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Information on how to get pre-arranged Visa on Arrival for Myanmar
In order to apply for VOA, the following information should be sent to EPG Travel preferably at least 3 weeks before arrival though we can do it in less time in some cases: (Most, but not all, of this will be on the passport page)
* Passport validity must be for at least 6 months
1) Copy of client's passport with photo and personal details page
2) Client's name
3) Sex
4) Nationality
5) Ethnic origin of client (e.g., Chinese, Spanish etc)
6) Religion
7) Passport number
8) Issue date of Passport
9) Date of Birth
10) Place of Birth
11) Client's occupation
12) Client's permanent address
13) Arrival day to Yangon
14) Arrival flight details
- Once we receive this information our staff will fill in the visa on arrival form on behalf of each client and these visa forms will be given to immigration services at the airport. Clients will need to go to Visa on Arrival counter to be processed.
- The clients will need to bring 2 passport photos (b/w or color) to give to immigration.
- EPG Travel will inform the airline that the clients are having visa on arrival so that they will be allowed to board the flight to Yangon.
- There is a fee of USD 30 that the clients pay to Immigration Services at the airport upon arrival.
- EPG Travel will also send a visa approval letter for the clients to show
(if needed) when boarding the international arrival flight.
- The EPG charge for processing the visa on arrival is USD 25 per person or USD 50 for a single traveler. This cost will be included in the invoice for the tour.
**Be sure to note the important information about CREDIT CARDS and TRAVELER'S CHECKS in the 'Money Matters' section**
Visa is required
1) A regular TOURIST VISA can be obtained by the traveler applying directly to an overseas Myanmar embassy. It may take a few days or longer depending on the particular embassy.
2) VISA ON ARRIVAL ( pre-arranged ) -
We would need the passport scan and other information about 3 weeks prior to arrival in order to apply.
Arrival Procedures
After your passport is checked at the immigration desk, you will proceed directly to the baggage area. After collecting your checked luggage and clearing the customs inspection, you will go out to the arrival area where you will be met by your tour guide (if you are on an escorted tour).
Customs Procedures
As a basic rule-of-thumb, all valuable items brought into the country such as jewelry, cameras, electrical equipment, etc. should be declared upon arrival and subsequently brought out of the country upon departure. (In actual practice however, it is not necessary to declare cameras or computers or even jewelry). All foreign currency in excess of $2,000 is supposed to be declared though in reality, this is rarely if ever checked.
Money Matters * CREDIT CARD & TRAVELERS CHECK ALERT!!
As a result of the US sanctions, credit cards and travelers checks are not accepted in Myanmar at most hotels or at any banks. A few deluxe hotels and restaurants have found a way to accept credit cards for expenses. Therefore travelers should bring enough CASH for all expected expenses (USD or Euros are the easiest- larger bills get slightly better rate). * Please also note there are no ATM machines.
Currency - The Myanmar currency is known as the 'kyat' (pronounced 'chaat'). The official rate is about 6 kyat to the dollar but the 'real' rate is much higher. Visitors may change their dollars into kyat at the local market rate. Major hotels and a few restaurants will charge in USD but most other expenses in Myanmar will be in kyats.
For a general reference, as of August 2011 the approximate exchange rate was One USD = 750 Kyats, however this can vary up or down over a period of days and weeks.
** USD notes which are old, torn or have marks are not accepted in Myanmar. Bring USD currency, with 'big heads' not the older 'small heads' design and avoid the series 'CB' as it is not accepted either.
Local Time
Myanmar Time is GMT + 6.5 (and is 30 minutes behind Bangkok time)
For comparison: New York is GMT - 5, Paris is GMT + 1, and Hong Kong is GMT +8
Language & Religion
Myanmar people speak Burmese although quite a few can also speak English.
The vast majority of Myanmar people (about 87%) are Buddhist with a minority of Christian, Muslim and Hindu.
Climate and Weather
Myanmar has three "seasons": Hot Season - March to mid-May with average temperatures 25-38 C Rainy Season - mid-May to September with average temperatures 23-33 C. "Winter" Season - October to February with average temperatures 18-24 C. The main tourist season is during the Winter season, but it doesn't rain much up-country and the travel season is now virtually all year long. In fact many prefer the rainy season for its lack of crowds and the cooler weather.
What to Wear
Warm weather clothing is quite adequate for Yangon and most tourist spots although up-country around the Inle Lake area and other higher elevations the temperature may reach near freezing at night during the 'winter' season. Travelers should bring appropriate cold weather clothing if traveling there. Additionally, suggestive or revealing clothing is never a good idea in this conservative and largely Buddhist culture. When visiting religious shrines and temples, modest dress is required and easily removable footwear (such as sandals) is recommended since such sacred grounds must be visited only in barefeet (no socks either). Hats and sunglasses are usually appreciated, as is an umbrella for the rainy season. (May – September). Sunscreen will also be of use to travelers as Myanmar is a sunny place, especially in high season (Oct – April)
Health Issues
While no immunizations are formally required, malaria prophylaxis is sometimes recommended by traveler's personal physicians. Occasionally, typhoid, hepatitis, tetanus and Japanese encephalitis vaccinations are also recommended. Drink only bottled or boiled water and it is suggested that food not be purchased from sidewalk vendors. Insect repellent to prevent mosquito bites is recommended, especially up-country and in wooded areas. Recent news articles have mentioned a general increase in Dengue fever risk in SE. Asian countries.
* Travelers should also remember that temperatures in Myanmar are generally hotter than their home country and should pace themselves according to their fitness level to avoid any medical problems from over exertion or dehydration.
Domestic Airlines in Myanmar
The quickest and most comfortable mode of domestic travel is by flying. Modern ATR aircraft are used by Air Mandalay and Air Bagan (which also uses Fokker 100 jets). There is a 20 kg luggage limitation. When traveling up country excess baggage can be left until returning to Yangon. There are no domestic airport taxes to pay at the airports ( already included in tickets price ).
The voltage throughout Myanmar is 220-230 Volts AC. Because the voltage may be inconsistent, valuable or sensitive equipment like stereos and computers should have appropriate electronic protection. Electrical sockets may be two pronged, usually able to take round or blade style plugs though sometimes you need a 3 prong adaptor. The
most convenient solution is a universal adapter able to fit any of these configurations.
Cameras, ( including video ) are permitted in Myanmar. Restrictions on photography include military facilities and any structure considered strategic (including bridges and train stations though this last may be loosely enforced).
Mobile phones
Your mobile phone will not work in Myanmar unless you rent a SIM card to use. For GSM it is only necessary rent the SIM card. For CDMA it is necessary to rent a handset as well as the SIM card. You can rent them at the airport at Yadanarpon Counter(09-410 10018) near door no. 2 at the Terminal 1 of the International arrival airport. Rates as of September, 2011 are given, however they are subject to change.
Rental For GSM SIM card, CDMA 450, CDMA 800
SIM card per day
deposit of SIM card
CDMA Handset per day
deposit for Handset
Traveling to Myanmar is for many reasons special and the information provided below will help you prepare for the trip. Please take special note of the chapters marked with an asterisk (*).
We use the following 4 domestic airlines: Air Bagan, Air Mandalay, Asian Wings and Air Cambawza. All these airlines fly French-Italian ATR turboprop planes (Avions de Transports Régionaux), a type of plane well suited for the local conditions, airports and distances. The configuration is either 40 seats (ATR-42) or 70-seats (ATR 72) in rows of 4 seats with a middle aisle. Entry-exit is at the back of the plane. Standard One-class configuration.
Air Bagan operates 1 Fokker-100 Dutch-made jet aircraft with 95 seats, 12 of which are business class seats (Lotus Class - 3 rows of 4 with middle aisle). Economy class configuration is: 2 seats –aisle- 3 seats. Entry/exit is at the front of the plane.
We do not use Myanma Airways (domestic) flights (not to be confused with Myanmar Airways International). If passengers insist on flying Myanma Airways (if for example no other airline is flying to that destination), passengers will be asked to sign a Liability waiver.
The following airlines currently fly into Myanmar: Thai Airways, Bangkok Airways, Air Asia, Myanmar Airways International, Malaysia Airlines, Silk Air, Air China, China Eastern, Mandarin Airlines, Biman Bangladesh Airlines, Indian Airlines and Vietnam Airlines.
