Exploring the influence of food labels and advertisements on eating habits of children: a cross-sectional study from Punjab, India.

BACKGROUND: Maintaining healthy eating habits among children is challenging due to industrial tactics. There is little research on the effect of nutritional labels and tv ads on the eating habits of children. So the primary aim of the study was to explore the noticeability of the food packaging labels by the children, the information retrieved from the food nutrition labels, and their role in increased frequency of eating out in addition to the perceptions of their parents about the television ads. METHODS: A cross-sectional study was conducted at schools in Punjab, India. Using multi-stage stratified random sampling, we included 722 school-going children aged 14-18 and their parents. A structured predefined questionnaire collected data using a four-point Likert scale. Descriptive statistics and binary logistic regression were used to draw our inferences. RESULTS: About 46% of children were eating out > 3 times a week. Nearly 49% said they never looked at the expiry dates on the food packet, and 40% have yet to notice the quality certification. Nearly half do not understand the components of the food label, and 59% said they never changed their buying behavior because of the label. Only 37% of parents expressed their concerns about the timing of the ads when children watch television, while only 25.5% were concerned about the accuracy of the information. Concerns of the parents regarding the timing of the ads, and celebrity endorsements, were potential predictors for the increased frequency of eating out by the children. CONCLUSIONS: Low awareness regarding the utility of nutrition labels and minimal concerns of the parents increase the frequency of eating out. Unification of our existing policies regarding food labels and tv advertisements to develop family-centric interventions will bring us one step closer to improving the enabling environment to curb the growing menace of childhood obesity.

Assessment of patient's satisfaction visiting a tertiary health care institute in north India.

BACKGROUND: Patient satisfaction is pertinent for measuring the performance of health-care service delivery, which is a multidimensional construct that depends on many factors. The main objective of this study was to assess the satisfaction of patients visiting a tertiary care hospital in Haryana. MATERIALS AND METHODS: A cross-sectional study was conducted among patients visiting the outpatient department (OPD) and inpatient department (IPD) of the hospital from January to March 2019. Exit interviews were conducted using a structured questionnaire among patients visiting the OPD or IPD. The patient satisfaction was assessed based on four domains, namely registration process and experience before meeting the doctor, interaction with the doctor, hospital infrastructure, and medicine availability. The responses were captured on a Likert scale from one to five, and the scores were used to calculate the overall satisfaction. RESULTS: Overall 84% of the patients were satisfied with the OPD services, whereas 77% of the patients were satisfied with the inpatient services. Male (odds ratio [OR] = 2.08; 95% confidence interval [CI]: 1.04-4.14) and literate patients (OR = 2.77; 95% CI: 1.4-4.14) had higher chances of being satisfied with the OPD services. Whereas students, retired and unemployed patients (OR = 4.67; 95% CI: 1.46-14.6), and those from a reserved social caste (OR = 3.38; 95% CI: 1.58-7.21) were more satisfied with the IPD services. CONCLUSION: This study suggests that patients were satisfied to a larger extent with both OPD and IPD services. Therefore, effective strategies should be in place to maintain high satisfaction among patients, and the institutes should strive to provide 100% satisfaction.

The perspective of our future doctors towards organ donation: a national representative study from India.

INTRODUCTION: Timely donation of organs has helped many get a new life. But in India, the pace of Organ Donation and Transplant (ODT) has been disturbingly sluggish. There is a wide gap between patients who need transplants and the organs that are available in India. Doctors can play a pertinent role in decreasing this gap. Therefore, the present study was done to assess the knowledge, attitude, and perception of the medical students in India regarding Organ Donation (OD). MATERIAL AND METHODS: A cross-sectional study was carried out among the undergraduate students (n=1463) in 10 different medical colleges across the country. Data were collected electronically through Google forms by using a pre-designed, semi-structured, self-administered questionnaire. RESULTS: About 65% of students had a positive attitude regarding ODT. Most of the students acknowledged that Internet sources (57.7%) and print media (46.5%) played a significant role in their awareness. 83% of the students felt that there is a need for effective laws to regulate the process of ODT. It was encouraging that most of the students (69.6%) were not biased for the type of recipients for the organ. CONCLUSION: In the face of acute shortage of donated organs in India, the medical students can be the torchbearers of a positive change. Topics on ODT should be stressed in the initial years and during the early clinical exposure through rapid implementation of the revised Medical curriculum. They can motivate the general public and patients during their routine interactions to make this idea more accessible and acceptable.

Trends and patterns of second-hand smoke exposure amongst the non-smokers in India-A secondary data analysis from the Global Adult Tobacco Survey (GATS) I & II.

