bluuebunny/crossref_metadata_2025 huggingface dataset:
The Epidemiology of Tuberculosis in Pacific Island Countries and Territories: 2000-2007
Authors: Viney Kerri , O'Connor Janet , Wiegandt Axel
Published: June 2011

This is a descriptive study of routinely collected tuberculosis (TB) surveillance data from 19 Pacific Island countries and territories. The objectives of the study are to describe ( a) the epidemiology of TB during the period 2000-2007 (with a focus on 2007), ( b) progress against World Health Organization (WHO) targets, and ( c) how TB control can be enhanced in the region. In 2007, there were 1544 cases of TB notified in the Pacific (excluding Papua New Guinea). The case notification rate was 52 per 100 000 population. The case detection rate for sputum smear positive cases in 2007 was 66%, slightly below the WHO target of 70%. The treatment success rate for new sputum smear positive cases in 2006 was 89%, above the WHO target of 85%. It is likely that the regional prevalence and mortality targets will be narrowly missed in 2010. There has been good progress in TB control in the Pacific region, but intensified efforts are needed to further reduce the burden of TB.
Mortality Trends and the Epidemiological Transition in Nauru
Authors: Carter Karen , Soakai Taniela Sunia , Taylor Richard , Gadabu Ipia , Rao Chalapati , Thoma Kiki , Lopez Alan D.
Published: June 2011

This article aims to examine the epidemiological transition in Nauru through analysis of available mortality data. Mortality data from death certificates and published material were used to construct life tables and calculate age-standardized mortality rates (from 1960) with 95% confidence intervals. Proportional mortality was calculated from 1947. Female life expectancy (LE) varied from 57 to 61 years with no significant trend. Age-standardized mortality for males (15-64 years) doubled from 1960-1970 to 1976-1981 and then decreased to 1986-1992, with LE fluctuating since then from 49 to 54 years. Proportional mortality from cardiovascular disease and diabetes increased substantially, reaching more than 30%. Nauru demonstrates a very long period of stagnation in life expectancy in both males and females as a consequence of the epidemiological transition, with major chronic disease mortality in adults showing no sustained downward trends over 40 years. Potential overinterpretation of trends from previous data due to lack of confidence intervals was highlighted.
Ensuring Economic, Health, and Social Well-Being for Papua New Guinea Through Trade
Authors: Fa'alili-Fidow Jacinta
Published: June 2011

The impacts of trade liberalization and open markets on global, regional, and local economies are a key consideration for those involved in government, business, and financial sectors. However, their impacts on health and social well-being of populations are not well-evidenced acknowledged within the health sector, let alone the impact on developing countries. As free trade becomes an inevitable outcome for many developing nations, the full implications of trade on economies, environments, and population health needs to be better articulated in order to ensure fully informed trade negotiations that support equitable outcomes. This article takes a broad look at the key issues for Papua New Guinea (PNG) in trade and how these translate to discrepancies in economic, health, and social benefits for its population. Despite its active trading and high GDP, only 10% of the population experience better economic and social outcomes. The bulk of PNG’s population lives in poverty, challenged by geographical, cultural, and political barriers to better income, education, and health. Progress needs to be made to minimize these barriers and to allow more of PNG’s population to experience the economic benefits generated through trade activities. A balance needs to be maintained between the desire of developed countries to broaden their markets, and the efforts of developing countries to promote and protect the health and well-being of their populations through increasing participation in global markets. PACER Plus presents an opportunity for pursuing alternative models of trade agreements that support and develop Pacific health.
Climate Change and Australian Agriculture: A Review of the Threats Facing Rural Communities and the Health Policy Landscape
Authors: Hanna Elizabeth G. , Bell Erica , King Debra , Woodruff Rosalie
Published: June 2011

Population health is a function of social and environmental health determinants. Climate change is predicted to bring significant alterations to ecological systems on which human health and livelihoods depend; the air, water, plant, and animal health. Agricultural systems are intrinsically linked with environmental conditions, which are already under threat in much of southern Australian because of rising heat and protracted drying. The direct impact of increasing heat waves on human physiology and survival has recently been well studied. More diffusely, increasing drought periods may challenge the viability of agriculture in some regions, and hence those communities that depend on primary production. A worst case scenario may herald the collapse of some communities. Human health impacts arising from such transition would be profound. This article summarizes existing rural health challenges and presents the current evidence plus future predictions of climate change impacts on Australian agriculture to argue the need for significant augmentation of public health and existing health policy frameworks. The article concludes by suggesting that adaptation to climate change requires planning for worst case scenario outcomes to avert catastrophic impacts on rural communities. This will involve national policy planning as much as regional-level leadership for rapid development of adaptive strategies in agriculture and other key areas of rural communities.
The Effects of Extreme Heat on Human Mortality and Morbidity in Australia: Implications for Public Health
Authors: Peng Bi  , Williams Susan , Loughnan Margaret , Lloyd Glenis , Hansen Alana , Kjellstrom Tord , Dear Keith , Saniotis Arthur
Published: June 2011

