OBJECTIVEBy means of Delphi method and expert panel consultations, to choose suitable indicators and improve the score table for classifying the hygienic condition of hotels so that it can be widely used at nationwide.

METHODSA two-round Delphi consultation was held to choose suitable indicators among 78 experts from 18 provinces, municipalities and autonomous regions. The suitable indicators were selected according to the importance recognized by experts.

RESULTSThe average length of service in public health of the experts was (21.08 +/- 5.78) years and the average coefficient of experts' authorities C(r) was 0.89 +/- 0.07. The response rates of the two-round consultation were 98.72% (77/78) and 100.00% (77/77). The average feedback time were (8.49 +/- 4.48) d, (5.86 +/- 2.28) d, and the difference between two rounds was statistically significant (t = 4.60, P < 0.01). Kendall's coefficient were 0.26 (chi(2) = 723.63, P < 0.01), 0.32 (chi(2) = 635.65, P < 0.01) and opinions among experts became consistent. The score table for the hygienic quantifying and classification of hotels was composed of three first-class indicators (hygienic management, hygienic facilities and hygienic practices) and 36 second-class indicators. The weight coefficients of the three first-class indicators were 0.35, 0.34, 0.31.

CONCLUSIONDelphi method might be used in a large-scale consultation among experts and be propitious to improve the score table for the hygienic quantifying and classification.

Delphi Technique ; Housing ; classification ; standards ; Hygiene ; Outcome Assessment (Health Care) ; Public Health Administration ; methods

OBJECTIVETo investigate thirdhand smoke (THS) pollution in certain places of Nanjing, as well as to analyze its distribution characteristics.

METHODSFrom March to May, 2014, we selected 3 types of places (residencies, public places and transportation vehicles) that were close to people's living in Jianye,Yuhua,Jiangning,Xuanwu,Gulou and Pukou districts of Nanjing city.For each of the above 3 types of places, 2-3 smoking and non-smoking (smoking ban) locations were investigated, totally 51 locations, 9-10 samples were collected each location, totally 477 samples. The surface wipe sampling method in conjunction with liquid chromatography-tandem mass spectrometry (LC-MS/MS) was utilized to quantify the levels of nicotine that served as the tracer of THS pollution.One-way ANOVA and t-tests were employed to compare the levels of nicotine collected at different places and locations.

RESULTSTotally 477 samples were collected in this study, of which 27.0% was from residencies (129/477), 61.0% (291/477) from public places and 11.9% (57/477) from transportations. The levels of indoor surface nicotine in smoking residences, public places and transportations were (214 ± 55),(1 408 ± 177) and (1 511 ± 785) µg/m(2), respectively, which were all higher than those in the corresponding non-smoking places ((23 ± 9),(62 ± 11), and (46 ± 15) µg/m(2); t values were 13.79, 13.15, 3.45, respectively. P values were <0.001, <0.001 and 0.006, respectively).In the smoking places, the levels of surface nicotine on walls, desks, sofas, cabinets, door backsides and air conditioning openings were (171 ± 62),(232 ± 38),(373 ± 151),(903 ± 239), (978 ± 212), (1 721 ± 517) µg/m(2) (F = 7.06, P = 0.009).In the smoking condition, the levels of surface nicotine collected from public places were higher (F = 9.25, P = 0.024), while under non-smoking (smoking ban) conditions, the levels of surface nicotine collected from residences were lower (F = 7.88, P < 0.001).

CONCLUSIONTHS pollution was widespread in public places, residences and transportations in Nanjing city, which was more serious in the smoking environments than non-smoking (smoking ban) environments; the contamination was less serious in non-smoking (smoking ban) private residences; in the smoking condition, the levels of surface nicotine were relatively high at locations close to air conditioning openings, door backsides and cabinets.

