bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Drug Sellers by Old People in Northeast Thailand
Authors: Bryant John , Prohmmo Aree
Published: June 2011

The paper describes an exploratory study of the use of private drug sellers by people age 60 and over in three districts in northeast Thailand. The survey paid special attention to problems of under-reporting, and found that respondents visited drug sellers two or three times a month - a much higher frequency than usually reported. The typical reason for visiting a drug seller was to obtain one or two days' worth of modern medicines to treat the symptoms of non-acute conditions. The paper discusses ways to improve on current survey methods for studying private drug sellers. Asia Pac J Public Health 2001; 13(2): 91-95
Differing Health and Health-Seeking Behaviour: Ethnic Minorities of the Chittagong Hill Tracts, Bangladesh
Authors: Masud Ahmed Syed
Published: June 2011

This study investigates the health and health-seeking behaviour of the indigenous population of Chittagong Hill Tracts, Bangladesh by surveying 2,550 randomly selected households from five major ethnic groups residing in the region. A structured questionnaire was used for collecting data. Morbidity prevalence (23%) and child malnutrition (19%) was highest among Bangalis. Fever (40 %), diarrhoeal diseases (37%) and malaria (16%) were the three most common illnesses reported among the study population. Around fifteen percent of the Bangalis sought care from the para-professionals while 'unqualified' allopaths were consulted more frequently by the Tripuras, Chakmas and the Marmas (60-70%). Qualified allopaths were mostly consulted by the Bangalis (26%). Sex, types of illness, ethnicity, household head's education and household's landholding were significant predictors of seeking treatment, and allopathic treatment in particular. The findings on the differential health and health-seeking behaviour among ethnic groups should help in the designing of any future health interventions in the area. Asia Pac J Public Health 2001; 13(2): 100-108
Evidence-based practice revisited
Authors: Leung Gabriel M.
Published: June 2011

The evidence-based practice (EBP) movement has gathered considerable momentum both locally and abroad since first promoted a decade ago. This paper presents an updated narrative overview of EBP from the clinical and public health perspectives. First, the origins and definition of EBP and how clinicians should go about incorporating it into routine practice are described. Reasons for adopting the EBP philosophy are outlined and the way to learn the process described. The latter can be summarised as the five A's of EBP - assess, ask, acquire, appraise and apply. Limitations of the approach and misperceptions about its weaknesses are also discussed. Potential solutions are offered and areas for future work in the discipline of EBP are highlighted, with particular reference to Hong Kong's situation and that of elsewhere in Asia. Asia Pac JPublic Health 2001; 13(2): 116-121
Issues in Public Health: Assuaging Concern from Contaminated Land Resulting from Land Use Dynamics in Malaysia
Authors: Singh Harwant
Published: June 2011

The anthropogenic disturbance of pristine natural areas caused by land use and transformation from one use to another as a result of increased pressure from demographic changes and the economics of this shrinking resource can result in adverse health hazards for the community. This paper appraises the consequential impact of land use dynamics, its assessment and measures required to assuage this overlooked public health issue. The anthropogenic impact from land use in Malaysia from the industrial sector alone points toward the potential capacity to cause adverse health hazards. A deficiency in assessing this impact due to limited information has resulted in the inability to establish the extent of this problem. Several necessary measures to establish the extent of the problem involving ways to characterise contaminated land and the evolution of a strategy to resolve it are discussed. Asia Pac JPublic Health 2001; 13(2): 122-127
Healthcare Financing in Malaysia
Authors: Kananatu K.
Published: June 2011

This paper presents an overview of the Malaysian healthcare system and its method of financing. The development of the healthcare delivery system in Malaysia is commendable. However, the strength and weaknesses of the public healthcare system and the financing problems encountered are also discussed. Cost of healthcare and funding of both the public and private sectors were also revealed. One must optimise the advantages of operating a health financing scheme which is affordable and controllable which contribute towards cost-containment and quality assurance. Thus, there is a need for the establishment of a National Healthcare Financing, a mechanism to sustain the healthcare delivery network and operate it as a viable option. A model of the National Health Financing Scheme (NHFS) was proposed. Asia Pac J Public Health 2002; 14(1): 23 - 28
Changing Emphases in Public Health and Medical Education in Health Care Reform
Authors: Patrick Walter K. , Cadman Edwin C.
Published: June 2011

Globalisation of economies, diseases and disasters with poverty, emerging infectious diseases, ageing and chronic conditions, violence and terrorism has begun to change the face of public health and medical education. Escalating costs of care and increasing poverty have brought urgency to professional training to improve efficiency, cut costs and maintain gains in life expectancy and morbidity reduction. Technology, genetics research and designer drugs have dramatically changed medical practice. Creatively, educational institutions have adopted the use of: (1) New educational and communication technologies: internet and health informatics; (2) Problem based learning approaches; Integrated Practice and Theory Curricula; Research and Problem Solving methodologies and (3) Partnership and networking of institutions to synergise new trends (e.g. core competencies). Less desirably, changes are inadequate in key areas, e.g., Health Economics, Poverty and Health Development, Disaster Management & Bioterrorism and Ethics. Institutions have begun to adjust and develop new programs of study to meet challenges of emerging diseases, design methodologies to better understand complex social and economic determinants of disease, assess the effects of violence and address cost containment strategies in health. Besides redesigning instruction, professional schools need to conduct research to assess the impact of health reform. Such studies will serve as sentinels for the public's health, and provide key indicators for improvements in training, service provision and policy. Asia Pac J Public Health 2002; 14(1): 35 - 39
Multiprofessional and Continuing Education of Health Professionals
Authors: Jiffry M.T.M. , Med M.
Published: June 2011

