ISRN Preventive Medicine The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Prevalence and Risk Factors of Hypertension among Male Occupational Bus Drivers in North Kerala, South India: A Cross-Sectional Study Wed, 23 Apr 2014 11:32:02 +0000 Background. Hypertension is a leading cause of morbidity and mortality worldwide. We aimed to evaluate the prevalence of hypertension in a population of male bus drivers in North Kerala, India. Methods. The study population included male bus drivers of Corporation Bus stand Kozhikode, Kerala. Blood pressure, height, and weight of subjects were measured, and relevance was obtained using a structured questionnaire. Results. Age varied from 21 to 60 years (mean ). Among 179 bus drivers studied, 16.8% (30/179) had normal BP, 41.9% (75/179) had prehypertension, and 41.3% (74/179) had hypertension. Isolated systolic HTN was seen in 6.70% (12/179) individuals. Out of 74 hypertensives, 9 (12.1%) were aware of their hypertension, while 3 (4.0%) were medicated and only 1 (1.3%) had BP adequately controlled. Age > 35 years (P = 0.015), BMI ≥ 23 kg/m2 (P = 0.007), supporting more than four family members (P = 0.011), and taking main meals from restaurants on most working days (P = 0.017) were independently associated with HTN in binary logistic regression. Conclusion. Prevalence of hypertension was high among bus drivers. Age > 35 years, elevated BMI, supporting a large family, and dietary habits associated with the job showed significant association with hypertension. Primary and secondary prevention strategies need to be emphasized in this occupational group. Arjun Lakshman, Neeraj Manikath, Asma Rahim, and V. P. Anilakumari Copyright © 2014 Arjun Lakshman et al. All rights reserved. Utilization of Maternal and Child Health Care Services by Primigravida Females in Urban and Rural Areas of India Wed, 26 Mar 2014 09:49:59 +0000 Maternal complications and poor perinatal outcome are highly associated with nonutilisation of antenatal and delivery care services and poor socioeconomic conditions of the patient. It is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies. Present longitudinal study was carried out to compare utilization of maternal and child health care services by urban and rural primigravida females. A total of 240 study participants were enrolled in this study. More illiteracy and less mean age at the time of marriage were observed in rural population. Poor knowledge about prelacteal feed, colostrums, tetanus injection and iron-follic acid tablet consumption was noted in both urban and rural areas. Very few study participants from both areas were counselled for HIV testing before pregnancy. More numbers of abortions (19.2%) were noted in urban study participants compared to rural area. Thus utilization of maternal and child health care (MCH) services was poor in both urban and rural areas. A sustained and focussed IEC campaign to improve the awareness amongst community on MCH will help in improving community participation. This may improve the quality, accessibility, and utilization of maternal health care services provided by the government agencies in both rural and urban areas. Hemant Mahajan and Bhuwan Sharma Copyright © 2014 Hemant Mahajan and Bhuwan Sharma. All rights reserved. Knowledge, Attitude, and Practice of Hand Hygiene among Medical and Nursing Students at a Tertiary Health Care Centre in Raichur, India Thu, 06 Feb 2014 06:33:36 +0000 Background. Hand hygiene is recognized as the leading measure to prevent cross-transmission of microorganisms. Regarding hospital acquired infections, the compliance of nurses with hand washing guidelines seems to be vital in preventing the disease transmission among patients. There is a paucity of studies exploring this subject in Asia. Especially medical and nursing student’s knowledge of standard hand hygiene precautions is rarely compared. Methods. A cross-sectional study was conducted among 98 medical and 46 nursing students in a tertiary medical college in India. Knowledge was assessed using WHO hand hygiene questionnaire. Attitude and practices were evaluated by using another self-structured questionnaire. test was used to compare the percentage of correct responses between medical and nursing students. A value less than 0.05 was considered significant. Results. Only 9% of participants (13 out of 144) had good knowledge regarding hand hygiene. Nursing students knowledge () , attitude (), and practices () were significantly better than medical students. Sreejith Sasidharan Nair, Ramesh Hanumantappa, Shashidhar Gurushantswamy Hiremath, Mohammed Asaduddin Siraj, and Pooja Raghunath Copyright © 2014 Sreejith Sasidharan Nair et al. All rights reserved. Cervical Cancer: Community Perception and Preventive Practices in an Urban Neighborhood of Lagos (Nigeria) Tue, 04 Feb 2014 12:26:07 +0000 Background. Cervical cancer prevention in developing countries is suboptimal compared with the developed world where there are fewer deaths and improved survival rates. This study