An international airport tax of 10 USD per person is payable cash in USD or FEC (Foreign Exchange Certificates) when departing Myanmar on an international flight. Departure tax is not charged for domestic flights.
Queue up at the immigration counters with a filled out arrival card and your passport with your visa stamped inside. After passing immigration, collect your luggage from the luggage belt and proceed to the customs counter. Hand over your filled-out customs form. Note that items of value and currency in excess of 2000 USD are supposed to be declared and taken again on departure, but in practice things are made quite easy for tourists. Also note that mobile phones and laptops are no longer kept in storage on arrival as is still claimed in some guidebooks.
There is no compulsory exchange of money anymore at the airport even for individual and independent travelers. Please DO NOT CHANGE money at the booth just behind immigration at the airport. The rate is much lower (50% less) than what you get in town.
US DOLLARS are accepted for change everywhere and the EURO is getting more and more popular, especially in Yangon. The exchange rate in Yangon is generally better than upcountry. If possible bring new series US Dollar bills ("big heads" instead of "small heads") and with series numbers not starting with CB as these are not accepted in Myanmar due to rumors of these series being counterfeit. Generally notes should be in very good condition and not torn, dirty or washed out as these will not be accepted in Myanmar, even in many hotels! Most hotels and better restaurants accept payment in USD.
Comfortable lightweight clothing in natural fabrics such as cotton is most suitable for traveling in Myanmar. The dress code is fairly casual as in most parts of the tropics but it is advisable to cover arms and legs in the evenings against biting insects. A lightweight raincoat and umbrella are a good idea in the rainy season and the umbrella can also offer useful shade from the sun.
Evenings in the hill stations and on Inle Lake can be quite chilly so bring a sweater or other warm clothing if visiting these areas. This applies especially for the winter months November-February for treks and the Inle lake area where early morning boat rides can be quite cold. Visitors should not wear shorts, short skirts or other skimpy clothing when visiting pagodas and monasteries.
Shoes (and socks!) must be removed before entering any religious building or private home. It is therefore useful to wear shoes without too many laces and which can easily be taken off. We provide small towels to clean your feet before putting back on your shoes.
Credit cards and Travelers Checks are currently mostly NOT ACCEPTED in Myanmar. Only some upscale restaurants and some hotels do accept credit cards with a surcharge (minimum 3%). As charging these cards requires going through the Internet, some delays can be experienced if the Internet connection is not working or slow (see chapter internet).
Please make sure to bring enough cash (USD or EUROS) for your purchases and payments. Most hotels accept US Dollars as payment. Please bring new series US Dollar bills ("big heads" instead of "small heads") and with series numbers not starting with CB as these are not accepted in Myanmar due to rumors of these series being counterfeit. Bank notes should be in very good condition and not torn, dirty or washed out.
Some roads in Myanmar are not in the best shape and most of the vehicles are also a bit older. For elderly people or those with health and back problems especially, we recommend avoiding longer road trips like Bagan to Kalaw or Inle Lake to Mandalay. In some places like Monywa-Po Win Taung, some jeep rides are planned. Please let us know in advance of people with back problems or who need special attention are traveling in order for us to make necessary arrangements.
Myanmar uses 220V, and a mixture of flat 2-pin, round 2-pin or 3 pin plugs. It is recommended to bring a universal plug adaptor. Power outages are quite common but most hotels have their own generator.
There is not much in the way of western style entertainment in Myanmar but Yangon has some good restaurants and there are a few bars and nightclubs, notably in the city's international hotels. In the rest of the country, entertainment is mainly confined to the hotels, mainly tourist-orientated restaurants and the ubiquitous Burmese teashops.
The staples of Burmese cuisine are rice, rice noodles, and curries (bot cari) . The main ingredient of the meal is usually rice and the curries tend to be not as spicy as those from India or Thailand. A clear soup called hingyo accompanies most meals and a fermented fish sauce or paste called ngapiye is usually served to add to the flavor. Chinese, Indian and European food is served in restaurants at most tourist places.
Myanmar is well known for its riches in precious stones, especially rubies (pigeon-blood) and jade (imperial-jade). Should visitors chose to purchase gems, they do so at their own risk and rely solely on their own judgment and knowledge. A & F Myanmar does not assume any responsibility for gem and antique purchases through "recommendations" made by our guides. Our guides are instructed not to recommend any specific shop. Even if pressed to do so by visitors, the sole responsibility for their purchase lies with the buyer.
A relative guarantee for the quality of purchases is given by an official receipt and certificate issued by government-licensed dealers. Prices in such shops are higher but are more credible and would theoretically allow you to return the purchase in case you are unhappy or if it is of lesser value. The issued paper can also be shown when exiting the country as export of gems and stones, and without such a government-issued paper are illegal.
No vaccinations are required except for yellow fever if you are coming from an area where the disease is present. However visitors should be inoculated against typhoid, cholera, hepatitis A & B, tetanus and polio. Malaria is present in Myanmar and it is advisable to take precautions especially if traveling off the beaten track. Please consult with your usual doctor or a doctor specialized in tropical countries before traveling.
Medical facilities are rather limited in Myanmar (Yangon has the best facilities) and it is essential to take out a good medical insurance policy before traveling. Such an insurance should cover the cost of an evacuation flight out of Myanmar (most of the time to Bangkok) which are sometimes necessary.
Offices are usually open from Monday to Friday from 09:30 until 16:00. Most shops are open every day. An exception is Bogyoke Market (Scott Market), which is closed on Monday, on public holidays and full moon days (like all markets in Myanmar).
Medical facilities are rather limited in Myanmar (Yangon has the best facilities) and it is essential to take out a good medical insurance policy before traveling. Such an insurance should absolutely cover the cost of an evacuation flight out of Myanmar (most of the time to Bangkok or Singapore) which is sometimes necessary either on a regular flight or on a special flight. For adventure tours, such as cycling, proof of purchase of a travel insurance policy will be required.
Internet access is still in its development stages. Internet is also regulated in Myanmar and the access to some websites is filtered or impossible. Note that most free mail services like Yahoo or Hot mail CANNOT be accessed in Myanmar. It is best to have your mail forwarded to A & F Myanmar (we will provide you with the right contact person) or the hotel e-mail address.
Most of the hotels have now some internet terminals and in cities like Yangon, Mandalay, Bagan and Nyaung Shwe (Inle Lake), you will also find some small internet cafés. Internet connections in Myanmar are generally slow and some patience will be required!
The national language of Myanmar is Burmese, of which there are over 80 different dialects spoken. The written language uses an amazing looking script based on ancient Indian characters. In the cities many of the older generation still speak very good English and it is also becoming popular again with the younger generation.
Your mobile phone will NOT work in Myanmar. Myanmar has currently no roaming agreement with any country. But prepaid cards in value of USD/FEC 50 (CDMA-450 MHZ) are available. USD/FEC 50 card is maximum 90 days validity once after activated. Clients can also rent mobile phones CDMA 450 & 800 MHZ with prepaid cards. These prepaid mobile phone cards are aimed at tourists visiting Myanmar who wish to keep in touch with friends and family.
The currency in Myanmar is the Kyat (pronounced 'chat'). As in many countries of the area, the US Dollar is the most useful currency to carry and it can be exchanged into local currency. However there is no need to change big amounts into the local currency as most of the places catering to tourists also accept payment in US Dollar bills. Furthermore the biggest kyat bill is 5000 kyats and 900 kyats equivalent approximate to 1 USD Dollar (subject to change).
Please bring new series US Dollar bills ("big heads" instead of "small heads") and with series numbers not starting with CB as these are not accepted in Myanmar due to rumors these series are counterfeit. The EURO is more and more accepted by money changers.
Credit cards and Travelers Checks currently CANNOT BE USED or exchanged in Myanmar (with some rare exceptions in upscale restaurants and hotels)! It is necessary to bring enough cash in US DOLLARS or EURO. Other foreign currencies are difficult to change.
There is a parallel official currency the FEC (Foreign Exchange certificate), which can be used (as you use cash US Dollars) to pay hotels, flight- train tickets, souvenirs, meals etc. It is at par (1:1) with the US Dollar but make sure to spend it before leaving Myanmar as it is valid only in Myanmar.
Banks are open Monday to Friday between 10:00 and 14:00. There is not anymore required to change 200 US Dollars into 200 FEC (Foreign Exchange Certificates) upon arrival at the airport.
