bluuebunny/crossref_metadata_2025 huggingface dataset:
BK Channels Mediate Synaptic Plasticity Underlying Habituation in Rats
Authors: Zaman Tariq , De Oliveira Cleusa , Smoka Mahabba , Narla Chakravarthi , Poulter Michael O. , Schmid Susanne
Published: March 2017

Habituation is a basic form of implicit learning and represents a sensory filter that is disrupted in autism, schizophrenia, and several other mental disorders. Despite extensive research in the past decades on habituation of startle and other escape responses, the underlying neural mechanisms are still not fully understood. There is evidence from previous studies indicating that BK channels might play a critical role in habituation. We here used a wide array of approaches to test this hypothesis. We show that BK channel activation and subsequent phosphorylation of these channels are essential for synaptic depression presumably underlying startle habituation in rats, using patch-clamp recordings and voltage-sensitive dye imaging in slices. Furthermore, positive modulation of BK channelsin vivocan enhance short-term habituation. Although results using different approaches do not always perfectly align, together they provide convincing evidence for a crucial role of BK channel phosphorylation in synaptic depression underlying short-term habituation of startle. We also show that this mechanism can be targeted to enhance short-term habituation and therefore to potentially ameliorate sensory filtering deficits associated with psychiatric disorders.

SIGNIFICANCE STATEMENTShort-term habituation is the most fundamental form of implicit learning. Habituation also represents a filter for inundating sensory information, which is disrupted in autism, schizophrenia, and other psychiatric disorders. Habituation has been studied in different organisms and behavioral models and is thought to be caused by synaptic depression in respective pathways. The underlying molecular mechanisms, however, are poorly understood. We here identify, for the first time, a BK channel-dependent molecular synaptic mechanism leading to synaptic depression that is crucial for habituation, and we discuss the significance of our findings for potential treatments enhancing habituation.
Proteomics and integrative omic approaches for understanding host–pathogen interactions and infectious diseases
Authors: Jean Beltran Pierre M , Federspiel Joel D , Sheng Xinlei , Cristea Ileana M
Published: March 2017

Organisms are constantly exposed to microbial pathogens in their environments. When a pathogen meets its host, a series of intricate intracellular interactions shape the outcome of the infection. The understanding of these host–pathogen interactions is crucial for the development of treatments and preventive measures against infectious diseases. Over the past decade, proteomic approaches have become prime contributors to the discovery and understanding of host–pathogen interactions that represent anti‐ and pro‐pathogenic cellular responses. Here, we review these proteomic methods and their application to studying viral and bacterial intracellular pathogens. We examine approaches for defining spatial and temporal host–pathogen protein interactions upon infection of a host cell. Further expanding the understanding of proteome organization during an infection, we discuss methods that characterize the regulation of host and pathogen proteomes through alterations in protein abundance, localization, and post‐translational modifications. Finally, we highlight bioinformatic tools available for analyzing such proteomic datasets, as well as novel strategies for integrating proteomics with other omic tools, such as genomics, transcriptomics, and metabolomics, to obtain a systems‐level understanding of infectious diseases.
Vozes institucionais e os discursos de dominação: análise dos grandes projetos hidrelétricos na Amazônia
Authors: Costa Alda Cristina , Oliveira Ivana Cláudia , Ravena Nírvea
Published: March 2017

O interesse pela Amazônia aumenta de acordo com o status que lhe é conferido no cenário econômico e geopolítico. No cenário mundial, constitui o imaginário segundo o qual é patrimônio de todos, mesmo que as políticas públicas empregadas localmente não atendam às necessidades da região ou das pessoas que nela vivem. Os projetos direcionados ao seu território baseiam-se em compromisso e discussões que passam pela sua representação simbólica de região vocacionada para o desenvolvimento sustentável. O presente artigo busca compreender em que medida as vozes institucionais, na formulação de políticas para a Amazônia, constroem discursos sobre os grandes projetos hidrelétricos na região. Tomam-se como corpus de análise 18 mensagens enviadas pelos presidentes Emilio Garrastazu Médici (1969-1974), José Sarney (1985-1990) e Luiz Inácio Lula da Silva (2003-2010) ao Congresso Nacional.
Isolados e ilhados: indigenismo e conflitos no Vale do Javari, Amazônia
Authors: Arisi Barbara , Milanez Felipe
Published: March 2017

Nesse artigo, pretendemos mostrar como um certo ideal de índio permeia as utopias indigenistas do Estado brasileiro e como a política de isolamento, influenciada por esses ideais, apresenta suas idiossincrasias e contradições. Apresentamos um estudo sobre os conflitos recentes na Terra Indígena Vale do Javari (AM) que levaram à morte violenta de índios Korubo e Matis, considerados pelo governo respectivamente como “isolados” e de “recente contato”. Analisamos a história do conflito a partir das narrativas indigenistas e dos indígenas. Observamos as formas como os servidores da FUNAI procuram ignorar e negar o direito à autodeterminação indígena e como procuram obliterar o papel e a presença do Estado nas relações interétnicas na região. Concluimos que um possível diálogo parece ser o primeiro passo para pôr fim a uma política de “índios ignorados”. O ideal de isolamento não pode se sobrepor à auto-determinação: o conceito é fragilmente sustentado em uma ideia romântica e contraditória de índios que vivem totalmente à margem de processos históricos, como se não sofressem e reagissem às pressões do velho (neo)desenvolvimento promovido pelo Estado e pela presença de frentes expansionistas como madeireiros, construtoras de barragens ou petroleiras.
A reforma agrária assistida pelo mercado do Banco Mundial na África do Sul e no Brasil (1994-2002)
Authors: Pereira João Márcio Mendes
Published: March 2017