describes the perception and preventive practices on cervical cancer by residents of an urban neighborhood of Lagos, Nigeria. Methods. A descriptive cross-sectional study was conducted on 317 consecutively recruited consenting participants at a medical outreach using a pretested, interviewer-administered, semistructured questionnaire. Data analysis was done using statistical package for social sciences version 19. Tests of significance were performed using 95% confidence interval with level of significance set at . Results. The majority of respondents were within 30–49 years of age (46.7%) and female (62.1%) and 70.3% had secondary level education and above. About 37.2% of respondents had heard about cervical cancer with 84.5% of the participants willing to attend a cervical cancer health education program. Among the female respondents, 4.1% had received the HPV vaccine, while 5.1% had undergone a Pap test. Awareness about cervical cancer was significantly higher with increasing age in the total population (). Conclusion. There is a need to improve awareness of at-risk groups and the menfolk about cervical cancer based on the immense benefit of male involvement in reproductive health matters. K. O. Wright, O. Aiyedehin, M. R. Akinyinka, and O. Ilozumba Copyright © 2014 K. O. Wright et al. All rights reserved. Prevalence of Cardiovascular Risk Factors among Tile and Ceramic Workers in Yazd, Iran Wed, 18 Dec 2013 16:24:50 +0000 Introduction. Cardiovascular disorders (CVDs) are among the most important diseases in the world and determination of their risk factors is essential for primary and secondary prevention. This study aimed to evaluate these risk factors in workers of tile and ceramic industry, a main industry in Yazd. Materials and Methods. In a cross-sectional study, 1075 tile and ceramic workers were selected by simple sampling method. BMI, blood pressure, FBS, and lipid profile were measured and compared to international standards. Results. 731 individuals (68%) had at least one risk factor, and 52%, 12%, 3%, and 0.7% had one, two, three, and four risk factors, respectively. The most common risk factor was abnormal BMI (49.6%); low HDL (48.4%) and high TG (14.1%) were in the second and third orders. Conclusion. This study showed a relatively high prevalence for CVD risk factors among tile and ceramic workers. Low HDL, high TG, and overweight were the most frequent risk factors in this population. Amir Houshang Mehrparvar, Seyyed Jalil Mirmohammadi, Mehrdad Mostaghaci, Maryam Bahaloo, Mohammad Heydari, Ehsan Samimi, Mahnaz Zohal, and Mohammad Hossein Davari Copyright © 2013 Amir Houshang Mehrparvar et al. All rights reserved. Allergy-Related Disorders in the Construction Industry Thu, 05 Dec 2013 15:32:03 +0000 Working conditions in the construction industry have improved in many industrialized countries, but heavy physical work with recurrent exposure to chemical agents, dust, and climatic influences still represents considerable risk for construction workers and may affect their health. The aim of this review is to analyze available data of the literature on allergy-related respiratory and skin disorders with emphasis on a preventive appraisal in order to produce statements and recommendations based on research evidence. The most common agents involved in the construction industry as a cause of occupational asthma (OA) in industrialized countries are isocyanates, wood dust, resins, glues, cobalt, and chromium. Allergic contact dermatitis (ACD) is an immunologic cell-mediated response to a sensitizing agent and the most common sensitizing agents associated with construction workers are epoxy resins, thiurams and thiazoles, and chromates. Medical surveillance must consider individual risk factors such as differences in individual susceptibility and sensitization to agents at workplace. Once work-related disorder is confirmed, adequate fitness for work should be assessed for the worker impaired by health condition. A reliable diagnosis of an index case is a sentinel event that may reveal risks for workers with similar exposure, leading to a revised risk assessment at the workplace that should reduce the risk and prevent further cases. Mauro Carino, Paolo Romita, and Caterina Foti Copyright © 2013 Mauro Carino et al. All rights reserved. Influenza Vaccination in Pregnant Women: A Systematic Review Thu, 07 Nov 2013 13:27:35 +0000 Objective. To assess the effects of the inactivated influenza virus vaccine on influenza outcomes in pregnant women and their infants. Methods. We performed a systematic review of the literature. We searched for randomized controlled trials and cohort studies in the MEDLINE, Embase, and other relevant databases (inception to September 2013). Two researchers selected studies and extracted the data independently. