bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a Health Education Intervention on Knowledge and Attitudes of Food Handlers Working in a Medical College in Delhi, India
Authors: Malhotra Rahul , Lal Panna , Krishna Prakash S. , Daga M.K. , Kishore Jugal
Published: June 2011

The present study assessed change in knowledge, attitudes, and self-reported hand-washing practices of 136 food handlers 3 months after providing them health education using posters and interactive sessions using a flip chart. There was a significant change in the proportion of study participants who named food borne or waterborne diseases, including gastroenteritis (79.4% to 91.9%), worm infestation (39.0% to 55.9%), cholera (16.2% to 42.7%), and typhoid (9.6% to 28.7%). Significant increase in knowledge about hand hygiene measures, namely, washing hands before handling food (23.5% to 65.4%) and keeping nails cut and clean (8.1% to 57.4%), was observed. Baseline self-reported hand-washing practices revealed low figures for washing hands after micturition (82.4%) and smoking (52.8%) and consistent use of soap at the workplace (24.3%) and after micturition (14.0%), which improved after health education but not to the desired extent. Findings highlight the importance of providing health education in food and personal hygiene to food handlers and incorporating the same in existing guidelines for food establishments laid down by civic agencies in Delhi and elsewhere.
The Economic Evaluation of a Health Screening Program on Congenital Heart Disease for School Children in Taichung, Taiwan
Authors: Chen Fong-Lin , Pai Jar-Yuan
Published: June 2011

Objective The objective of this study was the economic evaluation of screening school children for congenital heart disease (CHD). Methods The sample consisted of all the 45 725 students in grades 1 and 7 from Taichung County, Taiwan. STATISTICA, version 7.1, was used to determine descriptive statistics and Student's t tests on students' height, weight, and body mass index (BMI). Results The total cost of CHD screening was NT$4 863 866 (NT$32 = US$1), and the average cost was NT$106.37 per child. The rate of finding new asymptomatic students was 2.9174%, and the cost of finding 1 asymptomatic student was NT$3646. Also, a cost-effective analysis showed NT$165.7 per year of life saved. Conclusions Twelve Student's t tests were conducted, and it found that students' height, weight, and BMI was not associated with asymptomatic students. A goodness-of-fit χ2 found that females have a higher rate of asymptomatic CHD.
Cooperation, Integration, and Long-term Commitment: What Solomon Islanders and Development Workers Say About Health Sector Aid
Authors: Martiniuk Alexandra L. C. , Millar Heather C. , Malefoasi George , Vergeer Petra , Garland Trevor , Knight Simon
Published: June 2011

Introduction The Solomon Islands is experiencing instability and insecurity and also a concomitant increase in aid. This article aims to address the need for theoretical coordination frameworks to be further informed by the actual experiences, requirements, and views of the recipients of aid. Methods Qualitative research techniques were used to better understand governmental and nongovernmental leaders' views of health sector aid in the Solomon Islands. Data were collected using previously published literature, government and nongovernmental documents, and in-person interviews. Results Two key themes emerged from the interviews: the need for coordination and integration of aid and the need for this integration to occur over the long-term. These themes are presented using quotations from key informants. Conclusion Themes and quotations arising from the analyses may assist in understanding theoretical frameworks for coordination, particularly in postconflict states. Future needs regarding mechanisms of collaboration in the Solomons are also discussed.
Increased Fatalities and Cost of Traumatic Injuries in Elderly Pedestrians in Hawaii: A Challenge for Prevention and Outreach
Authors: Takanishi Danny M. , Yu Mihae , Morita Shane Y.
Published: June 2011

This study was carried out to evaluate and quantify risk factors, mechanisms, and cost of traumatic injuries in Hawaii's elderly and to identify potential preventive strategies. A retrospective review of a prospective database of patients admitted to the only Trauma Center in the Pacific Basin, between January 2000 and December 2001, was conducted. Of 2634 trauma admissions, 11% were ≥65 years of age. Mechanisms of injury included falls, motor vehicle crashes (MVCs), pedestrians hit by automobiles, and miscellaneous causes. The incidence of elderly pedestrians hit by automobiles in Hawaii is higher than previously reported. Hospital mortality rate was highest for the pedestrian hit group, followed by falls, and then MVCs. The pedestrian hit group consumed the largest quantity of resources and MVCs the least. Given the high mortality rate and associated resource consumption in the pedestrian hit group, it would be appropriate to give priority to this group while developing preventive measures for this age group.
The Influence of Low Blood Lead Concentrations on the Cognitive and Physical Development of Primary School Children in Malaysia
Authors: Zailina H. , Junidah R. , Josephine Y. , Jamal HH
Published: June 2011

