bluuebunny/crossref_metadata_2025 huggingface dataset:
Sharps Injury and Body Fluid Exposure Among Health Care Workers in an Australian Tertiary Hospital
Authors: Peng Bi  , Tully Phillip J. , Boss Karen , Hiller Janet E.
Published: June 2011

To examine sharps injury and body fluid exposure among health care workers, a descriptive epidemiological study was conducted in a 1000-bed tertiary hospital between 2000 and 2003 using surveillance data of all reported sharps injuries and body fluid exposures. A total of 640 sharps injuries and body fluid exposures were reported from hospital and nonhospital staff, although no seroconversions to HIV, hepatitis B virus, or hepatitis C virus were observed during the study period. Nurses reported 47% of sharps injuries and 68% of body fluid exposures, medical staff reported 38% and 16%, and other nonmedical staff notified 5% and 4%, respectively, while nonhospital staff reported the rest. Hollow-bore needles accounted for 56% of sharps injuries, while 11% of the incidents were sustained during recapping and inappropriate disposal. Further research into Australian work practices, disposal systems, education strategies, and the use of safety sharps should be emphasized to implement strategies to reduce work-related injuries among health care workers.
Urban—Rural Disparity of Overweight, Hypertension, Undiagnosed Hypertension, and Untreated Hypertension in China
Authors: Xiaohui Hou
Published: June 2011

The objective of this study was to examine the urban—rural variations in the prevalence of overweight, hypertension, undiagnosed hypertension, and untreated hypertension among adults. The China Health and Nutrition Survey was used to study adults 25 to 65 years old. Logistic regression was used to obtain the odds ratios (ORs) after adjusting for demographic, socioeconomic, and lifestyle variables. Urban adults have a higher probability of being overweight (OR = 1.18, P < .01) and having hypertension (OR = 1.19, P < .1). After further controlling for lifestyle variables, the difference is not significant. Urban hypertensive adults are less likely to be undiagnosed (OR = 0.54, P < .001) and untreated (OR = 0.53, P < .001), even after controlling for socioeconomic and lifestyle variables, suggesting that there are other reasons for the urban—rural disparity of undiagnosed and untreated hypertension. This finding suggests that modifying lifestyles is critical in preventing urban adults from being overweight. Interventions targeting rural adults should promote the awareness and treatment of hypertension.
Smoking Among Young Urban Malaysian Women and its Risk Factors
Authors: Manaf Rosliza A. , Shamsuddin Khadijah
Published: June 2011

This study was conducted to measure the prevalence of cigarette smoking and to determine the individual, family, and environmental factors associated with smoking among young urban women. A cross-sectional study through self-administered questionnaire was conducted on female students enrolled in private higher learning institutions in Kuala Lumpur and Selangor, Malaysia, between July and October 2005. Analysis on 408 respondents showed that current smoker prevalence rate was 18.6%. Adjusted analyses showed significant association between smoking and individual factors, which are the importance of slim image, average monthly allowance, and car ownership. For family factors, analyses showed significant association between smoking and parental marital status and smoking status of male siblings. Strong associations were seen between female smoking and environmental factors, such as having more smoker friends, having smokers as best friends, keeping cigarette-brand items, being offered free cigarette, and perceiving female smoking as normal. The identified risk factors could be used to develop more effective prevention programs to overcome smoking among young urban women.
Epidemiology of Insomnia in Malaysian Adults: A Community-Based Survey in 4 Urban Areas
Authors: Zailinawati AH , Ariff KM , Nurjahan MI , Teng CL
Published: June 2011

This study aimed to determine the prevalence and pattern of insomnia in a Malaysian population aged 30 to 70 years. The sample consisted of 1611 subjects, recruited by stratified random sampling and interviewed using a semistructured questionnaire conducted in 2004. This was a community-based survey in 4 Malaysian states. The prevalence of insomnia symptom was 33.8%, and 12.2% of the subjects had chronic insomnia. Insomnia was more common among elderly; those who were separated, divorced, or widowed; and those who smoked at bedtime. Subjects with insomnia had a higher prevalence of feeling depressed (12.7), loss of concentration (19.1%), exhaustion (17.2%), poor memory (9.2%), decreased work productivity (6.4%), and perceived poor health status (40.9%; all, P < .05). A total of 22.2% of those with insomnia had excessive daytime sleepiness based on their Epworth Sleepiness Score ( P = <.001). Those with insomnia used more sedatives (9.9%) compared with those without insomnia (2.6%; P < .001). About one-third of the population had insomnia associated with impaired daily function. This study concluded that insomnia is common in Malaysian adult population, and it has significant impact on psychological well being and daily functioning.
Prevalence of Anemia and Its Determinants Among Nonpregnant and Pregnant Women in India
Authors: Bharati Premananda , Som Suparna , Chakrabarty Suman , Bharati Susmita , Pal Manoranjan
Published: June 2011

