bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospects and Problems of Women Sanitarians Justifing Their Inclusion in the Environmental Health Profession: The Nigerian Situation
Authors: Emeharole P.O.
Published: September 2007

THE HISTORY of the Nigerian political arena, has vindicated the great political impact made by Nigerian women. This Nigerian 'Women Impact Continuum' did not terminate with the achievement of political independence 30 years ago. The inclusion of Nigerian women in what was hitherto men's special profession has already begun to yield tremendous fruitful socio-economic development dividends. Con temporary Nigeria is witnessing the emergence of a spectrum of women achievers who have excelled in their various professions. Women in the Environmental Health Profession may not be an exception.

The paper opines that if the current 'women impact continuum' permeates the Environmental Health Pro fession female sanitarians could justify their inclusion in the Profession, if: (i) there is strength in their number; (ii) the Federal Government grants the Environmental Health Profession a statutory Regula tory Board; (iii) Women Sanitarians are given oppor tunities for in-service training; and (iv) the women's wing of the Association is recognized and integrated into the National Council of Women's Societies (NCWS) of Nigeria and shown a sense of belonging by the Better Life Programme for Rural Women (BELPRW).
Birth Order, Socioeconomic Status and Birth Height of Saudi Infants
Authors: Al-Omair Abdullah O.I.
Published: September 2007

A survey of 4498 singleton births of Saudi infants provided information on birth height, gestational age, birth order and socioeconomic status. The average birth height for the Saudi infant was 49.8 centimeters. The study results indi cated a linear relationship between birth order and birth height significant at the probability level 0.001. The relationship between birth height and socioeconomic status was not statistically significant.
Dietary Habits of Technical and Vocational Students in Riyadh, Saudi Arabia - Part II Eating Between Meals
Authors: Al-Sudairy A. , Howard Kevin
Published: September 2007

Dietary habits of 452 young adult male students at 6 technical institutes and vocational training centres in Riyadh, Saudi Arabia were investigated as part of a nutritional assessment survey. The eating-between-meals habit was found to be common among the majority (72.3%) of those students. The association between this habit and age cohorts, marital status, accommodation status, self assessment of weight and exercising are discussed.
Pediculosis Pubis: A Surrogate Marker for Sexually Transmitted Diseases
Authors: Opaneye A.A. , Jayaweera D.T. , Walzman M. , Wade A.A.H.
Published: September 2007

A review of all the patients diagnosed to have Pediculosis pubis (P pubis) during a 2 year period 1989-1991 was carried out. They constituted the index group and were compared with 140 consecutive patients seen during the month of June 1990, who served as controls. Both groups were comparable with respect to age and use of modern contraception.

Coexisting sexually transmitted diseases (STDs) were found in 37% of the index group. Incidence of STDs was 51 % among the controls.

In the preceding 3 months, patients in the index group had significantly more sexual partners p < 0.005 . These findings emphasize the need to offer full STD screening and health education to sexually active people who present with P pubis.
Perinatal Mortality in a Northern Nigerian Rural Community
Authors: Akpala C.O.
Published: September 2007

87 perinatal deaths which occurred out of 1484 births in a rural area of Northern Nigeria over a 9 month period were reviewed. The perinatal mortality rate was 58.6 per 1000 births. Babies born to very young adolescent mothers aged between 10-14 years had the highest perinatal mortality of 375 per 1000 births. Statistically significant relationships were also established between perinatal mortality and par ity, educational status of the mother and birth weight. The leading cause of perinatal death was birth trauma which accounted for 48% of all perinatal deaths. Strategies for the reduction of perinatal mortality in the rural community are highlighted.
Tyre Disposal - A Burning Environmental Issue?
Authors: Horner Jonathan M.
Published: September 2007

Used road vehicle tyres are one of the less publicised environmental impacts of traffic. However, there is increasing concern about the proliferation of fly tipping and large potentially combustible tyre dumps, and a lack of policy for disposing of used tyres in the United Kingdom. Some worn tyres are retreaded, but most are either landfilled, stockpiled, incinerated or converted to crumb. This paper reviews the major tyre disposal methods used with particular reference to environmental implications and health effects. Suggestions are made concerning the future of UK disposal policy and for further monitoring to assess potential environmental problems.
Longer Term Functional Outcome and Societal Implications of Upper Limb Fractures in the Elderly
Authors: Madhok Rajan , Green Sandra
Published: September 2007

To ascertain how they cope with upper limb fractures and the implications for health and social services (H&SS) a cohort of elderly patients was followed up. 42 of the original 51 (82%) patients were interviewed almost one and a half years after sustaining their fracture. Information was collected on ability to perform activities of daily living (ADL), general health, and use of H&SS help from informal carers. Although there was an overall improvement in the ability to perform ADL, many (26%) patients reported a residual difficulty. Informal carers provided most of the support with some contribution from the statutory agencies. Demographic changes with increasing numbers of elderly and increasing employment of married women - the traditional carers, and epidemiological changes with increasing age-specific incidence of upper limb fractures mean that H&SS provision in the future will need to be increased.
Factors Associated with Awareness and Knowledge of Cervical Cancer in a Community: Implication for Health Education Programmes in Developing Countries
Authors: Dhamija Sarita , Sehgal Ashok , Luthra Usha K. , Sehgal Kusum
Published: September 2007