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the quality of the evidence. Results. We included eight studies out of 1,967 retrieved records. Influenza vaccination in pregnant women significantly reduced the incidence of influenza-like illness in mothers and their infants when compared with control groups (high-quality evidence) and reduced the incidence of laboratory-confirmed influenza in infants (moderate-quality evidence). No difference was found with regard to influenza-like illness with fever higher than 38°C (moderate-quality evidence) or upper respiratory infection (very-low-quality evidence) in mothers and infants. Conclusions. Maternal vaccination against influenza was shown to prevent influenza-like illness in women and infants; no differences were found for other outcomes. As the quality of evidence was not high overall, further research is needed to increase confidence and could possibly change these estimates. Tais F. Galvao, Marcus T. Silva, Ivan R. Zimmermann, Luiz Antonio B. Lopes, Eneida F. Bernardo, and Mauricio G. Pereira Copyright © 2013 Tais F. Galvao et al. All rights reserved. Dramatic Increases in Obesity and Overweight Prevalence among Asian Subgroups in the United States, 1992–2011 Tue, 29 Oct 2013 13:51:20 +0000 We examined trends in adult obesity and overweight prevalence among major Asian/Pacific Islander (API) subgroups and the non-Hispanic whites from 1992 to 2011. Using 1992–2011 National Health Interview Surveys, obesity, overweight, and BMI differentials were analyzed by logistic, linear, and log-linear regression. Between 1992 and 2011, obesity prevalence doubled for the Chinese, the Asian Indians, the Japanese, and the Hawaiians/Pacific Islanders; and tripled for the Filipinos. Obesity prevalence among API adults tripled from 3.7% in 1992 to 13.3% in 2010, and overweight prevalence doubled from 23.2% to 43.1%. Immigrants in each API subgroup had lower prevalence than their US-born counterparts, with immigrants’ obesity and overweight risks increasing with increasing duration of residence. During 2006–2011, obesity prevalence ranged from 3.3% for Chinese immigrants to 22.3% for the US-born Filipinos and 41.1% for the Native Hawaiians/Pacific Islanders. The Asian Indians, the Filipinos, and the Hawaiians/Pacific Islanders had, respectively, 3.1, 3.8, and 10.9 times higher odds of obesity than those of the Chinese adults. Compared with Chinese immigrants, the adjusted odds of obesity were 3.5–4.6 times higher for the US-born Chinese and the foreign-born Filipinos, 9 times higher for the US-born Filipinos and whites, 3.8–5.5 times higher for the US-born and foreign-born Asian Indians, and 21.9 times higher for the Native Hawaiians. Substantial ethnic heterogeneity and rising prevalence underscore the need for increased monitoring of obesity and obesity-related risk factors among API subgroups. Gopal K. Singh and Sue C. Lin Copyright © 2013 Gopal K. Singh and Sue C. Lin. All rights reserved. Physiological, Behavioral, and Dietary Characteristics Associated with Hypertension among Kenyan Defence Forces Tue, 28 May 2013 07:54:34 +0000 Background. Hypertensive disease is increasing in developing countries due to nutritional transition and westernization. Hypertensive disease among Kenya military may be lower because of health-focused recruitment, physical activities, routine checkups, and health awareness and management, but the disease has been increasing. Purpose. The purpose of this study was to determine physiological, behavioral, and dietary characteristics associated with hypertension among Kenyan military. Methods. A cross-sectional study involving 340 participants was conducted at Armed Forces Memorial Hospital. Participants' history, risk factors assessment, and dietary patterns were obtained by structured questionnaire, while physiological and anthropometric parameters were measured. Results. Hypertensive participants were likely to have higher age, physiological, and anthropometric measurements, and they participated in peace missions. Daily alcohol and smoking, frequent red meat, and inadequate fruits and vegetables were associated with hypertension. Conclusions. The findings mimic the main risk factors and characteristics for hypertensive disease in developed countries whose lifestyle adoption is happening fast in low and middle-income countries. Whether or not prediction rules and/or risk scores may identify at-risk individuals for preventive strategy for targeted behavioral interventions among this population require investigation. Victor Mundan, Margaret Muiva, and Samuel Kimani Copyright © 2013 Victor Mundan et al. All rights reserved. Adherence to Recommended Breast Cancer Screening in Iranian Turkmen Women: The Role of Knowledge and Beliefs Tue, 16 Apr 2013 09:40:13 +0000 The aim of the current study was to investigate breast cancer screening performance among Iranian Turkmen women along with their knowledge and beliefs. A cross-sectional study was carried out in June to December 2011. Through clustered sampling method, 1080 Iranian Turkmen women completed the questionnaire including breast cancer screening adherence, knowledge, fatalism beliefs, and perceived threat using Champions Health Belief Model Scale (CHBMS).The mean