Air Conditioning ; China ; Housing ; Humans ; Nicotine ; Public Facilities ; Smoking ; Tandem Mass Spectrometry ; Tobacco Smoke Pollution ; Transportation

BACKGROUND: Homelessness is associated with an increased risk of exposure to Mycobacterium tuberculosis. Several factors, including alcoholism, malnutrition, lack of stable housing, combine to make tuberculosis more prevalent in the homeless. The aims of this study were to determine the factors associated with increasing success rate of tuberculosis treatment in the homeless. METHODS: A cross-sectional analysis of the clinical features in 142 pulmonary tuberculosis-positive homeless patients admitted to the Busan Medical Center from January 2001 to December 2010 was carried out. These results were compared with a successful treatment group and incomplete treatment group. We also evaluated the risk factors of treatment non-completion. Statistical analysis for the comparisons was performed using a chi2 test, independent samples t-test, and multiple logistic regression. RESULTS: Comparison of clinical characteristics showed significant differences between the two groups in the type of residence (P < 0.001), diseases with risk factors (P = 0.003), and history of tuberculosis treatment (P = 0.009). Multiple regression analysis revealed the residence (odds ratio [OR], 4.77; 95% confidence interval [CI], 2.05 to 11.10; P < 0.001) and comorbidity with risk factor (OR, 2.72; 95% CI, 1.13 to 6.53; P = 0.025) to be independently associated with treatment success. CONCLUSION: To improve the success rate of tuberculosis treatment in the homeless person, anti tuberculosis medication should be taken until the end of treatment and a management system for the homeless person is required. Further social and medical concerns for stable housing and management of comorbidity may lead to an improvement in the successful tuberculosis treatment of homeless person.
Alcoholism ; Comorbidity ; Cross-Sectional Studies ; Homeless Persons ; Hospitals, Public ; Housing ; Humans ; Malnutrition ; Mycobacterium tuberculosis ; Risk Factors ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: This study was to investigate the needs of health & community services among the disabled at home in rural areas. METHODS: The subjects were 146 persons with disabilities living in J-gun. The questionnaire was based on the needs of 8 categorical services. Data were analyzed using frequency, percentage, mean, standard deviation, minimum, maximum, t-test, one-way ANOVA and Scheffe test. RESULTS: Among the respondents, 27.4% visited the public health center in community for rehabilitation therapy. The average score of need was 2.62+/-.79: education services (2.92+/-1.05); medical services (2.81+/-.82); nursing care services (2.75+/-1.08); connection services (2.62+/-1.20); housing services (2.60+/-1.09); emotional services (2.41+/-1.03); other services (2.24+/-1.06); and support of self-sustenance service (1.92+/-1.15). The items in highest need were medical checkup (70.7%), medication (62.1%), traditional oriental therapy (60.4%) and physical therapy (58.9%), and those of lowest need were device repair (8.7%) and guidance of facility admission (7.1%). Needs were significantly different according to age (F=4.751, p=.001), employment status (t=2.108, p=.037) and medical fee payer (F=5.061, p=.002). CONCLUSION: The needs of education & medical services were relatively high. Demographic factors were statistically significant in determining needs. For the disabled at home in rural areas, more various services or programs should be executed based upon the needs and characteristics of based upon the needs and characteristics of the subjects.
Surveys and Questionnaires ; Demography ; Disabled Persons ; Education ; Employment ; Fees, Medical ; Health Services ; Housing ; Humans ; Nursing Care ; Public Health ; Rehabilitation ; Social Welfare*

OBJECTIVES: Malaria remains a public health concern worldwide, including Indonesia. Purworejo is a district in which endemic of malaria, they have re-setup to entering malaria elimination in 2021. Accordingly, actions must be taken to accelerate and guaranty that the goal will reach based on an understanding of the risk factors for malaria. Thus, we analysed malaria risk factors based on human and housing conditions in Kaligesing, Purworejo, Indonesia. METHODS: A case-control study was carried out in Kaligesing subdistrict, Purworejo, Indonesia in July to August 2017. A structured questionnaire and checklist were used to collect data from 96 participants, who consisted of 48 controls and 48 cases. Univariate, bivariate, and multivariate analyses were performed. RESULTS: Bivariate analysis found that education level, the presence of a cattle cage within 100 m of the house, not sleeping under a bednet the previous night, and not closing the doors and windows from 6 p.m. to 5 a.m. were significantly (p≤0.25) associated with malaria. Of these factors, only not sleeping under a bednet the previous night and not closing the doors and windows from 6 p.m. to 5 a.m. were significantly associated with malaria. CONCLUSIONS: The findings of this study demonstrate that potential risk factor for Malaria should be paid of attention all the time, particularly for an area which is targeting Malaria elimination.
Animals ; Case-Control Studies* ; Cattle ; Checklist ; Education ; Housing ; Humans ; Indonesia* ; Malaria* ; Multivariate Analysis ; Public Health ; Risk Factors*