O artigo analisa a “reforma agrária assistida pelo mercado” (RAAM) do Banco Mundial, abordando a sua racionalidade, a agenda política da qual fez parte e os resultados da sua implantação na África do Sul e no Brasil. Após identificá-la ao processo mais amplo de atualização da agenda neoliberal articulado em meados dos anos 1990, o artigo discute o programa agrário do Banco e detalha os seus componentes, entre os quais a RAAM. Em seguida, resume tanto a crítica do Banco às reformas agrárias redistributivas do passado, baseadas na desapropriação de terras pelo Estado, como as supostas vantagens da RAAM. Também discute a intencionalidade política que orientou a sua implementação e analisa os resultados socioeconômicos e políticos da RAAM nos dois países.
A fogyókúrák buktatói – pszichés tényezők
Authors: Resch Mária
Published: March 2017

Abstract:

Introduction: Eating is one of the fundamental sources of happiness. Slimming diets would deprive you of this very enjoyment without granting something else instead, for example, proper eating behaviours for life or a permanent solution for overweight-related problems. Aim: This paper aims to investigate the psycho-dynamic relationships that might be the reason for the failure of all diets and slimming diets. Method: Analysing overweight, obesity and the failure of slimming diets with the help of the cognitive behavioral therapeutic approach. Results: By applying the principles confirmed and laid down by the cognitive behavioral therapy, we can identify specific ethological causes present in dieting and gaining weight behaviours that can successfully be used in curative symptom and problem oriented psychotherapy. Conclusion: In summary it can be stated that it is advised to approach the defined objective slowly, in small steps. With the help of learning methods and the continual transformation of the environment, obese individuals, having shred their own unwanted behavioral attitudes, can not only build up new attitudes and transform them into new desirable habits but will also have their personalities chiselled. Orv. Hetil., 2017, 158(13), 499–507.
PHAGOCYTIC ACTIVITY AND BLOOD NEUTROPHILS RESPIRATORY BURST STATE FEATURES AMONGST WIDESPREAD PURULENT PERITONITIS PATIENTS IN THE POSTOPERATIVE PERIOD DYNAMICS
Authors: Savchenko A. A. , Gvozdev I. I. , Borisov A. G. , Cherdancev D. V. , Pervova O. V. , Kudryavcev I. V. , Moshev A. V.
Published: March 2017

The research aim was to study the phagocytic activity and the blood neutrophils respiratory burst state amongst the patients with widespread purulent peritonitis (WPP) in the dynamics of the postoperative period. The study was involved patients with acute surgical diseases and injuries of the abdominal organs complicated by WPP. Blood sampling was performed prior to surgery (pre-operative period) and at 7, 14 and 24 day post-operative period. The neutrophil phagocytosis level was determined by flow cytometry using FITC-labeled staphylococcal protein A. There was counted the percentage of fluorescent neutrophils (defined as the phagocytic index — PI) and average of the cell fluorescence (phagocytic number — PN). According to the fluorescence intensity divided phagocytic neutrophils in an active (high PN) and weakly phagocytic (low PN). Condition of the respiratory burst in the neutrophils was examined using a chemiluminescent assay. It was found that patients with WPP in the preoperative period had increased phagocytic activity of the blood neutrophils. The maximum phagocytic activity observed on day 7 of the postoperative period and by 24 days the number of phagocytic cells is reduced to control level whereas phagocytic activity of the cells remains at the preoperative level. In the preoperative period in patients with WPP the amount of active phagocytic blood neutrophils 3.3 times higher than the number of weakly phagocytic cells. By the end of the observation period the number of active and weakly phagocytic neutrophils returning to normal. In the study of the state of respiratory burst in the neutrophils by the WPP patients discovered that the primary synthesis levels of reactive oxygen species (ROS) increases only with 7 days of postoperative period and the induced activity of NADPH-oxidase remains elevated to the end of the observation period. At the same time, the synthesis of secondary ROS in the blood neutrophil of the WPP patients increased already in the preoperative period and remains high until the end of the survey. Using correlation analysis it was found that if healthy people had a competitive relationship between the level of synthesis of primary ROS and the activity of phagocytosis then all detected correlations in the WPP patients characterized by high level of coordination between the respiratory burst and the phagocytic activity of the neutrophils. These relationships are identified in the preoperative period, postoperatively do not exist. It can be assumed that the surgery and the subsequent treatment leads to complete incoordination in the neutrophils the mechanisms of phagocytosis and respiratory burst.
Experience, Experiment, Evaluate: A Framework for Assessing Experiential Games
Authors: Lytle Nicholas , Floryan Mark , Amin David
Published: March 2017

