Effectiveness of selected small group teaching methods for undergraduate medical students on basic concepts of epidemiology: A quasi-experimental study.

BACKGROUND: Teaching epidemiology to young medical students using traditional teaching techniques is fraught with myriad challenges. Incorporating innovative small group teaching (SGT) approaches that promote active learning, practical application, and critical thinking can help in overcoming these challenges. AIM/OBJECTIVE: To identify the most effective SGT method from selected three approaches [tutorial technique (TT), problem-based learning (PBL), and fishbowl technique (FBT)] to teach the basic concepts of epidemiology to the third-year undergraduate medical students of a private medical college in Puducherry, Southern India. MATERIALS AND METHODS: A quasi-experimental study was conducted among third-year undergraduate medical students for 6 months. The sample size was calculated to be 60 using the nMaster 2.0 sample size software. Three groups were formed with 20 students each. A pre-test, which included fifty multiple-choice questions covering topic one, was conducted for students in all three groups. An SGT session on topic one (dynamics of disease transmission) was held on the same day by different facilitators for three groups A, B, and C using the TT, PBL, and FBT, respectively. After 6 weeks of the SGT session for topic one, a post-test using the same questions was organized for all three groups to identify the effectiveness of each SGT method. The above sequence of events was followed for topic two (study designs) and topic three (investigation of disease outbreak) among all groups in the subsequent months. A written informed consent was sought from all students. The collected data was entered in MS Excel 2010 and analyzed using SPSS 21. The pre- and post-tests for all topics in all three groups were compared using a paired t-test, and an ANOVA test was used to find any difference between the groups. RESULTS: The mean post-test score in each of the three groups for all topics had improved when compared with the mean pre-test score, which was significantly different between the three groups. Further, the mean score of group B (PBL group) was found to be higher than group C (FBT) but not significantly higher compared to group A (TT). The mean score of the feedback where the participants were asked to rate the overall session was found to be high in group B (PBL) followed by group A (TT). CONCLUSION: PBL and TT were found to be an equally effective way of small group methods for teaching-learning epidemiology in medical school.

Effectiveness of a multimodal intervention in promoting physical activity among sedentary elderly population in socially and economically constrained settings - A quasi-experimental study.

Introduction: Aging is becoming a major challenge for policymakers. Regular exercise helps keep elderly people mobile, enhances physical and mental abilities, and to some extent delays the effects of chronic illnesses. Objectives: To evaluate the effectiveness of a multimodal intervention to increase physical activity levels among sedentary elderly living in socially and economically constrained settings. Materials and Methods: A quasi-experimental study was conducted in selected old age homes in Puducherry, South India in 2022 for 3 months. Individuals aged ≥60 years, both genders residing in selected old-age homes were included through convenience sampling. The sample size was 36 subjects per arm [three arms namely E1, E2 (intervention arms), and C (control arm)]. Baseline data collection on physical activity was collected using a semi-structured questionnaire in all three arms. The intervention arms (E1 and E2) received a multimodal intervention to promote physical activity. In addition, E1 arms were instructed to perform exercises with an "exercise partner" and to maintain a daily log. At the end of 8 weeks, follow-up data collection was done using the same questionnaire in all three arms. Data entry was done by MS Excel 2010 and analysis using SPSS version 21. Results: The mean (SD) of the days of physical activity per week and time of physical activity per day before and after the intervention among E1 and E2 were compared using paired t-tests. The difference between pre- and post-intervention was found to be statistically significant, that is, P value <0.05 in both the groups, thereby proving the effectiveness of the intervention. The difference between the three groups was found to be statistically significant, that is, P value <0.05. Conclusion: This multimodal intervention is found to be effective in increasing the physical activity of the participants in the interventional arms. Furthermore, having an exercise partner was found to be beneficial in ensuring motivation and compliance to carry out physical activity among the elderly living in socially and economically constrained settings.

Early Preventive Strategies and CNS Meningioma - Is This Feasible? A Comprehensive Review of the Literature.

BACKGROUND: Meningiomas are one of the most common benign primary brain tumors; however, there is a paucity of literature on potential preventability. This comprehensive review aimed to explore the existing evidence for the potential risk factors that may contribute to meningioma development and to discuss early prevention strategies. METHODS: Literature search was conducted via MEDLINE, Embase, Web of Science, and Cochrane Database to retrieve existing literature on various environmental exposures and lifestyle behaviors that are potential risk factors for the development of meningiomas. RESULTS: Significant risk factors included exposure to ionizing radiation and certain environmental chemicals. Notably, this study also identified that cigarette smoking and obesity are associated with the development of meningiomas. To date, wireless phone usage, hormonal exposures, dietary factors, and traumatic brain injury remain inconclusive. Early prevention strategies should primarily be family-driven, community-based, and public health-endorsed strategies. Targeting unhealthy behaviors through healthcare organizations could execute a pivotal role in the maintenance of an optimum lifestyle, reducing the development of risk factors pertinent to meningiomas. CONCLUSIONS: To our knowledge, this is the first study that offers a perspective on prevention of meningiomas. A causal relationship of risk factors in developing meningiomas cannot be directly established with the current evidence. We are aware of the limitations of the hypothesis, but we believe that this study will raise more awareness and our findings could potentially be endorsed by organizations promoting health across the globe. Further prospective and retrospective studies will shed more light on this topic and help establish a definitive relationship.

Group Antenatal Care: A Paradigm Shift to Explore for Positive Impacts in Resource-poor Settings.

The delivery of high-quality antenatal care is a perennial global concern for improving maternal and neonatal outcomes. Antenatal care is currently provided mainly on a one-to-one basis, but growing evidence has emerged to support the effectiveness of group antenatal care. Providing care in a small group gives expectant mothers the opportunity to have discussions with their peers about certain issues and concerns that are unique to them and to form a support system that will improve the quality and utilization of antenatal care services. The aim of this article is to promote group antenatal care as a means to increase utilization of healthcare.

Cardiac surgery-associated acute kidney injury in a developing country: Prevalence, risk factors and outcome.

Little is known about cardiac surgery-associated acute kidney injury (CS-AKI) in children in developing regions of the world. The study aimed to determine the prevalence of CSAKI, associated factors and its impact on mortality and utilization of hospital services. The hospital records of children aged 0-17 years who underwent CS at an Indian hospital were reviewed. CS-AKI was defined as a rise in serum creatinine of ≥0.3 mg/dL in any 48 h and or by urine output <0.5 mL/kg/h for an 8-h period in the first five days after CS. The study included 323 children with a median age of one year (0.04-17), of whom 22 (6.8%) were neonates and 18.3% had a single ventricle. About 60% of the children had Risk Adjusted Congenital Heart Surgery-I category 1 or 2 interventions. CS-AKI occurred in 39 children (12.1%). Factors associated with CS-AKI were sepsis and intraand post-operative hypotension. In-hospital mortality was six-fold higher in children who developed CS-AKI. CS-AKI was associated with two to three days more of mechanical ventilation and Intensive care unit stay. CS-AKI occurs in children in developing countries, but at a lower frequency mainly due to the predominance of post-neonatal children undergoing less-complex CSs. CS-AKI was associated with higher in-hospital mortality and increased utilization of hospital services. Factors associated with CS-AKI included intraand post-operative hypotension and sepsis.