Construcciones identitarias en gendarmes: un enfoque de género / Identity constructions in gendarmes: a gender perspective / Construções de identidade em gendarmes: uma abordagem de gênero

Objetivo: Se presenta un análisis sobre la identidad organizacional y el rol ocupacional de los y las gendarmes pertenecientes al Centro de Detención Preventiva Santiago Sur desde el concepto de "trabajo sucio" y una perspectiva de género. Metodología: Se realizaron diez entrevistas semiestructuradas a gendarmes ­cinco gendarmes hombres y cinco gendarmes mujeres­ en cuanto a su rol e identidad organizacional, ocupacional, profesional y personal. Resultados: Se verificaron diferencias de género en cuanto a la configuración de sus identidades personales y ocupacionales, situación que no es replicada en el plano de sus identidades organizacionales y profesionales, que tienden a compartir. Conclusiones: Existen diferencias significativas en la forma en la que los y las gendarmes desarrollan su identidad personal, y que radican principalmente en la relevancia que atribuyen a los roles e identidades asociadas con la vida familiar. En cuanto a las restantes dimensiones identitarias, se identificaron importantes similitudes en cuanto a valores y creencias que los sujetos expresan y vivencian; estas parecen vincularse a prácticas y a una cultura tradicional y conservadora institucional en materia de género. Alcance: La investigación es de carácter exploratorio y busca aportar antecedentes empíricos sobre los cuales basar futuras investigaciones en este campo.

Objective: An analysis is presented on the organisational identity and occupational role of the gendarmes belonging to the Santiago Sur Preventive Detention Centre from the concept of "dirty work" and a gender perspective. Methodology: Ten semi-structured interviews were conducted with gendarmes -five male gendarmes and five female gendarmes- regarding their organisational, occupational, professional and personal roles and identities. Results: Gender differences were found in the configuration of their personal and occupational identities, a situation that is not replicated in their organisational and professional identities, which tend to be shared by both gendarmes and gendarmes. Conclusions: There are significant differences in the way in which gendarmes develop their personal identities, which lie mainly in the relevance they attribute to the roles and identities associated with family life. As for the remaining identity dimensions, important similarities were identified in terms of the values and beliefs that the subjects express and experience; these seem to be linked to traditional and conservative institutional gender practices and culture. Scope: The research is exploratory in nature and seeks to provide empirical background on which to base future research in this field.

Objetivo: Apresenta-se uma análise da identidade organizacional e do papel ocupacional dos gendarmes pertencentes ao Centro de Detenção Preventiva Santiago Sur a partir do conceito de "trabalho sujo" e de uma perspectiva de gênero. Metodologia: Foram realizadas dez entrevistas semiestruturadas com policiais - cinco homens e cinco mulheres - sobre seus papéis e identidades organizacionais, ocupacionais, profissionais e pessoais. Resultados: Foram verificadas diferenças de gênero em termos da configuração de suas identidades pessoais e ocupacionais, uma situação que não se repete no nível de suas identidades organizacionais e profissionais, que elas tendem a compartilhar. Conclusões: Existem diferenças significativas na forma como os gendarmes desenvolvem suas identidades pessoais, que residem principalmente na relevância que atribuem aos papéis e identidades associados à vida familiar. Quanto às demais dimensões da identidade, foram identificadas semelhanças importantes em termos dos valores e crenças que os sujeitos expressam e vivenciam, que parecem estar ligados às práticas e à cultura de gênero institucionais tradicionais e conservadoras. Escopo: A pesquisa é de natureza exploratória e busca fornecer antecedentes empíricos que sirvam de base para futuras pesquisas nesse campo

Screening of Non-Communicable Diseases and their Risk Factors among Tuberculosis Patients in Delhi: A Mix Method Study

Background: India has the highest burden of tuberculosis in the world. It is experiencing an increasing burden of noncommunicable diseases, thereby facing a dual disease burden. Recent evidence shows an association between TB and noncommunicable diseases like diabetes, CVD and chronic respiratory infections. Aims and Objectives: To assess the feasibility of screening for NCDs and risk factors for NCDs among patients with TB in DOTS centers of a medical college in Delhi and ascertain challenges for the same among providers and patients. Methodology: It was a mixed-methods study with a quantitative component (cross-sectional study using questionnaires, anthropometric measurements and records review) and a qualitative component (descriptive study using interview data). Results: Among the 139 patients screened, ten new cases of hypertension and six new patients were diagnosed with DM. Outof- pocket expenditure for tests was a concern of the patients. Health care providers found the screening tool easy to use but were apprehensive about increased workload Conclusion: The study provide useful visions for incorporating NCDs into routine TB care through DOTS centers under RNTCP/NTEP.

