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Sekaran VC, Prabhu V, Ashok L, D’Souza B, Shetty SD, Nair R. Predictors of Adolescent Internalizing and Externalizing Mental Health Symptoms: A School-Based Study in Southern India. Int J Environ Res Public Health 2024; 21:393. [PMID: 38673306 PMCID: PMC11050696 DOI: 10.3390/ijerph21040393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Mental illnesses are one of the major contributors to the overall burden of disease among the young. We investigated the predictors of emotional and behavioral problems among in-school adolescents in the Indian context. METHODS Using stratified sampling, 1441 adolescents were recruited to participate in the study in Udupi taluk. The study instruments included a socio-demographic pro forma and the adolescent self-reporting version of the Strengths and Difficulties Questionnaire (SDQ) to assess the emotional and behavioral problems among them. We explored the predictors of total difficulties, as well as externalizing and internalizing problems and gender differences. SPSS version 25 was used to analyze the data. Descriptive statistics, a Chi-square test for associations, an independent t-test to explore the gender differences, correlation analysis, and backward stepwise logistic regression for the predictors were used. RESULTS The mean age of the participants was 15.31 ± 0.76. An almost equal percentage of male (49.6%) and female (50.4%) participants provided data. Abnormal scores were highest under conduct problems (8.5%), and the total difficulties reached 5.1%. The male participants had higher levels of conduct, hyperactivity, peer relationship, and externalizing problems the while the female participants experienced higher levels of emotional and internalizing problems. It was observed that there was a significant positive relationship between age and emotional problems, conduct problems, hyperactivity, peer problems, and total SDQ score. An older age predicted an abnormal total difficulties score and externalizing and internalizing behaviors, while the type of school predicted the total difficulties and internalizing behaviors. CONCLUSION The age of the adolescent, their gender, and the type of school they attended emerged as predictors of the emotional and behavioral problems among them.
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Affiliation(s)
- Varalakshmi Chandra Sekaran
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India
| | - Vidya Prabhu
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India
| | - Lena Ashok
- Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India
| | - Brayal D’Souza
- Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India
| | - Surekha Devadasa Shetty
- Division of Anatomy, Department of Basic Medical Sciences, Manipal Academy of Higher Education, Manipal 576104, India
| | - Ravichandran Nair
- Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India
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Goenka A, Mundkur S, Sujir Nayak S, Shetty A, Thomas J, Mymbilly Balakrishnan J, Chandra Sekaran V, Dsouza B. Improving the emergency services using quality improvement project and Donabedian model in a quaternary teaching hospital in South India. BMJ Open Qual 2024; 13:e002246. [PMID: 38395464 PMCID: PMC10895229 DOI: 10.1136/bmjoq-2022-002246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/07/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION The primary goal of quality improvement is to enhance patient outcomes, particularly in the emergency department (ED). Timely and effective care is crucial in these situations. By comprehending the challenges, evaluating current performance and implementing quality improvement projects, areas in need of enhancement can be pinpointed and addressed, resulting in better outcomes. METHODOLOGY This interventional study explores the implementation of quality improvement in the ED of a quaternary care teaching hospital in South India. It follows the Plan-Do-Check-Act (PDCA) cycle guided by the Donabedian model. Descriptive statistics were employed to measure changes in outcomes before and after implementation. To improve processes, Donabedian principles were applied, and a performance audit was conducted based on patient feedback and stakeholder input. Various ED indicators were measured. To address identified issues, formal root cause analysis was performed, leading to the generation of PDCA rapid change cycles. These cycles were implemented over 6 months, with two cycles executed, followed by postimplementation evaluation. RESULTS Post implementation, improvements were observed in several aspects of ED operations. These included reduced ED average length of stay, decreased time to analgesia, shorter cross-consultation time, faster transfer time from ED and improved investigation turnaround time (TAT). Additionally, there was a reduction in revisits to ED within 72 hours and a decrease in patients who left without being seen. These positive changes demonstrate the effectiveness of the quality improvement intervention using the PDCA cycle. CONCLUSION A comprehensive understanding of patient profile in the ED and factors influencing care is essential for the hospital to ensure sufficient resources and skilled emergency medicine physicians are available 24/7. By enhancing services in the ED, reducing patient waiting times and improving TAT, the overall efficiency of services can be improved. This leads to provision of timely quality care to patients and ultimately improves their outcomes.
