Assessment of Knowledge on Palliative Care among the Community Health Officers in Rural Area of Purba Medinipur District, West Bengal, India.

Objectives: Palliative care deals with patients who are facing problems of life-threatening diseases. Under the Ayushman Bharat programme, a new cadre of Community Health Officers (CHOs) is provisioned at Health and Wellness Centres (HWCs) who are nursing graduates. Being the team leader at the HWC level, having a low level of knowledge of palliative care would compromise their service. The study assessed the knowledge of CHOs about palliative care services in a rural district of Purba Medinipur, West Bengal, India. Materials and Methods: A descriptive study with a cross-sectional design was carried out among 314 CHOs posted in different HWCs of Purba Medinipur, West Bengal, during July-August' 2022. We used to collect data based on questionnaires of 'Palliative-Care-Knowledge Questionnaire-Basic' comprising items related to palliative care, the requirement of palliative care, pain management, communication, and dealing with psychosocial issues. A chi-square test was performed to check the association with educational- and experience-related variables and knowledge. Results: Overall, adequate knowledge was present in 216 (68.8%) and inadequate knowledge in 98 (31.2%) of CHOs. Improper knowledge was present regarding the role of oxygen supplementation in dying patients, the need for palliative care in human immunodeficiency virus/acquired immunodeficiency syndrome, chronic non-malignant diseases, pain management, and communication about the prognosis of disease. The proportion of CHOs who had adequate knowledge who were highly educated (70%) and those who had previous job as CHO (73.3%). Almost similar knowledge scores were found among those who ever cared for or never cared for either terminally ill patients (P = 0.89) or cancer patients (P = 0.853). Conclusion: In-depth knowledge was lacking among the CHOs. Training and re-training of CHOs to develop technical and communication skills will help them deliver proper palliative care.

Contaminated pond water favors cholera outbreak at haibatpur village, purba medinipur district, west bengal, India.

Health workers reported an increased number of diarrhea cases at Haibatpur village on June 17, 2012. This outbreak was investigated with the following objectives: to confirm the existence of diarrhea outbreak, to find out the risk factors, and propose control measures. Cases were listed; spot map and epidemic curve were drawn. Attack rate was calculated by age and sex and risk factors were found out by calculating odds ratio (OR) with 95% confidence interval (CI). Rectal swabs were taken and water specimens were collected for laboratory test. Forty-one cases of patients were identified with overall attack rate (AR) was 5% (41/780). AR among men was higher 6% (25/404) than women. There was no death. V. cholerae 01 Eltor Ogawa was isolated from one (1/4) stool specimen. Spot map showed cases clustered around two ponds which were contaminated with coliform organisms. The underground water was a bit saline in nature. Using pond water for preparation of fermented rice (Panta Bhat) (OR 4.73, 95% CI 1.69-13.51), washing utensil in pond water (OR 7.31, 95% CI 1.77-42.29) were associated with cholera outbreak. Health education was done to villagers. Disinfection of two ponds with bleaching powder was done. We proposed supplying of safe drinking water and repairing defective deep tube well to village.

Leaf-level plasticity of Salix gordejevii in fixed dunes compared with lowlands in Hunshandake Sandland, North China.

To cope with adverse environments, the majority of indigenous plants in arid regions possess adaptive plasticity after long-term evolution. Leaf-level morphology, anatomy, biochemical properties, diurnal water potential and gas exchange of Salix gordejevii distributed in fixed dunes and lowlands in Hunshandake Sandland, China, were compared. Compared to plants growing in lowlands, individuals of S. gordejevii in fixed dunes displayed much smaller leaf area (0.26 vs 0.70 cm(2)) and thicker leaves (leaf total thickness 148.59 vs 123.44 mum), together with heavier crust wax, denser hairs, and more compacted epidermal cells. Moreover, those growing in fixed dunes displayed stronger drought-resistance properties as evidenced by higher levels of proline (3.68 vs 0.20 mg g(-1) DW) and soluble sugar (17.24 vs 14.49%). Furthermore, S. gordejevii in fixed dunes demonstrated lower water potential and lower light compensation point (28.8 vs 51.9 micromol m(-2) s(-1)). Our findings suggest that morphological and/or anatomical plasticity in leaves has had great adaptive value for Salix in responding to deteriorating environments. The evidence provided here may facilitate the prediction of plant adaptation in community succession in sandy habitats.

Potential of constructed wetlands in treating the eutrophic water: evidence from Taihu Lake of China.

Three parallel units of pilot-scale constructed wetlands (CWs), i.e., vertical subsurface flow (VSF), horizontal subsurface flow (HSF) and free water surface flow (FWS) wetland were experimented to assess their capabilities in purifying eutrophic water of Taihu Lake, China. Lake water was continuously pumped into the CWs at a hydraulic loading rate of 0.64 m d(-1) for each treatment. One year's performance displayed that average removal rates of chemical oxygen demand (COD), ammonia nitrogen (NH(4)(+)-N), nitrate nitrogen (NO(3)(-)-N), total nitrogen (TN) and total phosphorous (TP) were 17-40%, 23-46%, 34-65%, 20-52% and 35-66%, respectively. The VSF and HSF showed statistically similar high potential for nutrients removal except NH(4)(+)-N, with the former being 14% higher than that of the latter. However, the FWS wetland showed the least effect compared to the VSF and HSF at the high hydraulic loading rate. Mean effluent TP concentrations in VSF (0.056 mg L(-1)) and HSF (0.052 mg L(-1)) nearly reached Grade III (0.05 mg L(-1) for lakes and reserviors) water quality standard of China. Wetland plants (Typha angustifolia) grew well in the three CWs. We noted that plant uptake and storage were both important factors responsible for nitrogen and phosphorous removal in the three CWs. However, harvesting of the above ground biomass contributed 20% N and 57% P of the total N and P removed in FWS wetland, whereas it accounted for only 5% and 7% N, and 14% and 17% P of the total N and P removed in VSF and HSF CWs, respectively. Our findings suggest that the constructed wetlands could well treat the eutrophic lake waters in Taihu. If land limiting is considered, VSF and HSF are more appropriate than FWS under higher hydraulic loading rate.

Potentials for combating desertification in Hunshandak Sandland through nature reserve.

Desertification directly threatens more than 250 million people and one third of the earth's land surface. Although it is well known that desertification could be reversed in most cases if the intensity of land use were reduced, there have been no studies on how to achieve this reversed desertification on a large scale. We conducted a case study in Hunshandak Sandland of North China, exploring how creation of a nature reserve might aid restoration of a degraded ecosystem. Experimental data indicated that desertified regions, if designated as a nature reserve, could be restored with conservation of biodiversity. The buffer zones in moderately desertified lands could serve as a base for forage production and/or ecotourism industry. The construction of ecologically designed towns (ecotowns) in transition zones could accommodate migrants moved from core zones so as to develop stock production, related industry, and ecotourism, enabling both economic and environmental development. Up to now, 5778 local inhabitants in the core zones of Zhenglan Banner (county) in the Hunshandak Sandland have been moved out of the severely degraded areas with the financial assistance of the central government. Those people have been moved into three eco-towns of the Banner with an objective of greatly enhancing the economic and social status while restoring the degraded sandlands.