Road Rage Menace: A Cross-sectional Study to Assess Driver Anger Level in Public Motor Vehicle Drivers in a City in Central India

Introduction: Road rage and aggressive driving is a prevalent condition in today’s society due to motorists’ frustrations during heavy traffic volumes. Objective: This study was done to assess the level of anger amongst the drivers of public transport vehicles in Indore, using Driving Anger Scale (DAS by Deffenbacher et. al.) and various factors affecting it. Material and Methods: A cross-sectional study was conducted among 135 drivers of Public transport vehicle drivers (Star bus, City-van and star cab drivers) in Indore to assess their anger level using Driving Anger Scale. The participants were required to record the amount of anger they would experience in response to each item in the scale (1=not at all angry, 2=a little angry, 3=some anger, 4=much anger, 5=very much angry). Results: The mean DAS score in Indore was found to be 3.013 and in the three organizations namely Star bus drivers, City van drivers and Star cab drivers was 2.92, 3.08 and 3.04 respectively. The DAS score of drivers with respect to the 6 sub-scales were: hostile gestures (Star bus -3.42,City van -3.67,Star cab -3.38), slow driving (Star bus -2.73,City van driv-2.78,Star cab-3.17), traffic obstructions (Star bus-2.85,City van -3.25,Star cab-3.18), discourtesy (Star bus -3.23,City van-3.33,Star cab -3.25)and police presence (Star bus -2.15,City van -1.99,Star cab -2.78), illegal driving (Star bus -3.04,City van -3.14,Star cab -2.89). The DAS scores of the drivers did not vary significantly with age group, experience, and educational qualification. Conclusion: Though DAS scores did not vary between the three groups of drivers, however average level anger for various given circumstances commonly found in the Indian traffic scenario was on the higher side

Critical Appraisal of Baby Friendly Hospital Initiatives among the beneficiaries of Indore Urban - A Comparative Study

Background: Majority of the women in M.P who breastfeed their babies throw away the colostrum before they begin actual feed. Only 14.9% females feed their babies with in 1/2 an hour (National Family Health Survey-3). In Indore 2 hospitals have been given designation of baby friendly hospital (BFH) namely M.Y. hospital (MYH) which is a tertiary care center, attached to Medical College and District hospital (DH). Objectives: (1) To assess the process of implementation of baby friendly hospital initiative programme. (2) Knowledge, Attitude, Practice regarding breast feeding amongst the beneficiaries. Methods: A comparative study was conducted between two BFH and two NBFH (Non Baby Friendly Hospitals) of Indore. The respondents were categorized into health care providers and beneficiaries. A pretested questionnaire was used to interview the respondents which was made taking into consideration the essential 10 Criteria of BFHI Programme. Results: 89% in BFH and 97% in NBFH were having positive attitude towards colostrum feeding. 81% postnatal mothers in BFH and 96% in NBFH were having knowledge about benefits of exclusive breast feeding. 21% postnatal mothers in BFH and 39% in NBFH initiated breast feeding within ½ an hour. 64 % of mothers in BFH and 62 % mothers in NBFH were practicing exclusive breast Feeding. Conclusion: The above findings show that although designated as BFH, the breast feeding practices remained poor as compared to NBFH. There is an utmost need to reinforce training and constant monitoring of health care providers regarding BFHI

Assessment of Functioning of Village Health and Sanitation Committees (VHSCs) of Indore District

Background: The NRHM framework of implementation mentions provision of Village Health and Sanitation Committee (VHSC) in each revenue village that has to be formed within the overall framework of Panchayati Raj Institution (PRI). Objective: To review the current status of formation, training and functioning of VHSCs in Indore district and mechanism of utilization of united funds in these VHSCs. Materials and Methods: A cross sectional study was carried out in 32 villages, of four blocks of Indore district. Different stakeholders of VHSCs of these 32 villages were included purposively as study subjects. Data was collected using predesigned, pretested semi structured questionnaires and checklist. Total of 133 interviews of different stakeholders and 32 record reviews were carried out. The quantitative data collected by interviews and record reviews was analyzed by SPSS software and qualitative data was analyzed manually using qualifier. Results: Significant association between knowledge and awareness about any aspect of VHSC and type of stakeholder has been observed. PRI members and Self Help Group (SHG) members have been found to be totally ignorant about many aspects of VHSC. No formal training has ever been imparted to the members of VHSCs regarding functioning of VHSC at village level. None of the functionaries were found to be aware of village health plan. Conclusion: The efficiency and impact of VHSCs have been found to be very limited

