Autochthonous production contributes to the diet of wood-boring invertebrates in temperate shallow water.

Marine wood-boring invertebrates rapidly fragment coarse woody debris in the sea. These wood borers have the ability to digest wood cellulose, but other potential food sources have been less investigated. To assess the contribution of each potential food source to the diet of wood borers, we traced seasonal and environmental changes in δ13C of shipworms cultured under the same experimental conditions and related these changes to variations in δ13C of potential food sources, i.e., wood log and particulate organic matter (POM) by using multiple linear regression models rather than the Bayesian mixing model. Based on the standardized partial regression coefficients in the model, it became clear that wood-derived organic carbon was the main carbon source for the teredinids, and POM also accounted for 37.9% of the teredinids' carbon source. Furthermore, we clarified variations in supplemental nitrogen sources for the teredinids: one species depended on both POM and wood log, whereas the other three species depended on either POM or wood log for their nitrogen source. δ13C values of another wood-boring bivalve of Martesia (Pholadidae) increase as it grows, which suggests that the bivalve switches its feeding strategy from xylophagous to filter feeding as it grows. Wood borers are known to accelerate the transfer of organic materials derived from wood logs to marine ecosystems. However, this study suggests that autochthonous production strongly contribute to the diet of marine wood borers, helping them to decompose wood logs in temperate shallow water.

Impact of the village health center project on contraceptive behaviors in rural Jordan: a quasi-experimental difference-in-differences analysis.

BACKGROUND: Appropriate contraceptive use remains a major health challenge in rural Jordan. The Japan International Cooperation Agency implemented a project aimed at enhancing the capacity of village health centers (VHCs) to improve the quality and quantity of family planning (FP) services in rural Jordan in 2016-2018. Facility- and community-based approaches were integrated into the interventions. We evaluated the project's impacts on contraceptive behaviors and the effectiveness of the two approaches. METHODS: We used a difference-in-differences analysis based on the project baseline and endline surveys, and logistic regression analysis to assess associations between eight primary outcomes and three secondary outcomes (impacts). The unit of intervention was five target VHCs; the unit of analysis was currently married women of reproductive age (15-49 years) in five intervention and five control villages. RESULTS: Overall, 2061 married women participated; 83.8% were in need of FP. Compared with the control villages, significant effects, ranging from + 0.4% points (pp) to + 11.5 pp., were observed in the intervention villages for six primary outcomes in these categories: increasing the use of FP services at VHCs, participation in health promotion activities, and changing the sources of reproductive health information. There was a trend toward improved secondary outcomes in the intervention villages, but no significant differences were observed between the intervention and control villages regarding modern contraceptive use (mCU; + 4.3 pp), traditional contraceptive use (tCU; - 0.5 pp), and spousal agreement on contraception (+ 5.1 pp). mCU was positively associated with five primary outcomes: obtaining contraceptives at VHCs [adjusted odds ratio (AOR) 3.44, 95% confidence interval (CI) 1.26-9.40], education sessions at VHC (AOR 7.41, 95% CI 1.60-34.39), health activities in communities (AOR 7.41, 95% CI 3.28-16.78), counseling by private doctor/clinic (AOR 0.62, 95% CI 0.40-0.97), and information gained through TV (AOR 0.50, 95% CI 0.32-0.76). Spousal agreement on contraception showed similar positive trends. tCU was associated only with TV. CONCLUSIONS: The project had impacts on increased mCU and husbands' perception of contraception in rural Jordan. The integration of facility- and community-based approaches may be effective in shifting from tCU to mCU in other rural areas.

Cross-sectional analysis of self-efficacy and social capital in a community-based healthy village project in Santa Cruz, Bolivia.

