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Beyond Limitations: Practical Strategies for Improving Cancer Care in Nigeria

  • Eguzo, Kelechi;Camazine, Brian
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3363-3368
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    • 2013
  • Background: The burden due to cancers is an emerging public health concern especially in resource-limited countries like Nigeria. The WHO estimates that cancer kills more people than tuberculosis, HIV/AIDS and malaria combined. As people in Nigeria and other developing countries are beginning to survive infectious diseases, there is an observed epidemiologic transition to chronic diseases, such as cancers. In 2008, 75 out of 1,000 Nigerians died of cancer. Despite the rising incidence and public health importance, Nigeria lacks an organized and comprehensive strategy to deal with cancers. Materials and Methods: This article reviewed 30 peer-reviewed manuscripts on cancer care in four countries. It highlights the limitations to cancer care in Nigeria; due to lack of awareness, low health literacy, absence of organized screening programs, inadequate manpower (in terms of quality and quantity) as well as limited treatment options. Results: This review led to the formulation of a proposal for Nigerian National Cancer Policy, mainly drawn from effective strategies used in Canada, Brazil and Kenya. This is a vertical cancer program that is patient-centered with an emphasis on tobacco control and cancer disease screening (similar to Canada and Brazil). Additionally, it emphasizes primary cancer prevention (similar to Kenya). Its horizontal integration with other disease programs like HIV/AIDS will improve affordability in a poor resourced country like Nigeria. Capacity building for health professionals, hub-and-spoke implementation of screening services, as well as investment in effective treatment options and increased research in cancer care are essential. International 'twinning collaborations' between institutions in richer countries and Nigeria will enhance effective knowledge translation and improve the quality of patient care. Conclusions: A national cancer policy must be developed and implemented in Nigeria in order to overcome the present limitations which help contribute to the observed increases in cancer morbidity and mortality rates. Cancer control is feasible in Nigeria if the nation was to consider and employ some of the cost-effective strategies proposed here.

The Buyer's Remedies for Lack of Conformity under the PELS

  • Lee, Byung-Mun
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.40
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    • pp.3-30
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    • 2008
  • This article attempts to describe and analyze the rules on the buyer's remedies for lack of conformity under PELS. It shows that such remedies under the PELS operate in a two-tier remedial scheme which is alien to both domestic and international legal systems. That is, repair and replacement take the position of primary remedy, whereas termination, price reduction and damages are secondary remedies which are available only where the primary remedies cannot be invoked. Notwithstanding its superiority, the PELS have some drawbacks in several aspects. First, the PELS seems to place its focus on the factor of cost except the other factors, for instance, the significance of the lack of conformity, when one decides whether the first tier remedies cause the seller unreasonable effort or expense. It is argued that the factors can be considered by referring to art. 1:302 PECL. Second, the PELS does not expressively provide any exclusion of the seller's right to choose between repair or replacement on the basis of unreasonable uncertainty in reimbursing the expenses advanced by the buyer. It argues that if there is such uncertainty, it should be regarded as causing the buyer an unreasonable inconvenience under art. 4:204(1). Third, the PELS does not seem to properly reflect the consumer's interests in that most consumers prefer to have the absolute right of termination as against the commercial sellers who have a relatively stronger bargaining position. The reasons for that is that there is a big hurdle, i.e., a hierarchy of remedies, to be overcome by the consumer to battle with the commercial seller, and that unavoidable vagueness in defining a minor lack of conformity has been often used against the consumer, but in favour of the commercial seller with a strong bargaining position.

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Health Belief Model and Sick Role Behavior of Koream Chronic ill Paients (건강신념모델과 한국인 만성질환자의 환자역할 행위)

