Showing papers in "Open Journal of Preventive Medicine in 2012"

The effects of obesity on venous thromboembolism: A review.

Abstract: Obesity has emerged as a global health issue that is associated with wide spectrum of disorders, including coronary artery disease, diabetes mellitus, hypertension, stroke, and venous thromboembolism (VTE). VTE is one of the most common vascular disorders in the United States and Europe and is associated with significant mortality. Although the association between obesity and VTE appears to be moderate, obesity can interact with other environmental or genetic factors and pose a significantly greater risk of VTE among individuals who are obese and who are exposed simultaneously to several other risk factors for VTE. Therefore, identification of potential interactions between obesity and certain VTE risk factors might offer some critical points for VTE interventions and thus minimize VTE morbidity and mortality among patients who are obese. However, current obesity measurements have limitations and can introduce contradictory results in the outcome of obesity. To overcome these limitations, this review proposes several future directions and suggests some avenues for prevention of VTE associated with obesity as well.

Temporal variability of problem drinking on Twitter

Abstract: Twitter is a micro-blogging application, which is commonly used as a way for individuals to maintain social connections. Social scientists have also begun using Twitter as a data source for understanding more about human interactions. There is very little research about Twitter’s utility for monitoring health related attitudes, beliefs and behaviors. The purpose of this study was to examine the extent to which individuals tweeted about problem drinking, and to identify if such tweets corresponded with time periods when problem drinking was likely to occur. Data from this study came from tweets originating in one of 9 randomly selected states, one from each of the nine census geographies in the US. Twitter’s API was used to collect tweets during the month of October 2010, and again during the time period surrounding New Year’s Eve 2010. Keywords were selected which indicated problem-drinking behaviors, and tweets were coded for the presence or absence of these keywords. Twitter users were most likely to tweet about problem drinking on Friday, Saturday and Sunday during the hours from 10 pm to 2 am. Tweets originating during the New Year’s Eve holiday (0.53%) were twice as common when compared to tweets during weekends in the month of October (0.34%). Twitter may be a valid data source for social scientists, given that tweets about problem drinking corresponded with expected time periods of actual problem drinking. Furthermore, tweets that mention problem drinking may be problematic for public health if they establish incorrect normative beliefs that such behaviors are acceptable and expected. Social norms interventions may be an effective tool in correcting misperceptions related to problem drinking by informing Twitter followers that problem drinking behaveiors are not normative.

Osteoporosis Knowledge, Beliefs, and Calcium Intake of College Students: Utilization of the Health Belief Model

Abstract: Objective: The purpose of this study was to examine the relationships between osteoporosis knowledge, beliefs and calcium intake among college students. This study also examined perceived susceptibility, severity, benefits, barriers and self-efficacy related to osteoporosis prevention. Participants: Seven hundred and ninety two (n = 792) men and women ages 17 - 31 of all ethnicities at a mid-western regional university in the US participated in the study. Methods: The Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale, and Osteoporosis Preventing Behaviors Survey were utilized. Each of these tools were previously validated and found reliable. Correlation and multiple regression analyses were completed. Results: Participants did not perceive themselves as susceptible to osteoporosis and perceived minimal barriers to calcium intake. Their knowledge was minimal concerning alternate sources of calcium. Conclusions: Prevention programs should aim to increase osteoporosis knowledge of risk factors and osteoprotective behaviors and to decrease high-risk behaviors during college years when behavior changes can have the strongest impact on bone health.

Infant male circumcision: An evidence-based policy statement

Abstract: Here we review the international evidence for benefits and risks of infant male circumcision (MC) and use this to develop an evidence-based policy statement for a developed nation setting, focusing on Australia. Evidence from good quality studies that include meta-analyses and randomized controlled trials showed that MC provides strong protection against: urinary tract infections and, in infancy, renal parenchymal disease; phimosis; paraphimosis; balanoposthitis; foreskin tearing; some heterosexually transmitted infections including HPV, HSV-2, trichomonas, HIV, and genital ulcer disease; thrush; inferior hygiene; penile cancer and possibly prostate cancer. In women, circumcision of the male partner protects against HPV, HSV-2, cervical cancer, bacterial vaginosis, and possibly Chlamydia. MC has no adverse effect on sexual function, sensitivity, penile sensation or satisfaction and may enhance the male sexual experience. Adverse effects are uncommon (<1%), and virtually all are minor and easily treated. For maximum benefits, safety, convenience and cost savings, MC should be performed in infancy and with local anesthesia. A risk-benefit analysis shows benefits exceed risks by a large margin. Over their lifetime up to half of uncircumcised males will suffer a medical condition as a result of retaining their foreskin. The ethics of infant MC and childhood vaccination are comparable. Our analysis finds MC is beneficial, safe and cost-effective, and should optimally be performed in infancy. In the interests of public health and individual wellbeing, adequate parental education, and steps to facilitate access and affordability should be encouraged in developed countries.