Normal print films are available in Myanmar but professional quality films (like slide films) are very difficult to find and it is better to bring your own. In towns like Yangon, Bagan, Mandalay and Nyaung Shwe, digital photos can easily be downloaded and loaded onto a CD-ROM in case you run out of memory. It is not allowed to photograph facilities with strategic military interest (bridges, army compounds, police stations, army personnel, etc.).
Mobile telephones and laptop computers with modems are officially not allowed into the country but the rule is not enforced and they can be brought in. However mobile phones will not work in Myanmar, as the country does not have any roaming agreements. Items of jewelry, cameras and foreign currency (above USD 2000) are supposed to be declared at customs upon entry.
Export of Buddha images and antiques or articles of archaeological importance is prohibited. Gemstones can be safely bought only from government-controlled outlets and the buyer should ask for a certificate (please read more details under Gems/Precious Stones above).
January 4
Independence Day
February 12
Union Day
March 2
Farmer's Day (Peasants' Day)
March 19
Full Moon Day of Tabaung
March 27
Armed Forces Day
April 13-16
Water Festival
April 17
Myanmar New Year Day
May 1
Labour day ( May Day)
May 17
Full moon Day of Kasone
July 15
Full moon Day of Waso
July 19
Martyr's Day
October 12
Full moon Day of Thadingyut
November 10
Full moon Day of Tazaungmone
November 20
National Day
December 25
Christmas Day
Buddhism is the dominant religion in Myanmar and over 85% of the population practice it. The monastery is the traditional focal point of village life in Myanmar and monks rely on villagers for donations of both money and food. Every boy in Myanmar is expected to spend some time as a monk. The remainder of the population are Christians, Muslims and animists.
Road travel allows visitors to see more of the country and is a great way to get closer to the land and its people. However some distances are quite long in Myanmar, and they are even longer because road conditions make (relatively) fast travelling difficult. Roads are in poor conditions although efforts are being made to upgrade most roads especially after the yearly rainy season which ends in October. The relatively old vehicles used in Myanmar also make long distance travel less comfortable than in neighbouring countries.
There are many fantastic local products in Myanmar that make excellent souvenirs and memories from your trip. Traditional crafts include lacquerware, especially in Bagan, woodcarvings, stone carvings, bronze work, rattan, silver jewellery, silk longyis and hand-woven textiles.
Myanmar is 6h 30 min ahead of GMT in winter and 5h 30min in summer: 1500H GMT = 2130H in Myanmar (winter). Myanmar is 30 minutes behind Bangkok (Thailand) time: 1500H in Bangkok = 1430H in Myanmar.
Tipping for good service is not expected but is always appreciated in a country where the average annual income is only around 250 USD. It is customary, though not compulsory, to tip tour guides and drivers at the end of a tour. Hotel and station porters can also be tipped.
Vehicles used in Myanmar (from 4–seater saloon cars to 45-seater buses) are generally of an older manufacturing date (which can be 10-15 years back) as the import of new vehicles is currently not possible or prohibitively expensive, given the current economic situation in Myanmar. While every effort is made to provide the best possible and available options, visitors have to be prepared to travel in less comfortable vehicles than in neighbouring countries like in Thailand, Laos or Cambodia. We appreciate your understanding.
All vehicles do have air-conditioning and we provide all our clients with complimentary water and towels in ice-boxes in each vehicle.
A visa is COMPULSORY to enter Myanmar. A 28-day tourist visa is usually sufficient for most visitors. The current regulations for entering Myanmar are as following:
1. Individual visa
This visa is issued by a Myanmar Embassy or Consulate. An invitation letter is not mandatory, and it usually takes 3-5 working days to issue this visa. It is NOT REQUIRED anymore to change 200USD on arrival into FECs for the holder of a FIT visa.
2. Package Tour visa
This visa is issued by a Myanmar Embassy or Consulate. It usually takes 3-5 days to issue the visa. With the confirmation of your booking, A & F will send the letter to the Embassy. We will need the full names, passport numbers, nationality and name of Myanmar Embassy we have to send the letter. A copy of the letter will be send to you by fax or e-mail.
3. Visa on arrival
If the country you are living in doesn't have a Myanmar Embassy or Consulate, you can either send your application to the closest country with such a representation or ask us to arrange a Visa on Arrival (VOA). For a pre-arranged visa on arrival, please provide us passenger's full name, father's name, date of birth and place, Passport No, Issuance/Expiry date of passport, Nationality, Sex, Race, Religion, Occupation, Home address, Flights in/out and a scanned passport photo. The application process for visa on arrival will take at least 21 working days.
After getting the approval letter, we will send you a copy of this authorization by fax or scanned e-mail attachment. The letter should be presented at the airline check-in counter. Upon arrival in Myanmar you will get your visa stamped in your passport and pay 30USD/passport in cash at the airport (this fee can be included in your package price and we will then settle the visa fee for you). Our service fee for these arrangements is 20USD/passport and it will be included in your package rate. The service fee will be charged whether the visa application is accepted or not.
Please bring a supply of passport size pictures for any eventuality when traveling in the region (2 photos).
Myanmar has three seasons similar to many other parts of Southeast Asia. The Southwest monsoon starts at the end of May or beginning of June and lasts until the end of September. This season brings frequent and heavy downpours of rain, mainly in the afternoon and evening especially in Yangon, the rest of the country is dryer. In the rainy season the weather is more humid what can make travelling less comfortable. The rains give way to dry weather in October and the temperatures are generally lower and more pleasant at this time. In March the temperatures start to climb again leading up to the next rainy season at the end of May. Temperatures between March and May can be very hot reaching over 35oC in some places.
NOTE: Myanmar is in the northern hemisphere so it is also winter from November to February. You need to bring some warm clothing for early mornings everywhere, and especially for higher areas like Shan State (Kalaw, Inle Lake, Pindaya, Kengtung, Putao). The hotels in those areas are NOT equipped with heating or fireplaces so be prepared for some colder nights!
It is not advisable to drink tap water but bottled mineral water is safe and available everywhere. All hotels provide a complimentary bottle of local mineral water per person in the room. Ice cubes in drinks is generally OK in good standard hotels and restaurants but it is best to avoid it on street stalls or in country areas. Some minor stomach problems are always possible when travelling in exotic countries. Bring a supply of your usual anti-diarrhoea medicine.
Authentic, friendly and diverse is how most travellers to Myanmar, formerly known as Burma, describe this country, which has been one of the least accessible countries in the world up until very recently. The fact that the country has been inaccessible for so long has meant that Myanmar has been relatively untainted by the excesses of modern life and retains an aura of a bygone age.
Myanmar is the largest country in the South-East Asian peninsula stretching 2000km from north to south and over 900km from east to west and covering the area of Great Britain and France combined. Three quarters of Myanmar is covered by mountains and jungle and there are no less than 135 ethnic groups living in the country. Flat plains and wide rivers characterize the geography of the centre of the country while mountain ranges run along the Thai border up to the Himalayas in the east. The southern coast of the country borders the Bay of Bengal and the Andaman Sea. Myanmar's main river is the 2000km long Ayeyarwady River, formerly known as the Irrawaddy, around which most of the country's best farmland is found.
The main destinations visitors to Myanmar head for are Yangon, the former Rangoon of colonial times, Mandalay, the royal city surrounded by former ancient capitals, Bagan, with impressive ruins of the once famous Buddhist centre in Asia and Inle Lake with it's serene nature and colourful hill-tribes. As a destination Myanmar offers the authentic sights and sounds of Asia with great natural sceneries, magnificent archaeological sites, stunning pagoda and temple architecture, colourful bustling markets, impressive colonial buildings, and a very friendly, hospitable population: in Burmese language there is no word for tourist, there is only a word for guest!
Yangon, the former capital city, has an impressive colonial and spiritual heritage, which makes it one of the most fascinating capitals of Southeast Asia. Although a city of 4 million inhabitants, much of Yangon still retains a feeling of space, with wide tree-lined streets and many reminders of its colonial past.
Parts of the city look as if they have been transplanted from the shires of England with red brick houses surrounded by walled gardens. Fine examples of colonial architecture from the days of British India survive everywhere in the city especially around Sule Pagoda with the City Hall, the Supreme and High Court Buildings, the General Post Office, colonial offices on Pansodan Street and the beautifully restored Strand Hotel.
