Asia-Pacific Journal of Public Health RSS feed -- OnlineFirst Articles

Gender Differences in Age, Period, and Birth-Cohort Effect on Suicide Mortality Rate in Japan 1985-2006

Odagiri, Y., Uchida, H., Nakano, M. — Mon, 26 Oct 2009 22:37:51 PDT

Because suicide is increasingly becoming a public health threat in Japan, it is necessary to identify high-risk groups to develop effective preventive measures. The suicide mortality trends from 1985 to 2006 for Japanese aged between 15 and 79 years were analyzed by a Bayesian age–period–cohort analysis to evaluate the independent effects of age, period, and birth cohort. Agespecific effect showed an overall increase with age in both genders, but a distinct increase was noted only among men aged between 50 and 64 years. The period effect exhibited a sudden rise in 1998; this effect was more apparent in men than in women. The cohort-specific effect increased in male birth cohorts born after 1926 and in female birth cohorts born after 1956. In conclusion, a gender difference was detected in the effects of age, period, and cohort on suicide risk among Japanese.

Knowledge, Attitude, and Prevalence of Overweight and Obesity Among Civil Servants in Nepal

Simkhada, P., Poobalan, A., Simkhada, P. P., Amalraj, R., Aucott, L. — Mon, 12 Oct 2009 22:53:10 PDT

Obesity threatens developing countries as urbanization increases, with civil servants being particularly vulnerable. The authors assess overweight/obesity prevalence among Nepalese civil servants along with their knowledge and attitudes. A cross-sectional questionnaire survey conducted among 341 participants (97.4% response rate) also recorded height and weight. Participants were 40 ± 6.6 years, mostly males, married, and from a single ethnic group. Overweight/obesity prevalence was 33.4%. Knowledge of obesity was good. However, some attitudes toward obese people were negative, despite half of the participants believing obesity to indicate prosperity. Logistic regression indicated marriage and/or having a better job increased the overweight/obese risk by nearly 8 and 9 times, respectively. Heavier people were more likely to disagree with attitudes that obese people were "lazier" and "untidy." Obesity prevalence among Nepalese civil servants is already higher than the general population level. Health education and interventions are needed to translate knowledge into attitude and behavior changes in order to prevent this becoming an epidemic.

Short-Term Results of a Community-Based Program on Promoting Healthy Lifestyle for Prevention and Control of Chronic Diseases in a Developing Country Setting: Isfahan Healthy Heart Program

Mon, 12 Oct 2009 22:53:10 PDT

The objective of the study is to investigate the effect of a comprehensive community trial on behavioral modification after 2 years of intervention. The interventions of this 6-year, comprehensive community-based study target the whole population, of nearly 2 180 000, living in 2 cities in Iran and are compared with another Iranian city considered as reference. Educational, environmental, and legislative interventions are being conducted at the population level. From the baseline to the second year of evaluation of this study, the consumption of hydrogenated fat decreased significantly in the intervention community, but it remained nearly constant in the reference area. Meanwhile, the consumption of liquid oil increased in the intervention community, whereas it decreased in the reference area. The prevalence of current smoking and attempt to smoke decreased, respectively, in men and youths living in the intervention area but increased or remained constant in the reference area; however, no favorable change was seen for smoking among women. Leisure time physical activity increased in women and declined in men of both communities; the slopes of these changes were greater in the intervention area. Although the consumption of salty/fat snacks slightly decreased in the school students of the intervention area, it had a sharp increase in the reference area. This program succeeded in improving some aspects of lifestyle in its different target groups. The authors suggest that the synergy of activities intensified the dose of interventions and led to this improvement.