This study investigates the severity and distribution of anemia among nonpregnant and pregnant women aged 15 to 49 years in urban and rural sectors of 26 states in India and its association with certain economic and biosocial factors. A national survey was conducted to collect data on hemoglobin, height, weight, and certain economic and biosocial factors of 72 660 nonpregnant and 5619 pregnant women. Nonpregnant women aged less than 25 years are most affected by anemia. Women's education and standard of living in the households have a vital role in reducing anemia. Urban and well-nourished women also suffer less from anemia. The severity of anemia is higher among pregnant than nonpregnant women. Efforts must be made to educate women and enhance their level of economic status so that the prevalence of anemia can be reduced substantially.
Alcohol Consumption by Older Adults in Central and Southern Japan
Authors: Hirayama Fumi , Lee Andy H. , Binns Colin W. , Okumura Chikako , Yamamoto Sokatsu
Published: June 2011

This study ascertained the level of alcohol intake and alcoholic beverages consumed by Japanese older adults. Persons aged 55 to 75 years residing in central and southern Japan were recruited and interviewed face-to-face on their habitual alcohol consumption. Among the 577 (359 men and 218 women) participants from 10 districts/prefectures, 60.5% (75.5% for men and 35.7% for women) regularly drank alcoholic beverages on at least a monthly basis. Beer was the most preferred beverage (45.2%), followed by shochu (19.8%) and sake (16.1%). The mean alcohol consumption was 22.2 g/day (95% confidence interval 19.3-25.2) overall, but drinkers had a much higher mean intake of 36.6 g/day (95% CI 32.4-40.8). Moreover, it is alarming that 25.5% of male drinkers were heavy drinkers consuming more than 60 g of alcohol on average per day. Alcohol control measures should be developed to curtail the excessive drinking by older adults.
Profile of Hospital Charges for Chronic Conditions by Health Status and Severity Level
Authors: Thanapop Sasithorn , Pannarunothai Supasit , Chongsuvivatwong Virasakdi
Published: June 2011

The objective of this study is to identify charges for common chronic patients, by health status and severity of illness. Patients having 4 common chronic diseases—diabetics, hypertension, chronic lower respiratory diseases, and chronic renal failure—from 4 provinces were included (between 2002 and 2004). Patients were classified into clinically defined and health plan categories; charges were analyzed according to core health status and severity level of the chronic disease groups. Patients classified as single chronic condition (69.8%) had mean annual charges between 4089 and 7461 baht. Patients with multiple chronic conditions (30.2%) had mean annual charges varying, by health status and severity, from 611 to 16 794 baht, accounting for 40% of the total charges. Distribution of charges varied across health status groups. 1 USD = 35.1 baht The percentages of chronic health expenditures vary according to health status and severity of illness. This analysis can be used to identify patients for various purposes.
Costing Dental Restorations in Public Sector Dental Clinics
Authors: Abdul Muttalib Khairiyah  , Ishak Abdul Razak  , Raja Jalludin Raja-Latifah  , Bee Siew Tan  , Abu Talib Norain  , Noor-Aliyah Ismail , Che Salleh Natifah  , Rauzi Ismail
Published: June 2011

The objective of this study is to share cost analysis methodology and to obtain cost estimates for posterior restorations in public sector dental clinics. Two urban and 2 rural dental clinics in Selangor state were selected. Only cases of 1 posterior restoration per visit by dental officers were included over 6 months. One capsulated amalgam type, 1 capsulated tooth-colored, and 1 non-capsulated tooth-colored material were selected. A clinical pathway form was formulated to collect data per patient. Annual capital and recurrent expenditures were collected per clinic. The mean cost of an amalgam restoration was RM 30.96 (sdRM 7.86); and tooth-colored restorations ranged from RM 33.00 (sdRM 8.43) to RM 41.10 (sdRM 10.61). Wherein 1 USD = RM 2.8. Restoration costs were 35% to 55% higher in clinics in rural areas than in urban areas. The findings demonstrate economy of scale for clinic operation and restoration costs with higher patient load. Costs per restoration were higher in rural than in urban dental clinics. More studies are recommended to address the dearth of dental costs data in Malaysia.
Reliability (Internal Consistency) of the Job Content Questionnaire on Job Stress Among Office Workers of a Multinational Company in Kuala Lumpur
Authors: Maizura Husna , Masilamani Retneswari , Aris Tahir
Published: June 2011

This small, cross-sectional study assessed the reliability of 3 scales from the Job Content Questionnaire (JCQ)—decision latitude, psychological job demand, and social support—in a group of office workers in a multinational company in Kuala Lumpur. A universal sample of 30 white-collar workers from a department of the company self-administered the English version of the JCQ comprising 21 core items selected from the full recommended version of 49 items onsite. Reliability (internal consistency) was evaluated using Cronbach's α coefficients for each scale. Corrected item—total correlation was presented for each and every item. Cronbach's α coefficients were acceptable for decision latitude (.76) and social support (.79) but slightly lower for psychological job demand (.64). Values for all item—total correlations for all 3 scales were greater than .3. In conclusion, this study suggests that the JCQ is a reliable scale for assessing job stress in this group of workers.
Collaboration and “Visibility” of Health Research in the Western Pacific Region
Authors: Paraje Guillermo , Sadana Ritu , Salmela Reijo
Published: June 2011

