Under-nutrition among adolescents: a survey in five secondary schools in rural Goa.

BACKGROUND: This study was done in 2008-09 to assess the nutritional status among adolescents (10-19 years of age, Classes V-XII) in 5 schools in rural Goa to inform the content of a health promotion intervention in these schools. METHODS: Three methods were used. First, nutritional status was measured by assessing body mass index among 1015 students during a health camp in each school. Second, a diet analysis was done to measure energy and protein Intake of 76 randomly selected underweight students. Third, a self-report questionnaire survey measured the prevalence of hunger among 684 students. RESULTS: One-third of students (338; 37.8% boys and 27.5% girls) who attended the health camps were underweight and 59.2% of the 684 students who completed the survey reported experiencing hunger due to inadequate food consumption. More boys were underweight than girls (p<0.001) and under-nutrition was uniform across all the years of schooling. Energy intake of underweight students was significantly lower than the recommended daily allowance. The results were shared with the School Health Promotion Advisory Boards to generate information on the stakeholders' perception about the issue and ways to address it. CONCLUSION: There is an immediate need to address the high burden of hunger and under-nutrition in adolescents of both sexes in schools by instituting routine annual monitoring of nutritional status, extending the mid-day meal programme to all school-going adolescents, providing nutritional counselling for underweight adolescents and expanding research on the causes and impact of under-nutrition and evaluation of the impact of the enhanced mid-day meal programme

Dysmenorrhoea during the COVID-19 lockdown: a study of women in the age group 18-45 years in Goa, India

Background: Dysmenorrhea can be incapacitating and affect a woman’s quality of life and productivity. Our aim was to ascertain the prevalence and attributes of dysmenorrhea among women aged 18-45 years in the state of Goa, India; the attitude towards dysmenorrhea and management methods; and to also understand the impact of the COVID-19 lockdown on women experiencing dysmenorrhea.Methods: A self-administered Google form was circulated and analysed using STATA-statistical software version 16. The study was conducted under the observation of Goa Medical College, in the months of May and June of 2020.Results: 87.7% (664) of participants experienced dysmenorrhea of which 72% had moderate-severe pain during menses. The pain lasted for 1-4 days in 98.6% of the respondents. A total of 69.25% women took some measures to relieve the pain; however only 27% of them sought professional medical help. During the lockdown 17% participants noticed a change in their periods. A change in the method of pain management was reported in 12.05% of the women. It was noted that the younger age group reported more changes in their periods during the lockdown.Conclusions: Dysmenorrhea impacted the lives of a large proportion of women. Even though some experienced incapacitating pain, many women did not seek medical advice. The lockdown due to the COVID-19 pandemic affected the menstrual cycle including dysmenorrhoea and its management. The high prevalence of dysmenorrhea coupled with inadequate utilisation of health services, makes it all the more important to utilise the results of this study in order to educate women about the effective methods of treatment.

Calibrating EASY-Care independence scale to improve accuracy

Background there is currently limited support for the reliability and validity of the EASY-Care independence scale, with little work carried out in low- or middle-income countries. Therefore, we assessed the internal construct validity and hierarchical and classical scaling properties among frail dependent older people in the community. Objective we assessed the internal construct validity and hierarchical and classical scaling properties among frail dependent older people in the community. Methods three primary care physicians administered EASY-Care comprehensive geriatric assessment for 150 frail and/or dependent older people in the primary care setting. A Mokken model was applied to investigate hierarchical scaling properties of EASY-Care independence scale, and internal consistency (Cronbach's alpha) of the scale was also examined. Results we found that EASY-Care independence scale is highly internally consistent and is a strong hierarchical scale, hence providing strong evidence for unidimensionality. However, two items in the scale (unable to use telephone and manage finances) had much lower item Loevinger H coefficients than others. Exclusion of these two items improved the overall internal consistency of the scale. Conclusions the strong performance of the EASY-Care independence scale among community-dwelling frail older people is encouraging. This study confirms that EASY-Care independence scale is highly internally consistent and a strong hierarchical scale

Identifying common impairments in frail and dependent older people: validation of the COPE assessment for non-specialised health workers in low resource primary health care settings.

BACKGROUND: Frail and dependent older people in resource-poor settings are poorly served by health systems that lack outreach capacity. The COPE (Caring for Older PEople) multidimensional assessment tool is designed to help community health workers (CHWs) identify clinically significant impairments and deliver evidence-based interventions METHODS: Older people (n = 150) identified by CHWs as frail or dependent, were assessed at home by the CHW using the structured COPE assessment tool, generating information on impairments in nutrition, mobility, vision, hearing, continence, cognition, mood and behaviour. The older people were reassessed by local physicians who reached a clinical judgment regarding the presence or absence of the same impairments based upon clinical examination guided by the EASY-Care assessment tool. RESULTS: The COPE tool was considered easy to administer, and gave CHWs a sense of empowerment to understand and act upon the needs of older people. Agreement between COPE assessment by CHW and clinician assessors was modest (ranged from 45.8 to 91.3 %) for most impairments. However, the prevalence of impairments was generally higher according to clinicians, particularly for visual impairment (98.7 vs 45.8 %), cognitive impairment (78.4 vs. 38.2 %) and depression (82.0 vs. 59.9 %). Most cases identified by WHO-COPE were clinician confirmed (positive predictive values - 72.2 to 98.5 %), and levels of disability and needs for care among those identified by COPE were higher than those additionally identified by the clinician alone. CONCLUSIONS: The COPE is a feasible tool for the identification of specific impairments in frail dependent older people in the community. Those identified are likely to be confirmed as having clinically relevant problems by clinicians working in the same service, and the COPE may be particularly effective at targeting attention upon those with the most substantial unmet needs