Lifestyle Factors Associated With Blood Pressure Control Among Those Taking Antihypertensive Medication

Ham, O. K., Yang, S. J. — Mon, 12 Oct 2009 22:53:10 PDT

The purpose of this study was to explore the relations between lifestyle factors and blood pressure (BP) control among patients with hypertension who were regularly taking antihypertensive medication as prescribed. From the 2005 Korean National Health and Nutrition Examination Survey data, the 690 individuals diagnosed with hypertension who were regularly taking antihypertensive medication were identified. Slightly more than half of the patients (54.3%) had their BP under control. Younger patients, those having one or more comorbidities and those performing physical activity at least 4 days a week were more likely to have their BP under control, while overweight patients, heavy alcohol drinkers, and those with mild to very severe stress had lower rates of BP control. The study results suggested that to reduce uncontrolled BP, public health efforts should target old and overweight patients and those with unhealthy lifestyles including heavy alcohol drinking, stress, and lack of physical activity.

Stigmatized Attitudes Toward People Living With HIV in Bangladesh: Health Care Workers' Perspectives

Hossain, M. B., Kippax, S. — Mon, 12 Oct 2009 22:53:11 PDT

This study was conducted among 526 health care workers (HCWs) in Bangladesh to identify the levels and correlates of stigmatized attitudes toward people living with HIV (PLHIV). HIV-related stigmatized attitudes were measured by a set of items that reflected avoidance attitude of HCWs in hypothetical situations. A multiple linear regression model identified the following correlates of stigma: higher age, high level of irrational fear about HIV and AIDS, being HCW other than a doctor, working in teaching hospital, and rating religion as very important in their life (R² = .502). The findings are important for both public health policy planners and human rights activists as high prevalence of stigmatized attitudes among HCWs influence the decision-making process of PLHIV and stop them from accessing voluntary counseling and testing, care, support, and treatment services.

Measuring the Ability to Interpret Medical Information Among the Japanese Public and the Relationship With Inappropriate Purchasing Attitudes of Health-Related Goods.

Takahashi, Y., Sakai, M., Fukui, T., Shimbo, T. — Mon, 31 Aug 2009 22:49:19 PDT

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

Domestic Violence Against Women: A Qualitative Study in a Rural Community

Kaur, R., Garg, S. — Sun, 23 Aug 2009 21:17:08 PDT

Domestic violence is a major contributor to physical and mental ill health of women and is evident, to some degree, in every society in the world. The World Health Organization reports that globally 29% to 62% of women have experienced physical or sexual violence by an intimate partner. Ending gender discrimination and all forms of violence against women requires an understanding of the prevailing culture of bias and violence. The present study was conducted in a rural area in India. Focus group discussions (FGDs) were conducted among married women in the age group of 18 to 35 years. Physical violence was a major cause of concern among these women. Some women had to suffer even during pregnancy. An alcoholic husband emerged as the main cause for domestic violence. Husbands’ relatives instigating wife beating was also common. Majority of the women preferred to remain silent despite being victimized. The women feared to resort to law because of implications such as social isolation. To address this, all sectors including education, health, legal, and judicial must work in liaison. Gender inequality must be eliminated and equal participation of women in the decision-making and development processes must be ensured.

Understanding Predictors of Postdischarge Deaths: A Prospective Evaluation of Children 5 Years and Younger Discharged From Philippine District Hospitals

Mon, 17 Aug 2009 02:04:41 PDT

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

A Standardized Process for Developing a National Notifiable Diseases List in a Pacific Island Setting

Pavlin, B. I., Kool, J. L., Samo, M. H., Gerstel, L. — Mon, 10 Aug 2009 00:18:40 PDT

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

Prevalence and Associated Factors for Metabolic Syndrome in Taiwanese Hospital Employees

Ho, H.-H., Tsai, T.-Y., Li, C.-Y., Wu, S.-Y., Lin, C.-L. — Wed, 22 Jul 2009 01:29:51 PDT

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.

