<![CDATA[Universal Journal of Public Health]]> en-us 2020-02-18 15:36:12 2020-02-18 15:36:12 ZWWY RSS Generator <![CDATA[The Prevalence of High Blood Pressure and Its Relationship with Sociodemographic, Anthropometric and Lifestyles Indicators: A Population-Based Study in Aplahoue Health District, Benin]]> Source:Universal Journal of Public Health  Volume  8  Number  2  

Azandjeme Colette   Sossa Jerome Charles   Kandissounon Rosemonde   Patrick Makoutode   Sopoh E. Ghislain   No?l M. Para?so   Glele Ahanhanzo Yolaine   and Ouendo Edgard-Marius   

High blood pressure (HBP) is a public health problem with high prevalence and serious medical consequences. The objective of this study was to determine the prevalence of high blood pressure and its associated factors in adults aged 25 to 64 in the health district of Aplahoué in Benin. This was a cross-sectional study carried out in 2016. The study involved 540 participants randomly selected by cluster sampling techniques. A questionnaire was used to collect data on dietary patterns, lifestyles and socio-economic conditions. The multivariate logistic regression model was used to identify factors associated with HBP. The median age of participants was 40 years old with an interquartile range of [32-51.5] years. Mean systolic and diastolic blood pressure were 133.56 ± 20.68 and 83.26 ± 13.29 mmHg, respectively. The prevalence of HBP was 29.94%. The urban environment, the high frequency of salt consumption, the low frequency of fruit and vegetable consumption, the habit of smoking, physical inactivity, and being overweight were found to increase the risk of HBP. Interventions to promote healthy lifestyles are timely in the health district of Aplahoué.

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Mar 2020
<![CDATA[Addressing Mental Health Stigmas among Refugees: A Narrative Review from a Socio-Ecological Perspective]]> Source:Universal Journal of Public Health  Volume  8  Number  2  

Huaibo Xin   

Mental health stigmas have been predominantly prevalent among different refugee populations resettled in both western and non-western countries. It significantly affects refugees' mental healthcare seeking behaviors. The current narrative review is to examine the anti-stigma strategies/interventions/programs that specifically address refugees' mental health stigma. Twenty-six out of 711 peer-reviewed journal articles, book chapters, commentaries, reports, dissertations, and theses published in 2019 or prior in English were included in the final themes analysis. Results were organized using a socio-ecological multilevel framework (intrapersonal, interpersonal, institutional, community, and policy levels), which include increasing refugee individuals' awareness of mental health and improving their attitudes and perceptions towards mental disorders; enhancing interpersonal interactions between refugee patients and people who can encourage them to seek mental healthcare and can provide them with culturally competent mental health services; delivering mental healthcare through schools and ethnic organizations; developing community-based bottom-up interventions and mobilizing community assets to destigmatize and normalize mental illnesses within refugee communities; and advocating for a change of social norm towards mental illnesses and mental health treatment. There is a significant lack of studies designed to explore the effectiveness of anti-stigma approaches among refugees, which leads to an urgency of developing these studies and supporting evidence-based practice.

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Mar 2020
<![CDATA[Knowledge, Attitudes and Practices of Patients Diagnosed with Tuberculosis Related to Tuberculosis Treatment Adherence in Keetmanshoop District, Namibia]]> Source:Universal Journal of Public Health  Volume  8  Number  2  

Elizabeth Kateta   Josephine De Villiers   and Hermine Iita   

Ensuring that patients in chronic care and treatment such as tuberculosis adhere to medications has implications for their quality of life, health care costs and society at large. The purpose of this study was to assess and describe the knowledge, attitudes and practices of patients diagnosed with tuberculosis (TB) related to their treatments in Keetmanshoop district in Karas region, Namibia. A quantitative, cross sectional study was done among 76 patients who were receiving their TB treatment at various treatment centres in the district. Probability systematic random sampling method was used to select the participant for the study. Data was collected using a structured questionnaire, which was administered by trained interviewers. Data was analyzed using Epi-info software version 7. Analysis was done by means of a univariate and bi-variate analysis and association were explored using chi-squared test. The respondents were 18 to 60 years old of which 57.89 % were male and 42.11% were female. The findings of the study revealed that the respondents had a good knowledge on tuberculosis with regards to signs and symptoms of the disease. There was poor knowledge and misperceptions exist on the risk factors associated with transmission of tuberculosis such as shaking hands and drinking from the same cup with others. One third of the respondents (33 %, n=25) had missed their treatment and the main reasons given for interrupting the medication were forgetting to take the pills, long distance to health facility and not enough food to eat before taking pills. Treatment adherence is a big challenge in management and control of tuberculosis. Therefore, community and patient education and material support to patients remain important to ensure adherence to tuberculosis treatment. Stakeholder contributions and support are required to stem the scourge of TB in Namibia and globally.

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Mar 2020
<![CDATA[Public Perception of Medical Errors: Experiences and Risks Shared in Australia]]> Source:Universal Journal of Public Health  Volume  8  Number  1  

Jeong-ah Kim   Daniel Terry   Sunny Jang   Hoang Nguyen   Julia Gilbert   and Mary Cruickshank   

Background: Research into patient safety has largely focused on healthcare organisations bureaucratic routines, with little research available regarding the impact of patient perceptions on clinical practice. Acknowledging and openly discussing patient perceptions of medical errors may result in improved quality of healthcare. The research study aimed to gain a better understanding of the public's perception of medical errors to drive a structured approach to improve healthcare outcomes. Methods: In this study, we examined the public experiences of medical errors using an anonymous on-line survey to collect empirical data from April to December 2018. A total of 407 responses were obtained with 303 participants meeting the criteria for inclusion in the study. Results: The majority (74.9%) of these participants identified that they had experienced a medical error during receiving healthcare in Australia and 73% of these confirmed that they were harmed as a result of these errors. Conclusion: Findings from this study indicate that many participants have experienced medical errors when accessing healthcare in Australia. These findings provide information and a deeper understanding of patient experiences and perceptions of healthcare service delivery which can be used by healthcare organisations to improve healthcare services and promote patient participation in their care.

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Jan 2020
<![CDATA[Bioremediation of Crude and Refined Oil-Polluted Fresh Water Using Chlorella vulgaris Isolated from a Pond]]> Source:Universal Journal of Public Health  Volume  8  Number  1  

Onuorah Samuel   Okafor Gerald   and Nwankwo Joseph   

Crude and refined oil contamination of the aquatic environment is one of the major environmental problems that lead to unmanageable loss of biological life that impacts negatively on global economy particularly in the areas of petroleum production and transportation. Bioremediation potential of Chlorella vulgaris isolated from a pond in Uwani, Enugu State, Nigeria was studied using standard methods. The organism utilized crude oil heavily, kerosene moderately and petrol minimally as shown by the varying degree of turbidity produced during fourteen days of growth in mineral salts- oil medium. Biodegradation experiment was carried out for forty-two days and the results showed that there was a decrease in pH and an increase in the absorbance of the mineral salts - oil medium. The percentage of degradation of the crude oil, kerosene and petrol by the organism was 80%, 70% and 60% respectively. There was a reduction in the peak numbers and peak areas of the gas chromatograms of the total petroleum hydrocarbons and polyaromatic hydrocarbons of the residual crude oil as well as the residual kerosene and petrol. This work therefore indicated that the microalga C. vulgaris can be used for the bioremediation of crude and refined oil - polluted aquatic environments.

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Jan 2020
<![CDATA[Impact of Performance-Based Financing on Health Facilities Performance in Family Planning]]> Source:Universal Journal of Public Health  Volume  8  Number  1  

Agonnoude T. Maurice   Houeto S. David   Sambieni N. Emmanuel   Adoukonou T. Thierry A   and Aguessy Constant   

Toward the end of that scaling up of performance-based financing (PBF) started in Benin since 2015, it's important to realize whether the impacts in terms of performance improvement of health facilities (HFs) will still be confirmed or not, especially as far as family planning (FP) is concerned. A longitudinal retrospective study covered by the period of 14 quarters of a year (Q1 2014 to Q2 2017), was conducted including all public and private functional HFs of the two health district. The outcome variable (performance of HFs in FP) was the increase rates of new acceptance for any modern contraceptive method through the study period. The independent variables were the quality of the structure, the quality of the process and the context. A linear regression model was adjusted to find out the explanatory variable of the performance; the significance threshold was 5%. 55 HFs participated to the study. There was no improvement in supplying process of FP services (p=0.308). There was no improvement in both trained staff (p=0.67) and midwifery staff (p=0.75); however, there was a significant improvement in the rest of the structure at the risk of 10% (p=0.063) and the performance in FP (p<0.001). In multivariate analysis, the evolution of the structure was the only explanatory variable (p=0.029) of HFs performance in FP; in rural areas, the structure-process interaction (p=0.038) was the explanatory variable of HFs performance in FP, whereas in suburban and urban areas, the models were not significant. PBF should act not only on the structures but also on the processes of supplying services, taking into account the context.

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Jan 2020
<![CDATA[Supervision in Healthcare: A Critical Review of the Role, Function and Capacity for Training]]> Source:Universal Journal of Public Health  Volume  8  Number  1  

Daniel Terry   Hoang Nguyen   Alicia J Perkins   and Blake Peck   

This paper examines the notion of clinical supervision and takes a close look at what it means from the perspective of both the supervisee and the supervisor, considering how it can be of benefit to the learner, the teacher and the patient. Clinical supervision has been shown to be vital for the development and consolidation of undergraduate and postgraduate education, while having a positive impact on patient outcomes and as such is a fundamental component in healthcare education. Central to supervision is achieving the best outcomes for the supervisee, and effective supervision ensures the development of confidence, professional identity, and the consolidation of therapeutic knowledge. Clinical supervision provides a platform for extending the supervisor-supervisee relationship beyond the student-teacher model to one of mutual personal development in contemporary knowledge and skills for clinical practice. Despite the perceived importance of clinical supervision for healthcare more broadly, there is evidence to suggest that few supervisors are adequately prepared with the theory and practice of clinical supervision to adequately fulfill the expectations that the role entails. It follows therefore, that in many cases, there is an expectation that the health professionals will supervise without adequate preparation. This paper, although not a panacea, may assist those who are supervising and who seek or require some guidance and support.

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Jan 2020
<![CDATA[Factors Related to the Satisfaction with Pregnancy and Childbirth in Japanese Mothers Residing in the UK]]> Source:Universal Journal of Public Health  Volume  7  Number  6  

Motomi Otsuka   and Hiroya Matsuo   

This study aimed to investigate whether medical care and health services provided during pregnancy and childbirth influence the satisfaction with pregnancy and childbirth in Japanese mothers residing in the UK. The participants (N=41) were members of the Japanese child-rearing group in London, UK, who had experienced antenatal to postpartum care in the UK. The questionnaire contained the background of the Japanese mothers residing in the UK, pregnancy and childbirth, difficulties in the UK's hospital visiting, satisfaction with health care service, adviser and evaluation scales for pregnancy and childbirth. Almost all participants consulted their Japanese friends residing in the UK, or husbands/partners, and they obtained the information on pregnancy and childbirth from the Internet written in Japanese and Japanese friends who were living and had experienced childbirth in the UK. Approximately 80% of Japanese mothers were satisfied with pre-natal clinic and childbirth in the UK. They were satisfied with the health care provided by midwife and home visiting service after discharge from the hospital. The satisfaction with pre-natal clinics in Japanese mother residing was related to intercultural understanding, while the satisfaction with childbirth was related to understanding of medical system, cross-cultural understanding and trust of medical stuff.

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Nov 2019
<![CDATA[The Quality of Life of Students in the Commune of Dangbo (Republic of Benin) in 2017]]> Source:Universal Journal of Public Health  Volume  7  Number  6  

Gouthon Gilchrist Fabrice   Bio Nigan Issiako   Para?so Moussiliou   Tévoedjrè Doréana   Gouthon Polycarpe   Ouendo Edgard-Marius   and Ahodéhou Marlyse   

Children are an important part of any society. During the educational process, it is useful for them to enjoy a life of good quality in order to participate in the development of their community. Objective: This study aims to determine the quality of life of secondary school students in Dangbo in south-eastern Benin. Method: A total of 318 adolescent students (157 girls, 161 boys) from the 6th, 5th and 4th grade classes were selected according to the non-random method and the convenience technique answered a questionnaire that takes into account the five basic human needs: food, shelter, clothing, health and education. Results: A total of 159 (50.0%), 227 (71.4%), 318 (100.0%), 311 (97.8%) pupils met the criteria of good levels of educational conditions, housing, food and clothing respectively. Only one student, or 0.3% of the respondents, met the criteria for good levels of health conditions. The good quality of life resulting from the good living conditions was observed in only 122/318 or 38.4% of the students surveyed. Conclusions: Since health is the weak link in the quality of life of these students, an epidemiological diagnosis is necessary to identify the modalities of effective management.

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Nov 2019
<![CDATA[Influence of Socio-cultural and Physical Factors on Use of Skilled Birth Attendants by Pregnant Women at Central Region]]> Source:Universal Journal of Public Health  Volume  7  Number  6  

Christiana Asiedu   

The purpose of the study was to assess the effects of socio-cultural and physical factors on the use of SBAs in the Central Region of Ghana. Among socio-cultural and physical factors which may influence use of SBAs with current pregnancy were money for transport and health care (65%), distance (58%), knowledge about signs of labor (51%), and need for closer attention from relatives (51%). The differences from the two logistic regression model analysis that were done were statistically significant (χ2=7.06, p=0.0079). The odds of SBA utilization for mothers who needed closer attention from relatives were 1.6 times higher (OR=1.56, 95% CI=1.05-2.34, p-value=0.027) than mothers who did not need closer attention. It was recommended that health service providers should ensure client and family-centered care is provided to make the health facilities user-friendly.

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Nov 2019
<![CDATA[Paediatric Physical Facilities Design Characteristics in Southwestern Nigerian University Teaching Hospital: Lesson from Netherland Children Hospital]]> Source:Universal Journal of Public Health  Volume  7  Number  6  

Muyiwa Lawrence Akinluyi   Folusho Charles Awe   Oluwatoyin Olugbenga Adeleye   and Mayowa Paul Ogunruku   

This study appraised the influence of design characteristics of the paediatric hospital physical facilities with a view to develop the physical facilities design characteristics policies for paediatric hospital designers, managers and policy makers. In this study, the hospital physical facilities are defined by the spaces used by the professional staff, equipment, the building form, their furniture and fixtures. Also, the design characteristics of the hospital physical facilities are defined by the building proximity, privacy, wayfindings, flexibility and adaptability. The notable paediatric hospital selected in the developed country is Emma Kinderziekenhuis Pediatric Hospital in Amsterdam, Netherland because it has developed a remarkable work in the healthcare settings with a deep concern on child-centred design, which were informed, implemented and accompanied by architects. Also, Peadiatric department of University College Hospital (UCH), Ibadan Nigeria was selected because it is the largest city in Nigeria which can be used to generalize what is obtained in peadiatric hospital physical facilities in southwestern Nigeria. Through analysis of one of the notable hospitals in both the developed and developing worlds, the design characteristics of selected hospital were examined using case study method such as the use of building plans, the site layout and the use of photograph among others. The results of the investigation show that hospital design characteristics have a great influence on both the patients and staff including the visitors. However, the planning and design characteristics of the physical facilities in the Netherland Children Hospital were found to be very good compared with its counterpart in Southwestern Nigerian University Teaching Hospital. It is, however, concluded that, the Nigerian University Teaching Hospitals should learn from the design characteristics appraised from the Netherland Children Hospital. The result of this study will be useful as a design policies standard for the Nigerian government, healthcare developers and children hospital designers in southwestern, Nigeria.

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Nov 2019
<![CDATA[Early Intervention in Any Diabete Undiagnosed Patient Suffered from Ocular and Cardiovascular Diseases in Cardiology]]> Source:Universal Journal of Public Health  Volume  7  Number  6  

Anvoh Koutoua Yves Blanchard   Agbo Adouko Edit H   Koko Anoma Casimir   Diabagaté Hadja Fatim   Houroupou Mbambai Jacques   and Brou Kouakou   

Glycosylated haemoglobin (HbA1c) is a form of haemoglobin that is measured primarily to identify the average plasma blood glucose concentration prolonged periods previous 120 days. Cardiologist used to treat patients generally when glucose level is over 1.26g/l. Unfortunately, Haemoglobin A1c was seldom controlled. The objective of this study was to detect persons with type 2 diabetes risks by the correlation between HbA1c levels and random glucose one and propose a good management by lifestyles. Methods: This descriptive study included 216 patients selected randomly with cardiovascular complications and ocular diseases but none diabetes diagnosed. Glycaemia and HbA1c measurement were done. Results: All the patients were not diabetes diagnosed. There was a low correlation between the blood glucose levels and the glycated haemoglobin r=0.2761). Hypocaloric diet applied to type 2 diabetes management decreased glycaemia and Haemoglobin Hba1c. The decreasing of Hba1c was estimated from 14% to 17% of the initial values. Conclusions: Glycaemia must not only be considered to manage cardiovascular complications at Cardiology Institute of Abidjan. The contribution of hypocaloric diet with high vegetable and one fruit intake a day lead to better type 2 diabetes management.

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Nov 2019
<![CDATA[Parental Knowledge, Attitudes and Practices in Early Childhood Development among Low Income Urban Parents]]> Source:Universal Journal of Public Health  Volume  7  Number  5  

Taslima Begum   

The aim of the study was to examine parents' current level of knowledge, attitudes and practices related to early childhood development (ECD). The findings found that few parents have good knowledge and practices regarding ECD although most of them have good level of attitude. These results indicate gaps among knowledge attitude and practices. Regarding child's health and nutrition about 55% of infants were exclusively breastfed. Moreover, 45% infants received complementary liquids foods (typically around 4-5 months) and 12% were given infant formula. Interestingly, mothers engaged both controlling and indulgent feeding behaviors toward their child. Moreover, most of the mother used negative disciplinary techniques to guide their children. Finding on parental support for early learning found that 54% of households engaged in early and school readiness activities with their child. Only 25%, 3 to 5 year's old children attended kindergarten school among them 92% children recognized letter or numbers. Only 8% parents perceived their child had some type of physical or learning difficulty despite most of them (94%) did not consult with others. However, 18% children had been seriously injured when parents leaving their child to someone else.

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Sep 2019
<![CDATA[Assessment of Quality of Life Related to the Health of People Suffering from Chronic Diseases in Ouémé Department of Benin]]> Source:Universal Journal of Public Health  Volume  7  Number  5  

Tévoédjrè Doréana Frida   Para?so Moussiliou   Gouthon Polycarpe   Gouthon Fabrice Gilchrist   Tonon Affidéhomé Brigitte   and Ouendo Edgard-Marius Dona   

Measuring health-related quality of life (HRQoL) facilitates the monitoring and evaluation of the population's health status, and country's public health policies. Studies undertaken in the Republic of Benin on this issue are quite rare. Objective: The objective is to study the level of HRQoL in people with chronic communicable or non-communicable diseases at the Ouémé department in Benin. Method: This is a cross-sectional and analytical survey conducted at this department in 2018. Medical Outcomes Study SF-36 questionnaire was administered to 523 people over 15 years of age who were suffering from chronic disease, and they were selected by the snowball technique. The level of HRQoL defined in three modalities was determined from the four dimensions of each of its physical and mental components. Results: In the Ouémé department, eight chronic diseases were identified and the level of HRQoL appeared higher in rural areas for hypertension, sickle cell disease and sinusitis. In total, 73.8% of people with chronic diseases had high levels of HRQoL. The level of HRQoL was higher in rural areas than in urban areas (85.2% versus 64.8%; p < 0.0001). Interventions on HRQoL at the Ouémé department must take into account the disparities between urban and rural areas.

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Sep 2019
<![CDATA[Thyroid Uptake of Tc-99m and Its Agreement with I-131 for Evaluation of Hyperthyroid Function]]> Source:Universal Journal of Public Health  Volume  7  Number  5  

M Ohiduzzaman   R Khatun   S Reza   M A Kadir   S Akter   M F Uddin   M A Rahman   R Mallick   M A Samad   M M Billah   and M M Ahasan   

Thyroid uptake and scintigraphy using Tc-99m pertechnetate has proven to be more advantageous than with I-131 iodide, since the images have better quality, the procedure is faster and the patient is submitted to a lower radiation dose. Tc-99m has been used worldwide to study the thyroid function because of a number of advantages such as short half-life, short biological half-life, short effective half-life, short retention in gland and no Beta (β-) radiation, providing low dose to gland (10,000 times less than that of I-131), low cost and readily availability. Otherwise, I-131 with its high radiation burden (1-3 rad/mCi) has long half-life and causes Beta (β-) particle emission. Its main gamma photon has high energy (364 keV) which also causes poor image quality. The experiment is carried out at the Institute of Nuclear Medicine and Allied Sciences (INMAS), Bangladesh Atomic Energy Commission, Dhaka Medical College Hospital Campus, Dhaka-1000. In the present work, the study consists of 109 patients (76 female and 33 male) with ages ranging from 14 to 66 years. The patients studied with Tc-99m found to be hyperthyroid of 57 and in case of I-131, the findings were 60. The agreement between I-131 and Tc-99m is 95% and the correlation coefficient, r between Tc-99m & I-131 is = 0.879, which indicates strong correlation between them. So, it is statistically significant and makes a good agreement. The outcome of this study may provide valuable information about thyroid treatment and also may play important role in the management of thyroid patient.

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Sep 2019
<![CDATA[Early Outcomes of Obese Patients Undergoing Total Hip Arthroplasty: Comparison of Anterior to Posterior Approach]]> Source:Universal Journal of Public Health  Volume  7  Number  5  

Eric N. Windsor   William D. Zelenty   Blake M. Bodendorfer   Richard Verstraete   and Mark W. Zawadsky   

BACKGROUND: There has been an increase in total hip arthroplasty in obese patients and surgical complication rates are known to be higher in this population. This retrospective study evaluated complication rates for obese patients undergoing total hip replacement compared to non-obese patients. Additionally, we compared complication rates for direct anterior approach (ATHA) versus posterior approach (PTHA). METHODS: This study was an IRB approved retrospective review of 210 patients undergoing ATHA and 201 patients undergoing PTHA during the same time period by 2 total joint surgeons. Non-obese patients were compared to obese patients using body mass index (BMI) classification. Minor and major complications were reviewed as well as length of stay, disposition, and other short-term outcome measures. RESULTS: The non-obese cohort (BMI < 30) had lower complication rates (2.8% major, 4.4% minor) compared to the obese cohort (8.7% major, 9.9% minor). Major complications by obese class were: Class I 8.6%, Class II 7.1% and Class III 11.5%. The non-obese ATHA cohort had lower complication rates (0.8% major, 5.0% minor) compared to the PTHA cohort (5.0% major, 6.7% minor). Obese patients had 6.3% major and 9.9% minor complication rates in ATHA, compared to 11.1% major and 10.0% minor complication rates in PTHA. Lastly, the evaluation of short-term outcomes showed more favorable results for ATHA for both obese and non-obese patients. CONCLUSION: Obesity was associated with an increased risk of complications and less favorable short-term outcomes following THA. Direct anterior THA was associated with lower complication rates and more favorable short-term outcomes.

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Sep 2019
<![CDATA[High Road Traffic Noise in Residential Buildings, High Annoyance and Self-perceived Health Problems in a Sample from Santiago, Chile]]> Source:Universal Journal of Public Health  Volume  7  Number  4  

Mauricio Fuentes A.   Antonio Marzzano R.   and Karla Yohannessen V.   

The purpose of this study was to examine the association between exposure to high traffic noise levels in housing and the proportion of high annoyance and self-perceived health problems, through a survey applied to comparable groups of individuals with and without exposure, selected in residential buildings from urban Santiago, Chile. It was an observational, cross-sectional study. Buildings with sides exposed and unexposed to high traffic noise levels were considered. In each building, independent samples of dwellings from each side were selected. A questionnaire consisting of three parts was applied: socio-demographic and related characteristics, self-perceived health state, and annoyance caused by different sources including traffic noise. To assess association between exposure to traffic noise and each self-perceived health response (including high annoyance), multiple logistic and log-binomial regression analyses were applied, adjusting by sociodemographic and related variables. Four residential buildings were included, achieving a total of 425 respondents, 200 living in exposed dwellings and 225 living in unexposed dwellings. Adjusted significant association was found between exposure and high annoyance, high degree of problems with concentration, sleeping and feeling rested, presence of head or neck ache, and feelings of depression, anguish or neurosis.

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Jul 2019
<![CDATA[Trans-identity in Benin: Fact or Fiction? Social Response and Consequences]]> Source:Universal Journal of Public Health  Volume  7  Number  4  

Septime Hessou   Yolaine Glèlè Ahanhanzo   Alphonse Kpozèhouen   Tranquilin Yadouleton   Odile Sodoloufo   Virgile Capo-chichi   Bruno Doussoh   Bernard Gnahoui-David   Alphonse Biaou   and Colette Azandjèmè   

Transgender individuals are recognized globally as a key population that is at heightened risk than the general population for transmitting and contracting sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). One of the social outcomes of the gender transition process is the adoption of risky behaviours as coping strategies. Examining the unique health-related needs of transgender individuals in Benin, this study describes the experience of being transgender, along with the social and community ramifications associated with this identity. The research team conducted a cross-sectional study in 2017. Study participants were recruited via respondent-driven sampling among networks across Benin. Inclusion criteria included self-identifying as transgender and being over 15 years of age. Data were collected via questionnaires regarding individuals' management of the gender transition, reactions within their community and social spheres, and engagement in risky behaviours. A total of 326 transgender individuals were identified with a majority of participants being born biologically male (89.57%). The average age was 24.13±4.88, with a strong representation of students (36.50%). In 64.72% of cases, participants' families were informed of their transgender identity. The overall attitude of families was of acceptance/support in 7 cases out of 10. Stigmatization and discrimination were reported by 50% of the subjects and 59.02% were subjected to at least one assault. Among these, half were unable to pursue legal action in response, with the main reason being a lack of knowledge of their options for legal recourse. Having multiple sexual partners was the most common risky behaviour among participants, occurring in 81.54% of the cases. Transgender individuals constitute a population with specific needs in Benin. The services and interventions dedicated to this population must integrate the prevention of STIs and HIV, along with providing legal, social and psychological support.

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Jul 2019
<![CDATA[Progress towards Universal Health Coverage: Is Cameroon Investing Enough in Primary Care?]]> Source:Universal Journal of Public Health  Volume  7  Number  4  

Chenjoh Joseph Nde   Alice Raymond   Ndong Ignatius Cheng   Guy Roger Etoundi   Yauba Saidu   Johannes Tabi Atemnkeng   and Wilfred Fon Mbacham   

Cameroon faces significant income and health inequalities, due to the health sector's reliance on out-of-pocket spending for 70% of healthcare financing. To solve this problem, the government in 2015 began reflections for the putting in place of a universal health coverage (UHC) scheme. However, a number of planning, budgeting and resource management processes must be strengthened to facilitate this reform. This paper aims at reviewing the structure of resource allocation within the ministry of health to assess if it reflects the government's desire to enhance service availability and readiness for the impending UHC. Data was derived from finance laws (chapter 40) of 2014 to 2018. The data was analyzed using Microsoft Excel. The results reveal a high centralization of the budget in favor of the central administration to the detriment of the operational level. Allocations to the regional and district levels are insensitive to the size and needs of the population of the regions and districts. As a consequence, there are great disparities between the regions and between urban and rural areas, leading to inequity in service delivery. In order to increase the quantity and quality of primary care in an effort to reach UHC, we recommend that more resources be directed to the operational level while district managers are capacitated to effectively and efficiently use these funds.

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Jul 2019
<![CDATA[Unequal Conditions: A Systematic Review of the Relationship between Urban Poverty and Psychological Resilience]]> Source:Universal Journal of Public Health  Volume  7  Number  4  

Angélica Ojeda García   Bernardo Turnbull Plaza   Jaime Fuentes Balderrama   Cinthia Cruz del Castillo   and Alison K. Cohen   

Poverty is one manifestation of inequality: it is often a consequence of an unequal distribution of social resources, especially in urban settings. The lack of resources can impact people's quality of life and provoke a spiral that reinforces the cycle of poverty. The concept of resilience can be a useful framework for understanding a person's positive adaptations to urban poverty's environmental stressors. This paper seeks to comprehensively understand how urban poverty influences the social functioning and well-being of individuals in urban areas. We conducted a systematic review to identify the risk factors that limit or increase vulnerability and the resilient responses that promote development and psychological functioning among those experiencing urban poverty. We explore how resilience can help overcome the vulnerabilities urban poverty creates and identify the coping strategies some families experiencing urban poverty use. We encourage researchers and practitioners to take a strengths-based approach to understanding individuals' resilient responses and community involvement as they socially adapt to unequal conditions in diverse and myriad ways.

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Jul 2019
<![CDATA[The Removal of Charges for Health Services in the Jamaican Public Health System: Impact on the Health Practitioners' Performance]]> Source:Universal Journal of Public Health  Volume  7  Number  4  

Adella Campbell   Vanesa M. Tennant   and Fitzroy Henry   

There is an ongoing discussion between governments, international agencies, and advocacy groups on whether user fees imposed at government health facilities in poor countries should be removed. Proponents argue that abolition of charges would lead to greater access for the poor, therefore offering the underserved the opportunity to access health services. There are limited studies that examined how health practitioners, an important stakeholder are affected. This research examined the impact of the 2008 removal of charges for health services on health practitioners in Jamaica. Using a mixed method evaluation design, we found that main health practitioners - nurses, doctors and pharmacists were not satisfied with the policy change. When compared to that before removal of charges, 10% less practitioners felt that performance on the job was good. Health practitioners alluded to increased workload, negative effects on their physical and emotional status and dissatisfaction with their work environment. Other problems encountered by health practitioners included unavailability of resources, shortage of staff, lack of equipment and lack of administrative support. The lesson learned for policymakers is that the critical problems identified will eventually outweigh the substantial health gains if adequate resources (financial and human), administrative support as well as improved service management are not soon injected into the public health system.

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Jul 2019
<![CDATA[Twinning with Tonga: The Experiences of Tongan Stakeholders with a Long-term Partnership with Regional Victoria, Australia]]> Source:Universal Journal of Public Health  Volume  7  Number  3  

Carolyn Mornane   Michelle Franc   Maureen Waddington   Blake Peck   and Daniel Terry   

Twinning programs in health have gained increased recognition as a WHO preferred strategy for providing a sustainable strategy for enhancing the delivery of best practice healthcare globally. The Tonga Twinning Program (TTP), represents a longstanding relationship of some twenty-five years between The Ministry of Health in Tonga and St John of God Hospital, Ballarat, Australia and provides a compelling example of what can be achieved. This article presents the findings from a longitudinal exploration of the experiences and perceptions of the TTP through the voices of those key-stakeholders situated in Tonga who have engaged with the program. Informed by the tenets of hermeneutic phenomenology, a modified thematic analysis highlighted two major themes, ‘A shared mission' and ‘The outcomes are more than the tangibles', which supported by a series of sub-themes, identify the core components of the experience of the TTP. This study suggests that the TTP has supported a collective sense of bringing the very best available knowledge and skills to the people of Tonga and has fostered a genuine and open dialogue between partners as a mechanism for change that goes well beyond simply a capacity to replicate skills and instead has establish a genuine reciprocity akin to being a family.

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May 2019
<![CDATA[Death and Dying: A Nursing Focus on the Care of the Patient]]> Source:Universal Journal of Public Health  Volume  7  Number  3  

Kerry Brodbeck   and Nancy Duphily   

The role of the nurse is often associated with healing and helping bring people back to health. While this is a large aspect of the nursing profession, the nurse also cares for patients who are dying. The care delivered at this time revolves around the comfort of the patient, as well as ensuring that all of the patient's needs are met, including any cultural or spiritual needs. In order for the care of the patient to transition from curative to comfort measures, it is necessary for a diagnosis of dying to be made. This diagnosis should then be communicated with the patient and family. When the diagnosis of death is not communicated in a timely manner, it has been found that the patient's do not receive quality end of life care. This diagnosis surpasses all other diagnoses and shifts the focus towards the comfort and well-being of the patient. Care at the end of life includes pain management, discontinuation of routine vital signs and laboratory tests and coordinating care with other professionals to ensure the best quality care is being offered. Since the end of life is a new experience for most, it is important that the nurse informs the patient and the family of interventions that will occur and all resources available to them. Palliative care is a resource that can be implemented along curative measures at any stage of a disease, which assists the patient with pain and symptom management. As the disease course continues and the patient's life expectancy is less than six months, hospice care is a resource that should be offered. The nurse, along with the rest of the care team, should ensure that these resources, along with legal documents such as advanced directives or healthcare proxy forms are available to the patient. At the end of life, the nurse is on the front lines to ensure that the patient is receiving the best quality care possible. This is done by communicating and listening to the patient and developing a therapeutic relationship with them.

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May 2019
<![CDATA[Abernethy Malformation – Congenital Extra-hepatic Portosystemic Shunt Associated with Multiple Liver Adenomatosis: Case Report]]> Source:Universal Journal of Public Health  Volume  7  Number  3  

Guilherme Jose de Paula Oliveira   Samuel Ferreira   and Andre Barbosa   

In this article we report a case of Abernethy malformation, also known as congenital extrahepatic portosystemic shunt (CEPS). It is a rare vascular malformation in which the portal vein drains into a systemic vein, diverting it from its normal path to the liver. The clinical presentation is variable and most commonly the shunt is diagnosed during the propaedeutic for investigation of the symptoms. Discussion and diagnosis: R.B.S.R, 21 years old, male, with history of liver disease and previous diagnosis of multiple liver adenomatosis from 9 years of age, was hospitalized for pre-transplant liver evaluation. In the medical history, he presented delayed neuropsychomotor development, congenital scoliosis, neurogenic bladder and single kidney, and had also undergone two surgeries. His initial laboratory tests showed increased transaminases and canalicular enzymes. Ultrasonography, radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed, which enabled us to identify and confirm important points for diagnosis. Conclusions: It is important that the radiologist recognize the findings early. CT and MRI are fundamental in the management of the syndrome, since they provide the information for diagnosis, planning, intervention and follow-up, as well as the identification of complications.

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May 2019
<![CDATA[Experiences of Individuals Living with Chronic Mental Illness in Northern Namibia]]> Source:Universal Journal of Public Health  Volume  7  Number  3  

Ndapeua Shifiona   Marie Poggenpoel   and Chris Myburgh   

The aim of this study was to explore and describe the lived experiences of individuals living with chronic mental illness, and the experience of those caring for them. A qualitative, explorative, descriptive, and contextual research design was used. Data was collected from four (4) multiple case studies which comprised of twenty-four (24) participants, utilizing in-depth phenomenological interviews with individuals living with chronic mental illness; one focus group interview with family members from each case, community members and health care workers. Interviews and focus group discussions were tape-recorded and transcribed verbatim. Data was analyzed by means of Tesch's open coding method. Three (3) main themes were identified; (a) experience of ineffective individual coping related to living with chronic mental illness, (b) experience of alteration in family processes related to the presence of long term mental illness, and (c) experience of individuals' impaired social interaction related to substance abuse and dysfunctional system evidenced by verbalized discomfort in social situations. The study concluded that an understanding of patients' experience by mental health nurses will enable them to facilitate the development of constructive interaction between individuals living with chronic mental illness and caregivers.

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May 2019
<![CDATA[Reaching Universal Health Coverage by 2035: Is Cameroon on Track?]]> Source:Universal Journal of Public Health  Volume  7  Number  3  

Chenjoh Joseph Nde   Alice Raymond   Yauba Saidu   Ndong Ignatius Cheng   Divine Nzuobontane   Johannes Tabi Atemnkeng   and Wilfred Fon Mbacham   

Access to health care is a fundamental human right, which places a legal obligation on states to ensure access to quality, timely, acceptable, and affordable health care for its citizens. However, many states struggle to meet this basic right for their citizens given that every year about 100 million people are pushed into poverty, while 150 million people suffer financial catastrophe due to out of pocket payments for health. In Cameroon, studies have shown that about 64% of households cannot access healthcare, because they perceive the cost of care to be high. In 2012, the National Health Accounts (NHA) estimated that about 70% of the Total Health Expenditure (THE) for the country was borne by households. Compared to its peers, the contribution of Cameroonian households is the third highest in Sub-Saharan Africa, where the average is 34%. To remedy this situation, Cameroon has initiated reflections aimed at establishing a universal health coverage (UHC) scheme for its population. This paper therefore aimed at providing a synthesis of Cameroon's progress and assessing if the country is on track to achieving UHC by 2035.

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May 2019
<![CDATA[Community-based Participatory Research (CBPR) and Refugees' Health Studies: What's Working and What's Not Working]]> Source:Universal Journal of Public Health  Volume  7  Number  3  

Huaibo Xin   

The Community-based Participatory Research (CBPR) has been well defined and widely applied to different study populations in a variety of health topic areas to address the urgency of translating research into practice, reducing health disparities, improving health equity, and advocating for health policy changes. The current study aims to systematically examine how CBPR has been applied to improving underserved refugee populations' health and identify the successes and challenges of CBPR utilization among refugees. A total of 930 peer-reviewed journal articles, reports, commentaries, theses, dissertations, books, and book chapters in English, retrieved from several major databases (e.g., EBSCO, ERIC, PubMed, PsycINFO, CINAHL Plus, and Google Scholar) were initially reviewed. Fourteen peer-reviewed journal articles were finally selected and analyzed using the theme analysis. Results showed that successes of utilization CBPR in refugee health studies were achieved in areas of shared learning, trust, recruitment, methodological rigor, advocacy, sociocultural determinants, dissemination/ sustainability, ethics, cultural competency, and stigma. However, the CBPR practice was also challenged by issues emerging from institutional culture and structure, clinical procedures, non-probability sampling, self-reflection, and repetition. Current literature suggests that overcoming these challenges requires both institutional restructure and policy changes, and changes in the focus of both internal and external funding mechanisms.

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May 2019
<![CDATA[Evidence Based Abortion Stigma Reduction Using Radio Drama in Nigeria]]> Source:Universal Journal of Public Health  Volume  7  Number  3  

Eremutha Awasighe Francis   Okosun Onaburekhalen Thankgod   Gabriel Veronica Chizoba   and Diakpomrere Oghenevweta Vincent   

A substantial number of Nigerian women/ girls have unwanted pregnancies due to their low contraceptive prevalence. Many of these pregnancies are resolved through unsafe abortion. Unsafe abortion constitutes a huge burden to women's health and reproductive lives especially in Nigeria where it is perceived illegal. The media plays a significant part in shaping public perceptions of health issues, and abortion attracts continued media interest. The objective of this research was to explore the context of abortion stigma on campus using University of Benin as a reference point, through qualitative and quantitative research at baseline/ endline. In achieving this, related youth concerns on the campus that fuels unplanned pregnancy and unsafe abortion such as rape, none use of contraception, drug abuse and cultism were equally assessed to determine the level of stigmatization placed on perceived offenders. Findings were used to develop an intervention strategy on stigmatizing attitudes and beliefs about abortion. Following airing of 24 episodes radio drama on abortion and related concerns, findings were scored and interpreted using the Stigmatizing Attitudes, Beliefs and Actions Scale (SABAS). Our findings showed significant decrease in the negative dimensions and improvement in positive discuss of abortion following increased awareness and education on abortion and related concerns.

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May 2019
<![CDATA[Effect of High Blood Pressure and Other Cardiovascular Risk Factors on All-causes Mortality in Elderly People: A Joined Survival Analysis from Brazil, Argentina and Italy]]> Source:Universal Journal of Public Health  Volume  7  Number  3  

Liciana Vaz de Arruda Silveira   Alberto Rubén Osella   María del Pilar Díaz   and José Eduardo Corrente   

Non-Communicable Chronic Diseases (NCCDs) are the leading causes of ill health in elderly populations and are associated with increased risk of death. Then, the aim of this paper is to estimate the effect of High Blood Pressure on all-causes mortality among subjects aged ≥65 years old in three scenarios with different socio-economic backgrounds and urbanization processes by using flexible parametric survival models. Three cohorts coming from Brazil (n=365, 8 years of follow-up), Argentina (n=1800, 10 years of follow-up) and Italy (n=2472, 30 years of follow-up) were considered and only subjects older than 64 years included. Time to death (months) from enrolment and all-causes mortality were considered. Statistical analysis included Frailty Cox's Model and Flexible Parametric Survival Analysis. Due to the two-level structure of variability (subjects nested into cohorts), multilevel mixed-effect survival regression models were fitted. For modeling purposes, only the first twelve years of follow-up were considered. Frailty Cox model showed significant positive effects of age and an effect modification of High Blood Pressure and Non-communicable diseases, but not effects proportionality. Multilevel modeling evidenced a positive statistically significant effect of Age, Non-Communicable Chronic Diseases and Smoking. There was also an effect modification of Non-Communicable Chronic Diseases on High Blood Pressure. High Blood Pressure and Non-Communicable Chronic Diseases are important causal components and strong risk factors of cardiovascular mortality in these countries.

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May 2019
<![CDATA[Using Mobile Technology to Access Sexual and Reproductive Health Information and Services by Adolescent & Young Persons: Findings from Nigeria]]> Source:Universal Journal of Public Health  Volume  7  Number  2  

Eremutha Awasighe Francis   Gabriel Veronica Chizoba   and Olumide Adesola   

Sexual and Reproductive Health (SRH) issues are important aspects of adolescent health and development. Increasing access to newer mobile technologies such as computers and cell phones makes it possible to reach adolescents with sexual, reproductive and other health messages via these media. The study was designed to determine young people's knowledge and use of media technologies in the provision of SRH information and services. A cross-sectional study that employed a mixed methods approach was conducted. This involved both quantitative and qualitative methods. 1342 young persons were questioned: 53.1% males and 46.9% females with an overall mean age of 17.1 ± 3.5 years. Almost 66% of the adolescents had access to the internet and mostly at home (87.3%). More of those in the rural (approximately 70.5%) then urban (61.4%) had internet access and <50% of all the young people were aware that one could obtain information on locations of youth friendly centres from electronic media. Desires to improve their knowledge on the SRH issues were some reasons mentioned by the young persons for their choice of the internet as a source of SRH information. The findings shows that it is imperative for potential providers to ensure that SRH information made available through these mobile technologies is accurate and up-to-date and that information on reliable sources of care are also provided to facilitate linkages to reliable SRH care.

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Mar 2019
<![CDATA[Optimal Threshold of the Finnish Diabetes Risk Score (Findrisc) for Screening at-Risk Adults in an African Population in Southern Benin]]> Source:Universal Journal of Public Health  Volume  7  Number  2  

C. G. Metonnou-Adanhoume   V. Agueh   C. S. Azandjeme   C. J. Sossa   A. Kpozehouen   J. Hessou   J. Darboux   and M. N. Para?so   

This study aims to determine the performance of the FINDRISC tool for screening adults at risk for type 2 diabetes in an African population in southern Benin. This retrospective study included 536 subjects aged 25 to 65 years. The FINDRISC questionnaire score was calculated using seven components: age, body mass index, waist circumference, regular practice of 30 minutes of physical activity, regular consumption of five portions of fruits and vegetables, the family history of diabetes and the presence of high blood pressure. The performance of the tool was determined from the FINDRISC score and fasting blood glucose The "Receiver Operator Characteristic" (ROC) Curve of the FINDRISC score was used to define the optimal cut-off value of the tool for. The FINDRISC threshold-optimal value for detecting T2D risk in southern Benin was 8.5 with 77% sensitivity, 89% specificity, 45% positive predictive value and 71% negative predictive value. The area under the ROC curve was 0.86 (95% CI: 0.81-0.90). This study revealed that the optimal threshold value for detecting the medium or high risk of T2D observed in Benin is lower than Finland's one. Further studies including larger and more representative samples need to be carried out to confirm this finding.

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Mar 2019
<![CDATA[Benefits of a Clinical Pharmacist in Outpatient Diabetes Disease State Management]]> Source:Universal Journal of Public Health  Volume  7  Number  2  

Rola A Halabi   Wafaa Abou-Zeineddine   and Margaret Ann Breakenridge   

Diabetes is a chronic disease state affecting millions of patients, many of which have uncontrolled diabetes and not under a physician's care. The economic and health impacts that a pharmacist can have on patients overall health is well known. As an increasing number of patients suffer from uncontrolled diabetes and its complications which makes the role of pharmacists more important than ever to provide patients with knowledge of the many therapeutic options available, appropriate self-testing techniques, and other important lifestyle modifications. The role of pharmacists has expanded to include ambulatory care in an outpatient setting. The purpose of this study is to evaluate the impact of pharmacist involvement in diabetes management in an ambulatory clinic, where there previously has been no pharmacist participation. Comparing data from a pilot study performed without pharmacist involvement, pharmacists have been able to achieve better Hgb A1C reductions than the pilot study performed in fiscal year 16 (FY16) at an average of 3.36 ± 1.76. Although the sample size of patients was small at only 5, these are promising results of the impact that in depth patient education can have on improving outcomes.