An attempt has been made to study the correlates of knowledge of cervical cancer in a community. The survey undertaken is a part of Knowledge, Attitude and Practice (KAP) study prior to initiation of cytological screening. Total women interviewed by KAP survey were 1411 selected through 2 stage stratified random sampling. Subjects for the present analysis consisted of a group of women who had reported previous gynaecological problems related to cervical cancer. The study brought out that younger women had better awareness and knowledge about cervical cancer and related information. Literacy status for education and exposure to family planning was influential in creating awareness about cervical cancer. Lastly, the earlier episodes of gynaecological problems, and treatment seeking behaviour lead to higher awareness (efforts may be made to innovate ways to reach older and illiterate women at risk of cervical cancer for better awareness in the community).
New Trends of Postgraduate Education in Public Health in Slovakia (THE FIRST EXPERIENCES OF THE SCHOOL OF PUBLIC HEALTH IN BRATISLAVA)
Authors: Badalik L. , Paniakova M. , Farkasova D. , Kubjatkova A.
Published: September 2007

The School of Public Health (SPH) in Bratislava was estab lished on 1 July 1991, as an organisational unit of the Post graduate Medical School, directly subordinated to the Ministry of Health of the Slovak Republic. The SPH performs both postgraduate and continuing education of specialists in indi vidual public health branches. It participates in the research activities within the field of public health. Our SPH is engaged in the network of European schools of public health, in association with the Association of Schools of Public Health in the European Region (ASPHER). In coordination with these schools, the SPH elaborates on a system of training Europe- wide a comparable qualification degree in Master of Public Health (MPH). In collaboration with the World Health Organization (WHO), the SPH also organises training courses and seminars with international participation. The SPH entered into the school year 1992/93 with its 5 departments and sub-departments in the following organi sational structure:

1. Department of Health Strategy with sub-departments: Health Legislation Health Education Health Sociology 2. Department of Medical Informatics 3. Department of Health Management 4. Department of Medical Education 5. Department of Preventive Medicine with sub-departments: Epidemiology Hygiene of Children and Adolescents Environmental Hygiene Nutrition Preventive Occupational Health Health Protection against Ionization
Is the Prescription of Amphetamine Justified as a Harm Reduction Measure?
Authors: Fleming Philip M. , Roberts Dawn
Published: September 2007

Although amphetamine is the most widely illicitly used drug in the United Kingdom after cannabis, relatively few proble matic users present to treatment agencies. Injecting ampheta mine users are a high risk group as far as HIV transmission is concerned. This paper reviews the first 3 years' operation of an oral amphetamine prescribing programme for injecting users. Over half the subjects ceased injecting, and there was a consid erable reduction in injecting by the remainder. 85% had not used or shared injecting equipment during the programme. However, subjects reported still using street amphetamine and offending, although at a lower rate than previously. There was little change in sexual practices. There was an increase in primary amphetamine users presenting for treatment. There is a case to be made that closely controlled and monitored programmes such as this can be justified on harm reduction grounds. A number of issues concerned with amphetamine prescribing are discussed.
Whistle While You Work in the Health- related Professions?
Authors: Vinten Gerald
Published: September 2007

The spate of correspondence and publicity, following the disciplining, and subsequent settlement in his favour, at an Industrial Tribunal, of Stockport Health Authority Charge Nurse Graham Pink, suggested that the urge to blow the whistle was at almost epidemic proportions in the NHS. It might have been surmised that the only device which kept this under control was the fear of discipline and perhaps dismissal. This fear has been increased by the contracts of employment of the NHS Trusts which have outlawed acts of whistleblowing. There are similar pressures for those working in other health-related professions, and in health and safety, and environmental protection.

It is important to question whether such severe stric tures are in the public interest, or whether they are there to make the life of senior managers easier, or to make it possible to ensure that doctors, nurses, and other caring professionals and support staff, conform to budgetary con straints without resort to campaigning.
Water poverty
Authors: Lister Ruth
Published: September 2007

Water poverty has become to the 1990s what fuel poverty was to the 1970s and 1980s. Underlying the growing concern on the issue is, on the one hand, a steep rise in the numbers living on poverty level incomes over the past 15 years and on the other, increasing difficulties among many poorer households in paying for the water that they need. Having briefly outlined current trends in poverty, the article explores these difficulties in relation to the price of and methods of charging for water and sewerage; the options for helping poorer customers; and the consequences of non-payment. It will focus in particular on the implications for health of two controversial issues: compulsory volumetric metering and water disconnections.
Induced abortion in Taiwan
Authors: Pair Dong Wang  , Lin Ruey S.
Published: September 2007

