Hyperthermia: A Potential Game-Changer in the Management of Cancers in Low-Middle-Income Group Countries

Loco-regional hyperthermia at 40–44 °C is a multifaceted therapeutic modality with the distinct triple advantage of being a potent radiosensitizer, a chemosensitizer and an immunomodulator. Risk difference estimates from pairwise meta-analysis have shown that the local tumour control could be improved by 22.3% (p < 0.001), 22.1% (p < 0.001) and 25.5% (p < 0.001) in recurrent breast cancers, locally advanced cervix cancer (LACC) and locally advanced head and neck cancers, respectively by adding hyperthermia to radiotherapy over radiotherapy alone. Furthermore, thermochemoradiotherapy in LACC have shown to reduce the local failure rates by 10.1% (p = 0.03) and decrease deaths by 5.6% (95% CI: 0.6–11.8%) over chemoradiotherapy alone. As around one-third of the cancer cases in low-middle-income group countries belong to breast, cervix and head and neck regions, hyperthermia could be a potential game-changer and expected to augment the clinical outcomes of these patients in conjunction with radiotherapy and/or chemotherapy. Further, hyperthermia could also be a cost-effective therapeutic modality as the capital costs for setting up a hyperthermia facility is relatively low. Thus, the positive outcomes evident from various phase III randomized trials and meta-analysis with thermoradiotherapy or thermochemoradiotherapy justifies the integration of hyperthermia in the therapeutic armamentarium of clinical management of cancer, especially in low-middle-income group countries.

Proactive measures to eradicate Malaysia’s poverty in IR4.0 era: a shared prosperity vision

Background: In the country’s shared prosperity vision, Malaysia aspires to uplift the bottom 40% household income group (B40) by addressing wealth and income disparities. By 2030, the nation seeks to eradicate poverty through the provision of employment opportunities and career progression plans. A grey area between the nation’s aspirations and actions in practice can be observed because the goals have not been achieved despite numerous efforts aimed at the upliftment of the B40 group. The nation is still way behind its targeted outcomes despite various policies being implemented, which could be attributed to the mismatch between government policies and that of organisational practice. Thus, this study explores the rationale of strategic government intervention in managing B40 talent in the IR4.0 era. Methods: A general qualitative inquiry method that used 11 semi-structured interviews was carried out with representatives of Malaysia’s policy makers’, training providers, and trainees. All Interview questions centred around measures, importance and outcomes of B40 youth training from a multi-stakeholder perspective. Data were thematically analysed in five stages using NVivo. Results: Training, which includes IR4.0 era digital skills, is the key to uplifting the B40 youth to eradicate poverty. Proactive measures are imperative in the success of B40 youth training towards poverty eradication. Conclusions: This study contributes to the existing literature and helps practitioners by addressing the current gap in Malaysia’s aspirations versus organisational practice. Stakeholders should formulate proactive strategies to ensure that the right trainees are matched with the right training providers and government policies. A linkage between government policies and industry requirements needs to be established as opposed to the present discontinuity. A structured training needs analysis should be applied through a collaboration between industries and governments. Then, B40 individuals commonly found in lower-level positions can be pooled into the career pathway towards a shift into M40.

Prevalence and determinants of using complementary and alternative medicine for the treatment of chronic illnesses: A multicenter study in Bangladesh

