"CoviSainik Program" - A Novel Public Private Partnership Initiative in the Control of COVID-19 in Rural India.

Background: "CoviSainik Program" was implemented in collaboration with the Ambuja Cement Foundation and Community Medicine Department in rural districts of eight states of India from May to December 2021 to create a cadre of volunteers. The aim of the present paper is to describe the program and evaluate it so that the findings can be the guiding tool for policymakers to replicate a similar program. Material and Method: A cross-sectional, mixed-method - concurrent study design was adopted to evaluate the program for its short-term outcomes such as gain in the basic knowledge of COVID-19 amongst master trainers and their feedback and program output viz - the proportion of volunteers trained and their profile by census sampling. Motivational factors, experiences of volunteers, and outcomes of COVID-19 work in their villages were explored by purposive with maximum diversity sampling with 62 online in-depth interviews and 8 online focus group discussions (FGDs). Results: There was a statistically significant difference in the pre-test (12.8 ± 5.6) and post-test (25.9 ± 9.3) scores of the Master Training Program evaluation test. Out of 6534 trained volunteers, 5901 worked as volunteers, and amongst those, 47.1%, 35.1%, and 17.8% worked for ≤3 months, 3 to 6 months, and ≥6 months, respectively, in their villages. The major themes generated for motivational factors to join the program were altruism, savior nature, generating awareness, and concern for others. The major outcomes generated by trained volunteers COVID-19 vaccination were in raising awareness on COVID-19 appropriate behavior and early identification of COVID-19 cases in their villages. Conclusion: The "CoviSainik Program" was successful in creating cadres of trained volunteers.

"Written Formative Assessments with Peer-Assisted Learning" an Innovative Teaching Program for Postgraduate Students in Community Medicine.

Introduction: There is a paucity of research on conducting written formative assessment with constructive feedback for theory paper writing for postgraduates of Community Medicine in India. The concept of "Written Formative assessments with Peer-Assisted Learning Program" was implemented to improve the first 2 levels of Miller's Pyramid and assess its impact on the summative assessment. Materials and Methods: The program was conducted for 2 batches of postgraduate students in the Community Medicine enrolled for the academic session of 2016-2019 and 2017-2020. The written formative assessment was conducted every Saturday for 1 h from August to March month in 2018 and 2019. After each test, answer papers were evaluated by the peer and faculty from the department. Written and oral feedback was given by the peer. After IEC approval, we planned to assess the program's effect on level 1 and level 2 Kirkpatrick's framework. The data were analyzed using SPSS statistical package version 24 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Total 23 formative written assessments were conducted per year. The proportions of knowledge, comprehension, and analytical type of questions asked were 47%, 32%, and 21%, respectively. The mean attendance rate was 76.28% ±16.4%. There was no statistically significant difference in the average percentage of marks in formative (weekly test) and summative assessment (university final examination). There was a statistically significant positive co-relation of projected mean marks and summative assessment marks with the co-efficient of the determination being 22.6%. There was overall positive feedback of the formative and peer-assisted learning (PAL) from post graduate students. Conclusions: Written Formative Assessment with PAL program is one of the effective programs for postgraduate students to gain confidence in writing and presentation skills and to score higher in theory examination.

Epidemiological determinants of COVID-19 in the police personnel: A cross-sectional study.

Background: Police are the frontline warriors who themselves are at risk of getting corona infection. This research with considerable sample size is the first of its kind to assess the epidemiological determinants of coronavirus disease 2019 (COVID-19) infection in the police personnel. Material and Methods: The Institutional Ethics Committee (IEC) approval and permission from police authorities were taken. The cross-sectional, descriptive study was planned on randomly selected 375 police personnel in the month of September-November 2020. Police detected with COVID-19 were included and those who were critically ill were excluded from the study. The written informed consent was taken and data was collected by pretested questionnaire. The data were entered and analyzed using SPSS version 21. Results: The mean age of study subjects was 34.25 ± 9.1 years with 84% being males. There was no significant difference in age and sex distribution of study subjects. The most commonly affected police personnel were police constables (222 out of 375) followed by police nayak (42 out of 375). Around 88.2% were symptomatic. Symptoms were fever (64%), weakness (54.4%), cough (38.4%), loss of smell sensation (35.2%), cold (32.3%), shortness of breath (13.9%), diarrhea (11.7%), and pain in the abdomen (6.4%). "Cold" symptom was significantly higher in the younger age group as compared with the older age group. Shortness of breath was significantly higher in males as compared with females (P value < 0.05). The perceived probable sources of infection were from a colleague (33.9%), family member (4.5%), residential society member (2.4%) while performing duty (23.2%), and while traveling in public transport (4%). Regarding preventive measures, almost 99%, 94%, and 87%, followed hand hygiene, mask-wearing, and physical distancing, respectively, prior to getting corona infection. AYUSH self-care practices such as daily drinking of turmeric milk, warm water, and breathing exercises were practiced by 66.9%, 85.9%, and 54.1% of the police personnel, respectively. Conclusions: There is male preponderance for corona infection among police personnel. Breathlessness is common in males as compared with female police. The cold symptom is mostly observed in young police personnel. Police personnel needs to judiciously follow physical distancing and practice general measures recommended by AYUSH.

