Epidemiology of Road Traffic Accidents in Nepal: Data Review and Qualitative Analysis

Objective: To estimate the prevalence of falls in a group of older women and to measure the influence of risk factors associated with age.

Methods: Longitudinal study with a representative probability sample of the AGEQOL study (Aging, Gender and Quality of Life). This article is based on 1226 older Brazilian community-dwelling women. Participants were interviewed on falls in past 12 months, demographic and socioeconomic characteristics, health status, functional ability and access to and use of health services. Poisson regression was used to confirm the association of decline in women with possible determinants, separated by age (60-74 years and ≥75 years).

Results: Overall, 250 women (54.2%) had a single fall, and the prevalence of falls was significantly different between age groups (p<0.001). Women aged less than 75 years old who smoked, drank, and reported nausea and imbalance had a higher prevalence of falls. Among the oldest women, a dose-response relationship was present between falls and functional capacity of ADL.

Conclusions: The prevalence of falls differed in each age group of women. For older women aged 60-74 years, the prevalence of falls was associated with self-reported health status and the type of health services used. In addition to performing ADL, worse health conditions, surgeries, and higher education were risk factors associated with a higher prevalence of falls in older women.

Introduction: Devices for Magnetic Resonance Imaging (MRI) represent the specific conditions for disinfection. Among the relevant facts include the presence of electronic equipment in a single device that limits the possibility of selecting the appropriate biocide to disinfect the device. Disinfectants of choice are therefore expected to possess properties such as rapid, residue-free action without any damaging effect on the sensitive electronic equipment. The purpose of this study was to determine the reliability of Neutral Electrolyzed Oxidizing Water (NEOW) using two different methods of disinfection on 3.0 T MRI Scanner.

Materials and Methods: The MRI room disinfection was completed by using the sprayer and the method of cold fogging. The presence of micro-organisms before and after the aerosolization was recorded with the help of sedimentation andanalyse the total number of Colony-Forming Units CFU. The CFU was evaluated in absolute and log values.

Results: After disinfection we found reduction of microbial NEOW over 90% or more than 1log10 CFU/ cm2. With cold fogging disinfection, we found a reduction in the number of microorganisms by an average of 3.32 log10 CFU/cm2. Based on the results of the experiment we can conclude that with the model of NEOW Steriplant®N in practical terms we can see over 90% reduction of microorganisms (> 1log10 CFU/cm2) on MRI. The use of NEOW proved to be efficient and safe in all applied ways. Also, no eventual damage to exposed devices or staff was recorded.

Discussion: The use of the biocide aerosol Steriplant®N in practical terms in prepared space in which substantially reduces the burden of microorganisms. We believe that this helps to establish a bio-security between operational and diagnostic interventions. Considering the fact that the biocide aerosolization needs 6-8 ml of biocide solution / 1m3 can reach very small amounts of disinfectant effects on equipment.

Background: Earlier examinations of mortality patterns in West Virginia found higher total mortality in coal mining compared to non-coal mining counties. The objective is to further explore these findings and determine whether heart disease mortality in West Virginia is associated with coal mining or other factors.

Methods: West Virginia county Specific Standardized Mortality Ratios (SMRs) were calculated and base (sex, age group and time period-adjusted) and covariate-adjusted (base + income, smoking, and obesity) SMR models were computed for cumulative total, surface, and underground coal production. Models were also stratified by dichotomous versions of income, smoking, and obesity.

Results: Median income, obesity, and smoking were all found to be statistically significant predictors of heart disease SMRs and were also found to have statistically significant interactions with coal production. Specifically, SMRs generally increased as median income decreased in mining counties, and SMRs generally increased as obesity increased in mining counties. The same relationships were not evident in non-mining counties. Additionally, SMRs were elevated in the highest two quartiles of coal production in counties with high smoking prevalence.

Conclusion: SMRs for heart disease were elevated in the highest levels of total, surface and underground coal production compared to the state population. Further research should examine the relationship between coal-mining and heart disease at the individual level.

Whenever patients are involved in research, the occurrence of missing information is inevitable. Examples of missing data include missing data points, as in incomplete forms, or loss of entire follow-ups due to patient attrition

T he sentence “inadvertently coming to rest on the ground, floor or other lower level, excluding intentional change in position to rest in furniture, wall or other objects” defines accidental falls

Objective: This research was conducted with the aim of determining the possible effects of physical activity levels on quality of life in health care workers who are employed in a Training and Research Hospital.

Materials and Methods: This descriptive study was performed on 120 personnel consisting of physician, allied health and administrative personnel who employed and had no any chronic illness in GATF Training and Research Hospital. The life qualities of 30 health care employees who go to the gym regularly and whose physical activities were observed as being high, according to the results of the International Physical Activity Assessment Questionnaire-Short Form; and the life qualities of 90 employees whose socio-demographic characteristics and work places are similar to the first group were evaluated by using the SF-36 Life Quality Questionnaire. The Statistical Package for Social Sciences (SPSS) version 22.0 was used in the statistical analysis of data. p

Result: The mean age of the participants was 36.09 ± 4.89 years. There was no statistically significant difference between the groups for age, sex, education, occupation, body mass index and sitting time. Total Physical Health Score and Mental Health Score which is SF-36 subscales were found to be statistically higher in the group with high physical activity (p<0.001). Although mental health, pain and energy/fatigue scores did not make a statistically significant difference, they were found to be higher in HPA group.

Discussion: According to the results obtained from this study; quality of life has been found to be affected positively in health care workers with high physical activity. The development by encouraging action and opportunities should be provided for increasing the physical activity levels of health care workers who are role models in the community.