Analysis of Postural Control following Anterior Cruciate Ligament Reconstruction with Ipsilateral Peroneus Longus Tendon Graft

@#Introduction: Harvesting peroneus longus for ACL reconstruction is thought to create ankle instability which could add to postural instability from an ACL injury. This apprehension prevents its use as a graft of primary choice for many surgeons. To date, there is no evidence available describing changes in postural control after its use in ACL reconstruction. The purpose of the study was to analyse the changes in postural control in the form of static and dynamic body balance after ACL reconstruction with Peroneus Longus Tendon Graft and compare it with the unaffected limb at different time intervals. Materials and methods: Thirty-one participants with ACL injury were selected and subjected to an assessment of static and dynamic balance before and after ACL reconstruction using the HUMAC balance system. Outcome measures for Centre of Pressure (COP) assessment were average velocity, path length, stability score, and time on target. Comparison of scores was done pre-operatively as well as at three- and six-months post-reconstruction with Peroneus longus tendon graft. Results: Static balance of the affected limb showed significant improvement with a decrease in average velocity (F=4.522, p=0.026), path length (F=4.592: p=0.024) and improvement of stability score (F=8.283, p=0.001). Dynamic balance measured by the time on the target variable also showed significant improvement at six-month follow-up (F=10.497: p=0.000). There was no significant difference between the affected and non-affected limb when compared at the different time intervals. Conclusion: The static and dynamic balance, which is impaired after ACL injury, improves with ACL reconstruction with PLT autologous graft. Hence PLTG can be safely used as a graft for ACL reconstruction without affecting postural control and body balance.

Emergency centre patients in the Democratic Republic of Congo: Some epidemiological and clinical aspects at Beni General Referral Hospital

Introduction: Little information is available regarding the characteristics of patients attending the emergency centre (EC) in the Democratic Republic of Congo. This study aims to provide some epidemiological and clinical aspects of patients admitted to the emergency centre at Beni General Referral Hospital. Methodology: For a year, from January to December 2021, a cross-sectional study was conducted. Data regarding patients' characteristics, admission modality, stay duration, reason for admission, and discharge modality was anonymously collected from patients' registers. A descriptive analysis was done with Epi-Info 7. Result: A total of 1404 patients were admitted to the EC, with a male-to-female ratio of 1.2 to 1. The age group below 18 years accounted for 35.4%. Most of the patients (75.7%) originated from urban areas. In 83% of cases, there was no recommendation from another medical facility for EC admission. The most common reasons for admission are non-traumatic gathering on top of neuropsychiatric and non-specific symptoms. Road traffic accidents are the most frequent causes of trauma symptoms. Few patients (14.7%) spent less than 12 hours in the EC. Globally, 7.3% of patients admitted to the EC were discharged after being managed, and 89% were transferred to different wards. The intra-emergency centre mortality rate was 11.8% among admitted patients in the ER at Beni General Referral Hospital. Conclusion: This epidemiology database underlines the need for developing globalizing and multi-sectoral interventions (diagnosis, therapeutic strategy, organization, health program, or health policies) in the perspective of bringing change and/or taking action in the Democratic Republic of Congo's emergency medical system.

A Comparative study of Hematological Profile and Etiology of Anemia in Patients From Nutritional Rehabilitation Centre with patients from General Pediatric Ward in M.G.M. Hospital, Warangal

Severe acute malnutrition results in a spectrum of pathological changes in the body including substantial aberrations in hematological system. Aim of the study was to compare children from nutritional rehabilitation center with children from general ward with respect to: hematological profile, prevalence, etiology and severity of anemia. A cross sectional analytical study was done on 350 children aged from 6 to 59 months admitted in M.G.M. Hospital, Warangal. The prevalence of anemia in cases from nutritional rehabilitation center was 89.0% and 45.7% in cases from general ward. 82% cases from nutritional rehabilitation center had microcytic hypochromic picture and 67.4% cases from general ward had normocytic normochromic picture in peripheral smear. Iron deficiency was the most common cause of anemia in both groups, i.e., 92.3% cases from nutritional rehabilitation center and 46.2% cases from general ward. Megaloblastic anemia in 6.5% cases from nutritional rehabilitation center and 7.5% cases from general ward.

