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Emerging and Established Global Life-Style Risk Factors for Cancer of the Upper Aero-Digestive Tract

  • Gupta, Bhawna;Johnson, Newell W.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.5983-5991
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    • 2014
  • Introduction: Upper aero-digestive tract cancer is a multidimensional problem, international trends showing complex rises and falls in incidence and mortality across the globe, with variation across different cultural and socio-economic groups. This paper seeks some explanations and identifies some research and policy needs. Methodological Approach: The literature illustrates the multifactorial nature of carcinogenesis. At the cellular level, it is viewed as a multistep process involving multiple mutations and selection for cells with progressively increasing capacity for proliferation, survival, invasion, and metastasis. Established and emerging risk factors, in addition to changes in incidence and prevalence of cancers of the upper aero-digestive tract, were identified. Risk Factors: Exposure to tobacco and alcohol, as well as diets inadequate in fresh fruits and vegetables, remain the major risk factors, with persistent infection by particular so-called "high risk" genotypes of human papillomavirus increasingly recognised as also playing an important role in a subset of cases, particularly for the oropharynx. Chronic trauma to oral mucosa from poor restorations and prostheses, in addition to poor oral hygiene with a consequent heavy microbial load in the mouth, are also emerging as significant risk factors. Conclusions: Understanding and quantifying the impact of individual risk factors for these cancers is vital for health decision-making, planning and prevention. National policies and programmes should be designed and implemented to control exposure to environmental risks, by legislation if necessary, and to raise awareness so that people are provided with the information and support they need to adopt healthy lifestyles.

Effects of Nutrition Service Improvement Activities for Reducing Plate Waste of the Diabetic Mellitus Diet in a General Hospital (당뇨식 잔반 감량을 위한 영양서비스 개선 활동의 효과)

  • Sohn, Cheong-Min;Yeom, Hae-Sun
    • Korean Journal of Community Nutrition
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    • v.13 no.5
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    • pp.674-681
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    • 2008
  • Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one (26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.

An Investigation on Structural Analysis of Feldspars by Electron Diffraction Patterns (전자회절도형을 이용한 장석의 구조 분석에 대한 고찰)

  • 김윤중;이영부;박병규;이정후
    • Journal of the Mineralogical Society of Korea
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    • v.17 no.2
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    • pp.177-187
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    • 2004
  • Measurements of the lattice parameters of albite and oligoclase from electron diffraction patterns with the Au internal standard resulted in errors of less than 1 %. An electron diffraction map for natural oligoclase samples was constructed and 11 stations of zone-axes diffraction patterns were obtained. This process is indispensible for reliable TEM studies of triclinic feldspars. Utilizing the [001] cleavage plane of feldspar and the double-tilting TEM holder the following information is obtainable: Si-Al ordering and chemistry of alkali feldspars could be estimated from the $\alpha$* - * plot, where * is measured from the [001] orientation, while $\alpha$* is measured from the [100] orientation. Si-Al ordering of Na-rich plagioclase could be estimated from * [001] patterns. Structure and chemistry or Na-poor plagioclase could be estimated from existence of e-reflections, their intensity variations as well as their positional changes.

Prognostic Value of Vascular Endothelial Growth Factor Expression in Patients with Prostate Cancer: a Systematic Review with Meta-analysis

