bluuebunny/crossref_metadata_2025 huggingface dataset:
A Survey of Food Hygiene Knowledge and Attitudes among Chinese Food Handlers in Fong Song Tong District
Authors: Tang C.H. , Fong U.W.
Published: June 2011

The purpose of this study was to find out the knowledge and attitudes concerning food hygiene among Chinese food handlers in Fong Song Tong district, and to analyze the impact of variables on the degree of knowledge and attitudes. Face-to-face interviews were conducted within Chinese food handlers in Fong Song Tong district using a self-designed questionnaire, which contained food hygiene knowledge and attitudes. Main knowledge outcome measures included food handling, personal hygiene and legislation issues. Questionnaires were completed by 580 (72.0%) chinese food handlers from 91% premises of the district. 71.2% Chinese food handlers could respond correctly to eight or more out of 11 knowledge questions and 1.4% respondents only achieved full scores of knowledge. Fully correct response of personal hygiene knowledge was statistically and significantly higher than food handling knowledge ( p<0.05). 79.0% of respondents showed their need of more food hygiene education. Male respondents, age less than 30, secondary education or above, five years or more of working experience, or who had previously attended a health training within the last two years, generally performed better on the knowledge of food hygiene. Chinese food handlers working in the kitchen and owners' beliefs on 'cleaning the kitchen before getting off duty' was reasonable. Those with secondary education at least, or who had prior participation in a health training within the last two years would need more food hygiene knowledge than the people aged over 30 or who were the owners. It would be more motivated by changing the traditional training model, community-based education in an optimum situation, additional authoritative information, attitudes and intentions of learning on food hygiene. Asia Pac JPublic Health 2004; 16(2): 120-124
The Effect of a Disastrous Flood on the Quality of Life in Dongting Lake Area in China
Authors: Tan H.Z. , Luo Y.J. , Wen S.W. , Liu A.Z. , Li S.Q. , Yang T.B. , Sun Z.Q.
Published: June 2011

We carried out an epidemiological study to assess the impact of flood on the quality of life (QOL) of residents in the affected areas in China. We used a natural experiment approach, randomly selected 494 adults from 18 villages, which suffered from flooding as a result of embankments collapsing, 473 adults from 16 villages, which suffered from, soaked flood, and 773 adults from 11 villages without flood (control group). We used the Generic QOL Inventory-74 (GQOLI-74), social support scale, and questionnaires to assess the QOL of all study participants. The QOL was significantly poorer in soaked group (58.4) and (especially) in collapsed group (55.1) than in control group (59.5, p<0.001). Adjustment for potential confounding factors did not change the results. The impact of flood on QOL was stronger among farmers, seniors, persons with introvert personality, and residents with adverse life-events, whereas social support and extrovert personalities offset the negative impact of flood on QOL. Asia Pac J Public Health2004'; 16(2): 126-132.
The Asia Pacific Academic Consortium For Public Heath (APACPH) The First Ten Years, From 1984 To 1994
Authors: Michael J.M.
Published: June 2011

In January of 1984, five deans of schools of public health from Asia and the Pacific came together on the island of Kauai in Hawaii to formally establish the Consortium. The Consortium owes its cohesive strength through those first ten years of operation, to the dedicated faculty members in the fields of public health and community medicine whose overarching desire has been to seek representation of academic public health in the health decision making process affecting the positive promotion of health. By 1994 the Consortium found itself recognized on a world wide basis in the field of global health with what was described as having: "A great potential for extending the effectiveness of community and public health". "The author, a founding Dean feels that the Consortium's commitment is to shape rather than to await the future of health status improvement for the citizens of the Asia-Pacific region. Asia Pac J Public Health 2005; 17(2): 66-70.
Effects of Nutritional Status on Academic Performance of Malaysian Primary School Children
Authors: Anuar Zaini M.Z. , Lim C.T. , Low W.Y. , Harun F.
Published: June 2011

Numerous factors are known to affect the academic performance of students. These include prenatal conditions, birth conditions, postnatal events, nutritional, socio-economic factors and environmental factors. This paper examines the nutritional status and its relationship with academic performance of 9-10 years old primary school children recruited randomly in Selangor, Malaysia. A standard self-administered questionnaire was utilized to obtain pertinent information and a face-to-face interview was also conducted with the parents. Results of the academic performances were extracted from the students' report cards. The intellectual performance was assessed using Raven's Coloured Progressive Matrices. Physical examination was also conducted on these students by doctors. Overall 1,405 students and 1,317 parents responded to the survey. Of these 83.6% were Malays, 11.6% Indians, and 4.2% Chinese. The majority of them (82.9%) were from urban areas. The female: male ratio was 51:49; mean age was 9.71 years. The mean height and weight were 32.3 kg and 135.2 cm respectively. Their mean BMI was 17.42 kg/cm 2, with 0.9% underweight, 76.3% normal BMI, 16.3% overweight, and 6.3% obese. Academic performance was significantly correlated with breast feeding, income and educational level of their parents, BMI, and whether they have been taking breakfast. There was a weak correlation between presence of anaemia and intellectual performance. Improving the socio-economic status of the parents will lend a helping hand in the academic performance of the students. Since breast feeding is associated with better academic and intellectual performance it must be emphasized, particularly to expectant mothers in the antenatal clinics. Asia Pac J Public Health 2005; 17(2): 81-87.
Dietary Glycemic Load and Macronutrient Intake in Healthy Italian Children
Authors: Scaglioni S. , Sala M. , Stival G. , Giroli M. , Raimondil C. , Salvioni M. , Radaelli G. , Agostoni C. , Riva E. , Giovannini M.
Published: June 2011