Association of Serum Level of Vitamin D3 and Pulmonary Function in Bronchial Asthma Patients in A Tertiary Care Hospital of South Gujarat, India

Introduction: Asthma is a chronic lung disease characterised by reversible airway obstruction, cellular infiltration, and airway inflammation. The reaction is characterised by the interaction of genetic and environmental variables, as well as the activation of cells in the innate and adaptive immune systems. Method: The study was conducted in the Department of General medicine, in Tertiary Care Center, to study association of serum level of Vitamin D3 and pulmonary function in bronchial asthma patients. As per inclusion and exclusion criteria ,137 patients of bronchial asthma were included in the study. Result: In cases having serum vitamin D3 level <20 ng/ml mean value of FVC, FEV1, FEV1/FVC ratio, was 108.10�.89, 68.56�.40, and 62.35�17. In cases having serum vitamin D3 20-29 ng/ml, mean value of FVC, FEV1, and FEV1/FVC ratio was 109.72�.22, 72.34�.48, and 64.39�97. In cases having serum vitamin D3 >30 ng/ml mean value of FVC, FEV1, and FEV1/FVC ratio, was 115.0�27, 81.0�09, and 70.52�00. Conclusion: Vitamin D3 deficiency was highly prevalent in asthmatic patients, there was a strong correlation between asthma severity and vitamin D3 concentrations and there was a direct and a positive significant correlation between vitamin D3 levels and pulmonary function test in asthmatic patients.

Outcome of Haematological and Haemostatic Indices in Hospitalized Yellow Fever Patients at the Centre for Communicable Disease Control and Research (CCDCR) Federal Medical Centre, Asaba, Delta State, Nigeria

Study Design:Retrospective observational study.Place and Duration of Study:Centre for Communicable Disease Control and Research (CCDCR), Federal Medical Centre Asaba, Nigeria, between August and December 2020.Methodology:Descriptive data was collected from the records of fifty-six (56) patients aged 16 –65 years who were hospitalized and treated at the CCDCR FMC Asaba, within the months of August to December, 2020 and 56 non-Yellow Fever subjects as control subjects. The patients’ samples were previously collected and analyzed for haematological parameters (neutrophil, eosinophil, basophil, lymphocytes, monocytes, platelet count, mean cell volume (MCV), mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC), using an automated haematology analyzer. Data collected was analyzed using SPSS version 25 and P values less than .05were considered statistically significant. Results:There were higher levels of total white blood cell count, eosinophil and MCH in hospitalized yellow fever patients when compared with the control group (P < 0.05). On the other hand, there was a lower level in platelet count of hospitalized yellow fever patients when compared with non-yellow fever control subjects (P < 0.05). There was no significant difference in other haematological indices assayed which appeared normal (P > 0.05).Conclusion:In conclusion, it can be inferred that yellow fever can be associated with several haematological derangements which this study has succeeded to lay bare. Understanding these characteristics aids in planning therapy, management of patients as well as monitoring outcome.

Epidemiological and clinical profile of Laboratory confirmed cases of COVID 19 admitted in Tertiary care Hospital Jammu, Jammu & Kashmir

Background: Three or more waves of COVID 19 pandemic have hit the different parts of world including India very hard, taking toll on the lives of people both in terms of morbidity and mortality. Keeping this in mind, the present study was conducted with an aim to determine the socio-demographic and clinical profile of laboratory confirmed COVID 19 cases and to determine their association with oxygen requirement and outcome of disease at the time of discharge. Methods: The present cross-sectional study was conducted on lab confirmed COVID 19 cases admitted in tertiary care hospital in Jammu from June-July 2021.Data was collected using convenient sampling method. The self-designed questionnaire used for data collection obtained information regarding socio-demographic characteristics of patients as well as clinical features of the disease. Results: Out of total 161 patients studied, 60.8% were males and 39.2% were females. Mean age was 51.2 ± 17.5 years. Comorbid conditions were present in 37.8% patients, with hypertension being the most common ( 36%). Cough, Fever, breathlessness and myalgia were the main presenting symptoms (90%, 81%, 57.7% and 56% respectively). The variables which were found to have statistically significant association with oxygen requirement and the outcome of disease at the time of discharge were age, gender and presence of co-morbidity (p <0.05). Conclusions: Advancing age, male gender and presence of underlying co-morbidity were found to be significant risk factors for the requirement of oxygen and poor outcome of the disease.