The design of effective educational games has proven itself difficult for many years, leading to sparse and somewhat inconsistent insight into the principles governing such systems. While attempts at constructing frameworks for educational games certainly exist, their nature is often quite general (limiting the practical utility) or noticeably specific (limiting the scope of projects to which that framework might be applied). We present a design framework for a broad, but well-defined genre known as experiential games. We have named our framework the Experience, Experiment, Evaluate (EEE) framework and believe it to be an adequate lens under which to analyze such games. This article presents the EEE framework in detail and provides example analyses of three games (a U.S. Civil War history game, a medical diagnosis game, and The Legend of Zelda: Ocarina of Time). We present empirical results for two of these games showcasing evidence that presumed adherence to EEE provides benefits in the classroom. In particular, the medical diagnosis game, Rashi, is shown to elicit higher quantity and quality of student responses when features were added that more tightly bound the game to our framework. Additionally, we provide evidence that activities within our U.S. Civil War game, ‘A Nation Divided’, are more successful in providing learning gains to students when those activities more carefully apply the ideas within our framework. We do not present any empirical results regarding Ocarina of Time, but include it as an anecdotal example of how commercial games have applied these principles successfully in order to teach the mechanics of the game to players, and argue that this is, in many ways, an exercise in pedagogy. We end by offering suggestions for strategically incorporating elements of our framework in the development and design of future systems.
Flow experience in game based learning – a systematic literature review
Authors: Perttula Arttu , Kiili Kristian , Lindstedt Antero , Tuomi Pauliina
Published: March 2017

The entertaining elements implemented in a serious game are key factors in determining whether a player will be engaged in a play-learn process and able to achieve the desired learning outcomes. Thus, optimization of subjective playing experience is a crucial part of a game design process. Flow theory can be adopted for measuring user experience and analyzing the quality of serious game designs. In addition, flow seems to have a positive influence on performance enhancement, learning and engagement. The focus of this review is especially on examining the meaning of flow in the context of serious games as well as exploring the relationship between flow and learning, factors that influence occurrence of flow and how flow is operationalized. The review revealed that there are mainly conceptual considerations about flow in serious games, but no robust empirical evidence about the meaning of flow. This is in line with other studies. We argue that research on flow should focus on the specific aspects related to the very nature of serious games that combine enjoyment and learning. Furthermore, new methods to measure flow and analyse the data need to be developed and studied.
QUALIDADE DE VIDA EM DEGLUTIÇÃO E CÂNCER DE CABEÇA E PESCOÇO: REVISÃO DE LITERATURA
Authors: Carrera Manoela , Medrado Alena Ribeiro Alves Peixoto , Martins Gabriela Botelho , Lima Hayana Ramos , Marques Raquel De Santana Oliveira , Costa Agda Santana
Published: March 2017

Objetivo: O estudo teve como objetivo revisar a literatura a respeito da qualidade de vida relacionada à deglutição de pacientes com câncer de cabeça e pescoço. Métodos: Buscou-se estudos relatando a fisiologia da deglutição e os aspectos envolvidos na disfagia, como definição, causas e seu impacto na qualidade de vida. Foram utilizados os bancos de dados eletrônicos Pubmed, Medline, Scielo, livros, assim como de artigos identificados nas referências. Resultados: Distúrbios da deglutição podem ocorrer devido à doença e/ou modalidade de tratamento, persistindo durante ou após o término do tratamento. A frequência e gravidade da disfagia dependerão da modalidade de tratamento utilizada, localização e estágio do tumor, quando envolvidos em estruturas que participem da deglutição. Pacientes com tumores em estágios mais avançados e localizados na faringe tentem a apresentar piora na função da deglutição. Tais fatores poderão interferir diretamente na deglutição e qualidade de vida do paciente, sobretudo nas relações familiares, sociais e no estilo de vida.  Conclusão: Apesar de não substituir as avaliações clínicas e instrumentais, investigar a qualidade de vida em deglutição pode contribuir para avaliar aspectos específicos sobre o bem-estar do paciente que não são contemplados.
Management of intra-articular fracture of distal femur with LCP and Lag screws in adults
Authors: Daroch Manjit S. , Vashisht Deepak , Sreen Sanjeev
Published: March 2017

Background: Accurate reconstruction of articular surface of distal femur by closed manipulation is not possible. The recent trend for displaced intra-articular fractures of the distal femur is open reduction and stable osteosynthesis with early rehabilitation. The best exposure is achieved through Swashbuckler approach with good results. Purpose of the study was to review the surgical management with LCP and lag screws of complex and most challenging intra-articular fracture of distal femur.Methods: 30 cases of intra-articular fractures of distal femur were treated with LCP and Lag screws in adults. Regular follow-up with all records was carried out for a period of 36 months. Most of patients were treated with Swashbuckler approach. Final outcome was carried based on Neer’s criteria.Results: Union was achieved in all the cases and mean time was 15 weeks. Patients have more range of motion in C1 and C2 types of fracture as compare to C3 Types. Mean range of motion was 1140. Early physiotherapy has big role to achieve good range of motion.Conclusions: LCP is better implant in comminuted I/A fractures of distal end of femur and in elderly patients with osteoporotic bone. In spite of the worst fracture anatomy of the comminuted fracture of distal femur and the poor quality of bone in elderly patients, this can provide better post-operative range of knee motion with overall better Knee score, achieving bony union in all the cases with early physiotherapy.
Oxidative stress in cigarette smoker and smokeless tobacco user among ethnic group north-eastern population of Uttar Pradesh, India
Authors: Supriya K. , Chaudhary Janardan , Shamal S. N.
Published: March 2017