PURPOSE: Although breast milk is considered the best source of nutrition for infants because of its superiority over powdered milk, there are circumstances when breast milk is unavailable. Committee on Nutrition of the Korean Pediatric Society conducted an investigation into the current status of formula feeding in Korea. METHODS: This investigation was conducted using questionnaires produced by our committee and distributed to mothers of children under the age of two who were using formula feeding at 10 university hospitals and 22 public health centers nationwide between March 1999 to September 1999. A comparative analysis according to location, birth order, mother's occupation, education, housing tenure and normal birth status was performed on all 2696 questionnaires using the chi-square test. RESULTS: Formula feeding was found in 49.4% and formula feeding combined with breast milk were 21.5% of the respondents. The percentage of formula feeding was higher in working mothers who underwent a Cesarean section in metropolitan areas. The inadequacy of breast milk was the most common reason for feeding powdered rnilk followed by the unhealthy condition of the mother and mother's return to work. Of those investigated, 94.9% said that they changed products at each stage as recommended by the manufacturer. Promotions for special formulas were more active in metropolitan areas than other areas, and 57.7M said that they used special formulas based on recornmendations by the doctor and acquaintances(15.5%) or after seeing an advertisement(14.0%). CONCLUSION: This investigation revealed that many rnothers were misinformed concerning formula feeding and pediatricians should provide mothers with education, shedding light on proper feeding methods.
Birth Order ; Cesarean Section ; Child ; Surveys and Questionnaires ; Education ; Feeding Methods ; Female ; Hospitals, University ; Housing ; Humans ; Infant* ; Korea ; Milk ; Milk, Human ; Mothers ; Occupations ; Parturition ; Pregnancy ; Public Health ; Return to Work

BACKGROUND: We sought to determine the association between chronic pain and participating in routine health screening in a low socioeconomic-status (SES) rental-flat community in Singapore. In Singapore, ≥ 85% own homes; public rental flats are reserved for those with low-income. METHODS: Chronic pain was defined as pain ≥ 3 months. From 2009−2014, residents aged 40−60 years in five public rental-flat enclaves were surveyed for chronic pain; participation in health screening was also measured. We compared them to residents staying in adjacent owner-occupied public housing. We also conducted a qualitative study to better understand the relationship between chronic pain and health screening participation amongst residents in these low-SES enclaves. RESULTS: In the rental-flat population, chronic pain was associated with higher participation in screening for diabetes (aOR = 2.11, CI = 1.36−3.27, P < 0.001), dyslipidemia (aOR = 2.06, CI = 1.25−3.39, P = 0.005), colorectal cancer (aOR = 2.28, CI = 1.18−4.40, P = 0.014), cervical cancer (aOR = 2.65, CI = 1.34−5.23, P = 0.005) and breast cancer (aOR = 3.52, CI = 1.94−6.41, P < 0.001); this association was not present in the owner-occupied population. Three main themes emerged from our qualitative analysis of the link between chronic pain and screening participation: pain as an association of “major illness”; screening as a search for answers to pain; and labelling pain as an end in itself. CONCLUSIONS: Chronic pain was associated with higher cardiovascular and cancer screening participation in the low-SES population. In low-SES populations with limited access to pain management services, chronic pain issues may surface during routine health screening.
Asian Continental Ancestry Group ; Breast Neoplasms ; Chronic Pain* ; Colorectal Neoplasms ; Dyslipidemias ; Early Detection of Cancer ; Humans ; Mass Screening* ; Pain Management ; Public Housing ; Singapore ; Social Class* ; Uterine Cervical Neoplasms

INTRODUCTIONKnowledge of stroke symptoms is associated with seeking medical attention early, and knowledge of risk factors is an essential factor in stroke prevention. In this study, we evaluated the level of stroke literacy in Singapore.

MATERIALS AND METHODSA cross-sectional study of Singapore citizens and permanent residents aged 21 years and above was conducted in a public housing estate. Participants were randomly sampled using multi-stage stratified sampling. Assessment of awareness of stroke symptoms and risk factors was performed using open-ended questions. In total, 687 respondents were recruited, with a response rate of 69.7%.

