Prevalence and correlates of childhood obesity in suburban area of Odisha: A cross sectional study

Introduction: In India obesity and overweight is increasing among urban adolescents. Both under and over nutrition is grappling the country at faster rate. Present study was an attempt to explore obesity and overweight prevalence among school going children in suburban areas of Cuttack city, Odisha, India and their correlates. Methodology: A cross-sectional study was done among school children in suburban area of Cuttack city, Odisha. A predesigned and pretested questionnaire was used to interview the study participants to elicit information about their age, number of siblings, birth order of the child, working status of parents, television screen viewing time, mode of transport to school and dietary habit of the students. A total of 550 children studying in class five to ten participated in our study. Result: Out of 550 children screened, nearly (14) 2.5% students were thin or severely thin, whereas (67)12.1% students were overweight or obese. Univariate analysis revealed that girls were almost five times at higher risk of being overweight/obesity compared to boys (OR: 4.78 95%CI: 1.35-16.93). Children who used motorized vehicles for going to school had an unadjusted Odds ratio of 10.08 [95%CI: 2.08-48.77] of being overweight or obese compared to those who walked to school. Having more than one child at home (OR= 0.15, 95%CI: 0.039-0.6) and doing physical activity for more than 30min per day (0.105, 95%CI: 0.015-0.72) were found to be protective against overweight and obesity. Conclusion: Bearing in mind the burden of overweight and obesity among school children there is a need for periodic screening, awareness at school and parent counselling

A conceptual framework on health professionals' engagement towards pharmacovigilance: a qualitative exploration

Background: With the growing reliance on drug therapy in the recent era, the safety of medications is one of the vital parameters for the success of any medicine. Considering this, pharmacovigilance (PV) was developed to provide adequate identification, reporting, evaluation, and understanding of adverse drug reactions (ADR). The objective of this study was to understand the opinion of health care providers on PV, the current reporting mechanisms, identifying the causes for underreporting, and the existing process in clinical practice.Methods: A qualitative study using pretested interview guide was conducted among 20 different cadres of healthcare personnel (doctors, pharmacists, and staff nurses) from various hospitals such as government, private, corporate, and medical college of Odisha state. The data were analysed using a thematic analysis. The meaning units have been identified from the transcript and coded with MAXQDA software (MAXQDA Analytics Pro 2020, VERBI GmbH Berlin).Results: Participants showed a lack of awareness regarding the concept of PV. A cluster of challenges such as lack of ADR monitoring, non-conducive work atmosphere and lack of cooperation between staff, lack of knowledge among the health professionals, and fear of legal liability as major pitfalls causing poor ADR reporting. To enhance the pharmacovigilance practice, participants suggested context-specific strategies such as IEC activities, innovative ideas to improve ADR monitoring, regular monitoring.Conclusions: Capacity building through training, regular monitoring and supervision to strengthen the pharmacovigilance practices is the current need in India

Global Health Teaching in India: A Curricular Landscape

Today, health has transcended national boundaries and become more multifaceted. Global health has evolved as a new paradigm and is recently being identified as a thrust area now in India. Despite an existing need for a standardized global health curriculum, there is little information available on its education and curriculum in medical and health education space. In the Indian context, we are yet to have a fuller picture of the current status, including, content, structure, selection, teaching methods of global health, and how students are evaluated in India. The objective of this study was to map courses relating to studies on global health in India and analyze its mode of delivery. A detailed Internet search was carried out to identify global health courses and analyzed for: (i) whether global health is a part of the teaching curriculum, (ii) mode of teaching, (iii) broad contents, (iv) instructional formats, (v) assessment, and (vi) selection process. It was found that delivery of global health education in India was fragmented with limited focus at the undergraduate and postgraduate levels. Global health teaching was largely based on certificate courses or online courses, with hardly any institutions imparting a distinct global health education program. There is also no definite specification as to which institutes can impart teaching on global health education and what the specific eligibility requirements are. Our analysis suggests that efforts should be directed toward integrating global health education into broader public health curriculum. At the same time, the need for generation of global health leaders, creation of a common forum for addressing merits and demerits of global health issues, as well as creation of more opportunities for placements are recognized

