ISRN Public Health http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Binge Drinking among 12-to-14-Year-Old Canadians: Findings from a Population-Based Study Wed, 07 May 2014 07:07:02 +0000 http://www.hindawi.com/journals/isrn.public.health/2014/646250/ Purpose. This study’s objective is to document which factors are associated with binge drinking behaviour in a population-based sample of Canadian youth aged 12 to 14. Middle school is a key period in which binge drinking behaviour is initiated. Binge drinking is an important risk factor for alcohol-related injuries, accidental death, unsafe sexual behaviour, and substance abuse problems. Understanding the drinking patterns of this population can serve to better inform prevention programs and interventions targeted to middle school youth. Methods. This study was based on a secondary analysis of a regionally representative community-based sample drawn from the 2005 Canadian Community Health Survey (CCHS) cycle 3.1. Crude and adjusted logistic regression analyses of binge drinking were conducted using the 6,172 respondents aged 12 to 14 in the sample. Results. Approximately one in every twenty-five 12-to-14-year-olds had binged in the past year. The odds of binge drinking were higher among Whites, poorer adolescents, those with several chronic health conditions, and those with mood disorders. Neither sex, immigrant status, nor self-rated health was significantly associated with binge drinking in either the adjusted or the unadjusted analyses. Conclusions. These findings underline the importance of binge drinking as a public health issue for middle school adolescents. Esme Fuller-Thomson, Tamara Grundland, Matthew P. Sheridan, and Cathy Sorichetti Copyright © 2014 Esme Fuller-Thomson et al. All rights reserved. Medical and Nursing Students Perceived Knowledge, Attitudes, and Practices concerning Human Immunodeficiency Virus Mon, 31 Mar 2014 12:28:12 +0000 http://www.hindawi.com/journals/isrn.public.health/2014/975875/ Objective. To assess medical and nursing students’ knowledge, attitudes, and practices (KAP) regarding human immunodeficiency virus (HIV) in Fiji. Methods. A cross-sectional study of 275 medical and 252 nursing students that participated in a questionnaire survey on HIV KAP. Data was analysed according to their gender, program of study, and academic year. Results. The mean HIV knowledge (HK) and attitude scores were 16.0 and 41.3, respectively. Mean HK score was significantly higher in males compared to females. Significant positive correlations were found between HK and academic year for medical () and nursing () students and between HK and attitude scores (). The majority of students indicated fear in contracting HIV through clinical practice and felt that health care workers have the right to know a patients HIV status for their own safety. The majority would wear gloves to touch a patient if suspected of HIV. Conclusions. The study found a high level of HIV knowledge and positive attitude towards HIV patients. However, respondents also displayed negative attitudes and unacceptable practices probably due to fear. Training institutions need to ensure that students gain accurate knowledge on HIV especially on transmission routes to allay the fear of caring for HIV-infected patients. Paraniala S. C. Lui, Jeganathan Sarangapany, Kim Begley, Katherine Coote, and Kamal Kishore Copyright © 2014 Paraniala S. C. Lui et al. All rights reserved. Culture, Caregiving, and Health: Exploring the Influence of Culture on Family Caregiver Experiences Wed, 26 Mar 2014 00:00:00 +0000 http://www.hindawi.com/journals/isrn.public.health/2014/689826/ Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this study. We found commonalities among all of the cultural/ethnic groups in their experiences of the difficulties of caregiving. However, there were some significant differences in the cultural values and norms that shaped the caregiving experience. We categorized these differences as: (a) cultural embeddedness of caregiving, (b) cultural determinants of caregiving responsibilities or taxonomy of caregiving, and (c) cultural values and norms underlying the decision to provide care. The significance of this study is that it highlights the culturally perceived mandate to provide care in the African, Asian, and Hispanic American cultures. Jennifer R. Pharr, Carolee Dodge Francis, Christine Terry, and Michele C. Clark Copyright © 2014 Jennifer R. Pharr et al. All rights reserved. Nsambya Community Home-Based Care Complements National HIV and TB Management Efforts and Contributes to Health Systems Strengthening in Uganda: An Observational Study Thu, 06 Mar 2014 14:32:08 +0000 http://www.hindawi.com/journals/isrn.public.health/2014/623690/ Community Home-Based Care (CHBC) has evolved in resource-limited settings to fill the unmet needs of people living with HIV/AIDS (PLHA). We compare HIV and tuberculosis (TB) outcomes from the Nsambya CHBC with national averages in Kampala, Uganda. This retrospective observational study compared HIV and TB outcomes from adults and children in the Nsambya CHBC to national averages from 2007 to 2011. Outcomes included numbers of HIV and TB patients enrolled into care, retention, loss to follow-up (LTFU), and mortality among patients on antiretroviral therapy (ART) at 12 months from initiation; new smear-positive TB cure and defaulter rates; and proportion of TB patients tested for HIV. Chi-square test and trends analyses were used to compare outcomes from Nsambya CHBC with national averages. By 2011, approximately 14,000 PLHA had been enrolled in the Nsambya CHBC, and about 4,000 new cases of TB were detected and managed over the study period. Overall, retention and LTFU of ART patients 12 months after initiation, proportion of TB patients tested for HIV, and cure rates for new smear-positive TB scored higher in the Nsambya CHBC compared to national averages. The findings show that Nsambya CHBC complements national HIV and TB management and results in more positive outcomes. William Massavon, Levi Mugenyi, Martin Nsubuga, Rebecca Lundin, Martina Penazzato, Maria Nannyonga, Charles Namisi, Resty Ingabire, Daniel Kalibbala, Susan