Prevalence, patterns, and determinants of body image dissatisfaction among female undergraduate students of University of Delhi.

Background: Body image is an essential aspect of young girls' self-definition and individual identity and is influenced by multitude of factors including cultural, social, cognitive, affective, and biological. In recent times, excessive concern about the body image has been reported and the prevalence of body image dissatisfaction (BID) has increased among adolescent and young girls. Objectives: The objective of this study was to estimate the prevalence of BID, its pattern and the factors associated with it among female undergraduate students and also to assess the level of concern about their body image. Methods: This cross-sectional study was conducted among 180 female undergraduate students using a contour drawing rating scale and a body shape questionnaire to assess BID and its pattern, and the level of concern about body image, respectively. Binary logistic regression was applied to identify the factors determining body image perception. Results: The prevalence of body mage dissatisfaction was 76.7% with overweight and obesity, and media influences being significantly associated with it. Nutritional status, mother's educational status, and media influences were the determinants. Body shape concerns were found among 30.6% of the participants out of which 7.3% reported marked to moderate concerns. Conclusions: Our findings highlighted a higher prevalence of perceived dissatisfaction with the body image and also that it is not simply the outcome of sociocultural pressure to conform to a certain body type but is the result of a complex interaction between individual differences in actual body mass and preference for a thin body ideal.

Relationship of eating behavior and self-esteem with body image perception and other factors among female college students of University of Delhi.

BACKGROUND: Eating disorders (EDs) can lead to life-threatening nutritional deficiencies whereas self-esteem influences interpersonal relationships and academic performance. Excessive concerns about body image resulting in body dissatisfaction not only affect psychological well-being but also predisposes to disordered eating behaviors. The objective of this study is to assess the eating behavior and level of self-esteem, their relationship with body image perception and also identify factors associated with them among undergraduate female college students. MATERIALS AND METHODS: This cross-sectional study was conducted among 180 female undergraduate students of University of Delhi. Sociodemographic characteristics and anthropometric measurements were recorded. Eating Attitude Test-26, Rosenberg Self-esteem Scale, Contour Drawing Rating Scale and Body Shape Questionnaire 34 were used to assess eating behavior, self-esteem, body image dissatisfaction and body shape concerns, respectively. Both descriptive and inferential statistics were used and binary logistic regression was applied to identify the factors determining high risk eating behavior and low self-esteem. RESULTS: In this study, 27.8% of the study participants were overweight or obese, 30.6% had body shape concerns and 76.7% had body image dissatisfaction. Significant proportion (13.9%) of the participants was identified as high risk for the development of EDs and having low self-esteem (12.8%). Body shape concern and family influences were significant predictors of high risk eating behavior whereas type of college and family influences significantly predicted low self-esteem. CONCLUSIONS: The study concluded that factors such as nutritional status, family influences, type of college and body shape concerns lead to high risk eating behavior and low self-esteem. These findings will help in creating awareness on importance of concept of positive body image, healthy weight control behaviors and in developing future interventions.

Assessment of health-related quality of life in cancer patients undergoing treatment using Health Utilities Index (HUI-3®) in East Delhi, India.

Background: Health-related quality of life (HRQOL) is a construct that focuses on the capacity for living afforded by the health status of a patient. Measurement of HRQOL allows a composite estimation of the capacity for living of a patient and can help capture the suffering experienced by the patient due to adverse effects of therapeutic interventions. This study was conducted to understand the health-related quality of life of cancer patients undergoing various modalities of treatment to generate evidence source for need-based intervention, to assess patients diagnosed with cancers, using Health Utilities Index - 3 (HUI-3®) and assign them single-score values to gauge HRQOL and to measure the various domains of HRQOL and change in HRQOL after a period of three months of treatment. Methods: A descriptive, longitudinal study was conducted amongst patients aged more than 18 years, who were diagnosed with cancer at a tertiary care multispecialty hospital in New Delhi. They were administered a standardized HUI-3 Questionnaire® and their responses were recorded, simultaneously. Statistical significance for change in HRQOL score was assessed with paired t-test. Multivariate linear regression was used to identify the various correlates of HRQOL. Results: The mean (± standard deviation) overall HRQOL score for all participants was 0.71 (± 0.262) [range=-0.09 to 1.00]. A follow-up assessment was carried out after three months and changes in health scores were subsequently recorded. A significant decrease in mean overall HRQOL score was seen for the entire group after three months of having been administered treatment. Single-attributes of emotion and ambulation were maximally affected amongst cancer patients after three months of treatment. On linear regression analyses, baseline HRQOL was a significant correlate of HRQOL at follow-up after three months. Conclusion: ">Addressing the HRQOL of a cancer patient before starting treatment would address morbidity that might be present even after three months.