Developmental Defects of Enamel in Children of Davangere District and Their Relationship to Fluoride Levels in Drinking Water

Ramesh, G., Raghunath, V., Manohar, R., Nagarajappa, R. — Wed, 22 Jul 2009 01:29:51 PDT

Objective: To assess the prevalence and severity of developmental defects and their relationship to fluoride levels in drinking water. Methods: 739 (406 male and 333 female) schoolchildren aged 13 years formed the study population. We used the ion selective electrode method to estimate the fluoride concentration in drinking water. A modified developmental defects of enamel index was used for recording the developmental defects. The Karl Pearson coefficient for correlation and the chi-square test were used for statistical estimation. Results: The fluoride concentration ranged from 0.64 to 2.64 ppm. The prevalence of developmental defects was 88.5%. The most common type of defect was diffuse opacity in 61.2% of the children. There was a significant positive correlation between the type (r = 0.85; P < .001) and extent (r = 0.92; P < .001) of developmental defects in relation to fluoride levels in drinking water. Conclusion: The observed prevalence demonstrates the need to ascertain factors other than fluoride levels in drinking water that could contribute to its occurrence.

Effects of Information and Communication Technology on Youth's Health Knowledge

Ghorbani, N. R., Heidari, R. N. — Wed, 22 Jul 2009 01:29:51 PDT

Information technology (IT) has produced a deep impact on human lives, and the most important aspect of its effect is on education and learning. This study was done for the purpose of evaluating the effectiveness of electronic health information on our Web site http://www.teen.hbi.ir in the promotion of health education and in increasing the capabilities of the students in the use of the Internet. This study was performed on the basis of the information obtained from the questionnaires on selected health issues from 649 students from 3 high schools. Information was collected in 2 steps (pretest and posttest). The t test and Leven’s test were used in the statistical analysis of data. Results of the t test showed that educating students through health information Web sites has increased their knowledge by at least 14.5% on environmental health and 48.9% on nutrition and was statistically meaningful in all fields (P = .000) with the exception of mental health. The fact is that the use of IT has become a part of our society and is perhaps the most promising medium for achieving health promotion initiatives.

Local Wisdom and Health Promotion: Barrier or Catalyst?

Demaio, A. — Fri, 03 Jul 2009 00:29:43 PDT

The respectful, appropriate use of local wisdom (LW) in health promotion increases penetration and longevity of positive behavior change. Collaborations based on mutual respect, flexibility and trust between health program organizers, traditional and local practitioners, and the communities being served are the goal for public health physicians in our modern, globalized world. This meta-analysis reviewed literature from the past 18 years drawn from a wide range of sources. This investigations proposes a grassroots, material shift toward regarding health promotion interventions as partnerships when planning, executing, and evaluating health promotion projects. This holistic approach would be based on the premise that LW is equal to expert opinion. This article endorses the integration of LW at every stage of the health promotion process concluding that it is through empowerment and involvement of local communities, their culture and specific environmental conditions that best-practice health promotion can be achieved.

Oral Health Status of Vietnamese Adults: Findings From the National Oral Health Survey of Vietnam

Do, L. G., Spencer, A. J., Roberts-Thomson, K., Trinh, H. D., Nguyen, T. T. — Thu, 02 Jul 2009 00:28:32 PDT

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.

Oral Health Status of Vietnamese Children: Findings From the National Oral Health Survey of Vietnam 1999

Do, L. G., Spencer, A. J., Roberts-Thomson, K., Trinh, H. D., Nguyen, T. T. — Thu, 02 Jul 2009 00:28:32 PDT

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

Roles of Parents in Preventing Dental Caries in the Primary Dentition Among Preschool Children in Thailand

Narksawat, K., Boonthum, A., Tonmukayakul, U. — Thu, 02 Jul 2009 00:28:32 PDT

This study aimed to identify important roles of parents in preventing caries in primary dentition among preschool children in Thailand. A total of 664 preschool children aged 3 to 4 years and their parents were sampled from representative provinces of the 5 regions of Thailand. Dental examination to assess dental caries in preschool children was conducted. Questionnaires investigating roles of parents in caring for their children’s teeth were used to interview parents. Preschool children were more likely to have at least 1 carious tooth if parents did not always clean their teeth every time they bathed them, did not always examine the cleanliness of children’s teeth regularly, and always allowed children to consume snacks more than 3 times a day. Thai parents must be motivated to consistently spend the time required to take care of the primary dentition of their children by regular cleaning and controlling the snacking behavior of children.

