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With global estimates showing an increasing trend in flooding and its adverse effects on communities and population health, resilience is presented as a concept with potential to help integrate disaster risk management, sustainable development, and climate change adaptation concerns. Resilience research and practice have conceptual and empirical challenges of how to understand, characterize and measure resilience, particularly at community level. Using a multidimensional framework, this paper takes a systems approach to understanding, characterizing, and measuring community flood resilience. Through cluster analysis, bivariate methods and multivariable‐adjusted binary logistic regression modeling, we developed a context and hazard specific construct of community flood resilience and investigated its predictor variables. The factors defining the community flood resilience construct captured the community needs to withstand disasters through purpose‐built infrastructure, early warning systems for preparedness and utilization of local human capacity for adaptation. These results strengthen the previous arguments for utilizing a comprehensive multidimensional framework for resilience analysis. Access to services for improved health and psychosocial well‐being was significantly associated with the three‐item measure of being more flood resilient. Additionally, a strong sense of place and resistance to relocation were presented as key elements of resilience, maintaining community system function, and preserving livelihoods. The study further found that these key factors would not be adequate to guarantee community flood resilience outside the transformative capacity of a well‐resourced village civil protection committee that can prepare and mobilize stakeholders in response to flood emergencies. Our results suggest that, in the context where policymakers seek to strengthen resilience of communities without relocating them, a focus on public health and on strengthening and utilizing local capacities as adaptation, are key in disaster risk management policymaking and implementation. For the international research community, this study demonstrated the importance of utilizing context and hazard specific measures for defining, characterizing, and measuring resilience to inform policy. [ABSTRACT FROM AUTHOR]

An editorial is presented which addresses recommendations regarding the implementation of Article 14 of the World Health Organization's (WHO's) Framework Convention on Tobacco Control which deals with evidence-based support for tobacco smoking cessation. The international public health aspects of tobacco cessation are examined, along with well-being, premature mortality prevention, and the United Nations' Sustainable Development Goals. Tobacco cessation costs and affordability are assessed.

Background and Aims Tuberculosis ( TB) patients who smoke risk adverse TB outcomes and other long-term health effects of smoking. This study aimed to determine the efficacy of brief motivational interviewing by lay health-care workers ( LHCWs) in assisting TB patients to quit smoking. Design Multi-centre two-group parallel individual randomized controlled trial. Setting Six primary care tuberculosis clinics in a South African township. Participants Newly diagnosed adult TB patients identified as current smokers were randomized to brief motivational interviewing by a LHCW (intervention group, n = 205) or brief smoking cessation advice from a TB nurse (control group, n = 204). Measurements The primary outcome was self-reported sustained 6-month smoking abstinence. Exhaled carbon monoxide ( CO) testing was offered to about half the participants. Secondary outcomes were sustained abstinence at 3 months; 7-day point prevalence abstinence at 1, 3 and 6 months; and quit attempts. Allocation was concealed. Primary analysis relied on intention to treat. Multi-level analysis accounted for site heterogeneity of effect. Findings Self-reported 6-month sustained abstinence was 21.5% for the intervention group versus 9.3% for the control group [relative risk ( RR) = 2.29, 95% confidence interval ( CI) = 1.34, 3.92]. Biochemically verified 6-month sustained abstinence was also higher in the intervention group ( RR 2.21, 95% CI = 1.08, 4.51) for the 166 participants who were offered carbon monoxide testing. Self-reported 3-month sustained abstinence was 25.4% for the intervention group and 12.8% for the control group ( RR = 1.98, 95% CI = 1.24, 3.18). Conclusions Motivational interviewing by lay counsellors to promote smoking cessation in tuberculosis patients in South Africa approximately doubled sustained smoking abstinence for at least 6 months compared with brief advice alone. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between adolescents’ sense of coherence (SOC) and their tooth-brushing behaviour. Methods: This 18-month longitudinal study involved a representative sample of 8th-graders ( n = 1025) from 11 randomly selected public high schools in the Limpopo Province, South Africa. Data collected by means of a self-administered questionnaire included respondents’ socio-demographic profiles, vulnerability to depression, smoking status, dental treatment attendance pattern, frequency of and motivation for tooth-brushing. Based on the responses to the question on readiness to change brushing behaviour and in line with the integrated change model, respondents were also categorized as being in the pre-contemplation, contemplation or preparation/action stages. Respondents’ SOC was measured using a six-item adapted Antonovsky SOC scale. Data analysis included chi-squared analysis, t-tests and step-wise multiple logistic regression. Results: At baseline, 72.6% ( n = 744) of the respondents reported that they were not consistently brushing twice daily. Of those who did not brush twice daily and were followed up on ( n = 578), those living with their mother at baseline not only presented with a greater increase in their SOC over time (follow-up minus baseline), but they were also more likely to be brushing twice daily at the time of the follow-up (15.4% versus 10.6%; P = 0.04). Adding baseline intention state to a multivariate model attenuated the influence of baseline SOC to a statistically insignificant level. However, increasing within-subject SOC changes (β = 0.16; P < 0.01), living with the mother (β = 0.11; P < 0.05), smoking (β = −0.14; P < 0.05), being depression vulnerable (β = −0.23; P < 0.01) and in the preparation/action stage (β = 0.13; P < 0.05) remained associated with the transition to twice-daily tooth-brushing. Conclusions: In planning oral health promotion interventions, it should be considered that children’s psychological predisposition and family environment might significantly influence their tooth-brushing behaviour. [ABSTRACT FROM AUTHOR]