A Retrospective Cohort study on Utilization of Rashtriya Bal Swasthya Karyakra (RBSK) Services among Children Screened at an Urban Health Centre (UHC) ofAhmedabad Municipal Corporation (AMC)

Introduction : Rashtriya Bal Swasthya Karyakram (RBSK) is a systemic approach of 4‘D’s (Defect, Diseases, Deficiency, Developmental delay) for early identification and linkage with care, support and treatment. (1) Document utilization of RBSK services within a year of referral, (2) Assess reasonsObjectives : for non-utilization of services and (3) Assess out of pocket expenditure (OOPE) among users and non-users of the program. Retrospective Cohort Study was conducted at an Urban Health Centre (UHC) takingMethod: two cohorts of children referred for 4‘D’s during April 2018-March 2020 under RBSK. A total of 102 cases were sampled. Probability Proportionate to size (PPS) method was used to ensure proportionate representation of each of 4‘D’s in the sample. Required number of participants in each category were selected randomly. Out of 102 sampled cases, 97 were covered. Utilization of services was 50.5%; majorResults: reasons for non-utilization were preference for private providers and reluctance to stay at Comprehensive Malnutrition Treatment Centre (CMTC). Mean OOPE in users was Rs. 21545, significantly less (p <.05) than Rs. 70198 in non-users. After referral by RBSK team, only half utilized the services. Among users,Conclusion: OOPE was less for total cost incurred and also for direct cost incurred like consultation charges, medicines, consumables etc. Counselling those parents whose children are detected with any of 4Ds, to visit Child Malnutrition Treatment Center (CMTC)/ District Early Intervention Center (DEIC) remains a challenge.

Electrocardiographic Manifestations in COVID-19 Patients — An Observational Study from a Tertiary Care Centre in North Eastern India

Introduction : The Coronavirus disease 2019 (COVID-19) primarily involves respiratory system but may also affect the Cardiovascular System leading to abnormal ECGs. Its early recognition is crucial as it may be associated with increased mortality. Hence we aimed to find out various Electrocardiographic (ECG) manifestations of COVID19 patients admitted in a Tertiary Care Hospital and its relation to disease severity. Methods : We performed a hospital-based retrospective observational study between April, 2021 to November 2021 and analyzed the ECG changes at admission by three Cardiologists according to standard definitions and diagnostic criteria. Results : Out of 579 patients, ECG of 473 was available for analysis. ECG was normal in 227 (48%) and abnormal in 246 (52%) patients. Most common abnormal ECG finding in COVID19 patients was Sinus Tachycardia(19.5%) and less common findings were Sinus Bradycardia (5.3%), Incomplete Right Bundle Branch Block (RBBB) (3.2%), atrial fibrillation (2.5%), complete RBBB (2.3%), atrial premature complexes (2.3%), S1Q1T3 pattern (2.1%), first degree AV block (1.5%), ST-T wave changes (1.3%), Atrial flutter (1.1%). In mechanically ventilated patients, incidence of acute Right Ventricular Pressure Overload (RVPO) related ECG findings were more frequent. Conclusion : There is a wide spectrum of ECG manifestations in COVID-19 patients which varies depending upon the severity of COVID as well as prior Cardiovascular status, associated comorbidities and need for ventilatory support. Knowledge of ECG changes might help in risk stratification and triaging of COVID-19 patients.

