342 research outputs found
Geographic and socio-economic variation in markers of indoor air pollution in Nepal: Evidence from nationally-representative data
© 2019 The Author(s). Background: In low-income countries such as Nepal, indoor air pollution (IAP), generated by the indoor burning of biomass fuels, is the top-fourth risk factor driving overall morbidity and mortality. We present the first assessment of geographic and socio-economic determinants of the markers of IAP (specifically fuel types, cooking practices, and indoor smoking) in a nationally-representative sample of Nepalese households. Methods: Household level data on 11,040 households, obtained from the 2016 Nepal Demographic and Health Survey, were analyzed. Binary logistic regression analyses were conducted to assess the use of fuel types, indoor cooking practices, indoor smoking and IAP with respect to socio-economic indicators and geographic location of the household. Results: More than 80% of the households had at least one marker of IAP: 66% of the household used unclean fuel, 45% did not have a separate kitchen to cook in, and 43% had indoor smoking. In adjusted binary logistic regression, female and educational attainment of household's head favored cleaner indoor environment, i.e., using clean fuel, cooking in a separate kitchen, not smoking indoors, and subsequently no indoor pollution. In contrast, households belonging to lower wealth quintile and rural areas did not favor a cleaner indoor environment. Households in Province 2, compared to Province 1, were particularly prone to indoor pollution due to unclean fuel use, no separate kitchen to cook in, and smoking indoors. Most of the districts had a high burden of IAP and its markers. Conclusions: Fuel choice and clean indoor practices are dependent on household socio-economic status. The geographical disparity in the distribution of markers of IAP calls for public health interventions targeting households that are poor and located in rural areas
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Achieving universal health coverage in Nepal
https://blogs.bmj.com/bmj/2019/02/15/amrit-banstola-et-al-achieving-universal-health-coverage-in-nepal
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Home-related and work-related injuries in Makwanpur district, Nepal: A household survey
Data availability statement: Data are available upon reasonable request.Objective: To describe the epidemiology of home-related and work-related injuries, their mechanisms, inequalities and costs associated with these injuries.
Methods: A household survey was undertaken in three palikas of Makwanpur district between April and June 2019. Data were collected electronically on non-fatal injuries that occurred in the previous 3 months and fatal injuries that occurred in the previous 5 years.
Findings: 17 593 individuals were surveyed from 3327 households. Injury rates were 8.0 per 1000 population for home injuries and 6.4 per 1000 for work-related injuries; 61.0% of home injuries were among women and 69.9% of work-related injuries among men. Falls were the cause of 48% home injuries, affecting 50.9% of men and 46.5% of women. Burns/scalds were higher in women than men, affecting 17.4% of women reporting home injuries. Cuts and piercings accounted for 39.8% of all work-related injuries and 36.3% were falls. Injury incidence varied by ethnic group: home injuries were highest in Brahmin (12.0 per 1000) and work-related injuries highest in Rai groups (21.0 per 1000). The total mean costs (transport and treatment) of work-related injury was US130.4, SD 347.6). The number of home (n=74, 64.9%) and work-related (n=67, 77.9%) injuries were higher in families below the poverty line than families in the next income bracket (home: n=22, 19.3%; work: n=11, 12.8%).
Conclusions: Home-related and work-related fall injuries are common. The inequalities in injury identified in our study by rurality, age, sex, income level and ethnic group can help target injury prevention interventions for vulnerable groups.This research was funded by the National Institute for Health Research (NIHR) (Ref:16/137/49) using UK aid from the UK Government to support global health research
Role of Alfuzosin in Ureteral Stent Related Urinary Symptoms Score: A Comparative Study
Background: Ureteral stent placement is a routine urological procedure. However, patients inserted with ureteral stent exhibited increased urinary symptoms that compromise patients’ quality of life.
Objective: To assess the efficacy of alpha blockers (Alfuzosin) in the management of ureteral stent related urinary symptoms.
Methods: Total of 60 patients after ureteral stent insertion was randomly divided into two equal groups; 30 in alfuzosin group and the remaining 30 in control group. Urinary symptoms questionnaire was filled after two weeks and results were statistically analyzed.