BACKGROUND: An assessment of self-efficacy and social capital may have the potential to detect an effect of dynamic, complex and comprehensive collective actions in community-based health promotion. In 2003, a healthy village project was launched in Santa Cruz, Bolivia with technical assistance from the Japan International Cooperation Agency (JICA). The originally developed FORSA (Fortalecimiento de Redes de Salud) model accounted for participatory processes in which people could improve their health and well-being through individual behavioral changes and family/community-driven activities. This study aimed to examine the extent of self-efficacy and social capital obtained via project activities by a cross-sectional analysis. METHODS: We randomly selected 340 subjects from the healthy village project site and 113 subjects from a control area. Both groups were interviewed using the same structured questionnaire. Self-efficacy was assessed with a General Self-Efficacy Scale (GSES), while social capital was measured as the frequency of formal group participation in community meetings during the past three months, perceived social solidarity, and general trust. RESULTS: The study results showed that the participants in the project site had higher self-efficacy and social capital compared to those in the control site. The number of times a subject participated in the health committee activities was positively associated with the self-efficacy scale. Regarding social capital, females and lower-educated people were more likely to have had more frequent participation in formal groups; males and higher-educated participants showed less formal group participation, but more generosity to contribute money for the community. The main perceived benefit of participation in formal group activities varied among individuals. CONCLUSION: The findings suggest that people in the healthy village project site have higher self-efficacy, especially those with active participation in the health committee activities. To recruit more participants in future healthy village projects, we should consider the gender and level of education, and match the perceived benefits of participants accordingly.

An analysis of factors contributing to household transmission of COVID-19-using data from active epidemiological investigations performed in the Setagaya ward of Tokyo, Japan.

An active epidemiological investigation of COVID-19 cases in the Setagaya ward of Tokyo revealed that household transmission was the main route of infection spread. This study aimed to identify the factors affecting household transmission in patients diagnosed with COVID-19 and their cohabitants, during the wild type virus (December 2020) and alpha variant epidemic (May 2021). Index case factors significantly associated with household transmission for both wild type (WT) and alpha variant (AV), were at least 3 days from onset to diagnosis (WT: risk ratio [RR] 1.44, 95% confidence interval [CI] 1.16-1.79/AV: RR 1.66, CI 1.32-2.08), and a household size of three or more people (WT: RR 1.37, CI 1.10-1.72/AV: RR 1.29, CI 1.05-1.59). There were also significant differences in age ≥ 65 (RR 2.39, CI 1.26-4.54) and symptomatic at diagnosis (RR 3.05, CI 1.22-7.63) in index cases of WT. Among cohabitants, factors associated with household transmission for both strains were being the spouse/partner of the index case (WT: RR 1.68, CI 1.21-1.82/AV: RR 1.97, CI 1.59-2.43) and at least 3 days from onset to diagnosis of the index case (WT: RR 1.48, CI 1.34-2.10/ AV: RR 1.86, CI1.52-2.28). Early diagnosis and isolation are effective for preventing household transmission.

Prevalence and social determinants of depression: A cross-sectional survey of Myanmar migrant workers in Chiang Mai, Northern Thailand.

BACKGROUND: Depression is a common mental disorder and the sixth leading cause of disability in Thailand. Chiang Mai has historically been a city of attraction for labour migration for Shan migrants from the adjacent Southern Shan State of Myanmar. Currently, only infectious diseases are screened during the pre-employment period. Prevention and early detection of noncommunicable diseases can improve a healthy workforce and reduce the healthcare burden on the host country. Therefore, we aimed to determine the prevalence of depression and associated factors. METHODS: A cross-sectional survey was done among Myanmar migrant adults legally working in Chiang Mai, Thailand. RESULTS: The final analysis included 360 participants and the prevalence of depression was 14.4%. Being female, duration of stay in Thailand of more than 10 years, co-residence with co-workers, and marginalisation pattern of acculturation were significant associated factors affecting depression in a multivariate regression analysis model. CONCLUSION: Although the culture and dialect were not different between the host and country of origin, Myanmar migrant workers of Shan ethnicity suffered from depression. Our findings highlighted the importance of social determinants beyond common predictors of depression among migrants and the need for public health measures to promote migrants' integration into the host culture.

Association Between Dietary Habits and Type 2 Diabetes Mellitus in Thai Adults: A Case-Control Study.

