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PubMed2006

Knowledge and perceptions of parents regarding child sexual abuse in Botswana and Swaziland.

This study sought to explore the phenomenon of child sexual abuse by investigating the knowledge and perceptions of parents regarding this problem in Botswana and Swaziland. Although there are no published studies on child sexual abuse in Botswana and Swaziland, literature elsewhere has indicated that child abuse and prostitution prevail in Southern African Development Community countries and that children still continue to be rape victims within and outside the family structure [Muwanigwa, V. (1996). Child Abuse Demands More Preventive Measures. Harare: Zimbabwe. (Southern Africa News Features Southern African Research and Documentation Center)]. In Botswana in 1998, there were 300 cases of child abuse reported, of which 33 were sexual abuse cases. The same year in Swaziland, >50% of child abuse cases were sexual abuse related. In addition, the same year in Swaziland, >50% of sexual abuse case patients reporting for counseling were children younger than 21 years. Respondents of the study included 8 men (1 from Swaziland and 7 from Botswana) and 10 women (3 from Swaziland and 7 from Botswana) who were parents aged between 26 and 70 years; they were determined by way of purposive sampling. A focused interview guide with open-ended questions was used to collect data, and measures to ensure trustworthiness and ethical considerations were adhered to. Analysis of data was facilitated by categorization of themes and concepts and coding systems. The results of the study showed that the respondents acknowledged the prevalence of child sexual abuse in Botswana and Swaziland and further demonstrated their knowledge of the predisposing factors, perpetrators of the problem, and effects of sexual abuse on children. They placed major emphases on community involvement in fighting against the problem; appropriate education of children, parents, families, and community members about child sexual abuse; and improvement on the laws that protect children against sexual abuse to successfully curb the problem.

Adult↗
PubMed2006

Assessment of the health status and risk factors of Kham Tibetan pastoralists in the alpine grasslands of the Tibetan plateau.

The health status of Tibetan herders in the Sanjiangyuan region of the Tibetan Plateau, in southwest Qinghai Province, is assessed in this paper. The field study was conducted in 2002 in the context of a broader community development and research framework, the ultimate goal of which is to achieve an effective region-specific programme of preventative health care and training for Tibetan pastoralists. Specifically, the authors analysed the impact of a number of potentially health-related environmental and lifestyle risk factors on self-reported health indicators, with a special emphasis on mother and child health. Several health status indicators were used, including a general morbidity index and a measurement of functional incapacity due to illness in the sample households. Maternal and child health findings were alarming with high rates of miscarriage and infant loss, with no traditional midwives to assist in pregnancy and delivery. Preventable childhood illnesses were also common. Other debilitating diseases included hepatitis, tuberculosis, arthritis (gout), gall bladder disease, peptic ulcers and back pain. Finally, binary logistic regression analysis showed a significant link between general morbidity and the time it takes to obtain water. The survey findings, validated by the focus groups, indicate a real need for increased accessibility and quality of health service provision to women and men and effective preventative health strategies.

Adolescent↗
PubMed2001

Small scale variability of benthic assemblages: biogenic neighborhood effects.

In this study, patterns of community development were investigated within vs. outside 'habitats'. These habitats represented five different monospecific assemblages of one of the following species: the brown alga Fucus serratus, the red alga Delesseria sanguinea, the green alga Enteromorpha intestinalis, the seagrass Zostera marina and the blue mussel Mytilus edulis. Natural assemblages were allowed to develop on paired artificial substrata-separated by ca. 1 m-within (treatment) vs. outside (control) of habitats. The same colonizer species settled on treatment and control substrata for given habitats. However, after 5 months of settlement and post-settlement dynamics, their proportional abundance and the structure of treatment and control assemblages differed in many instances. Variability among replicates of a given treatment, seperated by up to 50 m, was large, indicating a patchy spatial distribution of organisms. Despite this spatial heterogeneity among within-treatment replicates, analysis of similarity revealed that in most instances significantly different assemblages developed between treatments on a small spatial scale depending on whether substrata were positioned within as compared to outside a given habitat.Consequently, the algae, seagrass or mussels constituting a habitat seem to control the structure of the benthic assemblage developing in their vicinity by one or more possible mechanisms: reduction of larval advection, exudation of metabolites that influence settlement and/or post-settlement survival, and/or-in the case of mussel assemblages-predation on larvae.In addition to spatial variability in larval supply, stochasticity in succession, substratum heterogeneity, competition and predation effects, this investigation reveals the potential of a further assemblage structuring factor: the impact of neighboring organisms.

