Incidence and mortality of female breast cancer in the Asia-Pacific region

Objective: To provide an overview of the incidence and mortality of female breast cancer for countries in the Asia-Pacific region. Methods: Statistical information about breast cancer was obtained from publicly available cancer registry and mortality databases (such as GLOBOCAN), and supplemented with data requested from individual cancer registries. Rates were directly age-standardised to the Segi World Standard population and trends were analysed using joinpoint models. Results: Breast cancer was the most common type of cancer among females in the region, accounting for 18% of all cases in 2012, and was the fourth most common cause of cancer-related deaths (9%). Although incidence rates remain much higher in New Zealand and Australia, rapid rises in recent years were observed in several Asian countries. Large increases in breast cancer mortality rates also occurred in many areas, particularly Malaysia and Thailand, in contrast to stabilising trends in Hong Kong and Singapore, while decreases have been recorded in Australia and New Zealand. Mortality trends tended to be more favourable for women aged under 50 compared to those who were 50 years or older. Conclusion: It is anticipated that incidence rates of breast cancer in developing countries throughout the Asia-Pacific region will continue to increase. Early detection and access to optimal treatment are the keys to reducing breast cancer-related mortality, but cultural and economic obstacles persist. Consequently, the challenge is to customise breast cancer control initiatives to the particular needs of each country to ensure the best possible outcomes.

Changing travel patterns and journeys to health services in Great Britain 1985-2012: An examination health service utilisation using the National Travel Survey

Background This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data (1985-2012). The National Travel Survey (NTS) is a series of household surveys designed to provide data on personal travel and monitor changes in travel behaviour over time. The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Methods Variables from the PSU, households, and individuals datasets were used as explanatory variables. Whereas, variables extracted from the journeys dataset were used as dependent variables to identify patterns of utilisation i.e. the proportion of journeys made by different groups to access health facilities in a particular journey distance or time band or by mode of transport; and geographic access to health services. A binary logistic regression analysis was conducted to identify the utilisation rate over the different time periods between different groups. This analysis shows the Odds Ratios (ORs) for different groups making a trip to utilise health services compared to their respective counterparts. Linear multiple regression analyses were conducted to then identify patterns of change in the accessibility and mobility level. Results Analysis of the data has shown that that journey distances to health facilities were signi fi cantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. Although rates of utilisation of health services we re Oral Abstracts / Journal of Transport & Health 2 (2015) S5 – S63 S43 signi fi cantly lower because of longer journey times. These fi ndings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension. Conclusions This fi nding, therefore, suggests the need to improve geographic access to services together with an enhanced mobility option for disadvantaged groups in order for them to have improved levels of access to health facilities. This research has also found that the volume of car trips to health services also increased steadily over the period 1985-2012 while all other modes accounted for a smaller number of trips. However, it is dif fi cult to conclude from this research whether this increase in the volume of car trips was due to a lack of alternative transport or due to an increase in the level of car-ownership.

A comparison of road traffic crashes along mountainous and non-mountainous roads in Sabah, Malaysia

Constrained topography and complex road geometry along rural mountainous roads often represent a demanding driving situation. As a result, traffic crashes along mountainous roads are likely to have different characteristics to crashes on roads in flatter areas; however, there is little research on this topic. The objective of this study is to examine the characteristics of road traffic crashes on rural mountainous roads and to compare these with the characteristics of crashes on non-mountainous roads. This paper explores and compares general crash characteristics including crash type, crash severity, roadway geometric features and environmental factors, and road user/vehicle characteristics. Five years of road traffic crash data (2008-2012) for Sabah were obtained from the Malaysian Institute of Road Safety Research. During this period, a total of 25,439 crashes occurred along federal roads in Sabah, of which 4,875 crashes occurred in mountainous areas. Categorical data analysis techniques were used to examine the differences between mountainous and non-mountainous crashes. Results show that the odds ratio of ‘out-of-control’ crashes and the crash involvement due to speeding are respectively about 4.2 times and 2.8 times higher on mountainous than non-mountainous roads. Other factors and crash characteristics that increase the odds of crashes along mountainous roads compared with non-mountainous roads include horizontal curved sections compared with straight sections, single-vehicle crashes compared with multi-vehicle crashes and weekend crashes compared with weekday crashes. This paper identifies some of the basic characteristics of crashes along rural mountainous roads to aid future research on traffic safety along mountainous roads.

