• Title/Summary/Keyword: Cost Effectiveness

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The Need for a Well-Organized, Video-Assisted Asthma Education Program at Korean Primary Care Clinics

  • Kim, Yee Hyung;Yoo, Kwang Ha;Yoo, Jee-Hong;Kim, Tae-Eun;Kim, Deog Kyeom;Park, Yong Bum;Rhee, Chin Kook;Kim, Tae-Hyung;Kim, Young Sam;Yoon, Hyoung Kyu;Um, Soo-Jung;Park, I-Nae;Ryu, Yon Ju;Jung, Jae-Woo;Hwang, Yong Il;Lee, Heung Bum;Lim, Sung-Chul;Jung, Sung Soo;Kim, Eun-Kyung;Kim, Woo Jin;Lee, Sung-Soon;Lee, Jaechun;Kim, Ki Uk;Kim, Hyun Kuk;Kim, Sang Ha;Park, Joo Hun;Shin, Kyeong Cheol;Choe, Kang Hyeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.169-178
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    • 2017
  • Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). Results: The study enrolled 144 patients (mean age, $56.7{\pm}16.7years$). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from $16.6{\pm}4.6$ to $20.0{\pm}3.9$ (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.

Recent Progress in Air Conditioning and Refrigeration Research -A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2000 and 2001- (공기조화, 냉동 분야의 최근 연구 동향 -2000년 및 2001년 학회지 논문에 대한 종합적 고찰 -)

  • 강신형;한화택;조금남;이승복;조형희;김민수
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.14 no.12
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    • pp.1102-1139
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    • 2002
  • A review on the papers published in the Korean Journal of Air-Conditioning and Refrigerating Engineering in 2000 and 2001 has been done. Focus has been put on current status of research in the aspect of heating, cooling, ventilation, sanitation and building environment. The conclusions are as follows. (1) Most of fundamental studies on fluid flow were related with heat transportation of facilities. Drop formation and rivulet flow on solid surfaces were interesting topics related with condensation augmentation. Research on micro environment considering flow, heat, humidity was also interesting for comfortable living environment. It can be extended considering biological aspects. Development of fans and blowers of high performance and low noise were continuing topics. Well developed CFD technologies were widely applied for developing facilities and their systems. (2) Most of papers related with heat transfer analysis and heat exchanger shows dealt with convection, evaporation, and channel flow for the design application of heat exchanger. The numerical heat transfer simulation studies have been peformed and reported to show heat transfer characteristics. Experimental as well as numerical studies on heat exchanger were reported, while not many papers are available for the system analysis including heat exchanger. (3) A review of the recent studies on heat pump system shows that performance analysis and control of heat pump have been peformed by various simulations and experiments. The research papers on multi-type heat pump system increased significantly. The studies on heat pipe have been examined experimently for change of working characteristics and strut lure. Research on the phase change has been carried out steadily and operation strategies of encapsulated ice storage tank are reported experimentally in several papers. (4) A review of recent studies on refrigeration/air conditioning system have focused on the system performance and efficiency for new alternative refrigerants. Evaporation and condensation heat transfer characteristics are investigated for tube shapes and new alternative refrigerants. Studies on components of refrigeration/air conditioning system are carried to examine efficiency for various compressors and performance of new expansion devices. In addition to thermophysical properties of refrigerant mixtures, studies on new refrigerants are also carried out, however research works on two-phase flow seemed to be insufficient. (5) A review of the recent studies on absorption cooling system indicates that heat and mass transfer phenomena have been investigated to improve absorber performance. Various experimental data have been presented and several simulation models have been proposed. A review of the recent studies on duct and ventilation shows that ventilation indices have been proposed to quantify the ventilation performance in buildings and tunnels. Main efforts have been focused on the applications of ventilation effectiveness in practice, either numerically using computational fluid dynamics or experimentally using tracer gas techniques. (6) Based on a review of recent studies on indoor thermal environment and building service systems, research issues have mainly focused on many innovative ideas such as underfloor air-conditioning system, personal environmental modules, radiant floor cooling and etc. Also, the new approaches for minimizing energy consumption as well as improving indoor environmental conditions through predictive control of HVAC systems, various activities of building energy management and cost-benefit analysis for economic evaluation were highlighted.