Using more than 3.5 million bibliographic references in Thomson ISI Web of Science (health-related articles, notes, and reviews) and a broad definition of health (covering related social, medical, environmental, and physical sciences) research production, collaboration patterns and “visibility” of that production for largest producers in the Western Pacific Region of the World Health Organization are estimated for the 1992-2001 period. Two findings are of particular interest in relation to the production of relevant knowledge on health topics and equity in the access to this knowledge. The first is that intraregional collaboration is low and that large regional producers of research (ie, Japan, Australia, China, etc) collaborate more with high-income countries from other regions than among themselves within the region, or with smaller regional research producers. The second one is that “visibility” of health research in the region is relatively low, even for high-income countries. High “visibility” research is mostly done with the involvement, through collaboration, of extra-region high-income countries. Collaboration between low-income or middle-income countries is mostly in low “visibility” research.
Probable Impacts of Climate Change on Public Health in Bangladesh
Authors: Shahid Shamsuddin
Published: June 2011

The recent report of the Intergovernmental Panel on Climate Change confirmed that there is overwhelming evidence that the global climate will severely affect human health. Climate change might have severe consequences on public health in Bangladesh, especially in light of the poor state of the country’s public health infrastructure. A number of possible direct and indirect impacts of climate change on public health in Bangladesh have been identified in this article. Adaptive measures that should be taken to reduce the negative consequences of climate change on public health have also been discussed.
A Study of the Impact of Tuberculosis on the Quality of Life and the Effect After Treatment With DOTS
Authors: Dhuria Meera , Sharma Nandini , Narender Pal Singh  , Ram Chander Jiloha  , Saha Renuka , Gopal Krishan Ingle
Published: June 2011

A prospective study was conducted on 90 patients of tuberculosis at 2 directly observed treatment short course (DOTS) cum microscopy centers in an urban area of Delhi. The WHOQOL-BREF (Hindi) questionnaire was used to assess the QOL at the onset of treatment, after 3 months of treatment under DOTS, and at completion of treatment. Patients with tuberculosis had significantly lower mean scores than controls for overall QOL. The most affected domains were physical and psychological. Women scored significantly better than men in the physical and environmental domains. Overall QOL scores were lowest for category II and significantly lower for the psychological and social domains. The mean scores after treatment were significantly lower than controls for overall QOL, the social and environmental domains. The DOTS regimen improves the QOL and its domains; however, they remain significantly affected compared to the healthy controls
Is It Really Medicine? The Traditional and Alternative Medicine Act and Informal Health Economy in the Philippines
Authors: Lee Mendoza Roger
Published: June 2011

This article examines one developing country's (Philippines) experience in legalizing the age-old but controversial practice and use of traditional, complementary, and alternative medicine (TCAM). The case studies in this article shed light on the problems, challenges, and opportunities offered by herbal therapies, natural products, and alternative healing methods, and the policy context in which they exist. The study finds that normative, axiological, and ethical considerations underlie the legitimacy of TCAM. These become critical when the scientific basis or validity of a therapy, product, or modality is at issue and political consensus is not readily available. The study suggests that both the objective and subjective aspects of TCAM be carefully evaluated in the process of integrating the informal and formal health care systems in developing countries. That, in turn, would require proactive regulatory and development-oriented roles on the part of their governments.
Exposure to Secondhand Smoke in Infants: Declining Trends From 2001 to 2008?
Authors: Shiva Farideh , Ahmad Reza Shamshiri  , Ghotbi Fatemeh , Shadnaz Fakhteh Yavari
Published: June 2011

Objective. To define the trend in young children’s exposure to parental secondhand smoke. Methods. Secondary analysis of data was done on families of infants between the ages of 6 and 24 months that had been enrolled for 2 cross-sectional studies in 2001 and 2008. Results. Data from 648 families were analyzed. Overall, 29.8% of children had been exposed to parental secondhand smoke; 32% in 2001 and 27.4% in 2008, ( P value >.05). In all cases, the source of exposure was the father; in 2008, 4 families reported both parents as being habitual smokers. Ratio of indoor to outdoor smokers was 2.92 in 2001 and 0.93 in 2008. Conclusion. The decline in the percentage of infants exposed to parental smoking is nonsignificant; parental indoor smoking has decreased significantly but remains at unacceptably high levels. Authorities responsible for the health of young children need to revise interventional policies.
Oral Health Status of Vietnamese Adults: Findings From the National Oral Health Survey of Vietnam
Authors: Loc Giang Do  , Spencer Andrew John , Roberts-Thomson Kaye Frances , Hai Dinh Trinh  , Thuy Thanh Nguyen
Published: June 2011

Background. The National Oral Health Survey of Vietnam 1999 was conducted to inform policy development. Aims. This article aims to describe the oral health status, analyze its socioeconomic distribution, and evaluate change over time in the oral health of the adult population of Vietnam. Methods. A multistaged stratified sampling process was used. Adults aged 18+ years completed a social survey and were examined by trained and calibrated dentists. Results. Oral symptoms were frequent. Dental care utilization was low and mostly problem driven. One third of adults had periodontal pockets. Calculus was highly prevalent. Caries level was moderate with a mean decayed, missing, and filled teeth score of 4.98 (SD 5.7), with most as untreated decay. Factors related to caries were gender, hygiene practices, socioeconomic status, location, and dental visiting. Conclusions. The oral health status of the Vietnamese adult population was compromised by various factors. There was indication of deteriorating oral health of this population.
Prevalence and Associated Factors for Metabolic Syndrome in Taiwanese Hospital Employees
Authors: Ho Hsueh-Hua , Tsai Tzung-Yi , Lin Ching-Ling , Wu Shu-Yuan , Li Chung-Yi
Published: June 2011