age of the participants was 43.04 (SD = 11.80) years. Compliance rate in a regular basis based on national guidelines was 13.1%, 2.5%, and 0.9% for SBE, CBE, and mammography, respectively. A mere 4% have been provided adequately with information about breast cancer. Having knowledge was the best predictor of breast cancer screening adherence along with high educated husbands for SBE performing. Susceptibility and fatalism were low and were influenced by participants’ educational level and age. In conclusion, Iranian Turkmen women had insufficient knowledge, low perceived susceptibility, high fatalistic belief, and very poor adherence to breast cancer screening. There is a need for providing breast cancer education programs among the Iranian Turkmen women to increase their adherence rate. Abdurrahman Charkazi, Afieh Samimi, Khadijeh Razzaghi, Ghorban Mohammad Kouchaki, Mitra Moodi, Kamal Meirkarimi, Ashoor Mohammad Kouchaki, and Hossein Shahnazi Copyright © 2013 Abdurrahman Charkazi et al. All rights reserved. The Association between Obesity and Cancer Risk: A Meta-Analysis of Observational Studies from 1985 to 2011 Thu, 04 Apr 2013 08:10:02 +0000 Background. Cancer and cardiovascular diseases are the leading causes of mortality and morbidity worldwide. The purpose of this meta-analysis is to synthesize the evidence evaluating the association between obesity and 13 cancers shown previously to be significantly associated with obesity. Methods. Relevant papers from a previously conducted review were included in this paper. In addition, database searches of Medline and Embase identified studies published from the date of the search conducted for the previous review (January, 2007) until May, 2011. The reference lists of relevant studies and systematic reviews were screened to identify additional studies. Relevance assessment, quality assessment, and data extraction for each study were conducted by two reviewers independently. Meta-analysis was performed for men and women separately using DerSimonian and Laird’s random effects model. Results. A total of 98 studies conducted in 18 countries from 1985 to 2011 were included. Data extraction was completed on the 57 studies judged to be of strong and moderate methodological quality. Results illustrated that obese men were at higher risk for developing colon (Risk Ratio (RR), 1.57), renal (1.57), gallbladder (1.47), pancreatic (1.36), and malignant melanoma cancers (1.26). Obese women were at higher risk for esophageal adenocarcinoma (2.04), endometrial (1.85), gallbladder (1.82), renal (1.72), pancreatic (1.34), leukemia (1.32), postmenopausal breast (1.25), and colon cancers (1.19). Conclusions. The results of this meta-analysis illustrate a significant, positive, and, for some cancers, strong association between obesity and cancer incidence. Given that approximately 23% of Canadians are obese, a significant proportion of cancer in Canada could be avoided if obesity was eliminated or significantly reduced. M. Dobbins, K. Decorby, and B. C. K. Choi Copyright © 2013 M. Dobbins et al. All rights reserved. Perceptions of Preventive Health Care and Healthy Lifestyle Choices for Low Income Families: A Qualitative Study Wed, 03 Apr 2013 15:29:51 +0000 This paper examines Head Start parents’ perceptions of preventive health and healthy lifestyle choices and Head Start administrators’ perceptions of the needs of parents they serve. To address the preventive health of the population, it is necessary that we explore perceptions, risks, and protective factors of preventive health. Focus groups were conducted with parents and administrators to elicit this information and to obtain suggestions for improving preventive health and healthy lifestyle choices among this group. Overall, nutrition and physical activity emerged as themes in parents’ definition of preventive health and healthy lifestyle choices. They further identified social support and education as major protective factors for engaging in preventive health and healthy lifestyle choices. Results of this study can be used to inform research and practice to develop interventions to increase preventive health and healthy lifestyle choices among low income families. Sasha A. Fleary, Reynolette Ettienne-Gittens, and Robert W. Heffer Copyright © 2013 Sasha A. Fleary et al. All rights reserved. Infectious Diseases and Vaccination Strategies: How to Protect the “Unprotectable”? Wed, 03 Apr 2013 15:13:21 +0000 Introduction. The circulation of infectious diseases puts small infants too young to be vaccinated at risk of morbidity and mortality, often requiring prolonged hospitalization. Material and Methods. We have reviewed the medical records of children not eligible for vaccination because of age, admitted to hospital for pertussis, measles, or varicella from February 1, 2010, till February 1, 2012. Results. Of the case records scrutinized, 21 were hospitalized for pertussis, 18 for measles, and 32 for varicella. Out of them, 42%, 66%, and 78% diagnosed with, respectively, pertussis, measles, and