Estimated Exposure Dose and Usage of Radiological Examination of the National Health Screening (국가건강검진의 방사선검사 이용량 및 피폭선량 추정)

  • Gil, Jong Won;Park, Jong Hyock;Park, Min Hui;Park, Chan Young;Kim, So Young;Shin, Dong Wook;Kim, Won Dong
    • Journal of Radiation Protection and Research
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    • v.39 no.3
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    • pp.142-149
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    • 2014
  • Korea conducts a national health screening program to improve and check-up on public health and in recent years, the screening usage has been increased. Given the increased screening usage for radiographic exams, this study predicts the frequency of using radiographic exams and the exposure dose. This study estimates the usage of radiographic exams by isolating radiographic exams from the 2011 analysis of the national health insurance corporation, and estimates the public exposure dose by applying each procedure's dose table from UNSCEAR 2008. As a result of the analysis, in the 2011 National Health Screening, the average exposure dose per person is assumed to be 0.57 mSv, and depending on the type of screening program from the radiographic exam, an examinee could be exposed to between 0.2 mSv and 11.081 mSv. The frequency of using radiographic exposure was found to be 16,005,914 and the exposure dose was 6,311.76 person-Sv. The most frequent exam is the Chest X-ray, which was performed 1,070,567 (69.17%), and the UGI has the highest exposure dose at 5,217.94 person-Sv (82.67%). The outcome is categorized based on gender and age, excluding those under 39 years old. In all age groups, the screening usage and exposure dose are higher in females than in males. In particular, females between 50 and 54 years old have the highest screening usage (1,674,787, 10.5%) and exposure dose (701.59 person-Sv, 11.1%). As UGI accounts for 82.76% of procedures, except when done for medical purposes, if the government supports a voluntary UGI exam (which includes the UGI exam in the National Screening Program) or abolishes it completely, as seen overseas, the cost-effectiveness and validity of the UGI exam, as well as the exposure dose from the National Screening Program will all decrease significantly.

A comparative study on bond strength and adhesive failure pattern in bracket bonding with self-etching primer (Self-etching Primer를 이용한 교정용 브라켓 부착시 전단결합강도와 파절양상에 관한 비교연구)

  • Kim, You-Kyoung;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.34 no.4 s.105
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    • pp.325-332
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    • 2004
  • A self-etching primer that combines the etchant and primer in one chemical compound saves time and should be mote cost-effective to the clinician and patient. The purpose of this study was to evaluate the clinical effectiveness of a self-etching primer by measuring shear bond strengths according to various conditions and observing adhesive failure patterns. For this Investigation, 120 upper and lower premolars extracted for orthodontic purposes were used and randomly divided into six groups of twenty teeth each. Human premolars were embedded in a metal cylinder with orthodontic resin. Metal brackets and ceramic brackets were bonded with XT primer and self-etching primer by means of XT adhesive. Upon curing, plasma arc light and visible light were used. After bonding, the shear bond strength was tested by Instron universal testing machine, and the amount of residual adhesive that remained on the tooth after debonding was measured by stereoscope and assessed with an adhesive remnant index. The results were as fellows: 1. When brackets were bonded, if other conditions remained the same, there was no significant difference in shear bond strength due to the type of primer - either self-etching primer or XT primer. 2. When metal brackets were bonded, there was no significant difference in shear bond strength according to the source of light - plasma arc light or visible light - and type of primer. 3. There was a very significant difference in shear bond strength according to the type of brackets - metal or ceramic brackets. The shear bond strength of ceramic brackets was stronger than metal brackets. 4. When the adhesive failure patterns of metal brackets bonded with self-etching primer were observed by using the adhesive remnant index, the bond failure of the metal bracket occurred more frequently at the bracket-adhesive. The failure of the ceramic bracket, however, occurred more frequently at the enamel-adhesive interface. The adhesive failure patterns of metal brackets bonded with XT primer observed the same patterns. The above results suggest that self-etching primer can be clinically useful for bonding the brackets without fear of a decrease in shear bond strength.