Background: The prevalence of T2DM is escalating in Thailand affecting over 10% of adults aged 20-79 years old. It is imperative to identify modifiable risk factors that can potentially help mitigate the risk of developing diabetes. Objective: This study aimed to investigate the relationship between dietary habits and type 2 diabetes in Chiang Mai, Thailand. Methods: This case-control study involved 300 individuals aged 25-74 years residing in Chiang Mai, Thailand including 150 newly diagnosed T2DM patients (cases) and 150 community residents without diabetes (controls). Dietary habits were assessed based on Food Frequency Questionnaire (FFQ). Socio-demographic characteristics and anthropometric information of the participants were collected. Data analysis was performed using the STATA-17. Results: The case group participants were older and had a higher proportion of males compared to the control group. The case group exhibited a significantly higher consumption of meat, beans, nuts, soft drinks, and topping seasonings (p<0.001), conversely, a lower intake of vegetables (p<0.001), fruits (p=0.006), fish, rice (p<0.001), eggs (p=0.032), milk products, coffee, and tea (p<0.001) compared to the control group. Furthermore, the case group demonstrated a higher level of certain dietary practices such as a greater frequency of having meals with family, not removing visible fat from food (p<0.001), and eating snacks between meals compared to controls. Multiple logistic regression analysis showed that after adjusting for potential confounding factors not removing visible fat from food (aOR 5.61, 95% CI: 2.29-13.7, p<0.001) and using topping seasonings (aOR 3.52 95% CI: 1.69-7.32 p=0.001) were significantly associated with the risk of T2DM, whereas daily vegetable intake (aOR 0.32 95% CI: 0.15-0.68 p=0.003) was inversely associated with T2DM. Conclusion: The study findings caution against the consumption of food rich in fat and using salty seasonings, while advocating for an increased intake of vegetables to prevent the prevalence of T2DM.

A Study on the Health-Related Issues and Behavior of Vietnamese Migrants Living in Japan: Developing Risk Communication in the Tuberculosis Response.

Ensuring a healthy lifestyle for the increasing number of Vietnamese migrants living in Japan is a key public health issue, including infectious disease responses such as tuberculosis (TB). To develop risk communication in relation to the TB response, this study aimed to explore the health issues and health-related behaviors of Vietnamese migrants living in Japan using a mixed method. A survey was conducted on Vietnam-born migrants, aged 18 years and over, in Tokyo. The survey consisted of questions on the following components: (1) demographics; (2) health-related issues and behavior; and (3) health-seeking behavior, information, and communication. A total 165 participants participated in the survey. The majority of the participants were young adults. 13% of the participants responded that they were concerned about their health. Moreover, 22% and 7% of the participants reported weight loss and respiratory symptoms, respectively. 44% of the participants answered they had no one to consult about their health in Japan when they needed it, and 58% answered they had no awareness of any Vietnamese-language health consultation services. Logistic regression analysis revealed that people who contact family members living in Vietnam or overseas using social networking services (SNSs) when they needed to consult someone about their health (adjusted odds ratio (AOR) = 6.09, 95% confidence interval (CI) 1.52-24.43) were more likely to present with one or more of the typical TB symptoms, compared to those who did not consult someone in this manner. Current smokers (OR = 3.08, 95% CI 1.15-8.23) were more likely to have health problems compared to non-smokers. The key informant interviews revealed that individual factors, the health system, and socio-environmental factors may hinder Vietnamese migrants' health-seeking and health-information-seeking behaviors in Japan. TB risk communication approaches for migrants need to be developed considering their health-related behaviors while addressing their health needs.

COVID-19 Phobia among Korean, Chinese, and Japanese students: An international comparative study.

This study aimed to identify the characteristic differences and potential contributing factors of coronavirus disease 2019 (COVID-19) phobia between undergraduate and graduate students in Korea, Japan, and China. We used the online survey tool, we retained 460 responses from Korea, 248 responses from Japan, and 788 responses from China for analysis. We performed the statistical analysis; ANOVA F-test and Multiple linear regression. We visualized the results of these calculations using GraphPad PRISM 9. The mean COVID-19 phobia score was highest in Japan at 50.5 points. Psychological fear was identically prevalent in Japan and China, at an average of 17.3 points. Psychosomatic fear was highest in Japan at 9.2 points. Further, economic fear was highest in Korea at 13 points, whereas social fear was highest in China at 13.1 points. In Korea, COVID-19 phobia scores were significantly higher among women than in men. In Japan, COVID-19 phobia scores were significantly higher in individuals who complied with social distancing mandates. In China, a lack of previous experience with self-administered testing kits was associated with significantly lower phobia scores. Individuals who were avoiding crowded places had significantly higher scores in 3 countries. This implies that the students knew that it was necessary to comply with COVID-19 preventive behaviors to prevent infections. The findings of this study could be used as a reference when establishing an approach strategy to reduce COVID-19 phobia among Chinese, Japanese, and Korean students.

