National model adolescent suicide prevention project.

The process evaluation of the National Model Adolescent Suicide Prevention Project has two central purposes; 1) to document and describe the processes by which the project was implemented and operated; and 2) to identify the methods used to implement the project that seem to be most effective for prevention and that have the greatest impact on measure of outcome. The National Model Adolescent Suicide Prevention Project is a community systems model implemented in 1990. It was anticipated that the suicide rate for the entire Jicarilla community, not just the adolescent target group, would decline as a result of the project. Since the implementation of the project, suicide rates have in fact declined for all age groups in the Jicarilla Apache community

Alcohol consumption among adult males in urban area of Thanlyin Township, Yangon Region, Myanmar

Background: Alcohol consumption is a major cause of morbidity and mortality worldwide. It is frequently related to health and behavioural problems as well as socio-economic hardship. Therefore, this study was conducted to determine the prevalence and risk factors of alcohol consumption among adult males residing in urban area of Thanlyin Township, Yangon Region.Methods: A cross-sectional study was conducted among 380 adult males. Multi-stage random sampling was applied. Data entry and analysis was done using Stata 11.0 statistical package.Results: The prevalence of current alcohol drinking, ex-drinking and never drinking were 20.5%, 9.0% and 70.5%, respectively. There was a significant decreasing trend of alcohol consumption across the levels of age-group. Age, education status and practicing other health-risk behaviours such as smoking and betel chewing were detected as significant risk factors of alcohol consumption. Ever smokers and ever betel chewers were about 4 times more likely to be ever alcohol user compared to their counterparts even if age and education level were adjusted. By controlling smoking and betel chewing habits, 79.2% and 76.6% of existing prevalence of alcohol consumption among respondents would be reduced, respectively.Conclusions: There is an urgent need to curb the habit of alcohol consumption among adult males living in urban area, especially young adults. Alcohol and tobacco control policies in Myanmar should be strengthened or reinforced. Tobacco control program also needs to be intensified. Health education and health promotion activities should be enhanced in order to reduce alcohol consumption in the country.

Comparison of baseline drinking practices, knowledge, and attitudes of adult s residing in communities taking part in the FAS prevention study in South Africa

Foetal Alcohol Syndrome (FAS) has been identified as among the most serious consequences associated with hazardous and harmful drinking in the Western Cape province, South Africa. Community surveys were conducted in two wine growing regions in this province to assess drinking behaviour, guide interventions and serve as a baseline for assessing the impact of population-level interventions. As part of a cross-sectional comparative study interviews were conducted with 384 and 209 randomly selected adults in the prevention (PC) and comparison communities (CC) respectively. Over 80% of respondents resided in urban areas, except inthe CC, where 61% of males resided on farms. Symptoms of hazardous or harmful drinking were reported by 16.0% of females and 32.5% of males in the PC, while 19.3% of females and 56.2% of males in the CC reported such drinking. Over two-thirds of respondents indicated that it was equally harmful for a woman to drink during any of the trimesters of pregnancy, but more than 30% of the women interviewed had never had a health worker speak to them about the effects of drinking during pregnancy. Over 10% had never heard of fetal alcohol syndrome. The findings reinforce the need for interventions to address hazardous/harmful use of alcohol inboth communities and also to address gaps in knowledge regarding the effects of drinking during pregnancy.Key Words: Alcohol, epidemiology, pregnancy, South Afric

A comprehensive mental health care system for Native Americans in New Mexico. A report of the Native American Mental Health Planning Project.

This is a comprehensive report of a seven-month study contracted through the State Division of Mental Health to the University of New Mexico, Department of Psychiatry/Center on Alcoholism, Substance Abuse and Addictions (CASAA). A select committee of representatives from New Mexico tribes, appropriate state and federal agencies, private entities, and consumers provided input for the project. The final plan is based on the collection and triangulation of a variety of sources. The primary sources utilized in this document included: 1) literature review; 2) indirect measure of the magnitude of alcohol, drug abuse, and mental health needs using selected measures from current census data; 3) extensive survey of current agencies providing services; 4) clinical programming survey to select from optional mental health care delivery system models and a prioritization of services needed; 5) ideas, visions, suggestions and recommendations of selected committees; and 6) private interviews and focus group discussions with tribal members, service workers, and tribal leaders. The plan provides information on: 1) epidemiology of mental health problems; 2) programmatic issues for mental health services; 3) needs assessment studies and findings; 4) system and program design; 5) program development and management; 6) physical plant requirements; 7) management information system; and 8) ten-year implementation process. Based on the findings of this planning effort, a system of comprehensive mental health care for American Indians was proposed. This continuum of care extends from the tribal communities, to regional centers of care, and to a centralized facility

Foot pain and foot health in an educated population of adults: results from the Glasgow Caledonian University Alumni Foot Health Survey

