bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuing Education in Occupational Medicine for Physicians
Authors: Jeyaratnam J , Phoon WO
Published: June 2011

Continuing education (CE) in occupational medicine is necessary in Singapore in view of the existing deficiencies and in order to maintain and enhance professional competence. CE should be designed with three categories in mind: physicians not practising occupational medicine, occupational medicine specialists and designated factory doctors. If CE is to be made mandatory there will be a need for a substantial increase in the existing manpower and financial resources. Furthermore, provider units will have to be institutionalised and have the active support of the health care system.
Protein-Calorie Malnutrition Does it aggravate toxicities of environmental pollutants?
Authors: Nomiyama K , Nomiyama H
Published: June 2011

Male rats, put on 15 g/day low calorie and/or low protein diets for three weeks, were subjects in a study to determine lethal doses of organic solvents, heavy metals and agricultural chemicals. Protein-calorie malnutrition enhanced tolerance to organic solvents and heavy metals, except for methylparathion. However, tolerance to environmental pollutants was down to ordinary levels in a hot environment (32°C) despite the beneficial effects of protein-calorie malnutrition. Toxic effects of repeated exposure to benzene were aggravated by protein-calorie malnutrition in a hot environment.
Measles Immunisation in Thai Children Aged Nine to 14 Months
Authors: Lumbiganon P , Sookpranee T , Tattawasart U , Sukprasert S , Paholpak S
Published: June 2011

Measles immunisation of nine-month-old Thai children has been part of the national health programme since 1984. In this study we compared the seroconversion rate following measles immunisation in nine-month-old Thai children with the older age groups, i.e. 10 to 14 months of age, to see whether revaccination at over 12 months of age is necessary. In 223 children, 204 had no measles haemagglutination inhibition antibody before measles vaccination. The seroconversion rates in children aged nine to ten, 11 to 12, and 13 to 14 months were 96.1%, 94.5% and 100% respectively with no difference statistically.
Impact of a School Milk Programme on the Nutritional Status of School Children
Authors: Chen ST
Published: June 2011

From the start of the school milk feeding programme in February 1985 to October 1986, a total of 2, 766 children aged six to nine years from 12 primary schools in Ulu Selangor were followed-up for about two years. The children's weight and height were monitored at the beginning, in the middle and at the end of the study.

The study shows that there is a reduction in the prevalence of protein-energy malnutrition in terms of underweight (15.3% to 8.6%), stunting (16.3% to 8.3%) and wasting (2.6% to 1.7%) from the start of the school feeding programme to two years later. Associated with this there was an improvement in the attendance rate of the children during the same period. As there was no major developmental change in Ulu Selangor during that period, it is likely that the reduction in the prevalence of protein-energy malnutrition and the improvement of the attendance rate among the children are due to the impact of the school milk feeding programme.
Mortality Trends in a Rapidly Developing Economy in Taiwan Part I: Comparison with the USA and Japan 1976-1983
Authors: Tsai SP , Wen CP
Published: June 2011

The mortality experience of Taiwan was examined for two time periods (1976 and 1983) to determine the magnitude and direction of change in age-adjusted mortality and to identify deviation from the expected progress by comparison with two industrialized nations, the USA and Japan. Between 1976 and 1983 the overall mortality showed an annual average of nearly 2% decrease, mostly contributed by the marked reduction in the number of young. Significant reductions were also observed for deaths from strokes, rheumatic heart disease, ill-defined conditions, cancer of the stomach, and infectious diseases such as tuberculosis. A disturbing increase in suicide as well as accidents primarily caused by motor vehicles was noted. In general, cancer increased, to an alarming degree for environmentally implicated cancers such as lung, pancreas, nasopharynx, brain and liver in men.

When compared to that of the USA or Japan, the mortality experience of Taiwan showed the following increases: overall female mortality, accidental deaths, suicide among elderly women, deaths from strokes, ulcers, asthma, and liver, nasopharyngeal and cervical cancers. However, the overall cancer mortality rate was still much lower than that either in the USA or Japan. Despite marked reductions in infectious disease mortality, deaths from tuberculosis were nearly 40 times those of the USA. Although deaths from ill-defined conditions decreased by half during this study period, they were still high, particularly among elderly women (13% of all deaths and 22 times higher than the USA), which probably reflects inadequate medical services for women.

