Advances in Public Health http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Changing Smoking Behavior of Staff at Dr. Zainoel Abidin Provincial General Hospital, Banda Aceh Wed, 17 Dec 2014 06:22:25 +0000 http://www.hindawi.com/journals/aph/2014/316274/ Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI) consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals. Said Usman, Soekidjo Notoadmodjo, Kintoko Rochadi, and Fikarwin Zuska Copyright © 2014 Said Usman et al. All rights reserved. Sexual Coercion and Associated Factors among Female Students of Madawalabu University, Southeast Ethiopia Tue, 16 Dec 2014 06:58:34 +0000 http://www.hindawi.com/journals/aph/2014/417517/ Introduction. Violence against women, in its various forms, is an important social and public health problem in different communities around the world. Although violence against women is against the inalienable human right and resulted in physical, sexual, and psychological harm or suffering to women, little has been documented regarding its factors and distribution among youth population such as university students. Therefore, the objective of this study was to assess factors associated with sexual coercion among female students at Madawalabu University. Methods. This was a cross-sectional institution based study conducted on 411 female students which were selected by systematic random sampling from the list of female students. Data were collected in April 2012 using structured-interview administered questionnaire. Descriptive, binary, and multivariable logistic regression analysis were carried out using SPSS version 16. Result. In this study, the mean (±SD) age at first sex was 18.19 (+1.83) years. Lifetime and coercion in last twelve months were 163 (41.1%) and 101 (25.4%), respectively. Twenty-one (5.9%) of the respondents were raped. Being influenced/forced into unwanted sexual act 74 (18.6%) and having their genitalia/breast unwillingly touched 44 (11.1%) were reported as the commonest mechanisms of coercion. Age at first sex (17–19 years) (AOR = 0.241, 95% CI: 0.074, 0.765) and occasional alcohol use (AOR = 4.161, 95% CI: 1.386, 12.658) were significantly associated with coercion in the last twelve months. Conclusion. The overall lifetime sexual coercion was found to be 41.1%. In this study 6.8% of female students were raped and majority have had trial of rape. But 93.75% did not report to any legal body. With the existing prevalence and identified factors, the university should work towards minimizing the risk of sexual coercion through intensifying life skill peer education and assertiveness trainings. Abulie Takele and Tesfaye Setegn Copyright © 2014 Abulie Takele and Tesfaye Setegn. All rights reserved. Body Mass Index in Clinic Attenders: Patient Self-Perception versus Actual Measurements Mon, 24 Nov 2014 13:43:18 +0000 http://www.hindawi.com/journals/aph/2014/160206/ Objectives. The objectives of the study were to measure actual BMI in patients attending chronic disease clinics in health centres and to relate this to the patients’ own perceptions of their body image and the need to lose weight. Study Design. A cross sectional study. Methods. The actual BMIs in patients who attended chronic disease clinics in 14 health centres were measured. All participants were asked to state where they thought they were on a visual body image scale and were also asked if they thought they needed to lose weight. Results. All participants approached agreed to participate (RR 100%). 70% of patients were found to have a raised BMI. Approximately 73% of patients using the visual scale indicated that an overweight or obese BMI was ideal for them. Conclusions. Patients think they are thinner than they actually are, with obvious implications for health and health seeking behaviour. A whole of society approach is needed to change weight status perceptions and improve exercise and dietary behaviour. S. Pooransingh, K. Ramgulam, and I. Dialsingh Copyright © 2014 S. Pooransingh et al. All rights reserved. Perspectives on Employment Integration, Mental Illness and Disability, and Workplace Health Thu, 20 Nov 2014 09:35:57 +0000 http://www.hindawi.com/journals/aph/2014/258614/ This paper reviews the literature on the interplay between employment integration and retention of individuals diagnosed with mental health and related disability (MHRD). Specifically, the paper addresses the importance of an integrative approach, utilizing a social epidemiological approach to assess various factors that are related to the employment integration of individuals diagnosed with severe mental illness. Our approach to the review incorporates a research methodology that is multilayered, mixed, and contextual. The review examines the literature that aims to unpack employers’ understanding of mental illness and their attitudes, beliefs, and practices about employing workers with mental illness. Additionally we offer a conceptual framework entrenched within the social determinants of the mental health (SDOMH) literature as a way to contextualize the review conclusions. This approach contributes to a holistic understanding of workplace mental health conceptually and methodologically particularly as practitioners and policy makers alike are grappling with better ways to integrate employees who are diagnosed with mental health and disabilities into to the workplace. Nene