The provision of appropriate education and training for health care workers is essential to ensure effective and efficient utilization of their services. Organising multiprofessional learning, providing opportunities for continuing education and utilising of new trends in medical education facilitates achievement of the desired outcome in health care. The delivery of health care is a team effort. Thus, it is beneficial that the members of the health care team are trained together. Such training would provide opportunity to recognise the capabilities and job functions of the fellow health care professionals by the trainees. Similarly, by organising continuing education programmes for health care workers already in service it would strengthen their confidence and also improve the quality of their services. For these purposes, new trends in medical education could be utilised. Asia Pac J Public Health 2002; 14(1): 40 - 43
The Development of an Intelligent Laboratory Information System for a Community Health Promotion Centre
Authors: Chae Young Moon , Lim Hwan-Sub , Lee Ju Hon , Bae Mi Young , Kim Gyu Hyung
Published: June 2011

This study aimed to develop an Intelligent Laboratory Information System (ILIS) for the community health promotion centre in Kwachun city to help process an increasing amount of laboratory test data in an efficient manner, and to support the clinical decision-making of public health doctors. A sample of 170 cases was used for validation of the system. Overall, the system correctly predicted 92.5% of the cases. This paper also analysed the economic feasibility of the ILIS based on the Information Economics approach. The results showed that the ILIS not only helps screen more people by increasing the capacity of a health promotion centre, but also brings in more revenue to the centre. Asia Pac J Public Health 2002; 14(2): 64-68.
The Introduction of Norplant in Cambodia through the Private Sector
Authors: van der Velden T. , Ping C.
Published: June 2011

The objectives of this study are to determine whether Norplant would be an acceptable contraceptive method for Cambodian women, given its technology and the socio-cultural context, and whether it can be delivered by a private sector clinic with good quality care. This is a prospective cohort study of the first 966 acceptors. It was found the one-year continuation rate was 90.5%, there were no pregnancies and client satisfaction was high. In general, Norplant was delivered with high quality of care. Findings indicate that Norplant suits the contraceptive needs of many Cambodian women and is appropriate for their socio-cultural context. Norplant can be introduced, with high quality care, in a private clinic in a developing country. Asia Pac J Public Health 2002; 14(2): 69-74.
Work and Lifestyle Factors Associated with Morbidity of Electronic Women Workers in Selangor, Malaysia
Authors: Lim Hwei-Mian , Chee Heng-Leng , Kandiah Mirnalini , Yahya Sharifah Zainiyah Syed , Shuib Rashidah
Published: June 2011

The objective of this study was to identify sociodemographic, work, living arrangement and lifestyle factors associated with morbidity of electronics women workers in selected factories in Selangor, Malaysia. The research design was a cross-sectional questionnaire-based survey. Most of the 401 respondents were young single Malay women. Morbidity was high as 85.5% of the women reported experiencing at least one chronic health problem, and 25.7% said that an illness or injury prevented them from carrying out normal activities within the last two weeks. Major acute illness symptoms were the common cold, backache, and diarrhoea while chronic health problems such as persistent headache, eye problems, menstrual problems, and persistent backache were also reported. After logistic regression, chronic health problems was significantly associated with room sharing; while illness that prevented normal activities within the last two weeks was significantly associated with overtime work and exercise. Further research is recommended to understand the complex inter-relationship between morbidity and working and living conditions. Asia Pac JPublic Health 2002; 14(2): 75-84.
The Effect of Work Status on Exclusive Breastfeeding in Nairobi
Authors: Lakati Alice , Binns Colin , Stevenson Mark
Published: June 2011

For many women today work is essential for the economic survival of their families while they also fulfil their role of providing optimum nutrition to their babies through breastfeeding. The objective of the study is to document the effect of returning to work on exclusive breastfeeding by mothers in Kenya.

A cross-sectional study of 444 working mothers was undertaken in Nairobi, Kenya. About one half of the mothers were in formal paid employment and the rest were self-employed. The mean number of hours the mothers were away from home due to work was 46.2 hours per week. The prevalence of exclusive breastfeeding was 13.3% at three months. Early introduction of complementary foods was high, with 46.4% of the mothers introducing other foods before one month. Breast milk insufficiency and return to work were the main reasons cited for the cessation of exclusive breastfeeding. In a logistic regression analysis the mode of work (fixed working hours versus shift working hours) was associated with exclusive breastfeeding at one month (OR=0.45) and two months ( OR=0.39).