The role of the Taiwanese government in the financing of health services was found to be far smaller than that of the USA or Japan. Expanding health care expenditure by the government is desirable if improvement in the maldistribution of medical services is to be achieved and the untoward health effects of rapid industrialization is to be reduced.
Cost Estimate of Health Care Coverage for the Medically Indigent in Hawaii
Authors: Mondragón D , Abou-Sayf FK
Published: June 2011

The objective of the study was to estimate the cost of health insurance coverage of the medically indigent in Hawaii. The number of uninsured was estimated deductively from the coverages of those insurance companies doing business in the state, with an additional factor for persons with more than one policy coverage. Age and sex breakdowns of the uninsured were entered into actuarial tables and fee-for-service and HMO plan costs were obtained for the most prevalent health plan in the state. Annual coverage is estimated at US $46.090866 million and US $58.040700 million for fee-for-service and HMO plans, respectively. Seven potential sources of financing and five recommendations for further research are given.
Occupational Exposure Standards for Pharmaceutical Agents
Authors: Aw Tar-Ching , Harrington J. Malcolm
Published: June 2011

Compared to the wide range of occupational exposure standards available in different countries for industrial chemicals, there are only a few similiar standards set for pharmaceutical agents. These substances produce physiological effects in relatively small doses, and there are documented ill-effects from worker exposures, hence the need for such standards. There are different approaches to setting occupational exposure standards for pharmaceutical agents. One derived from the nuisance dust standard may be used, although that may not be wholly appropriate. An approach has been previously suggested for ethinyl estradiol, and this requires the minimal effective dose, a safety factor, an assumption of equal absorption by inhalation as by the oral route, and the volume of air inhaled over an 8-hour day. Toxicological and pharmacological information for zeranol, an animal growth promoter with estrogenic properties, is used with these criteria to obtain an airborne standard. It can be shown that depending on what assumptions are made, there can be more than a tenfold difference in standards reached. There are other difficulties with setting standards for pharmaceutical agents, depending on the group of substances involved. Airborne standards are useful for medicines that are inhaled. A “skin” notation may be needed for those that can be absorbed via the dermal route. Biological standards should also be considered. Provision of standards for pharmaceutical agents will go some way towards protecting exposed pharmaceutical workers.
Knowledge, Attitude and Practice Factors in Childhood Acute Respiratory Infections in a Peninsular Malaysia Health District
Authors: Vasanthamala A , Arokiasamy JT
Published: June 2011

This study compares the knowledge, attitudes and practice of mothers in two ethnic groups with regard to acute respiratory infections (ARI) in their child. Most had traditional beliefs as to the cause of ARI with only a minority knowing the causes. Most mothers were aware of the effect of frequent attacks of ARI on the health status of their child and of the importance of early treatment. Reasons for their becoming worried during an episode of ARI in their child indicated that problems of distance, transportation and arrangements for care of their other children predominate. A large proportion of the respondents felt that their present knowledge of ARI was inadequate and were thus interested in obtaining more information.
Cancer Occurrence in Vanuatu in the South Pacific, 1980-86
Authors: Paksoy Nadir , Montaville Bernhard , McCarthy SW
Published: June 2011

A total of 269 pathologically confirmed carcinoma cases (118 male, 151 female) were recorded in the seven year period 1980 to 1986 in Vanuatu, an island nation within the Melanesia region in the South Pacific. Cervical cancer was numerically the most important malignancy in females (25% of all female cancers). In males, liver cancer was the most commonly observed (14.4% of all male cancers). Almost one-half (44.4%) of the available paraffin blocks from liver carcinoma cases (18 cases) demonstrated positivity of HBV antigens in liver tissue. The most interesting feature was the high proportion of thyroid cancers, especially in females. It represented 12.1 percent of all cancers in female and 5.2 percent in male Melanesians in Vanuatu. These percentages were found to be even higher than among Hawaiians for whom the highest incidence rates in the world have been recorded. Since our study was based solely on pathologically diagnosed cases, the findings should be regarded as minimum estimates.
Milk Tolerance Among Malnourished School Children in Malaysia
Authors: Chen ST , Domala Z
Published: June 2011

1, 256 malnourished children, aged seven to ten years, were selected for study, 575 from Kuala Langat, 416 from Wilayah Persekutuan and 265 from Ulu Selangor. Ninety-three percent of the children were from low socio-economic groups with large family size, and most of their parents had only primary or no formal education. During the study period, children in Kuala Langat received daily milk supplementation for five days per week, those in Wilayah Persekutuan for two days per week, while those in Ulu Selangor did not receive any milk supplementation.

The study shows that a majority of the malnourished primary school children liked to drink milk and that milk intolerance was not a problem among them.
Smoking Among Medical Students in Hong Kong
Authors: Cheng KK , Lam TH , Ratanasiri A.
Published: June 2011

A survey was conducted among two classes of medical students (N=293) at the University of Hong Kong to study their smoking habits and knowledge of and attitudes toward smoking. The response rate was 97.3%. There was only one daily smoker (0.4%) and 21 occasional smokers (7.4%). While the respondents regarded health and self-discipline as the main reasons for not smoking, the social taboo against smoking among young people might have also deterred this educated elite from smoking. Many of them failed to identify the major causal role of smoking in smoking related diseases. The potential of prevention in encountering a smoking patient seen for reasons unrelated to smoking was not fully realised. There was disagreement in the banning of cigarette advertising and in increasing the price of tobacco products. In the face of aggressive marketing by the tobacco industry in the Asia-Pacific region, every undergraduate medical curriculum should include organized instruction on smoking and its control.
The Cultural Definition of an Infantile Diarrhea in Tambon Korat and Koongyang, Northeast Thailand: Community Perceptions in Diarrhea Control
Authors: Baclig Paulita V , Patrick Walter K
Published: June 2011

