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A Consensus Plan for Action to Improve Access to Cancer Care in the Association of Southeast Asian Nations (ASEAN) Region

  • Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8521-8526
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    • 2014
  • In many countries of the Association of Southeast Asian Nations (ASEAN), cancer is an increasing problem due to ageing and a transition to Western lifestyles. Governments have been slow to react to the health consequences of these socioeconomic changes, leading to the risk of a cancer epidemic overwhelming the region. A major limitation to motivating change is the paucity of high-quality data on cancer, and its socioeconomic repercussions, in ASEAN. Two initiatives have been launched to address these issues. First, a study of over 9000 new cancer patients in ASEAN - the ACTION study - which records information on financial difficulties, as well as clinical outcomes, subsequent to the diagnosis. Second, a series of roundtable meetings of key stakeholders and experts, with the broad aim of producing advice for governments in ASEAN to take appropriate account of issues relating to cancer, as well as to generate knowledge and interest through engagement with the media. An important product of these roundtables has been the Jakarta Call to Action on Cancer Control. The growth and ageing of populations is a global challenge for cancer services. In the less developed parts of Asia, and elsewhere, these problems are compounded by the epidemiological transition to Western lifestyles and lack of awareness of cancer at the government level. For many years, health services in less developed countries have concentrated on infectious diseases and mother-and-child health; despite a recent wake-up call (United Nations, 2010), these health services have so far failed to allow for the huge increase in cancer cases to come. It has been estimated that, in Asia, the number of new cancer cases per year will grow from 6.1 million in 2008 to 10.6 million in 2030 (Sankaranarayanan et al., 2014). In the countries of the Association of Southeast Asian Nations (ASEAN), corresponding figures are 770 thousand in 2012 (Figure 1), rising to 1.3 million in 2030 (Ferlay et al., 2012). ASEAN consists of Brunei Darussalam, Cambodia, Indonesia, Lao, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. It, thus, includes low- and middle-income countries where the double whammy of infectious and chronic diseases will pose an enormous challenge in allocating limited resources to competing health issues. Cancer statistics, even at the sub-national level, only tell part of the story. Many individuals who contract cancer in poor countries have no medical insurance and no, or limited, expectation of public assistance. Whilst any person who has a family member with cancer can expect to bear some consequential burden of care or expense, in a poor family in a poor environment the burden will surely be greater. This additional burden from cancer is rarely considered, and even more rarely quantified, even in developed nations.

A Phenomenological Study on the Child-rearing Experience and Conflict of Grandmothers in Dual-income Families: from the Grandmother's and Working Moms' Point of View (맞벌이 가정 조모의 손자녀 양육경험와 양육갈등에 관한 현상학적 연구: 조모와 취업모 관점에서)

  • Kim, Mee Ok;Song, Seung Min;Lee, Sa Rah
    • Korean Journal of Childcare and Education
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    • v.11 no.4
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    • pp.239-269
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    • 2015
  • The purpose of this study is to understand the different views of grandparent's that are rearing children from the grandmother and working mom as co-caregivers by studying conflicts and the experience made by grandmothers by rearing children through a phenomenological approach, and to help to build healthy relationships and furthermore to promote a healthy educational environment. Data were collected from six working mothers from a child care center in Gyeonggi, and their six grandmothers who were rearing grandchildren through in-depth interviews, emails and observation based on the instruction of semi-structured interviews. For analysis, a phenomenological analysis method is used. As a result, 78 meaning units, 15 sub-elements and 6 theme categories were drawn. Theme categories were (1) grandmothers' rearing experience; perform a double-role through grandchildren-rearing (2) working moms' rearing experience; conflicts over ideologue of motherhood (3) grandmothers' rearing positive effect: increasing grandmothers' efficacy and intimate relationships with grandchildren (4) working moms' rearing positive effect: reducing working moms' children-rearing stress (5) negative effect: increasing grandmothers' children-rearing stress and working moms' low children-rearing efficacy (6) rearing conflicts: the two mothers' conflicts over children-rearing values. Through the study, it implies that social intervention is needed to solve the conflicts between two mothers over the rearing attitudes and methods as understanding and intervention is needed.