Impact of Educational Intervention Measures on Knowledge regarding HIV/ Occupational Exposure and Post Exposure Prophylaxis among Final Year Nursing Students of a Tertiary Care Hospital in Central India

Amongst the different Health Care Personnel nurses are at a greater risk of being accidentally exposed to HIV and other Blood Borne Pathogens. The present study was conducted among 50 final year nursing students of a Medical College Hospital to assess the knowledge regarding HIV, occupational exposure and Post Exposure Prophylaxis (PEP) among the students and analyses the impact of educational intervention measures on the issues amongst the study subjects. A Pre-designed and Pre-tested semi-structured questionnaire was used to evaluate the level of knowledge before and after educational intervention sessions. Knowledge regarding risk of transmission of HIV by needle-stick injury and body fluids against which universal precautions were mandatory increased by 72% following the intervention sessions (χ2 = 53.202, p <0.001). 72% and 36% respondents correctly knew the duration within which to start PEP and the drugs available for PEP, post educational sessions 98% and 96% students were aware of it: the difference being statistically significant (χ2 = 11.294, p <0.001) and (χ2 = 37.748, p <0.001) respectively. The mean pre-intervention score was 8.32; mean post-intervention score was 14.40: statistical analysis showed the results to be significant (t= 13.857, p< 0.001). The study reflects that there is a dearth of knowledge among the study group. Incorporating the concerned issues in the academic curriculum to provide the students with adequate knowledge and information during their formative years is needed

Pulmonary Echinococcal Cyst with a Filamentous Fungus Co-Infection

Fungal infections are known to colonize the preexisting lung cavities formed as a result of diseases like tuberculosis, sarcoidosis, bronchiectasis and cavitatary neoplasia, mostly encountered in immunocompromised patients. Pulmonary echinococcal cysts have been reported coexistent with cryptococcosis and other saprophytic mycosis, but the coexistence of aspergillosis and echinococcal cyst is extremely rare and occasionally been reported in English literature. Active invasion and proliferation of the fungi in the laminated ectocyst of the echinococcal cyst is very unusual. We report a case of 60 years old immunocompetent female, presented with cough, chest pain and shortness of breath. The chest X- ray showed a large thick walled cavity in the lower and mid zone of right lung with positive water lily sign. Surgical enucleation of the echinococcal cyst revealed aspergilloma involving the cavity with massive invasion of laminated ectocyst by filamentous fungus, morphologically resembling an Aspergillus species and was further treated with Itraconazole for 3 months. This unique coexistence of active pulmonary echinococcosis and aspergillosis is being reported because of its rarity and clinical importance for its management.Keywords: Aspergillosis, echinococcosis, echinococcal cyst, pulmonary, mycosis

Fear of the Market or Fear of the Competitor? Ambiguity in a Real Options Game

In this paper we study an investment game between two firms with a first--mover advantage, where payoffs are driven by a geometric Brownian motion. At least one of the firms is assumed to be ambiguous over the drift, with maxmin preferences over a strongly rectangular set of priors. We develop a strategy and equilibrium concept allowing for ambiguity and show that equilibria can be preemptive (a firm invests at a point where investment is Pareto dominated by waiting) or sequential (one firm invests as if it were the exogenously appointed leader). Following the standard literature, the worst--case prior for an ambiguous firm in the follower role is obtained by setting the lowest possible trend in the set of priors. However, if an ambiguous firm is the first mover, then the worst--case drift can fluctuate between the lowest and the highest trends. This novel result shows that ``worst--case prior'' in a setting with drift ambiguity does not always equate to ``lowest trend''. As a consequence, preemptive pressure reduces. We show that this results in the possibility of firm value being increasing in the level of ambiguity. If only one firm is ambiguous, then the value of the non--ambiguous firm can be increasing in the level of ambiguity of the ambiguous firm