Induced abortion is widely practised in Taiwan; however, it had been illegal until 1985. It was of interest to investigate induced abortion practices in Taiwan after its legalization in 1985 in order to calculate the prevalence rate and ratio of induced abor tion to live births and to pregnancies in Taiwan. A study using questionnaires through personal interviews was conducted on more than seventeen thousand women who at tended a family planning service in Taipei metropolitan areas between 1991 and 1992. The reproductive history and sexual behaviour of the subjects were especially focused on during the interviews. Preliminary findings showed that 46% of the women had a his tory of having had an induced abortion. Among them, 54.8% had had one abortion, 29.7% had had two, and 15.5% had had three or more. The abortion ratio was 379 induced abortions per 1,000 live births and 255 per 1,000 pregnancies. The abortion ratio was highest for women younger than 20 years of age, for aboriginal women and for nulliparous women. When logistic regression was used to control for confounding vari ables, we found that the number of previous live births is the strongest predictor relating to women seeking induced abortion. In addition, a significant positive association exists between increasing number of induced abortions and cervical dysplasia.
Can we learn lessons from the different ways stroke is managed in different countries?
Authors: Wolfe C. , Beech R. , Ratcliffe M. , Rudd A.G.
Published: September 2007

Stroke is a major health care problem in the European Union and consumes significant resources. The mortality rates from stroke and treatment strategies vary signifi cantly between member states. Only by comparison between centres in different member states with differing health care delivery can the effect of these varying approaches to the management of stroke on outcome be assessed. Conducting a study on a European wide basis in centres which are known to differ in terms of treatment strategies and outcomes allows an immediate analysis of the effectiveness, resource requirements and cost of diffe rent methods of managing stroke patients. This paper addresses the current burden of stroke and strategies for its management. An outline of a European Union project, assessing how stroke is managed in different countries, is provided with the aim of indicating a strategy for discovering and promoting more cost-effective services for stroke care in the future.
The growth pattern of Kuwaiti pre-school children
Authors: Al-Isa A.N. , Bener A.
Published: September 2007

The aim of this study was to present growth charts of pre-school children based on cross-sectional data of the population in Kuwait to determine their health status. This sur vey was carried out during September 1989 to June 1990. The growth patterns of weight and heights per age were designed separately for boys and girls. The growth pattern of height for age, and weight by age were constructed and smoothed by the spline regression polynomial technique. The girls were taller than the boys after the age of one year. The growth deficit in children from Kuwait compared with internationally recommended refer ence populations may be attributed to genetic and environmental factors. The growth pattern presented here will suffice as a standard in monitoring the growth of Kuwaiti children in particular and those in the Gulf region in general.
Vegetable and fruit consumption
Authors: Walker A R P
Published: September 2007

In Western populations, historically, from early times until the 19th century, diets were composed largely of plant foods — cereals, beans, vegetables and fruit. The huge major ity of populations were very poor with restricted food choices. The same situation prevails with most present-day Third World populations, although principally with rural dwellers. In Western populations, in recent times, stemming largely from urbanization and rise in prosperity, and accompanying increased partiality to animal foods, there have been falls in the intake of some plant foods yet rises in others. Potato intake has halved, whereas vegeta ble consumption has increased only slightly, although that of fruit more so. National consumptions of these foodstuffs vary widely, those in the United Kingdom and United States of America being only about half of those in Mediterranean countries, Spain, Portu gal and Greece. In the former countries, present dietary guidelines urge that vegetable consumption be doubled, with fruit up by a half. In southern Africa, consumption of veg etables and fruit by the white population appears similar to those in the USA and UK. Yet in African cities, intake is low due to their cost. In view of the protective role of high vegetable and fruit intake in the combating of coronary heart disease and many forms of cancer, the relatively low consumption of these foodstuffs, especially in the poorer populations, is disappointing, and alas, appears unlikely to rise in the near future.
The feeding of patients in hospital: a review
Authors: McGlone Pauline , Dickerson J.W.T. , Davies G. Jill
Published: September 2007

The feeding of patients in hospitals is a topical issue. This review considers the develop ment of feeding practices in British hospitals and highlights disturbing aspects which may have a bearing on recovery. The issues highlighted may also exacerbate the problem of hospital-induced malnutrition. There is little evidence that the provision of food per se is a cause for concern. It is rather the many other factors which may contribute to the patients consuming an in adequate diet.
Surveillance of tuberculosis caused by Mycobacterium bovis in Slovakia
Authors: Badalík L. , Honzátková Z. , Krištúfek P. , Švejnochová M. , Paniaková M.
Published: September 2007

The elimination of tuberculosis (TB) among cattle was claimed in Czecho-Slovakia in the middle of the sixties. Experiences from some countries which eliminated TB among cattle earlier than Czecho-Slovakia indicated a sporadic occurrence ofTB caused by M. bovis. A long-term investigation of the occurrence of this 'diminishing zoonosis' has been carried out by a special group of experts (epidemiologists, clinicians, bacteriologists, epizootiologists and veterinary surgeons) on the whole territory of Slovakia.