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Affiliation(s)
- Apoorva Goenka
- Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Innovation Think Tank, Siemens Healthineers, Bengaluru, Karnataka, India
| | - Suneel Mundkur
- Kasturba Medical College Manipal, Manipal, Karnataka, India
| | - Sachin Sujir Nayak
- Emergency Department, Kasturba Medical College Manipal, Manipal, Karnataka, India
| | - Avinash Shetty
- Department of Community Medicine, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Jibu Thomas
- Kasturba Hospital Manipal, Manipal, Karnataka, India
| | | | - Varalakshmi Chandra Sekaran
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Brayal Dsouza
- Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Remesan AK, Sekaran VC, Jothikaran TAJ, Ashok L. Substance Use among Emerging Adults during the COVID-19 Pandemic: A Review through the Lens of Sustainable Development Goals. Int J Environ Res Public Health 2023; 20:6834. [PMID: 37835104 PMCID: PMC10572374 DOI: 10.3390/ijerph20196834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/09/2023] [Accepted: 09/16/2023] [Indexed: 10/15/2023]
Abstract
Public health initiatives, including lockdowns to reduce the spread of COVID-19, have resulted in societal stressors like loneliness, job loss, and economic collapse linked to worsening mental health outcomes, such as depression, anxiety, and coping-related substance use. The various psychosocial stressors caused by the pandemic have potentially led to the increased use of substances across the globe, particularly among emerging adults. The current study summarises the literature on substance use among emerging adults during the COVID-19 pandemic. The terms "coronavirus", "COVID-19", "substance use", "substance abuse", "drug use", drug abuse", "emerging adults", and "young adults" were all used in different combinations throughout the search, using the Scopus, PubMed, and JSTOR databases. Using this method, a total of 28 English-language citations published between 2020 and 2023 were obtained. Following a study of the articles mentioned above, 16 papers were removed. The remaining 12 papers were included in this review. Even though substance use dropped when COVID-19 lockdowns began, it rose when restrictions were removed, particularly among those with prior substance use. Studies related to mental health need to assess substance use, as many emerging adults use substances to cope with distress, including isolation and loneliness, which are part of the current mental health crisis among emerging adults.
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Affiliation(s)
- Ajith K. Remesan
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India;
| | - Varalakshmi Chandra Sekaran
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India;
| | - Teddy Andrews Jaihind Jothikaran
- Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India; (T.A.J.J.); (L.A.)
| | - Lena Ashok
- Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, India; (T.A.J.J.); (L.A.)
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Dsouza B, Prabhu R, Unnikrishnan B, Ballal S, Mundkur SC, Chandra Sekaran V, Shetty A, Moreira P. Effect of Educational Intervention on Knowledge and Level of Adherence among Hemodialysis Patients: A Randomized Controlled Trial. Global Health 2023; 2023:4295613. [PMID: 37033597 PMCID: PMC10081894 DOI: 10.1155/2023/4295613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
Purpose. The purpose of the study was to assess the impact of an educational intervention on the level of knowledge and adherence to the treatment regimen among hemodialysis (HD) patients as well as to describe the association between these variables. Methods. In this randomized controlled trial, 160 HD patients at an HD centre of a 2030-bed tertiary teaching hospital in Southern India were randomly assigned into intervention (N = 80, received education and a booklet) and control (N = 80, received standard care) groups. Knowledge and adherence were measured preintervention and postintervention using a validated questionnaire for knowledge and the ESRD-AQ (End-Stage Renal Disease Questionnaire) for the level of adherence. The statistical analysis of the data was performed with the help of the Statistical Program SPSS version 19.0. The statistical significance level was set at 0.05. Results. The increase in knowledge on disease management, fluid adherence, and dietary adherence in the intervention group was significantly higher compared to the control group. There was no significant correlation between knowledge and adherence. Adherence improved for all the domains, i.e., dialysis attendance, episodes of shortening, adherence to medication, fluid restriction, and dietary restriction. Adherence to fluid and dietary restriction was statistically significant. This trail is registered with https://clinicaltrials.gov/ct2/show/CTRI/2018/05/014166.
