Advances in Preventive Medicine The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Comment on “Effects of Yoga on Utero-Fetal-Placental Circulation in High-Risk Pregnancy: A Randomized Controlled Trial” Tue, 15 Sep 2015 13:45:20 +0000 Siddharudha Shivalli Copyright © 2015 Siddharudha Shivalli. All rights reserved. Novel Longitudinal and Propensity Score Matched Analysis of Hands-On Cooking and Nutrition Education versus Traditional Clinical Education among 627 Medical Students Tue, 08 Sep 2015 06:46:44 +0000 Background. Physicians are inadequately equipped to respond to the global obesity and nutrition-associated chronic disease epidemics. We investigated superiority of simulation-based medical education with deliberate practice (SBME-DP) hands-on cooking and nutrition elective in a medical school-based teaching kitchen versus traditional clinical education for medical students. Materials and Methods. A 59-question panel survey was distributed to an entire medical school twice annually from September 2012 to May 2014. Student diet and attitudes and competencies (DACs) counseling patients on nutrition were compared using conditional multivariate logistic regression, propensity score-weighted, and longitudinal panel analyses. Inverse-variance weighted meta-analysis (IVWM) was used for planned subgroup analysis by year and treatment estimates across the three methods. Results. Of the available 954 students, 65.72% () unique students were followed to produce 963 responses. 11.32% () of responses were from 84 subjects who participated in the elective. SBME-DP versus traditional education significantly improved fruit and vegetable diet (OR = 1.38, 95% CI: 1.07–1.79, ) and attitudes (OR = 1.81, 95% CI: 1.40–2.35, ) and competencies (OR = 1.72, 95% CI: 1.54–1.92, ). Conclusions. This study reports for the first time superiority longitudinally for SBME-DP style nutrition education for medical students which has since expanded to 13 schools. Dominique J. Monlezun, Benjamin Leong, Esther Joo, Andrew G. Birkhead, Leah Sarris, and Timothy S. Harlan Copyright © 2015 Dominique J. Monlezun et al. All rights reserved. Predictors of Self-Management Behaviors in Older Adults with Hypertension Wed, 12 Aug 2015 06:33:41 +0000 The purpose of this study was to develop a prediction model of demographic and sociobehavioral characteristics common among older adults with hypertension (HTN) who engage in self-management behavior. A descriptive, correlational predictive design was used to collect data at 14 faith-based and senior citizen organizations in a major urban northeastern city. Participants ranged in age from 63 to 96 with a mean age of 77 (SD 6.9). A 33-item questionnaire was used to gather data on 15 explanatory and 5 outcome variables. Instruments were the Perceived Stress Scale, the Duke Social Support Index, the stage of change for physical activity scale, and the DASH Food Frequency Questionnaire. Correlation and regression analyses were used to test the hypothesis. Results indicate there is a common set of characteristics such as higher stage of change, reading food labels, and higher self-rated health that can predict the older adult’s likelihood to engage in hypertension self-management behavior. The significant correlations found in this preliminary study warrant further study and validation. Findings are clinically relevant as knowledge of demographic and sociobehavioral characteristics associated with engagement in self-management behavior enables health care clinicians to support and encourage older adults to improve management of this common, chronic condition. Brenda M. Douglas and Elizabeth P. Howard Copyright © 2015 Brenda M. Douglas and Elizabeth P. Howard. All rights reserved. Prevalence and Risk Factors for Oral Potentially Malignant Disorders in Indian Population Tue, 11 Aug 2015 11:37:09 +0000 Objective. To assess the prevalence of oral potentially malignant disorders and to determine the potential risk factors for its development in Indian population. Materials and Methods. This cross-sectional study was carried out on 1241 individuals in Indore, Madhya Pradesh. A questionnaire was designed to record information about sociodemographic characteristics, oral hygiene practices, dietary habits, and risk factors for oral potentially malignant disorders. Oral mucosal lesions were examined by a skilled person. Results. The overall prevalence of oral potentially malignant disorders was found to be 13.7% with oral submucous fibrosis (8.06%) found to be more common and erythroplakia (0.24%) found to be least prevalent. Results of Logistic Regression analysis showed that males (OR = 2.09, value < 0.0001) who were ever consumers of tobacco (OR = 2.06, value = 0.030) and areca nut chewing (OR = 2.64, value = 0.004) were more likely to develop oral potentially malignant disorders compared to never consumers. Diabetic (OR = 2.21, value = 0.014) and underweight individuals (OR = 2.23, value = 0.007) were more likely to suffer from oral potentially malignant disorders. Conclusion. The study reinforces the association of tobacco and areca nut consumption with oral potentially malignant disorders. An association of oral potentially malignant disorders with diabetes and BMI was confirmed by this study. Sandeep Kumar, Nitai Debnath, Mohammed B. Ismail, Arunoday Kumar, Amit Kumar, Bhumika K. Badiyani, Pavan K. Dubey, and Laxmi V. Sukhtankar Copyright © 