Cluster-randomised controlled trial of community mobilisation in Mumbai slums to improve care during pregnancy, delivery, postpartum and for the newborn

Background: The United Nations Millennium Development Goals look to substantial improvements in child and maternal survival. Morbidity and mortality during pregnancy, delivery and the postnatal period are prime obstacles to achieving these goals. Given the increasing importance of urban health to global prospects, Mumbai's City Initiative for Newborn Health aims to improve maternal and neonatal health in vulnerable urban slum communities, through a combination of health service quality improvement and community participation. The protocol describes a trial of community intervention aimed at improving prevention, care seeking and outcomes.Objective: To test an intervention that supports local women as facilitators in mobilising communities for better health care. Community women's groups will build an understanding of their potential to improve maternal and infant health, and develop and implement strategies to do so.Design: Cluster-randomized controlled trial.Methods: The intervention will employ local community-based female facilitators to convene groups and help them to explore maternal and neonatal health issues. Groups will meet fortnightly through a seven-phase process of sharing experiences, discussion of the issues raised, discovery of potential community strengths, building of a vision for action, design and implementation of community strategies, and evaluation.The unit of allocation will be an urban slum cluster of 1000-1500 households. 48 clusters have been randomly selected after stratification by ward. 24 clusters have been randomly allocated to receive the community intervention. 24 clusters will act as control groups, but will benefit from health service quality improvement. Indicators of effect will be measured through a surveillance system implemented by the project. Key distal outcome indicators will be neonatal mortality and maternal and neonatal morbidity. Key proximate outcome indicators will be home care practices, uptake of antenatal, delivery and postnatal care, and care for maternal and neonatal illness.Data will be collected through a vital registration system for births and deaths in the 48 study clusters. Structured interviews with families will be conducted at about 6 weeks after index deliveries. We will also collect both quantitative and qualitative data to support a process evaluation.Trial registration: Current controlled trials ISRCTN9625679

Dental caries experience among 8-9-year-old school children in a South Indian City: A cross-sectional study

Introduction: Dental caries is the most common dental disease and knowledge of a population′s epidemiological situation is vital for planning and providing prevention and treatment services. There is minimal data available in the literature with regard to the prevalence of dental caries in mixed dentition. Aim: The aim was to assess dental caries experience in 8-9 years old children in Davanagere, Karnataka. Materials and Methods:A descriptive cross-sectional study of 8-9 years old children in government and private schools was conducted. Total of 800 school children (both males and females) were randomly selected for the study. Dental caries status was recorded by means of deft for primary dentition and decayed, missing, and filled teeth (DMFT) for permanent dentition. The statistical tests used were t-test and Chi-square test. Results: Caries experience among the subjects for permanent teeth was 13.8% and for primary teeth was 60.1%. Mean deft and DMFT score were 2.77 and 0.26, respectively. Conclusion: Dental caries status for the sample of Indian children aged 8-9 years of Davangere city showed a declining trend

Piezoresistive 6-MNA coated microcantilevers with signal conditioning circuits for electronic nose

This paper presents a micro cantilever based piezo-resistive sensor and its fabrication process along with two different techniques for signal conditioning of sensor output aimed for artificial nose applications. The proposed micro-cantilevers feature a special coating of 6-Marcaptonicotonic acid (6-MNA) on one side of the cantilever which leads to a selective reaction of the target analyte molecules with the functionalized cantilever surface. Two signal conditioning schemes, a novel current excitation method and a resistance to frequency conversion (RFC) method using a new proposed circuit are implemented to precisely read the piezo-resistance changes. Current excitation method is implemented using commercial ICs while RFC method is implemented using a low-power test chip constituting of instrumentation amplifier, buffer and comparator in 180nm mixed-mode CMOS technology. It is shown that the implemented RFC method provides a resolution of 5ppm and is useful for low-cost on-chip measurements involving the piezo-resistive sensors. Implemented current excitation method provides measurement resolution of 40 parts per billion with minimum SNR value of 5 dB which is better than previously-reported values