Module to facilitate self-directed learning among medical undergraduates: Development and implementation.

CONTEXT: Currently, self-directed learning (SDL) is emphasized in medical institutions all over the world. The skills of SDL enable one to be a lifelong learner, a necessity to cope up with fast-expanding medical knowledge. AIMS: This study aims to develop and implement an "SDL" module for medical undergraduates and find out their perception about the same. SETTINGS AND DESIGN: A cross-sectional study using a mixed-method design (having both qualitative and quantitative components) was conducted in the Department of Community Medicine, UCMS, Delhi, India. METHODS: A module was developed following an extensive literature review and focus group discussions with the teaching staff of the institute. First-semester undergraduate students were invited to participate in the study and asked for feedback using a semi-structured questionnaire. STATISTICAL ANALYSIS: Quantitative data were expressed in mean, range, and frequency. For qualitative data, thematic analysis was performed. RESULTS: The module was implemented with 160 students, in November for 10 hour distributed over 5 weeks. Feedback could be obtained from 130 students. Sixty-seven percent of students were satisfied and 66% reported as motivated to study the allotted topic further. Qualitative analysis showed that though the students liked the learning process based on this module, they also felt facilitators could have been more active in imparting knowledge and skills. CONCLUSIONS: To make learners equipped with the ability to learn throughout a professional learning course, SDL as a learning tool should be introduced in the medical undergraduate curriculum.

Socioclinical profile of patients seeking treatment for cancer in a Teaching hospital in east Delhi, India.

BACKGROUND: Prevalence of cancer in urban India is seeing a discernible increase due to lifestyle modifications and adverse environmental exposures. The pattern of cancer incidence varies from one region to another within a large country like India. AIM AND OBJECTIVES: This study was conducted to understand the socioclinical profile of the patients attending a tertiary care hospital in east Delhi for the treatment of cancer. METHODS: Patients above the age of 18 years, who had been diagnosed with cancer, were recruited for our study and their socioclinical details were elicited. After 3 months they were reassessed and their treatment and side-effect profile were studied. RESULTS: Majority of our patients were diagnosed with cancers of the oral cavity and were married men in age group of 40-60 years, residing in the National Capital Region. Patients diagnosed with breast cancer were more likely to receive chemotherapy and suffer from side effects of treatment like nausea, anorexia, and loss of weight. CONCLUSION: Physicians need to be aware of these complications and should incorporate a proper counselling mechanism before treatment is started in such patients. Family physicians play a defining role in the palliative management since he remains a trusted face in his community and can provide professional and psychotherapeutic support.

Quality of routine immunization service: Perception of clients.

BACKGROUND: Immunization prevents over 2-3 million deaths each year worldwide. In India, even though vaccines are offered free of cost at public health facilities the coverage remains low. Limited scrutiny has been conducted at health service and client interface for routine immunization (RI) services, which may have been affecting the acceptance of vaccines. This emphasizes the importance of assessing the level of satisfaction and perceived quality of clients regarding RI services. OBJECTIVES: This study aimed to assess the perceived quality and level of overall general satisfaction with RI services of clients. In addition, determine the association of factors influencing clients perceived quality and overall general satisfaction with RI services. METHODS: A community-based cross-sectional study was conducted in an urbanized village of Delhi from November 2015 to April 2017. A total of 279 RI visits were covered in the study, and the clients were interviewed at their residence using a pretested tool. RESULTS: The dissatisfaction toward the domains of perceived quality of RI services was reported to be 3.2% for vaccine availability, 9.7% for vaccine information, 3.2% for staff behavior, 6.1% for doctor behavior, and 7.5% for infrastructure. Multivariable-regression analysis indicated that distance to health facility, literacy and age of the client, doctor behavior, staff behavior, and infrastructure had an effect on overall general satisfaction of client toward RI services. CONCLUSIONS: The client's perception is multidimensional; improvement in one domain is likely to strengthen the other. By understanding the client's perspective toward quality of RI service, the health-care mangers may improve the level of overall satisfaction.