Exposure to Secondhand Smoke in Infants: Declining Trends From 2001 to 2008?

Shiva, F., Shamshiri, A. R., Ghotbi, F., Fakhteh Yavari, S. — Thu, 02 Jul 2009 00:28:33 PDT

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.

Challenges for Injury Prevention Among the Elderly in Kazakhstan

Yegeubaeva, S. A., Kulzhanov, M. K., Aubakirova, A. S., Balabayev, T. F. — Thu, 02 Jul 2009 00:28:31 PDT

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

Prevalence of and Factors Associated With Cigarette Smoking Among University Students: A Study From Iran

Nakhaee, N., Divsalar, K., Bahreinifar, S. — Thu, 02 Jul 2009 00:28:32 PDT

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

An Analysis of WHO Data on Lethal Violence: Relevance of the New Western Millennium

Rezaeian, M. — Thu, 02 Jul 2009 00:28:33 PDT

Introduction. Suicide and homicide are considered to be lethal violent acts with a clear difference in their directions, that is, inwardly "killing oneself" or outwardly "killing another," respectively. There are some studies in which these 2 violent acts are considered under the same framework mostly within Western countries. This article for the first time investigates this issue throughout the world. Material and methods. The present study uses data that have been estimated by Global Burden of Disease (GBD) project for 2000 for the 6 different regions of the world proposed by WHO. The suicide/homicide ratio has been calculated by dividing the suicide rate by the sum of the suicide and homicide rates within each age and sex groups. Findings. Three distinct groups have emerged. In the first group, that is, Southeast Asia, Europe, and Western Pacific, lethal violence in both males and females usually directs inward whereas in the second group, that is, Africa, lethal violence in both males and females directs outward. In the third group, that is, America and Eastern Mediterranean, in males lethal violence generally directs outward whereas in females it often directs inward. Conclusion. Under the same framework if a factor causes external blame for the people’s failures it will increase the likelihood that the suicide/homicide ratio is expressed as homicide and vice versa. Although this might explain the observed pattern to some extent, more in-depth studies are needed to better understand the causal root of the pattern.

Regional Variations in Living Conditions During the North Korean Food Crisis of the 1990s

Schwekendiek, D. — Mon, 25 May 2009 03:12:26 PDT

In the 1990s, North Korea experienced one of the severest famines in modern history. Considering the level of food deprivation during famines in totalitarian states, substantial debate exists over how differently the crisis affected households and regions. Here, the authors investigate regional differences in socioeconomic living conditions by comparing height-for-age z scores (HAZs) of 9934 preschool children living in 11 administrative provinces. Data are based on 2 UN/DPRK anthropometric surveys performed in North Korea representing cohorts born from 1991 to 2002. Through regression of pooled HAZs on a set of province dummies, the authors find that children born in Pyongyang are more healthy, providing evidence that elites residing in the capital seemingly possess comparative advantages in food supply. When controlling for further variables, they find that boys and older children suffered more during the crisis, although cohorts born before the onset of the famine were significantly better-off.

An Assessment of Felt Needs and Expectations of People Living With HIV/AIDS Seeking Treatment at NGOs in Delhi, India

Singh, M., Garg, S., Nath, A., Gupta, V. — Thu, 14 May 2009 16:11:43 PDT

People living with HIV/AIDS (PLHAs) continue to face stigma and discrimination in society. The felt needs of PLHAs can be met by means of a comprehensive, holistic, and integrated approach by the concerned sectors. This study included 100 PLHAs admitted at 3 care homes run by nongovernmental organizations in New Delhi. As many as 22% of the patients had been diagnosed with pulmonary Koch’s. Unemployment rates were found to increase after disease onset. Majority were satisfied with the medical treatment and overall care provided at these centers. About 25% expressed that they would like the government to provide them with suitable jobs. Less than one third (30%) of the PLHAs expressed satisfaction with their family life whereas the rest yearned for love and acceptance from society. Study findings highlight the important role of nongovernmental organizations and stresses on the need for a holistic approach toward the care of these people.

