Medicine and Health Sciences Commons^™

Implementing The Physical Activity Vital Sign In An Academic Preventative Cardiology Clinic, Margaret M. Mccarthy, Jason Fletcher, Sean Heffron, Adam Szerencsy, Devin Mann, Allison Vorderstrasse

Elaine Marieb College of Nursing Faculty Publication Series

The aims were to implement physical activity (PA) screening as part of the electronic kiosk check-in process in an adult preventive cardiology clinic and assess factors related to patients’ self-reported PA. The 3-question physical activity vital sign (PAVS) was embedded in the Epic electronic medical record and included how many days, minutes and intensity (light, moderate, vigorous) of PA patients conducted on average. This is a data analysis of PAVS data over a 60-day period. We conducted multivariable logistic regression to identify factors associated with not meeting current PA recommendations. Over 60 days, a total of 1322 patients checked into …

Shortening Sow Restraint Period During Lactation Improves Production And Decreases Hair Cortisol Concentrations In Sows And Their Piglets, L. Morgan, J. Meyer, S. Novak, A. Younis, W.A. Ahmad, T. Raz

Elaine Marieb College of Nursing Faculty Publication Series

Food animal welfare is an issue of great concern, as society has a responsibility for animals under human care. Pork is the most consumed meat worldwide, with more than a billion pigs being slaughtered globally every year. Still, in most countries, sows are restrained in farrowing crates throughout lactation. In these crates, sows arc confined with bars to an area that is just slightly larger than their body. Thus, moving and turning around, grooming, or expressing other natural behaviors are typically impossible. In this study, we utilized a simple and practical modification of conventional farrowing crates to designed farrowing pens, …

Analysis Of Consistency Of Transthoracic Bioimpedance Measurements Acquired With Dry Carbon Black Pdms Electrodes, Adhesive Electrodes, And Wet Textile Electrodes, Hugo F. Posada-Quintero, Natasa Reljin, Caitlin Eaton-Robb, Yeon Sik Noh, Jarno Riistama

Elaine Marieb College of Nursing Faculty Publication Series

The detection of intrathoracic volume retention could be crucial to the early detection of decompensated heart failure (HF). Transthoracic Bioimpedance (TBI) measurement is an indirect, promising approach to assessing intrathoracic fluid volume. Gel-based adhesive electrodes can produce skin irritation, as the patient needs to place them daily in the same spots. Textile electrodes can reduce skin irritation; however, they inconveniently require wetting before each use and provide poor adherence to the skin. Previously, we developed waterproof reusable dry carbon black polydimethylsiloxane (CB/PDMS) electrodes that exhibited a good response to motion artifacts. We examined whether these CB/PDMS electrodes were suitable sensing …

Direct-Breastfeeding In The Neonatal Intensive Care Unit And Breastfeeding Duration For Premature Infants, Carrie-Ellen Briere, Jacqueline M. Mcgrath, Xiaomei Cong, Elizabeth Brownell, Regina Cusson

Elaine Marieb College of Nursing Faculty Publication Series

Aim

To explore the relationship between direct-breastfeeding in the neonatal intensive care unit (NICU) and breastfeeding duration after discharge.

Background

Initiating and maintaining breastmilk feeding is an important goal that begins in the NICU. Little is known about direct-breastfeeding in the NICU and its relation to breastfeeding duration.

Methods

Chart review of 46 infants (< 32 weeks gestational age or < 1500 grams) whose mothers provided breastmilk.

Results

One month after discharge, mothers still providing breastmilk were more likely to have provided ≥ 1 direct-breastfeed per day in the NICU (21.16, CI: 3.13–143.25, p < 0.01) and had prior breastfeeding experience (OR: 9.16, CI: 1.02–82.34, p < 0.05). At 4 months, mothers still providing breastmilk were more likely to have provided ≥ 1 direct-breastfeed per day in the NICU (OR: 12.80, CI: 1.39–118.32, p < 0.05).