Most regions of Australia are exposed to hot summers and regular extreme heat events; and numerous studies have associated high ambient temperatures with adverse health outcomes in Australian cities. Extreme environmental heat can trigger the onset of acute conditions, including heat stroke and dehydration, as well as exacerbate a range of underlying illnesses. Consequently, in the absence of adaptation, the associated mortality and morbidity are expected to increase in a warming climate, particularly within the vulnerable populations of the elderly, children, those with chronic diseases, and people engaged in physical labour in noncooled environments. There is a need for further research to address the evidence needs of public health agencies in Australia. Building resilience to extreme heat events, especially for the most vulnerable groups, is a priority. Public health professionals and executives need to be aware of the very real and urgent need to act now.
Climate Change and Infectious Diseases in Australia: Future Prospects, Adaptation Options, and Research Priorities
Authors: Harley David , Peng Bi  , Hall Gillian , Swaminathan Ashwin , Shilu Tong  , Williams Craig
Published: June 2011

Climate change will have significant and diverse impacts on human health. These impacts will include changes in infectious disease incidence. In this article, the authors review the current situation and potential future climate change impacts for respiratory, diarrheal, and vector-borne diseases in Australia. Based on this review, the authors suggest adaptive strategies within the health sector and also recommend future research priorities.
Climate Change and Health in the Urban Environment: Adaptation Opportunities in Australian Cities
Authors: Bambrick Hilary Jane , Capon Anthony Guy , Barnett Guy Bruce , Beaty R. Matthew , Burton Anthony John
Published: June 2011

Urban populations are growing rapidly throughout the Asia-Pacific region. Cities are vulnerable to the health impacts of climate change because of their concentration of people and infrastructure, the physical (geographical, material, and structural) attributes of the built environment, and the ecological interdependence with the urban ecosystem. Australia is one of the most highly urbanized countries in the region and its already variable climate is set to become hotter and drier with climate change. Climate change in Australia is expected to increase morbidity and mortality from thermal stress, bacterial gastroenteritis, vector-borne disease, air pollution, flooding, and bushfires. The cost and availability of fresh water, food, and energy will also likely be affected. The more vulnerable urban populations, including the elderly, socioeconomically disadvantaged groups, and those with underlying chronic disease, will be most affected. Adaptation strategies need to address this underlying burden of disease and inequity as well as implement broad structural changes to building codes and urban design, and infrastructure capacity. In doing so, cities provide opportunities to realize “co-benefits” for health (eg, from increased levels of physical activity and improved air quality). With evidence that climate change is underway, the need for cities to be a focus in the development of climate adaptation strategies is becoming more urgent.
Climate Change and Air Quality: The Potential Impact on Health
Authors: Spickett Jeff T. , Brown H.L. , Rumchev Krassi
Published: June 2011

The objectives of the study were to: consider the potential health impacts in Australia and the region arising from changes in air quality occurring as a result of climate change, identify vulnerable groups and potential adaptation measures and discuss the implications for policy. The authors provide an overview of international and national information on the potential health impacts of air pollutants that would most likely be affected by climate change and a discussion of the policy implications. Climate change is likely to have an impact on levels of ozone and possibly particulates, both of which are associated with increased mortality and a range of respiratory and cardiovascular health effects. One of the implications is therefore a possible increase in adverse health effects due to air pollutants. Regional health impact assessments of climate change should address the issue of air quality, consider current coping capacity, and determine the need for adaptation, particularly for vulnerable groups. Implications for policy include the need for improved modeling and forecasting of air pollutant levels, increased efforts to reduce emissions of air pollutants, continued monitoring of air pollutant levels, and monitoring of the incidence of health effects associated with air pollutants in all countries in the region.
Is Country of Birth a Risk Factor for Acute Hospitalization for Cardiovascular Disease in Victoria, Australia?
Authors: Dassanayake Jayantha , Gurrin Lyle , Payne Warren R. , Sundararajan Vijaya , Dharmage Shyamali C.
Published: June 2011