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Affiliation(s)
- Brayal Dsouza
- Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Ravindra Prabhu
- Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - B. Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sudarshan Ballal
- Manipal Hospitals, Manipal Health Enterprises Pvt Ltd, Bengaluru, India
| | - Suneel C. Mundkur
- Department of Paediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Varalakshmi Chandra Sekaran
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Avinash Shetty
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Paulo Moreira
- International Healthcare Management Research and Development Center (IHM-RDC), Shandong Qianfoshan Provincial Hospital, Shandong Medical University, Jinan, Shandong, China
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Phagdol T, Karkada SR, Barboza L, D'Souza B, Chandra Sekaran V. Assessment of Climacteric Symptoms and Its Impact on Daily Lives of Employed and Unemployed Perimenopausal Women in Selected Rural Villages in South India. Hosp Top 2023:1-8. [PMID: 36724822 DOI: 10.1080/00185868.2023.2171936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Perimenopause is a transitional state which occurs in women in their mid-life. These women may experience climacteric symptoms that affect their day-to-day life. The aim of the study was to assess and compare climacteric symptoms and their impact on daily lives among employed and unemployed perimenopausal women. A cross-sectional survey was done on 160 rural south Indian women aged 40 to 55 years who were identified as symptomatic of perimenopause as per the Stages of Reproductive Aging Workshop 10+ (STRAW) staging criteria. The study participants were grouped as employed and unemployed. Climacteric symptoms were assessed using Greene Climacteric Scale and climacteric symptoms' impact on daily lives was measured using a structured self-administered questionnaire. Both descriptive and inferential statistics were used to compare the variables between the two groups. The total Greene Climacteric score for unemployed perimenopausal women were found to be significantly higher than the employed group of perimenopausal women (14.5 ± 7.23 versus 12.52 ± 4.9, p < 0.05). The majority (58.8%) of the employed group had minimum impact whereas; the majority (51.2%) of the unemployed group had an average impact score. There was a strong positive correlation between climacteric symptoms and their impact on the daily lives of perimenopausal women. Employment status is a significant factor in causing variation in the climacteric symptoms. Unemployed perimenopausal women suffered more climacteric symptoms than their employed counterparts.
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Affiliation(s)
- Tenzin Phagdol
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sushmitha R Karkada
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Laveena Barboza
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Brayal D'Souza
- Professor-Senior Scale (MHA), Department of Health Innovation, Prasanna School of Public Health, Quality Management Representative - Kasturba Hospital, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Varalakshmi Chandra Sekaran
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Rajesh C, Ashok L, Rao CR, Kamath VG, Kamath A, Sekaran VC, Devaramane V, Swamy VT. Psychological well-being and coping strategies among secondary school teachers: A cross-sectional study. J Educ Health Promot 2022; 11:152. [PMID: 35847148 PMCID: PMC9277760 DOI: 10.4103/jehp.jehp_1248_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 10/13/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Educators, academicians, and teachers are responsible for the development of the nation's human capital. Teacher coping methods are becoming more widely recognized as a key factor in determining teacher effectiveness. The aim of this study was to identify the various coping strategies adopted by high school teachers in Southern India. MATERIALS AND METHODS A cross-sectional study was conducted in government, aided, and unaided schools of Udupi, a coastal district in Southern India. A self-administered questionnaire was used to collect the data from 460 high school teachers chosen based on convenience sampling. The coping strategies were identified using a modified version of Brief COPE(Coping Orientation to Problems Experienced) Inventory (Carver, 1997). Data were entered using SPSS version 15 and descriptive statistics was performed. RESULTS The study found that teachers had moderate level of coping skills in all domains. The most popular coping techniques used by secondary school teachers were positive reframing, active coping, and planning; nevertheless, substance use was recognized as the least popular coping strategy. CONCLUSION Positive reframing, active coping, and preparation were the most commonly used coping strategies by the teachers in the survey. Teachers are a vital resource who have received less attention than they deserve for their psychological well-being. A customized intervention program based on their perceived needs could be a good place to start.