The objective is of this study is to examine the relationship of dietary glycemic load (GL) and overall glycemic index (OGI) with macronutrients intake, body mass index (BMI) and insulin sensitivity in healthy children. The subjects comprised of 105 healthy non-obese eight -years old children, 60 boys and 45 girls. A Food Frequency Questionnaire (FFQ) evaluating dietary habits, GL and OGI. Insulin sensitivity was evaluated by the homeostatic model assessment (HOMA). GL was positively associated with dietary total (correlation coefficient, r=0.57) and starch (r=0.67) carbohydrates, daily consumption of pasta and white bread, cooked potatoes, bakery products and cookies, and negatively with dietary fats (r=-0.52). OGI was positively associated with daily consumption of white bread and cookies, and negatively associated with soluble carbohydrates (r=-0.35), and consumption of fibres, proteins, fruit, legumes and carrots. No significant association was found of GL or OGI with BMI or insulin sensitivity. In healthy children, GL and OGI may represent a useful indicator of quality of diet. Asia Pac J Public Health 2005; 17(2): 88-92.
Nutritional and Mental Health Status of Afghan Refugee Children in Peshawar, Pakistan: A Descriptive Study
Authors: Izutsu T. , Tsutsumi A. , Sato T. , Naqibullah Z. , Wakai S. , Kurita H.
Published: June 2011

The study sought to ascertain and describe the physical and mental health states of Afghan refugee children after the terrorist attack on September 11, 2001 in the US and the aerial bombing of Afghanistan that followed. A cross-sectional survey was carried out in four refugee camps in Peshawar, Pakistan from February to March 2002, and comparisons among camps were made. A total of 70 males (mean age SD = 9.81 ±1.98 years old) and 30 females (7.94 ±2.07) answered a self-developed questionnaire on demographic data, traumatic events experience, living environment in the camps, and physical and mental health, through interviews. Anthropometric measures were measured and physical symptoms including anaemia and edema were assessed. Severe malnutrition was not shown and there were no significant differences in most nutritional and physical states among the camps. Nevertheless, in the newer camps more children experienced war related traumatic events. Mental symptoms were prevalent in all camps, though the characteristics of the symptoms differed among the camps. Asia Pac J Public Health 2005; 17(2): 93-98.
Indoor Air Pollution and Respiratory Function of Children in Ashok Vihar, Delhi: An Exposure-Response Study
Authors: Kumar Raj , Nagar Jitendra K. , Kumar Harsh , Kushwah Alka S. , Meena Mahesh , Kumar Pawan , Raj Neelima , Singhal M.K. , Gaur S.N.
Published: June 2011

The objective of this study was to investigate the effects of indoor air pollution on respiratory function of children (aged 7-15 years). The study took place at Ashok Vihar, an urban locality in the northwest part of Delhi during the summer months of June and July 2004. The team did house visits. The questionnaire, administered at the house itself, asked about the history of smoking in the family, type of cooking fuel used, duration of cooking, ventilation and lighting at the cooking place, and other confounders. In total, 441 children (59% male, 41% female) between ages 7 and 15 years were considered for the study, and a detailed profile was collected. Clinical examination with special reference to respiratory system was done. Pulmonary function tests/peak expiratory flow rates of each child were measured. Indoor air pollutant (suspended particulate matter, SO2, NO2) was measured, and the effect of these pollutants on the children's respiratory function was analyzed. The respiratory health profile suggests that children had cough, sputum production, shortness of breath, wheezing, common cold, and throat congestion. Indoor SO2 , NO2, and suspended particulate matter levels were high in houses where there was a family history of smoking. SO2 level was significantly high according to occupancy per room. NO2 and suspended particulate matter levels were significantly high in houses where children had respiratory problems. It is concluded that indoor air pollution had an association with respiratory function of children.
Current Developments in Genomics and Personalized Health Care: Impact on Public Health
Authors: Manamperi Aresha
Published: June 2011

The knowledge gained from the characterization of genomes, especially the human genome, holds considerable potential for the development of new health care innovations for prevention, diagnosis, and management of many diseases in the coming decade. However, owing to the presence of highly complex scientific, economic, social, and ethical issues associated with this field, societies will need to be better prepared for the era of postgenomics and its consequences. It is important to ensure that the benefits of genomics are distributed fairly among all the countries of the world and that the well-tried and more conventional approaches to medical research and practice are not neglected while the medical potential of genomics is being explored. In this report, the author focuses mainly on human genomics, its applications, development of related technologies and issues related to the dissemination of knowledge derived from genome information, and finally, their impact on global health care.
Risk Factors For Fragility Fracture in Seremban District, Malaysia: A Comparison of Patients With Fragility Fracture in the Orthopedic Ward Versus Those in the Outpatient Department
Authors: Keng Yin Loh  , King Hock Shong  , Soo Nie Lan  , Lo Wan-Yi , Shu Yuen Woon
Published: June 2011

