ABSTRACT
Background: Adolescence is a period of transition where independence in thinking and behavior is established and food choices that are made are followed for several years, and this can influence their health in adulthood. Hence, understanding the eating habits are necessary to plan effective nutritional interventions in adolescents. Objectives: The main objective of the study is to find out the extent of malnutrition among rural adolescents as well as evaluate their eating habits against recommended dietary food groups and to compare eating habits across gender and age groups. Methods: A cross-sectional study was done among 1425 adolescents from 13 rural schools from 2014 to 2015, and the variables considered in this study were age, sex, body mass index (BMI), and the eating habits of the adolescents. Results: Undernutrition was seen among 23% and overweight/obesity among 8% of adolescents. The habit of taking milk and milk products, fruits, and green leafy vegetables were very poor among the adolescents. Significant association was found between eating habits and BMI. Furthermore, late adolescents had better eating habits, and significant gender difference was seen in certain eating habits. Conclusions: The study shows that it is possible to understand the gaps in eating habits of adolescents, and this can be used to plan tailor-made nutritional interventions to adolescent groups as their eating habits are different and have long-term nutritional and health implications.
ABSTRACT
Background: Adoption of competence-based medical education (CBME) is the need of the hour. Objectives: The objective of the study is to develop and validate appropriate assessment tools for the community medicine entrustable professional activities (EPAs) and to assess the usefulness of the validated tools in the assessment of postgraduate (PG) students. Methods: An interventional study for 14 months was done in the department of community medicine. After the sensitization of faculty members and PGs, three EPAs were selected through consensus between faculty members and appropriate assessment tools mini-clinical evaluation exercise (Mini-CEX), case-based discussion (CBD), and direct observation of procedural skills (DOPS). Rubrics of milestones were formulated for the selected tools, and the designed tools were validated. These three validated tools were used for the quarterly assessment. Results: The item-content validity index for all three assessment tools was one, while Scale Content Validity Index for Mini-CEX and CBD were 1, and for DOPS, it was 0.87. Three PG students were assessed using the validated tools thrice for the three selected EPAs. The PGs opined that assessment using rubrics made their task-specific, while faculties were quite satisfied with the assessment process as it removed subjectivity. Conclusions: The developed and selected tools of EPAs were found to have a substantial level of both face validity and content validity. The tools were also found to useful for periodic assessment in workplace settings and acceptable to both PG students and internal/external faculty members.
ABSTRACT
The purpose of the present review is to examine the new competency-based undergraduate curriculum in community medicine against the established frameworks and criteria and suggest the way forward for achieving competencies expected of the Indian Medical Graduate (IMG). The new Graduate Medical Education Regulations, 2018, is based on Harden's concept of the curriculum. Hence, we reviewed the components of new curriculum against Harden's conceptualization of various components of the curriculum, and since it claims it is competency-based, we used Tyler's Goal/Objective-Based Evaluation. The new undergraduate curriculum has shown a move toward integration of course content and defined the competencies in more measurable terms. However, it appears that the earlier information-based curriculum corresponding to book chapters (”topics”) has been modified to specify higher cognitive domains with no explicit link between the IMG level curriculum outcomes to subject level intended learning outcomes (ILOs). The mechanism to link ILOs to assessment is also not clear and so needs more clarity. The assessment system hinted at in the current document is mostly based on the existing conventional system of 50% as pass cutoff, etc., against criterion-referenced assessment applicable to competencies that need to be performed. Furthermore, there is no guidance on the creation of educational opportunities and environment for students and faculty – perhaps it is left to “Curriculum Implementation Support Programme (CISP) Workshops.” Hence, the need for preparing a roadmap/blueprint to learning experiences and assessment methods and levels and milestones to be reached at various phases of MBBS and during internship is required.
ABSTRACT
Asia Pacific region has been witnessing numerous public health emergencies in recent years with the Nipah outbreak in North Kerala (2018), India, needs special mention. Threats posed and experiences gained have compelled health systems to draft frameworks nationally and internationally for preparedness, outbreak response, and recovery. Our failure to obtain comprehensive guiding frameworks for application in the Indian context for Ebola, Severe Acute Respiratory Syndrome, Influenza A (H1N1), and Nipah outbreaks led us to the search outside India for frameworks that have worked in the past. A thorough review of the WHO, Centers for Disease Control and Prevention, and Malaysian framework was done to identify explicit components and replicable objectives to the national context. In the absence of a specific framework, Nipah recovery and response experience that worked in Kerala outbreak (2018) was compared against novel H1N1 (2015) guidelines at national level. This article provides the groundwork and insights as a value addition toward an India-specific framework of action for response and recovery for Nipah outbreaks in future.
ABSTRACT
Background: Schools are the best setting for health promotion activities, and in India, for many, the schools are in fact the only nurturing and supportive place where they learn health information and have positive behavior consistently reinforced. Therefore, health promotion addressing the nutrition and personal hygiene habits among school children would improve health of school children and mold them into healthy productive citizens of tomorrow. Objectives: The objective of the study is to find the effectiveness of multi-strategic health screening cum educational intervention model in promoting the health of school children. Methods: A school-based intervention was designed using multi-strategic approach to promote the health of 2500 school children in 13 schools in rural Coimbatore. Logic model was used to plan the intervention, and the approach included health screening, nutrition and personal hygiene assessment and educational intervention in three phases over a period of 1 year. The multi-strategic approach comprised of approach through doctors, teachers, and through peer educators. The effectiveness of the intervention was assessed with improved nutrition and personal hygiene habits, improved body mass index status, and reduction in sickness absenteeism. Results: There was a significant improvement in nutrition and personal hygiene habits among school children. There was also significant reduction in the proportion of underweight category. Furthermore, a slight increase in sickness absenteeism was observed. Conclusion: Our study shows evidently that a multi-strategic health screening cum educational intervention model can be implemented and can be effective in bringing changes in the nutrition and personal hygiene habits thereby promoting the health of school children.
ABSTRACT
Compared to adults, assessment of dietary intake of school children has always been a great challenge in public health practice. Hence, this paper aims to share our experience in overcoming the problems in dietary assessment of large number of school children aged 6� years and the practicality of the tool for quickly identifying the broad gaps in the diet of individual Children for providing them dietary counseling. Based on the Indian Council of Medical Research/National Institute of Nutrition recommendations for balanced diet among school children, a simplified dietary gap assessment tool was developed to identify gross gaps in their diet and also a system of scoring it so as to measure effectiveness of the nutritional educational program. The simplified tool was effective in overcoming the challenge of making the children understand the concept of portion size by replacing it with inquiry of frequency of food intake in 'yes� or 搉o� terms and thereby making it easy to administer and is time efficient enough to enable a large number of students to be screened.