Rewetting Strategies for the Drained Tropical Peatlands in Indonesia (인도네시아의 배수된 열대 이탄지에 대한 재습지화 전략)

  • Roh, Yujin;Kim, Seongjun;Han, Seung Hyun;Lee, Jongyeol;Son, Yowhan
    • Korean Journal of Environmental Biology
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    • v.36 no.1
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    • pp.33-42
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    • 2018
  • The tropical peatlands have been deforested and converted to agricultural and plantation areas in Indonesia. To manage water levels and increase the overall productivity of crops, canals have been constructed in tropical peatlands. The canals destructed the structure of the tropical peatlands, and increased the subsidence and fire hazard risks in the region. The Indonesian government enacted regulations and a moratorium on tropical peatlands, in order to reduce degradation. A practical method under the regulations of rewetting tropical peatlands was to permit a canal blocking. In this study, four canal blocking projects were investigated regarding their planning, construction priority, design, building material, construction, monitoring, time and costs associated with the canal blockings. In the protected areas, regulations restricted the development of the tropical peatlands areas that were noted as deeper than 3 m, and the administration stopped issuing new concessions for future work projects for this noted criteria of land use. A noted purpose of canal blockings in these areas was to effectuate the restoration of the lands in the region. The main considerations of the restoration efforts were to maintain a durability of the blockings, and to encourage the participation of the area stakeholders. In the case of a concession area, regulations were set into place to restrict clear-cutting and shifting cultivation, and to maintain groundwater level in the tropical peatland. The most significant priorities identified in the canal blocking project were the efficiency and cost-effectiveness of the project. Nevertheless, the drainage of tropical peatlands has been continued. On the basis of a literature review on regulations and rewetting methods in tropical peatlands of Indonesia, we discussed the improvements of the regulations, and adequate canal blockings to serve the function to rewet the tropical peatlands in Indonesia. Our results would help establishing an adequate direction and recommended guideline on viable rewetting methods for the restoration of drained tropical peatlands in Southeast Asia.

Effect of Vision Training using Fresnel Prism Lens on Fusional Vergence and Accommodation (프레넬 프리즘렌즈를 이용한 시기능 훈련이 조절과 융합버전스에 미치는 영향)

  • Kim, Yong-Gil;Kim, Min-Kyung;Jeong, Ju-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.2
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    • pp.159-164
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    • 2012
  • Purpose: Of the various methods of vision training, the essay aims to explore the effective ways of using the Fresnel prism lens in order to expand the positive fusional vergence for the patient having specific condition of convergence insufficiency or basic exophoria. Methods: 15 students of city of Daejeon university without an eye disease (average age $22.73{\pm}1.68$) were selected and underwent the subjective refraction test and binocular vision test, and recording their test results before vision training and replacing an identical frame with a lens of same quality after the full calibration, the lens was then adhered with the Fresnel prism lens and continued to train for thirty minutes daily during two weeks. Afterwards, the binocular vision test was reattempted. The observation of the change in the results of the binocular vision test in use of the fresnel prism lens in the vision training test was researched. Results: After training, the positive fusional vergence had increased to a number of $22.27{\pm}2.26$ $\Delta$, to 7.80 $\Delta$, at near, the fused cross cylinder test increased to an average of $0.55{\pm}0.09$ D, 0.40 D after training, showing a normal result. The value of negative relative accommodation after training had an average of $2.22{\pm}0.08$D, showing that 0.42 D had increased. The value of near point of convergence after training had an average of $6.13{\pm}0.53$ cm, showing that 2.80 cm had decreased. To patients who had convergence insufficiency or basic exophoria, the value of the near vision test that used the Fresnel prism lens which was able to expand BO positive fusional vergence had increased without phoria. Conclusions: The changes were tested and the effectiveness of the Fresnel prism lens, due to the nature of the lens itself, helped with both cosmetic effects and cost. It also allows good optical correction effects, in addition to these clinical effects indicated before. Therefore, it may be determined that the Fresnel prism lens binocular vision therapy for patients is more popular and highly recommended.

Fenton Oxidation of Landfill Leachate by $Fe^0,\;Fe^{2+},\;Fe^{3+}\;/\;H_2O_2$ Systems ($Fe^0$, $Fe^{2+}$, $Fe^{3+}$ / $H_2O_2$ 시스템을 이용한 침출수의 Fenton 산화반응)

