Virome Analysis of Paddy Floodwater in Two Cropping Seasons.

Paddy fields include two interconnected ecosystems-soil and floodwater. Microbes and viruses are an integral component of these ecosystems, yet the viral communities have not been extensively studied. We present an analysis of the viromes of paddy floodwater collected during the two cropping seasons in India, the kharif and rabi seasons respectively. The overall taxonomic and functional characteristics appeared to be similar in both seasons, suggesting stability of the viral community. Taxonomically, the families of tailed bacteriophages dominated. The predominance of functional roles related to lytic phages further confirmed this. We reconstructed two complete and several partial viral genomes from the assembled data. The genomes did not align with any known sequences, thus representing novel viruses of the floodwater ecosystem. Supplementary Information: The online version contains supplementary material available at 10.1007/s12088-024-01292-9.

ASHA-led community-managed intervention programme to improve maternal and neonatal outcomes in pregnant women with pregnancy hypertension: A study protocol.

AIM: The objective is to use the available technology in conjunction with the peripheral health workers to identify the early warning signs of pregnancy-induced hypertension (PIH), provide appropriate referral services and closely monitor the patient thereafter with the aim of improving the prognosis of the condition. STUDY DESIGN: Quasi-experimental design. METHOD: The research will be carried out in Udupi District Karnataka, India. The study will involve 250 pregnant women in total as well as 50 ASHA workers. All the participants will undergo a PIH knowledge assessment, which will be followed by a PIH risk assessment for expectant mothers. There will be an implementation of the community-managed intervention programme (CMIP). The creation of a mobile application, ongoing prenatal follow-up and training for ASHAs on mobile app usage are all part of the CMIP. The results for mothers and newborns will be monitored and to learn more about the efficacy of CMIP and the difficulties ASHA workers and expectant mothers encounter in identifying the early warning signals of PIH a focused group discussion will be held. DISCUSSION: A number of research on pregnancy-induced hypertension have demonstrated the necessity for community-based treatments to be developed in order to improve the outcomes for expectant mothers and newborns. These programmes assist in managing hypertension throughout pregnancy. Conversely, ASHA employees have had a favourable influence on community-level health outcome management. Currently, technology is being used extensively in healthcare and is receiving favourable reception. Thus, in an effort to improve maternal and newborn outcomes, this study attempts to incorporate mobile technologies in addition to ASHA workers and pregnant women. IMPACT: If the CMIP proves to be beneficial, it might be implemented nationwide, particularly in isolated regions, to monitor expectant mothers and avoid PIH-related concerns.

Creating a Dual Degree: Nursing Education Goes Global.

A global health human resource crisis has intensified the need for innovative education programs to maximize the supply of nurses worldwide. In response to the current and anticipated shortage of nurses globally, a novel collaborative undergraduate nursing program was developed at the University of New Brunswick in Fredericton, NB, and Manipal Academy of Higher Education in Karnataka, India. The resulting dual degree model is shaped by the contexts of the participating countries and current activities related to the international recruitment and migration of registered nurses. This partnership will increase program capacity and the potential number of graduates and will ease the immigration of internationally educated nurses.

Caring burden and quality of life among the caregivers of people living with dementia - a cross-sectional study in Udupi district of Karnataka.

Dementia is a chronic disorder of the brain that affects cognitive performance. The caregivers of individuals with dementia experience a greater burden that affects their Quality of Life (QoL). This cross-sectional study conducted in India was designed to assess the caring burden and QoL among the caregivers of people with dementia, as well as to ascertain the relationship between QoL scores and burden. Our sample included 80 caregivers of people with dementia. Most of the caregivers (n = 59, 73.8%) had a higher level of caregiver burden. There was a negative correlation between caregiver burden scores and QoL. A higher level of caregiver stress and low QoL were experienced by caregivers of dementia patients. In developing countries like India, counseling, and education on home health care for people with dementia should be provided to reduce the burden and enhance the QoL of caregivers.

Efficacy of mHealth Interventions for Improving Maternal and Neonatal Outcomes Among Pregnant Women With Hypertensive Disorders: Protocol for a Systematic Review.