Abstract Background Foot pain is common amongst the general population and impacts negatively on physical function and quality of life. Associations between personal health characteristics, lifestyle/behaviour factors and foot pain have been studied; however, the role of wider determinants of health on foot pain have received relatively little attention. Objectives of this study are i) to describe foot pain and foot health characteristics in an educated population of adults; ii) to explore associations between moderate-to-severe foot pain and a variety of factors including gender, age, medical conditions/co-morbidity/multi-morbidity, key indicators of general health, foot pathologies, and social determinants of health; and iii) to evaluate associations between moderate-to-severe foot pain and foot function, foot health and health-related quality-of-life. Methods Between February and March 2018, Glasgow Caledonian University Alumni with a working email address were invited to participate in the cross-sectional electronic survey (anonymously) by email via the Glasgow Caledonian University Alumni Office. The survey was constructed using the REDCap secure web online survey application and sought information on presence/absence of moderate-to-severe foot pain, patient characteristics (age, body mass index, socioeconomic status, occupation class, comorbidities, and foot pathologies). Prevalence data were expressed as absolute frequencies and percentages. Multivariate logistic and linear regressions were undertaken to identify associations 1) between independent variables and moderate-to-severe foot pain, and 2) between moderate-to-severe foot pain and foot function, foot health and health-related quality of life. Results Of 50,228 invitations distributed, there were 7707 unique views and 593 valid completions (median age [inter-quartile range] 42 [31–52], 67.3% female) of the survey (7.7% response rate). The sample was comprised predominantly of white Scottish/British (89.4%) working age adults (95%), the majority of whom were overweight or obese (57.9%), and in either full-time or part-time employment (82.5%) as professionals (72.5%). Over two-thirds (68.5%) of the sample were classified in the highest 6 deciles (most affluent) of social deprivation. Moderate-to-severe foot pain affected 236/593 respondents (39.8%). High body mass index, presence of bunions, back pain, rheumatoid arthritis, hip pain and lower occupation class were included in the final multivariate model and all were significantly and independently associated with moderate-to-severe foot pain (p < 0.05), except for rheumatoid arthritis (p = 0.057). Moderate-to-severe foot pain was significantly and independently associated lower foot function, foot health and health-related quality of life scores following adjustment for age, gender and body mass index (p < 0.05). Conclusions Moderate-to-severe foot pain was highly prevalent in a university-educated population and was independently associated with female gender, high body mass index, bunions, back pain, hip pain and lower occupational class. Presence of moderate-to-severe foot pain was associated with worse scores for foot function, foot health and health-related quality-of-life. Education attainment does not appear to be protective against moderate-to-severe foot pain

A simple cost-effective high performance liquid chromatographic assay of sulphadoxine in whole blood spotted on filter paper for field studies

<p>Abstract</p> <p>Background</p> <p>Artesunate plus sulphadoxine-pyrimethamine is one of the four artemisinin-based combination therapies currently recommended by WHO as first-line treatment for falciparum malaria. Sulphadoxine-pyrimethamine is also used for intermittent preventive treatment for malaria in pregnancy. Drug use patterns and drug pharmacokinetics are important factors impacting the spread of drug resistant parasites hence it is imperative to monitor the effect of pharmacokinetic variability on therapeutic efficacy. Unfortunately, information on the pharmacokinetics of sulphadoxine in children and pregnant women with malaria is very limited. Methods for the assay of sulphadoxine-pyrimethamine have been previously reported, but they are not cost-effective and practicable in analytical laboratories in low resource areas where malaria is endemic. Efforts in this study were thus devoted to development and evaluation of a simple, cost-effective and sensitive method for quantification of sulphadoxine in small capillary samples of whole blood dried on filter paper.</p> <p>Methods</p> <p>Sulphadoxine was determined in whole blood by reversed-phase high performance liquid chromatography with UV detection at 340 nm. Sulisoxazole (SLX) was used as internal standard. Chromatographic separation was achieved using a Beckman Coulter ODS C₁₈and a mobile phase consisting of 0.05 M phosphate buffer-methanol-acetonitrile (70:17:13 V/V/V) containing 1% triethylamine solution.</p> <p>Results</p> <p>Standard curves from sulphadoxine-spiked blood added to filter paper were linear over the concentration range studied. Linear regression analysis yielded correlation coefficient r²> 0.99 (n = 6). Extraction recoveries were about 82-85%. The limit of quantification was 120 ng/ml while the within and between assay coefficient of variations were < 10%. The inter-day precision was < 5.8% and inter-day accuracy ranged from 4.1 to 5.3%. There was no interference from endogenous compounds or any of the commonly used anti-malarial, analgesic and anti-infective drugs with the peaks of SDX or the internal standard.</p> <p>Conclusion</p> <p>The recovery and accuracy of determination of SDX from whole blood filter paper samples using the method described in this study is satisfactory, thus making the method a valuable tool in epidemiological studies and therapeutic drug monitoring in developing endemic countries. Furthermore, the applicability of the method in studying the pharmacokinetic disposition of SDX in a patient suggests that the method is suitable in malaria endemic areas.</p