Impact of Hospital Closure on Patients with Communicable and Non-Communicable Diseases During the COVID-19 Pandemic in Uganda: A Cross-Sectional and Mixed-Methods Study.

Background: The COVID-19 pandemic and its measures have had a profound impact on universal access to health services. We investigated the impact of the closure of the Entebbe Regional Referral Hospital (ERRH) for two years on the accessibility to necessary healthcare among non-COVID-19 patients. Methods: This mixed-methods study focused on ERRH patients with tuberculosis (TB), human immunodeficiency virus (HIV), diabetes/hypertension, and mental illness. A quantitative study used a structured-questionnaire with a primary outcome measure to assess the discontinuation of healthcare accessibility. A qualitative study with a focus group discussion (FGD) was conducted on eight patients. Results: Of the 202 quantitative survey participants, 17.8% discontinued necessary healthcare due to the ERRH closure, and the discontinuation rates differed by disease: 48.1% of TB patients, 16.0% of HIV patients, 7.8% of diabetes/hypertension patients, and 4.0% of mental health patients (P < 0.001). Almost 90% of the patients reported a worsened health condition, regardless of the disease. Multivariable logistic regression analysis showed that patients with diabetes/hypertension (adjusted odds ratio [AOR], 12.69; 95% confidence interval [CI], 2.57-62.52) and HIV (AOR, 7.52; 95% CI, 1.37-41.27) were more likely to discontinue healthcare than those with mental illness. The factors associated with discontinued healthcare included age ≥50 years vs ≤30 years (AOR, 4.88; 95% CI, 1.07-22.34), and high transportation cost vs low cost (AOR, 3.15; 95% CI, 1.13-8.75). The FGD also identified difficulties in obtaining medication, especially for TB, even though ERRH provided the outreach services. Conclusion: Our study revealed that the ERRH closure and lockdowns had an overall profound negative impact on access to healthcare and health conditions. Younger patients and those with TB were the most affected patients. This study provides practical suggestions from the field for policy makers to strengthen universal health access during health crises in Uganda and other sub-Saharan countries.

Prevalence and Risk Factors for Hypertension among Myanmar Migrant Workers in Thailand.

BACKGROUND: Non-communicable diseases (NCDs) are showing an increasing trend worldwide, and the COVID-19 pandemic may interrupt or delay NCD care, the leading cause of mortality in Thailand, which is hosting 2-3 million migrant workers. The transition of epidemiological risk factors, limited access to health-promoting activities, and pandemic containment measures may adversely impact NCD risks. Therefore, hypertension and associated risk factors were determined among registered Myanmar migrant workers in Thailand. METHODS: A cross-sectional survey with structured questionnaires was conducted in Thailand in 2017. Having hypertension was analyzed as a dependent variable, and the associated risk factors were explored by binary logistic regression analysis. RESULTS: A total of 414 participants with a mean age of 29.45 ± 9.03 years were included, and 27.8 percent of the study participants were hypertensive, which was a rate higher than that in their host country (24.7%) and country of origin (26.4%). An older age, being male, current alcohol drinking, and being overweight and obese with reference to the body mass index (BMI) were significantly associated with hypertension. CONCLUSIONS: Our findings reaffirmed the idea that NCDs are important public health concerns, and a simple BMI measurement would be a valuable tool with which to determine hypertension risks. Targeted surveillance and an appropriate health policy are necessary for such a vulnerable population in Thailand.

Digitally Inclusive, Healthy Aging Communities (DIHAC): A Cross-Cultural Study in Japan, Republic of Korea, Singapore, and Thailand.

One out of three people in Japan will be an older person before 2040. Half of those currently do not utilize the internet, smartphone apps, or digital technology. On the other hand, more than 70% of seniors in Republic of Korea use the internet, and 55% in Singapore had access to it in 2019. The use of digital technology for health promotion has the potential to promote individual and community empowerment, advocating for healthy, active aging. Maintaining equity in health promotion practice requires the digital inclusion of every senior. Therefore, we propose a cross-cultural study to explain the contextual influences of digital inclusion and its consequences on healthy aging in Japan, Korea, Singapore, and Thailand. Quantitatively: digital skills, e-health literacy, participation in health promotion, and quality of life will be analyzed in structural equation models. Qualitatively: thematic analysis will be developed to identify cultural patterns and contextual factors, making sense of what older persons in different countries materialize, say, do, think, and feel to reveal deeper beliefs and core values about digital inclusion and healthy aging. Logics and methods from this protocol would be useful to replicate the study in many countries globally. Evidence from this study is expected to pave the way to digitally inclusive, healthy aging communities (DIHAC) across Japan and Asia.