In Tambon Korat and Koongyang in North-eastern Thailand, 88% (n=60) of the mothers and significant other careproviders interviewed believe in poh, a mild, self-limiting diarrhea in infants which is considered a normal prerequisite in child development. The local definition of poh as to its nature, symptomatology and home management and implications for diarrhea control activities are presented in this paper.
Health in the Americas XX/XXI Centuries Perspectives in International Health
Authors: deMacedo Carlyle Guerra
Published: June 2011

A case is made that a new frontier of international health is developing technical cooperation among countries of the Americas for narrowing and eventually filling the gap between them. Several initiatives of PAHO are cited.
International Health in Transition
Authors: Frenk Julio , Chacon Fernando
Published: June 2011

The need for a transition towards a new concept of international health is emphasized and a paradigm for making the transition is proposed. The challenge of building a vigorous intellectual and academic tradition of international health which supports its efforts to generate knowledge and leads to its practical application is recognized and addressed. It is argued that the development of such an intellectual field is based on four elements: conceptual base, production base, reproduction base, and utilization base. The Unit for International Studies in Public Health (UISPH) of Mexico is presented as one example of efforts to consolidate an academic tradition in this field.
The Effects of Rooming-in on the Success of Breastfeeding and the Decline in Abandonment of Children
Authors: Buranasin Banphot
Published: June 2011

This study analyzed the effect of management of rooming-in, conducted in one of the regional hospitals in Thailand, on the success of breastfeeding. Data based on 2, 000 infants born in 1987 and 1990 showed a significant improvement on separation time of infant and mother after delivery and predominant breastfeeding, where the infant's predominant source of nourishment has been breastmilk. Separation time was reduced from 6.3 ± 3.2 to 1.62 ± 0.42 hours and predominant breastfeeding was significantly increased from 85 to 99 percent.

Data obtained from the community related to the initiation and predominant breastfeedings showed a significant increase (p<0.05). No significant difference was demonstrated, however, on current breastfeeding among infants who were delivery before and after initiation of the rooming-in system. Also analyzed were data on prevalence of deserted children. The findings showed a progressive reduction of deserted children after management of rooming-in.

The study concludes that the practices of obstetricians were a key to successful breastfeeding. Promotion and management of rooming-in significantly improves the success of breastfeeding and reduction of deserted children in the hospital.
Prevalence of Human T-Cell Lymphotropic Virus Type I Infection in Singapore: A Preliminary Report
Authors: Zhao Li-Gan , Yanagihara Richard , Mora Carlos , Garruto Ralph M , Wong Tze Wai , Gajdusek D Carleton
Published: June 2011

Human T-cell lymphotropic virus type i (HTLV-I) infection is endemic in southwestern Japan, the Caribbean basin, Colombia, Africa and in several isolated populations in Papua New Guinea, the Solomon Islands and Vanuatu. To determine the seroprevalence of HTLV-I infection in Singapore, we tested sera from 115 hospitalized patients with acute nephritis, 50 patients with suspected leptospirosis, 34 patients with non-A, non-B hepatitis, and from 28 healthy volunteers for IgG antibodies against HTLV-I using an enzyme-linked immunosorbent assay. Antibodies were detected in sera from 6 of the 199 patients and from 3 of the 28 healthy volunteers, but these positives could not be confirmed by Western immunoblotting. Our data are consistent with other reports of low seroprevalence of HTLV-I infection despite extensive Japanese contact in Korea, Taiwan, the People's Republic of China and Micronesia. Further studies on a larger sample size, however, are necessary to confirm the absence of any focus of infection in the Singapore population.
Job and Life Satisfaction among Rural Public Health Nurses in Taiwan
Authors: Lee Shu-Hsin , Lee Meng-Chih , Lee Maw-Sheng
Published: June 2011

This study sought to examine job and life satisfaction among rural public health nurses in Taiwan. All 339 public health nurses working in 31 aboriginal townships and on three offshore Islands were surveyed through a mailed questionnaire to them. The survey results showed that the public health nurses were moderately satisfied with jobs and lives in general. Areas of greatest job satisfaction included relationships with community residents and with coworkers. Areas of least job satisfaction Included salary and benefits, health resources available to them, and their abilities to remain knowledgeable. It Is suggested that public health administrators and government legislators take immediate and effective actions to Increase the economic incentives and to provide more on the job training programs for rural public health nurses.
AIDS Awareness Amongst School Teachers in a Rural Area of India
Authors: Srivastara VK , Nirupam S , Chandra R , Jam VC
Published: June 2011

One hundred and eighty-two teachers from a random selection of 15 schools in a rural area of Lucknow district of northern India were interviewed to assess their awareness and knowledge about AIDS using a pretested CARC proposed questionnaire. Observations revealed that only 79.7% of the teachers had heard about AIDS, newspapers being the main source of information. Awareness amongst graduate teachers was significantly higher than non-graduates. Many believed AIDS to be mosquito-borne and less than 2% knew that condom usage makes sex safer. The study reveals the need to undertake intensive health education efforts as school teachers are an important source of health-related information for rural populations.
Factors Contributing to the Severity of Childhood Pedestrian Injury in Perth, Western Australia
Authors: Stevenson Mark R , Laing Beverley A , Lot Sing Kai
Published: June 2011