Conclusions

Direct-breastfeeding in the NICU may play an essential role in preparing mothers for breastfeeding after …

Dietary B Vitamins And Depression In Persons With Human Immunodeficiency Virus Infection: The Positive Living With Hiv (Polh) Study, Kalpana Poudel-Tandukar

Elaine Marieb College of Nursing Faculty Publication Series

B vitamins have beneficial roles in mental health functional impairments; however, research on the role of B vitamins in depression among HIV-infected persons is limited. This study assessed the association between dietary B vitamin intake and depressive symptoms in a cohort of HIV-infected persons. A cross-sectional survey was conducted among 314 HIV-infected persons (180 men and 134 women) aged 18 to 60 y residing in the Kathmandu, Nepal. The Beck Depression Inventory-I was used to measure depression, with a cutoff score of 20 or higher. Dietary intake was assessed using two nonconsecutive 24-h dietary recalls. The relationships between B vitamins …

The Importance Of Screening For Sleep Apnea In The Heart Failure Population, Loreen Williams, Pamela Aselton

Elaine Marieb College of Nursing Faculty Publication Series

Background: Sleep disordered breathing occurs in over half of the estimated 5.1 million people in the United States diagnosed with heart failure.

Aim and Methods: The purpose of this integrative review is to find evidence for the routine use of a sleep apnea screening protocol in patients with heart failure.

Results: Several useful tools are described including the Epworth Sleepiness Scale, the STOP BANG questionnaire and the Berlin questionnaire. Using one of these tools along with an overnight pulse oximetry is a cost effective way to screen patients before the more costly sleep studies.

Conclusions: Evidence shows that treatment of …

Breast Milk Stem Cells: Current Science And Implications For Preterm Infants, Carrie-Ellen Briere, Jacqueline M. Mcgrath, Todd Jensen, Adam Matson, Christine Finck

Elaine Marieb College of Nursing Faculty Publication Series

Background: The benefits of breast milk are well described, yet the mechanistic details related to how breast milk protects against acute and chronic diseases and optimizes neurodevelopment remain largely unknown. Recently, breast milk was found to contain stem cells that are thought to be involved in infant development.

Purpose: The purpose of this review was to synthesize all available research involving the characterization of breast milk stem cells to provide a basis of understanding for what is known and what still needs further exploration.

Methods/Search Strategy: The literature search was conducted between August and October 2015 using the CINAHL, PubMed, …

Current Practice Of Neonatal Resuscitation Documentation In North America: A Multi-Center Retrospective Chart Review, Matthew S. Braga, Prakash Kabbur, Pradeep Alur, Michael H. Goodstein, Kari D. Roberts, Katie Satrom, Sandesh Shivananda, Ipsita Goswami, Mariann Pappagallo, Carrie-Ellen Briere, Gautham Suresh

Elaine Marieb College of Nursing Faculty Publication Series

Background

To determine the comprehensiveness of neonatal resuscitation documentation and to determine the association of various patient, provider and institutional factors with completeness of neonatal documentation.

Methods

Multi-center retrospective chart review of a sequential sample of very low birth weight infants born in 2013. The description of resuscitation in each infant’s record was evaluated for the presence of 29 Resuscitation Data Items and assigned a Number of items documented per record. Covariates associated with this Assessment were identified.

Results

Charts of 263 infants were reviewed. The mean gestational age was 28.4 weeks, and the mean birth weight 1050 g. Of …

Perceived Family Support And Antiretroviral Adherence In Hiv-Positive Individuals: Results From A Community-Based Positive Living With Hiv Study, Krishna Poudel, David Buchanan, Rachel Amiya, Kalpana Poudel-Tandukar

Elaine Marieb College of Nursing Faculty Publication Series

The purpose of this study was to examine the association between perceived family support, either positive or negative, and adherence to antiretroviral medication regimens among HIV-positive individuals in the Kathmandu Valley, Nepal. We measured past 3-month antiretroviral adherence among 233 HIV-positive individuals, in relation to perceived family support, both positive (in terms of emotional and instrumental support) and negative (in the form of negative interactions), using the 10-item Nepali Family Support and Difficulty Scale. Medium and high levels of perceived emotional support from family were associated with reduced risk of antiretroviral nonadherence, compared with low levels of perceived emotional support …

Serum Zinc Concentration And C-Reactive Protein In Individuals With Human Immunodeficiency Virus Infection: The Positive Living With Hiv (Polh) Study, Krishna Poudel, Elizabeth Bertone-Johnson, Kalpana Poudel-Tandukar