Results: Urinary symptoms like urgency, frequency and flank pain were significantly less in the alfuzosin group when compared with control group.
Conclusion: Alpha blocker (Alfuzosin) was found to be effective in reducing ureteral stent related urinary symptoms.
Journal of Gandaki Medical College
Vol. 10, No. 1, 2017, page: 28-3
Latin Americans show wide-spread Converso ancestry and imprint of local Native ancestry on physical appearance
Historical records and genetic analyses indicate that Latin Americans trace their ancestry mainly to the intermixing (admixture) of Native Americans, Europeans and Sub-Saharan Africans. Using novel haplotype-based methods, here we infer sub-continental ancestry in over 6,500 Latin Americans and evaluate the impact of regional ancestry variation on physical appearance. We find that Native American ancestry components in Latin Americans correspond geographically to the present-day genetic structure of Native groups, and that sources of non-Native ancestry, and admixture timings, match documented migratory flows. We also detect South/East Mediterranean ancestry across Latin America, probably stemming mostly from the clandestine colonial migration of Christian converts of non-European origin (Conversos). Furthermore, we find that ancestry related to highland (Central Andean) versus lowland (Mapuche) Natives is associated with variation in facial features, particularly nose morphology, and detect significant differences in allele frequencies between these groups at loci previously associated with nose morphology in this sample
The economic burden of HIV/AIDS on individuals and households in Nepal: a quantitative study.
BACKGROUND: There have been only limited studies assessing the economic burden of HIV/AIDS in terms of direct costs, and there has been no published study related to productivity costs in Nepal. Therefore, this study explores in detail the economic burden of HIV/AIDS, including direct costs and productivity costs. This paper focuses on the direct costs of seeking treatment, productivity costs, and related factors affecting direct costs, and productivity costs. METHODS: This study was a cross-sectional, quantitative study. The primary data were collected through a structured face-to-face survey from 415 people living with HIV/AIDS (PLHIV). The study was conducted in six representative treatment centres of six districts of Nepal. The data analysis regarding the economic burden (direct costs and productivity costs) was performed from the household's perspective. Descriptive statistics have been used, and regression analyses were applied to examine the extent, nature and determinants of the burden of the disease, and its correlations. RESULTS: Average total costs due to HIV/AIDS (the sum of average total direct and average productivity costs before adjustment for coping strategies) were Nepalese Rupees (NRs) 2233 per month (US 20.4), and average productivity costs (before adjustment for coping strategies) were NRs 721 (US$ 9.7). The average monthly productivity losses (before adjustment for coping strategies) were 5.05 days per person. The major determinants for the direct costs were household income, occupation, health status of respondents, respondents accompanied or not, and study district. Health status of respondents, ethnicity, sexual orientation and study district were important determinants for productivity costs. CONCLUSIONS: The study concluded that HIV/AIDS has caused a significant economic burden for PLHIV and their families in Nepal. The study has a number of policy implications for different stakeholders. Provision of social support and income generating programmes to HIV-affected individuals and their families, and decentralising treatment services in each district seem to be viable solutions to reduce the economic burden of HIV-affected individuals and households
Negotiating power relations, gender equality, and collective agency: are village health committees transformative social spaces in northern India?
BACKGROUND: Participatory health initiatives ideally support progressive social change and stronger collective agency
for marginalized groups. However, this empowering potential is often limited by inequalities within communities and
between communities and outside actors (i.e. government officials, policymakers). We examined how the participatory
initiative of Village Health, Sanitation, and Nutrition Committees (VHSNCs) can enable and hinder the renegotiation of
power in rural north India.
METHODS: Over 18 months, we conducted 74 interviews and 18 focus groups with VHSNC members (including female
community health workers and local government officials), non-VHSNC community members, NGO staff, and higherlevel
functionaries. We observed 54 VHSNC-related events (such as trainings and meetings). Initial thematic network
analysis supported further examination of power relations, gendered “social spaces,” and the “discourses of
responsibility” that affected collective agency.