During the period of years 1972-1990 there were discovered 68 new cases of TB in humans caused by M. bovis. This paper analyses the results of the epidemiological investiga tion of this group of patients from several aspects: eg age, sex, occupation and geographical distribution.
Health status of cement workers in the United Arab Emirates
Authors: Abou-Taleb Ahmed N. M. , Musaiger Abdulrahman O. , Abdelmoneim Roushdy B.
Published: September 2007

The aim of this study was to investigate some of the health problems among cement workers in the United Arab Emirates (UAE). A cross-sectional sample of 304 work ers was selected randomly from four cement factories in four Emirates. Most of the workers (88%) were from India, married (84%) and had received primary education or above (93%). Smoking was prevalent among 27% of the workers and about 24% consumed alcoholic beverages. Personal hygiene was found to be satisfactory among the workers. The main health symptoms reported by the cement workers were chronic cough, chronic bronchitis, burning, itching and runny eyes, headache and fatigue. Chronic bronchitis (p<0.007), burn ing, itching and runny eyes (p<0.002) and fatigue (p<0.004) were significantly increased with age of workers. Smoking was significantly associated with chronic cough (p<0.03) and chronic bronchitis (p<0.01). However, the chance of smokers getting respiratory health problems was two to five times greater compared with non-smokers. Future studies on the health of workers in UAE should include more investigations using specialised equipment to detect and diagnose health problems.
Typing of Proteus from Patients with Bacteriuria
Authors: Clarke Stuart C , McIntyre Michael
Published: September 2007

Forty-five strains of Proteus mirabilis isolated from hospital in-patients, out patients and community patients with significant bacteriuria, were investigated to deter mine whether a predominant type was present using the Dienes test. Antimicrobial sus ceptibility patterns of the 45 strains of Proteus mirabilis were also determined.

There were 38 different Dienes types which shows that there is no predominant type of Proteus amongst the isolates examined in this study. This suggests that there is no pre dominant type of Proteus mirabilis in the community and hospital acquired bacteriuria.

The antimicrobial susceptibility pattern of an isolate was not a useful marker for typing because susceptibility patterns between different Dienes types were so similar.
Health risk behaviour of a medical student population
Authors: Pikó Bettina , Barabás Katalin , Markos Judit
Published: September 2007

A pilot study of a cross-sectional nature was carried out to observe and describe the health risk behaviour of a medical student population. The participants (242) were drawn from the students of the University Medical School of Szeged, Hungary. The stu dents were aged 18-31 years (x = 23) and were randomly selected. The response rate was 73%.

The project focussed on 4 harmful habits ranked in the following order of prevalence: excessive coffee drinking (35%), smoking (20.9%), regular alcohol use (6.8%) and illicit drug use (5.1%). The non-parametric (Chi-square) test showed significant differences between the higher and lower physical activity groups in terms of psychological well-being (p<0.05) and health behaviour changes (p<0.005). Harmful habits, however, were report ed more frequently by the higher physical activity group. Significant differences could be detected in terms of women's illicit drug use (p<0.05). Using the Mann-Whitney U-test, it was detected that those who performed more physical activities rated their health signif icantly higher (p<0.001).

This study will be pursued in an expanded study with a larger sample and concentrate especially on the relationship of physical activity behaviour to harmful habits. Follow-up methods are also planned to study the medical student population over time, which should yield some greater insight into these relationships.
The smallpox saga and the origin(s) of vaccination
Authors: Cook G.C.
Published: September 2007

Two hundred years ago - in May 1796 - Edward Jenner carried out a pioneering feat in the history of 'clinical investigation' which not only paved the way for the eventual elimination of one of the world's most terrifying infections (variola), but also heralded widespread vaccination campaigns and the foundation of the discipline of clinical immunology. Vaccination superseded the formerly used technique of variolation which had been introduced into England by Lady Mary Wortley Montague. Under-recognised is the fact that the first clinical trial(s) of this new development were carried out under the supervision of William Woodville at the St Pancras Smallpox Hospital (situated at Battle Bridge - now King's Cross); this work was crucially important in the 'vaccination saga' and deserves far greater acceptance than is currently the case.
How can psychological theory help to promote condom use in sub-Saharan African developing countries?
Authors: Campbell T.
Published: September 2007

Condom use for HIV prevention has been very inconsistent in most sub-Saharan African countries. Studies from around the continent report that knowledge about HIV transmission is variable and seems to be related to gender, socioeconomic and educational status. There is a large body of psychological knowledge about HIV prevention which has been applied to condom promotion campaigns in developed countries. These approaches to condom promotion, based on formal theory, have not been used on a wide scale in African countries and this paper explores ways in which psychological theory might be appropriately applied in a situation of high HIV prevalence.
Are Saudi female college students prepared for successful breastfeeding?
Authors: Bella H.
Published: September 2007

A cross-sectional study was carried out on a sample of 285 female students from the Science and Arts tracks of the Dammam College for Girls in Eastern Province, Saudi Arabia. A self-administered questionnaire was answered by the girls to determine whether Saudi female college students were prepared for successful breastfeeding, and to assess their knowledge about relevant aspects of breastfeeding.

