Mayumi Ohnishi

Knowledge, experience, and potential risks of dating violence among Japanese university students: a cross-sectional study

BackgroundThe Domestic Violence Prevention Act came into effect in Japan in 2001, but covers only marriage partner violence and post-divorce partner violence, and does not recognize intimate partner violence (IPV). The present study was performed to determine the experience of harassment, both toward and from an intimate partner, and recognition of harassment as IPV among Japanese university students.MethodsA self-administered questionnaire survey regarding the experience of harassment involving an intimate partner was conducted as a cross-sectional study among freshman students in a prefectural capital city in Japan.ResultsA total of 274 students participated in the present study. About half of the subjects (both male and female students) had experience of at least one episode of harassment toward or had been the recipient of harassment from an intimate partner. However, the study participants did not recognize verbal harassment, controlling activities of an intimate partner, and unprotected sexual intercourse as violence. Experience of attending a lecture/seminar about domestic violence and dating violence did not contribute to appropriate help-seeking behavior.ConclusionsAn educational program regarding harassment and violence prevention and appropriate help-seeking behavior should be provided in early adolescence to avoid IPV among youth.

Sociocultural factors that reduce risks of homicide in Dar es Salaam: a case control study

Objectives This study was performed to examine the potential contributions of sociocultural activities to reduce risks of death by homicide. Methods This study was designed as a case control study. Relatives of 90 adult homicide victims in Dar es Salaam Region, Tanzania, in 2005 were interviewed. As controls, 211 participants matched for sex and 5-year age group were randomly selected from the same region and interviewed regarding the same contents. Results Bivariate analysis revealed significant differences between victims and controls regarding educational status, occupation, family structure, frequent heavy drinking, hard drug use and religious attendance. Conditional logistic regression analysis indicated that the following factors were significantly related to not becoming victims of homicide: being in employment (unskilled labour: OR=0.04, skilled labour: OR=0.07, others: OR=0.04), higher educational status (OR=0.02), residence in Dar es Salaam after becoming an adult (compared with those who have resided in Dar es Salaam since birth: OR=3.95), living with another person (OR=0.07), not drinking alcohol frequently (OR=0.15) and frequent religious service attendance (OR=0.12). Conclusions Frequent religious service attendance, living in the same place for a long time and living with another person were shown to be factors that contribute to preventing death by homicide, regardless of place of residence and neighbourhood environment. Existing non-structural community resources and social cohesive networks strengthen individual and community resilience against violence.

Reduction of Health-Related Risks Among Female Commercial Sex Workers: Learning From Their Life and Working Experiences

We performed this study to determine both positive and negative impacts on the health of sex workers working on the street. We conducted this study using key informant and focus group interviews in bars and streets in Mozambique. The interviewed sex workers were aware about the risks and protection against sexually transmitted infections (STIs), and they consistently used condoms. Most suffered from harmful behavior, including violence and assault by both customers and other commercial sex workers. We found that sex workers’ own skills and knowledge acquired through experience potentially could be developed into life skills that could save and protect their lives.

Reactions of community members regarding community health workers' activities as a measure of the impact of a training program in Amazonas, Brazil.

Objectives: The aim of this study was to evaluate the impact of community health worker (CHW) training on recognition and satisfaction regarding the performance of CHWs among members of the community in Amazonas, Brazil, which is a resource-poor area underserved with regard to medical health-care accessibility. Methods: Baseline and endline surveys concerning recognition and satisfaction with respect to CHW performance among members of the community were conducted by interview using a questionnaire before and after implementation of a program to strengthen community health projects in Manicoré, Amazonas, Brazil. One of the components of the project was CHW refresher training, which focused on facilitating adequate use of health-care services and providing primary health care, including health guidance. The baseline survey was performed in February 2004 at the beginning of the project, and the endline survey was performed in February 2006 at the end of the project. There were 82 and 120 CHWs working in Manicoré at the times of the baseline and endline surveys, respectively. Statistical analysis was performed to determine the significance of changes in experience with CHW activities, expected functions of CHWs, and satisfaction regarding the performance of CHWs between the baseline and endline surveys. In addition, qualitative analysis was conducted to evaluate the acceptability, feasibility, and sustainability of CHW refresher training. Results: Overall recognition and level of satisfaction regarding CHW performance among members of the community were improved from the baseline to the endline survey, regardless of type of residential area, such as town and/or remote area. Members of the community came to not expect CHWs to “provide strong medicine” (P < 0.001) and “provide injections” (P < 0.001), and came to appreciate “go to hospital with a sick person” (P = 0.031) as a function and role of CHWs. Conclusions: The results of the present study indicated that steady approaches to motivate and support CHWs in resource-limited settings could improve performance of CHWs and satisfaction of people in the community regarding the activities of CHWs to sustain their health.