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Affiliation(s)
- Chinthana Rajesh
- MSW program, Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Lena Ashok
- MSW program, Department of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Chythra R. Rao
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Veena G. Kamath
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Asha Kamath
- Department of Data Sciences, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Varalakshmi Chandra Sekaran
- Department of Community Medicine, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - V. Thippe Swamy
- Department of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Chandra Sekaran V, Bailey A, Kamath VG, Ashok L, Ravindran SK, Kamath A, Hegde A. 'No, you should not beat our child because he will become aggressive:' Applying a multi-method approach to explore intergenerational transmission of parenting practices. PLoS One 2021; 16:e0258306. [PMID: 34618867 PMCID: PMC8496842 DOI: 10.1371/journal.pone.0258306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/23/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Exploring the cultural context of intergenerational continuity of warm and harsh parenting informs parents motivations to adopt specific parenting behaviours. OBJECTIVE Parents' perceptions of being parented in the past and their current parenting as well as adolescents' perceptions of current parenting were explored applying a multi-method approach. METHODS Following written informed consent, a total of 24 interviews with 10 families (dyads of 14 parents and ten adolescents) from Udupi taluk in southern India was conducted. In the first stage, in-depth interviews were conducted with parent participants (Generation 1 (G1)) and in the second stage, adolescents (Generation 2 (G2)) participated in the photovoice component. Multiple forms of data including photographs, journals and interviews facilitated using the SHOWeD model were collected and were analysed thematically using ATLAS.ti(v.8). RESULTS Subtle changes in reinforcing culture-specific gender norms between generations were elicited. Differences in communication, granting autonomy to female adolescents, and in disciplining methods between G1 and G2 were observed. Warm parenting was transmitted between generations while harsh parenting in G1 in the presence of external social support was discarded in favor of warm parenting in G2. CONCLUSION We provide evidence for perceptions of parenting and adolescent behaviors across two generations. Transmission of warm parenting and interruption in the cycle of harsh parenting in the presence of external social support were significant findings. Related theoretical and methodological applications are discussed.
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Affiliation(s)
- Varalakshmi Chandra Sekaran
- Department of Community Medicine, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India
- Transdisciplinary Centre for Qualitative Methods, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Ajay Bailey
- Transdisciplinary Centre for Qualitative Methods, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
- Faculty of Geosciences, Department of Human Geography and Spatial Planning, International Development Studies, Utrecht University, Utrecht, Netherlands
| | - Veena Ganesh Kamath
- Department of Community Medicine, Kasturba Medical College (Manipal), Manipal Academy of Higher Education, Manipal, India
| | - Lena Ashok
- Department of Global Health, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Syam K. Ravindran
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Asha Kamath
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Asha Hegde
- Department of Paediatrics, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India
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Aithal Padur A, Kumar N, Lewis MG, Sekaran VC. Morphometric analysis of patella and patellar ligament: a cadaveric study to aid patellar tendon grafts. Surg Radiol Anat 2021; 43:2039-2046. [PMID: 34570285 PMCID: PMC8536615 DOI: 10.1007/s00276-021-02837-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/09/2021] [Indexed: 10/25/2022]
Abstract
PURPOSE Morphometric analysis of the patella and the patellar ligament is crucial in diagnosing and surgical corrections of knee injuries and patellofemoral joint disorders. Dimensions of the patella and the patellar ligament are frequently used in implant design and ACL reconstruction. This study aims to obtain detailed morphometric data on the patellar ligament and its localization based on gross anatomical dissections in the adult cadavers. METHODS The present study consisted of 50 lower limbs from formalin-fixed male adult cadavers aged about 70 years (45-85) belonging to the South Indian population. Total length of the quadriceps tendon, patellar height, patellar ligament height, proximal width, distal width and thickness of the patellar ligament were measured meticulously. Mean, standard deviation, median scores of each parameter were computed for groups using SPSS 16.0. Level of significance was considered as p < 0.05. Wilcoxon signed-rank test was used to compare the various parameters on the right and left limbs. The relationships between all parameters were analyzed using Spearman's rank correlation test. RESULTS There was no statistically significant difference in the various measurements of the patella and patellar ligament between the right and left lower limbs. Patellar ligament length showed positive correlation with ligament thickness (r = 0.36; p = 0.078 for right limb and r = 0.33; p = 0.104 for left limb). Proximal width of ligament showed significant positive correlation with distal width (r = 0.41; p = 0.041 for right limb and r = 0.54; p = 0.006 for left limb). CONCLUSION This morphometric data and analysis might be fundamental in understanding various knee conditions in situ and necessary to orthopedic surgeons for successful planning and execution for ACL reconstruction using patellar ligament graft and other patellofemoral joint disorders. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Ashwini Aithal Padur
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Naveen Kumar
- Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India.