Yangon's most famous sight is the Shwedagon Pagoda whose giant golden dome and stupa dominate the capital's skyline. Originally built around 2,500 years ago to house eight sacred hairs of the Buddha, the pagoda has changed beyond all recognition over the centuries. The first structure was only 9 metres high and it was not until 1774 that it reached its current height of 107 metres. The great bell-shaped dome is covered with 60 tonnes of gold leaf and the top of the stupa is encrusted with thousands of diamonds, rubies and sapphires. On the bustling terrace build around the stupa you will see devote Buddhists from all around the country paying respect to the pagoda by offering flowers, pouring water over the different Buddha statues or shopping around in for Buddhist artefacts to take home. A mysterious and impressive place to visit around sunset.
The Sule Pagoda situated at the centre point of the city dates back over 2,000 years and has a 48-metre high octagonal golden stupa. The Kyauktagyi Pagoda is famous for its enormous 70-metre reclining Buddha and definitely worth a visit. The National Museum contains some interesting items including the 8 metre-high Lion Throne that was used by Burma's last monarch, King Thibaw, at the Royal Palace in Mandalay. In the small downtown area a stroll over Mahabandoola Street is a must to see how diverse the population of Myanmar is! Walking through Indian town you will encounter street-stalls with Indian spices, mosques and colourful Hindu temples. Arriving in bustling China town you can stroll over the night-market, visit the mysterious temples with a strong incense smell or do some shopping.
For souvenir shopping the place to head for is Bogyoke Market, a sprawling mecca for bargain hunters, established by the British in 1920s as Scott's Market. Here you can find an enormous selection of Burmese souvenirs including woodcarvings, lacquerware, basketware, Shan shoulder bags, colourful textiles "longgyis" used as sarong, monks' umbrellas, gems, jewellery and cheroots, the famous Burmese cigar. For dining Yangon offers a variety of restaurants influenced by Myanmar, Indian, Chinese, Thai or western cuisine; from a simple "mohinga" soup till a top-western restaurant.
An interesting day excursion from Yangon is Bago, 80km to the north west of the capital. Formerly known as Pegu, Bago was the capital of the Mon Kingdom in the 15th century and its Mon style Shwemawdaw Pagoda with its 114-metre high stupa is one of the most venerated in Myanmar. Bago is perhaps most famous however for its huge 55-metre reclining Buddha, known as the Shwethalyaung Buddha. Another day-excursion on the opposite site of Yangon River brings you through rice paddies and small villages to the famous pottery village Twante, idyllic situated along the river.
A 6-hour drive to the east of Yangon is Mon State home to one of Myanmar's most important Buddhist sites, the magnificent "Golden Rock" at Kyaiktiyo. A huge boulder covered in gold leaf and said to contain a hair of Buddha is perched on a cliff at the peak of Kyaiktiyo Mountain. An incredible sight in a beautiful area covered with trees.
The magnificent archaeological site of Bagan, 690km to the north of Yangon used to be one of the great Buddhist centres of South-East Asia. Bagan is a truly remarkable sight. Scattered over an arid plain by the banks of the Ayeyarwady River are some 3,000 pagodas, temples and other brick structures dating from the 11th to 13th century. Originally there were well over 10,000 temples, an impressive landscape of ruins and restored temples, unique in the world. At some of the temples you will be the only person around to enter or climb the structure from which you have a magnificent view over this historical side amongst rice fields and toddy palms. The area that covers more than 40 square kilometre is great to visit by horse cart, bicycle or by car!
Ananda Temple, one of Bagan's largest and best-preserved temples, is often referred to as Bagan's masterpiece. Built in 1905, the design of Ananda inspired the style of later Burmese temples of the Middle Bagan period. Ananda is a perfectly proportioned temple with a central gold pillar with further gilded spires in the four corners. The four huge carved teak Buddha statues facing out from the centre of the temple to the north, west, south and east are a feature of Ananda. Just next to Ananda is Ananda Okkaung, one of the few surviving brick monasteries from the Early Bagan period.
The largest and one of the oldest of Bagan's temples is the Shwezigon, with its beautiful bell-shaped stupa. Shwezigon Temple is one of the most important places of pilgrimage for the Burmese and is said to contain the Buddha's collarbone and one of his teeth. South of Shwezigon is the 13th century Wekkyi-in Gubyaukgyi Temple with its Indian-inspired pyramidal spire. The interior of this temple was originally decorated with fine frescoes depicting scenes from the jatakas but unfortunately many of these were removed.
Htilominlo Temple is a two-storey redbrick temple standing close to the road from Bagan to Nyaung U, the main town of the Bagan area. Built in 1211 by King Htilomino at a height of 46 metres it is one Bagan's larger temples. There are good views of the surrounding plain from the upper levels of Htilomino and some good examples of the original stucco decoration survive on the temple exterior. At 62 metres high, Thatbyinnyu Temple is the tallest of Bagan's structures. It was built in 1144 and is a classic example of Middle Mon architecture. The construction is based on two enormous cubes with wide terraces leading to the top.
Other temples that are worth seeing in the little-visited Minnanthu area include the 13th century Leimyethna with its frescoed interior, and Payathonzu and Nandamannya which both contain fine Sino-Tibetan influenced murals. To the east of Bagan is the massive Dhammayangyi Temple an impressive looking structure. Right behind Dhammayangyi is Sulamani Temple, a fine example of Late Bagan period temple architecture. The use of small bricks, arches and elaborate stuccowork of Sulamani are characteristics of this period.
One of the not-to-be-missed experiences in Bagan is to watch sunset (or sunrise for early-birds) at one of the old temples. The upper terrace of Myauk Guni Temple, the Shwenandaw temple or Tayoke Pyay at nearby Minnanthu are fantastic places to see the sun go down behind the mountains with a background of centuries old brick temples and the big Irrawaddy River. According to many tourists the most beautiful sunset in the whole country.
The village of Nyaung U is a perfect place to walk around the colourful market, where woman are smoking cheroots while selling their agricultural products. Apart from exotic fruits and vegetables the market also offers a good range of lacquerware and other souvenirs. In the nearby village of New Bagan or in Myinkaba a visit to a local lacquerware factory is certainly very interesting. According to a centuries old process different kind of plates, boxes etc are covered several times with lacquer before skilled craftsmen decorate the lacquerware with a traditional design, a very affordable and great souvenir of Bagan.
On the banks of the Irrawaddy River there are always women doing the laundry, men loading boats or children playing in the water. A boat-ride from here takes you over the majestic river with a beautiful landscape with the temples of Bagan on the east-bank of the river.
Just over 50km from Bagan is the extinct volcano known as Mount Popa. Rising to 1518 metres above sea level Mount Popa is the most magical of Myanmar's mountains and has been a place of pilgrimage for over 700 years. Myanmar's most powerful nats, Burmese spirits associated with natural features, are said to live here making Mount Popa the country's centre for nat worship. On the way to this interesting spirit-place you will pass several small villages where people climb until the top of the palm trees to collect toddy-juice to make toddy sugar or sweet cookies, a local delicatessen!
Mandalay & the North
Among the religious sites to visit in Mandalay are the Mahamuni Pagoda, famous for its venerable golf leaf covered Buddha statue and the nice covered hallway to the Buddha statue full of shops where all kinds of Buddhist artefacts are for sale like Buddha's, monks robes or pictures of famous monks. The beautiful Shwenandow Monastery is noted for the exquisite woodcarving that covers both the inside and outside of the building.
Another interesting religious site, the Kuthodaw Pagoda has 729 white marble slabs of Buddhist scriptures, giving rise to Kuthodaw's nickname "the world's biggest book". The slabs took eight years to complete and for a monk to recite the full scripture would take about two years!
Mandalay's Royal Palace complex, originally built in the 1860s by King Mindon, consisted of fabulously ornate carved teak buildings surrounded by moats. Unfortunately the buildings were completely destroyed in fighting at the end of World War II and have recently been rebuilt in concrete.
It is a 30-minute climb to the top of Mandalay Hill, from where there are commanding views of the city including the Royal Palace compound. This 236 metre-high hill dominates the town and is a favourite spot for locals and visitors to watch the sun set over the mountains, river and paddy fields around Mandalay.
Mandalay is well known for producing some of the best traditional handicrafts in Myanmar and there are many workshops in and around the city producing gold leaf, marble Buddha-sculpture, tapestries, woodcarvings and other handicrafts. A visit to the simple workshops is truly a visit back in time.