Elaine Marieb College of Nursing Faculty Publication Series

Low zinc levels and chronic inflammation are common in individuals infected with human immunodeficiency virus (HIV). Zinc deficiency may promote systemic inflammation, but research on the role of zinc in inflammation among HIV-positive individuals taking account of antiretroviral therapy is lacking. We assessed the association between serum zinc and C-reactive protein (CRP) concentration in a cohort of HIV-positive individuals. A cross-sectional survey was conducted among 311 HIV-positive individuals (177 men and 134 women) aged 18–60 years residing in Kathmandu, Nepal. High-sensitive or regular serum CRP concentrations were measured by the latex agglutination nephelometry or turbidimetric method, and zinc concentrations were …

Privacy Issues With The Electronic Medical Record, Pamela Aselton, Sandra Affenito

Elaine Marieb College of Nursing Faculty Publication Series

Electronic medical records (EMR) all have privacy safeguards in place. Major healthcare institutions have taken steps to prevent employees from looking up information on patients whom they do not treat directly, however numerous potential intrusions into patient privacy are still possible. Centralization of medical records in the increasing number of multi-group practices distributes personal medical data over larger networks and increases the likelihood that personal medical data may be shared or viewed by unauthorized users. This article reviews the benefits of EMRs and the possible mechanisms by which data may be shared without patient knowledge, as well as solutions and …

Perceived Family Support And Depression Among People Living With Hiv/Aids In The Kathmandu Valley, Nepal, Sadhana Shrestha, Krishna Poudel, Kalpana Poudel-Tandukar, Jun Kobayashi, Basu Dev Pandey, Junko Yasuoka, Keiko Otsuka, Masamine Jimba

Elaine Marieb College of Nursing Faculty Publication Series

Background: Depression is emerging as a highly prevalent psychiatric condition among people living with HIV/AIDS (PLWHA). Perceived family support (PFS) buffers depression among chronic disease patients. However, a similar relationship among PLWHA is unexplored. Objective: To examine the relationship between PFS and depression among PLWHA in the Kathmandu Valley, Nepal. Methods: In this cross-sectional study, depression was measured by Beck Depression Inventory Ia. Perceived family support was measured by Nepali Family Support and Difficulties Scale. The status of depression was compared between 208 PLWHA and 208 HIV-negative participants. The relationship between PFS and depression was examined only among PLWHA. Results: …

Coinfection With Hepatitis C Virus Among Hiv-Positive People In The Kathmandu Valley, Nepal, Krishna Poudel, Paula Palmer, Masamine Jimba, Tetsuya Mizoue, Jun Kobayashi, Kalpana Poudel-Tandukar

Elaine Marieb College of Nursing Faculty Publication Series

Background: Previous research has studied the rate of hepatitis C virus (HCV) coinfection among HIV-positive people regardless of their antiretroviral therapy (ART) status. Our objectives were to measure the seroprevalence of HCV both in HIV-positive people receiving ART and in those not receiving ART and to describe the characteristics of coinfected people in the Kathmandu Valley, Nepal. Methods: We conducted a cross-sectional survey of 319 HIV-positive people residing in the Kathmandu Valley, Nepal. We screened the participants’ serum samples for HCV antibodies using the Latex Photometric Immunoassay based on third-generation assay. Results: A total of 138 (43.3%) participants were HCV …

Smoking Cessation Increases Short-Term Risk Of Type 2 Diabetes Irrespective Of Weight Gain: The Japan Public Health Center-Based Prospective Study, Shino Oba, Mitsuhiko Noda, Kayo Waki, Akiko Nanri, Masayuki Kato, Yoshihiko Takahashi, Kalpana Poudel-Tandukar, Yumi Matsushita, Manami Inoue, Tetsuya Mizoue, Shoichiro Tsugane

Elaine Marieb College of Nursing Faculty Publication Series

Objective: The effect of smoking cessation on the risk of diabetes has been reported previously. However, it is unknown whether the association is influenced by weight gain and other potential risk factors. Methods: The Japan Public Health Center-Based Prospective Study established in 1990 for Cohort I and in 1993 for Cohort II provided data, and 25,875 men and 33,959 women were analyzed. The response rate to the baseline questionnaire was 80.9%, and 68.4% of the respondents participated both the 5- and 10-year follow-up surveys. Smoking cessation was noted during the initial five years and the development of diabetes was reported …

Using The Internet For Qualitative Research In Nursing, Pamela Aselton

Elaine Marieb College of Nursing Faculty Publication Series

The nature of qualitative research lends itself to the use of the Internet for a variety of reasons. The Internet can be used for recruitment and provide immediate feedback from participants, either through online interviewing, or open ended questionnaires. Interviews may be conducted online with a set list of guiding questions, and follow up can be accomplished with email communication. If information is received in digital form, there is no need for labor intensive transcription that qualitative research often involves.