2015 Sandeep Kumar et al. All rights reserved. Breastfeeding Practices, Demographic Variables, and Their Association with Morbidities in Children Mon, 10 Aug 2015 06:43:08 +0000 Appropriate feeding practices are the key contributor to reducing morbidities and mortalities in under-five children. A cross-sectional questionnaire based survey of mothers of children aged less than 5years was conducted in 781 mothers. More than half of mothers (57.5%) started feeding within an hour of birth, 55.9% gave exclusive breastfeeding for six months, 89.1% of the mothers stopped breastfeeding before two years of age, 18.2% of the mothers bottle-fed the babies, and 15.6% had problems during breastfeeding in first 6 months. Early initiation of breastfeeding within one hour of birth promoted exclusive breastfeeding, and breastfeeding for longer duration. Exclusive breastfeeding increased frequency of feeds. Multivariable logistic regression showed that initiation of breastfeeding after an hour of birth (p = 0.035), not providing exclusive breastfeeding for 6 months (p < 0.0001), unemployed mothers (p = 0.035), having two or more kids (p = 0.001), and complementary feeds given by person other than mother (p = 0.007) increased hospitalization. Starting breastfeeding after an hour of birth (p = 0.045), severe malnutrition (p = 0.018), and breastfeeding for < two years (p = 0.026) increased rates of diarrhea. Breastfeeding practices were not optimum and interventions to improve these practices need to be strengthened. Dipen V. Patel, Satvik C. Bansal, Archana S. Nimbalkar, Ajay G. Phatak, Somashekhar M. Nimbalkar, and Rajendra G. Desai Copyright © 2015 Dipen V. Patel et al. All rights reserved. Neuropsychological Symptoms among Workers Exposed to Toluene and Xylene in Two Paint Manufacturing Factories in Eastern Thailand Tue, 28 Jul 2015 13:13:20 +0000 The study analyzed the exposure factors that may lead to neuropsychological symptoms among 92 workers who were exposed to xylene and toluene and 100 workers who were not exposed to the solvents. The airborne concentration of xylene and toluene was evaluated with personal passive badges. The levels of methyl hippuric acid and hippuric acid in urine were assessed, and interviews were performed to observe the neuropsychological symptoms that may result from exposure to the solvents. The result showed that the average concentration for the exposed group of xylene in the paint company working environment was 2.7 (SD = 2.4) ppm and the average concentration of toluene was 9.5 (SD = 10.4) ppm. The average level of methyl hippuric acid in urine was 78 (SD = 74.7) mg/g creatinine. Factors that affected the neuropsychological symptoms included the following. (1) The impact of age: the risk (adjusted odds ratio) for getting psychosomatic symptoms in persons over 40 and exposed to xylene was 9.5 and the aOR of those exposed to toluene was 8.3. (2) The impact of not providing personal protective equipment was found to be sleep disturbance; it was found that the aOR of those exposed to xylene was 3.9, and the aOR of those exposed to toluene was 4.4. In summary, periodic examination of workers by occupational physician is needed for detection of early neuropsychological effects, especially psychosomatic symptoms, and sleep disturbances. Anamai Thetkathuek, Wanlop Jaidee, Sastri Saowakhontha, and Wiwat Ekburanawat Copyright © 2015 Anamai Thetkathuek et al. All rights reserved. Effect of Simvastatin on Arterial Stiffness in Patients with Statin Myalgia Wed, 15 Jul 2015 09:23:53 +0000 Statins reduce arterial stiffness but are also associated with mild muscle complaints. It is unclear whether individuals with muscle symptoms experience the same vascular benefit or whether statins affect striated and smooth muscle cells differently. We examined the effect of simvastatin treatment on arterial stiffness in patients who did versus those who did not exhibit muscle symptoms. Patients with a history of statin-related muscle complaints () completed an 8 wk randomized, double-blind, cross-over trial of daily simvastatin 20 mg and placebo. Serum lipids and pulse wave velocity (PWV) were assessed before and after each treatment. Muscle symptoms with daily simvastatin treatment were reported by 38 patients (33%). Compared to baseline, central PWV decreased () following simvastatin treatment but not placebo (drug ∗ time interaction: ). Changes in central PWV with simvastatin treatment were not influenced by myalgia status or time on simvastatin (). Change in central PWV after simvastatin treatment was inversely correlated with age (, ), suggesting that advancing age is associated with enhanced statin-mediated arterial destiffening. In patients with a history of statin-related muscle complaints, the development of myalgia with short-term simvastatin treatment did not attenuate the improvement in arterial stiffness. Kevin D. Ballard, Lindsay Lorson, C. Michael White, Paul D. Thompson, and Beth A. Taylor Copyright © 2015 Kevin D. Ballard et al. All rights reserved. The Reduction of Distress Using Therapeutic Geothermal Water Procedures in a Randomized Controlled Clinical Trial Thu, 19 Mar 2015 09:18:01 +0000 Stress is an element of each human’s life and an indicator of its quality. Thermal mineral waters have been used empirically for the treatment of different diseases for centuries. Aim of the Study. To investigate the effects of highly mineralised