Kironde, Paola Costenaro, Davide Bilardi, Antonio Mazza, Bart Criel, James K. Tumwine, Janet Seeley, and Carlo Giaquinto Copyright © 2014 William Massavon et al. All rights reserved. Effectiveness of the Premarital Education Programme in Iran Thu, 06 Mar 2014 08:40:33 +0000 http://www.hindawi.com/journals/isrn.public.health/2014/964087/ Introduction. Iran is confronted with increasing trend of divorce in recent decades. Considering the probable role of sexual dissatisfaction in the breakdown of marriages, the Ministry of Health recently decided to enrich the educational content of the premarital education programmes. The aim of this study was to compare the effectiveness of the new program with the classic one. Methods. Three hundred fifty-one women were divided into two premarital education groups: classic education and new education . The mental health, quality of life, marital satisfaction, and sexual satisfaction of women were evaluated one year after marriage. Results. At one-year followup, both groups showed improvement in mental health ; however physical health-related quality of life decreased in both groups. The two groups showed no significant difference in terms of sexual satisfaction and marital satisfaction. Marital satisfaction showed significant correlation with sexual satisfaction . Conclusion. The new program of premarital education showed no superiority over the classic method. Considering the increasing rate of divorce in Iran, the premarital education programmes may not be successful in achieving their goals. Revision of the premarital education programme is warranted. Mahdieh Yazdanpanah, Mohammad Eslami, and Nouzar Nakhaee Copyright © 2014 Mahdieh Yazdanpanah et al. All rights reserved. Prevalence and Antimicrobial Susceptibility Pattern of Bacteria Isolated from Mobile Phones of Health Care Professionals Working in Gondar Town Health Centers Tue, 04 Mar 2014 09:08:44 +0000 http://www.hindawi.com/journals/isrn.public.health/2014/205074/ Background. Mobile phones of health professionals can harbor various potential pathogens and become exogenous sources of infection for the patients, self, and family members. This study assessed the frequency and antimicrobial susceptibility pattern of bacteria from mobile phones of health care workers. Methods. In this crosssectional study a total of 58 health care professionals mobile phones were swabbed before and after decontamination with 70% alcohol and assessed for contamination with bacteria. Bacterial isolation, identification, and antimicrobial susceptibility test was done as per the standard procedures. Results. About 98% of the mobile phones assessed in this study were contaminated with bacteria. Coagulase negative Staphylococci, S. aureus, and E. coli were the most frequently isolated bacteria. Decontamination with 70% alcohol significantly decreased the rate of contamination from 98.3% to 55.2% . About 17% of the isolates were resistant to two drugs. Conclusion. Appropriate infection prevention measures should be taken to minimize the risk that could be associated with mobile phones since the rate of contamination was high. Decontamination with 70% alcohol was effective in minimizing bacterial contamination of mobile phones so it should be used as a decontaminant agent for these apparatuses. Muktar Gashaw, Daniel Abtew, and Zelalem Addis Copyright © 2014 Muktar Gashaw et al. All rights reserved. Reproductive Intentions of HIV-Positive Women on ARV Treatment in Abia State, Southeast Nigeria Thu, 20 Feb 2014 07:18:38 +0000 http://www.hindawi.com/journals/isrn.public.health/2014/593067/ Introduction. In the African culture, the primary reason for marriage is procreation. Every female strives to perform this role irrespective of her health status so as to fulfill part of the conditions for maintaining the marriage. The question is, to what extent are HIV-positive women aware of the risks of fulfilling this role? The study aimed to determine the reproductive intentions of HIV-positive women in Abia State. Materials and Methods. This was a longitudinal cross-sectional descriptive study conducted among married HIV-positive women attending the Heart to Heart treatment centre in Abia State University Teaching Hospital from February to October 2013. Systematic sampling was used to select 250 married women between the ages of 15–49 years who are on antiretroviral therapy. Interviewer administered questionnaire and focus group discussion were used to obtain relevant information from the participants. Data were analysed qualitatively and quantitatively. SPSS version 17 software was also used in the analyses. Results. The mean number of living children of the respondents was 2.3 ± 4.7. A good proportion of the respondents, 158 (63.7%) the desired to have more children. The younger the age group of the respondents (OR = 7.33), the lower their parity (OR = 3.69) and more regular they attended ARV clinic (OR = 47.76) the more they desired to have more children. The main reason for desiring more children was the quest to have male children. In the words of one respondent, “without a male child, the marriage is not secure. The woman can be chased out at any time.” Conclusion. The fact that a large proportion of HIV-positive women, irrespective of the mean number of living children and their gender, still desired to have more children shows poor knowledge of the risk they are exposed to by having large number of children. Family counseling/education on the benefits of using family planning devices especially condom is necessary for HIV-positive women and their male partners. Ijeoma Nduka, Ezinna Ezinne Enwereji, Enyinnaya C. Nduka, and Reginald Ahuizi Eke Copyright © 2014 Ijeoma Nduka et al. All rights reserved. Prevalence, Purposes, and Perceived Effectiveness of Complementary and Alternative Medicine Use in a Hypertension Population: A Questionnaire Survey Wed, 25 Dec 2013 13:56:12 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/137472/ Complementary and alternative medicine (CAM) is widely used among patients with hypertension. This study aimed to determine the use of CAM in community-dwelling individuals with hypertension. A