Purchase of Antimicrobials in Retail Pharmacies Whena Prescription is Not Required

Objectives: The patterns of purchasing prescription antimicrobials with or without a prescription from retail pharmacies in Ulaanbaatar, Mongolia, were examined in relation to purchasers’ socioeconomic status and price of the product. Methods: A survey was conducted at 250 randomly selected pharmacies in Ulaanbaatar. A total of 619 customers were interviewed, and the medicines they bought at the stores were examined by medical doctors. The use of prescriptions and advice in purchasing medicines and sociodemographic characteristics of the subjects were determined. Results: Interviews were conducted with 297 customers who purchased prescription antimicrobials in front of the store in which they made their purchase. Among these 297 customers, only 19.5% (n=58) purchased medicine with a formal prescription, and 37.4% (n=111) purchased medicines on their own initiative and without the guidance of medical professionals. Purchase without a prescription was not associated with the subjects’ gender, age, educational status or area of residence. Lower-priced antimicrobials were purchased without prescriptions more frequently than those with a higher price (P<0.05). Conclusion: The purchase of antimicrobials without prescriptions is common across all sociodemographic strata in Ulaanbaatar, Mongolia. Considering the increases in number of retail pharmacies and in sales of antimicrobials associated with economic development, measures to enforce regulations and to promote education among the general public and pharmacy professionals are required.

Utilization of bar and izakaya -pub establishments among middle-aged and elderly Japanese men to mitigate stress

Japanese suicide rate is one of the highest among industrialized nations, especially following the economic crisis of the 1990s, with more than 30000 suicides every year since 1998. Previous studies have pointed out to relationships between overwork and/or job stress, and death and other health risks, and suggested several possible avenues for releasing stress and emotional burden, including suicidal ideation, through talking with intimate friends, family, and specialists, such as counselors and physicians. The present study was performed to explore the potential role of owners and managers of bars and izakaya-pub establishments in mitigating stress of middle-aged and elderly Japanese men by having informal conversations with them. A self-administered questionnaire was posted to all bars and izakaya-pubs registered in Ohmura-city, Nagasaki prefecture, in December 2009. Among 260 bars and izakaya-pubs, a total of 103 owners and managers completed the questionnaire. More than half of the respondents experienced engaging in conversations with their customers regarding customers’ various personal and private issues. The most frequently talked about problem was that regarding work (56.3%). Regardless of sex and age of the respondents, those with longer working experience in bar and izakaya-pub establishments were more likely to have had customers confiding in them financial problems including debts/loans (adjusted odds ratio: 5.48, p = 0.033). Owners and managers of bars and izakaya-pubs may be in a position to act as “listeners”, to whom middle-aged and elderly men can talk about their personal problems casually and without having to worry about conflict of interests, and direct those in need to professional counseling.

Capacity building of local governmental and non-governmental organizations on environmental hygiene through a community-based training workshop program.

This study was performed to evaluate the feasibility of a joint community-based environmental hygiene program in partnership between local governmental and non-governmental organizations with participants from different professional backgrounds, including inspectors of environmental sanitation and community leaders in Lagos, Nigeria, because no suitable collaboration had been implemented in this area. Qualitative and quantitative evaluations were performed with regard to malaria prevention and community-based environmental hygiene training workshops in three local communities in Lagos, Nigeria. Qualitative evaluation revealed the importance of establishment of close partnerships between local governmental and non-governmental organizations, and possible community participation in the program for its success. A total of 36 participants completed pre- and follow-up assessment before and after the three-day training course. The mean pre-test score was 27.8 ± 13.9 (mean ± standard deviation), while that of the follow-up test was 57.1 ± 17.8. This mean gain of 29.3 ± 17.4 in the score represented a significant improvement (p < 0.001). The objective of the training workshop, i.e., to implement the community-based environmental hygiene program, was successfully achieved. The training workshop also established good relations between governmental and non-governmental organizations with different professional backgrounds, and demonstrated the potential for sustained collaboration.