The negative oral health effects of smoking, such as stained teeth, gum infection, and bad breath may be more salient to adolescents, and therefore, more important expectancies for adolescent smokers and nonsmokers alike. Informed by the social cognitive theory, this prospective study sought to determine the role of smoking-related attitude to oral health on smoking onset among adolescents over a 12-month interval. This prospective study involved a community sample of 422 nonsmoking eighth graders selected from three public schools in the capital city of South Africa. Data were collected through a questionnaire, which included a 5-point Likert-scale-type question on dental disease belief related to smoking (smoking causes plaque and bad breath) and an affective evaluation of this effect (bad breath causes peer rejection). The product of these two later variables was used to compute an attitude score. Higher scores represent a more favorable oral health attitude. Health-risk behaviors recorded included past month smoking and alcohol use. The mean age of the participants was 13.9 years at baseline. At 1-year follow-up, 11.4 percent (n = 48) of nonsmokers at baseline had initiated smoking. Compared to nonsmokers, current smokers were more likely to report frequent bleeding gums (51.2 versus 33.1 percent; P = 0.02), but there was no significant difference in proportions brushing twice daily (64.4 versus 56.5 percent; P = 0.30). In addition to the independent influence of peers and binge drinking, smoking-related attitude to oral health significantly influenced smoking onset. The study findings support the development of smoking prevention programs that include restructuring of cognitions about the oral health outcomes of smoking. [ABSTRACT FROM AUTHOR]

Objective: This study sought to determine the influence of sense of coherence (SOC), a personal stress-coping resource, and smoking on the self-reported gingival health of a cohort of rural black South African adolescents. Methods: This 18-month study involved a three-wave survey of a representative sample of eighth graders from 11 randomly selected high schools in the Limpopo province, South Africa ( n=970). Using a generalized estimating equation model, we examined the correlates of recent gingivitis, defined as self-reporting frequent gingival bleeding (GB). Explanatory variables included baseline socio-economic status, age, gender, plaque levels, toothbrushing frequency, tobacco use status and SOC levels. Results: Among our sample, 74.6% reported experiencing gingivitis at some point during follow-up, while 41.9% reported frequent GB at the last survey. Factors that were positively associated with recent gingivitis include living in poor households [odds ratio (OR)=1.49; p<0.01], having higher plaque levels (OR=1.18; p=0.04) and smoking regularly (OR=1.57; p=0.04). Self-reporting gingivitis was negatively associated with being female (OR=0.76; p=0.02) and having a higher SOC (OR=0.96; p<0.001). Conclusions: Adolescent smoking and SOC levels are independent predictors of self-reported gingivitis. Therefore, in addition to plaque control, smoking prevention and the teaching of stress-coping skills may be important interventions for promoting adolescents' gingival health. [ABSTRACT FROM AUTHOR]