| | | | - Varalakshmi Chandra Sekaran
- Department of Community Medicine, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
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Mistry SK, Ali ARMM, Yadav UN, Ghimire S, Hossain MB, Das Shuvo S, Saha M, Sarwar S, Nirob MMH, Sekaran VC, Harris MF. Older adults with non-communicable chronic conditions and their health care access amid COVID-19 pandemic in Bangladesh: Findings from a cross-sectional study. PLoS One 2021; 16:e0255534. [PMID: 34324556 PMCID: PMC8320993 DOI: 10.1371/journal.pone.0255534] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Burgeoning burden of non-communicable disease among older adults is one of the emerging public health problems. In the COVID-19 pandemic, health services in low- and middle-income countries, including Bangladesh, have been disrupted. This may have posed challenges for older adults with non-communicable chronic conditions in accessing essential health care services in the current pandemic. The present study aimed at exploring the challenges experienced by older Bangladeshi adults with non-communicable chronic conditions in receiving regular health care services during the COVID-19 pandemic. MATERIALS AND METHODS The study followed a cross-sectional design and was conducted among 1032 Bangladeshi older adults aged 60 years and above during October 2020 through telephone interviews. Self-reported information on nine non-communicable chronic conditions (osteoarthritis, hypertension, heart disease, stroke, hypercholesterolemia, diabetes, chronic respiratory diseases, chronic kidney disease, cancer) was collected. Participants were asked if they faced any difficulties in accessing medicine and receiving routine medical care for their medical conditions during the COVID-19 pandemic. The association between non-communicable chronic conditions and accessing medication and health care was analysed using binary logic regression model. RESULTS Most of the participants aged 60-69 years (77.8%), male (65.5%), married (81.4%), had no formal schooling (58.3%) and resided in rural areas (73.9%). Although more than half of the participants (58.9%) reported having a single condition, nearly one-quarter (22.9%) had multimorbidity. About a quarter of the participants reported difficulties accessing medicine (23%) and receiving routine medical care (27%) during the pandemic, and this was significantly higher among those suffering from multimorbidity. In the adjusted analyses, participants with at least one condition (AOR: 1.95, 95% CI: 1.33-2.85) and with multimorbidity (AOR: 4.75, 95% CI: 3.17-7.10) had a higher likelihood of experiencing difficulties accessing medicine. Similarly, participants with at least one condition (AOR: 3.08, 95% CI: 2.11-4.89) and with multimorbidity (AOR: 6.34, 95% CI: 4.03-9.05) were significantly more likely to face difficulties receiving routine medical care during the COVID-19 pandemic. CONCLUSIONS Our study found that a sizeable proportion of the older adults had difficulties in accessing medicine and receiving routine medical care during the pandemic. The study findings highlight the need to develop an appropriate health care delivery pathway and strategies to maintain essential health services during any emergencies and beyond. We also argue the need to prioritise the health of older adults with non-communicable chronic conditions in the centre of any emergency response plan and policies of Bangladesh.
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Affiliation(s)
- Sabuj Kanti Mistry
- ARCED Foundation, Dhaka, Bangladesh
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - A. R. M. Mehrab Ali
- ARCED Foundation, Dhaka, Bangladesh
- Innovations for Poverty Action, New Haven, Connecticut, United States of America
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Center for Research Policy and Implementation, Biratnagar, Nepal
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, United States of America
| | - Md. Belal Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Manika Saha
- Action Lab, Department of Human-Centred Computing, Faculty of Information Technology, Monash University, Melbourne, Australia
| | - Sneha Sarwar
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Md. Mohibur Hossain Nirob
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Varalakshmi Chandra Sekaran
- Department of Community Medicine, Melaka Manipal Medical College (Manipal Campus) MAHE, Manipal, Karnataka, India
| | - Mark F. Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
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Roja VR, Narayanan P, Sekaran VC, Ajith Kumar MG. Living environment and health of under-five children in urban slums of a coastal region in South India. Ghana Med J 2021; 54:238-244. [PMID: 33883772 PMCID: PMC8042806 DOI: 10.4314/gmj.v54i4.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective The primary objective of the study was to determine the association between the living environment and morbidity, nutritional status, immunization status, and personal hygiene of under-five children living in urban slums in southern India. Methods This study included 224 mothers of under-five children living in urban slums of Udupi Taluk, Karnataka. A total of 17 urban slums were selected randomly using random cluster sampling. Results Undernutrition was high among children of illiterate mothers (63.8%), and the children of working mothers were affected by more morbidity (96.6%) as compared with housewives. Morbidity was also found to be high among children belonging to families with low incomes (66.1%) and low socio-economic backgrounds (93.1%). Safe drinking water, water supply, sanitation, hygiene, age of the child, mother's and father's education, mother's occupation and age, number of children in the family, use of mosquito nets, type of household, and family income were significantly associated with child morbidity, nutritional status, immunization status, and personal hygiene of under-five children living in urban slums. Conclusion Overall, in our study, family characteristics including parental education, occupation and income were significantly associated with outcomes among under-five children. The availability of safe drinking water and sanitation, and the use of mosquito nets to prevent vector-borne diseases are basic needs that need to be urgently met to improve child health. Funding Self-funded.