Metabolic syndrome (MS) is most important because of its association with subsequent development of cardiovascular diseases. However, few studies about the prevalence of MS among hospital employees had been published.The aims of our study were to examine the prevalence of MS and associated factors. The up-to-date health examination data of 1,400 hospital employees of a medical center in North Taiwan were included, and MS was defined according to the criteria that were promulgated by the National Department of Health. The overall prevalence of MS was 10.3% (21.8% males, 7.0% females). Associated factors included male gender, aging, low education, administrative employees, abnormal hemoglobin concentration, and abnormal liver function indexes. According to our study, the prevalence of MS in hospital employees was lower than the general population, and the findings could be a reference to make more efficient health-promotion programs to lower the prevalence of MS in hospital employees.
A Survey of Occupational Exposure to Blood and Body Fluids in Physiotherapists in Western Australia
Authors: von Guttenberg Yvonne , Spickett Jeff
Published: June 2011

The aim of this pilot project was to investigate the occurrence of occupational exposure to blood and body fluids in registered physiotherapists in Western Australia. Surveys were sent to physiotherapists with questions regarding personal background, exposure characteristics, and contributing factors included. Descriptive statistical methods were used to identify the area of practice posing the highest risk of exposure to physiotherapists. The authors found that 56.1% of surveyed physiotherapists recorded one or more exposures within the past 5 years. Work in hospitals was found to carry the highest rate of exposure for the physiotherapy profession. Other areas of practice, including community work, private practice, nursing homes/hostels, and work at sporting events carry comparable but lower risks of exposure. In private practice, 50% of exposures were associated with acupuncture. In nursing homes, 60% of exposures were brought on by exposure to contaminated materials, whereas in the community setting most exposures (64%) were attributed to unpredictable/uncontrollable situations. At sporting events, 90% of all exposures were associated with already existing sources of blood and body fluids (wounds). Within the hospital setting, the 3 dominant immediate causes reported were unpredictable situations (33.3%), existing sources (28.4%), and procedural causes (22.2%). The use of personal protective equipment for prevention of exposure is investigated and discussed. Data collected for this survey were not enough to draw conclusive assumptions regarding hazard management. A repeat of this study on a larger scale may provide physiotherapists with the tools and knowledge to minimize the likelihood of exposure and harm arising from exposure.
A Phase II Randomized Controlled Trial to Evaluate the Safety and Efficacy of Praneem Polyherbal Vaginal Tablets Compared With Betadine Vaginal Pessary in Women With Symptoms of Abnormal Vaginal Discharge
Authors: Salhan Sudha , Tripathi Vrijesh , Sehgal Raman , Kumar Gaurav , Talwar Gursaran P. , Chatterjee Arani
Published: June 2011

Abnormal vaginal discharge (AVD) caused by a variety of reproductive tract infections is a widespread syndrome among women in India and in other developing countries. The purpose of this study was to determine whether a polyherbal formulation, Praneem, can be used for the regression of the syndrome. A phase ΙΙ randomized controlled study was carried out with Praneem polyherbal tablets and Betadine vaginal pessary in 99 women with AVD. The authors found that 92% of women using Praneem were relieved of their symptoms of AVD as against 81.6% women using Betadine. Significant reduction was also seen with both treatments in lower abdominal pain, vaginal itching, and dysuria. Thus, the study indicates the efficacy of Praneem for the treatment of AVD and provides a rationale for planning a further Phase III study on a larger sample size for definitive conclusions.
A Survey of Coronary Heart Disease Knowledge in a Sample of Hong Kong Chinese
Authors: Choi Wan Chan  , Lopez Violeta , Chung Joanne W. Y.
Published: June 2011

Using a self-developed questionnaire, this study examined the knowledge of coronary heart disease (CHD) in 467 Hong Kong Chinese, comprising participants with a low risk (LR) of CHD and high risk (HR) of CHD, and those who had had a myocardial infarction (MI). The results showed that the LR and HR respondents were less likely to respond correctly to items regarding knowledge of typical symptoms and certain risk factors for CHD. The MI group had the highest level of CHD knowledge. Significant differences were found across the 3 target populations in most of the domains of CHD knowledge. Women and older respondents of the LR population were found to have better CHD knowledge than their counterparts. The study highlighted that CHD prevention in Hong Kong should not focus on secondary prevention at the expense of primary prevention. Promotion of knowledge should be targeted to primary education, in particular among the male population and younger Chinese.
Development of an HIV Clinical Cohort Database for Enhancing Epidemiologic Surveillance in Hong Kong
Authors: Shui Shan Lee  , Lee Krystal Chi Kei , Man Po Lee  , Tse Ian Chi Tat , Wai Lai Mak  , Li Patrick Chung Ki , Ka Hing Wong  , Sung Joseph Jao Yiu
Published: June 2011