Relationship Of Serum Fatty Acid Composition And Desaturase Activity To C-Reactive Protein In Japanese Men And Women, Kalpana Poudel-Tandukar, Masao Sato, Yuko Ejima, Akiko Nanri, Yumi Matsushita, Katsumi Imaizumi, Tetsuya Mizoue

Elaine Marieb College of Nursing Faculty Publication Series

Background: Although fatty acid composition in serum and desaturase activity, which alters serum fatty acid composition, has been associated with C-reactive protein (CRP) concentration in Western populations, no study has been carried out in non-Western populations. We examined the association of serum fatty acids and estimated desaturase activity with CRP concentrations in Japanese men and women. Methods: Subjects were 489 Japanese municipal employees aged 21–67 yearswhoparticipated in a survey at the time of a periodic health check-up. Serum high-sensitivity CRP concentrations were measured using the latex agglutination nephelometry method. Fatty acid composition was measured in serum cholesteryl esters and desaturase …

Social Support And Suicide In Japanese Men And Women E The Japan Public Health Center (Jphc)-Based Prospective Study, Kalpana Poudel-Tandukar, Akiko Nanri, Tetsuya Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Elaine Marieb College of Nursing Faculty Publication Series

Although the important role of social support in mental health is acknowledged, no prospective study has yet examined the relation of social support to suicide. Here, we investigated the associationbetween social support and suicide in a cohort of Japanese men and women. A total of 26,672 men and 29,865 women aged 40e69 years enrolled in the Japan Public Health Center-based prospective study in1993e1994 completed a self-administered questionnaire which included four items of social support, and were followed for death through December 2005. Hazard ratios (HRs) and 95% confidence intervals (95% CI) of suicidal death by social support index were estimated …

Differences In Suicide Risk According To Living Arrangements In Japanese Men And Women – The Japan Public Health Center-Based (Jphc) Prospective Study, Kalpana Poudel-Tandukar, Akiko Nanri, Tetsyta Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Elaine Marieb College of Nursing Faculty Publication Series

Background: Living alone has been suggested as a risk factor for suicide. However, the effect on suicide risk of living together with spouse, child(ren) and parent(s) is unclear. This study aims toexamine the association between living arrangements with spouse, child(ren), and parent(s) and suicide in a Japanese men and women.Methods: Altogether 104, 528 participants aged 40–69 years, who completed baseline questionnaire (1990–1994), were followed for death through December 2005. We used Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for suicide according to living arrangements.Results: During an average 13.2-year follow up, …

Association Between Serum Ferritin Concentrations And Depressive Symptoms In Japanese Municipal Employees, Siyan Yi, Akiko Nanri, Kalpana Poudel-Tandukar, Daisuke Nonaka, Yumi Matsushita, Ai Hori, Tetsuya Mizoue

Elaine Marieb College of Nursing Faculty Publication Series

It remains unclear whether levels of body iron store are related to milder forms of depression, which are more common among apparently healthy people. We examined the association between serum ferritin concentrations and depressive symptoms among 312 men and 216 women working in two municipal offices in Japan. Depressive symptoms were assessed by using the Center for Epidemiologic Studies Depression (CESD) scale. In men, increased prevalence of depressive symptoms (defined by using a cutoff value of ≥19) was significantly associated with decreased levels of serum ferritin. In age- and study-site-adjusted models, ORs (95% CIs) for depressive symptoms for men in …

Serum 25-Hydroxyvitamin D Concentrations And Season-Specific Correlates In Japanese Adults, Akiko Nanri, Leng Huat Foo, Kazutoshi Nakamura, Ai Hori, Kalpana Poudel-Tandukar, Yumi Matsushita, Tetsuya Mizoue