Male Partner Involvement in Prevention of Mother to Child Transmission of HIV in Sub-Saharan Africa: Successes, Challenges and Way Forward

Abstract: Sub-Saharan Africa has the highest number of mother to child transmissions of HIV. PMTCT programme plays a big role in reducing the MTCT nevertheless its effectiveness in Sub-Saharan Africa depends on involvement of male partners considering the fact that men are decision makers in African families. They make important decisions that have big impact on women’s health. Male partner involvement has been seen to increase uptake of PMTCT services and their involvement underscores their importance in reducing HIV infection in children. Recently many sub-Saharan countries adopted male partner involvement in PMTCT programme with an aim of increasing the uptake of PMTCT services. The programme has made some progress in improving the effectiveness of PMTCT services. On the other hand the strategy is facing a lot of challenges, the biggest being low male partner involvement. This article therefore seeks to review the successes and challenges faced by male involvement in Sub-Saharan Africa. It also proposes the way forward in order to improve its effectiveness. We used peer reviewed articles of research studies conducted in Sub-Saharan Africa and other related reliable sources of data to write the paper.

Sample preference for colorectal cancer screening tests: Blood or stool?

Abstract: Objective: Despite the high prevalence of CRC and the proven benefits of faecal sampling tests, participation rates in CRC screening are suboptimal. Literature has identified a number of barriers to participation, including faecal aversion. Emerging test technologies suggest blood-based molecular markers might provide an alternative, more acceptable option, for CRC screening tests. We aim to determine preference for blood compared to faeces as the sample for the screening test. Methods: A survey was mailed to 956 South Australians aged 50 to 74 years. Data were collected on sample preference, demographic variables, and ratings of screening test convenience and comfort. Results: The survey yielded a 43% response rate. The majority of participants preferred to provide a blood sample (78% v 22%, p < 0.001). Women were more likely to prefer blood than men (82% vs 74%, p = 0.05). Sample experience influenced preferences, with a significantly higher preference for faeces among participants with experience in faecal sampling (27% vs 17% with no experience, p < 0.05). Participants who preferred to provide a faecal sample rated it significantly more convenient (p < 0.001), more comfortable (p < 0.001), and more acceptable (p < 0.001) than those who preferred blood sampling. Conclusions: Survey participants overwhelmingly indicate a preference for the idea of a blood sample over a faecal sample for CRC screening. Preference was influenced by gender, experience with sampling method and the individual’s perception of sampling convenience, sampling comfort and sample acceptability. Our results suggest population participation rates are likely to improve with blood-based screening tests.

Developing a School-Based Drug Prevention Program to Overcome Barriers to Effective Program Implementation: The CLIMATE Schools: Alcohol Module

Abstract: Although effective school-based alcohol prevention programs do exist, the overall efficacy of these programs has been compromised by implementation failure. The CLIMATE Schools: Alcohol Module was developed to overcome some of the obstacles to high fidelity program implementation. This paper details this development of the CLIMATE Schools: Alcohol Module. The development involved two stages, both of which were considered essential. The first stage, involved reviewing the literature to ensure the program was based on the most effecttive pedagogy and health promotion practice and the second stage involved collaborating with teachers, students and specialists in the area of alcohol and other drugs, to ensure these goals were realised. The final CLIMATE Schools: Alcohol Module consists of computer-driven harm minimisation program which is based on a social influence approach. The program consists of six lessons, each with two components. The first component involves students completing an interactive computer-based program, with the second consisting of a variety of individual, small group and class-based activities. This program was developed to provide an innovative new platform for the delivery of drug education and has proven to be both feasible and effective in the school environment. The success of this program is considered to be testament to this collaborative development approach.

Division of labor, perceived labor-related stress and well-being among European couples

Abstract: Background: The objective of this study was to analyze how involvement in paid and unpaid work and perceived labor-related stress are related to the well-being of married or cohabiting men and women in Europe. Methods: Data from the European Social Survey round two has been used. The sample consists of 5800 women and 6952 men, aged between 18-65 years. Exposure variables were divided into labor involvement, time spent on paid and unpaid work, and labor-related stress. Multiple logistic regressions with 95 % confidence interval were used. Results: Women spent more hours on housework than men did, but fewer hours on paid work. Women tended to perceive higher degrees of housework-related stress than men did. Furthermore, women who experienced houseworkrelated stress tended to have higher odds of reporting a low level of perceived well-being than men, while men had higher odds of reporting a low level of perceived well-being when they experienced work/family conflicts. Conclusion: For both men and women, the perceptions of labor involvement are of more importance for the well-being than the actual time spent on paid and unpaid work. This implies that, when studying the relationship between labor involvement and well-being, perceived stress should be considered.