Pedestrian-motor vehicle collisions that involved children aged 0 to 14 years in Perth, Western Australia were examined for the period 1980-1989 in order to identify factors which contribute to the severity of injury. Nearly half (49%)of the l, 82children injured during this period required hospitalization, with a further 46% of the children requiring some form of medical treatment. Multivariate analysis indicated that children aged 0 to four years had a higher risk of sustaining a severe injury compared with children aged five to nine and ten to 14 years, with relative risks of 1.6 and 1.7 respectively. A greater proportion of more severe injuries occurred after 3 pm. Injuries tended to be more severe when the collision occurred on a highway or main road, and when the child was actually on the road at the point of impact Further research on more comprehensive datasets, which consider the child's behavior at the time of injury as well as driver attributes, will provide greater insight into factors contributing to the severity of injury.
Factors Affecting the Duration of Breastfeeding in a Rural Population of Saudi Arabia
Authors: Kordy Mohammad Naji , Ibrahim Mohammad Abdulbari , El-Gamal Fathi M , Bahnassy Ahmed A
Published: June 2011

A study was conducted to demonstrate factors influencing duration of breastfeeding in Al-Jamoom Western region of Saudi Arabia. Information was obtained on 476 children under the age of three years and their mothers in nine of the villages in this area. A predesigned questionnaire was administered to the mothers to obtain information on age, education, fertility parameters and antenatal care during pregnancy with the index children. Multiple regression analysis was used to analyze the effect of different biological and environmental factors on the duration of breastfeeding. The data showed that over 57% of the mothers breastfed their children for more than a year, and the mean duration of breastfeeding was 14.61 ± 3.53 months. A considerable proportion of the mothers (42.3%) stopped breastfeeding during the first year. The most common reason for terminating breastfeeding during the first year was insufficient milk (30.9%), and recurrence of pregnancy (27.3%). A minority of the mothers (6.5%) were given advice about breastfeeding by health care professionals(physicians and nurses). Other factors such as the age of the mother, age of the infant when a supplement diet was first introduced, birth order of the child and attendance in an antenatal care clinic had a significant effect on the duration of breastfeeding. It is therefore recommended that Maternal and Child Health services must be strongly reinforced in the Primary Health Care Centers of the Ministry of Health and other health care providers.
Chronic Arsenic Poisoning from Well Water in a Mining Area in Thailand
Authors: Foy Hjordis M , Tarmapai Samran , Eamchan Poovanon , Metdilogkul Orapun
Published: June 2011

Endemic arsenic poisoning manifested by palmoplantar keratoderma and hyperpigmentation was surveyed in a village in a tin and wolfram mining area in southern Thailand where two cases of Bowen's carcinoma had occurred. Nine percent of examined adults randomly selected from 58 households were found to have skin manifestations of arsenic poisoning. Also, children with typical palmoplantar keratoderma were recognized, the youngest being four years old. A seven-year-old with severe keratoderma also had neurological manifestations and appeared mentally retarded. Arsenic concentration in shallow wells varied between 0.02-2.7 mg/1 (average 0.82), and piped water had 0.07 mg/1. A major source of the contamination of ground water probably was slag heaps positioned next to a stream that led the village.
Impact of Urban Basic Services on Immunization Coverage In a Slum Area of Northern India
Authors: Chandra R , Srivastava V K , Nirupam S
Published: June 2011

The Urban Basic Services (UBS) programme was launched in some of the urban slums in the major cities of India in the year 1986. The main objective of the Urban Basic Services (UBS) Program is to improve and upgrade the quality of life of the urban poor, particularly the women and children. The major thrust area under the UBS programme includes child survival and development, learning opportunities for women and children, water and sanitation, and community organization. The present study attempts to find out the impact of the UBS Program in terms of the immunization coverage carried out in slums covered by UBS and comparing it with non-UBS slums using the 30-cIuster sampling technique as suggested by WHO. The percentage of fully immunized children was higher (16.2%) in the UBS slums compared to 10.9% in non-UBS slums. The immunization coverage of children was slightly better in the UBS slums for BCG, DPT and Oral Polio Vaccines, while for measles it was 18.6% in UBS slums and 11.9% in non-UBS slums. The dropout rates for I to III doses of DPT was much higher (36.4%) in non-UBS slums as compared to 28% in UBS slums. The availability of immunization cards was found to be higher in both mothers (16.7%) and children (22.4%) in UBS slums compared to the non-UBS ones (5.2% and 8.6% respectively). The slums thus covered under the UBS program have done marginally better in immunization but it appears that to assess the overall impact of UBS, all the components of services and not merely immunization should be assessed.
Diet and Blood Nutrient Correlations with Ischemic Heart, Hypertensive Heart, and Stroke Mortality in China
Authors: Guo Wande , Li Jun-Yao , King Haitung , Locke Frances B
Published: June 2011