Journal Article↗
PubMed2003

Water pollution and habitat degradation in the Gulf of Thailand.

The Gulf of Thailand has been a major marine resource for Thai people for a long time. However, recent industrialization and community development have exerted considerable stress on the marine environments and provoked habitat degradation. The following pollution problems in the Gulf have been prioritized and are discussed in details: (1) Untreated municipal and industrial waste water are considered to be the most serious problems of the country due to limited waste water treatment facilities in the area. (2) Eutrophication is an emerging problem in the gulf of Thailand. Fortunately, the major species of phytoplankton that have been reported as the cause of red tide phenomena were non-toxic species such as Noctiluca sp. and Trichodesmium sp. (3) Few problems have been documented from trace metals contamination in the Gulf of Thailand and public health threat from seafood contamination does not appear to be significant yet. (4) Petroleum hydrocarbon residue contamination is not a problem, although a few spills from small oil tankers have been recorded. A rapid decrease in mangrove forest, coral reefs, and fisheries resources due to mismanagement is also discussed.

Animals↗
PubMed2003

Some aspects of toxic contaminants in herbal medicines.

A World Health Organisation survey indicated that about 70-80% of the world populations rely on non-conventional medicine mainly of herbal sources in their primary healthcare. In recent years, we have witnessed the increasing growth in popularity of over-the-counter (OTC) health foods, nutraceuticals, and medicinal products from plants or other natural sources in developed countries. This indirectly indicates that the public is not satisfied with their orthodox medical (OM) treatment. Such increase in popularity has also brought concerns and fears over the professionalism of practitioners, and quality, efficacy and safety of their treatment methods and products from herbal and natural sources available in the market. Over the past decade several news-catching episodes in developed communities indicated adverse effects, sometimes life threatening, allegedly arisen consequential to taking of OTC herbal products or traditional medicines from various ethnic groups. These OTC products may be contaminated with excessive or banned pesticides, microbial contaminants, heavy metals, chemical toxins, and for adulterated with orthodox drugs. Excessive or banned pesticides, heavy metals and microbial contaminants may be related to the source of these herbal materials, if they are grown under contaminated environment or during collection of these plant materials. Chemical toxins may come from unfavourable or wrong storage conditions or chemical treatment due to storage. The presence of orthodox drugs can be related to unprofessional practice of manufacturers. Some of these environment related factors can be controlled by implementing standard operating procedures (SOP) leading to Good Agricultural Practice (GAP), Good Laboratory Practice (GLP), Good Supply Practice (GSP) and Good Manufacturing Practice (GMP) for producing these medicinal products from herbal or natural sources. The public's belief that herbal and natural products are safer than synthetic medicines can only be ascertained by imposing regulatory standards on these products that should be manufactured using these Good Practices. Using Chinese medicines, as examples, this paper illustrate how advances in chemical and biomedical analysis would help to detect intentional and unintentional toxic contaminants in herbal substances. The paper also summarises how modernization and progress are being carried out to get the best out of Chinese medicines for public healthcare.

Consumer Product Safety↗
PubMed1985

Prevalence of diverticular disease, hiatus hernia, and pelvic phleboliths in black and white Americans.

Phleboliths, and especially diverticular disease and hiatus hernia, are rarer in developing countries than in economically more developed communities, but all three conditions were as common in Black as in White Americans. This finding suggests that they are due to environmental rather than to genetic causes. A deficient intake of dietary fibre may be the common factor predisposing to these three conditions.

Black People↗
PubMed2001

Dynamics of the microbial community responsible for traditional sour cassava starch fermentation studied by denaturing gradient gel electrophoresis and quantitative rRNA hybridization.