The body mass index (BMI) as a public health tool to predict metabolic syndrome

Abstract: Objective: To analyze the body mass index (BMI) as an indicator of metabolic alterations, including the metabolic syndrome (MetS), at both individual level and public health level. Method: We recruited 3683 undergraduate students (17 - 24 years old) from Mexico City identifying metabolic alterations, including the MetS, and comparing its prevalence by BMI ranges. We applied a sensitivity analysis to define BMI optimal cut-off point values. Results: We found 14.6% of MetS prevalence with a BMI average of 24.2%, and 34.5% of overweight prevalence (BMI ≥ 25). A BMI cut-off point value of 22.5 is suggested as an upper limit of a normal weight condition, only for public health purpose; while at individual level the BMI cut-off point of 25 was corroborated as the upper limit for a normal weight condition. A public health tool to estimate the MetS prevalence based on BMI percentages is proposed, and a study case is presented. Conclusion: BMI fails predicting at individual level both, healthy condition or metabolic alterations, when values are lower than 25. At population level, the BMI is a valuable public health tool to estimate MetS prevalence: based on the prevalence of MetS by BMI ranges of a sample of the population.

Glycemic and cardiovascular parameters improved in type 2 diabetes with the high nutrient density (HND) diet

Abstract: Objective: The purpose of this study was to provide an initial assessment of the effectiveness of the high nutrient density (HND) diet on glycemic control and cardiovascular risk factors in participants with type 2 diabetes. Design: This was a retrospective case series study. Participants were 13 adult type 2 diabetic U.S. women and men between the ages of 30 - 80 years old. Glycosylated hemoglobin (HbA1C), lipid profile, blood pressure, BMI, and medication requirements before and after commencement of the HND diet were compared. Results: After a median length on the HND diet of 7 months, the mean HbA1C dropped from 8.2% to 5.8% (p = 0.002), with sixty-two percent of participants reaching normoglycemic levels (HbA1C p = 0.0004 for systolic blood pressure, p = 0.01 for diastolic blood pressure). Triglycerides significantly decreased from a mean of 171 mg/dl to a mean of 103 mg/dl (p = 0.02). The HDL increased significantly from 48.3 mg/dl to 54.6 mg/dl (p = 0.03). The mean number of medications dropped from 4 to 1 (p = 0.0006). Conclusions: The HND diet was very effective in controlling glycemic levels and cardiovascular risk factors in 13 participants with type 2 diabetes. Therefore, there is a well-justified need for further study with the HND diet.

Using UNAIDS’s organizing framework to assess Nigeria’s national HIV monitoring and evaluation system

Abstract: The Nigeria National Response Management Information System (NNRIMS), developed in 2004 as a framework for monitoring and evaluating the country’s response to HIV, does not function at an optimum level due to several challenges, including a bewildering proliferation of vertical reporting systems, competition among sectors, and the nascent nature of the monitoring and evaluation (M&E) sub-systems within many institutions. An assessment of the existing M&E system was conducted to verify whether the system has the capacities to provide essential data for monitoring the epidemic and identifying critical programming gaps. Nigeria’s National Agency for the Control of AIDS (NACA) used an organizing framework for a national HIV M&E system developed by UNAIDS, to assess the strengths and weaknesses of the NNRIMS to generate data for evidence-based decisionmaking. The participatory approach used during an assessment workshop ensured that the process was country-led and -owned to build consensus and local capacity, and that it encouraged adoption of a single national-level multisectoral HIV M&E system. The assessment found an operable M&E system at the national level but a much weaker system at the state and local levels and across seven other sectors. There are multiple data collection and reporting tools at the facility level that lead to vertical reporting systems, which increases the burden of reporting at lower levels, especially by service providers. Human resources are being developed, but problems remain with the quantity and quality of staff. Data use, though evident at the national level, is still very weak among five of the seven sectors assessed. The assessment results have been used to develop a national costed M&E workplan to which all stakeholders contributed in a coordinated response to strengthen the system.

Nervous system disorders induced by occupational and environmental toxic exposure

Abstract: Encephalopathy, extrapyramidal features, neurodegenerative diseases, and peripheral neuropathy are commonly encountered in presentations of occupational neurotoxic syndromes. Epidemiological findings have suggested the role of pesticides, solvents and metals on the onset and progression of neurological diseases. The aim of this review is to present clinical manifestations of occupational and environmental neurologic disorders, to discuss toxic’s implications of these conditions, and to give indications about occupational branches and main jobs concerned. Better to know and categorize the clinical manifestation of neurologic disorders and toxics implicated, will improve the clinical management of occupational neurologic diseases. We performed a research of studies, case reports and review, particularly among most recent, available into Pub Med databases about occupational and environmental neurologic disorders and main toxics incriminated.