RESULTSOverall, 52.4% of respondents identified the brain as the source of pathology, and 47.6% could cite at least 1 of the 3 FAST symptoms (facial droop, arm weakness and speech difficulty), while 40% could name 2 or more of 7 established risk factors for stroke (high blood pressure, high cholesterol, cigarette smoking, diabetes mellitus, older age, previous heart attacks and stroke). Respondents at higher risk of stroke (older individuals and those with stroke risk factors) did not have greater awareness of stroke symptoms and risk factors. The majority of respondents reported they would seek immediate medical care if they experienced stroke symptoms. Only 59.4% knew the emergency ambulance service telephone number.

CONCLUSIONIn a sample of Singaporean adults residing in a public housing estate, we found evidence of poor stroke literacy, highlighting the need for comprehensive population-based education efforts. There is a role for opportunistic education among those at higher risk of stroke.

Adult ; Aged ; Cross-Sectional Studies ; Female ; Health Literacy ; Humans ; Male ; Middle Aged ; Public Housing ; Risk Factors ; Singapore ; Socioeconomic Factors ; Stroke ; Surveys and Questionnaires ; Young Adult

Exposure to secondhand smoke (SHS) not only can cause serious illness, but is also an economic and social burden. Contextual and individual factors of non-smoker exposure to SHS depend on location. However, studies focusing on this subject are lacking. In this study, we described and compared the factors related to SHS exposure according to location in Korea. Regarding individual factors related to SHS exposure, a common individual variable model and location-specific variable model was used to evaluate SHS exposure at home/work/public locations based on sex. In common individual variables, such as age, and smoking status showed different relationships with SHS exposure in different locations. Among home-related variables, housing type and family with a single father and unmarried children showed the strongest positive relationships with SHS exposure in both males and females. In the workplace, service and sales workers, blue-collar workers, and manual laborers showed the strongest positive association with SHS exposure in males and females. For multilevel analysis in public places, only SHS exposure in females was positively related with cancer screening rate. Exposure to SHS in public places showed a positive relationship with drinking rate and single-parent family in males and females. The problem of SHS embodies social policies and interactions between individuals and social contextual factors. Policy makers should consider the contextual factors of specific locations and regional and individual context, along with differences between males and females, to develop effective strategies for reducing SHS exposure.
Administrative Personnel ; Child ; Commerce ; Drinking ; Early Detection of Cancer ; Fathers ; Female ; Housing ; Humans ; Korea* ; Male ; Multilevel Analysis ; Public Policy ; Single Person ; Single-Parent Family ; Smoke ; Smoking ; Tobacco Smoke Pollution*

PURPOSE: We made a clinical comparison of elderly patients from home and residential aged care facilities (RACFs) who visited the emergency department and were hospitalized with acute ischemic stroke. In addition, we investigated the factors associated with prehospital delay in acute ischemic stroke. METHODS: A retrospective study was conducted in a public hospital between January 2013 and December 2016. Information regarding the patients was registered including gender, age, comorbidities, symptoms at onset, use of emergency medical services, National Institute of Health Stroke Scale (NIHSS) at the emergency department, symptom-to-door time, etc. Characteristics of the patients were analyzed and logistic regression analysis was conducted to identify factors associated with symptom-to-door time. RESULTS: A total of 402 patients were enrolled during the study period. Overall, 339 elderly patients visited from home and 63 patients from RACFs, and patients from home were divided into two groups, living with family (n=274) and living alone (n=65). Patients from RACFs were older (≤0.001) and had higher NIHSS (p=0.007) than patients from home, but there were no significant relationships between symptom-to-door time and age (p=0.525), NIHSS (p=0.428). There was no difference in symptom-to-door time between patients living with family and patients from RACFs, but patients living alone had delayed symptom-to-door time (p < 0.001). CONCLUSION: Elderly patients living alone were among the three groups that had the most delayed symptom-to-door time. Therefore, it is necessary to expand and supplement support for elderly patients living alone, as well as to improve education regarding acute ischemic stroke.
Aged ; Cerebral Infarction ; Comorbidity ; Education ; Emergency Medical Services ; Emergency Service, Hospital ; Hospitals, Public ; Housing for the Elderly ; Humans ; Logistic Models ; Nursing Homes ; Retrospective Studies ; Stroke ; Transportation of Patients