Hand hygiene behavior among urban slum children and their care takers in Odisha, India

Objective. To study the knowledge and practice of hand washing among mothers and children of shikharchandi slum of Bhubaneswar, Odisha and to recommend possible measures to improve the current practices. Methodology. Present cross-sectional study was carried out in the Shikharchandi slum located in the Bhubaneswar city of Orissa state in India. 150 women and 80 children were interviewed. Chil- dren questionnaire were prepared to suit to their age and accord- ing to local context. Components of sanitation like food handling and hand washing were covered in this questionnaire. Results. Hand washing before preparing food is being practiced by 85% of women. Of all women interviewed, 77% wash hands before serving food. Only 15% children said soap was available in their school to wash hands. Out of total children interviewed, 76% told that their teachers tell about sanitation and hand washing in the class. Only 5% children told they were consulted by doctor/health worker during last 3 months. As many as 81% children told that they wash their hands before taking food and 19% children said they take their food without washing hands. Though most of the children told that they wash hands before tak- ing food, but only 17.5% told that they use soap for hand washing. Only 29% children told that their teachers check hand washing in school. When asked about critical timing of hand washing, 44% children told about at least two critical timings and 56% were unaware about the critical timings of hand washing. Conclusion. Inadequate knowledge on this among our study par- ticipant is a point of concern. Systematic integration of health and hygiene education in schools through curricular modifications could be an appropriate strategy

PRACTICING HEALTH PROMOTION IN PRIMARY CARE – A REFLECTIVE ENQUIRY

IntroductionHealth promotion is an integral part of routine clinical practice. The physicians’ role in improving the health status of the general population, through effective understanding and delivery of health promotion practice, is evident throughout the international literature. Data from India suggest that physicians have limited skills in delivering specific health promotion services. However, the data available on this is scarce. This study was planned to document the current health promotion knowledge, perception and practices of local primary care physicians in Odisha. MethodsAn exploratory study was planned between the months of January – February 2013 in Odisha among primary care physicians working in government set up. This exploratory study was conducted, using a two-step self-administered questionnaire, thirty physicians practicing under government health system were asked to map their ideal and current health promotion practice, and potential health promotion elements to be worked upon to enhance the practice. ResultsThe study recorded a significant difference between the mean of current and ideal health promotion practices. The study reported that physicians want to increase their practice on health education. ConclusionWe concluded that inclusion of health promotion practices in routine care is imperative for a strong healthcare system. It should be incorporated as a structured health promotion module in medical curriculum as well

Association of Oral Health with Multimorbidity among Older Adults:Findings from the Longitudinal Ageing Study in India, Wave-1, 2017–2019

India is witnessing an increase in the prevalence of multimorbidity. Oral health is related to overall health but is seldom included in the assessment of multimorbidity. Hence, this study aimed to estimate the prevalence of oral morbidity and explore its association with physical multimorbidity using data from Longitudinal Ageing Study in India (LASI). LASI is a nationwide survey amongst adults aged ≥ 45 years conducted in 2018. Descriptive analysis was performed on included participants (n = 59,764) to determine the prevalence of oral morbidity. Multivariable logistic regression assessed the association between oral morbidity and physical multimorbidity. Self-rated health was compared between multimorbid participants with and without oral morbidity. Oral morbidity was prevalent in 48.56% of participants and physical multimorbidity in 50.36%. Those with multimorbidity were at a higher risk of having any oral morbidity (AOR: 1.60 (1.48–1.73)) than those without multimorbidity. Participants who had only oral morbidity rated their health to be good more often than those who had physical multimorbidity and oral morbidity (40.84% vs. 32.98%). Oral morbidity is significantly associated with physical multimorbidity. Multimorbid participants perceived their health to be inferior to those with only oral morbidity. The findings suggest multidisciplinary health teams in primary care should include the management of oral morbidity and physical multimorbidity