Working mothers were able to continue breastfeeding, although the exclusive breastfeeding rates were low. The early introduction of other foods is of public health importance as it exposes infants to increased risk of infection and poor nutrition, particularly diarrhoeal diseases and may lead to flattening of the growth curve. Shift work makes it impossible for some mothers to exclusively breastfeed their infants. Asia Pac J Public Health 2002; 14(2): 85-90.
Periodontal Status of Rural Inhabitants in Prek Russey, Cambodia
Authors: Amarasena Najith , Ikeda Noriaki , Win Kyu Kyu Swe , Yamaguchi Yoshiko , Takehara Tadamichi , Miyazaki Hideo
Published: June 2011

There is a paucity of information pertaining to oral disease patterns including periodontal disease in Cambodia, which is just emerging from a 20-year ruin. A house-to-house survey was conducted to assess the periodontal status of 1948 subjects aged 15-74 years in a rural commune in Cambodia using Community Periodontal Index (CPI) and measuring Attachment Loss (LA). The periodontal status of Cambodians increased with age as indicated by both CPI and LA. Calculus was the most common finding among Cambodians pointing to overall poor oral hygiene levels. Notwithstanding the poor oral hygiene, however, the severe periodontitis as denoted by ≥ 6mm periodontal pockets was rare even in the elderly while edentulousness was not frequently observed until 65 years. Preventive programmes targeting periodontal disease in Cambodia should focus on oral health education and simple oral hygiene instructions while the ubiquitous calculus could be dealt with oral prophylaxis. Asia Pac J Public Health 2002; 14(2): 105-109.
Social and Functional Status of Older Persons in a North Indian Community
Authors: Swami H.M. , Bhatia Vikas , Parashar Anupam , Bhatia S.P.S.
Published: June 2011

With increase in life expectancy, the geriatric population is growing in developing countries. The Union Territory of Chandigarh has a population of about 0.9 million with nearly 90% in urban and 10% in rural areas. This cross-sectional, descriptive study was conducted in Chandigarh over a period of one year; 1998-99 among 362 subjects 65 years or more of age covering a population of 7937 family members in 1882 houses. The sampling was done by random sampling technique covering urban and rural population. The proportion of older persons in Chandigarh comprised 5.47% of the population. Most of the respondents were living with their spouses. More than one-fifth of urban and two third of rural older persons were illiterate. About 86% were living with their families and only 3.6% were living alone. Major modes of recreation were visiting religious places by two-thirds followed by going to parks and gardens by nearly one-fourth. Among 203 older persons having living partners in the study, one in every fifth older persons had indulged in sexual intercourse in the past six months. Nearly 2% of older persons needed assistance (partial or full) in activities of daily living like bathing, dressing, toileting, feeding, continence etc. The study also observed rural and urban variation in the use of aids and appliances by older persons. On the basis of very few having functional limitations, there is a need to include components of recreational facilities, activities of daily living, and not just assistance and aids and appliances, while developing a comprehensive geriatric health care programme in developing countries. Asia Pac J Public Health 2003; 15(1): 10-16.
A Knowledge, Attitude and Practices (KAP) Study on Dengue among Selected Rural Communities in the Kuala Kangsar District
Authors: Hairi Farizah , Ong Cyril-H.S. , Suhaimi Anwar , Tsung Teoh-Wei , bin Anis Ahmad Mohd Azhar , Sundaraj Charlotte , Soe Myint Myint
Published: June 2011

A cross-sectional survey was conducted to assess the level of knowledge, attitude and practices concerning dengue and its vector Aedes mosquito among selected rural communities in the Kuala Kangsar district from 16 - 25th June, 2002. It was found that the knowledge of the community was good. Out of the 200 respondents, 82.0% cited that their main source of information on dengue was from television / radio. The respondents' attitude was found to be good and most of them were supportive of Aedes control measures. There is a significant association found between knowledge of dengue and attitude towards Aedes control ( p = 0.047). It was also found that good knowledge does not necessarily lead to good practice. This is most likely due to certain practices like water storage for domestic use, which is deeply ingrained in the community. Mass media is an important means of conveying health messages to the public even among the rural population, thus research and development of educational strategies designed to improve behaviour and practice of effective control measures among the villagers are recommended. Asia Pac JPublic Health 2003; 15(1): 37- 43.
Knowledge, Attitude and Intentions Related to Colorectal Cancer Screening Using Faecal Occult Blood Tests in a Rural Australian Population
Authors: Janda Monika , Stanton Warren R. , Hughes Karen , Del Mar Christopher , Clavarino Alexandra , Aitken Joanne F. , Tong Shilu , Short Leonie , Leggett Barbara , Newman Beth
Published: June 2011

A telephone survey with 604 men and women without history of colorectal cancer (CRC)(age 50-74 years) explored knowledge of, attitudes toward, and intention to screen for CRC using faecal occult blood tests (FOBT) in a rural Australian population. Overall, 53% intended to participate in and 86% would follow a doctor's recommendation for FOBT screening. In contrast, only 18% had ever had a FOBT, and fewer than 60% of those with high-risk family history had undergone appropriate screening for CRC. Prior use of FOBT ( OR=3.2) , high perceived susceptibility to CRC ( OR=2.4), belief in the importance of screening despite the absence of symptoms ( OR=2.1) were positively and older age ( OR = 0.5) was negatively related to screening intention in multivariate logistic regression analysis. A doctor's recommendation improved screening intention among those who never tested for CRC before but believe in the importance of early treatment. This study highlights the lack of compliance with standard CRC screening recommendations in Australia and provides evidence for the importance of continued educational efforts, with the particular emphasis on older adults and the medical community. Asia Pac JPublic Health 2003; 1 5(1): 50-56.
Low Back Pain in Australian Adults: The Economic Burden
Authors: Walker B.F. , Muller R. , Grant W.D.
Published: June 2011