  • Gu, Mi-Ok;Lee, Eun-Ok
    • The Korean Nurse
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    • v.29 no.3
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    • pp.49-63
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    • 1990
  • This article reviewed & analyzed 33 studies of the Health Belief Model applied to korean chronic ill patients which were published from 1975 to 1990. The findings of analysis are as follows. The subjects of researchs are patients with various chronic illness including Pulmonary Tb., DM., Hemodialysis & Kindney Transplantation, Hypertension, etc. The type of research is retrospective survey in all studies. The measurement of health' belief in all studies & sick role behavior in most studies have relied on self report. The analysis of the relationship between health belief and sick role behavior was done using correlation coefficient in most studies. To analyze empirical support for the relatiohship between health belief and sick role behavior, Significance ratio was computed. This ratio is value wherein the number of statistically significant findings with relationship in the expected direction for an HBM dimension are divided by total number of studies which reported significance levels for that dimension. Examination of this ratio across the 33 studies reveals susceptibility(30.3%), severity(34.4%), benifit(65.6%), barrier(50%). The following suggestions are based on the above findings and literature review. 1. It is necessary to develop the reliable, valid and standadized instrument for measurement of health beliefs. 2. In the further 'measurement of perceived susceptibility of the chronic ill patients, It is considering that the perceived susceptibility and perceived severity are measured together or the measurement of perceived, susceptibility is eliminated. 3. Relationship between perceived severity and sick role behavior is suggested to be analized using ANOV A, $x^2$ square instead of correlation coefficient. 4. Sick role behaviors should be measured by both self report and objective measurement. 5. Prospective, longitudinal survey should be needed. 6. Other factors influencing sick role behaviors of chronic ill patients should be investigated further.

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Prevention of Fungal Contamination during Cheese Ripening - Current Situation and Future Prospects (치즈 숙성 중의 곰팡이 오염 방제 - 현황과 전망)

  • Jung, Hoo Kil;Choi, Ha Nuel;Oh, Hyun Hee;Huh, Chang Ki;Yang, Hee Sun;Oh, Jeon Hui;Park, Jong Hyuk;Choi, Hee Young;Kim, Kyoung Hee;Lee, Seung Gu
    • Journal of Dairy Science and Biotechnology
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    • v.30 no.2
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    • pp.75-81
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    • 2012
  • Molds cause severe cheese deterioration, even though some white and blue molds are used for the manufacture of Camembert and Blue cheese, respectively. The species of Geotrichum, Moniliella, Aspergillus, Penicillium, Mucor, Fusarium, Phoma, and Cladosporium are the main fungi that affect contamination during cheese ripening. Once deteriorated by fungal spoilage, cheese becomes toxic and inedible. Fungal deterioration of cheese decreases the nutritional value, flavor profiles, physicochemical and organoleptic properties, and increases toxicity and infectious disease. Fungal contamination during cheese ripening is highly damaging to cheese production in Korean farmstead milk processing companies. Therefore, these companies hesitate to develop natural and ripened cheese varieties. This article discusses the recent and ongoing developments in the removal techniques of fungal contamination during cheese ripening. There are 2 categories of antifungal agents: chemical and natural. Major chemical agents are preservatives (propionic acid, sodium propionate, and calcium propionate) and ethanol. Among the natural agents, grapefruit seed extract, phytoncide, essential oils, and garlic have been investigated as natural antifungal agents. Additionally, some studies have shown that antibiotics such as natamycin and Delvocid$^{(R)}$, have antifungal activities for cheese contaminated with fungi. Microbial resources such as probiotic lactic acid bacteria, Propionibacterium, lactic acid bacteria from Kimchi, and bacteriocin are well known as antifungal agents. In addition, ozonization treatment has been reported to inhibit the growth activity of cheese-contaminating fungi.

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Using Local Flaps in a Chest Wall Reconstruction after Mastectomy for Locally Advanced Breast Cancer

  • Park, Joo Seok;Ahn, Sei Hyun;Son, Byung Ho;Kim, Eun Key
    • Archives of Plastic Surgery
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    • v.42 no.3
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    • pp.288-294
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    • 2015
  • Background Surgical ablation for locally advanced breast cancer results in large chest wall defects, which can then be managed with local flaps or skin grafts. The purpose of this article is to evaluate the outcomes of three types of local skin flaps. Methods Among 25 local flaps in 24 patients, 6 were bilateral advancement (BA) flaps, 9 were thoracoabdominal (TA) flaps, and 10 were thoracoepigastric (TE) flaps. Clinical outcomes were compared including complications, the need for a secondary surgical intervention, and the timing of adjuvant therapy. Results The mean defect size was $436.2cm^2$. Two patients with TA flaps and 6 patients with TE flaps developed distal flap necrosis, and skin grafts were needed to treat 2 patients with TE flaps. Radiation was administered to the BA, TA, and TE patients after average postoperative durations of 28, 30, or 41 days, respectively. The incidence of flap necrosis tended to be higher in TE patients, which lead to significant delays in adjuvant radiation therapy (P=0.02). Conclusions Three types of local skin flaps can be used to treat large chest wall defects after the excision of locally advanced breast cancer. Each flap has its own merits and demerits, and selecting flaps should be based on strict indications based on the dimensions and locations of the defects.