Experiences of intimate partner violence as perpetrated among Japanese university freshmen

Objectives: To compare experiences regarding the perpetration of intimate partner violence among Japanese university freshmen between 2008 and 2014. Study design: Two-stage cross-sectional study. Methods: A self-administered questionnaire survey was completed in both 2008 and 2014 by students at the same university. Results: There were significant reductions in episodes of verbal harassment (adjusted odds ratio [AOR]: 0.601, 95% confidence interval [CI]: 0.382, 0.945, P = 0.027) that occurred when a boy/girlfriend said “you don’t give me priority” to his/her partner when they did not see them (AOR: 0.450, 95%CI: 0.207, 0.979, P = 0.044), and also in instances of irritation that resulted when a boy/girlfriend disobeyed his/her partner (AOR: 0.385, 95%CI: 0.161, 0.921, P = 0.032) from 2008 to 2014. The perpetration scores were reduced from 1.87 ± 0.16 in 2008 to 1.41 ± 0.117 in 2014 (t test, P = 0.016). The perpetration scores in 2014 were significantly lower than those in 2008, regardless of gender, age, university faculty, and participation in lectures/seminars about domestic violence (DV) and/or dating DV (P = 0.030). Conclusions: Findings showed reductions in some types of harassment, as well as in perpetration scores, between 2008 and 2014 among Japanese university freshmen at the same university. However, further study is required to determine the factors related to the perpetration of harassment.

Contribution of social relationships to self-rated health among Japanese community-dwelling elderly

Objective: Participation in social activities is associated with physical and psychological health in the community-dwelling elderly population. We examined the two factors of social relations and community health resources, associated with higher self-rated health levels in the community-dwelling elderly. Methods: A total of 145 community-dwelling elderly people ≥ 65 years old from two neighborhood associations in Nagasaki City were recruited for this study, representing 85% of the officially registered ≥ 65-year-old population in the target area. Face-to-face interviews using a structured questionnaire were conducted by trained interviewers in August 2009, with questions related to sociodemographic characteristics, social relationships, and self-rated health (SRH). Community health resources (type and walking distance from home) were evaluated by one of the authors as a community assessment. Results: Seventy-eight community-dwelling elderly people (25 men and 53 women) participated in the study. Elderly people who reported going out every day were more likely to show higher SRH scores (excellent/good) than those going out less often (OR: 3.7; 95% confidence interval [CI]: 1.0, 14.2; P = 0.056). The numbers of interactions with friends in higher and lower SRH groups were 6.5 ± 8.4 (mean ± standard deviation) and 2.4 ± 1.1 (P = 0.01, Mann-Whitney U test), respectively. The numbers of relatives talking on the phone in higher and lower SRH groups were 2.9 ± 1.3 and 2.2 ± 1.2 (P = 0.031, Mann-Whitney U test), respectively. Meeting scores with friends in higher and lower SRH groups were 7.8 ± 5.8 and 4.5 ± 3.6 (P = 0.068), respectively. The scores of community health resources among higher and lower SRH groups were 21.2 ± 1.5 and 20.9 ± 1.4 (P = 0.547), respectively. The scores of community association/activities in higher and lower SRH groups were 3.9 ± 1.0 and 3.6 ± 0.9 (P = 0.227), respectively. Conclusion: This study indicated the importance of interaction with friends and relatives for maintaining higher SRH among community-dwelling elderly people.

Challenges in morbidity and mortality statistics of the elderly population in Tanzania: a call to action

Purpose The purpose of this paper is to highlight the challenges in the reported statistics of diseases and deaths in the rapidly expanding elderly cohort of Tanzania. Design/methodology/approach A rapid appraisal of available gaps from known facts and figures targeting the old age cohort of Tanzania. Findings There appears to be no available mechanism(s) to generate reliable statistics on diseases and death patterns in the elderly population of Tanzania. The few available ones are largely hospital-based statistics as well as findings from a select sample of unrepresentative population. Practical implications The findings of morbidity and mortality statistics among the elderly cohort of Tanzania are likely to be confounded by other factors. There is palpable evidence that the elderly cohort in Tanzania is a rapidly growing segment of the population pyramid and therefore needs significant and sustainable resource allocation and utilisation. Social implications Socio-cultural and economic barriers influencing diseases and deaths among old-aged people largely remain unaccounted in Tanzania. Originality/value Scanty evidence of work that specifically targets morbidity and mortality patterns of people aged > 65 years in Tanzania.