Though major differences exist in sabcategory mortality levels, cardiovascular disease remains a leading cause of death among both Asian Chinese and Westerners. This paper examines the possible relationship between cardiovascular mortality and biochemical, diet and lifestyle factors based on two surveys in China. Statistically significant associations indicate five variables negatively correlated: molybdenum, oleic acid, liquor consumption (males), legumes, and age at first pregnancy with ischemic heart disease; molybdenum, oleic acid (females) and age at first pregnancy with hypertensive heart disease; and legumes and age at first pregnancy with stroke. Five variables were positively correlated: triglycerides and herpes antibodies with ischemic heart disease; salt and phosphorus (females) with hypertensive heart disease; and only albumin (males) with stroke. Some findings confirm those observed in the West (salt, triglycerides, herpes, legumes, oleic acid, and liquor), but molybdenum and age at first pregnancy have not been emphasized previously. Still others significant in the West have not been observed here, such as cholesterol and smoking.
The Managerial Process as a Key to Successful Breastfeeding for promoting Infant Health in Thailand
Authors: Durongdej Somchai , Mangklasiri Ruchira
Published: June 2011

A strengthening of the managerial process within the health care delivery system can facilitate and encourage successful breastfeeding. This process includes problem-based planning, multidisciplinary team approach, leadership development and generation training. The process has proved to be very successful in promoting breastfeeding and improved infant health. It can be applicable to other urban settings throughout Thailand and perhaps to other developing countries.
Pacific Health: An Analysis for Training New Leaders
Authors: Finau Sitaleki A
Published: June 2011

History, economics, culture, and politics have created health systems that can no longer meet the health challenges in the Pacific. An analysis of the health situations in the region revealed health trends, health service deficiencies and the various issues that need to be addressed.

The morbidity and mortality experience in the Pacific has been approaching that of the developed countries. The contributing factors to diseases and death have been changing but other health issues, such as matters pertaining to environmental sanitation, management, health information, food and nutrition, ethnic pluralism, colonialism, and technological arrogance, may exacerbate these experiences.

To appropriately meet these constraints, the health services need reorientation. However, these need new types of health leadership. Doctors, being the most socially acceptable and politically powerful, should be trained for this new leadership role. This training must be guided by the biopsychosocial model to produce community health physicians. This is being undertaken at the Pacific Basin Medical Officer Training Program, Pohnpei. It is characterized by an integrated, community-oriented, student-centered, career-ladder and competency-based approach. The graduates will then provide the leadership and catalyst for the needed health service reorientation.
Smoking Behavior, Knowledge and Opinion of Medical Students
Authors: Yaacob Ismail , Abdullah Zainal Abidin
Published: June 2011

A questionnaire survey on smoking was conducted among 395 medical students (40% males, 60% females) at the School of Medical Sciences, Universiti Sains Malaysia at Kubang Kerian, Kelantan. Thirty-five students (9%), all of them males, were current smokers. Twenty-eight percent of the smokers smoked more than ten cigarettes per day and 88% began smoking before entering the medical school. Social influence and cigarette advertisements were the main reasons given for starting smoking. Both smokers and non-smokers were adequately informed of the common adverse effects of smoking. Ninety percent of smokers had tried to give up smoking but failed. Among the ex-smokers and non-smokers, the main reasons given for not smoking was that smoking was useless. Among the female students, one-third felt that cigarette smoking was socially unacceptable among females. This was one of the three main reasons for not smoking. Very few of the students (4.6%) considered that doctors' advice would play an important role in smoking prevention.
Observations of Human Behavior Influencing the Use of Insecticide-impregnated Bednets to Control Malaria in Sabah, Malaysia
Authors: Leake David W , Jeffrey L K
Published: June 2011

Observational and survey methodologies were used to probe human behavioral factors influencing the use of insecticide-impregnated bednets to control malaria in rural Sabah, Malaysia. One aim was to investigate why a Geld trial of such nets in an interior area yielded disappointing results. A second aim was to gather baseline data prior to a field trial proposed for a coastal area. Interior villagers reported a significantly higher net usage rate than that observed directly, suggesting that subject self-reports need to be validated in some way. The poor results of the interior field trial appeared related to reluctance to regularly use nets, which were not in wide use previously. Prospects for reducing malaria transmission through bednets appeared better for the coastal area since nearly half of observed villagers were sleeping in them. However, significantly more coastal than interior villagers were observed watching television at night, an activity that may increase malaria risk by keeping villagers awake and out of bednets.
The Association Between Breast Cancer and Diet and Other Factors
Authors: Qi Xiu-Ying , Zhang An-Yu , Wu Guang-Lin , Pang Wen-Zhen
Published: June 2011