Shear Strength of Interface between Natural Aggregate Concrete and Recycled Aggregate Concrete (천연골재 콘크리트와 순환골재 콘크리트 접합면의 전단강도)

  • Moon, Hoon;Choi, Ik-Je;Kim, Ji-Hyun;Chung, Chul-Woo;Kim, Young-Chan
    • Journal of the Korean Recycled Construction Resources Institute
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    • v.8 no.1
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    • pp.26-32
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    • 2020
  • Concrete recycling is becoming mandatory rather selective due to depletion of constructional materials and increase of concrete waste. Studies on recycling concrete are conducted in various point of view for long time. However, standard or guideline of many countries for the application of recycled aggregate concrete(RAC) has restrictions such as low replacement rate of coarse aggregate and no fine aggregate allowed due to inferior material properties of recycled aggregate. This study intends to figure out the feasibility of casting natural aggregate concrete(NAC) and RAC separately in a structural member. In making RAC, replacement rate of coarse aggregate was 50, 100% in RAC and treatment of interface of two concretes is introduced. RAC treatment of recycled aggregate or inclusion of additives was not done as it can increase embodied energy of concrete work. Double-shear test with uniformly distributed loading was adopted to evaluate shear strength at the interface of two concretes. After curing it was hard to distinguish interface of two concretes. Experimental result revealed that specimen with higher replacement rate showed higher shear-to-compressive strength ratio, which is possibly attributed to coarse aggregate size and roughness of sheared section. Further study on the effect of various parameters is required and subsequent research activity is on-going.

Growth and Yield Responses of Soybean to Planting Density in Late Planting (남부지방 콩 만파 재배 시 재식밀도에 따른 생육 및 수량변이)

  • Park, Hyeon-Jin;Han, Won-Young;Oh, Ki-Won;Ko, Jong-Min;Bae, Jin Woo;Jang, Yun Woo;Baek, In Youl;Kang, Hang-Won
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.60 no.3
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    • pp.343-348
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    • 2015
  • Soybean is one of the important food crop around the world. Especially in East Asia, it is the main ingredient for traditional food like soy sauce and soy paste. The double cropping system including soybean following onion, Chinese cabbage, and potato is widely adopted in Southern region of Korea. In this system, sowing date of second crop (soybean) can be delayed depending on first crops' growth period and weather condition. When planting date is delayed it is known that soybean yield is declined because of shorter vegetative growth period and earlier flowering induced by warm temperature and changes in photoperiod. The objective of this study was to determine soybean growth and yield responses as plant populations at late planting date. Field experiment was conducted at Department of Functional Crop, National Institute of Crop Science, RDA located in Miryang, Gyeongsangnam-Do for two years ('13-'14) in upland field with mid-late maturity cultivar Daewon. A split-plot block design was used with three replications. Main plots were three sowing dates from June 20 to July 20 with 15 days intervals, and subplots were 4 levels of planting densities. Data of maturity (R8) was recorded, yield components and yield were examined after harvesting. Experimental data were analyzed by using PROC GLM, and DMRT were used for mean comparison. Optimum planting population for maximizing soybean yield in late planting which compared with standard population. In mid-June planting, higher planting density causes increased plant height and decreased diameter which lead to higher risk of lodging, however, reduced growth period due to late planting alleviated this problem. Therefore higher seeding rates can provide protection against low seedling emergence caused by late planting in this region.