This paper reports the results of a "cost-of-illness" study of low back pain (LBP) in Australian adults. It estimates the direct cost of LBP in 2001 to be AU$1.02 billion. Approximately 71% of this amount is for treatment by chiropractors, general practitioners, massage therapists, physiotherapists and acupuncturists. However, the direct costs are minor compared to the indirect costs of AU$8.15 billion giving a total cost of AU$9.17 billion. LBP in Australian adults represents a massive health problem with a significant economic burden. This burden is so great that it has compelling and urgent ramifications for health policy, planning and research. This study identifies that research should concentrate on both direct but particularly the indirect costs including cost-effective management regimes that encourage an early return to duties. Asia Pac J Public Health 2003; 15(2): 79-87.
Waist Circumference as a Screening Tool for Weight Management: Evaluation Using Receiver Operating Characteristic Curves for Malay Subjects
Authors: Moy F.M. , Atiya A.S.
Published: June 2011

Body Mass Index (BMI) is the most established anthropometric indicator used for assessment of nutritional status. Other anthropometric indicators which are related closely to BMI are waist hip ratio (WHR) and waist circumference. In this paper, receiver operating characteristics (ROC) curves were constructed to assess the value of waist circumference and waist hip ratio as a screening measure for the need of weight management using BMI as the reference test. Sensitivity and specificity were calculated at several cut-offs.

The areas under the ROC curve calculated by comparing waist circumference with BMI were high (0.70 - 0.86) while the areas calculated for WHR were low (0.46 - 0.67). Sensitivities of 0.745 and 0.800 were observed at cut-off points of waist circumference at 90cm and 80cm for males and females respectively, while the false positive rates were 0.233 for males and 0.250 for females. These cut-off points could be considered as a fair trade-off.

Therefore it is concluded that waist circumference performed better than WHR as a screening test. It is indicative that waist circumference could be used as a tool in raising awareness of weight management in this population. Asia Pac JPublic Health 2003; 15(2): 99-104.
Leaching of Bisphenol A from New and Old Babies' Bottles, and New Babies' Feeding Teats
Authors: Tan B.L.L. , Mustafa A.M.
Published: June 2011

Bisphenol A is the monomer used in the manufacture of polycarbonate. Bisphenol A is also known to mimic the female hormone estrogen. In this study, the possibility of the leaching of bisphenol A from polycarbonate babies' bottles and feeding teats was investigated. Bisphenol A was extracted from water samples exposed to the bottles and teats using liquid-liquid extraction. Bisphenol A was analysed by gas chromatograph-mass spectrometer with quadrapole detector in selected ion monitoring mode. Mean leaching of bisphenol A from 100 used babies' bottles when filled with water at 25°C and 80°C were 0.71±1.65 ng/cm2 (mean ± standard deviation) and 3.37±5.68 ng/cm2 respectively. Mean leaching of bisphenol A from 30 new babies' bottles when filled with water at 25°C and 80°C were 0.03±0.02 ng/cm2 and 0.18±0.30 ng/cm2 respectively. Bisphenol A was observed to have leached from babies' feeding teats into 37°C water ranged from non-detectable to 22.86 ng/g. The technique employed in this study is fast, reliable and economical. Asia Pac J Public Health 2003; 15(2): 118-123.
Smoking, Adolescents and Health: Isfahan Healthy Heart Programme-Heart Health Promotion from Childhood
Authors: Kelishadi R. , Sadry G. , Zadegan N.S. , Hashemipour M. , Sabet B. , Bashardoust N. , Ansari R. , Alikhassy H.
Published: June 2011

To evaluate the effect of some environmental factors on smoking, and to assess some health hazards of smoking in adolescents, this cross-sectional study was performed among 1950 students, ages11-18, selected by multi-stage random sampling from three cities in Iran. According to self-administered questionnaires, 12.9% of boys and 4% of girls reported to be smoker (OR=3.34, 95%CI: 2.33, 4.77, p<0.001). The mean values of total-and LDL-cholesterol were higher in smokers and their HDL-C was lower than non-smokers (163.33± 33.83, 90.73± 31 and 46.7± 12.24 vs.156± 29.53, 85±26.5 and 49.4±13.7 mg/dl, respectively, p<0.05). The mean systolic and diastolic blood pressures were higher in smokers than non-smokers (110.7± 14.5, 67.6± 11.55 vs. 104.9± 14.3, 63.2± 10.8 mmHg, respectively, p<0.05). The smokers had higher BMI than non-smokers (20.34 ±3.84 vs.19.55 ± 3.66, p<0.05). The mean food consumption frequency was lower for fruits and vegetables and higher for fat/salty snacks and fast foods in smokers than non-smokers. Logistic regression analysis showed significant association between sex, age, the number of family members and number of smokers in the family and smoking in students. The findings of this study have implications for future tobacco prevention strategies through community-based interventions. Asia Pac JPublic Health 2004; 16(1): 15-22.
How Well were Asthmatic Patients Educated about Their Asthma? A Study at the Emergency Department
Authors: Lee P.Y. , Khoo E.M.
Published: June 2011