To explore the effects of diet and other factors on breast cancer development, a case-control study was conducted in Tianjin between 1986-87. After adjusting for confounding factors, it was found that factors associated with increased risk of breast cancer included —-early age at menarche; late age at menopause; late age at first birth; high Qutelet's index; histories of breast wound, disease and benign tumor; and a family history of malignant tumor, high fat, high calorie, low vegetable intake; elevated serum cholesterol and LDL-cholesterol; and lower levels of serum HDL-cholesterol and whole blood selenium.
Essential Factors in the Implementation of an Expanded Program on Immunization in an Urban-Periurban Community in Nigeria
Authors: Okoro Jones I , Egwu Igbo N
Published: June 2011

The aim of this study was to identify some of the factors that affected the implementation of the Expanded Program on Immunization (EPI) in the Local Government Area (LGA). The study covered the three communities in Calabar LGA. Data on vaccine-eligible children and pregnant women were sought with questionnaires; other information on technical and community aspects of the EPI was gathered with specially designed checklists. EPI coverage for most antigens increased between 70-100% in response to highly-organized immunization campaigns initiated in 1985. In subsequent years, up to 1989, similar campaign-induced responses to national, state and local campaign efforts were observed. In contrast, coverage levels attributable to routine immunization remained unsatisfactory. When tested with the Z-statistic using 1985 as the base year (p < 0.05), there was a significant difference between the proportion of eligible children and pregnant women who did not receive their full dose of immunization. Socio-Iogistic variables found to be important in EPI implementations included scheduling, health staff attitude, intersectoral collaboration, and health education. Lack of community participation was also found to be a crucial constraining factor. As community participation/involvement is critical in sustaining health programs, social marketing techniques are suggested for future use.
An Economic Analysis of AIDS — Towards a Proposed Model of Costing: A Singapore Experience
Authors: Lim JY , Chew BW , Phua KH
Published: June 2011

With the increasing prevalence of HIV infection/AIDS and the extending range of care and treatment, the economic implications of the various prevention and control strategies, and of treatment, have become the subject of interest to policy-makers, public health specialists and health economists. This paper presents an overview of the methods used for the economic analysis of AIDS/HIV infection. It proposes an activity-oriented, cost center-based model for the costing of the economic impact of AIDS, using cost figures in Singapore since 1985, when the National AIDS Control Program was started. Priorities for future research are also identified. Asia Pac J Public Health1994;7(3):143-50.
A Comparative Study on the Efficacy of a Mass Screening Program for Colorectal Cancer — Comparison Between Cancer Cases Detected by Mass Screening and by Outpatient Clinics
Authors: Nakama Hidenori
Published: June 2011

The present study was carried out to investigate the efficacy of colorectal screening through a comparison of the characteristics of the cancer cases detected by screening programs and by outpatient clinics. A total of 78 cases with colorectal cancer diagnosed by screening programs using fecal occult blood test in Nagano Prefecture, Japan, was collected as the index group and the same cases (one matched cases) diagnosed through outpatient clinics served as the control group for the present study. A comparison of various factors, such as tumor site, Dukes' stage, histological type, and survival rate, was made between the index and control groups. No differences were noted in tumor site and histological type between the two groups examined. The proportion of early cancer and the survival rate, however, were significantly higher in the index group than in the control group (p < 0.01). These results suggest that colorectal screening is an efficient preventive measure. Asia Pac J Public Health1994;7(3):159-64.
Knowledge and Use of Maternal and Child Health Services by Mothers in Papua New Guinea
Authors: Karel Harumi Sasaki
Published: June 2011

A survey was conducted in the coastal area of Morobe Province in Papua New Guinea between March to April 1992 in order to obtain and examine the current health knowledge and practices of mothers with children under two years of age. The purpose of the survey was to gather data for the detailed planning and implementation of a Child Survival Intervention Project funded by USAID. A total of 30 villages in the area were selected utilizing the WHO 30-cluster sampling technique. The results indicated that breastfeeding was a very common practice. However, because nutritional intake was not increased during pregnancy and lactation for many of the women, it is likely that their nutritional intake was insufficient. Although many mothers knew the importance of immunization, they were unclear about the importance of completing immunization series. The utilization of contraceptive methods was very low among women who did not want to have another child within the subsequent two years. The most common methods were injections and pills.

The dissemination of health education to isolated rural villages is one of the most important interventions in reducing maternal and infant mortality. As there currently is no health education unit at the Morobe Provincial Department of Health. It is crucial to establish the unit and to emphasize the importance of health education as the tool for disease prevention and health promotion. Asia Pac J Public Health1994;7(3):191-3.
Possibility of Lyme Disease as an Occupational Disease — Seroepidemiological Study of Regional Residents and Forestry Workers
Authors: Nakama Hidenori , Muramatsu Koichi , Uchikawa Kimito , Yamagishi Tomoko
Published: June 2011