varicella had a complicated course of the disease. Discussion. To avoid infectious disease circulation, childhood immunization strategies should be adopted, such as vaccination of healthcare givers, adult household contacts, and parents planning to have, or who have had, a newborn baby. Elena Bozzola, Mauro Bozzola, Valeria Calcaterra, Salvatore Barberi, and Alberto Villani Copyright © 2013 Elena Bozzola et al. All rights reserved. A Six-Month Study of Pulmonary Cancer in Albanian Women Mon, 04 Mar 2013 13:36:49 +0000 Lung cancer is a potentially lethal disease, whose prevalence in Albania is constantly increasing, especially in women. Early diagnosis is extremely important with regard to life expectancy and quality. The authors conducted a survey on the behaviour in a sample group of Albanian women diagnosed with primary and secondary lung cancers. A discussion upon diagnostic methods, smoking habits, histological type, Karnofsky performance status (KPS), and treatment modalities is made. The data collected by the authors suggest that nonsmokers formed the main group of lung cancer female patients. The most frequent histological type was adenocarcinoma. Mesothelioma was the most frequent of the secondary pulmonary lung cancers, followed from metastasizing breast cancer. Despite a generally good performance of the cases, the diagnosis of pulmonary cancer is delayed. The data collected could not find a convincing etiological role of tobacco smoking, but caution is needed, regarding the short time length of the study and the sustained number of participants. Jolanda Nikolla, Milda Nanushi, Gentian Vyshka, and Hasan Hafizi Copyright © 2013 Jolanda Nikolla et al. All rights reserved. Media and Cultural Influences in African-American Girls’ Eating Disorder Risk Sun, 03 Feb 2013 17:13:08 +0000 Objective. To investigate media and cultural influences in eating disorder development in African-American adolescent females. Method. Fifty-seven participants were recruited through churches and community organizations to complete a questionnaire. Results. Mainstream sociocultural identification was associated with more eating disorder behavior in African-American females; cultural ethnic identification was not significantly associated with eating disorder behavior in African-American females, mainstream sociocultural identification, cultural ethnic identification, and body dissatisfaction significantly predicted eating disorder behavior; and cultural ethnic identification was positively correlated with mainstream sociocultural identification. This study provides support for the importance of eating disorder prevention interventions that focus specifically on African-American girls. Lakaii A. Jones and Catherine Cook-Cottone Copyright © 2013 Lakaii A. Jones and Catherine Cook-Cottone. All rights reserved. Surgical Site Infection Complicating Breast Cancer Surgery in Kuwait Thu, 27 Dec 2012 10:15:19 +0000 Background and Objectives. Surgical site infection (SSI) is the most common postoperative complication associated with breast cancer surgery. The present investigation aimed to determine the SSI rate after breast cancer surgeries and the causative microorganisms. Patients and Methods. All patients who underwent breast surgery in Kuwait Cancer Control Center as a treatment for breast cancer from January 2009–December 2010 were prospectively followed for the development of SSI. Indirect detection was used to identify SSIs through medical record to review and discussion with the treating surgeons. Results. The number of operations was 438. Females represented 434 (99.1%) cases while males constituted only 4 (0.9%) cases. SSIs were diagnosed after 10 operations, all for female cases. Most of the SSIs (8 cases; 80%) were detected after patients were discharged, during outpatient followup. Out of those 5/8; (62.5%) were readmitted for management of SSI. Nine patients (90%) received systemic antibiotic therapy for management of their wound infection. The SSI rate was 2.3%. The main causative organism was Staphylococcus aureus (S. aureus) which was responsible for 40% of infections. Gram negative bacteria were isolated from 40% of the cases. Conclusion. SSI is an important complication following breast cancer surgery. Microbiological diagnosis is an essential tool for proper management of such patients. Abeer A. Omar and Haifaa H. Al-Mousa Copyright © 2013 Abeer A. Omar and Haifaa H. Al-Mousa. All rights reserved. An Overview of the Malaria Control Programme in Zambia Sun, 09 Dec 2012 09:05:42 +0000 The Zambian national malaria control programme has made great progress in the fight against Malaria. The country has solid, consistent, and coordinated policies, strategies, and guidelines for malaria control, with government prioritizing malaria in both the National Health Strategic Plan and the National Development Plan. This has translated into high coverage of proven and effective key preventive, curative, and supportive interventions with concomitant marked reduction