70 patients presented with acute asthma exacerbation requiring nebulised bronchodilator treatment at the emergency department of a teaching hospital in Kuala Lumpur, Malaysia, were interviewed over a two-week period in July 2001. The results showed that 45 (64%) patients had not been educated on the nature of asthma; 30 (43%) had not been advised on preventive measures or avoidance of triggers; 54 (77%) were not advised about the medications used and their side effects; 42 (60%) patients did not know the difference between reliever and preventive medications; 37 (53%) were unable to recognize features of worsening asthma and 68 (97%) were not told about the danger of non-prescribed self-medication or traditional medications. Only six (9%) patients were using peak flow meters and were taught self-management plans. The multiple regression results suggest that patients who were followed up at teaching hospital based clinics were better educated on asthma. In conclusion, asthmatic patients are still not educated well about their disease. Health care providers need to put more emphasis on asthma education so that the number of emergency room visits can be reduced. Asia Pac J Public Health 2004; 16(1): 45-49.
Factors Associated with Severe Periodontitis in Rural Cambodia
Authors: Amarasena N. , Ikeda N. , Win K.K.S. , Yamaguchi Y. , Takehara T. , Miyazaki H.
Published: June 2011

An analytical cross-sectional study was conducted with 812 subjects aged 35-74 years in Prek Russey commune, Cambodia to detect some factors associated with severe periodontitis. Four calibrated examiners employed Community Periodontal Index (CPI) to ascertain periodontal pocket depth (PD) and loss of epithelial attachment (LA). A questionnaire was used to obtain tobacco and alcohol consumption habits. One hundred (12.3%) subjects had one or more sextants with ≥ 4mm PD and ≥ 6mm LA (severe periodontitis). Smoking, tobacco chewing and age were significantly associated with severe periodontitis in bivariate analysis while only age and quantified smoking remained significant in a logistic regression analysis. The impact of quantified smoking on severe periodontitis was almost negligible [OR: 1.0006 (95% CI: 1.0001, 1.001)] compared to that of age [OR ranged from 8.3 at 45-54 years to 22 at 65-74 years (95% CI: 3.1, 62.3)]. Nevertheless, both age and quantified smoking can be considered as factors associated with severe periodontitis in rural Cambodians. Asia Pac J Public Health 2004; 16(1): 50-53.
The Monitoring of Pesticides and Alkylphenols in Selected Rivers in the State of Selan Jor, Malaysia
Authors: Tan B.L.L. , Mustafa A.M.
Published: June 2011

Alkylphenols and most pesticides, especially organochlorine pesticides are endocrine-disrupting chemicals and they usually mimic the female hormone, estrogen. Using these chemicals in our environment would eventually lead us to consume them somehow in the food web. Several rivers in the State of Selangor, Malaysia were selected to monitor the level of alkylphenols and pesticides contamination for several months. The compounds were extracted from the water samples using liquid-liquid extraction method with dichloromethane and ethyl acetate as the extracting solvents. The alkylphenols and pesticides were analyzed by selected ion monitoring (SIM) mode using the quadrapole detector in Shimadzu QP-5000 gas chromatograph-mass spectrometer (GCMS). Recovery of most alkylphenols and pesticides were in the range of 50% to 120%. Trace amounts of the compounds were detected in the river water samples, mainly in the range of parts per trillion. This technique of monitoring the levels of endocrine-disruptors in river water is consistent and cost effective. Asia Pac JPublic Health 2004,- 16(1): 54- 63.
Information Technology in Health Care - What the Future Holds
Authors: Bulgiba A.M.
Published: June 2011

In 1998, Malaysia opened its first hospital based on the "paperless and filmless" concept. Two are now in operation, with more to follow. Telemedicine is now being used in some hospitals and is slated to be the technology to watch. Future use of technology in health care will centre on the use of centralised patient databases and more effective use of artificial intelligence. Stumbling blocks include the enormous capital costs involved and difficulty in getting sufficient bandwidth to support applications on a national scale. Problems with the use of information technology in developing countries still remain; mainly inadequate skilled resources to operate and maintain the technology, lack of home-grown technology, insufficient experience in the use of information technology in health care and the attitudes of some health staff. The challenge for those involved in this field will not be in building new "paperless and filmless" institutions but in transforming current "paper and film-based" institutions to "paperless and filmless" ones and changing the mindset of health staff. Universities and medical schools must be prepared to respond to this new wave by incorporating elements of medical/health informatics in their curriculum and assisting governments in the planning and implementation of these projects. The experience of the UMMC is highlighted as an example of the difficulty of transforming a paper-based hospital to a "paperless and filmless" hospital. Asia Pac J Public Health 2004; 16(1): 64-71.
Effectiveness of Nurse Counselling in Discouraging the Use of the infant Walkers
Authors: Tan N.C. , Lim N.M.L.H. , Gu K.
Published: June 2011