BACKGROUND: Hypertension is one of the most prevalent medical conditions that arise during pregnancy, resulting in maternal and neonatal complications. Mobile health (mHealth) has emerged as an innovative intervention for delivering maternal and child health care services. The evidence on the effectiveness of mHealth interventions in improving the health outcomes of pregnant women with hypertensive disorders is lacking. Therefore, there is a need for evidence synthesis using systematic review methods to address this evidence gap. OBJECTIVE: This review aims to determine the efficacy of mHealth interventions in improving maternal and neonatal outcomes among pregnant women with hypertensive disorders. The review will answer the following research questions: (1) What are the types of mHealth interventions used in pregnant women with hypertensive disorders? (2) Are the various mHealth interventions effective in improving maternal and neonatal health outcomes, health behaviors, and their knowledge of the disease? and (3) Are mHealth interventions effective in supporting health care providers to make health care decisions for pregnant women with hypertensive disorders? METHODS: This review will include randomized controlled trials, nonrandomized controlled trials, and cohort studies focusing on mHealth interventions for pregnant women with hypertensive disorders. Studies reporting health care providers use of mHealth interventions in caring for pregnant women with hypertensive disorders will be included. The search strategy will be tailored to each database using database-specific search terms. The search will be conducted in PubMed-MEDLINE, ProQuest, CINAHL, Scopus, Web of Science, and CENTRAL. Other literature sources, such as trial registries and bibliographies of relevant studies, will be additionally searched. Studies published in English from January 2000 to January 2023 will be included. A total of 2 review authors will independently perform the data extraction and the quality appraisal. For quality appraisal of randomized controlled trials, the Cochrane Risk of Bias 2 tool will be used. The Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-1) tool will be used for nonrandomized controlled trials, and the Critical Appraisal Skills Programme checklist for cohort studies will be used. Any disagreements between the 2 reviewers will be resolved through discussion and a third reviewer if required. A meta-analysis will be performed based on the availability of the data. RESULTS: As per the protocol, the study methodology was followed, and 2 independent reviewers conducted the search in 6 databases and clinical registries. Currently, the review is in the full-text screening stage. The review will publish the results in the first quarter of 2024. CONCLUSIONS: The evidence synthesized from this systematic review will help guide future research, support health care decisions, and inform policy makers on the effectiveness of mHealth interventions in improving the maternal and neonatal outcomes of pregnant women with hypertensive disorders. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51792.

Effect of Lifestyle Modification Intervention Programme on Bone Mineral Density among Postmenopausal Women with Osteoporosis.

Objectives: Osteoporosis is one of the major public health problems worldwide among postmenopausal osteoporotic women. Lifestyle modification interventions along with pharmacotherapy help to revert bone loss and prevent complications. Methods: A randomised controlled trial was conducted at Kasturba Hospital, Manipal from January 2019 to December 2021 among postmenopausal women with osteoporosis. The postmenopausal women who attended the osteoporosis clinic and were within the age group of 45-65 years, could speak and understand English or Kannada and whose bone mineral density (BMD) score was between -1 and -3 were included in the study. The total sample size of the study was 120 with 60 in each of the experimental and control groups. After obtaining informed consent, a stratified block randomisation method was used to allocate the participants to intervention and control groups. The BMD was monitored by the portable ultrasound densitometer by a technician at the outpatient departments. The baseline information was collected by a structured demographic questionnaire. Intervention group participants received a lifestyle modification intervention program (LMIP) whereas the control group received standard regular care from the physician. Follow-up was done at three and six months. Results: The results revealed that the increase in the BMD median score among the experimental group was from -2.2 (-2.5- -1.8) to -1.5 (-1.8- -0.65) whereas in the control group, it was from -2.3 (-2.6- -1.9) to -2.0 (-2.4- -1.5). The results of the Mann Whitey U test showed a statistical significance between the intervention and control groups in the post-test after six months (U = 505.5; P <0.05). Wilcoxon signed rank test showed a significant change in both the intervention and control groups from pre-test to post-test I (3 months) and post-test II (6 months; P <0.001). Conclusion: The lifestyle modification intervention was found to be effective in improving the bone health status of postmenopausal women. Hence it is very important to integrate it into regular therapy.

Prevalence of road traffic injuries in South East and South Asian region - A systematic review.