International mortality studies show that some subgroups of migrants have a higher risk of Cardiovascular Disease (CVD) than the native-born. To investigate whether country of birth increases the risk for acute myocardial infarction (AMI) and cerebral infarction (stroke) hospitalization in Victoria, Australia. A retrospective analysis of Victorian AMI (ICD-10-AM codes I21 and I22) and stroke (ICD-10-AM I63 and I64) discharges from routinely collected hospital data in 2001-2002 was conducted. The outcome measures were directly age standardized rate ratios (RRs) of AMI and stroke hospitalization, calculated using 2001 Australian census data, with the Australian-born as the reference group. Males from 4 ethnic groups — USSR/Baltic; Southern Asia; Middle East; and Eastern Europe, displayed higher risk for AMI hospitalization than Australian-born men, whereas males and females from Southeast Asia and Northeast Asia were at lower risk. Furthermore, males from Western Europe and females from the Pacific were also at lower risk. Females from the Middle East, Southern Asia, and Southern Europe were at higher risk of stroke hospitalization than Australian-born women; in contrast, males from Eastern Europe, NorthAsia, Southern Asia, Southern Europe, and the United Kingdom and Ireland were at lower risk. Risk for AMI and stroke hospitalization varies by country of birth in comparison with the Australian-born population. It will be import to identify the factors associated with these varying risks in order to target preventive strategies aimed at reducing risk of AMI and stroke.
Public Health: Myth, Mysticism and Reality
Authors: Ko U Ko
Published: June 2011

In England, public health was divorced from clinical medicine during the mid-nineteenth century, following a directive from Edwin Chadwick. Since then, the two disciplines have gone their separate ways with physicians receiving training for curative practice on the one hand and for public health practice on the other. The United States, among many other countries, followed suit. In due course, the frontiers of both curative medicine and public health have expanded.

This divorce between the two disciplines of medicine cannot be justified. Medicine includes the whole enterprise: sanitation, hygiene, genetics, nutrition, behaviour and therapeutics, all in relationship to man himself in his natural, social, economic and political environment. Each branch of medicine has its distinct role to play, but it is only a part and not the whole; all of them together make the whole. Unmindful of these realities, curative medicine on the one hand and preventive medicine on the other, each finds itself shrouded in mystery. They have become enlarged and out of proportion to their real utility and a sense of realism is called for.

The mythical dichotomy in curative medicine and public health is reflected in the various training programmes for physicians and other prof essionals for the two distinct branches of medicine as well as in the organisational arrangements for curative medicine and public health. However, there was much dissatisfaction with this arrangement around the middle of the 20th century, a dissatisfaction reflected in the social medicine movement both in England and the United States. In spite of this, medicine continues to be divided along curative and public health lines.

Several attempts were made to bring the two branches of medicine together.

Notable among these efforts were those of Lord Dawson in the 1920s when he sought a national health service integrating all branches of medicine and of the Bhor's Commission in post World War II India which sought to do likewise. The most recent attempt is the movement of Health for All by the Year 2000 with primary health care as the key. approach. This movement seeks to bring primary health care, in essence a package of social medicine, to all people, especially at the first level of the health organisation. However, among others, it poses serious challenges to health manpower education. Since schools of public health and other schools for health prof essionals are intimately concerned with health manpower education, some relevant issues are presented for reflection and deliberation. At a critical time like this, it is natural to look to these centres of excellence to prepare and to produce health leaders, wise men, and educators to forge ahead to meet these challenges.
Developing Primary Health Care for A Nomad Tribe: The Penans of The Baram
Authors: Chen P C Y
Published: June 2011

Unlike much of Peninsular Malaysia, the Baram District of Sarawak remains sparsely populated and underserved, one of the most underserved peoples being the nomadic and semi-nomadic Penans of the Baram. Until quite recently these Penans lived as small nomadic bands of hunter-gatherers. More recently, they have begun to settle in longhouses. However, lacking the necessary skills to live a settled mode of life, these Penans suffer a great deal of hunger, malnutrition, disease and death. Primary health care with its emphasis on the seven essential elements, including food production and nutrition, environmental sanitation, good maternal and child health, knowledge of disease and how it can be prevented as well as the treatment and control of locally endemic diseases, is of critical value in the survival of the semi-nomadic Penans. The specially designed primary health care programme for the Penans of the Baram is outlined briefly in this paper.
Intestinal Parasitism Among Penan Children of the Upper Baram, Sarawak
Authors: Kan S P , Yap S B , Yap P L
Published: June 2011

A total of 120 Penan children (from two months to ten years of age) in the Lio Matu area of the Upper Baram district in Sarawak was examined for intestinal parasitic infections. Stool samples were collected in plastic stool packets and examined with the ether formalin concentration method. Those positive for hookworm were cultured with the Petri dish method for identification. Exactly one-third of the children were infected with the soil-transmitted helminths- Ascaris lumbricoides, Trichuris trichiura and Necator americanus. Single helminthic infections were more common than mixed infections among these children. Only 2.5% of them had intestinal protozoa. The factors for the relatively low prevalence of intestinal parasitic infections and the role of intestinal parasitism in the aetiology of malnutrition among these Penan children were discussed.
The Influence of Alcohol Countermeasures in Changing Drink Driving Attitudes
Authors: Trinca G W
Published: June 2011

Action to reduce the Australian road death toll has largely depended on legislative initiatives. The response can be judged by the reduction in the annual number offatalities from 3, 798 in 1970 to 2, 812 in 1984. A significant component of road accident countermeasures concerns the control of illegal drink driving. Alcohol misuse remains the single most important factor contributing to road crash deaths and injuries in a country where solid drinking by the majority of the community is normal behaviour. In Australia, the effectiveness of drink driving control has depended on the development of a package of countermeasures, which includes a blood alcohol legal limit of 0.05g% in all but two states, compulsory blood alcohol testing of casualties, random breath testing and heavy penalties.