Elaine Marieb College of Nursing Faculty Publication Series

Background: Several lines of evidence indicate an important role for vitamin D in the prevention of a range of diseases. Blood vitamin D levels show clear seasonal variation; however, data on the determinants of vitamin D status for each season are limited. We investigated the association between lifestyle and serum vitamin D concentration by season in Japanese workers. Methods: Subjects were 312 men and 217 women aged 21 to 67 years who worked in municipal offices in Northern Kyushu, Japan and participated in a periodic checkup in July or November. Multiple linear regression analysis was used to examine the association …

Long Chain N-3 Fatty Acids Intake, Fish Consumption And Suicide In A Cohort Of Japanese Men And Women — The Japan Public Health Center-Based (Jphc) Prospective Study, Kalpana Poudel-Tandukar, Akiko Nanri, Motoki Iwasaki, Tetsuya Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Elaine Marieb College of Nursing Faculty Publication Series

Objective: Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been implicated as protective against suicide. However, it is uncertain whether a higher intake of EPA and DHAor of fish, a major source of these nutrients, lowers suicidal risk among Japanese, whose fish consumption and suicide rate are both high. This study prospectively examined the relation between fish, EPA, or DHA intake and suicide among Japanese men and women.Method: Subjects were 47,351 men and 54,156 women aged 40–69 years who participated in the JPHC Study, completed a food frequency questionnaire in 1995–1999, and were followedfor death through December 2005. We used …

An Intervention To Prevent Symptoms Associated With Hepatitis C: A Pilot Study, Donna M. Zucker

Elaine Marieb College of Nursing Faculty Publication Series

The objectives of this study were to (a) pilot test instruments measuring fatigue and quality of life (QOL); (b) pilot test an exercise intervention; and (c) estimate the effect size of this intervention relative to completion of combination therapy, fatigue, QOL, and walking distance in 20 patients with chronic hepatitis C about to begin interferon alpha and ribavirin treatment. Alpha reliabilities for both the Schwartz Cancer Fatigue Scale and Hepatitis Quality of Life Questionnaire were moderately high. Power analyses of all outcome measures indicated a small effect size and sample size estimate of 30–40 per group to achieve power of …

Differential Effects Of Out-Of-Home Day Care In Improving Child Nutrition And Augmenting Maternal Income Among Those With And Without Childcare Support: A Prospective Before–After Comparison Study In Pokhara, Nepal, Shinji Nakahara, Krishna Poudel, Milan Lopchan, Om Raj Poudel, Kalpana Poudel-Tandukar, Masao Ichikawa

Elaine Marieb College of Nursing Faculty Publication Series

Objectives: We examined (1) whether attending out-of-home day care centres (DCCs) has differential effects on improvement of child nutrition and facilitation of maternal employment depending on availability of non-institutionalised childcare support and (2) whether attendance increases infectious diseases. Methods: In a prospective before–after comparison study at public DCCs in Pokhara, Nepal, we compared weight-for-age Z-score (WAZ) and height-for-age Z-score (HAZ) among children attending DCCs between at admission, after 6 months, and after 1 year and determined differential changes in these measures between those with and without appropriate childcare support. We used repeated measures analysis of variance with interaction terms between …

Correlates Of Sharing Injection Equipment Among Male Injecting Drug Users In Kathmandu, Nepal, Krishna Poudel, Kalpana Poudel-Tandukar, Junko Yasuoka, Anand Joshi, Masamine Jimba

Elaine Marieb College of Nursing Faculty Publication Series

Background: HIV prevalence is high and risky injection practices occur frequently among injecting drug users (IDUs) in Nepal. We explored the correlates of sharing injection equipment (having injected with a needle or syringe previously used by another) among male IDUs in Kathmandu, Nepal. Methods: From August to September 2007, we anonymously interviewed 296 male IDUs in Kathmandu, Nepal, using a structured questionnaire. We performed bivariate and multivariable logistic regression analysis and identified variables associated with sharing injection equipment. Results: Over half (n = 152) of the participants reported injecting drugs with a needle or syringe previously used by another in …

Dietary Intakes Of Α-Linolenic And Linoleic Acids Are Inversely Associated With Serum C-Reactive Protein Levels Among Japanese Men, Kalpana Poudel-Tandukar, Akiko Nanri, Yumi Matsushita, Satoshi Sasaki, Masanori Ohta, Masao Sato, Tetsuya Mizoue