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Affiliation(s)
- V R Roja
- ICMR NTF HI project, Dept. of ENT & HNS, AIIMS Raipur, India
| | | | | | - M G Ajith Kumar
- Baby Memorial Hospital and Malabar Hospital, Calicut, Kerala, India
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11
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D'Souza B, Suresh Rao S, Hisham S, Shetty A, Sekaran VC, Pallagatte MC, G S, Suresh Rao T. Healthcare Delivery through Telemedicine during the COVID-19 Pandemic: Case Study from a Tertiary Care Center in South India. Hosp Top 2021; 99:151-160. [PMID: 33528313 DOI: 10.1080/00185868.2021.1875277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has necessitated medical centers across the world to deliver healthcare through telemedicine. We discuss the adoption, delivery of telemedicine services at a tertiary care center and patient satisfaction involving 456 patients in south India. Most respondents had sought telemedicine care at the department of Medicine (16.23%). The maximum satisfaction was reported by patients in OBG (100%). The responses were generally positive across all the age groups. The paper offers insights on best practices adopted at the center, lessons learnt, and provides recommendations for health care systems offering telemedicine during COVID-19 times.
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Affiliation(s)
| | - Shreyas Suresh Rao
- Department of Computer Science & Engineering, Sahyadri College of Engineering and Management, Mangalore, India
| | | | | | | | | | - Somu G
- Department of Hospital Administration, KMC Manipal, MAHE, Manipal, India
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12
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Rajesh C, Ashok L, Rao CR, Kamath V, Kamath A, Chandra Sekaran V. Predictors of psychological well-being among high school teachers: A cross-sectional study from Southern India. Indian J Community Health 2020. [DOI: 10.47203/ijch.2020.v32i04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background: Well-being is increasingly emerging as an important determinant of teacher effectiveness. Aim and objective: To assess the predictors of psychological well-being in Southern India. Settings and design: A cross-sectional study was conducted among 460 high school teachers from government and private schools in Udupi district. Methods and materials: Ryff’s psychological well-being scale (1989) was used. Statistical analysis used: Predictors were identified using logistic regression and p<0.05 was considered to be statistically significant Results: Autonomy, personal growth, positive relations, purpose in life and self-acceptance emerged as predictors of psychological well-being. Age predicted the subdomain of autonomy; number and age of children predicted environmental mastery; gender, monthly income and travelling time of teachers predicted the subdomain of self-acceptance among teachers. Conclusion: Teachers are an important resource whose psychological well-being has not received the attention it is due. An intervention program designed to fit their felt needs may be a step in the right direction.
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Chandra Sekaran V, Bailey A, Kamath VG, Ashok L, Kamath A. 'This is the place where I can be alone, no tension:' Photovoice evidence for adolescent perceptions of their microsystem and psychological adjustment. Asian J Psychiatr 2020; 51:102021. [PMID: 32315964 DOI: 10.1016/j.ajp.2020.102021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/05/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022]
Abstract
Adolescents experience myriad emotions which occur in relation to their immediate social space which may shape their perceptions of members within the microsystem. The photovoice method uniquely provides participants with the means to capture their life through the lens of a camera while also enabling them to express emotions and meanings they attach to their particular life situations. We explore the various emotions adolescents attach to the spaces they occupy and how they link them to socialization in the context of the microsystem. This study was conducted in rural and urban areas of Udupi taluk, southern India. A total of 21 participants, ranging from early to late adolescence participated and provided multiple forms of data with 112 photographs, 21 journals on their daily interactions and one-on-one interviews facilitated using the SHOWeD model. The analytical method involved compiling visual data from photographs, journal content and interview data pertaining to each participant as a single data file, developing codes using ATLAS.ti, version 8, and further developing sub-themes and themes as they emerged into narratives. Our study was able to elicit emotions and meanings that adolescents attached to social interactions with gendered nuances specific to the Indian cultural setting. Future applications of the photovoice methodology on research among adolescents have also been discussed.