in both malaria cases and deaths. The achievements attained can be attributed to increased advocacy, communication and behaviour changes, efficient partnership coordination including strong community engagement, increased financial resources, and evidence-based deployment of key technical interventions in accordance with the national malaria control programme policy and strategic direction. The three-ones strategy has been key for increased and successful public-private sector partner coordination, strengthening, and mobilization. However, maintaining the momentum and the gains is critical as the programme strives to achieve universal coverage of evidence-based and proven interventions. The malaria control programme’s focus is to maintain the accomplishments, by mobilizing more resources and partners, increasing the government funding towards malaria control, scaling up and directing interventions based on epidemiological evidence, and strengthen active malaria surveillance and response to reduce transmission and to begin considering elimination. Emmanuel Chanda, Mulakwa Kamuliwo, Richard W. Steketee, Michael B. Macdonald, Olusegun Babaniyi, and Victor M. Mukonka Copyright © 2013 Emmanuel Chanda et al. All rights reserved. PreView: Development and Pilot Testing of an Interactive Video Doctor Plus Provider Alert to Increase Cancer Screening Thu, 06 Dec 2012 15:11:52 +0000 Background. Interventions to increase recommended cancer screening tests and discussions are needed. Methods. We developed the PREventive VIdeo Education in Waiting Rooms Program (PreView), a multimedia cancer prevention intervention for primary care clinics based on the Transtheoretical Model of Behavior Change. We pilot tested PreView, an interactive Video Doctor plus Provider Alert for feasibility and acceptability in primary care clinic settings in the San Francisco Bay Area , CA in 2009-2010. Results. Eighty participants (33 men and 47 women; more than half non-White) at 5 primary care clinics were included. After PreView, 87% of women were definitely interested in mammography when due, and 77% were definitely interested in a Pap test. 73% of participants were definitely interested in colorectal cancer screening when due, and 79% of men were definitely interested in a discussion about the PSA test. The majority indicated that they received an appropriate amount of information from PreView and that the information presented helped them decide whether or not to be screened. Conclusions. PreView was well received and accepted and potentially provides an innovative and practical way to support physicians' efforts to increase cancer screening. Millie Arora, Barbara Gerbert, Michael B. Potter, Ginny Gildengorin, and Judith M. E. Walsh Copyright © 2013 Millie Arora et al. All rights reserved. Parental Perceptions of Giardiasis: A Study in an Outpatient Paediatric Hospital Setting in Havana, Cuba Mon, 03 Dec 2012 10:33:32 +0000 Background. Giardia lamblia is an important cause of diarrhoeal disease throughout the world. Giardiasis— a mild and self-limiting disease that this protozoan causes— is perceived as a harmful disease. Aim. To explore the general level of awareness about giardiasis, clinical features, mode of transmission, prevention, and consequences and describe the sources and channels of information caregivers would prefer using to be informed about this disease. Methods. A cross-sectional survey was conducted among caregivers attending to the outpatient paediatric hospital setting in Havana. Results. A total of 202 caregivers were interviewed. Nearly 73% considered giardiasis as a modern problem, and 39% considered that it could be a fatal disease. Although 76.7% were aware that small intestine is the organ affected, other localizations were cited. Abdominal pain and diarrhoea were recognized as the commonest symptoms. Around one-third could identify that giardiasis may spread through drinking unboiled water and unwashed vegetables other incorrect ways were mentioned; respondents with more than 12 years of formal education were more likely to have better knowledge. Discussion. Strategies to control giardiasis need to be through an integrated approach aiming at boosting caregivers’ knowledge and encouraging healthcare workers to act as a readily available source for health information. Pedro Almirall, Angel A. Escobedo, Yohana Salazar, Maydel Alfonso, Ivonne Ávila, Sergio Cimerman, and Isabel V. Dawkins Copyright © 2013 Pedro Almirall et al. All rights reserved. High Blood Pressure Prevalence and Significant Correlates: A Quantitative Analysis from Coastal Karnataka, India Mon, 03 Dec 2012 10:16:30 +0000 Hypertension is a premier risk factor for cardiovascular disease which can be recognized if sought and treated effectively. Effective management of high blood pressure is possible when the magnitude of the problem is identified. So, a cross-sectional community based survey among 1,239 respondents aged ≥30 years was designed to estimate the prevalence and the sociodemographic correlates