A study of organizational versus individual needs related to recruitment, deployment and promotion of doctors working in the government health system in Odisha state, India

Background An effective health workforce is essential for achieving health-related new Sustainable Development Goals. Odisha, one of the states in India with low health indicators, faces challenges in recruiting and retaining health staff in the public sector, especially doctors. Recruitment, deployment and career progression play an important role in attracting and retaining doctors. We examined the policies on recruitment, deployment and promotion for doctors in the state and how these policies were perceived to be implemented. Methods We undertook document review and four key informant interviews with senior state-level officials to delineate the policies for recruitment, deployment and promotion. We conducted 90 in-depth interviews, 86 with doctors from six districts and four at the state level to explore the perceptions of doctors about these policies. Results Despite the efforts by the Government of Odisha through regular recruitments, a quarter of the posts of doctors was vacant across all institutional levels in the state. The majority of doctors interviewed were unaware of existing government rules for placement, transfer and promotion. In addition, there were no explicit rules followed in placement and transfer. More than half (57%) of the doctors interviewed from well-accessible areas had never worked in the identified hard-to-reach areas in spite of having regulatory and incentive mechanisms. The average length of service before the first promotion was 26 (±3.5) years. The doctors expressed satisfaction with the recruitment process. They stated concerns over delayed first promotion, non-transparent deployment policies and ineffective incentive system. Almost all doctors suggested having time-bound and transparent policies. Conclusions Adequate and appropriate deployment of doctors is a challenge for the government as it has to align the individual aspirations of employees with organizational needs. Explicit rules for human resource management coupled with transparency in implementation can improve governance and build trust among doctors which would encourage them to work in the public sector

Prevalence, pattern and determinants of disabilities in India: Insights from NFHS-5 (2019–21)

There is a need to provide an overview of the disability burden in India as there are limited studies. The present study aimed to estimate the prevalence and assess the pattern and determinants of disability in India. We analyzed National Family Health Survey-5 data using the “svyset” command in STATA software. We assessed the correlates by multivariable regression and reported an adjusted prevalence ratio (aPR) with a 95% confidence interval (CI). QGIS 3.2.1 software was used for spatial analysis of distributions of different disabilities. The mean (SD) age of 28,43,917 respondents was 30.82 (20.62) years, with 75.83% (n = 21,56,633) and 44.44% (n = 12,63,086) of them being from a rural area and were not educated, respectively. The overall prevalence of disability was 4.52% [(95% CI: 4.48–4.55), n = 1,28,528]. Locomotor disabilities accounted for 44.70% of all disabilities (n = 51,659), followed by mental disabilities (20.28%, n = 23,436). Age 75 years and above (vs. 0–14 years) [aPR: 2.65 (2.50–2.81)], male (vs. female) [aPR: 1.02 (1.0–1.04)], no education (vs. higher education) [aPR 1.62 (1.56–1.68)], unmarried (vs married) [aPR: 1.76 (1.70–1.82)], seeking the care of non-governmental organization (NGO) (vs. other) [aPR: 1.32 (1.13–1.55)] were significant independent determinants. The highest overall prevalence of locomotor was in Lakshadweep/UTs (8.88%) and Delhi (57.03%), respectively. Out of every hundred individuals in India, four have a disability. More intervention strategies should be planned, considering factors like education, residence, health promotion and caste so that the services provided by the government can be available and accessible to everyone in need