Infant walkers are widely used by caregivers in Singapore despite being recognized as a household hazard. The study determined the effectiveness of nurse counselling in dissuading caregivers from using the walker. Caregivers of children 4 months of age were recruited and divided into the intervention group (nurse's advice and illustrated pamphlets), a conventional group (questionnaire alone) and a control group (without any intervention in a separate polyclinic). The percentage of the caregivers, who used the walkers in each group when their child was 9 months old, was taken as a surrogate indicator of effectiveness of nurse's intervention. The study analyzed 708 caregivers. Fewer caregivers (62.7% intervention vs. 80.4% questionnaire alone vs. 83.0% control) used the walker after nurse's advice with illustrated pamphlets. 8% of the users reported walker-related injuries (n=43). Nurses' counselling could be a simple yet effective method to discourage the use of walkers. Asia Pac J Public Health 2004; 16(2): 104-108.
Non-occupational Lead and Cadmium Exposure and Blood Pressure in Thai Men
Authors: Sirivarasai J. , Kaojarern S. , Wananukul W. , Deechakwan W. , Srisomerarn P.
Published: June 2011

In this study, the effects of low level exposure to lead and cadmium on blood pressure among 212 men have been examined. The mean age was 41 years (range 34-53). The means of systolic and diastolic blood pressure were 126 (range 94-159) and 78 (range 58-117) mmHg, respectively. Blood lead concentration ranged from 144.31 to 779.34 ηmol/L with a geometric mean (GM) of 363.11 ηmol/L. Blood cadmium levels ranged from 1.33-37.81ηmol/L with GM of 8.09 ηmol/L. For stepwise regression analysis, an increase in systolic blood pressure was significantly predictive by an increasing blood lead ( p<0.001) whereas blood cadmium showed no significant correlation with blood pressure. Body mass index and alcohol consumption also contributed to both systolic and diastolic blood pressure. These findings also supported our proposal concerning the association between blood lead and blood pressure. Asia Pac J Public Health 2004; 16(2): 133-137.
Thailand's National Death Registration Reform: Verifying the Causes of Death between July 1997 and December 1999
Authors: Choprapawon C. , Porapakkham Y. , Sablon O. , Panjajaru R. , Jhantharatat B.
Published: June 2011

A fundamental aspect of public health is the accuracy of death certification. Assessing the death registration system is a step toward improving the quality of death reporting. Thailand implemented a more rigorous and informative pilot death registration system in March 2001 in 18 provinces, followed by nationwide implementation in August 2003. Since Thailand is an industrializing nation, its experiences will be of interest to other developing nations planning similar reforms. The causes of all deaths in the 15 provincial pilot projects (of Thailand's 76 provinces) and a random sampling in Bangkok were investigated between July 1997 and December 1999. Health workers interviewed close relatives and three medical doctors reviewed hospital records to verify the causes of death. We were able to interview 78% of the relatives ( i.e. 47,632 in number). Three-quarters (76%) of the deceased had sought prior medical care; 41% died in hospital and 54% at home. The overall agreement between the causes of death in our survey vs. that reported on the death certificate was 29%. The highest agreement was for: III-defined' causes (33%), 'Cancer and Tumors' (17%), 'External Causes' (16%), and 'Infectious Diseases' (10%). Considering the different patterns among age groups and sex, hypertension with stroke, cancer of the liver and bile duct, and HIV infection, were the highest ranking causes among females. Infectious diseases (especially HIV/AIDS), hypertension with stroke and accidents, were the leading causes of deaths among males. External causes were highest among children and young adults. Asia Pac J Public Health 2005; 17(2): 110-116.
Exploratory Study on Psychosocial Impact of the Severe Acute Respiratory Syndrome (SARS) Outbreak on Chinese Students Living in Japan
Authors: Zheng G. , Jimba M. , Wakai S.
Published: June 2011

The aim of this study is to explore the impact of the 2003 SARS outbreak on Chinese students living in Japan. A cross-sectional study was conducted using a semi-structured questionnaire. The participants were recruited at multiple locations at the University of Tokyo, Japan. The results showed approximately 60% (96/161) of the respondents felt an impact of SARS on college life; they had experienced SARS-related fear, worry, depression as well as social discrimination and had taken SARS prevention measures for daily protection in Japan during the epidemic. The magnitude of the impact was associated with sociodemographic factors, including their age, specialty, area of previous residence in China and length of stay in Japan. The findings suggest that the SARS outbreak had a psychosocial impact on the Chinese students living in Japan, even though none of them had SARS. Social support tailored for these foreign students should be provided during such a disease outbreak. Asia Pac J Public Health 2005; 17(2): 124-129.
Exposure to Secondhand Smoke in Kanchanaburi Demographic Surveillance System, Thailand
Authors: Thongthai Varachai , Guest Philip , Sethaput Chanya
Published: June 2011

Using data from the Kanchanaburi demographic surveillance system in Thailand, this article documents that tobacco smoke affects 60% of the population. The main effect is through exposure to secondhand smoke. More than half of men are smokers compared with only one tenth of women. Most men tend to start smoking during their teenage years, whereas the majority of women start at later ages. The majority of households are exposed to secondhand smoke. The highest level of exposure is in rural areas. Smokers are most likely to be male and older, but those exposed to secondhand smoke tend to be female and younger. Exposure to secondhand smoke is more likely to occur in households with lower socioeconomic status. Logistic regression analysis supports 2 study hypotheses: that children and women are the most affected by secondhand smoke, and household factors are the most important factors affecting the exposure to secondhand smoke.
Smoking Among Vietnamese Health Professionals: Knowledge, Beliefs, Attitudes, and Health Care Practice
Authors: Dao Thi Minh An  , Nguyen Van Huy  , Dao Ngoc Phong
Published: June 2011