Support for obesity policy: The effect of perceptions of causes for obesity and national identity in Canada

Abstract: Interventions in Canada to address obesity have largely been limited to individual-level change through education rather than a population-level public policy approach. Little is known about obesity policy support in Canada, and substantial national variation in obesity policy support prevents direct transferability of these policies among nations. Our study recruited 521 young adults for an online survey through leaflets and flyers. We investigated how respondents’ demographics, health characteristics, political attitudes, beliefs regarding causes of obesity, and national identity affected their support for obesity policy. Results showed that there is high support for many obesity policies among Canadian young adults. Including Canadian national identity in regression models was significant in explaining obesity policy support beyond the combined effect of other predictors. Further exploration of national identity, in Canada and elsewhere, has implications for understanding obesity policy support that might assist policy makers in making more informed decisions in addressing obesity.

Misperceptions of peer gambling norms among adolescents: Analysis of a national sample in Finland

Abstract: Introduction: Misperceptions of peer drinking norms are widely documented in the US student populations and are associated with increased personal consumption. Few studies have examined misperceptions of peer gambling, and none of these have been conducted among adolescents in the European context. In a national sample, we examined misperceptions of peer gambling in Finland. Tenets of the social norms approach form a framework for discussion of the findings. Methods: Participants were 4526 adolescents aged 12 to 18 years who completed the nationwide Adolescent Health and Lifestyle Survey in 2011. Main measures were gambling behavior and the perception of same age-sex peers’ gambling. Misperception was an overestimation of the frequency of gambling by others compared to the actual frequency of gambling. Results: Adolescents held substantial misperceptions of peer gambling, imagining they gambled much more than they actually did. Age, sex, and gambling behavior were correlated with the perceptions. The extent of misperception was greatest among monthly gamblers, whereas non-gamblers and daily gamblers were more accurate in their perceptions. Estimations of peers’ gambling frequency were more accurate in boys than in girls and among those aged 12 years than among older adolescents. Conclusion: Our findings suggest that adolescent gambling prevention efforts could benefit from adopting a social norms approach; that is, correcting gambling-related misperceptions might discourage gambling and protect adolescents from adopting more severe gambling patterns.

Metabolic syndrome occurrence in university students from México City: The binomium HDL/waist circumference is the major prevalence factor

Abstract: Objective: Metabolic Syndrome (MetS) is the leading cause to develop type 2 diabetes worldwide. We examined associations of MetS components early in life, and their use as risk factors of acquiring MetS. Method: We used an international definition of MetS. Subjects were categorized into “Healthy”/“Not Healthy”, altered parameters are low HDL-cholesterol, large waist circumference (WC), hypertriacylglycerolemia, hypertension, and hyperglycemia, in 32 combinations (2^5) with two values (altered/not altered). MetS was identified with three or more altered parameters. Results: A total of 3424 students (ages 17 - 24 years) participated in the survey, and 2475 were “Not Healthy” showing at least 1 parameter altered; from them 49.6% showed low blood HDL either alone or combined, 38.2% had altered waist circumference either alone or combined; while 18.1% showed hypertriacylglycero-lemia either alone or combined. Hypertension and hyperglycemia were the lowest in frequency. Conclusion: We propose that the binomium HDL/ Waist Circumference is the main prevalence factor to develop MetS in the asymptomatic young population, followed by hypertriacylglycerolemia which together define MetS; while hypertension and hyperglycemia seem to occur later in MetS.

Cross-cultural psychometric assessment of the parent-teen sexual risk communication (PTSRC-III) scale in Jamaica

Abstract: Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult females are at particularly high risk. US studies have shown that parent-teen sexual communication may significantly influence the sexual risk-related beliefs and behaviors. However, no studies have examined parent-teen sexual communication in Jamaica or the wider Caribbean. Objective: The study aims to describe patterns of parent-teen sexual communication between Jamaican mothers and adolescent daughters and assess the psychometric properties of the Parent-Teen Sexual Risk Communication (PTSRC-III) scale when used with this population. Method: Data were collected as part of a larger randomized controlled trial study. A total of 330 urban Jamaican adolescent girls, ages 13 - 17, and their mothers or female guardians completed the 8-item PTSRC-III scale at baseline and 3-month follow-up. Results: Mothers’ and daughters’ scores covered the full range of possible scores. Internal reliability of the PTSRC-III scale was excellent (α = 0.92 and 0.93 for mothers and daughters, respectively). There was evidence of consistency over time (r = 0.57, p r = 0.27, p r = 0.427, p r = 0.146, p = 0.008). A two-factor structure was identified, although the second factor showed a lower eigen-value than was found in previous US studies. The loading pattern and explanation of variance were very similar to the factor 2 described in the initial psychometric testing of the PTSRC-III instrument. Discussion: Patterns of sexual communication and the psychometrics of the scale when used in Jamaica were consistent with US results, and provided evidence of the cross-cultural reliability and validity of the PTSRC-III scale.