Preservation of Exposed Breast Implant for Immediate Breast Reconstruction (보형물을 이용한 즉시 유방재건술에서 노출된 보형물의 보존)

  • Lee, Taik-Jong;Oh, Tae-Suk
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.26-30
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    • 2010
  • Purpose: Common complications of immediate breast reconstruction with implant are capsular contracture, malposition of implant, hematoma and seroma. Especially, the most severe complication is implant exposure caused by inflammation or necrosis of skin flap margin of mastectomy site. This article reports the experience of cases of salvage in such an exposure of implant. Methods: From July, 2002 to Feb., 2009, sixty-five patients who underwent immediate breast reconstruction with implant were retrospectively analyzed. Exposure of implant was happened in 5 of 65 patients and they were treated at out patient district. Two of five patients were reconstructed with saline implnt and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$ and Serratus muscle flap. Remaning three patients were reconstructed with silicone implant and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$. Results: In the group of patients who underwent reconstruction with saline implant, implant exposure was found in one patient due to partial necrosis of the margin of skin flap and debridement and primary repair were done. In the other one patient, dressing with antibiotic ointment were done. And debridement and primary repair were proceeded. In the group of patients who underwent reconstruction with silicone implant, implant exposure was found in one patient. After removal of the implant, tissue expansion was done and a new silicone implant was inserted. Implant exposure were found in the other two patients, antibiotics ointment application and primarily repaired. Conclusion: It was the common knowledge that the exposed implant should be removed. But salvage of the exposed implants may be possible with proper treatment. Four of five patients (80%) with exposed breast implant were salvaged with conservative management.

Bayesian inference on multivariate asymmetric jump-diffusion models (다변량 비대칭 라플라스 점프확산 모형의 베이지안 추론)

  • Lee, Youngeun;Park, Taeyoung
    • The Korean Journal of Applied Statistics
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    • v.29 no.1
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    • pp.99-112
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    • 2016
  • Asymmetric jump-diffusion models are effectively used to model the dynamic behavior of asset prices with abrupt asymmetric upward and downward changes. However, the estimation of their extension to the multivariate asymmetric jump-diffusion model has been hampered by the analytically intractable likelihood function. This article confronts the problem using a data augmentation method and proposes a new Bayesian method for a multivariate asymmetric Laplace jump-diffusion model. Unlike the previous models, the proposed model is rich enough to incorporate all possible correlated jumps as well as mention individual and common jumps. The proposed model and methodology are illustrated with a simulation study and applied to daily returns for the KOSPI, S&P500, and Nikkei225 indices data from January 2005 to September 2015.

A Literature Review on the Type of Joseon Dynasty Jwabans (조선시대 좌반류(佐飯類)의 종류에 대한 문헌적 고찰)