  • Park, Sung-Ho;Han, Ihn-Sup
    • Journal of Korean Society of Environmental Engineers
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    • v.27 no.4
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    • pp.402-408
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    • 2005
  • This investigation aimed at selecting the optimum catalyst and reaction conditions used in Fenton oxidation for landfill leachate treatment and was carried out at ambient temperature using a lab-scale experiment. The investigation led to the following results: 1) The optimum pH and dose for each iron catalyst were as follows: $Fe^{2+}\;=\;1,200\;mg/L$, $H_2O_2\;=\;1,200\;mg/L$, initial pH=3.0; $Fe^{3+}\;=\;1,200\;mg/L$, $H_2O_2\;=\;1,500\;mg/L$, initial pH=4.5; $Fe^0\;=\;1,200\;mg/L$, $H_2O_2\;=\;900\;mg/L$, initial pH=4.0, respectively. 2) The progress of Fenton oxidation could be instrumentally monitored by measuring redox potential evolution during leachate oxidation, thus, indicating the possibility of an on-line process monitoring. 3) A simple acid-base titration of Fenton-treated leachate proved that a relevant fraction of by- products formed during the treatment was made of acidic compounds in the optimum reaction condition for each catalyst used, thus demonstrating that the higher the extent of Fenton oxidation the greater was the amount of acids formed. 4) With the aim of selecting the optimum catalyst among $Fe^0$, $Fe^{2+}$ and $Fe^{3+}$, removal efficiency of each parameter in the optimum reaction conditions was considered. Although $Fe^{3+}$ was higher than other catalysts($Fe^0$, $Fe^{2+}$) in removal efficiency, $Fe^0$ was a optimum catalyst with a view of cost effectiveness.

Oil Fluorescence Spectrum Analysis for the Design of Fluorimeter (형광 광도계 설계인자 도출을 위한 기름의 형광 스펙트럼 분석)

  • Oh, Sangwoo;Seo, Dongmin;Ann, Kiyoung;Kim, Jaewoo;Lee, Moonjin;Chun, Taebyung;Seo, Sungkyu
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.18 no.4
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    • pp.304-309
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    • 2015
  • To evaluate the degree of contamination caused by oil spill accident in the sea, the in-situ sensors which are based on the scientific method are needed in the real site. The sensors which are based on the fluorescence detection theory can provide the useful data, such as the concentration of oil. However these kinds of sensors commonly are composed of the ultraviolet (UV) light source such as UV mercury lamp, the multiple excitation/emission filters and the optical sensor which is mainly photomultiplier tube (PMT) type. Therefore, the size of the total sensing platform is large not suitable to be handled in the oil spill field and also the total price of it is extremely expensive. To overcome these drawbacks, we designed the fluorimeter for the oil spill detection which has compact size and cost effectiveness. Before the detail design process, we conducted the experiments to measure the excitation and emission spectrum of oils using five different kinds of crude oils and three different kinds of processed oils. And the fluorescence spectrometer were used to analyze the excitation and emission spectrum of oil samples. We have compared the spectrum results and drawn the each common spectrum regions of excitation and emission. In the experiments, we can see that the average gap between maximum excitation and emission peak wavelengths is near 50 nm for the every case. In the experiment which were fixed by the excitation wavelength of 365 nm and 405 nm, we can find out that the intensity of emission was weaker than that of 280 nm and 325 nm. So, if the light sources having the wavelength of 365 nm or 405 nm are used in the design process of fluorimeter, the optical sensor needs to have the sensitivity which can cover the weak light intensity. Through the results which were derived by the experiment, we can define the important factors which can be useful to select the effective wavelengths of light source, photo detector and filters.