We conducted a study to investigate the state of human infection by the Lyme disease pathogen by determining the prevalence of positivity for serum antibody to Borrelia burgdorferiamong regional residents and forestry workers in Nagano Prefecture. Assay of the antibody titer was performed by indirect fluorescent antibody technique (IFA) using Borrelia burgdorferistrain B-31 as the antigen. The study was based on the results of an earlier investigation to test our prediction of high infection rates for the adult ticks of I. persulcatusand I. ovatusin Nagano Prefecture. The study results showed infection to regional residents and forestry workers by the Lyme disease pathogen and a significantly higher positive rate in forestry workers than in regional residents. These findings indicate the need to consider this disorder as an occupational disease of forestry workers. Asia Pac J Public Health1994;7(4):214-17.
Relationship between Mean Lead Levels in the Atmosphere and in Blood from Data Published since 1977
Authors: Kawada Tomoyuki , Tri-Tugaswati A , Yasuo Kiryu , Suzuki Shosuke
Published: June 2011

The authors attempted to confirm the reliability of the linear log-log model presented by Goldsmith and Hexter in 1967. The data used were from seven reports published since 1977, including that of the authors. The age of the subjects in these reports ranged from three to over 65 years. Various methods of air sampling and pre-treatment of collected particulate matter were employed. Lead was determined by atomic absorption spectrophotometry. The mean value of lead in the atmosphere ranged from 0.11 to 19 μg/m3. A regression line obtained from 13 pairs of averaged lead in the atmosphere and in blood was log(Pb-B) = 0.259 x log(Pb-A) +1.243, and the Pearson's moment correlation coefficient between the logarithm of Pb-A and the logarithm of Pb-B was 0.839. These results were roughly the same as those of Goldsmith. This finding confirms the consistency of the association between Pb-A and Pb-B, which may be used to monitor atmospheric and blood lead quantitatively in those countries conducting a lead reduction program in gasoline. Asia Pac J Public Health1994;7(4):233-5.
A Study of Hepatitis Outbreaks in Between 1986 and 1988
Authors: Chu Quan-Sheng , Xiu Yu-Zhen , Suen Si-Yan , Xie Zhong-Ben , Yu Ping
Published: June 2011

Outbreaks of hepatitis in the urban districts and villages of Qingdao, China, were investigated over a two-year period to examine what affected the spread of hepatitis. A total of nine outbreaks were recognized, involving a total of 89 cases. Serological tests confirmed that all nine outbreaks were caused by the hepatitis A virus (HAY). Eighty-five percent of the patients were between three and 13 years of age; the others were adults. The introduction and spread of hepatitis A into a site was related to unsanitary housing conditions, poor hygiene habits, and source patients who had not been diagnosed and isolated promptly. The ratio of symptomatic to asymptomatic cases was 0.38:1. Control of hepatitis A outbreaks requires prompt and exact diagnosis of the source patients who need to be educated about washing their hands after they go to the toilet and before eating.
Impact of Midday Meal Program on Educational and Nutritional Status of School-going Children in Andhra Pradesh, India
Authors: Sarma KV Rameshwar , Rao D Hanumantha , Rao K Mallikharjuna , Galreddy Ch , Kumar Sharad , Rao Vishnu Vardhan , Rao N Pralhad
Published: June 2011

The Midday Meal Program(MDM) is in operation in several states of India. This program aims to improve school enrollment and attendance, to reduce dropout rate to better the children's school performance, and to improve the nutritional status of primary school children. A study was undertaken in the State of Andhra Pradesh to assess the impact of the MDM program on the above parameters. A total of 83 schools from three districts, 45 schools with program and 38 schools without program, were included in the study.

Results of the study on the educational component indicated improved attendance, increased retention rate with reduced dropout rates, and a marginal improvement in the scholastic performance. The nutritional component revealed better growth performance among the regular beneficiaries in the program.
Mortality Mapping in Hong Kong, 1979-83 and 1984-88: Feasibility Study and the Patterns of Cancers
Authors: Lloyd Owen L , Wong SL , Yu TS , Wong TW
Published: June 2011

To examine the practicability and value of mapping cancers in Hong Kong, selected data from consecutive censuses were used to assess the demographic stability and sociocconomic characteristics of the 27 districts. Mortality data in two quinquennia (1979-1988) were used to calculate the districts' standardized mortality ratios (SMRs) for various cancers and their ranks were presented in maps. Correlations were calculated between the SMRs for the cancers, and between the SMRs and the sociocconomic characteristics.

Population sizes and sociocconomic characteristics of the districts were fairly stable in most districts. The SMRs of many cancers differed widely between districts. Affluent districts tended to have high SMRs for colorectal and breast cancers, but low SMRs for nasopharyngeal cancer (NPC) as well as liver and lung cancers. The directions of the SMR ranking correlations between the two quinquennia were generally consistent. Statistically significant correlations between some cancers were replicated, particularly for males, and between some cancers and sociocconomic characteristics.
Factors Influencing Smoking Behavior in Hong Kong Primary Schoolchildren: Targets for Prevention
Authors: Peters J , Hedley A J , Lam TH , Liu J , Wong CM , Ong SG
Published: June 2011

