Study of impact of sociocultural and economic factors of mothers on the nutritional status of their malnourished children in a rural area of Delhi, India

Background: Even after following the multi-strategy approach of Integrated Child Development Services (ICDS) in India for the last four decades, reducing malnutrition among children below 6 years has turned out to be a herculean task, because of the poor focus by Anganwadi workers (AWWs) on empowering community to manage malnutrition among the children at home level. Therefore, it becomes necessary to assess the role of the mothers in managing malnutrition in their children. Objectives: To study the impact of sociocultural and economic factors of mothers on the nutritional status of their malnourished children in a rural area of Delhi, India. Materials and Methods: The study was conducted for a 6-month duration (July–December 2013) in a rural ICDS block (Narela) of Delhi. The 80 mothers of both the healthy and malnourished children (40 mothers in each group) were interviewed in depth via semi-structured interview schedule; and all these mothers were separately studied further by focus group discussion technique to explore their beliefs, opinions, and practices on malnutrition management in their children. All the collected data were finally triangulated and analyzed after applying w2-test from SPSS, version 22.0. Results: The main reasons behind inadequate efforts made by mothers in nutritional management of their children were the following: sporadic nutrition and health education given by AWWs at Anganwadi centers (AWCs) and homes to mothers leading to a lack of nutritional knowledge (p o 0.05) and inadequate treatment-seeking behavior toward malnourished children (47.5%) and the poverty causing mothers to work outside home (p o 0.05). Conclusion: AWWs need to focus urgently on their proper nutritional and health educational activities for mothers of malnourished children, regarding key messages on proper child-feeding practices and also the concerned government needs to provide more income opportunities to fathers of such children along with a targeted Public Distribution System

Study of psychiatric morbidity among residents of government old age homes in Delhi

Context: The increased demand on long-term old age care homes in urban India is a result of demographic transition together with the disintegration of joint family system and changing social values which make them increasingly vulnerable to mental health problems. Aims: This study attempted to find out an array of mental health problems and associated morbidity among inhabitant of government old age homes. Settings and Design: This was a cross-sectional study which included government run old age homes (OAHs) in Delhi. Subjects and Methods: The sample comprised a total of 148 elderly in four OAHs with a mean age of 72.81 years. The World Health Organization Quality of Life-BREF Scale (QOL), Mini-Mental State Examination, Geriatric Depression Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, and Kesseler-10 Scale were administered. Statistical Analysis: Data were analyzed through SPSS version 20.0 version. Frequency distribution and cross-tabulation used to create summary tables and compare items. Results: Female constituted two-third of study population whereas one-third of subjects were illiterate and two-third without income. The study demonstrated psychiatric morbidity profile among OAH inhabitants and exhibited mild-moderate anxiety symptoms in almost 95% followed by mild-severe depression reported by 85%, mild-moderate psychotic illnesses, psychological distress, cognitive impairments, and poor QOL. Low income and education, low social connections and loss of spouse were key risk factors. Conclusions and Recommendation: Psychiatric morbidity profile and QOL among OAH residents is influenced by various psychological, social, and economic factors. This emphasized the need for better management of the government-run OAHs to ensure better overall mental health of the residents

Depression effects on hospital cost of heart failure patients in California: An analysis by ethnicity and gender

Background: Depression often interferes with self-management and treatment of medical conditions. This may result in serious medical complications and escalated health-care cost. Objectives: Study distribution of heart failure (HF) cases estimates the prevalence of depression and its effects on HF-related hospital costs by ethnicity and gender. Methods: Secondary data files of California Hospital Discharge System for he year 2010 were examined. For patients with a HF diagnosis, details regarding depression, demographics, comorbid conditions, and hospital costs were studied. Age-adjusted HF rates and depression were examined for whites, blacks, Hispanics, and Asians/Pacific Islanders (AP) by comparing HF patients with depression (HF +D) versus HF without depression (HFND). Results: HF cases (n = 62,685; average age: 73) included nearly an equal number of males and females. HF rates were higher (P < 0.001) among blacks compared to Hispanics, AP, and whites and higher among males than females. One-fifth of HF patients had depression, higher among females and whites compared to males and other ethnic groups. Further, HF hospital costs for blacks and AP were higher (P < 0.001) compared to other groups. The cost for HF +D was 22% higher compared to HFND, across all gender and ethnic groups, largely due to higher comorbidities, more admissions, and longer hospitalization. Conclusion: Depression, ethnicity, and gender are all associated with increased hospital costs of HF patients. The higher HF and HF +D costs among blacks, AP, and males reflect additional burden of comorbidities (hypertension and diabetes). Prospective studies to assess if selective screening and treating depression among HF patients can reduce hospital costs are warranted