Travel, sexual behaviour, and the risk of contracting sexually transmitted diseases

This study investigates sexual behaviour and the risk of contracting sexually transmitted diseases among travellers departing from Hong Kong, with an aim supporting the design of local intervention in continuing health promotion. Travellers were interviewed by five trained multilingual interviewers in the departure lounge at Kai Tak International Airport, Hong Kong, between May and June 1996, by using a structured, pretested questionnaire. Forty-four percent (168/383) of the respondents who travelled at least once within the previous year had had sex with strangers during their travel and 37% (139/376) of the respondents reportedly do not use condoms during sexual intercourse. Middle-aged and married travellers were more likely to be in the high-risk group. These findings reflect the urgent need to target travellers in any strategy that is designed to prevent the spread of sexually transmitted diseases in Hong Kong and Asia Pacific region.published_or_final_versio

Predictors of smoking cessation among Chinese parents of young children followed up for 6 months

Health Services Research Fund & Health Care and Promotion Fund: Research Dissemination Reports (Series 2)published_or_final_versio

Effectiveness of smoking reduction intervention for hardcore smokers

© 2015 Lam et al.; licensee BioMed Central.Background: The prevalence and correlates of hardcore smokers, who have high daily cigarette consumption, no quitting history and no intention to quit, have been studied in several western developed countries, but no previous trials of smoking cessation have tested intervention effectiveness for these smokers. The current study examined if hardcore smokers can benefit from smoking reduction intervention to achieve cessation, and explored the underlying reasons. Methods: A posteriori analysis was conducted on data from a randomized controlled trial of smoking reduction intervention on 1,154 smokers who did not want to quit. Odds ratios of 7-day point prevalence of abstinence, smoking reduction by at least 50% and quit attempt at the 6-month follow-up comparing subgroups of smokers were analyzed. Results: In hardcore smokers, the odds ratio comparing the quit rate between the intervention and control group was 4.18 (95% CI: 0.51-34.65), which was greater than non-hardcore smokers (OR = 1.58, 95% CI: 0.98-2.54). The number needed to treat for hardcore and non-hardcore smokers was 8.33 (95% CI: 5.56-16.67) and 16.67 (95% CI: 8.33-233.64), respectively. In smokers who did not have quit attempt experience and those who smoked more than 15 cigarettes daily, the odds ratio comparing intervention and control group was 3.29 (95% CI: 0.72-14.98) and 1.36 (95% CI: 0.78-2.36), respectively. Conclusions: The a posteriori analysis provided pilot results that smoking reduction intervention may be effective to help hardcore smokers to quit and reduce smoking. Having no previous quit attempt was identified as more important than having large cigarette consumption in explaining the greater effectiveness of the intervention.published_or_final_versio

Smoking reduction intervention for smokers not willing to quit smoking: a randomised controlled trial

Key Messages 1. This smoking reduction study examined the effectiveness of smoking reduction counselling together with free nicotine replacement therapy (NRT) for smoking cessation and tested the effectiveness of brief counselling on adherence to NRT among Chinese smokers who were not willing to quit but intended to reduce cigarette consumption. 2. The smoking reduction intervention was effective in helping the unmotivated smokers in quitting (intervention: 17.0% vs control: 10.2%, P=0.012) and in reducing their daily cigarette consumption by 50% or more (intervention: 50.9% vs control: 25.7%, P<0.001) at 6-month follow-up. 3. Our results provided evidence for the effectiveness of smoking reduction intervention, which is important for planning smoking cessation services. 4. Free NRT was widely accepted by participants (8-week NRT adherence rate: 54.5%). Free NRT together with smoking reduction counselling was a feasible and cost-effective approach to help unmotivated smokers to reduce and quit smoking, especially in developing countries like China where NRT is expensive and not used extensively. 5. The motivation to quit smoking was not undermined by smoking reduction intervention. To the contrary, offering assistance to reduce smoking could attract smokers who were not willing or ready to quit.published_or_final_versio

Cause and analysis of cost of living allowance fluctuation in Yokosuka, Japan

In June 1995, an unexpected decrease in COLA index on the Kanto Plain of Japan, to include the Yokosuka area, caused concern amongst service members stationed in this area. The purchasing power of the dollar was in decline when compared to the yen and all other economic indicators at the time of the COLA decrease suggested that the COLA index should have increased or at least remained constant. What explains the apparent inconsistency between the declining value of the dollar relative to the yen and the concurrent decrease in COLA provided to service members? This thesis conducted a critical analysis of the procedures and methods used by the Per Diem, Travel and Transportation Allowance Commiflee (PDTATAC) to calculate the cost of living allowance (COLA) index and determine the cause and effect of the June 1995 decrease in COLA index. This thesis addressed the policies of the COLA system, utilizing both historical data and a stylized model, to determine if they are equitable from an economic standpoint. The analysis revealed that the Living Pattern Survey (LPS) was a viable tool to obtain information on where service members made purchases, if exchange rates were stable. If exchange rates were increasing, the LPS prevented overpayment of service members. If exchange rates were declining, the LPS reduced the 'purchasing power' of service membershttp://archive.org/details/causeanalysisofc00woodLieutenant, United States NavyApproved for public release; distribution is unlimited

Midwife-led birthing centre in the humanitarian setup: An experience from the Rohingya camp, Bangladesh.

