Correlates of Intimate Partner Physical Violence Among Young Reproductive Age Women in Mysore, India

Few studies have examined intimate partner physical violence (IPPV) in south India. This article examines the frequency and correlates of IPPV among 898 young married women from urban, rural, and periurban areas of Mysore, India. Most (69.2%) of the participants were Hindus and 28.7% were Muslims. Overall, 50% of participants reported some type of IPPV. Factors that were independently associated with IPPV included being younger than 18 years at the time of marriage, contributing some household income, having anal sex, reporting sexual violence, and having a sex partner who drinks alcohol and smokes cigarettes. Women with skilled occupation were at reduced odds of experiencing IPPV compared with women who did not work. These findings suggest that IPPV is highly prevalent in this setting and that additional interventions are needed to reduce morbidity particularly among young women. These data also suggest that more studies are needed among men who perpetrate IPPV in south India

Literature Review and Meta-Analysis on Micronutrient Fortified Condiments and Noodles: Reduction of Anemia in Children and Adults

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Examining the Determinants of Sexual Violence Among Young, Married Women in Southern India

The prevalence of sexual violence is increasingly being studied in India. Yet the determinants of sexual violence, irrespective of physical violence, remain largely unexplored. Here the authors identify the determinants of sexual violence, and additionally, explore how the presence of physical violence modifies these determinants. A cross-sectional analysis is conducted using baseline data from a longitudinal study involving young married women attending reproductive health clinics in Southern India. A multivariable logistic regression analysis is conducted to first identify determinants of sexual violence and then repeated after stratifying elements based on presence or absence of physical violence identified from participants’ reports. 36% and 50% of the participants report experiencing sexual and physical violence, respectively. After adjusting for other covariates, women’s partners’ characteristics are found most significantly associated with their odds of experiencing sexual violence. These characteristics include husbands’ primary education, employment as drivers, alcohol consumption, and having multiple sex partners. Women’s contribution to household income also increases their odds of experiencing sexual violence by almost twofold; however, if they are solely responsible for “all” household income, the relationship is found to be protective. Physical violence modifies the determinants of sexual violence, and among women not experiencing physical violence, husbands’ primary education and employment as drivers increase women’s odds of experiencing sexual violence nearly threefold, and women who contribute “all” the household income (n = 62) do not experience sexual violence. These relationships are not significant among women experiencing physical violence. Study findings improve the understanding of the determinants of sexual violence. Future research is needed to examine the risk factors for different types of GBV independently and to tease apart the differences in risk factors depending on women’s experiences. The significance of male partners’ characteristics warrants in-depth research, and in order to promote gender-equitable norms, future interventions need to focus on male behaviors and men’s day-to-day survival challenges, all of which likely influence conflicts in marital relationships

Structural Equation Modeling to Detect Correlates of Childhood Vaccination: A Moderated Mediation Analysis

OBJECTIVES: This study used a health belief theory derived framework and structural equation model to examine moderators, mediators, and direct and indirect predictors of childhood vaccination. METHODS: A secondary analysis was conducted using data collected from a cross-sectional survey of a random sample of 1599 parents living in urban and rural areas of Mysore district, India. Applying two-stage probability proportionate-to-size sampling, adolescent girls attending 7th through 10th grades in 23 schools were selected to take home a questionnaire to be answered by their parents to primarily assess HPV vaccine intentions. Parents were also asked whether their children had received one dose of Bacillus Calmette-Guérin; three doses of Diphtheria, Pertussis, Tetanus; three doses of oral Polio vaccine; and one dose of Measles vaccine. In addition, parents were asked about their attitudes towards childhood vaccination. RESULTS: Out of the 1599 parents, 52.2% reported that their children had received all the routine vaccines (fully vaccinated); 42.7% reported their children had missed at least one routine vaccine, and 5.2% reported that their children had missed all routine vaccinations. Perceptions about the benefits/facilitators to childhood vaccination significantly predicted the full vaccination rate (standardized regression coefficient (β) = 0.29) directly and mediated the effect of parental education (β = 0.11) and employment (β = -0.06) on the rate of full vaccination. Parental education was significantly associated indirectly with higher rates of full vaccination (β = 0.11). Parental employment was significantly associated indirectly with decreasing rates of full vaccination (β = -0.05). Area of residence moderated the role of religion (β = 0.24) and the \u27number of children\u27 in a family (β = 0.33) on parental perceptions about barriers to childhood vaccination. The model to data fit was acceptable (Root Mean Square Error of Approximation = 0.02, 95% CI 0.018 to 0.023; Comparative Fit Index = 0.92; Tucker-Lewis Index = 0.91). CONCLUSIONS: Full vaccination rate was relatively low among children in Mysore, especially among parents who were unsure about the benefits of routine vaccination and those with low educational levels. Interventions increasing awareness of the benefits of childhood vaccination that target rural parents with lower levels of education may help increase the rate of full childhood vaccination in India