geothermal water balneotherapy on distress and health risk. Methodology. A randomized controlled clinical trial was performed with 130 seafarers: 65 underwent 2 weeks of balneotherapy with 108 g/L full-mineralisation bath treatment; the others were in control group. The effect of distress was measured using the General Symptoms Distress Scale. Factorial and logistic regression analyses were used for statistical analysis. Results. A significant positive effect on distress () was established after 2 weeks of treatment: the number of stress symptoms declined by 60%, while the intensity of stress symptoms reduced by 41%, and the control improved by 32%. Health risks caused by distress were reduced, and resources increased, whereas the probability of general health risk decreased by 18% (). Conclusion. Balneotherapy with highly mineralised geothermal water reduces distress, by reducing the health risk posed by distress by 26%, increasing the health resources by 11%, and reducing probability of general health risk by 18%. Balneotherapy is an effective preventive tool and can take a significant place in integrative medicine. Lolita Rapolienė, Artūras Razbadauskas, and Antanas Jurgelėnas Copyright © 2015 Lolita Rapolienė et al. All rights reserved. Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation Wed, 21 Jan 2015 09:55:31 +0000 Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS) persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs) have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH) transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs) and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited. Olga Moshkovich, Lydie Lebrun-Harris, Laura Makaroff, Preeta Chidambaran, Michelle Chung, Alek Sripipatana, and Sue C. Lin Copyright © 2015 Olga Moshkovich et al. All rights reserved. Effects of Yoga on Utero-Fetal-Placental Circulation in High-Risk Pregnancy: A Randomized Controlled Trial Tue, 20 Jan 2015 08:11:09 +0000 Introduction. Impaired placentation and inadequate trophoblast invasion have been associated with the etiology of many pregnancy complications and have been correlated with the first trimester uterine artery resistance. Previous studies have shown the benefits of yoga in improving pregnancy outcomes and those of yogic visualization in revitalizing the human tissues. Methods. 59 high-risk pregnant women were randomized into yoga (n = 27) and control (n = 32) groups. The yoga group received standard care plus yoga sessions (1 hour/day, 3 times/week), from 12th to 28th week of gestation. The control group received standard care plus conventional antenatal exercises (walking). Measurements were assessed at 12th, 20th, and 28th weeks of gestation. Results. RM-ANOVA showed significantly higher values in the yoga group (28th week) for biparietal diameter (P = 0.001), head circumference (P = 0.002), femur length (P = 0.005), and estimated fetal weight (P = 0.019). The resistance index in the right uterine artery (P = 0.01), umbilical artery (P = 0.011), and fetal middle cerebral artery (P = 0.048) showed significantly lower impedance in the yoga group. Conclusion. The results of this first randomized study of yoga in high-risk pregnancy suggest that guided yogic practices and visualization can improve the intrauterine fetal growth and the utero-fetal-placental circulation. Abbas Rakhshani, Raghuram Nagarathna, Rita Mhaskar, Arun Mhaskar, Annamma Thomas, and Sulochana Gunasheela Copyright © 2015 Abbas Rakhshani et al. All rights reserved. Vaccines for Canine Leishmaniasis Wed, 31 Dec 2014 13:40:12 +0000 Leishmania infantum is the obligatory intracellular parasite of mammalian macrophages and causes zoonotic visceral leishmaniasis (ZVL). The presence of infected dogs as the main reservoir host of ZVL is regarded as the most important potential risk for human infection. Thus the prevention of canine visceral leishmaniasis (CVL) is essential to stop the current increase of the Mediterranean visceral leishmaniasis. Recently considerable advances in achieving protective immunization of dogs and several important attempts for achieving an effective vaccine against CVL lead to attracting the scientists trust in its important role for eradication of ZVL. This paper highlights the recent advances in vaccination against canine visceral leishmaniasis from 2007 until now. Faeze Foroughi-Parvar and Gholamreza Hatam Copyright © 2014 Faeze Foroughi-Parvar and Gholamreza Hatam. All rights reserved. Retracted: Immunization Coverage: Role of Sociodemographic Variables Mon, 29 Dec 2014 08:33:43 +0000 Advances in Preventive Medicine Copyright © 2014 Advances in Preventive Medicine. All rights reserved. Differences in the Malariometric Indices of Asymptomatic Carriers in Three Communities in Ibadan, Nigeria Tue, 23 Dec 2014 08:32:02 +0000 This study was conducted to determine the malariometric indices of children in three different settings in Ibadan, Nigeria. Children were recruited from an urban slum (Oloomi) and a periurban (Sasa) and a rural community (Igbanda) in Ibadan. Children aged between 2 and 10 years were randomly selected from primary schools in the urban and periurban areas. In the rural community, children were recruited from the centre of the village. A total of 670 (55.0%) out of 1218 children recruited were positive for malaria parasitaemia. The urban population had the highest proportion of children with malaria