  • Wang, Kai;Peng, Hong-Ling;Li, Long-Kun
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5665-5669
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    • 2012
  • Background: The vascular endothelial growth factor (VEGF) mediates vasculogenesis and angiogenesis through promoting endothelial cell growth, migration and mitosis, and has involvement in cancer pathogenesis, progression and metastasis. However, the prognostic value of VEGF in patients with prostate cancer remains controversial. Objectives: The aim of our study was to evaluate the prognostic value of VEGF in prostate cancer, and summarise the results of related research on VEGF. Methods: In accordance with an established search strategy, 11 studies with 1,529 patients were included in our meta-analysis. The correlation of VEGF-expression with overall survival and progression-free survival was evaluated by hazard ratio, either given or calculated. Results: The studies were categorized by introduction of the author, demographic data in each study, prostate cancer-relatived information, VEGF cut-off value, VEGF subtype, methods of hazard ratio (HR) estimation and its 95% confidence interval (CI). High VEGF-expression in prostate cancer is a poor prognostic factor with statistical significance for OS (HR=2.32, 95%CI: 1.40-3.24). However, high VEGF-expression showed no effect on poor PFS (HR=1.30, 95%CI: 0.88-1.72). Using Begg's, Egger's test and funnel plots, we confirmed lack of publication bias in our analysis. Conclusion: VEGF might be regarded as a prognostic maker for prostate cancer, as supported by our meta-analysis. To achieve a more definitive conclusion enabling the clinical use of VEGF in prostate cancer, we need more high-quality interventional original studies following agreed research approaches or standards.

Survey of completeness of medical records in one educational hospital using new checklist (일개 교육병원에서 의무기록의 충실도의 대한 조사)

  • Park, Seok Gun;Kim, Heung Tae;Kim, Kwang Hwan;Seo, Sun Won
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.174-183
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    • 1997
  • Background : Medical records thought to be reflecting the quality of medicine. By this ground, examination of medical records can be served to evaluate, and to improve the quality of medical care. To examine the medical records, we need some standards or checklists which can be used to sort out the problems. Methods: We developed checklists for medical records evaluation. We studied 1,677 medical records about its completeness using this checklists in one educational hospital. Survey was completed by 5 well trained staffs of medical record department. Results are analyzed. SPSS/PC+ program was used for statistics. Results : 13.8% of discharge summary was incomplete. Recording of the demographic information was also poor in incomplete medical records compared to complete ones. Progress note was recorded average 4.16 times during 11.9 hospital days. After 4th hospital day, recording rate of progress note dropped sharply. Rate of professor's signature on operation records was poor(27%). He or she who described the discharge summary well also wrote progress note well. Conclusions: Fill-up of demographic date should be stressed during medical record education program. Strategy to create the environment emphasizing the responsibility of professor on quality medical record should be made. We suggest new index (number of records/hospital stay) for the evaluation of completeness of progress note.

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Socioeconomic Inequality in the Prevalence of Smoking and Smokeless Tobacco use in India

  • Thakur, Jarnail Singh;Prinja, Shankar;Bhatnagar, Nidhi;Rana, Saroj;Sinha, Dhirendra Narain;Singh, Poonam Khetarpal
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6965-6969
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    • 2013
  • Background: Tobacco consumption has been identified as the single biggest cause of inequality in morbidity and mortality. Understanding pattern of socioeconomic equalities in tobacco consumption in India will help in designing targeted public health control measures. Materials and Methods: Nationally representative data from the India Global Adult Tobacco Survey (GATS) conducted in 2009-2010 was analyzed. The survey provided information on 69,030 respondents aged 15 years and above. Data were analyzed according to regions for estimating prevalence of current tobacco consumption (both smoking and smokeless) across wealth quintiles. Multiple logistic regression analysis predicted the impact of socioeconomic determinants on both forms of current tobacco consumption adjusting for other socio-demographic variables. Results: Trends of smoking and smokeless tobacco consumption across wealth quintiles were significant in different regions of India. Higher prevalence of smoking and smokeless tobacco consumption was observed in the medium wealth quintiles. Risk of tobacco consumption among the poorest compared to the richest quintile was 1.6 times higher for smoking and 3.1 times higher for smokeless forms. Declining odds ratios of both forms of tobacco consumption with rising education were visible across regions. Poverty was a strong predictor in north and south Indian region for smoking and in all regions for smokeless tobacco use. Conclusions: Poverty and poor education are strong risk factors for both forms of tobacco consumption in India. Public health policies, therefore, need to be targeted towards the poor and uneducated.

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.