of hypertension among adults aged ≥30 years. Data was collected by personal interviews, followed by anthropometric and blood pressure measurements. Analysis was done using Statistical Package for the Social Sciences (SPSS) version 11.5. The prevalence of hypertension was 43.3%, with the prevalence being more among males (51.6%) as compared to females (38.9%). Of the total prevalence 23.1% (287) were known cases, and 20.2% (250) were newly detected cases. Based on the seventh report of the Joint National Committee (JNC VII) on high blood pressure, prehypertension was noted among 38.7%. Advancing age, male gender, current diabetic status, central obesity, overweight and obesity as defined by body mass index, and family history of hypertension were identified as significant correlates for hypertension by multivariate logistic regression. Chythra R. Rao, Veena G. Kamath, Avinash Shetty, and Asha Kamath Copyright © 2013 Chythra R. Rao et al. All rights reserved. Effect of Green Tea Mouthwash on Oral Malodor Sun, 02 Dec 2012 16:30:22 +0000 This study aimed to determine the effect of green tea mouthwash on oral malodor, plaque, and gingival inflammation. Gingivitis subjects who had over 80 parts per billion of volatile sulfur compounds (VSC) in the morning breath were randomly assigned into green tea or placebo mouthwash group. At baseline, VSC, Plaque Index (PI) and Papillary Bleeding Index (PBI) were recorded. Participants were rinsed with the assigned mouthwash, and VSC level was remeasured at 30 minutes and 3 hours postrinsing. For the following 4 weeks, participants were asked to rinse with the assigned mouthwash twice daily. VSC, PI and PBI were remeasured at day 28. It was found that, at 30 minutes and 3 hours postrinsing, VSC was reduced by 36.76% and 33.18% in the green tea group and 19.83% and 9.17% in the placebo group, respectively. At day 28, VSC was reduced by 38.61% in the green tea group and 10.86% in the placebo group. VSC level in the green tea group was significantly different when compared to the placebo. PI and PBI were significantly reduced in both groups. However, no significant difference was found between groups. In conclusion, green tea mouthwash could significantly reduce VSC level in gingivitis subjects after rinsing for 4 weeks. Supanee Rassameemasmaung, Pakkarada Phusudsawang, and Vanida Sangalungkarn Copyright © 2013 Supanee Rassameemasmaung et al. All rights reserved. Development of a Composite Lifestyle Index and Its Relationship to Quality of Life Improvement: The CLI Pilot Study Sun, 04 Nov 2012 16:00:44 +0000 An important component to optimal health is quality of life (QOL). Several healthy lifestyle behaviors have independently shown to improve QOL. The simultaneous implementation of multiple lifestyle behaviors is thought to be difficult, and the current literature lacks the assessment of multiple lifestyle behaviors simultaneously with respect to the effect on QOL. This current pilot study sought to develop a method to quantify multiple lifestyle behaviors into a single index value. This value was then measured with QOL for a possible correlation. The results showed that it is possible to convert multiple raw healthy lifestyle data points into a composite value and that an improvement in this value correlates to an improved QOL. After 12 months of participation in a cardiovascular risk reduction program, study participants () demonstrated a 37.4% () improvement in the composite lifestyle index (CLI). The improved CLI demonstrated a correlation with a statistically significant improvement in how participants rated their overall health in 12 months (, ) as well as the number of self-reported unhealthy days per month in 12 months (, ). Thomas L. Lenz, Nicole D. Gillespie, Jessica J. Skradski, Laura K. Viereck, Kathleen A. Packard, and Michael S. Monaghan Copyright © 2013 Thomas L. Lenz et al. All rights reserved. Candida Infections and Their Prevention Sun, 04 Nov 2012 08:56:28 +0000 Infections caused by Candida species have been increased dramatically worldwide due to the increase in immunocompromised patients. For the prevention and cure of candidiasis, several strategies have been adopted at clinical level. Candida infected patients are commonly treated with a variety of antifungal drugs such as fluconazole, amphotericin B, nystatin, and flucytosine. Moreover, early detection and speciation of the fungal agents will play a crucial role for administering appropriate drugs for antifungal therapy. Many modern technologies like MALDI-TOF-MS, real-time PCR, and DNA microarray are being applied for accurate and fast detection of the strains. However, during prolonged use of these drugs, many fungal pathogens become resistant and antifungal therapy suffers. In this regard, combination of two or more antifungal drugs is thought to be an alternative to counter the rising drug resistance. Also, many inhibitors of efflux pumps have been designed and tested in different models to effectively treat candidiasis. However, most of the synthetic