Demand for family planning satisfied with modern methods and its associated factors among married women of reproductive age in rural Jordan: A cross-sectional study.

BACKGROUND: A novel indicator, 'percentage of women of reproductive age who are sexually active and who have their demands for FP satisfied with modern contraceptive methods (mDFPS)', was developed in 2012 to accelerate the reduction of unmet needs of family planning (FP). In Jordan, unmet needs for modern contraception remain high. To address this situation, this study measured the mDFPS and identified its associated factors in rural Jordan. METHODS: This cross-sectional study included married women of reproductive age (15-49 years) from ten villages in Irbid Governorate, Jordan, where advanced health facilities are difficult to reach. A two-stage stratified sampling with random sampling at the household stage was used for this field survey which was conducted between September and October 2016. Univariate analysis was used to assess the differences between mDFPS and unmet mDFPS groups. Logistic regression analysis was performed to identify the correlates of mDFPS. RESULTS: Of 1019 participants, 762 were identified as needing modern contraception. mDFPS coverage accounted for 54.7%. The most significant factors associated with mDFPS were the husband's agreement on FP (adjusted odds ratio [AOR]: 15.43, 95% confidence interval [CI]: 5.26-45.25), knowledge of modern contraceptives (AOR: 8.76, 95% CI: 5.72-13.40), and lack of awareness of the high risk of conception in the postpartum period (AOR: 2.21, 95% CI: 1.41-3.47). Duration of current residence, receipt of FP counselling at health centres and number of living children were also correlated. In addition, 95.3% of local women were aware of the presence of health centres that were mostly located in a 10-minute walking distance. CONCLUSION: To increase mDFPS, this study suggested that accelerating male involvement in FP decision-making is necessary through community-based health education. Furthermore, expanding FP services in village health centres and improving the quality of FP counselling in public health facilities are required to correct misconceptions about modern methods among rural women.

Acculturation and Its Effects on Health Risk Behaviors among Myanmar Migrant Workers: A Cross-Sectional Survey in Chiang Mai, Northern Thailand.

Thailand hosts many workers who have migrated from neighboring countries and is facing a large burden of non-communicable diseases (NCDs). Health screening for migrant workers routinely emphasizes infectious diseases but overlooks NCDs. We surveyed prevalent health behaviors for NCDs and their influencing factors, particularly cultural adaptation patterns among Myanmar migrant workers in Chiang Mai, Northern Thailand. A total of 414 migrant workers consented to participate in the study. Lack of exercise (75.8%), current alcohol consumption (40.8%), current smoking (26.9%), and central obesity (24.3%) were major lifestyle problems. Being female and uneducated was associated with a lack of exercise. Current alcohol consumption was significantly associated with being male and being of Myanmar ethnicity, with an integrative strategy for acculturation, and with a higher income. Male participants and participants with a lower mean score of marginalization were more likely to smoke. Central obesity was associated with being older than 40 years, being female, engaging in an assimilation strategy, and being uneducated. These findings highlight the need for gender inclusive health promotion, the screening of NCD risk behaviors, and timely health education for migrant workers. It may assist authorities to devise strategies to extend health promotion and universal health coverage to the migrant population.

Geographic information system (GIS) maps and malaria control monitoring: intervention coverage and health outcome in distal villages of Khammouane province, Laos.

BACKGROUND: Insecticide-treated nets (ITNs) are a key intervention to control malaria. The intervention coverage varies as a consequence of geographical accessibility to remote villages and limitations of financial and human resources for the intervention. People's adherence to the intervention, i.e., proper use of ITNs, also affects malaria health outcome. The study objective is to explore the impact of the intervention coverage and people's adherence to the intervention on malaria health outcome among targeted villages in various geographic locations. METHODS: Geographic information system (GIS) maps were developed using the data collected in an active case detection survey in Khammouane province, Laos. The survey was conducted using rapid diagnostic tests (RDTs) and a structured questionnaire at 23 sites in the province from June to July, the rainy season, in 2005. A total of 1,711 villagers from 403 households participated in the survey. RESULTS: As indicated on the GIS maps, villages with malaria cases, lower intervention coverage, and lower adherence were identified. Although no malaria case was detected in most villages with the best access to the district center, several cases were detected in the distal villages, where the intervention coverage and adherence to the intervention remained relatively lower. CONCLUSION: Based on the data and maps, it was demonstrated that malaria remained unevenly distributed within districts. Balancing the intervention coverage in the distal villages with the overall coverage and continued promotion of the proper use of ITNs are necessary for a further reduction of malaria cases in the province.

