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Using Implementation Science to Advance Cancer Prevention in India

  • Krishnan, Suneeta;Sivaram, Sudha;Anderson, Benjamin O.;Basu, Partha;Belinson, Jerome L;Bhatla, Neerja;D' Cruz, Anil;Dhillon, Preet K.;Gupta, Prakash C.;Joshi, Niranjan;Jhulka, PK;Kailash, Uma;Kapambwe, Sharon;Katoch, Vishwa Mohan;Kaur, Prabhdeep;Kaur, Tanvir;Mathur, Prashant;Prakash, Anshu;Sankaranarayanan, R;Selvam, Jerard M;Seth, Tulika;Shah, Keerti V;Shastri, Surendra;Siddiqi, Maqsood;Srivastava, Anurag;Trimble, Edward;Rajaraman, Preetha;Mehrotra, Ravi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3639-3644
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    • 2015
  • Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

Social Determinants of Health and 5-year Survival of Colorectal Cancer

  • Heidarnia, Mohammad Ali;Monfared, Esmat Davoudi;Akbari, Mohammad Esmail;Yavari, Parvin;Amanpour, Farzaneh;Mohseni, Maryam
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5111-5116
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    • 2013
  • Background: Early in the 21st century, cancers are the second cause of death worldwide. Colon cancer is third most common cancer and one of the few amenable to early diagnosis and treatment. Evaluation of factors affecting this cancer is important to increase survival time. Some of these factors affecting all diseases including cancer are social determinants of health. According to the importance of this disease and relation with these factors, this study was conducted to assess the relationship between social determinants of health and colon cancer survival. Materials and Methods: This was a cross-sectional, descriptive study for patients with colon cancer registered in the Cancer Research Center of Shahid Beheshti University of Medical Science, from April 2005 to November 2006, performed using questionnaires filled by telephone interview with patients (if patients had died, with family members). Data was analyzed with SPSS software (version 19) for descriptive analysis and STATA software for survival analysis including log rank test and three step Cox Proportional Hazard regression. Results: Five hundred fifty nine patients with ages ranging from 23 to 88 years with mean${\pm}$standard deviation of $63{\pm}11.8$ years were included in the study. The five year survival was 68.3%( 387 patients were alive and 172 patients were dead by the end of the study). The Cox proportional hazard regression showed 5-year survival was related to age (HR=0.53, p=0.042 for>50 years versus<50 years old) in first step, gender (HR=0.60, p=0.006 for female versus male) in second step, job (HR=1.7, p=0.001 for manual versus non manual jobs), region of residency (HR=3.49, p=0.018 for west versus south regions), parents in childhood (HR=2.87, p=0.012 for having both parents versus not having), anatomical cancer location (HR=2.16, p<0.033 for colon versus rectal cancer) and complete treatment (HR=5.96, p<0.001 for incomplete versus complete treatment). Conclusions: Social determinants of health such as job, city region residency and having parents during childhood have significant effects in 5-year survival of colon cancer and it may be better to consider these factors in addition to developing cancer treatment and to focus on these determinants of health in long-time planning.

Characteristics of Meniscus Tear in Tibial Plateau Fractures (경골 고평부 골절의 반월상 연골 파열 양상)

  • Lee, Dong-Hoon;Kim, Byung-Kuk;Kim, Jae-Hwa;Chung, Ju-Hwan;Lee, In-Sung;Lee, Jun-Ku;Lee, Soon-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.9-16
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    • 2012
  • Purpose: Tibial plateau fractures cause a variety of problems in the knee joint. The purpose of this study was to investigate the characteristics of the meniscus injuries in tibial plateau fracture arthroscopically. Materials and Methods: Thirty-three out of 39 consecutive patients diagnosed with tibial plateau fractures underwent arthroscopy between March 2007 and March 2010. According to Schatzker classification, there were 1 type I (3.3%), 19 type II (53.3%), 4 type III (13.3%), 2 type IV (6.6%), 2 type V (6.6%) and 5 type VI (20%) fracture patterns in 33 patients. Results: Twenty-five cases (75.8%) had lateral meniscus tears. There were 18 meniscal tears in 19 cases of Schatzker type II fractures (94.7%), 3 meniscal tears out of 4 cases of Schatzker type III fractures (75%) and 4 meniscal tears out of 5 cases of Schatzker type VI fractures (80%). The most commonly affected site (22/25) was the anterior horn of the lateral meniscus. Of the 25 documented meniscal tears, all but one were vertical longitudinal tear at meniscocapsular junction so most cases are amenable to arthroscopic repair. Conclusion: Arthroscopy for the meniscal injuries in tibial plateau fractures is a valuable diagnostic and treatment tool, we recommend arthroscopy in tibial plateau fracture.