Background: Cigarette smoking and other form of tobacco abusing habits are high prevalence in India at present which can be compare the oxidative level among them. This study aimed to measure the oxidative level among different cigarette smoke and other form of users in north-eastern, Uttar Pradesh of India.Methods: Total of 934 male and female subjects were selected in which 387 were controls (Group I), 140 were active smokers (Group II), 105 were passive smokers (group III), 182 were tobacco users (Group IV) and 120 were active smokers plus tobacco users (group V). Cigarette smoker and tobacco user prevalence <10/day, >10/day for 5 years’ duration were collected. MDA, SOD, GR and CAT were measured.Results: Cigarette smoker and tobacco user prevalence is high in >10 cigarette/day for 5 years, Mean and SD value in oxidative stress in cigarette smokers and tobacco users MDA level 1314±330.1µmol/mg is increased, whereas SOD, GR and CAT level 2.229±0.248 units/ml, 0.0152±0.0071mg/ml and 0.345±0.046mg/ml respectively were reduced in active smoker plus tobacco users.Conclusions: Present study concluded that cigarette smoker and tobacco user showed their increased MDA and decreased SOD, GR and CAT which represented the significantly increased oxidative stress in north-eastern of Uttar Pradesh, India.
Spirituality as an internal protective factor of resilience in children after exposing flood
Authors: Syukrowardi Delly A. , Wichaikull Susheewa , Von Bormann Suparpit
Published: March 2017

Background: Flooding is recognizing as a risk element that effect many difficulties to children and could impact to their academic performance. In order to buffer such risk condition, some abilities are required to overcome that situation. One of abilities is resilience. The main purpose of this study was to investigate predictor of internal factors (age, illness, gender, emotion, behaviour, spirituality and physical activity) in resilience of elementary school-aged children who exposed the major flood in Serang, Indonesia. The framework used in this study was Resilience Model proposed by Karol Kumpfer.Methods: A cross-sectional correlation design was employed to accomplishing the study. The total final samples were 162 children who were 9-12 years and who were studied in 3rd to 6th years. All of them are those who were exposed to major flood in Undar Andir, Serang, Indonesia in 2013. The instruments used were self-report questionnaires. The Connor-Davidson Resilience Scale- 10, The Daily Spiritual Experience Scale, The Strengths and Difficulties Questionnaire and The Physical Activity Questionnaire were utilized in this study after the validity and reliability test. Pearson’s correlation, point biserial and multiple regressions were employed for analysing data.Results: The results showed that there were significant correlated between behaviour (r = 0.157, p <0.05), spirituality (r = 0.261, p<0.01), physical activity (r = 0.185, p<0.05), and resilience of children. However, age, illness, gender, and emotion were not significantly correlated with resilience. In multiple regressions, spirituality showed as a predictor of resilience (Beta = 0.213, p <0.05) in children after exposing the flood.Conclusions: In conclusions, flooding is considered as a risk for children. In order to prevent the potential problems due to flood, children need protective factor. This study discovered that high spirituality increases resilience of children. Therefore, spirituality is well thought-out as an internal protective factor of resilience. This study suggested the developing of nursing intervention with religion-activities.
Efficacy of fine needle aspiration cytology in the diagnosis of lymphadenopathies
Authors: Fatima Rasheed , M. Sandhya
Published: March 2017

Background: Enlarged lymph nodes were the first organs to be diagnosed by fine needle aspiration. Objectives were to study the role of FNAC in the evaluation of lymphadenopathies, to study the various cyto-morphological patterns in correlation with histopathology of various lymph node lesions and to document the diagnostic accuracy of FNAC in correlation with histopathology.Methods: All patients referred to the department of pathology K.V.G. Medical College and Hospital, Sullia, Karnataka, India for FNAC of palpable lymph nodes were included in present study. FNAC was done and the standard method for the procedure adopted. All the slides were reviewed and their diagnosis was made. FNAC diagnosis was compared with histopathology in cases which underwent surgical excision and thus its diagnostic accuracy determined. This was two years and two months’ prospective study from July 2008 to August 2010.Results: A total of` 150 patients were included in the present study, reported to various clinical departments with history of swelling. Lymph node biopsy was done in 50 cases. Statistical analysis was done in 50 cases, where FNAC diagnosis was correlated well with histopathological diagnosis. Maximum number of cases was in the age group of 31-40 years. Present study showed female preponderance of cases. Cervical group of nodes were most commonly involved. Benign lymphadenopathies were diagnosed in 69.8% of cases. Maximum number of cases being reactive lymphadenitis (65.4%). Metastatic deposit was diagnosed in 23.5% of cases. Most common subtype being adenocarcinoma. Lymphomas were diagnosed in 09 cases. 1 case of Hodgkin’s lymphoma and 8 cases of NHL were diagnosed. The overall correlation between FNAC and histopathology was 98% (49 out of 50).Conclusions: FNAC is an accurate, sensitive, specific and cost effective procedure in the diagnosis of lymphadenopathies.
An analysis of stromal expression of CD10 in invasive ductal carcinoma of breast and its correlation with histological grade
Authors: G. S. Thiriveni Balajji , S. Ulaganathan , Venkatachalam A. Suresh , Akila K. B. , Lavanya K. B. , Vijayalakshmi S.
Published: March 2017