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Affiliation(s)
- Varalakshmi Chandra Sekaran
- Department of Community Medicine, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India; Transdisciplinary Center for Qualitative Methods, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Ajay Bailey
- International Development Studies, Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, the Netherlands; Transdisciplinary Center for Qualitative Methods, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.
| | - Veena Ganesh Kamath
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Lena Ashok
- MSW Program, Department of Global Health, PSPH, Manipal Academy of Higher Education, Manipal, India
| | - Asha Kamath
- Department of Data Science, PSPH, Manipal Academy of Higher Education, Manipal, India
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Sekaran VC, Kamath VG, Ashok L, Kamath A, Hegde AP, Devaramane V. Parenting attitudes and dimensions as predictors of adolescent behavioural problems in the Indian context: A community-based study. Asian J Psychiatr 2020; 50:101941. [PMID: 32070886 DOI: 10.1016/j.ajp.2020.101941] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/23/2019] [Accepted: 02/08/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Adolescent behavioural problems are a growing public health concern. The authors in this study investigated paternal and maternal reports of parenting attitudes and dimensions as predictors of adolescent behavioural problems in the Indian context. MATERIALS AND METHODS Using stratified sampling at the community level, 640 parents including 419 mothers and 221 fathers participated in the study. Tools included a socio-demographic pro-forma; Parental attitude inventory (PAI) to assess parenting attitudes, Parent Global Report of the Alabama Parenting Questionnaire (APQ) to assess current parenting dimensions, and the parent version of the Strengths and Difficulties Questionnaire (SDQ) to assess behavioural problems among adolescents. We examined the prevalence and predictors of total difficulties, externalizing and internalizing behavioural problems among adolescents from paternal and maternal reports. RESULTS Paternal and maternal reports of total difficulties (11.3 %, 13.6 %), externalizing (2.3 %, 1.9 %) and internalizing behaviours (8.6 %, 7.4 %) among adolescents are reported. Predictors of abnormal behaviours per paternal reports included lower social class and poor paternal control. Being a male adolescent increased the odds of total difficulties and externalizing problems. Favourable maternal attitude, good maternal warmth and control predicted the reduced likelihood of total difficulties and externalizing behaviours per maternal reports. Paternal control and maternal warmth and control were found to reduce the likelihood of internalizing behaviours among adolescents. CONCLUSION Maternal attitude, paternal control and maternal warmth and control dimensions emerged as significant predictors of total difficulties, externalizing and internalizing behavioural problems among adolescents.
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Affiliation(s)
- Varalakshmi Chandra Sekaran
- Community Medicine, Melaka Manipal Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Veena Ganesh Kamath
- Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
| | - Lena Ashok
- Public Health (MSW Program), Prasanna School of Public Health (PSPH), Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Asha Kamath
- Department of Data Science, Prasanna School of Public Health, (PSPH), Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Asha P Hegde
- Paediatrics, Melaka Manipal Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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Tamang MK, Yadav UN, Hosseinzadeh H, Kafle B, Paudel G, Khatiwada S, Sekaran VC. Nutritional assessment and factors associated with malnutrition among the elderly population of Nepal: a cross-sectional study. BMC Res Notes 2019; 12:246. [PMID: 31039794 PMCID: PMC6492417 DOI: 10.1186/s13104-019-4282-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 04/25/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives This study aimed at assessing the nutritional status among the elderly population and factors associated with malnutrition in the community setting in rural Nepal. Results Out of 339 participants, 24.8% (95% CI 20.21–29.30) fell into the normal nutritional status range; 49.6% (95% CI 44.29–54.91) were at risk for malnutrition while 24.8% (95% CI 20.21–29.30) were in the malnourished range, based on Mini Nutritional Assessment scores. Our findings revealed that belonging to a Dalit community, being unemployed, having experience of any form of mistreatment, lack of physical exercise, experiencing problems with concentration in past 30 days and taking medication for more than one co-morbidity was significantly associated with the malnutrition status of the elderly.
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Affiliation(s)
- Man Kumar Tamang
- Department of Nutrition and Dietetics, Central Campus of Technology, Tribhuvan University, Dharan, Nepal
| | - Uday Narayan Yadav
- Forum for Health Research and Development, Dharan, Nepal. .,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | - Hassan Hosseinzadeh
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Bharat Kafle
- Central Department of Population Studies, Tribhuvan University, Kirtipur, Bagmati, Nepal
| | - Girish Paudel
- Forum for Health Research and Development, Dharan, Nepal
| | - Saroj Khatiwada
- School of Medical Sciences, University of New South Wales, Sydney, Australia
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Chandra Sekaran V, Kamath VG, Ashok L, Kamath A, Hegde AP, Devaramane V. Role of Micro- and Mesosystems in Shaping an Adolescent. J Nepal Paedtr Soc 2018. [DOI: 10.3126/jnps.v37i2.18307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Adolescence is a vulnerable period in an individual’s life during which several physiological and psychological changes occur. Increasingly, across the globe, there is increasing incidence of mental health and behavioural problems documented, especially among the youth. The WHO states that mental health conditions and delinquent behaviours contribute significantly to the global disease burden. The transition from adolescence to adulthood is also marked by increasing manifestation of emotional and behavioural disorders with first episodes making their appearance in early adolescence. This review attempts to delve into the influence of microsystem and mesosystems as described by Bronfenbrenner on adolescent behaviours.