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Clinical Application of Radial Head Prosthesis (요골두 치환술의 임상적 적용)

  • Moon, Jun-Gyu
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.140-145
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    • 2011
  • Purpose: Installing a radial head prosthesis has developed into a reliable procedure to replace the native radial head for treating unreconstructible radial head fracture when this is associated with an unstable elbow or forearm. A variety of implants have been developed and these are now commercially available. This article reviews the literature related to the indications, the available implants and the surgical techniques of radial head replacement arthroplasty. Materials and Methods: The main indication for a metallic radial head prosthesis is a comminuted fracture that is not amenable to reconstruction, and particularly if it is associated with complex elbow injuries. Excision of the radial head should be avoided in the presence of combined injured ligaments or interosseous membrane injury. Three different implants are available in Korea, including the bipolar, press fit monopolar and loose fit monopolar radial head prostheses. A primary technical goal of radial head arthroplasty is the insertion of an implant that closely replicates the native radial head. The major pitfall when using a metallic radial head prosthesis is the insertion of a longer implant, which results in overstuffing of the radiocapitellar joint. Results and Conclusion: Satisfactory clinical results can be anticipated when a radial head prosthesis is used for the correct indications and when a systemic approach is undertaken to ensure proper sizing. For the future studies, we need data regarding the long term outcomes and comparison of the various types of prostheses.

Thoracoscopic Lung Biopsy for Diffuse Interstitial Lung Disease (미만성 간질성 폐질환에서 흉강경폐생검)

  • Son, Dong-Seop;Jo, Dae-Yun;Yang, Ki-Min
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1232-1236
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    • 1997
  • Diffuse lung disease is amenable to diagnosis by means of clinical evaluation, bronchoalveolar lavage, transbronchial biopsy, and lung biopsy. The recently introduced technique of thoracoscopic wedge biopsy provides the potential advantages of greater selection of biopsy sites and reduced postoperative pain compared with those associated with standard open lung biopsy. Video assisted thoracoscopic lung biopsy was performed in 22 patients for the diagnosis of diffuse lung disease during the period from August 1994 to December 1996, and the following results were obtained: 1. The patients were 14 men and 8 women. The average age was 54.6 years. 2. 13 lung biopsy specimens were obtained from the right lower lobe, 4 from he right upper lobe, 3 from the right middle lobe, 3 from the left upper lobe, and 3 from the left lower lobe. 3. A comparison of pulmonary function tests between preoperative and postoperative values showed no significant differences in FVC, FEVI, and FEVl/FVC(p>0.05). All patients were pathologically diagnosed and the most common disease was usual interstitial pneumonia(8/22). In conclusion, thoracoscopic lung biopsy was a safe and effective diagnostic method of diffuse lung disease.

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INVERTED LABIAL BOW APPLIANCE FOR ANTERIOR CROSSBITE CORRECTION : REPORT OF A CASE (Inverted labial bow appliance를 이용한 전치부 반대교합 치험례)

  • Park, Jin-A;Park, Ho-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.4
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    • pp.694-699
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    • 2001
  • The prognosis for class III patients in growing child can be made in mixed dentition and the severity of the symptom is often amenable to early intervention. Class III malocclusion can be classified as functional class lit and skeletal origin. Skeletal Class III malocclusion is usually characterized by overdeveloped mandible, underdeveloped maxilla, but the cause of pseudo class III is most dentoalveolar or functional shift of mandible. The primary goal of early intervention of malocclusion is to supply an environment that is conducive to the development of favorable occlusal relationships and avoiding of worsening of the problems. Inverted labial bow appliance is introduced as an appliance to combine the advantage of active plate and activator. It is undemanding with this appliance to initiate not only dentoalveolar expansion of upper dentition but also to orient the functional retrusion of mandible. With simple design the compliance for patients such as mouth breathing problem can be improved. For successful use of this appliance it is utmost important to make accurate and early diagnosis between pseudo- and skeletal class III malocclusion. This article will demonstrate the use of an Inverted labial bow appliance for early treatment of a functional Class III malocclusion. After 4 month treatment, anterior crossbite was treated and the results were achieved mainly dentoalveolar change of upper and lower anterior teeth.