Prevalence of and factors associated with various level of body weight among Inner Mongolia medical students in China

Abstract: Background: To date no study on the body weight of medical students in Inner Mongolia has been carried out. The aim of the present study was to determine the prevalence of and factors associated with various body weight levels, and the physical health status associated with body weight levels among medical students attending the Inner Mongolia Medical College of China in 2011. Methods: Data on participant characteristics came from basic information contained in the school database. Students’ body weight was categorized using standard height and weight and physical health status using the college student physical health standard. Factors associated with various level of body weight were identified using multinomial logistic regression analysis. Results: The sample comprised 2060 males and 5096 females. The appropriate body weight prevalence among the students was 51.7%. The prevalence of being overweight or obese was 5.8 and 8.5%, respecttively, higher compared to the typical prevalence among college students in China. Both male and female students in the 24-28-years age group had the lowest appropriate weight percentage and the highest obesity percentage among all the age groups. For female medical students, the prevalence of obesity for students studying in Clinical Medicine was higher than for other faculties. Multinomial logistic regression analysis of male students showed that lowest year of education (year 1) was a protective factor in regard to appropriate weight. For both male and female medical students, the obese group had the highest proportion of poor physical health status compared to other categories of body weight and the proportion with excellent physiccal health status constituted < 1% for males and 0% for females. Conclusions: School administrators should encourage medical students to actively participate in body weight training and education to improve attitudes toward inappropriate body weight, to increase protective factors, and reduce the risk factors for inappropriate body weight.

The relation between ambulance transports due to heat stroke and air temperature using daily data in Okayama prefecture, Japan

Abstract: The aim of this study was to investigate the link between ambulance transports due to heat stroke and air temperature by using daily data of ambulance transports in Okayama prefecture, Japan. Daily observations for ambulance transports due to heat stroke from July to September in 2010 in Okayama prefecture, Japan were obtained from Fire and Disaster Management Agency in Japan. Data of meteorological parameters in Okayama prefecture, Japan were also obtained from Japan Meteorological Agency. Effect of meteorological parameters on ambulance transports due to heat stroke was analyzed. A total of 1133 ambulance transports due to heat stroke were observed in from July to September of 2010 in Okayama prefecture, Japan. Ambulance transports due to heat stroke was significantly correlated with air temperature. In addition, number of subjects with ambulance transports due to heat stroke over 34°C in the highest air temperature was 21.2 ± 9.8 per day. Higher air temperature was closely associated with higher ambulance transports due to heat stroke by using daily data in Okayama, prefecture, Japan.

Pre-lacteal feeding practices among newborn in urban slums of Lucknow city UP, India

Abstract: Aim: To study the Practices of Pre-lacteal feeding among Newborns in Urban slums of Lucknow city. Setting and Design: A cross-sectional study in Urban slums of Lucknow city, UP. Methods and Material: A cross-sectional study in Urban slums of Lucknow city, UP included 524 women who had a live birth during last one year preceding data collection. A pre-desined and pretested questionnaire was used for data collection. Statistical analysis used: The data was tabulated on Microsoft Excel sheet and analyzed using the software SPSS 10.0 for Windows and Discrete data were analyzed using the chisquare test. Results: Study findings showed that Half (50.6%) of the mothers had given pre-lacteal feedings to their newborn. Out of those who had given pre-lacteal feed, 55.1 percent had given mugli ghutti/griipe water and 49.4 percent had given boiled water as pre-lacteal feed Only mother’s education (p < 0.01), father’s education (p < 0.001) and socioeconomic status (p < 0.05) were statistically associated with the practice of giving prelecteal feeding. Conclusion: It was concluded that maternal knowledge and awareness of correct feeding practices is essential for the normal growth, health and well being of the children. We therefore suggested that the primary focus of various nutrition related national programs in India for children should aim at imparting nutrition and health education to the mothers.