Study of pattern & distribution of adverse drug reactions in acute coronary syndrome patients in a tertiary care hospital

Background & objectives: With the availability of a wide range of drugs to treat patients with acute coronary syndrome (ACS), adverse drug reactions (ADRs) have become inevitable in clinical practice. Thorough knowledge of such reactions is essential for the treating physician for optimal treatment and better outcomes. There are many scales to define, measure and assess the ADRs, but there is a dearth of data available on such drug reactions among ACS patients. Hence, this study attempted to analyze the pattern, causality, severity, predictability and preventability of ADRs in ACS patients. All the ADRs reported during the study period were analyzed for causality by the World Health Organization–Uppsala Monitoring Centre (WHO-UMC), Naranjo’s and Karch and Lasagna scales; severity by modified Hartwig and Siegel scale; predictability by Rawlins and Thompson criterion and preventability by Schumock and Thornton scale. Methods: A single-centre, record-based analysis for the occurrence of ADRs was done among ACS patients admitted to the department of Cardiology between January and October 2017. Demographic data, comorbid conditions, reported ADRs and ADR assessment details were noted from the hospital case records and ADR monitoring centre (AMC) records. The data were analyzed and presented in a descriptive manner using percentages, mean and standard deviation. The Pearson’s chi-squared test was used to ascertain the significance of the association between different groups. Results: Out of 324 patients under evaluation, 67 had developed one or more ADRs. There were 30 different types of ADRs reported, headache being the most common. Among the drugs, heparin was the most common factor, causing 27 per cent of ADRs. Definite causality of a suspected drug causing ADRs was seen in 11.9 (n=8), nine (n=6) and 7.5 (n=5) per cent cases as per WHO-UMC, Naranjo (Naranjo algorithm) and Karch and Lasagna scales, respectively. In the severity of ADRs, the most severe reactions according to the modified Hartwig-Siegel scale (level 4a in our study) were seen in 17.5 (n=12) per cent of patients, and the rest were either level 2 or 3 reactions. Nearly 92.5 (n=62) per cent of reactions were predictable according to the Rawlins and Thompson criterion. Application of the modified Schumock-Thornton scale showed that 22.4 per cent of ACS patients had preventable reactions, and the rest were not preventable.Interpretation & conclusions: The study results suggest that ADRs are relatively common among ACS patients. Most of these can be identified and assessed for causality, severity, predictability and preventability using various available scales. Diligent pharmacovigilance for identifying and assessing ADRs may help manage and mitigate morbidity associated with these in high-risk ACS patients.

A cross sectional study on the evaluation of MCH services provided by “ASHA” working at Urban Health Centers of Ahmedabad City, Gujarat

Introduction: National Rural Health Mission (NRHM) was launched by Indian Government with key feature of introduction of a new designated health care worker – “Accredited Social Health Activist” (ASHA) who acts as interface between community and public health system. Objectives: To assess knowledge about MCH related functions and to estimate status of support to beneficiaries by “ASHAs”, To Assess Quality of Home Based New Borne Care performed by ASHA and to find out impact of number of modular training rounds on knowledge and practices of ASHAs. Methodology: A cross-sectional study was conducted during February 2019 to December 2020 using a mixed approach, with a combination of quantitative and qualitative research methods after approval of institutional Ethics committee. All Urban Health Centres (UHC) under Municipal Corporation in Ahmedabad were covered. From each UHC, 2 ASHAs were selected by lottery method. So, total 144 ASHAs were selected from 72 UHCs. Performance assessment was done by direct interview with ASHA and their beneficiaries. Results: All 144 ASHAs were aware about responsibilities of Antenatal-women registration and Immunization. Nearly all ASHAs (99.3%) knew about task of PNC registration. Escorting to delivery and tertiary care centre, if complications arise was facilitated by 61.8% and 29.2% ASHAs respectively. Conclusion: All ASHAs were aware of their major responsibilities related to MCH and also providing same in their field area. Statistically significant association was observed between number of rounds for modular training undertaken by ASHAs and knowledge and practice of ASHAs in context to various components of MCH care.

Client Satisfaction with Services Provided at Integrated Counselling and Testing Centre in a Rural Hospital, Panvel, Maharashtra, India