The effectiveness of these measures in changing drinking habits and attitudes to drink driving is reflected statistically by the reduction in the national percentage of drivers and riders killed with an illegal blood alcohol concentration from 44% in 1981 to 36% in 1984. Over a similar period there was a fall in all fatalities per 10, 000 registered vehicles from 8.5 to 2.9. In the State of Victoria, there was a fall in alcohol-affected casualties from 37% in 1977 to 24% in 1984.

A plea is made for uniformity of drink driving legislation on a national basis: more systematic and sequential education programmes for road safety knowledge and behaviour; a better balance in advertising between the promotion of alcohol use and the awareness of the health hazard of alcohol consumption.
A Pilot Study of Occupational Health Problems Among Hospital Nurses
Authors: Samarawickrama G.
Published: June 2011

An investigation was carried out using an interviewer-administered questionnaire on a study group of 300 nurses and on a reference group of 250 school teachers to determine the health problems associated with the nursing prof ession. Sensitivity to penicillin and other substances was found to be the most common health problem associated with nursing. Nearly 60% of the nurses were hospitalized for over three days for various types of illnesses as compared with 11% of teachers, the most common illness being typhoid fever. Recurrent sore throat, backache and varicose veins were more common in nurses and in fact, most of the illnesses were developed after joining the nursing prof ession. A considerable proportion of injuries, which involved leave for over three days, was seen among the nursing staff. The differences in prevalence rates of these diseases and disabilities are statistically significant.
The Difference Between Males and Females in Lung Cancer Mortality in Japan
Authors: Kano K , Santamaria MJ , Yamaguchi S
Published: June 2011

In 1980, cancer was the most common cause of death in Japan accounting for 23.9% of all deaths. Although stomach cancer is still the major type of malignant neoplasm, trends indicate that, in the future, lung cancer will take this position. The information on lung cancer obtained from Japanese vital statistics was analysed to show secular trends as well as comparisons between the sexes. The information also examined the difference between rural and urban areas and clarified some of the causal factors in the increase of lung cancer, especially among men. Factual increase in lung cancer among males compared with females may be considered to be mainly related to excessive smoking habits.
Health Risk Appraisal by Ventilatory Capacity
Authors: Phoon W O , Chia KS
Published: June 2011

Ventilatory evaluation has been widely used to investigate occupational effects on the respiratory system. This paper reports on a cross-sectional epidemiological study in Singapore carried out on four different occupational groups. A total of 999 male workers were evaluated by a spirometer interphased with a microcomputer. Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC) of each worker were measured. The results suggested that ventilatory capacities are significantly correlated to age and height. Smokers, however, did not differ significantly from non-smokers in their FEV1 and FVC values. This was probably due to the fact that they were relatively light smokers. After adjustment for age and height, the Chinese were found to have slightly higher ventilatory capacities than the Malays in both the FEV1 and FVC. One important observation from the present study was that occupation was found to have a significant influence on lung capacity. Aircraft mechanics and firemen were found to have a higher mean FEV1 than other occupational groups-probably due to the stringent recruiting criteria of these two groups of workers. However, firemen also tended to have a greater reduction in lung volumes with increasing age. The rates of decrease in FEV1 for firemen, blue collar telecommunications workers, aircraft mechanics and sedentary workers were 0.031, 0.029, 0.026 and 0.016 litres/year, respectively. The rate of decrease in FVC showed a similar pattern of 0.022, 0.019, 0.011 and 0.006 litres/year, respectively. This finding indicates that sedentary workers appear to have a lower respiratory health risk compared with their counterparts in other sectors. In contrast, firemen are constantly facing possible respiratory hazards. As demonstrated here, measurement of ventilatory function could be a useful predictor for surveillance of respiratory hazards. However, certain factors like age, height, ethnic origin and smoking habits must be considered in the analysis and interpretation of results.
Epidemiology, Behaviour and Health: A Melanesian Example
Authors: Pataki-Schweizer K J
Published: June 2011