This study aimed to determine the relationship between blood lead (BPb) concentrations and cognitive and physical development in school children. A total of 169 urban children and 100 industrial children of Malay ethnicity, in the age range of 6½ to 8½ years, were selected. BPb was determined using GF atomic absorption spectrophotometer. The mean cognitive score (102.55) of the children from the industrial area was significantly higher than that of the urban children (95.09; P < .001). However, no significant differences were found in the BPb levels between the 2 groups (industrial, 3.75 µg/dL; urban, 3.56 µg/dL). There was significant inverse correlation between BPb and cognitive scores for all children ( P < .05). The cognitive scores for all children were influenced by BPb after adjustments ( P < .05). The urban children had significantly better Weight for Height and Left Arm Circumference values than those from industrial area. There was no significant correlation between BPb and the anthropometric measurements. In conclusion, low BPb influenced the cognitive development, whereas physical development was not affected.
Prevalence of Rubella Susceptibility Among Pregnant Mothers in a Community-Based Antenatal Clinic in Malaysia: A Cross-Sectional Study
Authors: Ai Theng Cheong  , Ee Ming Khoo
Published: June 2011

Introduction: routine rubella antibody screening is not done for antenatal mothers in community health clinics in Malaysia. However, congenital rubella syndrome has persisted with its associated health burden. Objectives: to determine the prevalence of rubella susceptibility among pregnant mothers and its associated risk factors. Methodology: a cross-sectional study was carried out in the Petaling district, Selangor, Malaysia, where 500 pregnant mothers were recruited, and face-to-face interviews were conducted. Rubella IgG tests were performed. Results: the prevalence of rubella susceptibility among pregnant mothers was 11.4%. Using logistic regression, a history of not having received rubella vaccination or having unknown rubella vaccination status was found to be a significant predictor for mothers to be rubella susceptible (odds ratio = 2.691; 95% confidence interval = 1.539-4.207). Conclusions: routine rubella IgG screening tests need to be offered to all antenatal mothers in view of the high prevalence found.
The Evolving Evidence Base for Child Protection in Chinese Societies
Authors: Dunne Michael P. , Jing Qi Chen  , Wan Yuen Choo
Published: June 2011

Child maltreatment is a substantial public health problem worldwide. Although extensively studied in Western countries, until recently little systematic research had been published about the situation in the world's most populous nation and ethnic diaspora. In this review, we examine trends from community-based research with Chinese young people and parents in mainland China, Hong Kong SAR, Taiwan, Singapore, and Malaysia. It is clear that many Chinese adolescents experience a substantial burden from various forms of maltreatment and the psychological and behavioral correlates are similar to those found in other cultures. However, the research reveals a large gap between this reality and Chinese adults' perceptions about emotional, physical, and sexual abuse. Comprehensive awareness programs are needed to close this information gap and thereby mobilize support for prevention and care initiatives.
Public Health Policy and Medical Missions in the Philippines: The Case of Oral—Facial Clefting
Authors: Mendoza Roger Lee
Published: June 2011

This article examines the critical role of medical missions as alternative or proxy health delivery agencies in developing countries like the Philippines. Why and how they exist, what they can and cannot do, how they interact with the for-profit and public health sectors, and what challenges they face in the context of underdevelopment are analyzed by using a proposed structural— behavioral framework. We find that these missions can offer short-term benefits to specialized public health problems, such as oral—facial clefting, but depend on public and private partnerships and resources for long-term solutions. The article thus suggests that health care provision in developing countries should also be treated as a managerial issue. The challenge is for Third World governments to promote effective trisector collaborations, improve accessibility and adequacy of services, and support socially redistributive health policies.
Clinicians' Attitude on Mass Drug Administration Under the Program to Eliminate Lymphatic Filariasis: A Qualitative Study From Orissa, India
Authors: Anna Salomi Kerketta  , Bontha Veerraju Babu
Published: June 2011

The global program to eliminate lymphatic filariasis (LF) is currently based on mass drug administration (MDA) with annual single dose of antifilarials. In India, the MDA is implemented by primary health centers (PHC) of the district health system. The aim of the present study was to explore the attitudes of clinicians working at PHC level in three districts of Orissa, India. The data are obtained from interviews of 50 clinicians (35 from PHCs and 15 private). Only 11 PHC clinicians and 1 private clinician opined that the elimination of LF is possible through MDA of diethylcarbamazine (DEC); and 40% PHC and 87% private clinicians strongly felt that the elimination is not feasible through MDA and that the yearly single dose of DEC was not efficacious. The remaining clinicians were unable to comment on the feasibility and efficacy of MDA. The indifferent attitudes arise from lack of knowledge or erroneous beliefs. A good understanding of the program through reorientation and rigorous training should be emphasized to make the MDA successful.
Sentinel Surveillance of Soil-Transmitted Helminthiasis in Selected Local Government Units in the Philippines
Authors: Belizario Vicente Y. , de Leon Winifreda U. , Lumampao Yvonne F. , Anastacio Marilyn Benedith M. , Tai Cyndi Mae C.
Published: June 2011

This study describes baseline prevalence and intensity of soil-transmitted helminth infections as well as baseline anthropometric and school performance data among public elementary school children in 6 sentinel provinces in the Philippines. Stratified cluster sampling was used to select 6 provinces, where grade 3 elementary school pupils were surveyed. Secondary anthropometric data and achievement test results of the immediate past academic year were examined. Overall cumulative prevalence and proportion of heavy intensity infections for the 6 selected provinces were 54.0% and 23.1%, respectively. These recent findings further support the need for mass treatment to be given at least twice a year. The findings of the study also demonstrate the relationship that exists between worm burden and nutritional status. Strategies focusing on mass treatment integration, environmental sanitation, personal hygiene, and health education should be developed to control soil-transmitted helminth infections and their detrimental effects.
Chronic Disease Risk Factors in Rural Australia: Results From the Greater Green Triangle Risk Factor Surveys
Authors: Laatikainen Tiina , Janus Edward , Kilkkinen Annamari , Heistaro Sami , Tideman Philip , Baird Andrew , Tirimacco Rosy , Whiting Malcolm , Franklin Lucinola , Chapman Anna , Kao-Philpot Anna , Dunbar James
Published: June 2011