A systematic review

Background: Multimorbidity is the co-occurrence of two or more diseases in the same individual. One method to identify this condition at an early stage is the use of specific markers for various combinations of morbidities. Nonetheless, evidence related to physiological markers in multimorbidity is limited. Objective: The aim was to perform a systematic review to identify physiological markers associated with multimorbidity. Design: Articles available on PubMed, Register of Controlled Trials, Academic Search Premier, CINAHL, Scopus, SocINDEX, Web of Science, LILACS, and SciELO, from their inception to May 2018, were systematically searched and reviewed. The project was registered in PROSPERO under the number CRD42017055522. Results: The systematic search identified 922 papers. After evaluation, 18 articles were included in the full review reporting at least one physiological marker in coexisting diseases or which are strongly associated with the presence of multimorbidity in the future. Only five of these studies examined multimorbidity in general, identifying five physiological markers associated with multimorbidity, namely, dehydroepiandrosterone sulfate (DHEAS), interleukin 6 (IL-6), C-reactive protein (CRP), lipoprotein (Lp), and cystatin C (Cyst-C). Conclusions: There is a paucity of studies related to physiological markers in multimorbidity. DHEAS, IL-6, CRP, Lp, and Cyst-C could be the initial focus for further investigation of physiological markers related to multimorbidity.info:eu-repo/semantics/publishedVersio