The changing pattern of disease in the world today involves both developed and developing societies. Increasingly, health problems are a combination of both long-established and newer diseases, their pathogens and a complex ecological interaction with culturally-mediated human behaviour. This paper discusses the characteristics of the contemporary health/illness interface in relation to a particularly important discipline-epidemiology. It considers a part of the Pacific area where examples of these changes are particularly evident, ie Melanesia, with specific attention to the recently-independent nation of Papua New Guinea. The paper poses the need for viable concepts and models accurately representing present-day disease dynamics, especially for developing countries. The success or otherwise of primary health care programmes and of health services overall depends on formal recognition of the relationship between health and behaviour, with particular reference to the direct implementation of this programme into health services and medical education.
The Prevalence of Antibody to Hepatitis A Virus in Singapore
Authors: Goh K T , Wong L YM , Oon C J , Kumarapathy S
Published: June 2011

Sera collected from 1, 630 healthy children and adults aged between six months and 55 years during the period 1984 to 1985 were tested for hepatitis A virus (HAV) immunoglobulin G antibody by enzyme immunoassay. The over all antibody prevalence rate was 31.8%. It increased from 0% in children under five years old to 15.5% in adolescents and young adults (15 to 24 years) and reached the highest level of 88.2% in adults over 55 years of age. No statistically significant differences in the overall prevalence by sex and ethnic group were observed. None of the 938 samples tested for HAV immunoglobin M antibody was positive. Compared with the data in 1975, the survey showed that the level of exposure of Singapore children to HAV was declining as the result of vast socio-economic progress made during the past decade.
Changes in the Health Situation Among the Rural Population and the Challenges to the Preventive Services in China
Authors: Wang TG , Chen YD , Yang H , Peng RC
Published: June 2011

China has a population of one billion, of which 80% live in rural areas. Faced with the changing situation in rural health care work subsequent to the economic structural reform in the vast rural areas and their challenges to the prevention services, appropriate measures in Chinese rural health care work were taken. All levels of leaders of health care and other departments were instructed to adhere to the policy of “prevention first”, to expand the functions and tasks of prevention, to reform the current health organisational structure, to strengthen the three-level health care network and to collect funds from various sources to support health care work and the prevention of disease.
Towards a Stationary Population in Singapore
Authors: Swee-Hock Saw
Published: June 2011

The aim of the national population control programme in Singapore is to work towards a stationary population in the twenty-first century. In this paper we will describe the methodology used to simulate such a stationary population and discuss the results and implications of the simulation exercise. We can expect this stationary population to be attained by the year 2030 when the size of the population will stand at about 3.4 million. In moving towards this stationary state, the number of births will rise slightly from about 42, 000 in 1985 to 45, 000 in 2030, but the number of deaths will rise steeply from about 13, 000 to 45, 000 during the same period. The ageing process of the population is expected to continue rapidly until the stationary state in 2030 when the proportion of persons aged 60 years and over will constitute more than one-fifth of the total population. Singapore is now faced with the difficulty of achieving the demographic goal of a stationary population because fertility has remained consistently below replacement level since 1975. It is necessary to relax, or eliminate, the present strong anti-natalist policies so that fertility can have a chance of moving back up to replacement level.
Primary Health Care, Community Participation and the Urban Poor: A Review of the Problems and Solutions
Authors: Rifkin S B
Published: June 2011

Community participation is seen as the key to Primary Health Care (PHC) but to date is the most difficult and least understood principle. To assist health planners to implement PHC programmes, three simple questions can be asked: why participate? who participates? how do they participate? This paper explores in detail the latter question by asking how communities can be mobilised and what structures can be developed to support community participation. An analysis is made of community participation in programmes for the urban poor to examine the answers to these questions. Case studies from Asia are given to illustrate various points. The study concludes that if PHC has a chance of succeeding then all social services must be integrated, planning and management mechanisms must be developed, agency work must be coordinated and finally, planners must have flexible responses to programmes.
Fish and Nutrition in the Pacific Islands
Authors: Kent G
Published: June 2011

Malnutrition in the Pacific islands arises partly because local production offish and other foods is strongly export-oriented and imported foods are of ten of inferior nutritional value. Some types of malnutrition in the Pacific islands might be remedied through improved use offisheries products.

In the production phase offisheries operations, increasing attention should be given to local production for local consumption. In processing, improvements could be made in traditional techniques of drying, salting and smoking fish. The use offish products in weaning foods should be strengthened. In distribution, means could be found to improve the delivery offish to the poor, whether through commercial channels, barter, traditional gifting or institutional feeding. Consumption patterns in households could be improved through educational programmes, which address traditional taboos and which promote improved home preservation and preparation techniques.

