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Articles by N Kapur
Total Records ( 5 ) for N Kapur
  J. G Silverman , M. R Decker , J Gupta , N Kapur , A Raj and R. T. Naved
 

Objective  To provide an estimate of the risk of recent acute respiratory tract infection (ARI) and diarrhea among children 5 years and younger based on recent violence against their mothers.

Design  The 2004 Bangladesh Demographic Health Survey, conducted from January 1 to May 31, 2004.

Setting  Selected urban and rural areas of Bangladesh.

Participants  A total of 1592 women currently married, with at least 1 child 5 years of age or younger, each living with her husband and child(ren).

Main Exposure  Intimate partner violence (IPV) against women.

Outcomes Measures  The prevalence of past-year IPV was calculated. The risk of ARI and diarrhea within the past 2 weeks among young children was determined based on maternal experiences of IPV within the past year via analyses adjusted for demographics and environmental risks.

Results  More than 2 of 5 married Bangladeshi mothers (42.4%) with children aged 5 years and younger experienced IPV from their husbands in the past year. Mothers who experienced IPV were more likely to report recent ARI (adjusted odds ratio, 1.37; 95% confidence interval, 1.03-1.83) and diarrhea (adjusted odds ratio, 1.65; 95% confidence interval, 1.15-2.38) among their young children compared with those who did not experience IPV.

Conclusions  Large numbers of married Bangladeshi women with young children experience IPV. Associations of maternal experiences of IPV with 2 leading causes of childhood mortality strongly suggest that such abuse threatens not only the health of women but also that of their children. Prevention of IPV perpetration by men may be critical to the improvement of maternal and child health.

  F Milton , N Muhlert , D. M Pindus , C. R Butler , N Kapur , K. S Graham and A. Z. J. Zeman
 

Transient epileptic amnesia is a form of temporal lobe epilepsy in which sufferers often complain of irretrievable loss of remote memories. We used a broad range of memory tests to clarify the extent and nature of the remote memory deficits in patients with transient epileptic amnesia. Performance on standard tests of anterograde memory was normal. In contrast, there was a severe impairment of memory for autobiographical events extending across the entire lifespan, providing evidence for the occurrence of ‘focal retrograde amnesia’ in transient epileptic amnesia. There was a milder impairment of personal semantic memory, most pronounced for midlife years. There were limited deficits of public semantic memory for recent decades. These results may reflect subtle structural pathology in the medial temporal lobes or the effects of the propagation of epileptiform activity through the network of brain regions responsible for long-term memory, or a combination of these two mechanisms.

  I Burstyn , N Kapur , C Shalapay , F Bamforth , T.C Wild , J Liu and D. LeGatt
  Introduction

Our main objective was to estimate smoking prevalence as well as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of self-reported smoking among pregnant women in Edmonton, Canada, at 15–16 weeks of gestation.

Methods

We used serum samples to assemble a cohort of pregnant women who underwent an optional second-trimester screening for chromosomal and developmental anomalies. We determined cotinine concentrations for 92 self-reported smokers (11% of the cohort) and for 285 self-reported nonsmoking mothers, using adapted urinary cotinine assay. Self-reports were collected at the time of delivery. In a validation study, serum cotinine was determined for known smokers and nonsmokers and used, within a Bayesian statistical framework, to define the distribution of cutoffs that differentiate true smokers from nonsmokers. This distribution of cutoffs was used to construct multiple two-by-two tables to obtain the distribution of sensitivity, specificity, PPV, NPV, and prevalence.

Results

Sensitivity was poor (M = 47.4%, SD = 17.3%), but specificity was nearly perfect (M = 94.9%, SD = 1.1%). PPV (M = 66.6%, SD = 11.7%) was smaller than NPV (M = 84.7%, SD = 14.3%). In our sample, the prevalence of true smoking at 15–16 weeks of gestation was described by a skewed distribution with a mean of 21.6% (SD = 13.8%) and a median of 16.6%.

Discussion

The strength of the present study includes blinding of subjects to the intention to test their sera for a biomarker of smoking. A limitation was the use of a nonrandom sample restricted to pregnancies that resulted in live births. We discuss data collection methods that would elicit more accurate smoking histories from pregnant women.

  N Kapur , J Cooper , O Bennewith , D Gunnell and K. Hawton
 

Self-harm is a major public health problem and universal interventions such as contacting individuals by post or telephone following a self-harm episode have received much attention recently. They may also appeal to service providers because of their low cost. However, a widespread introduction of these interventions cannot be justified without a better understanding of whether they work, and if so how.

  L Biddle , J Donovan , A Owen Smith , J Potokar , D Longson , K Hawton , N Kapur and D. Gunnell
 

Background

Hanging is the most frequently used method of suicide in the UK and has high case fatality (>70%).

Aims

To explore factors influencing the decision to use hanging.

Method

Semi-structured qualitative interviews with 12 men and 10 women who had survived a near-fatal suicide attempt. Eight respondents had attempted hanging. Data were analysed thematically and with constant comparison.

Results

Hanging was adopted or contemplated for two main reasons: the anticipated nature of a death from hanging; and accessibility. Those favouring hanging anticipated a certain, rapid and painless death with little awareness of dying and believed it was a ‘clean’ method that would not damage the body or leave harrowing images for others. Materials for hanging were easily accessed and respondents considered it ‘simple’ to perform without the need for planning or technical knowledge. Hanging was thus seen as the ‘quickest’ and ‘easiest’ method with few barriers to completion and sometimes adopted despite not being a first choice. Respondents who rejected hanging recognised it could be slow, painful and ‘messy’, and thought technical knowledge was needed for implementation.

Conclusions

Prevention strategies should focus on countering perceptions of hanging as a clean, painless and rapid method that is easily implemented. However, care is needed in the delivery of such messages as some individuals could gain information that might facilitate fatal implementation. Detailed research needs to focus on developing and evaluating interventions that can manage this tension.

 
 
 
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