The aim of this article was to assess the level and prevalence of major chronic disease risk factors among rural adults. Two cross-sectional surveys were carried out in 2004 and 2005 in the southeast of South Australia and the southwest of Victoria. Altogether 891 randomly selected persons aged 25 to 74 years participated in the studies. Surveys included a self-administered questionnaire, physical measurements, and a venous blood specimen for lipid analyses. Two thirds of participants had cholesterol levels ≥5.0 mmol/L. The prevalence of high diastolic blood pressure (≥90 mm Hg) was 22% for men and 10% for women in southeast of South Australia, and less than 10% for both sexes in southwest of Victoria. Two thirds of participants were overweight or obese (body mass index ≥25 kg/m2). About 15% of men and slightly less women were daily smokers. The abnormal risk factor levels underline the need for targeted prevention activities in the Greater Green Triangle region. Continuing surveillance of levels and patterns of risk factors is fundamentally important for planning and evaluating preventive activities.
Severity of Visual Impairment and Depression Among Elderly Malaysians
Authors: Naqiah Hairi Noran  , Muldha Ghazali Izzuna  , Awang Mahmud Bulgiba  , Mimiwati Zahari , Said Mas Ayu
Published: June 2011

Objective. This study aimed at evaluating the relationship between severity of visual impairment and depression among elderly Malaysians attending an eye clinic. Methods. This was a cross-sectional study. The study population included patients, aged ≥60 years who attended the Eye Clinic in University Malaya Medical Centre. Exposure measurement was based on ophthalmologic examinations by an ophthalmologist. Data on outcome were measured using the Geriatric Depression Scale. Results. After adjusting for important confounders, severity of visual impairment either having low vision or blind were independent risk factors of depression. The odds of developing depression among elderly with low vision were 2 times more than those with normal vision, and elderly who were blind had almost 5 times the odds to be depressed compared with those having normal vision. Conclusion. Findings from this study suggest a positive relationship between the severity of visual impairment and depression among elderly Malaysians.
Socioeconomic Determinants of Age at First Birth in Rural Areas of Bangladesh
Authors: Aminul Haque Md. , Amir Mohammad Sayem
Published: June 2011

The age at first birth is very low under existing rural sociocultural settings in Bangladesh. This study examined the socioeconomic and cultural determinants of age at first birth. The study subjects were married women aged 15 to 29 years in 2 rural areas that were identified through a multistage sampling technique. To collect the relevant information, a semistructured interviewer schedule was applied to the eligible women. This study found that 72.8% women gave first birth at <20 years of age with mean age at first birth 18.74 years. Simple linear regression model explained 30.9% of variance in age at first live birth. Among socioeconomic and cultural determinants, family pressure explained the most significant variance. It is really difficult to reduce fertility in complex sociocultural settings in rural Bangladesh. However, the findings of this study may provide an answer to increase the age at first birth and hence to reduce the high fertility among these group of women.
Predictors of Malaria Among Malaysian Aborigines
Authors: Kaur Gurpreet
Published: June 2011

The Asia-Pacific region has at least 50% of its population at risk for malaria. In Malaysia, indigenous malaria is largely concentrated among the Orang Asli in Peninsular Malaysia. A cross-sectional study was conducted in an Orang Asli community in the district of Raub, Pahang, to determine the predictors of malaria. Age, seldom/never wearing protective clothing while in the jungle, going out at night, ever staying in another village, and living in bamboo-walled homes were found to be associated with malaria (crude odds ratio = 1.8-4.5; 95% confidence interval [CI] = 1.1-9.1) After adjusting for confounding, major predictors of malaria were age ≤12 years (adjusted odds ratio [aOR] = 4.3;95% CI = 2.2-8.4),), never/seldom wearing protective clothing while in the jungle (aOR = 3.8; 95% CI = 1.8-8.0), and going out at night (aOR = 2.5; 95% CI = 1.4-4.8). The findings lend support for intensifying behaviour modification in this population.
A New Japanese Vegetarian Food Guide
Authors: Nakamoto Keiko , Arashi Masako , Noparatanawong Somboon , Kamohara Seika , Radak Tim , Tuchida Mitsuru , Miyazaki Kyoichi , Watanabe Sanae , Kudo Hideki , Tanaka Akira
Published: June 2011