At the national level, nutritional impacts should be taken into account along with economic impacts in the evaluation offishery development plans and projects.
Child Care Services in Malaysia: An Overview
Authors: Yusof K , Wong YL , Ooi GL , Hamid-Don F
Published: June 2011

In 1982, under the patronage of the Ministry of Social Welfare and with financial aid from UNICEF, three consultants from the University of Malaya conducted a National Child Care Survey to: provide an overview of child care services in Malaysia; to design a monitoring system to help child minders and relevant personnel to assess the standards of child care at the centres; and to develop a series of policy recommendations for implementing “better child care” in the country. This paper presents the first part of the National Child Care Survey, that is, an overview of child care services available in Malaysia.

The survey was conducted in five states in Peninsular Malaysia — Penang, Perak, Selangor, Kelantan and Melaka — and in two cities — Kuching and Kota Kinabalu — in East Malaysia. The national survey studied the type of care found at 537 centres where 824 minders looked after 7, 884 children. Four major aspects of child care were identified and subsequently examined: the physical conditions and environmental hygiene of the premises; profile of children under care; daily practices; and the personnel in the three basic types of centres, i.e., Institution-based, plantation-or estate-based and home-based.
Different Therefore Equal: Towards Equity in the Health Services in Fiji
Authors: Waddington C , Newell K
Published: June 2011

“Equitable resource distribution” is one of the health policy indicators used to monitor the World Health Organization's (WHO) Health for All by the Year 2000 strategy. However, many countries find the monitoring of equity problematic because it is a difficult notion to define. This article discusses various possible definitions and concludes that equality of expenditure per unit of population (or preferably, per unit of need) is the best definition of equity to pursue In operational terms. However, the weaknesses of this approach are acknowledged — most importantly, the definition ignores the fact that geography and the distribution of the population into small, Isolated groups result in different costs for equivalent items of service. This is clearly of great relevance to Pacific Island states.

The state of resource distribution in 1986 in the government health services in Fiji is examined. Only equity amongst divisions and provinces — i.e., geographical equity — is considered. Per capita annual expenditure ranges from F$15.70 in Nadroga and Navosa province to F$36.20 in Naitasiri. It would be premature to conclude that such a distribution is necessarily inequitable and unfair. Rather, the data should be seen as a springboard for further research to investigate to what extent, if at all, the “over-funding” of some divisions and provinces is justified.

This article does not answer neatly the question: are government health service resources distributed fairly in Fiji? This cannot be done without the development of either nationally defined norms of service or calculations of the costs of meeting needs in different regions. Finally, it is emphasised that empirical investigations into equity will lead nowhere unless the political will exists to supply services fairly, regardless of the user's race, religion or place of residence.
Accidents-A Major Public Health Problem
Authors: Stoke J
Published: June 2011

Injuries rank above disease as a major cause of death in many groups in society. Using New Zealand data, this article shows that accidents are a major public health problem. It is suggested that this problem can only be solved by using a multidisciplinary approach. The factors involved in this approach are discussed and presented in the form of a fatal injury equation.
Radiation Surveys of Video Display Terminals: Report of a Two-Year Study, June 1983-June 1985
Authors: Karel SG
Published: June 2011

Growing concern about possible harmful visual display terminal (VDT) radiation emissions by East-West Center (EWC) staff members, particularly secretarial staff, resulted in the formation of a VDTs Health Effects Committee in August, 1982. The Committee recommended that all EWC VDTs currently in use be surveyed for X-ray and ultraviolet radiation emissions to determine if staff members were being exposed to potentially hazardous levels of radiation. The committee also recommended that all VDTs falling into one of the following categories be surveyed: those that were being used for the first time; those that had just been repaired or serviced; those that were five years old; or those that were being used after being in storage.

In total, 186 VDTs were surveyed for X-ray and ultraviolet radiation emissions by the University of Hawaii radiation safety of ficer and the East-West Center health of ficer between April 1983 and June 1985. The surveys were done in two phases. In the first phase, 101 VDTs were surveyed during April and May, 1983. This constituted all the available terminals in use at that time. Over the next two years, 85 VDTs were surveyed when they experienced one of the four conditions mentioned above. The majority of VDTs surveyed (163 or 87.6% of the sample size) were from one manufacturer and the remaining 23 terminals (12.3% of the sample size) were from eight different manufacturers. All surveys were done during work hours and disruption of the employee's work routines was minimal. All terminals surveyed were being used by EWC employees.

Two instruments were used to measure ultraviolet radiation in the range of 254 to 400 nanometers (nm). This is the known range of carcinogenic effects in humans. All the measurements with the instruments were taken on contact with the VDT screen. Two instruments that were capable of detecting low energy X-rays (the type potentially emitted by VDTs) were used to measure X-ray radiation.