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Abstract
BACKGROUND Early recognition of mental health problems gives an individual the opportunity for better long-term outcomes if intervention is initiated early. Mental health literacy is a related concept which is increasingly seen as an important measure of the awareness and knowledge of mental health disorders. AIM AND OBJECTIVES This study aimed at assessing the mental health literacy, help-seeking behavior and beliefs and attitudes related to mental illnesses among adolescents attending preuniversity colleges. MATERIALS AND METHODS A cross-sectional study was conducted among randomly selected preuniversity college students (n = 916). Data were collected through self-administered questionnaires. Data were computed using STATA. Analysis and interpretation were carried out using descriptives and Chi-square test. RESULTS Of the 916 respondents, 54.15% were male while 45.85% were female. The majority (78.60%) of the respondents ascribed to the Hindu religion, hailed largely from rural areas (57.21%) and were mostly studying in the 11(th) standard (72.49%). The percentage of mental health literacy among the respondents was very low, i.e., depression was identified by 29.04% and schizophrenia/psychosis was recognized by 1.31%. The study findings indicate that adolescents preferred reaching out more to informal sources including family members such as mothers than formal sources for self than for others indicating deeply prevalent stigmatizing attitudes toward mental health conditions. CONCLUSIONS There is a need for immediate improvement in the knowledge of adolescents on mental health literacy which suggests that programs need to be developed such that adolescents can seek help from valid resources if the need were to arise and have appropriate knowledge on whom to approach for help.
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Affiliation(s)
| | | | - Sreekumaran Nair
- Department of Biostatistics, Manipal University, Manipal, Karnataka, India
| | - Lena Ashok
- Department of Public Health, Manipal University, Manipal, Karnataka, India
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Thapa P, Kamath R, Shetty BK, Monteiro A, Sekaran VC. Prevalence and Associated Factors of Alcoholism among Tuberculosis Patients in Udupi Taluk, Karnataka, India: A Cross Sectional Study. J Nepal Health Res Counc 2014; 12:177-181. [PMID: 26032055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Tuberculosis (TB) is a major public health problem in India. Several studies carried out in India have shown alcoholism as a risk factor for tuberculosis mortality, factor for default in TB and reason for non-compliance under the Revised National Tuberculosis Control Program (RNTCP). The aim of this study was to assess the prevalence, pattern and associated factors of alcohol use among tuberculosis patients in Udupi taluk, Karnataka, India. METHODS A cross-sectional study was conducted with the complete enumeration of all the cases undergoing Directly Observed Treatment Short-course (DOTS) treatment in Primary Health Centre and Community Health Centre of Udupi taluk from March to April 2013. Interview was conducted to obtain the socio-demographic and health information and participants were screened using WHO developed Alcohol Use Disorders Identification Test (AUDIT) for alcohol use. RESULTS Out of 123 participants, 78% were males, 86.2% were Hindu, 79.7% were married and 88.6% were from low socio-economic status. About 20.3% (n=25) participants were alcoholic. Among them, 44% were low risk drinkers, 32% were hazardous drinkers, 4% were harmful drinkers and 20% were alcohol dependent. Age, sex, occupation, tobacco use, perceived health status and discrimination due to tuberculosis positive status were significantly associated with alcohol use. On logistic regression sex, tobacco use, perceived health status and facing discrimination due infection with tuberculosis were found to be factors associated with alcohol use. CONCLUSIONS This study found a high prevalence of alcoholism among tuberculosis patients which is of concern and has to be addressed.
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Affiliation(s)
- P Thapa
- Department of Public Health, Manipal University, Manipal, India
| | - R Kamath
- Department of Public Health, Manipal University, Manipal, India
| | - B K Shetty
- Department of Public Health, Manipal University, Manipal, India
| | - A Monteiro
- Department of Statistics, Manipal University, Manipal, India
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