Utilizing "Positive deviance inquiry" to explore factors influencing child health: A qualitative study.

BACKGROUND: India is a lower middle-income country with one of the fastest growing economies in the world. Despite improvements in its economy, it has a high child mortality rate, with significant differences in child mortality both between and within different states. In this research, we tend to explore factors as to how a particular child's growth is optimal. With this aim, we utilized positive deviance inquiry to study the factors influencing under five child's health. MATERIALS AND METHODS: This qualitative study was carried out in Naigoan, an urban health setting of metropolitan city with 37 sample size between July 2020 and September 2020. It consisted of total 16 in-depth interviews (IDIs), 3 focus group Discussion (FGDs), and 7 key informant interviews (KIIs) which were performed by predesigned guides. RESULTS: Various themes evolved with the interviews; however, triangulation of the concept (from FGDs, IDIs, and KIIs) occurred with the following themes: satisfaction among mothers for health-care services, community participation, family support, and new interventions. CONCLUSION: Mothers' satisfaction to health-care services, community participation, family support, and innovations by the health-care providers are the influencing factors in promoting child's health. Further research can be conducted to understand the in-depth understanding of each factor.

Flipped classroom - An innovative teaching model to train undergraduate medical students in community medicine.

BACKGROUND: Second-year MBBS students need to be trained in applying theoretical knowledge into practice so that they can give appropriate advice during family visits in the community. For this, it is necessary to utilize the classroom timing for discussion and facilitation. In "flipped classrooms," what is normally done in class and what is normally done as homework is switched or flipped. Thus, a study was planned to train the students to apply theory into practice by using flipped classroom methodology. METHODS: After ethical committee approval and informed consent, 48 second year MBBS students were enrolled in the study. Selected topics (i.e., "nutrition in under-five children") was taught through the "flipped classroom"model after a pretest assessment. Students were allotted a family case in the urban slums having at least one under-five child so that they can apply theory into practice. The formal assessment was done through structured case viva and spot examination. After 3 months, a posttest was conducted in the classroom to assess retention in knowledge. Feedback of the students was taken on the flipped classroom model. RESULTS: The average marks scored in structured case viva with spot examination was 8.28 ± 2.4 marks. There was a statistically significant association of scores in the structured case viva with spot examination with participation in all pre- and in-class activities (P < 0.05). There was a statistically significant difference in pre- and posttest marks (10.03 ± 2.17 vs. 18.84 ± 3.8). The class average normalized gain was 44%. Overall, there was positive feedback for "flipped classroom teaching." Most of the students felt that this was a practical approach to the topic. DISCUSSION: Students can apply theory into practice and knowledge gained is also retained through the use of the flipped classroom teaching method.

Adsorption-desorption and leaching behavior of kresoxim-methyl in different soils of India: kinetics and thermodynamic studies.

The sorption and leaching behavior of kresoxim-methyl was explored in four different soils, viz., clay, sandy loam, loamy sand, and sandy loam (saline), representing vegetables and fruits growing regions of India. Adsorption of kresoxim-methyl in all the soils reached equilibrium within 48 h. The rate constants for adsorption and desorption at two different temperatures were obtained from the Lindstrom model, which simultaneously evaluated adsorption and desorption kinetics. The data for rate constants, activation energies, enthalpy of activation, entropy of activation, and free energy indicated physical adsorption of kresoxim-methyl on soil. The relative adsorptivity of the test soils could be attributed to different organic matter and clay contents of the soils. A good fit to the linear and Freundlich isotherms was observed for both adsorption as well as desorption. The groundwater ubiquity score (GUS) for different soils varied between 0 and 2.26. The GUS and leaching study indicated moderately low leaching potential of kresoxim-methyl. The adsorption on four soil types largely depended on the soil physicochemical properties such as organic carbon content, cation-exchange capacity, and texture of the soil.

Kresoxim methyl dissipation kinetics and its residue effect on soil extra-cellular and intra-cellular enzymatic activity in four different soils of India.