Effect of Interlayer Composition on the Properties of Laser-Directed-Energy-Deposition-Based Additively Manufactured Copper-Stainless Steel Wall Structures

Laser-directed energy deposition (LDED) is one of the advanced techniques used for the sustainable manufacturing of engineering components with minimal material wastage and higher performance. This paper reports an investigation on LDED-based additive manufacturing of compositionally graded Copper (Cu)-stainless steel (SS) wall structures for improved performance of tooling components. Three different approaches, such as Cu-SS direct joint, 20% graded Cu-SS, and 50% graded Cu-SS, are used to build the wall structures. Optical microscopy of LDED-built graded samples reveals defect-free deposition of Cu-SS direct joint and 50% graded Cu-SS wall structures at identified process parameters, whereas the 20%-graded wall yields micro-cracks in the lower Cu region. The elemental distribution shows gradual traditions in the weight percentages of Cu and Fe along the built wall. Furthermore, the ultimate tensile strengths of the direct Cu-SS joint wall structure and the 50%-graded Cu-SS wall structure are higher than the strength of LDED-deposited Cu, while the 20%-graded Cu-SS wall structure has lower ultimate tensile strength than the strength of LDED-deposited Cu. Lower ultimate strength and failure in the lower-Cu zone of 20% graded Cu-SS wall structure can be attributed to the presence of micro-cracks in the Cu 20SS 80 zone of 20%-graded Cu-SS wall structures. The study establishes LDED as a technique for building multi-material components promoting sustainability in terms of manufacturing and component performance.</p

An Educational Interventional Study to Assess Awareness about Mosquito Breeding, Diseases Caused and Protective Measures Against them among Families Residing in an Urban Slum of Indore City

Background: Community participation plays an important role in control of Mosquito borne diseases. This study tries to assess impact of educational intervention on various aspects of mosquito borne diseases in an urban slum. Methodology: An educational interventional study was done in 200 families residing in a slum (Badi Gwaltoli) which is in field practice area of Urban Health Centre attached to Department of Community Medicine of M.G.M.Medical College, Indore. A pretested semi-structured questionnaire was administered to the Head of the family which studied their awareness and perception regarding breeding sites and biting habits of mosquitoes, diseases spread by them and personal protective measures used, followed by an educational intervention and post assessment. Data was entered into Microsoft excel spread sheet and analysed using SPSS version 20 software. Results: 46% of study population knew the correct breeding season of mosquitoes (monsoon season) during pre-intervention and 68% of the population post- intervention (p- value 0.004). When asked at what time mosquitoes bite the most, maximum number (92%) of people said that mosquitoes bite most in the evening and night, while only 6% and 2% were for morning and noon, respectively. Only 3.5% of the population who knew about breeding sites knew about artificial collections of water. Majority said mosquito breed in dirty stagnant water (78.5%). About 96%of the study population was aware that mosquitoes spread diseases. However, only 33.3%of respondents knew correctly about the diseases spread which improved to 68% in the post-intervention period (p-value=.000). 46% knew all the protection measures against mosquitoes in the pre-intervention which increased to 86% in the post intervention (p.value-.005). Conclusion: Awareness about Aedes mosquitoes and its habits is quite poor and many people still believe that only dirty water serves as a breeding place in mosquitoes. Regular IEC sessions informing community about mosquito-borne diseases will improve community participation

Revisiting the relationship between host attitudes and tourism development: A utility maximization approach

Host attitudes toward tourists are critical to the sustainable development of the tourism industry. Although numerous studies have focused on investigating host attitudes toward tourists and tourism development, the theoretical support from an economic perspective in this field is still underdeveloped. By following the social exchange theory and applying a utility maximization model, the current study not only explains Doxey’s Irridex model from an economic perspective but also complements the findings of the tourism area life cycle model proposed by Butler. Results show that the public resources at the destination, along with the ability of local community in channeling (foreign) tourism income into productivity advancement, influence the optimal level of tourism development in a destination