  • Oh, Soon-Duk
    • Journal of the Korean Society of Food Culture
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    • v.26 no.3
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    • pp.239-248
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    • 2011
  • This article examines the types of Jwabans as recorded in 21 old books of the Joseon dynasty (1392-1909). The ingredients used in Jwabans during the Joseon dynasty were root vegetables, sea algae, seeds nuts, bird, meat, and fish. In the early, middle, and late eras of the Joseon dynasty, 10, nine, and 181 kinds of Jwabans were prepared, and two, one, and seven kinds of Jwabans were prepared using root vegetables (根菜類). During the early and late eras of the Joseon dynasty, one and 14 kinds of Jwabans were prepared using sea algae (海藻類), respectively, and four kinds of Jwabans were prepared using seeds nuts during late eras of the Joseon dynasty (種實類). During the early, mid and late eras, one, two, and 17 kinds of Jwabans were prepared using bird (鳥類), three, one, and 47 kinds of Jwabans were prepared using meat (肉類), and one, five, and 81 kinds of Jwabans were prepared using fish (魚類). The frequency of the Jwabans ingredients in order were fish (30.5%), meat (23.5%), pheasant (7%), root vegetables (5%), abalone (全鰒) (5%), laver (海苔) (4%), shellfish (貝類) (3%), fish eggs (魚卵) (2.5%), fleshy prawn (大蝦) (2.5%), sea tangle (昆布) (2%), dried tangle (海草) (1.5%), sparrow meat (雀肉) (1.5%), and etc during the Joseon dynasty. It seems that the appearance and supplementation with different ingredients increased throughout the Joseon dynasty. This may be associated with the commercial industrial development that prevailed during the late Joseon dynasty. Further study will be conducted on recipes and ingredients recorded in these old books to develop a standardized recipe to globalize Jwabans.

Effects of External Environment and Organizational Resources and Capabilities on Strategy and Performance: An evidence from an analysis on ventures (벤처기업의 전략 및 성과에 대한 외부환경과 조직자원 및 능력의 영향)

  • Song, Woo-Yong;Hwang, Kyung-Yun
    • The Journal of the Korea Contents Association
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    • v.12 no.2
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    • pp.369-387
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    • 2012
  • Based on the survey data, this study focused venture firms examines how organizational resources and capabilities along with its external environmental conditions have an effect on its strategy and performance. In particular, this article attempts, by performing a binary logistic regression analysis, to identify the venture-specific importance and priority of the factors that may influence firms' strategy patterns, with multiple regression analysis on the relationships between some variables included in the model. The survey was conducted from October 1, 2010 through October 30, 2010. The results of this study are the following. First, the more firms are exposed to high industry growth and low competitive intensity, the higher chance they get to pursuit aggressive strategy. And then a firm seeks aggressive strategy, when it has more technological resources and human resources. Third, environmental uncertainty, industry growth, technological resources, human resources, financial resources and marketing capabilities have positive effects on firm's performance. But, competitive intensity has no direct influence firm's performance. Finally, CEO competence directly influences firm's performance, but the interaction. of CEO competence with other variables is not significant.

Designing of the pattern of Tight Pants, an article of Modern Dancewear, Made of Stretchy Materials (스트레치 소재를 사용한 현대무용 타이츠팬츠원형 설계)

  • 김순분;곽명숙;박채련
    • Journal of the Korean Home Economics Association
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    • v.42 no.4
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    • pp.45-54
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    • 2004
  • The Purpose of this study was to research and develop a Pattern of tight Pants, featuring excellent appearance, movement and suitability for the lower body, which are widely used as a basic item for modem dance, aerobic dance and dance sports, and to provide manufacturing data for the pants. This study was carried out with 118 People who majored in dance, using questionnaires asking questions about their understanding and preference of dancewear The experimental dancewear was produced, using 5 kinds of patterns for tight pants on the market, to find out the most excellent pattern in appearance and movement performance. Then, the most excellent pattern was again improved to produce a pattern for this study. The result of this study is summarized as follows. 1. Regarding shops where they purchased dancewear exclusive shops accounted for 97%, their average price was ₩30,000 to ₩50,000(51%), and dancewear separated between the upper and lower halves was most preferred(56%). Cotton span was preferably used for a dancewear material(71%), and their dissatisfaction of a fit accounted for 38% which appeared to be highly unsatisfied with its suitability. 2. When S types of experimental dancewear prepared with a comparative pattern were tested by the senses, it was shown that the comparative pattern of experimental wear number 5 with a strip w3s excellent in movement functions and appearance. 3. The basic items necessary to design the tight pants' study pattern were categorized into waist circumference, hip circumference, crotch depth and slacks length. The shrinkages of 15% in width, 10% in crotch length md 20% in inside leg length were applied, respectively, referring to previous studies and the experimental dancewears' comparative patterns. 4. When the improved study pattern for this study was tested by the senses, it showed higher scores in movement functions and appearance than the comparative pattern did, which confirmed the study pattern's improvement of functions and appearance.