Self-Directed Learning, A Guide for Learners and Teachers

Systematic Review and Meta-Analysis of Epidemiology of Internet Addiction

Rabies is a zoonotic, fatal and progressive neurological infection caused by rabies virus of the genus Lyssavirus and family Rhabdoviridae. It affects all warm-blooded animals and the disease is prevalent throughout the world and endemic in many countries except in Islands like Australia and Antarctica. Over 60,000 peoples die every year due to rabies, while approximately 15 million people receive rabies post-exposure prophylaxis (PEP) annually. Bite of rabid animals and saliva of infected host are mainly responsible for transmission and wildlife like raccoons, skunks, bats and foxes are main reservoirs for rabies. The incubation period is highly variable from 2 weeks to 6 years (avg. 2-3 months). Though severe neurologic signs and fatal outcome, neuropathological lesions are relatively mild. Rabies virus exploits various mechanisms to evade the host immune responses. Being a major zoonosis, precise and rapid diagnosis is important for early treatment and effective prevention and control measures. Traditional rapid Seller's staining and histopathological methods are still in use for diagnosis of rabies. Direct immunofluoroscent test (dFAT) is gold standard test and most commonly recommended for diagnosis of rabies in fresh brain tissues of dogs by both OIE and WHO. Mouse inoculation test (MIT) and polymerase chain reaction (PCR) are superior and used for routine diagnosis. Vaccination with live attenuated or inactivated viruses, DNA and recombinant vaccines can be done in endemic areas. This review describes in detail about epidemiology, transmission, pathogenesis, advances in diagnosis, vaccination and therapeutic approaches along with appropriate prevention and control strategies.

https://tandfonline.com/doi/pdf/10.1080/01652176.2017.1343516

Rabies – epidemiology, pathogenesis, public health concerns and advances in diagnosis and control: a comprehensive review

Inappropriate feeding practice increases risk of under nutrition, illness, and mortality amongst children less than 2 years of age. The objective of this study is to assess minimum dietary diversity, meal frequency and its associated factors among infant and young children aged 6–23 months in Dangila Town, Northwest Ethiopia. A community based cross sectional study was conducted. Simple random sampling technique was used to select study participants. Interviewer administered questionnaire were used. Bivariate and multivariable logistic regression analyses was employed to identify factors associated with minimum dietary diversity and meal frequency. A total of 920 children 6–23 months were included. Proportion of children who met the minimum dietary diversity and meal frequency was 12.6 and 50.4 %, respectively. Mothers education [AOR =2.52], age of a child [AOR = 2.05], birth order of index child [AOR = 2.08], living in urban area [AOR = 2.09], having home gardening [AOR = 2.03], and media exposure [AOR = 2.74] were positively associated with dietary diversity. Moreover, age of the child [AOR = 3.03], birth order of index child [AOR = 1.58], mothers involvement in decision making [AOR = 1.51], media exposure [AOR = 2.62], and having postnatal visit [AOR = 2.30] were positively associated with meal frequency. The proportion of children who received minimum dietary diversity and meal frequency was low. Being at younger age, first birth order, and lack of media exposure affect both dietary diversity and meal frequency. Increasing mother’s education, home gardening, mass media promotion and empowering women in decision making are highly recommended to increase dietary diversity and meal frequency.

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Dietary diversity, meal frequency and associated factors among infant and young children in Northwest Ethiopia: a cross- sectional study.

Purpose This review aimed to synthesise some of the extant work on the use of entrustable professional activities (EPAs) for postgraduate physicians, to assess the quality of the work and provide direction for future research and practice. Method Systematic searches were conducted within five electronic databases (Medline, Scopus, Web of Science, PsycINFO and CINAHL) in September 2018. Reference lists, Google Scholar and Google were also searched. Methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Results In total, 49 studies were included, classified as Development of EPAs (n = 37; 76% of total included), Implementation and/or assessment of EPAs (n = 10; 20%), or both (n = 2; 4%). EPAs were described for numerous specialties, including internal medicine (n = 14; 36%), paediatrics (n = 8; 21%) and psychiatry (n = 4; 10%). Of the development studies, 92% utilised more than one method to generate EPAs. The two most commonly used methods were developing initial EPAs in a working group, (n = 27; 69%) and revising through deliberation (n = 21; 54%). Development papers were of variable quality (mean QATSDD score = 20, range 6-41). Implementation and assessment studies utilised methods that included observing trainee performance (n = 6; 50%) and enrolling trainees in competency-based curricula, which included EPAs (n = 4; 33%). The methodological quality of these implementation studies varied (mean QATSDD score = 19.5, range = 6-32). Conclusions This review highlighted a need for: (i) consideration of best practice guidelines for EPA development; (ii) focus on the methodological quality of research on EPA development and of EPAs, and (iii) further work investigating the implementation of EPAs in the curriculum.