RESULTS: VHSNCs supported some re-negotiation of intra-community inequalities, for example by enabling some
women to speak in front of men and perform assertive public roles. However, the extent to which these new gender
dynamics transformed relations beyond the VHSNC was limited. Furthermore, inequalities between the community
and outside stakeholders were re-entrenched through a “discourse of responsibility”: The comparatively powerful
outside stakeholders emphasized community responsibility for improving health without acknowledging or correcting
barriers to effective VHSNC action. In response, some community members blamed peers for not taking up this
responsibility, reinforcing a negative collective identity where participation was futile because no one would work for
the greater good. Others resisted this discourse, arguing that the VHSNC alone was not responsible for taking action:
Government must also intervene. This counter-narrative also positioned VHSNC participation as futile.
CONCLUSIONS: Interventions to strengthen participation in health systems can engender social transformation. However
they must consider how changing power relations can be sustained outside participatory spaces, and how discourse
frames the rationale for community participation.ISIScopu
Clinical and molecular epidemiology of methicillin-resistant Staphylococcus aureus in New Zealand: rapid emergence of sequence type 5 (ST5)-SCCmec-IV as the dominant community-associated MRSA clone.
The predominant community-associated MRSA strains vary between geographic settings, with ST8-IV USA300 being the commonest clone in North America, and the ST30-IV Southwest Pacific clone established as the dominant clone in New Zealand for the past two decades. Moreover, distinct epidemiological risk factors have been described for colonisation and/or infection with CA-MRSA strains, although these associations have not previously been characterized in New Zealand. Based on data from the annual New Zealand MRSA survey, we sought to describe the clinical and molecular epidemiology of MRSA in New Zealand. All non-duplicate clinical MRSA isolates from New Zealand diagnostic laboratories collected as part of the annual MRSA survey were included. Demographic data was collected for all patients, including age, gender, ethnicity, social deprivation index and hospitalization history. MRSA was isolated from clinical specimens from 3,323 patients during the 2005 to 2011 annual surveys. There were marked ethnic differences, with MRSA isolation rates significantly higher in Māori and Pacific Peoples. Over the study period, there was a significant increase in CA-MRSA, and a previously unidentified PVL-negative ST5-IV spa t002 clone replaced the PVL-positive ST30-IV Southwest Pacific clone as the dominant CA-MRSA clone. Of particular concern was the finding of several successful and virulent MRSA clones from other geographic settings, including ST93-IV (Queensland CA-MRSA), ST8-IV (USA300) and ST772-V (Bengal Bay MRSA). Ongoing molecular surveillance is essential to prevent these MRSA strains becoming endemic in the New Zealand healthcare setting
Regular and chaotic vibration in a piezoelectric energy harvester
We examine regular and chaotic responses of a vibrational energy harvester composed of a vertical beam and a tip mass. The beam is excited horizontally by a harmonic inertial force while mechanical vibrational energy is converted to electrical power through a piezoelectric patch. The mechanical resonator can be described by single or double well potentials depending on the gravity force from the tip mass. By changing the tip mass we examine bifurcations from single well oscillations, to regular and chaotic vibrations between the potential wells. The appearance of chaotic responses in the energy harvesting system is illustrated by the bifurcation diagram, the corresponding Fourier spectra, the phase portraits, and is confirmed by the 0–1 test. The appearance of chaotic vibrations reduces the level of harvested energy
Search for Gravitational Waves from Primordial Black Hole Binary Coalescences in the Galactic Halo
We use data from the second science run of the LIGO gravitational-wave
detectors to search for the gravitational waves from primordial black hole
(PBH) binary coalescence with component masses in the range 0.2--.
The analysis requires a signal to be found in the data from both LIGO
observatories, according to a set of coincidence criteria. No inspiral signals
were found. Assuming a spherical halo with core radius 5 kpc extending to 50
kpc containing non-spinning black holes with masses in the range 0.2--, we place an observational upper limit on the rate of PBH coalescence
of 63 per year per Milky Way halo (MWH) with 90% confidence.Comment: 7 pages, 4 figures, to be submitted to Phys. Rev.
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