The radiation levels emitted by VDTs are very low compared to current occupational exposure standards. The results from the 186 VDTs surveyed at the EWC demonstrated that exposure to ultraviolet and X-ray radiation was below the detection capability of the survey Instruments and thus well below current occupational exposure standards. Based on this survey data, it appears that VDTs do not present a radiation hazard to the employee working on or near a terminal.
Development and Environmental Health: Criteria for Professional Education
Authors: MD GM Green
Published: June 2011

Economic and technologic development cause Increasingly complex health problems for the environmental health professional to resolve. The public health professional, who will be charged to give counsel and solve problems in major environmental health Issues currently may have an Insufficient educational background for the adequate performance of such responsibilities. This paper will explore the rationale for identifying and formalising improved criteria for the interdisciplinary education of the environmental health professional and describe briefly an experimental programme.
Health Effects of Air Pollution due to Automotive Lead in Jakarta
Authors: Tri-Tugaswati A , Suzuki S , Koyama H , Kawada T
Published: June 2011

Atmospheric lead and its health effects were surveyed in Jakarta, indonesia. Public transportation drivers of small tricycles in downtown Jakarta (exposed group) and farmers who lived in the suburbs of Jakarta (control group) were examined for biomedical effects of lead. Lead concentration in the air along the streets where the drivers work is 3.6 and 1.7 μg/m3with a traffic volume of 5, 148/hour and 1, 284/hour for one side during the day. In the suburbs of Jakarta it was 0.3 μg/m with a traffic volume of 40/hour. The driver group had double the lead concentration both in blood and urine, delta-amlnolevullnic acid (ALA) dehydrase activity decreased by 30%, and higher coproporphyrin excretion compared to the control group on average. The differences were statistically significant. Mean ALA concentration and haematocrit value showed no difference between the groups. An increased absorption of lead and effects of lead at enzyme level are so pronounced that a lead reducing programme of gasoline may be recommended.
Prevalence of Serological Hepatitis B Markers in a Working Population in Hefei, China
Authors: Seiji K , Inoue O , Kasahara M , Nakatsuka H , Watanabe T , Hu YT , Wang JF , Wen ZR , Li SQ , Ikeda M
Published: June 2011

Hepatitis B surface antigen and antibody (HBsAg and anti-HBs, respectively) prevalence was examined by means of solid-phase radioimmunoassay in 503 serum samples obtained from factory workers (230 men and 273 women) in Hefei, the capital city of Anhui Province, China, in 1985. The prevalence of HBsAg-positlve cases was 8% and that of anti-HBs-positive cases was 46%; the overall prevalence rate was 53% when the positivity in either of the two was considered to be indicative of hepatitis B virus (HBV) infection. There was no significant sex difference in the rate, whereas anti-HBs rate was slightly elevated in accordance with increased age. The review and evaluation of existing data in 14 articles led to a conclusion that the current HBV prevalence among Chinese populations will be in the range of 50% to 60%.
Environmental Health in Japan — A Retrospective and Prospective Review
Authors: Tsuchiya K
Published: June 2011

This paper is a review of environmental quality over recent decades in Japan. It refers to the compensation system of environmental pollution-related health impairment first. Currently, those with any of the following four diseases: respiratory diseases (chronic bronchitis; bronchial asthma; asthmatic bronchitis and pulmonary emphysema); Minamata disease; Ital-ital disease associated with cadmium poisoning; and chronic arsenic poisoning are eligible for certification to receive benefits under the Compensation Law.

In addition to a brief history and description of the present situation regarding these diseases, air quality standard and compliance rate are discussed. Other environmental pollutants such as water pollution, noise and vibration are also noted.

Finally, the importance of international cooperation concerning the problems of acid rain and increased carbon dioxide in the atmosphere, is discussed.
Occupational Health of Working Women in China
Authors: Wang YL , Zhao XH
Published: June 2011

This paper is a review of occupational health of working women in China over the past 37 years. Only four papers in connection with the subject of occupational health for working women published before liberation could be found, in which only 543 female workers were surveyed. Since liberation, 317 papers on the subject have been published, Involving 934, 177 female workers. Owing to tradition and the physiological features women are endowed with, they have a heavy load; what is usually known in China as the ‘double burden'. That is to say, women are not only taking care of household duties but also bearing children.

This paper summarises some major occupational hazards Chinese working women are exposed to, such as chemical, physical, and biological agents and their effects. It also lists certain effective preventative measures now being taken in China.
Weight-for-Height as a Measure of Nutritional Status in Filipino Pregnant Women
Authors: Magbitang JA , Tangco JBM , de laCruz EO , Flores EG , Guanlao FE
Published: June 2011