Background: Breast cancer is one of the most common cancers among women in India. Stroma has an important role in the pathogenesis of carcinoma of breast. Stromal marker can be novel marker for assessing the prognosis of breast cancer.Methods: With the representative sections of 30 invasive ductal carcinoma of breast NOS type Hematoxylin and eosin staining was done. Immunohistochemistry was done with CD10. CD10 expression in stroma in cases and control slides were studied and statistically analyzed with histopathological grade.Results: 46% (14 out of 30) of cases showed strong positivity for stromal CD10. Only two cases of strong positivity for CD10 were noted in the adjacent normal breast parenchyma. Stromal expression of CD10 had a statistically significant association with breast carcinoma than in control slides, p value is 0.002. 77% (10 out of 13) of CD10 positive cases were high grade carcinomas. Association of CD10 expression with high grade tumour was statistically significant (p value is 0.04 which is less than 0.05). No association was found with mean age.Conclusions: As the grade of breast carcinoma increases the stromal expression of CD10 is increased. Stromal CD10 expression is directly correlated with higher tumour grade. CD10 could be used as novel prognostic marker and used to develop newer drugs.
Distribution of leptospirosis patients in Sri Lanka: a retrospective study
Authors: Karunathilaka Nimantha , Jayasekara Kithsiri , Chathurangani Ishara , Thudugala Ranga , Silva Athige Rajith , Ratnasooriya Wanigasekara Daya
Published: March 2017

Background: Leptospirosis [LP] is zoonotic diseases and one of the main communicable diseases in Sri Lanka [SL]. SL is a tropical country in the Indian Ocean with favorable environmental and geographical conditions for dispersion of the LP infection. The aim of the study was to determine the pattern of distribution with possible environmental conditions/factors contributing to the LP in SL.Methods: The study was carried out as retrospective study from 2009-14 throughout the all 25 administrative districts in SL.Results: The multiple regression was performed to investigate any associations between the prevalence of LP and independent variable parameters namely, annual rainfall, average humidity, area of paddy lands and annual flood data. The results revealed that factors affecting prevalence of the LP in Sri Lanka can’t be investigated in toto. Seasonal analysis is needed in the wet and dry zones corresponding to the main Yala and Maha agricultural seasons. Annual rainfall is mainly associated with the prevalence of LP in the wet zone while agricultural environment associated with the prevalence of LP in the dry zone (p<0.05). Furthermore, geographical distribution, high annual water discharge and low precipitation of the river water provides favorable environment for dispersion of LP in the wet zone whilst large reservoirs with highly functioning cascades correlated in the dry zone in SL.Conclusions: It is concluded that pattern of distribution with possible environmental conditions/factors contributing to the LP in SL is vary in the wet and dry zones.
Epidemiologic insight into Trinidad’s awareness and prevention of heart disease. The EPITAPH study - a trinidadian cardiovascular health literacy survey
Authors: Seecheran Naveen , Baldeo Stefan , Balbosa Khadia , Baksh Salisha , Bethelmy Shantel , Balkaran Sarah , Bhagaloo Karishma , Bethel Philan , Seecheran Rajeev , Rodriguez Mario , Seecheran Valmiki , Ramlal Rudiger , Persad Sangeeta , Motilal Shastri
Published: March 2017

Background: The aim of the study is to assess the degree of CV health literacy in the Trinidadian public health sector and to identify any factors associated with it. Methods: The descriptive, cross-sectional study was conducted at a single, public health care tertiary hospital, cardiology outpatient clinic located in northern-central Trinidad. Participants: A total of 420 persons were approached, of whom, 390 agreed to participate. Participants included all sexes and ethnicities. The study only excluded patients who declined participation and those younger than 18 years of age. Primary and secondary outcome measures: The primary endpoints were the mean score and percentage of correctly answered items, and percentages of modest and high levels of knowledge. Secondary endpoints were the proportion of participants with tertiary or above level education. Results: The study had a response rate of approximately 93%. The domain of “risk factors” had the most correct responses (69.4%), whereas “medical knowledge” reflected the least correct (57.7%) responses. The overall mean score was 19.7 out of the 30-question questionnaire. This translated to a 65.8% correct response rate. The percentage of participants who scored less than 70% and greater than 70% of the questions correctly were 56.2% and 43.8% respectively. The study participants were found to be more knowledgeable about CVD if they reported “tertiary education,” OR 2.572 (95% CI 1.508-4.387) (p = .001).Conclusions: Respondents displayed a modest level of knowledge and key deficiencies were identified which could potentially translate into suboptimal CV clinical outcomes. The study underscores the paramount importance of establishing comprehensive educational interventions to improve overall CVD literacy in Trinidad and Tobago. Further studies are required to confirm and validate these findings.
Strategies to improve the maternal health programmes under NHM towards MDG-5: maternal mortality in Karnataka
Authors: Kularni R. R. , Venkatesh D
Published: March 2017

