Different cultures often express the same symptoms of physical and mental disorders in different ways. Therefore, the original four-factor structure of the Center for Epidemiologic Studies Depression Scale (CES-D) may not be appropriate in all cultural contexts. This study aimed to develop a Laotian version of the CES-D, investigate the reliability and validity of the Laotian CES-D, and examine its factorial properties. This study was conducted in Laos PDR in February 2010. Data were collected from 189 staff members and teachers from the Faculty of Education, National University of Laos using the Laotian CES-D. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted to determine the structure of the Laotian CES-D. We tested whether the Laotian CES-D differed from a single factor model of the 20-item CES-D, and from Radloff's original four-factor solution. CFA results indicated that neither the single factor model nor the four-factor solution was a good fit for a Laotian sample. EFA was conducted to determine a Laotian-specific model, which was tested using CFA. Five items that had low commonality and low factor loadings were excluded in the CFA. Next, we determined a best fit structure comprising three factors: "Sadness/loneliness", "Psychosomatic symptoms", and "Lack of positive affect". This Laotian CES-D model showed high reliability (alpha = 0.81). "Dislike" items loaded on the "Interpersonal" factor in Radloff's model, but loaded on the "Sadness/loneliness" factor in the Laotian model. Items indicating depressive feelings, somatic complaints, and interpersonal relationships were com

BackgroundThe World Bank has reported that global smoking rates declined from 2000 to 2012, with the only exception found in males in Sub-Saharan Africa. Sub-Saharan Africa is considered to be in stage one of the tobacco epidemic continuum. To address this problem, school-based programs for smoking prevention are considered cost-effective and promising. Since tobacco prevention programs are influenced by social competence or customs of each country, tobacco prevention programs that have success in Western countries are not always effective in African countries. Therefore, the current study systematically reviewed relevant literature to examine the effects of these types of programs in African countries.MethodOnline bibliographic databases and a hand search were used. We included the studies that examined the impact of school-based programs on preventing tobacco use in Africa from 2000 to 2016.ResultsSix articles were selected. Four were conducted in South Africa and two were performed in Nigeria. Four programs were systematically incorporated into annual curriculums, targeting 8th to 9th graders, while the other two were temporary programs. All programs were based on the hypothesis that providing knowledge and/or social skills against smoking would be helpful. All studies utilized smoking or polydrug use rates to compare outcomes before/after intervention. There were no significant differences between intervention and control groups in three studies, with the other three demonstrating only partial effectiveness. Additionally, three studies also examined change of knowledge/attitudes towards smoking as an outcome. Two of these showed significant differences between groups.ConclusionAll RCTs studies showed no significant change of smoking-rate by the intervention. The effectiveness of intervention was observed only in some sub-group. The cohort studies showed school-based interventions may be effective in improving knowledge and attitudes about smoking. However, they reported no significant change of smoking-rate by the intervention.

Summary This paper argues the effectiveness of Ecohealth education for improving the quality of health and environmental education and for achieving sustainable development in developing countries. To illustrate the need for Ecohealth education, we review the transitions in health education, environmental education and Education for Sustainable Development (ESD) in various developing countries. Moreover, we discuss issues relating to these disciplines and consider the possible roles that Ecohealth education can play. Then, drawing on a case study conducted in Lao PDR, we propose a concrete example of the teaching content of Ecohealth education. We conclude that Ecohealth education can embody the concepts of ESD with respect to health and environmental issues, and thus can contribute to improvements in the quality of health and environmental education, and of ESD. In addition, we propose the following five actions for implementing Ecohealth education in developing countries: (i) promote research based on the approaches of public health and anthropology, and develop teaching materials that use the research results, (ii) empower school-aged children, (iii) encourage the active involvement and sharing of problems among communities, (iv) strengthen participatory teaching and learning methodology and (v) build a training system and train relevant teachers.