National Journal of Community Medicine

Technology-Based Gratitude Interventions for Enhancing Mental Health and Well-Being in The Community

Suneetha Kandi — 2023-09-01

In the contemporary society, technology has emerged as a significant tool for fostering emotional expression, particularly in conveying feelings of gratitude, love, and affection towards others and oneself. This review investigated the efficacy of technology-based gratitude interventions in promoting gratitude, enhancing mental health, and improving overall well-being among individuals within the community. Comprehensive search was conducted across various electronic databases, including PubMed, PsycINFO, Scopus, Google Scholar, Ingenta and other sources. Through a rigorous procedure eleven relevant studies were identified, each shedding light on the impact of technology-based gratitude interventions on psychological outcomes. The studies listed different technology-based gratitude interventions such as telehealth services, counseling and psychotherapy platforms, and web-based interventions like daily gratitude writeups on social media, blogging, and gratitude journaling apps. These interventions have proven to be effective in fostering positive psychological changes among individuals from different backgrounds and age groups, making them accessible and scalable mental health tools. Mental health professionals can integrate technology-based gratitude interventions into their practice, providing individuals with practical and engaging strategies. Moreover, the interventions exhibit promise in mitigating psychopathological behaviors, offering promising implications for addressing mental health challenges in the community.

Tuberculosis Elimination: Implications and Challenges

Rasha Aziz Salama — 2023-09-01

Background: Tuberculosis elimination remains a significant global health challenge, despite the efforts made by governments and international organizations to control and eliminate the disease. The study objectives were to explore the global TB control efforts and highlight the possible challenges and implications in the way to TB elimination. Recommendations to add momentum to current health care efforts were also outlined.

Methods: Relevant works of literature were retrieved from different journals and web pages. The electronic databases were searched using the key.

Results: A review of the progress made over the past years in the control of TB has shown that the goal of TB elimination has not yet been achieved. The high burden of TB, limited access to TB diagnosis and treatment, drug-resistant TB, weak health systems particularly in low- and middle-income countries, socioeconomic factors, and lack of political commitment and resources are among the major challenges that have hindered the successful elimination of tuberculosis.

Conclusions: a sustained and coordinated effort from governments, private sector, international organizations, and other stakeholders, including increased funding, political commitment, and a focus on addressing the root causes of TB transmission and disease burden are required to address these challenges.

Covid-19 Vaccine Booster Dose and The Indian Scenario: When We Will Have a Fully Immunized Population?

Amitesh Datta — 2023-09-01

Is India Quietly Becoming a Favourable Hub for Clinical Trials?

Deepali Desai — 2023-09-01

In recent years, India has become a go-to destination hub for clinical trials. The manpower, labour, patient recruitment, and medical infrastructure are cost-effective. India has a growing number of world-class research facilities and hospitals well equipped with advanced medical technology, which is essential for conducting high-quality clinical trials.

Health Impact of School Built Environment on Children

Ujjwala Chorasia — 2023-09-01

School-built environment impacts mental health, physical health, obesity, bullying, learning disorder, and respiratory disorders in children. The built environments of schools have a direct implication on the health of children. Indoor air quality in school buildings will play a role in children's exposure to pollution. One of the most consistently reported factors associated with children's active travel rates to school is the distance to school, with children more likely to walk or cycle to school the closer they live to the school. An evidence base regarding the built environment factors that shape decision-making and behavior related to active modes of travel in adults is emerging for policymakers. Functional aspects of the built environment include the distance between places; street design and geometry; street connectivity; path infrastructure, aesthetic qualities; safety; the mix of land uses; and the proximity and quality of destinations. Regarding architecture, the primary goal should be to create a space that maximizes natural light, airflow, and captivating aesthetics. Students spend their most important and developing years on school campuses; it is essential to consider their mental and physical health to create an environment where they can learn and develop their personalities in comfort. This paper discusses the health impacts that school-built environments have on children from a public health professional's perspective as well as an architect's viewpoint, as both institutions are crucial for children and adolescents to grow up in environments that encourage more active, safe, and sustainable lifestyles.

Fecal Myeloperoxidase Levels in Pregnant Women and Risk Factors to Low Birth Weight in A Makassar Slum Settlement: A Sub-Study of The Indonesian Birth Cohort Study

Sri Inriani — 2023-09-01

Purpose: Intestinal inflammation can affect the absorption of micronutrients from the bowel, which can lead to maternal malnutrition and adverse pregnancy outcomes. This study aimed to measure fecal myeloperoxidase (MPO) levels as a biomarker of inflammation in pregnant women and explore risk factors for low birth weight in the slum area of the Tallo District, Makassar City.

Method: This study used a retrospective cohort study design with a purposive sample of 172 pregnant women. Stool specimens were collected and tested using a human myeloperoxidase enzyme-linked immunosorbent assay kit. Data were collected through interviews using the Kobo Toolbox.