Background: Since from the inception of safe mother hood programs in India during 1982-1990, there is no enough maternal health initiative and financial resource for funding public health activities. So number of maternal deaths is more in India, presently which is accounted 20% of the world total maternal deaths. The global and national importance has been given during 1990 by forming millennium development goal -5 (MDG) to improve maternal health programs. During these days MMR was high and there has been recognition for Maternal Health Programs since from 1997, when RCH-I, in the year 2005. National rural health mission (NRHM) was launched with the primary and main objective was to reduce infant and maternal mortality rate as per goal and target fixed by the 12th five year plan (NHM) and MDG -5. Under NHM enough financial resources envelop has been allotted to states of India as per program implementation plan (PIP), so effective utilization of these strategic and financial resources to reduce MMR. Hence this study needs to form strategies to improve the maternal health programs to reduce maternal mortality ratio as per NHM and MDG. Methods: We used the range of methods, like analytical methods to generate the strategies to reduce maternal deaths due to the particular cause by introducing the maternal health programmes with the strategies. Results: Maternal mortality ratio reduced from an estimated level of 437 in 1990 to 178 in 2010–12.The all India and Karnataka target for 2015 was 109 so far not reached. It has to be reached at least by 2017. Conclusions: Optimal using of resources with the implementation of proper strategies, it will give the exact result for achievement of planned goal. This study is also revealed that all the aspects of maternal health programmes and MMR.
Carrier choices and the factors influencing it among medical students in a private medical college in Tamilnadu
Authors: Sharma Dhananjay , Pattnaik Satyajit
Published: March 2017

Background: Career choices of undergraduate students are influenced by many factors. The present study was conducted to elicit the most preferred specialty and to ascertain the factors influencing such choices.Method: A cross sectional study was conducted among the final year and students undergoing internship at a private medical college in South India using a pre designed self-administered questionnaire.Results: Out of three hundred and fourteen students who participated, 298 want to pursue specialization. The preferred specialties of choice are medicine, surgery, obstetrics and gynecology, pediatrics and orthopedics. The two most important factors which supposedly influenced their career choice are scope for self-practice and stable and secure futureConclusion: Most students prefer clinical subjects and there were few takers for pre and para clinical subjects. There is a need to analyze the reasons for such preferences and undertake corrective modifications to increase interest in other subjects.
Ecological study for prioritization of districts of Odisha for swacch bharat mission implementation based on a new modified environmental sanitation index using census 2011 and AHS 2012 data
Authors: Kshatri J. S. , Panda Manasee , Tripathy R. M.
Published: March 2017

Background: Open defecation practices and contaminated drinking water are the two major sources of excreta-related infections. Swacch Bharat Mission (SBM) is a cleanliness campaign launched in India in 2014 for duration of five years. Primary Objectives: 1. Determine the effect of open defecation and drinking water sources on the incidence of diarrheal diseases in Odisha. 2. Categorisation of the districts according to a Modified Environmental Sanitation Index (M.E.S.I).Methods: Type of study: Ecological study. Study instrument: Secondary data collected from Census of India-2011 and Annual Health Survey report, 2012. A Modified E.S.I (M.E.S.I.) score was calculated for Odisha using ESI template developed by Balamurugan and Ravichandran. Statistical analyses were done using GNU PSPP Statistical Analysis Software Release 0.9.0. Results: According to the Census of India, 2,129,276 (22.04%) households in Odisha used latrines, including water closet and pit latrines. From the AHS-2012 data it was found that the overall incidence of diarrhea /dysentery in Odisha was 5.92 per 1000 population. Association with diarrheal disease incidence was estimated after classifying districts into 4 categories according to the use of latrines as <10%, 10-20%, 20-30% and >30%. The mean incidence of diarrheal diseases was lower in districts that had higher use of toilets. The variables from each broad category were classified into positive and negative indicators for ESI calculation and MESI score was calculated. Based on the M.E.S.I, the districts were ranked. Dhenkanal, Kandhamal, Nayagarh were ranked worst. Conclusions: Districts should be prioritized based on MESI score for effective SBM implementation.
Caesarean section and its determinants: a hospital based cross-sectional study
Authors: Panigrahi Namrata , Karmee Nivedita , Tripathy R. M. , Kar Monali
Published: March 2017