Utilization of the current national antimalarial treatment guidelines among doctors in army hospitals in Lagos, Nigeria

Abstract: Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treatment have been affected by factors like wrong diagnosis, wrong attitude of the people, unavailability of drugs, fake and substandard drugs, attitude and practices of medical and paramedical personnel. Nigeria’s national standard for malaria treatment was recently changed to artemisinin combination therapy. Methods: A descriptive study using a structured questionnaire was administered to all doctors (123) practicing in the three Army hospitals in Lagos. The study was done between March, 2009 and April, 2009. The findings were precoded; data entry and analysis was done using EPI INFO version 3.5.1 statistical software. Results: Presumptive/clinical diagnosis was still a common practice for diagnosing malaria among doctors, as well as the use of microscopy. None of the doctors had the facility for diagnosing malaria with rapid diagnostic test in their hospitals. Fifty one percent of the doctors stated that they utilized the current National antimalarial treatment guidelines. Significant proportion of the doctors used Artemisinin-based Combination Therapy (ACTs) as first line treatment of uncomplicated malaria in adults and children. Chloroquine was the commonest drug for first line treatment of uncomplicated malaria in pregnancy. Only 45.5% of the doctors had correct knowledge of Intermittent Preventive Treatment in pregnancy (IPTp), while 33.3% knew the stage of pregnancy in which a pregnant woman should receive IPTp with sulphadoxine-pyrimethamine. Awareness and the content of knowledge of the current National antimalarial treatment guideline were not affected by the category or current position of the doctors. Thirteen percent of the respondents had attended training/update workshop organized by the Federal Ministry of Health (FMOH) Roll Back Malaria programme on the current National antimalarial treatment guideline. Conclusion: The study showed that there is need to improve use of recommended antimalarial medicines for all categories of patients by doctors in Army Hospitals in Lagos. More effort should be made by the Federal Ministry of Health and other stakeholders to organize training and refresher courses on the current National antimalarial treatment guidelines for all categories of health care providers.

Cervix and breast cancers in Oujda city in Eastern Morocco: Determinants and risk factors

Abstract: A retrospective study was conducted in 2008 on 681 in Eastern Morocco in order to estimate the incidence of cervical and breast cancer, and to determine the social determinants and risk factors associated with these two types of cancer. Another goal of the study was to give health decision makers evidence of the necessity for early diagnosis and treatment. A questionnaire was used before the clinical gynecological examination and sampling cell for the Pap smear. Any woman with a Pap smear suspect had to do a biopsy at the reference centre. Physicians, obstetricians and midwives in the consultation process did gynecological examination and breast palpation. Patients with a suspicious nodule underwent ultrasound and mammography by radiologists on site. Gynecological samples were carried out systematically to all ever-married women to detect cancer of the cervix. Software Excel and SPSS 17 were used for data processing. Patients with high social status were more susceptible to develop breast cancer whereas women with cervical cancer were poor, belonging to a class with a low marital status of widowed or divorced having been married at an early age. The majority of women were married (81%), poor (80%) and illiterate (66%). Breastfeeding women were less affected by breast cancer than women not breastfeeding. For cervical cancer, the difference was not statistically significant. Women using contraceptives were vulnerable to both breast and cervical cancer. For cervical cancer, over 15% of women with a family history were screened positive. No relationship was found between breast cancer and family history. Taking into account regional particularities, we stress the importance of social determinants and risk factors and show that our results are consistent with those published by other researchers. Breast and cervical cancers constitute a real challenge in Morocco. Their socioeconomic burden can be reduced by early detection and treatment. The delayed diagnosis complicates the task both in terms of survival and cost of treatment. Consequently, Moroccan health authorities are urged to adopt preventive and cost effective strategies.

Patient safety practices and medical errors: Perception of health care providers at Jimma University Specialized Hospital, Southwest Ethiopia

Abstract: Background: Even though evidences are limited in developing countries, the probability of patients being harmed in hospitals when receiving care might be much greater than that of the industrialized nations. Thus, aim of this study was to assess patient safety practice and the perceived prevalence of medical errors at Jimma University Specialized Hospital, Southwest Ethiopia. Methods: A facility based cross-sectional study was conducted during June, July and August 2010 in Jimma University Specialized Hospital. Patient safety grade and the perceived prevalence of medical errors were computed descriptively. Then, the effect of various independent variables on patient safety grade was assessed using multiple linear regressions analysis. Result: The overall patient safety grade as rated by the participants was excellent (7.2%), very good (20.7%), acceptable (36.0%), poor (30.0%) and failing (6.4%). Complications related to anesthesia occurred sometimes, rarely and never according to 30.8%, 43% and 15.8% of the respondents, respectively. Death in low mortality patients was reported to occur most of the time by 10.4% of the respondents. In addition, failure to rescue, infection due to medical care, postoperative hemorrhage, postoperative sepsis, birth injury to the neonate, obstetric trauma to the mother were reported to happened. Supervisor expectation and actions promoting patient safety (p < 0.001), and communication openness and feedback about errors (p = 0.002) had positive correlation with patient safety grade. Conclusion: this study indicated that poor patient safety practice and potentially preventable medical errors in the hospital.

