Kathmandu, Nepal
Kathmandu, Nepal

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Pandey S.,Chestnut Hill College | Murugan V.,Washington University in St. Louis | Karki Y.B.,Population | Mathur A.,University of Washington
Health and Social Work | Year: 2017

Authors examined the prevalence and predictors of in-home smoking in households with women of reproductive age. They analyzed data from 9,837 ever married women from 2011 Nepal Demographic Health Survey. About 17 percent of women and 66 percent of their husbands smoked and 58 percent of the women lived in homes that permitted in-home smoking. About 6 percent of the women were pregnant and 42 percent had given birth within the past five years. In-home tobacco use was equally prevalent in homes with and without young children and irrespective of women's pregnancy status. Husband's use of tobacco doubled the odds of in-home smoking (odds ratio [OR] = 2.36; 95% confidence interval [CI] = 1.52-3.69) and wife's use of tobacco quadrupled the odds of in-home smoking controlling for other factors (OR = 3.94; 95% CI = 3.30-4.70). In addition, employed women were 39 percent more likely to allow in-home smoking than their unemployed counterparts (OR = 1.39; 95% CI = 1.19-1.63). Protective factors against in-home smoking were women's education, intrahousehold decision-making ability, household wealth, and urban residence. To reduce in-home smoking, social workers should increase awareness about the adverse consequences of secondhand smoke by providing counseling services to male and female tobacco users. © 2016 National Association of Social Workers.


Andersen K.,University of North Carolina at Chapel Hill | Ganatra B.,University of North Carolina at Chapel Hill | Stucke S.,University of North Carolina at Chapel Hill | Basnett I.,Family Health Division | And 2 more authors.
BMC Public Health | Year: 2012

Background: In March 2002, Nepal's Parliament approved legislation to permit abortion on request up to 12 weeks of pregnancy. Between 2004 and 2007, 176 comprehensive abortion care (CAC) service sites were established in Nepal, leading to a rise in safe, legal abortions. Though monitoring systems have been developed, reporting of complications has not always been complete or accurate. The purpose of this study was to report the frequency and type of abortion complications arising from CAC procedures in different types of facilities in Nepal. Methods. A total of 7,386 CAC clients from a sample of facilities across Nepal were enrolled over a three-month period in 2008. Data collection included an initial health questionnaire at the time of abortion care and a follow-up questionnaire assessing complications, administered two weeks after the abortion procedure. A total of 7,007 women (95%) were successfully followed up. Complication rates were assessed overall and by facility type. Multivariable logistic regression was used to assess the association between experiencing a complication and client demographic and facility characteristics. Results: Among the 7,007 clients who were successfully followed, only 1.87% (n = 131) experienced signs and symptoms of complications at the two-week follow up, the most common being retained products of conception (1.37%), suspected sepsis (0.39%), offensive discharge (0.51%) and moderate bleeding (0.26%). Women receiving care at non-governmental organization (NGO) facilities were less likely to experience complications than women at government facilities, adjusting for individual and facility characteristics (AOR = 0.18; 95% CI: 0.08-0.40). Compared to women receiving CAC at 4-5 weeks gestation, women at 10-12 weeks gestation were more likely to experience complications, adjusting for individual and facility characteristics (AOR = 4.21; 95% CI: 1.38-12.82). Conclusions: The abortion complication rate in Nepali CAC facilities is low and similar to other settings; however, significant differences in complication rates were observed by facility type and gestational age. Interventions such as supportive supervision to improve providers' uterine evacuation skills and investment in equipment for infection control may lower complication rates in government facilities. In addition, there should be increased focus on early pregnancy detection and access to CAC services early in pregnancy in order to prevent complications. © 2011 Andersen et al; licensee BioMed Central Ltd.


Polek B.,Santhera Pharmaceuticals Holding | Roach M.J.,Santhera Pharmaceuticals Holding | Andrews W.T.,Santhera Pharmaceuticals Holding | Ehling M.,Population | Salek S.,University of Cardiff
Frontiers in Pharmacology | Year: 2013

Objective: The study intended to substantiate healthcare resource utilization, costs, and funding patterns of US and Canadian Friedreich's Ataxia (FRDA) populations, to assess compliance with treatment guidance and to identify areas where novel healthcare measures or improved access to existing care may improve patients' functional and social capabilities and reduce the financial impact on the healthcare systems. Methods: Healthcare resource utilization and costs were collected in a cross-sectional study in the US (N = 197) and Canada (N = 43) and analyzed across severity of disease categories. Descriptive statistics, correlation analysis, and hypothesis testing were applied. Results: In the US, healthcare costs of FRDA patients were higher than those of "adults with two and more chronic conditions." Significantly higher costs were incurred in advanced stages of the disease, with paid homecare being the main driver. This pattern was also observed in Canada. Compliance with the recommended annual neurological and cardiological follow-up was high, but was low for the recommended regular speech therapy. In the US public and private funding ratios were similar for the FRDA and the general populations. In Canada the private funding ratio for FRDA was higher than average. Conclusion: The variety of healthcare measures addressing the broad range of symptoms of FRDA, and the increasing use of paid home care as disease progresses made total US healthcare costs of FRDA exceed the costs of US adults with two and more chronic conditions. Therefore, measures delaying disease progression will allow patients to maintain their independence longer and may reduce costs to the healthcare system. Novel measures to address dysarthria and to ensure access to them should be further investigated. The higher than average private funding ratio in Canada was due to the relatively high cost of the pharmacological treatment of FRDA. © 2013 Polek, Roach, Andrews, Ehling and Salek.


WASHINGTON, Nov. 2, 2016 /PRNewswire-USNewswire/ -- The first American Indian Day was celebrated in May 1916 in New York. Red Fox James, a Blackfeet Indian, rode horseback from state to state to get endorsements from 24 state governments to have a day to honor American Indians. In 1990,...


WASHINGTON, Nov. 22, 2016 /PRNewswire-USNewswire/ -- The first American Indian Day was celebrated in May 1916 in New York. Red Fox James, a Blackfeet Indian, rode horseback from state to state to get endorsements from 24 state governments to have a day to honor American Indians. In 1990,...


WASHINGTON, Nov. 2, 2016 /PRNewswire-USNewswire/ -- The first American Indian Day was celebrated in May 1916 in New York. Red Fox James, a Blackfeet Indian, rode horseback from state to state to get endorsements from 24 state governments to have a day to honor American Indians. In 1990,...

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