Osteoporosis is a silent disease and becomes clinically significant in the presence of fragility fracture. Identifying risk factors that are associated with osteoporosis in the community is important in reducing the incidence of fragility fracture. The aim of this study is to identify risk factors associated with fragility fracture in the Seremban District of Malaysia. This is a population comparison study between orthopedic ward patients and outpatients attending a community health clinic for 6 months. Epidemiological data and the possible risk factors for osteoporosis were collected by direct interview. This study demonstrates that advancing age, low body weight, smoking, lack of regular exercise, low consumption of calcium containing foods, and using bone depleting drugs (steroids, thyroid hormone, and frusemides) are major risk factors for fragility fracture. Most of these risk factors are modifiable through effective lifestyle intervention.
Factors Associated With Inconsistent Condom Use Among Female Sex Workers in Nha Trang, Vietnam
Authors: Tran Thi Tuyet Mai  , Le Cu Linh  , Nguyen Thanh Long
Published: June 2011

This study examined consistent condom use with clients, self-reported sexually transmitted infections (STIs), and associated factors among Vietnamese female sex workers (FSWs). Data were collected through a cross-sectional survey among 192 FSWs in Nha Trang city, in 2005. The rate of consistent condom use with casual clients, regular clients, and nonpaying partners were 59.3%, 38.3%, and 5.3%, respectively. About 5.7% of the FSWs admitted that they are intravenous drug users, and 66.7% of the sample had symptoms of STIs in the past 12 months. Indirect FSW, being drug users, having many clients per week, not watching television on a regular basis, those who thought that they themselves are at extremely high risk of having HIV, and those have never been tested for HIV have been found to be associated with inconsistent condom use. Our results suggest the need to improve STI control in FSWs, further promotion of condom use and information, education, and communication among FSWs.
Orgasmic Dysfunction Among Women at a Primary Care Setting in Malaysia
Authors: Sidi Hatta , Midin Marhani , Sharifah Ezat Wan Puteh  , Abdullah Norni
Published: June 2011

Aim. The aim of this study was to investigate the prevalence of orgasmic dysfunction and the potential risk factors that may be associated with orgasmic dysfunction among women at a primary care setting in Malaysia. Methods. A validated questionnaire for sexual function was used to assess orgasmic function. A total of 230 married women aged 18 to 70 years participated in this study. Their sociodemographic and marital profiles were compared between those who had orgasmic dysfunction and those who did not, and the risk factors were examined. Results. The prevalence of orgasmic dysfunction in the primary care population was 51.9%. Women with orgasmic dysfunction were found to be significantly higher in the following groups: age >45 years, being non-Malay, having lower academic status, married longer, having more children, married to an older husband, and being at menopausal state. Conclusion. Women with infrequent sexual intercourse are less likely to be orgasmic (odds ratio = 0.29, 95% confidence interval = 0.11-0.74).
Home Smoking Restrictions Among Koreans in Seoul
Authors: Hughes Suzanne C. , Corcos Isabel A. , Hofstetter C. Richard , Hovell Melbourne F. , Irvin Veronica L. , Hae Ryun Park  , Hee Young Paik  , Ding Ding M.
Published: June 2011

The prevalence and correlates of home smoking bans in the Republic of Korea were examined using population-based data from telephone interviews with 500 Seoul adult residents in 2002. Most (97%) respondents indicated that they smoked, or that their spouse, other family member, or a regular friend smoked. Nearly all indicated that environmental tobacco smoke (ETS) is harmful. Only 19% of homes banned smoking, 65% allowed smoking anywhere, and 16% allowed smoking by special guests or in certain areas. The odds of having a full ban were significantly greater for men, married individuals, those less than 35 years or more than 50 years of age, non-smokers, individuals whose nonspouse family members did not smoke, and individuals with more sources of anti-ETS messages. Home smoking bans should be promoted by media campaigns and other tobacco control activities, because knowledge of the effects of ETS was already high.
Effects of Dental Caries on Nutritional Status Among First-Grade Primary School Children
Authors: Ngoenwiwatkul Yaowaluk , Leela-adisorn Niramon
Published: June 2011

The aim of this study was to explore association between caries prevalence and nutritional status among first-grade primary school children. A cross-sectional study of 212 students was conducted. All students were weighed and measured and then the body mass index (BMI) was calculated. Each student underwent dental examination and was interviewed. Overall, caries prevalence was 80.2% and the average decayed, missing, and filled surfaces (dmfs) were 12.4 ± 12.3. Although none of the students was in the underweight category, 45.8% were in low percentile (5th < BMI-for-age < 15th). Multiple logistic regression showed that each extra carious surface (dmfs) increased the odds of being at risk for underweight (5th < BMI-for-age < 15th) by 3.1% after adjusting for gender and dental visits. Our findings stressed that caries has significant implications on overall child health and health personnel should increase awareness of negative impacts and promote healthy nutritional choices for children.
Smoking Knowledge, Attitudes, and Behaviors Among Rural-to-Urban Migrant Women in Beijing, China
Authors: Finch Karen , Novotny Thomas E. , Shaojun Ma  , Dingxin Qin  , Wan Xia  , Guo Xin
Published: June 2011