The Hong Kong HIV Cohort Database is an observational cohort including all patients enrolled in 2 HIV specialist clinical services in Hong Kong. Basic demographics, HIV transmission category, and the diagnoses of AIDS were captured using a standardized template. As of December 2006, 2132 HIV cases had been registered in the database, representing two thirds of all reports submitted to the government’s surveillance system. Non-Chinese and young females ≤24 years were less represented in the cohort. Description of cohort cases was, however, more complete in terms of transmission category and presentation with AIDS-defining illnesses. Overall, Pneumocystis jirovecci, tuberculosis, and systemic mycosis accounted for a majority of AIDS cases within 3 months of HIV diagnosis. There was a gradual rise of HIV positive men having sex with men in the cohort, notably after 2002, an observation also made in other Asian countries.
Seasonal Variation of Blood Pressure in Normotensive Females Aged 18 to 40 Years in an Urban Slum of Delhi, India
Authors: Sinha Pragya , Taneja Davender Kumar  , Narender Pal Singh  , Saha Renuka
Published: June 2011

Season is one of the factors affecting blood pressure. The objectives of this study are to quantify the magnitude of seasonal changes in blood pressure among normotensive women aged 18 to 40 years and to find out the association of blood pressure variation between winter and summer with body mass index, temperature, humidity, day length, and salt intake. The study was carried out on 132 women, included 4 home visits during the seasons of spring, summer, autumn, and winter. Mean increase in systolic blood pressure (SBP)/diastolic blood pressure (DBP) in winter was 11.07/6.79 mm Hg during summer ( P < .001). No significant relationship in blood pressure variation with change in environmental variables was observed. Mean increase in SBP/DBP in winter was more among underweight than individuals who were normal/overweight/obese ( P < .05). There was significant increase in SBP/DBP during winter compared with summer. This seasonal factor should be considered while evaluating individual blood pressure and comparing community studies.
Sociodemographic and Health-Lifestyle Determinants of Obesity Risks in Malaysia
Authors: Tan Andrew K. G. , Dunn Richard A. , Samad Mohamed Ismail Abdul , Feisul Mustapha Idzwan
Published: June 2011

The purpose of this study was to examine the sociodemographic and health—lifestyle factors that affect the likelihood of obesity among Malaysians. Data were obtained from the Malaysian Non-Communicable Disease Surveillance-1. The cross-sectional population-based survey consisted of 2447 observations, with an obesity prevalence rate of 17.2%. Based on logit regression analysis, the results suggest that obesity risks in Malaysia are affected by gender, education level, family history, health conditions, smoking status, and ethnic backgrounds. Specifically, Malaysians more likely to be obese are females (5.3%), lower educated (0.9%), those with history of family illnesses (4.8%), and nonsmokers (6.4%). However, Chinese (9.3%) and other (5.5%) ethnic groups are less likely to be obese when compared with Malays. Based on these results, several policy implications are discussed vis-à-vis obesity risks in Malaysia.
Satisfaction With School Dental Service Provided by Mobile Dental Squads
Authors: Othman Noormi , Ishak Abdul Razak
Published: June 2011

Feedback on satisfaction with dental care is vital for continuous improvement of the service delivery process and outcome. The objective of this study was to assess the satisfaction with school dental service (SDS) provided via mobile dental squads in Selangor, Malaysia, under 4 domains of satisfaction: patient—personnel interaction, technical competency, administrative efficiency, and clinic setup using self-administered questionnaires. Among the 607 participants who had received treatment, 62% were satisfied with the services provided. In terms of domains, technical competency achieved the highest satisfaction score, whereas clinic setup was ranked the lowest. As for items within the domains, the most acceptable was “dental operator did not ask personal things which were not dentally related,” whereas privacy of treatment was the least acceptable. In conclusion, whereas children were generally satisfied with the SDS, this study indicates that there are still areas for further improvement.
Leading a Healthy Lifestyle: The Challenges for China
Authors: Griffiths Sian M
Published: June 2011

Increasing affluence and changing lifestyles are resulting in a greater burden of noncommunicable diseases (NCDs) in China. The challenge of how to counter the rising rates of obesity associated with increasingly sedentary lifestyles and diets higher in fats and sugars as well as countering the persistent threat from high rates of tobacco smoking among men, including male doctors, need to be public health priorities within the rapidly developing economy of China. While promoting a healthier environment is one important element, the increasing rates of diabetes and hypertension throw into sharp relief the need not only for primary prevention but also for screening programs to detect and provide early treatment for these common diseases. There is an increasing need for an integrated response that emphasizes the key role the health system can play in preventing mortality and morbidity from NCDs. As such, this needs to be a priority within the health care reform agenda.
New Steps for Tobacco Control In and Outside of China
Authors: Kohrman Matthew
Published: June 2011