Introduction : HIV is a global pandemic and has been a serious concern for public health among individuals and communities. Measuring client satisfaction can help the country to carry out an evaluation of the health service system as well as, clients can develop a long-lasting relationship with the service provider. Objectives: 1) To assess the client satisfaction by the services provided at the Integrated Counselling and Testing Centre at the Rural Hospital, Panvel. 2) To provide recommendations to improve the services provided at the Integrated Counselling and Testing Centre. Method: A descriptive, cross- sectional, facility-based study was conducted in an Integrated Counselling and Testing Centre (ICTC) at a Rural Hospital, Panvel using simple random sampling technique. Exit interviews were conducted for three hundred clients after the required consent was obtained. Clients were stratified into pregnant and non- pregnant females. All clients above 18 years were included in the study however, clients not giving consent or severely ill were excluded. The data was analyzed using Microsoft Excel, and Epi Info Version 7.2. Results: Among 300 clients, 66% (198) of the clients belonged to the age group of 18-28 years and 54.3% (163) were literate. The study found that nearly74% (222) of the clients were referred and about 71.7% (215) clients were unsatisfied with the ICTC services. Conclusion: Majority of the clients were unsatisfied with the services provided at ICTC. Literate clients were more unsatisfied as compared to illiterate clients.It is further recommended that the counsellors at ICTCs should spend more time with the clients and tere should be a mandatory requirement of female counsellors.

Hope and Quality of the life of People living with HIV: A Cross-Sectional Study at ART Center, Bagalkot, Karnataka

Background: HIV/AIDS emerged as the most important public health issue of the late twentieth and early twenty-first centuries. Hope & Quality of life (QoL) of People living with HIV/AIDS are affected by multiple socio-demographic variables as a major predictor of Hope & QoL. Methods: This cross-sectional descriptive survey research design included a sample of 430 PLHIV attending the ART centre, District Government Hospital, Bagalkot. Data were collected using the self-report method and Hospital records by socio-demographic questionnaire, Herths Hope Scale and WHO QOLHIV-BREF scale. Pearson's Correlations, chi-square test and multiple linear regression analysis were used. Results: A significant positive association was found between Hope and QoL among PLHIV (r= 0.483, p<0.001). A significant regression equation (F429, 42= 1.842, R2=0.167, p<0.01). Married status i.e. married, Occupation i.e. doing Labor work has positively and 3rd and 4th clinical-stage have negatively predicted Hope of PLHIV. A Non significant regression equation (F429,42=1.37, R2=0.13, p<0.05). Being a private employee had positively and Heterosexual had negatively predicted and remained determinants have not predicted QoL among PLHIV and there was a significant association found between marital status and remained variables are not associated with Hope. There was a significant negative relationship found between Family monthly income and a positive relationship found between the duration of HIV and QoL. Marital status is significantly associated with QoL. Conclusions: The overall findings reveals that a significant positive correlation between Hope and QoL among PLHIV. There was a significant association found between marital status with Hope. There was a significant negative relationship found between Family monthly income and positive relationship found Duration of HIV and QoL.

Processo de trabalho e sofrimento institucional em Centros de Atenção Psicossocial Infanto-juvenis (Capsi): uma pesquisa-intervenção junto a trabalhadores / Work process and institutional suffering in Children and Youth Psychosocial Care Centers (Capsi): an intervention research with workers / Processus de travail et souffrance institutionnelle dans des Centres de soins psychosociaux pour enfants et adolescents (Capsi) : une recherche-intervention auprès de ses intervenants / Proceso de trabajo y sufrimiento institucional en los Centros de Atención Psicosocial para Niños y Adolescentes (Capsi): una investigación-intervención con trabajadores

Esta avaliação participativa junto a trabalhadores dos Centros de Atenção Psicossocial Infantojuvenil de um município de grande porte do sudeste brasileiro enfoca o processo de trabalho e sua relação com o sofrimento institucional, na perspectiva de René Käes. O curso ofertado para tal envolveu a construção e validação de narrativas junto a trabalhadores, pactuação de indicadores de avaliação e um guia de boas práticas. Os trabalhadores expressaram modalidades de sofrimento institucional relacionadas com: condições de trabalho, relações na instituição, falta de espaço de diálogo e formação permanente, como a supervisão clínico-institucional. Manifestaram ainda uma importante identificação com os valores das reformas sanitária e psiquiátrica e com a história peculiar das políticas de saúde no município, que contribuiu para a manutenção do que Onocko-Campos denomina "ilusão institucional".

Resumos This participatory evaluation involving workers from Psychosocial Care Centers for Children and Adolescents in a large city in southeastern Brazil addresses the work process and its relationship with institutional suffering from the perspective of René Käes. A course was offered to workers that involved the construction and validation of narratives, an agreement on evaluation indicators and a guide to good practices. Workers expressed different types of institutional suffering that was related to working conditions, relationships at the institution and lack of spaces for dialogue and permanent training, such as institutional clinical supervision. They also showed that they are highly identify with the values of the health and psychiatric reforms, as well as with the city's peculiar history of health policies, which contributed to keep up what Onocko-Campos calls "institutional illusion".