Background: China has the largest population of cigarette smokers worldwide; surveys suggest rising prevalence among young women. Migratory lifestyles may confer increased susceptibility. Objectives: we aimed to understand how migration relates to smoking among young women. Methods: we implemented a cross-sectional behavioral survey of rural-to-urban Chinese women (n = 206) working in restaurants and commercial sex venues, assessing smoking attitudes, behaviors, and health-risk knowledge. Results: rates of ever smoking and current smoking among restaurant workers were high compared with the rates in general population surveys (16.1% and 6.5%, respectively); rates were much higher among sex workers (54.9% and 33.3%, respectively). Multivariate analysis revealed education to be protective, whereas exposure to female-branded cigarettes was a risk for ever smoking. Conclusions: Chinese migrant women appear to be smoking at higher rates than nonmigrant women. Priorities for future research include representative studies in multiple cities examining reasons for uptake and stimuli to quit.
Exposure to and Attitudes Regarding Secondhand Smoke Among Secondary Students in Taiwan
Authors: Chen Ping-Ling , Weigang Huang  , Chuang Yi-Li , Warren Charles W. , Jones Nathan R. , Lee Juliette , Asma Samira
Published: June 2011

The 2003 School Health Act of Taiwan stipulated that school campuses of senior high and below should be smoke free, but data from the Global Youth Tobacco Survey show that the majority of students are exposed to smoke in public and at home. More than 50% of nonsmokers indicated that they had been exposed to secondhand smoke (SHS) in public places, with the exposure rate as high as 90% among smokers. More than 40% of junior and senior high school students were exposed to SHS at home. Support for banning smoking in public places ranged from almost 60% to almost 80%. More than 60% of current smokers and almost 90% of never smokers think that smoke from others is harmful to them. With a clear body of evidence detailing the harmful effects, reduction and eventual elimination of exposure to SHS should be the goal of the tobacco control community.
Review Paper: Epidemiology, Evidence-Based Medicine, and Public Health
Authors: Tang Jin-Ling , Griffiths Sian
Published: June 2011

This article reviews the relation between evidence-based medicine and epidemiology and the recent evolution of the former. The meaning of evidence and the international efforts to collect, summarize, and disseminate findings from scientific research that are relevant for medical decision making are discussed. Evidence, current resources, and people's values, all play a role in making evidence-based medical decisions. This also has important implications for public health practice. However, decision making differs considerably between clinical care of individual patients and public health decision and policies that normally apply to populations. Although more closely related to epidemiology than clinical medicine, public health should also adopt a more systematic approach to evidence-based practice.
Review Paper: Gender Competencies in the Medical Curriculum: Addressing Gender Bias in Medicine
Authors: Wong Yut-Lin
Published: June 2011

Gender inequalities in health and gender bias in medicine are interrelated challenges facing health care providers and educators. Women and girls are disadvantaged in accessing health care because of their low social status and unequal treatment in medical care. Gender bias has long been inherent in clinical practice, medical research, and education. This can be traced to the medical curriculum that shapes the perceptions, attitudes, and behavior of the future doctor. The author advocates medical curricula change to address gender inequalities in health and gender bias in medicine. She analyses the reasons for integration of gender competencies in the medical curriculum, discusses what gender competencies are, and reviews ways to in-build gender competencies and their assessment. Efforts to change and gender sensitize medical curricula in developed and developing countries are also reviewed. The review hopes to contribute to strategic medical curriculum reform, which would lead to gender-sensitive health services and equity in health.
The Association Between Socioeconomic Status and Overweight/Obesity in a Malay Population in Singapore
Authors: Sabanayagam Charumathi , Shankar Anoop , Saw Seang Mei , Tai E. Shyong , Wong Tien Yin
Published: June 2011

In developed countries in the West, lower socioeconomic status (SES) is associated with a higher prevalence of overweight/obesity. The authors examined the association between SES defined by education and income and overweight/obesity in a population-based cohort of 2807 individuals of Malay ethnicity (age 40-80 years, 51% women) in Singapore. The prevalence of overweight/ obesity (body mass index ≥25 kg/m2) in men and women was 50.4% and 65.1%, respectively. In women, the prevalence of overweight/obesity increased with lower levels of education and income. Compared with the higher categories of SES, the odds ratio (95% confidence interval) of overweight/obesity in women was 1.42 (1.06-1.89) for education and 2.08 (1.33-3.26) for income. In contrast, in men, the prevalence of overweight/obesity decreased with lower levels of education and income ( P interaction by gender <.05 for all SES variables). Lower SES was positively associated with overweight/obesity in Malay women, and the association was in the opposite direction in Malay men.
Prevalence of Diabetes Mellitus, Glycemic Control, and Associated Factors in a Malay Population in Singapore
Authors: Sabanayagam Charumathi , Shankar Anoop , Saw Seang Mei , Tai E. Shyong , Lim Su Chi , Lee Jeanette Jen-Mai , Wong Tien Yin
Published: June 2011