Effectiveness analysis of attitude improvement through educational robot utilization (교구로봇활용을 통한 행동문제 개선 효과분석)

  • Cho, So-Rum;Han, Jeong-Hye;Jo, Mi-Heon;Kim, Jin-Oh;Park, Ill-Woo
    • 한국정보교육학회:학술대회논문집
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    • 2011.01a
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    • pp.261-264
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    • 2011
  • Recently, poor child problem becomes severe, which is induced by earning differentials, because of the growing social polarization; the gap between the rich and the poor. The children in low-income group tend to have low dignity, anxiety, offense, and shrinking problems, because they frequently confront many negative circumstances, such as eliminating family, leaving home, and financial hardship. Those behavior problems can result in the low scholastic performance. This study deals with the effectiveness of attitude improvement using educational robots. We have a result that the children in welfare institutions have been improved not only in creativity but also in attitude points of view.

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Radiotherapy for Brain Metastases in Southern Thailand: Workload, Treatment Pattern and Survival

  • Phungrassami, Temsak;Sriplung, Hutcha
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1435-1442
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    • 2015
  • Purpose: To study the patient load, treatment pattern, survival outcome and its predictors in patients with brain metastases treated by radiotherapy. Materials and Methods: Data for patients with brain metastases treated by radiotherapy between 2003 and 2007 were collected from medical records, the hospital information system database, and a population-based tumor registry database until death or at least 5 years after treatment and retrospectively reviewed. Results: The number of treatments for brain metastases gradually increased from 48 in 2003 to 107 in 2007, with more than 70% from lung and breast cancers. The majority were treated with whole brain radiation of 30 Gy (3 Gy X 10 fractions) by cobalt-60 machine, using radiation alone. The overall median survival of the 418 patients was 3.9 months. Cohort analysis of relative survival after radiotherapy was as follows: 52% at 3 months, 18% at 1 year and 3% at 5 years in males; and 66% at 3 months, 26% at 1 year and 7% at 5 years in females. Multivariate analysis demonstrated that the patients treated with combined modalities had a better prognosis. Poor prognostic factors included primary cancer from the lung or gastrointestinal tract, emergency or urgent consultation, poor performance status (ECOG 3-4), and a hemoglobin level before treatment of less than 10 g/dl. Conclusions: This study identified an increasing trend of patient load with brain metastases. Possible over-treatment and under-treatment were demonstrated with a wide range of survival results. Practical prognostic scoring systems to assist in decision-making for optimal treatment of different patient groups is absolutely necessary; it is a key strategy for balancing good quality of care and patient load.

KR-WordRank : An Unsupervised Korean Word Extraction Method Based on WordRank (KR-WordRank : WordRank를 개선한 비지도학습 기반 한국어 단어 추출 방법)

  • Kim, Hyun-Joong;Cho, Sungzoon;Kang, Pilsung
    • Journal of Korean Institute of Industrial Engineers
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    • v.40 no.1
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    • pp.18-33
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    • 2014
  • A Word is the smallest unit for text analysis, and the premise behind most text-mining algorithms is that the words in given documents can be perfectly recognized. However, the newly coined words, spelling and spacing errors, and domain adaptation problems make it difficult to recognize words correctly. To make matters worse, obtaining a sufficient amount of training data that can be used in any situation is not only unrealistic but also inefficient. Therefore, an automatical word extraction method which does not require a training process is desperately needed. WordRank, the most widely used unsupervised word extraction algorithm for Chinese and Japanese, shows a poor word extraction performance in Korean due to different language structures. In this paper, we first discuss why WordRank has a poor performance in Korean, and propose a customized WordRank algorithm for Korean, named KR-WordRank, by considering its linguistic characteristics and by improving the robustness to noise in text documents. Experiment results show that the performance of KR-WordRank is significantly better than that of the original WordRank in Korean. In addition, it is found that not only can our proposed algorithm extract proper words but also identify candidate keywords for an effective document summarization.