Self-reported ischemic heart disease: Prevalence, sociodemographics, health behavior, health-care utilization, and quality of life

Abstract: The aim of this study was to present the prevalence of self-reported Ischemic Heart Disease (IHD) based on a national population-based survey and to characterize people with self-reported IHD with respect to health behavior, risk factors, health-care services utilization and health-related HRQoL; further to compare people with self-reported IHD to those with other chronic illness and people without chronic illness. Based on the Danish Health Interview Survey 2005 (SUSY), a sample of 10,983 persons aged 35 years or older was examined. Data was collected through personal interviews (response rate = 66.7%) and self-administered questionnaires (51.5%). The sample was divided into three mutual exclusive groups: IHD; other chronic illnesses; and no chronic illness. The prevalence of IHD was 5.6% (5.2 - 6.0). The disease was more common in men than women, and the average age was 67.5 years. People with self-reported IHD were characterized as having poorer health behaviors; more risk factors: 40% smokers, 21% sedentary lifestyle, 26% obese; higher utilization of the health-care services; and poorer HRQoL. When compared to people with other chronic diseases, people with IHD continued to show the same characteristics. The IHD group had more problems affecting their daily lives than the other two groups. The issues that affected the people with IHD have also been shown to increase the load on the health-care system. Therefore, it is important to the patients, health-care, and society that the prevalence of IHD is reduced and the burden of disease is made a priority.

Physical activity, screen time and pediatric health-related quality of life in the Mississippi Delta

Abstract: Background: The association of physical activity (PA) and screen time (ST) on health-related quality of life (HRQOL) among predominantly low-income children in the Mississippi Delta region has not been previously described. Methods: We performed a cross-sectional survey to assess health risks from a representative sample of the population ≥3 years old in the Delta Region of Arkansas, Louisiana, and Mississippi. Linear models were utilized to examine Pediatric Quality of Life Inventory (PedsQL) scores based on reported PA and ST. Results: Median age of the 371 participants was 9.8 years, 57% were African American, and 26% had annual household income ≤$14,999. Overall, 262 (75%) were categorized as physically active and 48% reported >2 hours ST per day. Children reporting exercising 5 - 7 days per week had significantly better PedsQL total score (84.3 vs 80.8; p 2 hours per day) did not significantly impact HRQOL. Conclusions: Findings suggest that PA among children living in the Mississippi Delta was related to higher HRQOL; however, the positive effects of PA on HRQOL may be less for minority and low-income children.

Prevalence of smoking among universities students of Shahroud in 2010

Abstract: This study in 2010 determined the prevalence of smoking and its associated factors among universities students in Shahroud located in the North Eastern of Iran. 1800 students were selected randomly among 20000 students of Shahroud universities, to complete a questionnaire Which was prepared based on the Global Youth Tobacco Survey. The prevalence of current smoking was 20% (80% male and 20% female). The most important factors in the tendency to smoking were: friends smoking, stress, separation from family and fun.

Human health sciences—From cultivation to utilization of medicinal plants

Abstract: The aim of this review is to recognize the ability of plants used as food and medicine for our health care. From this point of view, we have studied economical production techniques of medicinal plants and vegetables that have physiological functions such as disease prevention, health maintenance and improvement of physical function. We revealed the suitable cultivation techniques such as the long-term freezing seed storage, and systematic and efficient seedling production of Swertia japonica in the future domestication in Japan. We have also studied the development of a new and friendly product for preparing decoction of Kampo medicine (Japanese traditional medicine) to utilize medicinal plants effectively. It was possible that the decoction of some Kampo medicines in a micro-wavable container could be carried out in substitution for a common method. This study revealed that the improvement of decoction method of Kampo medicine might contribute to conserve the energic or natural resources, especially medicinal plants of crude drugs in comparison with the conventional way. Moreover, the reevaluation of some vegetables such as Japanese radish and carrot in terms of the suitability as materials for “Yakuzen”, and creating and producing of newly low potassium tomatoes for improving the quality of life (QOL) of dialysis patients and potassium restricted patients were also studied by focusing traditional and local vegetables. Some local cultivars containing stronger flavor and taste with higher amount of functional constituents are suitable for our health care than F1 (first filial generation) cultivars. Our research will give feedback each other by cross cutting way, and human health science from the cultivation to utilization of medicinal plants and vegetables will be important and needed for our healthy and comfortable life in the future.