A not to be missed day trip from Mandalay takes you to the former capitals cities of Amarapura, Ava and Sagaing. The 18th century capital of Amarapura is the site of the largest monastery in Myanmar, the Mahagandayon Monastery, which has over 1,000 monks. The 1.2km long U-Bein Bridge was built over 200 years ago from teak taken from the Ava Royal Palace and is always a lively place where you will see people walking over the bridge carrying all kind of goods to the other side of the small lake. Ava, also known as Inwa, was the capital between the 14th and 18th centuries. After crossing the river you can take a horse cart and enjoy a great ride passing villages and ruins of the former capital. The beautiful teakwood Bagaya Kyaung Monastery is a quiet stop on the way, hidden in a picturesque scenery with toddy-palms, rice-fields and ox-carts ploughing the fields. Sagaing, on the opposite bank of the Ayeyarwady River is generally regarded as the religious hub of the country with over 600 pagodas and monasteries. From the top of the hill you have a fantastic view over the area dotted with white pagodas.
Mingun, an old city at the other side of the Irrawaddy River is perhaps the most interesting city around Mandalay to visit on a day trip. The boat trip on the Irrawaddy River gives a great view at the bustling banks of the river and people on passing sail boats (with sails often made out of cotton sarongs) will certainly start waving to welcome you. After a 1 ½ hour boat ride a stroll through the nowadays small village brings you to the huge bell of Mingun and the brick unfinished-pagoda with it's impressive crack caused by an earthquake.
Around 140km to the west of Mandalay on the east bank of the Chindwin River is Moniwa, a typical Burmese town. Moniwa is the major trading centre for agricultural products from the surrounding Chindwin Valley. The Thanbokde Pagoda with its 6,000 Buddha images, the Boddhi-tataung Pagoda with its grove of 1,000 sacred banyan trees and the huge reclining Buddha are the main sights of Moniwa. On the opposite bank of the Chindwin River are Po Win Daung Caves, a recently opened extraordinary complex of caves containing thousands of mural paintings showing daily life at the Royal Court, some dating back to the 14th century.
A short drive to the east of Mandalay on a plateau 1,000 metre above sea level, is the former British hill station of Maymyo, now known as Pyin U Lwin. Many reminders of the colonial era are still present in Pyin U Lwin, including brick and timber houses with British names, the old clock tower and the recently renovated botanical gardens in the south of town. A visit to the market and a drive around town or to the gardens in one of the many antique horse carts is not to be missed. Train fanatics shouldn't miss the ride from Mandalay to Maymyo, a beautiful track with stunning views and a zig-zag system to climb forward and backward upon the mountain.
Inle Lake & Shan State
The beautiful Inle Lake is one of the must see destinations on a Myanmar tour. Over 1,300 metres above sea level, the 22km long lake is in a picture postcard setting encircled by wooded hills. Inle is home to the Intha people and is famous for its unique leg-rowing fishermen. Travelling on Inle Lake by motorboat is an exhilarating experience for nature lovers and a chance to observe the unique traditions of the Intha people: the leg-rowing fishermen, the "floating gardens" (built up from strips of water hyacinth and mud and anchored to the bottom with bamboo poles). A trip also features Ywama, one of the floating villages, Phaung Daw Oo pagoda, the main shrine on the lake and local handicrafts industries (traditional weaving, silversmiths and cheroot, the typical Burmese cigars). The beautiful teakwood Nga Phe Kyaung Monastery build on stilts on the lake is one of Myanmar's most unusual religious sites with its hoop-jumping cats. In the villages around the lake a local market is organised on a 5-day rotating schedule. A very colourful and authentic place to visit since all kind of hill-tribes in traditional clothes come and visit the market from the surrounding mountains. By canoe you can visit the smaller canals and less visited villages built on stilts on the lake.
Kakku is a hidden treasure, 46 kilometres south of Taunggyi with an unusual, magnificent collection of centuries old Buddhist stupas. More than 2000 stupas lie here in a small area of just one square kilometre, surrounded by mountains and trees. Until very recently this area, which is inhabited by the colourful Pa-O tribes with their distinctive habits, was closed for tourist. A 2-hour drive (or a 5 hour trekking through rice-fields and Pa O villages) will take you from Nyaung Shwe to Kakku, passing the capital of Shan State; Taunggyi. A Pa O guide will lead you around the area and introduce you to the customs and life of the Pa O people when you visit one of the villages.
Kalaw is another former British hill resort in the west of Shan State and about 70km from Inle Lake. Kalaw is a little higher than Pyin U Lwin at 1,320m but has a similar faded colonial atmosphere with its ramshackle country houses and other colonial buildings. The cool mountain air, pine forests and ethnic minority villages make it the perfect starting point for good trekking in and around the Kalaw area. During a day-trek you can visit several Palaung and Danu village and have lunch on the way. If you want to have a more adventurous trekking it is possible to do a 3-day monastery trekking from Kalaw to Inle Lake. During the trekking a local English-speaking guide will accompany you to explain more about the traditions of the different hill-tribes. Porters will go with you to carry the food and other luggage. Simple accommodation is arranged in the local villages in the mountains in the monastery of the village, a unique experience! The main luggage will by transported by car directly to the hotel where you arrive after the trekking.
The road from Kalaw to Pindaya is very scenic with panoramic mountain views passing area's where often people are working on the fields. Pindaya is famous for its caves carved out of a limestone ridge overlooking a small lake in the middle of the town. The caves contain over 8,000 Buddha images, all in different size and shape that are spread out in the cave, whatever direction you look you will see Buddha statues.
Kengtung, Myanmar's gateway to the Golden Triangle, is a small town, often compared to Chiang Mai 50 years ago, a treasure trove of traditional architecture with old style houses and their intricately designed wooden balconies so characteristic of Shan architecture. A great area to visit the different ethnic minority communities of the Golden Triangle area as the red clothed Palaung tribe, the Akha people or the Lahu tribe. Make certainly a stop at the beautiful Pin Tauk Waterfall. Further places to visit in and around Kengtung are the market, the meeting point for many hill tribe people, a traditional pottery workshop, the village of colourfully dressed Li Shaw people and the unique Wan Kwan mud houses.
Inle Lake & Shan State Highlights
Western Myanmar
Western Myanmar is made up from Rakhine State, formerly known as Arakan, and Chin State, bordering Bangladesh and India. The main attractions of Western Myanmar are the ancient city of Mrauk U in Rakhine State and the deserted sandy beaches on the Bay of Bengal. A newly opened area is Mount Victoria in Chin State, the over 3000 meter high mountain is part of a beautiful National Park, a great place for people who like adventurous expeditions to places where only a few people go, and who don't mind a lack of international facilities.
Back in its 15th century heyday Mrauk U was one of the richest cities in all of Asia but today the town is more like a sleepy village. There are however still many places of interest to visit in the ruins of this once great city including the well-preserved Shittaung Temple, Laungbanpyauk Pagoda, with its exquisite carvings, the ornate Sakyamanaung Pagoda and the largest of Mrauk U's stupas, Yadana Mannaung. Also of interest are the ruins of the Royal Palace and the Archaeological Museum. From Mrauk U it is easy to make a daytrip to the nearby local Chin villages. One of their most unique customs is the tradition for women to tattoo entirely their face. Mrauk U is reached by a 5-hour boat journey on the Kaladan River from Sittwe, the capital of Rakhine State.
Chin State is an area in the west of Myanmar bordering India and Bangladesh. A state that was until recently closed to foreigners but that is partly opening. The mountainous area is offering great views and astonishing landscapes! Visit the small villages where it looks if time stood still for centuries. People are working in the paddy fields while in the villages some older men are sitting peacefully at the local teashop enjoying their hand rolled cigarette. Kanpetlet (at almost 1400 meter altitude) is a small village built at the foot of Mount Victoria (3.150 meter). The views from the village are simply breathtaking! Kanpetlet is inhabited by the Chin people who are having their own culture and language. During the Bagan period (11th century) the Chin people were afraid that their women were taken to serve the king in Bagan; therefore the woman started to tattoo their face to make themselves too strange for the Bagan kings to be asked to come and live in Bagan, so they could stay in the mountains in Chin State. Starting from Kanpetlet excursions to Nat Ma Taung National Park can be easily made. The beautiful park covers a big area with dense jungle forest, pine trees at a higher altitude and finally oak trees at the second base camp. Not only is there a diverse flora, also the fauna is unique with many kinds of rare, colourful birds (as for example horn bird). Mount Victoria is the highest mountain in the park, with superb views from the top! A trekking to the top is not as hard as it sounds since it is possible to go up to the second base camp by jeep from which it is only a 2 ½ hour walk to the top. An expedition to Mount Victoria is only possible in the dry season (October – April), keep in mind that the jeep tour to Mount Victoria is partly over unpaved roads and only very primitive shared accommodation is available.