Le travail fait partie d'une évaluation participative avec des travailleurs des Centres de Soins Psychosociaux pour Enfants et Adolescents dans une grande ville du sud-est du Brésil, où nous abordons le processus de travail et son rapport avec ce que René Käes conceptualise comme souffrance institutionnelle. Un cours a été proposé qui impliquait la construction et la validation de récits avec les travailleurs, un accord sur des indicateurs d'évaluation et un guide de bonnes pratiques. Les travailleurs expriment de différents types de souffrances institutionnelles qui sont liées aux conditions de travail, aux rapports dans l'institution et au manque d'espaces de dialogue et de formation permanente, comme la supervision clinique institutionnel. Ils manifestent également une identification importante avec les valeurs des réformes sanitaires et psychiatriques, ainsi qu'avec l'histoire particulière des politiques de santé de la municipalité, ce qui a contribué à la préservation de ce que Onocko-Campos appelle « l'illusion institutionnelle ¼.

Esta evaluación participativa con los trabajadores de los Centros de Atención Psicosocial para Niños y Adolescentes de un gran municipio de la región sureste de Brasil se enfoca en el proceso de trabajo y en su relación con el sufrimiento institucional, desde la perspectiva de René Käes. Para este fin, se ofreció un curso que incluía la construcción y validación de narrativas con los trabajadores, el consenso sobre los indicadores de evaluación y una guía de buenas prácticas. Los trabajadores expresaron diferentes tipos de sufrimiento institucional relacionados con: las condiciones de trabajo, las relaciones en la institución, la falta de espacios de diálogo y de formación permanente, así como con la supervisión clínica institucional. También manifestaron una importante identificación con los valores de las reformas sanitaria y psiquiátrica, y con la peculiar historia de las políticas de salud en el municipio, que contribuyeron al mantenimiento de lo que Onocko-Campos denomina "ilusión institucional".

Vision centre helps reduce blindness and vision impairment. Proof of concept in a four-year longitudinal study in an urban area in India

Purpose: To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door?to?door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact. Methods: Four trained community health workers measured the visual acuity and performed an external ocular examination in patients’ homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years. Results: In the study, 44,535 people in 2015–16 and 98.14% (n = 43,708) of them in 2018–19 were examined. Blindness (vision < 3/60 in better eye), and moderate?to?severe visual impairment (MSVI, vision 6/18–6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort (P < 0.001). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 (P < 0.001). Females (P < 0.001) and older individuals (P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years.Conclusion: The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality.

Cost of delivering primary healthcare services through public sector in India

Background & objectives: Public health spending on primary healthcare has increased by four times (in real terms) over the last decade and continues to constitute more than half of the total public health expenditure. The present study estimated the cost of providing healthcare services at sub centre (SC) and primary health centre (PHC) level in four selected States of India. Methods: A total of 51 SCs and 33 PHCs were selected across the four States (Himachal Pradesh, Odisha, Kerala and Tamil Nadu) of India. The economic cost of delivering health services at these facilities was assessed using bottom-up costing methodology during the reference year of 2014-2015. The cost of capital items was annualized and allocation of shared resources was based on appropriate apportioning statistics. Results: The mean annual cost of providing health services at SC and PHC was ? 0.69 million (US$ 11,392) and ? 5.1 million (US$ 83,837), respectively. Nearly 3/4th and 2/3rd of this cost at the level of SC (74%) and PHC (63%) were spent on salaries. In terms of unit cost, the costs per antenatal care and postnatal care visit were ? 221 (173-276) and ? 333 (244-461), respectively, at SCs. Similarly, the costs of per patient outpatient consultation and per bed day hospitalization at PHC level were ? 121 (91-155) and ? 1168 (955-1468), respectively. Interpretation & conclusions: The cost estimates from the present study can be used in economic evaluations, assessing technical efficiency and also for providing valuable information during scale-up of health facilities.