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A systematic review of 7 years of research on entrustable professional activities in graduate medical education, 2011-2018

A cross sectional study was conducted to study the diet pattern of children less than 2 years with regard to certain infant and young child feeding (IYCF) indicators. A total of 374 children less than 24 months of age coming to the immunization clinic were studied using a standard pretested and prevalidated questionnaire. Exclusive breastfeeding was followed by 57.1% of children under 6 months of age. Minimum dietary diversity, minimum meal frequency, and minimum acceptable diet were seen adequate in 32.6%, 48.6%, and 19.7% of children between 6 months and 2 years of age, respectively.

A study on infant and young child feeding practices among mothers attending an urban health center in East Delhi.

Introduction: Internet addiction (IA) is an emerging phenomenon among the youth of India. It has been found to be associated with mental health problems. This study was therefore conducted to find out the burden of IA among college students in Delhi, its risk factors and association with depression, anxiety, and stress. Methods: A cross-sectional study was conducted, with face-to-face interviews, among the nonprofessional college students of the University of Delhi. Simple random sampling was used to select the students from the list obtained from the three colleges. Young's IA test scale and depression, anxiety, and stress short scale were used to measure IA and the mental health correlates, respectively. Chi-square tests were applied for testing the association of IA with the sociodemographic variables, the variables related to internet usage patterns, and the mental health variables. Independent predictors were determined using logistic regression modeling. Results: The prevalence of IA was 25.3%. The mean (standard deviation) age of the participants was 19.1 (1.02) years and 62.1% were males. The median family income was INR 50,000. IA was significantly associated with higher family income, greater screen time, always online status, and greater duration of internet use per week. The independent predictors of IA were greater duration of internet use per week and always online status, depression, anxiety, and stress. Conclusion: The burden of IA among the college students was high. depression, anxiety, and stress were found to be independent predictors of IA.

Internet addiction and its mental health correlates among undergraduate college students of a university in North India.

Determinants of delay in initiating post-exposure prophylaxis for rabies prevention among animal bite cases: hospital based study.

Background: Depression is the most common geriatric psychiatric disorder. Other than organic, socio‑demographic factors, have been found to play an important role in mental health. In this study we evaluated the association of some socio‑de mographic factors with geriatric depression Methods: A cross‑sectional study was carried out in the Out Patient Department registration area of a tertiary care teaching hospital in Delhi. Questionnaire based interviews were conducted among the elderly people visiting the hospital. A 15‑item geriatric depression scale‑Hindi was used to assess depression. Results: Six hundred and seventy eight subjects were interviewed. The age of the subjects ranged from 65 to 85 years. About three‑fourth of the study population were males. About 61.4% scored positive for depression. Multiple logistic regression analysis revealed that the following were significant (P<0.05) independent predictors of depression: Higher age, low educational status, financial dependence and presence of any chronic health problem. Conclusions: The present study found that the prevalence of depression among the study subjects was high. Also the independent risk factors found in this study need to be targeted in formulating mental health policy for geriatrics.

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Amir Maroof Khan

Papers

A study on infant and young child feeding practices among mothers attending an urban health center in East Delhi.

Internet addiction and its mental health correlates among undergraduate college students of a university in North India.

Determinants of delay in initiating post-exposure prophylaxis for rabies prevention among animal bite cases: hospital based study.

Socio-demographic Predictors of Depression among the Elderly Patients Attending Out Patient Departments of a Tertiary Hospital in North India.

R-software: A Newer Tool in Epidemiological Data Analysis.