Vegetarianism continues to gain popularity in Japan and the Westernized world, in part from decades of science supporting the health advantages of properly planned vegetarian-based diets. Although there are Asian nutritional tools, one specific to a Japanese vegetarian diet is lacking. Thus, the Japanese vegetarian food guide (JVFG) was developed and based in part on the American Dietetic Association position paper for vegetarian diets and the Japanese Food Guide Spinning Top. The JVFG was developed by collecting dietary information from 3 different institutes in Japan that specialize in regularly offering vegetarian meals. The JVFG was divided into 6 groups with respective recommended servings: vegetables (7.5), grains (4.5), protein foods (4), milk (3), fruits (2), and fats, sugar, and seasonings (<3). The JVFG was developed so that it would adequately provide for all nutrients and be structured for practical use by the general public as well as health professionals.
Prevalence of Obesity Among Adolescents (10 to 14 Years) in Kuwait
Authors: El-Bayoumy Ibrahim , Shady Ibrahim , Lotfy Hesham
Published: June 2011

The purpose of this cross-sectional study was to find out the prevalence of obesity and overweight among intermediate school adolescents aged 10 to 14 years. The study comprised a multistage stratified random sample that included 5402 children (2657 males and 2745 females). They represent 12.7% of the total number of children between 10 and 14 years during the educational year 2005-2006. The weights and heights of adolescents were measured, from which the body mass index (BMI) was calculated, which is the weight in kilograms divided by the height in meters squared (kg/m2). BMI values higher than 95 percentile were accepted as being obese and those in between 85 and 94 percentile were accepted as overweight. Dietary intake was assessed by the investigators using food exchange lists designed by American Diabetic Association and physical fitness was measured by modified Harvard step test. Data regarding monthly income of the chosen sample were collected from parents of those children. The overall prevalence of overweight and obesity in adolescent Kuwaiti children aged 10 to 14 years was 30.7% and 14.6%, respectively. The overall prevalence of overweight and obesity among males was 29.3% and 14.9%, respectively ( P < .001) and the prevalence of overweight and obesity among females was 32.1% and 14.2%, respectively ( P < .001). High daily caloric intake by the obese and overweight children and physical inactivity was reported among the majority of them. Health education programs should be conducted to control this syndrome in order to prevent future risk of obesity-related disease, and physical activity programs should be incorporated in the schools. Any management plan for overweight and obese children should include 3 major components: diets, exercise, and family-based behavior and they should not be placed on restrictive diets because adequate calories are needed for proper growth.
Factors Associated With Underweight and Stunting Among Children in Rural Terai of Eastern Nepal
Authors: Pramod Singh G.C. , Nair Manju , Grubesic Ruth B. , Connell Frederick A.
Published: June 2011

Malnutrition continues to affect a large proportion of children in the developing world. The authors undertook this study to identify biologic, socioeconomic, and health care factors associated with underweight and stunting in young children in an the eastern Tarai (plains) district of Nepal. Data were collected via questionnaires from mothers of 443 children aged 6 to 36 months in Sunsari district. Multistage cluster sampling was used to select villages and children. Anthropometric measurements were made on both children and their mothers. Logistic regression was used to measure the independent (adjusted) effect of risk and protective factors on the odds of underweight or stunting. More than half (53.3%) of the children were found to be underweight (<2 standard deviations weight for age below reference median) and more than one third (36.6%) had stunting (<2 standard deviations height for age below reference median). Low maternal body mass index, child's age, higher birth order, and lower standard of living score were strong predictors of underweight, whereas mother's education >5 years and participation in vitamin A and nutritional programs were protective. Infant age, low maternal body mass index, and low standard of living score were significant risk factors for stunting, whereas mother's education >5 years was strongly protective. These results suggest that underweight and stunting are the result of a nexus of biological, socioeconomic, and health care factors.
Susceptibility of New Entrant University Students in Sri Lanka to Varicella Zoster Infection
Authors: Kurukulasooriya G.M.P.C.P. , Thevanesam V. , Agampodi S.B. , Abeykoon A.M.S.B. , Amarasiri S.P. , Goonasekera K.P.C.
Published: June 2011

To investigate the susceptibility of Sri Lankan new entry university students to varicella zoster virus (VZV) infection, a cross-sectional descriptive study was carried out among new entrant medical and engineering students of the University of Peradeniya, Sri Lanka. Self-reported history of chicken pox was studied first, followed by serological evaluation for VZV IgG antibodies. A total of 451 students participated in the study out of which 189 (41.9%) reported a history of chicken pox. Median age of reported age of acquiring the disease was 14 years with an interquartile range of 10 to 17 years. Only 25% of the population reported history of infection prior to age of 10 years. The seropositive rate of VZV IgG antibodies among undergraduates with a negative history of chicken pox was 10.1% ( 25/247). The present study indicates that nearly half (222/436) of the study population (50.9%, 95% CI 46.2-55.6) was susceptible to VZV infection.
Variation in the Prevalence, Awareness, and Control of Diabetes in a Multiethnic Population: A Nationwide Population Study in Malaysia
Authors: Rampal Sanjay , Rampal Lekhraj , Rahmat Ramlee , Azhar Md Zain  , Yee Guan Yap  , Mohamed Mafauzy , Taha Mohamad
Published: June 2011

