Current Issue : April - June Volume : 2013 Issue Number : 2 Articles : 6 Articles
Background: Observations of increasing asthma incidence, decreasing age at menarche, and common risk\r\nfactors have led investigators to hypothesize potential associations of age at menarche or menstrual characteristics\r\nwith incidence of adult onset asthma. We evaluated these associations among reproductive age women.\r\nMethods: Study participants were selected from among women enrolled in a pregnancy cohort study. Information\r\non age at menarche, menstrual characteristics, and history of asthma was collected using interviewer-administered\r\nquestionnaires. Adult onset asthma was defined as asthma first diagnosed after onset of menarche. Women who had\r\nno information on asthma and menstrual history and those who were diagnosed with asthma before menarche were\r\nexcluded. A total of 3,461 women comprised the analytic population. Logistic regression was used to estimate adjusted\r\nrelative risk (aRR) and 95% confidence intervals (95% CI) relating age at menarche and menstrual characteristics with\r\nadult onset asthma.\r\nResults: Mean age at menarche was 12.8 years (standard deviation=1.46). Among study participants, 7.5%\r\nwere diagnosed with asthma after the onset of menarche. After controlling for potential confounders (age, race, body\r\nmass index, and socio-economic status), women who had early menarche (<12 years old) had 60% higher risk of\r\nbeing diagnosed with adult onset asthma as compared with women who did not have early menarche (= 12 years old)\r\n(aRR=1.59, 95% CI 1.19-2.13). Menstrual irregularities or abnormal (short or long) cycle length were not associated\r\nwith risk of adult onset asthma. In addition, no significant interaction was observed between age at menarche or\r\nmenstrual characteristics with body mass index or physical activity (in adolescence) in relation to adult onset asthma.\r\nConclusion: Early menarche is associated with a higher risk of developing adult onset asthma among reproductive\r\nage women. Mechanisms for this association are potential areas of future research....
Background: In Gambella region, inhabitants owe socio-cultural factors that might favor refusal for HIV testing\r\nservice utilization among Antenatal Care attendees.\r\nObjective: To assess determinants for refusal of HIV testing service utilization among ANC attendees in Gambella\r\nRegion.\r\nMethods: A comparative cross sectional study was conducted among ANC attendees from March 2008 to May\r\n2008 in four selected health facilities of Gambella region. Sample size of 332 participants (83 who refused HIV\r\ntesting and 249 who accepted HIV testing) were taken for the study. The study was supplemented with four focus\r\ngroup discussions. Multivariate binary logistic regression was employed to control for confounding factors.\r\nResults: When adjusted with other factors pregnant women with 2ââ?¬â??3 live births in the past; who claimed divorce\r\nas a perceived response of their husband following HIV positive test result; who had not sought agreement from\r\ntheir husband for testing; disclosure of test for husband and being from certain ethnic group (E.g. Mejenger) were\r\nindependent predictors for refusal of HIV testing among ANC attendees.\r\nConclusion and recommendation: Based on the findings, the following recommendations were forwarded:\r\nProvision of innovative information and education on the pre-test session for those pregnant women having two\r\nor more children; community involvement to tackle stigma; women empowerment; designing couple friendly\r\ncounseling service; and fighting harmful traditional practices related with decision of HIV testing....
Background: High temperature requirement factor A 1 (HtrA1) and A Disintegrin And Metalloproteinase 12 \r\n(ADAM12), which play roles in placental implantation and placental growth, have been implicated in the pathogenesis \r\nof preeclampsia.\r\nMethods: We investigated relative mRNA expression of both genes in placental tissues from women with \r\npreeclampsia (N = 18) (average gestational age 36 weeks) and an equal number of women with normotensive \r\npregnancies (average gestational age 39 weeks). Real-time polymerase chain reaction was used to measure mRNA \r\nextracted from term placental biopsies. Differential gene expression was evaluated using Student�s T-test and fold \r\nchange analyses. \r\nResults: Statistically significant increases in placental HtrA1 (1.69-fold, p = 0.030) and ADAM12 (1.48-fold, p = \r\n0.010) mRNA expression were observed among preeclamptic cases as compared with normotensive controls. HtrA1 \r\nexpression was correlated with maternal age (p-value< 0.01) among preeclampsia cases. \r\nConclusion: Increases in HtRA1 and ADAM12 placental gene expression in placentas from preeclamptic \r\npregnancies are consistent with some earlier reports of altered serum protein concentrations in preeclamptic \r\npregnancies. This adds to the literature suggesting that defects in placentation (e.g. involving trophoblast invasion) are \r\nof etiologic importance in preeclampsia....