Ernest Khalema and Janki Shankar Copyright © 2014 Nene Ernest Khalema and Janki Shankar. All rights reserved. Magnitude of Domestic Violence and Associated Factors among Pregnant Women in Hulet Ejju Enessie District, Northwest Ethiopia Mon, 10 Nov 2014 12:09:19 +0000 http://www.hindawi.com/journals/aph/2014/484897/ Introduction. Domestic violence during pregnancy is one of the barriers to achieve MDG 3 due to its adverse health consequences. Comparable population-based data on the problem are lacking as existing literatures differ in time periods explored. Such discrepancies among study findings indicate the importance of site specific studies, especially in rural parts of Ethiopia, where little is known about the problem. Objective. The aim of this study was to assess the magnitude of domestic violence and its associated factors among pregnant women in Hulet Ejju Enessie district, northwest Ethiopia. Methods and Materials. Quantitative community based cross-sectional study was carried out from January 1 to 31, 2014. A total of 425 randomly selected pregnant women were involved in the study. A standard WHO multicountry study on women’s health and domestic violence questionnaire were used for data collection. Four trained female data collectors were involved. Odds ratio with 95% CI was estimated to identify factors associated with domestic violence during pregnancy using multivariate logistic regression. Statistical significance was declared at value ≤0.05. Results. The prevalence of domestic violence during current pregnancy was 32.2%. The prevalence of psychological, sexual, and physical violence was 24.9%, 14.8%, and 11.3%, respectively. Married women at the age of ≤15 years were about four times (AOR = 4.2, 95% CI 1.9–9.0) more likely to experience domestic violence during pregnancy than their counterparts. Meanwhile, interparental exposure to domestic violence during childhood (AOR = 2.3, 95% CI 1.1–4.8), having frequently drinker partner (AOR = 3.4, 95% CI 1.6–7.4), and undesired pregnancy by partner (AOR = 6.2, 95% CI 3.2–12.1) were the main significant factors that increase risk of domestic violence during pregnancy. Conclusion and Recommendation. In this study, the prevalence of domestic violence during current pregnancy is high which may lead to a serious health consequence both on the mothers and on their foetuses. Thus, targeted efforts should be made by all concerned stakeholders to reduce the problem in the study area. Tenaw Yimer, Tesfaye Gobena, Gudina Egata, and Habtamu Mellie Copyright © 2014 Tenaw Yimer et al. All rights reserved. Perception and Barriers to Indoor Air Quality and Perceived Impact on Respiratory Health: An Assessment in Rural Honduras Mon, 13 Oct 2014 09:11:03 +0000 http://www.hindawi.com/journals/aph/2014/105260/ Objective. The aim of this study was to identify household-specific factors associated with respiratory symptoms and to study the perceived impact of indoor air pollution (IAP) as a health issue. Methods. An IRB-approved, voluntary, anonymous 23-item survey was conducted in Spanish at a medical outreach clinic in June 2012 and at the homes of survey respondents . Comparative analyses were performed to investigate relationships between specific house characteristics and respiratory complaints. Results. Seventy-nine surveys were completed. Respiratory symptoms were frequently reported by survey respondents: 42% stated that smoke in their household caused them to have watery eyes, 42% reported household members with coughs within the past two weeks, and 25% stated that there were currently household members experiencing difficulty in breathing. Stove location and kitchen roof construction material were significantly associated with frequency of respiratory symptoms. The vast majority used firewood as their major fuel type. Most respondents indicated that neither indoor air quality was a problem nor did it affect their daily life. Conclusions. Respiratory complaints are common in Yoro, Honduras. Stove location and kitchen roof construction material were significantly associated with frequency of respiratory symptoms; this may have implications for efforts to improve respiratory health in the region. Audrey Le, Gonzalo Bearman, Kakotan Sanogo, and Michael P. Stevens Copyright © 2014 Audrey Le et al. All rights reserved. Control of an Outbreak of Acinetobacter baumannii in Burn Unit in a Tertiary Care Hospital of North India Sun, 28 Sep 2014 08:08:39 +0000 http://www.hindawi.com/journals/aph/2014/896289/ Acinetobacter infection is increasing in hospitals and now it is considered as a global threat, as it can be easily transmitted and remain viable in the hospital environment for a long time due to its multidrug-resistant status, resistance to desiccation, and tendency to adhere to inanimate surfaces. Outbreaks caused by multidrug-resistant Acinetobacter baumannii (MDRAB) are difficult to control and have substantial morbidity and mortality, especially in vulnerable host. Here we are describing an outbreak of multidrug-resistant Acinetobacter baumannii in burn unit of a tertiary care hospital in India followed by its investigation and infection control measures taken to curtail the outbreak. Outbreak investigation and environmental sampling are the key factors which help in deciding the infection control strategies for control of outbreak. Implementation of