The purpose of this study was to determine the association between different ethnic groups and the prevalence, awareness, and control of diabetes in Malaysia. A population-based cross-sectional study using multistage sampling was conducted in Malaysia. Diabetes is defined as having a fasting blood glucose ≥7 mmol/L or a self-reported diabetic on treatment. Among the 7683 respondents aged ≥30 years, the prevalence of diabetes mellitus was 15.2% (95% CI = 14.1, 16.4). Multivariate analysis showed that compared with Malays, Chinese had lower odds (adjusted odds ratio [aOR] 0.71; 95% CI = 0.56, 0.91) and Indians had higher odds of having diabetes (aOR 1.54; 95% CI = 1.20, 1.98). The odds of diabetes increased with age, family history of diabetes, body mass index, and lower education levels. Among those with diabetes mellitus, 45.0% were aware and 42.7% were under treatment. Among treated diabetics, 25.1% had their fasting blood sugar under control. There is a significant association between prevalence of diabetes and different ethnic groups.
Seven Attributes of Primary Care in Thailand
Authors: Kitreerawutiwong Nithra , Kuruchittham Vipat , Somrongthong Ratana , Pongsupap Yongyuth
Published: June 2011

Primary care must be defined with a given country’s contexts because primary care services vary across countries. This study aimed to define the concept of primary care in Thailand, which had not been systematically formulated. Methods of in-depth interview, focus group discussion, and Delphi were used to derive the attributes of primary care from 66 participants, including primary care providers, community representatives, general population, and national experts.The study yielded a total of 7 attributes of primary care categorized into 3 dimensions: medical care services (accessibility, continuity, comprehensiveness, and coordination), individual and family (trust and patient-centeredness), and population and community (population and community orientation).These 7 attributes provide a conceptual framework of how primary care in Thailand should be evaluated. Results of the evaluation will offer insights on which aspects of primary care need to be improved to achieve better health care.
Prevalence of Primary Infertility in the Islamic Republic of Iran in 2004-2005
Authors: Vahidi Serajeldin , Ardalan Ali , Mohammad Kazem
Published: June 2011

This study aimed to determine the prevalence of lifetime and current primary infertility in Iran. The study was conducted in 2004-5 in all the 28 provinces of Iran. A cluster sampling method was used to select 10 783 women aged 19 to 49 years for the survey. Lifetime primary infertility was defined based on 1 of 2 contraception scenarios immediately after marriage to find experience of infertility despite 1 year of unprotected intercourse. The term “current primary infertility” designated a woman who, in addition to meeting the definition of lifetime infertility, had been unable to conceive up to the study time. A complex sampling design and SVY commands in the software package STATA 8.0 were used to derive 95% confidence intervals. A history of lifetime primary infertility was present in 24.9% of the subjects (95% CI: 23.5-26.2), and the prevalence of current primary infertility was 3.4% (95% CI: 3.0-3.8). As for age trends in lifetime primary infertility, the highest prevalence rates were observed in individuals with the lowest age at marriage. Minimum prevalence (17.2%) occurred with marriage age of 21 to 26 years, and the rates rose with higher age at marriage. About one fourth of the Iranian couples experience primary infertility at some point in their lives and 3.4% suffer from this problem at any time. For a correct interpretation of prevalence rates and the implications in terms of health care and service delivery, factors such as age at marriage and the couple's fertility potential must be taken into consideration.
Vision-Related Quality of Life Among Elders With Cataract in Sri Lanka: Findings From a Study in Gampaha District
Authors: Nanayakkara Shyama D.
Published: June 2011

The objective of this study was to establish the prevalence of cataract and measure vision related quality of life among elders in Sri Lanka. The 4-part study consisted of a survey to establish cataract prevalence, a case control study of risk factors, an assessment of the National Eye Institute Visual Functional Questionnaire (NEI-VFQ), and a comparison of quality of life among elders with and without cataract. Cataract prevalence was 56%. Significant risk factors were age, being female, occupational exposure, lower social class, presence of chronic illnesses, and smoking. The NEI-VFQ was validated for use in Sri Lanka and quality of life of elders with cataract was significantly lower on the NEI-VFQ and 2 other standard measures. The findings inform the development of public health strategies for treatment and prevention of cataract in Sri Lanka where the impact of cataract is increasingly being felt with rapid population aging and are applicable to other developing countries.
A Qualitative Evaluation of the Information, Education, and Communication Component of the Tuberculosis Control Program in Delhi, India
Authors: Sharma Nandini , Nath Anita , Davender Kumar Taneja  , Gopal Krishnan Ingle
Published: June 2011

Tuberculosis control programs have recognized and addressed those system components in which knowledge and behavior of the patient and the general population are key issues because they have a profound influence on the treatment-seeking behavior and completion of course of treatment. As a part of the Revised National Tuberculosis Control Program, the ongoing information, education, and communication (IEC) efforts in Delhi were further intensified in the form of a multipronged media campaign. The objectives of this study are to evaluate ( a) the impact of the campaign on awareness generation among the target audiences, ( b) their opinion for making the campaign more effective and suited to their needs, and ( c) perceptions of health personnel regarding the campaign. The study follows a descriptive cross-sectional design. The following qualitative methods were used: ( a) focus group discussions of patients and the general population, ( b) 3 key informant interviews of the health care personnel and a defaulter patient, and ( c) in-depth interviews of 20 DOTS (directly observed treatment, short course) providers. The study observed that ( a) different sociocultural segments of the population varied in terms of their observations of IEC messages, ( b) stigma associated with tuberculosis is widely prevalent despite having a campaign, and ( c) television was voted as the most effective IEC medium. IEC strategies should be tailor-made and suited to the needs of a particular subpopulation.
Prevalence of and Factors Associated With Cigarette Smoking Among University Students: A Study From Iran
Authors: Nakhaee Nouzar , Divsalar Kouros , Bahreinifar Sareh
Published: June 2011