The microbial community developing during the spontaneous fermentation of sour cassava starch was investigated by cultivation-independent methods. Denaturing gradient gel electrophoresis (DGGE) of partially amplified 16S rDNA followed by sequencing of the most intense bands showed that the dominant organisms were all lactic acid bacteria (LAB), mainly close relatives of Bifidobacterium minimum, Lactococcus lactis, Streptococcus sp., Enterococcus saccharolyticus and Lactobacillus plantarum., Close relatives of Lb. panis, Leuconostoc mesenteroides and Ln. citreum were also found. A complementary analysis using hybridization of 16S rRNA with phylogenetic probes was necessary to detect the presence of the recently discovered species Lb. manihotivorans. Although it represented up to 13% of the total lactic acid bacteria of sour cassava starch, this species could not be detected by DGGE as the PCR product migrated to the same position as Lc. lactis. In addition, it was shown that a strong pH decrease in the time course of fermentation was most probably responsible for the competitive selection of acid-resistant LAB vs. both homo and heterofermentative acid-sensitive LAB.

Acetates↗
PubMed1998

Blood pressure and coronary heart disease in NIDDM subjects at diagnosis: prevalence and risks in a Bangladeshi population.

Overall obesity and central fat distribution are frequently accompanied by hyperglycemia, hypertension (HTN) and coronary heart disease (CHD) observed in developed nations and in South Asian migrants. This study attempts to estimate the prevalence of CHD and HTN and to assess the related risks among the newly diagnosed diabetics in the developing communities. From a total of 3583 non-insulin-dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) subjects, the authors investigated 693 (M = 295, F = 398) randomly selected non-smokers of age 30-60 years. WHO diagnostic criteria were used for NIDDM and IGT. Systolic and diastolic hypertension (sHTN and dHTN) were defined as systolic blood pressure (SBP) > or = 140 and diastolic (DBP) > or = 90 mmHg. Diagnosis of CHD was based on electrocardiogram either on rest or on stress or both when equivocal. The overall prevalence of CHD in the NIDDM subjects was 18.6%. The prevalence rates of sHTN and dHTN were 23.2 and 13.6%, respectively. CHD and HTN did not differ significantly between male and female and between urban and rural subjects. CHD prevalence was significantly higher in the higher tertiles of age, SBP and DBP (P < 0.001, for all cases). Logistic regression showed that only the increasing age, high waist-to-hip ratio (WHR) and high BP were the independent risks for CHD. For sHTN, the independent risks were increased age and high body mass index (BMI) (kg/m2). Regardless of sex and area, increased prevalence of CHD and HTN were found in the newly diagnosed diabetic subjects. Increased age, central obesity and HTN were the independent risks for CHD while advancing age and overall obesity was related to sHTN.

Adult↗
PubMed1998

A holistic approach to the economic evaluation of health programs using institutionalist methodology.

The paper examines possibilities for employing more holistic approaches to the evaluation of health care programs. It is argued that the reductionism of conventional forms of economic evaluation, where value (or benefit) is seen in terms of either health consequences or individuals' utility, can cause a number of aspects of such programs to be overlooked. As such, this imposes fairly strict limits on the capacity of economic evaluation to inform public policy. In contrast, institutionalist economic theory in common with the community development approach to health promotion is an area of research which acknowledges that change to the broader socio-political environment can be a source of value. It is suggested that this idea has, for instance, significance for the evaluation of indigenous health programs where notions of "cultural appropriateness" have strong influence over the effectiveness and acceptability of such programs. It is concluded that no one evaluative approach is appropriate in all situations and that a greater receptiveness to broader sources of social value can help to improve the way evaluations are conducted.

Evaluation Studies as Topic↗
PubMed1998

Medical ethnobotany of the Zapotecs of the Isthmus-Sierra (Oaxaca, Mexico): documentation and assessment of indigenous uses.