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Mar 2019
<![CDATA[Knowledge, Attitude and Practice of Hand Washing among Mothers of Children 0-59 Months of Age in Lagos Nigeria]]> Source:Universal Journal of Public Health  Volume  7  Number  2  

Abigail Odozi Ogwezzy-Ndisika   and Tommy Solomon   

This study examined the knowledge, attitudes and practice of hand washing among mothers of children 0-59 months of age in Lagos Nigeria. The descriptive survey method was used to gather data for the study. The study was conducted in three local government areas of Lagos. The local government areas are Eti-Osa, Lagos Mainland and Alimosho. 934,886 female residents of the three local government areas formed the population of study while 406 respondents formed the sample size. Purposive sampling technique was used to select the respondents. The study found that 7 in 10 mothers of children 0-59 months of age had high exposure to the campaign about the danger of dirty hands (73.8%). About 6 in 10 of them similarly had high knowledge of the subject matter and as a result, mothers who were knowledgeable about hand washing practiced it. It concluded that has been a gap between recommendations on improving hand washing practice and actual actions on such recommendations. Hence, this study recommends that intervention efforts should address the infrastructure gaps that negatively impact on the availability of these hand washing-boosting factors, particularly, access to water, if improvement is to be achieved in terms of practice.

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Mar 2019
<![CDATA[Knowledge and Practice about Transportation of Infectious Substance among Healthcare Providers, Khartoum State]]> Source:Universal Journal of Public Health  Volume  7  Number  2  

Muatsim Ahmed Mohammed Adam   Salma Faroug   Rasha Sayed   Adel Elduma   Hamdan Mustafa   and Eltahir Awad Gasim Khalil   

Proper shipping of infectious materials is an important practice to prevent healthcare workers (HCWs), other people and environment from spread of biological threats. The main purpose of this study was to determine healthcare providers' knowledge, and practices about transportation of infectious substances. A self-administered designed questionnaire was used to collect relevant data from study respondents. Primary data were double entered and analyzed by using statistical package for social sciences (IBM SPSS statistics 20). Descriptive, in addition to the effects of predictors on dependent variables were applied. Multiple logistic regression model was used to assess the association between dependent variables and predictors. It has been found that; the overall mean percentage of knowledge was 57.1 (95 CI: 54.1, 60.2), while mean percentage of practice was 68.9 (CI: 95% 66.7 – 71.1). Response reliability scale was 89.0% based on Cronbach's alpha. The highest knowledge regarding transportation of infectious substances was observed among laboratory specialist (33.9%) and doctors (25.4%) respectively. High percentage of practice was observed among laboratory specialist was (34.6%) and low percentage was among public health officers and doctors (15.9%). Majority of study respondents did not receive training in transportation of infectious substances (70.9%). Knowledge and practice on transportation of infectious substances among health care providers are low. More efforts are needed to fill the gap in knowledge and practice by applying effective training programs that can lead to increase skills and awareness of health care providers.

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Mar 2019
<![CDATA[Barriers Limiting Youth Access to Reproductive Health Services by Primary Health Care Facilities in Nigeria]]> Source:Universal Journal of Public Health  Volume  7  Number  1  

Eremutha, Francis   and Veronica Chizoba Gabriel   

Youth represent a tremendously valuable asset to the society therefore working with them to make a healthy transition to adulthood is critical to the world's development now and in the future. The issue of youth-friendly health service has become a matter of concern as many young people still do not have access to such in the country. The community survey was designed to generate increased understanding of the barriers that limit youth access to sexual and reproductive health services(SRH) offered by Primary Health Care (PHC) facilities in Nigeria. Stratified and Purposive Sampling with qualitative and quantitative research methodology was adopted. Qualitative data were obtained through 12 Focus Group Discussions (FGDs) and 48 Key Informant Interviews (KIIs). For the quantitative component, an interviewer-administered questionnaire was used to elicit information from 300 randomly selected adolescents and youth. The mean age of respondents was 18.9 ± 4.4 years. Reported barriers to youth's access to SRH services were lack of awareness (67.3%), cost of services (46.7%), negative attitude of health care providers (39.7%) and fear of parents and what people will say (32.0%). The results shows that community mobilization for awareness creation and support on SRH issues (59.3%), will support youth to better access SRH services in PHC facilities

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Jan 2019
<![CDATA[Non-functioning Pancreatic Neuroendocrine Tumor in a Patient with Multiple Endocrine Neoplasia Type 1 Syndrome: Case Report]]> Source:Universal Journal of Public Health  Volume  7  Number  1  

Gabriel Brito Barbosa   Lucas Santos Pimentel   Arthur Ribeiro Costa Carvalho   Thais Ribeiro Costa Carvalho   and Ana Rita Marinho Ribeiro Carvalho   

Background: Neuroendocrine tumors are rare, but when coexisting with Multiple Endocrine Neoplasia Type 1 Syndrome in the same patient, the literature shows 80 to 100% association. Represents an autosomal dominant disorder due to mutations in tumor suppressor gene MEN1 and it's defined as the development of two or more tumors from the main three endocrine sites: the parathyroid glands, the pancreatic islet and the Pituitary gland. We present a case of a patient with a compatible family history and classic imaging findings for MEN1 Syndrome. Case report: Male, 28 years old patient genetically diagnosed with the MEN 1 Syndrome who presented to our image service for abdominal tumors' screening. Submitted through multiples imaging exams such as CT, MRI, PET/CT to follow up the diagnosis, in which was found a pancreatic mass measuring over 3 cm, with another 3 little pancreatic lesions as well. The patient received indication to surgery, with further anatomopathological and immunohistochemistry studies confirming the well- differentiated neuroendocrine tumor. Conclusion: Due to the wide range of malignant potential, it's recommended annual screening, as minimum, with biochemical and image techniques. Surgery is the only treatment capable of tumor's eradication, which consists on a pancreatectomy (lesions sized more than 1-2 cm).

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Jan 2019
<![CDATA[Acute Pulmonary Thromboembolism Retrospective Auditory - The Benefits of Clinical Predictive Tools]]> Source:Universal Journal of Public Health  Volume  7  Number  1  

Bruno Sousa Dos Santos   Maya Wielert   Ieva Krieva   Kathryn Mullan   Sandra Seimane   Aleksejs Visnakovs   and Olegs Sabelnikovs   

Several studies in recent years have identified the importance of developing a more standardized diagnostic approach to patients suspected of acute pulmonary embolism (PE). Still many doctors prefer a theoretical approach to the diagnosis of PE without the use of pre-test clinical predictive tools. Through the process of audit, we collected data available from the files of patients who underwent computer tomography pulmonary angiography (CTPA) and tested this data within the pre-test probability tool "Wells criteria score". Additionally, other important variables that were previously validated as well as those with possible diagnostic value were also analysed, as these may prove to be useful indicators to further develop the pathway towards a more efficient diagnosis of PE. The results within this study were compared to similar studies. With the aim of understanding the possible benefits of a more purposely structured approach, this study ultimately intends to support the development of PE protocols towards a more standardized approach to its diagnosis. Subsequently, it seeks to promote improvement in patient safety and accuracy in diagnosis as well as clinical decision-making. The main results in this study show a clear correlation between Wells criteria score risk levels with an increased predictive likelihood of a positive PE. Dyspnea and chest pain proved to be the most frequent clinical findings outside wells criteria. The age-adjusted D-dimer in this study data demonstrated to be a candidate for further evaluation with great potential for clinical application. Electrocardiogram S1Q3T3 findings displayed a specificity of 92,86% and positive predictive value 69,70%. The conclusion of this study reveals that a standardized approach that includes Wells criteria together with an age-adjusted D-dimer may avoid unnecessary steps and examinations in diagnosis of PE, namely that of D-dimer tests and CTPA.

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Jan 2019
<![CDATA[Determinants of Delays in Health Care Utilization for Malaria Treatment (HCUMT) in Children under Five in Benin Southern Setting]]> Source:Universal Journal of Public Health  Volume  7  Number  1  

Moussiliou N. Para?so   Alphonse Kpozèhouen   Yolaine Glèlè Ahanhanzo   Camara Facely   Charles Sossa-Jerome   and Achille Massougbodji   

Untreated or poorly treated malaria case is reported to progress to the severe form over time. Studies showed a high prevalence of untimely utilization of health service in low-income countries. The objective was to identify the determinants of late use of malaria treatment in children under five years of age in Ouidah, Benin. The study was cross-sectional and carried out during June 2017. Data on sociodemographic characteristics and malaria management were collected in randomly selected 450 couple mother-child pairs using a questionnaire. A multivariate analysis using a logistic regression and the stepwise digressive method was used to identify the determinants of late use of malaria treatment in children under five years of age. The prevalence of delayed utilization of health facilities for malaria management in children under 5 years was 87.8% (95% CI: 81.6% - 92.8). Delays in health care utilization depended on whether mothers were married (OR = 4.4, 95% CI: 2.2-8.8), they used the motorcycle as a means of travel to health facilities (OR = 2.3, 95% CI: 1.1-5.2), complained about the high cost of transport (OR = 2.4, 95% CI 1.2-4.7), or believed in the possibility of preventing malaria (OR = 2.4, 95% CI: 1.2 - 4.7). When health care costs are paid by both the parents or by grandparents at the same time, then children were less likely to experience a delay (OR = 0.4, 95% CI: 0.2 - 0.7). The prevalence of delays in health care utilization for malaria treatment (HCUMT) in children under five years is high in Ouidah in Benin south setting. Organization of simple malaria management through community training, regular and continuous supply of inputs (medicines and diagnostic tests) for malaria control would reduce the delays in HCUMT in children in Ouidah, Benin.

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Jan 2019
<![CDATA[Perceptions and Therapeutic Challenges in the Management of Chronic STIs in Africa: Comparing HIV and Hepatitis B in the University Teaching Hospital Yaounde, Cameroon]]> Source:Universal Journal of Public Health  Volume  7  Number  1  

Loveline Ndi   

Sub-Saharan Africa and Cameroon in particular are experiencing a persistence and consistency in the incidence rates in chronic sexual infections such as HIV and HBV. The prevalence rates stands between 8-10% for HBV and 4.3% for HIV in the general population. Surveys on therapeutic results show more challenges in the management of HIV than HBV. This disparity is due to the differences in perceptions and representations, although similar in pathogenic forms, modes of transmission and chronicity. A call to compare these differences that creates fear, shame and guilt towards HIV compared to HBV, thus, preventing many patients from disclosing their HIV statuses and exposing uninfected partners. A health education system that embraces health beliefs highly needed to demystify the mystery around HIV. This study explains the reasons for negative perceptions with stigma resulting to therapeutic challenges in the management process. A qualitative study that uses in-depth interviews and participant observations on a sample population of about 250 patients undergoing therapeutic education sessions, collected data, analyzed and interpreted using the content analyzes model. Findings show that, negative perceptions towards HIV are the cause of therapeutic challenges. Need to integrate socio-cultural realities in strategies to demystify this prejudice around HIV.

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Jan 2019
<![CDATA[A Reliability Comparison of Different Methods for Detecting Step Rate and Foot Strike Pattern in Runners Using Two-dimensional Video]]> Source:Universal Journal of Public Health  Volume  6  Number  6  

Miller Erin   Morris Jamie   Watson Daniel   and Goss Donald   

Two-dimensional (2D) video is often used to evaluate running gait. Cost effective and clinically applicable methods have not been validated. The objective of this study was to evaluate the concurrent validity and agreement of methods used to determine step rate (SR) and foot strike pattern (FSP) during running using 2D video. We observed excellent agreement assessing SR from a 30 Hertz (Hz) video for 10 seconds (s) and multiplying it by 6. We observed excellent interrater agreement assessing FSP for 10s at 240 Hz. These 10s methods for assessing running may be used to inform clinical decision making when evaluating running gait. Key point's Two-dimensional video assessment at 30 Hz demonstrated high intra- and interrater reliability for detecting step rate; the 10-second method is valid and reliable for detecting step rate when compared to the 60-second method; Detecting foot strike using a 2-point scale is more reliable at 240Hz rather than 30Hz.

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Nov 2018
<![CDATA[Current Status of Knowledge and Attitude toward STI Prevention among Out-of-school Youth in the Philippines]]> Source:Universal Journal of Public Health  Volume  6  Number  6  

Mariko Gunchi   Yuko Tanaka   Maria Teresa Reyes Tuliao   Geraldine Ordonez   Elsi Dwi Hapsari   and Hiroya Matsuo   

The objectives of this study were to determine the knowledge and attitude toward STI prevention, and actual situation of infections (chlamydia and gonorrhea infections) among out-of-school youth in the Philippines. As many as 129 out-of-school youth age 13-20 years old were participated in this study in September 2017. A self-administered questionnaire was used to assess characteristics, knowledge of STIs; sexual behavior; counselors for sexual problems; access to the internet; concerns about STIs; coping with STI symptoms using the scenario setting; sexual risks for STIs; and opinion. The presence or absence of chlamydia and gonorrhea infections in urine was determined with using Aptima Combo 2 Assay. Data was analyzed statistically with using mean, standard deviation, percentage, Mann-Whitney U, and Chi-square. p Value of <0.05 were considered statistically significant. The subjects were concerned about STI and had basic knowledge toward STI prevention but negative attitude toward safer sex. On the urine test, ten out of 126 participants (7.9%) had positive reactions about chlamydia and three of them were co-infection with gonorrhea. Female participants were much more likely to get infected (12.8%) than male (3.2%). In conclusion, the knowledge toward STI prevention had no correlation with their attitude. Therefore, sexual education is not enough to focus on STI knowledge but also put more emphasis on practice to promote safer sexual behavior.

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Nov 2018
<![CDATA[The Social History of Chronic STIs in Africa: Experiences from Cameroon]]> Source:Universal Journal of Public Health  Volume  6  Number  6  

Ndi Loveline   

The emergence of chronic STIs in Africa has been a nightmare to medical and social scientists, making infected persons to show differences in clinical, therapeutic and social histories. Medical history shows that HIV/AIDS and HBV are the only chronic STIs in the world for now. This study presents social modifications within this community as persons infected with HIV/AIDS and HBV live their experiences in the context of Cameroon. It presents the traumatic experiences of these infections on the social lives of the infected and affected persons with their entourage. A contribution enriches the current literature on the social history of chronic STIs in Africa. A qualitative study that used the techniques of in-depth interviews, FGD and participant observations to collect data from a sample population of 108 persons living with HIV/AIDS, HIV/HBV co-infections, and HBV presenting therapeutic complications in the UTHY Cameroon. A FGD carried out with patients who are members of social networks and associations. Data analyzed and interpreted using a content analysis and the Social Dynamic Analysis of George Balandier. Persons living with HIV/AIDS have life-experiences that are quite traumatizing and differ from those with HBV. From the 80s till date, HIV patients lived a life of shame, fear, rejection and stigmatization causing a good number of suicidal deaths. This has caused many patients to die due to the refusal to seek medical care. Ignorance around HBV makes it stigma-free and more deadly as compare to the former. Coping strategies developed by these patients result in social modifications of this community.

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Nov 2018
<![CDATA[Factors Leading to Reluctance of Blood Donors from Blood Donation in Saudi Arabia]]> Source:Universal Journal of Public Health  Volume  6  Number  6  

Abdul Rahman Ali A Alsogair   Yousef Duhaim A Al-Rashdi   Thamer Z Aldugieman   Saleh Hadi Alharbi   Fahad A. Alateeq   Ibrahim Bin Ahmed   and Hussain Gadelkarim Ahmed   

Background: Recruitment of safe blood donors is challenging in many countries, worldwide. Assessment of knowledge and attitude towards blood donation is a cornerstone in implementing a sustainable blood donation system. Therefore, the aim of the present study was to assess the factors leading to reluctance of blood donors from blood donation in Saudi Arabia. Methodology: This is a cross-sectional descriptive study conducted in city of Hail, Northern Saudi Arabia. Data about blood donation were obtained from 711 Saudi volunteers living in of Hail. Results: Approximately 293/711(27%) of the participants believed that absence of awareness campaigns is a major reluctance factor for blood donation. Around 143/711(20%) of the participants believed that Lack of awareness in the media is a major reluctance factor for blood donation. Conclusion: Addressing the factors leading to donor's reluctance towards blood donation can improve the development of positive attitude towards blood donation among Saudi population. Factors leading to donor's reluctance towards blood donation should be considered when designing a competent program for sustainable, safe and sufficient blood donation system.

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Nov 2018
<![CDATA[Impact of Pharmacist Interventions on the Treatment of Hepatitis C Patients at a Veterans Affairs Healthcare Facility]]> Source:Universal Journal of Public Health  Volume  6  Number  6  

Bennett J. Doughty   Eric J. Kuszewski   and Seth T. Cioffi   

Purpose: The purpose of this project is to demonstrate the impact of pharmacy interventions and interdisciplinary care on the treatment of hepatitis C virus (HCV) within the outpatient liver clinic at VA Connecticut Healthcare System (VA CT). Methods: This project consisted of a retrospective analysis of patient data conducted from 1/1/2014 – 8/1/2016 within the outpatient liver clinic at VA CT. The following information was collected and analyzed for patients referred to the clinic through the initial consult notes within the VA’s Computerized Patient Record System (CPRS): HCV genotype, human immunodeficiency virus (HIV) status, cirrhosis status, treatment history, adherence pattern per refill histories and appointment attendance, initially requested therapy, pharmacist approved therapy, drug-drug interactions (DDIs) identified by a pharmacist, and sustained viral response at 12 weeks (SVR12). Patients excluded from the above data collection included those that were not chosen to begin treatment after referral to the clinic due to issues such as significant DDIs, history of non-adherence, etc. After data collection, pharmacist recommendations were quantified over the study population and compared to the primary endpoint of SVR12 status. All data was analyzed and presented as percentages in this frequency analysis, requiring no formal statistical analysis software. Results: After comparing the initially requested regimens to those prescribed, 20% of the total 510 regimens were adjusted by a pharmacist. Changes were made for various reasons, including guideline changes, resulting labs (i.e. hemoglobin, platelets, etc.), side effects, and adherence. Approximately 73% of patients had at least one drug interaction identified. Of these identified, 31% of the interacting medications were adjusted by the provider. Finally, SVR12 status through 3/2016 was achieved in 94% of the total patient population, excluding those who did not initiate or complete therapy. Conclusion: This study concludes that the pharmacists involved in patient care within the outpatient liver clinic at VA CT have been a valuable asset to patient care and should continue to provide pharmacy services in a provider role to patients.

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Nov 2018
<![CDATA[Incidence of Urinary Tract Infections, among Adolescent and Adult Women in Ogbete Coal Camp, Enugu]]> Source:Universal Journal of Public Health  Volume  6  Number  6  

Onwujekwe Emmanuel Chijioke   Agbo Angela   and Ezemba Constance Chinyere   

This study was to determine the bacteria that are prevalent in Urinary tract infections and the sensitivity of organisms isolated from the urine of adolescent and adult women of 8- 52 years old in Ogbete Coal camp in Enugu metropolis, south east Nigeria. A total of 218 individuals, both in and out patients were investigated, 197 (90.3%) women were diagnosed for Urinary tract infections. Therefore, incidence of UTI were prevalent in the age groups of 13-17 and 18-22, with P value (p=0.047 and S.D of ± 5.6). The microorganisms implicated in infection were bacteria, fungi, yeast and protozoa. Among the bacteria, two were identified as Gram positive cocci i.e. Staphylococcus aureus and Staphylococcus saprophyticus, while Gram negative bacilli were Escherichia coli, Klebsiella, Proteus, Pseudomonas aeruginosa. Yeast like fungus Candida albican, protozoan (Trichomonas vaginalis) was also identified. The isolated organism which was prevalent was Staphylococcus aureus (48.2%); followed by Escherichia coli (34.5%). Also, Pseudomonas aeruginosa, Proteus and Klebsiella were isolated. Factors responsible for frequent cases of Urinary tract infections among diagnosed women include shortness of urethra among the females, lack of personal hygiene, sexual intercourse, socio economic challenges in various homes and others. Sensitivity profiles revealed that Augumentin was highly susceptible to Staphylococcus aureus (65%) while Escherichia coli were highly resistant to commonly used drugs such as Ampicillin, and Cloxacillin while Gentamycin was the most active against bacteria isolates.

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Nov 2018
<![CDATA[Know Your Response: Pilot Mapping of HIV Prevention Responses by Non-governmental Organizations in Southern Province, Zambia]]> Source:Universal Journal of Public Health  Volume  6  Number  6  

Mbozi, Parkie   Anastasia J. Gage   Munukayumbwa Munyima   and Mubiana Macwang'wi   

ZAMBIA’S nation-wide adult Human Immunodeficiency virus (HIV) prevalence stood at 13.3 percent in 2014. In Southern Province, 12.8 percent of adult men and women aged 15-49 years were HIV positive. The prevalence was higher in women than in men (15.1% compared to 11.3%). The most recent data also suggested that key populations were disproportionately infected with HIV compared to the general population. The Measure Know Your Response (KYR) study took place from September 2013 to July 2014 in the Southern Province of Zambia. The aim was to map and characterize the HIV response among both government (health and none health) and non-government organizations (NGOs). The purpose was to identify gaps in the response, in particular in terms of the geographical areas and the key populations attended to and those disproportionately missed. This paper focuses on the results from the mapping of NGOs involved in HIV and AIDS response. For this aspect of the mapping data were collected using the NGO Sector Questionnaire. Focus was interventions of NGOs and their services to target populations across all the 12 districts of the Southern Province. All program implementers working in a given district were asked questions to assess the extent to which their HIV-prevention activities in the district included strategies to address all key populations, including gender issues. Data from the quantitative questionnaires was analyzed using STATA version 12.0 and Microsoft Excel. The results of the pilot test revealed gaps in both geographic spread and content of programs in the NGOs run HIV-prevention response. For instance, hardly any NGOs worked in the new and smaller districts of Pemba, Siavonga, and Zimba. Similarly, certain services, such as mass media campaigns, interpersonal education and persuasion programs were being implemented across all the districts. Further, fewer than three of the 93 organizations surveyed targeted key populations, notably sex workers, incarcerated populations, men who have sex with men (MSM), transgender people and injective drug users. With respect to gender, about 25% of the organizations did not integrate gender issues into their HIV-prevention activities. From a methodological standpoint, the pilot test revealed the need to examine dimensions of program content, quality and intensity. In spite of these limitations, the study permits us to know which interventions are being implemented by the NGO sector, contributing to new knowledge in Zambia about geographic gaps in the availability of HIV-prevention interventions.

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Nov 2018
<![CDATA[Immunization of Children: Knowledge, Attitude and Practice of Care-givers]]> Source:Universal Journal of Public Health  Volume  6  Number  6  

Habiba Jiri-Musa   Gidado Abubakar Auta   Bobga Bala Ishaya   Arziki Simeon Zoaka   and Lumsami Shadrach   

Vaccine preventable diseases are the commonest cause of mortality in children under five years of age. Therefore, immunizing a child significantly reduces cost of treating diseases and subsequently provides a healthy childhood. The objective of this study was to assess the knowledge, attitude and practice of caregivers to immunization of children under five years of age. This study was conducted over a period of four weeks with four hundred interviewer-based questionnaires given to our respondents, in a College Hospital at the North Eastern region of Nigeria. A cross sectional descriptive study was carried out using convenience sampling method. The data obtained was analyzed using Epi info software. The result of the study showed that 63% of children were fully immunized while 27% were either partially vaccinated or not vaccinated at all. It also showed that 72.9% of children delivered in the hospital were fully vaccinated as against the 35.2% of children who were delivered at home. A major concern that affects vaccination practices is the requirement for good storage and transportation of vaccines. Implementation of policies that will encourage both hospital delivery and strict adherence to the immunization schedule is an important step towards achieving adequate immunization.

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Nov 2018
<![CDATA[Effect of Using Emotional Intelligence, Wellness, and Leadership Training on Lived Experiences of Medical Program Directors Burnout]]> Source:Universal Journal of Public Health  Volume  6  Number  5  

Zeina Ghossoub   Relly Nadler   and Naim El-Aswad   

Physician burnout is a malignant, contagious phenomenon with significant morbidity and mortality for providers and patients alike. Major problems with physician burnout include lack of awareness, decreased ability to recognize symptoms and poor knowledge in combating the disease. Over 50% of students, residents and physicians are affected by severe burnout. Medical knowledge, practice approaches, and technical proficiency are taught and learned in residency training programs. This is also when self-care habits and work/life balance need to be taught and learned. The literature has shown that medical schools and residency programs/directors need two key ingredients in training that help prevent burnout and mitigate its effects: emotional intelligence (EI) and self-care. Another key factor in the development of physicians and combating burnout is leadership skills. The art and science of teaching medicine is hindered by the susceptibility of the trainers themselves to burnout and its consequences without having the tools to diagnose and combat it. For a residency-based intervention program that targets burnout, it has to start with its leaders/directors. Study: In 2016, 6 program directors from the Houston area underwent a two-day workshop that utilized emotional intelligence, wellness/self-care techniques, and leadership skills training to help them become aware of burnout, acknowledge, and identify it within them and their residents, and take action to combat it. Results: The study showed that the results of the intervention were not only qualitatively significant but were sustained 9 months later. Awareness of burnout, the acknowledgement and actions taken against had helped the directors on a personal, professional and leadership level. The overall average improvement/impact across the 15 items studied was 4.6/5. Conclusion: Training directors using the unique combination of emotional intelligence, self-care techniques and leadership skills maybe an effective intervention against combating burnout in residency programs.

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Sep 2018
<![CDATA[An Evaluation of a Secure Email Service (Healthmail): A Cross-sectional Survey of Irish GPs]]> Source:Universal Journal of Public Health  Volume  6  Number  5  

James Larkin   Ivana Pericin   Brian O'Mahoney   Karina Hull   and Claire Collins   

Securing sensitive patient information has become increasingly important after cyber-attacks on healthcare systems. Many current forms of communication such as fax and letter are insecure. Effective cybersecurity can increase patient safety. Healthmail is a secure email service which acts as a means of transferring patient information. Healthmail is available to a range of Irish medical workers. An online survey was sent to Healthmail account holders and to general practitioners (GPs) in Ireland. Self-declared GP account holders' responses were examined to evaluate their usage of Healthmail, opinions on Healthmail's merits and suggestions for improving Healthmail. The response rate was 19.5% (276/1415). Over half (51.5%) of respondents sent at least one Healthmail email in the previous week. Overall, 64.7% (n=178) of respondents said Healthmail improves patient care. Also, 58.7% (n=155) of respondents said Healthmail should be expanded to other disciplines. Many respondents (40.5%) said they would be happy to communicate with patients using secure email. These results suggest that Healthmail's perceived utility is high and could increase. Therefore, Healthmail has the potential to become part of mainstream communication between healthcare workers.

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Sep 2018
<![CDATA[The Current Status of Knowledge and Behavior Related to STI Prevention among High School Students in Korea]]> Source:Universal Journal of Public Health  Volume  6  Number  5  

Jungok Yu   Yuko Tanaka   Yuko Yamaguchi   and Hiroya Matsuo   

This study explores coping with STIs and related factors including knowledge, sexual behavior, and sex education among Korean adolescents. Anonymous self-administered questionnaires were distributed to 135 male and 150 female high school students. The results showed that 2.1% of participants had had sexual experience. Males had less information than females (p<0.05); 38.5% of males did not consult anyone. In contrast, females acquired information from and consulted with their parents. Although females' sexual abstinence behavior was higher than that of males (p<0.001), there were no significant differences in the STI knowledge test. Regarding sex education, 32.4–59.5% of students had received education on STIs. Students' degree of satisfaction with sexual knowledge was 10.2%, their understanding of STIs was poor, and they could not cope with having a checkup. In conclusion, high school students receive insufficient education to protect themselves from STIs. Their knowledge was not related to sexual abstinence behavior and coping behavior. Therefore, schools in Korea should provide high school students with appropriate education on STI prevention and coping behavior. In addition, an environment that facilitates consultation and clinics for helping young people deal with sexual problems should be provided.

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Sep 2018
<![CDATA[A Comparison of Two Dietary Assessment Methods in a Mediterranean Lebanese Adults Population: A Food Frequency Questionnaire and a Dietary Recall]]> Source:Universal Journal of Public Health  Volume  6  Number  5  

Maya Tueni   Afifee Mounayar   and Ines Birlouez-Aragon   

Objective: To compare the results of a food frequency questionnaire (FFQ) of traditional Lebanese dishes with a weekly dietary recall (WDR). Methods: A food list of 56 traditional Lebanese dishes was constructed with color photographs to quantify portion sizes. 566 Lebanese, aged 20–62 years completed a FFQ before a WDR in the same day. Results: The FFQ overestimated the intakes of most food groups (10%) and nutrients (7%) in both sexes. Spearman correlation coefficients ranged from 0.22 for vegetables with meat to 0.95 for cereals, pastries and dairy products in men and from 0.30 for fish to 0.86 for dairy products in women (median: 0.53 for 10 food groups). 10% or less of participants were misclassified in opposite extreme quartiles (except for vegetables with meat in men 14.6% and fish in women 22.7%). Spearman correlation coefficients ranged from 0.66 for retinol to 0.87 for folates in men and from 0.58 for PUFA to 0.69 for energy, fat, folates and potassium in women (median: 0.69 for 21 nutrients). 10% or less of participants were misclassified in opposite extreme quartiles. Conclusions: The FFQ of traditional food intake with a photographic atlas seems a reliable tool for dietary assessment in Mediterranean regions.

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Sep 2018
<![CDATA[Olecranon Enthesophytes Growth Rates: A Case Study]]> Source:Universal Journal of Public Health  Volume  6  Number  5  

Charles Milligan   

Many older citizens are besieged with chronic ailments that are associated with becoming older. Activities conducted as a young adult can play a significant role in your condition, later in life. Olecranon enthesophytes (bone spurs) of the elbow are one of those chronic health issue that can be quite debilitating and we really have no idea how long it takes the condition to develop. This is a case study that involves dating an olecranon posterior enthesophyte (bone spur) to determine the growth rate and associated behaviors that were more likely than not, responsible for the condition. A growth rate of .11mm per month was determined as a starting point for investigating causes for enthesophyte development. With organized fitness becoming more and more a part of everyday life, understanding growth rates of enthesophytes can allow for earlier detection. Most enthesophytes are asymptomatic; until they become major alignments. Policy makers, coaches, school athletic coordinators, the military and parents can make informed decisions about participating in risk associated behaviors. Health education that focuses on prevention in our younger children and adults as they become more and more athletically oriented and susceptible to sustaining injuries, may avoid later chronic ailments.

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Sep 2018
<![CDATA[Group Therapy Model for Torture Survivors: A Case on the Ghosts of 82-IMLU]]> Source:Universal Journal of Public Health  Volume  6  Number  5  

Hilda Nyatete   Carolyne Lisanza   Anne Masika   George Obiero   Teddy Chakee   Calvin Otiu   Peter Kiama   and Karen Abbs   

This article discusses Group Therapy Model in addressing the long term effects of torture as applied in resource poor setting in an emerging democracy in Sub Saharan Africa. The group therapy model was implemented by the Independent Medico Legal Unit (IMLU), working with 56 ex Kenya Air-force soldiers who were subjected to brutal torture following a botched coup attempt in 1982 in Kenya. The model engaged 9 survivors as peer counselors who worked hand -in-hand with trained trauma counsellors to support their counterparts in the Nyanza region of western Kenya. IMLU, - one of the leading centers against torture in Africa, provides psychological rehabilitation, medical treatment and legal support to about 500 survivors and victims of torture and their families annually, through national network of 53 trauma counselors, 70 medical doctors and 100 lawyers across Kenya. Historical torture leaves its mark, and survivors struggle to cope with the impact of torture, up to decades later. The long term psychological and social impact of torture include ongoing PTSD symptoms (flashbacks, nightmares, anxiety, and depression), substance abuse, suicidal ideation, hopelessness, family breakdown and lack of integration into society (Blanchard et al., 1997) [1]. In addition, torture leaves scars even decades later, affecting families, even communities as was evidenced working with the group of soldiers' spouses. As part of IMLU's support, full medical assessments were conducted to determine the extent of the torture on the 56 ex Kenya Air-force soldiers. By the end of the 10-week group therapy, there was a 42% reduction in symptoms across all categories of physical, behavioral, PTSD, Anxiety and Depression- A clear indication that group therapy, coupled with medical, legal and social assistance played a pivotal role in the healing process for the ex-soldiers.

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Sep 2018
<![CDATA[Vibroacoustic Therapy and Development of a New Device: A Pilot Study in the Health Resort Environment]]> Source:Universal Journal of Public Health  Volume  6  Number  5  

Eha Rüütel   Ivar Vinkel   and Moonika Laanetu   

This study was motivated by the development of a new model of vibroacoustic (VA) therapy device which, in terms of its design and characteristics, could be used in various health promotion and treatment environments. In the case of VA therapy, a bed or lounge chair is used to transmit special low frequency sounds for the purpose of affecting the whole body. In the review of previous studies, the results of applying VA therapy in the case of somatic and functional disruptions are described. In this study a new VA device prototype was used. The study was carried out at a health resort where, over the course of a two month period, visitors had the opportunity to participate in VA therapy. Twenty-six volunteers participated in the study. Data was collected through self-rate scales, which were completed at the beginning and end of the VA treatment session. The results of the study indicated an improvement in feeling – a reduction in muscle tension, pain, fatigue, anxiety – as well as the suitability of the device and therapy for health improvement related purposes, integrated with other health services.

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Sep 2018
<![CDATA[Bonding, Bridging, and Linking: Social Capital and Its Potential Health Impact among Refugees in Their Resettlement Countries]]> Source:Universal Journal of Public Health  Volume  6  Number  5  

Huaibo Xin   

Literature has highly emphasized the importance of social capital on health and mental health. This study aimed to identify the patterns of the structures and relations of social capital among refugee populations through a systematic review so as to promote their health by fostering the growth of their social capital in their resettlement countries. A total of 1,476 peer-reviewed journal articles, book chapters, reports, theses, dissertations, and commentaries, related to refugees' social capital building were thoroughly reviewed. Thirty-seven articles were included in the final theme analysis. Information was organized based on the three categories: bonding capital, bridge capital, and linking capital. Findings indicated that refugees in their resettlement countries commonly relied on religious practice, their ethnic organizations, school/workplaces, social and sports events, and social media to develop all three categories of social capital. Additionally, they built both their bonding and bridging capital through family, neighbors, and friends. They were further linked to a broader spectrum through both government and non-government organizations, and transnational network. Literature also revealed barriers that refugees encountered in capital building. The needs of both a policy change and research in identifying more effective and innovative strategies of helping refugees in social integration should be addressed.

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Sep 2018
<![CDATA[Knowledge, Attitude and Practice of Birth Preparedness and Complication Readiness Amongst Pregnant Women in Eti-osa Lga, Lagos]]> Source:Universal Journal of Public Health  Volume  6  Number  4  

Mbonu, Ebere Ogonna   

Background: Maternal mortality still remains a major challenge in developing countries. In sub-Saharan Africa, one out of every sixteen women dies of pregnancy-related causes. Birth preparedness and complication readiness is the process of planning for normal birth and anticipating the actions needed in case of an emergency .This is a study to assess the knowledge, attitude and practice of birth preparedness and complication readiness. Methodology: This is a descriptive cross-sectional study to assess the knowledge, attitude and practice of birth preparedness and complication readiness among antenatal care attendees in Eti-Osa local government area of Lagos State. A systematic sampling technique was used to select the respondents .The data used for this study were collected from pregnant women attending antenatal care in Six Primary Health Care centers in Eti-Osa local government area of Lagos State, using a structured pretested English language, interviewer-administered questionnaire. Results: The mean age of the respondents was 28.9 years, with standard deviation of 5.3 years. The proportion of respondents who have been prepared for birth and for its possible complication was 124 (33.4%). A higher proportion of the married women 212 (72.6%) were better prepared for birth and ready for its possible complication. 120 (83.9%) of pregnant women who had attended tertiary education were prepared for birth and for its complications (p=0.001) Conclusion: Few pregnant women had made adequate arrangements in anticipation for a safe normal delivery.

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Jul 2018
<![CDATA[Lack of Knowledge and Negative Beliefs about Colorectal Cancer: FOBT and Dietary Risk Factors in Makkah, KSA]]> Source:Universal Journal of Public Health  Volume  6  Number  4  

Hassan M. Bukhari   

Colorectal cancer (CRC) is the third most common disease in males and second in females. A negative attitude about information such as prevalence, screening tests and poor dietary factors might increase risk. The aim was to measure knowledge and beliefs about screening test and some dietary factors. A cross-sectional study with 2564 participants was done. A validated questionnaire was used. SPSS (version 16) was used. The majority (60-80%) did not have knowledge about the risk of CRC. Only 25% knew it is widely occurring, about 22% knew it is higher in western society. Only about 5% men and 13% women realized the correct order to have CRC for their gender. Of total, 21% recognized that it is most common in men, yet, men scored better than women (23% vs 18%). Approximately 12% vs 17%, of men and women resp, have chosen FOBT as the screening test for CRC. Both genders understand the role of high fiber to reduce CRC (54% vs 63% men and women resp). In comparison, only about 10-13% of both genders do not believe that nor does cooking type neither obesity affect CRC risk negatively. More health programs to increase the awareness and changing wrong beliefs should be done.

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Jul 2018
<![CDATA[Level of Parent Adolescent Communication on Sexual and Reproductive Health Issues and Associated Factors among Debre Markos Preparatory School Students, in Debre Markos Town, East Gojjam, Zone, Ethiopia]]> Source:Universal Journal of Public Health  Volume  6  Number  4  

Mekuanint Taddele   Dube Jara   and Alebachew hunie   

Background: World Health Organization defines adolescents as those in the age group of 10-19. While parent-adolescent sexual and reproductive health communication is one potential source of sexual and reproductive health information for adolescents. But, it appears to be inadequately practiced in Ethiopia. Objective: To assess level of parent adolescent communication on sexual and reproductive health issues and associated factors among Debre Markos preparatory school students in Debre Markos Town, East Gojjam Zone, Ethiopia. Methods: An institution-based cross-sectional study was conducted among preparatory school students from 22 sections in Debre Markos Town from December 15/2016-March to 15/2017. Simple random sampling technique was used to select 394 participants from 1653 total students. Self-administered questionnaire was employed. Results: A total of 394 students were participated in our study from Debre Markos preparatory school. Of these, 232 (58.9%) were males and 162 (41.1%) were females. The study showed that communication between adolescence and parent was 114 (28.9%), from this majority of students preferred to discuss with their mothers (42.1%) than others. Knowledge about reproductive health issues [AOR= 4.106 95% CI: 2.328, 7.243)] and knowledge about contraceptive [AOR=2.119 95% CI: (1.107, 4.054)] had significant association .Conclusion: This study revealed that parent adolescent communication on sexual and reproductive health issues is inadequate. Therefore, there is a need to equip and educate parents and students on different sexual and reproductive health issues to prevent adolescences from risk sexual behaviors.

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Jul 2018
<![CDATA[Determination of Natural Radioactivity Concentration in Consumed Nuts and Seeds and Their Implications in Human Body]]> Source:Universal Journal of Public Health  Volume  6  Number  4  

A. H. Al-Ghamdi   

The concentrations of natural radioactivity of 226Ra, 232Th and 40K were measured in nuts and seeds samples consumed in Saudi Arabia. A high-resolution HPGe detector was used for the natural radionuclides measurement. The results indicate that 40K was detected in all samples, whereas 226R and 232Th were found only in Brazil nut sample. The average concentration of 40K in the investigated samples was 363.82 Bq kg-1. The estimated annual effective dose due to ingestion of nuts and seeds was 0.068 mSvy-1 lower than the annual dose limit of 1 mSv y-1 for public exposure. This indicates that no risk is expected by the intake of the studied nuts and seeds samples. The radionuclide concentrations were compared with those reported from different countries.

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Jul 2018
<![CDATA[Reminder System Intervention for Increasing Breast Cancer Knowledge and Screening among Underserved Women in a Community Setting]]> Source:Universal Journal of Public Health  Volume  6  Number  4  

Jay Brown   and Saleh M. M. Rahman   

Though incidence rates of female breast cancer has declined since 1975 to 2014, in women of ages 20-59 years old, breast cancer is the leading cause of cancer-related deaths in the United States. Early detection of breast cancer via screening mammography has been shown to improve options for treatment, outcomes, and survival. Despite the success of screening mammography, screening adherence remains critical for clinical outcomes. This study explored the effect of a reminder system with educational materials on breast cancer knowledge and screening practices among primarily African-American women in North Florida. The participants were divided into two groups: the experimental group, which received this reminder system, and a control group, which did not. Both groups were surveyed using a questionnaire that included nine true or false questions regarding breast cancer facts, statistics, and screening guidelines. The experimental group scored significantly higher [t (138) = 2.60, p < .010] than the control group regarding breast cancer knowledge. Based on this study, a reminder system can be recommended as an effective intervention for increasing breast cancer knowledge.

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Jul 2018
<![CDATA[Seroprevalence of Hepatitis A Virus in Children and Adults]]> Source:Universal Journal of Public Health  Volume  6  Number  4  

Tekin Karsligil   and Mervat Saeed   

Hepatitis A is the most common form of acute viral hepatitis in the world. Major geographical differences in endemicity of hepatitis A are closely related to hygienic and sanitary conditions and other indicators of the level of socioeconomic development. In this study we aimed to investigate the seroprevalence of hepatitis A for adults and pediatric in university hospital- Gaziantep, and to demonstrate the relationship between various socio-demographic data and seropositivity. Serum samples were investigated by ELISA method for Anti HAV IgG and Anti HAV IgM. A total of 102 individuals, 55 male and 47 female, were included in the study. Anti HAV IgG positivity was detected in 87(85.3%), anti HAV IgM positivity was detected in 2 (2.0%). There weren't any significant gender differences in HAV IgG. By analysis according to the age, Anti-HAV IgG seropositivity increased with age. Although there was no significant difference in HAV IgG seropositivity according to the types of drinking water supply, HAV IgG seropositivity was detected in a less percentage in individuals who drink the commercial water. In Turkey HAV infection has been shifted to older ages than younger age. The disease is more complicated in advanced age than younger people. We recommend the importance of applying the vaccine.

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Jul 2018
<![CDATA[Biomolecular Aspect of Apoptosis Pathway: Caspase-8 and Caspase-9 on Polifenol Exposure of Phaleria macrocarpa (Scheff.) Boerl. on Mice Balb/c]]> Source:Universal Journal of Public Health  Volume  6  Number  4  

Theopilus Wilhelmus Watuguly   

Objective: The Polyphenol compound of Phaleria macrocarpa has potential as an anticancer agent, and it has shown to inhibit lung carcinogenesis. The objective of this study was to elucidate the role of polyphenol induced apoptosis via caspase-8 and caspase-9. Methods: Balb/c mice were randomly divided into 2 groups: Group 1: control group with administration of sterile aquades and group 2: treatment group with administration of 50 mg polyphenols. The development of lung tumors was confirmed by observing post-operation tissue at week 8, 17 and 26. The expression of caspase-8 and caspase-9 were assayed. Data was analyzed using Kruskal-Wallis, Mann-Whitney, one way ANOVA, Post hoc LSD test, with a significance level of p < (0.05). Results: Administration of 50 mg polyphenols from P. macrocarpa extract, showed inhibition of lung carcinogenesis through increased expression of caspase-8 and caspase-9 in the treatment group at week 8, 17 and 26 (p = 0.000). Conclusion: The administration of poliphenol from P. macrocarpa extract was shown to effectively inhibited lung carcinogenesis through increased of caspase-8 and caspase-9 in mice strain Balb/c.

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Jul 2018
<![CDATA[Intra-subject Variability of Impact Shock of Foot on the Ground during Walking and Running Activities]]> Source:Universal Journal of Public Health  Volume  6  Number  4  

Graziella Aghilone   and Massimo Cavacece   

Aim: The intra–subject variability is evaluated by a deterministic acceleration model in the frequency content between walking and running activities. The usefulness of this research is to explore the dependence of peak acceleration of foot on different pedestrian's velocity. Method: The mathematical model can be represented in time domain as a sum of Fourier harmonic components. The mathematical approach is applied to fit the accelerations of the foot, acquired during the impact shock of the human body on treadmill during walking and running activities at different speeds. Spectral analysis evaluates the frequency field of impact shock during walking and running activities. Results: The fitting of experimental data, by a mathematical approach, offers the analysis of the peak force of the foot on the ground, the dynamic acceleration factor (DAF) and the activity rate harmonics during walking and running activities. Conclusion: Marked differences in vertical accelerations are illustrated between walking and running activities. Recommendations could be deducted with regard to the dose of impacts that can be beneficial or detrimental to human health.

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Jul 2018
<![CDATA[Is there Relationship between Pectoralis Minor Muscle Length and Shoulder Rotator Muscles Strength?]]> Source:Universal Journal of Public Health  Volume  6  Number  3  

Tu?ba Kocahan   Bihter Ak?no?lu   ?a?lar Soylu   ?zge ?oban   and Necmiye ün Y?ld?r?m   

Problem Statement: In joint movement, agonist and antagonist muscle strength, as well as the length and the shortness of these muscles is an important parameter. Muscle shortness is one of the factor that responsible of sports injuries. Shoulder is one of the most injured joint in Judo. In this joint, determination of the relationship between muscle shortness and agonist-antagonist muscles strength will be effective to increase muscle strength, sportive performance and prevent sports injuries. Purpose of Study: This study was conducted to determine the relationship between pectoralis minor (PM) muscle length and shoulder internal(IR)/external(ER) rotation isokinetic muscle strength in Judo athletes. Methods: The study included 80 (56 males, 24 female) professional Judo athletes aged between 14-25 (mean 17,31±2,51). Isokinetic muscle strength was assessed by ISOMED 2000® device. Pectoralis minor length was evaluated using a flexible tape measure in resting position. The assessments were made bilaterally. Findings and Results: There was a strong and statistically significant correlation between the PM length and the shoulder IR and ER peak torque values at both angular velocities and both sides (p <0,01). Conclusions and Recommendations: It was determined that the relationship between the length of the PM muscle and the internal and external rotator muscle strength of Judo athletes. Therefore, we think that by increasing shoulder muscle strength to enhance sportive performance, stretching exercises for PM muscle shortening should be added to training programs.