There is substantial heterogeneity regarding diabetes mellitus prevalence and glycemic control in Asian populations. The authors examined a population-based sample of 3000 adults (52% women) of Malay ethnicity (40-80 years) in Singapore. The age-standardized prevalence of diabetes mellitus was 18.4% (95% confidence interval = 17.0% to 19.8%). Being overweight, presence of hypertension, presence of cardiovascular disease, and family history of diabetes were found to be positively associated with diabetes mellitus. Higher education, employment status, and current smoking were found to be inversely associated with diabetes mellitus. Among those treated for diabetes, 29% achieved the optimal glycemic goal (glycosylated hemoglobin <7%). Lower levels of low-density lipoprotein cholesterol, total cholesterol, and systolic and diastolic blood pressure were associated with good glycemic control. Nearly 1 in 5 middle-aged Malay adults living in a developed Asian society had diabetes mellitus and a substantial proportion had suboptimal glycemic control.
Cardiovascular Disease Risk in a Semirural Community in Malaysia
Authors: Chia Yook Chin  , Pengal Srinivas
Published: June 2011

Background and aim. It has been argued that cardiovascular disease (CVD) is not very prevalent in developing countries, particularly in a rural community. This study examined the prevalence of CVD risk of a semirural community in Malaysia through an epidemiological survey. Methods. Subjects were invited to a free health screening service carried out over a period of 6 weeks. Then, a follow-up study of the initial nonresponders was done in the villages that showed a poorer response. The survey was conducted using a standardized questionnaire. Hypertension was defined as blood pressure ≥140/90 mm Hg. The Framingham Coronary Disease Risk Prediction Score (FRS) was used as a measure of CVD risk. Results. A total of 1417 subjects participated in this survey. The response rate was 56%. A follow-up survey of the nonresponders did not show any differences from the initial responders in any systematic way. The prevalence of CVD risk factors was high in both men and women. The mean (±SD) FRS was 9.4 (±2.5) and 11.3 (±4.1) for men and women, respectively. The mean predicted coronary heart disease (CHD) risk was high at 20% to 25% for men and medium at 11% to 13% for women. Overall, 55.8% of the men had >20% risk of having a CHD event in the next 10 years whereas women’s risk was lower, with 15.1% having a risk of ≥20%. Conclusion. The prevalence of CVD risk even in a semirural community of a developing country is high. Every effort should be made to lower these risk factors.
Alcohol Expectancies Among High School Students in Inner Mongolia, China
Authors: Shell Duane F. , Newman Ian M. , Qu Ming
Published: June 2011

Objective. This study examines differences in Chinese high school students’ alcohol expectancies by drinking status (nondrinker, occasional drinker, regular drinker) and gender (male, female). Method . The authors administered the Chinese Adolescent Alcohol Expectancy Questionnaire (CAEQ) to a convenience sample of 1244 high school students (M = 627; F = 617) from schools in Huhhot City and Tongliao City in Inner Mongolia, China. Results . Differences were found in the 8 CAEQ factors (3 negative and 5 positive factors). Regular drinkers had lower negative consequences and higher positive perception expectancies than nondrinkers or occasional drinkers. Nondrinkers had higher harm to person/reputation expectancies than occasional or regular drinkers. Occasional drinkers had higher beneficial/moderation and lower harm to person/ reputation expectancies than nondrinkers. Boys had higher positive perception expectancies than girls. Conclusions . Expectancies are associated with Chinese adolescents’ drinking. Identifying the characteristics of alcohol consuming youth can inform the development of prevention interventions and alcohol policies.
Differentials of Tobacco Consumption and Its Effect on Illicit Drug Use in Rural Men in Bangladesh
Authors: Kamal S.M. Mostafa , Islam Md. Aynul , Raihan Md. Abu
Published: June 2011

This study examined socioeconomic differentials of tobacco consumption and its effect on illicit drug use among rural men, extracting data from the 2004 Bangladesh Demographic and Health Survey. Overall, 58.4% of the respondents consumed tobacco either by smoking or chewing. Smoking bidi (33.9%) and cigarette (23.6%) were the most prevalent forms of tobacco use. The prevalence of illicit drug use was 3.5%. The predominant illicit drug used was ganja (2.3%). Socioeconomic and behavioral factors such as age, education, religion, marital status, premarital and extramarital sexuality, and having STDs were found to be significantly ( P < .001) associated with tobacco consumption. Multivariate logistic regression analyses yielded significantly ( P < .001) increased risk of illicit drug use for different forms of tobacco consumption, for young age, premarital and extramarital sexuality, and non-Muslims. Appropriate measures should be undertaken to prevent smoking and illicit drug use for a healthy Bangladesh.
Public Health and Health Services Development in Postconflict Communities: A Case Study of a Safe Motherhood Project in East Timor
Authors: Marlowe Penny , Mahmood Mohammad Afzal
Published: June 2011