A comparison of road traffic crashes along mountainous and non-mountainous roads in Sabah, Malaysia

Constrained topography and complex road geometry along rural mountainous roads often represent a demanding driving situation. As a result, traffic crashes along mountainous roads are likely to have different characteristics to crashes on roads in flatter areas; however, there is little research on this topic. The objective of this study is to examine the characteristics of road traffic crashes on rural mountainous roads and to compare these with the characteristics of crashes on non-mountainous roads. This paper explores and compares general crash characteristics including crash type, crash severity, roadway geometric features and environmental factors, and road user/vehicle characteristics. Five years of road traffic crash data (2008-2012) for Sabah were obtained from the Malaysian Institute of Road Safety Research. During this period, a total of 25,439 crashes occurred along federal roads in Sabah, of which 4,875 crashes occurred in mountainous areas. Categorical data analysis techniques were used to examine the differences between mountainous and non-mountainous crashes. Results show that the odds ratio of ‘out-of-control’ crashes and the crash involvement due to speeding are respectively about 4.2 times and 2.8 times higher on mountainous than non-mountainous roads. Other factors and crash characteristics that increase the odds of crashes along mountainous roads compared with non-mountainous roads include horizontal curved sections compared with straight sections, single-vehicle crashes compared with multi-vehicle crashes and weekend crashes compared with weekday crashes. This paper identifies some of the basic characteristics of crashes along rural mountainous roads to aid future research on traffic safety along mountainous roads.

Developing the ASEAN regional road safety strategy

In 2011, more than 75,000 people died in road crashes in the ten member countries of the Association of South East Asian Nations (ASEAN) and many times this number sustained long term injuries. Improving road safety outcomes in ASEAN is not only important for the welfare and economic benefit of these countries, but given that a significant proportion of the world’s population lives in ASEAN, it will strongly influence whether the aims of the United Nations Decade of Action for Road Safety and the Sustainable Development Goals are reached. For this reason, the Asian Development Bank, funded by the Japan Fund for Poverty Reduction, has funded a package of action to improve road safety in ASEAN, including the development of a regional road safety strategy. The diversity of the member nations of ASEAN poses significant challenges for the development of the strategy. For example, the road fatality rates per 100,000 population in Malaysia and Thailand are about 5 times greater than in Singapore. In addition, the importance of particular road safety issues varies across the ASEAN countries and for countries which are undergoing rapid motorization, the order of importance may change over the life of the strategy. The development of the ASEAN Regional Road Safety Strategy has adopted the five pillars of road safety of the UN Decade of Action but focused on those aspects which are most relevant at the regional level and where a regional approach will support and facilitate actions taken by individual countries.

Malesia, Singapore ja etniset kiinalaiset : Kaksi tapaa rakentaa kansallista yhtenäisyyttä