Green Care kuntoutumisen tukena mielenterveyskuntoutujien palvelukodissa

Tämän opinnäytetyön tavoitteena oli suunnitella ja toteuttaa Green Care-menetelmillä toiminnallisia ryhmiä. Ryhmien tavoitteena oli selvittää mielenterveyskuntoutujien kokemuksia eräässä mielenterveys- ja päihdekuntoutujien palvelukodissa. Opinnäytetyön tavoitteena oli myös tarkastella Green Care-menetelmien merkitystä palvelukodin asiakkaiden kuntoutumiseen. Opinnäytetyön tarkoituksena oli myös lisätä mielenterveys- ja päihdekuntoutujien palvelukodin palvelutarjontaa ja toimintatapoja Green Care-menetelmien avulla. Palvelukoti tarjoaa asumis-, kuntoutus- ja tukipalveluja 30:lle päihde- ja mielenterveyskuntoutujalle ja siellä noudatetaan yhteisöllisyyden periaatteita. Opinnäytetyön viitekehyksessä kuvaan erilaisia Green Care-menetelmiä ja niiden hyvinvointivaikutuksia sekä Green Caren etiikkaa. Kerron myös Green Care-käsitteestä, sen historiasta sekä esiintymisestä Suomessa. Green Care-toimintaa pidetään sateenvarjokäsitteenä erilaisille luontolähtöisille ja eläinavusteisille menetelmille, joilla pyritään edistämään ihmisten sosiaalista, fyysistä, psyykkistä ja koulutuksellista hyvinvointia. Green Care-toiminnan keskeisimmät elementit ovat luonto, luonnossa tapahtuva ja luontoelementtejä käyttävä toiminta sekä yhteisö, jossa toiminta tapahtuu. Teoriaosuudessa kerron myös mielenterveyskuntouksesta, sen käsitteistä ja kuntoutuksen prosessista. Kuvaan myös kuntoutusvalmiutta ja toimintakyvyn arviointia sekä mielenterveystyön etiikkaa. Mielenterveys on hyvinvoinnin tila, jossa ihminen näkee omat kykynsä selviytyä elämän haasteista ja työstä ja ottaa osaa yhteisönsä toimintaan. Opinnäytetyö on toiminnallinen opinnäytetyö, jonka tutkimuksellisessa osuudessa on käytetty osallistuvaa havainnointia ja avointa haastattelua. Haastattelut olivat ryhmähaastatteluja ja kolmelle asiakkaalle tehtiin myös yksilöhaastattelut. Tutkimuksen tulokset on analysoitu teemoittelun avulla. Sekä havaintojen että haastattelujen perusteella palvelukodin asiakkaat kokivat Green Care-menetelmät positiivisina, aktivoivina ja erilaisia hyvinvointivaikutuksia tuottavina. Yleisimmin koettu hyvinvointivaikutus oli menetelmien rauhoittava vaikutus. Green Care-toiminnan merkitystä palvelukodin mielenterveyskuntoutujille oli vaikea arvioida neljän toimintakerran avulla, mutta viitteitä antavana tuloksena voidaan pitää kahden asiakkaan toimintakyvyn lisääntymistä toiminnan aikana. Palvelukodin asiakkaat osallistuivat Green Care-menetelmillä toteutettuihin toimintaryhmiin aktiivisemmin kuin koskaan aikaisemmin ulkopuolisen tahon järjestämään toimintaan. Näiden kokemusten vuoksi palvelukoti aikoo hyödyntää jatkossa luontolähtöisiä menetelmiä enemmän palveluissaan. Opinnäytetyön tulokset ovat hyvin saman suuntaiset kuin Green Care-toiminnasta tehdyissä tutkimuksissa Suomessa ja ulkomailla. Menetelmien hyvinvointivaikutuksista on olemassa paljon näyttöä erilaisille asiakasryhmille. Mielenterveys- ja päihdekuntoutujien palvelukodissa, jossa opinnäytetyö tehtiin, ei ollut aikaisemmin juurikaan hyödynnetty luontoa asiakkaiden kuntoutumisen tukena. Neljä toimintakertaa oli melko lyhyt aika arvioida, miten Green Care-toiminnat tukevat asiakkaiden kuntoutumista palvelukodissa, joten toivon, että asiaa tutkitaan lisää, kun palvelukodissa on käytetty Green Care-toimintoja vähintään vuoden ajan.Using Green Care methods to support rehabilitation of mental health rehabilitees in a service flat. This thesis goal was to plan and help groups with certain functions and “Green Care” methods. The main goal of the groups was to find out about the experiences of mental health rehabilitees in one mental health and drug addict institution. The idea of the thesis was also to study the meaning of “Green Care” methods in the rehabilitation of rehabilitees in the institution. The goal was to increase the services and methods in the mental health and drug addict institution using “Green Care” methods. The service flats provide housing, rehabilitation and other support services to 30 mental health and drug addict rehabilitees and they try to bring a community spirit within the service. In the framework of the thesis I give information about the different “Green Care” methods, the welfare effects and the ethics of “Green Care”. I also described the concept of “Green Care”, its history and its appearance in Finland. “Green Care” methods are known as a rainbow concept of different methods were nature and animals play a part in advancing humans` social, physical, metal and educational welfare. The main elements in “Green Care” methods are nature, activities in nature and the use of nature elements. Also the community were the actions take place is important. In the theory part I wrote about mental health rehabilitation, concepts and the process of rehabilitation. I described the willingness for rehabilitation, the ability to function and the ethics of mental work. Mental health is a state of welfare where you can see your ability to survive the challenges of life and work and you can take part in a community’s functions. The thesis is a functional thesis in which there was used an examinational part, participating observation and open interviews. The interviews were group interviews and three customers also participated in the individual interviews. The results of the examination were analysed using the theme method. When analysing the results of the examination it was discovered that the customers of the mental health and drug addict institution found “Green Care” methods positive, activating and providing welfare. The customers found that the methods had a calming effect. The meaning of “Green Care” methods to the institutions rehabilitees was hard to estimate based on four visits to the service flats. But some progress was seen on two rehabilitees ability to function during the time “Green Care” methods were used. The customers in the service flats participated more willingly to functioning groups using “Green Care” methods than to any other functioning groups that were organized by an outsider. Because of these experiences the institution will use more nature based methods in its services. The results of the thesis are very similar to other examinations made in Finland and other countries about “Green Care” methods. The welfare effects of the methods used show various evidence using different customer groups. Nature was hardly ever used as a method of rehabilitation for the customers in the mental health and drug addict institution in which the thesis was made. Four times using the methods was quite a short time to evaluate how “Creen Care” methods was quite a short time to evaluate how “Green Care” methods support the rehabilitation of the customers in the service flat so I hope that there is a possibility to study the rehabilitees more when the methods are used at least for a year