cross-sectional questionnaire survey was administered to 318 hypertension patients to examine prevalence and patterns of CAM use; the use of CAM, specifically for treatment of hypertension or other conditions, and perceived effectiveness of CAM were examined. CAM use in the last 12 months was reported by 236 (74.2%) participants. Only 13.1% of these CAM users reported using CAM to treat hypertension. CAM users did not differ statistically from non-CAM users by age, marital status, health status, duration of hypertension, income, or education. Females showed a significantly higher prevalence of CAM use than that of males (OR 1.82, 95% CI 1.09, 3.11). Family/relatives, doctors, and patients themselves were the three main sources of information about CAM. More than 70% of responses were able to perceive the effectiveness of alternative medical systems, mind-body medicine, and manipulative/body-based therapies. There was a high prevalence of CAM use among hypertension patients, although the majority of CAM use was not specifically for hypertension. Further research is needed to assess the safety and efficacy of diverse CAM. Huanhuan Hu, Gang Li, Jiali Duan, and Takashi Arao Copyright © 2013 Huanhuan Hu et al. All rights reserved. Children’s Quality of Life in Europe: National Wealth and Familial Socioeconomic Position Explain Variations in Mental Health and Wellbeing—A Multilevel Analysis in 27 EU Countries Sun, 15 Dec 2013 10:20:45 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/419530/ Sizeable variations in quality of life (QoL) and wellbeing according to socioeconomic status and national wealth have been observed. The assessment of children’s wellbeing may vary, depending on whether a parental or a child perspective is taken. Still, both perspectives provide important and valid information on children’s wellbeing. The Flash Eurobarometer no. 246 which was conducted for the European Commission assesses parents’ reports on their children’s health and wellbeing in 27 EU member states. Overall, 12,783 parents of 6–17-year-old children in the 27 EU states participated in telephone interviews. Parents reported children’s QoL and wellbeing using the KIDSCREEN-10 measure, as well as their occupational status and education level. Within a multilevel analysis, the KIDSCREEN-10 was regressed on parental occupation and education level. Random intercepts and slopes were regressed on gross domestic product per capita and income inequality. Low QoL was reported in 11.6% of cases, whereby cross-national variation accounted for 13% of the total variance in QoL. Children from countries with higher national wealth and lower income inequality were at lower risk for low QoL and wellbeing. Higher age of the child, a medium or low parental occupational status, and low parental educational status were associated with a higher risk for low QoL and wellbeing. Ulrike Ravens-Sieberer, Hana Horka, Agnes Illyes, Luis Rajmil, Veronika Ottova-Jordan, and Michael Erhart Copyright © 2013 Ulrike Ravens-Sieberer et al. All rights reserved. Socioeconomic Factors Associated with Underweight and Stunting among Adolescents of Jimma Zone, South West Ethiopia: A Cross-Sectional Study Tue, 10 Dec 2013 13:20:16 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/238546/ Background. Nutrition during adolescence plays an important role in the individual’s life. Socioeconomic status, age, sex, and mothers’ educational level are among the important determinant factors of nutritional status of adolescents. In this study, we test the competing hypotheses about the correlates of nutritional status among Ethiopian adolescents. Methods. We report a total of 2084 adolescents and univariate and multivariable linear regression were used to assess socioeconomic factors associated with underweight and stunting among adolescents. Results. Age, highest grade completed, job, and last attended in community school were positively associated with BMI for Age z-score and highest grade completed, household income, and job were positively associated with Height for Age z-score. However, male gender was negatively associated with BMI for Age z-score and male gender, last attended in community school, abdominal pain, and household size were negatively associated with Height for Age z-score. Conclusion. Age of the adolescents, gender, educational status, employment status, and type of last school attended are associated with underweight; gender, place of residence, household size, household income, educational status, employment status, type of last school attended, and abdominal pain are associated with stunting. The findings reflect socio-economic characteristics are associated with underweight and stunting. Huruy Assefa, Tefera Belachew, and Legesse Negash Copyright © 2013 Huruy Assefa et al. All rights reserved. Occupational Exposure to Respirable Suspended Particulate Matter and Lung Functions Deterioration of Steel Workers: An Exploratory Study in India Tue, 17 Sep 2013 08:11:31 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/325410/ Objective. Manufacturing industry, especially casting and forging (iron and steel) industry, comprises a major part of the occupation in India. However, health protection is still ignored. Therefore the present study explores the respiratory symptoms among steel workers and subsequently measured the level of exposure to RSPM and lung functions parameters using spirometry investigation. Method. Present study assessed the level of respiratory symptoms through questionnaire survey of 572 workers, out of which 309 workers and another control group of 74 subjects were assessed for the spirometry test. Both of the groups were statistically matched for age and BMI. Students’ t-test and one-way ANOVA were used to compare the various subgroups. Results. The results reveal that workers are exposed to higher respirable suspended particulate matter (RSPM) levels than the limit of 5 mg/m3 prescribed by Indian factory act. The spirometric parameters such as FVC, FEV1, FEV1/FVC ratio, FEF25–75, PEFR, PIFR, and FIVC were significantly lower in exposed group than in controls. In the present scenario the iron and steel SMEs of the region