OBJECTIVES: The primary objective of the present study was to compare the prevalence and patterns of second-hand smoke (SHS) exposure in the home, workplace, public places, and at all three places amongst the non-smoker respondents between the two rounds of Global Adult Tobacco Survey (GATS) in India. The secondary objectives were to assess the differences in various factors associated with SHS exposure among non-smokers. STUDY DESIGN: This secondary data analysis incorporated data generated from the previous two rounds of the cross-sectional, nationally representative GATS India, which covered 69,296 and 74,037 individuals aged 15 years and above. Exposure to the SHS at home, workplace, and public places amongst the non-smokers were the primary outcome variables. Standard definitions of the surveys were used. RESULTS: The overall weighted prevalence of exposure to SHS amongst the non-smokers inside the home and public places reduced. In contrast, the prevalence in the workplace increased marginally in round II compared to I. The proportion of adults who were exposed to SHS at all three places did not change much in two rounds of surveys. A decrease in the knowledge of the respondents exposed to SHS at home and public places was observed about the harmful effects of smoking in round II. Age, gender, occupation, place, and region of respondents were found to be significant determinants of SHS exposure at all the three places on multinomial logistic regression analysis. CONCLUSIONS: The study calls for focused interventions in India and stringent implementation of anti-tobacco legislation, especially in the workplaces for reducing the exposure to SHS amongst the non-smokers and to produce encouraging and motivating results by next round of the survey.

Non-communicable diseases risk factors and their determinants: A cross-sectional state-wide STEPS survey, Haryana, North India.

BACKGROUND: Recent studies have documented high variation in epidemiologic transition levels among Indian states with noncommunicable disease epidemic rising swiftly. However, the estimates suffer from non-availability of reliable data for NCDs from sub populations. In order to fill the knowledge gap, the distribution and determinants of NCD risk factors were studied along with awareness, treatment and control of NCDs among the adult population in Haryana, India. METHODS: NCD risk factors survey was conducted among 5078 residents, aged 18-69 years during 2016-17. Behavioural risk factors were assessed using STEPS instrument, administered through an android software (mSTEPS). This was followed by physical measurements using standard protocols. Finally, biological risk factors were determined through the analysis of serum and urine samples. RESULTS: Males were found to be consuming tobacco and alcohol at higher rates of 38.9% (95% CI: 35.3-42.4) and 18.8% (95% CI: 15.8-21.8). One- tenth (11%) (95% CI: 8.6-13.4) of the respondents did not meet the specified WHO recommendations for physical activity for health. Around 35.2% (95%CI: 32.6-37.7) were overweight or obese. Hypertension and diabetes were prevalent at 26.2% (95% CI: 24.6-27.8) and 15.5% (95% CI: 11.0-20.0). 91.3% (95% CI: 89.3-93.3) of the population had higher salt intake than recommended 5gms per day. CONCLUSION: The documentation of strikingly high and uniform distribution of different NCDs and their risk factors in state warrants urgent need for evidence based interventions and advocacy of policy measures.

Pattern of cancer in a tertiary care hospital in malwa region of punjab, in comparison to other regions in India.

CONTEXT: Cancer pattern varies in different regions and depends on race, lifestyle and diet. There is a lack of definitive information regarding hospital-based cancer profile in Southern Punjab, which is a cotton growing area. Excess of toxins in the macro-environment is thought to be the reason for the high incidence of cancer in this area. AIMS: To generate data on the magnitude and pattern of cancer cases reporting in the medical college hospital and to plan activities for prevention of cancer in the field practice area. SETTINGS AND DESIGN: A five year record-based retrospective study from 1(st)January 2007 to 31(st)December 2011. MATERIALS AND METHODS: All cancer cases who reported either for diagnosis or for treatment (radiotherapy/chemotherapy/surgery) were included in the study. These confirmed cases of cancer were classified according to the International classification of Disease (ICD-10) given by WHO. STATISTICAL ANALYSIS: Descriptive statistics, percentages. RESULTS: Out of a total of 1328 cancer cases, females accounted for 809 (60.9%) and males for 519 (39.1%) cases. Male to female ratio was 1:1.55. The maximum number of patients were seen in 35-64 yr age group (63.5%). Top five leading sites of cancer in males were lung (9.6%), myeloid leukemia (8.3%), prostate (6.8%), mouth (6.1%) and gall bladder (6.0%); and in females were breast (35.7%), cervix (19.1%), esophagus (5.1%), myeloid leukemia (4.7%) and gall bladder (3.9%). Our figures have been compared with the national data from NCRP. CONCLUSION: Population-based epidemiological studies are required to find out the disease burden & its cause in this region.