parasitaemia. Splenomegaly was present in 31.5%, hepatomegaly in 41.5%, hepatosplenomegaly in 27.5%, and anaemia in 25.2% of the children. The parasite density was not significantly different among children in the three communities. Children in the rural community had the highest mean PCV of 34.2% and the lowest rates of splenomegaly (6.1%), hepatomegaly (7.6%), and hepatosplenomegaly (4.6%). The spleen rates, liver rates, and presence of hepatosplenomegaly and anaemia were similar in the urban and periurban communities. The malariometric indices among the asymptomatic carriers were high, especially in the urban slum. This stresses the need for intensified efforts at controlling the disease in the study area. Olukemi K. Amodu, Adesola O. Olumide, Obioma C. Uchendu, Folakemi A. Amodu, and Olayemi O. Omotade Copyright © 2014 Olukemi K. Amodu et al. All rights reserved. The 2007 Los Angeles Mommy and Baby Study: A Multilevel, Population-Based Study of Maternal and Infant Health in Los Angeles County Thu, 11 Dec 2014 10:10:24 +0000 Objectives. In order to comprehensively examine the risks and resources associated with racial-ethnic disparities in adverse obstetric outcomes, the Los Angeles County Department of Public Health and the University of California, Los Angeles, joined efforts to design and implement the 2007 Los Angeles Mommy and Baby (LAMB) study. This paper aims to present the conceptual frameworks underlying the study’s development, highlight the successful collaboration between a research institution and local health department, describe the distinguishing characteristics of its methodology, and discuss the study’s implications for research, programs, and policies. Methods. The LAMB study utilized a multilevel, multistage cluster design with a mixed-mode methodology for data collection. Two samples were ultimately produced: the multilevel sample (n = 4,518) and the augmented final sample (n = 6,264). Results. The LAMB study allowed us to collect multilevel data on the risks and resources associated with racial-ethnic disparities in adverse obstetric outcomes. Both samples were more likely to be Hispanic, aged 20–34 years, completed at least 12 years of schooling, and spoke English. Conclusions. The LAMB study represents the successful collaboration between an academic institution and local health department and is a theoretically based research database and surveillance system that informs effective programmatic and policy interventions to improve outcomes among LAC’s varied demographic groups. Shin M. Chao, Fathima Wakeel, Dena Herman, Chandra Higgins, Lu Shi, Jessica Chow, Stacy Sun, and Michael C. Lu Copyright © 2014 Shin M. Chao et al. All rights reserved. The Preventive Effects of Diminazene Aceturate in Renal Ischemia/Reperfusion Injury in Male and Female Rats Thu, 13 Nov 2014 10:08:18 +0000 Background. Angiotensin-converting enzyme 2/angiotensin (1-7)/Mas receptor (ACE2/Ang-1-7/MasR) appears to counteract most of the deleterious actions of angiotensin-converting enzyme/angiotensin II/angiotensin II receptor 1 (ACE/Ang II/AT1R) in renal ischemia/reperfusion (I/R) injury but ACE2 activity and its levels are sexually dimorphic in the kidney. This study was designed to evaluate the effects of activation endogenous ACE2 using the diminazene aceturate (DIZE) in renal I/R injury in male and female rats. Methods. 36 Wistar rats were divided into two groups of male and female and each group distinct to three subgroups (). I/R group was subjected to 45 min of bilateral ischemia and 24 h of reperfusion, while treatment group received DIZE (15 mg/kg/day) for three days before the induction of I/R. The other group was assigned as the sham-operated group. Results. DIZE treatment in male rats caused a significant decrease in blood urea nitrogen (BUN), creatinine, liver functional indices, serum malondialdehyde (MDA), and increase kidney nitrite levels (), and in female rats a significant increase in creatinine and decrease serum nitrite levels compared to the I/R group (). Conclusions. DIZE may protect the male kidney from renal I/RI through antioxidant activity and elevation of circulating nitrite level. Maryam Malek and Mehdi Nematbakhsh Copyright © 2014 Maryam Malek and Mehdi Nematbakhsh. All rights reserved. Operational Efficiency of an Immunization Clinic Attached to Rural Health Training Centre in Delhi, India: A Time and Motion Study Thu, 06 Nov 2014 13:17:06 +0000 Background. Obtaining baseline data about current patterns of work is important for assessing the effects of interventions designed to improve care delivery. Time and motion studies allow for the most accurate measurement of structured components. Therefore, the present study was conducted to study the operational efficiency of an immunization clinic in Delhi, India. Methods. An observational cross-sectional study was conducted at the immunization clinic of Rural Health Training Centre in Delhi, India, from January 2014 to March 2014. The study composed two stage evaluations, a passive observation and a time and motion study. Systemic random sampling method was used to select 863 mothers/caregivers attending the immunization clinic. Results. At the immunization clinic, the study participants spent 64.1% of their total time in waiting. For new cases, the mean time taken for initial registration and receiving postvaccination advice was found to be significantly longer