are very much lagging behind in implementing the occupational health and safety practices. Conclusions. The majority of the workers were not wearing proper PPEs like masks due to ergonomically bad design, and at the same time they were working 60 to 72 hrs/week, which leads to very high level of exposure to RSPM. Therefore, the workers were under higher risk of lungs functions deterioration. Lakhwinder Pal Singh, Arvind Bhardwaj, and Kishore Kumar Deepak Copyright © 2013 Lakhwinder Pal Singh et al. All rights reserved. Effects of a Teacher-Centred, School-Based Intervention Program on Health Behavior and Cardiovascular Disease Risk in Elementary School Children Sun, 08 Sep 2013 17:31:15 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/513183/ The increasing prevalence of overweight and obese children along with accompanying comorbidities has prompted an early acknowledgement of a healthy lifestyle. The purpose of this study was to examine the effect of a teacher-centered, school-based intervention on cardiovascular disease (CVD) risk and health behavior in elementary school children. 935 first- and second-grade children in southwest Germany provided valid data at baseline and follow-up. Trained technicians measured height and weight along with blood pressure, cholesterol, and intra-abdominal fat to determine CVD risk. Parent questionnaires were used to assess children’s health behavior. Within one year CVD risk declined in the intervention group, particularly due to an attenuation of the age-related increase in mean arterial pressure. The age-related decline in habitual sports participation was attenuated, and children in the intervention groups displayed higher odds of playing outside. Further, the consumption of sugar-sweetened beverages declined in the intervention group, and TV time remained stable, while it increased in the control group. These results indicate that a teacher-centered intervention positively affects health behavior and CVD risk. The incorporation of the intervention by the classroom-teacher should allow for a sustainable participation, which may result in more pronounced effects over time. Clemens Drenowatz, Olivia Wartha, Susanne Brandstetter, and Jürgen M. Steinacker Copyright © 2013 Clemens Drenowatz et al. All rights reserved. Adverse Health Effects Associated with Increased Activity at Kīlauea Volcano: A Repeated Population-Based Survey Wed, 28 Aug 2013 11:24:02 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/475962/ Eruptive activity at the Kīlauea volcano (Hawai`i, USA) has increased since 2008 resulting in volcanic air pollution (vog) at levels exceeding the national air quality standard for sulfur dioxide. Previous investigations during lower vog levels found adverse cardiorespiratory effects in the residents. The purpose of this 2012 survey was to reassess and compare the impact of the increased volcanic activity on population health. Prevalence of cardiorespiratory signs, symptoms, and diseases was estimated in vog exposed and unexposed communities, and descriptions of perceived health and environmental effects were collected door-to-door. Vog exposure was significantly associated with increased odds of self-reported cough, phlegm, rhinorrhea, sore/dry throat, shortness of breath, sinus congestion, continual wheezing, eye and skin irritation, and diagnosed hypertension. Field measurements identified significantly higher average systolic and diastolic blood pressures () and lower blood oxygen saturation (). Half of the participants perceived that Kīlauea’s intensified eruption had negatively affected their health with reports of financial impacts from degradation of agriculture and livestock. Relatively stronger magnitudes of health effects were associated with the higher exposure to vog. Public concerns remain about attributed effects of the ongoing eruption. Enhanced public health efforts are recommended at Kīlauea and other degassing volcanoes worldwide. Bernadette M. Longo Copyright © 2013 Bernadette M. Longo. All rights reserved. Health Professionals’ Role in Helping Patients Quit Tobacco Use: Attitudes among Iranian Dental Students Thu, 22 Aug 2013 14:20:29 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/706451/ Background. Health professionals play an essential role in tobacco control. Our objective was to assess Iranian dental students' attitudes towards tobacco control. Methods. Eight dental schools were randomly selected, and a survey using Global Health Professions Student Survey (GHPSS) instrument was conducted among dental students in 2010 in Iran. The chi-square test served for statistical analyses. Results. Of the participants (325 students, 66% female), about one-fifth (21%) were current tobacco (including cigarettes and waterpipe) users. A clear majority (over 80%) of the students agreed as to the responsibility of health professionals on serving as role models for patients and the public, routinely advising patients using tobacco to quit, and giving patients advice about smoking cessation. Over 75% believed that cigarette-smoking health professionals are less likely to advise their patients to stop smoking. Current tobacco users were significantly less likely to agree with these beliefs (). Conclusion. Future oral health professionals have generally positive attitudes towards tobacco control. However, their own current tobacco use has a significant negative impact on these attitudes, an impact which ought to be taken into account in tobacco control. Hooman Keshavarz, Ahmad Jafari, Mohammad Reza Khami, and Jorma I. Virtanen Copyright © 2013 Hooman Keshavarz et al. All rights reserved. Comparative Study of Leaching of Aluminium from Aluminium, Clay, Stainless Steel, and Steel Cooking Pots Tue, 20 Aug 2013 08:14:52 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/517601/ Analyses on the absorption of aluminium by rice boiled in distilled water in a variety of containers, such as old and new aluminium pots, clay receptacles, stainless steel pots, and steel pots, were carried out. 10 g of rice was taken as a representative sample. Colorimetric analysis of classical methods was used to determine the concentration of aluminium. The