The Zapotec inhabitants of the Sierra de Oaxaca foothills (Mexico) live in an area of great botanic diversity. In daily subsistence and in response to illness, plants play a major role. An inventory of the Zapotec medicinal ethnobotany was carried out during 17 months of fieldwork. A total of 3611 individual responses concerning medicinal and non-medicinal uses for 445 different species of plants were documented. For the subsequent semi-quantitative analysis of data, the uses were grouped into ten categories and the responses for each species were summed up in each of these ten groups to yield rank-ordered lists. For the high rank-ordered and, hence, culturally important species, an assessment of the therapeutic potential was conducted using ethnobotanical, phytochemical and pharmacological data in the literature. Studies confirming the attributed properties or a scientific explanation of therapeutic use, as well as toxicological data, are still lacking for many of these species. The quantitative approach described will be the basis for future studies on the pharmacology and phytochemistry of Zapotec medicinal species. Finally, these data should also serve as a basis for biodiversity conservation and community development.

Ethnobotany↗
PubMed2002

Microbiology: breaking down biofilms.

Biofilms--adherent bacterial communities embedded in a polymer matrix--are common in nature and can cause persistent human infections that are highly resistant to antibiotics. Recent work provides insight into how these communities develop and function, and offers clues to combating them.

Bacteria↗
PubMed1997

Social aspects of AIDS-related stigma in rural Uganda.

In the process of collecting sexual behaviour data through in-depth interviews, 24 respondents offered information on stigma related to HIV-1 infection. Observations of social relations in public places and families of infected individuals were made. The findings suggest that although HIV/AIDS-related stigma has had adverse effects on treatment seeking behaviour of PWAs and coping mechanisms of their families, a more tolerant attitude is starting to emerge in this area. Probably, due to improvements in counselling services and home care schemes for those with AIDS. This supports the call for increased investments in counselling and community development aimed at caring for people with AIDS (PWAs).

Acquired Immunodeficiency Syndrome↗
PubMed2006

Impact of maternal age on birth outcomes: a population-based study of primiparous Brazilian women in the city of São Paulo.

The aim of this study is to analyse the impact of maternal age at first birth on low birth weight, preterm birth and low Apgar scores at one minute and at five minutes among live births delivered to primiparous Brazilian women in the city of São Paulo. Analyses were based on 73,820 birth records from the 1998 birth cohort. Logistic regression was used to assess the association between maternal age and each outcome variable, controlling for the following risk factors: delivery mode, plurality, sex, maternal education, number of prior losses, prenatal care, race, parity and community development. Maternal ages below 20 and above 30 years were significantly associated with the risks of low birth weight and preterm birth, but no association was found between maternal ages and Apgar score, with the exception that ages 15-19 reduced the odds of a low one-minute score. Even though this result seems to be inconsistent, low birth weight, preterm birth and low Apgar scores measure different dimensions of newborn well-being, and the association of each measure with maternal age is expected to diverge.

Adolescent↗
PubMed2006

Child immunization in Vietnam: situation and barriers to coverage.

This paper addresses the overall performance and inequalities in the immunization of children in Vietnam. Descriptive and logistic analysis of cross-national demographic and health data was used to examine inequality in immunization, identify the most vulnerable groups in immunization coverage, and identify the gap in coverage between hard-to-access people and the remainder of the population. The gap in the coverage was found to occur primarily in vulnerable groups such as the poor minority or poor rural children. No evidence was found of a difference in immunization coverage because of sex or birth order. However, the age of children showed a significant influence on the rate of immunization. Mother's education and regular watching of television had a significant influence on child immunization. In order to improve child immunization coverage in Vietnam, efforts should be concentrated on poor children from minority groups and those living in rural areas, especially remote ones. Community development, investment for immunization and re-organization of immunization services at the grassroots level are also key factors to remove the barriers to immunization for vulnerable populations in Vietnam.

Child↗
PubMed1999

Proteinuria is associated with persistence of antibody to streptococcal M protein in Aboriginal Australians.