A weight-for-height table by week of pregnancy for Filipinos was developed and its potential use in identifying mothers at risk of delivering low birth-weight babies was tested. The table derived from the weight-for-height table for adult Filipinos developed by de Leon et al assumed the following: 1). Average increase in weight during pregnancy is 20% of pre-pregnant weight, with an increase of 1.7% of pre-pregnant weight in the first trimester of pregnancy and the remaining 18.3% increase achieved during the second and third trimesters. 2). The pre-pregnant weight of the subject equals the standard reference for her height. The derived table was subsequently tested on existing data on 158 urban and rural pregnant women sampled by Magbitang et al2and Baltazar et al.3Results showed that pregnant women whose weight at first visit was below 95% of the proposed standard had twice as much risk of delivering low birthweight babies than those whose weights were greater than or equal to 95% of the proposed standard. The table can be used by barangay level workers as a risk indicator for screening mothers at risk of delivering low birthweight babies so that appropriate and timely preventive measures can be taken.
Family Planning as a Priority for Maternal and Child Health
Authors: Viegas OAC , Singh K , Ratnam SS
Published: June 2011

Maternal, perinatal, Infant and child mortality rates in the developing world are significantly higher than in Industrialized countries. Much of this mortality is attributable to pregnancies “too young, too old, too many and too close.” It Is therefore obvious that the potential impact of family planning on maternal and child health can be immense. Such measures successfully implemented will improve the health of women by enabling them to have children when they are best prepared for them, thereby avoiding the complications of a high-risk pregnancy.

This paper reviews the world literature in an attempt to stress the need for recognising family planning as an important public health priority. It also discusses some of the socio-demographic changes that have occurred in Singapore as a result of unique family planning policies and their contribution to an overall improvement in maternal and child health in this Republic.
Influence of Long-Term Malnutrition on Educational Performance
Authors: Rajapaksa L C , Fernando DN
Published: June 2011

A random sample of 60 Grade I school children, who were chronically malnourished, were studied along with an age-sex matched control group of nutritionally “normal” children from the same class, information on environmental factors were obtained from the parents and a behavioural assessment was done by the teacher. Two sets of tests in language and arithmetic were used to measure educational performance. In addition, a development quotient was obtained for each child. The majority of the stunted children were from an economically deprived background and were likely to show a deviant behavioural pattern. They also had a lower level of educational performance. This study indicates that inter-relationships between socio-economic factors, stunting, deviant behaviour and development quotient influence educational performance, even though the relative contributions made by each of these factors vary.
Tetanus in Southeast Asia
Authors: Kim-Farley R , Mochny I , Schnur A
Published: June 2011

With an estimated 337, 000 cases and 270, 000 deaths due to neonatal tetanus each year, tetanus remains a major public health problem in Southeast Asia. Although immunisation coverage of pregnant women with tetanus toxoid and infants with Diphtheria Pertussis Tetanus (DPT) has increased, it is clear that immunisation activities must be accelerated to meet the 1990 goal of Universal Child Immunisation and eliminate the needless suffering, disability and death from tetanus.
Acceptability and Efficacy of Purified Vero-Cell Rabies Vaccine in Thai Children Exposed to Rabies
Authors: Chutivongse Supawat , Supich Chalida , Wilde Henry
Published: June 2011

A field trial of purified vero-cell tissue culture rabies vaccine (PVRV) was carried out, and 566 children under 15 years of age were studied. Of these 309 (54.6%) had been exposed to laboratory proven rabid animals. Rabies immune globulin (RIG) was given to 47 children with severe exposures. The vaccine was given by the conventional six-dose intramuscular route to 467 patients (82.5%). The remaining 99 victims (17.5%) were given vaccine by the multiple site intradermal route using a schedule of 0.1 ml at two sites on days 0, three and seven, and at one site on days 30 and 90. Adequate follow-up was achieved in 100% of the cases with proven exposure to rabid animals at three months, and in 94.1% at one year. The overall follow-up rate for the entire group was 91.1% at the end of one year, and all patients traced were alive and healthy. The incidence of minor adverse reactions to PVRV was equal to that of other tissue culture rabies vaccines. Regional lymphadenopathy and itching at the injection sites were significantly more common in the group receiving intradermal vaccine than in those who received vaccine by the intramuscular route.
Revisited: Is Subclinical Protein Deficiency A Significant Public Health Concern?
Authors: Keller S
Published: June 2011

In the mid 1970s an emphasis on protein mainutrition shifted to an emphasis on energy deprivation as the crux of the world's nutrition problems. While energy is indeed critical, and clinically pure protein deficiency (i.e. kwashiorkor) relatively uncommon, mild to moderate protein deficiency may be a significant and widely overlooked problem. Studies of dietary intake on an individual level show that foods high in protein are particularly subject to skewed intra-familial distribution, with adult males receiving a disproportionate share. Women and children of ten fail to meet their protein requirements even when consuming adequate or near-adequate amounts of energy. A number of studies suggest that the functional effect of such subclinical protein deficiency is a decreased immunological response, resulting in increased frequency and severity of illness in a group already at risk: women and children in the developing countries. Without underestimating the importance of energy staples, protein intake in these vulnerable groups warrants renewed attention.