control for aluminium was 350 ± 130 μg/g. The new aluminium pots had a concentration of 126 ± 64 μg/g, old aluminium pots had 314 ± 128 μg/g, new clay pots had 132 ± 68 μg/g, old clay pots had 195 ± 137 μg/g, new steel pots had 241.00 ± 200 μg/g, old steel utensils had 186.83 ± 75.18 μg/g, new stainless steel utensils had 294.83 ± 163 μg/g, and old stainless steel utensils had 289.00 ± 75.155 μg/g. Aluminium leaching was detected in all forms of new and old cooking utensils, and leaching was below and within the control concentration range. Old aluminium pots had the highest concentration of leaching while new steel pots had the least leaching of aluminium. However, the aluminium contamination of the foods tested was insufficient to constitute a hazard to health. A. T. Odularu, P. A. Ajibade, and P. C. Onianwa Copyright © 2013 A. T. Odularu et al. All rights reserved. Risk Perception and Its Foundation among Swedish Individuals Occupationally Exposed to Air Pollutants and Chemicals: A Comparison of 1975 and 2011 Wed, 31 Jul 2013 13:28:00 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/469714/ Although work environment conditions have improved much in the last decades, occupational exposures to chemicals and air pollutants still cause adverse health effects. The risk perception of occupational exposures to hazardous substances and the motivations for it have been investigated through a questionnaire study. These results have also been compared to previous studies performed by the largest trade union confederation in Sweden in 1975. In the current survey, 30% of the respondents believe to be at risk, 48% not, and 22% state to be unsure. The proportion of persons experiencing to be at risk due to exposures to chemicals or air pollution at work is unexpectedly similar to that of 1975. The explanations offered for the risk perception were in many cases vague and of a subjective nature, but again results are similar to those of 1975. References to more solid justifications such as performed exposure measurements or medical health checks are scarce, with the latter case being as scarce today as in 1975. There are only a few indications that a more systematic management of work environment issues has developed at Swedish workplaces; for instance, managers were more commonly stated as a source of information in 2011 than in 1975. Linda Schenk Copyright © 2013 Linda Schenk. All rights reserved. Rise of Clinical Trials Industry in India: An Analysis Wed, 31 Jul 2013 11:29:11 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/167059/ Clinical trials industry has seen a phenomenal increase in last ten years or so, and India has emerged as one of the foremost global destinations for clinical trials. Changed intellectual property regimen after WTO has been the prime mover of the phenomenon, and maximizing profits rather than serving any altruistic motives forms the main ideological underpinning of the rise of clinical trial industry in India. The paper examines the ideological underpinnings of the rise of clinical trials industry in the country in detail and how the ruling classes of India have tried to capitalize on this as a great economic opportunity. In the process the interests of India’s poor have been the main casualty. Vikas Bajpai Copyright © 2013 Vikas Bajpai. All rights reserved. Remarks on Ambient Air Pollution and Health Outcomes Sun, 21 Jul 2013 13:24:10 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/846297/ Background. Ambient air pollution is a recognized risk factor for multiple health conditions. For some health problems, the impact of air pollution is particularly evident to the patients in a specific age range. Nonsimultaneous exposures to two or more air pollutants may have different relationships with health outcomes than do simultaneous exposures. Methods. Case-crossover technique was used to analyze data on emergency department (ED) visits for ischemic heart disease (IHD), epistaxis, and upper respiratory infection (URI). Conditional logistic regression models were used to estimate odds ratios and their 95% confidence intervals corresponding to an increase in an interquartile range of air pollutant concentrations. Results. The results for IHD show that for older patients (age 60+ years), the association between sulphur dioxide (SO2) exposure and IHD is weak. For ED visits for epistaxis (O3 and SO2 in one model) and URI (O3 and NO2 in one model), air pollutants lagged differently in the common model indicated significant statistical associations but not for common lags. Conclusion. The study findings, based on analyzed examples, suggest that (i) IHD cases in older age are less related to air pollution and (ii) air pollutants may affect some health conditions by a specific sequence of exposure occurrences. Mieczysław Szyszkowicz Copyright © 2013 Mieczysław Szyszkowicz. All rights reserved. Extreme Weather Events and Mental Health: Tackling the Psychosocial Challenge Thu, 18 Jul 2013 09:50:06 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/127365/ Climate change is an emerging challenge to the mental health of entire humanity. Several studies, in recent times, have brought to light the adverse public mental health outcomes of extreme weather events for the suffering communities. The general public and the policy making bodies need to gain awareness about these impacts. Through such awareness, communities and their governments can institutionalize mechanisms to provide psychological support to the populations affected by climate change, before it becomes a massive public health challenge and starts affecting the social and vocational lives of people. There is an urgent need for addressing these impacts. The aim of this paper is to provide an overview of the deleterious effects of climate change related extreme weather events on mental health, the worldwide response of several communities to such events, and preparedness of the public and government to deal with these adverse mental health impacts. Policy imperatives to prevent and mitigate these impacts have been suggested. It is hoped that the psychologists, governments, and communities will act earnestly to prevent the