Beak Trimming Methods - Review -

  • Glatz, P.C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.13 no.11
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    • pp.1619-1637
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    • 2000
  • A review was undertaken to obtain information on the range of beak-trimming methods available or under development. Beak-trimming of commercial layer replacement pullets is a common yet critical management tool that can affect the performance for the life of the flock. The most obvious advantage of beak-trimming is a reduction in cannibalism although the extent of the reduction in cannibalism depends on the strain, season, and type of housing, flock health and other factors. Beak-trimming also improves feed conversion by reducing food wastage. A further advantage of beak-trimming is a reduction in the chronic stress associated with dominance interactions in the flock. Beak-trimming of birds at 7-10 days is favoured by Industry but research over last 10 years has shown that beak-trimming at day-old causes the least stress on birds and efforts are needed to encourage Industry to adopt the practice of beak-trimming birds at day-old. Proper beak-trimming can result in greatly improved layer performance but improper beak-trimming can ruin an other wise good flock of hens. Re-trimming is practiced in most flocks, although there are some flocks that only need one trimming. Given the continuing welfare scrutiny of using a hot blade to cut the beak, attempts have been made to develop more welfare friendly methods of beak-trimming. Despite the developments in design of hot blade beak-trimmers the process has remained largely unchanged. That is, a red-hot blade cuts and cauterises the beak. The variables in the process are blade temperature, cauterisation time, operator ability, severity of trimming, age of trimming, strain of bird and beak length. This method of beak-trimming is still overwhelmingly favoured in Industry and there appears to be no other alternative procedures that are more effective. Sharp secateurs have been used trim the upper beak of both layers and turkeys. Bleeding from the upper mandible ceases shortly after the operation, and despite the regrowth of the beak a reduction of cannibalism has been reported. Very few differences have been noted between behaviour and production of the hot blade and cold blade cut chickens. This method has not been used on a large scale in Industry. There are anecdotal reports of cannibalism outbreaks in birds with regrown beaks. A robotic beak-trimming machine was developed in France, which permitted simultaneous, automated beak-trimming and vaccination of day-old chicks of up to 4,500 chickens per hour. Use of the machine was not successful because if the chicks were not loaded correctly they could drop off the line, receive excessive beak-trimming or very light trimming. Robotic beak-trimming was not effective if there was a variation in the weight or size of chickens. Capsaicin can cause degeneration of sensory nerves in mammals and decreases the rate of beak regrowth by its action on the sensory nerves. Capsaicin is a cheap, non-toxic substance that can be readily applied at the time of less severe beak-trimming. It suffers the disadvantage of causing an extreme burning sensation in operators who come in contact with the substance during its application to the bird. Methods of applying the substance to minimise the risk to operators of coming in contact with capsaicin need to be explored. A method was reported which cuts the beaks with a laser beam in day-old chickens. No details were provided on the type of laser used, or the severity of beak-trimming, but by 16 weeks the beaks of laser trimmed birds resembled the untrimmed beaks, but without the bill tip. Feather pecking and cannibalism during the laying period were highest among the laser trimmed hens. Currently laser machines are available that are transportable and research to investigate the effectiveness of beak-trimming using ablasive and coagulative lasers used in human medicine should be explored. Liquid nitrogen was used to declaw emu toes but was not effective. There was regrowth of the claws and the time and cost involved in the procedure limit the potential of using this process to beak-trim birds.

Implementing a Cervical Cancer Awareness Program in Low-income Settings in Western China: a Community-based Locally Affordable Intervention for Risk Reduction

  • Simayi, Dilixia;Yang, Lan;Li, Feng;Wang, Ying-Hong;Amanguli, A.;Zhang, Wei;Mohemaiti, Meiliguli;Tao, Lin;Zhao, Jin;Jing, Ming-Xia;Wang, Wei;Saimaiti, Abudukeyoumu;Zou, Xiao-Guang;Maimaiti, Ayinuer;Ma, Zhi-Ping;Hao, Xiao-Ling;Duan, Fen;Jing, Fang;Bai, Hui-Li;Liu, Zhao;Zhang, Lei;Chen, Cheng;Cong, Li;Zhang, Xi;Zhang, Hong-Yan;Zhan, Jin-Qiong;Zhang, Wen Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7459-7466
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    • 2013
  • Background: Some 60 years after introduction of the Papanicolaou smear worldwide, cervical cancer remains a burden in developing countries where >85% of world new cases and deaths occur, suggesting a failure to establish comprehensive cervical-cancer control programs. Effective interventions are available to control cervical cancer but are not all affordable in low-income settings. Disease awareness saves lives by risk-reduction as witnessed in reducing mortality of HIV/AIDS and smoking-related cancers. Subjects and Methods: We initiated a community-based awareness program on cervical cancer in two low-income Muslim Uyghur townships in Kashi (Kashgar) Prefecture, Xinjiang, China in 2008. The education involved more than 5,000 women from two rural townships and awareness was then evaluated in 2010 and 2011, respectively, using a questionnaire with 10 basic knowledge questions on cervical cancer. Demographic information was also collected and included in an EpiData database. A 10-point scoring system was used to score the awareness. Results: The effectiveness and feasibility of the program were evaluated among 4,475 women aged 19-70 years, of whom >92% lived on/below US$1.00/day. Women without prior education showed a poor average awareness rate of 6.4% (164/2,559). A onetime education intervention, however, sharply raised the awareness rate by 4-fold to 25.5% (493/1,916). Importantly, low income and illiteracy were two reliable factors affecting awareness before or after education intervention. Conclusions: Education intervention can significantly raise the awareness of cervical cancer in low-income women. Economic development and compulsory education are two important solutions in raising general disease awareness. We propose that implementing community-based awareness programs against cervical cancer is realistic, locally affordable and sustainable in low-income countries, which may save many lives over time and, importantly, will facilitate the integration of comprehensive programs when feasible. In this context, adopting this strategy may provide one good example of how to achieve "good health at low cost".