To determine the prevalence of cigarette use among college students and to identify correlates of cigarette smoking, a cross-sectional study was conducted on 1750 college students in the city of Kerman, located in southern Iran. The average age of college students was 21.2 ± 2.1 years. A total of 52% participants were female, 92% were single, and 11% (184) were smokers (22% of men and 2.4% of women). The average age of smoking initiation was 15.9 ± 4.5 years. A high association was shown with the use of cigarettes among close friends (odds ratio [OR] = 4.3), alcohol use (OR = 2.95), and being a male (OR = 2.81). Less cigarette use was shown among participants who prayed (OR = 0.52) and those with better academic standing (OR = 0.68). Based up the high prevalence of cigarette use among college students and also taking into account the correlates of cigarette use, gender-specific programs need to be tailored for cigarette use prevention among college students.
Challenges for Injury Prevention Among the Elderly in Kazakhstan
Authors: Yegeubaeva Saltanat Askarovna , Kulzhanov Maksut Karimovich , Aubakirova Alma Serkpayevna , Balabayev Timur Faritovich
Published: June 2011

Injury prevention is one of the most important issues facing governmental public health programs today. Injuries lead to premature mortality and disability of the population, decrease quality of life, and damage community property. Data demonstrate that 54.1% of domestic (household related) and traffic injuries among the elderly were caused by a general lowering of attention and inadequate caution associated with increased age. This shows the necessity for the development of injury-prevention programs targeting the elderly. Currently, several different types of institutions working in areas such as public health, promotion of healthy lifestyles, social and clinical medicine are engaged in a period of detailed study of the injury status and discussion of strategies to implement injury prevention programs among the elderly. These programs must be oriented toward both the creation of safe injury-free environments and to actively engage the elderly to increase overall physical fitness to increase self-injury protection.
Roles of Parents in Preventing Dental Caries in the Primary Dentition Among Preschool Children in Thailand
Authors: Narksawat Kulaya , Boonthum Angsana , Tonmukayakul Utsana
Published: June 2011

This study aimed to identify important roles of parents in preventing caries in primary dentition among preschool children in Thailand. A total of 664 preschool children aged 3 to 4 years and their parents were sampled from representative provinces of the 5 regions of Thailand. Dental examination to assess dental caries in preschool children was conducted. Questionnaires investigating roles of parents in caring for their children’s teeth were used to interview parents. Preschool children were more likely to have at least 1 carious tooth if parents did not always clean their teeth every time they bathed them, did not always examine the cleanliness of children’s teeth regularly, and always allowed children to consume snacks more than 3 times a day. Thai parents must be motivated to consistently spend the time required to take care of the primary dentition of their children by regular cleaning and controlling the snacking behavior of children.
Oral Health Status of Vietnamese Children: Findings From the National Oral Health Survey of Vietnam 1999
Authors: Loc Giang Do  , Spencer Andrew John , Roberts-Thomson Kaye Frances , Hai Dinh Trinh  , Thuy Thanh Nguyen
Published: June 2011

The National Oral Health Survey of Vietnam 1999 was conducted to inform policy development. Aims. The aims were to describe the oral health status, to analyze its socioeconomic distribution, and to evaluate change over time in the oral health of Vietnamese children. Methods. A multistaged stratified sampling process was employed. Children aged 6 to 17 years were examined by trained and calibrated dental examiners. A parental questionnaire was used. Drinking water was analyzed. Results. Preventive oral health behaviors and dental care utilization were infrequent. The decayed, missing, and filled surfaces referring to primary dentition (dmfs) and permanent dentition (DMFS) scores (SD) were 8.9 (11.3) and 2.5 (4.4), respectively. Primary caries experience was associated with fluoride level in drinking water, age, gender, residential status, and geographical location. Permanent caries was also associated with dental visiting and parental education. There was an increase in the prevalence of dental caries in the Vietnamese child population compared with 10 years earlier. Conclusion. The oral health of Vietnamese children was characterized by high level of dental caries with variation among socioeconomic groups. It suggests the need for a population oral health program that includes measures to target high-need children.
Developmental Defects of Enamel in Children of Davangere District and Their Relationship to Fluoride Levels in Drinking Water
Authors: Ramesh Gayathri , Nagarajappa Ramesh , Raghunath Vandana , Manohar Ram
Published: June 2011

To assess the prevalence and severity of developmental defects and their relationship to fluoride levels in drinking water. 739 (406 male and 333 female) schoolchildren aged 13 years formed the study population. We used the ion selective electrode method to estimate the fluoride concentration in drinking water. A modified developmental defects of enamel index was used for recording the developmental defects. The Karl Pearson coefficient for correlation and the chi-square test were used for statistical estimation. The fluoride concentration ranged from 0.64 to 2.64 ppm. The prevalence of developmental defects was 88.5%. The most common type of defect was diffuse opacity in 61.2% of the children. There was a significant positive correlation between the type ( r = 0.85; P < .001) and extent ( r = 0.92; P < .001) of developmental defects in relation to fluoride levels in drinking water. The observed prevalence demonstrates the need to ascertain factors other than fluoride levels in drinking water that could contribute to its occurrence.
Programmatic Aspects of Dropouts in Child Vaccination in Bangladesh: Findings From a Prospective Study
Authors: Quaiyum Md. Abdul , Gazi Rukhsana , Khan Azharul I. , Uddin Jasim , Islam Meghla , Ahmed Faiz , Saha Nirod C.
Published: June 2011