impending harm to human mental health due to climate change. Jyotsana Shukla Copyright © 2013 Jyotsana Shukla. All rights reserved. Analysis of Medication-Related Deaths in Denmark Mon, 17 Jun 2013 18:52:08 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/214893/ Objective. To investigate the circumstances associated with medication-related deaths. Design and Setting. This retrospective study investigated closed claims concerning medication-related deaths from 1996 to 2008 registered by the Danish Patient Insurance Association (DPIA). Results. A total of 80 were patients registered as having died because of an adverse event or error associated with a medication, and 37 of these cases were considered to have been preventable. The circumstances of the 37 deaths are described in detail in this report. Orthopaedic surgery, anaesthesiology, and internal medicine were the specialties involved in the majority of the deaths. Incorrect dosing was the cause of 17 deaths, and the use of the wrong drug caused 11 deaths. The administration of a drug despite a known allergy/intolerance or contraindication caused 6 deaths. Other 5 deaths were caused by anticoagulation medications. Methotrexate given daily by mistake caused 2 deaths. Conclusion. This study describes the circumstances of 37 preventable deaths caused by medication. Drug administration despite a known allergy, opioids, sedative, anticonvulsive medicine, and incorrect dosing and incorrect use of anticoagulants are the most important areas to be addressed in the development of future patient safety measures to reduce patient deaths caused by or related to medications. Lars Dahlgaard Hove, Johannes Bock, and Jens Krogh Christoffersen Copyright © 2013 Lars Dahlgaard Hove et al. All rights reserved. Availability of Adequately Iodized Salt at Household Level and Associated Factors in Gondar Town, Northwest Ethiopia Sun, 09 Jun 2013 10:07:28 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/160582/ Background. Iodine deficiency has serious effects on body growth and mental development. This study assessed availability of adequately iodized salt at household level and associated factors in Gondar town, northwest Ethiopia. Methods. Community based cross-sectional study was carried out among households in Gondar town during August 15–25, 2012. Multistage sampling technique was used. Data were collected using a pretested and structured questionnaire by a face-to-face interview technique. Bivariate and multivariate analyses were performed to check associations and control confounding. Results. A total of 810 participants were participated. The availability of adequately iodized salt (≥15 parts per million) in the study area was 28.9%. Multivariate analysis showed that using packed salt (AOR (95% CI) = 9.75 (5.74, 16.56)), not exposing salt to sunlight (AOR (95% CI) = 7.26 (3.73, 14.11)), shorter storage of salt at household (AOR (95% CI) = 3.604 (1.402, 9.267)) and good knowledge of participants about iodized salt (AOR (95% CI) = 1.94 (1.23, 3.05)) were associated with availability of adequately iodized salt at household level. Conclusions. Availability of adequately iodized salt at household level was very low. Hence, households should be sensitized about importance of iodized salt and its proper handling at the household level. Hailay Gebrearegawi Gebremariam, Melkie Edris Yesuf, and Digsu Negese Koye Copyright © 2013 Hailay Gebrearegawi Gebremariam et al. All rights reserved. Modern Natural Gas Development and Harm to Health: The Need for Proactive Public Health Policies Thu, 16 May 2013 15:06:04 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/408658/ High-volume horizontal hydraulic fracturing of shale formations has the potential to make natural gas a significant, economical energy source, but the potential for harm to human health is often dismissed by proponents of this method. While adverse health outcomes of medical conditions with long latency periods will not be evident for years and will depend on the exposure, duration of exposure, dose, and other factors, we argue that it would be prudent to begin to track and monitor trends in the incidence and prevalence of diseases that already have been shown to be influenced by environmental agents. The dirty downside of modern, unconventional natural gas development, as well as the potential for harm, is discussed. Madelon L. Finkel, Jake Hays, and Adam Law Copyright © 2013 Madelon L. Finkel et al. All rights reserved. The European Hot Spot of B[a]P and PM2.5 Exposure—The Ostrava Region, Czech Republic: Health Research Results Thu, 09 May 2013 15:08:19 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/416701/ The Ostrava Region in the Czech Republic is a heavily polluted industrial area. Concentrations of PM10, PM2.5, and benzo[a]pyrene (B[a]P) significantly exceed limit values. To investigate the impact of these levels on human health, epidemiological, molecular epidemiology, and in vitro studies were done in 2008–2011. Morbidity of children was followed in 10 pediatric districts. In the most polluted district, children suffered higher incidence of acute respiratory diseases in the first year of life, and higher prevalence of asthma bronchiale. Gene expression was studied in children from Ostrava and from a control rural area. Genes specific to asthma bronchiale differed, suggesting a different molecular phenotype in children in the polluted region compared to children in the control area. A molecular epidemiology study showed adverse effect of the Ostrava exposures, but also an increased expression of XRCC5, which probably protects these exposed subjects against the degree of genetic damage that would otherwise be expected. In vitro studies clearly related concentration of B[a]P from PM2.5 extracts to induced PAH-DNA adducts. These studies clearly demonstrate that under the present local environmental conditions, the health of the population is severely impaired and will likely remain so for a significant period of time. Radim J. Sram, Miroslav Dostal, Helena Libalova, Pavel Rossner Jr., Andrea Rossnerova, Vlasta Svecova, Jan Topinka, and Alena Bartonova Copyright © 2013 Radim J. Sram