Myanmar's best beaches are to be found 200km to the south of Mrauk U on the Bay of Bengal. Ngapali is the country's premier beach destination and has long stretches of sandy beach, swaying palm trees and some very nice small-scale hotels. From the small fishing village of Ngapali you can make a day tour by boat to "treasure-island" for snorkelling, have a ride around the rice-fields by bicycle, or just enjoy the empty beach and the clear and refreshing sea and have some delicious and cheap fresh seafood.
Further south, near to the city of Pathein, is Ngwe Saung, another area with a 14 km long pristine sandy beach, a clear blue sea and palm trees. This newly opened beach destination has some charming, international standard hotels (with swimming pool), offers different kind of water sport activities and serves excellent seafood. A charming tourist class cruise boat with private cabins started recently with interesting overnight boat trips through the green Irrawaddy Delta to Pathein, which can be reached in less then 2 hours by car from Ngwe Saung Beach. An excellent alternative for Ngapali if you want to combine sightseeing in the Irrawaddy Delta with a boat cruise and a stay at a pristine beach.
Western Myanmar Highlights
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Background: Both greater body size and higher mammographic density seem to be associated with a risk of breast cancer. To understand a mechanism through which body size confers a higher risk of breast cancer, associations between mammographic measures and various measures of body size were examined.
Method: Study subjects were 730 Korean women selected from the Healthy Twin study. Body size measurements were completed according to standard protocol. Mammographic density was measured from digital mammograms using a computer-assisted method from which the total area and the dense area of the breast were calculated, and nondense area and percent of dense area were straightforwardly derived. Linear mixed models considering familial correlations were used for analyses.
Results: Total and nondense areas were positively associated with current body mass index (BMI), BMI at 35 years, total fat percent, waist circumference, and waist-hip ratio, whereas percent dense area was inversely associated with these characteristics in both premenopausal and postmenopausal women. Height was not associated with any mammographic measure. Total and nondense areas had strong positive genetic correlations with current BMI, total fat percent, waist circumference, and waist-hip ratio, whereas percent dense area had strong inverse genetic correlations with these body size measurements.
Conclusion: Mammographic density and obesity are inversely associated with each other possibly from common genetic influences that have opposite effects on mammographic density and obesity in Korean women.
Impact: The association between obesity and breast cancer does not seem to be mediated through mammographic density. Cancer Epidemiol Biomarkers Prev; 19(6); 1523–31. ©2010 AACR.
Mammographic density reflects the relative amount of connective and epithelial tissue (dense area) and fat tissue (nondense area) in a breast (1, 2), which varies among women. Higher mammographic density has been found to confer a greater risk of breast cancer than does lower mammographic density (1, 3-11). Even in nonwhite women with a lower incidence rate of breast cancer compared with Caucasians, higher mammographic density is associated with an increased risk of breast cancer (12, 13).
Body size indices such as body mass index, waist circumference, waist-hip ratio, and height have been found to be associated with breast cancer risk (14-17). Taller (16) and more obese postmenopausal women (14, 15, 17, 18) tend to have a higher risk of breast cancer. The underlying mechanism for the relationship between body size indices and breast cancer risk is still uncertain, and greater height and obesity may increase the risk of breast cancer through their effects on the components of breast tissue. However, the associations of body size indices and mammographic density have not been in accordance with the associations between the body size indices and breast cancer in studies of Western populations (19, 20) as well as of Singaporean Chinese women (21, 22). Replication of these findings in other Asian populations would provide strong evidence that body size increases the risk of breast cancer through another mechanism than their influence on breast tissue components.
In this regard, we conducted a twin and family study in a general Korean population to evaluate the relationship between mammographic measures and various measures of body size considering menopausal status. The association between mammographic measures and body size characteristics considering menopausal status is worth examining, given that more obese women have an evidently increased risk of breast cancer only in their postmenopausal years. Investigating families from the general population not selected by their health status and using the various family relationships enabled us not only to examine the association, but also to explore the possible shared genetic factors influencing between body size measurements and measures of mammographic density.
Materials and Methods
Study participants were female members from the Healthy Twin study who had received a mammogram and had body size measurements taken during a routine health examination. Participants were not ascertained by their health status or breast diseases. Details on overall methodology of this multicenter cross-sectional survey have been previously published (23). From April 2005 to December 2007, a total of 2,278 Korean adult (≥30 years of age) twins and their first-degree adult family members were recruited. Among the 734 women who received a mammogram, four were excluded because they were shown to be genetically unrelated with their family by genetic tests. Thus, 730 women from 341 families were finally included in the analysis, with 122 pairs of monozygotic twins, 28 pairs of dizygotic twins, and 430 female family members among them.
All mammograms were taken using the same full-field digital mammography system (Senographe 2000D/DMR/DS, General Electric Company) in female participants if they were age ≥40 years at the time of participation in the study, or were willing to undergo a mammogram. A single observer measured one cranio-caudal view of the right breast of each woman using a computer-assisted thresholding technique called Cumulus, in which the total area of the breast and the area of dense tissue are measured. Nondense area and percent dense area were straightforwardly derived. This measure has been shown to be highly reproducible and reliable (24).
Mammograms were randomized first by family into reading sets of approximately 100, ensuring that all twins and/or relatives of the same family were measured in the same set. The reader was blinded to all identifying information, and a 10% random sample of repeats was included in each set and between every third set to test the reliability of the measurement.
Body size measurement
All measurements of body size for each participant were completed twice by trained research assistants, and the average value of two measurements was used for the analysis. Body weight (kg) was measured to the nearest 0.1 kg using a digital scale with the participant in light clothing and wearing no shoes. Height (cm) was measured to the nearest 0.1 cm using a stadiometer while the participant stood with heels together, arms to the side, legs straight, shoulders relaxed, and the head positioned so the gaze was straight ahead. Body mass index (BMI) was calculated as the weight divided by the height squared (kg/m2). Waist circumference (WC) was measured (cm) at the narrowest area between the lower margin of the rib cage and iliac crest as viewed from the front while the participant stood erect with arms at the side. Hip circumference (cm) was measured at the point of greatest circumference around the buttock with the participant standing. Waist-hip ratio (WHR) was calculated by dividing the waist circumference by the hip circumference. Total percent fat was measured using a Lunar Prodigy version 8.50 dual-energy X-ray absorptiometer (Lunar Radiation/Delphi W, Hologic). Total fat percentage was calculated as fat mass divided by the sum of fat mass, lean mass, and bone mineral content.
A self-administered questionnaire collected information pertaining to weight at 20 years of age and at 35 years of age (if applicable), health behaviors (smoking, alcohol consumption, and physical activity), reproductive history (age at menarche, age at first childbirth, live birth, duration of breast feeding, menopause, use of oral contraceptives, and use of hormone replacement therapy), and medical and demographic characteristics (age, education level). An additional face-to-face interview was carried out by a trained interviewer to clarify incomplete or ambiguous responses.
Zygosity of twin pairs was identified by 16 short tandem repeat markers (15 autosomal short tandem repeat markers and one sex-determining marker) in 67% of twin pairs. For the remaining 33% of twin pairs, zygosity was determined by a self-administered zygosity questionnaire that was validated as being 94.3% accurate through a short tandem repeat marker study (25).
All participants provided written informed consent when they visited one of the study centers. The study protocol was approved by the Korea Center for Disease Control and the institutional review board of the three participating centers (Samsung Medical Center, Pusan Paik Hospital, and Dankook University Hospital).
Statistical analysis
Intraclass correlation coefficients were estimated to assess reliability of repeated measurements of mammographic density within reading sets. Age-adjusted residuals of each of the mammographic measures were inspected for normality, and log transformations were applied to all of the mammographic measures.
As mammographic density is strongly associated with age, age-adjusted measures according to body size level were calculated using analysis of covariance. Linear trends of the mammographic measures with the body size measures were examined using age-adjusted linear regression analysis.