Background: The rapid rise in CS rate has become a serious public health issue now-a-days because unnecessary caesareans generate higher expenditure at individual and national levels and have the potential to divert human and financial resources from higher priority intervention. Therefore the present study was carried out to know the indications and determinants of caesarean births in a tertiary hospital of Odisha.Methods: A hospital based cross-sectional study was conducted among women who delivered by caesarean section in O and G department of MKCG Medical College Hospital, Berhampur from July to October 2016 using a pretested semi-structured questionnaire. The data was analysed using appropriate statistical tests such as proportion, chi square test using SPSS software. P value of less than 0.05 is considered as statistically significant.Results: Premature rupture of membrane with oligohydramnias was the major indication in 31.4% cases followed by previous CS in 20.1% cases. Out of socio-demographic factors age (P value = 0.001) and educational status of women (P value= 0.042) were significantly associated with type of CS. Foetal presentation (P value= 0.003), interval between labour and CS (P value <0.01) and type of admission (P value = 0.05) were major obstetric determinants of CS.Conclusions: In order to safeguard the health of mother and child from effects of unnecessary caesarean births, regular antenatal checkups, proper birth preparedness along with timely diagnosis and management of complications is necessary.
Status of maternal and child health services amongst migrants in Ludhiana slums – how far from the MDG targets?
Authors: Sengupta Paramita , Benjamin Anoop I. , Babu Bontha V.
Published: March 2017

Background: It is essential to monitor the coverage of health interventions in subgroups of populations, especially the marginalized and those at higher risk, because national averages can hide important inequalities. This study was carried out to find out the utilization and coverage of MCH services among migrants in the slums of Ludhiana, Punjab.Methods: Cross-sectional sample study.  370 women, who had childbirth within two years prior to the survey, were randomly selected from the 3947 newer migrant households in 30 slum settlements in Ludhiana surveyed for provision of health care, and information obtained from them with regard to MCH services availed by them for their last pregnancy and childbirth. Their children 12-23 months old, 195 in number, were studied for child health services.Results: Antenatal care (ANC) was availed by 44.0% of the women, with 24.6% of them going for minimum 4 antenatal visits and 29.1% having an institutional delivery but only 35.9% by trained health personnel. Place of delivery was found to be a significant predictor of antenatal care. Women staying in Ludhiana availed the least ANC. Complete immunization coverage in the 12-23 month olds was 37.4%. Government health worker visited 7.8% of the homes.Conclusions: Despite the relative proximity and concentration of health centers in urban compared to rural areas, migrant slum-dwellers are still not able to access quality MCH care. The problem of non-availability of essential healthcare and uneven distribution of skilled health care providers is the central challenge in meeting our health goals.
A study to assess the prevalence of behavioral risk factors for lifestyle diseases among late adolescents in Chennai, Tamil Nadu
Authors: Mary A. Evangeline , P. Seenivasan , R. I. Shibiyeswanth , V. Prakash , S. Solaimuthurajagopal , N. C. Valaiyapathy
Published: March 2017

Background: Lifestyle diseases are now the major causes of premature morbidity, mortality, and economic loss in developed and developing countries, including the younger age groups.The four major preventable behavioral risk factors are tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. Life of adolescents is a transitional period, offering them good opportunities for establishing health-promoting lifestyles. This study is done to assess the prevalence of behavioral risk factors for lifestyle diseases of college going adolescents of Chennai. Methods: This cross-sectional study was conducted among 483 randomly selected undergraduate students from randomly selected colleges in Chennai between March and September 2016 by two stage stratified sampling method using a semi-structured questionnaire. Data was fed into excel sheet and Descriptive and inferential statistical analysis was done using SPSS v.21 package. Results: The participants were between 17 and 20 years. They belonged to professional and non professional colleges. 78% students had unhealthy lifestyle habits. All the participants had at least one risk factor in them. The awareness on the risk factors was significantly less among non professional students, but they had significantly better behavioural habits than the professional students. Boys had significantly better habits than girls and students who were overweight significantly had unhealthy lifestyle habits. Conclusions: The study reflects the poor lifestyle habits of all college-aged individuals, which can be effectively improved by health education and behaviour change communication.
Comparative study of awareness and practices regarding menstrual hygiene among adolescent girls residing in urban and rural area
Authors: Dabade Kuldeep Jagannath , Dabade Sheetal Kuldeep
Published: March 2017

Background: Menstruation is still regarded as something unclean or dirty in Indian society and it is strongly related with misconceptions and cultural restrictions. Learning about hygiene during menstruation is a vital aspect of health education for adolescent girls as patterns that are developed in adolescence are likely to persist into adult life. Methods: A community based cross sectional study conducted in urban and rural field practice area of Department of Community Medicine, Khaja Banda Nawaz Institute of Medical Sciences, Gulbarga from Feb 2015 to July 2015. A total 230 adolescent girls were included in the study of which 123 from urban and 107 from rural area, after taking their verbal consent. Results: Total 163 (70.9%) adolescent girls were aware about menstruation before the attainment of menarche. Awareness in urban area 95 (77.2%) was found higher compared to rural area 68(63.5%) and this difference was found to be statistically significant (p<0.02). It has been found that 83(67.5%) study participants from urban area used sanitary napkin during menstruation compared to only 56(52.3%) from rural area and this difference found statistically significant (p<0.01). Conclusions: Overall awareness about menstruation was found low in both urban and rural area and needed to be increased by intensive health education among adolescents.
Awareness about cervical cancer screening among reproductive aged women attending gynaecology outpatient department in ESI PGIMSR & ESIC medical college & Hospital, Joka, Kolkata
Authors: Chaudhuri Susmita , Dutt Rekha , Goswami Shweta , Roychowdhury Joydeb
Published: March 2017