Development of a new armor unit against high waves (고파랑 대응 신형 소파블록 개발)

  • Park, Young Hyun;Youn, Daeok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.6
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    • pp.737-743
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    • 2016
  • Coastal hazards such as high waves are expected to increase due to global climate change. Therefore, we investigated new armor unit structures for disaster prevention. Recently, a concrete caisson has been used in many breakwaters against high waves in South Korea, but the demand for concrete armor unit has increased due to the high cost and many installation requirements. Though many new armor units have been developed over the world since Tetrapod in 1950, few have been used due to lack of systematical development. The representative armor units in current use have many advantages, but they cannot be applied to waves higher than 8 m. One of the new armor units developed by the design guide based on recent trend and hydraulic model experiments were conducted. The new armor unit was developed as a single layer due to cost effectiveness. However, the thickness is close to 1.5 times by overlapping the alphabet A and V. It showed higher overtopping compared to a double layer because of the thickness and the high packing density. It has a high interlocking vertically but low horizontally. It shows good stability at 9 m in model testing.

The Synthesis and Characterization of (TBMA)Macromer Grafted Anionic Acrylic Copolymer ((TBMA)Macromer를 그라프트시킨 음이온성 아크릴 공중합체의 합성과 물성)

  • Kim, Hyoung-Ook;Noh, Si-Tae;Kang, Shin-Chun
    • Applied Chemistry for Engineering
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    • v.4 no.3
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    • pp.627-636
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    • 1993
  • Anionic acrylic resin utilizing macromer(TBMA-g-MMA) copolymer was synthesized by preparing (TBMA) macromer using anionic living polymerization, followed by graft copolymerization with MMA macromer. To control the anionic site content in graft copolymer, the relative composition((TBMA) macromer/MMA ratio) of the graft copolymer was controlled at 7/3, 10/90, 15/85, 20/80, 30/70, 40/60, 50/50 in weight content. In the course of anionic living polymerization of(TBMA) macromer, broad molecular weight distribution (1.4~1.5) was obtained by using n-butyllithium-diphenyethylene initiatior system at $-78^{\circ}C$. To introduce the double bond at the end of chain in termination step, methacryloyl chloride was reacted after insertion of benzaldehyde as capping material. Moreover, TBMA parts in graft copolymer were hydrolyzed in the presence of p-toluenesulfonic acid catalyst, and neutralization of graft copolymer with triethylamine was granted acrylic resin to anionic site. Molecular weight and molecular weight distribution of(TBMA) macromer were determined by GPC, and the hydrolysis of TBMA with neutralization of acrylic resin were determined by IR and NMR. From water dispersion and stability point of view, stable dispersion state appeared at low molecular weight(TBMA) macromer with a small TBMA content as a result of scrutiny about the relation to TBMA content and branch length for(TBMA) macromer molecular weight in graft copolymer.

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Financial Projection for National Health Insurance using NHIS Sample Cohort Data Base (국민건강보험 표본코호트 DB를 이용한 건강보험 재정추계)

  • Park, Yousung;Park, Haemin;Kwon, Tae Yeon
    • The Korean Journal of Applied Statistics
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    • v.28 no.4
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    • pp.663-683
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    • 2015
  • The change of the population pyramid due to low fertility and rapid aging threatens the financial sustainability of National Health Insurance. We construct statistical models for prevalence rates and medical expenses using National Health Insurance Service (NHIS) sample cohort data from 2002-2013. We then project yearly expenditures and income of national health insurance until 2060 that considers various assumptions in regards to future population structure and economic conditions. We adopt a VECM-LC model for prevalence rates and the double exponentially smoothing method for the per capita co-payment of healthcare expense (in which the two models are institution-disease-sex-age specific) to project of national health insurance expenditures. We accommodate various assumptions of economic situations provided by the national assembly and government to produce a financial projection for national health insurance. Two assumptions of dependents ratios are used for the projection of national health insurance income to conduct two future population structures by the two assumptions of aging progresses and various assumptions on economic circumstances as in the expenditure projection. The health care deficit is projected to be 20-30 trillion won by 2030 and 40-70 trillion won by 2060 in 2015 constant price.