Associations of body size characteristics with the mammographic measures were evaluated using mixed linear models in which household and twin effects were adjusted as random effects and other covariates (age, smoking, alcohol consumption, physical exercise, educational level, number of live children, age at birth of first child, duration of breast feeding, and use of oral contraceptives) were adjusted as fixed effects. Correlation structures from family relationships were adjusted by using a mixed linear model, in which both family (as family number) and twin (as twin number) effects were considered as random effects (26). For postmenopausal women, hormone replacement treatment was added in the model as a fixed effect.
To ascertain evidence of common genetic regulation between percent dense area and body size indices, we conducted bivariate variance-component-based genetic analysis to partition the phenotypic correlations into genetic (ρG) and environmental correlations (ρE) using SOLAR (Sequential Oligogenic Linkage Analysis Routines) version 2.0 (27). The bivariate variance-component analysis allows examining whether the correlation between two or more phenotypes of an individual and among family members is concurrently determined by shared genes and environments. If a significant genetic correlation existed, it was considered evidence of pleiotropy, genetic effect of a single gene on multiple phenotypic traits, or common genetic factors influencing both phenotypes through shared pathways. To estimate independent genetic correlations, age was adjusted at first and then other covariates were adjusted additionally.
When we estimated the reliability of mammographic density measurement in 65 randomly chosen women, intraclass correlation coefficients between the repeated measurements for total area, dense area, nondense area, and percent dense area were 0.99, 0.98, 0.97, and 0.98, respectively.
Tables 1 and 2 show the characteristics of participating women and the distribution of the mammographic measures according to quartiles of body size characteristics. Women with higher current BMI, higher BMI at 20 and at 35 years of age, higher total fat percent, higher WC, and higher WHR had greater total and nondense areas, and less percent dense area (all P < 0.001). Dense area was inversely associated with current BMI (P < 0.05), WC (P < 0.01), and WHR (P < 0.01). There was no relation between height and any of mammographic measures (all P > 0.05).
Table 3 shows the associations between the body size characteristics and the mammographic measures by menopausal status. Consistent with Table 2, in both premenopausal and postmenopausal women, total and nondense area were positively associated with current BMI, total fat percent, WC, and WHR, whereas percent dense area was inversely associated with those characteristics. The inverse associations found between dense area and current BMI, WC, and WHR existed in premenopausal women only (all P < 0.01). Height was not associated with any of mammographic measures in both premenopausal and postmenopausal women.
Table 4 shows the analysis of additive cross-trait correlations between the mammographic measures and body size characteristics. Total and nondense area showed strong positive genetic correlation with current BMI, total fat percent, WC, and WHR, whereas percent dense area showed strong inverse genetic correlation with these body size measurements (all P < 0.01). There were significant but weak inverse genetic correlations between dense area and current BMI, WC, and WHR (all P < 0.05). The estimates of genetic correlation did not change materially when covariates were fully adjusted (Table 4).
In this Korean female twin and family study, we found that body size characteristics that describe obesity were associated with mammographic measures, whereas height was not associated with any of the examined mammographic measures. Our study has its unique strength in several aspects. First, we examined the relationship of mammographic density with various measures of obesity, including abdominal obesity and BMI level at various ages. Second, we examined genetic correlation between mammographic density and body size characteristics using various types of family relationships, including monozygotic twins and nontwin family members.
Consistent with results from previous studies involving Western populations (19, 28-30), measures of obesity had strong positive associations with nondense mammographic area, whereas it had a weak inverse association with dense area. Menopausal status did not confer any difference in the associations between the body size characteristics and the other mammographic measures.
Findings from bivariate analysis suggested that pleiotropy exists between measures of obesity and mammographic density. General and localized adiposity had strong positive genetic correlations with nondense area and weak but significantly inverse correlation with dense area. These findings are compatible with the findings regarding the associations between obesity and mammographic density, and indicate that common genetic factors regulate both general obesity and the nondense area of the breast.
Because percent dense area reflects the relative proportion of parenchyma (dense area) over total breast area (sum of the parenchyma and fat tissue), both dense and nondense areas directly influence the percent dense area. In this study, dense area decreased only slightly with increasing adiposity, but nondense area increased more, which resulted in a strong negative association between obesity and percent dense area.
The biological mechanism explaining the association between obesity and nondense area is still unclear. Given that fat tissue is a major component of mammary nonparenchymal tissue (nondense area), it is plausible that an obese woman could have greater nondense area in mammography regardless of the absolute dense area, and accordingly lower percent dense area, which in theory should lower the risk of breast cancer in obese women. This hypothesis on the adiposity-mammographic density-breast cancer relation is compatible with the commonly observed lower risk of breast cancer in obese premenopausal women (31, 32), and it may be probable that adiposity acts on breast cancer risk through mammographic density in premenopausal women. However, the greater risk of breast cancer in obese postmenopausal women (18, 33) contradicts this hypothesis, and it is less likely that the association between obesity and breast cancer is mediated through breast tissue subcomponents reflected in mammographic density among postmenopausal women.
Evaluations of the relationship among body size, mammographic density, and breast cancer risk have shown that the positive association between obesity and breast cancer becomes stronger with an adjustment for mammographic density, particularly measures that reflect percent dense area, and that the positive association between mammographic density and breast cancer becomes stronger with an adjustment for obesity in both premenopausal and postmenopausal women (6, 28, 34). These findings suggest that obesity and mammographic density independently play a role in the association with breast cancer, rather than a role as a mediating factor (28).
In accordance with this, a randomized controlled trial showed that mammographic density was weakly influenced by level of estrogen (35, 36), whereas obesity renders its main effect on the risk of breast cancer through its effect on estrogen level, especially in postmenopausal women (9, 37, 38). Although some cross-sectional studies reported a positive association between mammographic density and estrogen levels (39, 40), many other studies reported no or inverse association (41-43) when BMI and other risk factors of breast cancer were adjusted. These findings further suggest that adiposity does not act on breast cancer risk through mammographic density at least in postmenopausal women.
Mammographic density seems to be associated with level of insulin-like growth factor-I (IGF-I; refs. 41, 44-48), especially in premenopausal women (39, 41, 44, 45). Several meta-analyses in which most studies included had controlled for obesity level found that IGF-I level was positively associated with breast cancer, especially in premenopausal women (49-51). Although some exceptional findings exist (40, 52), prolactin level also has been positively associated with mammographic density in both premenopausal (39) and postmenopausal women (41, 53), and a positive association between prolactin level and breast cancer risk independent of BMI level has been reported (54-56). Those findings suggest that IGF-I and prolactin may affect breast cancer risk, at least in part, through their influence on breast tissue morphology as reflected on mammogram.
The inverse association between general adiposity and percent dense area, as well as the inverse additive genetic correlation between them, regardless of menopausal status, suggests a more complex scenario underlying the association of obesity with breast cancer. One possibility is that in the general population local adiposity in breast tissue predominates rather than the hyperplasia of parenchyma from the hyperinsulinemia induced by obesity, whereas in those who are susceptible to breast cancer the parenchymal hyperplasia outgrows or matches increased adiposity. This possibility is supported by the finding of negative associations among weight, BMI, and area of dense tissue in controls but not in those with breast cancer (28).
As our study was done in community-dwelling women and only one breast cancer case was included, we could not examine whether the association between dense area and obesity would differ in the presence of breast cancer. A logical next step would be to explore whether there are genetically susceptible subgroups that are more vulnerable to increased adiposity, or whether there are certain susceptible time windows when both breast parenchymal tissue and adiposity increase and result in an increased risk of breast cancer.
In our study, height was not associated with any of the mammographic measures and, in accordance with this finding, there was no significant genetic correlation between the two. This finding is compatible with findings from previous studies (28, 30) and suggests that height does not operate through relative proportion of breast tissue components manifested in mammographic density on the risk of breast cancer.
To date, the association between breast cancer risk and mammographic density has been established using film-screen mammograms, not digital mammography. However, given that digital mammography has been shown to be similar to or more sensitive than film-screen mammography in overall diagnostic value and in detecting breast cancer (57, 58), it is unlikely that our findings were affected by the use of digital instead of digitized film images. Also, all of the mammograms measured in this study were taken using the same type of digital mammography machine, eliminating any potential bias due to image processing.
In conclusion, mammographic density and measures of obesity were inversely associated with each other, and an inverse additive genetic correlation exists between them in Korean women. The association between obesity and breast cancer, especially in postmenopausal women, does not seem to be mediated through mammographic density.