Aboriginal communities in Northern Australia with high rates of group A streptococcal (GAS) skin infection in childhood also have high rates of renal failure in adult life. In a cross-sectional study of one such high risk community, albuminuria was used as a marker of renal disease. The prevalence of albuminuria increased from 0/52 in subjects aged 10-19 years to 10/29 (32.9%) in those aged 50 or more (P < 0.001). Antibodies to streptococcal M protein, markers of past GAS infection, were present in 48/52 (92%) at ages 10-19 years, 16/32 (50%) at ages 30-39, and 20/29 (69%) in those aged 50 or more. After allowing for the age-dependencies of albuminuria and of M protein antibodies (P < 0.001) albuminuria was significantly associated with M protein antibodies (P < 0.01). Thus, 72% of adults aged 30 or more with M protein antibodies also had albuminuria, compared with only 21% of those who were seronegative. More detailed modelling suggested that although most Aboriginal people in this community developed M protein antibodies following GAS infection in childhood, the development of proteinuria was associated with the persistence of such seropositivity into adult life. The models predicted that proteinuria developed at a mean age of 30 years in seropositive persons, at 45 years in seronegative persons who were overweight, and at 62 years in seronegative persons of normal weight. We demonstrated a clear association between evidence of childhood GAS infection and individual risk of proteinuria in adult life. This study provided a strong rationale for prevention of renal disease through the more effective control of GAS skin infections in childhood and through the prevention of obesity in adult life.

Adolescent↗
PubMedDate not supplied

Computerized hospital on-line resources allocation link (CHORAL): a mechanism to monitor and establish policy for hospital ambulance diversions.

Ongoing monitoring of the availability of hospital critical care resources is necessary to assure patients in the emergency medical services (EMS) system reach appropriate care. In this densely populated area Multnomah County, Oregon, ambulances have been diverted by radio from several hospitals before finding one that would accept the patient. Dispatch centers and base-stations had no reliable method to monitor the availability of hospital resources. Data were not available for use in establishing policy. In response, this community developed an on-line, computerized system known as Computerized Hospital On-Line Resources Allocation Link (CHORAL) that visually displays the resource status of all hospitals to the 911 center, base station, and participating hospitals. A change of status requires simple keystrokes for entry into the computer which in turn transmitted automatically to all other CHORAL computers. Six patient care resources are monitored: Adult Ward (AW); Computerized Axial Tomography Scan (CT); Critical Care (CC); Labor and Delivery (LD); Pediatric (PEDS); and Psychiatric Secure Beds (PSB). Paramedics use protocol to determine if a particular patient fits one of these categories. Availability is relayed to paramedics by the 911 center and the base-station. During the first three months of system operation, there were 337 diversions representing 4,527 hours among 10 of the 12 participating hospitals. The most common resource resulting in diversion was PSB, which was unavailable for 2,195 hours (48.5%). Unavailability of CT resulted in the lowest number of diversions (1.3%, 60.3 hours).(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulances↗
PubMedDate not supplied

Lessons in emergency evacuation from the Miamisburg train derailment.

Hazardous materials incidents result from the release of materials considered to be harmful or potentially harmful to human beings or the environment. This article describes a train derailment and subsequent hazardous materials release with the evacuation of approximately 50,000 citizens. The hazardous materials release took five days to control and resulted in 561 patient visits to local emergency departments for symptoms related to chemical exposure. The evacuation and emergency medical operations are described and serve as a model for developing community emergency preparedness plans and managing victims involved in hazardous materials incidents.

Accidents↗
PubMed1999

Face and contents validity, and feasibility of Healthometer: a Delphi study.

Our recent descriptive report in this journal of "Healthometer", an interactive instrument for self-mediated health counseling, was well received in the medical systems research and development community. Suitable for paper as well as electronic mediation and covering both screening, processing/storage, and advisory tasks in a positively reinforcing and confidential way, it has on the whole been considered to be an interesting model in the advancing "information society technologies" perspective; however, a closer scientific and operative evaluation is warranted. Because the power of the instrument in addition to the hardware is critically dependent upon the wet- and software quality, the present study aims at examining in the same forefront forum some basic aspects of all these modalities, with emphasis on face and content validity, feasibility, and users' attitudes and opinions. It can be summarized, quite briefly, that all of them were satisfactory.

Attitude to Health↗