The Review on the Prostate Disease-related Studies with Acupuncture Therapy in PubMed (PubMed 검색(檢索)을 이용한 전립선(前立腺) 질환(疾患)의 침치료(鍼治療)관련 연구(硏究)에 대한 고찰(考察))

  • Song, Ho-Sueb
    • Journal of Pharmacopuncture
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    • v.7 no.2
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    • pp.65-73
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    • 2004
  • Objective : This study was to review on the prostate disease-related studies with Acupuncture therapy in renowned medical internet site of PubMed, and to make master plan of the study, especially, on Bee Venom Acupuncture(BVA) of Prostate disease and then to devise the idealistic therapeutic ways of it. Method : We made the internet search with the key words of bee venom(bee venom therapy, apitoxin, apitherapy, bee sting, bee sting therapy), acupuncture, prostate, prostatitis, prostrate cancer in Pubmed, from June 1st to July 1st,2004. Results : 1.25 papers were found in 19 publised jounals. of which two named'Urology'and Prostate' had three papars, two called 'JUrology' and 'Cancer Immunol Immunother' had two papers, and the others had a paper respectively. 2. In the classification by papers' types, Review papers were 8 and Original were 17 where there were 5 clinical trials, 11 experimental studies and 1 epidemiologic paper. Of 5 clinical trials, 2 belonged to Randomized Control Study, and of 11 experimental studies, 4 belonged to in vitro and 7 belonged to in vivo with in viro studies, and 1 epidemeologic belonged to meta-analysis. 3. In the classification by prostate diseases, 4 were about prostatitis, 3 were about prostate related symptoms, 16 were about prostate cancer, and two were about the others. 4. In the classification by applied treatment methods, 5 were related with Acupuncture, 10 were related with BVA(Bee Venom, Bee), and 10 were related with the others. Of 5 related with Acupuncture, 3 used general acupuncture, 1 used electrical acupuncture, and 1 used general acupuncture and electrical acupuncture at the same time. 5. In 2 RCTs of Clinical trials, Control group was set up to the group using different compatible treatment method or using meridians not related with treating prostate disease. Single or double blind methods couldn't be found. 6. In the clinical trials, IPSS, NIH, CPSI or subjective global assessment were used as the Index of Evaluation. 7. The Leg Greater Yang Bladder Meridian(B), The Leg Lesser Um Kidney Meridian(K) and Conception Vessel Meridian(CV) were used as major meridians, and B10(Taejo, Dazhu), B23(Shinsu, Shenshu), B28(Panggwangsu, Pangguangshu), B35(Hoeyang, Huiyang), B39(Wiyang, Weiyang), B40(Wijung, Weizhong), B54(chilbyon, Zhibian), K1(Yongchon, Yongquan), K10(Umgok, Yingu), CV3(Chungguk, Zhongji), CV4(Kwanwon, Guanyuan),S6(Hyopko, Jiache) were used as acupoints. Electrical acupuncture(EA) was considered to be more important and CV3(Chungguk, Zhongji), CV4(Kwanwon, Guanyuan) were mainly selected as EA applied acupoints. 8. It is mostly said that Acupuncture appeared to be a safe, effective, and durable treatment alternative in improving symptoms of patients with prostate diseases, refractory to conventional medicine. A larger controlled study was required to confirm these encouraging initial results. Conclusion : Papers about BVA of Prostate cancer or Prostatitis were not found, and low permeability of Prostate is concerned, BVA with the anti-inflammatory and anti-cancer effect can be adopted as a new alternatives of Prostate disease treatment, so it is thought that Study of how to make access to prostate, animal experiment including in vivo and in vitro and more clinical trials with using acupoints on related meridian should be followed.

Practical and Effective Method for the Solubilization and Characterization of Mammalian ${\beta}$-adrenergic receptor