Identifying common impairments in frail and dependent older people: Validation of the COPE assessment for non-specialised health workers in low resource primary health care settings

Background Frail and dependent older people in resource-poor settings are poorly served by health systems that lack outreach capacity. The COPE (Caring for Older PEople) multidimensional assessment tool is designed to help community health workers (CHWs) identify clinically significant impairments and deliver evidence-based interventions Methods Older people (n = 150) identified by CHWs as frail or dependent, were assessed at home by the CHW using the structured COPE assessment tool, generating information on impairments in nutrition, mobility, vision, hearing, continence, cognition, mood and behaviour. The older people were reassessed by local physicians who reached a clinical judgment regarding the presence or absence of the same impairments based upon clinical examination guided by the EASY-Care assessment tool. Results The COPE tool was considered easy to administer, and gave CHWs a sense of empowerment to understand and act upon the needs of older people. Agreement between COPE assessment by CHW and clinician assessors was modest (ranged from 45.8 to 91.3 %) for most impairments. However, the prevalence of impairments was generally higher according to clinicians, particularly for visual impairment (98.7 vs 45.8 %), cognitive impairment (78.4 vs. 38.2 %) and depression (82.0 vs. 59.9 %). Most cases identified by WHO-COPE were clinician confirmed (positive predictive values - 72.2 to 98.5 %), and levels of disability and needs for care among those identified by COPE were higher than those additionally identified by the clinician alone. Conclusions The COPE is a feasible tool for the identification of specific impairments in frail dependent older people in the community. Those identified are likely to be confirmed as having clinically relevant problems by clinicians working in the same service, and the COPE may be particularly effective at targeting attention upon those with the most substantial unmet needs

Minified Augmented Reality as a Terrestrial Analog for G-Transitions Effects in Lunar and Interplanetary Spaceflight

Brief periods of extreme gravitational transition are anticipated during interplanetary spaceflight, including transitions between microgravity, hypogravity, and hypergravity. Rapid sensorimotor adaptation will occur following these G-transitions which may affect astronaut performance including gaze control and dynamic visual acuity. Significant decrements in dynamic visual acuity could lead to mission compromise or failure (e.g., impairing mission critical tasks or spacecraft maneuvering). It is crucial to provide astronauts with the training necessary to overcome these physiological barriers they are bound to encounter during spaceflight missions. Minifying lenses in augmented reality may serve as an easily applicable, low-cost, method to simulate vestibulo-ocular dysfunction that occurs during gravitational transitions. In this paper, we review the effects of G-transitions on the vestibulo-ocular system and report on the novel development of minified augmented reality as a potential simulator and training tool for future spaceflight. We also report the results from an early validation study with a mean decrease in DVA (0.370 LogMAR) with 80% minifying effect, as well as a mean increase of DVA post-minifying (0.030 LogMAR). These early results suggest that minified augmented reality may serve as an accessible terrestrial analog for G-transitions, thus having potential for pre-mission training, particularly for lunar and interplanetary spaceflight

Rigidly linked dinuclear platinum( ii ) complexes showing intense, excimer-like, near-infrared luminescence

Many luminescent platinum(ii) complexes undergo face-to-face interactions between neighbouring molecules, leading to bimolecular excited states that may emit at lower energy (dimers and/or excimers). Detailed photophysical studies are reported on dinuclear complexes, in which two NCN-coordinated Pt(ii) units are covalently linked by a xanthene such that intramolecular formation of such dimeric or excimeric states is possible. These complexes display strong excimer-like photoluminescence at low concentrations where their monometallic analogues do not. However, a striking difference emerges between complexes where the Pt(NCN) units are directly connected to the xanthene through the tridentate ligand (denoted Class a) and a new class of compounds reported here (Class b) in which the attachment is through a monodentate acetylide ligand. The former require a substantial geometrical rearrangement to move the metal centres of the Pt(NCN) units to a distance short enough to form excimer-like states. The latter require only a small deformation. Consequently, Class a compounds display negligible excimer-like emission in solid films, as the rigid environment hinders the requisite geometric rearrangement. Class b complexes, in contrast, display strong excimer-like emission in film, even at very low loadings. The new dinuclear molecular architecture may thus offer new opportunities in the quest for efficient NIR-emitting devices

Exceptionally Fast Radiative Decay of a Dinuclear Platinum Complex Through Thermally Activated Delayed Fluorescence

