No abstract

A cross-sectional seroprevalence study on leptospirosis, using microscopic agglutination test (MAT), was conducted in rural villages in Khammouane Province, Lao People's Democratic Republic, in December 2006. The overall prevalence of leptospiral infection among 406 subjects was 23.9% (95% confidence interval [CI] 19.7-28.0%). Independent risk factors for the infection, identified by multivariate logistic regression, were male sex (odds ratio [OR], 1.92; 95% CI: 1.24-2.98), recent flooding on one's own property (OR, 2.12; 95% CI: 1.25-3.58), and collecting wood in the forest (OR, 1.90; 95% CI: 1.17-3.09). Age, occupation, and animal ownership were not associated with seropositivity. Flooding was associated with the risk of infection particularly for women, whose behaviors or activities involving contact with floodwater were presumed to play an important role. This study showed that leptospirosis is endemic in Khammouane Province and that local flooding plays an important role in the transmission of the disease.

BackgroundDiet is a modifiable factor that may affect sleep, but the associations of macronutrient intakes with insomnia are inconsistent. We investigated the associations of protein, fat, and carbohydrate intakes with insomnia symptoms.MethodsIn this cross-sectional analysis of 4435 non-shift workers, macronutrient intakes were assessed by the brief-type self-administered diet history questionnaire, which requires the recall of usual intakes of 58 foods during the preceding month. Presence of insomnia symptoms, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and poor quality of sleep (PQS) were self-reported. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs adjusted for demographic, psychological, and behavioral factors, as well as medical histories.ResultsLow protein intake (<16% vs ≥16% of total energy) was associated with DIS (OR 1.24, 95% CI 0.99–1.56) and PQS (OR 1.24, 95% CI 1.04–1.48), while high protein intake (≥19% vs <19% of total energy) was associated with DMS (OR 1.40, 95% CI 1.12–1.76). Low carbohydrate intake (<50% vs ≥50% of total energy) was associated with DMS (OR 1.19, 95% CI 0.97–1.45).ConclusionsProtein and carbohydrate intakes in the daily diet were associated with insomnia symptoms. The causality of these associations remains to be explained.

These findings imply that higher hs-CRP itself or existence of chronic systemic inflammation precedes onset of T2DM independent of obesity and smoking.

Background: The north-east (NE) region of Sri Lanka observed a critical health workers' shortage after the long-lasting armed conflict. This study aimed to explore medical students' attitudes towards working in the NE and to identify factors determining such attitudes. Methods: A semi-structured, self-administered questionnaire survey was conducted in two medical schools, one in the NE and the other near the capital, in October 2004. Data were qualitatively analysed using the framework approach. Results: Three main themes were identified: 1) Professional motives and career plans; 2) Students' perceptions of the healthcare situation in the NE; and 3) Students' choice of the NE as a future practice location. It was found that familiarity with the difficulties faced by the NE people was a major motivation for medical students to work in the NE in the future. For NE students, familiarity was linked to their sense of belonging. For non-NE students, their personal experience of the NE familiarized them with the difficult situation there, which positively influenced their willingness to work there. Demotivations to work in the NE were poor working and living conditions, fewer opportunities for postgraduate education, language differences, insecurity, and fear of an unpleasant social response from the NE communities. Conclusions: NE local medical students had a sense of belonging to the NE and compassion for the Tamil people as members of the ethnic group. They were willing to work in the NE if their concerns about difficult working and living conditions and postgraduate education could be solved. Non-NE students who were familiar with the NE situation through their personal experience also showed a willingness to work there; thus, early exposure programmes in medical education might help to increase the health workforce in the NE. It is also expected that non-NE physicians working for the NE people would facilitate reconciliation and the rebuilding of trust between two ethnic groups.