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May 2018
<![CDATA[Assessment of the Daily Safety and Operations Huddle of a Pharmacy Department]]> Source:Universal Journal of Public Health  Volume  6  Number  3  

Kenneth M Komorny   Amy Rosenberg   and Emily McCleary   

A daily huddle was tested in an academic medical center pharmacy department to see if it resulted in a positive impact on the safety culture and communication. The huddle is a short daily briefing conducted at shift change in a main pharmacy area with a dial in number for those not present in the main pharmacy area. The purpose of the huddle is to raise awareness of any current safety or operational issues. The effectiveness of the huddle was primarily tested through a targeted survey and the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Culture Survey results. A survey evaluating daily huddle effectiveness had a 24% response rate. The majority of respondents indicated positive feelings towards the huddle: 58.7% indicated effective communication of information between shifts, 67% indicated effective communication of safety events, and 63% indicated effective communication of daily operational issues. Additionally, the department's AHRQ Patient Safety Culture Survey results improved following the huddle implementation. Departmental staff gave their work unit an overall safety score of the top possible answer, excellent, (vs. very good, acceptable, poor, failing) 11% of the time before the huddle began. Eight months after the huddle started, the number of respondents answering with the top possible score increased to 23% (p<0.05). This positive impact sustained to the next year as well (25% top possible score). Additional positive results are discussed. Implementation of a safety huddle positively influenced measures of communication and safety culture in the Department of Pharmacy Services.

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May 2018
<![CDATA[Appraisal of HIV/AIDS Information and Usefulness among Senior Secondary School Students in Zaria Town, Kaduna State, Nigeria]]> Source:Universal Journal of Public Health  Volume  6  Number  3  

Suleiman, M. S.   

A study to appraise HIV/AIDS information and its usefulness among senior secondary students in Zaria town, Kaduna State of Nigeria was undertaken. Senior secondary school students in Nigeria are mostly teenagers and are more often than not interested in sexual relationships. The adolescents at this period may want to test sex without much consideration of the end result of engaging in such actions. It may be noticed that HIV/AIDS is one of the greatest challenges to sustainable economic, socio-cultural and political development of any civilization. It is acknowledged fact that the adolescents of today are leaders of tomorrow; therefore, for a meaningful sustainable development to be attained in any society, young people are required to live healthy lives. Therefore, social survey research was adopted for this research work. A sample of 240 students, across 8 selected senior secondary schools in Zaria town was used as the population sample. The questionnaires were coded and analyzed using the SPSS software. The data collected was then subjected to simple descriptive statistical analysis. The study revealed that majority of the respondents had knowledge of HIV/AIDS, but are reluctant to submit themselves to HIV/AIDS test. Most of the respondents are aware of the various mode of transmission of HIV/AIDS as well agreed that use of condom as a mode of prevention. It was also noted that the students' sources of information and their effectiveness were through posters and pamphlets. The study concluded by recommending that the government and other stakeholders should technically strategize on HIV/AIDS campaign initiative in secondary schools. HIV/AIDS policy should be initiated and implemented for sustainable development. As a matter of policy, all secondary schools in the state should have a functional HIV/AIDS club.

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May 2018
<![CDATA[Tensegrity Structure: Experimental Methodology for Wheelchair Design]]> Source:Universal Journal of Public Health  Volume  6  Number  3  

Carlos Mauricio da Costa Ramos   Raquel Barbosa Teixeira   and José Luiz Mendes Ripper   

This experimental research is inserted in the universe of people with special needs and intends to develop a new technology to design the structure of wheelchair. This structure consists of a tensegrity module composed of bamboo sticks and tensioned cables and adopts all the anthropometric standards with the observance to the ergonomic studies and individual needs of the use of the wheelchair users. This new concept of structure design, as it is unprecedented, results in an innovative product and allows new interpretations and unfolding. This research also initiates a new interpretation of tensegrity by its application to orthotics for rehabilitation that is currently widely diffused in the plastic arts, architecture, but incipient in product design. The use of tensegrity can meet some needs as a favorable body adaptation due to the malleability of the structure that absorbs the more sudden movements that can cause discomfort, injury and bad accommodation of the user to the wheelchair, besides providing a product of low cost and of easy production , because the structure is assembled by fit and wired.

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May 2018
<![CDATA[A Report Based on Analysis of Posture and Occupational Health of Welders in Different Welding Units]]> Source:Universal Journal of Public Health  Volume  6  Number  3  

Das Suman   Banerjee Debamalya   and Mukherjee Shankarashis   

Analysis of work posture of workers is an effective research area in manufacturing sector in India. Manufacturing plays a significant role to develop a country. Lots of human involvements are required to successfully execute the various operations involved in this area. Long manual working hours with traditionally designed tools and un-ergonomic work posture can cause musculoskeletal disorders and other occupational health problems among welders. Prolonged working hours exceed the physical capacity of the workers that causes' discomfort, physical fatigue, joints pain, swelling, strain, sprain of ligaments and soft tissues. Work related musculoskeletal disorders (WRMSD) in the form of repetitive motion injuries, cumulative trauma disorders, body fatigue and strain injuries are very common health problems of workers of different small & medium scale welding units in our country. The productivity and cost benefits of welding units are highly related with the physical comfort of the welders. The data of musculoskeletal disorder of workers of welding units was collected evaluated and validated by using RULA, OWAS and Discomfort Questionnaire and a design solution suggested.

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May 2018
<![CDATA[The Sweat Factor in Bikram Yoga]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Bradley Y. Bartholomew   

It is common ground that the practice of hatha yoga will yield many health benefits, both physical and mental. Much of the recent research on hatha yoga has focused on Bikram Yoga, which differs from other forms of hatha yoga by virtue of it being practiced in an elevated ambient temperature which occasions profuse sweating, and is generally referred to as 'hot yoga'. Much of the recent research tends to be negative about this form of yoga, for instance Bikram yoga doesn't assist in removing impurities from the body, doesn't increase aerobic fitness and doesn't yield any more benefits, physically or mentally, than other schools of hatha yoga. This article reviews the sweaty rituals that have evolved throughout human history, principally the Buddhist and Hindu practices, the Greco-Roman baths, the Finnish Sauna, Russian Bania, Islamic Hammam, Japanese Mushi-Buro, the African sweat huts, Irish sweat mounds and the Native-American & Eskimo sweatlodge, and it is shown that most of these sweaty traditions have a purification, rejuvenation and spiritual significance, and that human beings have a primary and primeval need to sweat. The fact that Bikram yoga resonates with this primeval need elevates it to a higher level than other schools of hatha yoga. The health benefits (both physical and mental) of profuse sweating are also presented, in particular that it rids the body of toxins such as arsenic, cadmium, lead, mercury and some pesticides and thus is a cleansing and rejuvenating process. But over and above the health benefits profuse sweating as a purification ritual is a major morale booster; it is a natural way to make us feel good and to make us feel good about our lives.

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Mar 2018
<![CDATA[Ten-Year-Trend of HIV Prevalence among Pregnant Women in Benin]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Aguemon Badirou   Sossa Jér?me Charles   Sopoh Ghislain Emmanuel   Damien Barikissou Georgia   Saizonou Jacques   Houeto David   Gado Thalouth A A   and Ouendo Edgard Marius   

Background: HIV infection for children is mainly due to mother-to-child transmission (MTCT) that can occur during pregnancy, childbirth and breastfeeding. In Benin, the residual rate of HIV transmission from mother to child remained high. The objective of the study was to describe a ten-year-trend of HIV prevalence in pregnant women in Benin. Methods: A retrospective study was carried out from 2006 to 2015 across the country and consisted in reviewing the reports of the annual surveys of HIV infection among pregnant women. Chi square test was used to assess the trend over time of HIV prevalence among pregnant women. Equations of regression lines of HIV prevalence trend graphs were estimated to determine the direction of the trend. Results: A total of 138,319 pregnant women participated in the annual HIV surveys from 2006 to 2015. The prevalence of HIV infection from 2006 to 2015 for pregnant women decreased significantly in the group of women aged 20-29 years, in the group of craftswomen and in the group of women with their first pregnancy. In contrary, the prevalence of HIV increased significantly for women with at least four past pregnancies and those writing in local language. Conclusion: The National AIDS control program may take these results into account by maintaining the epidemiological surveillance in HIV, and reinforce interventions for the vulnerable groups where the prevalence increased.

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Mar 2018
<![CDATA[Pharmacist-managed Warfarin in Pediatric Cardiac Patients: Quality-improvement Study]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Carrie Tilton   Mary Subramanian   Lauren Wyatt   Elizabeth Woods   and Derek A. Williams   

Objective: To compare the efficacy of warfarin management by a pharmacist-managed group to a cardiologist-managed group (usual care) in an outpatient pediatric population. Methods: Fourteen patients with an international normalized ratio (INR) goal determined by a cardiologist were included. The pharmacist-managed group included twelve patients. There were seven patients in the cardiologist-managed group. Prior to the transition to a pharmacist-managed service in September 2014, cardiologists managed anticoagulation. For the cardiologist-managed group, INR values were recorded for six months. Following a washout period of three months, INR values were obtained for the pharmacist-managed group for the subsequent six months. Patients were included in each analysis if they were followed for more than 3 months. A protocol guided dose adjustments, recommended monitoring, and allowed for pharmacist-managed warfarin. Results: The median number of INR tests per patient was not significantly lower in the cardiologist-managed group compared to the pharmacist-managed group (28 versus 36 measurements, p=0.06). The median percentage of time in therapeutic range using the Rosendaal method was not significantly higher in the pharmacist-managed group compared to the cardiologist-managed group (55.5% versus 54%, p=0.93). The median percentage of values in therapeutic range using the traditional method was also not significantly higher in the pharmacist-managed group compared to the cardiologist-managed group (41.9% versus 36.8%, p=0.93). Conclusion: Warfarin management in a pharmacist-managed group compared to a cardiologist-managed group provided similar care. Differences in time in therapeutic range and median values in therapeutic range were not found between the pharmacist-managed group and cardiologist-managed group. These results describe and provide support that pharmacist-managed anticoagulation of pediatric cardiology patients is safe and effective in the outpatient setting.

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Mar 2018
<![CDATA[Determinants of Maternal Care Services Utilization within Conjugal Context in Lagos State]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Felicia A. Oyekanmi   Kennedy Eborka   and Olusegun Temilola   

Antenatal care attendance is an essential component of maternal health and critical to reducing high maternal and child mortality in Nigeria. This study focused on factors that influence maternal healthcare services utilization at the conjugal level. The study was carried out among ever-married men and women in Shomolu, Lagos State, between March and June, 2017. Both quantitative and qualitative approaches were adopted to implement the study. At the quantitative level, cross-sectional survey was adopted while In-Depth Interview (IDI) was used at the qualitative level. The probability sampling technique was adopted to select a sample size of 480 respondents for the quantitative aspect of the study, while 36 participants were purposively selected for the qualitative aspect. The study examined the relationship between men's perception of the influence of antenatal clinic attendance on pregnancy outcome and their approval of wives' antenatal clinic attendance. It equally investigated the relationship between educational attainment and perception of non-attendance of antenatal clinic among women, and the relationship between requirement to obtain husband's permission and number of antenatal care attendance among women. Results showed that no relationships exist between men's perception of antenatal care attendance and their approval for wives' attendance of antenatal care facility. However, educational attainment among men was found to be positively related to their perception of antenatal clinic attendance. Similarly, test result showed a relationship between women's perception of antenatal care attendance and number of attendance, with t(83.395) = 7.718, p<0.001.

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Mar 2018
<![CDATA[Evaluating the Determinants and Prevalence of HIV among Intravenous Drug Users in Benin]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Septime Hessou   Yolaine Glèlè Ahanhanzo   Tranquillin Yadouléton   Victorien T. Dougnon   Odile Sodoloufo   Rhéal Drisdelle   Moussa Bachabi   Clément Ahoussinou   Bernard Gnahoui-David   Nelson Magalie   Bernabé Yaméogo   Christian R. Johnson   and Marcel Djimon Zannou   

HIV remains a serious global health problem. In Benin, intravenous drug users (IDUs) are at higher risk for HIV infection and are one of the groups the National AIDS Control Council (CNLS) has focused on in its strategic planning. The present study was conducted to estimate the rate of HIV prevalence among IDUs in Benin and identify potential risk factors. To this end, the 2013 and 2015 directives issued by the World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS (UNAIDS) regarding Second generation surveillance were followed. In total, 386 IDUs participated in the study from all departments of Benin, 3.1% of them were women. The average age of participants was 35 (±10.7). The median length of time that participants had been using drugs was 10 years (range: 0 - 45) and cocaine was the most frequently consumed substance (56.0%). During their last injection, 90.9% of respondents used sterile injecting equipment. The HIV prevalence rate among IDUs was 4.7% (95% CI: 2.63% - 7.11%), compared to 1.2% within the general population. The results of this study highlight the need to implement continual HIV surveillance systems and develop prevention tools that specifically address the needs of IDUs.

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Mar 2018
<![CDATA[World Café at Summer School of WHO Collaborating Centre for Epidemiology and Community Dentistry]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Rossini, Gisella   Concia Valentina   Cagetti Maria Grazia   Campus Guglielmo   and Strohmenger Laura   

Objectives of the study: This study is a qualitative evaluation of a teaching method. The 2015 Summer School organized by the WHO Collaborating Centre for Epidemiology and Community Dentistry of Milan took place in Sardinia. The educational objectives of the first day included: make an informal conversation with other members of the summer school; create an interesting exchange of ideas and experiences also between new, "habitué" and beginners with senior professionals of this event; make a group for the works in the next days. Considering the different professional roles, age and context of origin, the purpose of the Pedagogists was to create a positive, relaxed but intimate atmosphere using the pleasure of "informal" conversation, through a creative and practical method: The World Cafè. Materials & methods: The Pedagogists' first task focused on: caring of the location and the physical setup of the table, creating relevant questions to the concerns of the group, establishing the rules, managing the process to encourage participants to have a non- formal learning experience consequently improving thinking, speaking and listening skills. Finally the participants answered self-administered questionnaire to write about their emotions and cognitive processes that went out during the World Cafè. Results: The analysis of the questionnaires was carried out with Interpretative Phenomenological Analysis (IPA), The interpretative steps identified two emerging themes: "different vs peer" and "discovering vs practicing". Conclusions: The World Café experience improves learning by connection; thinking and learning become dynamic processes instead of learning outcomes.

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Mar 2018
<![CDATA[Cancer Survivorship in General Practice - Barriers Encountered by General Practitioners in Ireland]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Marie O'Shea   and Claire Collins   

Cancer survivors may experience a wide range of complex health issues as a result of their cancer type and treatment. With increased rates of health care utilisation compared to non-cancer patients, the transition back into the primary care setting post-cancer treatment can be difficult for both GPs and patients to navigate. To identify the current barriers encountered by GPs in Ireland in the area of cancer survivorship, an online survey of GPs was undertaken. A total of 514 completed surveys were analysed, a response rate of 18.2%, which is typical of response rates from GPs in Ireland and internationally. The majority of GPs had never attended a survivorship course, conference or workshop. Only 17.2% and 19.7% of GPs respectively considered that they had enough information on the possible long-term issues from cancer treatments. Further education on cancer survivorship and improved access to services for GPs is necessary in order for the healthcare system in Ireland to be prepared to provide improved cancer survivorship care.

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Mar 2018
<![CDATA[Psychosocial Safety Climate Predicts Health and Safety Status of Ghanaian Fuel Attendants]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Edward W. Ansah   Joseph K. Mintah   and Joseph K. Ogah   

The purpose of this study was to determine the level of psychosocial safety climate (PSC) at fuel stations in Accra and test the paths via which PSC predicts health and safety of the attendants. We surveyed 876 conveniently sampled attendants from four major Oil Marketing Companies (OMCs). A questionnaire derived from three pre-existing ones (PSC-12, Job Content Questionnaire and Short Form Health Survey) was used for data collection. It yielded composite reliability between 0.91 and 0.95. Partial Least Squared-Structural Equation Model was used for analysis. Results shows a high risk of (36.08) PSC perception among the attendants. PSC directly, and indirectly, via the path of job resources, predict health and safety of the attendants. Job demands have significant direct influence on health and safety with its path being the strongest (r = -0.66) and most significant (t = 39.48, p = 0.00) compared with PSC (r = 0.16) and job resources (r = -0.12). The health, safety and well-being of the fuel station attendants appears to be preserved where management takes practical steps to raise PSC of the fuel stations and supervisor provides increased support for the attendants. An increase in PSC is most likely to cause increase in supervisor support to the attendants. In such stations, daily productivity is more likely to increase due to well-being of the workers.

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Mar 2018
<![CDATA[An Open-label Randomized Clinical Study to Compare the Effects of a Nutritional Supplement versus Vitamin E on Fibroscan Score in Nonalcoholic Steatohepatitis (NASH) Patients]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Shahed Ashraf   Jamshed Alam   Jahangir Alam Sarkar   Faiz Ahmed Khondaker   Yusuf Farhana   and Naila Atik Khan   

Background: Despite the benefit of lifestyle changes, there is no standard treatment for Fibrotic NASH. However the concept of reversibility of liver fibrosis and cirrhosis with various natural biologically active compounds and antioxidant micro-nutrients is not new. Aim: The aim of this study was to compare effectiveness of Viusid® (a nutritional supplement) and Vitamin E in reducing steatosis and liver fibrosis score in patients with fibrotic NASH. Methods: 52 patients diagnosed with nondiabetic and noncirrhotic NASH on liver fibroscan were divided into 2 groups randomly and given Viusid® 3 sachets daily to 25 patients or Vitamin E 800 IU daily to 27 patients along with a hypocaloric diet and exercise for 3 months. Results: After 3 months treatment with Viusid®, as compared with Vitamin E, was associated with a significant reduction of both mean steatosis score (CAP value reduces from 286±16.3 to 208±18.5 dB/m in Viusid® group vs. from 278±14.4 to 253±12.1 dB/m in Vitamin E group; p<0.00001) and fibrosis score (E value reduces from 6.8±0.5 to 5.1±0.7 kPa in Viusid® group vs. from 6.9±0.5 to 6.5±0.4 kPa in Vitamin E group; p<0.00001). Similarly, the mean alanine transaminase (ALT) levels also significantly decreased from 114±25.9 U/L to 43±9.1 U/L in Viusid® group compared to from 105±15.5 U/L to 55±11.7 U/L in vitamin E group (p>0.00001). Conclusions: Viusid® was superior to Vitamin E in reducing steatosis & fibrosis score in nondiabetic and noncirrhotic NASH patients. However, further large scale trial is needed to better assess the value of Viusid® for fibrotic NASH management.

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Mar 2018
<![CDATA[The Factors Associated with the Delayed First Antenatal Care in the Philippines]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Hanna Horiguchi   and Minato Nakazawa   

The maternal mortality ratio has decreased in many countries since 2000, but in the republic of the Philippines. World Health Organization recommends that the standards of antenatal care (ANC) should start as early as possible in the first trimester, while only 63.4% of pregnant women began the ANC within the first trimester. This study aimed to clarify socio-economic status and current situation regarding pregnancy, and to explore the factors associated with the timing of the first ANC in Leyte by comparing the women who took first ANC within first trimester (early ANC group) with the women whose first ANC delayed after 4 months of pregnancy (late ANC group). We visited 108 women who had pregnancy experience by opportunistic sampling and conducted the semi-structured interview. The early ANC group and the late ANC group were 76 and 27 respectively. Only one person did not take any ANC and 4 people did not remember the timing of first ANC. Monthly income and consultation with husband significantly differed between 2 groups. Around 15% women did not have accurate knowledge about determining pregnancy. In conclusion, it is necessary to spread the right and practical information about pregnancy and antenatal care in the community.

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Mar 2018
<![CDATA[A Systematic Review on Long Term Effects of Weight Loss Diet on Body Weight and Lipid Profile: Findings from Randomized Controlled Trials]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Nurul Umirah Abdul Manaf   Aryati Ahmad   and Noor Aini Mohd Yusoff   

Various diets with different macronutrient compositions have been designed and practiced to achieve desirable weight loss. However, evidence on the benefits and risks of these diets over long- term duration on weight loss and fasting serum lipid is still scarce with different opinions and perspectives. A systematic literature search for relevant eligible trials was conducted on randomized controlled trials (RCTs) with parallel design that examined the effects of weight loss diet on body weight and fasting serum lipid, in overweight or obese adults aged 18 to 50 years old; focusing on calorie restriction with specific macronutrient distribution. Nine trials with a total of 1016 individuals fulfilled inclusion criteria. After 12 months, low carbohydrate diet (LC) showed significant increment in body weight (weighted mean difference, 1.22kg: 95% confidence interval (CI), 0.17 to 2.28, P=0.02) and triglyceride (TG) value (weighted mean difference, 0.11mmol/L, 95% CI: 0.02, 0.19, P=0.01). Low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein (HDL-C) did not significantly change after both diets. In conclusion, the long term use of LC should be reconsidered due to unfavorable effect of LC on weight changes and TG. Nevertheless, more long term studies are warranted to confirm the efficacy and safety of these weight loss diets.

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Mar 2018
<![CDATA[Environmental and Psychosocial Factors into Polices Designed to Promote Drinking Water Consumption among Children and Adolescents]]> Source:Universal Journal of Public Health  Volume  6  Number  2  

Arely Vergara-Casta?eda   María de los Angeles Pe?a-Farfán   Donovan Raúl Ríos-Hernández   Laura Martino-Roaro   Edgar Vergara C   César Jesús Sandoval-García   and Ma. Rosario Ayala Moreno   

Low drinking water intake in Mexico is considered a public health problem due to its linkage with some other negative factors related to lifestyle and eating behavior. Choosing beverages is the result of the interaction between physiological mechanisms, common knowledge and social context; including social interaction, availability, convenience, marketing, peer pressure and cultural practices. Until recently, there was limited interest on these ecological factors related to water consumption in Mexican children and adolescents. Understanding the relationships among this population habits and psychosocial or environmental factors, which shape drinking behavior, will enable the identification of specific populations at the risk of low water intake and allow to understand the problem of low drinking water consumption and the need to consider this factors while planning an strategy or policy to improve water intake among children and adolescents. In Mexico, one sixth of the population has no access to drinking water and almost 40% lack basic sanitation. These figures are worse in marginalized vulnerable urban communities where it has been suggested that only 18% of children and adolescents reach water consumption recommendations. As this population spends most of their time in schools and home, these places should been considered key places to promote water consumption as long as the availability, quality of water, sociodemographic conditions, water security, and social norms/cultural behaviors being ensured. Despite drinking water promotion has gained a global spotlight and even though numerous campaigns and policy interventions to promote water intake has been considering for creating population-wide improvements in health behavior, there is a need to innovate campaigns and widespread government public health initiatives through a novel approach which involves multicomponent environmental modification. Thus, in this paper, we provide an overview of the major environmental and psychosocial factors related to water consumption behavior that should be considered to guarantee a better impact of drinking water policies.

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Mar 2018
<![CDATA[The Effectiveness of Health Information Technology on Promoting Medication Adherence in Adults with Diabetes Mellitus Type 2: A Systematic Review Protocol]]> Source:Universal Journal of Public Health  Volume  6  Number  1  

Claudia Jorge de Sousa Oliveira   Helena José   Alexandre Castro Caldas   and Carolina Gon?alves Venda   

The objective of this review is to identify the effectiveness of health information technology on promoting medication adherence in adults with diabetes mellitus type 2. More specifically, the review questions are: What is the effectiveness of health information technology on promoting medication adherence in adults with diabetes mellitus type 2? What is the effectiveness of health information technology for enhancing medication adherence in adults with diabetes mellitus type 2 on quality of life? What is the effectiveness of health information technology for enhancing medication adherence in adults with diabetes mellitus type 2 on hospital readmissions?

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Jan 2018
<![CDATA[Evaluation of Nutritional Status in Relation to the Cognitive Performance of Medical Students at Oman Medical College]]> Source:Universal Journal of Public Health  Volume  6  Number  1  

Firdous Jahan   P.J.Joseph Francis   Rizwan Qasim   Zaid Mukhlif   and Zoya Shaikh   

Objective: Dietary assessment to describe eating practices and asses the nutritional status of students in relation to the cognitive performance of students by Mini-Mental State Examination. Methods: A cross-sectional study was conducted using a food frequency questionnaire, Mini mental state examination, anthropometric measurements, and blood analysis for measuring hemoglobin(Hb) and glucose levels. Third year medical students of Oman medical college Sohar campus (Sample size, N=80) were involved in this study. Statistical Analysis was done using the food frequency, MMSE and blood analysis data to study the dietary patterns, nutrition status and cognitive performance of the students. Results: The data revealed low intake of legumes, eggs and red meat (mutton/beef), hence low protein intake by majority of students. 47.5% of the students consumed only two meals in a day. 20.9% of the students were underweight, 13.4% were overweight and 9% were obese. Physical inactivity was present in 51.2% of the students. Low hemoglobin (Hb<12mg/dl) and low glucose level (<3.9mmol/L) was observed in 32% and 28.7% of study sample respectively. Low MMSE score among 11.6% subjects indicated mild cognitive impairment. A significant correlation existed between MMSE and glucose level (p<0.05). Conclusion: A strategy is required to monitor the nutrition of young Omani adults in order to improve health status and prevent deficiency diseases. There is an urgent requirement to promote healthy food choices and lifestyle among medical students.

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Jan 2018
<![CDATA[Validation of the Declared Withdrawal Periods of Antibiotics]]> Source:Universal Journal of Public Health  Volume  6  Number  1  

Razia Khatun   Abdul Jabbar Howlader   Shamim Ahmed   Nazrul Islam   Khorshed Alam   Shariar Haider   Mohammad Showkat Mahmud   and Md. Amirul Hasan   

Drug residues in poultry and poultry products are becoming an alarming or burning concern for public health because of improper use of drugs/feed additive, or failure to observe drug withdrawal period, non-existence of restrictive legislation and lack of consumer awareness in the poultry industry. The declared withdrawal periods and safe level/tolerance level of any antibiotics will be stay in same points. The aim of the study was to validate the declared withdrawal periods and to see whether there is any alteration of these declared withdrawal periods that farmers are practicing in in-situ and ex- situ condition in Bangladesh context. For this, a total of 2100 broilers and 2100 eggs were collected from different markets of poultry rich area in seven divisions of Bangladesh. Seven different drugs such as Enrofloxacin, Oxytetracycline, Ciprofloxacin, Sulfonamide, Chloramphenicol, Gentamycin, Furazolidone were used as Maximum Residue Limit (MRL). In case of Enrofloxacin, Ciprofloxacin and Sulfonamides residues persist in broiler meat after the declared withdrawal periods, on the other hand Oxytetracycline, Cloramphenical and Gentamycin maintains the withdrawal period as per stated but the Furazolidone disappears for broiler meat before the declared withdrawal periods. It was found that 55% poultry samples remain above MRL during 1-3 interval period's in the validation of withdrawal period indicates not safe for human health. It can be concluded that lack of observation of withdrawal period might be a common practice given the high level of antibiotics in the poultry farm of Bangladesh.

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Jan 2018
<![CDATA[Prevalence of Worm Infection in Relation to Body Mass Index in Children of 5-10 Yrs of Age in Tehsil Narowal, Pakistan]]> Source:Universal Journal of Public Health  Volume  6  Number  1  

Muhammad Abdul Shakoor   Imtiaz Ahmad Khan   Hajira Ahmed   Mahpara Safdar   Zaheer Ahmed   and Asma Afreen   

Aim: To assess the magnitude of worm infections, their type and to correlate the impact of worm infections in children with their body mass index. Method: The study was carried out on school going children for 5-10 years of age in Tehsil Narowal, District Narowal, and Pakistan. They were of different age groups with lower socio economic status. 406 children randomly selected from various government and private schools from the various union councils for both genders (male and female). Early morning fresh stool samples were collected in sealed labeled plastic containers with lid and analyzed microscopy for the presence of eggs/ova/larvae or worm infections in laboratory. Anthropometric measurements were taken at the spot by using measuring scale for weight and height along with their mid arm circumferences. Body Mass Index was calculated and compared with standard percentile charts for age and gender. Results: 145 (35.71%) children found with various types of worm infection. 56 (35.67%) and 89 (35.74%) children were positive with helminthes male and female respectively in the studied population. Sixth and seventh year of age in both male and female were more susceptible for the infestation. Taenia saginata was the more common found organism in gastrointestinal tract of male population and Giardia lamblia in female among the children of studied area. 137 (94.48%) children were infected with the single intestinal worm while only 8 (5.52%) children with more than one intestinal worm. 57.24% had lower, 41.4% had normal and only 1.4% had above normal BMI among infected children. Majority (65.9%) had normal, 27.2% had lower than normal, and 6.9% had above normal BMI found among non-infected children. Conclusion: From the results of present study it can be concluded that intestinal worms play significant role in reducing anthropometric measurement of school going children. The factors including personal hygiene, dietary habits, type of drinking water, animals and pets keeping, overcrowded and congested living environment, large family members, toilet facility, toilet trainings, personal hygiene awareness, PICA habits and lack of de-worming contributes largely towards the worm burden in the children. A single cause is not only the attributing factor to reduce the anthropometric measurements.

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Jan 2018
<![CDATA[Impact of Health Education on Awareness of Sedentary Lifestyle as Predisposing Factor to Cardiovascular Diseases among Secondary School Principals in Zone 4 Nigeria]]> Source:Universal Journal of Public Health  Volume  6  Number  1  

Adetoun Tayewo Akinwusi   and Olusola Jacob Odelola   

Skeletal muscles contract to produce body movement. Essentially, skeletal muscle activities affect the health of other organs such as heart, adipose tissue, brain. Engaging in physical exercise enhances proper functioning of body organs, thus promoting healthy living. Nigerian secondary school principals are not known to engage in physical exercise, probably due to poor awareness of its importance to their health. Meanwhile, a life of inactivity otherwise called sedentary lifestyle is a risk factor to cardiovascular disease. In recent times, cardiovascular disease has led to a significant increase in deaths among administrators in Nigeria. Therefore, this study examined impact of Health Education on awareness of sedentary life style as predisposing factor to cardiovascular diseases among secondary school principals in zone 4, Oyo State, Nigeria. The study adopted a single group pre-test-post-test quasi experimental research design. Participants were given Health education on sedentary lifestyle and related diseases as its resultant effect. A split plot analysis of variance (SPANOVA) was employed to find the difference in pre-test-post-test scores of the participants. The result showed that, health education given was effective. The participants' awareness level increased, thus willing to refrain from sedentary lifestyle and adopt a sporting lifestyle. It was recommended that, the Ministry of Education should mandate school managements to create time during the school hours for principals and members of staff to engage in physical exercises. Also, health education in which disease prevention will feature prominently should form part of the agenda during meetings of school principals.

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Jan 2018
<![CDATA[Voluntary Counselling and Testing (VCT) Visit among Tuberculosis Patients in Pulogadung Sub-district Primary Health Centre]]> Source:Universal Journal of Public Health  Volume  5  Number  7  

Marsigit J   Wibowo JA   Basir R   Devi JBP   Kaligis AD   Nurhisan L   and Werdhani RA   

Background: Based on Indonesian Ministry of Health Regulation no. 74 year 2014, Voluntary Counseling and Testing (VCT) is an obligatory national program for all lung tuberculosis (TB) patients. However, according to annual report year 2016 of Pulogadung Sub-District Primary Health Care, East Jakarta, Indonesia; there were only 175 out of 237 (73.8%) TB patients who have been checked for their Human Immunodeficiency Virus (HIV) status, but the target of the program was 100%. However, a community diagnosis to investigate this shortage for about two years has not been done before. Objective: To explore related-factors that causes the low number of VCT among TB patients in Pulogadung Sub-District Primary Health Care. Methods: In-depth individual interviews were performed on twenty TB patients that had not done VCT along with Focus Group Discussion (FGD) on eight TB officers from seven villages under Pulogadung Primary Health Care. Thematic keywords were found and analyzed qualitatively. Results: From the TB patients, it was found that the majority of them knew about TB but only some of them knew about HIV. Most of them did not know the correlation between TB and HIV. Patients were not willing to take VCT because they felt that they were not in the risk of HIV. Meanwhile, there were still TB officers who only gave HIV education to risky TB patients. Conclusion: In conclusion, TB patients who had not done VCT felt they did not have risky behaviors to HIV. This was also because of lack of HIV counseling from TB officers to TB patients.

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Dec 2017
<![CDATA[Assessing the Impact of Climatic Variables on Malaria Cases among Pregnant Women in South-Western Nigeria]]> Source:Universal Journal of Public Health  Volume  5  Number  7  

Babajide Sadiq   and Perry Brown   

The purpose of this study was to determine the effect of climatic factors on malaria cases among pregnant women in Ogun State. A zero-truncated negative binomial regression was used to analyze the effect of meteorological variables and malaria cases among pregnant women using a 10 year historical data from January 2004 to December 2013. A bivariate analysis shows an association between rainfall ((0.000935), 95% CI 0.00026-0.00161, p-value 0.0070), humidity ((0.007698), 95% CI 0.00054-0.01486, p-value 0.0353), and maximum temperature ((-0.04628), 95% CI -0.08037- -0.01219, p-value 0.0082) and malaria cases among pregnant women. There is a significant relationship between meteorological variables and malaria cases among pregnant women in Ogun State, Nigeria.

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Dec 2017
<![CDATA[The New Incinerator in Parma and the News from Newspapers - The Importance of Communication in Terms of "Environment and Health"]]> Source:Universal Journal of Public Health  Volume  5  Number  7  

Alessandra Rampini   Elisa Mariani   Rosanna Giordano   Licia Veronesi   Matteo Goldoni   Giuliano Ezio Sansebastiano   and Maurizio Impallomeni   

Objective is the evaluating of news concerning the incinerator in Parma and assessing any potential information gap, which could be addressed by institutional communication. Articles from both online and printed newspapers were selected, then underwent to double-blind review and were further evaluated also by a non-partisan expert. 2,390 articles were found through 'Google News' (incinerator, waste-to-energy plant, Parma); 96 of these were selected according to the relevance of the theme, then they were categorized as 'informative', 'scientific', 'political', 'socio-political' and 'economic' by all three evaluators. Such classification was finally contextualized depending on the type of newspaper. The agreement was considered using Cohen's kappa statistic. Within the 96 articles, 3 were economic, 34 political, 29 socio-political, 28 informational and only 2 scientific. The articles were further categorized by type of newspaper: 1% economic, 1% political, 5.2% environmentalist, 15.6% self-defined independent, 35.4% national and 41.7% local newspapers. This review shows that both local and national press are interested in the topic at issue, nevertheless it reveals a lack of scientific information. This analysis has not found articles in which the institutions directly involved have been consulted. Thus it would be desirable to have a greater mutual cooperation between the press and such institutions.

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Dec 2017
<![CDATA[CD4 Recovery and Survival among Adults Co-infected with HIV and Hepatitis B or C Virus, Ho Chi Minh City, Vietnam]]> Source:Universal Journal of Public Health  Volume  5  Number  7  

Hao Duong   Son Nguyen   Ray Shiraishi   Hung Trinh   Hanh Vo   Thu-Van Tieu   Hung Van   Thinh Tran   Marta Ackers   and Siobhán O'Connor   

This study assessed associations between hepatitis B and C virus (HBV, HCV) and increases in CD4 count and survival among 4316 HIV-infected patients on non-tenofovir (TDF)-based antiretroviral treatment (ART) in Ho Chi Minh City, Vietnam during 2006-2010, using mixed-effects model and survival analysis. More than half of patients (52.4%) participating in the study were HBsAg-negative/anti-HCV-negative, 9.0% HBsAg positive/anti-HCV-negative, and 38.6% anti-HCV-positive. Anti-HCV-positive males had smaller increases in CD4 count during the first two years of ART, but larger increases between two and three years after ART initiation than anti-HCV-negative females (regardless of HBsAg status) and HBsAg-negative/anti-HCV-negative males. Magnitude of the differences was small. Overall mortality rate was 15 per 1000 person-years; HBsAg and anti-HCV status were not significantly associated with mortality. Co-infection with HBV (HBsAg-positive) and/or exposure to HCV (anti-HCV-positive) does not seem to have substantial effects on outcomes of patients on non-TDF-containing ART during a median follow-up of 1.72 years. It may take a longer time for assessing effects of co-infection with HBV and/or HCV on ART outcomes. Such assessments should focus on those with positive HCV RNA, instead of positive anti-HCV.

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Dec 2017
<![CDATA[Prognostication of Cardiovascular Risk in Patients with Stable Coronary Heart Disease Depending on SYNTAX Score II on the Background of Nonalcoholic Fatty Liver Disease]]> Source:Universal Journal of Public Health  Volume  5  Number  7  

Iryna Vakalyuk   

Aim of the study was to evaluate the contribution of nonalcoholic fatty liver disease in predicting risk of major cardiovascular events by cumulative proportion surviving depending on the SYNTAX score II in patients with stable coronary heart disease. Materials and methods: Patients with stable coronary heart disease with and without nonalcoholic fatty liver disease underwent clinical examinations, electrocardiography, echocardiography, liver elastography, liver ultrasound, evaluation of the liver functional state. Then SYNTAX score I and II were calculated to all patients. Results: The two-year death-free survival (100.00% vs. 60.00%; P = 0.0165), and a repeated nonfatal myocardial infarction-free survival (85.36% vs. 33.33%; P = 0.0045), and a stroke-free survival (88.95% vs. 37.85%; P = 0.0021), and a repeated revascularization-free survival (85.83% vs. 31.81%; P = 0.0006) in patients with SS II ≥29 and without nonalcoholic fatty liver disease were significant higher than in those with nonalcoholic steatohepatitis. Conclusions: the long-term prognosis of the patients with stable coronary heart disease is a most prognostically unfavorable on the background of SYNTAX score II ≥29 and nonalcoholic steatohepatitis combination.

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Dec 2017
<![CDATA[Refugee Resettlement in the U.S.: The Impact of Contextual Factors on Psychological Distress]]> Source:Universal Journal of Public Health  Volume  5  Number  7  

Laura M. Ramzy   Danielle M. Jackman   Adam Soberay   and Jamie Pledger   

The purpose of the current study was to examine the contribution of behavioral health treatment and several contextual factors – employment, English language proficiency, family separation, and local family support -- to psychological distress among newly resettled refugees over one year. Pre- and post-data were collected between July 2014 and January 2016 at an integrated care refugee clinic located in the western United States. The sample (N = 77) consisted of a diverse group of refugees, most of whom recently arrived from Burma, Iraq, Bhutan, Democratic Republic of Congo, and Somalia. The Refugee Health Screener-15 (RHS-15) was used to measure psychological distress at the initial screening and at 12 months for refugees who indicated distress at baseline. Findings indicated a significant increase in psychological distress for those who were employed, and a significant decrease in distress for those with at least some English language proficiency and for those who have family residing in or near their country of origin. Research recommendations include using a larger sample size and more robust assessment tools to further understand the influence of family separation on psychological distress. Practice recommendations include providing advanced employment options and increasing host country language class access for newly arrived refugees.

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Dec 2017
<![CDATA[The 9 Stress-free Stitches Technique: Feasibility and Outcomes of a New Technique for Aortic Valve Replacement]]> Source:Universal Journal of Public Health  Volume  5  Number  7  

Apicella G   El Nakadi B   and Joris M   

Objective: This study aims to evaluate the feasibility and short-term outcomes of a novel surgical technique, named 'the nine stress-free stitches technique' for aortic valve replacement (AVR) in patients with aortic valve disease. Methods: From May 2013 to October 2015, 63 consecutive patients underwent aortic valve replacement with the nine stress-free stitches technique, using the Magna Ease bioprosthesis (Edwards Lifesciences, Irvine, CA, USA). Demographics, clinical and echocardiographic data were collected retrospectively. The primary endpoints were paravalvular leak, pacemaker insertion, and mortality. Results: There was one case of moderate paravalvular leak. 2 patients required permanent pacemaker implantation. In-Hospital mortality was 6.3%. All deaths were in redo or combined procedure patients. Conclusion: This preliminary series demonstrates that the nine stress-free stitches technique is an acceptable technique for aortic valve replacement. The potential advantages are reduced ischemic time, especially in combined procedures, with easy replication.

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Dec 2017
<![CDATA[Spatial Analysis of Distribution Patterns of Healthcare Facilities in Osun State, Nigeria]]> Source:Universal Journal of Public Health  Volume  5  Number  7  

Fadahunsi, J. T.   Kufoniyi, O.   and Babatimehin, O. I.   

The study examined the distribution patterns and developed a model for determining the optimum location of healthcare facilities in Osun State, Nigeria. These were with a view to improving the spatial distribution of and equitable access to healthcare facilities in the State. Primary and secondary data were used in the study. The primary data comprised the geographic coordinates of all the healthcare facilities in the State, while the secondary data included the list of all the healthcare facilities in the State. The cartographic model for determining the optimum location of healthcare facilities was developed. The data were analysed using percentage and Geographical Information System (GIS) analysis tools such as nearest neigbour ratio (NNR), buffering, overlay and query. The study identified 919 healthcare facilities of four categories, namely, primary (603, 65.6%), private (262, 28.5%), secondary (51, 5.6%) and tertiary (3, 0.3%) in the State. Primary and private healthcare facilities depicted clustered patterns of distribution; while secondary and tertiary depicted random distribution patterns. Using the secondary healthcare facilities as a case study, the developed cartographic method revealed both the optimum number and locations of additional facilities required, at 10km buffer distance to meet the set standards. The study identified that additional seven secondary healthcare facilities are required in four of the 30 LGAs of the State. The model also holds for primary, private and tertiary healthcare facilities by simply varying the buffer distance at 5km, 5km and 20km respectively. The study concluded that there were inequalities in the spatial distribution of healthcare facilities in the study area.

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Dec 2017
<![CDATA[Comparison of Different Saturation Pulse Types in a Series of Saturation Transfer Difference NMR Experiment Based on Cox-1 Enzyme and Ibuprofen Interaction]]> Source:Universal Journal of Public Health  Volume  5  Number  6  

Nil E. Binbay   and Berrin Ziyadano?ullar?   

Here we report, comparison of two different saturation pulse types with different shapes, Gaussian pulse and Reburp pulse. Pulses are comparatively used in a series of STD-NMR experiments for determine which one is more effective for saturation and also saturation transfer for ibuprofen and COX1 mixture. Both pulses have been comparatively studied, and they are applied to identical samples in identical experimental conditions to see the difference. Also they are examined over different pulse parameters, like lengths and powers. Finally it is shown that, re-burp pulse gives more intensive STD-NMR signals than Gaussian pulse shape under same conditions and same samples. That means Reburp pulse shape causes more effective saturation than Gaussian pulse shape for COX enzyme and ibuprofen. Results are in accordance with literature.

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Oct 2017
<![CDATA[General Medical Examination of the Employed for Screening for Increased Cardiovascular Risk]]> Source:Universal Journal of Public Health  Volume  5  Number  6  

Dragan Jankovi?   Manda Herceg   Dunja Stolnik   Nikola Volari?   Sanja Beki?   and Ljiljana Majnari? Trtica   

Introduction: Systematical calculation of cardiovascular risks with middle aged persons is not recommended, but in that age start of measures of primary prevention is recommended. Methods: Retrospective research study. Laboratorial data were used from persons aged 40 to 50 who have done a physical examination for working employees in the private Medical Centre for Occupational Medicine during 2014. Results: There were 54% of overweight examinees, 17% really obese, with a greater representation of men. Higher systolic blood pressure was found with 24% of males and 10% of females, a diastolic with 28% of males and 8% of females. High total and LDL cholesterol were found with 71% of examinees, while low HDL cholesterol and high triglycerides were found with 21% i.e. 25% of examinees, regardless of gender. Conclusion: Register of physical examinations of employees should be used as a source of information on representation of cardiovascular risks with middle aged persons, which would allow a timely start of measures of primary prevention.

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Oct 2017
<![CDATA[A Case Report on Life Threatening Hemorrhage in Preterm Pregnancy with Placenta Praevia and Management Challenges in a Low Neonatal Resourced Regional Hospital 187 km away from a Tertiary Center]]> Source:Universal Journal of Public Health  Volume  5  Number  6  

Ayesha Akhter   Bruno Giorgio   Adebayo Adeyemi   and Md Rafiqul Islam   

Placenta praevia is one of the obstetric emergencies, which can cause life threatening hemorrhage. Time interval to access support for these patients from emergency retrieval team are often challenging. Also, dilemmas may appear on taking decision for in-utero versus ex-utero transfer of neonates to tertiary hospital. In this case study, the patient presented with a life threatening antepartum hemorrhage (APH) in a low neonatal resourced regional hospital at 29 weeks of gestation. She was extremely needle phobic that delayed the resuscitation process. The overall situation and the patient's clinical condition were inappropriate for road transfer. Moreover, considering the weather condition on the day, air ambulance was grounded. Eventually, in-utero transfer of the neonate to tertiary hospital was impossible. As a result, she was delivered by an uncomplicated caesarean section and an initial resuscitation of the newborn was provided by the pediatric team of the hospital. Emergency neonatal retrieval team was able to arrive 3 hours after the birth for transferring the premature neonate to a tertiary center.