Background While conventional medicine (CM) is commonly used to treat non-communicable diseases (NCDs), complementary and alternative medicine (CAM) is gaining popularity as a healthcare option in Bangladesh. We aimed to investigate the prevalence and factors associated with using CAM solely and using CAM in conjunction with CM for chronic illness treatment among NCD patients in Bangladesh. Methods A multicenter cross-sectional study was conducted, including 549 adults with a confirmed chronic illness diagnosis from three tertiary care hospitals in Dhaka city. Interviews were used to gather socio-demographic data, while medical records were used to get information on chronic illnesses. A multinomial logistic regression model was used to determine the associated factors of utilizing CAM primarily and CAM use in conjunction with CM to manage the chronic disease. Results Out of 549 NCD patients (282 women [51.4%], mean [standard deviation] age 45.4 [12.8] years), 180 (32.8%) ever used CAM for the treatment of chronic illness. Also, 15.3% of patients exclusively used CAM among the NCD patients, while 17.5% used CAM in conjunction with CM. Homeopathy medicine was the most prevalent type of treatment among CAM users (52.2%). Furthermore, 55.5% of CAM users said they used it due to its less adverse effects, and 41.6% trusted its effectiveness for chronic illness. Elderly patients (≥60 years) preferred CAM in complementary with CM, but they did not rely only on CAM. According to the multinomial regression analysis, unmarried patients, predominantly in the younger age group, adopted CAM significantly for chronic illness treatment (Relative risk ratio, RRR = 0.29, 95% CI = 0.12–0.71, reference = Unmarried). Patients in the high-income group used CAM in conjunction with CM (RRR = 6.26, 95% CI = 1.35–18.90, reference: low-income), whereas patients in the high-income group did not rely on CAM alone (RRR = 0.99, 95% CI = 0.34–2.85). Conclusion Although CM remains the mainstream of health care in Bangladesh, CAM services play an essential role in people’s health care, particularly in treating chronic illnesses. Physicians of Bangladesh should be aware that their patients may be using other services and be prepared to ask and answer questions regarding the risks and benefits of using CAM in addition to regular medical care. Thus, clinicians required to follow best-practice guidelines, which are currently not practiced in Bangladesh, when disseminating information regarding integrative techniques that combine CM and CAM approaches.

Smoking-related behaviour changes among Korean men after the 2015 tobacco price increase: assessing the implications for the tobacco endgame using a reconstructed retrospective cohort study

ObjectivesTo examine the effect of Korea’s 2015 tax policy, discuss its effectiveness and limitations and present future directions for tax policy in the context of the tobacco endgame.DesignA retrospectively reconstructed cohort study.SettingKorea, August 2014–October 2015.ParticipantsThe study examined 41,605 male smokers aged 19 years and older who participated in the 2015 Korea Community Health Survey.Measures and analysisBinary and multinomial logistic regression was used to assess the impact of the tax policy on smoking-related behaviour. We adjusted for demographic and health-related variables.ResultsAmong 41,605 men who were smokers in 2014, 15,499 (35.85%, weighted) reported being affected by the price increase. Of all smokers, 1,772 (3.96%, weighted) reported quitting smoking because of the tobacco price increase. Others reduced their smoking amount (n=9,714, 22.48%, weighted) or made other changes such as switching brands (n=4,013, 9.41%, weighted). An additional 2,401 smokers (5.72%, weighted) quit smoking for reasons other than the tobacco price increase. Compared with those in the highest quintile of household income, the odds that those in the lowest quintile quit smoking due to the price increase were almost twice as high (OR=1.98, 95% CI 1.54 to 2.54).ConclusionsKorea’s 2015 tobacco price increase affected a significant number of smokers within a year, especially in the lowest income group, inducing some to quit or reduce their smoking amount. However, more smokers quit for reasons independent of the price change. Tax policy can effectively reduce smoking, but needs to be combined with other policies for optimal results.

Financial Inclusion between Financial Innovation and Economic Growth A Study of Lower Middle Income Economies

Financial inclusion is a key concern that has achieved much impulsion in the last two decades internationally. It has the scope of reporting of financial scheme and institutions to the underserved community in the economy. This study examined the effect of financial innovation on economic growth with the mediation of financial inclusion. To address the relationship researchers in this study have used measures from a dataset of low and lower middle income group economies over a sample period from 2010-2017. The results of this study shows that financial innovation creates opportunities for financially excluded segment of the society which results in financial inclusion that leads to economic growth of low and lower middle economies. Therefore, financial innovation is a way for creation of financial inclusion in low and lower middle economies.