Clients' Perspective for Quality of Services at One of the Urban Primary Health Centres (U-PHC) at Municipal Corporation Area in One of the cities of Western India

Introduction: Client satisfaction surveys are central to quality improvement at health facility. It helps in identifying areas of low satisfaction and steps to maximize patient satisfaction. Objectives: To assess client satisfaction towards services at Out Patient Department (OPD) of at an U-PHC under Ahmedabad Municipal Corporation (AMC), identify areas of low satisfaction and suggest feasible remedial measures for improvement. Method: Out of 74 U PHCs under AMC, 1 was selected through simple random sampling. Quality of care was evaluated through client's feedback which was gathered through 10 check points (on structure, process and outcome) developed by state level quality team. Responses of 300 adult (> 18 years) subjects and their mean ± standard deviation scores were calculated. These subjects were selected nd thconsecutively as 25 cases (new cases who came first and were willing) on every 2 and 4 Mondays for 6 months (Sep 2019 – Feb 2020). Results: While availability of drugs was perceived as very satisfying that of investigations was relatively an area of concern. Overall, only 1 client rated the services as average while all rest (99.6%) rated services as very good to excellent. Conclusion: Quality of services at this U PHC was good to excellent and had wider acceptability among its client.

Stigma Experienced by Covid-19 Patients: A Descriptive Study

From the start of the Covid-19 pandemic, stigma and discrimination have fuelled the transmission of Coronavirus and has negatively impacted the people who turn Covid-positive. Stigma and its negative feelings have kept people with Covid symptoms from testing and seeking prompt treatment. Identifying the severity of its impact, taking corrective measures to treat the disease and mitigating the stigma related to this novel disease are important roles to be carried out by nurses. This study was conducted among patients discharged from a Dedicated Covid Health Centre (DCHC) in Satara (Maharashtra) to assess the level of stigma faced by them. A quantitative design using a non-probability purposive sampling technique was adopted. Sixty adults in the age group of 18 to 60 years who recovered from Covid -19, who were able to understand Marathi, Hindi or English participated in the study. The study subjects were telephonically interviewed using a self-prepared structured questionnaire. The responses received were collated and analysed. The study revealed that 16 (26.6%) experienced mild stigma, 31 (51.7%) experienced medium stigma and 13 (21.7%) experienced moderate stigma. The stigma was associated signifi cantly with age and there were no signifi cant association between variables such as marital status, gender and occupation.

Antibiogram Profile of Enteric Pathogens Isolated from Fomites in Cross River University of Technology Medical Centre, Calabar, Nigeria

Background: Healthcare environments are considered as potential reservoirs for pathogenic microorganisms especially those responsible for nosocomial infections. Such microorganisms often present with varying degrees of drugs resistance. This study was aimed at evaluating the Cross River University of Technology (CRUTECH) Medical Center Environment for the presence of pathogenic bacterial contaminants and antibiotics susceptibility profile of such isolates. Materials and Methodology: A total of 72 swab samples were collected from nineteen frequently touched hospital surfaces and processed using the standard bacteriological procedures. The emergent bacterial colonies were identified using phenotypic and biochemical tests. Antibiotic susceptibility testing of the presumptively identified isolates was carried out using Kirby-Bauer抯 method. Results: Out of 72 swab samples collected, 44 (61.1%) were positive for Enteric bacterial pathogens. The mean viable count ranged from 1.8 x 106 Cfu/cm2 (weighing scales) to 2.41 x 107 Cfu/cm2 (wash sinks). The most prevalent isolate was E. coli (48 of 127, 37.8%) followed by Klebseilla sp (27 of 127, 21.3%), Salmonella sp (19 of 127, 14.9%), Proteus sp (12 of 127, 9.4%), Citrobacter sp (11 of 127, 8.7%), Enterobacter sp (7 of 127, 5.5%) while Shigella sp (3 of 127, 2.4%) was least isolated. Isolates demonstrated high level of susceptibility to Norfloxacin 124 (97.6%), Imipenem 116 (91.3%) and Chloramphenicol 105 (82.7%). Resistance to Erythromycin was 95 (74.8%), Gentamycin 84 (66.1%) and Amikacin 82 (64.6%). Conclusion: Contamination of healthcare surfaces by multi-drugs resistant pathogens is a potential risk, especially to hospitalized patients and health care workers. Thus, it is therefore imperative that appropriate hygienic measures be implemented to suppress any potential microbial cross-contamination.