Understanding the emerging and reemerging terminologies amid the COVID-19 pandemic.

Coronavirus disease (COVID-19) has been declared as a Public Health Emergency of International Concern by the World Health Organization (WHO). During this phase of the health crisis posed by the COVID-19 pandemic, news in print, electronic as well as the social media is abuzz with several emerging and reemerging terminologies. Some of them, such as "social distancing," "infodemic," "flattening the curve," "quarantine," "cluster containment," and others were not in routine use but have suddenly reemerged and become the key toward understanding the disease and its prevention. Many of these terms have been a part of public health strategies used for centuries for containment of the spread of infectious diseases. These terms span across social, epidemiological, and administrative contexts concerning the COVID-19 pandemic. Our article aims to present a better understanding of the meaning and origin of these terms and their application in the context of the current pandemic based on a review of the available literature such as chapters from textbooks, published guidelines of the WHO and Centre for Disease Control and Prevention (CDC) and published articles in journals and newspapers through a comprehensive search of the electronic database in English.

Diabetes self care activities among adults 20 years and above residing in a resettlement colony in East Delhi.

BACKGROUND: Self-care activities are the cornerstone of diabetes care that ensures patients participation to achieve optimal glycemic control and to prevent complications. OBJECTIVE: The aim of this study is to find the level of self-care activities among diabetics aged ≥20 years residing in a resettlement colony in East Delhi and its association with sociodemographic factors, disease, and treatment profile. METHODS: Using cross-sectional survey, 168 known diabetic patients were selected from Nand Nagri, a resettlement colony in East Delhi. Data were collected using Hindi translation of revised version-Summary of Diabetic Self Care Activities along with a pretested semi-open-ended questionnaire. Self-care was assessed on six parameters as follows: (a) general diet, (b) specific diet, (c) exercise, (d) blood sugar testing, (e) foot-care, and (f) smoking. The study period was from November 2014 to April 2016. RESULTS: Nearly 35.1% of respondents belonged to 60-69 years age group. About 52.4% of respondents were female. Fifty-two diabetics (31%) reported having practised diet control on all 7 days in the past 1 week. Nearly 39.3% of patients did not perform any physical activity. The blood test was not practised by 92.3% of respondents. Foot-care was practised by only 19% of patients. There was a significant association between general diet among diabetics with family support (P = 0.020), place of diagnosis (P = 0.033), and treatment funds (P = 0.017). The exercise score among diabetics who were below the poverty line was higher than those above poverty line (P = 0.029). Younger age (P = 0.005) and treatment with insulin (P = 0.008) were positively associated with blood glucose testing. The foot-care practice was better in patients aware of complications and foot-care practices (P < 0.001). CONCLUSION: Self-care activities among diabetic patients were very poor. Self-management educational programs at hospitals along with information, education, and communication activities at the community level and one-to-one counseling are recommended.

Awareness of cervical cancer and willingness to participate in screening program: Public health policy implications.

BACKGROUND: Cervical cancer is one of the most common malignancies among women in India. There is a high mortality as patients usually present at an advanced stage because of lack of awareness and nonexistent screening programs. AIM: This study was planned to find out awareness about cervical cancer among women and their willingness to utilize screening services in an urban resettlement colony of Delhi, India. SETTINGS AND DESIGN: A community-based, cross-sectional study was carried out in a resettlement colony of North-West Delhi. MATERIALS AND METHODS: Semi-structured interview schedule was used to collect information regarding different aspects of cervical cancer. Analysis was done using SPSS package (SPSS version 16 (UCMS and GTBH, Delhi, India)). RESULTS: A total of 373 women were included in the study. Mean age of study participants was 39.14 years. Two-third of the study population were illiterate. Half of the study population was aware of cervical cancer, and only one-fourth of population were willing to participate in a screening test. Willingness was higher among educated, ever user of family planning method and having knowledge about at least one risk factor, signs or symptoms, or possibility of early diagnosis of cancer cervix. CONCLUSIONS: The country's national program advocates for opportunistic and targeted screening of women. An understanding of the factors that influences womens' willingness to participate in screening program is essential for the success of such programs. Hence, this study emphasizes the need for dissemination of knowledge about various aspects of cancer cervix which is critical for uptake of any screening program in a developing country.