Attack rate and household secondary attack rate of acute conjunctivitis during an outbreak in South India: A community‑based survey.

Introduction: Knowledge on epidemiology of the disease in the contemporary world will help to develop appropriate strategies to curtail the transmission during an outbreak. This study was carried out during an outbreak of conjunctivitis in selected areas of Puducherry, South India, to assess the attack rate of conjunctivitis, identify factors associated with developing conjunctivitis and calculate household secondary attack rate (HSAR) of conjunctivitis and its correlates. Methodology: During December 2014, a community‑based survey was conducted in a selected urban and rural area in Puducherry, South India. Simple random sampling was used to select primary sampling units and systematic sampling to select households. All individuals in the selected households were studied. A questionnaire was used to obtain data on sociodemographic characteristics, conjunctivitis during September–November, 2014, and number of household contacts who developed conjunctivitis within 7 days of index case. The attack rate and HSAR of conjunctivitis was expressed as percentage. Multivariate logistic regression was used to find factors independently associated with developing conjunctivitis and also 100% HSAR. Results: Of 3193 study participants from 772 households, 509 (15.9%, 95% confidence interval 14.7–17.2%) had an attack of conjunctivitis during the reference period. Of the 772 households, 218 (28.2%) had at least one case of conjunctivitis. Of 218 households, 33 (15.1%) households had 100% HSAR. Lower age, not being unemployed, low socioeconomic status, and residing in rural area were independently associated with developing conjunctivitis. Index case being male and living in a household with ≥5 members were independently associated with 100% HSAR. Conclusion: In the outbreak under study, more than one‑fourth of households had at least one case of conjunctivitis and about one in every six individuals had an attack of conjunctivitis.

Palliative care in India: Situation assessment and future scope.

Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life‑threatening illness, through prevention and relief of suffering by means of early identification, assessment and treatment of pain, and other problems – physical, psychosocial, and spiritual. It is estimated that in India the total number of people who need palliative care is likely to be 5.4 million people a year. Though palliative care services have been in existence for many years, India ranks at the bottom of the Quality of Death index in overall score. However there has been steady progress in the past few years through community‑owned palliative care services. One of the key objectives of the National Programme for prevention and control of cancer, diabetes, cardiovascular diseases, and stroke is to establish and develop capacity for palliative and rehabilitative care. Community models for the provision of home‑based palliative care is possible by involving community caregivers and volunteers supervised by nurses trained in palliative care. Training of medical officers and health care professionals, and sensitization of the public through awareness campaigns are vital to improve the scope and coverage of palliative care. Process of translating palliative care plan into action requires strong leadership, competent management, political support and integration across all levels of care.

Student-centred learning in Community Medicine: An experience from Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry.

Background. Student-centred learning (SCL) places the student at the centre of policies, practices and decision-making in the teaching–learning process. SCL methodology also advocates active involvement of students in the curriculum planning, selection of teaching–learning methods and assessment process. We planned an education innovation project to assess the perception of fifth semester undergraduate medical students towards implementation of an SCL methodology. Methods. The study was done among 87 fifth semester undergraduate medical students (batch of 2010–11) in the noncommunicable disease epidemiology section of Community Medicine at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. The students divided themselves into seven groups and developed the learning objectives, selected teaching–learning methods and assessment process for each session. The facilitators had 3–5 rounds of interaction with each group before the session. Qualitative analysis of feedback collected from students and external faculty after each session was done. The effect of implementing the SCL methodology was assessed by the reaction level of Kirkpatrick’s training evaluation model by using a rating scale. Results. Of the 87 eligible students, 73 (83.9%) returned the forms for evaluation. All seven groups were able to formulate the learning objectives. Most of the groups had used PowerPoint slides and videos as a teaching–learning tool. Innovative assessment methods such as crosswords and ‘chocopati’ were used by some groups. In general, the perception of students was favourable towards SCL compared to conventional methods and they felt that this methodology should be adopted more often. Time management and organization of sessions were the main problems encountered by the students. The mean (SD) score for the items ‘sessions were useful’, ‘sessions were enjoyable’ and ‘sessions improved my knowledge’ were 6.2 (1.8), 7.1 (1.8) and 6.3 (1.9), respectively. Conclusion. The majority of students found the sessions on innovative teaching–learning and assessment techniques enjoyable, useful and informative. The sessions showed that students took an active part in curriculum planning, execution and evaluation.

Community-based physical activity intervention using principles of social marketing: A demonstration project in southern India.

Background. We aimed to study the development and implementation of promotion of physical activity in a rural community by applying the principles of social marketing and to determine participation behaviour in a physical activity programme in a community setting. Methods. The intervention targeted 485 people, 20–49 years of age, residents of Periakattupalayam and Rangareddipalayam villages, Tamil Nadu. This community-based participatory research was based on the principles of ‘social marketing’. Health education by one-to-one counselling, written materials and community events were used to popularize moderate intensity physical activity (brisk walking for 30 minutes on 4 days/week). We formed 30 walking groups under four coordinators, in a home-based setting with professional supervision and guidance. A log of physical activity sessions for the 10-week intervention period was maintained in the form of group attendance record. Village leaders, self-help groups and youth clubs were involved in promoting physical activity. Results. Of the 485 subjects, 265 people (54.6%) engaged in brisk walking >4 days a week, while 156 subjects (32.2%) performed walking on 1–4 days per week during the intervention. The drop-out rate was 13.2% (64 subjects). Age, occupation and educational status were important determinants of participation and adherence to the physical activity programme. Conclusion. Application of social marketing techniques in an intervention to promote physical activity was successful in a rural Indian community. Studying the determinants of adoption of a physical activity programme and addressing the barriers to behaviour change are essential for designing relevant policies and effective programmes.