than old cases. Delivering health care services took more time during Mondays and also during the first hour of the day. Conclusion. Results of this study will guide public health decision-makers at all government levels in planning and implementation of immunization programs in developing countries. Varun Kumar, Abha Mangal, Sanjeet Panesar, Geeta Yadav, Richa Talwar, Deepak Raut, and Saudan Singh Copyright © 2014 Varun Kumar et al. All rights reserved. Multilevel and Urban Health Modeling of Risk Factors for Diabetes Mellitus: A New Insight into Public Health and Preventive Medicine Thu, 06 Nov 2014 13:16:52 +0000 This study aimed to apply multidisciplinary analysis approaches and test two hypotheses that (1) there was a significant increase in the prevalence of diabetes mellitus (DM) from 2002 to 2010 in the city of Philadelphia and that (2) there were significant variations in the prevalence of DM across neighborhoods, and these variations were significantly related to the variations in the neighborhood physical and social environment (PSE). Data from the Southeastern Pennsylvania Household Health Surveys in 2002–2004 (period 1, ) and in 2008–2010 (period 2, ) were analyzed using a cross-sectional comparison approach. An index of neighborhood PSE was constructed from 8 specific measures. The results show that age-adjusted prevalence of DM increased from period 1 (10.20%) to period 2 (11.91%) . After adjusting age, sex, and survey years, an estimate of 12.14%, 18.33%, and 11.89% of the odds ratios for DM was related to the differences in the neighborhood PSE disadvantage, the prevalence of overweight/obesity, and those with lower education attendance, respectively. In conclusion, prevalence of DM significantly increased from 2002 to 2010 in the city of Philadelphia. In addition to risk factors for DM at personal level, neighborhood PSE disadvantage may play a critical role in the risk of DM. Longjian Liu and Ana E. Núñez Copyright © 2014 Longjian Liu and Ana E. Núñez. All rights reserved. Usage of EMBRACETM in Gujarat, India: Survey of Paediatricians Thu, 30 Oct 2014 07:24:12 +0000 Aim. EMBRACETM is an innovative, low cost infant warmer for use in neonates. It contains phase change material, which stays at constant temperature for 6 hours. We surveyed paediatricians using EMBRACETM regarding benefits, risks, and setup in which it was used in Gujarat. Methods. Questionnaire was administered telephonically to 52 out of 53 paediatricians. Results. EMBRACETM was used for an average of 8.27 (range of 3–18, SD = 3.84) months by paediatricians. All used it for thermoregulation during transfers, for average (SD) duration of 42 (0.64) m per transfer, 62.7% used it at mother’s side for average (SD) 11.06 (7.89) h per day, and 3.9% prescribed it at home. It was used in low birth weight neonates only by 56.9% while 43.1% used it for all neonates. While hyperthermia was not reported, 5.9% felt that EMBRACETM did not prevent hypothermia. About 54.9% felt that they could not monitor the newborn during EMBRACETM use. Of paediatricians who practiced kangaroo mother care (KMC), 7.7% have limited/stopped/decreased the practice of KMC and substituted it with EMBRACETM. Conclusions. EMBRACETM was acceptable to most but concerns related to monitoring neonates and disinfection remained. Most paediatricians felt that it did not hamper KMC practice. Somashekhar Nimbalkar, Harshil Patel, Ashish Dongara, Dipen V. Patel, and Satvik Bansal Copyright © 2014 Somashekhar Nimbalkar et al. All rights reserved. Posttonsillectomy Bacteremia and Comparison of Tonsillar Surface and Deep Culture Wed, 22 Oct 2014 08:31:16 +0000 Objective. This study aimed to identify the microorganisms of surface and depth of tonsils and whether these microorganisms bring the menace of bacteremia during tonsillectomy in the children under surgery. Materials and Methods. The culture specimens were taken from surface and depth of tonsil from the patients suffering from chronic tonsillitis at the time of operation. Also, 10 mL venous blood samples were taken 5 minutes before and after the operation for microbiological study. Results. According to the results, 112 (76.1%) and 117 (79.6%) cultures from surface and depth of tonsils represented multiple microorganisms, respectively. Besides, staphylococci coagulase positive was the most common organism in both surface and depth of tonsils. None of the preoperation blood cultures were positive, while 3 postoperation blood cultures (2.1%) were positive. Staphylococci coagulase negative and alpha hemolytic streptococcus were detected in 2 cases (1.4%) and 1 case (0.7%), respectively. Conclusion. In the present study, the two cultured sites were almost similar regarding the types of isolated microorganisms. Our results suggested that bacteremia might occur after tonsillectomy. Therefore, to avoid the possible dramatic outcomes after tonsillectomy, pre- and postoperation attendances are essential. Mahmood Shishegar and Mohammad Javad Ashraf Copyright © 2014 Mahmood Shishegar and Mohammad Javad Ashraf. All rights reserved. Prevalence of Acute Symptoms among Workers in Printing Factories Thu, 16 Oct 2014 09:02:37 +0000 Objective. To identify socioeconomic situation factors and behavioral factors associated with the prevalence of acute symptoms among 150 printing workers in 16 printing factories in Southern Thailand. Materials and Methods. A cross-sectional