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Oct 2017
<![CDATA[Enhancing Adaptive Capabilities of Hospitalized Child]]> Source:Universal Journal of Public Health  Volume  5  Number  6  

Kazimierz Kopczyński   Marta Gajek   and Aneta Micha?owska   

Hospitalization is always a difficult situation for a child as well as for its parents. It is also a new situation, accompanied by fear and negative emotions. Child's adaptation to hospital conditions and reduction of fear are not always taken into consideration properly, as the whole process of hospitalization is concerned. The most significant issues are diagnosis and treatment, most often pharmacological or surgical. Usually, there is also not enough qualified personnel (clinical psychologist, special educator), who could provide necessary support to a child and his or her parents. Not much however, has been written so far regarding the subject of our research, that is why, in our opinion, there is an urgent need of conducting further studies based on theory and developing appropriate model of prevention and psycho-correction, which would take into consideration an individual approach towards the child, depending on its age, family situation, type of disease, the length of hospitalization, as well as child's interests and talents. In our research on children from the age of pre-kindergarten to older schoolchildren, we chose the monographic method to conduct a conversation and an interview (most often with the parents), observation, analysis of the child's works and the gap-test (version for children). The aim of our research was to familiarise with the child's history and its psychic activity, with emphasis on cognitive factors which make the child aware of the whole situation concerning disease, help to estimate losses and benefits, the role of the parents and the child itself. While doing our research, in relation to the examined children, we made psycho-corrective proceedings of enhancing their adaptive capabilities to hospital conditions. One of integrative plays we used, was called Guess the emotions. We also used an exercise called Paint the feelings moreover, forming the attitudes of positive thinking and self-acceptance as well as development of interests were also introduced. Individual approach to ill children considering mentioned above effects, presented in the article have become a part of so called integrated therapy which may turn out to be the most promising and effective form of therapy developed in future.

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Oct 2017
<![CDATA[Civil Society's Contribution to Rolling out of Option B+ in Malawi - A Case of Umunthu Foundation]]> Source:Universal Journal of Public Health  Volume  5  Number  6  

David Odali   and Yohane Gadama   

Option B+ was developed in Malawi in 2010 and adopted in 2011 in response to the impracticality of implementing the World Health Organization (WHO) 2010 guidelines on prevention of mother-to-child transmission (PMTCT) of HIV. The approach was deemed very ambitious in a Malawian setting given the ongoing service delivery challenges. Major challenges included shortage of human resources (qualified health staff), lack of proper infrastructure, stigma associated with taking antiretroviral drugs, shortages of HIV test kits and related accessories. Amidst these challenges, civil society organizations like Umunthu Foundation (UMUFO) partnered with government to better serve mothers living with HIV. UMUFO actively worked with communities to enhance awareness of Option B+ and aide in retaining women in care once initiated on ART. UMUFO has particularly been working with two public health facilities (Limbe and Bangwe Health Centers) in providing HIV testing services, infrastructural needs and hiring health workers. With these services, UMUFO has managed to maintain a significant increase of women tested and started on Option B+ by almost 200% (from 408 in 2014/2015 to 1219 women in 2016/2017) in 3 years. The impact UMUFO has had on rolling out of Option B+ clearly demonstrates the critical role civil society organizations can have in meeting national and global public health targets.

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Oct 2017
<![CDATA[Macroeconomic Determinants of Health Crises in Sub-Saharan Africa]]> Source:Universal Journal of Public Health  Volume  5  Number  6  

Boyé Gnandé Roméo   

The purpose of this article is to identify the macroeconomic determining factors of health crises. In order to reach our purpose, we use a logit model on a panel of 25 countries in sub-Saharan Africa from 1995 to 2012. The main results of this study indicate that international migration flows, the ratio of short-term debt by currency reserves, and the organization of the health care system explain health crises. These results imply that the poor management of information related to unforeseen events, the ability of reimbursement of the short-term debt, and the privatization of health services make most sub-Saharan African countries vulnerable to unforeseen events. This study suggests a better management of information related to unforeseen events, the increase of exportations and the improvement of the access to health services to all people during any unforeseen events outbreak.

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Oct 2017
<![CDATA[Learning Styles and Use of Clinical Knowledge Sources among Junior Doctors]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Christian Gerdesk?ld   Eva Toth-Pal   Inger W?rdh   Lars-Erik Strender   and Gunnar H. Nilsson   

Objective: The primary aim of this study was to explore the use of clinical knowledge sources among junior doctors in relation to their learning styles. The secondary aim was to describe how junior doctors value different qualities of knowledge sources in clinical situations. Methods: A cross-sectional study among 63 junior doctors in a Swedish hospital. A questionnaire was used to collect information about the use of knowledge sources, to identify learning styles according to Kolb and to record the value of qualities of knowledge sources in clinical situations. The 1-Sample Sign Test and the Mann-Whitney test were used to analyse the non-parametric data. Results: The most frequently used knowledge sources were personal contacts with colleagues (n=14, p=0.0002) followed by internet-based guidelines (n=14, p=0.0034) and printed reference literature (n=14, p=0.0225). Learning styles aggregated into two main clusters, converging (54%) and assimilating (30%). Access was the most valued quality of knowledge sources. Conclusions: Although personal contacts were most frequently used, internet-based sources reached almost the same level. Learning styles among junior doctors were in accordance with the findings in previous studies. Convergers seemed to use computer-based knowledge sources less than the assimilators. This needs further investigation. Access should be addressed in the design of knowledge tools since this was overall the most valued quality in clinical situations.

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Aug 2017
<![CDATA[Are Australian Regional Hospitals Doing Enough for Coeliac Disease Testing in 2012-2013? A Pilot Study]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Shu Wen Xu   Rafiqul Islam   and Arup Bhattacharya   

Coeliac disease diagnosis requires adequate testing, and insufficient testing may increase complications. This pilot study determined the prevalence of appropriate testing for coeliac disease among eligible in-patients admitted in a regional Australian hospital. A retrospective review of all admissions were conducted between August 2012 and January 2013 in the medical, surgical and geriatric divisions for the patients diagnosed with haematinic-deficiency anaemia due to unspecified causes, protein-energy malnutrition due to unspecified causes and irritable Bowel Syndrome. Secondarily an extended review between February 2012 and February 2013 was also conducted to review all serology test requests for coeliac disease to identify the positive serology testing. We observed that, except for Iron Deficiency Anemia (IDA) and Irritable Bowel Syndrome (IBS), a very small proportion of unspecified anaemia and Protein Energy Malnutrition (PEM) patients were investigated (15.6% and 11%, respectively) for celiac disease. Invasive testing such as histopathology was requested only for about 52% of serology positive cases. Low diagnostic test requests for coeliac disease warrants the demand for availability of specialist gastroenterologist services and telemedicine support in regional Australia. Training for practicing doctors and continuing medical education around this may help adequate testing and diagnosis.

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Aug 2017
<![CDATA[Biomedical, Sharps and General Waste Disposal in India: Potential for the Spread of Contagious Diseases and Serious Environmental Contamination]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Vasudha Iyengar   and Md Rafiqul Islam   

Biomedical waste, contaminated sharps, and general garbage disposal is a huge problem in many developing countries including India. There are different waste management rules in India for managing different kinds of waste. These rules were revised in 2016. However, the application and practice of handling different kinds of waste as per the rules are still inadequate. Mixing general and medical waste together for disposal accentuates the situation, especially as a significant threat for sharp or needle-stick injuries. India's waste production is huge and traditional management of these mixed and contaminated wastes is a serious public and population health issue. It is also creating massive environmental concerns. Adequate hospital or biomedical waste management policy enforcement, strong public health promotional research and media campaigns, safe practice and personal hygiene education via social and mass media may alleviate the spread of serious contagious diseases. India has a high social media utilization and excellent wireless and broadband coverage. These can be used as an educational or health promotional tools to keep the public away from contagious diseases. In addition to enforcement of practicing waste management rules or guidelines, a global public health campaign on many levels is urgently required to ensure India is able to contain potential pandemics of blood borne conditions due to poor medical waste disposal practices.

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Aug 2017
<![CDATA[Linking Weather Data, Satellite Imagery and Field Observations to Household Food Production and Child Undernutrition: An Exploratory Study in Burkina Faso]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Sorgho R   Franke J   Simboro S   Barteit S   Phalkey R   and Sauerborn R   

Worldwide, 50 million children under five are acutely malnourished, while 16 million amongst them suffer from severe wasting. Chronic malnutrition is more common and accounts for an estimated 159 million children, approximately 23.8% of all children under five worldwide are stunted. The proportion of stunted children has decreased worldwide between 1990 (39.6%) and 2014 (23.8%), but the progress has been imbalanced: While Asia as a whole reduced stunting by half (-47.0%) between 1990 and 2014, there are still 78 million stunted children in South Asia alone. Unlike Asia, Africa has reduced stunting by one quarter (24.0%). In contrast, the absolute number of stunted children in Africa has increased, from 47 million in 1990, to 58 million in 2014. Under-nutrition is caused by a complex web of interdependent environmental/climatic, agricultural and socio-economic factors. Climate change has recently been identified as a major risk factor for childhood undernutrition, although there scientific evidence base is weak. Studies that simultaneously combined the well-known drivers of undernutrition with climate change while being grounded in one population in one-time and in one location, , are prerequisite for the relative attribution of the various risk factors, including climate chance, as causes of childhood undernutrition. An exploratory study was conducted employing multiple methods applied to 20 randomly selected households in the village of Bourasso in rural Burkina Faso, where more than 80% of the population are subsistence farmers. Well-tested methods, such as household-level agricultural and nutritional surveys, anthropometric measurement of undernutrition with innovative methods, measuring household level-crop yields, were combined. This was done by participatory mapping of each household's plots. Remote sensing algorithms were applied to RapidEye satellite scenes covering the study area in order to map the actual cultivated area and to derive qualitative harvest estimates for the surveyed micro-fields. Weather data were obtained from a research meteorological field station, about 20 km away from Bourasso. In addition to bringing together field methods from different sectors through the lens of a household, one further advanced method was integrated: The linkage between each household plot and satellite scenes making it possible to estimate crop yields at the plot level for each household and linking this to the nutritional status of that specific household. Thus the exploratory study produced the following results: High-resolution remote sensing data can assist studies on malnutrition in Burkina Faso; RapidEye is a promising data source in regard to the spatial resolution for micro-field assessments; The strong inter-annual variation of malnutrition is suggestive that climate is a casual factor in the absence of other explanatory factors (political unrest, price shocks of inputs, epidemics). Population-based studies replicating the described multi-sectoral toolbox should be up-scaled to larger sample sizes and longer observational time series. This could contribute to generating crucial climate-health impact functions, in this case for malnutrition.

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Aug 2017
<![CDATA[Delay in the Provision of Antiretroviral Therapy to HIV-infected TB Patients in Nigeria]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

B. Odume   I. Pathmanathan   S. Pals   K. Dokubo   D. Onotu   O. Obinna   D. Anand   Okuma J   E. Okpokoro   S. Dutt   E. Ekong   N. Chukwurah   P. Dakum   and H. Tomlinson   

Background: Nigeria has a high burden of HIV and tuberculosis (TB). To reduce TB-associated morbidity and mortality, the World Health Organization recommends that HIV-positive TB patients receive antiretroviral therapy (ART) within eight weeks of TB treatment initiation, or within two weeks if profoundly immunosuppressed (CD4<50 cell/μL). Methods: TB and HIV clinical records from facilities in two Nigerian states between October 1st, 2012 and September 30th, 2013 were retrospectively reviewed to assess uptake and timing of ART initiation among HIV-positive TB patients. Healthcare workers were qualitatively interviewed to assess TB/HIV knowledge and barriers to timely ART. Results: Data were abstracted from 4,810 TB patient records, of which 1,249 (26.0%) had HIV-positive or unknown HIV status documented, and the 574 (45.9%) HIV-positive TB patients were evaluated for timing of ART uptake relative to TB treatment. Among 484 (84.3%) HIV-positive TB patients not already on ART, 256 (52.9%, 95% CI: 45.0-60.8) were not initiated on ART during six months of TB treatment. 30.0% of 273 patients with a known CD4≥50cells/μL started ART within eight weeks, and 14.8% of 54 patients with a known CD4<50cells/μL started within the recommended two weeks. Only 42% of health workers interviewed reported knowing to interpret guidelines on when to initiate ART in HIV-positive TB patients based on CD4 cell count results. CD4 cell count significantly predicted timely ART uptake. Conclusion: A large proportion of HIV-positive TB patients were not initiated on ART early or even at all during TB treatment. Retraining of staff, and interventions to strengthen referral systems should be implemented to ensure timely provision of ART among HIV-positive TB patients in Nigeria.

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Aug 2017
<![CDATA[Introducing a Sugar Tax, Morally Justifiable? A Debate on the Introduction of the UK Soft Drinks Industry Levy]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Charlotte Cliffe   

Obesity is increasing throughout the world's population and has been associated with a number of diseases, from cardiovascular disease, diabetes and stroke to cancer and respiratory diseases [1, 2]. In the United Kingdom, an astonishing 62% of the population was classified as obese or overweight in 2015 [3]. Complications of obesity have resulted in high rates of morbidity and mortality. The announcement last year that the UK government is to impose a tax on sugar is an attempt to tackle this problem; therefore, it is a timely moment to discuss the justifications and ramifications of this, from a moral point of view. This essay will analyse whether obesity can be considered a public health matter and discuss the ethical challenges and criticisms that paternalistic interventions, designed to combat this epidemic may encounter, focusing on the sugar tax.

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Aug 2017
<![CDATA[A Quarter for Prevention? Global Fund Investments in HIV Prevention Interventions in Generalized African Epidemics]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Gemma Oberth   Mary Ann Torres   Olive Mumba   and Michael O'Connor   

The Joint United Nations Programme on HIV/AIDS estimates that ending AIDS by 2030 will cost $25 billion a year. About a quarter (26%) of this amount is required for HIV prevention. The Global Fund to Fight AIDS, Tuberculosis and Malaria is a major financier of African HIV responses and a vital source of prevention investments. A search was performed for Global Fund funding requests and signed grants from a sample of African countries over the 2014-2016 funding cycle to see if the Global Fund is investing "a quarter for prevention". Funding requests were accessed for 23 countries and signed grants were accessed for 15 countries. Some documents were not publicly available. Among the funding requests examined, an average of 16% was dedicated to HIV prevention. Wealthier countries requested more money for HIV prevention, as did countries with greater numbers of annual new infections. Of the grant agreements examined, an average of 15% of the total funding invested was dedicated to HIV prevention. For the Global Fund to achieve its HIV prevention targets in its new strategy (2017-2022) it must increase its investments in HIV prevention in Africa from current levels towards the UNAIDS benchmark of 26%.

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Aug 2017
<![CDATA[The Role of Drinking Places in Enhancing Risky Sexual Behaviours and the Spread of HIV/AIDS amongst the Tiv People of Benue State, Central Nigeria]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Timiun, Godwin Aondohemba   and Timothy Scrase   

In 2013, the prevalence and incidence rates of HIV/AIDS infection in Nigeria were 3,229,757 and 220,394 respectively. Despite the fact that the influence of alcohol consumption on unsafe sexual behaviours and HIV risk in Nigeria has been documented, gaps still exist in knowledge on the roles of drinking places. This paper examines the roles of drinking places in enhancing illicit, risky sexual behaviours (irregular condom use and having sex while drunk) and the spread of HIV. A sample of 1,621 (864 women; 757 men; 815 HIV seropositive; 806 HIV seronegative) respondents who participated in survey and in-depth interviews were selected from 2 clinics and 2 other locations using multi-stage and purposive sampling methods. SPSS (version 21) software was used for quantitative data analysis. Drinking places are meeting points for lovers, alcohol consumption, verbal pornography and negotiations for illicit sexual activities with high risk of HIV infection. Understanding, and then addressing the impact of drinking places on risky sexual behaviours would assist in reducing the spread of HIV/AIDS amongst the Tiv people. Consequently, there likely would be an improvement in the sexual wellbeing of individuals and the public in Nigeria more generally.

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Aug 2017
<![CDATA[The Effects of Recreational and Sports Activities on Psychological Status in Young People Aged 11-13 Years]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Yener Aksoy   Soner ?ankaya   and M. Yal??n Ta?mektepligil   

This study was conducted to investigate the depressive state and loneliness in a total of 219 male adolescents between the ages 11 and 13 who were registered at the summer school of the Vezirk?prü Provincial Directorate of Youth Services and Sports based on whether or not they participated in recreational and sports activities during the summer holiday. One hundred and fifteen of the participants participated in recreational and sports activities organized during the summer, while 104 did not. Information about the depressive states of the participants was collected via the Beck Depression Scale, while information about their loneliness was collected with the UCLA Loneliness Scale. High total scores on both scales indicated that depression and loneliness levels were high. The Cronbach's alpha internal consistency coefficient was calculated to determine the reliability of the answers given by the participants to the items of Beck Depression Scale and UCLA-LS. In the statistical assessment of the research results, it was found that the error terms were not normally distributed (P<0.05). Thus, the differences between the group that participated in recreational activities and the group that did not were shown via a Mann-Whitney U-test. In addition, the association between the total scores on both scales was calculated using Kendall's tau b correlation coefficient. At the end of the study, the Beck Depression scores of the adolescents who did not participate in any recreational or sports activities during the summer holiday (13 weeks) were found to be significantly higher than the scores of those who did. Thus, while the depression levels of individuals who did not participate in recreational or sports activities were high, the levels of individuals who regularly participated in these activities were low. Similarly, the loneliness scores of individuals also differed based on participation in these activities. The loneliness scores of adolescents who did not participate in the related activities were found to be significantly higher than those who did. In short, the reason for these low levels of depression and loneliness following participation in sports activities is understood to result directly from participation in these activities. Also, a strongly positive significant association was found between the Depression and Loneliness Scale scores of adolescents who did engage in sports. An increase was seen in the Beck Depression scores of the participants as their loneliness scores increased. In other words, as Beck Depression scores increase, so do the levels of loneliness. Thus, engaging in regular recreational and sports activities over extended periods of time can be said to be effective in eliminating the depressive and lonely feelings of adolescents. Educational institutions should include such programs within regular education.

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Aug 2017
<![CDATA[Screening for Type 2 Diabetes Risk Factors in a Greek Municipality towards Health-literate Healthcare]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Bakides Sofoclis   Kushitashvili Nino   and Sakellariadis George   

Diabetes prevention is possible and a lot of strategies have been implemented worldwide. Unfortunately, we lack systematic efforts of combined Type 2 Diabetes risk factors screening with the concept for patients knowledge and evaluation of health information. This is true in semi-urban Greek areas stricken by the socio-economy crisis. We used the FINDRISK questionnaire and a knowledge attitude and perceptions questionnaire for cardiovascular risk factors. Totally 358 people were recruited from March to June 2014. Young doctors examined the patients and filled in the questionnaires after their fully informed consent. We have found 75 people (20,95%) with score >15. Mean age: 52,14 years and mean BMI: 27,43kg/m2 Accordingly their knowledge about health risk factors >90% knew the significance of high blood cholesterol, Diabetes, bad diet, exercise, smoking, obesity and hypertension, but over 60% underestimated their exact mortality impact on cardiovascular events. In our area pilot study, the burden of the problem for future development of T2D is probably heavy. Although health risk factors knowledge is growing, there are gaps in the field of person oriented methodology approach for enhanced health literacy. We need the development of targeted intervention programmes towards interdisciplinary working, transparent decision-making and active health-literated involvement of patients.

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Aug 2017
<![CDATA[The Co-production of Biomedical Research in Canada: Are Scientists Ready to Take the Plunge? An Empirical Example from Food Allergy Research]]> Source:Universal Journal of Public Health  Volume  5  Number  5  

Jenna Dixon   Susan J. Elliott   and Ann. E. Clarke   

End-user involvement in research through collaborative research models, known as Integrated Knowledge Translation (IKT) in Canadian health, can improve recruitment, quality, relevance and acceptability of research. Despite potential benefits, application to biomedical research remains rare. This study aims to explore baseline knowledge, attitude and practices of Canadian biomedical scientists towards IKT as a foundation for a funded program of research related to causes and treatments of an emerging public health epidemic. A qualitative methodology was used. Semi-structured in-depth interviews were conducted with all 16 scientists on the GET-FACTS project. Interviews were audio-recorded and transcribed verbatim. Thematic content analysis was performed on the data. Findings highlight the limited exposure of biomedical scientists to IKT activities. Though Knowledge Translation (KT) was a term familiar to participants, most described it as end of grant activity (not 'integrated'). A majority of participants expressed that their research could take on a new direction or focus with the input of end-users, would prove to be a valuable research tool, and that IKT could help researchers think creatively about problems. All participants acknowledged challenges associated with this approach to research. We argue that biomedical scientists are open and eager to engaging in IKT but are held back by a lack of concrete examples and experiences to draw on. Integrating end-users and research scientists is an important step in ensuring end-users receive the research knowledge they require and that research is created to address their pressing needs.

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Aug 2017
<![CDATA[Evaluating Lean Thinking and Facility Design in Two University Hospitals]]> Source:Universal Journal of Public Health  Volume  5  Number  4  

Virpi Ruohom?ki   Emmi Reijula   and Jori Reijula   

Hospitals will be expected to work more efficiently in the upcoming years due to several factors, one of which is aging population groups. Meanwhile, healthcare resources are dwindling, as is the amount of available personnel. This paper examines interviews and questionnaires that were conducted to assess the experiences and effects of Lean implementation in two university hospitals. Several factors, such as emphasis on the participatory, user-centric design approach and integrating Lean as an integral part of the operational facility design process in both target hospitals have proven to be beneficial. This study delivers promising evidence from the two university hospitals, which supports the implementation of Lean in the healthcare sector for improving facility design and work processes.

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Jul 2017
<![CDATA[Correlates of Coping Styles in Young Women with Type 1 Diabetes]]> Source:Universal Journal of Public Health  Volume  5  Number  4  

Paulina Wróbel   

Introduction: Type 1 diabetes mellitus is a chronic disease strongly affected physical and psychical aspects of patient life. It requires self-discipline and regular active participation in the management of the condition. Diabetes is obliged to face a lot of stress and restrictions caused by daily living with disease. Objective: to examine correlates of coping styles in young women with type 1 diabetes mellitus. The aim of the study was particularly concerned with characteristics, which are known to be connected with coping: self-esteem, illness representation, affect, social support and metabolic control. Material and methods: 32 young women (aged 19-30) with type 1 diabetes mellitus were included into the study. The participants completed MSEI, IBS, PANAS, CISS and BSSS. The metabolic status was assessed by HbA1C. Results: There were connections between coping styles and self-esteem, illness representation, metabolic control and social support. Relationships between coping styles and affect were not confirmed. Conclusions: The results indicate that the individual characteristics and preferences of young diabetic women such as: their styles of behavior in difficult situations, self-confidence, sense of disease-control, belief in efficacy of medical recommendations and constant necessity of health control should be taken under consideration in the treatment of diabetes.

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Jul 2017
<![CDATA[The Economic Burden of Water Related Infections in the Bamenda Health District: The Case of Diarrhoea]]> Source:Universal Journal of Public Health  Volume  5  Number  4  

Chenjoh Joseph Nde   Ndong Ignatius Cheng   Johannes Tabi Atemnkeng   and Wilfred Mbacham   

Diarrhoea remains a major public health concern of our times with bad drinking water and frequent poor disposal of human waste matter. Caused by a variety of conditions, it spans from diarrhoea which are of viral bacterial to sometimes metal intoxication. In Cameroon, it is one of the 10 major causes of illness. To assess the burden and lost income due to diarrhoea, the study quantified how much households in the Bamenda Health District (BHD), North West Region (NWR) of Cameroon are losing because of the incidence of diarrhoea related infections. A cluster sampling technique was used to select 8 Public Integrated Health Centres in 8 Health Areas, with an estimated population of about 189,730 people. Data for all reported diarrhoea cases for 2011 and 2012 was collected from the Health Centres. The Cost of Illness (CoI) methodology was used to quantify the direct and indirect cost of diarrhoea infections. It was estimated that about USD22, 361 and USD37, 198 was lost by households in general in 2011 and 2012 respectively. The economic burden over the two years was estimated at USD53, 602.3. If this amount were projected over 10 years it will imply that about USD260, 000 will be lost to the treatment of diarrhoea infections.

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Jul 2017
<![CDATA[Bacteremia Pattern in Febrile Neutropenia among Adults Cancer Patients Receiving Chemotherapy in an Australia Regional Hospital]]> Source:Universal Journal of Public Health  Volume  5  Number  4  

Tunde Maiyaki Ibrahim   and Christine Pang   

Background: Febrile neutropenia (FN) remains one of the most concerning complications of cancer chemotherapy, and is a major cause of morbidity and mortality, consuming significant healthcare resource .This audit was carried out to determine the pattern of microbial pathogens responsible for FN in our institution as this will result in the appropriate choice of empirical antibiotic(s) for treatment of FN in the future. Methods: This is a retrospective audit of adult patients with cancer admitted with FN post chemotherapy in Goulburn valley base hospital, Shepparton, Australia between 2011- 2013.Only patients who met the diagnostic criteria of FN as defined by the Infectious diseases society of America (IDSA) were included in the audit. Results: Twenty six patients presented with 31 episodes of FN between January 2013 and January 2014. 65 blood cultures (BC) were obtained with an average of 2.5 sets of BC per patients, 10.8% of these were positive. 66.7% of the BC yielded Gram Positive Cocci (GPC) (50% of which were coagulase positive staphylococci), 33.7% of the BC yielded gram negative bacilli (GNB) and 2 yielded multiple organisms. The mean neutrophil count on admission for all the 26 patients was 0.303 ± 0.25/ul. Those with positive BCs had significantly higher hs-CRP with the mean value of 223.83±94.27 mg/l, compared to those with negative BCs with 89.37±79.53 mg/l (t-test = -3.489, p=0.002).The most common malignancies were hematological and breast cancers with 8 patients each. The presumed focus of infection was mostly in the respiratory tract accounting for 42% of the cases. 30.8% of the 26 patients with FN had central venous access device(CVAD) in-situ but all had negative BCs however the odd ratio of developing FN if CVAD is present is high at 4.3(95% CI 1.01-18.0). Conclusions: the prevalence rate of bacteremia in post chemotherapy FN in our center is relatively low and GPC are the most commonly isolated organisms. Our study also support the notion that hs-CRP may be a sensitive biomaker of bacterial infection in cancer patients with post chemotherapy FN as it is significantly higher in those with positive BC.

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Jul 2017
<![CDATA[Effect of Massage Therapy in Cancer Patients in Palliative Situation]]> Source:Universal Journal of Public Health  Volume  5  Number  4  

Marcia Alves   Maria Helena de Agrela Gon?alves Jardim   and Bárbara Pereira Gomes   

The increase in longevity and incidence of chronic diseases reveals an increased importance in terms of public health. The oncologic illness is a debilitating and progressive pathology with need for prevention and symptomatic relief. In order to find the answer to the question: "What is the effect of massage therapy in cancer patients?" we have reviewed the empirical literature indexed in databases online, finding only 21 articles published between 1990 and 2015. It was possible to verify some of the effects of massage therapy, particularly in relieving pain, decreased anxiety, depression and nausea and increased well-being. However, it was not found the effect of this intervention on the relief of suffering and the quality of life of patients. With the heterogeneity of methodologies, studies suggest the development of more homogeneous research, materials and methods to assess the effects of massage therapy in cancer patients.

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Jul 2017
<![CDATA[Perinatal Dissociation and Post-traumatic Stress Disorder among Mothers of Preterm Infants: A Comparative Study]]> Source:Universal Journal of Public Health  Volume  5  Number  4  

Sahar Ellouze   Jihène Aloulou   Najla Halouani   Afef Ben Thabet   Amira Bouraoui   Abdellatif Gargouri   and Othmen Amami   

Preterm delivery is a particularly challenging experience that can be experienced by mothers as a traumatic event, causing dissociative reactions and authentic post-traumatic stress disorder (PTSD). In this work, we proposed to study the prevalence of perinatal dissociation and PTSD in mothers of preterm babies compared to a control group of mothers of term babies and to identify factors that may contribute to the occurrence of perinatal dissociation and PTSD following premature childbirth. We conducted a cross-sectional and comparative study, including 97 mothers of premature babies and 80 controls. We used the Perinatal Posttraumatic Stress Disorder Questionnaire to screen for PTSD, the peri-traumatic dissociation questionnaire to measure the level of perinatal dissociation, and the Perinatal Risk Inventory to assess perinatal risk. Compared to mothers of term infants, mothers of preterm infants had significantly higher rates of peri-traumatic dissociation and PTSD. Our results are consistent with previous studies, and add additional credit to the traumatic nature of preterm delivery. Setting up specific support modalities seems essential in the case of premature births in order to ensure a better quality of mother-child interactions and optimal development of the child.

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Jul 2017
<![CDATA[Is Prior Aspirin Use Associated with Reduced Severity in Patients with Acute Pancreatitis?]]> Source:Universal Journal of Public Health  Volume  5  Number  4  

Alvin Lim   Vasudha Iyengar   Daniel Terry   and Rafiqul Islam   

Clinical severity of Acute Pancreatitis (AP) following the use of Aspirin is inconclusive in previous studies. This study investigated predicting the severity of AP using Ranson criteria at admission and at 48 hours and, the length of hospital stay by prior aspirin use. Medical records of first-presentation AP patients during the five years between 2010 and 2015 were examined in the Goulburn Valley Base Hospital, Victoria, Australia. Uses of aspirin at admission with some co-morbidity, Ranson criteria at admission and at 48 hours, duration of hospital stay including other information were collected. A total of 245 AP medical records were reviewed, of them, 178 used and 67 did not use aspirin prior attending to the hospital. In simple regression analysis, Ranson score was 60% higher at admission (P< 0.001) and 64% higher at 48 hours (P <0.01) among aspirin users compared to non-aspirin users. These findings remained statistically significant after adjusting for other potential indicators. Aspirin use was also found associated with a longer hospital stay both in the unadjusted and adjusted analysis (P<0.01). Further studies using revised Atlanta classification instead of Ranson scoring for the diagnosis of AP severity in aspirin users are critical for clinical guidance.

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Jul 2017
<![CDATA[Investigation of Drivers and Determinants of Inpatient and Outpatient Satisfaction in Public Ambulatory and Hospital Departments]]> Source:Universal Journal of Public Health  Volume  5  Number  4  

Vesna Velikj Stefanovska   Miodraga Stefanovska-Petkovska   Marjan Bojadziev   and SonjaBojadzieva   

The last two decades have been marked by increased attention towards patient satisfaction as a valuable tool for quality improvement in health care organizations and delivering patient-centred care. However, few articles have investigated the factors of patient's satisfaction among outpatients and inpatients, especially in developing economies. This cross-sectional, quantitative research contributes by analysing patient satisfaction in the context of a developing country and its public health care system among 1318 patients from the Clinic for Plastic and Reconstructive Surgery in Skopje. The study had two main objectives. The first was to analyse factors that influenced patient's satisfaction. The second objective was to analyse the differences in the reported patient satisfaction between outpatients and inpatients within the Clinic for Plastic and Reconstructive Surgery in Skopje. The results indicated higher satisfaction among outpatients scores compared to inpatients. The findings confirm the importance of socio-demographic variables and health status on patient's satisfaction. Improved awareness of these factors may improve the patient experience and increase therapeutic benefits. Furthermore, this research provides an initial insight and understanding into the drivers of patient's satisfaction in the context of developing countries.

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Jul 2017
<![CDATA[Characteristic of Households with Women Using Unskilled Birth Attendants in Urban Slum of Kisumu East District Nyalenda Community Unit]]> Source:Universal Journal of Public Health  Volume  5  Number  4  

Celestine A. Okang   and Oyugi Henry   

Maternal and child mortalities can be reduced if all women deliveries are attended by trained and skilled birth attendants that can provide Emergency obstetric care. Community health strategy has been put in place as an intervention to reduce maternal mortalities. In the urban slum of Kisumu a third (34.7%) mothers still use unskilled attendant. This study set out to investigate characteristic of households with women using unskilled birth attendants in urban slum of Nyalenda, kisumu, Kenya. The study was comparative in design in which all the households with women who used unskilled attendants during their last delivery included in the study as cases, next nearest, neighboring households with women who used skilled attendants in the last delivery, included as controls, at a ratio of 1:1. Therefore, a total of 1033 cases and 1033 controls were analyzed with a total sample of 2066 as valid cases. The study showed age group 35 and above was higher among the mothers using unskilled delivery (14%) as compared to those using skilled attendants (10.3%), while mothers who had secondary and above level of education were less likely to have unskilled birth attendant odds ratio (OR) = 0.420 (95% CI=0.257- 0.685) as compared to mothers with primary level of education OR= 0.552 (95% CI=0.470- 0.649). Based on the study results, the odds ratio showed minimal difference on the household characteristic with only individual characteristic showing some significant results on, age, education level and ante natal clinic (ANC). The study found that older mothers do not go for skilled attendance, despite the fact that most young mothers go for skilled attendance, it is a concern that the older mothers who should attend skilled delivery tend not to go yet they are a risk factor in terms of delivery and childbirth, and hence they need to use maternity health care services from skilled health personnel.

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Jul 2017
<![CDATA[Knowledge, Behavior and Attitudes Concerning STI Prevention among Out-of-School Youth in the Philippines]]> Source:Universal Journal of Public Health  Volume  5  Number  3  

Yuko Tanaka   Cecilia L. Llave   Maria Teresa Reyes Tuliao   Tadashi Yamashita   and Hiroya Matsuo   

The purpose of this study is to determine the current knowledge, behavior and attitude toward STI prevention among out-of-school youth in the Philippines. Anonymous self-administered questionnaires were distributed separately to 28 out-of-school youth (15 male, 12 female, one unspecified). The mean age of the subjects was 18.0 ± 3.0 years, with an overall age range of 15 to 24 years. The female respondents were younger than the male respondents on average. The out-of-school youth obtained information on STIs mainly from the media, and had fewer information sources than in-school students. Although the out-of-school youth had insufficient knowledge of STIs compared to the students, they were fairly knowledgeable about cervical cancer. They were also more sexually active than the students. The out-of-school youth consulted their parents on STI prevention, but received insufficient knowledge on STI prevention from just this source. It was concluded that out-of-school youth could constitute a high risk demographic for STIs, and health education may be essential to help them protect themselves from STIs.

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May 2017
<![CDATA[Community Empowerment and the Associated Factors among the 2014 Flood Victims in Pahang]]> Source:Universal Journal of Public Health  Volume  5  Number  3  

Rozita Hod   Humadevi Sivasamy   Sharifa Ezat Wan Puteh   Azmawati Mohammed Nawi   Idayu Badilla Idris   Izzah Syazwani Ahmad   Chamhuri Siwar   and Mohd Raihan Taha   

Community empowerment plays an important role in adapting and preparing towards flood risks and impacts. The flood which occurred in 2014 had severely affected three states in the east coast of Peninsular Malaysia and left a significant mark on the communities residing in those areas. A cross sectional study was conducted in 2015 by distributing a validated semi guided questionnaires among flood victims in three worst affected districts in Pahang. The objective was to assess the status of community empowerment and its associated factors. The Individual Community Related Empowerment (ICRE) tool was used to assess the community empowerment. A total of 602 respondents participated in this study. The majority of the respondents were males of Malay ethnic, residing in rural villages. Their ages ranged from 19 to 88 years old, with an average age of 48 years old. The community empowerment domains in our study were self-efficacy, intention, participation, motivation and critical awareness. Younger age was associated with higher self-efficacy. Males were found to have higher participation and motivation. Those who experienced more health symptoms were positively significantly correlated with all domains of empowerment except for self-efficacy. In conclusion, low status of empowerment is seen in all domains except for motivation and critical awareness.

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May 2017
<![CDATA["Medtep DBT": A Dialectical Behavior Therapy Native App and Web Platform for Borderline Personality Disorder Patients and Their Therapists]]> Source:Universal Journal of Public Health  Volume  5  Number  3  

Jacob Su?ol   Josefa María Panisello   Eudald Castell   Pedro Juan Tárraga López   Carme Sánchez   and Víctor Pérez   

Objective: The present article is aimed at describing the development process of Medtep DBT, a native app and web platform, based on Dialectical Behavior Therapy (DBT) for Borderline Personality Disorder (BPD) patients and their therapists. Materials and Methods: The development of Medtep DBT involved five steps: Analysis of the current mobile apps related to DBT and BPD. Development of a beta version of Medtep DBT in collaboration with psychiatrists, psychologists and BPD patients in knowledge of DBT. Testing the beta version by other BPD patients and introducing changes based on provided feedback. Content validation of the final version by mental health professionals. Results: Content validity has been granted by psychologist and psychiatrist whose experience with the use of the platform has been satisfactory. Feedback from BPD patients has also been positive. Discussion: Medtep DBT can be very useful for both, BPD patients and psychologists and psychiatrists; besides being built on evidence-based DBT standards, it is reinforced by BPD patients' and mental health professionals' feedback and collaboration. Even though its content validity has been granted, a pilot study is being carried out to assess its effectiveness. Conclusion: Medtep DBT facilitates BPD patients the accessibility to digital therapeutic tools to register all the information related to the therapy in a more patient-friendly manner versus paper. Moreover, therapists can provide personalized care in a timely manner. So far, Medtep DBT provides a patient-therapist approach like no other app available in the market.

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May 2017
<![CDATA[Exemption from Health Care Fees Influences Indications of Caesarean Section in a Urban Health District Hospital in Benin]]> Source:Universal Journal of Public Health  Volume  5  Number  3  

Sossa Jér?me C   Sopoh GE   Ogoudjobi OM   Issoufou Namassa F   Jacques Saizonou   Aguemon B   Alphonse Kpozehouen   Mongbo V   Azandjemè C   Aguey V   Ouendo EM   and Ouédraogo TL   

Rising caesarean birth rates in recent decades are an issue of public health. Potential harms for mothers and newborns are associated with caesarean delivery. Determinants of caesarean birth rates in Benin are unknown. The objective was to assess changes in caesarean rate and compare its indications before and during the implementation of policy of caesarian section fee exemption (PCSFE) in an urban district hospital in Cotonou, Benin. This cross-sectional study conducted at Suru Léré hospital, Cotonou, in 2014. Data on caesarean section were collected from completed medical records of 2104 women who underwent caesarean section before and during the implementation of the PCSFE. Caesarean rates by quarter varied between 17% and 26% (p=0,133) before the PCSFE while the rate increased significantly from 28% to 48% (p<0,001) during the implementation PCSFE. During the period of implementation of PCSFE, frequencies of "placenta pr?via" (p=0.022) and excessive uterine height (p<0.001) were significantly higher while frequencies of "uterine pre-rupture syndromes" (p=0.017) and generally contracted pelvis (P=0.013) decreased compared to period prior the PCSFE. Caesarean section rate increased during the implementation PCSFE and some caesarean section indications increased during the PCSFE. Further prospective studies are needed to follow the evolution of indications of caesarean section to inform preventives measures in urban district hospital Suru Léré Cotonou.

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May 2017
<![CDATA[The Effectiveness of the Smoking Cessation Programme for Smoker Prisoners Living with HIV/AIDS]]> Source:Universal Journal of Public Health  Volume  5  Number  3  

Farzad Jalali   Seyedeh Fatemeh Hashemi   Ali Babaei   Hassan Abbaspour   Alireza Hasani   and Heshmat Shakeri   

This study aims to determine the effectiveness of the SCP (MI+NRT) for smoker prisoners living with HIV. The study design was semi-experimental with pre-test, post-test, follow-up, and a control group. As many as 34 smoker prisoners living with HIV were selected by convenience sampling and randomly assigned to an experimental group and a control group. The experimental group received the SCP, while the control group received no treatment. The research measurement instruments comprised FTND and BMS. MANCOVA models were employed to test the hypothesis. The results showed that the indicators of 'quit smoking' reduced among prisoners in the experimental group.

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May 2017
<![CDATA[Assessment of Knowledge of Medical Students on an Important Health Issue Neagleria Flowri Infection at a Medical College of Karachi, Pakistan]]> Source:Universal Journal of Public Health  Volume  5  Number  3  

Syed Ijlal Ahmed   Syeda Beenish Bareeqa   Munazza Suherwardy Obaid   Saad Qureshi   Samra Khan   and Sara Memon   

Background: Since 2005 Neagleria Flowri infection appeared as a major health issue in Karachi, Pakistan. Most infections were acquired due to swimming in fresh water, ablution with fresh stagnant water. Our objective was to assess the knowledge of medical students regarding this important health issue and to highlight any deficiencies in medical education system. Material and methods: It was a prospective cross sectional study conducted at a medical college of Karachi, Pakistan. The sample size was calculated and sampling technique was randomized stratified sampling. Knowledge of the students was assessed through designed questionnaire. The data was recorded and analyzed on SPSS vs 21. Results: Our study included 250 medical students from five years of medical school. The highest response was recorded from final year regarding type of organism and habitat. Regarding treatment of Naegleria most correct response was from 4th year MBBS. Most final years answered correctly regarding the ablution as risk factor. The knowledge of medical students regarding incubation period of Neagleria was generally low. Conclusion: The knowledge of medical students regarding this significant medical issue appears low. The response of medical students was generally poor regarding treatment of infection, incubation period of infection and earliest presenting symptom of infection. Important measures should be taken to improve the knowledge of medical students regarding this significant health issue.

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May 2017
<![CDATA[The Level of Compliance of Food Handlers with National Regulations on Food Hygiene and Safety Practices: A Case of Selected Fast Food Outlets in Thohoyandou, South Africa]]> Source:Universal Journal of Public Health  Volume  5  Number  3  

T.S Murwira   A.M Amosu   and L.H Nemathaga   

Food safety is becoming a key public health priority because a large number of people consume their meals outside their homes. As a result, they are exposed to food borne illnesses that originate from food stalls, restaurants and other food outlets. Hence the study focused on level of compliance of food handlers with national regulations on food hygiene and safety practices. The method used to collect data was participant observational checklist where the researcher had to go round with the workers during their daily chores. Simple random sampling was used to select 122 food handlers as participants in the study. Fast food outlets were also evaluated according to codified regulations and sixty food premises were observed for compliance using a checklist and compared with standards and the requirements prescribed by in Foodstuffs, Cosmetics and Disinfectants Act of 1972, regulation Data analysis involved descriptive statistics (frequencies and percentages) and analysis was made based on the standards and the requirements prescribed by Regulation R962 of November 2012. The findings showed that food handlers observed personal hygiene by wearing clean uniforms, covering their heads with hair nets, and washed their hands, indicating that food handlers maintained accepted standards in terms of personal hygiene regulations.

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May 2017
<![CDATA[Examining the Effectiveness of Physical Activity on Mental Health among Bosnian Refugees: A Pilot Study]]> Source:Universal Journal of Public Health  Volume  5  Number  2  

Huaibo Xin   Ajlina Karamehic-Muratovic   and Nicole Aydt Klein   

This pilot study aimed to reduce Bosnian refugees' vulnerability to and severity of mental disorders and sustain their mental health through adopting culturally appropriate and tailored physical activity. The study used the Community-Based Participatory Research approach and the quasi-experimental study design. A total of 35 participants in the intervention group received 12-week regular physical activity while 35 participants in the control group received 12-week educational materials concerning mental health. The effectiveness of the intervention was measured by the validated and culturally and linguistically competent instrument, Mental Health Inventory (MHI)-38. At the end of the study, both intervention and control groups demonstrated statistically significant improvement on the scales of MHI-38 either within or between groups. The study served as a non-clinical example to sustain, replicate, and expand the current intervention activities among the rest of the Bosnian community and other refugee/immigrant populations in the U.S. regarding their mental health well-being.

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Mar 2017
<![CDATA[Sociodemographic and Nutritional Factors Associated with Adherence to Antiretroviral Therapy in PLWHA in Benin]]> Source:Universal Journal of Public Health  Volume  5  Number  2  

Charles Sossa Jérome   Maurice Togbédji Agonnoudé   Moussiliou Noel Paraiso   Ali Imorou Bah-Chabi   Amédée de Souza   Moussa Bachabi   Gratien Gbetowenonmon   and Victoire Agueh   

Adherence to antiretroviral treatment (ART) is critical for suppression of viral replication, repletion of CD4 cells, avoiding viral resistance, improving immune response and slowing HIV infection progression. This study sought to measure adherence to ART and to determine its associated sociodemographic, lifestyle and nutritional factors in HIV-infected adults taking antiretroviral (ARV). Using a cross-sectional study design, medical records of 991 HIV positive patients who started antiretroviral therapy from July, 1st 2011 to June, 30th 2012 were reviewed. Data were collected in 2014 in 46 HIV/AIDS therapy centers across Benin, The independent variables were sociodemographic, lifestyle, nutritional and therapeutic factors. The main dependent variable was the adherence to the ART. Chi-square test was used to determine the association between dependent and independent variables. A p-value < 0.05 was considered statistically significant. Out of 991 PWLHIV, 30.2% showed poor adherence to ARV. Factors associated with ART adherence were social network (p<0.001), gender (p=0.020) and nutritional status based on body mass index (p=0.006). The prevalence of non-adherence to ART was high in PLWHA taking ARV. Efforts are needed to improve adherence to antiretroviral therapy in PLWHA in Benin. Intensive adherence counseling should be provided to all patients before initiation of antiretroviral therapy. Health care providers must contribute to social networking in patients and ensuring nutritional support to them.