Comparison of Machine Learning Analysis on Predictive Factors of Children’s Planning-Organizing Executive Function by Income Level: Through Home Environment Quality and Wealth Factors

Background and objective: This study identifies whether children's planning-organizing executive function can be significantly classified and predicted by home environment quality and wealth factors.Methods: For empirical analysis, we used the data collected from the 10th Panel Study on Korean Children in 2017. Using machine learning tools such as support vector machine (SVM) and random forest (RF), we evaluated the accuracy of the model in which home environment factors classify and predict children's planning-organizing executive functions, and extract the relative importance of variables that determine these executive functions by income group.Results: First, SVM analysis shows that home environment quality and wealth factors show high accuracy in classification and prediction in all three groups. Second, RF analysis shows that estate had the highest predictive power in the high-income group, followed by income, asset, learning, reinforcement, and emotional environment. In the middle-income group, emotional environment showed the highest score, followed by estate, asset, reinforcement, and income. In the low-income group, estate showed the highest score, followed by income, asset, learning, reinforcement, and emotional environment.Conclusion: This study confirmed that home environment quality and wealth factors are significant factors in predicting children’s planning-organizing executive functions.

Hit Hard but Recover Slowly: The Asymmetric Effects of Social Distancing Policies on the US Labor Market

This study employs a difference-in-differences approach to examine the US labor market response to two widely used social distancing policies, stay-at-home (SAH) order and non-essential business closure, with special attention paid to the asymmetric effect of the policies’ imposition and lifting. Exploiting the variation across states and time, we find that state employment rates declined by 4.3% and 1.9% for the two policies respectively, within one month of the enaction of social distancing policies, but the recovery was slower after the policies were removed. We also highlight that the low-income group suffered the highest employment rate drop from the SAH enaction while presenting the mildest rebound. Self-employed workers were more affected by the policy impositions but recovered slightly faster than wage earners. Our results suggest persistent efforts must be made after the pandemic, especially for more vulnerable groups in the labor market.

STATUS OF SANITATION FACILITIES AND ITS IMPACTS ON HEALTH IN MAINPURI CITY OF UTTAR PRADESH, INDIA

Nearly 60 million people in urban areas lack access to improved sanitation arrangements, and more than two-thirds of wastewater is let out untreated into the environment, polluting land and water bodies. Urban sanitation in India faces many challenges. To respond to these environmental and public health challenges, urban India will need to address the full cycle of sanitation, i.e., universal access to toilets, with safe collection, conveyance and treatment of human excreta. There has been a significant increase in waste generation because of rapid population growth and economic development. Thus, waste management and sanitation became major environmental and health problem. In rainy season condition gets worse. This paper outlines these concerns, and highlights the need for focusing on access to water and the full cycle of sanitation for the urban poor, as fundamental to addressing the sanitation challenge. In this paper an attempt has been made to identify the sanitation related risk factors and its relationship with associated diseases in Mainpuri city. The study is based on primary sources of data collected through household surveys in Mainpuri city. Households belong to different income groups. The total sample size consists of 1836 households. The result showed that the sanitation condition and associated diseases or living standards and health conditions are related to each other. In this paper typhoid fever, cholera, malaria, etc. diseases were observed. The lower income group households are most vulnerable. They suffer most because of their poor sanitation conditions.

Determine the Food Access among Low-Income Households in Rural Area, Kedah, Malaysia

Objective - This study aims to determine the low-income group in rural areas to food access. This study also determines the main source of choice for this group to get food. Methodology - This study was conducted in Baling, Sik, and Padang Terap districts in Kedah. There is 200 respondent involved in this study. Findings - The results showed that 97.87% of low-income households in Baling, 82.36% in Sik, and 71.43% in Padang Terap had low food access status and were prone to food deserts areas. Low -income households in the area prefer grocery stores for food access over supermarkets. A large number of low-income households access food at the supermarket once a month causing geographical factors. Novelty - In conclusion, policymakers need to determine the measurement and assessment of food deserts in rural areas in Malaysia. Kedai Rakyat 1 Malaysia (KR1M) and the KedaiRuncit Transformation Program (TUKAR) can be re-implemented with the improvement of their implementation structure to improve food access in rural areas. Type of Paper - Empirical. Keywords: Food Access; Low-Income Households; Food Deserts; Rural Area; Kedah