The present study investigated prospectively programmatic factors relating to dropouts in child vaccination in 6 subdistricts of Bangladesh. A cross-sectional survey (n = 2700) was conducted estimating overall coverage of immunization using cluster sampling. The eligible subsample of children (n = 1064) was followed up prospectively to understand reasons for dropouts. In-depth interviews (n = 73) with mothers/caregivers and service providers were done and EPI (Expanded Programme on Immunization) sessions were observed (n = 131). Irregular EPI sessions were the prime cause of dropouts particularly in low-performing subdistricts. The other programmatic factors linked with dropouts were ( a) no reminder about subsequent session/doses, ( b) unfriendly behavior or absence of vaccinator, ( c) refusal due to lost card or vaccine exhausted, and ( d) short duration of sessions. Providers highlighted constraints such as financial problems for transportation, particularly in the hard-to-reach areas and vacancies of the posts of health assistants. The barriers to completing full schedules of vaccination can be removed to a large extent through programmatic adjustments.
Understanding Predictors of Postdischarge Deaths: A Prospective Evaluation of Children 5 Years and Younger Discharged From Philippine District Hospitals
Authors: Panelo Carlo Irwin A. , Shimkhada Riti , Solon Orville C. , Quimbo Stella A. , Florentino Jhiedon F. , Peabody John W.
Published: June 2011

Background. Factors that increase likelihood of readmission or mortality postdischarge from diarrhea and pneumonia cases among children is less understood. Methods. This study investigated the deaths of 24 children from a cohort of 3275. Using logistic regression, the authors compared data from those who survived with those who died to estimate the determinants of mortality in the study population. The authors also analyzed the hospital charts and completed mortality interviews with families of the deceased children. Results. Poor quality of care significantly increased the likelihood of mortality. Sicker children, those born to less-educated mothers, and those who had longer lengths of stay also had a higher likelihood of mortality. Hospital charts corroborated findings from clinical vignettes. The mortality interviews revealed delays in seeking care from onset of symptoms. Conclusion. Quality of care contributes to postdischarge mortality and that clinical vignettes are an effective means to identify where quality can be improved.
Politicians in Apron: Case Study of Rebel Health Services in Nepal
Authors: Devkota Bhimsen , van Teijlingen Edwin R.
Published: June 2011

This article presents the findings of a systematic review on the health consequences of Nepal’s armed conflict waged by the Maoists and the development and trajectory of their health workers. Nepal’s decade-long violent conflict resulted in more than 13 000 deaths, the destruction of more than 1000 health posts and poor health services delivery. At present, most of the former rebel health workers live in remote/rural areas and some are running health centers. The review found that the Maoists had trained more than 2000 health workers, who can be categorized into 4 levels. However, there is little evidence on their competencies and career motivation. The Maoists demand restructuring of the Nepalese health sector and the integration of their health workforce into the national health system. However, there has been no national discussion in Nepal of what kind of health reform and integration model is appropriate for a sustainable peace and improved service delivery.
A Standardized Process for Developing a National Notifiable Diseases List in a Pacific Island Setting
Authors: Pavlin Boris Igor , Kool Jacob L. , Samo Marcus H. , Gerstel Lisanne ,   Working Group on National Notifiable Diseases Prioritization of the Federated States of Micronesia Department of Health and Social Affairs
Published: June 2011

The authors describe an adapted method, originally developed for infectious disease resource allocation, for prioritizing infectious diseases for inclusion in a Pacific island nation’s National Notifiable Diseases List. Using a process that was systematic, transparent, objective, and addressed multiple criteria, a panel of stakeholders judged candidate diseases against 12 objective criteria and arrived at weighted scores for the diseases, which were then ranked. The result was the successful creation of a list of 22 urgently notifiable conditions. However, the process was only incrementally more useful than the use of consensus, and certain anomalies necessitated a reality check and adjustment of the final results. The process described herein may be more useful in settings where there is wide disagreement among stakeholders; it also appears more useful for its original purpose—prioritizing public health resource allocation for infectious disease control. The modifications discussed may make it more relevant to notifiable disease selection.
Knowledge About Osteoporosis in a Malaysian Population
Authors: Swan Sim Yeap  , Goh Emily Man Lee , Das Gupta Esha
Published: June 2011

