RESUMO
BACKGROUND: In the densely populated slums of Kolkata, informal healthcare providers' (IHP) diarrhea-related knowledge and rationality of practices should be improved to reduce risk of adverse outcome, expenditure, and antimicrobial resistance. METHODS: A multicomponent intervention was conducted among 140 representative IHPs in the slums of 8 wards in Kolkata to assess its impact on their diarrhea-related knowledge and practice. Six intervention modules in local languages were provided (1 per month) with baseline (Nâ =â 140) and postintervention (Nâ =â 124) evaluation. RESULTS: Mean overall (61.1 to 69.3; Pâ <â .0001) and domain-specific knowledge scores for etiology/spread (5.4 to 8.1; Pâ <â .0001), management (6.4 to 7.2; Pâ <â .0001), and oral rehydration solution ([ORS] 5.7 to 6.5; Pâ <â .0001) increased significantly (at αâ =â 0.05) after intervention and were well retained. Impact on knowledge regarding etiology/spread (adjusted odds ratio [aOR]â =â 5.6; Pâ <â .0001), cholera (aORâ =â 2.0; Pâ =â .0041), management (aORâ =â 3.1; Pâ <â .0001), ORS (aORâ =â 2.3; Pâ =â .0008), and overall (aORâ =â 4.3; Pâ <â .0001) were significant. Intervention worked better for IHPs who practiced for ≥10 years (aORâ =â 3.2; Pâ <â .0001), untrained IHPs (aORâ =â 4.8; Pâ <â .0001), and pharmacists (aORâ =â 8.3; Pâ <â .0001). Irrational practices like empirical antibiotic use for every cholera case (aORâ =â 0.3; Pâ <â .0001) and investigation for every diarrhea case (aORâ =â 0.4; Pâ =â .0003) were reduced. Rationality of testing (aORâ =â 4.2; Pâ <â .0001) and antibiotic use (aORâ =â 1.8; Pâ =â .0487) improved. CONCLUSIONS: Multicomponent educational intervention resulted in sustainable improvement in diarrhea-related knowledge and practices among IHPs in slums of Kolkata. Policy implications should be advocated along with implementation and scale-up.
Assuntos
Cólera , Diarreia , Conhecimentos, Atitudes e Prática em Saúde , Áreas de Pobreza , Cólera/diagnóstico , Cólera/tratamento farmacológico , Cólera/prevenção & controle , Efeitos Psicossociais da Doença , Diarreia/diagnóstico , Diarreia/tratamento farmacológico , Diarreia/prevenção & controle , Humanos , Higiene , Saneamento , Abastecimento de ÁguaRESUMO
Herein, we report that borazine (B3N3H6), alternatively known as inorganic benzene, has the tantalizing potential to act as a multifunctional molecular spin diode with a significantly large spin valve action. The present computational foray into the multifunctionality of (B3N3H6)n=1-4 as a simultaneous spin diode and spin valve has been rationalized by the current rectification ratio with a maximum value of 34 for the tetramer and large tunneling magneto-resistance in the range of 50-100%, respectively. Remarkably, both the properties are evolved due to a single parameter, namely, the electrodes [Fe(100)] surface spin orientation induced charge density localization/delocalization in the singly occupied highest molecular orbital in the Fe(100)-(borazine)n=1-4-Fe(100) system.