The questionnaire contained questions about time of first feed, frequency of breast feeding, duration of a feed and duration of breastfeeding. Correct answers were made by 38%, 33%, 35% and 59% of the students respectively. Those with a high knowledge score who would breastfeed in the future were significantly more than those with a lower knowledge score (p<0.001). When the knowledge score and seven other variables were entered into a logistic regression model, knowledge was found to be the only significant predicting factor for the decision to breastfeed in the future.

The study showed that the attitude of young Saudi women is favourable towards breast feeding. However, they do not seem to be prepared to breastfeed so successfully. Knowledge was the only predictory factor for the decision to breastfeed in the future. An educational programme may increase the prevalence of breastfeeding in this community.
Smoking, Diabetes and Hyperlipidaemia
Authors: Mikhailidis D.P. , Papadakis J.A. , Ganotakis E.S.
Published: September 2007

The epidemiological evidence linking smoking with insulin resistance is considerable. This evidence is even more convincing because there is a dose response relationship between smoking and the risk of non-insulin dependent diabetes (NIDDM). Similarly, there is a time-dependent decrease in risk of NIDDM for those who quit smoking. Insulin resistance (in the form of impaired glucose tolerance, IGT) may precede the development of NIDDM. There is a biochemical basis for the smoking- IGT / NIDDM relationship.

Smoking increases the risk of developing diabetic complications like nephropathy, neu ropathy and retinopathy. Smoking is also an independent risk factor for myocardial infraction and all-cause mortality in NIDDM.

Smokers are both insulin resistant and lipid intolerant. Smoking cessation increases circulating high density lipoprotein (HDL) and reduces low density lipoprotein (LDL) levels, despite weight gain.

Those providing advice or treatment to improve cardiovascular risk factors should be aware of these smoking-related harmful effects. This is especially true if IGT is underdiag nosed despite the fact that this condition increases the risk of vascular events. Explaining that smoking increases the chance of developing diabetes as well as raising 'blood fat' levels may convince more smokers to quit.
Pruritus in children
Authors: Leung Alexander K C , Wong Byron E , Chan Paul Y H , Cho Helen Y H
Published: September 2007

Pruritus is the most common of all dermatological complaints. Although pruritus is usual ly due to a primary skin disease, it may be a manifestation of a systemic illness. The major ity of causes can be diagnosed from the history and physical examination. Laboratory inves tigations are usually not necessary Treatment should be directed at the underlying cause whenever possible.
Help with HACCP
Authors: Worsfold Denise
Published: September 2007

An evaluation of a new short HACCP course is presented as a case study involving a group of representatives from Residential Homes. HACCP awareness was assessed before and after the course. Following the course, participants were encouraged to collaborate to produce a generic HACCP model suitable for their industry sector. Work was co-ordinated by the course tutor and support was provided for participating businesses who wished to customise the model and implement their own HACCP system. The course was judged favourably by the participants and the tutor, but all recommended that an elementary knowledge of food hygiene be a pre-requisite for participation on the course. The course increased HACCP awareness and the practical exercise increased the confidence of the participants to apply the HACCP principles. By working together the group produced a model, which half have since employed as the basis of their own HACCP system.
Lessons to be learned: a case study approach: Prolonged methaemoglobinaemia due to inadvertent dapsone poisoning; treatment with methylene blue and exchange transfusion
Authors: Southgate H.J. , Masterson R.
Published: September 2007

The authors present a case of methaemoglobinaemia of acute onset, with an unusually protracted course. The long persistence of this disorder led to a search for the cause which was eventually traced to medication with dapsone. The latter was found to be inappropriately being taken by the patient instead of an antispasmodic that had been prescribed for a spinal condition; this was because the tablets had been incorrectly labelled and dispensed in a pharmacy. The patient took increasing doses of the presumed `antispasmodic' tablets as they seemed to lack clinical effect, thus further exacerbating the toxic consequences. Moreover, the patient brought his wrongly labelled tablets into hospital and was allowed to use them there, contrary to normal hospital policy. As treatment for the methaemoglobinaemia both bolus and continuous infusions of methylene blue were used, which probably contributed to the severe haemolysis which followed. Furthermore, the development of a rare side effect of dapsone toxicity. namely that of a sensorimotor neuropathy, is reported.
Health and cancer prevention: implications of the knowledge and beliefs of 15-16 year old school pupils in South Africa
Authors: Walker A.R.P. , Walker B.F. , Jerling J. , Rossouw K. , Lelake A.
Published: September 2007