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Mar 2017
<![CDATA[Exploring Differences between Faculty and Student Perceptions of Pre-clinical Preparation Activities]]> Source:Universal Journal of Public Health  Volume  5  Number  2  

Laureen Turner   Courtney Keeler   Daniel Long   and Vernon Newton   

Introduction: A review of the literature demonstrates a paucity of research relating to faculty and student experiences regarding prelab. Given the increasing number of students entering nursing programs and the finite number of clinical sites, educators must weigh the relative benefits of each component of the clinical experience, including pre-laboratory (or "prelab") activities. Methods: The research team designed and administered a descriptive study exploring prelab practices and attitudes in one pre-licensure baccalaureate program among students and instructors. Mean comparison tests were used to assess differences in perceptions across the two groups. Results: The results emphasized a disconnection between student and faculty views on several critical indictors, including the impact of prelab on stress, anxiety, and sleep. Conclusion: While stress and anxiety are natural components to any learning process, students may gain more from prelab if stress or anxiety were reduced.

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Mar 2017
<![CDATA[The Effect of an Education Program on Japanese Nurses' Attitudes toward Foreign Patients]]> Source:Universal Journal of Public Health  Volume  5  Number  1  

Airi Takashima   and Hiroya Matsuo   

To improve Japanese nurses' ability to take care of foreign patients, we developed an active learning education program and examined whether it had any effect on their nursing skills and attitudes toward foreign patients. Our education program consisted of three sessions, conducted at two general hospitals in Osaka Prefecture. Thirty-nine nurses joined the education program (comprising the education group), while 138 nurses completed the questionnaire (comprising the control group). The questionnaire consisted of questions on demographics, attitudes toward foreign patients, and self-efficacy. For the education group, questionnaires were evaluated at three time points, and for the control group, at two time points. The study demonstrated that both nurses' understanding of and communication with foreign patients were significantly improved after taking the education program. Nurses' anxiety levels regarding foreign patients likewise showed a decrease, and nursing care to foreign patients significantly improved, after taking the education program. On the GSES scale, the "Very high" responses increased in the education group. We concluded that the active learning education program had positive effects on nurses' understanding of and communication with foreign patients as well as the alleviation of nurses' anxiety, thereby enabling nurses to acquire nursing care skills necessary for foreign patient care.

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Jan 2017
<![CDATA[Professionalism Characteristics of Nurses Working in Internal Medicine Clinics]]> Source:Universal Journal of Public Health  Volume  5  Number  1  

Sevilay Hintistan   and Burcu Topcuoglu   

Although there has long been a focus on professionalism in nursing in many countries, it is just now gaining importance in Turkey. In fact, few studies on this topic have been conducted in our country, and this is the first study carried out in the Eastern Black Sea region of Turkey. The aim of the current study was to determine professionalism characteristics of nurses working in the internal medicine clinics of a university hospital located in Trabzon Province. This descriptive study was done with 103 nurses between Feb.1 and Feb. 28, 2015. The data were gathered using a "Personal Information Form" and a "Professionalism Information Form" through face-to-face interviews. To assess the data, numbers, percentages and arithmetical means were employed. In the current study, 95.1% of the participating nurses were female. Their mean age was 31.54±7.42 years, 66.0% of them had an undergraduate degree, 85.4% were clinic nurses, and their average work duration was 8±6.2 years. This current study determined that nurses thought the most important professionalism characteristics were "taking individual responsibility in nursing practices (92.2%)" and "paying attention to using a simple and clear language by establishing a good communication with patients and team members (90.3%)". The characteristics of "becoming a member of a nursing association (24.3%)" and "feeling the necessity to use the titles of specialist nurse, doctorate nurse (19.4%)" were less meaningful to our study participants.

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Jan 2017
<![CDATA[Awareness and Knowledge of Diarrhoeal Home Management among Mothers of Under-five in Ibadan, Nigeria]]> Source:Universal Journal of Public Health  Volume  5  Number  1  

Olubunmi Omowumi Olopha   and Bolaji Egbewale   

Improving maternal and child health care is one of the most utmost priorities of every responsible society. Civilization is adjudged by the level of assistance and help a society renders to its most vulnerable groups. Under-five children constitute an important population group in terms of vulnerability to health conditions that could adversely affect their health and well-being. Diarrhoea disease has been reported to be one of the most common causes of infant deaths especially in the developing countries of the world. Oral rehydration therapy (ORT) with oral rehydration solution (ORS) is the appropriate management of diarrhoeal dehydration and is the single most effective strategy in preventing diarrhoeal deaths in children. The extent to which mothers of under-five children can adopt this therapy is tied to their level of knowledge on its efficacy and preparation. This study was designed to examine awareness and knowledge of ORS in diarrhea home management among mothers of under-five in Ibadan. The cross-sectional descriptive survey was employed in the study and data was generated from households using a self-developed and validated questionnaire. Generated data were analysed using descriptive statistics of frequency counts and percentages. Findings showed that while awareness of ORS in diarrhea prevention was high, knowledge relating to its preparation and use was found to be low. Population-specific intervention to improve knowledge of under-five mothers on diarrhea home management was recommended.

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Jan 2017
<![CDATA[Anaemia Health Literacy of Community Members and Health Practitioners Knowledge of Best Practice Guidelines in a Remote Australian Aboriginal Community]]> Source:Universal Journal of Public Health  Volume  5  Number  1  

Thérèse Kearns   Felicity Ward   Stefanie Puszka   Roslyn Gundjirryirr   Bonnie Moss   and Ross Bailie   

Anaemia is a critical public health problem in Australian Aboriginal and Torres Strait Islander people for which the health literacy of community members and health practitioners is unknown. Worldwide, pregnant women and children have the highest anaemia rates and are the major groups targeted for screening and intervention programs. In the Northern Territory, Australia, 15% of Aboriginal mothers are anaemic during pregnancy and up to 25 % of children aged 0-5 years are anaemic, with the highest prevalence of 31% identified in those aged 6-11 months. Anaemia can have adverse effects on physical and cognitive development in the early years and has long-term implications for the development of chronic diseases later in life. The aim of this study was to assess anaemia health literacy of community members and health practitioner's knowledge of anaemia best practice guidelines in a remote Aboriginal community where English is not the first language. Focus groups and individual interviews were conducted with 39 community members and 12 health practitioners. Among community members there were mixed levels of anaemia health literacy with the majority assessed as having 'good' literacy. Health practitioners had a 'very good' level of anaemia knowledge that was excellent for one group.

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Jan 2017
<![CDATA[Interventions to Improve Medication Adherence in Aged People with Chronic Disease - Systematic Review]]> Source:Universal Journal of Public Health  Volume  5  Number  1  

Claudia Jorge de Sousa Oliveira   Helena José   and Alexandre Castro Caldas   

Currently, demographic trends, at a global level, are characterized by an increase in the older age group. Associated to advanced age, older people are more prone to chronic diseases, and they are confronted with the need to adhere to an often complex medication regimen. Non-adherence has a negative impact at individual and global level. The purpose of this systematic review was answering the question "What are the nursing interventions able to improve in medication adherence in aged people with chronic disease?". The search was conducted in PubMed (including MEDLINE), CINAHL, LILACS, SciELO and EMBASE, on January 2015, without time limit; the articles were selected according to the inclusion and exclusion criteria. It was used the PICOS method for the critical analysis. The electronic search identified 9 articles meeting the inclusion criteria. Interventions to improve medication adherence among the elderly should be complex and adapted to the factors of non-adherence. Strategies to improve medication adherence in older adults include educational and behavioral approach. Nurses need to lead the way in researching interventions that can affect medication adherence in older people, working with the current generation to develop plans that meet their needs and using interventions that make sense to them.

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Jan 2017
<![CDATA[The Effectiveness of Positive Communication Skills in Reducing Pain during Physiotherapy Session: A Quantitative Result from Questionnaire Surveys of Palestinian Orthopaedic Patients]]> Source:Universal Journal of Public Health  Volume  5  Number  1  

M. Amoudi   R. Anabtawi   A. Bzoor   S. Keelani   and W. Abu Hassan   

Background: Physiotherapist has to communicate on a daily basis with clients and their families, friends, and other health care professionals. Physiotherapists assist patients with their pain in primary care settings aiming at relieving their pain, and improving their quality of life. Studies showed that poor communication often results in many negative consequences. However, few studies provide sufficient evidence to support the use of positive communication skills in reducing pain among orthopedic patient. Objectives: Examine the effectiveness of positive communication skills in reducing pain among orthopedic patient during physiotherapy sessions in 20 Palestinian rehabilitation centers dispensers on several areas and through an investigative program for the views of the orthopaedic patients among interview questionnaire for the inclusion of positive communication skills in the treatment session and its impact on relieving their pain. Methods: The current study employed non-experimental design by conducting a self-report questionnaires has approved by 3 of academic in the physiotherapy section at AAUJ, the study group covered a total number of (96) orthopaedic patients used a normal distribution to calculate an optimum sample size randomly selected from 20 centers in different Palestinian regions; 48 were male and 48 were female. Results: There was statistically significant change in intensity of pain in correlation with integration positive communication skill among orthopedic patients regardless of nature of disease during physiotherapy sessions indicate that (sig. =0.00, p< 0.05). Non-significant correlations were evident between patient's demographic factors, pain and disease related factors, and change in the intensity of pain. Validity and reliability of the instrument were tested and the total instrument reliability test (Cronbach's Alpha) was 0.732. Conclusion: Physiotherapist communication skills play an essential role during treatment sessions to relive patient's pain. Our data showed high impact of positive communication skills in reducing pain among orthopedic patient during physiotherapy session. The results show positive impact on patient's psychology and physiologies which are inseparable. However, results showed there are no statistical variances between study samples according to the independent variables.

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Jan 2017
<![CDATA[Women's Empowerment and Nutritional Status of their Children: A Community-based Study from Villages of Bhaktapur District, Nepal]]> Source:Universal Journal of Public Health  Volume  5  Number  1  

Shiwakoti R   Devkota MD   and Paudel R   

Under-nutrition is one of the leading causes of morbidity and mortality among children. Since women are often the primary caregivers, their empowerment can influence nutritional status of their children. The objective of the study was to assess relationship between women's empowerment and nutritional status of their children. A cross-sectional descriptive study was carried out in randomly selected five villages of Bhaktapur district. A total of 402 children aged six to 59 months were selected using systematic random sampling and their mothers were interviewed. Women's empowerment was assessed using composite index. Anthropometric measurements were obtained using height board and digital scale. Multivariate logistic analysis was carried out. The results show that among 402 mothers, 18 percent were low empowered whereas 27 percent were highly empowered. The prevalence of underweight, stunting and wasting of children was 13, 19 and 7 percent respectively. Low empowerment of women was found to be positively associated with underweight (AOR=5.070; 95 percent CI: 1.885-13.638), stunting (AOR=3.031; 95 percent CI: 1.281-7.141) and wasting (AOR=10.056; 95 percent CI: 1.127-89.693) of their children. Women with low empowerment had children that were more underweight, stunted and wasted. These results suggest that improving women empowerment could have a positive impact on nutritional status of their children.

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Jan 2017
<![CDATA[The Effect of Using Nutritional and Herbal Supplements on Uterine Fibroids as an Alternative Community Based Management in Kisumu]]> Source:Universal Journal of Public Health  Volume  5  Number  1  

Susan Aruwa   Andrew Opondo Otieno   and Francis Owino Rew   

For a long time, community based alternative methods of treating illnesses/conditions has not been given much weight that it deserves, as it is also contributing considerably towards health care and many people in the communities are using the alternative ways. In Kenya nearly 80% of the populations including the Maasai are still dependent on herbal medicine; it remains an important source of treatment, particularly for rural communities. The World Health Organization's global strategy includes popularizing and incorporating herbal medicine in the national health systems of member countries. However, knowledge on community based alternative management of fibroids is still not well understood by many in the population. The purpose of the study was to determine the various methods of alternative fibroid management using nutritional and herbal supplements at community level and their effectiveness at eliminating uterine fibroids. The main objective of the study was to find out the types of community based nutritional and herbal supplements that women use to manage fibroids. There was therefore the need to find out the activities of the alternative medicine practitioners with specific interest on nutritional and indigenous herbal supplements treatment and determine whether the supplements and herbal medicines being administered were effectively eliminating uterine fibroids. There was an existing gap in the naming of the local herbs being used, quantities of drug being administered, the ratios of different drugs mixed in a given concoction, effectiveness and documentation of the local herbs used for alternative management of fibroids in this country.

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Jan 2017
<![CDATA[Effects of Results Based Financing Models on Data Quality Improvement in Benin on 2014]]> Source:Universal Journal of Public Health  Volume  4  Number  6  

Lamidhi Salami   Edgard-Marius Dona Ouendo   and Benjamin Fayomi   

The performances generated by results based financing (RBF) raise questions about the quality of data used to measure them. This study was carried out to evaluate the RBF contribution to the quality improvement of maternal and child health data. Sixty seven health facilities are sampled randomly in three strata (RBF_PRPSS, RBF_PASS, No_ RBF) gathering health zones in Benin. The strata comparison with maternal and child health data for the first halves 2014 and 2011 revealed that timeliness and completeness have improved in the strata exposed to results based financing compared to unexposed (p <0.05). Compared to No_RBF stratum, accuracy deteriorated in RBF_PRPSS stratum, with a 52% decrease in the proportion of concordance reports between 2011 and 2014. In 2014, recorded discrepancies are largely under-reported in the RBF_PRPSS stratum, and over-reported in RBF_PASS stratum. The accuracy of National Health Information and Management System (SNIGS) data compared to RBF's validated data was low, verification factors varying between 30% and 97%. In total, the data quality was globally poor in most areas in Benin and it is not improved by the results based financing models implemented between 2011 and 2014. There is a need to target data quality in RBF models and to use SNIGS as a unique system of reporting.

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Nov 2016
<![CDATA[Socio-cultural Issues of Allergens in Foods Served in School Canteens, in Prague, the Capital City of the Czech Republic]]> Source:Universal Journal of Public Health  Volume  4  Number  6  

Marek Merhaut   

Allergies to a certain food are most likely to occur in children under six years of age; however, they can develop later, even into adulthood. Ironically, the most common allergens in older children and adults are the foods that we consider to be healthy or even necessary, such as nuts, cheese, fish, poppy seeds, or aromatic fruit and vegetables [1]. A food allergy is an oversensitive reaction by the organism to a food or foods, where the body may exhibit one or more symptoms from a relatively wide range of symptoms. It affects 2-3% of people, and in infants and children up to three years of age it affects upwards of 5-8% (with some sources saying more than 10%). Food allergies cause an adverse reaction to a food and involve a conditional response by the immune system. This definition is important because there is also the possibility of adverse reactions to foods that may be caused by something other than the immune system (e.g., lactose intolerance or irritation when digesting certain foods, such as coffee or ripened cheeses). An allergy is a hypersensitive reaction of the immune system to common substances, allergens, to which it often comes into contact. School canteens should strive to offer a varied and balanced diet, especially to our children, so that they get everything necessary to support their successful development and overall health. The composition of the menus should include the recommended amounts set to fulfill the daily requirement of essential nutrients. Activities of school canteens in the Czech Republic are governed by Act no. 561/2004 Coll., on preschool, primary, secondary, vocational and other training, in particular the provisions of § 119, section 11, with the relevant implementing rules and regulations [3].

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Nov 2016
<![CDATA[The Survey for Nursing Management Behavior of Diabetes Liaison Nurses in Guangdong Province]]> Source:Universal Journal of Public Health  Volume  4  Number  6  

Xueyan Liu   and Peiru Zhou   

Aim: To develop a specific nursing work assessment scale for diabetes liaison nurses to standardize their practice. Background: Currently, there are no validated tools to assess the special practices of diabetes liaison nurses; therefore, the efficacy of these nurses cannot be evaluated properly. Design: The Delphi method, using 12 nurse experts from 8 tertiary hospitals in China, was used to construct the diabetic liaison nurse work assessment scale based on the Hamric Model of Advanced Practice Nurses. The scale was then tested on 21 diabetic liaison nurses. Method: An expert panel participated in 2 rounds of Delphi exercises to develop the assessment scale for diabetic liaison nurses by consensus using a Likert scale to indicate whether a dimension or item should be included in the assessment scale. The initial scale was then revised based on the suggestions from the experts' importance ratings. The final version of the scale was formed after 2 Delphi rounds and was tested for applicability in a preliminary test with 21 diabetic liaison nurses. A convenience and cluster sample of 426 diabetes liaison nurses from 25 hospitals in Guangdong province was invited to participate and complete the scale. Results: Experts reached consensus on a scale with 4 dimensions and 13 items. The item-level content validity index was 1 for 10 items and ≥ 0.75 for 3 items, and the scale-level content validity index was 0.96. The reliability was high; Cronbach's alpha was 0.851, and the retest reliability was 0.822. Construct validity was supported by the results of factor analysis; the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.822, and Bartlett's Test of Sphericity was statistically significant (P < 0.0001). Four components with eigenvalues > 1 accounted for 69.93% of the total variance. The results of the Rotated Component Matrix demonstrated that the factor loading of 12 items was > 0.6. Conclusion: The content validity of the scale was high; The specific nursing work assessment scale for diabetes liaison nurses is a promising tool that can be used to evaluate the specific nursing practices of diabetes liaison nurses. Relevance to clinical practice: Diabetes liaison nurses have been appointed at many hospitals to improve diabetes management of hospitalized patients. The specific nursing work assessment scale for diabetes liaison nurses is a validated tool that can be used to assess the special practices of diabetes liaison nurses.

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Nov 2016
<![CDATA[A Contemplation on Rehabilitation Models for Adult Clients with Dual Diagnosis of Acquired Brain Injury and Mental Illness in Australia]]> Source:Universal Journal of Public Health  Volume  4  Number  6  

Reshmy Radhamony   

Acquired Brain Injury (ABI) of different forms represents one of the major public health problems for the world. Numerous neuropsychiatric disorders are associated with brain Injury including depression, anxiety disorder, irritability and aggression and mania which makes the presentation of these patients complex. The dual diagnosis of ABI and mental illness is often missed making the management of these patients difficult. Review of literature, websites and case study examples are used to illustrate the implications on care needs and discharge planning of these patients post rehabilitation phase. Majority of the models reviewed in Australia have advanced approaches for rehabilitation of clients with brain injury but none of them other than the brain disorders programme in Victoria offers rehabilitation services to clients with dual diagnosis of acquired brain injury and mental illness. Despite of the evidence that ABI can often result in ongoing mental health problems, there are a few facilities that provide for this dual diagnosis and there is not even a single model of rehabilitation which can cater for the needs of these patients. Current and existing models offer alternative approaches that are particularly applicable to person with disabilities. These include the strength-based and empowerment approaches as well as case management and independent living models.

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Nov 2016
<![CDATA[Factors Influencing Health Information-seeking Behavior among Health Care Providers at Health Facilities in Tanga Region: A Case Study of Muhef Project]]> Source:Universal Journal of Public Health  Volume  4  Number  6  

Damian G. Laki   

In Tanzania, health information-seeking behavior among health care providers is not yet fascinating enough to provide high quality health services. Little is known about how health care providers integrate what they find from various information sources, to improve both preventive and curative health services. The purpose of the study was to determine factors influencing health information-seeking behavior and utilization of ICT resources among health care providers to provide high quality health services. A cross sectional study was conducted in July 2008 among 202 health care providers in Tanga region. The results show that health care providers located in urban areas were more likely to search health information and use it than those in rural areas (OR =14.18; 95% CI: 1.96, 288.6). Health care providers in both urban and rural health facilities should continuously be trained on how to search and use health information.

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Nov 2016
<![CDATA[Punicalagin Induce the Production of Nitric Oxide and Inhibit Angiotensin Converting Enzyme in Endothelial Cell Line EA.hy926]]> Source:Universal Journal of Public Health  Volume  4  Number  5  

Ulfat Omar   Akram Aloqbi   Marwa Yousr   and Nazlin K. Howell   

Introduction: punicalagin, a hydrolysable tannin polyphenol from pomegranate, reported to have a protective effect against many diseases due to its high antioxidant and free radical scavenging activities. Aim, this study investigated the potential antihypertensive activity of punicalagin in human derived EA.hy926 endothelial cell model, via two mechanisms. In first mechanism, punicalagin enhance the nitric oxide production through scavenging reactive oxygen specious (ROS) and activating the endothelial nitric oxide synthase enzyme (eNOS). In second mechanism, punicalagin showed effect activity by inhibiting the angiotensin converting enzyme (ACE). Methods: The effect of different concentrations (1-100 μM) of punicalagin on EA.hy926 cells was measured using MTT assay. Induction of ROS was done using Ang II and scavenging activity of punicalagin was assessed by flow cytometer and fluorimeter. NO production was measured in order to determine the effective dose of punicalagin followed by measuring the ability of punicalagin to induce eNOS activity and the enzyme expression by Western blotting cellular Ca2+ concentration and ACE inhibition were also determined. Results: Punicalagin (1-60 μM) reduced ROS production in EA.hy926, which induced by added angiotensin II, as shown by flow cytometry and by fluorometry. In addition, at the same concentration the nitric oxide production was increased in a dose-dependent manner due to increased eNOS activation. The activation of eNOS enzyme was promoted by an increase of cellular calcium concentration at the tested concentrations. Examined punicalagin concentrations significantly inhibited ACE activity, possibly due to zinc binding. Conclusion: punicalagin clearly exhibits the potential for reducing hypertensive activity by a dual mechanism of nitric oxide synthase induction by increasing nitric oxide levels, and ACE inhibition.

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Sep 2016
<![CDATA[Television and Electronic Device Use and Overweight/Obesity Status: Children and Adolescents with and without Autism Spectrum Disorders]]> Source:Universal Journal of Public Health  Volume  4  Number  5  

Maureen K. Johnson   Mark C. McInerney   Wan-Ju Yen   and Matthew D. Hutchins   

Because of its association with obesity, excessive "screen time" is a concern. Children and adolescents with autism spectrum disorders (ASD's) have been found to spend much of their free time watching television more than children and adolescents without ASD's. Thus, the purpose of the current study was to determine if the time spent watching television, videos, playing video games and using other electronic devices contributed to overweight and obesity status among children and adolescents with ASD's compared to children and adolescents without ASD's. The current study analyzed data (n = 95,677) that had been previously collected through the 2011/2012 National Survey of Children's Health (NSCH). Children and adolescents with an ASD had significantly higher odds of being overweight or obese than children and adolescents without an ASD. Time watching television was a predictor of overweight/obesity status for children and adolescents both with ASD's and without ASD's. However, only children and adolescents with ASD's who used electronic devices four or more hours per day were significantly more likely to be overweight/obese than those who did not use electronic devices. A discussion of the results and limitations of the study are also provided.

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Sep 2016
<![CDATA[Community Health Workers' Role in Solving Health Problems at the Community Level in Bénin and Togo]]> Source:Universal Journal of Public Health  Volume  4  Number  5  

Panaveyi Vicky Malou Adom   Charles Patrick Makoutode   Edgar Marius Ouendo   Takpaya Gnaro   Gado Napo-Koura   and Michel Makoutode   

The resolution of health problems at the community level requires firm political will on the part of governments and the effective participation of communities in co-management programs and health activities. The objective of this work is to study the role of Community Health Workers (CHWs) in solving health problems at the community level in Bénin and Togo, from 2009 to 2015. This is an evaluative study of the quasi-experimental type, with its variant 'here elsewhere'; it was conducted in six health zones in Bénin and five health districts in Togo, ail randomly chosen from the list of districts and zones within the regions or departmental directions covered. The study involved 385 community health workers and 6150 heads of households. Female heads of households were predominant. The community health workers were predominantly male and their level of education was secondary school and up. Only level of education, marital status and the matrimonial régime of heads of households were not significantly correlated to their level of knowledge in both Bénin and Togo (p>5%). The heads of households had an acceptable knowledge of community health workers and their activities, but the subsequently expected favorable behavior towards health remained low. Thus, the role of CHWs in solving health problems was perceived as weak. For a visible impact of the actions of this new class of agents at the community level, a strong political will is needed from the countries in the implementation of World Health Organisation's recommendations on community health.

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Sep 2016
<![CDATA[The Embedded System Integrated ECG Monitoring and Low Energy Led Light Stimulation]]> Source:Universal Journal of Public Health  Volume  4  Number  5  

Yi-Chia Shan   Jih-Huah Wu   Wei-Hao Chen   Shau-Ming Tseng   and Wei Fang   

Background: Nowadays people usually have higher work pressure and faster life rhythm. In the long-term stress environment, easily lead to autonomic nervous system (ANS) disorders and lead to physiological or psychological problems. To resolve the problem, we propose an embedded system which integrates ANS monitoring and low energy light stimulation. When the ANS was detected abnormal, a recommended low energy infrared light was activated to stimulate the subject to balance ANS. Materials and Methods: The experiment instruments included electrocardiogram (ECG) module, LED array and the embedded system. ECG module received ECG signal, and then transferred analog signal to digital data. The microprocessor calculated time-domain and frequency-domain data of heart rate variability (HRV), and analyzed the time-domain data, and power spectral density data. The autonomic nervous system (ANS) of the user can be monitored by this device we developed. When the calculated values are out of the criteria, the system will alert the user to turn on infrared light to stimulate and balance ANS. LED wavelength is 850 nm, the default output power is 10 mW, and the default repetition rate is 10 Hz. Result: Wu et al. proposed that using low level laser to stimulate on Neiguan point (PC6) was used to adjust the ANS of the night shift workers. And in other studies, Laser array and LED array were used to stimulate the palm of the subjects with open eyes in different clinical trial, the alpha powers were both increased significantly. So the combination of ANS monitoring and light therapy was useful and feasible. Besides ECG monitoring, LED irradiation and HRV calculation, the data of the embedded system can be transmitted by UART to the remote PC for storage, display and analysis. Furthermore, the embedded system can receive the setting value from PC. For example, adjusting the irradiated dosage, LED operation rate and duty cycle to find out the influence factor of the ANS. Conclusion: an embedded system with ECG monitoring and LED infrared stimulation was realized, it combined physiological state monitoring and light stimulation, it make the ANS feedback and real time adjustment possible.

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Sep 2016
<![CDATA[Comparison of Radiological Criteria (RECIST - MASS - SACT -Choi) in Antiangiogenic Therapy of Renal Cell Carcinoma]]> Source:Universal Journal of Public Health  Volume  4  Number  5  

Vancini C.   De Falco Alfano D.   Abousiam R.N.   Totaro M.   Murri Dello Diago N.   and Giganti M.   

Aim: To compare the diagnostic accuracy of different radiological criteria used in the assessments of antiangiogenic response in patients with metastatic Renal Cell Carcinoma (RCC). Methods: 44 patients were retrospectively evaluated from January 2007 through September 2014, the patients had histologic diagnosis of RCC, existence of target lesions, in therapy with Sorafenib or Sunitinib assumed continuously for 4 weeks for a total of 6 cycles and went through multiphase CT before and 3 months after the therapy. Results: Out of the 44 patients, 21 had Progression Free Survival (PFS) > 250 days. In this group of patients, all the radiological criteria had high predictive value with slightly higher sensitivity for the RECIST 1.1 criteria (sensitivity 100%). In the remaining group of 23 patients (with PFS < 250 days), RECIST criteria also showed slightly higher specificity values by identifying 9 patients (60.86%) compared with Choi, MASS and SACT who identified respectively 56.52%, 52.17% and 56.52% of the patients as having stable disease or indeterminate response to the therapy. Conclusion: All studied radiological criteria had high predictive value with slightly higher sensitivity results for the RECIST 1.1 criteria.

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Sep 2016
<![CDATA[The Impact of Socioeconomic Factors on Tuberculosis Prevalence in Latvia]]> Source:Universal Journal of Public Health  Volume  4  Number  5  

Andrejs Ivanovs   Ieva Salmane-Kulikovska   and Ludmila Viksna   

Tuberculosis (TB) is commonly linked to poverty, overcrowding and malnutrition. It was known earlier that TB more frequently attacks the most vulnerable part of the society – people who have lower socioeconomic status and harmful habits. Being aware of determinants of TB, attenuation of morbidity can be accomplished. This paper identifies impact of socioeconomic risk factors and risk conditions on prevalence of TB in Latvia, using the Four Layers of Health Determinants Model. The impact of risk factors and risk conditions is analysed in two levels – individual and societal. The results of the study show that the strongest risk factors and risk conditions are HIV positive, homelessness, experience of imprisonment and underweight. BMI, drug abuse and unemployment are the strongest TB predictors. TB prevention programmes should be redesigned to involve additional factors that may contribute to the onset of TB.

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Sep 2016
<![CDATA[Impact of Health Education on Usage of Malaria Prevention Methods and Reported Malaria in Western Kenya]]> Source:Universal Journal of Public Health  Volume  4  Number  5  

Jomama One Jomama Lual   Constatin Loum   and Richard Mugga   

Some of the expected impacts of households' health education on usage of malaria prevention methods include increase in use of insecticide treated bed nets and subsequent reduction in households' reported malaria. This study intended to measure impacts of health education on usage of insecticide treated nets and reported malaria, from November 2012 to June 2013, among rural households in five districts in Western Kenya. At baseline, 1,898 responded to questions on ITN use and 1,016 households responded at end line. At baseline 1,083 households responded to question on households' reported malaria whereas 1,002 responded at end line. Statistical analysis was done using SPSS version 17.0. This study found that there was significant increase in ITNs use (baseline 90.3% (1714/1898); end line 94.9% (964/1016); p-value = 0.0001; OR = 0.36; 95% CI = 0.4- 0.7). However, it found that there was insignificant reduction in households' reported malaria (baseline 61.7% (668/1083); end line 58.6% (587/1002); p-value = 0.149; OR = 1.14; 95% CI 0.95-1.36. The study concluded that, while households' health education resulted in a significant increase in use of insecticide treated nets, significant increase in ITN usage did not significantly lower households' reported malaria in Five Districts in Western Kenya.

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Sep 2016
<![CDATA[The Occupational Role of the Lay Health Trainer in England: A Review of Practice]]> Source:Universal Journal of Public Health  Volume  4  Number  4  

Rachel Williams   Geoff Middleton   Jacquelyn Allen-Collinson   Ros Kane   and Adam Coussens   

Health Trainers constitute an emergent occupational group in the Public Health system in England with the key purpose to reduce health inequalities by helping or 'nudging' people in local communities to adopt healthier lifestyles. Whilst primarily supplying health-related information and support regarding smoking cessation, diet, alcohol, physical activity and mental wellbeing issues, the role also requires awareness of, and sensitivity toward the specific needs of local communities. This literature review charts current research on the occupational context of the Health Trainer role since its implementation in the English Public Health system. It provides a critical examination of current literature whilst highlighting the theoretical basis of Health Trainers' roles, the potential boundary-crossing nature of their work, along with professional development issues.

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Jul 2016
<![CDATA[Managing Indigenous Knowledge for Corrective and Preventive Cares: The Case of Horro Guduru Wollega Zone, Oromia, Ethiopia]]> Source:Universal Journal of Public Health  Volume  4  Number  4  

Hambisa Mitiku   Worku Jimma   and Chala Diriba   

This study aimed to investigate the extent to which knowledge management approaches can be used to manage indigenous knowledge (IK) of corrective and preventive cares in local communities of Horro Guduru Wollega zone. This study used descriptive research design through qualitative research method to collect reliable data about perception of disease and its main cause, the types of IK of traditional healthcare practice, indigenous self-medication and required from traditional healthcare practitioners. The respondents were chosen from local communities (traditional healthcare practitioners and community members) and stakeholders (Health Bureau, Agricultural Bureau and NGO). Accordingly, 84 key respondents were chosen through purposive sampling. The qualitative data was analyzed using thematic content analysis. The analysis results have shown that, people in the local community conceptualize disease as the disequilibrium between body and spirit; whereas God, ancestral spirit and witches and sorcerers are the main cause of disease. The above cause's related diseases can be treated by using traditional healthcare IK such as by traditional medicine, physiotherapy treatment and spiritually treatment by self-medication and traditional healthcare practitioners. Therefore, there is a need to capture and manage IK of traditional healthcare practices to save it from loss by local community, community leader and elders, young generations, governments, higher education institutions and researchers.

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Jul 2016
<![CDATA[Exploration of Zika Virus Travel-related Transmission and a Review of Travel Advice to Minimise Health Risks to UK Travellers]]> Source:Universal Journal of Public Health  Volume  4  Number  4  

Vincent Icheku   and Chinelo Icheku   

The World Health Organization (WHO) on 1 February 2016 declared the Zika virus outbreak is a global public health emergency. Zika virus is thought to have led to more than 11,000 deaths and nearly 4,000 cases of microcephaly in Brazil since the start of the outbreak in May 2015. WHO predicted that, in 2016, as many as four million people may be infected with the virus. [1] Health experts have warned that the risk of transmitting Zika virus in the United Kingdom (UK) is very high because South America has become an increasingly popular tourist destination for UK travellers. [2] Given the declaration of Zika virus outbreak as a global public health emergency, this study explores Zika virus travel-related transmission and review current travel advice to minimise health risks to UK travellers. The evidence from our initial literature review showed that there is a paucity of research information on the recent Zika virus outbreak. Thus, the evidence used in this study was gathered from surveillance reports published by the European Centre for Disease Prevention and Control (ECDC), the United States Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Public Health England (PHE), Fitfortravel (NHS Scotland) and NHS Choices reports were reviewed for Zika virus outbreak alerts and travel advice. The study finds that Zika virus, which originated in East Africa, is now transmitted in South and North American countries and the Caribbean islands through travel and, to prevent the disease epidemic in the UK, health care professionals are required by PHE to offer advice to travellers to and from the Zika-affected countries. [3] As travel advice is likely to change as more information becomes available, we recommend that professionals supplying this service should be checking on the National Travel Health Network and Centre (NaTHNaC) website to stay abreast of the latest Zika virus updates.

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Jul 2016
<![CDATA[Psychological Predictors of Premarital Sexual Relationship among In-school Adolescents in a Western Nigerian City]]> Source:Universal Journal of Public Health  Volume  4  Number  4  

Okeke, Sylvester Reuben   Okeke-Obayemi   and Deborah Oluwatosin   

Adolescence is a stage in life that is considered very turbulent as the psychological and physiological changes that accompany this period predispose young people to risky sexual behaviour. Therefore, finding out factors that predict sexual behaviour among this group is an important issue for research. It is against this backdrop that this study was designed to investigate psychological predictors of premarital sexual relationships among in-school adolescents in a western Nigerian city. The descriptive survey research design was adopted in the study. A multi-stage sampling technique was used to select 675 respondents for the study although analysis was based on the 643 questionnaires that were returned from the field and found useful for analysis. Data was collected using a self-developed and modified instrument from standardized scales. The questionnaire was examined for reliability using the Cronbach alpha which yielded 0.81 coefficients. On the spot administration technique was used to collect data and the generated data were analysed using inferential statistics of regression models at 0.05 alpha level. The findings of the study showed that all the psychological variables investigated were found to significantly predict premarital sexual relationships among the respondents. Findings showed that self-esteem (R = 0.290, Adj. R2 = 0.080, F(1,641)= 19.508, p = 0.000<0.05), self-efficacy (R = 0.290, Adj. R2 = 0.080, F(1,641) = 19.508, p = 0.000<0.05), and attitude towards premarital sex (R = 0.290, Adj. R2 = 0.080, F(1,641) = 19.508, p = 0.000<0.05) significantly predicted premarital sexual relationships among the respondents. It was therefore concluded that modifying psychological factors of self-esteem, self-efficacy and attitude towards premarital sex can be effective in regulating involvement in premarital sexual relationships among in-school adolescents in the city. Scaling up the level of school counseling especially in the area of sexual adjustment and modification of the psychological variables investigated were recommended.

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Jul 2016
<![CDATA[The Examination of Muscle Balance in Dancers]]> Source:Universal Journal of Public Health  Volume  4  Number  4  

Kovácsné Bobály Viktoria   Makai Alekszandra   Kiss Gabriella   Szilágyi Brigitta   ács Pongrác   and Jaromi Melinda   

The aim was to examine the anthropometric parameters of representatives of different dance styles, the strength and extensibility of trunk muscles, and whether low back pain influences performance during a show or stage appearance. According to our hypothesis, low back pain and deviations in the functional conditions of the spine are common in dancers aged 9-18, and can have a negative effect in their performance on stage. In addition, we assume that weakness can be experienced in the strength of the trunk muscles, their extensibility is not appropriate even in spite of regular training.92 dancers (average age: 14,15± 2,95 years) participated in the examination: 30 ballet dancers, 32 ballroom dancers, and 30 hip-hop dancers. The anthropometric data was measured with OMRON KaradaScan body composition monitor, the level of the negative effect of low back pain on stage performance was measured by visual analogue scale, and the strength and extensibility was measured with a Kraus-Weber test. On the basis of the anthropologic evaluation, we received a significant difference concerning each examined parameters (body weight: p=0,000, height: p= 0,000, muscle mass: p= 0,001, BMI: p=0,000, body fat percentage: p=0,000), the reason of which was the fact that the different dance styles have different physical requirements for the dancers. In accordance with data measured by the visual analogue scale, no significant difference was received (p=0,104) between the examined groups, although the hip-hop dancers reported the highest percentage (10,54%) of the occurrence of low back pain that negatively affects their stage performance. On the basis of the Kraus-Weber test, in the case of both abdominal muscle exercises the hip-hop group had significantly better performance (K-W A.: p=0,016, K-W B.: p=0,001) than the other two groups. Concerning muscle extensibility, (K-W F.: p= 0,030) the ballet group had significantly better results. In the case of all three examined groups it can be claimed that despite regular training, low back complaints occur at a very young age, which also have negative effects on stage performance.

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Jul 2016
<![CDATA[Evaluation of the Performance of Expanded Immunization Programme Supply Chain and Logistics Management in Southern Benin Rural Health District]]> Source:Universal Journal of Public Health  Volume  4  Number  4  

V. Agueh   C. Sossa Jerome   D. Nyametso   M.N. Paraiso   C.S. Azandjemè   C. Metonou   and Laurent T. Ouédraogo   

The objective was to evaluate the performance of the expanded immunization programme's (EPI) supply chain of and logistics management in Comé health district in 2015. This cross-sectional and evaluative study concerned the central deposit of vaccines and 19 health care centers randomly selected. Data on the performance of EIP supply chain of and logistics management were collected from 5 to 30 March 2015 using direct observation, document exploitation, questionnaire and individual interview in 20 health workers directly involved in EIP activities and 59 mothers of children aged 0-11 months. The performance of the supply chain and logistics management was assessed through three components "structure", "process" and "results" using predetermined score of two scales seeking for achievement of criterions included in components. The overall performance of the EIP's supply chain and logistics in the health district of Comé was rated fair (score = 75.2%). The performance level was good for "structure" (score = 90.3%), acceptable for the "process" (score = 79, 85%) and poor for the "results" of the management of supply chain and logistics (score = 59.48%). The level of performance EIP supply chain and logistics was sub-optimal. Adequate measures should be considered to improve the component "result" of the EIP supply chain and logistics management in the health district of Comé.

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Jul 2016
<![CDATA[Mending the Gaps: Community Health Workers in the Age of the Affordable Care Act]]> Source:Universal Journal of Public Health  Volume  4  Number  4  

Early J.O.   Breckwich Vásquez, V.A.   and Sylvia Elena Sobrinho Herrera   

The Affordable Care Act recognizes Community Health Workers (CHWs) as lay health professionals that promote positive health behaviors and outcomes for patients in medically underserved communities. Despite this validation, there remains a lack of awareness, and some controversy, about the role of CHWs, the value of their work, and ultimately how their roles relate to primary care. The purpose of this feature article is to increase awareness about the contributions of community health workers to primary prevention and to report several key issues identified in the literature and from organizations working with CHWS about their evolving and multifaceted role in improving primary care and population health.

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Jul 2016
<![CDATA[North West Province Department of Health and BroadReach Healthcare Partnership Model]]> Source:Universal Journal of Public Health  Volume  4  Number  3  

Ernest Darkoh   Ebrahim Variava   Shuabe Rajap   Bongani Nkosi   and Fiona de Korte   

South Africa has the largest number of people living with HIV globally, and the world's largest antiretroviral therapy (ART) programme with over 2 million people estimated to have received ART by 2013 [2,3]. Recognizing the significant constraints on public sector resources to meet increasing public demand and need for ART initiation, BroadReach Healthcare and the North West Province Department of Health (DOH) implemented the private General Practitioner (GP) 'Down Referral' Model commencing in 2005 and ongoing, to provide HIV treatment and care for patients stable on ART. Implementation of this model leverages existing capacity within the private sector, shifting delivery of ART in stable patients from hospitals to lower-level private health facilities, and allowing public facilities to focus on initiating new ART eligible patients and managing complex cases. Over 10 years, the model has proved highly successful where the probability of patient survival at 12 and 48 months is 99% and 89% respectively, and retention at 48 months remains high at 94% [7]. This model is a simple, robust, evidence based and easily replicable model for rolling out a defined health service at scale, and further demonstrates potential for public private partnerships in addressing the burden of chronic disease.

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May 2016
<![CDATA[What Do the People Who Use the Research Results Think? Attempting Integrated Knowledge Translation in the 'Knowledge Creation' Phase]]> Source:Universal Journal of Public Health  Volume  4  Number  3  

Andrea Rishworth   Susan Elliott   Jenna Dixon   and Ann Clarke   

Collaboration among researchers and knowledge users, referred to as integrated knowledge translation (iKT), (potentially) enhances the relevance and use of research, leading to improved policies and practice. However, iKT is often applied in idiosyncratic ways, limiting integration of both knowledge creation and action. Further, iKT is rarely used at the stage of knowledge creation. Rather, it is typically used at the stage of knowledge synthesis or dissemination. This paper reports results of one part of a larger research program undertaking iKT through the integration of knowledge users and scientists in the process of knowledge creation around food allergies in Canada. A focus group discussion with 14 knowledge users involved in an ongoing biomedical research project was conducted with the purpose to: (1) share results of recent national survey data describing the prevalence and determinants of food allergy in Canada; and (2) elicit input into the next wave of survey activity in order to ensure the relevance of the next round of data collection. Stakeholders reported a lack of relevant, credible data sources to establish accurate understandings of food allergy for constituents. Confusion and doubt around information resources underline issues of insufficient knowledge translation, hindering knowledge user's credibility as providers of important public health messages. Integrating knowledge users in the process of knowledge creation is essential to facilitate stronger communication between researchers and knowledge users, help modify approaches, and improve population health outcomes; in short, iKT makes science useful.

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May 2016
<![CDATA[Construction and Validation of the Scale of Practices and Behaviors of Institutionalized Elderly to Prevent Falls]]> Source:Universal Journal of Public Health  Volume  4  Number  3  

Cristina Lavareda Baixinho   and Maria dos Anjos Dixe   

Falls are a public health problem, which directly contribute to functional decline, increased dependency and increased complications associated with immobility syndrome. The investigation has been productive in biophysiological identification of risk factors, but less successful to identify environmental risk and even less to identify behavioral risk factors. This methodological study aimed to build and validate an instrument to assess management practices and behaviors for risk of falls. The Scale of Practices and Behaviors for Institutionalized Elderly to Prevent Falls has two dimensions: 1 – communication practices and behaviors between elderly and different professionals from the institution (α=0.881; KMO=0.775), 2- safety practices and behaviors adopted by elderly (α=0.817; KMO=0.727). The instrument has good psychometric characteristics and it can be used for investigation and for clinical practice to identify practices and behaviors related to fall risk.

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May 2016
<![CDATA[Outcome of Cemented Bipolar as Primary Management of Comminuted Unstable Intertrochanteric Fracture Femur in Elderly Sudanese Patients]]> Source:Universal Journal of Public Health  Volume  4  Number  3  

Ammar Hassan Abdelgadir   Mohamed Hamid Awadelsied   Emadeldin Mustafa Elbushra   and Yasir Noureldaim Gashi   

Unstable intertrochanteric fractures in osteoporotic bones of elderly patients was a real challenge that face orthopedic surgeon because of difficult anatomical reduction, poor bone quality and complication of prolonged bed redden or limited ambulation. The aim of study was to assess the clinical outcome of cemented bipolar as primary management of comminuted intertrochanteric fracture femur in elderly Sudanese patients. Material and methods: (30) Elderly Sudanese patients with unstable intertrochanteric fractures (kyle type III or IV) treated by primary hemiarthroplasty using a cemented bipolar prosthesis. Suture or wire fixations were used for reconstruction of greater trochanter fracture. Harris hip score was used for the clinical evaluation. Result: There was a significant relation between age and kyle classification (p value 0.05). According to Harries hip score 17 out of 30 had a good to excellent result (56.7 %) If the patients with a fair result were also included, the percentage goes up to (93.4%). Conclusion: The primary cemented bipolar hemiarthroplasty in unstable intertrochanteric fracture in elderly patients' dose provide staple, pain free with early mobilization, better range of motion and less complication rate in short term follow up.