Armed conflict causes suffering in many countries; it contributes to poor health and hinders health services development. The effects of conflict are evidenced by weakened community structures and can make reconstruction efforts challenging. East Timor has a history of prolonged conflict and saw a resurgence of internal violence in 2006. This participant observation study discusses considerations for implementing public health and health systems development projects in postconflict settings using a case study of a maternal and child health project. It illustrates the importance of appreciating the historical context and community dynamics when implementing development projects. The sequelae of conflict are often characterized by reduced human resource development capacity, distrust of hierarchy, and limited capacity for resource mobilization. Working in such postconflict communities requires flexibility in program design, stronger efforts for community capacity building, and rebuilding trust between various stakeholders.
Sexual and Reproductive Health Knowledge Among Female College Students in Wuhan, China
Authors: Dongxian Zhang  , Yongyi Bi  , Maddock Jay E. , Shiyue Li
Published: June 2011

The purpose of this study was to explore demographic correlates of sexual and reproductive health knowledge among Chinese female college students. A total of 4769 participants were surveyed about sexual and reproductive health knowledge and related sociodemographic factors, using random cluster sampling between 2005 and 2006, in 16 colleges and universities in Wuhan, China. To evaluate knowledge, the scores of 60 questions on reproduction, contraception, and sexually transmitted infections were combined for a possible score of 100. The average score on the knowledge scale was 42.6 ± 13.0 (1.1 to 79.7). Knowledge scores were statistically significant ( P < 0.01) between different sociodemographic factors using χ2 test. Multilinear stepwise regression showed that 11 of 16 factors, including age, grade, major, menarche age, family residence, being the only child, and mother’s occupation were significantly related to knowledge. Female college students lack knowledge of sexual and reproductive health, and their knowledge was influenced by numerous sociodemographic factors.
Review Paper: Epidemiology of Traumatic Spinal Cord Injury: Comparisons Between Developed and Developing Countries
Authors: Chiu Wen-Ta , Lin Hsiao-Chiao , Lam Carlos , Chu Shu-Fen , Chiang Yung-Hsiao , Tsai Shin-Han
Published: June 2011

A review of global epidemiological studies of traumatic spinal cord injury (TSCI) within 2 decades was undertaken to compare the incidence, mortality rate, patients’ age, gender, causes, and severity of injury between developed countries and developing countries. The incidence rates varied greatly, and there was also a 2-fold difference between the highest mortality rate in developing countries and that in developed countries. Male sex and age from 30 to 50 years are strong risk factors in both these groups. Traffic accidents are the leading cause of injury in developed countries, whereas falls are the leading cause in developing countries. To clarify regional differences, future studies should contain long-term data about TSCI characteristics in a region-based population.
Review Paper: Organ Transplants: Ethical, Social, and Religious Issues in a Multicultural Society
Authors: Noor Zurani Md Haris Robson  , Azad Hassan Razack  , Dublin Norman
Published: June 2011

Recent advances in the fields of organ donation and organ transplant have introduced new hope for the treatment of serious diseases. However, this promise has been accompanied by several issues. The most common issue raised is ethical implications, but in a multicultural society like Malaysia, additional concerns arise pertaining to social and religious issues. These concerns needs to be addressed as attitudes toward and acceptability of organ donation varies according to social, culture, and religion. The diverse cultural, religious, and traditional concepts pertaining to organ donation may hamper its acceptability and cause a lack of willingness to donate organs. The purpose of this article is to briefly explore the ethical issues involved in organ transplant and the various religious opinions on organ donation. It is hoped that this knowledge and understanding may benefit both health care providers and patients in a multicultural society like Malaysia.
Island Health: Hope and Challenges for Public Health
Authors: Binns Colin , Hokama Tomiko , Wah Yun Low
Published: June 2011

The Asia-Pacific region is a region of small islands, perhaps 100 000 of them. The health, communication, and development problems of islands present difficult challenges for the delivery of health care. The discussions at the Okinawa Symposium centred on how health can be provided to all in the region, not only those in metropolitan areas, but also the poor in rural areas and those on living on far-flung island archipelagos. It is important to apply principles of “public health” and “primary health care” so that all island residents may have a reasonable expectation of health care. Schools of public health have a special responsibility to educate those who are responsible for the delivery and management of health care in these remote locations. The development of telehealth systems will be important to support health workers in remote locations and to deliver continuing education programs.
Competency-Based Learning Program in System Analysis and Design for Health Professionals
Authors: Byung Hwa Lee  , Young Moon Chae  , Hokama Tomiko , Kim Suk
Published: June 2011

This study aims to evaluate the effectiveness of a competency-based learning (CBL) approach to an e-learning course on systems analysis and design (SAD). The competency of 18 students who registered for an SAD course was measured at different 3 times during the semester with the use of a competency diary. The changes in the competency scores through the semester were analyzed by a Friedman test, and the factors affecting learning effectiveness were identified by multiple regression. The competency scores increased as the semester progressed. The factors that had a significant effect on learning effectiveness were course management and learning materials. The authors found that the CBL approach worked well for this particular e-learning course on SAD and that nontechnical aspects of the instruction, such as course management and lecture materials, were more important than the technical aspects even in this Internet environment.
Review Paper: The Health Status of Migrants in Australia: A Review
Authors: Anikeeva Olga , Peng Bi  , Hiller Janet E. , Ryan Philip , Roder David , Han Gil-Soo
Published: June 2011