The study aimed to investigate smoking patterns and compare knowledge, beliefs, and attitudes, as well as explore predictors of smoking status among Vietnamese health professionals. A global survey questionnaire on tobacco use among health professionals by the World Health Organization and the Centers for Disease Control and Prevention was adapted for data collection. Data from 2151 health workers from the 3 largest hospitals-each of which is located in South, Central, and North Vietnam, respectively-were collected using quantitative methods. Both descriptive and inferential statistics were used in the data analysis. Smoking prevalence among Vietnamese health professionals is 13.4%, dominant among male health professionals compared with female counterparts (35.6% vs 1.8%), and significantly varies by regions. Physicians and dentists display a greater smoking proportion than nurses (23.0%, 10.5%, and 7.7%, respectively). The findings highlight the importance of improving and promoting beliefs of health professionals about being role models for their patients by not smoking. Special attention should be given to the following slogan: "Health professionals should act as nonsmoking role models for their patients and the public." This message should be incorporated into cigarette restriction regulations and policies at hospitals and recognized as one of the effective measures in cigarette control in the hospital context.
Identifying Types of Domestic Violence and Its Associated Risk Factors in a Pregnant Population in Kerman Hospitals, Iran Republic
Authors: Salari Zohreh , Nakhaee Nouzar
Published: June 2011

The objective of this study was to estimate the prevalence of different kinds of physical and emotional violence in an Iranian pregnant population and to examine its associated risk factors. This cross-sectional study was done from March through July 2005 in the 4 main hospitals of Kerman, Iran, which had maternity units. In total, 416 out of 460 women who were asked to participate agreed to be interviewed, a 90.4% response rate. All respondents were interviewed privately during the first 48 hours after delivery. The mean age (± SD) was 28.0 ± 5.6, and all were married. Most of the women were urban residents (89.2%), and the majority of them were multiparous (78.8%). Nearly 16% of mothers said the pregnancies were unintended. In total, 35% (95% confidence interval: 30%-40%) of women had experienced 1 or more episodes of emotional violence during the pregnancy inflicted by their husbands, and 106 women (25%; 95% confidence interval: 21%-30%) had experienced at least 1 episode of physical violence. The highest odds of domestic violence during pregnancy was associated with unintended pregnancies (odds ratio: 7.66; 95% confidence interval: 3.45-16.99) and multiparous pregnancies (odds ratio: 6.88; 95% confidence interval: 3.46-13.68). Considering the high prevalence of different types of domestic violence during pregnancy, it should be regarded as a priority for health policy experts in Kerman and possibly Iran.
Treatment-Seeking Behavior and Treatment Practices of Lymphatic Filariasis Patients With Lymphoedema in the Colombo District, Sri Lanka
Authors: Wijesinghe Rushika Shalindri , Wickremasinghe Ananda Rajitha , Ekanayake Sriyani , Antoinette Perera Marian Shanthy
Published: June 2011

This cross-sectional, descriptive study describes the treatment-seeking behavior of 413 lymphoedema patients attending 2 filariasis clinics in the Colombo district, Sri Lanka. A pretested, interviewer-administered questionnaire obtained information regarding sources and types of treatment taken, time taken for diagnosis, and details regarding diethylcarbamazine citrate (DEC) treatment. There was a mean delay of 2.37 years (SD 1.37) in diagnosing filariasis after the first appearance of limb swelling. General practitioners were the most frequent first-contact health care providers and the most visited source overall, followed by government hospitals and Ayurvedic practitioners. Approximately 95% of patients were on DEC treatment ranging from 10 days to 43 years (mean 2.5 years SD ± 1.1). Sixty-one percent of patients reported always having taken the recommended DEC course. Nonsteroidal anti-inflammatory drugs, diuretics, and antibiotics were liberally prescribed. Approximately 97% had sought treatment from a medical practitioner for an acute adenolymphangitis attack. Despite the area being endemic for filariasis, there was a delay in treatment and inappropriate use of DEC in patients with chronic filarial lymphoedema.
Reproductive Health Awareness Among Adolescent Girls in Rural Bangladesh
Authors: Md. Jashim Uddin  , Abdul Mannan Choudhury
Published: June 2011

This article presents the status of rural Bangladeshi adolescent girls' awareness about reproductive health. Analysis of data revealed that a sizable proportion of adolescent girls had incorrect knowledge or misconceptions about the fertile period, reproduction, sexually transmitted diseases, and HIV/AIDS. Age, education either of adolescents or their mothers, residence, and exposure to mass media were the significant predictors of adolescent girls' knowledge about reproductive health. Strong efforts are needed to improve awareness and to clarify misconceptions about reproductive health. Improved access to mass media and education could improve rural Bangladeshi adolescent girls' awareness about reproductive health.
Deaths Due to External Causes Among Adolescents in Hong Kong
Authors: Tze Wai Wong  , Tam Wilson Wai Sun
Published: June 2011