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May 2016
<![CDATA[Effects of Biomass Fuel on Child Acute Respiratory Infections in Rural Areas of Cameroon and Gabon]]> Source:Universal Journal of Public Health  Volume  4  Number  3  

Loty Pierre Jean-Daniel   

Use of biomass cooking fuel is a known risk factor of child Acute Respiratory Infections (ARI). However, studies so far did not focus on rural areas where biomass fuel use is common. The purpose of this study was to measure the effect of biomass fuel on child ARI in rural areas of Cameroon and Gabon. The analysis was based on DHS national surveys. Logistic regression helped to estimate the risk of suffering from ARI among rural children living in households using only biomass fuel compared to children living in households using a mix of gas and biomass fuel, after controlling for several confounders. In both countries, the relationship was significant, although ARI prevalence in Gabon was twice higher. In Cameroon, the effect was stronger and regional differentials were striking, rural children from the North West region being 23 times more affected than those from rural areas of Littoral.

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May 2016
<![CDATA[Narrative Social Work Practice for HIV/AIDS Clients]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

Yumi Oshita   

This article aims to present and discuss an innovative narrative social work theory, and to demonstrate its effectiveness through a case study of liberating a client who was dominated by HIV/AIDS discourse. The innovative construction entails four components: basic theory, clinical theory, intervention skills, and a measurement method. The selected basic theory, derived from Foucault's theory of the power of knowledge as well as Bateson's theory of difference, is aimed at theorizing a process that could help an individual to construct a new story by activating a force of differentiation in the vertical and horizontal feedback loops. Clinical theory, which provides a practical framework for problem solving, was formulated as the generation of a difference within the circular process of horizontal and vertical feedback loops. This article identifies a set of intervention skills and their effective application for generating a difference in a strategic direction. Circular questions are considered as key skills for generating a difference, while the categorization of each skill indicates a strategic application. The measurement method is theorized using modified Bales' theory to demonstrate the dynamics of the transformation process. Three-dimensional graphs are used to visualize the activation of the force of the difference.

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Mar 2016
<![CDATA[Improving Maternal, Neonatal and Child Health through Manoshi Project in Bangladesh]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

Shamima Nasrin   and Faisal Ahammed   

This article presents the description of changes in terms of maternal, neonatal and child health due to the initiatives of Manoshi Project by Bangladesh Rural Advancement Committee (BRAC). Analysis of changes is also highlighted here. BRAC started the Manoshi Project to bring skilled care into the informal settlement of six major cities in Bangladesh in 2007. Three core methods including social mapping, census tacking and community engagement were adopted to achieve the aims of Manoshi project. This project has successfully reached to the most vulnerable women and children with very low cost and minimum infrastructure. The Manoshi Project has empowered the community through social mobilization, advocacy and communication.

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Mar 2016
<![CDATA[There Ought to be a Law?: Comparative Case Studies in the Role of Community Engagement and Policy Making Targeting HSV-1 Infection Following Ritualized Circumcision]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

Akiva Turner   

This paper compares and contrasts two different public health case studies in which public health authorities sought to address HSV-1 infection in Orthodox Jewish communities following ritualized circumcision. Using these cases, the author critiques the use of a governmental regulatory approach when public health authorities target a minority community for a practice which is not valued by the dominant political culture. Lastly, the author describes the benefits of community engagement in addressing such non-emergent public health concerns, particularly if the community involved is a religious minority one.

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Mar 2016
<![CDATA[WEDworks: Enhancing Participatory Drug Research and Prevention with Resources of the Roma Community. Effective Community‐based Intervention Model and Practice Recommendations]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

Tzvetina Arsova Netzelmann   Savka Savova   Silvia Vassileva   Joyce Dreezens-Fuhrke   and Elfriede Steffan   

Multiple social determinants e.g. poverty, lower education, unemployment aggravate the health inequities that the Roma population experiences in many European countries. Marginalized Roma communities in Central and Eastern Europe (CEE) face particular societal discrimination and limited access to health/social care, not least due to lacking health insurance. As a consequence young Roma suffer adverse health problems, including problematic drug use harms. The WEDworks project (Women, Ethnic Minorities, Drug-help Services) implemented a qualitative drug study among 123 Roma young people, 44 Roma parents and 23 local experts in Bulgaria, Latvia, Romania and the Slovak Republic. Based on its results gender-sensitive and needs-driven prevention actions were piloted. The interventions combined comprehensive setting-based approach on individual, family, and community levels with participatory behavior-change methods (popular-opinion-leader, peer drama and life-skills trainings) for prevention of drug use, HIV/STI and sexual health promotion. The main results were sensitization and mobilization of Roma community social networks for drug prevention and direct involvement of community young people in the co-shaping of the behavior-change process. Both research and prevention produced community- and resource-building effects and fostered inclusion and empowerment of vulnerable Roma youth. The formulated practice-driven recommendations support successful further roll-out of the piloted community-based model.

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Mar 2016
<![CDATA[Medical Decision-making and Logics of Negotiation in Living Organ Donation]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

Natascha Sánchez H?vel   

End-stage renal disease requires replacement therapy including renal transplant. Far from being a matter of biomedical criteria or individual choice, the decision whether preferring a dead or a living donor depends on availability. In Spain, cadaveric donation has been the hegemonic practice with an only recent introduction of living donation. The present paper focuses on the logics in the process of decision-making and negotiation between medical professionals and living donors while shaping, developing and giving meaning to an emerging social practice. Concepts of blood, courage, legitimacy and nature are central in the discourse of decision-making inserted in traditional constructions of kinship.

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Mar 2016
<![CDATA[Adopting Community Health Principles in Veterinary Practice]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

Erwin W. Hohn   

One Health offers the veterinary community the opportunity to re-evaluate the paradigms underpinning animal health care delivery systems. To be more effective animal health care delivery, especially as traditionally viewed by small animal practitioners, needs to be broadened and move away from a primarily technologically led clinical curative approach. Improved access to clinical care does not result in improvements in the health status of populations. The distinction between Primary (Medical) Care and Primary Health Care (PHC) is made. An overview of Community Health and, in particular PHC, as practiced in human health care is provided. For this approach to have relevance and be impactful on service users (and communities), the undergraduate curriculum needs to be community oriented and community based. Veterinary Community Health (including veterinary PHC) needs to become a recognised specialty and provide the overriding context within which the more traditional specialties are presented to the student. A model that will allow for cost effective, holistic and integrated animal health care is proposed. This provides opportunities for the profession to expand it role and influence as well as collaborate with allied stakeholders.

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Mar 2016
<![CDATA[Optimizing Non-invasive Wellness Care for Maximum Impact: Multisensory Meditation Environments Promote Wellbeing]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

H J Moller   L Saynor   H Bal   and K Sudan   

Public health models of wellness care embracing holistic models of mental health are currently needed that are, protocol-driven and have the capacity for standardization without losing a personalized human-centred intention and execution. Increasing evidence is pointing towards the health benefits of leisure: freely chosen, intrinsically motivated and self-directed "flow states", often environment-directed and quite probably with the potential to enact potent changes of consciousness. Our group has been exploring the phenomena of immersive induced "Leisure" and "Wellbeing" in clinical and research endeavours in recent years, allowing for optimized development of both therapeutics and diagnostics to support these efforts. This update offers a review of our optimized wellness care, designed for maximum effectiveness and minimal invasiveness. Optimal leisure experiences are thought to result in enhanced mental wellbeing, positive affect and transformational learning states that carry over into effectively coping with daily routines, stresses and roles. Our group has developed and researched the medically supervised administration of standardized simulated leisure-state meditation experiences in the context of pleasant, hedonic sensory input incorporating multiple sensory channels (visual, auditory, haptic) to promote broad-spectrum wellbeing in mental health care. In this brief report, we report on a novel clinical mental health methodology: TEMM- a technology-enhanced multimodal meditation stress-reduction program with a broad-spectrum mental health benefit, analogous to conventional Mindfulness Based Stress Reduction (MBSR) programs, and a therapeutic risk-benefit margin possibly superior and often preferred by patients to medication therapy attending the PRAXIS holistic health centre. We touch upon seamless diagnostic evaluation and clinical utility of Wellpad, our Electronic Medical Record (EMR) system developed using an iterative Inclusive Design approach. We place our multisensory TEMM meditation therapy within the scope of Virtual Environment Therapy (VET) and suggest the mechanism of action as an induced leisure or flow state to potentiate relaxation, stress-reduction, resilience and personal transformation. The relevance of leisure states to wellbeing and specifically positive experiential learning through inspirational/motivational shifts in consciousness delivered via multimodal immersive environments are described as an important health promotion avenue to pursue and the public mental health research community to consider as new improved, paradigms are developed, aimed at maximizing efficacy and cost-efficiency while minimizing iatrogenic outcomes.

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Mar 2016
<![CDATA[Hygiene Awareness; Improving School Attendance and Participation in Kenya]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

Susan T. Njau   

Prevention of illness amongst school going children is crucial in enabling access and participation in learning. Educational achievements can be linked to healthy behavior, a healthy body and a healthy living environment. There is need to ensure that schools maintain good hygiene in order for the learners to be able to be in school and continue to learn. Quality education entails that children have a holistic learning which includes the emotional, physical psychomotor as well as the academic aspects. Learners should be made to be responsible for their well being both in school and while out of school. It is therefore expected that the school administration, the parents and the community should strive to maintain good hygiene. Schools should put in place measures such as school sanatorium, adequate and appropriate sanitation facilities, provision of clean safe water to ensure that students are in good health.

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Mar 2016
<![CDATA[A Vital Decision about Life – Doctors' and Nurses' Attitudes to Current Procedures for DNR-orders at Swedish University Hospital]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

Adrian D. Meehan   and Linn Brosché   

Objective: Hospital physicians in Sweden most often decide do-not-resuscitate orders (DNR) without collaboration. Systematic pre-arrest indicators of cardiopulmonary resuscitation (CPR) do not exist. Therefore, new, and for the first time, national ethical guidelines on CPR have recently been published in Sweden. We aimed primarily to investigate if doctors and nurses knew about the guidelines and thereafter to gauge their attitudes concerning DNR. Methods: An anonymous questionnaire was conducted of 48 doctors and 45 nurses (n=93) at surgical, medical and geriatric clinics at ?rebro University Hospital, Sweden. A response rate of 62% was achieved. The questionnaire contained 17 questions; four about background information and 13 questions about procedures concerning DNR-orders where responses "yes, always", "normally", "seldom", "no, never" and "don't know" were most often available. Respondents were also invited to leave explanatory remarks. Results: Eighty percent of doctors knew about the new ethical guidelines, in contrast to 42% of nurses. Twenty-seven percent of doctors discussed with patients DNR-orders "normally", though 31% did it "seldom". Whereas nurses did this either "seldom" (40%) or "never" (58%). Ninety-one percent of nurses were in favour of patient involvement in decision-making concerning DNR-orders. Conclusion: While a moderate level of knowledge of the ethical guidelines existed, especially in doctors, the present study highlights a possible discrepancy between the awareness of the guidelines with the prevailing hospital praxis and the general attitudes of respondents. The study questions to what extent the guidelines are in fact implemented. Greater involvement of nurses, other paramedic staff and patients may lead to improve in-hospital patient care. Further descriptive and qualitative studies would be useful to explore these issues.

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Mar 2016
<![CDATA[Barriers to Perinatal Care among Migrant Women Farmworkers in Northern Ohio]]> Source:Universal Journal of Public Health  Volume  4  Number  2  

Stacey A. Pilling   and Larissa J. Estes   

The purpose of this qualitative study was to examine the barriers that may inhibit migrant women farmworkers' management of perinatal care while working in Northern Ohio. Face-to-face interviews were conducted with 15 migrant women farmworkers who had experienced at least one gestational period while working in the Midwest agricultural stream. Participants were voluntarily recruited using purposeful sampling. All participants reported several occupational and access barriers that hindered them from receiving perinatal care while working in the fields. These findings may inform public health providers and migrant healthcare clinicians of the barriers migrant women farmworkers' experience while working in Northern Ohio; results can also be used to influence local and national migrant healthcare policies on developing comprehensive maternal healthcare.

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Mar 2016
<![CDATA[Susceptible Factors of Type-2 Diabetes in a Population of Bangladesh]]> Source:Universal Journal of Public Health  Volume  4  Number  1  

Afsana Al Sharmin   and Munima Haque   

Diabetes is a buzzing word nowadays in Bangladesh as well as the world. The prevalence and incidence of type-2 diabetics is also increasing in Bangladesh. Secondary data is used in this study. It is anticipated that most patients will fall in the age range of 20-75 years. All patients, who are newly detected diabetes patients, from the year of 2012 of the BIRDEM General hospital in Bangladesh are requested to fill up a form of the Patients History Sheet. The study use bivariate analysis and a multiple regression analysis considering fifteen risk factors as covariates controlling one by one and two hours before fasting blood glucose of type-2 diabetic patients as a response variable. After controlling one by one fifteen risk factors, it is examined that there is relationship between age and type-2 diabetes. Moreover, fifteen models are considered by controlling individual outcomes to find out the confounding factors. Physical activities, occupation, family history of diabetic patients, Systolic Blood Pressure (SBP) (>140mm Hg), and Diastolic Blood Pressure (DBP) (<70 mm Hg) are confounders for the association of diabetes and age among Bangladeshis. None of the model showed the significant effect of sex, marital status, number of family members and smoking status on the relationship.

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Jan 2016
<![CDATA["You're Totally on Your Own": Experiences of Food Allergy on a Canadian University Campus]]> Source:Universal Journal of Public Health  Volume  4  Number  1  

Alexandra S. Olarnyk   and Susan J. Elliott   

With the prevalence of food allergies within Canada estimated at approximately 7%, researchers have sought a variety of perspectives to inform our understanding of food allergy risk and perception (Soller et al., 2012). However, university students' perception of food allergies is an area of little research that needs prompt attention in light of a recent death (2015), due to anaphylactic shock, of an 18-year old Canadian university student (Vuchnich, 2015b). Since the perception that the prevalence of food allergies is increasing, investigation into the risks involved when transitioning into university with a food allergy are needed (Harrington et al., 2012). This study explores the experiences and perceptions of food allergic undergraduate students of the University of Waterloo, Canada. The two main objectives include: (1) to understand how food allergic university students experience and perceive food allergy risk on campus; and (2) to understand their management and coping strategies. Five focus groups were conducted with a total of twenty participants. Focus groups were audio-recorded and transcribed verbatim for subsequent thematic analysis. Results are organized into three themes: perceptions and experiences, coping and management, and changes and improvements. The key findings indicate that participants are experiencing difficult transitions into university and social isolation as a result of their food allergy, which has caused them to engage in risk-taking behaviours. This sets the stage for serious policy implications that the university should undertake in order to create a context that is inclusive for students with food allergies.

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Jan 2016
<![CDATA[Clearance Failure Rates of Plasmodium falciparum after Treatment among Children (6-11 years) in Kisumu East Sub County]]> Source:Universal Journal of Public Health  Volume  3  Number  6  

Jomama One Jomama Lual   Dan Owino Kaseje   James Aggrey Oloo   and Peter Sumba Odada   

Plasmodium falciparum is said to be yet sensitive to artemether-lumefantrine (AL) among all age groups in Kisumu County, despites report of its isolated strain with reduced sensitivity in Kilifi and reported reduced sensitivity to artemisinins in South East Asia. This trial intended to compare Plasmodium falciparum clearance failure rates among children (6-11 years) with uncomplicated falciparum malaria randomly allocated to artesunate-mefloquine or generic artemether-lumefantrine. We conducted a two arms open label randomized controlled trial with a fourteen day follow up and a sample size of 130 children with uncomplicated falciparum malaria in government primary schools of Kisumu East Sub County. This study showed Plasmodium falciparum clearance failure rates significantly higher (P = 0.02) with generic artemether-lumefantrine than with artesunate-mefloquine on day one of treatment. However, no significant difference (P = 0.999) was observed between the two arms on day seven and day fourteen of treatment. Thus, Plasmodium falciparum was less likely to fail to clear as it responded to artesunate-mefloquine than to generic artemether-lumefantrine on day one of treatment. Nevertheless, it was unlikely to fail to clear as it responded to both artesunate-mefloquine and generic artemether-lumefantrine on day seven and day fourteen of treatment.

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Nov 2015
<![CDATA[Assessment of Prevalence and Reasons for Termination of Pregnancy at Jimma University Teaching Hospital, Ethiopia]]> Source:Universal Journal of Public Health  Volume  3  Number  6  

Diriba Gebeyehu   Bitiya Admassu   Makida Sinega   and Merga Haile   

Background: Increasing legal access to abortion is associated with improvement in sexual and reproductive health. Conversely, unsafe abortion and related mortality are both highest in countries with narrow grounds for legal abortion. The objective of this study was to determine the prevalence and reasons for terminations of pregnancy at Jimma university teaching hospital. Methods: A retrospective cross sectional study was conducted at JUTH from June15-28, 2015, a total of 194 cards of women who came for abortion services from January 2012-January 2014 were included by systematic random sampling with inclusion and exclusion criteria. Chi square (x2) test calculated to analyze the statistical association between abortion types and other variables, p-value less than 0.05 was considered statistically significant. Result: According to this study, of the total calculated 194 sample size from clients admitted for both spontaneous and induced abortion 125(64.4%) were spontaneous and 69(35.6%) were induced abortion. 28(14.4%) of incomplete spontaneous abortion occurs between age of 25-years.one of the most common complication in this study was sepsis 23(11.9%). This study revealed that the main reason for induced abortion was due to rape and economic problem which holds 30(15.5%) and 16(8.2%) respectively Occupation and marital status are strongly associated with types of abortion with p-value of P<0.001. Conclusion and recommendation: The study concludes that majority of abortion were spontaneous abortion which almost hold all septic abortion and majority of induced abortion were teenage, single students and most of them presented after 2nd trimester of pregnancy which increases the complication of abortion. Thus, health education on dangers of induced abortion, spontaneous abortion and utilization of contraceptive methods services to all women are highly recommended.

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Nov 2015
<![CDATA[HIV/AIDS Related Knowledge and Attitudes in Navakholo Community, Kenya]]> Source:Universal Journal of Public Health  Volume  4  Number  1  

Mukhwana Eugine Sundays   Ayuku D O   and Baliddawa J   

The purpose of this study was to assess levels of knowledge on HIV/AIDS, attitudes towards PLWHAs and programs to prevent HIV infection of community members of Navakholo in Western Kenya. This was a cross-sectional study that used quantitative data collection methods. Three hundred and eighty four (384) Household Heads randomly selected from the study area were interviewed using a questionnaire. Data obtained was analyzed using SPSS computer software program Version 18. ANOVA was used to check for probable differences between core variables of HIV/AIDS knowledge, attitude, and perceptions against gender, education and age. Study findings revealed that the level of knowledge was high (92% of the respondents had high levels of knowledge, although some gaps in knowledge and misconceptions about HIV infection and AIDS were also evident). Attitudes towards PLWHAs and programs to prevent HIV infection were varied with 34% of the respondents displaying stigmatizing attitudes. The study concluded that gaps in knowledge, misconceptions about modes of HIV transmission as well as negative attitudes are an impediment to the community's efforts to control the spread of AIDS. The study recommends intensive HIV/AIDS education to members of the community to fill the gaps in knowledge and to correct the misconceptions noted. The education should be tailored to help improve on attitudes towards PLWHAs and programs to prevent HIV infection.

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Jan 2016
<![CDATA[An Assessment of Canadian Criminalized Women's Health Information Preferences and Health Literacy Skills]]> Source:Universal Journal of Public Health  Volume  4  Number  1  

Lorie Donelle   Ebony Rempel   and Jodi Hall   

This research assessed criminalized women's health literacy skills. Health literacy is conceptualized as one's ability to access, understand, appraise, communicate, and act upon health information. Estimates of health literacy skill for criminalized women in Canada do not exist. The research question that guided this study was: what are the assessed health literacy skills of criminalized women? A cross-sectional survey design assessed participant demographics, health information preferences, and health literacy skills. The Newest Vital Sign (NVS) was administered to incarcerated women in Ontario, Canada. Descriptive statistics of demographic data and assessed health literacy skills were reported. Eighty-five women with a mean age of 29 years participated. The majority (N= 50, 65%) reported an income less than $14,999 (CAN) and 81% (N=68) reported their education level as a high school diploma or less. A range of health literacy skill [inadequate (51%), marginal (15%), adequate (34%)] were documented with a mean NVS score of 2.79± 1.75/6. The results demonstrated participants' had limited health literacy skills, which have far reaching implications for the development of health resources that strive to accommodate diverse health literacy skill and lived complexity. The results support population level reports of limited health literacy skill among marginalized Canadians.

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Jan 2016
<![CDATA[Knowledge, Attitude, and Practice Concerning the Prevention of STIs among High School Students in Northern, Thailand]]> Source:Universal Journal of Public Health  Volume  4  Number  1  

Yuko Yamaguchi   Punpilai Sriareporn   Prueksalada Khiaokham   Piyawan Numtapong   Yuko Tanaka   and Hiroya Matsuo   

The objectives of this study were to examine the current state of knowledge and sexual behavior concerning the prevention of Sexually Transmitted Infections(STIs), and to evaluate attitudes toward safe sex and coping with STIs. We performed a self-administered questionnaire and focus group interview among 197 high school students in Northern, Thailand. We also determined the presence or absence of chlamydia and gonorrhea infections in urine samples taken from 70 students. The participants were actively concerned with emotional relationships and homosexuality, but held negative attitudes toward sexual behavior including premarital sex and kiss, and had less chance for sex education along with their developmental stages. Consciousness of sexuality, knowledge level of STI prevention, self-efficacy toward safe sex, and coping ability with STIs were significantly higher in females than in males. In the urine test, all of the participants as a sub-set of those surveyed had negative results for STIs. In conclusion, the knowledge level of the participants on STI prevention correlated with self-efficacy toward safe sex and coping ability with STIs. Thus, the authors of this study conclude that sex education is effective for students to get comprehensive knowledge about STI prevention, and educators need to consider students' individual sexual issues.

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Jan 2016
<![CDATA[Secular Trends of Age at Menarche from 1985 to 2010 among Chinese Urban and Rural Girls]]> Source:Universal Journal of Public Health  Volume  4  Number  1  

Hong Zhu   Hong-Peng Sun   Chen-Wei Pan   and Yong Xu   

We sought to determine whether average age at menarche (AAM) declined in Chinese girls during the past decades, and whether there were any differences of AAM among urban and rural girls in the mainland of China. The analysis of the study was based on Han schoolgirls aged 9 to 18 years in 22-30 provinces during 6 cycles (1985, 1991, 1995, 2000, 2005 and 2010) of Chinese National Survey on Students' Constitution and Health. The average AAM overall was determined using probit analysis and compared between urban and rural areas. Correlation analyses and line regression models were used to explore the relationship of socioeconomic factors with AAM. In 1985-2010 the median AAM decreased rapidly at the speed of 3.9 months/decade for urban girls from 13.17 year (95% CI, 13.14-13.20) to 12.35 year (95% CI,11.65-13.01) and 5.95 months/decade for rural girls from 13.83 year (95% CI, 13.80-13.85) to 12.59 years (95% CI, 12.36-12.82). The urban-rural difference reduced continuously from 0.66 year in 1985 to 0.24 year in 2010. The average AAM in southeastern areas was lower than that in the northwest, both in urban girls and rural girls. Higher relative Gross Domestic Product per capita and residents' consumption level was consistently associated with increased likelihood of having reached menarche; the strength of associations for rural girls was stronger than that for urban girls. Our findings suggested presence of an obvious downward trend of AAM in Chinese girls from 1985 to 2010, both in urban and rural areas. The urban and rural distribution, regional difference and socioeconomic factors should be considered when interpreting trends in age at menarche in China.

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Jan 2016
<![CDATA[Factors Influencing Teenager to Initiate Smoking in South-west Bangladesh]]> Source:Universal Journal of Public Health  Volume  3  Number  6  

Akil Hossain   Quazi Zahangir Hossain   Qazi Azad-uz-zaman   and Farzana Rahman   

Long term smoking poses many health hazards that most of the teenagers know, but many do not care. Once they start smoking, struggle to cease throughout the lifespan. Peer pressure is one of the main causes of initiating smoking observed by many studies. The research was mainly carried out to explore the factors influencing the teen to initiate smoking in south-west region of Bangladesh. A number of 408 students from level 7 to 12 were interviewed using a semi-structured questionnaire during February to November, 2014. The curiosity of the teen and 'to get rid of frustration' is the two main reasons of initiating smoking. Some other acknowledged reasons are peer pressure; desire to fit with friends, fun making, copying parent or elderly, and to relief from mental stress. More than half of the teens smoke to overcome psychological stress. Some others are smoking to keep relaxed from study load, to keep away family problem as well as for outlook and personality. Many of the teen smokers used to smoke because of reasonably priced and easy to obtain. To overcome the situation, academic institutes can arrange workshop or seminar regarding the consequences of smoking on health. Health effects of smoking can also be added in the curriculum so that the teen can understand and re-think about their harmful habit.

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Nov 2015
<![CDATA[What are We Waiting for, Another Child to Die? A Qualitative Analysis of Regulatory School Environments for Food Allergic Children]]> Source:Universal Journal of Public Health  Volume  3  Number  6  

Susan J Elliott   Nancy Fenton   C-L Joanna Sinn   and Ann Clarke   

Severe food allergy, or anaphylaxis, is an immediate and severe allergic reaction that may cause difficulty breathing, hypotension, unconsciousness, and even death. Given there is no cure, managing life-threatening reactions is limited to strict avoidance of implicated foods and provision of medication for symptomatic treatment of an adverse reaction. A key piece of this management is the regulatory frameworks used in public spaces such as schools. This paper explores the perceptions and experiences of 'school' as a safe place for students with anaphylaxis and their parents in two Canadian provinces with very different regulatory environments in order to assess the impact of alternative regulatory environments on the quality of life of affected individuals. A qualitative research design involving draw-and-tell exercises along with in-depth interviews with elementary school-aged children (n=45) and their parents in the provinces of Ontario and Quebec, Canada was used. Results indicate that these very different regulatory environments had differing impacts on kids and parents. Ontario parents found security in the Ontario legislation, while the heterogeneity of the Quebec school regulatory environments resulted in reported stress and anxiety among the parents interviewed. The kids themselves just wanted to feel normal and not be teased or bullied.

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Nov 2015
<![CDATA[Environmental Hazard Effects on Agricultural Production among Rural Households in Imo State, Nigeria]]> Source:Universal Journal of Public Health  Volume  3  Number  6  

Izuogu C. U   

This study evaluated environmental hazard effects as a critical issue relating to agricultural production of rural households in Imo State, Nigeria. Multi- staged purposive and random sampling techniques were used to choose the samples. The study determined the farming activities of the respondents, ascertained the respondents knowledge of the effects of environmental hazard on agricultural production among respondents and analysed the relationship between environmental hazard and agricultural production of respondents. Primary data collected from 116 respondents were used for the study. Data analysis was carried out with the use of descriptive statistics and multiple regression analysis. Results from the study show that majority (76.54%) of the respondents were engaged in cassava production as their major cash crop. A mean score of 2.18 on a three point likert-liked scale showed that majority of the respondents were aware of the effects of environmental hazard on their agricultural production. Results from the regression analysis shows that flood, oil pollution, erosion and wind storm were significant and negatively related to the agricultural production. Oil explorations that go on in the rural areas should be adequately monitored to reduce its negative effect on the rural environment. It was therefore recommended that more efforts should be made to mitigate the effects of environmental hazard on agricultural production of rural dwellers. This could be achieved by providing agricultural insurance schemes for farmers, paying compensation to farmers over losses arising from environmental hazards.

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Nov 2015
<![CDATA[Determinants of Low Antenatal Care Services Utilization during the First Trimester of Pregnancy in Southern Benin Rural Setting]]> Source:Universal Journal of Public Health  Volume  3  Number  5  

Ouendo Edgard-Marius   Sossa Jerome Charles   Saizonou Jacques   Guedegbe Capo-Chichi Justine   Mongbo Ade Virginie   Mayaki Alzouma Ibrahim   and Ouedraogo T. Laurent   

Antenatal care services for pregnant women improve maternal and child health outcomes. It is recognized that antenatal care services are underutilized in developing countries. The objective of the study was to identify the determinants of low utilization of antenatal care services during the first trimester of pregnancy in southern Benin rural setting. The cross-sectional and analytical study included 301 pregnant women, 29 husbands and 21 health workers in Athiémé municipality (southern Benin rural setting) and was conducted from 14 April to 14 July 2014. Data on sociodemographic and antenatal services characteristics were collected using questionnaire, semi-structured interviews and focus groups. Determinants of low utilization of antenatal care services were identified using logistic regression model. Among 301 pregnant women, only 24.6% utilized antenatal care services during the first trimester of the pregnancy. Five independent determinants of low utilization of antenatal care services were identified: low education level of pregnant women, OR= 3.3 [95%CI= (1.534:7.071)]; wrong knowledge of the required period for the first attendance to antenatal care service during pregnancy, OR=5.131 [95%CI= (1.972:13.353)]; adequate knowledge of the benefits of the antenatal care service, OR=4.031 [95%CI= (1.401:11.594)]; participation in the behavior change communication sessions, OR=0.059 [95%CI= (0.028:0.125)]; adequate patient-welcome in antenatal care services, OR= 0.162 [95%CI= (0.051:0.513)]. Sociocultural reasons were also mentioned. Pregnant women underutilize free antenatal care services in Athiémé municipality. Effective interventions taking into account the identified determinants may contribute to improve the utilization of antenatal services in southern Benin rural setting.

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Sep 2015
<![CDATA[Determinants of Adherence to Recommendations of the Dietary Approach to Stop Hypertension in Adults with Hypertension Treated in a Hospital in Benin]]> Source:Universal Journal of Public Health  Volume  3  Number  5  

Nikiema Leon   Sossa Charles   Agueh Victoire D.   Dedewanou Magloire   Metonnou Clemence   Colette Azandjeme   Noel M. Paraiso   Ouedraogo T. Laurent   Michel Makoutode   and Houinato Dismand   

The dietary approach to stop hypertension (DASH) is an effective nutritional strategy to prevent and treat cardiovascular disease. Optimal benefit from dietary recommendations in management of hypertension depends on the compliance. This analytic cross sectional study aimed at establishing determinants of DASH among adults with hypertension treated at hospital in Benin. The study included 150 hypertensive adults selected during medical visit for blood pressure monitoring at hospital Saint-Luc in Cotonou from June 3rd to July 1st, 2014. Data on consumption of sodium, fruits and vegetables, alcohol, saturated and trans fat rich products were collected by questionnaire. A score of adherence to DASH was built. Determinants of adherence to DASH were identified using logistic regression model. Only 20% of subjects showed adherence to DASH. Better knowledge on hypertension OR=5.18 (95%IC 1.98-13.22) and healthy dietary habits and lifestyle prior to diagnosis of hypertension OR=4.26 (95%IC 1.67-13.18) increased the likelihood of adherence to dietary recommendations for hypertension management. Nutrition education and information of patients on hypertension and its complications during medical consultations may increase their adherence to dietary recommendations for management of the disease.

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Sep 2015
<![CDATA[Prevent or Cure? – A New Philosophy of Health Care]]> Source:Universal Journal of Public Health  Volume  3  Number  5  

Izabela Nawrolska   

Health care systems evolve at the same time in many different ways: in area of developing technologies, the development of the medical knowledge, because of demographical changes and particularly - aging of the society. This induces modifications of the priorities of the health policy, new methods of organization and more complex funding mechanisms. Individual components of the health care system: illness prevention and health promotion, basic health care, hospital care have different contribution into the health care systems of different countries. The worlds growing awareness that for keeping and improving the population health the governments must create effective and efficient health system leads to the effective illness prevention. It shouldn't be expected that the health effects and economic efficiency of the health care system will improve, without appropriate expenditures on actions which delay or prevent illness, and also allow early diagnosis and effective (usually cheaper) treatment. In the first part of the paper there will be discussed issues connected with modern health conceptions which create the fundaments of the approach to the illness prevention. Health care is the specific public goods. This induces the choice of criteria, used by policy makers, to allocate public sources. In the second part the crucial significance is to specify the determinant of the changes of the health benefits structures financed from the public means. The last part of this elaboration, based on gathered empirical data, will discussed experiences of the selected European countries on prevention of the selected illnesses, indicating the links between expenditures and the effects of the prevention activities.

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Sep 2015
<![CDATA[Exploring Cyber Harrassment among Women Who Use Social Media]]> Source:Universal Journal of Public Health  Volume  3  Number  5  

Sloane Burke Winkelman   Jody Oomen Early   Ashley D. Walker   Lawrence Chu   and Alice Yick-Flanagan   

The number of Internet users around the word is at an all-time high. The majority of North Americans are internet users and over two-thirds participate in some kind of social network (i.e. Facebook, Twitter, etc.). Social networks and mobile technology enable individuals to connect instantaneously or asynchronously, across geographic boundaries publicly or anonymously. Few studies exploring cyber harassment have been conducted, primarily because these technologies are relatively recent. The purpose of this descriptive study was to examine U.S. women's experiences with and attitudes toward cyber harassment by way of an anonymous electronic survey. A total of 293 adult women (mean age 24.6) recruited from popular social networking sites participated in the research. The majority of participants (58.5%) reported being a student enrolled at a college or university. Close to 20% repeatedly received an unsolicited sexually obscene message and/or sexual solicitation (excluding Spam messages for all categories) on the Internet. More than 10% (11.5%, n = 33) repeatedly received pornographic messages from someone they did not know. More than a third of those who did experience some form of cyber harassment reported feeling anxious. One- fifth indicated they noticed changes in their sleeping and eating patterns as well as feeling helpless because of the harassment. Implications and recommended strategies for health education and personal safety in the online environment are provided.

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Sep 2015
<![CDATA[Determinants of Uptake and Utilization of National Hospital Insurance Fund Medical Cover by People in the Informal Sector in Kakamega County, Kenya]]> Source:Universal Journal of Public Health  Volume  3  Number  4  

Mukhwana Eugine Sundays   Ngaira J. K   and Mutai C   

Low and middle-income countries have extended state sponsored Social Health Insurance (SHI) to people outside the formal sector to enhance access to healthcare. However, in spite of the relatively low costs of signing up and the benefits offered by SHIs, up-take rates are very low among the informal sector populations. The objective of this study was to investigate factors affecting participation of people in the informal sector in the National Hospital Insurance Fund (NHIF) scheme in Kakamega County, Kenya. This cross-sectional study was conducted in Kakamega County in Western Kenya. The study employed a mixed methods designs approach. In the first phase of the study, 400 participants were recruited using both probability and non-probability sampling methods; 400 persons engaged in informal sector activities were recruited through random sampling. In the second phase of the study, 24 key informants and 5 groups consisting of 8-12 persons were purposively selected for in-depth interviews and Focus Group Discussions respectively. The study established that people in the informal sector with higher income (> Kshs.10, 000) are more likely to enroll (odds ratio 2.21 with 95% CI: 1.07 to 4.03) compared to those with low incomes and similarly, higher level of education was significantly associated with enrolment in NHIF scheme (odds ratio 31.07 with 95% CI: 17.19 to 87.94). Rigid scheme design features create difficulties for people in informal sector to participate. In conclusion, policy decisions should focus on interventions directed at educating poor populations, people with low educational levels and those working outside formal employments on the benefits of subscribing to the NHIF scheme in Kenya. The study recommends subsidies or waivers to increase affordability of participation in the NHIF scheme, particularly for people with low monthly incomes.

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Jul 2015
<![CDATA[The Impact of Cigarette Type on Consumers' Perception of Health Risks of Smoking]]> Source:Universal Journal of Public Health  Volume  3  Number  5  

Zee Ying Lim   Ai Ling How   and Jing Ming Zhao   

Background: Smoking prevalence in Singapore has increased from 12.6 % in 2006 to 14.3% in 2011 despite restrictions on tobacco advertising and promotion act, largely due to the strategies of the tobacco industry such as cigarette packaging suggesting lower tar content to target the young and the health conscious. Objectives: To review the perception of health risks of different types of cigarettes across smoking status, age-group and gender, and to determine if smokers perceive differences in health risks based on the taste of cigarettes alone. Method: 240 smokers and 240 non-smokers were presented with cigarette boxes a pair each time and were asked a series of questions on perception of tar content, taste and perceived health risk. Participants who identified themselves as smokers were blindfolded and asked to take 2 puffs of each cigarette type and asked to rate for 'Presence of tar', 'Smoothness of taste' and 'Health risk'. Results: A significant majority of the participants selected 'regular' cigarettes as delivering more tar than 'light' and 'menthol' cigarettes, while 'lights' and 'menthol' cigarettes were perceived as smoother-tasting and being able to reduce health risks. Non-smokers were more susceptible to perceive 'lights' cigarettes as a 'healthier' choice, compared to smokers, but not females or adolescents. Smokers, based on taste alone, rated regular cigarettes to be higher in health risks compared to both 'lights' and 'menthol' cigarettes, which were similarly rated. Discussion: The perception of health risks across different types of cigarettes are affected by the deceptive descriptors on the packaging, but the local increase in prevalence of youth and female smoking cannot be explained by their susceptibility to packaging influences. Taste of cigarettes seems to affect smokers' perception of health-risks as well; hence bans on deceptive descriptors on cigarette packaging may not totally eliminate differences in perception of health risks of different types of cigarettes.

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Sep 2015
<![CDATA[Strategies to Enhance Utilization of National Hospital Insurance Fund Scheme Medical Cover by Informal Sector Populations in Kakamega County, Kenya]]> Source:Universal Journal of Public Health  Volume  3  Number  5  

Mukhwana Eugine Sundays   Ngaira J. K   and Mutai C   

Social Health Insurance (SHI) has been preferred form of financing health care to reduce out of pocket expenditure on health care. Most countries are extending SHI programmes to people outside the formal sector in an effort to increase access to healthcare. However, this approach faces challenges of enrolment of sufficient numbers of people into a common risk pool and collection of contributions. The objective of this study was to evaluate strategies to enhance participation of people in the informal sector in Kakamega County in the National Hospital Insurance Fund (NHIF) Scheme for access to health care. This was a descriptive qualitative study with sample units purposively selected. Ten Focus Group Discussions were conducted and several Key informants interviewed. Data obtained was scrutinized for emerging themes. The study established that people in the informal sector in Kakamega County were aware of the value of the NHIF cover for accessing health care but lack accurate information on the insurance function of the NHIF cover. Rigid scheme design features also discourage subscription. Major recommendations included policy review of rigid scheme conditions, making the scheme attractive and increasing registration centers. Policy decisions should focus on educating people working outside formal employments on insurance functions of the NHIF cover.

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Sep 2015
<![CDATA[What Does Not Kill Us Makes Us Stronger: Implications for Bosnian Refugees' Coping Skills during a Natural Disaster]]> Source:Universal Journal of Public Health  Volume  3  Number  5  

Huaibo Xin   Ajlina Karamehic-Muratovic   and David Cluphf   

This study explored Bosnian refugees' attitudes and beliefs about how to cope with a potential natural disaster. A total of thirty-three Bosnian adult refugees participated in the study. Face-to-face, in-depth individual interviews were conducted. The findings indicated that Bosnian refugees developed a number of coping skills for survival and sustainability through their previous disaster experiences and emergency trainings. Their preparedness for a natural disaster can be characterized by strong leadership qualities, with more economic and social resources to draw on for coping, and close ties to local community. In case of an emergency, they would likely be calm, optimistic, and emotionally independent. Given the development of this group's coping skills, Bosnian refugees have a strong potential for serving as volunteers in disaster preparedness, response, and recovery. Particular attention should be paid, nevertheless, to these refugees' emotional and mental health needs in the aftermath of a natural disaster.

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Sep 2015
<![CDATA[Factors Associated with Male Involvement in Family Planning in West Pokot County, Kenya]]> Source:Universal Journal of Public Health  Volume  3  Number  4  

Dennis Butto   and Samuel Mburu  

The Contraceptive Prevalence Rate for West Pokot County is estimated to be at a low of 23% compared to the national prevalence which stands at 43%. This analytic cross sectional study was aimed at establishing the male factors associated with family planning in West Pokot County, Kenya. A total of 266 married men were involved and household was the unit of analysis. The findings of this study demonstrated that 48% of the respondents were not involved at all in family planning and only 6% of men were using a family planning method. The age of respondents, educational level, number of children, and type of marriage, knowledge and ease of access to family planning services were all significantly associated with male involvement. Having no education made a man 89% less likely to be highly involved in family planning (OD 0.117; 95% CI: 0.03-0.454). The study concludes that the level of male involvement in family planning in the county is still low despite interventions both by the government and other nongovernmental organizations. Therefore, more efforts should be made to improve education standards especially for men and to reorient family planning services to make them more accessible to men.

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Jul 2015
<![CDATA[Incidence, Contributing Factors and Outcomes of Antepartum Hemorrhage in Jimma University Specialized Hospital, Southwest Ethiopia]]> Source:Universal Journal of Public Health  Volume  3  Number  4  

Nega Chufamo   Hailemariam Segni   and Yibeltal Kiflie Alemayehu   

Background: Antepartum haemorrhage complicates three to five percent of pregnancies contributing to perinatal and maternal morbidity and mortality. Timely access to quality obstetric services is the major determinant of both maternal and newborn outcomes after antepartum haemorrhage. In Ethiopia, the magnitude and consequences of antepartum haemorrhage are not well studied. The objective of this study was to determine the incidence, factors associated with and maternal and perinatal outcomes of antepartum haemorrhage in Jimma University Specialized Hospital. Methods: A hospital-based prospective cohort study was conducted in Jimma University Specialized Hospital, from January 1 to December 31, 2013. Data were collected by reviewing medical records and interviewing mothers. Cumulative incidence of antepartum hemorrhage among mothers who gave birth and odds of adverse outcomes among mothers with and without antepartum hemorrhage were calculated. Odds ratio was calculated to estimate the effect of antepartum hemorrhage on maternal and new born adverse outcomes. Results: Between January and December 2013, 3854 women gave birth in JUSH. The incidence of antepartum hemorrhage was 5.1% (n=195) in 2013. The major causes of antepartum hemorrhage were abruptio placentae and placenta previa occurring in 127(65.1%) and 52(26.7%) of cases, respectively. Six (3.1%) of the patients with antepartum hemorrhage died. Of the 206 babies born, 63 (30.6%) were stillborn and additional 13 (6.3%) newborns died during the first seven days of life making perinatal mortality rate of 36.9%. Conclusion: Antepartum hemorrhage is a common complication of pregnancy and cause of maternal and perinatal mortality in Jimma University Specialized Hospital. The risk of adverse outcomes is very high compared to other countries. Efforts to improve access and quality of comprehensive emergency obstetric care services are required.

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Jul 2015
<![CDATA[The Influence of Aerobic Fitness on the Relationship between Academic Performance and Motor Proficiency]]> Source:Universal Journal of Public Health  Volume  3  Number  4  

Ryan Alexander   John A. Hay   Jian Liu   Brent E. Faught   Joe Engemann   and John Cairney   

Purpose: To determine whether physical fitness mediates the relationship between academic performance and motor proficiency in children. Methods: The academic achievement of 1864 students (F:926, M:938, age 11.91 (SD:0.34) from the Niagara Region of Ontario was derived from the average of provincial standardized tests for reading, writing, and mathematics. The Bruininks-Oseretsky Test of Motor Performance (short-form) determined motor proficiency. Fitness (peak oxygen uptake) was established with the 20-metre shuttle run multistage test. Results: Hierarchical linear modeling identified several significant predictors of academic performance. After controlling for age (p=0.7002), gender (p<0.0001), and parental education (p<0.0001), both motor proficiency (p<0.0001) and physical fitness (p=0.0004) remained significant. The addition of physical fitness to the model reduced the point estimate of motor proficiency from 0.004 to 0.003, a reduction of 25%. However, further examination of the 95% confidence intervals suggests that this reduction is not significant. Conclusions: These results suggest that aerobic fitness does not mediate the relationship between motor proficiency and academic performance. Both physical fitness and motor proficiency have independent roles in predicting academic performance.

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Jul 2015
<![CDATA[Health Status Change of English, French and Chinese Immigrants in Ottawa and Gatineau, Canada]]> Source:Universal Journal of Public Health  Volume  3  Number  3  

Ning Tang   and Colin MacDougall   

Background: Health status change of the immigrants is of particular interest to health researchers and policy-makers, because it can impact population health outcomes; English, French and Chinese speaking immigrants are main immigrant sub-groups in Canada. Objectives: The multicultural study aims at examining general Health Status Change of English, French and Chinese speaking immigrants in Ottawa and Gatineau, Canada, and identifying demographic factors that correlate with the change and impact the change. Methods: In total, 810 English, French and Chinese speaking immigrants in Ottawa and Gatineau, Canada were recruited by purposive-sampling. Using self-reports, respondents answered questions regarding general Health Status and Demography in a Multicultural Lifestyle Change Questionnaire of English, French or Chinese version. Data in Health Status Change were analyzed statistically in percentage, significance of difference, correlation and regression. Results: Immigrants of different gender, language and category sub-groups exhibited different Health Status Change Rates, Health Status Improving Rates and Health Status Declining Rates, but no statistical difference between the rates. Immigrant general Health Status Change was correlated positively with Age and Primary Occupation, and negatively with Income. Mother Tongue, Primary Occupation and Income significantly impacted Health Status Change. Conclusion: Immigrants of different sub-groups in Canada experienced different health status change. The results supported "healthy immigrant effect". The "decline in immigrant health status" over time existed in some of immigrant sub-groups. Data of immigrant health status change can provide evidence for health policy-making and policy-revising in Canada.