The objective was to collect information from African and white pupils aged 15-16 years on their knowledge of and attitudes towards cancer, and their understanding of health-related behaviours in relation to their future experience. Questionnaires were completed by a series of 338 African and 378 white pupils in suburban secondary schools. African and white pupils knew most about lung cancer, and had some knowledge of skin and breast cancers.. Smoking was seen by most as the chief cause of the disease. Half of both groups perceived a high intake of vegetables and fruit as protective. Television and printed media were the most important sources of information. The children in both groups were more anxious about unemployment and violence, and also, among African children, about AIDS, than about future ill-health. Thus, health was not perceived by many as the most important goal in life. Discussion indicates that white adolescents and also white adults, with more advanced understanding of cancer causation, make very limited use of their knowledge, dietary and non-dietary, to avoid the disease. In brief, level of cancer knowledge has very limited implications. Although young Africans in the course of their transition are very unlikely to seek to diminish their risk of cancer, there must be no lessening of urgent warnings and advice through the media on the avoidance of the disease.
Historical perspectives on health
Authors: Jordan Thomas E.
Published: September 2007

The health of society is the sum of recent public policy and the heritage of public health and welfare. The degree of improvement in the health of young males in the nineteenth century may be gauged by scrutinising changes in the ratio of weight to height 2 (W/H2). The two variables summate the developmental history of individuals, and so are an index of biosocial circumstances for a set of people. Such data are uncommon, and this essay formulates the ratio for the years 1832 to 1911. The conclusion is that, according to the W/H 2 criterion, innovations in public policy produced improvement in the health of young males.
Cigarette smoking habits among high school boys in a developing country
Authors: Bener A. , Al-Ketbi L.M.B.
Published: September 2007

The aim of this cross-section study was to determine the habits, practices, attitudes and knowledge about cigarette smoking among high school boys aged 15-19 years in the United Arab Emirates, and to provide a basis for comparisons with international data. The World Health Organisation questionnaire was used, together with a multi-stage stratified cluster sampling technique; 1,700 subjects aged 15 years and above were randomly selected. A total of 1,486 individuals (87.4%) from among the populations of Al-Ain City, Abu-Dhabi and Dubai Emirates participated in the study. The prevalence of smoking among the studied group was 19%; 28.2% admitted that they had smoked before but had now given up, and the remaining 52.9% denied having ever smoked. Among 18-year-olds (or older) 30.3% smoked. In 70.8% of cases a friend was reported as having been the first source of their cigarette. Fifty-four percent of smokers started between the age of 10 and 15 years. The families of 15.7% of those studied approved of their smoking, while 78.3% did not: 6% did not have an opinion. Nearly two-thirds of the smokers (66.5%) wanted to stop smoking, while the remaining third (33.5%) did not. Differences in parental education (specifically that of the father) were found to have a significant effect on attitudes towards smoking. Contrary to expectations, the highest prevalence of smoking was found among sons of university graduates, and the lowest among sons of illiterate fathers (12.6% and 24.3%, respectively). There was a statistically significant difference in respect to family income and smoking. Among the ex-smokers, religion (40%) and health (26%) were important reasons for giving up smoking. Of the smokers, 33% claimed that stress is the most important factor which makes people smoke. The source of the student's information regarding smoking hazards was lowest from doctors (17-19%), and highest from the media (35%). All student groups were equally aware that smoking is a risk factor for lung cancer, respiratory diseases, and ischaemic heart diseases, but among the smokers only 28.9 % were very concerned about the harmful effects of cigarettes. At the time of their graduation (18 years or older), one-third of the students were already regular smokers, a figure liable to increase as they start university or work.
Health information systems in developing countries: benefits, problems, and prospects
Authors: Azubuike M.C. , Ehiri J.E.
Published: September 2007

Health information systems are important support tools in the management of health care services delivery in both developed and less developed countries. An adequate health information system is vital not only for assessing the health needs of populations and groups, but also for planning and implementation of health interventions. It is equally important in the evaluation of programmes from both the perspectives of effectiveness and coverage. This paper examines the practical difficulties of health care provision amidst inadequate statistics to inform decisions. Major obstacles to the introduction of effective health information systems in developing countries are examined, and practical suggestions on measures to overcome them discussed. It is concluded that the establishment of well co-ordinated information collection systems at the various levels of the health care system in developing countries, using appropriate staff, could contribute greatly to improvements in health care delivery.
Healthy housing: the role of the Environmental Health officer
Authors: Stewart J.
Published: September 2007

The relationship of health and housing has been well documented. There is less said about action that can be taken to deal with poor housing conditions. Environmental Health Officers in UK Government are key actors enforcing legislation relevant to housing conditions. Despite a century of legislative intervention in private sector housing conditions, the English House Condition Survey continues to report an excessive amount of poor conditions, and a particular decline in quality amongst the most disadvantaged in society who are increasingly accommodated in the private rented sector. This paper examines the role of poor housing in ill health and the difficulties faced in enforcing largely reactive legislative, arguing that wider changes are needed if the link between poor health and housing is to be broken.
Is continued weight gain inevitable in type 2 diabetes mellitus?
Authors: Tremble J.M. , Donaldson D.
Published: September 2007