et al. All rights reserved. Life Style Factors Associated with Premenstrual Syndrome among El-Minia University Students, Egypt Thu, 09 May 2013 12:01:43 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/617123/ Aim. To determine the score and frequency of premenstrual syndrome (PMS) among female college students and to detect the possible risk factors of PMS. A trial of life style modification regarding prevention and control of PMS symptoms was carried out using counseling. Materials and Methods. A cross-sectional study was conducted on 253 El-Minia University unmarried female students. A self-administered questionnaire inquiring about symptoms of PMS in the previous three months and risk factors possibly related to it was used. PMS score was calculated. Multiple regression analysis was performed to determine which of several biopsychosocial and dietary factors influenced PMS. Life style modification counseling was done to prevent and control PMS. Results. The study revealed that 80.2% of the participants experienced various degrees of PMS symptoms which were significantly associated with a family history of PMS, physical inactivity, habitual excess consumption of coffee, BMI, frequent consumption of fast food, and smoking, but these factors explained only 52% of the variability in the logistic regression model. Conclusion. We recommend the introduction of a reproductive health component into school and college health education programs and encourage female adolescents and young adults to adopt a healthy behavior. Amany Edward Seedhom, Eman Sameh Mohammed, and Eman Mohammed Mahfouz Copyright © 2013 Amany Edward Seedhom et al. All rights reserved. Sex, Conception Interval, Gestational Age, Apgar Score, and Anthropometric Surrogates in relation to Birth Weight of Bangladeshi Newborns: A Cross-Sectional Study Wed, 08 May 2013 16:31:43 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/405725/ In developing countries, where about 75% of births occur at home or in the community, logistic problems prevent the weighing of every newborn child. Baby born with a weight less than 2,500 g is considered low birth weight, since below this value birth-specific infant mortality begins to rise rapidly. In Bangladesh, the prevalence of low birth weight is unacceptably high. Infant's sex differences, birth to conception interval, gestational age, and Apgar score are associated with infant birth weight. To screen low-birth-weight babies, simple anthropometric parameters can be used in rural areas where 80–90% of deliveries take place. A sample of 343 newborn singletons, 186 male and 157 female babies, were studied in Southwest region of Bangladesh to examine the birth weight status of newborns and to identify the relationship between birth weight and other anthropometric parameters of newborns. The mean birth weight was  g, and 28.6% were low-birth-weight (<2,500 g) babies. All key anthropometric parameters of the newborns significantly correlated with infant birth weight . Mid upper arm circumference and chest circumference were identified as the optimal surrogate indicators of LBW babies. In the community where weighing of newborns is difficult, these measurements can be used to identify the LBW babies. Bably Sabina Azhar, Md. Monirujjaman, Kazi Saiful Islam, Sadia Afrin, and Md. Sabir Hossain Copyright © 2013 Bably Sabina Azhar et al. All rights reserved. Biomedical Pollutants in the Urban Environment and Implications for Public Health: A Case Study Tue, 07 May 2013 08:36:02 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/497490/ This study investigated the management of biomedical pollutants in the Accra Metropolitan Area in Ghana, using a qualitative case study approach involving interviews, focus-group discussions, and observation techniques. A state of precariousness was found to characterize the management of biomedical pollutants in the study area, culminating in the magnification of risks to the environment and public health. There is neither a single sanitary landfill nor a properly functioning incineration system in the entire metropolis, and most of the healthcare facilities surveyed lack access to suitable treatment technologies. As a result, crude burning and indiscriminate dumping of infectious and toxic biomedical residues were found to be widespread. The crude burning of toxic biomedical pollutants was found to provide environmental pathways for carcinogenic substances. These include polynuclear aromatic hydrocarbons (PAHs), polychlorinated dibenzofurans (PCDFs), polychlorinated dibenzo-para-dioxins (PCDDs), polychlorinated biphenyls (PCBs), hydrogen, lead, mercury, cadmium, chlorobenzenes, particulate matter, and chlorophenols. The improper disposal of biomedical pollutants in open dumps and unsanitary landfills also carries a risk of providing environmental entry points for volatile organic compounds (VOCs), inorganic macrocomponents, heavy metals, and xenobiotic organic compounds. Jeffrey N. T. Squire Copyright © 2013 Jeffrey N. T. Squire. All rights reserved. Validation of a Chinese Version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale in Patients with Hypertension in Primary Care Thu, 02 May 2013 14:47:08 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/298986/ The aim of this study was to validate a Chinese version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C). In 2012, a cross-sectional study was conducted in a community clinic, in Beijing, China. A total of 262 hypertension patients participated in this study. Concurrent validity was validated by Pearson’s correlations between the SES6C and Hospital Anxiety and Depression Scale (HADS). Intraclass correlation coefficients (ICC) were performed to evaluate test-retest reliability of the scale. Related factors of self-efficacy were explored in linear regression models. The results of our study display acceptable psychometric properties: the scale was two-dimensional, reproducible (ICC = 0.78; 95% CI, 0.70–0.84), and the reliability was good (Cronbach’s alpha = 0.88). Significant (; ) correlation was found between the level of self-efficacy and the level of psychological distress. In multivariable analysis, the