Unsafe abortion�s significant contribution to maternal mortality and morbidity was a critical factor leading to\r\nliberalization of Nepal�s restrictive abortion law in 2002. Careful, comprehensive planning among a range of\r\nmultisectoral stakeholders, led by Nepal�s Ministry of Health and Population, enabled the country subsequently to\r\nintroduce and scale up safe abortion services in a remarkably short timeframe. This paper examines factors that\r\ncontributed to rapid, successful implementation of legal abortion in this mountainous republic, including deliberate\r\nattention to the key areas of policy, health system capacity, equipment and supplies, and information\r\ndissemination. Important elements of this successful model of scaling up safe legal abortion include: the preexistence\r\nof postabortion care services, through which health-care providers were already familiar with the main\r\nclinical technique for safe abortion; government leadership in coordinating complementary contributions from a\r\nwide range of public- and private-sector actors; reliance on public-health evidence in formulating policies\r\ngoverning abortion provision, which led to the embrace of medical abortion and authorization of midlevel\r\nproviders as key strategies for decentralizing care; and integration of abortion care into existing Safe Motherhood\r\nand the broader health system. While challenges remain in ensuring that all Nepali women can readily exercise\r\ntheir legal right to early pregnancy termination, the national safe abortion program has already yielded strong\r\npositive results. Nepal�s experience making high-quality abortion care widely accessible in a short period of time\r\noffers important lessons for other countries seeking to reduce maternal mortality and morbidity from unsafe\r\nabortion and to achieve Millennium Development Goals....
Introduction: Intimate partner violence against women is more prevalent in Ethiopia and among the highest in\r\nthe world. This study was aimed to explore the attitudes of the community on intimate partner violence against\r\nwomen, the strategies women are using after the violence act, and suggested measures to stop or reduce the act\r\nin East Wollega Zone.\r\nMethods: A total of 12 focus group discussions involving 55 men and 60 women were conducted from December,\r\n2011 to January, 2012. Discussants were purposefully selected from urban and rural settings of the study area. The\r\nanalyses followed the procedure for qualitative thematic analysis.\r\nResults: Three themes (attitudes, coping strategies, and suggested measures) were emerged. Most discussants\r\nperceived, intimate partner violence is accepted in the community in circumstances of practicing extra marital sex\r\nand suspected infidelity. The majority of women are keeping silent and very few defend themselves from the\r\nviolent husbands/partners. The suggested measures by the community to stop or reduce women�s violence were\r\ntargeting actions at the level of individual, family, community, and society.\r\nConclusion: In the study community, the attitude of people and traditional norms influence the acceptability for\r\nthe act of intimate partner violence against women. Most victims are tolerating the incident while very few are\r\ndefending themselves from the violent partners. The suggested measures for stopping or reducing women�s\r\nviolence focused on provision of education for raising awareness at all levels using a variety of approaches\r\ntargeting different stakeholders. It is recommended that more efforts are needed to dispel myths, misconceptions\r\nand traditional norms and beliefs of the community. There is a need for amending and enforcing the existing laws\r\nas well as formulating the new laws concerning women violence including rape. Moreover, providing professional\r\nhelp at all levels is essential...
Background: The status of menââ?¬â?¢s knowledge of and awareness to maternal, neonatal and child health care are\r\nlargely unknown in Bangladesh and the effect of community focused interventions in improving menââ?¬â?¢s knowledge\r\nis largely unexplored. This study identifies the extent of menââ?¬â?¢s knowledge and awareness on maternal, neonatal and\r\nchild health issues between intervention and control groups.\r\nMethods: This cross sectional comparative study was carried out in six rural districts of Bangladesh in 2008. BRAC\r\nhealth programme operates ââ?¬Ë?improving maternal, neonatal and child survivalââ?¬â?¢ intervention in four of the abovementioned\r\nsix districts. The intervention comprises a number of components including improving awareness of\r\nfamily planning, identification of pregnancy, providing antenatal, delivery and postnatal care, newborn care, under-5\r\nchild healthcare, referral of complications and improving clinical management in health facilities. In addition,\r\ncommunities are empowered through social mobilization and advocacy on best practices in maternal, neonatal and\r\nchild health. Three groups were identified: intervention (2 years exposure); transitional (6 months exposure) and\r\ncontrol. Data were collected by interviewing 7,200 men using a structured questionnaire.\r\nResults: Men prefer to gather in informal sites to interact socially. Overall menââ?¬â?¢s knowledge on maternal care was\r\nhigher in intervention than control groups, for example, advice on tetanus injection should be given during\r\nantenatal care (intervention = 50%, control = 7%). There were low levels of knowledge about birth preparedness\r\n(buying delivery kit = 18%, arranging emergency transport = 13%) and newborn care (wrapping = 25%, cord cutting\r\nwith sterile blade = 36%, cord tying with sterile thread = 11%) in the intervention. Men reported joint\r\ndecision-making for delivery care relatively frequently (intervention = 66%, control = 46%, p < 0.001).\r\nConclusion: Improvement in menââ?¬â?¢s knowledge in intervention district is likely. Emphasis of behaviour change\r\ncommunications messages should be placed on birth preparedness for clean delivery and referral and on newborn\r\ncare. These messages may be best directed to men by targeting informal meeting places like market places and tea\r\nstalls....
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