study was conducted by interviewing 150 printing workers in 16 printing factories in Southern Thailand. Results. Acute symptoms comprised dizziness, drowsiness, eye irritation, light-headedness, rhinitis, shortness of breath, cough, chest tightness, nausea/vomiting, exacerbation of asthma, allergic skin reaction, and visual disorder. The prevalence of symptoms was consistently higher among workers in the printing process than among other workers. Smoking cigarettes and drinking alcohol were not associated with an increased prevalence of acute symptoms among these printing-factory workers. Conclusion. The significant associations were found between personal protective equipment and personal hygiene and prevalence of acute symptoms in printing workers. Somsiri Decharat Copyright © 2014 Somsiri Decharat. All rights reserved. Training in Dietary Practices and Physical Activity to Improve Health among South Asian Medical Students Tue, 30 Sep 2014 00:00:00 +0000 Introduction. We designed a pilot intervention to test the effect of a training program on the dietary and physical activities of medical students after weekly group discussions about healthy living, maintaining a healthy diet, and healthy lifestyle. Methods. Two groups of students from first and second years of medical school were selected with the intervention group having high BMI (overweight or obese) while control group had normal BMI. An eight-week educational intervention was completed. A closed Facebook group ensured continuous communication. Results. Out of 42 participants, 19 were controls and 21 received educational training. Male : female ratio was 1 : 1.7 in control group and 1 : 1.3 in intervention group. The mean (SD) weight gain in controls (1.16 Kg, SD = 1.51) was higher than that in intervention (0.13 Kg, ) group (). The average reduction in caloric intake was higher in control group (117.85, ) vis-a-vis the intervention group (73.22, SD = 266.84) (). Conclusion. Educational intervention in small groups for bringing about behavioral changes towards dietary, nutrition, and physical activity can lead to changes in the target population. The short duration of our study was a limitation which should be overcome in future studies. Divyanshi Shani, Archana Nimbalkar, Ajay Phatak, and Somashekhar Nimbalkar Copyright © 2014 Divyanshi Shani et al. All rights reserved. Prevalence of Risk Factors for the Metabolic Syndrome in the Middle Income Caribbean Nation of St. Lucia Mon, 22 Sep 2014 00:00:00 +0000 The objective of this research was to measure the presence of metabolic syndrome risk factors in a sample population in the middle income Caribbean nation of St. Lucia and to identify the demographic and behavioral factors of metabolic syndrome among the study participants. Interviews and anthropometric measures were conducted with 499 St. Lucians of ages 18–99. Descriptive statistics were used for the analysis. Fifty-six percent of females and 18 percent of males had a waist size equal to or above the indicator for the metabolic syndrome. Behavioral risk factors such as sedentary lifestyle, smoking, and alcohol consumption varied by gender. Thirty-six percent of women and 22% of men reported a sedentary lifestyle and 43% of women and 65% of men reported any alcohol consumption. More research should be done to determine the cultural norms and gender differences associated with modifiable risk behaviors in St. Lucia. Colleen O’Brien Cherry, Elizabeth Serieux, Martin Didier, Mary Elizabeth Nuttal, and Richard J. Schuster Copyright © 2014 Colleen O’Brien Cherry et al. All rights reserved. Iranian Patients Require More Pertinent Care to Prevent Type 2 Diabetes Complications Tue, 22 Jul 2014 11:47:04 +0000 Background. Accurate care of patients with type 2 diabetes may reduce risk of complications. This study was conducted to envisage current status of cares that are provided for a sample of Iranian patients with type 2 diabetes and highlight the domains that need to be focused on in the country’s national type 2 diabetes care program. Methods. Behavioral risk factors and diabetes related complications were investigated among 234 randomly selected type 2 diabetic patients residing in the city of Khoy, Northwest of Iran. Data were collected by a semistructured questionnaire in face to face or telephone interview. Proportions and confidence intervals of the observed difference were calculated by the Confidence Interval Analysis (CIA) software version 2.2.0. Results. Diabetes complications were evident amongst 67.2% of the patients. Inappropriate dietary pattern, insufficient physical activity, and anxiety were reported by 26.5%, 74.8%, and 69.7% of the respondents. Quality of life was reported to be affected in 94.6% of the respondents but its burden was significantly greater in females (P < 0.001, 95% CI of the difference: −0.75 to −0.53). Conclusions. The findings reflect discrepancies in providing the required care for the studied Iranian patients with type 2 diabetes to prevent their disease’s complications. Abdolreza Shaghaghi, Ali Ahmadi, and Hossein Matlabi Copyright © 2014 Abdolreza Shaghaghi et al. All rights reserved. Prevalence of Voluntary Counseling and Testing Utilization and Its Associated Factors among Bahirdar University Students Thu, 03 Jul 2014 09:16:37 +0000 Background. In Ethiopia university students are among the most sexually active and high HIV risk young population group but unfortunately VCT uptake was low (35%–38%) among this group. Examining the factors contributing to VCT uptake is vital to facilitate HIV prevention and control efforts. Objective. To assess the prevalence of voluntary counseling and testing utilization and its associated factors among Bahirdar University students in April 2012. Methods. Cross-sectional study was conducted in April 2012, among Bahirdar University students. A multistage sampling procedure was used to select 801 students. Data were collected using pretested self-administered questionnaire and analyzed by using SPSS version-16. Results. 