factors significantly associated with self-efficacy were regular exercise (, ), HADS total score (, ) and health status (, ). The study provides evidence that the SES6C is acceptable, valid and repeatable for hypertension patients. Huanhuan Hu, Gang Li, and Takashi Arao Copyright © 2013 Huanhuan Hu et al. All rights reserved. Alcohol Exposures, Alcohol Marketing, and Their Associations with Problem Drinking and Drunkenness among Youth Living in the Slums of Kampala, Uganda Tue, 30 Apr 2013 14:21:45 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/948675/ This study determined the associations between alcohol use exposures, marketing, education, and problem drinking and drunkenness among youth living in the slums of Kampala. This cross-sectional study of youth was conducted in 2011 to quantify and describe high-risk behavior and exposures in a convenience sample () of urban youth living in the slums, 14–24 years of age, who were participating in a drop-in center for disadvantaged street youth. Logistic regression analyses were computed to determine associations between alcohol use exposures, marketing exposures, alcohol education, and problem drinking and drunkenness while controlling for possible confounders. Among participants, 30.2% reported problem drinking and 32.8% reported drunkenness. In multivariate analyses, obtaining free drinks was associated with problem drinking (AOR: 2.47; 95% CI =  1.23–4.96) and drunkenness (AOR: 2.40; 95% CI = 1.22–4.70) after controlling for potential confounders. Alcohol education measures were not significantly associated with either problem drinking or drunkenness in multivariate analyses. There are important associations between alcohol marketing and drinking among these youth. Moreover, the findings underscore the need for additional research related to the impact of alcohol marketing among vulnerable youth and also the need for policy regulations that restrict alcohol marketing that involve providing free alcohol directly to youth. Monica H. Swahn, Jane B. Palmier, and Rogers Kasirye Copyright © 2013 Monica H. Swahn et al. All rights reserved. Risky Sexual Practices and Associated Factors for HIV/AIDS Infection among Private College Students in Bahir Dar City, Northwest Ethiopia Tue, 12 Mar 2013 15:41:52 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/763051/ Background. Adolescents and young adults engage in risky sexual behaviours that may expose them to risk of contracting sexual transmitted diseases. The aim of this study was to assess risky sexual practices and associated factors for HIV/AIDS infection. Methods. A cross-sectional study was conducted in March 2012 among 790 college students. Self-administered questionnaire was used to collect the data. The data were analyzed using univariate, bivariate, and multivariate analyses with SPSS version 16 software package. Results. About 40.6% of sexually active respondents had risky sexual behaviours. Multiple sexual partners and unprotected sex were reported by 45.3% and 38.4% of sexually active respondents. Having multiple sexual partners was associated with alcohol use (AOR = 3.20; 95% CI: 2.02–5.08) and having a close friend who started sex (AOR = 5.99; 95% CI: 3.66–9.81). Unprotected sex was associated with marital status (AOR = 2.68; 95% CI: 1.55–4.64), alcohol intake (AOR = 2.19; 95% CI: 1.36–3.54), and frequency of visiting night clubs (AOR = 0.25; 95% CI: 0.12–0.52) for those who visit occasionally and (AOR = 0.45; 95% CI: (0.21–0.97) for those who visited at least once a week. Conclusion. Large proportions of students engaged in risky sexual behaviours and various risk factors were associated with risky sexual behaviours. Therefore, interventions targeting on alcohol intake, peer pressure, and attending night clubs are recommended. Zelalem Alamrew, Melkamu Bedimo, and Muluken Azage Copyright © 2013 Zelalem Alamrew et al. All rights reserved. Impact of Comorbidities on Racial/Ethnic Disparities in Hypertension in the United States Tue, 15 Jan 2013 11:38:16 +0000 http://www.hindawi.com/journals/isrn.public.health/2013/967518/ Background. Racial/ethnic disparities in hypertension (HTN) prevalence continue to persist in United States. We aimed in this study to examine the racial/ethnic disparities in hypertension prevalence and to determine whether or not health disparities may be explained by racial/ethnic disparities in co-morbidities. Materials and Methods. A cross-sectional design was used to examine the prevalence of hypertension among African Americans (AAs), Caucasians, and Hispanics in the National Health Interview Survey, 2003. The overall sample comprised 30, 852 adults. Results. There was a statistically significant racial/ethnic variability in hypertension prevalence, with AA/Blacks with the highest prevalence, (3), . Hypertension was associated with co-morbidities, age, education, physical inactivity, marital status, income, sex, alcohol, and cigarette consumption, but not insurance. Relative to Caucasians, AAA/Blacks were 43% more likely while Hispanics were 40% less likely to report being diagnosed with high blood pressure, prevalence odds ratio (POR)  =  1.43, 99% CI, 1.25–1.64, , and POR  =  0.60, 99% CI, 0.55–0.66, respectively. After adjustment for the relevant covariates including co-morbidities, racial/ethnic disparities in hypertension persisted; thus compared to Caucasians, African Americans were 61% more likely to be told by their health care providers that they were hypertensive, adjusted prevalence odds ratio (APOR)  =  1.61, 99% CI, 1.39–1.86, . In contrast, Hispanics were 27% less likely to be diagnosed with hypertension compared to Caucasians, APOR  =  0.73, 99% CI, 0.68–0.79, . Conclusions. There was racial/ethnic variability in hypertension prevalence in this large sample of non-institutionalized US residents, with the highest prevalence of hypertension observed among African Americans. These disparities were not removed after controlling for relevant covariates including co-morbidities. Franklin Opara, Kimberly Hawkins, Aparna Sundaram, Munira Merchant, Sandra Rasmussen, and Laurens Holmes Jr. Copyright © 2013 Franklin Opara et al. All rights reserved.