Seven Attributes of Primary Care in Thailand

Kitreerawutiwong, N., Kuruchittham, V., Somrongthong, R., Pongsupap, Y. — Thu, 14 May 2009 16:11:41 PDT

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

Probable Impacts of Climate Change on Public Health in Bangladesh

Shahid, S. — Thu, 14 May 2009 16:11:43 PDT

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.

Smoking Knowledge, Attitudes and Behaviors Among Rural-to-Urban Migrant Women in Beijing, China

Finch, K., Ma, S., Qin, D., Xin, G., Xia, W., Novotny, T. E. — Thu, 14 May 2009 16:11:40 PDT

Background: China has the largest population of cigarette smokers worldwide; surveys suggest rising prevalence among young women. Migratory lifestyles may confer increased susceptibility. Objectives: we aimed to understand how migration relates to smoking among young women. Methods: we implemented a cross-sectional behavioral survey of rural-to-urban Chinese women (n = 206) working in restaurants and commercial sex venues, assessing smoking attitudes, behaviors, and health-risk knowledge. Results: rates of ever smoking and current smoking among restaurant workers were high compared with the rates in general population surveys (16.1% and 6.5%, respectively); rates were much higher among sex workers (54.9% and 33.3%, respectively). Multivariate analysis revealed education to be protective, whereas exposure to female-branded cigarettes was a risk for ever smoking. Conclusions: Chinese migrant women appear to be smoking at higher rates than nonmigrant women. Priorities for future research include representative studies in multiple cities examining reasons for uptake and stimuli to quit.

Variation in the Prevalence, Awareness, and Control of Diabetes in a Multiethnic Population: A Nationwide Population Study in Malaysia

Rampal, S., Rampal, L., Rahmat, R., Zain, A., Yap, Y. G., Mohamed, M., Taha, M. — Thu, 14 May 2009 16:11:42 PDT

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

Susceptibility of New Entrant University Students in Sri Lanka to Varicella Zoster Infection

Fri, 01 May 2009 02:07:00 PDT

To investigate the susceptibility of Sri Lankan new entry university students to varicella zoster virus (VZV) infection, a cross-sectional descriptive study was carried out among new entrant medical and engineering students of the University of Peradeniya, Sri Lanka. Self-reported history of chicken pox was studied first, followed by serological evaluation for VZV IgG antibodies. A total of 451 students participated in the study out of which 189 (41.9%) reported a history of chicken pox. Median age of reported age of acquiring the disease was 14 years with an interquartile range of 10 to 17 years. Only 25% of the population reported history of infection prior to age of 10 years. The seropositive rate of VZV IgG antibodies among undergraduates with a negative history of chicken pox was 10.1% ( 25/247). The present study indicates that nearly half (222/436) of the study population (50.9%, 95% CI 46.2-55.6) was susceptible to VZV infection.

Health Promotion Financing With Mongolia's Social Health Insurance

Bayarsaikhan, D., Nakamura, K. — Tue, 17 Feb 2009 05:33:05 PST

Health promotion is receiving more attention in Mongolia. A survey is undertaken to examine health promotion in terms of health-related information, education, counseling, screening, preventive and medical checkups. Almost all (97.5%) of the subjects feel that access to reliable and systematically organized health-related information is important. About 60% of the subjects expressed that the amount of currently available information is inadequate. There are several factors that limit the implementation of public health programs. These include inadequate focus on promoting health at individual level, lack of funds, and limited incentives to promote health. This article examined social health insurance as an option to address these issues. Three hypothetical benefits package options expanded to health promotion were developed and simulated by a computerized tool. The simulations show that all 3 options are financially sustainable at the existing level of contribution if Mongolia will gain near universal health insurance coverage and improve revenue collection practices.