Publications (72) View all
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Article: A lifetime experience of violence and adverse reproductive outcomes: findings from population surveys in India.
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ABSTRACT: Intimate partner violence (IPV) is a global public health issue that threatens the reproductive health of women. Despite a growing demand for research on the potential threat of IPV in relation to adverse reproductive outcomes, there have been no population-based studies of India. The current study analyzed the National Family Health Survey 3, which contained detailed information on types of violence in relation to the single question of pregnancy outcomes. The dataset was used to assess the association between a lifetime experience of IPV and terminated pregnancies among married Indian women. Multiple logistic regression analysis was then used to assess the association between these variables, controlling for socio-demographic characteristics. Results showed that 39.6% of Indian women have experienced violence by their husbands, while 18.3% of women have terminated a pregnancy during their lifetimes. The odds ratio of a terminated pregnancy among women who had experienced any type of partner violence was 1.62 (95% CI (confidence interval) = 1.51-1.73). All combinations of violence except a combination of emotional and sexual violence were associated with an increased risk of a terminated pregnancy. These results suggest that prevention of IPV would reduce the high incidence of terminated pregnancies, thus improving maternal health in India.Bioscience trends 06/2012; 6(3):115-21. · 0.97 Impact Factor -
Article: Improved quality of life after surgery for pelvic organ prolapse in Nepalese women.
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ABSTRACT: BACKGROUND: Pelvic organ prolapse (POP) is a common gynecological condition that can affect quality of life (QOL) in women. In Nepal, the prevalence of POP is high, but many affected women are still deprived of treatment. Vaginal hysterectomy with pelvic floor repair is one of the common treatment options for advanced POP. However, QOL outcomes after surgery have not been reported in low-income countries. Thus, we aimed to examine changes in QOL among Nepalese women with POP after such surgery. METHODS: This longitudinal study was conducted in the selected central and peripheral hospitals in Nepal where vaginal hysterectomy was being performed free of cost for POP. A baseline study first measured the QOL domains (physical, psychological, social relationships and environment) among 252 women with advanced POP. Follow-up data was then collected at six weeks and three months after surgery. Among the 177 women that were available at six weeks post-surgery, 166 participated in the follow-up study at three months post-surgery. To evaluate QOL at baseline, 142 women with no history of POP were included as a comparison group. RESULTS: The mean scores across QOL domains improved from baseline to 3 months after surgery. The baseline score for the physical domain increased from 11.2 to 12.8 at six weeks and 13.5 at three months post-surgery (p < 0.001); the psychological domain score increased from 11.6 to 13.1 at six weeks and 13.8 at three months post-surgery (p < 0.001); the social relationships domain score increased from 13.6 to 14.4 at six weeks and 15.0 at three months post-surgery (p < 0.001); and the environmental domain score increased from 12.9 to 13.9 at six weeks and 14.0 at three months post-surgery (p < 0.001). CONCLUSION: QOL progressively improved among women undergoing surgery for POP. Such surgical services need to be scaled up for treatment of advanced POP in low-income countries.BMC Women s Health 05/2013; 13(1):22. -
Article: Better learning in schools to improve attitudes toward abstinence and intentions for safer sex among adolescents in Urban Nepal.
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ABSTRACT: BACKGROUND: School-based sex education is an effective medium to convey health information and skills about preventing sexually transmitted infections (STIs) and unwanted pregnancies among adolescents. However, research on school-based sex education is limited in many developing countries, including Nepal. This study thus had two main objectives: (1) to assess students' evaluation of school-based sex education, and (2) to examine the associations between students' evaluations of school-based sex education and their (a) attitudes toward abstinence and (b) intentions for safer sex. METHODS: This cross-sectional study was conducted among 634 students from six schools in the Kathmandu Valley during May--June 2010. We used a self-administered questionnaire to assess students' evaluations of school-based sex education, attitudes toward abstinence, and intentions for safer sex. The data were then analyzed using multiple linear regression models. RESULTS: Regarding "information on HIV and sexual health", many students perceived that they received the least amount of information on HIV counseling and testing centers (mean 2.29, SD 1.00) through their schools. In terms of "support and involvement of teachers and parents" in sex education, parents' participation ranked as the lowest (mean 1.81, SD 1.01). Audiotapes were reported as the least used among the listed "teaching aids for sexual health education" (mean 1.54, SD 0.82). In multivariate analysis, receiving more "information on HIV and sexual health" was positively associated with more positive "attitudes toward abstinence" (beta = 0.11, p = <0.018) and greater "intentions for safer sex" (beta = 0.17, p = <0.001) among students. Similarly, increased "support and involvement from teachers and parents" was also positively associated with more positive "attitudes toward abstinence" (beta = 0.16, p = <0.001) and greater "intentions for safer sex" (beta = 0.15, p = <0.002). CONCLUSION: Our results suggest that students' needs and expectations regarding HIV and sexual health education are not being met through their schools. Moreover, comprehensive information on HIV and sexual health along with increased support and involvement of teachers and parents in sex education might help to improve adolescents' attitudes toward abstinence and intentions for safer sex. Adapting future school-based interventions to incorporate such elements may thus be an effective strategy to promote adolescent sexual health.BMC Public Health 03/2013; 13(1):244. · 2.00 Impact Factor -
Article: Acculturation Factors and Metabolic Syndrome Among Japanese-Brazilian Men in Japan: A Cross-Sectional Descriptive Study.
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ABSTRACT: This study examines the acculturation effects on metabolic syndrome (MetS), and its related factors, among immigrant Japanese-Brazilian men in Japan. Quantitative and qualitative approaches were utilized. In the quantitative study (n = 149), multiple logistic regression analyses estimated the impact of length of residence and arrival age on MetS. For the qualitative study, five focus group discussions were conducted with participants (n = 26) from the quantitative study sample. The oldest arrival age group was more likely to have MetS (OR, 95 % CI 4.41, 1.09-17.78) after adjusting for covariates; whereas, length of residence had no association with MetS. The oldest arrival age group, with shorter residence period, was also associated with increased MetS prevalence. Qualitative results identified participants' Brazilian dietary habits as being potential risk factors for MetS. Japanese-Brazilian immigrant men with older arrival age in Japan were more likely to suffer from MetS, especially shortly after arrival.Journal of Immigrant and Minority Health 02/2013; · 1.16 Impact Factor -
Article: At the intersection of public health and criminal justice systems.
The Lancet 02/2013; 381(9866):534. · 38.28 Impact Factor