Prevention and treatment of obesity are major clinical problems encountered in the management of Type 2 diabetes mellitus (DM); indeed, up to 90% of such patients are regarded as being overweight. Except for a brief period following diagnosis, when presumably enthusiasm to adopt lifestyle change is at its greatest, weight gain is generally progressive unless severe hyperglycaemia or complications inter vene. Even a relatively modest weight loss of 10% can have major benefits in terms not only of reducing the risk of developing DM in the first place, but also in improving metabolic control after the disorder has become established. Behavioural therapy (BT) in combination with a hypocaloric diet achieves weight loss in the short-term, but is poorly sustained in the long-term. Exercise has metabolic benefits beyond its rather minimal effects on short-term weight loss in that it may also aid long-term weight control. The difficulties encountered in maintaining lifestyle change do, however, suggest the need for ongoing intervention - perhaps including a regular period on a stricter dietary regimen (800-1000 kcalday-1), possibly a very low calorie diet (VLCD) (<800 kcalday-1) or even the use of orlistat, a pancreatic lipase inhibitor which reduces the absorption of dietary fat. Realistically, the aim should be for long- term weight stability.
Lessons to be learned: a case study approach: Metastatic bronchogenic carcinoma presenting as a gluteal abscess
Authors: Srikanth B. , Sai Sankar N. , Kong K.C. , Bassily A.A.
Published: September 2007

It is well known that bronchogenic carcinoma frequently metastasises to the bony skeleton, but it is most unusual for it to present in the form of a musculoskeletal abscess. Presented here is the case report of a patient with what appeared initially to be a right sided gluteal abscess and which turned out to be the metastasis from a bronchogenic carcinoma. The Magnetic Resonance Image (MRI) scan carried out proved to be very helpful in arriving at a probable clinical diagnosis; however, it was histopathological studies of the abscess wall itself that ultimately gave the definitive diagnosis. We believe that this may represent one of the first documented cases in which an MRI scan has been used to confirm the presence of a gluteal abscess.
Review: The metabolic syndrome as an endocrine disease: is there an effective pharmacotherapeutic strategy optimally targeting the pathogenesis?
Authors: Schindler Christoph
Published: September 2007

The metabolic syndrome (MetS) represents a combination of cardiovascular risk determinants such as obesity, insulin resistance and lipid abnormalities such as hypertriglyceridemia, increased free fatty acids, low high-density-cholesterol and hypertension. As a multiple component condition it imparts a doubling of relative risk for atherosclerotic cardiovascular disease (ASCVD). It is currently controversial which component of the syndrome carries what weight. There is even a considerable debate whether the risk for ASCVD is greater in patients diagnosed with MetS than that by the individual risk factors. At present, no unifying pathogenetic mechanism can explain the metabolic syndrome and there is no unique treatment for it. This review summarizes and critically reviews the currently available clinical and scientific evidence for the concept that the MetS is causally an endocrine disease and discusses pharmacotherapeutic strategies targeting the pathogenesis rather than single symptoms of the cluster.
Review: Obesity and cardiometabolic syndrome in children
Authors: Velasquez-Mieyer Pedro , Neira Claudia P. , Nieto Ramfis , Cowan Patricia A.
Published: September 2007

The cardiometabolic syndrome is highly prevalent among overweight youth. The risk of developing the cardiometabolic syndrome is likely triggered or exacerbated by concurrent obesity, unhealthy lifestyle/eating habits, and hormonal changes (puberty). Current screening recommendations include measurement of blood pressure, fasting insulin and glucose, and total cholesterol. However, limiting assessments to these measures underestimates cardiometabolic risk in overweight youth, particularly minorities. Early identification of cardiometabolic risk in its incipient stages may justify early and more aggressive intervention to prevent progression and complications. This review provides rationale for additional assessments to determine cardiometabolic risk in overweight youth and recommends treatment options.
Child and adolescent psychiatric disorders in general practice
Authors: Jezzard R. G.
Published: September 2007

It has been known for some time that the majority of adult mental health problems within any community are seen within general practice, making up a fifth to a quarter of the general practitioner's workload (Shepherd & Clare, 1981). Most patients are not referred to specialist services. It is therefore the primary care team and not the psychiatric specialist who assumes the major burden of responsibility for the care of mental disorder. Hence, more attempts are now being made to improve the quality of psychiatric care within general practice. Most of the research on mental health morbidity within primary care has been in the field of adult mental health and it is only relatively recently that equivalent information on child mental health morbidity has become available. In parallel, an increasing number of studies examining the effectiveness of interventions in primary care have been undertaken and different models of mental health service provision within this context have been described (Strathdee & Williams, 1984). There are few evaluated studies of interventions in primary care focused on child mental health. Most guidance for the development of such services has to be obtained from the adult mental health literature, or from work with other types of childhood disorder, often in non-general practice settings.
The NHS Information Management and Technology strategy from a mental health perspective
Authors: Knight Susan
Published: September 2007