The authors compared adolescent mortalities due to external causes in two 5-year periods (from 1986-1990 and 1996-2000) in Hong Kong. Leading external causes are traffic accidents and suicide. The mortality rate is comparatively low and has decreased significantly over time. Suicide deaths are, however, on the increase. Monitoring the changing trend is useful in setting public health priorities.
Early Detection and Prevention of Domestic Violence Using the Women Abuse Screening Tool (WAST) in Primary Health Care Clinics in Malaysia
Authors: Yut-Lin Wong , Othman Sajaratulnisah
Published: June 2011

Despite being an emergent major public health problem, little research has been done on domestic violence from the perspectives of early detection and prevention. Thus, this cross-sectional study was conducted to identify domestic violence among female adult patients attending health centers at the primary care level and to determine the relationship between social correlates of adult patients and domestic violence screening and subsequent help/health-seeking behavior if abused. Face-to-face interviews were conducted with 710 female adult patients from 8 health centers in Selangor who matched the inclusion criteria and consented to participate in the study, using a structured questionnaire that included adaptation of a validated 8-item Women Abuse Screening Tool (WAST). Statistical tests showed significant differences in ethnicity, income, and education between those screened positive and those screened negative for domestic violence. Of the participants, 92.4% reported that during consultations, doctors had never asked them whether they were abused by their husband/partner. Yet, 67.3% said they would voluntarily tell the doctor if they were abused by their husband/partner. The findings indicate that primary care has an important role in identifying domestic violence by applying the WAST screening tool, or an appropriate adaptation, with women patients during routine visits to the various health centers. Such assessment for abuse could be secondary prevention for the abused women, but more important, it will serve as primary prevention for nonabused women. This approach not only will complement the existing 1-stop crisis center policy by the Ministry of Health that copes with crisis intervention but also will spearhead efforts toward prevention of domestic violence in Malaysia.
Factors Contributing to Medication Noncompliance of Newly Diagnosed Smear-Positive Pulmonary Tuberculosis Patients in the District of Colombo, Sri Lanka
Authors: Janakan Navaratnasingam , Seneviratne RdeA
Published: June 2011

Medication noncompliance hinders effective tuberculosis control. This descriptive study investigates the factors contributing to medication noncompliance among new patients with smear-positive pulmonary tuberculosis on treatment at government health institutions in Colombo, Sri Lanka. In a cohort of patients aged ≥15 years (n = 326), 23% were found to be noncompliers (n = 74) on follow-up. The median age of noncompliers (50 years) was significantly higher than the compliers (45 years). In multivariate logistic regression analysis, factors associated with noncompliance are as follows: being a male, living alone or with extended family, experiencing side effects to medication, perceiving nonsusceptibility to adverse effects of illness, and perceiving no benefit in regular treatment. The participants of a focus group discussion on service factors opined that the reception at treatment facilities and the interaction with certain categories of staff were poor. Noncompliance is related to a multiplicity of factors involving patients and healthcare services.
Patterns of Smoking Among Adolescents in Malaysia and Thailand: Findings From the International Tobacco Control Southeast Asia Survey
Authors: Hammond David , Kin Foong , Prohmmo Aree , Kungskulniti Nipapun , Lian Tan Y. , Sharma Sharad K. , Sirirassamee Buppha , Borland Ron , Fong Geoffrey T.
Published: June 2011

At present, 70% of the world's 1.1 billion smokers are in developing countries, with over 50% in Asia alone. The current study examined patterns of youth smoking in Thailand and Malaysia. Respondents were 2002 youths between the ages of 13 and 17 from Thailand (n = 1000) and Malaysia (n = 1002). Respondents were selected using a multistage cluster sampling design and surveyed between January 2005 and March 2005. Approximately 3% of youth between the ages of 13 and 17 were current smokers, with an additional 10% to 12% reporting experimental smoking. Males were between 7 and 15 times more likely to report smoking behavior than females. Less than 1% of females respondents in either country met the criteria for current smoking, and less than 5% met the criteria for experimental smoking. In contrast, more than 50% Thai males and approximately one-third of Malaysian males aged 17 met the criteria for either experimental or current smoking.
Cigarette Smoking Status and Smoking Cessation Counseling of Chinese Physicians in Wuhan, Hubei Province
Authors: Han Zao Li  , Weixing Sun  , Fangmei Cheng  , Xiangrong Wang  , Weiping Liu  , Aisheng Wang
Published: June 2011

Among the 347 physicians surveyed, 58% of the male physicians and 18.8% of the female physicians were current cigarette smokers; 54.4% of the male and 70.4% of the female physicians often or always provided smoking cessation counseling for patients; 37.5% of the physicians thought that for a Chinese smoker, cigarette smoking served as a social lubricant; 31.5% thought it a habit; 21.7% thought it a stress reliever; and 9.2% thought it a social status symbol. The following 5 variables were significantly associated with physicians' smoking cessation counseling frequency: their smoking status, perceived success in their past counseling, perceived influence, perceived exemplary role, and perceived responsibility. To increase physicians' smoking cessation counseling, the Chinese Ministry of Health would need to discourage physicians to smoke and appeal to their sense of responsibility to help patients quit smoking.