Intrinsic Capacity of Rural Elderly in Thar Desert using World Health Organization Integrated Care for Older Persons Screening Tool: A Pilot Study

Integrated Care for Older Persons (ICOPE) screening tool helps to address declines in physical and mental capacities in older people. In India, majority of the older population resides in rural areas and there is a paucity of studies that demonstrates the utility of the ICOPE screening tool in India. Thus, a cross-sectional study was conducted to demonstrate the feasibility of using the World Health Organization ICOPE screening tool in a rural population. Comprehensive geriatric assessment of intrinsic capacity revealed cognitive decline in 31.5% (n = 142) participants, diminished mobility 52.1% (n = 235) participants, eye problems in 49.4% (n = 223) participants, and hearing loss in 68.3% (n = 308) participants. Gender difference was statistically significant with mobility limitation (P = 0.005; ?2 = 7.95) and feeling of pain (P = 0.001; ?2 = 15.64), being more in females than males. This tool seems suitable in identifying the intrinsic capacity of the rural elderly.

Process of Developing the Online Certification Tests for Research Project Trainees and Assessing the Feasibility for Adaptation in Maternal and Child Health Projects.

An innovation launched by Datta Meghe Institute of Medical Sciences emphasized on promoting early child development through govt. Anganwadi centers under the project ‘Stepping Stones’. The innovation includes delivery of Enhanced Anganwadi Curriculum and Parenting Sessions through home visits by trained Anganwadi Workers with support from Community Health Workers. A system of computerized online and of training certification test was developed. This paper outlines the results of feasibility and acceptance of this system by Community Health Workers in maternal and child health programs.METHODSPre-tested questionnaire with questions on different aspects of certification test and responses with Likert-type scoring scale was provided to 30 randomly selected community health workers trained by DMIMS. Weighted means of total scores for agreement/disagreement for feasibility and acceptability questions was calculated.RESULTSAverage Weighted Mean of 4.07 demonstrated a strong agreement by all participants towards the feasibility and acceptability of this test. 47.67% candidates showed strong agreement.CONCLUSIONSSuch type of tests can be framed and utilized as, time saving screening, and certification test, for different types of community healthcare cadre.

Stimulating Home Environment for Early Childhood Development by Household Play Materials for Under 5 Rural Children in Forest Buffer Zone of Wardha District.

Home Environment of a child comprises of toys, books and stimulating play materials which are critical for promoting early development. Parents, family and atmosphere at home play a key role in stimulating child’s physical, cognitive and socio-emotional developments. This assessment was done in rural settings of forest buffer zone of Bor Tiger Sanctuary in Vidarbha to have a baseline picture about availability of play materials at households that promote child development and parent’s view about these play materials.METHODSThis was a cross-sectional survey which included assessment of 894 households in 45 villages from Seloo block of Wardha district. Survey tools included pretested questionnaire and home observation checklist which was administered at home visit and during interviews of parent-child dyads. Data was collected in android based ODK app and exported to server. Data imported from server was analysed using STATA-11.RESULTSAvailability of play materials as represented by Mean Item Availability Score (MIAS) was significantly associated with family structure, wealth index and parent’s education and occupation. Though 84.2% households had materials for moving around and outdoor play, only 26.9% households had materials for promoting coordinated gross-motor movements, 41.6% households had materials meant for stacking, constructing. Only 19.8% households had materials for learning shapes and colours, 29.8% households had picture books/charts, 32.4% households had materials for drawing and writing and only 11.3% children had materials promoting counting.CONCLUSIONSObvious gap can be seen in terms of paly materials available for under 5 children in rural and urban settings. Remote rural areas in this region need a well framed parenting program to sensitise parents about Early Child Development that can be blended with the existing ICDS program

A Study on Effect of Educational Level of Parents on Breast Feeding Practices in Urban and Rural Areas of Lucknow

Background: It is well known that education level of father and mother is an important factor to achieve breastfeeding. But, according to some literature, there is still controversy that education of parents is really a major factor to affect breastfeeding practices. Objective: To find out relationship of educational level of parents with their breast feeding practices. Methods: A community based cross-sectional study was carried out in rural and urban areas of Lucknow. Multistage random sampling was used. A pre designed & pretested questionnaire was used and house to house survey was done. 528 infants with their mothers as respondent were interviewed and information about their educational level and breast feeding practices were collected. Results: Majority of mothers in rural areas were illiterate (58.3%) as compared to only 20.5% in urban areas. Majority of fathers were literate in both urban and rural areas.Lower educational status of mother and father were significantly negatively associated with initiation of breastfeeding within 1 hr, colostrum giving, exclusive breastfeeding.36.7% mothers started breast feeding within one hour, while 83.0% mothers gave colostrum. Exclusive breast feeding was present in 65.6% mothers. Similar to breastfeeding initiation, a random but statistically significant difference in number of women who exclusively breastfed their infants was observed in different educational classes with maximum proportion for graduates and above (82.1%) and minimum proportion for those who were just literate or educated upto primary level. Conclusion: The study reveals that perceptions of breastfeeding are higher in educated parents than illiterate parents. To reach at an ever satisfactory level of breastfeeding practice, more attention and education need to be given amongst the general people.