The limited number of tools and resources available to guide emergency response in conflict settings is particularly grim. In order to improve response in areas impacted by emergencies, responders need new frameworks to guide the inclusion of wider macro-level determinants such as conflict throughout the program cycle. The Conflict Determinant Model (CDM) provides a theoretical base for emergency responders, public health professionals, and social scientists to include the social determinants of health in their programming and for analysis of the impact of conflict on health status. By considering conflict as a macro-level determinant of health, responders and agencies can design high quality contextually relevant programming that identifies and responds to the wider social inequalities that create conflict. We propose five uses of the CDM: Health disparity analysis, community engagement, program design, impact measurement, and monitoring and evaluation tool development. When applied in the program cycle for emergency programs, CDM improves the understanding, application, and analysis of conflict as a determinant of health. CDM informs the evidence base needed for effective and efficient response in conflict settings.

Background: Debate about the influence of costs of seeking Antenatal Care (ANC) on the maternal health service utilization in Africa has remained controversial and generally inconclusive, calling for more systematic, robust and reliable evidence. A study was done to assess the influence of real and perceived costs of ANC seeking on pregnant women’s access to Intermittent Preventive Treatment in Pregnancy (IPTp) against malaria in two rural districts in Tanzania.

Methods: Exist interviews were administered to 823 pregnant women leaving ANC clinics, among which 417 and 406 came from Mkuranga and Mufindi districts, respectively. Data analysis was executed using STATA 8 statistical software.

Result: Of all interviewees, 66.2% and 89.3% of respondents in Mkuranga and Mufindi, respectively, previously contacted government clinics during their current pregnancies; less than 20% and 15% of these districts, respectively, had contacted private clinics. Respondents reporting to have paid user-fees on the study day accounted for 36.7% and 7.0% in both districts, respectively. Few (<2%) of the respondents in each district reported unofficial payments asked of them by clinic staff for the services sought. In both districts, long travel distance was identified as the main disappointing factor against ANC seeks, followed by health care user-fees. Apparently, perceived low quality of care at particular clinics had more influenced the respondents found in public clinics to visit private clinics than it had influenced those found at private clinics to contact public ones. Respondents from wealthier families and those with decision-making autonomy for spending family income were less likely to have faced user-fee payment hardship than those without such opportunities. Lack of money for user-fees or transport delayed 12.6% and 12.4% of the respondents in Mkuranga and Mufindi, respectively to register for the ANC and receive IPTp during the recommended period.

Conclusion: Evidently, real and perceived costs together with perceived quality of care influence rural women to seek ANC and determine their chance to access malaria IPTp in Tanzania.

Background: Evidence indicating that sexual behaviors are the leading mode of acquisition and transmission of Human-Immunodeficiency Virus (HIV) responsible for causing the Acquired Immune-Deficiency Syndrome (AIDS) in a majority of countries in the world remains. However, knowledge about the disease and methods for its control varies across socio-economic groups as well as between and within countries. This paper reports and discusses the findings from a study done to assess the perceptions of secondary school students and their teachers on the importance of voluntary counseling and testing (VCT) for HIV among students in Tanzania.

Methodology: The study was conducted in two regions – Iringa and Mtwara using a questionnaire designed with closed and open-ended questions seeking opinions from 125 secondary school teachers and 2,060 students. Two districts from each region were covered. While the teachers were identified using a convenient sampling strategy, a random sampling strategy was employed to identify students from forms I-VI, excluding Form Fours who had left the school. The students were asked to state whether they personally participated in sexual relationships involving sexual intercourses with fellow students or other people, their knowledge of other students who behaved in the latter way, and views regarding the need for VCT services for students, teaching staff and other members within school compounds, Teachers were asked the same questions except their own participation in sexual affairs. Data analysis was aided by the use of the Stata 10 software.

Result: Admission of either personal or fellow students’ recent participation in premarital sex relationships was expressed by students in all districts, although a relatively larger number reported the behavior of fellow students than the respondents stating their own sexual behavior. Possessing multiple sexual partners were claimed as being a common behavior of sexual active students, although most of the respondents in this case also were referring to their peer students. While many students responding appreciated that secondary school students were also at risk of facing HIV, most of the teachers in all districts shied away to confirm this or show their belief in this, and denied to know students who engaged themselves in sexual love relationships. The Majority of teachers did not find it needful for suggesting schools as appropriate centers for delivering VCT services for HIV. Variations in the perceptions about the readiness of the students to undergo VCT were noted between male and female students; female and male teachers, and between the two study regions and districts of the same region. However, the difference was significant statistically for selected cases only.

Conclusion: To attain their goals, HIV/AIDS Control Programs in Tanzania need to address the challenges faced in their quest for enhancing knowledge about HIV/AIDS and encouraging behavior change attitudes towards HIV/AIDS related VCT services.

Background: In Italy cardiovascular diseases are the leading cause of death. Percutaneous Transluminal Coronary Angioplasty (PTCA) reduces short-term deaths in patients with Acute Myocardial Infarction (AMI). We evaluated inequalities in accessing PTCA among AMI patients.

Methods: This is a retrospective cohort study on 9894 Italian patients hospitalized for AMI in 2003-2007. Generalized linear models were estimated for the probability of PTCA and for time between hospital admission and intervention.

Result: Gender was the most relevant factor in the probability of intervention. Patients ≥75 years and those with higher Charlson index had lower probability. The presence of a coronary unit was associated with greater probability. Surgical intervention within 24 hours from admission was more likely with increasing age and Charlson index and less likely for patients living near a coronary unit. Days between admission and intervention resulted affected by all covariates and deprivation index.

Conclusion: Consistently with literature, we pointed out the role of gender and age on the likelihood of PTCA. Additional factors affecting time to intervention (coronary units and deprivation index) were also identified.