772 students (79.7% males) participated in the study. The mean age of the respondents’ was 21.3. From all respondents 37.8% of the study participants had undergone HIV test. Different variables showed significant association with VCT uptake. Conclusion. The major factors identified for increased VCT service utilization were having a friend who got VCT, having discussion about HIV/AIDS with family, origin of residence, year of study, and having boy- or girlfriend. Therefore, actions targeting these predictors are necessary to effectively enhance the use of the VCT services utilization among students. Getachew Fikadie, Melkamu Bedimo, and Zelalem Alamrew Copyright © 2014 Getachew Fikadie et al. All rights reserved. Occupational Exposure to HIV: Perceptions and Preventive Practices of Indian Nursing Students Thu, 17 Apr 2014 08:47:33 +0000 Introduction. Nurses have a frontier caring role that brings them in close contact with patients' blood and body fluids. An understanding of their professional behavior is essential to assess and minimize the occupational exposure to HIV among them. Objectives. (1) To appraise the knowledge, attitudes, and preventive practices of nursing students pertaining to occupational exposure to HIV. (2) To quantify the risk and correlates of exposure to HIV among them. Methodology. Cross-sectional study was conducted in a nursing college of Varanasi, India. A semistructured and pretested pro forma consisting of questions pertaining to modes of HIV transmission, universal precaution practices, and various aspects of nursing HIV patients was utilized. Independent sample - and -tests were applied to judge the association of study variables with the knowledge and risk of HIV. Results. The study sample consisted of 87 female and 16 male nurses. Participants' knowledge of HIV transmission was satisfactory. More than 80% of them had an exposure to blood/body fluid in the last year. Exposure rates for blood/body fluid did not show a significant association with study variables. Conclusion. There were serious lacunae in implementation of the universal precautions despite satisfactory knowledge. Reinforcement of universal precautions is required. Siddharudha Shivalli Copyright © 2014 Siddharudha Shivalli. All rights reserved. Dental Sealants: Knowledge, Value, Opinion, and Practice among Dental Professionals of Bathinda City, India Thu, 10 Apr 2014 17:38:48 +0000 Objective. The purpose of the study was to assess the knowledge, value, opinion, and practice regarding use of dental sealants among private dental practitioners in Bathinda City, Punjab, India. Materials and Methods. A cross-sectional survey was conducted among all private dental practitioners in Bathinda City, Punjab. A self-administered structured questionnaire consisting of 28 items was used to assess their knowledge, value, opinion, and practice regarding dental sealants. One-way analysis of variance, independent sample t-test, and multivariate regression analysis were utilized for statistical analysis. Confidence level and level of significance were set at 95% and 5%, respectively. Results. The mean scores for knowledge, value, opinion, and practice were 41.8 ± 3.7, 18.7 ± 2.8, 18.1 ± 1.4, and 12.9 ± 2.3, respectively. Analysis revealed that qualification was statistically significant among all dependent variables (); work experience was significantly associated with both knowledge and opinion means scores (). Conclusion. The results suggest that dental practitioners had sufficient knowledge about dental sealants. They also acknowledge the importance of use of dental sealants. Practice of dental sealants in clinics was found adequate but they were not following the specific guidelines and standardized procedures. Kailash Asawa, Vivek V. Gupta, Mridula Tak, Ramesh Nagarajappa, Pulkit Chaturvedi, Salil Bapat, Prashant Mishra, and Santanu Sen Roy Copyright © 2014 Kailash Asawa et al. All rights reserved. Modifiable Cardiovascular Disease Risk Factors among Indigenous Populations Thu, 06 Feb 2014 14:45:16 +0000 Objective. To identify modifiable cardio-metabolic and lifestyle risk factors among indigenous populations from Australia (Aboriginal Australians/Torres Strait Islanders), New Zealand (Māori), and the United States (American Indians and Alaska Natives) that contribute to cardiovascular disease (CVD). Methods. National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized, and synthesized. Results. Compared to their non-indigenous counterparts, indigenous populations exhibit lower life expectancies and a greater prevalence of CVD. All indigenous populations have higher rates of obesity and diabetes, hypertension is greater for Māori and Aboriginal Australians, and high cholesterol is greater only among American Indians/Alaska Natives. In turn, all