The prevalence pattern of locomotor disability and its impact on mobility, self-care, and interpersonal skills in rural areas of Jodhpur district

Context: Impact of disability is deleterious, affecting an individual's every aspect. Majority of disabled reside in rural areas of developing countries. Moreover, different types of disability add to its wide spectrum. All these make it a major health issue. Aims: The aim of this study was to note the prevalence rate and pattern of locomotor disability in a rural population of Jodhpur District and to observe its impact on mobility, self-care, and interpersonal skills of disabled. Settings: This study was carried out in rural field practice area of the Community and Family Medicine Department of tertiary care setup. Design: This was a cross-sectional study. Materials and Methods: House-to-house survey for a sample size of 1656 was conducted by a team of trained doctors, therapists, and anganwadi workers for identification of locomotor disability applying a pretested survey questionnaire. Statistical Analysis: SPSS version 22 was used for descriptive analysis of variables (frequency distribution), and the Chi-squared test was used for the association of sociodemographic factors with performance qualifier score. Results: The prevalence rate of 2.08% for locomotor disability (male = 57% and female = 43%) was noted, with 31% from 40 to 60 years, 49% were illiterate, and 60% were from lower class. The main etiologies were cerebrovascular accident (25%) and cerebral palsy (23%). About 80% faced some difficulties in mobility domain, 57% in self-care, and 63% in interpersonal skills. Statistically significant association was seen for self-care domain with education level (P = 0.04) and for interpersonal skill domain with age groups and diagnosis (P = 0.022 andP = 0.035, respectively). Conclusion: The overall prevalence of locomotor disability in rural Jodhpur was 2.08%, higher for males and higher from 40 to 60 years. Most disabled were illiterate and were from low socioeconomic status. Self-care, mobility, and interpersonal skills were primarily affected and require proper intervention

Knowledge assessment about risk prevention of rabies amongst doctors in AIIMS, Jodhpur.

Background: Rabies still continues to be a public health problem in India and to protect our citizens from this menace; medical professionals have to be well equipped to tackle it more efficiently. The paper aims to assess the knowledge of residents and faculty in newly established AIIMS regarding risk prevention of rabies. Methods: A cross sectional study using a structured questionnaire on rabies was done at AIIMS Jodhpur amongst the doctors and the data was compiled in Microsoft excel 2010 were further analysed using SPSS version 21. Results: Out of the total sixty respondents, faculty constituted 38.3%, and junior residents and senior residents 28.3% and 33.3% respectively. Nearly 72% responded correctly regarding post exposure prophylaxis (PEP) i.e. 5 dose regimen of intramuscular administration of Anti Rabies Vaccine (ARV) and 56.7% doctors were unaware about the current recommendation of intradermal (ID) route. Rabies immunoglobulin (RIG) or Anti-Rabies Serum (ARS) against Rabies infection used in Class III bites was known to only 45% of the total doctors. Conclusion: The study reveals that there is a scope of improvement in important areas related to the knowledge of doctors in AIIMS regarding animal bites which needs to be upgraded time to time through continuing medical education in order to follow the standard protocol and guidelines at the apex institute.

A case control study to explore the risk factors for acquisition of leptospirosis in Surat city, after flood.

BACKGROUND: Between August and November 2006, a population-based case control study was conducted to identify the probable risk factors for leptospirosis during flooding in Surat city. MATERIALS AND METHODS: Sixty-two laboratory confirmed cases out of 129 suspected cases, and 253 age and sex matched fever and healthy controls were interviewed with the help of predesigned questionnaire. The association of risk factors with acquiring leptospirosis was assessed by adjusted OR with the help of logistic regression model to control confounders. RESULTS: By univariate analysis, factors identified were, walking barefoot (OR = 10.34, 95% CI 5.09-21.31, P <0.05). CONCLUSIONS :Prompt and vigilant fever surveillance activities in pre-monsoon preparedness plan, intensive IEC messages, rodent control programs and improvement of environmental sanitary conditions may help to greatly reduce the incidence of leptospirosis.