Body mass index estimation and measurement by healthcare professionals

Abstract: Background: Severe obesity has increased more than three-fold in prevalence over the past fifteen years in Europe and the United States. Correctly identifying severe obesity permits access to mortality-reducing interventions. We aimed to determine the accuracy of healthcare professionals (HCPs) in recognising severe obesity and the frequency of body mass index (BMI) assessment by HCPs. Methods: We performed two cross-sectional surveys: one of 206 HCPs in Ireland and Canada and another of 515 Irish hospital healthcare records. The first survey evaluated BMI estimation from photographs and the second examined recording of weight and height during outpatient clinic visits. Results: HCPs underestimated the BMI of severely obese people by an average of 22% to 39%. For a patient with a BMI of 52 kg/m2, 35.4% of family physicians appreciated that the patient was severely obese (BMI > 40 kg/m2) compared with 81.0% of endocrinologists. During clinic visits only 18.1% (n = 75), 1% (n = 4) and 0% (n = 0) of patients had their respective weights, heights and BMIs recorded. Conclusions: HCPs frequently fail to recognise severe obesity from photographs and, in our centre, do not routinely record weight or height. Whether patient outcomes can be improved by measuring weight and height during every HCP encounter warrants further study.

Certainty of patient survival with reference to game information dynamic model

Abstract: This paper is concerned with Hepato-Cellular Carcinoma (HCC) patients treated naturopathic agents. Patients treated with ≥4 agents survived significantly longer than patients treated with ≤3 agents. The great effect is seen in patients treated with at least 4 agents that include Cordyceps sinensis. This greater certainty of patient survival without toxic side effects is significant benefit comparing with the conventional therapy. Treatment of HCC with a regimen of ≥4 agents prepared from natural products is associated with greater certainty of patient survival in a substantial portion of patients. The information dynamic model for certainty of patient survival is derived based on fluid mechanics, where a series of approximate solutions of the flow between two parallel flat walls, one of which is at rest, the other is suddenly accelerated from the rest to a constant velocity are used. The kinetic energy of certainty of patient survival decreases with increasing time, while the potential energy increases with increasing time. Total mechanical energy of patients treated with 4 or more agents is smaller than that treated with 3 or fewer agents. The kinetic energy (potential energy) of patients treated with 4 or more agents decreases (increases) more slower than the kinetic energy (potential energy) of patients treated with 3 or fewer agents.

Daily step-count and change in waist circumference during a workplace pedometer program

Abstract: Background: The health benefit associated with a daily step-count target within pedometer programs is unclear. The aim of this study was to determine if the daily step-count attained during a four month pedometer-based workplace health program was associated with change in waist circumference (WC). Methods: 762 Australian adults enrolled in a workplace pedometer program were recruited from ten workplaces in 2008. At the end of the program (four months), 436 participants were eligible for the current analysis. Data included demographics, perceived physical activity change during the program, measured WC at baseline and follow-up, and reported daily pedometer step-counts throughout the program. The association between daily step count and change in WC was examined using linear regression. Results: WC improved by an average of –1.61cm (95% CI: –2.13, –1.09) by the end of the program. There was no relationship between daily step-count and the degree of change in WC. However, among participants reporting an increase in physical activity during the program a relationship between daily step count and change in WC was observed, such that those who undertook on average 10,000 steps or more per day improved their WC by –1.38cm (95%CI: –2.14, –0.63) more than those who did not achieve an average of 10,000 steps per day. Similarly, among individuals not meeting WC guidelines at baseline a greater daily step count was associated with a greater decrease in WC. Conclusions: Within a workplace pedometer program, reported daily step count was not associated with greater reductions in WC. However, it was a useful indicator of potential health benefits in those who increased their level of physical activity during the program. Pedometer programs need to communicate clearly the importance of both a step goal and improvement in step count to manage participant expectations about improvements in health markers.

Effect of adult leader participation on physical activity in children

Abstract: Background: Participation in physically active games is one way to increase energy expendture in children. However, it is unknown whether adult leader participation (LP) in games can impact children’s physical activity (PA) levels. The purpose of this study was to examine the influence of LP compared to no LP on PA levels among children participating in organized active games. Methods: Children (n = 14) in grades 4 - 6 (Male = 42.8%, White = 50%, Overweight/ Obese = 42.8%) participated in four active games across two consecutive days. Each day, children participated in two 16-minute games and received verbal encouragement from an adult leader. Each game was divided into four-minute intervals alternating between LP or no LP. LP was counter-balanced across two days. Each child wore an Actigraph GT1M accelerometer. Time spent in moderate-to-vigorous PA (MVPA), vigorous PA (VPA), and sedentary behavior (SB) was determined by Freedson’s MET prediction. Data were analyzed using a condition (LP or no LP) by game repeated-measures ANCOVA. Results: Children participated in MVPA 52.3% of game time across all games. There were no differences in MVPA, VPA, and SB by gender, weight status, or ethnicity. LP and no LP conditions were not different for MVPA, VPA, or SB. Conclusions: These results show no effect of LP on PA in children during active games. It may be that LP could not increase PA because the children were already exhibiting high levels of MVPA.