Comparison of characteristics among Korean American male smokers between survey and cessation studies

This study compared characteristics of Korean American men in two studies: a telephone survey with a random sample of Korean American men who reported daily smoking versus a smoking cessation clinical trial with a convenience sample of Korean American men who reported smoking at least 10 cigarettes a day. Guided by the Theory of Planned Behavior (TPB), both studies attempted to explain how much its theoretical variables (attitudes, perceived social norms, and self-efficacy) would explain quit intentions in Korean American men. Participants in the cessation study were less likely to have health insurance coverage (χ2 [2, 271] = 138.31, p = 0.001) than those in the survey study. The cessation group was more likely to smoke in indoor offices (χ2 [1, 231] = 18.09, p = 0.003) and had higher nicotine dependence than the survey group (t269 = 3.32, p = 0.001) but these differences became insignificant when only those who smoked 10 or more cigarettes were compared. Participants in the cessation study had more positive attitudes towards quitting (t267 = 4.99, p < 0.001), stronger perceived social norms favoring quitting (t269 = 5.63, p t268 = 9.86, p < 0.001) at baseline than those in the survey study. Korean American men are more likely to have a quit intention and make a quit attempt when they have more positive and fewer negative attitudes towards quitting and perceive stronger social norms favoring quitting. To motivate Korean American men to quit smoking, clinicians should underscore the immediate health benefits of quitting, promote quitting with cessation aids to reduce perceived risks of quitting in anticipation of withdrawal symptoms, and encourage family members to relate firm anti-smoking messages.

Accessing acute medical care to protect health: the utility of community treatment orders

Background The conclusion that people with severe mental llness require involuntary care to protect their health(including threats due to physical-nonpsychiatric-illness)is challenged by findings indicating that they often lack access to general healthcare and the assertionthat theywould access suchcarevoluntarily if available and effective.Victoria,Australia's single-payer healthcare system provides accessible medical treatment;therefore,it is an excellent context in which to test these challenges.AimsThis study replicates aprevious investigation in considering whether,in Australia's easy-access singlepayer healthcare system,patients placed on community treatment orders,specifically involuntary community treatment,are more likelyto access acute medical care addressing potentially life-threatening physical illnesses than voluntary patients with and without severe mental illness.Methods Replicating methods used in 2000-2010,for the years 2010-2017,this study compared the acute medical care access of three new cohorts:7826 hospitalised patientswith severemental illnesswho received a post-hospitalisation,community treatment order;13896 patients with severe mental illness released from the hospital without a community treatment order and 12101outpatients who were never psychiatrically hospitalised(individuals with less morbidity risk who were not considered to have severe mental llness)during periods when they were under versus outside community mental health supervision.Logistic regression was used to determine the influence of community-based community mental health supervision and the type of community mental health supervision(community treatment order vs non-community treatment order)on the likelihood of receiving an initial diagnosis of a life-threatening physical illness requiringacutecare.Results Validating their shared elevated morbidity risk,43.7%and 46.7%,respectively,of each hospitalised cohort(community treatment order and non-community treatment order patients)accessed an initial acute-care diagnosis for a life-threatening condition vs 26.3%of outpatients.Outside community mental health supervision,the likelihood that a community treatment order patient would receive a diagnosis of physical illness was 36%lower than non-community treatment order patients-1.30 times that of outpatients.Under community mental health supervision,their likelihood was two times greater than that of non-community treatment order patients and 6.6 times that of outpatients.Each community treatment order episode was associated with a 14.6% increasein the likelihood of a community treatment order patient receiving a diagnosis.The results replicate those found in an independent 2000-2010 cohort comparison.Conclusions Community mental health supervision,notably community treatment order supervision,in two independent investigations overtwodecades appeared to facilitate access to physical healthcare in acute care settings for patients with severe mental illness who were refusing treatmenta group that has been subject to excess morbidity and mortality.

Incomplete Reporting of HIV/AIDS by Uganda’s Surveillance System and the Associated Factors

Introduction: The United States government supported Ugandan government by introducing the District Health Information Software 2 (DHIS2) in 2012 to improve HIV/AIDS surveillance. Districts have yet to fully adopt this relatively new system given a 70.2% reporting completeness achieved nationally between April-June 2013. Methods: The study examined one dependent variable of districts’ reporting completeness against four independent variables: 1) Number of client visits;2) Number of district health units;3) Number of NGOs delivering HIV/AIDS services;and 4) Regional location. The study employed cross-sectional study design which allowed researchers to compare many different variables at the same time. HIV/AIDS program data that were reported by districts into DHIS2 during the period of April to June 2013 were used to assess for reporting completeness. Findings: Districts with the lowest number of client visits (under 2500) achieved the highest mean reporting completeness (81.6%), whereas a range of 2501 - 5000, or over 5001client visits recorded 72.4% and 51.7% respectively. The higher the number of client visits is, the lower the reporting completeness is (p < 0.05). Those districts that were receiving support from only one and two NGO recorded 56.7% and 67.2% respectively. Districts supported by over three NGOs had the highest (80.6%) mean reporting completeness. NGOs-district support was statistically associated with reporting completeness (p < 0.05). The number of health units operated by a district was also significantly associated with reporting completeness (p < 0.05). The regional location of a district was not associated with reporting completeness (p = 0.674). Conclusion: The study results led us to recommend targeted future NGO support to districts with higher patient volume for HIV/AIDS services. Particularly, newly funded NGOs are to be established in districts operating over 40 health units. Incomplete reporting undermines identification of HIV-affected individuals and limits the ability to make evidence-based decisions regarding HIV/AIDS program planning and service delivery.