This review summarizes the findings of studies conducted in Australia between 1980 and 2008 that focused on the health status of migrants in one or more of Australia’s National Health Priority Areas (NHPAs), identifies gaps in knowledge, and suggests further research directions. Systematic literature searches were performed on CINAHL, MediText, PsycINFO, and MEDLINE. It was found that the majority of migrants enjoy better health than the Australian-born population in the conditions that are part of the NHPAs, with the exception of diabetes. Mediterranean migrants have particularly favorable health outcomes. The migrant health advantage appears to deteriorate with increasing duration of residence. Many of the analyzed studies were conducted more than 10 years ago or had a narrow focus. Little is known about the health status of migrants with respect to a number of NHPAs, including musculoskeletal conditions and asthma.The health status of recently arrived migrant groups from the Middle East and Africa has not been explored in detail.
Evaluation of the Hypertension Disease Management Program in Korea
Authors: Kim Younmi , Lee Kunsei , Shin Eunyoung , Kim Hyeongsu , Kyung Ja June
Published: June 2011

This study evaluated how the Hypertension Disease Management Program (HDMP) affects patient’s blood pressure, knowledge, health behaviors, and use of medical services. Evaluation was performed by 2 measures, which were before and after comparison within the management group (n = 210) and comparison between the management group and control group (n = 1050) in 2005. Systolic and diastolic blood pressure of management group significantly decreased from 137.5 and 86.0 mm Hg to 131.2 and 83.8 mm Hg ( P < .001, P < .01), respectively. Dieting, snack control, consumption of low-sodium meals, low-cholesterol meals, and fruits or vegetables, regular checking of blood pressure, and stress management techniques significantly increased after HDMP. However, there was no significant difference in the use of medical service between the disease management group and the control group. This study showed that the HDMP improved lifestyle and reduced blood pressure on the disease management group, but changed neither medical costs nor use of medical services. Long-term evaluation should be performed to determine if the HDMP reduce medical costs and use of medical services.
From Jollibee to BeeBee: “Lifestyle” and Chronic Illness in Southeast Asia
Authors: Manderson Lenore , Naemiratch Bhensri
Published: June 2011

Throughout Southeast Asia, the number of people living with chronic conditions and degenerative disease has increased proportionately and absolutely. Public health interventions and effective medical treatment and surgeries have increased life expectancy. Concurrently, social and economic conditions have led to the rapid escalation of lifelong illnesses, characterized as “lifestyle” conditions. Drawing on ethnographic and survey research conducted in Southeast Asia, the authors illustrate the multiple factors contributing to people’s health. Changes in food production; the organization, nature, and conditions of work; living conditions; and other factors affecting contemporary living increase vulnerability to noncommunicable diseases. These factors are largely beyond the control of most people. Efforts to reduce chronic illnesses predominantly focus on individual interventions, overlooking the lack of individual capacity to address the structural and institutional factors that compromise people’s health.
Defending Against Disasters: Global Public Health Emergencies and Opportunities for Collaboration and Action
Authors: Iain Blair
Published: June 2011

The World Health Organization project on the Global Burden of Disease quantifies the main causes of premature death and disability. Changing patterns of physical activity, diet, and alcohol and tobacco consumption are producing a growing burden of noncommunicable disease in low-and middle-income countries. This article focuses on a different group of health risks: major health emergencies that do not respect national borders and have an impact on health and the determinants of health such as housing, access to food and water, and other life essentials. Health emergencies, including accidents and natural events, are described, and data on disasters in the Middle East are presented. Disaster response is contrasted with disaster prevention, and disaster risk reduction is discussed in the context of vulnerability, climate change, and sustainable development. Finally, the international policy context of disaster risk reduction is discussed along with opportunities for multidisciplinary and multiinstitutional collaboration and research.
Psychosocial Profiles of Adolescent Nonsmokers in the Pacific
Authors: Phongsavan Philayrath , Smith Ben John , Chey Tien , Gilmete Mercedes , Havea Drew , Bauman Adrian Ernest ,   Members of the Health Behaviour and Lifestyle of Pacific Youth Survey Collaborating Group and Tonga Core Survey Team
Published: June 2011

Studies examining adolescent smoking have focused on at-risk individuals, while overlooking the psychosocial profiles of those adolescents who have managed to remain nonsmokers. Accumulating evidence suggests that positive emotions such as happiness may be associated with the adoption of healthy practices, but limited evidence has emerged from developing countries. This study examined the association between non-smoking and positive emotions and psychosocial correlates in 3 large population samples of Pacific youths (N = 5659) living in Tonga, Vanuatu, and Pohnpei in the Federated States of Micronesia. Across all 3 samples, being confident was significantly associated with nonsmoking and being happy (Tonga, odds ratio [OR] = 1.39, 95% confidence interval [CI] = 1.12-1.73; Vanuatu, OR = 1.29, 95% CI = 1.02-1.63; Pohnpei, OR = 2.34, 95% CI = 1.60-3.34). Some cross-country differences in relationships were found in the associations between societal factors (ie, perceived connections with school, teachers, and peers, and perceived community importance and involvement) and nonsmoking and happiness. Findings have implications for developing innovative strategies aimed at preventing smoking uptake and suggest the need for focusing on identifying the determinants of nonsmoking and measuring positive emotions.
Climate Change and Farmers’ Mental Health: Risks and Responses
Authors: Berry Helen L. , Hogan Anthony , Owen Jennifer , Rickwood Debra , Fragar Lyn
Published: June 2011