Disclosure of Potential Conflicts of Interest
The authors have nothing to disclose.
Grant Support: National Genome Research Institute, Korea, National Institute of Health research contract (budgets 2005-347-2400-2440-215, 2006-347-2400-2440-215, 2007-347-2400-2440-215, 2008-E00255-00, 2009-E00500-00), Korean Ministry of Education, Science and Technology, (Grant Number M10305030005), and by the Samsung Biomedical Research Institute (SBRI C- A9-218-1). The views expressed in this paper are those of the authors and not necessarily of any funding body.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
- Received September 26, 2009.
- Revision received March 10, 2010.
- Accepted March 29, 2010.

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Home > AJTE > Vol. 37 (2012) > Iss. 2
Australian Journal of Teacher Education
Volume 37, Issue 2 (2012)
Journal Articles
Moving Physical Activity Beyond the School Classroom: A Social-ecological Insight for Teachers of the facilitators and barriers to students' non-curricular physical activity
Brendon Hyndman, Amanda Telford, Caroline F. Finch, and Amanda C. Benson
Understanding Learning and Teaching in Papua New Guinea: Elementary Teacher Trainers Engaged in Cultural Authorship in the Context of National Educational Reforms
Joanne M. Brownlee, Ann Farrell, and Julie Davis
Pre-service Chemistry Teachers' Expectations and Experiences in the School Experience Course
Zubeyde D. Kirbulut, Yezdan Boz, and Elif S. Kutucu
Teacher Professional Development: Who is the learner?
Kirsten Petrie and Clive McGee
Grammar Teaching Revisited: EFL Teachers between Grammar Abstinence and Formal Grammar Teaching
Ahmad Nazari and Negah Allahyar
Listening to Unheard Voices: Professional Development Reforms for Pakistani Tertiary Teachers
Imran Anjum Chaudary and Shahida Imran


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Inland Empire Council for the Social Studies Bringing Social Studies to Teachers in the Inland Empire A California Council for the Social Studies Affiliate
U.S. – Cuban Relations: Are the Two Nations Ready for a Meaningful Change?
Tuesday, May 17, 2016 4:30 – 6:15 pmSBCSS West End Educational Services Center
8265 Aspen Ave., Rancho Cucamonga
U.S. – Cuban relations have dominated the international news since December. Under Raul Castro, Cuba is changing rapidly. Restored diplomatic ties and a visit by President Obama, the first American president to travel there since the 1920's make it seem like all is ready for change. Congressional resistance to lifting sanctions and Fidel Castro's response to Obama's visit with an anti-American protest letter on state media, saying: 'We don't need the empire to give us any presents" remind us that change still has many costs as well as benefits.
What can we expect from the people and the regime just 90 miles from America's shore?
Tuesday, May 17th, Dr. Paul Ryer, UCR anthropologist, who has been studying Cuban identity both inside Cuba and among those who have fled or migrated, has seen the changes first hand. He will share his experiences and insights and answer of our questions.


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For an orchestra to develop its maximum potential it takes not only competent and self-assured musicians, but also an outstanding conductor with strong leadership skills – in other words someone who can both lead and motivate. This combination of strengths is exactly what should characterise the working relationships in companies, executive boards and project teams. In this regard, business life is in harmony with the world of music: success depends on cooperation founded on motivation and leadership.
I put my professional know-how and experience into action for the benefit of my clients to help them achieve their business goals. Solid professional training, a long career in the financial sector and my experience as a member of various Executive Boards and Boards of Directors enable me to analyse business problems rapidly and tackle them in a solutions-oriented manner.
Please do not hesitate to contact me if you believe this combination of know-how, competence and experience can be of service to your business goals and problem-solving in your company. Sincere thanks in advance for your interest and I look forward to hearing from you.
Roland Frey


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Author(s): Justin D'Ath
Sixteen-year-old Sunday Balewo is next in line for the presidency of Zantuga. When his father dies, Sunday finds himself on the run from the unlikeliest of assassins - a baboon with a bomb. Not just an action-packed thriller, but a novel about friendship, loyalty and the value of life itself.
Justin D'Ath lives in Queenscliff, Victoria. He has written 50 books for children and young adults. His 12-book Extreme Adventure series have been published worldwide and made into a popular TV series. His YA novel, Pool, was short-listed in the Victorian Premier's Awards. He has written six CBC Notable Books and gained five Yabba/Koala nominations. Also by Justin D'Ath: Pool, Extreme Adventures series, Mission Fox series, Lost World Circus series and Stuff Happens: Cooper.


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Box Score – Ripon / Box Score – Minnesota-Morris
CLERMONT, Fla. – The University of Scranton softball team bounced back from a pair of setbacks on Sunday with two wins on Monday to improve to 4-2 on its Spring Break trip. The Royals (4-2) opened the day with a 4-2 victory over Ripon before edging out Minnesota-Morris in its second contest of the day, 6-5.
Game 1 vs. Ripon
In Monday's first game against Ripon (3-6), Scranton built a 4-0 lead after four innings and held off the Red Hawks to post the 4-2 victory.
The Royals took a 1-0 lead in the top of the third inning when Molly Hampsey (Tunkhannock, Pa./Tunkhannock) scored on a wild pitch.
Scranton extended its advantage to 4-0 in the visitor's fourth by plating three runs on four hits. Cyan Scarduzio (Ossining, N.Y./Ossining) and Kaitlyn Brogan (Oreland, Pa./Saint Basil Academy) hit back-to-back RBI doubles before Brogan scored on an infield single off the bat of Hampsey.
Ripon hit a pair of solo home runs in the bottom of the seventh inning before Morgan Rentzheimer (Allentown, Pa./Parkland) shut the door, closing out a complete game win with nine strikeouts and six hits against.
Scarduzio led Scranton with at 3-3 performance at the plate including a double, an RBI, and a run scored. Hampsey and Casey DeSarno (Wall Township, N.J./Wall) added two hits apiece for the Royals, who outhit the Red Hawks, 11-6, in the victory.
Game 2 vs. Minnesota-Morris
In the Royals' second contest on Monday against Minnesota-Morris, Scranton scored all six off its runs in the first inning and held off a comeback attempt by the Cougars (2-10) to notch a 6-5 victory.
The Royals' big first inning came on five hits and one error. Scranton's first two runs came when
Anna Price (Bordentown, N.J./Bordentown Regional) reached on an error before Rentzheimer and Scarduzio delivered RBI base hits to make it a 4-0 game.
Brogan then connected on a two-run double to give Scranton a 6-0 advantage.
Minnesota-Morris got three runs back in the top of the third inning and added single runs in the fifth and sixth innings, but the Royals were able to shut the door for their second win of the day.
Rentzheimer and Scarduzio led Scranton with two hits apiece as Scranton outhit the Cougars 9-4 in the contest.
Jennifer Sweeney (Dumont, N.J./Dumont) picked up the win in the circle after allowing two runs – only one of which was earned – on three hits while fanning five batters in six innings of work. Caitlin Long (Ho Ho Kus, N.J./Northern Highlands Regional) worked one inning and surrendered three unearned runs with one hit against.
Up Next
Scranton will enjoy a day off before returning to the diamond on Wednesday when they will take on Concordia (Wis.) at 2:00 p.m. followed by a 7:00 p.m. game against the Massachusetts College of Liberal Arts.


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The bills are due, the children want to play sports and take dance lessons, and your spouse hasn't paid child support in months so what can you do?
If you and your spouse agreed to child support in a separation agreement then you have a contract with your spouse on this issue. If your spouse or former spouse isn't paying as agreed you can sue for breach of contract. If you have a court order for child support you can ask the court to enforce the order through its contempt powers. There are also many other avenues. Failure to pay child support can result in tax refunds being redirected to pay the child support, wage garnishment, credit bureau reporting, passport denial, drivers license revocation, professional license revocation, lien on property, bank account levy, or even jail time. You cannot deny the noncustodial parent visitation because child support is not being paid as agreed.
In NC the Department of Social Services provides child support services to custodial parents. If your spouse or former spouse is behind on child support or refusing to pay support you can find more information at North Carolina Child Support Enforcement website. If child support was court ordered and is being sent through the Centralized Collections office you can also check the status of payments on the website above. If you do not want to go through social services to collect child support you can also hire an attorney to help you with the process.