Iran, America and Iranian American Community in Firoozeh Jazayeri Dumas\u27 Funny in Farsi

Post 9/11 the United States of America concerns the reconstruction of already demonized identities of Arabs and Middle-eastern cultures. Postcolonial works reside in their rendering a tragic or serious image of Middle Easterners to bring the Western (American) audience into sympathizing with the Middle Eastern ethnicities. Could it be the case that a fundamentally humorous (not derogatory) depiction might contribute to easing such cultural tensions? Firoozeh Jazayeri Dumas\u27 works stand out as critically acclaimed and successful works familiarizing the American audience with the more humane, likeable, sweet and funny aspects of the Iranians and Iranian culture, and the hardships of being an Iranian immigrant and becoming a hybrid individual. This article explores the already-hybridized self and psyche of Firoozeh as an Iranian American. She writes about her mother land and her residence country and comparing the way she has written about them can help readers understand how one can make peace between different parts of her identity

Psychosocial and obstetric determinants of women signalling distress during Edinburgh Postnatal Depression Scale (EPDS) screening in Sydney, Australia

Background and objectives: The perinatal period presents a high-risk time for development of mood disorders. Australia-wide universal perinatal care, including depression screening, make this stage amenable to population-level preventative approaches. In a large cohort of women receiving public perinatal care in Sydney, Australia, we examined: (1) the psychosocial and obstetric determinants of women who signal distress on EPDS screening (scoring 10-12) compared with women with probable depression (scoring 13 or more on EPDS screening); and (2) the predictive ability of identifying women experiencing distress during pregnancy in classifying women at higher risk of probable postnatal depression. Methods: We analysed routinely collected perinatal data from all live-births within public health facilities from two health districts in Sydney, Australia (N = 53,032). Perinatal distress was measured using the EPDS (scores of 10-12) and probable perinatal depression was measured using the EPDS (scores of 13 or more). Logistic regression models that adjusted for confounding variables were used to investigate a range of psychosocial and obstetric determinants and perinatal distress and depression. Results: Eight percent of this cohort experienced antenatal distress and about 5 % experienced postnatal distress. Approximately 6 % experienced probable antenatal depression and 3 % experienced probable postnatal depression. Being from a culturally and linguistically diverse background (AOR = 2.0, 95% CI 1.8-2.3, P < 0.001), a lack of partner support (AOR = 2.9, 95% CI 2.3-3.7) and a maternal history of childhood abuse (AOR = 1.9, 95% CI 1.6-2.3) were associated with antenatal distress. These associations were similar in women with probable antenatal depression. Women who scored 10 to12 on antenatal EPDS assessment had a 4.5 times higher odds (95% CI 3.4-5.9, P < 0.001) of experiencing probable postnatal depression compared with women scoring 9 or less. Conclusion: Antenatal distress is more common than antenatal depressive symptoms and postnatal distress or depression. Antenatal maternal distress was associated with probable postnatal depression. Scale properties of the EPDS allows risk-stratification of women in the antenatal period, and earlier intervention with preventively focused programs. Prevention of postnatal depression could address a growing burden of illness and long-term complications for mothers and their infants

Perinatal distress and depression in culturally and linguistically diverse (CALD) Australian women : the role of psychosocial and obstetric factors

Perinatal distress and depression can have significant impacts on both the mother and baby. The present study investigated psychosocial and obstetric factors associated with perinatal distress and depressive symptoms among culturally and linguistically diverse (CALD) Australian women in Sydney, New South Wales. The study used retrospectively linked maternal and child health data from two Local Health Districts in Australia (N = 25,407). Perinatal distress was measured using the Edinburgh Postnatal Depression Scale (EPDS, scores of 10–12) and depressive symptoms, with EPDS scores of 13 or more. Multivariate multinomial logistic regression models were used to investigate the association between psychosocial and obstetric factors with perinatal distress and depressive symptoms. The prevalence of perinatal distress and depressive symptoms among CALD Australian women was 10.1% for antenatal distress; 7.3% for antenatal depressive symptoms; 6.2% for postnatal distress and 3.7% for postnatal depressive symptoms. Antenatal distress and depressive symptoms were associated with a lack of partner support, intimate partner violence, maternal history of childhood abuse and being known to child protection services. Antenatal distress and depressive symptoms were strongly associated with postnatal distress and depressive symptoms. Higher socioeconomic status had a protective effect on antenatal and postnatal depressive symptoms. Our study suggests that current perinatal mental health screening and referral for clinical assessment is essential, and also supports a re-examination of perinatal mental health policy to ensure access to culturally responsive mental health care that meets patients’ needs

Household air pollution and under-five mortality in South Asia : epidemiology and policies for prevention

Household air pollution (HAP), predominantly from cooking fuel, is a major public health hazard and one of the leading causes of respiratory illness and death among young children under-five years of age. Approximately, 3 billion people still rely on solid fuels (e.g. wood, crop residue, coal, animal dung etc.) for their everyday cooking and heating. Exposure to HAP resulting from indoor smoke from solid fuels is a substantial cause of respiratory illness and death among young children in low and middle-income countries, and globally, more than 2.9 million annual deaths have been attributed to HAP. Very few studies in the South Asian region have addressed HAP related child mortality outcomes, which is an ongoing public health concern. Most of the studies in this region have mainly focused on HAP related morbidity outcomes among young children. This thesis examined the association between HAP from cooking fuel and under-five mortality in South Asia by using nationally representative surveys. Specifically, a series of studies for Bangladesh, India, Pakistan and Nepal were conducted in this thesis to investigate the following: (1) to establish the strength of the association between HAP from use of cooking fuel and under-five mortality in Bangladesh, India, Pakistan and Nepal; (2) to investigate trends in HAP and its impact on under-five mortality over time in South Asia; (3) to identify the role of key environmental and behavioral factors (for example, breastfeeding status, place of residence and location of kitchen) that might affect the level of HAP exposure from use of cooking fuel associated with under-five mortality within South Asian countries; (4) to assess the attributable risk associated with HAP from use of cooking fuel and under-five mortality, and to examine theoretical scenarios assessing the potential impact of interventions to reduce HAP exposure. A series of nationally representative Demographic and Health Survey (DHS) datasets for Bangladesh, India, Pakistan and Nepal were used to address these specific objectives