Result: The median fecal myeloperoxidase level in pregnant women was 24.2 ng/ml. The correlation with low birth weight was insignificant (r = -0.0037, p = 0.96). Based on bivariate analysis, the risk factors significantly associated with low birth weight were first parity (RR = 2.8 (95% CI: 1.3-6.4), and preterm birth (RR = 3.9 (95% CI: 1.9-8.3), while the multivariate analysis showed that the most significant risk variable for low birth weight was preterm birth (ARR = 4.9 (95% CI: 2.6-9.1).

Conclusion: This study found that gestational age at birth was significantly associated with low birth weight in infants. There was no significant association with fecal myeloperoxidase level in the pregnant mother.

Determinants of Stress and Coping Mechanisms Adopted among Medical Undergraduate Students in Coastal Karnataka, India: A Cross-Sectional Study

Divya Venkatesh Pai — 2023-09-01

Background: The progressively worsening performance of students in classroom, the health problems induced due to stress, below average academic accomplishments of students in classroom and in hospital postings is directly attributable to the tremendous stress, medical students undergo during their course to become future doctors of the country. We conducted this research survey to find out the magnitude of stress as perceived by medical undergraduate students and to measure the association of such stress with various factors which may influence it.

Methodology: About 612 students studying in private medical colleges in Mangalore from first year to final year were interviewed after obtaining their informed consent. The data collection tool used for this study consisted of a pre-designed questionnaire which contained social and demographic variables of study participants and a perceived stress scale developed by Cohen et al.

Results: The immenseness of curriculum which was the academic stressor that was cited, financial and family issues were psychological stressors and accommodation which was the environmental stressor were some of the significant factors contributing towards perceived stress.

Conclusion: Only one of the coping strategies adopted by students was found to be significantly associated with perceived stress.

Effect of Positive Deviance Approach on Promotion of Safe Disposal of Child’s Faeces in Rural Tamil Nadu: A Community-Based Quasi-Experimental Study

S Nancy — 2023-09-01

Background: Unsafe disposal of child’s faeces plays a crucial role in disease transmission and environmental pollution. These areas are overlooked by many sanitation promotion interventions. The objective was to determine the effect of Positive Deviance (PD) approach on safe disposal of child’s faeces among households who owned a toilet.

Methodology: A community-based quasi-experimental study was carried out in the four field practice villages of UHTC, Villupuram for 18 months. Households who owned a toilet and had a child <5 years were included. After IEC clearance, information was collected from a representative sample of 100 households before intervention and another 100 households after intervention. PD approach was applied for six months to promote safe disposal practices. Data was analyzed in SPSS 24 software. Chi square test and Effect size (Cramer’s V) were employed.

Results: Before intervention, only 3% households disposed the faeces into a toilet. While, after intervention, almost 38% households disposed in the toilet (c²=37.39; df=1; p=0.001). Effect size was found to be 0.43.

Conclusion: PD approach demonstrated considerable improvements in safe disposal of child’s faeces in rural settings. Further, in order to sustain the behaviour, change frequent reinforcement of key messages at frequent intervals need to emphasized.

Analysis of the Influence of Environmental Health Interventions Based on The Health Belief Model (HBM) on the Risk Factors of Dengue Hemorrhagic Fever (DHF) Benteng Village, Indonesia

Andi Murni Alwi Paluseri — 2023-09-01

Background: Palopo city is one of the endemic areas of DHF, which during the last 5 years DHF morbidity rate has fluctuated. One solution could be environmental health interventions, which aim to enhance disease prevention behavior through positive views based on powerful health messaging. Assessment of entomological indices (Container Index, Breteau Index, and House Index) which is one of risk factors for DHF incidents to see level of density of Aedes sp. larvae can help determine focus of vector control. This study wants to see whether there is an effect of environmental health interventions based on Health Belief Model (HBM) theory on risk factors for DHF.

Methods: This research is an experimental study with a Quasy experimental design using One Group Pre-Post test design. The sampling technique is total sampling so that entire population is a sample of 71 houses. Data were analyzed using Mc Nemar test.

Results: Result indicated that perceived susceptibility (p value = 0.021), perceived severity (p value = 0.000), perceived benefits (p value = 0.001), perceived barriers (p value = 0.000) and behavior to prevent contact vector (p value = 0.015) were all influenced by environmental health intervention, the entomological index Container Index (CI) was in the low group of moderate, whereas Breteau Index (BI) and House Index (HI) were in the high category of moderate. This indicates that HBM-based environmental health interventions can lower the density of larvae.

Conclusion: Environmental health interventions based on HBM can be recommended as an effort to reduce the risk factors for DHF.