Health risk behaviors, musculoskeletal disorders and associated cultural adaptation, depression: a survey among Myanmar migrant workers in Chiangmai, Northern Thailand.

BACKGROUND AND PURPOSE: When migrants go to a new country to work, they experience transition of epidemiological risk factors, a new system of access to healthcare and changing life styles. Their comprehension of health risk factors will depend on acculturation pattern. Moreover, musculoskeletal disorders (MSDs) are significantly prevalent in such a population due to the manual work in their jobs. Myanmar immigrant's acculturation level has not yet been studied in relation to prevalent diseases. This study aimed to investigate health risk behaviors, the prevalence of musculoskeletal disorders, and associated factors. METHODS: A cross-sectional study surveyed 414 Myanmar migrant workers in Chiangmai, Thailand. Face-to-face interviews administered structured questionnaires which comprised the transculturally validated East Asian Acculturation Measure scale, Standardized Nordic musculoskeletal questionnaires, Patient Health Questionnaires 2 and 9 for depression and questionnaires to screen health behaviors and jobs. Data analysis applied binary logistic regression. RESULTS: About 26.3% were current smokers and 40.8% current drinkers. Of the 75.8% of participants did not exercise, 40.1% were overweight and obese, 44.7% had prehypertension, 27.1% hypertension, and 13% had depression. The prevalence of MSDs at any site over the previous 12 months was 53.4% and it was significantly associated (P-value≤0.05) with female (adjusted odd ratio (aOR)=1.75; 95% confidence interval (CI)=1.04-2.94), depression (aOR=2.19;CI=1.10-4.39), marginalization pattern of acculturation (aOR=1.87;CI=1.09-3.21) and MSDs at any site last week (aOR=8.41;CI=4.09-17.30). CONCLUSION: Health behaviors in this young, working migrant population are risky, and MSDs are common problems for migrant workers in northern Thailand. Findings of the current study highlighted health behaviors and cultural adaption as attributes to chronic, disabling, and common health problems of migrant workers. Public health interventions and recommendations considering this evidence may improve migrants' health status, leading to better quality-of-life and productivity.

Evolutionary history of larval skeletal morphology in sea urchin Echinometridae (Echinoidea: Echinodermata) as deduced from mitochondrial DNA molecular phylogeny.

The larval skeletons of sea urchins show considerable morphological diversity, even between closely related species, although the evolutionary history and functional significance of this diversity are poorly understood. To infer the evolutionary history of the skeletal morphology, we focused on echinometrid species for which the morphological variation in larval skeletons had been investigated qualitatively and quantitatively. We reconstructed the phylogenetic relationships among 14 echinometrid species based on mitochondrial ND1 and ND2 genes and mapped the morphological characters onto the resultant trees. The monophyly of each genus in the Echinometridae was well supported by our results, as was the close affinity between Colobocentrotus, Heterocentrotus, and Echinometra. The mapping of the morphological characters of the larval skeletons indicated that the length, direction, and density of spines on the postoral rods was well conserved in each group of Echinometridae and that the abundance of spines and the size and shape of the body skeleton changed relatively frequently and hence were less conserved. In Echinometrid species, morphological variation in relatively unconserved features tends to be associated with latitudinal distributions, rather than phylogenetic relationships, indicating that the morphological diversity of larval skeletons could have been caused by adaptation to the habitat environment. Some morphological differences, however, seem to be nonfunctional and generated by the constraints on larval skeletogenesis. Thus, echinometrid species can be a good model with which to study the evolutionary history from both ecological and developmental standpoints.

Monitoring malaria control in Khammouane province, Laos: an active case detection survey of Plasmodium falciparum malaria using the Paracheck rapid diagnostic test.