Tutkimuksen tavoitteena on perehtyä Malesian ja Singaporen kiinalaisten etniseen ja kansalliseen identiteettiin. Tutkimus tarkastelee ja vertailee erityisesti Malesian ja Singaporen valtionhallintojen keinoja rakentaa kansallista yhtenäisyyttä ja vähentää etnisen identiteetin merkitystä. Lisäksi tutkimus luo kriteerijoukon, jonka avulla voidaan vertailla Malesian ja Singaporen yhteiskuntien onnistumista tai epäonnistumista kansallisen yhtenäisyyden rakentamisessa. Tutkimustehtävä jakautuu kahteen kysymykseen: Miten Malesian ja Singaporen valtionhallinnon menetelmät vaikuttavat etnisten kiinalaisten kansalliseen ja etniseen identiteettiin, ja miten maiden menetelmät eroavat toisistaan? Lopuksi vertailemalla Malesiaa ja Singaporea tutkimuksessa päätellään luodun kriteerijoukon avulla, miten kansallinen yhtenäisyys on toteutunut näissä kahdessa maassa. Tutkimuksen teoriatausta perustuu etnistä ja kansallista identiteettiä tutkineiden Fredrik Barthin, Nathan Glazerin ja Daniel P. Moynihanin, Donald Horowitzin, Milton J. Esmanin, Benedict Andersonin, Anthony D. Smithin ja Stuart Hallin teorioihin. Nämä tutkijat painottavat eri tekijöiden merkitystä kansalliselle identiteetille ja yhtenäisyydelle, toisiaan täydentäen. Kyseessä on teoreettinen tutkimus. Siksi sen aineisto koostuu pääasiassa sekundaarilähteistä: tieteellisistä teoksista ja artikkeleista sekä sähköisistä lehtiartikkeleista. Primäärilähteitä ovat Malesian ja Singaporen perustuslait, Malesian ja Singaporen tilastokeskuksien tilastot sekä Malesian entisen pääministerin Mahathir bin Mohamadin vuonna 1991 pitämä Vision 2020 -puhe. Aineistoa on analysoitu tutkimuksen teoriataustan avulla. Monipuolisemman kuvan muodostamiseksi on tutkimukseen valittu sekä länsimaalaisten tutkijoiden että singaporelaisten ja malesialaisten tutkijoiden tutkimuksia. Lisäksi, puolueellisuuden välttämiseksi, on tutkimukseen valittu eri etnisiin ryhmiin kuuluvien tutkijoiden artikkeleita ja teoksia. Tutkimuksessa on päädytty seuraavan tulokseen. Jotta kansallinen yhtenäisyys voidaan saavuttaa Malesian ja Singaporen monietnisissä yhteiskunnissa, tulee valtionhallinnon keskittyä erityisesti seuraaviin viiteen tehtävään: kansantalouden kehittämiseen, etnisten ryhmien välisen taloudellisen tasa-arvoisuuden edistämiseen, poliittisen aktiivisuuden ja osallistumisen kannustamiseen, etnisten yhteisöjen samanarvoisuuden toteuttamiseen lain edessä ja tasa-arvoisen koulutusjärjestelmän rakentamiseen. Näiden kriteerien perusteella Malesia ja Singapore eivät ole kansallisesti yhtenäisiä valtioita. Singapore on kuitenkin kansallisesti yhtenäisempi, sillä se täyttää viidestä kriteeristä kolme, kun Malesia täyttää vain kaksi kriteeriä. Malesialla ja Singaporella on kaksi hyvin erilaista tapaa rakentaa kansallista yhtenäisyyttä, mutta lopputulokset ovat kuitenkin hyvin samankaltaiset. Tutkimus päättelee, että etnisten yhteisöjen institutionaalinen asema molemmissa maissa on yksi ratkaisevimmista esteistä kansalliselle yhtenäisyydelle.

Community, Power, and Colonialism: The U.S. Army in Southern Arizona and New Mexico, 1866-1886

Empire is central to U.S. history. When we see the U.S. projecting its influence on a global scale in today s world it is important to understand that U.S. empire has a long history. This dissertation offers a case study of colonialism and U.S. empire by discussing the social worlds, labor regimes, and culture of the U.S. Army during the conquest of southern Arizona and New Mexico (1866-1886). It highlights some of the defining principles, mentalities, and characteristics of U.S. imperialism and shows how U.S. forces have in years past constructed their power and represented themselves, their missions, and the places and peoples that faced U.S. imperialism/colonialism. Using insights from postcolonial studies and whiteness studies, this work balances its attention between discursive representations (army stories) and social experience (army actions), pays attention to silences in the process of historical production, and focuses on collective group mentalities and identities. In the end the army experience reveals an empire in denial constructed on the rule of difference and marked by frustration. White officers, their wives, and the white enlisted men not only wanted the monopoly of violence for the U.S. regime but also colonial (mental/cultural) authority and power, and constructed their identity, authority, and power in discourse and in the social contexts of the everyday through difference. Engaged in warfare against the Apaches, they did not recognize their actions as harmful or acknowledge the U.S. invasion as the bloody colonial conquest it was. White army personnel painted themselves and the army as liberators, represented colonial peoples as racial inferiors, approached colonial terrain in terms of struggle, and claimed that the region was a terrible periphery with little value before the arrival of white civilization. Officers and wives also wanted to place themselves at the top of colonial hierarchies as the refined and respectable class who led the regeneration of the colony by example: they tried to turn army villages into islands of civilization and made journeys, leisure, and domestic life to showcase their class sensibilities and level of sophistication. Often, however, their efforts failed, resulting in frustration and bitterness. Many blamed the colony and its peoples for their failures. The army itself was divided by race and class. All soldiers were treated as laborers unfit for self-government. White enlisted men, frustrated by their failures in colonial warfare and by constant manual labor, constructed worlds of resistance, whereas indigenous soldiers sought to negotiate the effects of colonialism by working in the army. As colonized labor their position was defined by tension between integration and exclusion and between freedom and colonial control.

