get to the closest radiotherapy facility.
CONCLUSION: On average, Malaysians need to travel far and long to reach radiotherapy facilities. The accessibility to radiotherapy facilities is not equitable. The disparity may be reduced by adding centres in East Malaysia and the East Coast.
METHOD: A systematic Boolean search in PubMed, EMBase and EBSCOhost research databases was performed. Keyword search and citation analysis were also conducted. Empirical studies reporting ICT based interventions, and their implications on relative effectiveness in reducing unnecessary diagnostic tests (pathology tests or medical imaging) were evaluated independently by two reviewers based on a rigorously developed coding protocol.
RESULTS: 92 research articles from peer-reviewed journals were identified as eligible. 47 studies involved a single-method intervention and 45 involved multi-method interventions. Regardless of the number of interventions involved in the studies, ICT-based interventions were utilized by 71 studies and 59 of them were shown to be effective in reducing unnecessary testing. A clinical decision support (CDS) tool appeared to be the most adopted ICT approach, with 46 out of 71 studies using CDS tools. The CDS tool showed effectiveness in reducing test volume in 38 studies and reducing cost in 24 studies.
CONCLUSIONS: This review investigated five frequently utilized intervention methods, ICT-based, education, introduction of guidelines or protocols, audit and feedback, and reward and punishment. It provides in-depth analysis of the efficacy of different types of interventions and sheds insights about the benefits of ICT based interventions, especially those utilising CDS tools, to reduce unnecessary diagnostic testing. The replicability of the studies is limited due to the heterogeneity of the studies in terms of context, study design, and targeted types of tests.