To determine the depth and sources of knowledge about osteoporosis (OP) among the public in Malaysia. A self-administered questionnaire was distributed to attendees of health-related public forums. A total of 87.1% of the attendees had heard of OP. Of these, 89.5% were concerned about getting OP. Significantly more women than men ( P = .015), those with more than 10 years of schooling ( P < .001), and those earning more than $US285 per month ( P = .022) had heard of OP. Knowledge of OP risk factors was good: 97.1% identified low calcium intake, 87.8% lack of exercise, 80.0% family history of OP, and 75.8% postmenopausal status. A total of 38.7% of the attendees thought that OP was more serious than cancer and 35.1% more serious than heart disease; 55.7% obtained information about OP from newspapers and 46.4% from magazines. In this self-selected population, women, the better educated, and those earning higher incomes were more aware of OP. Knowledge of OP was obtained mainly from printed materials.
Sexual Behavior Model Among Young Thai Women Living in Slums in Bangkok, Thailand
Authors: Powwattana Arpaporn
Published: June 2011

There has been a dramatic drop in age at first intercourse and concurrent rise in HIV infections among young Thai women living in slums. The participants included 492 young Thai women (average age = 19.7 years). They provided detailed self-perception, emotion, sexual self-efficacy, cognitive strategies, and power in relationships. Logistic regression analysis was used to explore sexual behavior model. Findings highlight the extreme vulnerability of Thai female adolescents who engage in risky sexual behaviors: 55.8% were sexually active with 41.8% having vaginal sex without using condom. Significant enabling factors included perceived ability to precautions (odds ratio [OR] = 1.7), relational gain thinking (OR = 1.5), and curious gain thinking (OR = 1.3). The significant protective factors were decision-making dominance (OR = 0.3), perceived ability to say no (OR = 0.7), and ethical-related punishment avoidance thinking (OR = 0.8). These findings contribute to greater understanding of factors involved in sexual risk taking. Implications for behavioral modification addressing cognition and power in relationships are discussed.
Correlates of College Students’ Physical Activity: Cross-Cultural Differences
Authors: Seo Dong-Chul , Torabi Mohammad R. , Jiang Nan , Fernandez-Rojas Xinia , Park Bock-Hee
Published: June 2011

This study examined cross-cultural differences in personal and behavioral determinants of vigorous-intensity and moderate-intensity physical activity (PA) among college students living in distinctly different cultures, that is, the United States, Costa Rica, India, and South Korea. Participants of this study were recruited from randomly chosen public universities in the 4 countries during the 2006-2007 academic year. A total of 4685 students participated in the study (response rate 90%). Vigorous-intensity PA was measured by asking on how many of the past 7 days the participants participated in PA for at least 20 minutes that made them sweat or breathe hard. For moderate-intensity PA, participants were asked on how many of the past 7 days they participated in PA for at least 30 minutes that did not make them sweat or breathe hard. Findings indicate that whereas perceived overweight and fruit and vegetable consumption are relatively culture-free predictors of PA, gender and TV/video watching are culture-specific predictors. Binge drinking was not predictive of meeting the vigorous-intensity and moderate-intensity PA guidelines in any of the 4 countries.
Migration and Hypertension: A Cross-Sectional Study Among Neo-Migrants and Settled-Migrants in Delhi, India
Authors: Kusuma Yadlapalli , Gupta Sanjeev , Pandav Chandrakant
Published: June 2011

Understanding the blood pressure (BP) distribution within populations is fundamental to an understanding of the etiology of cardiovascular diseases and to develop effective preventive strategies. This study focuses on whether the BP levels and hypertension prevalence differ between neo-migrants and settled-migrants in the city of Delhi. Data on BP, anthropometry, social variables, and demographic variables were collected from a cross-sectional sample of 226 settled-migrants and 227 neo-migrants. Men possessed significantly higher BP levels than women. Settled-migrants possessed higher BP levels, except diastolic BP in males. The prevalence of hypertension ranges from 15% (neo-migrant women) to 25% (settled-migrant men), with no significant gender differences. Group differences were significant for men. Hypertension was more prevalent in older settled-migrants and younger neo-migrants. Recent migration was found to be a significant contributor to hypertension prevalence. Age contributed significantly to BP variation in both groups except in neo-migrant men. Pulse rate also contributed to systolic BP among neo-migrant women and settled-migrant men. Thus, urban residence and migration to urban areas can be a leading cause of increased prevalence of hypertension. Neo-migrants were subjected to more lifestyle insults and the stress generated during the adjustment process may be contributing to rise of BP even at younger ages.
Measuring the Ability to Interpret Medical Information Among the Japanese Public and the Relationship With Inappropriate Purchasing Attitudes of Health-Related Goods
Authors: Takahashi Yoshimitsu , Sakai Michi , Fukui Tsuguya , Shimbo Takuro
Published: June 2011

To investigate the relationship with uncritical purchasing attitudes toward health-related goods, the authors devised a test for ability to interpret medical information (TAIMI) among the Japanese public, designed to measure numeracy, literacy, and also critical appraising skills. An online survey was conducted, and 6047 participants were randomly chosen from the Japanese public and 36 physicians. TAIMI score for the public was 3.9 ± 1.7 (mean ± standard deviation); the physicians’ was higher at 6.2 ± 1.3 ( P < .01). The lower TAIMI scoring group was more prone to purchasing health-related goods in response to exaggerated advertising than the higher-scoring one ( P < .01). Factor analysis indicated that TAIMI included 2 factors related to the ability to critically appraise the validity and impact of evidence. In conclusion, TAIMI successfully measured the ability to interpret medical information, including the critical aspect of appraising validity and impact of the information. People competent in the interpretation tended to have more critical purchasing attitudes.