contact precautions, hand hygiene, personnel protective equipment, environmental disinfection, isolation of patients, and training of health care workers are effective measures to control the outbreak of MDRAB in burn unit. Shweta Sharma, Nirmaljit Kaur, Shalini Malhotra, Preeti Madan, and Charoo Hans Copyright © 2014 Shweta Sharma et al. All rights reserved. Rural-Urban Differences in Health Care Expenditures: Empirical Data from US Households Tue, 09 Sep 2014 09:28:51 +0000 http://www.hindawi.com/journals/aph/2014/435780/ Purpose. To estimate the rural-urban differences in expenditures of outpatient care, hospital inpatient care, hospital emergency room services, medications, and total services. Methods. This cross-sectional study used data from the 2010 Medical Expenditure Panel Survey. The overall sample size for the study was 22,772. Weighted frequencies, means, or percentages were estimated to illustrate the distribution of each variable. Five two-part utilization models were then fit to determine the likelihood of having nonzero expenses and to identify how residence in a rural versus urban area affected expenditures in our five expense categories. Quantile regressions were estimated to further explore relationships between residence and each quantile of nonzero expenditure. Results. The results of two-part model suggest that rural populations spent more on medications, while urban populations spent more on emergency care. However, no rural-urban difference was found in total health expenditures. The results of quantile regressions suggest that the highest users (at the upper quantiles) of medication and total expenditure experienced the strongest positive effects of living in rural areas. Conclusions. Total health expenditures do not seem to vary significantly across urban and rural areas. However, rurality does have important effects on those who make the most use of outpatient care and prescription medications. Reviewing total health expenditures for urban and rural populations is not enough. Policymakers should monitor the effects of geographic differences, especially in the highest expenditure quantiles, for specific types of health expenditures. Differences in the influence of rurality across this distribution of health expenditures may provide important guidance for interventions. Wei-Chen Lee, Luohua Jiang, Charles D. Phillips, and Robert L. Ohsfeldt Copyright © 2014 Wei-Chen Lee et al. All rights reserved. Assessment of Knowledge, Attitude, and Practice of Risky Sexual Behavior Leading to HIV and Sexually Transmitted Infections among Egyptian Substance Abusers: A Cross-Sectional Study Mon, 25 Aug 2014 05:28:35 +0000 http://www.hindawi.com/journals/aph/2014/701861/ Background. Rapidly growing youth population with changing sexual trend in Egypt raised HIV potential. The aim of this study is to assess knowledge, attitude, and practice regarding unsafe sexual behavior among Egyptian drug abusers. Methods. This cross-sectional study was conducted in 2008 in the Freedom Drugs and HIV Program on 410 drug abusers in Egypt. Included respondents were subanalyzed by gender, age, education, and intravenous drug usage. Results. KAP average scores on safe sexual behavior were low compared to the maximum possible denoting low awareness and action of drug addicts towards avoidance of infection. Respondents with higher education had significantly better knowledge about safe sexual behavior. Significant positive correlation was shown between age and knowledge of safe sexual behavior. Older age groups were predicted to know more about safe sex, while gender; educational level and intravenous drug usage were not. Similarly, females and intravenous drug users were predicted to have higher attitude for safe sex while age and educational level did not. Conclusion. KAP of safe sexual behavior were low among drug addicts in Egypt increasing potential towards infection with STDs including HIV. The more the age and education level, the better the knowledge towards safe sexual behavior. Atef Y. Bakhoum, Max O. Bachmann, Ehab El Kharrat, and Remon Talaat Copyright © 2014 Atef Y. Bakhoum et al. All rights reserved. Awareness and Self-Reported Health Hazards of Electromagnetic Waves from Mobile Phone Towers in Dhaka, Bangladesh: A Pilot Study Wed, 20 Aug 2014 06:45:30 +0000 http://www.hindawi.com/journals/aph/2014/952832/ Background. Over the last few years there have been concerns regarding the health effects of electromagnetic waves (EMW) produced by mobile phone base transmitter stations (BTS). Data on possible health effects of EMW in developing countries are rare. This study was conducted to determine the awareness and self-reported health hazards of EMW from the mobile phone BTS in Dhaka city. Methods. A cross-sectional study was conducted among 220 respondents living around BTS in Dhaka city. Data was collected on sociodemographic characteristics, mobile phone use, BTS and EMW awareness, and self-reported health problems. Results. The majority of respondents (92.7%) reported to have seen a BTS but only 29.5% knows how it works and 74.5% had no knowledge about the EMW. 49% respondents experienced sleeping disturbances while recent episodes of headache or dizziness were reported by 47% and mood change or anxiety or depression by 41%. About 22% complained about other physical or mental symptoms. Conclusion. Awareness