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A Study on the Integrated Management System of Municipal Solid Waste from Seoul Metropolitan City (서울시 일반폐기물의 통합적 관리체계에 관한 연구)

  • 우세홍;홍상균
    • Journal of Environmental Health Sciences
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    • v.19 no.4
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    • pp.51-58
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    • 1993
  • The integrated solid waste management for Seoul Metropolitan city can be established on the basis of the following hierarchy of priorities: 1. Efforts for source reduction should be propelled by both government and citizens to achieve the effects of resource conservation. The adequate production and consumption which are environmentally amenable and sustainable can be induced by the reasonable imposition of deposit money for waste treatment to one-time use products. To accomplish source reduction effectively, the induction of legal and institutional regulation of producer and consumer participation is requisite. 2. For resource recovery, wastes generated should be recycled as far as practicable. Community residents are responsible to separate discharge, the authorities concerned have responsibility of separate collection, and recycling industry should be assissted through tax reduction and financing. Resource separation facilities can be constructed at Kimpo Metropolitan landfill site for wastes not separately collected due to some unavoidable circumstances. 3. Garbage should be composted. Garbage is uneconomical for incineration, because it has high moisture content and low calorie, thus there is no reason for the incineration of garbage even though garbage is classified into combustibles. Composting facilities can be located at sites which are not densely populated and easily accessible to transportation, for example, Kimpo Metropolitan landfill site. Compost produced can be managed by the authorities for the use of fertilizer to a green tract of suburban land and farms. 4. Nonhazardous combustible wastes not recyclable can be utilized for thermal recovery at the incinerators which are completely equipped with pollution control devices. According to the trend of local autonomy and the equity principle of local autonomous entities, incineration facilities of minimal capacity required can be constructed at each districts of Seoul Metropolitan city which have organized local assembly. In case of Yangcheon district, the economically combustible waste quantity is about 260 tons/day which exceeds 150 tons/day, the incineration capacity of existing facility. But, from now on, waste quantity can be reduced substantially by the intensive efforts of citizens for source reduction and recycling and the institutional support of administrative organizations. Especially, it is indispensable for the government to constitute institutional and technological bases that can recycle paper and plastics form 43% of waste generated. A good time for constructing of incineration facilities for municipal solid waste can be postponed to the time that pollution control technologies of domestic enterprises are fully developed to satisfy the standards of air pollution prevention, because the life expectancy of Kimpo Metropolitan landfill site is about 25 years. Within this period, institutional improvements and technological advancements can be attained, while the air qual. ity of Seoul Metropolitan city can be ameliorated to the level to afford incineration facilities. 5. For final disposal, incombustibles and ash are landfilled sanitarily at Kimpo Metropolitan landfill site.

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Breeding of Phalaenopsis 'SM 333' with Mini Multiple Flower Formation (소형 다화 분지성 호접란 'SM 333' 육성)

  • Park, No Eun;Son, Beung Gu;Kim, Hong Yul;Lim, Ki-Byung
    • Horticultural Science & Technology
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    • v.33 no.1
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    • pp.149-154
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    • 2015
  • A new Phalaenopsis cultivar 'SM 333' was bred by Sangmiwon Orchid, Korea, which produces young plants through tissue culture techniques. The new cultivar 'SM 333', showing the phenotype of multiflora with pink color and small, multibranching-type characteristics, was derived from crossing between Phalaenopsis 'Odoriko' and 'Be Tris'. An elite individual number '02-03-33' later termed 'SM 333' was selected among about 300 individual progenies, based on an intensive selection process covering vegetative and flowering distinctiveness over more than 2 years. In year 2004-2005, the 1st and 2nd characteristic analyses were carried out through performance and uniformity tests. 'SM 333' shows flower color that is bright clean pink (RHS # RP69D) and flower shape that is formal type with 5.0 and 5.8 cm in flower height and width, respectively. 'SM 333' is regarded as raceme flower type suitable for the small casual flower market. The leaves of 'SM 333' grow horizontally and about 20.8 cm in length and 6.5 cm in width. This cultivar also possesses no genetic variation, and is amenable to fast in vitro propagation and easy growth due to its vigorous growth habit. This 'SM333' was registered (Reg. # 2916) with Korea Seed & Variety Service (KSVS) on 1st December, 2009, and the plant breeder's right is currently controlled by Sangmiwon Orchid Company, Korea.