Climate change is exacerbating climate variability, evident in more frequent and severe weather-related disasters, such as droughts, fires, and floods. Most of what is known about the possible effects of climate change on rural mental health relates to prolonged drought. But though drought is known to be a disproportionate and general stressor, evidence is mixed and inconclusive. Over time, like drought other weather-related disasters may erode the social and economic bases on which farming communities depend. Rural vulnerability to mental health problems is greatly increased by socioeconomic disadvantage. Related factors may compound this, such as reduced access to health services as communities decline and a “stoical” culture that inhibits help-seeking. Australia has the world’s most variable climate and is a major global agricultural producer. Yet despite Australia’s (and, especially, rural communities’) dependence on farmers’ well-being and success, there is very little—and inconclusive—quantitative evidence about farmers’ mental health. The aim of this review is to consider, with a view to informing other countries, how climate change and related factors may affect farmers’ mental health in Australia. That information is a prerequisite to identifying, selecting, and evaluating adaptive strategies, to lessen the risks of adverse mental health outcomes. The authors identify the need for a systematic epidemiology of the mental health of farmers facing increasing climate change— related weather adversity.
Sociodemographic Differentials of Selected Noncommunicable Diseases Risk Factors Among Adults in Matlab, Bangladesh: Findings From a WHO STEPS Survey
Authors: Razzaque Abdur , Nahar Lutfun , Abu Haider Mohammad Golam Mustafa  , Karar Zunaid Ahsan  , Mohammad Shafiqul Islam  , Yunus Mohammad
Published: June 2011

The study examined noncommunicable diseases risk factors among adults 25 to 64 years old of the Matlab Health and Demographic Surveillance System using World Health Organization STEP-wise methodology. The prevalence of smoking was found to be very high for males (53.9%) and it increased initially with age, whereas smoking was almost nil for females (0.8%). About 30% each of males and females used smokeless tobacco and its consumption increased with age. Consumption of vegetable/fruit is very low in this population (90% below recommended level), whereas one third of males and two thirds of female have low levels of physical activities. The raised blood pressure was more prevalent among females than in males (21.0% vs 12.5%, respectively) and the same was true for being overweight (13.9% vs 10.3%, respectively). Raised blood pressure increased with age but overweight did not vary by age for males, whereas it increased initially for females. Smoking (males) and use of smokeless tobacco decreased with increase in education, but both blood pressure and overweight increased.
Preparing Health Services for Climate Change in Australia
Authors: Blashki Grant , Armstrong Greg , Berry Helen Louise , Weaver Haylee J. , Hanna Elizabeth G. , Peng Bi  , Harley David , Spickett Jeffery Thomas
Published: June 2011

Although the implications of climate change for public health continue to be elucidated, we still require much work to guide the development of a comprehensive strategy to underpin the adaptation of the health system. Adaptation will be an evolving process as impacts emerge. The authors aim is to focus on the responses of the Australian health system to health risks from climate change, and in particular how best to prepare health services for predicted health risks from heat waves, bushfires, infectious diseases, diminished air quality, and the mental health impacts of climate change. In addition, the authors aim to provide some general principles for health system adaptation to climate change that may be applicable beyond the Australian setting. They present some guiding principles for preparing health systems and also overview some specific preparatory activities in relation to personnel, infrastructure, and coordination. Increases in extreme weather—related events superimposed on health effects arising from a gradually changing climate will place additional burdens on the health system and challenge existing capacity. Key characteristics of a climate change—prepared health system are that it should be flexible, strategically allocated, and robust. Long-term planning will also require close collaboration with the nonhealth sectors as part of a nationwide adaptive response.
Review Article: Freedom to Lead a Life We Have Reason to Value? A Spotlight on Health Inequity in the Asia Pacific Region
Authors: Friel Sharon , Chiang Tung-liang , Youngtae Cho  , Yan Guo  , Hashimoto Hideki , Jayasinghe Saroj , Loring Belinda , Matheson Don , Huong Thanh Nguyen  , Mala Rao
Published: June 2011

The Asia Pacific region is home to more than 60% of the world’s population. Life expectancy at birth differs between countries by as much as 27 years. This article suggests that asymmetric economic growth, unplanned urbanization, marked environmental change, unequal improvements in daily living conditions, and the unequal distribution and access to quality health care have contributed to health inequities in the Asia Pacific region. Contextually specific evidence and action are needed. This requires ongoing monitoring of health inequities and systematic evaluation of societal changes and their impact on health inequities. It requires better understanding of how to translate theoretical and empirical demonstrations of the social and environmental impact on health inequities into evidence-informed policies and programs, in diverse geopolitical, socioeconomic, and sociocultural contexts across the Asia Pacific region and the range of associated complex policy processes. A spotlight is needed on health inequities and their causes else the status quo will persist.