In Bangladesh, Midwife Led Birthing Centres (MLBCs) have been established to provide midwifery care and sexual and reproductive health services for the displaced Rohingya population in Cox's Bazar. The aim of this study was to explore MLBCs in this humanitarian context from the perspectives of women, midwives, and other key stakeholders. A mixed-method case study was conducted at one of the MLBCs within the Rohingya refugee camps in Cox's Bazar. The MLBC serves a population of approximately 8,500 people. Quantitative data were collected from the medical records and documents of the MLBC. Qualitative data included two key informant interviews (KIIs) with policy makers, one focus group discussion (FGD) with 7 midwives and ten in-depth interviews (IDIs) with Rohingya women who gave birth in this MLBC. Thematic analysis of qualitative data was performed. In 2022, 267 women gave birth at the MLBC, and 70 women with complications were transferred to higher-level facilities. Women chose the MLBC because of the respectful care provided by kind and skillful midwives, and the high-quality services. The MLBC was often recommended by community volunteers and relatives. Midwives provided a range of health services including antenatal, labour and birth, postnatal, family planning, mental health support and gender-based violence services. Challenges included language barriers, difficulty obtaining transport from home and back particularly at night in remote areas, security fears and weak cell phone coverage that affected communication for referral and follow-up. Recommendations included increased support and security staff, establishing a referral hospital nearer to the camp, refresher training for midwives and monitoring, and mentoring to improve service quality. The MLBC in the Rohingya camp shows that respectful midwifery care including management and referral of obstetric complications with wider sexual and reproductive health services can be provided in a humanitarian setting to optimize maternal and neonatal health outcomes

Effect of an Enhanced Self-Care Protocol on Lymphedema Status among People affected by Moderate to Severe Lower-Limb Lymphedema in Bangladesh, a Cluster Randomized Controlled Trial

Background: Lymphatic filariasis (LF) is a major cause of lymphedema, affecting over 16 million people globally. A daily, hygiene-centered self-care protocol is recommended and effective in reducing acute attacks caused by secondary infections. It may also reverse lymphedema status in early stages, but less so as lymphedema advances. Lymphatic stimulating activities such as self-massage and deep-breathing have proven beneficial for cancer-related lymphedema, but have not been tested in LF-settings. Therefore, an enhanced self-care protocol was trialed among people affected by moderate to severe LF-related lymphedema in northern Bangladesh. Methods: Cluster randomization was used to allocate participants to either standard- or enhanced-self-care groups. Lymphedema status was determined by lymphedema stage, mid-calf circumference, and mid-calf tissue compressibility. Results: There were 71 patients in each group and at 24 weeks, both groups had experienced significant improvement in lymphedema status and reduction in acute attacks. There was a significant and clinically relevant between-group difference in mid-calf tissue compressibility with the biggest change observed on legs affected by severe lymphedema in the enhanced self-care group (∆ 21.5%, −0.68 (−0.91, −0.45), p < 0.001). Conclusion: This study offers the first evidence for including lymphatic stimulating activities in recommended self-care for people affected by moderate and severe LF-related lymphedem

Infrared Thermal Imaging as a Novel Non-Invasive Point-Of-Care Tool to Assess Filarial Lymphoedema

Lymphatic filariasis causes disfiguring and disabling lymphoedema, which is commonly and frequently exacerbated by acute dermatolymphangioadenitis (ADLA). Affected people require long‐term care and monitoring but health workers lack objective assessment tools. We examine the use of an infrared thermal imaging camera as a novel non‐invasive point‐of‐care tool for filarial lower‐limb lymphoedema in 153 affected adults from a highly endemic area of Bangladesh. Tem‐perature differences by lymphoedema stage (mild, moderate, severe) and ADLA history were vis‐ualised and quantified using descriptive statistics and regression models. Temperatures were found to increase by severity and captured subclinical differences between no lymphoedema and mild lymphoedema, and differences between moderate and severe stages. Toes and ankle temperatures detected significant differences between all stages other than between mild and moderate stages. Significantly higher temperatures, best captured by heel and calf measures, were found in partici‐pants with a history of ADLA, compared to participants who never had ADLA, regardless of the lymphoedema stage. This novel tool has great potential to be used by health workers to detect sub‐clinical cases, predict progression of disease and ADLA status, and monitor pathological tissue changes and stage severity following enhanced care packages or other interventions in people af‐fected by lymphoedema

Cigarette smokers' intention to quit smoking in Dire Dawa town Ethiopia: an assessment using the Transtheoretical Model

<p>Abstract</p> <p>Background</p> <p>Cessation of smoking reduces morbidity and mortality related to tobacco smoking. It is essential to explore the intention of individuals to quit smoking to design effective interventions. The objective of this study was to assess cigarette smokers' intention to quit smoking in Dire Dawa town using the Transtheoretical model.</p> <p>Methods</p> <p>From February 15 to 19, 2009, we conducted a community based cross-sectional study among 384 current cigarette smokers in Dire Dawa town east Ethiopia. Data was collected by trained personnel using a pretested structured questionnaire. The data was analyzed using SPSS version 16.0.</p> <p>Results</p> <p>Two hundred and nineteen (57%) smokers in the study area had the intention to quit cigarette smoking within the next six months and all the process of change had an increasing trend across the stages. Based on the Fragestrom test of nicotine dependence of cigarette, 35 (9.1%), 69 (18%) and 48(12.5%) were very high, high and medium dependent on nicotine respectively. For the majority 247(64.3%) of the respondents, the mean score of cons of smoking outweighs the pros score (negative decisional balance). Only 66(17.2%) had high self efficacy not to smoke in places and situations that can aggravate smoking.</p> <p>Conclusions</p> <p>Majority of the smokers had the intention to quit smoking. All the process of change had an increasing trend across the stages. Those who had no intention to quit smoking had high level of dependence on nicotine and low self efficacy. The pros of smoking were decreasing while the cons were increasing across the stages. Stage based interventions should be done to move the smokers from their current stage to an advanced stages of quitting cigarette smoking.</p