indigenous groups exhibit higher rates of smoking and dangerous alcohol behaviour as well as consuming less fruits and vegetables. Aboriginal Australians and American Indians/Alaska Natives also exhibit greater rates of sedentary behaviour. Conclusion. Indigenous groups from Australia, New Zealand, and the United States have a lower life expectancy then their respective non-indigenous counterparts. A higher prevalence of CVD is a major driving force behind this discrepancy. A cluster of modifiable cardio-metabolic risk factors precede CVD, which, in turn, is linked to modifiable lifestyle risk factors. Adam A. Lucero, Danielle M. Lambrick, James A. Faulkner, Simon Fryer, Michael A. Tarrant, Melanie Poudevigne, Michelle A. Williams, and Lee Stoner Copyright © 2014 Adam A. Lucero et al. All rights reserved. Alcohol and Other Drug Use during Pregnancy among Women Attending Midwife Obstetric Units in the Cape Metropole, South Africa Mon, 03 Feb 2014 06:39:43 +0000 Little is known about the nature and extent of alcohol and other drug (AOD) use among pregnant women in Cape Town, South Africa, despite the very high levels of AOD use in this part of the country. A cross-sectional survey was conducted among pregnant women attending 11 Midwife Obstetric Units (MOUs) in greater Cape Town. A two-stage cluster survey design was used. In total, 5231 pregnant women were screened to assess self-reported prevalence estimates. Of these, 684 (13.1%) were intentionally subsampled and completed an interviewer-administered questionnaire and provided a urine sample for biological screening. Urinalyses showed that 8.8% (95% CI: 6.7–10.9) of the subsample tested positive for at least one illicit drug. This is higher than the self-reported prevalence (3.6%). In addition, 19.6% (95% CI: 16.3–22.8) of the sub-sample tested positive for alcohol which is lower than the self-reported prevalence (36.9%). There are high levels of substance use among pregnant women attending public sector antenatal clinics. There is a need for routine screening for AOD use and appropriate responses depending on the women’s level of risk. Petal Petersen Williams, Esmé Jordaan, Catherine Mathews, Carl Lombard, and Charles D. H. Parry Copyright © 2014 Petal Petersen Williams et al. All rights reserved. Short-Term Effectiveness of a Lifestyle Intervention Program for Reducing Selected Chronic Disease Risk Factors in Individuals Living in Rural Appalachia: A Pilot Cohort Study Thu, 16 Jan 2014 09:25:52 +0000 Most Western chronic diseases are closely tied to lifestyle behaviors, and many are preventable. Despite the well-distributed knowledge of these detrimental behaviors, effective efforts in disease prevention have been lacking. Many of these chronic diseases are related to obesity and type 2 diabetes, which have doubled in incidence during the last 35 years. The Complete Health Improvement Program (CHIP) is a community-based, comprehensive lifestyle modification approach to health that has shown success in addressing this problem. This pilot study demonstrates the effectiveness of CHIP in an underserved, rural, and vulnerable Appalachian population. Two hundred fourteen participants in CHIP collectively demonstrated significant reductions in body mass index, systolic and diastolic blood pressure, and fasting blood levels of total cholesterol, low-density lipoprotein, and glucose. If these results can be repeated in other at-risk populations, CHIP has the potential to help reduce the burden of preventable and treatable chronic diseases efficiently and cost-effectively. David Drozek, Hans Diehl, Masato Nakazawa, Tom Kostohryz, Darren Morton, and Jay H. Shubrook Copyright © 2014 David Drozek et al. All rights reserved. Interaction of Some Commercial Teas with Some Carbohydrate Metabolizing Enzymes Linked with Type-2 Diabetes: A Dietary Intervention in the Prevention of Type-2 Diabetes Thu, 16 Jan 2014 09:04:28 +0000 This study is aimed at assessing the inhibitory effect of teas on key enzymes (-amylase and -glucosidase) linked with type-2 diabetes and their antioxidant properties. Four samples of three brands were used; infusions of green tea (GT), 2 brands of black tea (BT), and a formulated herbal preparation for diabetes (ADT) (white tea, Radix Puerariae, Radix ophiopogonis, hawthorn berry, Chinese yam, and fragrant Solomon seal rhizome) were prepared and subsequently analyzed for their total phenol, ascorbic acid contents, antioxidant properties (2,2-Azizobis (3-Ethylbenzo-Thiazoline~6-sulfonate) “ABTS” scavenging ability and ferric reducing antioxidant property), and inhibition of pancreatic--amylase and intestinal--glucosidase in vitro. The study revealed that GT had the highest total phenol content, ascorbic acid content, ABTS* scavenging ability, and ferric reducing ability. Furthermore, all the teas inhibited Fe2+ and sodium nitroprusside induced lipid peroxidation in pancreas, with GT having the highest inhibitory effect. Conversely, there was no significant difference () in the inhibitory effects of the teas on -amylase and -glucosidase. The antidiabetic property of the teas could be attributed to their inhibitory effect on carbohydrate hydrolyzing enzymes implicated in diabetes and their antioxidant activities. Ganiyu Oboh, Omodesola O. Ogunruku, Funke O. Ogidiolu, Adedayo O. Ademiluyi, Bukola C. Adedayo, and Ayokunle O. Ademosun Copyright © 2014 Ganiyu Oboh et al. All rights reserved.