The effects of psychosocial factors on the emotional well-being of women during pregnancy: A cross-cultural study of Britain and Greece

The effects of life events, social support and the emotional well-being of partner on the emotional well-being of the mother during pregnancy was examined within the cultural contexts of Britain and Greece. It was proposed that social support, impact of life events and relationship of the mother with her partner would be affected by the different social structures of each culture and would influence emotional well-being. A sample of 200 Greek and 156 British mothers and their partners completed questionnaires which included a life event inventory, measure of social support and measure of emotional well-being (Crown-Crisp Experiential Index). Greek mothers were found to score significantly higher on measures of depression, anxiety and somaticism, experience more stressful life events (most relating to family issues) and report feeling less supported than British mothers. Life events, particularly those relating to family stresses were found to predict poor emotional well-being among Greek mothers. For British mothers, social support was the strongest predictor of emotional well-being. Findings were discussed in the light of differences in social structure and it was suggested that future research might focus on the disruption of established social support structures rather than the differences in availability of social support per se when considering maternal emotional well-being.

The effects of psychosocial factors on the mother's emotional well-being during early parenthood: A cross-cultural study of Britain and Greece

The effect of psychosocial factors on the emotional well-being of mothers following childbirth were examined within the cultural contexts of Britain and Greece. These mothers had already completed questionnaires during pregnancy and were contacted a second time in the postpartum period. At 4–6 weeks postpartum a sample of 165 Greek mothers and 101 British mothers and their partners completed the Edinburgh Postnatal Depression Scale. The relationship between mothers' EPDS scores and measures of emotional well-being in pregnancy (CCEI), social support, life events, fathers' EPDS score, and father's perception of change in partner was examined in each culture. No difference in the distribution of EPDS scores in each culture was found. Social support and life events were found to predict postnatal depression in both cultures. Additionally, in Greece, emotional well-being in pregnancy made a separate contribution to prediction. The major difference between the two cultures was in the relationship between mothers and their partners. Greek fathers were more emotionally and physically distanced from their partners during pregnancy, birth and early parenthood and perceived their partners as being more changed by the transition to parenthood. These differences were not reflected in differences in emotional well-being possibly because they accord with social expectation in each culture.

Population genetic evidence for the east–west division of the narrow-barred Spanish mackerel (Scomberomorus commerson, Perciformes: Teleostei) along Wallace’s Line

Mitochondrial DNA D-loop (control) region (426-bp) was used to infer the genetic structure of Spanish mackerel (Scomberomorus commerson) from populations in Southeast Asia (Brunei, East and West Malaysia, Philippines, Thailand, Singapore, and China) and northern Australia (including western Timor). An east–west division along Wallace’s Line was strongly supported by a significant AMOVA, with 43% of the total sequence variation partitioned among groups of populations. Phylogenetic and network analyses supported two clades: clade A and clade B. Members of clade A were found in Southeast Asia and northern Australia, but not in locations to the west (Gulf of Thailand) or north (China). Clade B was found exclusively in Southeast Asia. Genetic division along Wallace’s Line suggests that co-management of S. commerson populations for future sustainability may not be necessary between Southeast Asian nations and Australia, however all countries should share the task of management of the species in Southeast Asia equally. More detailed genetic studies of S. commerson populations in the region are warranted.

Agricultural intensification, priming for persistence and the emergence of Nipah virus: a lethal bat-borne zoonosis

Emerging zoonoses threaten global health, yet the processes by which they emerge are complex and poorly understood. Nipah virus (NiV) is an important threat owing to its broad host and geographical range, high case fatality, potential for human-to-human transmission and lack of effective prevention or therapies. Here, we investigate the origin of the first identified outbreak of NiV encephalitis in Malaysia and Singapore. We analyse data on livestock production from the index site (a commercial pig farm in Malaysia) prior to and during the outbreak, on Malaysian agricultural production, and from surveys of NiV's wildlife reservoir (flying foxes). Our analyses suggest that repeated introduction of NiV from wildlife changed infection dynamics in pigs. Initial viral introduction produced an explosive epizootic that drove itself to extinction but primed the population for enzootic persistence upon reintroduction of the virus. The resultant within-farm persistence permitted regional spread and increased the number of human infections. This study refutes an earlier hypothesis that anomalous El Nino Southern Oscillation-related climatic conditions drove emergence and suggests that priming for persistence drove the emergence of a novel zoonotic pathogen. Thus, we provide empirical evidence for a causative mechanism previously proposed as a precursor to widespread infection with H5N1 avian influenza and other emerging pathogens.

Bianca and Felix Gerstmann with monkey in Malaysia ? Portraits Couples

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Bianca and Felix Gerstmann boarding a Royal Air Mail airplane; Singapore Portraits Couples

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Bianca and Felix Gerstmann boarding a Royal Air Mail airplane; Singapore Portraits Couples

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Royal Air Mail plane in Singapore Transportation

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