In China during the last decade, citizens have rarely agitated against the ubiquity of cigarettes, at the same time that tobacco products have been responsible for killing more than a million people a year and tobacco-control programs have been enjoying a marked growth in logistical support, discursive attention, and funding. In this article, the author argues that China’s ongoing popular quiescence regarding tobacco stems in part from strategic miscalculations that public health advocates are making. Favoring conceptual logics of expertise, population management, health economics, disease etiology, and rational choice, tobacco control in China is leaving unproblematized the political economic sources of cigarettes, the social suffering tobacco generates, and the ethics, everyday practices, and desires binding citizens and cigarettes together into webs of sociality. Bringing anthropological research to bear, the article describes ways that these strategic miscalculations have unfolded and makes suggestions for alternative ways that public health advocates can help Chinese citizens achieve the collective purpose to repudiate tobacco.
Airline Operating Realities and the Global Spread of Infectious Diseases
Authors: Webster Cliff H.
Published: June 2011

The advent of long-haul travel in the past 10 years has considerably reduced the time of potential disease spread from one side of the world to the other. The implication for travelers is that they may unwittingly be in the prodromal phase of influenza and become symptomatic a few days after travel. Alternatively they may knowingly travel with an infectious disease by masking symptoms. This article outlines the myths that have abounded about the cabin environment being “unclean” and discusses the low likelihood of in-flight transmission with effective air-conditioning and filtration systems. The 2009 H1N1 pandemic highlighted the operational challenges of dealing with infectious disease, including the need for accurate passenger information to allow contact tracing, in contrast to futile measures such as thermal scanners. Containment attempts did not stop the rapid global spread of H1N1 influenza.
Tongan Adolescents’ Eating Patterns: Opportunities for Intervention
Authors: Cacavas Katherine , Mavoa Helen , Kremer Peter , Malakellis Mary , Fotu Kalesita , Swinburn Boyd , de Silva-Sanigorski Andrea
Published: June 2011

The purpose of this mixed methods study was to examine the sources of food and dietary patterns of Tongan adolescents (n = 2084) and their perceptions of sociocultural influences. The study incorporated anthropometric measurements, a behavioral survey, and qualitative interviews. More adolescent Tongan females (82.5%) than males (74.3%) reported sourcing morning tea and/or lunch (females 81.9%, males 72.6%) from school canteens or nearby food outlets. More females than males reported consuming obesity-promoting foods such as packaged snack foods (females 38.2%, males 21.3%), chocolates (females 24.7%, males 15.0%), and soft drinks (females 55.3%, males 50.4%). Food purchased for consumption at schools was predominantly energy dense and nutrient poor. Ensuring that students have access to foods of high nutritional quality sourced from school or home, and restricting access to local food outlets that supply unhealthy products would improve the nutrition status of adolescents in Tonga. Furthermore, it is important that obesity prevention interventions are informed by culture-specific influences to optimize uptake of healthy diets.
Tobacco Promotion in the Pacific: The Current State of Tobacco Promotion Bans and Options for Accelerating Progress
Authors: Cussen Ashleigh , McCool Judith
Published: June 2011

Tobacco consumption is a major contributor to the burden of chronic noncommunicable disease within the Pacific region. Low and lower-middle income countries are acutely vulnerable to exploitation by the tobacco industry as they often lack the resources and capacity to implement protective tobacco control policies. The Framework Convention on Tobacco Control, which has been signed by 14 Pacific Island Countries and Territories, was introduced in 2004 to guide the priorities for tobacco control policy implementation. Legislation, tobacco industry documents, and peer-reviewed journals were evaluated to assess the current status of tobacco advertising bans of the 8 low and lower-middle income countries within the Pacific region. Results identified that of the 8 Pacific countries reviewed, 3 had comprehensive tobacco advertising bans that prohibit tobacco advertisements in 5 to 7 forms of media, and the remaining 5 countries have weak tobacco advertising bans that provide no protection for youth against tobacco advertising. This research reveals the need for resources to support the introduction of effective policies around tobacco advertising in the low and lower-middle income countries within the Pacific region.
Climate Change and Rising Heat: Population Health Implications for Working People in Australia
Authors: Hanna Elizabeth G , Kjellstrom Tord , Bennett Charmian , Dear Keith
Published: June 2011

The rapid rise in extreme heat events in Australia recently is already taking a health toll. Climate change scenarios predict increases in the frequency and intensity of extreme heat events in the future, and population health may be significantly compromised for people who cannot reduce their heat exposure. Exposure to extreme heat presents a health hazard to all who are physically active, particularly outdoor workers and indoor workers with minimal access to cooling systems while working. At air temperatures close to (or beyond) the core body temperature of 37°C, body cooling via sweating is essential, and this mechanism is hampered by high air humidity. Heat exposure among elite athletes and the military has been investigated, whereas the impacts on workers remain largely unexplored, particularly in relation to future climate change. Workers span all age groups and diverse levels of fitness and health status, including people with higher than “normal” sensitivity to heat. In a hotter world, workers are likely to experience more heat stress and find it increasingly difficult to maintain productivity. Modeling of future climate change in Australia shows a substantial increase in the number of very hot days (>35°C) across the country. In this article, the authors characterize the health risks associated with heat exposure on working people and discuss future exposure risks as temperatures rise. Progress toward developing occupational health and safety guidelines for heat in Australia are summarized.
Strategies to Strengthen Public Health Inputs to Water Policy in Response to Climate Change: An Australian Perspective
Authors: Goater Sarah , Cook Angus , Hogan Anthony , Mengersen Kerrie , Hieatt Arron , Weinstein Philip
Published: June 2011