about the possible health hazards from EMW of BTS is low among the inhabitants of Dhaka city. A number of respondents mentioned recent health effects but the association with BTS could not be established. Sheikh Mohammed Shariful Islam Copyright © 2014 Sheikh Mohammed Shariful Islam. All rights reserved. Eating Behaviours and Body Weight Concerns among Adolescent Girls Wed, 16 Jul 2014 12:58:53 +0000 http://www.hindawi.com/journals/aph/2014/257396/ This paper presents a global review of research done on adolescent eating behaviours and food choices and the probable factors underlying it. Worldwide adolescent girls tend to develop moderate to high level of disordered eating behaviour as a result of their excessive concern with body weight or obsession with thinness. The objective of the review is to understand the concerns over body weight and the current eating patterns of adolescent girls in the developed and developing countries. Nadira Mallick, Subha Ray, and Susmita Mukhopadhyay Copyright © 2014 Nadira Mallick et al. All rights reserved. The Challenges Confronting Public Hospitals in India, Their Origins, and Possible Solutions Sun, 13 Jul 2014 08:45:58 +0000 http://www.hindawi.com/journals/aph/2014/898502/ Despite the implementation of National Rural Health Mission over a period of nine years since 2005, the public health system in the country continues to face formidable challenges. In the context of plans for rolling out “Universal Health Care” in the country, this paper analyzes the social, economic, and political origins of the major challenges facing public hospitals in India. The view taken therein holds the class nature of the ruling classes in the country and the development paradigm pursued by them as being at the root of the present problems being faced by public hospitals. The suggested solutions are in tune with these realities. Vikas Bajpai Copyright © 2014 Vikas Bajpai. All rights reserved. Reducing Colorectal Cancer Incidence and Disparities: Performance and Outcomes of a Screening Colonoscopy Program in South Carolina Mon, 23 Jun 2014 07:51:14 +0000 http://www.hindawi.com/journals/aph/2014/787282/ This study evaluated the efficiency, effectiveness, and racial disparities reduction potential of Screening Colonoscopies for People Everywhere in South Carolina (SCOPE SC), a state-funded program for indigent persons aged 50–64 years (45–64 years for African American (AA)) with a medical home in community health centers. Patients were referred to existing referral network providers, and the centers were compensated for patient navigation. Data on procedures and patient demographics were analyzed. Of 782 individuals recruited (71.2% AA), 85% (665) completed the procedure (71.1% AA). The adenoma detection rate was 27.8% (males 34.6% and females 25.1%), advanced neoplasm rate 7.7% (including 3 cancers), cecum intubation rate 98.9%, inadequate bowel preparation rate 7.9%, and adverse event rate 0.9%. All indicators met the national quality benchmarks. The adenoma rate of 26.0% among AAs aged 45–49 years was similar to that of older Whites and AAs. We found that patient navigation and a medical home setting resulted in a successful and high-quality screening program. The observed high adenoma rate among younger AAs calls for more research with larger cohorts to evaluate the appropriateness of the current screening guidelines for AAs, given that they suffer 47% higher colorectal cancer mortality than Whites. Sudha Xirasagar, Yi-Jhen Li, James B. Burch, Virginie G. Daguisé, Thomas G. Hurley, and James R. Hébert Copyright © 2014 Sudha Xirasagar et al. All rights reserved. Clinical and Microbiologic Efficacy of a Water Filter Program in a Rural Honduran Community Mon, 07 Apr 2014 06:32:58 +0000 http://www.hindawi.com/journals/aph/2014/734254/ Water purification in the rural Honduras is a focus of the nonprofit organization Honduras Outreach Medical Brigade Relief Effort (HOMBRE). We assessed water filter use and tested filter microbiologic and clinical efficacy. A 22-item questionnaire assessed water sources, obtainment/storage, purification, and incidence of gastrointestinal disease. Samples from home clay-based filters in La Hicaca were obtained and paired with surveys from the same home. We counted bacterial colonies of four bacterial classifications from each sample. Sixty-five surveys were completed. Forty-five (69%) individuals used a filter. Fifteen respondents reported diarrhea in their home in the last 30 days; this incidence was higher in homes not using a filter. Thirty-three paired water samples and surveys were available. Twenty-eight samples (85%) demonstrated bacterial growth. A control sample was obtained from the local river, the principal water source; number and bacterial colony types were innumerable within 24 hours. Access to clean water, the use of filters, and other treatment methods differed within a geographically proximal region. Although the majority of the water samples failed to achieve bacterial eradication, water filters may sufficiently reduce bacterial coliform counts to levels below infectious inoculation. Clay water filters may be sustainable water treatment measures in resource poor settings. Jaclyn Arquiette, Michael P. Stevens, Jean M. Rabb, Kakotan Sanogo, Patrick Mason, and Gonzalo M. L. Bearman Copyright © 2014 Jaclyn Arquiette et al. All rights reserved.