The rate of degradation of kresoxim methyl and its effect on soil extra-cellular (acid phosphatase, alkaline phosphatase and ß-glucosidase) and intra-cellular (dehydrogenase) enzymes were explored in four different soils of India. In all the tested soils, the degradation rate was faster at the beginning, which slowed down with time indicating a non-linear pattern of degradation. Rate of degradation in black soil was fastest followed by saline, brown and red soils, respectively and followed 1st or 1st + 1st order kinetics with half-life ranging between 1-6 days for natural soil and 1-19 days for sterile soils. The rate of degradation in natural against sterilized soils suggests that microbial degradation might be the major pathway of residue dissipation. Although small changes in enzyme activities were observed, kresoxim methyl did not have any significant deleterious effect on the enzymatic activity of the various test soils in long run. Simple correlation studies between degradation percentage and individual enzyme activities did not establish any significant relationships. The pattern and change of enzyme activity was primarily due to the effect of the incubation period rather than the effect of kresoxim methyl itself.

Dissipation kinetics, safety evaluation, and assessment of pre-harvest interval (PHI) and processing factor for kresoxim methyl residues in grape.

A field dissipation study was conducted to evaluate the pre-harvest interval (PHI) and processing factor (PF) for kresoxim methyl (Ergon 44.3 SC) residues in grapes and during raisin making process at recommended dose (RD) and double the recommended dose (DRD). Kresoxim methyl residues dissipated following 1st-order kinetics with a half-life of 10 and 18 days at RD and DRD, respectively. The PHIs with respect to the European Union maximum residue limit (EU-MRL) of 1 mg kg(-1) for grapes were 13 and 30 days at RD and DRD, respectively. The degradation data during grape to raisin making process were best fitted to nonlinear 1st + 1st-order kinetics with a half-life ranging between 4 and 8 days for both shade drying and with raisin dryer at different doses. The PFs were 1.19 and 1.24 with shade drying and 1.09 and 1.10 with raisin dryer, respectively, which indicates concentration of the residues during raisin making process. The dietary exposure of kresoxim methyl on each sampling day was less than the respective maximum permissible intake both at RD and DRD. The residues of kresoxim methyl in market samples of grapes and raisins were well below the EU-MRL and were also devoid of any risk of acute toxicity related to dietary exposure.

Validation of a residue analysis method for streptomycin and tetracycline and their food safety evaluation in pomegranate (Punica granatum L.).

A single-step methanol extraction based method was developed and validated for simultaneous estimation of the residues of streptomycin and tetracycline group compounds in pomegranate fruits by LC-MS/MS. The limits of quantification for all target compounds were ≤0.005 mg kg(-1) with recoveries (%) at fortification levels of 0.005, 0.01, and 0.05 mg kg(-1) being within 90-116% (RSD ≤ 9%) and interday precision RSD ≤ 12% at 0.01 mg kg(-1). A field experiment on the dissipation of streptomycin and tetracycline (including 4-epimers) residues in pomegranate fruits with regards to field applications of the commercial formulation Streptocycline SP (streptomycin sulfate 90% + tetracycline hydrochloride 10%) at 200 and 400 g a.i. ha(-1) indicated preharvest intervals of 45 and 55 days for streptomycin and 12 and 15 days for tetracycline, respectively. The study will be useful in promoting effective residue monitoring and ensuring safe use of these antibiotics in managing bacterial diseases of pomegranate.

Working condition and health hazards in beedi rollers residing in the urban slums of Mumbai.

BACKGROUND: Beedi rollers are exposed to unburnt tobacco dust through cutaneous and pharyngeal route. They are not aware of their rights. Studies have been conducted on beedi workers but not many studies are carried out in urban areas. Thus, study was carried out to understand working condition and health hazards in beedi workers residing in the urban slums of Mumbai and to know whether beedi roller are in better condition in urban areas. AIM: To study working condition and health hazard in beedi rollers in the urban slums. MATERIALS AND METHODS: Descriptive, cross-sectional, community based study was carried in the urban slums of Mumbai with population of 8985 from April 2011 to June 2011. With snow balling sampling technique, 52 beedi workers were interviewed regarding their socio-economic status, working conditions and health problems after informed consent. Data entry and statistical analysis were performed using the SPSS windows version 14.0 software. RESULTS: The mean age was 45 years with SD of 12 years. All were Hindu females. Around 42.31% were illiterate. Mean years of service were 30 years and they work on an average for eight hours. Children were not involved in beedi rolling. Most common morbidity was fatigue. None were aware of the benefits provided for them. Awareness regarding health hazard and safety measures was poor. CONCLUSIONS: The working condition of beedi rollers in the urban areas is not favourable.