Background: Cervical cancer is a leading cause of morbidity and mortality in women especially India. The mainstay of prevention rests on early detection of cases through screening. So, this study aims to determine the knowledge of cervical cancer screening, Human papilloma virus & its vaccination status. Methods: This was an observational study of cross-sectional design conducted among the adult reproductive aged women (18-45 years) visiting Gynaecology OPD at ESI-PGIMSR and ESIC Medical College and Hospital, Joka. A pre-designed and pre-tested interview schedule was prepared. Face to face interview was conducted in local language. Data was compiled & computed in SPSS software version 20. Results: Total respondents were 97. Majority of the respondents (62.9%) belong to the age group of 21-30 years. 8 in 10 participants follow Hinduism. Almost equal percentages of participants were from urban & rural areas (51.5% & 48.5% respectively). 6 in 10 participants had heard about cervical cancer. Majority of the respondents (55%) mentioned friends & family as a source of information. 48.3% of the respondents knew poor genital hygiene as a predisposing risk factor for cervical cancer. Very few knew about other factors like multiple sexual partner (20%), early marriage (33.3%), young age (20%), repeated childbirth (35%), OCP usage (26.7%) as risk factors for cervical cancer. Only one participant had undergone screening test for cervical cancer (1.7%). 46.7% of the respondents were aware about association of HPV infection with cervical cancer. But none of the participants had received vaccine against cervical cancer & they cited lack of awareness as a reason for not receiving the vaccine. Conclusions: A well-designed health education program focusing on effective multipronged IEC strategies utilizing pictorials, audio-visual and personal communication on cervical cancer could yield beneficial results.
Antenatal counselling- is it adequate? A cross-sectional study from Chandigarh tricity, India
Authors: Dhiman Anupama , Goel Naveen K. , Kumar Dinesh , . Navpreet , Galhotra Abhiruchi
Published: March 2017

Background: Antenatal care (ANC) provides an important opportunity to improve maternal understanding about pregnancy, childbirth, and care of the newborn. Adequate and quality ANC can help ensure a favourable pregnancy outcome, but the coverage of ANC in India remains inadequate. The present study was conducted with an objective to assess ante natal counselling services at health centers in Chandigarh Tricity.Methods: The cross-sectional study was conducted in the Chandigarh Tricity during April 2012 to September 2013. Stratified multistage sampling technique was used to select health centers in tricity. A total of 345 pregnant women in second and third Trimester were interviewed with the help of pre-designed, structured and pre-tested questionnaire after taking their written informed consent. It was supplemented by observation of ante natal sessions. Data was entered and analyzed using SPSS version 19.Results: Nearly one-fourth (28.1%) participants received counselling regarding diet and rest. Only 26 (07.5%) participants were explained about danger signs during pregnancy. Significant difference was found between counseling given regarding ‘diet and rest’ with respect to city (p=0.03) and health centers (p=0.00). Significant difference was found between counselling for ‘family planning’ with respect to city (p=0.01) and health centers (p=0.00).Conclusions: Findings from our study indicate low level of counselling on various components of ANC. Thus, strategies under National Health Mission to improve quality of antenatal communication as well as maternal understanding should be strengthened.
Knowledge, attitude and practices of patients’ relatives about cancer: a study from Eastern India
Authors: Paul Rudrajit , Sinha Sourav , Asifullah Md. , Mallick Swapan K. , Mondal Jayati
Published: March 2017

Background: Knowledge, attitude and practice (KAP) about a disease can significantly affect healthcare seeking behaviour and thus, ultimate outcome of a disease. This is particularly true in chronic diseases like cancer. In India, the influence of family members on the treatment decision of an individual is paramount. Hence, KAP of the family about a disease will significantly affect the healthcare pathway of any individual. However, actual data on KAP of common people about cancer are very rare from India. In this Eastern Indian study, we aimed to generate data on this very important aspect. Methods: In this hospital based study, the relatives of cancer patients were interviewed about their perception about various aspects of cancer. The interview was based on a pre-structured questionnaire modelled after the “Illness Perception Questionnaire”. Results: We had 65 subjects in our study with a mean age of 43.5 years. 32% of the subjects belonged to some profession related to medicine. 44.6% of the subjects thought that cancer was synonymous with tumour. The chief source of information for our respondents was their physician only. Only 5% got their information about cancer from the mass media. The relationship between tobacco and cancer was known to a significant fraction with 21.5% responding that smoking causes cancer and a further 18.5% knowing about other tobacco products as the cause. More than 1/4th of the subjects thought that any cancer was a permanent disease. Most (71%) study subjects thought that living with a cancer patient was difficult. 32% believed that cancer meant inevitable death. Almost 2 out of every 5 had used some form of alternative medicine therapy for cancer. Subjects with lower educational status were statistically more likely to use alternative medicine. Regarding the prevention of cancer also, opinions varied widely according to educational level with almost 70% of the subjects in the illiterate subset opining that cancer is non-preventable. Conclusions: This study shows that the perception about cancer varied widely in the society according to various factors like educational level and/or gender. A significant number of subjects had personal outlook which was quite different from current scientific data. Hence, proper dissemination of information about diseases like cancer in the society is an important need of the hour.