Predictors of Cigarette Smoking Progression Among a School-Based Sample of Adolescents in Irbid, Jordan: A Longitudinal Study (2008–2011)

INTRODUCTION: Little evidence regarding longitudinal predictors of cigarette smoking progression is available from developing countries. This study aimed to identify gender-specific individual and social predictors of cigarette smoking progression among a school-based sample of adolescents in Irbid, Jordan. METHODS: A total of 1781 seventh graders (participation rate 95%) were enrolled and completed an annual self-administered questionnaire from 2008 through 2011. Students who reported ever-smoking a cigarette at baseline or in the subsequent follow-up but not being heavy daily smokers (\u3e10 cigarettes per day) were eligible for this analysis (N = 669). Grouped-time survival analyses were used to identify predictors of cigarette smoking progression in boys and girls. RESULTS: Among the study sample, 38.3% of students increased the frequency and /or amount of cigarette smoking during the 3 years of follow-up. Among individual factors, the urge to smoke in the morning predicted smoking progression for boys and girls. The independent predictors of cigarette smoking progression were friends\u27 smoking and attending public schools in boys, and siblings\u27 smoking in girls. Discussing the dangers of smoking with family members was protective for girls. CONCLUSION: Boys and girls progressed similarly in cigarette smoking once they initiated the habit. Progression among girls was solely family-related, while it was peer-related for boys

Waterpipe a gateway to cigarette smoking initiation among adolescents in Irbid, Jordan: a longitudinal study

SETTING: According to anecdotal evidence, waterpipe smoking may lead to the initiation of cigarette smoking among young people. This hypothesis is yet to be examined using an appropriate study design and a theoretical model for behavioral change. OBJECTIVE: To compare the risk of cigarette smoking initiation among waterpipe-only smokers and never smokers in a school-based sample of adolescents from Irbid, Jordan. METHODS: A total of 1454 cigarette-naïve participants were drawn from a longitudinal study on smoking behavior conducted in Irbid among 1781 seventh graders who were enrolled at baseline (2008) and completed the study questionnaire on smoking behavior annually until 2011. Grouped time-survival analysis was used to compare the risk of subsequent initiation of cigarette smoking between waterpipe smokers (n = 298) and never smokers (n = 1156) using adjusted hazard ratios (aHRs) and 95% confidence intervals (95%CI). RESULTS: Risk of initiation of cigarette smoking among waterpipe smokers was significantly higher than among never smokers after adjusting for potential confounders (aHR 1.67, 95%CI 1.46–1.92). The association between waterpipe and cigarette smoking initiation was dose-dependent. The risk of initiating cigarette smoking increased with increase in the frequency of waterpipe smoking (P for linear trend < 0.001). CONCLUSIONS: Waterpipe smoking led to the initiation of cigarette smoking among this cohort of Jordanian adolescents; the effect was dose-dependent

Role of Healthcare Providers� Recommendation Style in HPV Vaccine Decision-Making among Haitian Parents and Female Patients

