A community-based case control study was conducted to identify risk factors of hypertension in Phuttamonthon District, Nakhon Pathom Province, Thailand. The selected case sample comprised of 115 females aged 40 years and over who were diagnosed as hypertensive (Blood Pressure (BP) >140/90 mmHg). The control sample consisted of 109 females in the same age range with normal blood pressure (BP<140/90 mmHg). Data collection was carried out between January 15 and February 14, 2004. A structured questionnaire was used to collect information that was required for the objective determination in this study. The results indicated that the most significant risk factor of hypertension in the study area was obesity (OR = 2.05, 95% CI = 1.62-3.63). It was confirmed that diabetes was also a risk factor of hypertension (OR = 2.42, 95% CI = 1.08-5.43). When obesity and diabetes were combined, the risk of developing hypertension was elevated (OR = 4.10, 95% CI = 1.17-15.72). There was no significant association between hypertension and sodium consumption behavior, salty food consumption (OR = 0.78, 95%CI = 0.44-1.36) and risky eating habit (OR = 1.04, 95%CI = 0.60-1.83).
According to the results, the most prioritized intervention to control hypertension in the study area is body weight modification. Although moderating sodium consumption is becoming the most prioritized nationwide intervention to control blood pressure based on findings of studies mostly conducted in Bangkok, it is not the most effective strategy in the study area. Considering regional differences, it would lead effective results if future interventions can focus on specific areas in which people are having similar patterns of diet and physical exercise, social conventions and culture, in combinations with population-wide approaches as well as with individual-based interventions.
When participating in international disaster relief operations (IDR), medical staff must work under limited human resources and medical equipment. The actual role of a nurse in IDR has not yet been clarified, while the role of a doctor is relatively clear. In this study, we have examined the actual role of nurses in IDR through a survey by questionnaire to 61 medical staff who have worked in past IDR. Full usable responses were received from 50 (82%) of them. These 50 were consisted of 24 doctors, 17 nurses, and 9 medical coordinators. The questionnaire was distributed from September 1 to December 31 in 2005. We investigated 17 activities reported variously in the literature;-setting up temporary medical facilities, inside arrangements, health care of the medical staff, coordination within the team, keeping medical records, performing triage, wound irrigation, debridement, performing incisions, removing stitches, suturing, reception of patients, medical interview of patients, assisting a doctor performing medical examination and treatment, management of commodities, management of medical waste, management of medical records, and conventional nursing care. The questionnaire asked the respondent to indicate a level of appropriate for a nurse to perform each of the activities in IDR. Provided that the nurse had a basic national licence in nursing and IDR education and training, then triage and wound irrigation were each considered appropriate during IDR with a doctor supervising, beyond the conventional nursing role. But suturing, performing incisions, removing stitches, and debridement were each considered to be problematic for nurses.
Introduction: The outbreak of severe acute respiratory syndrome (SARS) began in Guangdong, China in November 2002 and spread to Hong Kong around March 2003. It stopped spreading in July of the same year. However, a sense of crisis toward potential new infections may exist in epidemic areas. “College-prep students” are regarded as a high-risk group as a source of infection because of certain factors, such as the differences in linguistic capabilities and their customs. The purpose of this study was to clarify the knowledge, attitude, and behavior toward SARS, and also to collect the information as baseline data for the control of emerging infectious diseases toward them. Methods: We conducted a self-administered questionnaire to 303 “college-prep students” from June 27 to July13, 2003. For statistical analyses, the chi-square test, t-test and factor analysis were used. Results: The average age of subjects was 22.8 years for males, and 22.6 years for females. The majority of subjects was from China (76.8%, n= 218), and had only stayed in Japan less than one year (70.9%, n= 205). Most subjects were knowledgeable of the symptoms of and preventative measures for SARS. There were no significant differences in knowledge, attitude, and behavior items between students from epidemic areas and those from non-epidemic areas. However, we observed a statistically significant difference in the proportion of subjects in the two groups stratified by information source: radio (p<0.01) and family (p<0.05), where the proportion was higher in epidemic areas than in non-epidemic areas. Three factors were extracted by factor analysis on information sources, which suggested an inverse correlation for language and frequency of communication. Conclusions: This study clarified the knowledge, attitude, and behavior toward SARS for “college-prep students”. These findings must be useful for the control against emerging infectious diseases.
This article presents harm reduction, which was recently developed in response to the expansion of injection drug use and the HIV/AIDS epidemic. The authors describe the essence of harm reduction, proposing that harm reduction is a pragmatic strategy from a public health perspective to deal with injection drug use. Also, how harm reduction complements the traditional strategies to eradicate illicit drug use based on abstinence (so called, War on Drugs, or Just Say NO) is discussed. By describing key principles of harm reduction, such as low-threshold programs, non-judgmental attitudes, priority of immediate goals, and balancing costs and benefits, the authors introduce major harm reduction programs, which include needle/syringe exchange, outreach, counseling and education, supervised injection sites, and substitution treatment. Substantial evidence demonstrates harm reduction is effective in preventing the spread of HIV. Although international bodies, such as UNAIDS and WHO, advocate harm reduction strategies for the better prevention from the spread of HIV/AIDS, and some countries have adopted national harm reduction policies, United States discourages harm reduction policies in fighting the global HIV/AIDS pandemic. Finally, the authors address the effectiveness of harm reduction from the public health perspectives to deal with AIDS epidemic among injection drug users and the necessity of comprehensive understanding and multifaceted application of harm reduction. They also present the need to rethink Japanese government policies and social programs to meet drug users' health needs.
Introduction: The main objective of this study is to clarify the daily life and social support system for the children with cerebral palsy in Vientiane Municipality, Lao P. D. R. Methods: Twenty school-age children with cerebral palsy who need help in most of their activities in daily life, and their families were interviewed in their homes. Data on15 children were suitable for analysis. Two of these 15 children were observed for 5 consecutive days, and their daily activities and interactions with family members and other people were recorded. Results: Few public social welfare services were provided by specialized staff. Family members provided most of the children's care. However, although the children's activities were limited to their homes and immediate surroundings, the children had extensive contact with extended family members and neighbors, including other children. Discussion: The social welfare system in Vientiane Municipality is still underdeveloped. However existing community networks for watching over children offer significant potential for community based care for children with disabilities.