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May 2015
<![CDATA[Health Services Consumers Perceptions on Task Shifting of Primary Healthcare Functions to Community Health Workers in Rural Butere Sub County, Western Kenya]]> Source:Universal Journal of Public Health  Volume  3  Number  3  

Diana S. Mombo   and Dan C. O. Kaseje   

Background: Attaining universal access to primary healthcare services require radical changes in human resource and retention strategies. Hence, the task shifting is introduced. This is a process of delegation whereby tasks are moved to the most appropriate but less specialized level of Community Health Workers (CHWs). Effective planning to enhance scaling up of this strategy however, needs evidence which according to many researchers is vital but lacking. Methodology: This study provides such data for evidence based health policy decision making through the health services consumers' perceptions on task shifting in relation to CHWs current roles and responsibilities. The study was qualitative with fifteen focus group discussions held with health service consumers linked to the CHWs services. Ethical approval was gained through the Moi University and Great Lakes University of Kisumu Ethical Review Board and Committee respectively. Results: Short duration training programs, with mostly promotional, preventive and some curative tasks were suggested to be shifted to CHWs with a relatively strong monitoring and supervision mechanism. Consumers agreed that task shifting had significantly increased access to health services and improved health outcomes. Conclusion: Task shifting if well implemented could play a major role in improving access to, and equity in provision of primary healthcare services. However, there is the need to recognize, and carefully plan and implement task shifting. Failure to do so could result in it becoming a parallel health system competing with the formal healthcare system but with compromised quality. Hence, the Ministry of Health and other relevant stakeholders need to institute quality assurance frameworks, including standardized training, supervision, certification and regular assessments for effective task shifting models.

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May 2015
<![CDATA[Multimorbidity and Unobserved Heterogeneity in the Study of Clinical Mortality]]> Source:Universal Journal of Public Health  Volume  3  Number  3  

Gabriel Asare Okyere   Richard Tawiah   and Kwaafo Awuah-Mensah   

In most epidemiological data sets one cannot be certain that all risk factors are measured or observed. This paper studies the risk for mortality associated with diseases and deals with heterogeneity in mortality owing to unobserved covariates. We extracted medical records of 186 hospitalized patients from an urban health facility in Ghana. Patients with at least 2 diagnoses of chronic diseases were considered multimorbid. Using age of patients at death as survival time we executed our analysis with and without incorporating frailty effect to Cox proportional hazards (PH) model. The Cox PH model with Gaussian frailty fitted the data better when compared to the standard Cox PH model and Cox PH model with gamma frailty. On average patients were aged 62.3 15.3 years, with 66.1% being multimorbid. Varying degrees of mortality risks were found for different diseases, with the highest associated with having pulmonary valve disorders (HR 7.99, 95% CI 1.45-44.0). Heterogeneity in mortality resulting from unmeasured factors was insignificant. This study demonstrates that patients share similar risk with respect to unobserved factors, but varying risk when conditioned on observables.

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May 2015
<![CDATA[Understanding Motivations: Exploring Adolescents Perceptions and Experiences of Physical Activity-Nutrition Program]]> Source:Universal Journal of Public Health  Volume  3  Number  3  

Jenifer Li   Nancy Fenton   Stephanie Thayer   Caryl Russell   and Monica Gray   

The increasing rate of obesity among children and youth is a major health concern for the Canadian population. Although exercise-based intervention programs have shown significant improvements in clinical markers, maintenance and management of these improvements are often stunted or reversed due to barriers relating to negative attitudes and lack of motivation towards exercise. The Self-Determination Theory suggests a shift in motivation towards physical activity, from lack thereof to autonomous, can occur within supportive environments. It is thus crucial to explore the perceptions and experiences of overweight adolescents enrolled in fitness-nutrition programs. This research attempts to go beyond the biophysical markers of health to provide insight on individual experiences that affect attitudes towards exercise and making healthy choices. In-depth interviews were conducted with adolescents (aged 12-16years) to discuss their experience(s) in a referral-based fitness-nutrition program. Results from this study revealed that participants' attitude and perception of exercise shifted from apprehension to full engagement/enjoyment and were associated with individuals gaining self-confidence. These attitudes further translated to individual lifestyle changes outside of the program, illustrating the shift in motivation from external to internal. These results suggest that a potential key to enhancing physical activity and making healthy choice among overweight adolescents lie in shifting individual attitudes from a motivation to autonomous motivation in pressure-free supportive environments.

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May 2015
<![CDATA[Evaluation of a Service Intervention to Improve Uptake of Breast Cancer Screening in a London Borough with Many Hard to Reach Communities]]> Source:Universal Journal of Public Health  Volume  3  Number  2  

Vincent Icheku   and Nike Arowobusoye   

Uptake of breast cancer screening is lowest in areas of London with many hard to reach communities. This report evaluates two interventions to improve uptake of breast cancer screening in the Royal London Borough of Greenwich with many hard to reach communities. The interventions involved splitting 2,004 women eligible for screening into two groups. Group 1 who were sent letter only invites has a target group (n=1,452) and eligible women screened were (n=878). Whilst, group 2 who were sent letter invites combined with Short Message service (SMS) reminder has a target group (n=552) and eligible women screened were (n=376). The result shows a significant difference in attendance rates between the two invitation methods. The screening uptake by the women who received invitation letter only had an attendance rate of 60 percent (table1). The screening uptake by the women who received invitation letter and SMS reminder was 68 percent (table 2). This amounts to 8 percent differential rate, which translates to an additional 44 women who were screened, as a direct result of receiving an SMS reminder. Applying the achieved result to the “Letter Only” group indicates that an additional 12 women would theoretically have been screened if the ‘Letter only’ invites were also sent with SMS reminder. An overall 2.54 percentage point increase in screening outcome was achieved when compared the uptake in the months of the project (July to Dec 2011) with the uptake in similar months in 2010. Finally, the results prove that intervention by letter invite combined with SMS reminder is the most effective method of improving uptake of breast cancer screening in the borough with many hard to reach communities.

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Mar 2015
<![CDATA[Birth Prevalence of Overt Congenital Anomalies in Kano Metropolis: Overt Congenital Anomalies in the Kano]]> Source:Universal Journal of Public Health  Volume  3  Number  2  

Lofty-John Chukwuemeka Anyanwu   Barnabas Danborno   and Wilson O. Hamman   

Congenital anomalies are abnormalities of prenatal origin, and their prevalence varies worldwide. The objective of this study was to determine the prevalence and spectrum of overt congenital anomalies in live born neonates in selected hospitals in the Kano metropolis of North western Nigeria, as well as the associated maternal, paternal and neonatal risk factors. A descriptive study design was employed. All live born neonates in three major hospitals in Kano metropolis were prospectively studied from April 2013 to December 2013. Detailed family history and clinical data were recorded in a structured questionnaire for each child. A total of 1456 live born neonates were recruited into the study, of which 41 (28.15 per 1000 live births) had overt congenital malformations with 5 (12.20%) having multiple system involvement and 36 (87.80%) having a single system affectation. The most common system involved in neonates with isolated single system malformations were the central nervous system (10 cases) and the genitourinary system (10 cases). The consanguinity rate in the study was 17.83%. Birth weight of the neonates had a significant but negative association with the likelihood of being born with a congenital malformation [OR = 0.374; (95% CI 0.196 – 0.711) P = 0.003]. Given the high frequency of potentially preventable central nervous system malformations in this study, emphasis on the primary prevention of congenital malformations by encouraging periconceptional use of folic acid containing multivitamin supplements is recommended.

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Mar 2015
<![CDATA[HIV/AIDS Scourge and Economic Growth in Sub-Sahara Africa]]> Source:Universal Journal of Public Health  Volume  3  Number  2  

S. Twumasi-Ankrah   J. T. Ashaolu   and Isaac Ankrah   

This study examines the impact of HIV/ AIDS scourge on economic growth of some selected Sub-Sahara African countries. The three sub-Sahara African regions (Southern, West and Eastern) are categorized into lowest and highest HIV prevalence rate, using the global report of the UNAIDS 2012 data. In each region, the lowest and the highest HIV prevalence rate countries are selected respectively. Thus, we consider a panel of three countries in each category over a period from 1995 – 2012. We used these data to estimate the cross-country level regressions of these two categories, using panel data models. Thus, our results are in twofold: For lowest HIV prevalence rate category, the pooled OLS model was the “best” model. This pooled OLS model indicated that, for one unit increase in HIV prevalence rate, the gross domestic product per capita of countries is expected to decrease by US$23.46, holding all other variables constant. Again for highest HIV prevalence rate category, the fixed effect model was the “best” model. The fixed effect model revealed that, one unit increase in HIV prevalence rate will cause the gross domestic product per capita of countries to decrease by US$9.98, holding all other variables constant. Generally, for a unit increase in HIV prevalence rate, the impact of HIV on the economy is two-thirds larger in lowest HIV prevalence rate countries than that of the highest HIV prevalence rate countries.

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Mar 2015
<![CDATA['It's not as Easy as just Saying 20 Minutes a Day': Exploring Teacher and Principal Experiences Implementing a Provincial Physical Activity Policy]]> Source:Universal Journal of Public Health  Volume  3  Number  2  

Kristin M. Brown   and Susan J. Elliott   

In 2005, the Ontario Ministry of Education implemented the Daily Physical Activity (DPA) Policy to provide every elementary student with at least 20 minutes of sustained moderate to vigorous intensity physical activity each day. This exploratory research sought to understand the factors shaping DPA implementation in schools and classrooms, from the perspective of elementary school teachers and principals. Semi-structured interviews were conducted with Ontario grade 1-8 teachers (n=14) and elementary school principals (n=5) regarding DPA implementation, facilitators, barriers, perceived outcomes, and suggestions for change. The majority of participants stated that students were not meeting the requirements daily. However, participants shared activities and techniques for incorporating physical activity into instructional time. Facilitators and barriers to implementation were organized using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework in order to identify factors acting at four environmental levels. The facilitators and barriers identified indicate that staff and resources within individual schools strongly influence implementation. Although many positive outcomes for students were identified, increased fitness was not mentioned, highlighting additional benefits above physical health. The findings suggest DPA is not being implemented as intended, as school staff are finding it difficult to meet the time and intensity requirements. Policy makers must consider the local school environment and the roles of school staff when designing school-based health policies.

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Mar 2015
<![CDATA[Risk Factors for Multi-drug Resistant Tuberculosis in Addis Ababa, Ethiopia]]> Source:Universal Journal of Public Health  Volume  3  Number  2  

Fikadu Tadesse   

Multi-Drug resistant Tuberculosis (MDR-TB) is becoming a major challenge of the tuberculosis (TB) control program in Ethiopia. The objective of the study was to investigate risk factors for MDR-TB in Addis Ababa. Comparative cross-sectional study was conducted to determine the risk factors for MDR-TB in Addis Ababa. MDR and non MDR-TB cases were compared on key socio-demographic and patient related clinical features for multidrug-resistance. A total 439 (113 MDR-TB and 326 non MDR-TB) were enrolled in to the study. Standard data abstraction instrument were used. Data were entered and analysed using SPSS version 18 for windows. Initial descriptive analyses of all variables of interest, odds ratio, univariate and subsequent multiple regression analysis was carried out. Male sex (OR 2, 95%CI 1.4-5), younger age of 15-34 years (OR 2.8, 95%CI 1.7–6.4), twice or more episodes of TB treatment (OR 14, 95%CI 1.3-9), treatment category of failure after re-treatment (OR 4, 95%CI 2.5-6.83), pulmonary TB (OR 2, 95%CI 1.7-5) and TB/HIV co-infection (OR 2.66, 95%CI 1.32-5.6) were associated with the risks of becoming ill with MDR-TB. The national TB prevention and control programme should be given priority for routine Line Probe Assay to make early diagnosis of MDR-TB particularly among those identified risk groups.

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Mar 2015
<![CDATA[The Perceptions of Community Change through Promoting Positive Sexual Health: A Teenage Pregnancy Program Evaluation]]> Source:Universal Journal of Public Health  Volume  3  Number  2  

Quynh Lê   Stuart Auckland   Hoang Boi Nguyen   and Daniel R Terry   

Teenage pregnancy is associated with adverse social, economic and health outcomes for both mother and child. The factors frequently associated with teenage pregnancy or related sexual health issues include teenagers' knowledge, attitudes, and beliefs about sex and other social-economic factors such as levels of poverty, academic success or failure, and parents' education. This paper reports on the evaluation of a teenage pregnancy program conducted in the Southern and North Western regions of Tasmania to address the high levels of teenage pregnancy and sexually transmitted infection (STIs) in these regions. The aim of the study was to examine the effectiveness of the Teenage Pregnancy Programs by examining any evidence for a community change in attitudes and behaviours, and any changes in youth awareness about sexual health. The study adopted a qualitative approach and data were collected from a total of 25 participants (17 who were interviewed and eight who participated in focus groups) residing in the target regions. Data were analysed using thematic analysis using Nvivo 9.0. The study results indicated that the program was well managed and delivered. There were reported changes in the awareness, attitudes and behaviours regarding sexual health within the target communities, which were considered necessary for young people to make well informed choices. The evaluation of the program provides valuable knowledge regarding the processes and outcomes that may have application in future community based sexual health initiatives may be delivered into regional communities.

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Mar 2015
<![CDATA[Recognizing the Danger Signs and Health Seeking Behaviour of Mothers in Childhood Illness in Karachi, Pakistan]]> Source:Universal Journal of Public Health  Volume  3  Number  2  

Anwar-ul-Haq   Hameed Mumtaz Durrani   Ramesh Kumar   and Salma Mumtaz Durrani   

Introduction: Maternal behaviour regarding child health care has been recognized as an important social and anthropological factor explaining high mortality rates among children under five years of age. Delays in seeking appropriate health care is known to be the largest risk behaviour which contribute large number of child deaths in developing countries especially in Pakistan. Mothers are mostly responsible for their child health, however, the importance of knowledge among mothers while in identifying the danger sign in their child are very imperative for preventing their illness. Method: A cross sectional study was conducted in an urban setting in Karachi city. The objective of study was to assess the knowledge of mother's regarding danger signs in their child illness and their care seeking behavior with aims to improve the neonatal and child health in Pakistan. Results: The majority of respondent mothers (81.5%) were literate, housewives (90%). Regarding child care the mothers are responsible for the immediate needs of their child. In the context of breast feeding and immunization of the infants, majority of the mothers were aware of practicing early initiation and uses of colostrum because of its importance. Although a large proportion of mothers (90.1%) sought 'appropriate' care for childhood illness, generally care was sought from private doctors (69.4%) instead of government medical practitioners. Conclusion: Study concluded that the Health seeking behviour of mothers has been found appropriate, however, their knowledge regarding the danger signs and illness of their children was reported low. It is recommended that some urgent awareness intervention by the policy makers for reducing the child death should be given to increase their knowledge on the danger sign of child diseases in Pakistan.

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Mar 2015
<![CDATA[Canadian Policy on Food Allergen Labelling: Consumers' Perspectives Regarding Unmet Needs]]> Source:Universal Journal of Public Health  Volume  3  Number  1  

Kristin M. Brown   Nancy E. Fenton   Larry D. Lynd   Carlo A. Marra   Mark J. Fitzgerald   Stephanie S. Harvard   Meagan Rosenthal   Bonnie Y. L. Chow   Ann E. Clarke   and Susan J. Elliott   

It is estimated that 50% of Canadian households are directly or indirectly affected by food allergies. Since accidental exposure to food allergens can cause life-threatening reactions, the need for accurate allergen labelling is key. In Canada, new food allergen labelling guidelines were mandated in August 2012. While a substantial improvement, gaps remain. This study explored the perspectives of directly affected individuals as well as members of the general public regarding their needs and preferences for precautionary labelling, allergen symbols, and suggestions for improving labelling practices in Canada. Eight qualitative focus groups were conducted with directly affected (n=27) and general public (n=24) consumers in Vancouver, Canada. Focus groups were audio recorded and transcribed verbatim for subsequent thematic analysis using NVivo9. Although "may contain" is recommended by Health Canada, it was the least preferred precautionary statement among research participants. Both participant groups described how many consumers' purchasing habits are indirectly affected by food allergy; hence, their views should be considered in addition to those of directly affected individuals when developing allergen labelling policies. The findings identify future policy needs: 1) mandating and standardizing precautionary/allergen statements and symbols, 2) increased monitoring, and 3) increasing food allergy education and awareness among consumers and manufacturers.

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Jan 2015
<![CDATA[Assessment of the Potential for Spread of Deadly Ebola Virus across International Borders by Returnee Travelers and Humanitarian Health Workers from West Africa]]> Source:Universal Journal of Public Health  Volume  3  Number  1  

Vincent Icheku   

The recent Ebola Virus Disease (EVD) outbreak in West Africa is so far the largest and deadliest in recorded history. The rapid spread of the disease in the region and its potential for international spread prompted the World Health Organization to declare the outbreak a public health emergency of international concern. [1] This paper assesses the potential for the spread of the disease across international borders by returnee travelers and humanitarian health workers, given that the disease spreads through physical contact. The surveillance data published by both the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) were reviewed to identify the EVD epidemiological situation in West Africa from March 2014 to September 2014. The risk assessment data published by Public Health England (PHE) and CDC travel updates were reviewed to identify travel group(s) most at risk of transmitting EVD across international borders. Studies focusing on West African cultural practices were also reviewed to identify aspects that carry risk of EVD transmission. The study found that the risk of travelers transmitting EVD across international borders is low and would remain so on two conditions. First, all travelers must avoid direct physical contact with a sick or dead person or animal infected with EVD. Second, international humanitarian health workers in affected areas of West Africa who will eventually return to their home countries must work in safe environments with adequate protective equipment. The risk of travelers acquiring EVD is considered very low, yet there is serious concern that the disease may spread further within West Africa and across international borders. Local burial practices exacerbate the disease spread while poor working environments and inadequate supply of equipment increase risk of exposure to EVD of humanitarian workers. This researcher recommends addressing the issues through local awareness, pre-travel advice and capacity investment in the healthcare infrastructure in the EVD affected areas.

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Jan 2015
<![CDATA[The Association between Sleep Loss and Women's Wellness Decisions]]> Source:Universal Journal of Public Health  Volume  3  Number  1  

Amber S Linde   and Gudeta Fufaa   

Sleep loss is an important determinant of health status owing to its relationships with molecular, immune, and neural changes; these changes, in turn, are important etiological mechanisms for the development of cardiovascular, metabolic diseases and increased risk of accident related injuries. While the association between sleep loss and risk of weight gain is established, studies on the association between sleep loss and nutrition and physical activity are limited. The purpose of this research was to determine if there are significant associations between reported sleep variations and nutrition and physical activity level while recognizing the association between body mass index (BMI) and sleep loss. Data from the 2011 sleep-related questions captured by the Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS) was used to identify possible behavioral indicators related to sleep loss in women. Multiple logistic regression was used to assess the hypothesized associations between sleep loss and fruit and vegetable consumption and physical activity levels. The odds ratios for the association between fruit/vegetable intake and sleep loss and that of BMI and sleep loss were (OR =0.761, 95% CI =0.651, 0.889) and (OR = 1.108, 95% CI =0.972, 1.262), respectively. The odds ratio for the association between physical exercise and sleep loss was (OR = 0.991, 95% CI =0.864, 1.137). Having adjusted for relevant covariates, consumption of fruits and vegetables was significantly associated with sleep loss; physical activity was not significantly associated with sleep loss.

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Jan 2015
<![CDATA[Using Waist Circumference Measurements to Enhance the Public's Understanding of Childhood Obesity: Accounting for Health Literacy]]> Source:Universal Journal of Public Health  Volume  3  Number  1  

Madelyn P. Law   John Hay   Brent E. Faught   and John Cairney   

This study examined the extent to which the measurement of waist circumference (WC) can categorize overweight/obesity status similarly to BMI in children. Height and weight were measured and BMI was calculated for participants' age 9 to 11 years old. Children were classified as either normal-weight, overweight, or obese. WC was measured twice and the average of these measures recorded. Receiver-operator characteristic curves were computed for each age and gender for both overweight and obese using BMI as the standard. For each analysis the area under the curve was used as an overall indicator of agreement between the two measures. WC achieved very strong sensitivity for both overweight and obesity for both genders, ranging from .90 to .93. Specificity for obesity for both genders was very strong, ranging from .89 to .93 for girls and from .90 to .93 for boys. While specificity for obese remains high for both genders (.89 - .93) across all three years, the specificity for overweight fell to .68 to .84 for boys and to .66 to .74 for girls. Due to low levels of health literacy in the population, using WC may provide an easy to understand measure of obese or overweight status.

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Jan 2015
<![CDATA[Bureaucratic Barriers to Evidence-based Tobacco Control Policy: A Tasmanian Case Study]]> Source:Universal Journal of Public Health  Volume  3  Number  1  

Kathryn Barnsley   Haydn Walters   and Richard Wood-Baker   

The aim was to examine bureaucratic barriers to implementing strategies for tobacco control in Tasmania. We analysed documents provided by government agencies under Right to Information legislation; documents provided by non-government organisations (NGOs), newspaper reports, websites and Hansards relevant for the period 1997 to 2010. Responsible Tasmanian bureaucratic organisations have had a culture of avoiding responsibility for high smoking rates, their processes being excessively complex, under-resourced in expertise and funding for mass media campaigns, having poor accountability mechanisms, failed to adhere to international standards in dealings with the tobacco industry, failed to follow evidence-based public policy despite being aware of its existence, were distracted by immediate needs, experienced passive and active obstruction from other government agencies, and did not adequately inform the Parliament about measures which might reduce smoking rates. The operation and culture of the Tasmanian bureaucracy has been a significant barrier to evidence-based tobacco control public policy. This deficiency was not confined to the Department of Health and Human Services, but also included the Departments of Premier and Cabinet and Treasury. Major barriers to evidence-based tobacco control have existed within the bureaucratic systems in Tasmania in the period 1997 to 2010. They were excessively process-driven, complex structures, with lack of "evidence transfer", antipathetic in culture and had scant resources. Similar barriers exist in some other jurisdictions. All this served to undermine the effectiveness of public-health expert-driven action.

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Jan 2015
<![CDATA[Chronic Fatigue Syndrome Prevalence and its Relation to Job Performance among Nurses]]> Source:Universal Journal of Public Health  Volume  3  Number  1  

Mohsen Haddadi   Seyed Abolfazl Zakerian   Mahmoud Mahmoudi   Gebraeil Nasl Saraji   Zohreh Parsa Yekta   and Abolfazl Aliyari   

Background and Objectives: Chronic Fatigue Syndrome (CFS) is a severe, debilitating disorder. Permanent chronic fatigue that affects the daily routine activities at least for six months and4 of the 8 patients reported symptoms associated with this disorder (problems of memory / concentration, restless sleep, joint pain, swollen lymph nodes, muscle pain, headache, sore throat, weakness due to work) and the absence of any underlying disease is the another sign of this disorder. One of the important things that are noticeable about the syndrome, is causing physical and mental disabilities in the person that will lead to approximately 50% reduction in his job performance. Methods: This study has been conducted through self-reported questionnaire and field and library studies. So the desired randomly set of 78 nurses have been selected to answer the two demographic information and symptoms questionnaires CFS (DSQ. revised)which it's reliability and validity has been verified. These questionnaires have been adjusted to the patient's preliminary data record and their symptoms. In the second stage, each individual job performance questionnaire was completed by department head. Results: The information obtained from the chronic fatigue syndrome questionnaire shows 14.1% prevalence of CFS. In discussing the relationship between CFS and indicators of job performance, it was cleared that people with the syndrome has lower job performance than those are healthy. Conclusions: In many similar studies, the effects of CFS on overall job performance in subjects were discussed and in most cases have been verified. The only differences are in subdivisions of job performance which are considered in this research

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Jan 2015
<![CDATA[Continuous Survey on Child Health Assessed by Medical Checkups in Deprived Areas of the Philippines]]> Source:Universal Journal of Public Health  Volume  2  Number  8  

Yaho Yamamoto   Hiroya Matsuo   and Kuniyoshi Mori   

The aim of this study is to evaluate the current status of child health in deprived areas of the Philippines and to investigate the influence of poverty on health outcomes. Children and parents belonging to a preschool leaning center in Malabon city participated in this study over a five-year period. A questionnaire survey answered by parents concerning characteristics, child-rearing anxieties, and hygiene was undertaken. Kaup index was measured and medical checkups were performed by Japanese medical staff. The ratio of underweight children was 0%-3.8%, while those with obesity were 2.4%-7.7%. The ratio of students with dental caries was 54.8%-74.4%. Parents had various child-rearing anxieties. Poverty affected the Kaup index, caries, and hygiene. It is suggested that children in deprived areas had problems of nutrition, earwax plugs, caries, and hygiene and there might be an influence from poverty on health outcomes.

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Dec 2014
<![CDATA[Heart Failure – A Public Health Issue in Oman: Would Heart Failure Program be Cost Effective?]]> Source:Universal Journal of Public Health  Volume  2  Number  8  

Matlooba ALZadjali   

This review article explores the complexity and importance of heart failure globally as well locally. We attempted to study the current situation of heart failure in Oman by using very limited data from the Ministry of Health annual health report. This data were concentrating mainly on the number of cases admitted in the regional hospitals, and it showed that in 2010 the number of beds occupied by heart failure patients in the hospitals in certain Regions in Oman namely; Muscat Region (Royal hospital), ALDakhalia Region and North ALBatina was high. The data is convincing enough to think of having a comprehensive heart failure program at the national level in order to decrease the burden on tertiary care, save number of beds and ultimately the budget of the health economy.

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Dec 2014
<![CDATA[Assessment of Post Abortion Contraceptive Intention and Associated Factors among Abortion Clients in Gondar Town, North West Ethiopia, 2013]]> Source:Universal Journal of Public Health  Volume  2  Number  8  

Dejenie Seyoum   Abebaw Gebeyehu   and Zemichael Gizaw   

Unintended pregnancies continue to be a major global tragedy for millions of women and abortion is an issue which affects every country in the world. The World Health Organization estimates that 20 million unsafe abortions take place each year, in which 80,000 maternal deaths occur due to complications. Cross- sectional study was employed to assess post abortion contraceptive intention and associated factors among abortion clients in Gondar town, Northwest Ethiopia 2013. Six hundred thirty study subjects were included in the study by using a simple random sampling technique. The collected data entered and analyzed by using SPSS version 20.0 software packages. The degree of association between independent and dependent variables were assessed using odds ratio with 95% confidence interval and p-value ≤0.05. The data analyzed using bivariate and multivariate logistic regression. A total of 630 study participants with abortion were assessed. The extent of the post abortion contraceptive intention among 630 clients was (73.5%). Divorced/widowed women [AOR: 0.277, 95% CI :( 0.151, 0.508).] was a factor negatively associated with the post abortion contraceptive intention whereas married women [AOR: 1.747, 95% CI :( 1.046, 2.916)], abortion from unintended pregnancy [AOR: 3.430, 95% CI (1.597, 7.366) and post abortion contraceptive counseling [AOR: 2.627, 95% CI: (1.366, 5.049)] were factors positively associated with post abortion contraceptive intention. Generally, the post abortion contraceptive intention found in this study was low as compared with others study. Variables like married women, divorced/widowed, abortion from unintended pregnancy and post abortion contraceptive counseling were significant predictors of the post abortion contraceptive intention.

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Dec 2014
<![CDATA[Mental Health among Undergraduate University Students: A Background Paper for Administrators, Educators and Healthcare Providers]]> Source:Universal Journal of Public Health  Volume  2  Number  8  

Khaldoun M. Aldiabat   Nasir A. Matani   and Carole-Lynne Le Navenec   

University students worldwide are at risk for mental health disorders because of the range of stressors they experience. The aim of this background paper is to convey salient evidence about this issue to university administrators, educators, and healthcare providers, and to offer a few illustrative examples of interventions they might consider to address it. It is hoped this paper will evoke outcomes such as increased awareness of this issue and creation of a supportive academic environment on the part of the three groups mentioned above. Content in this background paper includes some facts about prevalence, risk factors, and consequences of mental health issues among university students, as well as the reasons expressed by these students for not seeking help. It is expected that these data will provide insights for administrators, educators, and healthcare providers in academic institutions for both preventing mental illness and promoting mental health among their students by developing collaborative, multidimensional, and culturally sensitive preventive mental health programs, which in turn will facilitate the development of a more supportive academic context, and enhanced psychosocial well-being and productivity among the university student population.

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Dec 2014
<![CDATA[Assessment of Health Care Waste Segregation Practice and Associated Factors of Health Care Workers in Gondar University Hospital, North West Ethiopia, 2013]]> Source:Universal Journal of Public Health  Volume  2  Number  7  

Avier Mesfin   Walelegn Worku   and Zemichael Gizaw   

Introduction: Health care wastes are of great importance due to its potential environmental hazards and public health risks. The ineffective handling and segregation of healthcare waste can result additional costs related to the disposal of waste if not segregated appropriately. Objective: To assess health care workers practice and associated factors towards health care waste segregation in Gondar University hospital Gondar, Ethiopia, 2013.Methods: Institutional based cross- sectional study was employed and Study participants were selected by stratified random sampling using profession category. Pretested standardized questionnaire and observational check list were used. Result: This study showed that 173 (46.3%) of the respondents had correctly practiced health care waste segregation. Being a nurse profession (AOR =0.27; 95% CI= 0.15-0.51), working more than eight hours (AOR =0.28; 95% CI= 0.17-0.47) and unavailability of color coded containers (AOR =0.18; 95% CI= 0.08-0.38) were factors influencing the practice of health care waste segregation. Conclusion: This study showed that health care workers practice towards segregation of health care waste in university of Gondar hospital is poor. Profession, working hours in a day and availability of color coded containers were factors that affect the health care waste segregation practice.

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Oct 2014
<![CDATA[Factors Associated with the Uptake of Health Facility Based Skilled Delivery Services in Kajiado Central District, Kenya]]> Source:Universal Journal of Public Health  Volume  2  Number  7  

Christopher Onyango   

In Kajiado Central District, the proportion of births delivered in a health facility is as low as 28% compared to the Kenya national average of 43% despite implementation of the community strategy in the area. The main objective of this study was to determine the factors associated with the uptake of health facility based skilled delivery in Kajiado Central District in Kajiado Kenya. This cross-sectional study used data from the project "Strengthening the Health System through Collaborative Research to Address Factors Influencing Scaling up of the Community Strategy towards Millennium Development Goals in Different Contexts in Kenya". The unit of analysis was women of reproductive age 15-49 years (n=714). Knowledge of HIV status, use of modern family planning methods, ownership of livestock and education levels had significant associations with health facility delivery. The odds of a mother without livestock delivering in a health facility was 2.5336 times the odds of a mother with livestock (OD: 2.5336: 95% CI 1.818-3.533). More training should be done for the Community Health Workers in the area on health facility based skilled delivery with emphasis on the role of pastoralism on skilled delivery among the women of reproductive age.

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Oct 2014
<![CDATA[Views and Perceptions of Local Council Partners Concerning a Regional-scale Health Promotion Initiative in Rural Australia]]> Source:Universal Journal of Public Health  Volume  2  Number  7  

Quynh Lê   Stuart Auckland   Hoang Boi Nguyen   and Daniel R Terry   

There are a number of risk factors which increasingly impact the health and wellbeing of Australians, particularly in rural communities. To address the health and wellbeing of communities, local governments are taking on a more focused role by supporting healthy community initiatives (HCI). This paper presents local council partners perceptions concerning a regional-scale health promotion initiative that was undertaken in rural Tasmania, Australia. The evaluation provides insight into the future decisions and strategies that may be developed to improve processes, methods and outcomes of health initiatives undertaken by local governments. The study used a mixed methods approach collecting data through a questionnaire, focus group discussions and interviews with stakeholders and participating councils to provide an understanding of the effectiveness and success of, and barriers to, the health promotion initiative. It was found that there was an emphasis by local councils on programs that promoted physical activities, while programs that focused on healthy food and other health promotion topics, such as quit smoking and healthy workplaces were less emphasised. Overall, the health promotion initiative was perceived to be effective; however, there was little measureable evidence as to the outcomes of the various projects within the initiative and there was concern regarding the sustainability of the initiative beyond the funding timeframe. Community based, health promotion interventions are complex. Local government are suitably placed to deliver health promotion initiatives, as they have a greater understanding and can affect the greatest change by investing in projects with the highest priority among those communities within their boundaries. Nevertheless, sustainability of projects beyond funding allocation, while building and improving partnerships among local governments, and service agencies to pool resources and capture specific target groups must be central to ongoing initiatives.

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Oct 2014
<![CDATA[Health Care Providers’ Perspective on Voluntary HIV Counseling and Testing in Health Clinics in Tanzania - A Qualitative Study]]> Source:Universal Journal of Public Health  Volume  2  Number  6  

Gunnel Balaile   Frida Kingazi   and Anna-Berit Ransj? Arvidson   

The aim of this study was to explore the perspectives of health care providers on voluntary counseling and testing (VCT) patients for human immunodeficiency virus (HIV) or counseling those living with the virus. Semi-structured interviews were conducted with 12 Tanzanian HIV counselors in different health service clinics in Dar es Salaam, Tanzania. The interviews were analyzed using a qualitative method. Three themes emerged from the interviews: a person-centered approach is necessary to build trusting relationships to negotiate behavioral change; challenges in the variations in counseling sessions as well as the maintenance of confidentiality; and the requirement for privacy and disclosure only with the patient/client's consent. The health care providers, who all had considerably long experiences of VCT, showed confidence in the counseling situation and were aware of the many challenges and barriers they encountered at work as a counselor. They stressed that the basis for creating a trusting relationship between a counselor and a patient was a person-centered approach. Patient confidentiality was an important factor in the counseling work, but confidentiality could also be a challenge and dilemma to protect both the patient and sexual partners at risk, and this should be taken into consideration in counseling guidelines.

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Aug 2014
<![CDATA[Knowledge and Synthesis Gaps in Men’s Health: Type 2 Diabetes and Depression in Northern British Columbia, Canada]]> Source:Universal Journal of Public Health  Volume  2  Number  6  

Mamdouh M. Shubair   Meck Chongo   and Jamie Reschny  

The workplace is notable as an optimal setting for health promotion programs. The workplace offers a natural convenient environment to support the promotion of health and wellness of workers in organizations. Adult men (18 years of age or over) in natural resource industries who work full-time spend more of their waking hours at work, away from their families due to shift work, hectic hours, and busy lifestyles. The workplace setting can therefore be harnessed to offer workers frequent and sustained exposure to effective interventions during prime hours. The purpose of this Scopus review paper is to assess the magnitude of type 2 diabetes (T2D) and depression among working men in resource-based occupations (trucking; logging; mining; oil and gas; and forestry). The paper proposes a settings-based workplace health promotion (WHP) framework to be adapted from a community-based perspective. We argue the proposed framework can be applied to effect individual worker’s lifestyle behaviours, and from a socio-ecological perspective to influence organizational change and health policy. We propose WHP programs for men recognizing that gender has an important role in influencing one's lifestyle and overall health. From a socio-ecological perspective, the environment also plays a pivotal role in affecting lifestyle choices by supporting or hindering behaviours that occur in 'settings' such as family, school, workplace, or community environments. While arguing for WHP interventions, the paper recognizes the importance of upstream policy initiatives that should enhance and cultivate such interventions at organizational and community levels.

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Aug 2014
<![CDATA[Road Traffic Injuries Involving Illegal Blood Alcohol Levels and Psychoactive Drug Use in C?te d’Ivoire: A Hospital-based Study]]> Source:Universal Journal of Public Health  Volume  2  Number  5  

A?ssata DIAKITE   Blandine GADEGBEKU   Sébastien Djédjé DANO   Hélène YAPO ETTE    Koffi BOTTI    AngladeKla MALAN   and Bernard LAUMON   

In C?te d’Ivoire alcohol and drugs consumption in the general population is a serious issue. However, their role in Road Traffic Accidents (RTAs) has never been investigated. Our study aimed to estimate the prevalence of alcohol-impaired road users at the time of the RTA and report psychoactive drug use, in various categories of casualties, and in various circumstances of the crash. We conducted a cross-sectional study including 893 casualties involved in fatal or non-fatal RTAs and admitted at the Emergency Room or the Forensic Institute from March to September 2012. Blood alcohol dosage (BAC) and urine drug screening were carried out, and results were linked with hospital and police crash report data. The mean BAC in positive cases indicated heavy drinking before the crash: drivers (1.9 g/L), pedestrians (2.1 g/L), passengers (1.5 g/L). The prevalence of alcohol-impairment was significantly higher in drivers (41%) and riders (27%) compared to pedestrians (17%) and passengers (13%). Over 75% of casualties that tested positive for alcohol had a BAC largely above the legal limit. Psychoactive drug use was twice more prevalent in alcohol-impaired drivers than in sober drivers (20% vs 10%). Binge drinking is an emerging issue in African countries, which should be taken into account in the management or prevention of road traffic injuries.

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Jun 2014
<![CDATA[Management, Structure and Perceived Positive Outcomes of Hospital Alliances: An Exploratory Multinational Study]]> Source:Universal Journal of Public Health  Volume  2  Number  5  

Daniel Pelletier   Frances Wildhaber   Pierre Collerette   and Michael M.G. Heberer   

Pooling resources, knowledge and technologies is a necessity in the health sector. Many hospitals do so through alliances with compatible establishments, which have been studied from the organizational perspective for many years. However, many alliances are reported to fail and the conditions which could foster their success are still not well known. The aim of this exploratory study was to identify the administrative and governance structures of hospital alliances associated with reported positive outcomes. A questionnaire was mailed to hospital administrators and directors from Germany, Switzerland, Austria and Canada. Administrative and governance practices were ascertained and correlated with reported outcomes. Management practices pertaining to initiation, formalization, steering and operations of alliances were correlated with financial, treatment and corporate outcomes. Characteristics significantly linked to perceived positive alliance outcomes include: clearly defined targets and their monitoring, governance by executive management and involving the board of directors, rather formal coordination mechanisms, a project champion and a written contract including conflict resolution mechanisms.

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Jun 2014
<![CDATA[The Formation of Organ Donation Policy in Germany: Evidence, Politics and Public Opinion]]> Source:Universal Journal of Public Health  Volume  2  Number  5  

David Wainwright   and Anne Christine Hanser   

The gap between the demand and supply of organs for transplantation is a worldwide phenomenon that continues to tax policy-makers. We consider recent policy reforms in Germany, drawing on evidence from Spain and Austria for comparison. Our analysis adopts Kingdon’s multiple streams model which suggests that windows of opportunity for policy change open when an issue of public concern combines with a plausible solution and favorable political circumstances. Evidence is central to this process, but the type of evidence and the ways it is used, differ from technocratic formulations of evidence based policy-making. Scientific evidence may contribute to the rational appraisal of options, but this and other forms of evidence are also used rhetorically to generate political will and public support for change. We conclude by considering what the formation of organ donation policy in Germany reveals about the processes of policy-making under the competing imperatives of rationalism and democracy.

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Jun 2014
<![CDATA[Alcohol Knowledge and Consumption among Medical Students in Lagos, Nigeria]]> Source:Universal Journal of Public Health  Volume  2  Number  4  

Kofoworola Odeyemi   Babajide Odeyemi   and Folu Olatona   

Alcohol consumption has been linked to the risk of developing cancers and other Non communicable diseases. The knowledge, attitude and practices of alcohol use among the next generation of health care professionals will affect efforts to prevent alcohol related diseases. The aim of this study was to assess the knowledge, attitude and practices of medical students regarding alcohol consumption. It is a descriptive cross-sectional study conducted among a representative sample of 240 students using self administered questionnaires. Majority (83.3%) of the respondents had good knowledge about alcohol however less than half (46.6%) recognized that alcohol was a risk factor for cancer. About a third (33.3%) of the respondents drinks alcohol. The majority (73.8%) of the respondents who consumed alcohol did so “to have fun with friends”. Most (66.3%) of the respondents that did not consume alcohol did not do so because it is against their religion. The senior level students had better knowledge on alcohol than the junior students (p<0.05). However, this did not influence their practice. (p<0.05). Alcohol consumption was more prevalent among males than females (p<0.05). Education on alcohol needs to be given more emphasis to prepare them for work in alcohol control.

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Apr 2014
<![CDATA[It’s about More Than Just Baby Teeth: An Examination of Early Oral Care in Canada]]> Source:Universal Journal of Public Health  Volume  2  Number  4  

Leonard Smith   Larry Katz   Herbert Emery   Jackie Sieppert   Zoe Polsky   and Kimberly Nagan   

It may come as a surprise to the public and to medical practitioners that the most common infectious disease in young children is dental decay and that oral health is the most prevalent unmet healthcare need of children. Children who present with early childhood caries (ECC) can suffer from pain, sleeplessness, malnutrition, difficulty playing, struggles in school, and toxic stress. Although it is almost completely preventable through low-cost preventive measures, prevalence is very high in Canada affecting over one quarter of children. Several factors interact on different levels (child, family and community) to create a situation in which ECC prevails. Recommendations for prevention are presented and include early visits to a dentist, dental care as part of prenatal care, interdisciplinary collaboration across health and social services, as well as many others.

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Apr 2014
<![CDATA[Vitamin D Levels in Serum, Vitamin D Receptor Polymorphisms and Semen Quality Correlations in Lebanon: A Pilot Cross-Sectional Study]]> Source:Universal Journal of Public Health  Volume  2  Number  4  

Aline Hamadé   Sandra Bhanini   Theresa Saade   YoumnaFakih   Chadi Fakih   Rita Azzi   Mira Hazouri   and Francine Rizk   

Background: The role of the steroid hormone Vitamin D (VD) and its nuclear receptor (VDR) in skeletal metabolism is well known. Furthermore, research suggests that VD plays a role in female and male reproduction. However, semen quality status is not clear in infertile men with different VD serum concentrations. The aim of this study is to measure serum VD levels in infertile Lebanese men, to investigate semen quality parameters and their correlation to serum VD levels and polymorphic variations in the VDR. Materials and methods: From March to April 2013, 40 men presenting to an IVF center located in Mount-Lebanon to undergo IUI or ICSI procedure were recruited to our study. VD in serum was evaluated using ELISA method. The polymorphic regions were amplified using PCR followed by digestion with restriction enzymes FokI(rs10735810), ApaI G/T(rs11168271), TaqI T/C(rs731236). Results: No correlation was found between the ApaI and FokI polymorphismsand both VD levels in serum (P= 0.367, P=0.75 respectively) and sperm count (P=0.919).Positive correlation was found between ApaIpolymorphisms and the number of non progressive and immotile spermatozoa (P=0.012, P=0.033 respectively). Also, positive correlation was found between TaqIpolymorphisms and VD serum levels (P= 0.038). Conclusions: More studies on VD could be relevant of a potential VD supplementation that might improve semen quality of involuntary infertile men and would be beneficial both for the infertile couples and the society in general. VD supplementation can opens for a safe treatment of some cases of "idiopathic" impaired semen quality.

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Apr 2014
<![CDATA[A Universal Model of Epidemic: Optimizing Interventions]]> Source:Universal Journal of Public Health  Volume  2  Number  4  

Alexander G. Bachinsky   and Lily Ph. Nizolenko   

The outbreaks of infectious diseases caused by natural factors or bioterrorism acts are, unfortunately, quite real threats for the overall population. Planning of an efficient response to an outbreak of an infectious disease requires coordinated efforts of various services aimed to most efficiently utilize the limited resources. This paper describes a model that optimizes utilization of resources when preparing to counter the bioterrorism threats or responding to epidemics caused by epidemiologically dangerous or socially significant pathogens. The model computes the volume of limited resources as well as the particular control activities (isolation, ring vaccination, or mass vaccination) necessary to minimize the optimization criterion, comprising the total number of infected persons, number of lethal cases, and several other characteristics. The model is available remotely via WEB-interface at http://vector-epimod.ru.

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Apr 2014
<![CDATA[Prevalence, Patterns and Associated Factors of Injuries in School-aged Cameroonian Children]]> Source:Universal Journal of Public Health  Volume  2  Number  3  

Christelle Senterre   Alain Levêque   Michèle Dramaix   and Danielle Piette   

Few studies have addressed the patterns of injuries in Africa, and most of them were based on hospital data. The objectives of this study were to describe, on the basis of the "First Survey Health Young People" performed in 2008 in Cameroon, the prevalence and the patterns of injuries and to investigate the relationship between these injuries and some health behaviors. The dataset included 47327 pupils, aged 9 to 25 years, with a sex-ratio close to one. The prevalence of reported injuries during the past 12 months was 50.8% for boys and 42.1% for girls. Most injuries occurred at home for girls (43.6%) and during sports for boys (22.5%). Multivariable models, by gender, showed that age, alcohol consumption, exercise performed during free time, feelings about school, truancy, happiness, feeling alone, number of close friends, feeling of kindness and helpfulness of the other pupils, possibility to talk with parents or tutors, perception about one’s own health, feeling tired on the morning of schooldays and some violent behaviors (fights, racket events and number of times students reported taking a weapon at school) were all associated with the occurrence of injuries. These results increase the knowledge of the epidemiology of injuries in Africa (in terms of morbidity and associated factors) and should lead to an integrated approach of the health behaviors in injury prevention.