  • Shin, Chan-Young;Kim, Hee-Jin;Lee, Sang-Bong;Ko, Kwang-Ho
    • Biomolecules & Therapeutics
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    • v.1 no.2
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    • pp.188-195
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    • 1993
  • In order to understand the machanism of action and regulation of ${\beta}$-adrenergic receptor in terms of molecular level, the purification of receptor protein has a fundamental importance. Moreover, species differences among avian, amphibian and mammalian ${\beta}$-adrenergic receptors make it more important to purify mammalian ${\beta}$-adrenergic receptor. Because ${\beta}$-adrenergic receptor is an integral membrane protein, it must be solubilized from the membrane for the purification. The purpose of the present study was to solubilize and characterize the mammalian $\beta$-adrenergic receptor from guinea pig lung in quantities by more efficient and practical method eventually to purify receptor. Guinea pig lung membrane preparation was solubilized by sequential treatment of buffers containing low and high concentration of digitonin which are 0.2 and 1.2% respectively. About 50% of the total receptor pool was released by this double extraction procedure. The $\beta$-adrenoceptors in the digitonin extract were identified using the ${\beta}$-adrenergic antagonist, (-)-[$^3H$]-dihydroalprenolol ([$^3H$]DHA). The solubilized receptor retained all of the essential characteristics of membrane-bound receptor, namely saturability; stereoselectivity; high affinity to ${\beta}$-adrenergic drugs. For the measurement of soluble receptor activity, Sephadex G-50 chromatography method has been widely used. Inspite of its accuracy and wide acceptance, this technique employed troublesome column work which required long time to assay the activity of receptor. We employed another methods to measure receptor activity. When using 0.5% polyethylenimine pretreated GF/B glass fiber filter, filtration technique could be used to measure soluble receptor activity. This technique enabled us to reduce the total amount of time to assay by a factor of 4 as well as to detect soluble receptor. In the present study, we could establish more efficient and practical solubilization method of mammalian $\beta$-adrenergic receptor. The rapidity and high yield of this solubilization scheme, together with the favorable recovery of the receptor activity, are significant steps toward the ultimate purification of the mammalian $\beta$-adrenergic receptor. The result of this study together with more convenient purification method could provide large amount of purified receptor with ease for various research purposes.

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Mineral Status in Cattle Fed Rice Straw and Para Grass Combined with Different Levels of Protein Derived from Cassava Foliage

  • Sath, K.;Pauly, T.;Holtenius, K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.1
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    • pp.59-64
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    • 2013
  • Eight male cattle of the Local Yellow breed with an average live weight of 121 kg and an average age of 18 months were used to evaluate the effects of different levels of sun-dried cassava (Manihot esculenta) foliage supplementation on mineral metabolism in growing cattle fed rice straw and para grass as basal diet. Rice straw ad libitum and para grass (Brachiaria mutica) at 1% DM of BW comprised the basal diet. The study was arranged as a $4{\times}4$ double Latin square design, with cassava foliage contributing 0, 0.8, 1.6 or 2.4 g CP/kg BW. The cassava foliage intake was lower than the planned levels. DM consumption was significantly affected by cassava foliage supplementation, with the largest intake observed at the two highest levels of cassava foliage supplementation. Rice straw intake showed the opposite pattern, with lower intake at higher cassava foliage supplementation. No refusals occurred for para grass in any of the treatments. Ca, P, Mg, K, S and Mn intake increased significantly with increasing intake of cassava foliage, but Na intake was not affected by treatment. Faecal excretion of Ca, Mg, S and Mn increased significantly with increasing cassava foliage intake. There were no differences between P, K and Na excretion in faeces. There was a significant diet effect on Mg, S and Mn digestibility. Mg and Mn digestibility increased with increasing cassava foliage supplementation, while S digestibility decreased. Ca, P, K and Na digestibility was not affected by diet. There was a significant effect of treatment on P retention, with the highest value observed for supplementation with 1.6 g CP/kg BW cassava foliage. Ca and Mg showed similar trends, with the highest retention again for supplementation with 1.6 g CP/kg BW cassava foliage. There were weak but significant positive correlations between nitrogen retention and the macro minerals Ca, P and Mg. Furthermore, retention of all these minerals was positively correlated. Mineral losses in urine were not affected by dietary treatment with the exception of P excretion, which was affected by treatment. In conclusion, cassava foliage is a good Ca source which compensates for the low Ca content in rice straw and para grass, but P deficiency appears to be exaggerated in cattle with higher cassava intake. The results suggest that under these conditions growing cattle on a high cassava intake would benefit from P and S supplementation.