Potential impacts of modifiable behavioural and environmental exposures on reducing burden of under-five mortality associated with household air pollution in Nepal

Objectives Household air pollution (HAP) is one of the leading causes of respiratory illness and deaths among young children in low and lower-middle income countries. This study examines for the first time trends in the association between HAP from cooking fuel and under-five mortality and measures the potential impact of interventions to reduce HAP using Nepal Demographic and Health Survey datasets (2001–2011). Methods A total of 17,780 living children across four age-groups (neonatal 0–28 days, post-neonatal 1–11 months, child 12–59 months and under-five 0–59 months) were included and multi-level logistic regression models were used for analyses. Population attributable fractions of key risk factors and potential impact fractions assessing the impact of previous interventions to reduce exposure prevalence were also calculated. Results Use of cooking fuel was associated with total under-five mortality (OR 2.19, 95% CI 1.37–3.51, P = 0.001) in Nepal, with stronger associations evident for sub-group analyses of neonatal mortality (OR 2.67, 95% CI 1.47–4.82, P = 0.001). Higher association was found in rural areas and for households without a separate kitchen using polluting fuel for cooking, and in women who had never breastfed for all age-groups of children. PIF estimates, assuming a 63% of reduction of HAP based on previously published interventions in Nepal, suggested that a burden of 40% of neonatal and 33% of under-five mortality cases associated with an indoor kitchen using polluting fuel could be avoidable. Conclusion Improved infrastructure and behavioral interventions could help reduce the pollution from cooking fuel in the household resulting in further reduction in under-five mortality in Nepal

Household air pollution and under-five mortality in India (1992-2006)

Background: Household air pollution (HAP) - predominantly from cooking fuel is a major public health hazard and one of the leading causes of respiratory illness and deaths among children under-five years in India. This study investigates the association between HAP from cooking fuel and under-five mortality using India’s National Family and Health Survey (NFHS) datasets over the period 1992–2006 (total of 166,382 children), and the extent to which the association differed by environmental and behavioral factors affecting level of exposure. Methods: The association between HAP and under-five mortality of three age-groups (neonatal age between 0–28 days, post-neonatal age between 1–11 months and children aged between 12–59 months) was examined using multi-level logistic regression models. Results: HAP was associated with mortality among children aged under-five (OR = 1.30, 95%CI = 1.18-1.43, P < 0.001) and was more strongly associated in sub-group analyses of post-neonatal mortality (OR = 1.42, 95%CI = 1.19-1.71, P < 0.001) and child mortality (OR = 1.42, 95%CI = 1.05-1.91, P = 0.021) than neonatal mortality (OR = 1.23, 95%CI = 1.09-1.39, P = 0.001). The association was stronger for households in rural areas and for households without a separate kitchen using polluting fuel, and in women who had never breastfed for all age-groups. Conclusion: Use of cooking fuel in the household is associated with increased risk of mortality in children aged under-five years. Factors relating to access to clean fuels, improvements in infrastructure and household design and behavioral factors are discussed, and can result in further declines in under-five mortality in India

Household air pollution and under-five mortality in Bangladesh (2004-2011)

Household air pollution (HAP) is one of the leading causes of respiratory illness and deaths among children under five years in Bangladesh. This study investigates the association between HAP from cooking fuel and under-five mortality using Bangladesh Demographic and Health Survey (BDHS) datasets over the period 2004–2011 (n = 18,308 children), and the extent to which this association differed by environmental and behavioral factors affecting level of exposure. The association between HAP and neonatal (age between 0–28 days), infant (age between 0 and 11 months) and under–five (age between 0 and 59 months) mortality was examined using multilevel logistic regression models. HAP was not strongly associated with overall neonatal (OR = 1.49, 95% CI = 1.01–2.22, p = 0.043), infant (OR = 1.27, 95% CI = 0.91–1.77, p = 0.157) or under-five mortality (OR = 1.14, 95% CI = 0.83–1.55,p = 0.422) in the context of overall decreasing trends in under-five mortality. The association was stronger for households with an indoor kitchen using polluting fuels, and in women who had never breastfed. Reductions in exposure to pollution from cooking fuel, given it is a ubiquitous and modifiable risk factor, can result in further declines in under-five mortality with household design and behavioural interventions

Risk of child and under-five mortality by breastfeeding status and kitchen location.

<p>Risk of child and under-five mortality by breastfeeding status and kitchen location.</p

Use of cooking fuel associated with total under-five mortality in Pakistan.

<p>Ref = Reference category; n = number of under-five mortality cases and N = total number of under-five children; n(%) = weighted incidence proportion of under-five mortality cases; OR (95% CI) = odds ratio adjusted for wealth index, place of residence, mother’s age, education and working status, sex of child, breastfeeding status, household’s floor material and wall material, location of kitchen and smoking status of mother; clean fuels = electricity, liquid petroleum gas (LPG), natural gas, biogas; Polluting fuels = kerosene, coal/lignite, charcoal, wood, straw/shrubs/grass and animal dung.</p