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Mar 2014
<![CDATA[Changing World of Health Care Finance- Private and Social Health Insurance]]> Source:Universal Journal of Public Health  Volume  2  Number  3  

Shwetha H.L   and Padma K. Bhat   

The way in which healthcare is financed is critical for equity in access to healthcare. A common feature of all health systems is the distinction between public and private health care. This distinction refers to both the finance and the provision of health services. Before launching any major health initiative, there ought to be a well articulated vision of health care system for the country, and public health policy must be devised to realise that vision. Ideally, certain basic health services, including inpatient care, must be made available to every member of the society[19]. These services must be paid through insurance, which means that every member must have health insurance cover or at least have access to health insurance, with government subsidising insurance premium, in full or in part, for those who cannot afford it. Health insurance gives the insured population an entitlement to health services. It is therefore important to ensure that the health infrastructure exists to provide those services and that there is some incentive to comply with the insurance. Skill-building for the personnel involved, and capacity-building of all the stakeholders involved, would be a critical component for ensuring the success of any health insurance programme.

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Mar 2014
<![CDATA[The Impact of Teaching Factor on University Hospitals' Cost Structure: The Case of Greece]]> Source:Universal Journal of Public Health  Volume  2  Number  3  

Georgios L. Thanasas   

In this paper an attempt is made to determine the additional costs being undertaken by the University Hospitals of Greece in relation to those of General Hospitals. To determine the additional cost of University Hospitals, called teaching impact cost, a model of eight factors was constructed. The sample of examined Hospitals consists of fifty-three (53) Hospitals in Greece which issued financial statements for the years 2008-2009. This effort is intend to a direct comparison of the results that incurred in Greece, to other similar efforts that made in other European Countries. The results showed that the University Hospitals of Greece, similar to other European University Hospitals, face a higher operational cost compared to General Hospitals, which is due to education of the future health professionals.

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Mar 2014
<![CDATA[Z-Score Anthropometric Indicators Derived from NCHS-1977, CDC-2000 and WHO-2006 in Children Under 5 Years in Central Area of Peru]]> Source:Universal Journal of Public Health  Volume  2  Number  2  

Castro Bedri?ana Jorge  and Chirinos Peinado Doris  

Objectives. To Identify and analyze the distribution of Z-scores of anthropometric indices of children between 36-60 months of age in the province of Huancayo, Peru, which were calculated based on the NCHS-1977, CDC -2000 and WHO-2006 references. Methods. We analyzed a database of 2640 children (1268 males and 1372 females) collected between 1992-2007. The Z-scores were determined using the Anthro V.3.0 and the EpiInfo 6.04. The data were divided into four chronological periods: First, 1992 with 532 data; Second, from 1993 to 1997 with 370 data; Third. From 1998 t0o 2002 with 494 data, and Fourth from 2003 to 2007 with 1244 data. Results. The weight-for-age, height-for-age, weight-for-height and body mass index Z-scores were different for each assessment standard. The mean+SD of the weight-for-age, height-for-age, weight-for- height and BMI Z-scores with NCHS were -0.85+0.88, -1.29+1.07, -0.04+0,84 and 0.05+1.05 respectively, with CDC the values were -0.79+0.95, -1.08+1.05, -0.12+1.00 and 0.05+0.91 and with WHO the values were -0.75+0.84, -1.40 +1.02, 0.15+0.91 and 0.21+0.91, correspondingly. With the new WHO standard it was obtained lower Z-scores of height-for-age than with NCHS, being the farthest curve from the median. The new WHO standard would be the most accurate and realistic standard used to determine the Z-scores, because was determined in a multicentric study to world level, and it should be officially adopted for the nutritional assessment in children under 5 years.

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Feb 2014
<![CDATA[Effect of Resilience on Self-Perceived Stress and Experiences on Stress Symptoms A Surveillance Report]]> Source:Universal Journal of Public Health  Volume  2  Number  2  

KWOK Sin Tung   WONG Wai Ning   and Kris, LEE Tse Yan Alexander   

The objectives of the study were to examine the level of perceived stress, emotional syndromes and quality of life among students and evaluate if personal resources is associated with students’ stress level. All students were invited to participate. Socio-demographic characteristics and outcome measures including students’ physical and psychological well-being and their personal resource/resilience (optimism, perceived control and self-esteem) were assessed via validated self-reporting questionnaires. Although only half of the student participants experienced some form of emotional symptoms, about 86.8% of the students still reported to have endured higher to much higher than average level of perceived stress. Significantly higher level of perceived stress was experienced by engineering students and those with lesser level of [poorer] resilience. Stressed students reported to have significantly poorer physical, psychological, social and environmental health. Results indicated that personal resilience affect the level of perceived stress experienced, and in turn affecting students’ general well-being and hence, quality of life. In conclusion, a high level of stress and psychological symptoms associated with poor personal resilience in withstanding stress, as well as poor quality of life and general health among students were reported. Regular monitoring students’ stress level and implementing appropriate intervention are recommended.

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Feb 2014
<![CDATA[Congenital Anomalies: Prevalence and Risk Factors]]> Source:Universal Journal of Public Health  Volume  2  Number  2  

Rizk Francine   Salameh Pascale   and Hamadé Aline1a   

Objective: The aim of this study is to assess the incidence, types and correlates of congenital anomalies (CA) among stillborn and liveborn infants in two Lebanese hospitals in Mount-Lebanon. Methods: In this cross-sectional study, all the newborns who were born during 9 months period from January to December 2009 (n=1000) at two hospitals setting in Mount-Lebanon hospital, Lebanon were studied. The newborns were assessed for CA. Neonatal data were extracted from medical records of the nursery. The classification of malformations was based upon the anatomical system affected according to the WHO classification of CA. Results: Of the all 1000 single births, 24 (2.4%) were diagnosed as being congenitally malformed. Cardiovascular system defects and limbs anomalies (4/1000) were mostly detected, followed by genitourinary system (2/1000), nervous system (2/1000), respiratory system (2/1000) malformations and chromosomal anomalies (1/1000). A marked association of parental consanguinity and alcohol consumption of the mother during the pregnancy with increased CA rates was found (p= 0.015 and p=0.027 respectively). Conclusions: The frequency of malformations in the study was approximately similar to previous investigations. The increased incidence of CA in cases of parental consanguinity prompts the necessity of establishing educational programs to avoid these complications in the offspring.

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Feb 2014
<![CDATA[Summative Evaluation of a Malnutrition Program for Children in the Dominican Republic]]> Source:Universal Journal of Public Health  Volume  2  Number  2  

Lauri Wright   and James Epps   

Due to the prevalence and impact of childhood undernutrition, the objective of the study was to investigate causes of malnutrition and evaluate the effectiveness of a Nutrition-Supplementation Program (NSP) in rural Dominican Republic with and without nutrition counseling. Causes of undernutrition were examined by qualitative interviews conducted with parents. Program effectiveness was measured by comparing children’s pre- and post-percentage goal weight/age. The most prevalent contributors of malnutrition found were food insecurity, disease, poor maternal and child health policies, and lack of knowledge. Children who received only milk and vitamin supplementation did not improve % goal weight/age (MEAN pre=77.3; MEAN post=78.1; t=0.21; p<.83). Children who had both nutrition counseling and supplementation improved markedly (MEAN pre=67.2, MEAN post=78.2; t=3.01; p<.07). Because of the complexity of malnutrition, programs are most successful when multiple interventions including nutritioncounseling are provided.

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Feb 2014
<![CDATA[Review and Synthesis of Smoking Cessation Interventions in the Canadian Aboriginal Population]]> Source:Universal Journal of Public Health  Volume  2  Number  2  

Mamdouh M. Shubair   

Smoking is a major public health concern among the Aboriginal Canadian Population. The age-adjusted smoking-attributable death rates are two times those of other Canadians; 20% of adult deaths among Aboriginal Canadians is attributable to smoking. There is no research that implemented and examined interventions of smoking cessation in Aboriginal Canadians, particularly in Northern British Columbia. This paper represents a critical review of some of the successful smoking cessation programs conducted in different jurisdictions. It is evident that little consideration is given to Aboriginal knowledge transfer in program development and delivery. This review indicates that in order for an Aboriginal cessation strategy to be successful, culturally relevant criteria must be identified and implemented. Without consideration of culture, there will always be limited success in tobacco cessation initiatives. To be effective, smoking cessation programs need to be comprehensive. Social determinants of health and socio-economic disparities that influence health status outcomes need to be considered as they have major influence in adopting smoking among Canadian Aboriginals. These factors have implications for public health policy.

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Feb 2014
<![CDATA[Mobile Health (mHealth): A Conceptual View]]> Source:Universal Journal of Public Health  Volume  2  Number  2  

Sergey Pankratov   and Tatiana Znamenskaya   

The value of mHealth for sustainable healthcare is discussed. It is projected that mHealth can become a disruptive technology that is set out to radically transform the current state of medical disciplines. In particular, the mHealth solutions can provide better understanding of the organism stability margins and of the emergence of diseases as well as ensure more patient safety under drug and physiotherapy prescription. The issue of measuring the physiological quantities is addressed, with the conventional yet complex task of quantitative accuracy evaluation being discussed. The concept of complexity and its relevance for the physiological parameters defining both the health state and disorders is accounted for. The principles of body area networking and the relevant standards are briefly overviewed, with a focus on security issues. The concept of biofeedback implemented through mHealth sensor technologies is examined. Basic requirements to facilitate market acceptance and response are analyzed. Selected case studies of pervasive health monitoring are presented. Possible current and future mHealth applications are considered. Since some general problems of healthcare are touched upon in the article, it is intended to provoke a controversy.

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Feb 2014
<![CDATA[Prevalence and Correlates of Experience of Physical and Sexual Intimate Partner Violence among Men and Women in Eastern DRC]]> Source:Universal Journal of Public Health  Volume  2  Number  1  

Stella Babalola   Amrita Gill-Bailey   and Mathurin Dodo   

This manuscript uses large-scale survey data to examine the prevalence and correlates of intimate partner violence (IPV) in the eastern part of the Democratic Republic of the Congo (DRC), namely in North Kivu and South Kivu provinces. We examine two form of IPV: physical and sexual. The data show that two of every five women and more than one quarter of men had reportedly ever experienced physical IPV while one quarter of women and 15.7 percent of men reported ever experiencing sexual IPV. The correlates of IPV differ for men and women and depend on the type of IPV. For men, the strongest correlates of physical IPV include current employment, education and recent experience of sexual IPV. The strongest correlates for experiencing sexual violence among men were young age, problematic use of alcohol, gender-equitable attitudes, province of residence, and recent experience of physical IPV. For women, young age, low education, gender-equitable attitudes, partner problematic use of alcohol, partner controlling behaviors, recent experience of sexual IPV, and recent experience of public humiliation were the correlates of physical IPV. The strongest correlates of sexual IPV for women include province of residence, partner problematic use of alcohol, partner controlling behaviors, and recent experience of physical IPV. The programmatic implications of the findings are discussed.

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Jan 2014
<![CDATA[Comparing Health Impairments in Special Health Care Needs Children with and without Diabetes]]> Source:Universal Journal of Public Health  Volume  2  Number  1  

Maureen K. Johnson   and Florence Uruakpa   

Health impairments in special health care needs (SHCN) children with diabetes were compared with those of SHCN children without diabetes. Data from the 2009/2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) were analyzed. Demographic and health impairment variables were measured in terms of their association with ever being diagnosed with diabetes by a medical professional. Demographic variables included sex, ethnicity/race, and age group. Health impairment variables included difficulties with: swallowing/digesion/metabolism; coordination/movement; difficulties using hands or fingers; vision; hearing; breathing; and circulation. Multivariate logistic regression analysis and adjusted odds ratios (OR) were used to determine associations. The variables of sex, age group, swallowing/digestive/metabolic impairments, vision difficulties, and circulation impairments were significantly associated with ever having been diagnosed with diabetes. Findings from the current study suggest that SHCN children with diabetes have specific health impairments beyond those of other SHCN children without diabetes.

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Jan 2014
<![CDATA[Benefits from Increasing Salary, Employee Benefits and Rank for Promotion the Nursing Shortage in Macao Chinese Society]]> Source:Universal Journal of Public Health  Volume  2  Number  1  

Cindy Sin U Leong   

The purpose of this study was to compare and discuss the modified policy for nursing staff in the public sector in Macao Chinese society. This study compared the past and present modifications in the bill of the Rank and Grade System in the public sector. The greatest concerns of the nursing staff included the old bill of rights, the grading system for the nursing staff, which needed to be modified, and improvements, especially with regard to salary, employee benefits and rank for promotion. The essential elements of the updated policy regarding salary (increasing from 22 to 43%), employment benefits (increasing more than 100% based on tenure), on-shift allowance (flexible) and rank for promotion (number of ranks added) were adjusted. These improvements are not only beneficial on a personal and professional level but are also beneficial at the healthcare institution level, society level and academic nursing school level. Multiple levels of benefit detailed in the present study may provide a good impetus to end the nursing manpower shortage in the near future.

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Jan 2014
<![CDATA[Perceived Parental Support and Self-efficacy for Avoiding Sedentary Behaviors and Overweight Status among School Children]]> Source:Universal Journal of Public Health  Volume  2  Number  1  

Melvena N. Wilson   Saleh M.M. Rahman   Ivette A. Lopez   Gabre E. Kiros   Delores C.S. James   and Mark B. Dignan   

Overweight in childhood is a serious public health concern. Approximately 31% of 6-19-year-old children in the United States are obese, overweight or at risk of overweight. The sample (N=721) consisted of students between the ages of 9-14 years of age enrolled in grades 4th-8th in Leon and Gadsden Counties, Florida. Using a multinomial regression model, analyses revealed that students with increased perceived self-efficacy were approximately 1.4 times more likely to be overweight than their counterparts, and those who lived in Gadsden County were 1.7 times more likely to be overweight. Those enrolled in the free/reduced lunch program were 7% less likely to be overweight than their counterparts. The purpose of this study was to explore the relationship of weight with sedentary behavior, self-efficacy in sedentary behavior avoidance, perceived parental support and socio-environmental factors among African American children. The study findings contradict much of the literature in terms of perceptions about the relationship of perceived self-efficacy and behavior and underscore the need for additional research to better understand possible differences between African American and White children.

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Jan 2014
<![CDATA[Improving a Case-Control Study of Multiple Sclerosis Using Formative Research]]> Source:Universal Journal of Public Health  Volume  1  Number  4  

Dhelia M. Williamson, Ph.D   Laurie Wagner, M.P.H.   and Judy P. Henry, Ph.D   

Formative research (i.e. focus groups and key informant interviews) was conducted to understand risk perceptions and identify barriers to participation in a case-control study of environmental exposures and genetic susceptibility as risk factors for multiple sclerosis (MS). Individuals with MS were recruited to participate in a focus group discussion and individual interviews. Participants were asked to review and comment on study materials and process including participation, interview, genetic testing, confidentiality, and questionnaire. A structured discussion guide was used with all participants to ensure uniformity and coverage of all predetermined topics. Participants reported an increased likelihood of participation if they were informed about the study by their neurologist and not a government agency. All participants expressed willingness to provide a blood sample for genotyping but disagreed about the setting for the blood draw (at home or in a lab). Participants were concerned that they would not receive their individual genotyping results. The study protocol and materials were revised based on comments from the focus group participants. Formative research is an under-utilized resource for researchers conducting epidemiologic studies. Even with limited resources, piloting study materials with individuals similar to the proposed study population can provide opportunities to make modifications to effectively meet the needs of participants and promote participation and retention.

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Dec 2013
<![CDATA[Impact of Life Expectancy on Economics Growth and Health Care Expenditures in Bangladesh]]> Source:Universal Journal of Public Health  Volume  1  Number  4  

Rashidul Alam Mahumud  Golam Hossain   Ripter Hossain   Nurul Islam   and Lal Rawal   

Life expectancy is one of the major key indicators of population health condition and economic development of a country. The main objective of this study was to find determine the impact of the life expectancy on changes of economic growth and health care expenditure, and also to find examine the sex difference trend of life expectancy according to the sex difference. Using We used multiple regression models are fitted to estimate the impact of the life expectancy on economic growth and health care expenditure and also to estimate elasticity of life expectancy on health care expenditure and economic growth. Results shows female life expectancy was more than male over the past 15 years. The higher Gross Domestic Product (GDP) per capita was seen in a longer life expectancy. i.e., one dollar increasing in GDP per capita will change in an average the life expectancy by 33 days, and also one unit increase in per person Health Expenditure Per Capita (HEPC) will increase the life expectancy in an average of 8 days in a year. one dollar increasing in GDP per capita by 33 days will also increase life expectancy, for Health Expenditure Per Capita (HEPC), by 8 days by one year on average. The higher proportion of total expenditure on health as a percentage of GDP and direct personal expenditure on health by household as a share of private expenditure on health results in also longer life span. The study has some policy implications for Bangladesh, we conclude that the increased life expectancy has direct impact on increase in per capita real income and higher expenditure on health., population planning and equity for health important for life expectancy. This study has policy implications for Bangladesh, in particular the needs for increased per capita real income and planning for future health and population policies/programs. Therefore, political stability, adequate and suitable social sector policies and government interventions are required to increase life expectancy and economic growth. There is also a need for involvement of health human force in macro and micro policy-makings and critically examine other determinant of health care expenditure.

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Dec 2013
<![CDATA[Coverage of CFS within U.S. Medical Schools]]> Source:Universal Journal of Public Health  Volume  1  Number  4  

T. Mark Peterson, D.D.S   Thomas W. Peterson, D.D.S.   Sarah Emerson, B.S.   Eric Regalbuto, Meredyth A. Evans, M.A.   and Leonard A. Jason, Ph.D.   

Little is known about the extent to which chronic fatigue syndrome (CFS) is covered within medical schools in the United States (U.S.) The current study is an exploration of the extent that CFS is covered in the areas of treatment, research, and curricula in U.S. Medical Schools. Surveys were sent to personnel at 132 accredited U.S. medical schools and a total of 71 schools responded. The extent of coverage across the three domains was extremely limited. Only 29.6% of schools met the clinical criterion, 28.2% met the curricula criterion, and 15% met the research criterion. Only four of the 71 (5.6%) responding schools met criteria for all three domains. While the current study is preliminary, it points to significant gaps in the coverage of CFS among medical institutions, which is likely impacting the ability of physicians to fully acknowledge, understand, effectively treat, and find a cure for CFS.

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Dec 2013
<![CDATA[Indoor Air Pollution by Tobacco Smoke and Study on Tobacco Use among School and College Students in India]]> Source:Universal Journal of Public Health  Volume  1  Number  4  

Jyotsna Lal ,Ph.D   

Burning tobacco is the main source of indoor pollution in the developed world. Tobacco smoke contains about 4,000 chemicals including carcinogens, irritants and toxic gases. The health impact of breathing environmental tobacco smoke is well documented. Tobacco smoke contains over 4000 chemicals in the form of particles and gases. Many potentially toxic gases are present in higher concentrations in sidestream smoke than in mainstream smoke and nearly 85% of the smoke in a room results from sidestream smoke. The particulate phase includes tar (itself composed of many chemicals), nicotine, benzene and benzo(a)pyrene. The gas phase includes carbon monoxide, ammonia, dimethylnitrosamine, formaldehyde, hydrogen cyanide and acrolein. Some of these have marked irritant properties and some 60 are known or suspected carcinogens (cancer causing substances). The Environmental Protection Agency (EPA) in the USA has classified environmental tobacco smoke as a class A (known human) carcinogen along with asbestos, arsenic, benzene and radon gas.[WHO 2004] Breathing other people's smoke is called passive, involuntary or secondhand smoking. The non-smoker breathes "sidestream" smoke from the burning tip of the cigarette and "mainstream" smoke that has been inhaled and then exhaled by the smoker. Secondhand smoke (SHS) is a major source of indoor air pollution. In the longer term, passive smokers suffer an increased risk of a range of smoking-related diseases.Non-smokers who are exposed to passive smoking in the home, have a 25 per cent increased risk of heart disease and lung cancer.This paper deals with study of various effects of passive smoking on human health as well as how adolescent school and college students are most influenced by tobacco use around them and get initiated easily in smoking .

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Dec 2013
<![CDATA[The Ability of Women to Overcome Household Food Insecurity: Social Support & Social Networks]]> Source:Universal Journal of Public Health  Volume  1  Number  4  

P. Qasimah Boston, MPH, DrPH   Saleh M.M. Rahman, MD, PhD, MPH   C. Perry Brown, MSPH, DrPH   Ivette A. Lopez, PhD   Mitwe Musingo, PhD   and Coumba Mar Gadio, PhD   

Food insecurity is a daily reality for millions globally and persists in rural northern Ghana. Being more a problem in resource poor countries, it challenges the wellbeing of children, adults, families and communities by creating public health problems including; low birth weight babies, mental health conditions, diabetes and obesity. This research examined associations between social networks and social support and women’s ability to overcome household food insecurity. A two-phase mixed method quantitative and qualitative data collection technique was applied. A 24-item instrument was developed, pilot tested, validated and administered among women responsible for food preparation in the household (n=241). Measures of household food insecurity, socio-demographic, social network, and perceived social support were constructed and analyzed using SPSS 19?. Women in northern rural Ghana who were married, with higher social supports and social networks were more likely to experience low household food insecurity. Of 241 women, 88% were married, 39% had co-wives, 80% did not have formal education, the average age was 40 years and the average number of adults per household was 7. Correlation analysis and logistic regression models revealed social networks, perceived social support, marital status and years living in the village were significantly associated to the experience of low household food insecurity.

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Dec 2013
<![CDATA[International Medical Graduates: A Cohort Study of Key Informant Perspectives]]> Source:Universal Journal of Public Health  Volume  1  Number  4  

Daniel R Terry   and Quynh Lê   

An Australian wide shortage of doctors has led to an increased reliance on International Medical Graduate (IMG) recruitment. However, there is very little research regarding the acculturation of IMGs as they reside in the rural Tasmanian context. This paper explores from the perspective of IMG informants, the experiences and challenges of IMGs living and working in rural and remote Tasmania and how it informs the acculturation process. It identifies the barriers facing IMGs as they work and live in Tasmanian communities. It is part of a larger doctoral study looking at IMGs in Tasmania. The study adopted a qualitative research approach. Twenty-three semi-structured interviews were conducted with IMG informants in the North, South and North West of Tasmania. Informants were recruited through purposive snowball sampling. The findings indicate that Tasmanian based IMGs encounter both professional and social challenges. These challenges include vulnerability due to fear of job security, and loss of status, discrimination and communication challenges within the workplace. Additional challenges include spouse employment, obtaining high quality academic access for children, and cultural and religious connectivity. These challenges influence IMGs and their families to stay or relocate. In addition, a number of identified needs have been identified to improve retention of IMGs within Tasmania. The study adds to existing knowledge and identifies three factors which further determine the retention of IMGs. These factors include, job opportunities, vocational training and greater commensurate support provided to IMGs and their families.

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Dec 2013
<![CDATA[Comparison of NCHS-1977, CDC-2000 and WHO-2006 Nutritional Classification in 32 to 60 month-old Children in the Central Highlands of Peru (1992-2007)]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Doris Maritza Chirinos Peinado and Jorge Jorge Isaac Castro Bedri?ana 

Objective. The aim is to compare the three references used for the classification of the nutritional status of 36 to 60 month-old children in Huancayo province (Peru). For a long time, NCHS-1977 reference has been used for child growth monitoring, recently the new WHO-2006 Child Growth Standards is being used, and CDC-2000 reference usage has been restricted. Methods. Data collected from 2640 children over the period 1992 to 2007 served as basis for determining the nutritional children status using Anthro V.3.0 and EpiInfo 6.04. Internationally cutoff points used in every assessed reference system helped to determine the nutritional status and to calculate the Z-scores of height-for-age, weight-for-age, weight-for-height and body mass index differentiated by sex. Results. The underweight, stunting and wasting percentages (period 992-2007), determined with NCHS-1977 reference were 8.4%, 28.8% and 0.9%; with CDC-2000 reference were 10.2%; 19.1% and 3.3%, and with WHO-2006 standard were 6.6%, 33.9% and 1.4% respectively. The overweight and obesity percentages determined with CDC-2000 standard were 11.4% and 4.20%, and with WHO-2006 standard were 8.0% and 0.9%, respectively. Conclusions. A more realistic and accurate detection of malnutrition prevalence in 36-to-60 month-old children from Huancayo province was carried out using the new WHO Child Growth Standard. Using the CDC-2000 standard is recommended in overweight monitoring cases.

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Oct 2013
<![CDATA[Shrimp Cultivation with Water Salinity in Bangladesh: The Implications of an Ecological Model]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Md. Mizanur Rahman Vincentas Rolandas Giedraitis Leslie Sue Lieberman Mrs. Tahmina Akhtar and Vaida Taminskien? 

Despite unplanned and haphazard expansion of shrimp cultivation that immensely affects on the coastal regions of Bangladesh, the exploration of its adverse effects has not received significant attention from the researcher community yet. There were few researches and studies in Bangladesh conducted to elicit the colossal effects of shrimp production at different times that did not particularize its focus on proposing an ecological design of shrimp production. In order to elicit the concomitant impacts and propose an ecological model of shrimp cultivation based on secondary data, the present study was conducted by applying ‘Systematic Review and Content Analysis’ as research method. The study findings manifest that the continuous and unregulated shrimp farming has immense impacts on human health, ecology, environment and sustainability though few of them directly benefit the shrimp farmers and the people who live around them. The extensive farming systems negatively expedite the processes: infringement of mangroves, intrusion of salinity, degradation of land, de-stabilization of coastal ecosystems. The major socio-economic effects challenge the patterns of livelihood pattern, displacement of family and social structure, internal migration, and livestock. The coastal regions suffer from environmental degradation due to increased salinity of soil, canals and ponds within dams, reduction in grazing field and livestock, changes in the cropping calendar and its pattern, bio-diversity. Ecological aspects and sustainability are also overlooked during the shrimp cultivation. In conclusion, proper implementation of the resilient strategies designed in an ecological model can minimize the adverse effects on the coastal dwellers and local environment, and improve the unplanned shrimp cultivation process in similar areas of Bangladesh.

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Oct 2013
<![CDATA[A Cross-sectional Epidemiological Survey on Prevalence of Malocclusion in Government, Aided and Private School Children of Karnataka]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Roopa Siddegowda and Rani. M.S 

Many population surveys have been carried out in different parts of the world with the objective of estimating prevalence of malocclusion and orthodontic treatment needs. Malocclusion is still considered a dental problem in developing country like India and often neglected because more priority is given to the problems of dental caries and periodontal diseases. Most malocclusion cases are still not treated properly because due to ignorance of patients and parents, inadequacy of dental resources, lack of dental workforce and many of the other factors that have influenced the availability of services. This survey was formulated to investigate the same and to provide strategies for prevention, corrective treatment and to create awareness of orthodontic treatment.

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Oct 2013
<![CDATA[Prevalence and Determinants of HIV among Symptomatic STI Cases in Southern Nations, Nationalities and People’s Regional States, Ethiopia]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Getu Kassa and Tadesse Anteneh 

Background: Recognition of HIV/STI co infection has tremendous contribution for targeted intervention. Sexually transmitted infections have far reaching health, social and economic consequences. Sexually transmitted infections are very important because of their potential complication and interaction with HIV/AIDS. By evaluating the HIV/STI co infection it will be a signal to know the affected groups and major determinants. In doing so, the study finding would help in the planning, resource allocation and designed targeted prevention and control program. Objective: To determine the prevalence and determinants of HIV among symptomatic STI cases. Methods: Cross-sectional survey was conducted for HIV Sero prevalence and determinants among 415 symptomatic new STI cases that had been attended for treatment in eight hospitals in SNNPR, Ethiopia from November, 2011 to February, 2012. Standard rapid HIV antibody test was used to screen the sample blood following the national rapid HIV testing algorithm. Results: The overall HIV sero positivity was found to be 10.6%. Among 415 samples 371(89.4%) were negative and 44(10.6%) turned out to be positive.( Table 4) The rate varies among the major STI syndromes, namely, Urethral discharge syndrome (18.2%), vaginal discharge syndrome (56.8%), genital ulcer syndrome (15.9%), and lower abdominal pain (9.1%). (Table 4)Limitation of the study: Limitation of this study is the use of rapid HIV test kits which fails to detect recent infection. Moreover, the study is hospital based it can’t be representative of the whole population, Conclusion and Recommendation: High prevalence of HIV in STI patients is explained by the role of STI in predisposing for HIV transmission which offers a unique opportunity for strengthening the prevention of HIV/STI co infection putting in place routine HIV test. Furthermore, public health intervention on consistent condom use and partner notification and referral should be given due emphasis targeted to the most at risk population.

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Oct 2013
<![CDATA[Leaflet Preparation and Validation Procedures]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Piddennavar Renuka and Krishnappa Pushpanjali 

Health education can be effective with audiovisual aids. However, oral communications often fail because they are misunderstood and/or forgotten. Therefore, information leaflets could be considered as a way of supplementing health education. Numbers of guidelines for producing written information have been produced over the last few years; these include advice on planning, writing and design but also emphasize the importance of obtaining evidence-based information, and involving both medical personnel, patient groups and members of public. The evaluation of information leaflet, however an essential part of this process is and is often neglected or inadequate. The aim of this review is to describe the steps involved in the production and evaluation of information leaflet. The present review has been attempted to describe methods, which can be employed to prepare and evaluate written patient information leaflet.

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Oct 2013
<![CDATA[Developing and Validating an eHealth Communication Belief Inventory (eHealth-BI) among Chinese Middle-and Older-Age Adults]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Su-I Hou and Peng-Hsi Hou 

Purpose: As the world population rapidly aging, especially in Asia, and “the graying of the Internet”, opportunities of eHealth communication among middle-and older-age adults warrants more attention. Methods: The eHealth communication survey was administered to employee age 40+ in two major worksites in Taiwan. The development and validation of a 7-item eHealth communication belief inventory (eHealth-BI) by age groups were examined. Results: A total of 533 employees participated (mean age = 46.21 (SD=5.01) years). The reliabilities of the eHealth-Pros (4-items) and the eHealth-Cons (3-items) measured by Cronbah alphas were satisfactory in both age groups (40-49 and 50-64 years), demonstrating sufficient internal consistencies among items. Confirmatory factor analysis showed that all items were loaded significantly on these two eHealth-BI sub-scales with good model fits. Males and those with college education overall were more likely to perceive higher benefits and lower barriers towards eHealth communication. Conclusion: Findings provide needed validation on this new theory-based bi-lingual eHealth-BI tool. Results provide health researchers and practitioners an important tool to measure beliefs towards eHealth communication for better understanding of system design needs, and for effective eHealth communication intervention development among middle-and older-age Chinese adults.

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Oct 2013
<![CDATA[The Effect of Education on Compliance to a Workplace Health and Wellbeing Intervention: Closing the Loop]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Lachlan Smith Scott Pedersen and Dean Cooley 

Desk-based worksites are increasingly the focus of workplace health and wellbeing interventions. These interventions often utilize an educational session prior to participants engaging, yet limited studies have specifically examined the effect education has on compliance. The purpose of this study was to investigate the effect pre-intervention participant education had on the odds of compliance to a passive e-health software program designed to increase non-exercise activity thermogenesis throughout the workday. Participants in the experimental group (n=46) were exposed to multifaceted pre-intervention participant education one day prior to initiating the e-health software intervention for an eight-week study period. The control group (n=33) also received the intervention for eight weeks, however these participants received no education prior to initiation. The e-health software had a self-report progress recording function, which recorded all logged movement entries to gain frequency counts of per day usage. The experimental group logged more active days, more movements per day and was significantly more compliant to the e-health software (OR=1.87, 95% CI = 1.56-2.24). A pre-intervention participant education session, coupled with a passive e-health software program, was an effective mechanism for decreasing prolonged employee sedentary periods and increasing movement throughout the workday.

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Oct 2013
<![CDATA[Pilot Surveys of Ethics and Short-Term Medical Mission Work: University of Wyoming Agua Salada Clinic, Honduras]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Juanita L Bonner Jessica Hopper Linda Gore Martin and Penelope Caldwell 

This research, performed in Agua Salada, Honduras, was done to help identify ethical issues perceived by the recipients of short-term medical missions and to examine how these issues differ between volunteers and patients. Using the four principles of medical ethics (non-maleficence, beneficence, autonomy, and justice) as a guide, patient-participants and brigade volunteers were surveyed using open-ended questions on the ethical aspects of taking western medicine to an underdeveloped region. Both the patient-participants (n=58) and brigade volunteers (n=12) agreed that medical missions should come to Honduras. Interestingly, with questions related to the benefit of medical mission work, volunteers were more likely to report benefit to themselves (60.3%) than to patients. In conclusion, patients and volunteers primarily share common perceptions of beneficence and justice while volunteers are more likely to be concerned with non-maleficence and undervalue indicators of autonomy.

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Oct 2013
<![CDATA[Expanding the Pharmacist’s Role in Public Health]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Elizabeth Lai Le Trac and Annesha Lovett 

Today pharmacists are using their clinical skills to serve the community through vaccinations, emergency preparedness and response, drug education, health screenings, medication therapy management (MTM), and counseling services. This article provides a summary of why the pharmacist’s role should be expanded in the public health arena. It is essential to realize the capability of pharmacists and further expand their role in the public health arena in order to improve the quality of care and control costs of the nation. Pharmacists are more accessible to patients than any other healthcare professional and are well-trained to further advance the mission of public health: to promote health, wellness and prevention.

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Oct 2013
<![CDATA[Knowledge of Female Medical Students about Breastfeeding]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Doaa Abdel-Hady Noha Eladawi and Abdel-Hady El-Gilany 

Objective: to highlight the knowledge of female medical students about breastfeeding in general and in special situations. Subjects and methods: A descriptive cross-sectional study on female medical students enrolled in the academic year 2011/2012 in Mansoura Faculty of Medicine from first to final years using self-administered questionnaire. Results: A total of 631students participated with 258 in the preclinical and 373 in the clinical grades. Generally, the majority of students were more aware about initiation, duration and advantages of breastfeeding than correct breastfeeding practice in some special situations. Conclusion: Educational stage is a significant variable in the level of knowledge and medical students and the joiner year’s curricula must include more knowledge about breastfeeding.

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Oct 2013
<![CDATA[Closing the Gap: An Evaluation of Community-Based Projects to Reduce Diabetes Disparities among Minority and Underrepresented Groups]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Saleh M.M. Rahman Selina Rahman Helen Vilme and Monica Hayes 

Diabetes poses severe disease and economic burden in the United States of America as well as in Florida State. The study aimed at evaluating eight community-based diabetes disparities projects funded by FDOH ‘Closing the Gap’ initiatives. This three-phase evaluation included evaluability assessment, process, immediate outcome and impact evaluation using qualitative assessment, case study approach, survey, document analysis, and face-to-face interviews. In 2006-2007, 2007-2008, and 2008-2009 total 3,764; 3,280; 1,691 individuals participated in the programs respectively. In 2006-07 to 2007-08, the proportion of participants referred for the wellness program decreased 8.64%, and participants enrolled in the wellness program decreased 3.4%. On the other hand, DSME and wellness program referrals, enrolment, and completions increased significantly from the 2007-08 to 2008-09 program year (12.6+8.64=21%, 3.4+36.1=39.5%, and 31.8-2.2=29.6%, respectively). The largest increase happened in the DSME with a change of (51.2-8.7= 42.5%). From the 2006-2007 to 2007-2008 funding year, with the largest increase in pre and post-test score, HbA1c, eye-exam etc. participation and in 2008-2009 participation of females in the diabetes program increased significantly. Overall, the diabetes program successfully recruited minority populations and had immediate positive outcomes and impact on minorities, hard-to-reach populations, and women which are good indicators of the program’s success.

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Oct 2013
<![CDATA[Targeting Obesity in Rural and Appalachian Children and Families: A Systematic Review of Prevention and Treatment Interventions]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Melinda J. Ickes and Kira M. Slagle 

Children living in rural and Appalachian communities are at high risk for childhood obesity. The purpose of this manuscript was to review existing childhood and family obesity interventions targeting Appalachian and rural communities to explore recommendations for intervention development. Peer-reviewed studies were selected through a systematic literature search. Seventeen studies met inclusion criteria. Cultural, economical and geographical characteristics of rural and Appalachian communities often make it difficult to reduce childhood obesity. Future research should aim to promote sustainable solutions to complications of childhood obesity in rural and Appalachian communities.

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Oct 2013
<![CDATA[The Shortage-Surplus Paradox: A Literature Review of Primary Health Care Accessibility]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

Melissa M Terry Daniel R Terry Ha Hoang and Chona Hannah 

The National Primary Health Care Strategy in Australia recommends primary health care services need to be clinically and culturally appropriate and delivered in a timely and affordable manner. However simultaneously recognised, access is still inequitable in among various population groups and many areas of Australia. Geographical Information System (GIS) have been used to explore geographical health disparities, planning health care service delivery and provide data in a meaningful way to inform public health strategies. Moreover, GIS has also been used to spatially analyse, measure and provide insight into a population’s accessibility to health care services. A literature search was conducted to identify studies which examined primary health care accessibility using GIS techniques among various urban and rural populations. A limited number of studies demonstrated in addition to distance; time; and location, low socioeconomic status, Culturally and Linguistically Diverse (CALD) background among other factors influences health care access. In addition, other factors were identified to impact health care access, which is an individualised process, influenced by individual characteristics, beliefs, attitudes, and an individual’s activity space. As health care accessibility becomes more prominent within policy, among practitioners and increasingly researched, it has the potential to move beyond recognising areas of poor accessibility among individuals and communities. With a greater integration of both spatial and aspatial data, the process has the likelihood, to provide greater insight into patient behaviour, public perception, amelioration service quality and improve population health and wellbeing.

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Oct 2013
<![CDATA[Solid Waste Management for Sustainable Development and Public health: A Case Study of Lagos State in Nigeria]]> Source:Universal Journal of Public Health  Volume  1  Number  3  

OYEBODE    and Oluwadare Joshua 

Public health is a fundamental requirement to human existence. Waste is directly linked to human development, both technologically and socially, some components of waste have economical value and can be recycled once correctly recovered. Effects of poor environmental hygiene on public health were studied in the precarious living quarters of Lagos state in Nigeria. This study examined the waste management; identified the challenges facing its operation; proffered possible solutions necessary for the growth of the waste market, and also the need to harness the inherent economic and environmental benefits. Data collected in various centers in the town on cases of morbidity, revealed that malaria is much contracted by populations with 58% cases against 14% for diarrhea and 28% for acute respiratory infections. Under-five children are much affected with 24% of the patients among which 43% were cases of the diarrheic diseases. Also, malaria and respiratory infections are more important during rainy seasons, in contrast to diarrheal diseases caused by poor hygiene of people. It has been ascertained that the level of education affects the public health. The concept transformation of waste from an exhausted utility to a valuable commodity as a mechanism for effective solid waste management is yet to be properly utilized in Lagos State.

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Oct 2013
<![CDATA[Measurement of Radon Concentration of Air Samples and Estimating Radiation Dose from Radon in SARI Province]]> Source:Universal Journal of Public Health  Volume  1  Number  2  

Seyed Ali Rahimi and Behzad Nikpour 

Exposure to radon is the second leading cause of lung cancer after smoking. Radon is an odorless, tasteless and invisible gas produced by the decay of naturally occurring uranium in soil and water. The amount of radon in the air is measured in "picocuries per liter of air," or "pCi/L." There are many kinds of low-cost "do-it-yourself" radon test kits you can get through the mail and in some hardware stores and other retail outlets. In this study to measure radon in homes in the province of Sari by dosimeters DOSEman (SARAD GmbH company). Population of the city of Sari 495,369 people and the urban population of village of forty to sixty is the degree of concentration of 116.5 people/ km2. A percentage of the total household population of Sari in areas geographically different samples is selected. Radon measuring in four different seasons (in one year) at home for sampling was done. Sensors 60-minute room bedroom or living at an altitude of 50 to 90 cm from the floor, away from windows and sunlight placed howe dose rate and radon gas in homes has been measured. Amount of radon in your home in spring 28.615Bq m-3, in summer Bq m-3 27.20, in autumn 27.07Bq m-3 in winter Bq m-3 36.95 measures. Both dose levels in spring .0032 μSv, in the summer 0.026 μSv, in the autumn 0.037μSv in winter 0.056 μSv is measured. Annual dose equivalent to approximately 0.0151μSv / year .Radon measurement results show that the average radon concentration is higher in winter than other seasons. This difference could be due to lack of air movement and stillness, and the dose of radon indoors in winter.

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Aug 2013
<![CDATA[Improving the Odds of Compliance: Using a Brief Telephone Call to Decrease Pre-treatment Attrition in Cardiac Rehabilitation]]> Source:Universal Journal of Public Health  Volume  1  Number  2  

Dean Cooley Karla Kubitz Scott Pedersen and Andrew Williams 

The purpose of this study was to test the effect of a brief telephone intervention based on the principles of motivational interviewing to reduce pre-treatment attrition in an Australian cardiac rehabilitation centre. The study was an intact comparison randomly trial. Twenty-eight adult patients diagnosed with symptoms associated with cardio-vascular disease, who were noncompliant to an initial appointment, were randomized to receive either a standard cue call or a motivational interview-based recruitment call. Compliance was measured as attendance at a booked session at the cardiac rehabilitation center. Results showed that patients who received a motivational based telephone call had 6 times the odds as those who received a standard cue telephone call for attending a booked appointment. Reducing pre-treatment attrition from cardio-vascular rehabilitation centers can be accomplished with a brief telephone intervention, which incorporates the spirit of motivational interviewing.

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Aug 2013
<![CDATA[Patient-held Logbooks for Cancer Care Treatment: the Users’ Evaluative Perspective]]> Source:Universal Journal of Public Health  Volume  1  Number  2  

Quynh Lê Stuart Auckland Hoang Boi Nguyen Daniel R Terry and Dustin V.A. Lê 

The quality and usefulness of patient held logbooks as a record to improve communication between healthcare professionals providing cancer care was evaluated. Its aim was to facilitate greater coordination and information sharing between patients, carers, clinicians and other health professionals. A mixed-method exploratory study conducted 12-week post distribution of logbooks to patients undertaking cancer care. Data was gathered through questionnaires returned by 66 participants (response rate of 57.4%) and interviews with five clinical oncology nurses at a Tasmanian hospital. The logbook quality was evaluated against two sets of indicators, including content and layout. The general effectiveness of the patient logbook was also assessed based on its usefulness, usability, efficiency and satisfaction. The logbook was considered useful among 63 (95.1%) participants. They acknowledged the logbook enabled them to be better informed, created a feeling of empowerment and greater control over their medical condition. The logbook was observed to improve communication between clinicians, their patients and families. The evaluation generated rich, in-depth information and provided useful insights into the general quality and usefulness of the logbook for cancer care. The strengths and weaknesses of the logbook were highlighted and how to better utilise its functions in the current medical system.

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Aug 2013
<![CDATA[Screening for Cervical Cancer - Uptake and Associated Factors in a Representative Sample in the City of Patras, West-Greece]]> Source:Universal Journal of Public Health  Volume  1  Number  1  

Eleni Jelastopulu Pania Karnaki Christos Bartsokas Panagiotis Plotas and Aris Sissouras 

The aim of this study is to provide a profile of cervical cancer screening practices among the women in Patras and to assess factors associated with cervical cancer screening uptake. Data from a representative sample of 873 women were analyzed. 67.2% had at least one Pap test in their life, with 54.4% having been tested in the previous three years. Women aged 35-44 and 45-54 years were more likely to have had a recent Pap test (OR>3) as well as married/partnered women (OR=2.4). Unemployed women and women with the lowest educational level were less likely to have had a recent Pap test. Compared to women with a monthly household income of <500€, those with higher income were more likely to have had a Pap test. The prevalence of Pap testing in Patras is very low. Our findings support the necessity of implementation of national screening programs or targeted screening interventions mainly in the identified under-screened population subgroups, i.e. women with socioeconomic disadvantages.

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Jun 2013
<![CDATA[Continuity of Carer in the Public Hospital System in the Eyes of Rural Women and Maternity Health Providers in Tasmania, Australia]]> Source:Universal Journal of Public Health  Volume  1  Number  1  

Ha Hoang Quynh Lê Daniel Terry Sue Kilpatrick and Jacqueline Stuart 

This study investigates Tasmanian maternity health providers’ and rural women’s experiences and views of continuity of care in the public health system and the feasibility of this model is explored. Semi-structured interviews were conducted with 22 women who had childbirth experiences in six rural areas in Tasmania in the past five years. In addition 20 multidisciplinary maternity health providers currently employed by the health care system were also interviewed. Multidisciplinary maternity health providers and rural women believed that continuity of carer would help them build up relationship with each other and contribute to their satisfaction with care. However, both Tasmanian maternity health providers and rural consumers recognised the challenges of providing continuity of carer in the current public health system due to the constraints of human resources. Given the human resource constraints in the public hospital system, women would be happy with the quality of care provided by the team of health professionals.

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Jun 2013
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