Under current climate change projections, the capacity to provide safe drinking water to Australian communities will be challenged. Part of this challenge is the lack of an adaptive governance strategy that transcends jurisdictional boundaries to support integrated policy making, regulation, or infrastructural adaptation. Consequently, some water-related health hazards may not be adequately captured or forecast under existing water resource management policies to ensure safe water supplies. Given the high degree of spatial and temporal variability in climate conditions experienced by Australian communities, new strategies for national health planning and prioritization for safe water supplies are warranted. The challenges facing public health in Australia will be to develop flexible and robust governance strategies that strengthen public health input to existing water policy, regulation, and surveillance infrastructure through proactive risk planning, adopting new technologies, and intersectoral collaborations. The proposed approach could assist policy makers avert or minimize risk to communities arising from changes in climate and water provisions both in Australia and in the wider Asia Pacific region.
Effects of a Visual Feedback Device for Hip Adduction on Trunk Muscles and Sitting Posture in Visual Display Terminal Workers
Authors: Kim Min-hee , Yoo Won-gyu
Published: June 2011

This study was designed to identify the effects of a visual feedback device for hip adduction on trunk muscles and sitting posture when working at a visual display terminal. The forward head and trunk flexion angles of 20 workers were analyzed using a motion analysis system, and the activities of the lower trapezius, external abdominal oblique, internal abdominal oblique, and L5 paraspinal muscles were analyzed using a electromyography system. The statistical significance of differences between using and not using a visual feedback device was assessed by paired t tests. Using the visual feedback device during Visual Display Terminal work significantly decreased the forward head and trunk flexion angles, and significantly increased the activities of the external abdominal oblique, internal abdominal oblique, and L5 paraspinal muscles. The authors suggest that the visual feedback device for hip adduction promotes the adoption of standard spine and pelvic postures, which might be effective in preventing poor sitting postures.
Health Manpower Allocation in Developing Countries
Authors: Roemer Milton I.
Published: June 2011

Most developing countries have shortages of health manpower in rural areas. To address this problem, national strategies have included the establishment of salaried posts for rural doctors, construction of rural hospitals and health centres, mandating periods of rural service for all new medical graduates, providing special financial incentives to attract practitioners to rural communities, furnishing transport of personnel, and restricting settlement in major cities. If universal entitlement to health care were legislated for, as in Western Europe and in socialist countries, rural as well as urban populations would be covered. China's development of the “barefoot doctor” dramatised the value of the briefly trained community health worker (CHW) after 1971. Unfortunately, CHWs in many countries proved disappointing, because of inadequate training, poor supervision, and other deficiencies. With political commitment, however, these problems can be overcome.
Impact Study of Thailand's National Family Planning Programme on Fertility Decline in the First Half of the Fifth National Socio-Economic Development Plan (1982-1986)
Authors: Muangman Debhanom , Porapakkham Yawarat
Published: June 2011

The evaluation of the National Family Planning Programme (NFPP) in the First Half of the Fifth National Socio-economic Development Plan (1982-1986) was conducted by the joint Thai-US team in mid 1984. It was found that the continuing fertility decline, from a crude birth rate of 26.9 per 1, 000 in 1981 to 21 per 1, 000 in 1984, was attributable to increased contraceptive prevalence, which was largely a result of the NFPP. This has affected the population growth rate, which has declined from 1.8% to an estimated 1.6% over the 1981 to 1984 period. This study forecasted that there would be a 30% increase in the number of currently-married women, aged 15-44 by the end of the Sixth Development Plan (1991). This increase will put a great burden on the NFPP. However, the possibility of attaining the growth rate of 1.2% by the end of 1991 is conditional upon the persistence of current trends in contraceptive prevalence with the full support of all family planning and FP-related agencies.
Leptospirosis: A Newly Identified Disease in Korea
Authors: Kim J S
Published: June 2011

A new clinical syndrome, epidemic pulmonary haemorrhagic fever, which is characterized by malaise, fever, myalgia and nausea or vomiting at the onset of the illness and chest pain, haemoptysis and dyspnoea with pneumonia-like X-ray shadow in the later stage, has been occurring sporadically in Korea since October 1975 as a disease of unknown aetiology. Upon the massive occurrence of the same syndrome again in the autumn of 1984 after a flood, the government commissioned an analytic epidemiological investigation that was conducted by the author. The objective of the investigation was to identify the aetiological agent of the syndrome by testing the hypothesis that the cause of the new syndrome is leptospiral infection, which had been formulated by the author on the basis of 1975 materials, a few years prior to the 1984 epidemic. Patients with a diagnosis of the syndrome (cases) and patients' families and/or villagers (controls) were interviewed and specimens to isolate leptospires, ie blood and urine, were collected. In addition, rodents and water from the paddy fields in the same areas that the patients came from were collected to be examined for leptospiral organisms. Spiral organisms were isolated from most of the specimens inoculated, from guinea pigs and mice. These organisms were reported by the microbiologists to have characteristics of Leptospira interrogans in every aspect examined. Subsequent community studies on a healthy population revealed 2.3-16% subclinical leptospiral infection rates on whole blood cultures in artificial media. Over 90% of rodents examined harboured leptospires. The results of this study served to confirm the endemicity of leptospirosis in Korea.
Prevention of Cement Dermatitis in Construction Workers With Iron Sulphate
Authors: Goh C L , Kwok S F
Published: June 2011