Healthcare organisations are currently in the midst of a period of fundamental change. Mental health services in particular have moved away from institutional care towards a complex inter-related community health social and voluntary model of service delivery, involving a diverse range of care professionals and commissioners.
Care plans by code
Authors: White Christopher
Published: September 2007

Formal care plans extend the functions of traditional psychiatric case assessments by specifying more of the operational details of case management practice. They usually include descriptions of case management problems and objectives, the planned case management interventions, and who is involved in providing care.
Management of alcohol misuse within the context of general psychiatry
Authors: Raistrick Duncan
Published: September 2007

The general psychiatrist and the addiction specialist have a shared agenda of concerns and interests about the misuse of alcohol. The task of this paper is to highlight and develop thoughts on items for inclusion on the shared agenda, rather than to define, or limit in any other way, how the generalist role might unfold in a particular place at a particular time. It is certain that the general psychiatrist will see a role that is more than just signposting their own specialist colleagues, local counselling services, or self-help groups such as Alcoholics Anonymous, but opinion on just how broad that role could or should be will vary considerably. One point of difference may be a mismatch of views as to where patients with alcohol misuse problems are best treated: the general psychiatrist seeing alcohol misuse, or even dependence, as having little to do with general psychiatry and belonging within a specialist service, the specialist seeing alcohol misuse as very much part of the every day work of the general psychiatrist. Happily both positions can be correct, but not totally and not without dialogue.
Hyperkinetic disorder: assessment and treatment
Authors: Cameron Mary , Hill Peter
Published: September 2007

Hyperkinetic disorder is the generic ICD-10 (WHO, 1992) term used to describe one of the most common childhood psychiatric disorders. It is a severe form of a syndrome which is referred to in DSM–IV (APA, 1994) and the American literature as attention deficit hyperactivity disorder (ADHD). Hyperactivity or hyperkinesis can be defined as “an enduring disposition to behave in a restless, inattentive, distractible and disorganised fashion” (Taylor, 1994). It is thus more than motor overactivity. Diagnostically there are three main groups of symptomatology: overactivity, inattentiveness and impulsiveness.
Setting up an assertive community treatment service
Authors: Kent Andrew , Burns Tom
Published: September 2007

The last 20 years have witnessed a surge of interest in assertive community treatment (ACT) for the severely mentally ill (Drake & Burns, 1995). ACT aims to help people who would otherwise be in and out of hospital on a ‘revolving door’ basis live in the community and enjoy the best possible quality of life. Services based on the ACT model seek to replace the total support of the hospital with comprehensive, intensive and flexible support in the community, delivered by an individual key worker or core services team. They are organised in a way that optimises continuity of care across different functional areas and across time.
Neuroleptic malignant syndrome
Authors: Kohen D. , Bristow M.
Published: September 2007

Although a rare form of ‘lethal’ catatonia, involving high temperature and rigidity, was first described long before the advent of neuroleptic drugs, Delay's description of asyndrome malinin 1960 is usually regarded as the first recognition of this syndrome. Over the next 20 years the number of case reports grew and the appearance of reviews such as Caroff's in 1980 marked the birth of the neuroleptic malignant syndrome (NMS). Reports of its incidence give variation rates of up to fiftyfold, possibly due to differences in diagnostic criteria, and mortality reports are similarly variable. Although it is debatable whether it is a rare, severe idiosyncrasy or one of many neuromuscular side-effects of dopamine antagonists (Levinson & Simpson, 1986), most clinicians nowadays regard it as a serious but recognisable risk of neuroleptic treatment which merits further attention.
Management aspects of care for the homeless mentally ill
Authors: Timms P.
Published: September 2007

People with mental illness have always been marginalised and economically disadvantaged. Warner (1987) has shown that this is particularly true in times of high unemployment. Poor inner-city areas have excessive rates of severe mental illness, usually without the health, housing and social service provisions necessary to deal with them (Faris & Dunham, 1959). The majority of those who suffer major mental illness live in impoverished circumstances somewhere along the continuum of poverty. Homelessness, however defined, is the extreme and most marginalised end of this continuum, and it is here that we find disproportionate numbers of the mentally ill.
Cross-cultural psychiatric assessment
Authors: Bhugra Dinesh , Bhui Kamaldeep
Published: September 2007

Different cultures vary in their perceptions of mental illness (Karno & Edgerton, 1969), which can affect their utilisation of orthodox psychiatric facilities (Padillaet al, 1975; Sue, 1977). Mental health services may be seen by ethnic minorities as challenging the value of traditional support systems, reflecting dominant Western cultural values and harbouring implicitly racist psychological formulations. The clinician-patient interaction may become fraught with misunderstandings if the two parties come from different cultural backgrounds and bring distinct cultural expectations to the encounter.