Out of Pocket Expenditure and Utilization of Government Financial Assistance Among Women Who Had Institutional Delivery in An Urban Slum of Telangana, India

Pavani Varma — 2023-09-01

Background: Out of Pocket Expenditure (OOPE) are expenditures directly made by households at the point of receiving health care. In Telangana State the average OOPE per delivery in public health facility is Rs. 3846. The study helps to know the OOPE among mothers undergoing institutional deliveries and emphasise on the expenditure even after utilising the government financial assistance.

Objectives: To estimate the OOPE among women undergoing institutional delivery and to find its association with government financial assistance utilization and socio-demographic factors.

Methodology: A community based cross sectional study was done among 200 mothers who delivered recently residing in an urban slum under our health and training centre. Ethical clearance was taken before the conduct of study.

Results: The median direct out of pocket expenditure among mothers in our study was Rs.500 i.e., 6.6 $ (0 to 1600). OOPE was present among 68.5% of mothers. Availability of government financial assistance, age and occupation of the mother and type of delivery was found to be significantly associated with p value <0.05.

Conclusion: The financial assistance definitely reduced the burden of OOPE among the mothers. The implementation of such schemes is important and needs to be evaluated time to time to ensure proper reach of its benefits to the community.

Development and Validation of a Screening Tool for The Identification of Refractive Errors Among School Going Children In Tamil Nadu, India

Sudharsan V — 2023-09-01

Background: The inability to focus light onto the retina, known as refractive error, is a significant cause of correctable visual impairment. Unfortunately, students' ocular complaints often go unnoticed due to a lack of awareness. To address this issue, a questionnaire with high sensitivity and reasonable specificity was developed for teachers to identify students with refractive error.

Methods: A questionnaire with surrogate indicators for refractive error in children was used and the data was analysed using SPSS. Significant markers were scored and a ROC curve determined a suitable cut-off. Sensitivity and specificity were calculated based on this cut-off.

Results: The questionnaire was developed using five variables that had a 65% probability of identifying refractive error, including copying errors, copying from peers, eye squeezing, previous use of glasses, and eye deviation. A cut-off score of 5.5 out of 14 achieved 90% sensitivity and 50% specificity in detecting refractive errors.

Conclusion: This study created a tool with five markers that demonstrated good internal consistency and content validity, it had an average sensitivity and specificity of 84% and 63%, respectively. The tool is twice as likely to identify someone with refractive error than someone without it.

The Effect of a Pharmacist-Intervention Program on Clinical Outcomes in Diabetes Mellitus Patients

Sini T Inasu — 2023-09-01

Background: Clinical pharmacists are skilled in identifying patient medication-related problems such as adverse drug responses and non-adherence. Pharmacists participate in diabetes management teams and offer direct patient treatment using several practice models in different ambulatory practice settings. The objective is to evaluate the effect of a pharmacist-intervention program on clinical outcomes in diabetes mellitus patients.

Materials and methods: The cohort consisted of diabetes patients attending multi-speciality care hospitals. Eligible patients were randomly assigned in a 1:1 ratio to the intervention and control groups. Each patient in the intervention group was counselled by the research pharmacist. The measure of diabetes self-management was assessed using the Summary of Diabetes Self –Care activities (SDSCA) questionnaire.

Results: 150 patients out of this population met the inclusion criteria. The study succeeded in proving the effect of pharmacist-led patient education in the improvement of the quality of life and clinical parameters of diabetes. The pronounced differences in the SDSCA scores of the test group and control group signify the impact of interventions and the consistency of the scale as well.

Conclusion: The effect of pharmacist-led interventions on diabetic treatment outcomes was evaluated. The results recommend the need for extensive pharmacist-led intervention programs in metabolic disorder management.

Quality of Life and Its Determinants Among Diabetic Patients in A Rural Area of Gautam Buddha Nagar, Uttar Pradesh, India

Sangeeta Dewan — 2023-09-01

Context: Diabetes has become the largest health emergencies of 21^st century. The burden of diabetes is increasing globally especially in developing economies like India. In the recent years, Physician’s interest has turned to the concept of quality of life (QOL) as an important treatment goal and an important component of therapy in the management of diabetes. The study was aimed to compare the quality of life of adult diabetic subjects with healthy subjects and to assess the factors affecting the quality of life among diabetic subjects.

Methodology: A Community based cross sectional study was conducted among 250 diabetic subjects and 50 healthy subjects more than 18 years of age, based on WHO-Quality of Life-BREF (WHO-QOL-BREF) questionnaire manual in the rural area of District Gautam Buddha Nagar from Jan 2021-June 2022. Data collected were entered and statistically analyzed using statistical software (SPSS-22)

Results: Overall quality of life and general health score was significantly poor among diabetic subjects as compared to healthy subjects. Quality of life was significantly lower in diabetic subjects ≥ 60 years of age, illiterate subjects and in diabetic subjects with presence of comorbidity.

Conclusions: Overall QOL was poor among diabetic subjects as compared to healthy subjects.