A novel dinuclear platinum(II) complex featuring a ditopic, bis-tetradentate ligand has been prepared. The ligand offers each metal ion a planar O^N^C^N coordination environment, with the two metal ions bound to the nitrogen atoms of a bridging pyrimidine unit. The complex is brightly luminescent in the red region of the spectrum with a photoluminescence quantum yield of 83% in deoxygenated methylcyclohexane solution at ambient temperature, and shows a remarkably short excited state lifetime of 2.1 μs. These properties are the result of an unusually high radiative rate constant of around 4 × 105 s–1, a value which is comparable to that of the very best performing Ir(III) complexes. This unusual behaviour is the result of efficient thermally activated reverse intersystem crossing, promoted by a small singlet–triplet energy difference of only 69 ± 3 meV. The complex was incorporated into solution-processed OLEDs achieving EQEmax = 7.4 %. We believe this to be the first fully evidenced report of a Pt(II) complex showing thermally activated delayed fluorescence (TADF) at room temperature, and indeed of a Pt(II)-based delayed fluorescence emitter to be incorporated into an OLED

Effect of a Lay Counselor Intervention on Prevention of Major Depression in Older Adults Living in Low- and Middle-Income Countries:A Randomized Clinical Trial

Importance: Preventing depression in older adults living in low- and middle-income countries is important because of the scarcity of treatment resources and the risk of disability, suicide, and dementia. Objective: To assess whether an intervention for depression prevention provided by lay counselors is effective in older adults from low- and middle-income countries. Design, Setting, and Participants: This parallel-group randomized clinical trial with masked outcome assessment was performed in 181 older adults (≥60 years) with subsyndromal depressive symptoms at rural and urban primary care clinics in Goa, India. The first participant entered the trial on March 31, 2015, and the last exited on June 2, 2017. Data analysis used the intention-to-treat approach. Interventions: Lay counselors provided problem-solving therapy, brief behavioral treatment for insomnia, education in self-care of common medical disorders such as diabetes, and assistance in accessing medical and social programs. Main Outcomes and Measures: The main outcome was incidence of major depressive episodes. The study also assessed symptom change during 12 months (12-item General Health Questionnaire [GHQ-12]; score range of 0 to 12, with higher scores indicating greater symptoms of depression and anxiety), functional status (World Health Organization Disability Assessment Schedule 2.0; score range of 12 to 60, with higher scores indicating greater disability), cognition (Hindi Mini-Mental State Examination; score range of 0 to 30, with higher scores indicating better cognitive functioning), blood pressure, and body mass index to provide further clinical context. Results: The study enrolled 181 participants (mean [SD] age, 69.6 [7.2] years; 114 [63.0%] female): 91 to the intervention arm (depression in later life [DIL] intervention) and 90 to care as usual (CAU). Incident episodes of major depression were lower in the DIL intervention than in the CAU group (4.40% vs 14.44%; log-rank P =.04; number needed to treat, 9.95; 95% CI, 5.12-182.43). The 12-month Kaplan-Meier estimates of percentage of depression-free participants were 95.1% (95% CI, 90.5%-99.9%) in the DIL group vs 87.4% (95% CI, 80.4%-95.1%) in the CAU group. The incidence of depressive symptoms (GHQ-12) was also less (12-month mean difference, -1.18; 95% CI, -2.03 to -0.31; group × time interaction P <.001). There were no changes in measures of disability or cognition. The DIL intervention was associated with a significantly greater lowering of systolic blood pressure (12-month mean difference, -6.98; 95% CI, -11.96 to -2.01; group × time interaction P <.001) and change in body mass index (12-month mean difference, 0.23; 95% CI, -0.97 to 1.43; P =.04). Conclusions and Relevance: The DIL intervention is effective for preventing episodes of major depression in older persons with subsyndromal symptoms. If replicated, the DIL intervention may be effective in older adults living in low- and middle-income countries

d=3 Bosonic Vector Models Coupled to Chern-Simons Gauge Theories

We study three dimensional O(N)_k and U(N)_k Chern-Simons theories coupled to a scalar field in the fundamental representation, in the large N limit. For infinite k this is just the singlet sector of the O(N) (U(N)) vector model, which is conjectured to be dual to Vasiliev's higher spin gravity theory on AdS_4. For large k and N we obtain a parity-breaking deformation of this theory, controlled by the 't Hooft coupling lambda = 4 \pi N / k. For infinite N we argue (and show explicitly at two-loop order) that the theories with finite lambda are conformally invariant, and also have an exactly marginal (\phi^2)^3 deformation. For large but finite N and small 't Hooft coupling lambda, we show that there is still a line of fixed points parameterized by the 't Hooft coupling lambda. We show that, at infinite N, the interacting non-parity-invariant theory with finite lambda has the same spectrum of primary operators as the free theory, consisting of an infinite tower of conserved higher-spin currents and a scalar operator with scaling dimension \Delta=1; however, the correlation functions of these operators do depend on lambda. Our results suggest that there should exist a family of higher spin gravity theories, parameterized by lambda, and continuously connected to Vasiliev's theory. For finite N the higher spin currents are not conserved.Comment: 34 pages, 29 figures. v2: added reference