The uptake of smoking by children and factors influencing such behavior, although well documented in the West, have not been studied in the Asia-Pacific region. A cross-sectional survey was carried out on 3, 521 children, aged 8-11 years living in two districts of Hong Kong. Knowledge, attitude and behavior related to smoking and sociodemographic data were obtained from questionnaires completed by parents and children. Eleven percent of boys and 5 percent of girls were ever-smokers, 5 percent of all eight-year-olds and 21 percent of 11-year-olds. Believing that parents will not interfere with their smoking (adjusted odds ratio 5.52; 95% confidence interval 2.72, 11.18), living with family members who smoke (1.72; 1.33, 2.23), and having a positive attitude to smoking (4.13; 1.43, 11.98) were factors predictive of ever-smokers. Experimentation with smoking is a major health risk for primary school children in Hong Kong and indicates failure of current smoking prevention programs. Effective culture-specific programs to counteract risk factors and with continuing evaluation are urgently needed; they should be based on information from appropriately-designed epidemiological studies.
Absenteeism in the Workforce, Klang Valley, Malaysia—Preliminary Report
Authors: Indran Saroja Krishnaswamy , Gopal Rampal Krishna , Omar Ainsah
Published: June 2011

The aim of this study was to determine the prevalence of sickness absenteeism among the three types of agencies, government, semi-government (boards) and private (public) companies. The methodology involved eliciting retrospective data on medical leave over the year 1990 by requesting the agencies to fill up a questionnaire (Appendix I), and calculating the indices of absenteeism from this data. The results show that the private agencies scored higher for all the indices but only the “lost time” percentage was significantly increased. Females also had significantly higher severity of sickness absenteeism rates in all the agencies. Overtime work was associated with higher absenteeism indices, markedly noted in the private agencies. In conclusion, agencies showed work out their own indices of absenteeism so that it could be compared with national rates.
Battered Women: Presentation At A&E Departments In Singapore
Authors: Seow Eillyne , Poh Wong Ho , Yong Low Boon , Anantharaman V , Ooi Shirley
Published: June 2011

This study was undertaken to assess the characteristics of battered women seen at the A&E departments in Singapore. The first part was conducted at the A&E department of a general hospital in Singapore from July 4, 1992 to November 9, 1992. Ninety-six victims were interviewed using a standard questionnaire. Information was obtained about the characteristics of victims, assailants and the assaults as well as the cause of presentation. In order to verify the universality of the findings, battered women seen at A&E departments of the four main general hospitals on the island from November 1, 1993 to January 31, 1994 were interviewed using a similar questionnaire. We found that the majority of the women were beaten by someone they knew and, for most, it was not a first-time assault. Most times, no weapon was used. Injuries were sustained mainly to the face and extremities. The majority of the victims were at the A&E department either because of the medical examination required in conjunction with a police report or because of the severity of their injuries.
Longitudinal Studies of Blood Pressure in Children
Authors: Li Liming , Wang Yanying , Cao Weihua , Xu Fujie , Cao Jiaqi
Published: June 2011

A longitudinal study of six years was conducted to find out the pattern of longitudinal changes of blood pressure and to affirm the “tracking phenomenon” of blood pressure in children in China. We initially measured blood pressure and related parameters of 2, 946 children (aged 4-14 years) in 1981 at Fanshan county, Beijing, and then two follow-up remeasurements were conducted in 1985 and 1987, respectively. The results indicated that: the average level of blood pressure increases with age even after adjusting for height and weight; tracking coefficients of systolic blood pressure range from weak to moderate levels, increasing with age. Only 30% of the children whose systolic blood pressure was beyond the 90th percentile of the systolic pressure distribution at the first examination remained at the same region after four years. Multiple stepwise regression was used to determine factors correlated with blood pressure. Our results indicate that systolic blood pressure in children is correlated with body w eight, pulse rate, scrum glucose and HDL-C, while diastolic blood pressure is correlated only with pulse rate and serum glucose.
Hepatitis B Sero-prevalence and Risk Factors Among School-age Children in a Low Socioeconomic Community, Bangkok
Authors: Luksamijarulkul Pipat , Maneesri Prangthong , Kittigul Leera
Published: June 2011

A cross-sectional study of 165 school-age children who had no history of HBV vaccination was carried out in a low socioeconomic community of Din-Daeng, Bangkok. Blood specimens were collected for determination of HBV seromarkers (HBsAg, Anti-HBs and Anti-HBc) by EIA commercial kits. The results showed that the prevalence of HBV seromarkers was 24.85%, the HBsAg carrier rate was 3.64%, the anti-HBs positive rate was 15.15%, and the prevalence of only anti-HBc was 6.06%. To investigate factors associated with the positivity of HBV seromarkers, children were divided into two groups-the first group consisted of 41 children with HBV seromarkers and the second consisted of 124 children without HBV seromarkers. The study variables between the two groups were compared and analysed. The results revealed that factors associated with HBV positivity were (a) child factors: child's age, child's sex, ear piercing in female, sharing blade during haircutting, contact wound from other persons, using wares with other persons, searching things in garbage, and (b) family factors: older parent, low education in parent, low family income per month, low parent's knowledge and attitude about HBV infection and vaccination, (P < 0.05). After using stepwise regression analysis, the factor of ear piercing in female was only one significant variable (P = 0.007).