Allergic dermatitis to chromate in cement is the most common occupational dermatitis among construction workers in Singapore. Hexavalent chromate in cement can be removed by iron sulphate. This study determined the minimum concentration of iron sulphate required to remove the hexavalent chromate from nine brands of Asian cement. The hexavalent chromate concentrations in cements were determined by colorimetric spectrophotometry. The minimum amount of iron sulphate required to remove completely hexavalent chromate in all the cements was 0.35% w/w. Iron sulphate should be used in the construction industry to prevent cement dermatitis in construction workers.
The Integration of Psychosocial Components in Nutrition Education in Northeastern Thai Villages
Authors: Kotchabhakdi N J , Winichagoon P , Smitasiri S , Dhanamitta S , Valyasevi A
Published: June 2011

The impact of a series of interactive video nutrition education programmes was studied in northeastern villages in Thailand. One of the five modules (VTR-4) was particularly child development oriented, aimed at creating maternal awareness of the child as an individual with early perceptual ability, importance of mother-child interaction, play and supplementary feeding. Village mothers with children under two years old were interviewed individually prior to the introduction of the media and at two, ten and 14 months later when the VTR-4 had been shown three, four and seven times, respectively in each village. A supplementary food product was produced and made commercially available at a low cost. Four hundred and seventy-eight men, 930 women and 3, 225 school children watched the VTR-4. Nutritional status of the children, maternal knowledge and attitude towards child rearing were assessed as well as some aspects of practice observed during home visits. There was a significant improvement in maternal awareness of infants' perceptual abilities, knowledge and attitude toward breast feeding, childplay and play materials and supplementary feeding, especially a more positive approach to tongue thrusting. Random observation during home visits revealed some changes in accordance with the media, i.e., mother-child interaction, existing play materials and the type of cradle used. Significant difference was also noted in the percentage of mothers intending to give their next baby colostrum compared to the control group at post tests 2 and 3. Although the prevalence of malnutrition among those under two years old in these villages has not decreased significantly during the study period, it was clear that the integration of psychosocial components into nutrition education had a considerable impact on maternal knowledge, attitudes and some aspects of child-rearing practice.
Epidemiological Studies of Hypertension Among Elderly Japanese and Japanese Americans
Authors: Reed D , Yano K
Published: June 2011

A prospective international study of cardiovascular disease among Japanese men living in Japan, Hawaii and California in 1965 provided the opportunity of comparing the levels of blood pressure and hypertension among men aged 45 to 68 years, and of examining the factors which accounted for the differences. In addition, within the group of 8, 006 men from Hawaii, a subsample of men were examined 15 years later when they were aged 60 to 80 to study the influence of migration, the stressful aspects of culture change, diet, life-style, Type A behaviour and biological characteristics for association with blood pressure and as predictors of hypertension.

At the initial examination, the men in California had the highest levels of blood pressure and hypertension, the men in Japan had the lowest levels, and the men born in Hawaii had intermediate levels. When blood pressure was adjusted for relative weight, the differences among the groups disappeared.

Within the Hawaii cohort, bivariate and multivariate analyses of more than 50 variables indicated that age, obesity, alcohol intake, serum glucose and parental history of hypertension were the major variables independently associated with cross-sectional levels of blood pressure and, except for alcohol intake, with longitudinal changes in blood pressure.

Reported dietary intake of calcium, magnesium, potassium, protein and other nutrients were all inversely associated with blood pressure levels. The intake of those nutrients was so highly correlated with each other that it was not possible to identify the independent association of any single dietary factor. The results suggested that the foods which are major sources of the nutrients (vegetables, fruits, whole grains and low fat dairy products) may be protective against hypertension. Blood pressure was not associated with salt, or salty Japanese foods, either in the international comparisons or in the group from Hawaii.

Among the psychosocial factors, there was no evidence that measures of theoretically stressful social situations, social support or the Jenkins measure of Type A personality were associated with blood pressure within the Hawaiian group.

From the perspective of prevention of hypertension in the elderly, these data suggest that obesity, alcohol intake and low intake of minerals found in fruits, vegetables and whole grains are the factors which should receive primary consideration.
A Microcomputer Program for Significance Testing of the Difference Between Statistically Adjusted Rates Obtained by Direct Standardisation
Authors: Koh D , Lee J
Published: June 2011

Direct standardisation is a method that is commonly employed for the statistical removal of confounding bias in the comparison of occurrence rates. The procedure is useful in clinical and epidemiological research.

This paper presents a microcomputer program written in BASIC for the significance testing of the difference between statistically adjusted rates obtained by the direct standardisation method.