In Khammouane province, Laos, over 5000 slide-positive malaria cases were reported at local health facilities in 1997. To combat the spread of malaria, insecticide-treated nets (ITNs) and community health education were provided to the people in this province by the Lao Ministry of Health and the Japan International Cooperation Agency. In order to document the current malaria situation, an active case detection (ACD) survey using rapid diagnostic tests was conducted at 23 sites from June to July, the rainy season, in 2005. A total of 1711 villagers from 403 households participated in the survey. The proportion of positive cases was 0.7% (12/1711) with a range in each village of 0-8.2%. The low infection rate observed in this ACD survey was consistent with the decrease in the number of slide-positive malaria cases at local health facilities (from over 5000 cases to 536 cases), indicating the substantial progress made in malaria control. Although the reduction of malaria cases can be attributed to multiple factors, continued promotion of the proper use of ITNs as well as community-based testing and treatment services, especially in remote areas, may lead to a further reduction of malaria cases in the province.

Modern medicine and indigenous health beliefs: malaria control alongside "Sadsana-phee" (animist belief system) in Lao PDR.

The major religion in Lao PDR is Buddhism, but many ethnic groups in rural Lao PDR hold an animist belief system called "Sadsana-pee". At the same time, the Bourapar District study site in Khammouane Province, Lao PDR is at high risk of malaria infection. Due to their belief in traditional ways of healing, the promotion of malaria prevention and treatment with modern medicine was not always welcomed by the villagers. Based on the results of questionnaire interviews with 240 heads of households from February to March of 2003, the effect of local beliefs on malaria control activities was discussed. Despite widely available western medicine and widely conducted health education, some people still believe that evil spirits cause malaria and rely on traditional medicine and/or religious ceremonies for treatment. Based on our findings, we recommend that future education and malaria control programs be revised and made sensitive to those people holding indigenous beliefs.

Hearing Aid Use and Adherence to Treatment in a Publicly-Funded Health Service from the City of São Paulo, Brazil.

Introduction Periodic follow-up appointments are important to ensure long-term effectiveness of rehabilitation with hearing aids. However, not all users are able to maintain adherence to recommendations prescribed during the fitting process and some do not attend those appointments, which compromises the effectiveness of treatment. Objective Compare hearing aid use after 1 year between subjects who did not attend a follow-up evaluation appointment at a publicly-funded health service (nonattenders) and those who attended the appointment (attenders). Reasons for nonuse of hearing aids and unscheduled appointments were also analyzed. Methods Prospective observational cross-sectional study. Nonattenders and attenders in a follow-up evaluation appointment were interviewed by telephone about hearing aid use, reasons for nonuse, and unscheduled appointments. Results The nonattenders group consisted of 108 subjects and the attenders group had 200 subjects; in both groups, most users kept bilateral use but the nonuse rate was higher in nonattenders. The main reason for nonuse of hearing aids among nonattenders was health problems; fitting problems was the main reason for nonuse in the attenders group. Health problems and issues like unavailable companion and transportation difficulties were the reasons for unscheduled follow-up appointments. Conclusion Nonattenders had a greater nonuse rate and were more likely to abandon hearing aid use. Measures to increase hearing aid use and adherence to prescribed recommendations are also necessary to ensure long-term effectiveness of rehabilitation with hearing aids.

Taxonomic study of the kinorhyncha in Japan. III. Echinoderes sensibilis n. sp. (Kinorhyncha: Cyclorhagida) from Tanabe Bay.

A new species of echinoderid kinorhynch, Echinoderes sensibilis, is described and illustrated using light and electron microscopy. The specimens were collected from masses of the red algae Corallina pilulifera growing in intertidal pools in Tanabe Bay, Honshu Island, Japan. Diagnostic characters of E. sensibilis include the presence of middorsal spines on segments 6-10; lateral spines/tubules on segments 4, 7-12; remarkable trapezium-like subventral fields of minute cuticular hairs on segments 5-12. The positions of numerous sensory spots, large sieve areas, glandular tubes and the shape of terminal tergal and sternal extensions are also diagnostic. All taxonomic characters used for this description are illustrated by SEM. Echinoderes sensibilis constitutes the fifty-eight valid species of the genus Echinoderes and the fourteenth species described from the Pacific Ocean. This is the third representative of Pacific kinorhynchs found only in the intertidal zone and the first Pacific Echinoderes living on red macroalgae in intertidal pools.