drugs have side effects and biomedicines like antibodies and polysaccharide-peptide conjugates could be better alternatives and safe options to prevent and cure the diseases. Furthermore, availability of genome sequences of Candida  albicans and other non-albicans strains has made it feasible to analyze the genes for their roles in adherence, penetration, and establishment of diseases. Understanding the biology of Candida species by applying different modern and advanced technology will definitely help us in preventing and curing the diseases caused by fungal pathogens. M. Anaul Kabir and Zulfiqar Ahmad Copyright © 2013 M. Anaul Kabir and Zulfiqar Ahmad. All rights reserved. Indoor Tanning within UK Young Adults: An Extended Theory of Planned Behaviour Approach Mon, 17 Sep 2012 11:54:31 +0000 The indoor tanning industry poses a long-term public health risk. Despite the adverse health effects, indoor tanning seems to be gaining considerable popularity. The study examined indoor tanning intentions and behaviour within UK young adults using an extended theory of planned behaviour model, which included variables on “appearance reasons to tan,” “perceived susceptibility to damaging appearance,” “perceived susceptibility to health consequences,” and “tanning knowledge.” The model was successful in predicting indoor tanning intentions and behaviour (explained 17% and 71%, resp.). An interesting outcome was the magnitude of the variable “appearance reasons to tan.” A current tanned appearance therefore seemed to outweigh any adverse future appearance or health consequences caused by indoor tanning. Appearance-focused interventions to reduce such behaviour may now prove to be efficacious within a UK sample. Lorna J. Dodd, Mark J. Forshaw, and Stella Williams Copyright © 2013 Lorna J. Dodd et al. All rights reserved. The Efficacy of Vectron 20 WP, Etofenprox, for Indoor Residual Spraying in Areas of High Vector Resistance to Pyrethroids and Organochlorines in Zambia Wed, 05 Sep 2012 08:45:12 +0000 The selection of insecticide resistance in malaria vectors has the potential to compromise any insecticide-based vector control programme. To ensure that the insecticides used for indoor residual spraying and insecticide-treated nets in Zambia remain effective and their choice is evidence based, insecticide resistance surveillance and monitoring are essential. This study assessed and compared the residual efficacy of etofenprox (Vectron 20 WP), an ether pyrethroid, at 0.1 g/m2 with pyrethroids: bifenthrin (Bistar 10 WP) and lambda-cyhalothrin (Icon 10 CS) at 25 mg/m2 for indoor residual spraying. We also assessed the resistance status of etofenprox to local malaria vectors, An. funestus s.s and An. gambiae s.s, using World Health Organization standard protocols. The residual efficacy of Vectron 20 WP on cement, rendered walls of houses lasted for four months with 100% mortality. By the eighth month, the killing effect had reduced to 73.8% compared to 63.3% for bifenthrin and 77.0% for lambda-cyhalothrin. Susceptibility tests using standard World Health Organization assays on An. gambiae s.s showed susceptibility to etofenprox (0.1%) but some resistance was detected to Anopheles funestus s.s. The product is recommended as an ideal insecticide for indoor residual spraying for malaria control in Zambia as part of a resistance management programme in selected areas of the country. Emmanuel Chanda, Alister Kandyata, Javan Chanda, Faustina N. Phiri, Lucy Muzia, and Mulakwa Kamuliwo Copyright © 2013 Emmanuel Chanda et al. All rights reserved. Incomplete Early Childhood Immunization Series and Missing Fourth DTaP Immunizations; Missed Opportunities or Missed Visits? Tue, 14 Aug 2012 16:29:21 +0000 The successful completion of early childhood immunizations is a proxy for overall quality of early care. Immunization statuses are usually assessed by up-to-date (UTD) rates covering combined series of different immunizations. However, series UTD rates often only bear on which single immunization is missing, rather than the success of all immunizations. In the US, most series UTD rates are limited by missing fourth DTaP-containing immunizations (diphtheria/tetanus/pertussis) due at 15 to 18 months of age. Missing 4th DTaP immunizations are associated either with a lack of visits at 15 to 18 months of age, or to visits without immunizations. Typical immunization data however cannot distinguish between these two reasons. This study compared immunization records from the Oregon ALERT IIS with medical encounter records for two-year olds in the Oregon Health Plan. Among those with 3 valid DTaPs by 9 months of age, 31.6% failed to receive a timely 4th DTaP; of those without a 4th DTaP, 42.1% did not have any provider visits from 15 through 18 months of age, while 57.9% had at least one provider visit. Those with a 4th DTaP averaged 2.45 encounters, while those with encounters but without 4th DTaPs averaged 2.23 encounters. Steve G. Robison Copyright © 2013 Steve G. Robison. All rights reserved.