Elaine Marieb College of Nursing Faculty Publication Series

Investigations suggest a protective role of n-3 polyunsaturated fatty acids (PUFA) but opposing roles of n-6 PUFA in inflammation, but the effects in vivo the human are not clear. We therefore tested the hypothesis that higher intakes of n-3 PUFA and n-6 PUFA are associated with lower levels of inflammation among a population consuming a diet high in PUFA. This study aimed to assess theassociation between PUFA intake and serum C-reactive protein (CRP) concentrations in a group of Japanese employees. The study subjects were 300 men and 211 women aged 21 to 67 years workingin 2 municipal offices of Japan. …

How To Do Case Study Research, Donna M. Zucker

Elaine Marieb College of Nursing Faculty Publication Series

No abstract provided.

Association Between Serum 25-Hydroxyvitamin D And Depressive Symptoms In Japanese: Analysis By Survey Season, A. Nanri, T. Mizoue, Y. Matsushita, Kalpana Poudel-Tandukar, M. Sato, M. Ohta, N. Mishima

Elaine Marieb College of Nursing Faculty Publication Series

Both depressive symptoms and vitamin D insufficiency are common during winter. This study examined the association between serum 25-hydroxyvitamin D and depressive symptoms by survey season. Subjects were 527 municipal employees aged 21–67 years of two municipal offices in Japan. Overall, there was no measurable association. However, in the workplace surveyed in November, multivariate-adjusted odds ratios (95% confidence interval) of having depressive symptoms (Center for Epidemiologic Studies Depression score of X16) for the lowest through highest quartiles of serum 25-hydroxyvitamin D were 1.00 (reference), 0.84 (0.45–1.58), 0.83 (0.44–1.58) and 0.59 (0.30–1.15), respectively (trend P ¼ 0.14). The association with the …

Peer Education For Hepatitis C Prevention, Donna M. Zucker

Elaine Marieb College of Nursing Faculty Publication Series

The purpose of this article is to describe a model of education about hepatitis C virus prevention tested in a county correctional facility. The Teach One Method and Relational Communication models inform this work. Using a one-group pretest–posttest prospective design our aims were to (1) convey education about prevention, protection, and safety; (2) provide this information through relationship-centered communication; (3) test the reliability and validity of the instruments; and (4) measure changes in behavior, knowledge, and relationship in the learner. A convenience sample of 25 men was recruited at a Massachusetts county jail. Subscale reliability was 0.78 and 0.79 for …

Unsafe Sexual Behaviors Among Hiv-Positive Men In Kathmandu Valley, Nepal, Krishna Poudel, Shinji Nakahara, Kalpana Poudel-Tandukar, Junko Yasuoka, Masamine Jimba

Elaine Marieb College of Nursing Faculty Publication Series

We assessed unsafe sexual behaviors of the Nepalese HIV-positive men and their knowledge about the consequences of unsafe sex. We interviewed 167 participants recruited conveniently in the Kathmandu Valley, Nepal. Of total, 125 participants (75%) had sex in the past 6 months, 47% of whom with multiple partners. Fiftyseven (46%) of 123 participants who had sex did not always use condoms; unsafe sex was common in seroconcordant or serodiscordant relationships or in serounknown relationships. Only 41% (50/123) participants knew about the possibility of HIV superinfection. Our results suggest the urgent need of HIV prevention interventions for the Nepalese HIV-positive men.

Relationship Between Mechanisms And Activities At The Time Of Pedestrian Injury And Activity Limitation Among School Adolescents In Kathmandu, Nepal, Kalpana Poudel-Tandukar, Shinji Nakahara, Masao Ichikawa, Krishna Poudel-Tandukar, Susumu Wakai

Elaine Marieb College of Nursing Faculty Publication Series

This study assessed the relationship between pedestrian activity at the time of injury, the type of vehicle involved and resulting activity limitation among school adolescents in the Kathmandu and Lalitpur districts of Nepal. A cross-sectional study of 1557 students in grades 6–8 across 14 schools was conducted using a self-administered questionnaire from August to September 2003. Twenty-three percent of adolescents reported pedestrian injuries, 38% were from urban and 21% from semi-urban areas. Adolescents were commonly injured by motorcycles and motor vehicles while crossing the road; however, while walking and playing, they were commonly injured by bicycles and motorcycles. Bicycles and …