Background and Purpose: The strong influence of physician recommendation on vaccine uptake is well established in the literature. However, its influence on HPV vaccine decision-making among young Haitian women is understudied. This study investigated the role of healthcare providers� recommendation style in Haitian parents� and female patients� HPV vaccine decision-making. Methods: Thirty selfidentified Haitian women aged 17-26 years were recruited from a large university campus in the Southeastern United States (N=30). They completed in-depth face-to-face interviews regarding their HPV vaccine decision-making process. Transcripts were analyzed using thematic analysis. Results: Provider recommendation was cited as a major factor that influenced HPV vaccine uptake. Additionally, the framing of the HPV vaccine message greatly influenced vaccine decisions. Messages that framed the vaccine as a preventive measure for cervical cancer or as a preventive vaccine without an emphasis on the sexual transmission route of the virus were most effective. Messages that framed the vaccine as a preventive measure against a sexually transmitted infection did not positively influence young women to be vaccinated. Conclusions: These findings indicate that providers� recommendation style highly affects HPV vaccine decision. Thus, appropriate HPV vaccine framing is important for encouraging vaccine uptake in this ethnic group

Plasmodium falciparum and soil-transmitted helminth co-infections among children in sub-Saharan Africa: a systematic review and meta-analysis

The epidemiology of soil-transmitted helminth (STH) and Plasmodium co-infections need better understanding. The findings of the individual studies are inconclusive. A systematic review was conducted to synthesize evidence on the association of STH infection with the prevalence and density of Plasmodium falciparum infection, and its effect on anaemia among children in sub-Saharan Africa (SSA)

Predictors of waterpipe smoking progression among youth in Irbid, Jordan: A Longitudinal Study (2008-2011)

BACKGROUND: The predictors of waterpipe smoking progression are yet to be examined using a longitudinal study that is guided by a theoretical model of behavioral change. This study identifies the gender-specific predictors of waterpipe smoking progression among adolescents in Irbid, Jordan. METHODS: This study uses data from a school longitudinal study of smoking behavior in Irbid, Jordan. A random sample of 19 schools was selected by probability proportionate to size. A total of 1781 seventh graders were enrolled at baseline, and completed a questionnaire annually from 2008 through 2011. Students who reported ever smoking waterpipe (N = 864) at any time point were assessed for progression (escalation in the frequency of waterpipe smoking) in the subsequent follow-up. Grouped-time survival analysis was used to identify the risk of progression. RESULTS: During the three years of follow-up, 29.6% of students progressed in waterpipe smoking. Predictors of waterpipe smoking progression were higher mother's education, enrollment in public school, frequent physical activity, and low refusal self-efficacy among boys, having ever smoked cigarettes, and having friends and siblings who smoke waterpipe among girls. Awareness of harms of waterpipe was protective among boys and seeing warning labels on the tobacco packs was protective among girls. CONCLUSIONS: Even at this early stage, about a third of waterpipe smokers progressed in their habit during the 3 year follow up. Factors predicting progression of use differed by gender, which calls for gender-specific approaches to waterpipe interventions among Jordanian youth

Are marginalized women being left behind? A population based study of institutional births in Rural India

Background While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. Methods A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery. Results Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. While increasing numbers of women were accessing antenatal care and delivering in hospitals, large disparities were found in uptake of these services among different castes. Mothers belonging to general castes were almost twice as likely to have an institutional birth as compared to scheduled castes and tribes. Mothers belonging to other backward caste or general castes had 1.8 times higher odds (95% CI: 1.21, 2.89) of having an institutional delivery as compared to scheduled castes and tribes. In multivariable analysis, which adjusted for inter- and intra-village variance, Below Poverty Line status, caste, and receiving antenatal care were all associated with institutional delivery. Conclusion The results of the study suggest that while the Indian Government has made significant progress in increasing antenatal care and institutional deliveries among rural populations, further success in lowering maternal mortality will likely hinge on the success of NRHM programs focused on serving marginalized groups. Health interventions which target SC/ST may also have to address both perceived and actual stigma and discrimination, in addition to providing needed services. Strategies for overcoming these barriers may include sensitization of healthcare workers, targeted health education and outreach, and culturally appropriate community-level interventions. Addressing the needs of these communities will be critical to achieving Millennium Development Goal Five by 2015