Sudden Deafness (돌발적난청)

  • 조중환;류태현
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.85.3-86
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    • 1976
  • Sudden deafness requires immediate investigation and treat if there is to be any prospect of salvaging the hearing. It present an otological emergency and a diagnostic challenge. Sn Sudden sensorineural deafness can be caused by a wide variety of pathologies. A battery of tests and investigations must be performed forthwith if treatment is to be started without further delay. The concept that nothing can be done for the patient with sensori-neural deafness must be abandoned. Some pathologies causing sudden deafness are not amenable to therapy or can show only partial reversibility. But there are several causes, showing little or no spontaneous recovery, which do responed to appropriate treatment. It is important to identify them and concentrate on their management. The age and sex ratios and the unilaterral or bilateral nature of the lesion are related to the etiology and depend upon which type of case is included in the series. Though individually rare, collecting for about 2.5 per cent of new otoloical patients. Some 70 per cent of cases are unilateral. Viral, bacterial and treponemal infections accounted for about 30 per cent of the cases. Some 16 per cent were due to vascular lesions of the cochlea. In almost 22 per cent there was no obvious cause (idiopathic), they occurred in young adult and were either sensory or neural. About 12 per cent were traumatic and 9 per cent were ototoxic in origin. The remaining 11 per cent were due to a group of rarities. The two vital factors are the site of the lesion and the duration of the hearing loss. The earlier these are diagnosed and treated the better the response. The etiology, pathology and treatment are reviewed.

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qEEG Measures of Attentional and Memory Network Functions in Medical Students: Novel Targets for Pharmacopuncture to Improve Cognition and Academic Performance

  • Gorantla, Vasavi R.;Bond, Vernon Jr.;Dorsey, James;Tedesco, Sarah;Kaur, Tanisha;Simpson, Matthew;Pemminati, Sudhakar;Millis, Richard M.
    • Journal of Pharmacopuncture
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    • v.22 no.3
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    • pp.166-170
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    • 2019
  • Objectives: Attentional and memory functions are important aspects of neural plasticity that, theoretically, should be amenable to pharmacopuncture treatments. A previous study from our laboratory suggested that quantitative electroencephalographic (qEEG) measurements of theta/beta ratio (TBR), an index of attentional control, may be indicative of academic performance in a first-semester medical school course. The present study expands our prior report by extracting and analyzing data on frontal theta and beta asymmetries. We test the hypothesis that the amount of frontal theta and beta asymmetries (fTA, fBA), are correlated with TBR and academic performance, thereby providing novel targets for pharmacopuncture treatments to improve cognitive performance. Methods: Ten healthy male volunteers were subjected to 5-10 min of qEEG measurements under eyes-closed conditions. The qEEG measurements were performed 3 days before each of first two block examinations in anatomy-physiology, separated by five weeks. Amplitudes of the theta and beta waveforms, expressed in ${\mu}V$, were used to compute TBR, fTA and fBA. Significance of changes in theta and beta EEG wave amplitude was assessed by ANOVA with post-hoc t-testing. Correlations between TBR, fTA, fBA and the raw examination scores were evaluated by Pearson's product-moment coefficients and linear regression analysis. Results: fTA and fBA were found to be negatively correlated with TBR (P<0.03, P<0.05, respectively) and were positively correlated with the second examination score (P<0.03, P=0.1, respectively). Conclusion: Smaller fTA and fBA were associated with lower academic performance in the second of two first-semester medical school anatomy-physiology block examination. Future studies should determine whether these qEEG metrics are useful for monitoring changes associated with the brain's cognitive adaptations to academic challenges, for predicting academic performance and for targeting phamacopuncture treatments to improve cognitive performance.