Background: South and South-East Asian countries report a great liability for the world's road traffic injuries (RTIs) and deaths. A vast number of research studies tested various interventions including specific protective devices to prevent accidents, but no review papers have been conducted to find out the prevalence of RTIs in South-East and South Asian countries. Objective: This review paper was an attempt to find out the prevalence of RTIs and their associated factors in South-East and South Asian countries. Methods: Following the guidelines of Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), we searched the articles in the electronic databases of PubMed/Medline, Scopus, CINAHL, ProQuest, and Web of Science. Articles were selected if they reported the prevalence of RTI, or road traffic accident (RTA) deaths. In addition, a data quality assessment was done. Results: Out of the 10,818 article hits from the literature search, ten articles found the eligibility and inclusion criteria. Most of the studies reported that males are involved in the RTIs more than females. The male mortality rate is more than the female mortality in RTI mortality. Young adult males are the major victims when compared with the different age groups of male victims. Two-wheelers are the major contributors to the accident rate. Religious or national festivals are not free from accident-prone times. Climatic seasons and nighttime have a major influence on the RTIs. RTIs are increasing due to the sudden and huge increase in the number of motor vehicles and the development of cities and towns. Conclusion: Accidents are non-predictable but controllable disasters in society. Overspeeding, bad conditions on road, the vulnerability of the vehicles, and careless driving are the major reported reasons for RTIs. Making and implementing strict laws can help us to control RTAs. The major effect on the reduction of RTI can be assured only with the presence of responsible people. That can be achieved only by creating awareness in society about traffic rules and responsibilities.

The utilization of systematic review evidence in formulating India's National Health Programme guidelines between 2007 and 2021.

Evidence-informed policymaking integrates the best available evidence on programme outcomes to guide decisions at all stages of the policy process and its importance becomes more pronounced in resource-constrained settings. In this paper, we have reviewed the use of systematic review evidence in framing National Health Programme (NHP) guidelines in India. We searched official websites of the different NHPs, linked to the main website of the Ministry of Health and Family Welfare (MoHFW), in December 2020 and January 2021. NHP guideline documents with systematic review evidence were identified and information on the use of this evidence was extracted. We classified the identified systematic review evidence according to its use in the guideline documents and analysed the data to provide information on the different factors and patterns linked to the use of systematic review evidence in these documents. Systematic reviews were mostly visible in guideline documents addressing maternal and newborn health, communicable diseases and immunization. These systematic reviews were cited in the guidelines to justify the need for action, to justify recommendations for action and opportunities for local adaptation, and to highlight implementation challenges and justify implementation strategies. Guideline documents addressing implementation cited systematic reviews about the problems and policy options more often than citing systematic reviews about implementation. Systematic reviews were linked directly to support statements in few guideline documents, and sometimes the reviews were not appropriately cited. Most of the systematic reviews providing information on the nature and scale of the policy problem included Indian data. It was seen that since 2014, India has been increasingly using systematic review evidence for public health policymaking, particularly for some of its high-priority NHPs. This complements the increasing investment in research synthesis centres and procedures to support evidence-informed decision making, demonstrating the continued evolution of India's evidence policy system.

Effectiveness of Music on Perinatal Anxiety Among Pregnant Women and Newborn Behaviors: A Systematic Review and Narrative Synthesis.

Background: Perinatal anxiety affects the antenatal woman, the growing fetus, and the newborn. This systematic review evaluated the effect of listening to music on perinatal anxiety among pregnant women and on newborn behaviors. No available reviews focus on interventions that include only classical forms of music or its benefit on perinatal anxiety among low-risk pregnant women or on newborn behaviors. Methods: We included peer-reviewed primary research studies on the effect of music on perinatal anxiety, published in English, between January 2010 and August 2022. PubMed, Embase, Scopus, and ProQuest were searched using specific keywords, resulting in 225 studies for screening by title, abstract, and full text. Two independent reviewers screened them and assessed the quality of the included randomized controlled trials (RCTs) using Cochrane's Risk of Bias 2.0 tool (RoB2) and non-randomized controlled trial studies using the Joanna Briggs Institute Critical Appraisal tool. Due to the heterogeneity of outcome measures, the review's findings were summarized qualitatively. Results: Nine studies with 1646 pregnant women and one with 260 pregnant women and their neonates were included. Results of all studies suggest that listening to classical music reduces the anxiety levels among pregnant women, as measured by the State-Trait Anxiety Inventory (STAI). Only one study reported the beneficial effect of antenatal exposure to music on improving newborn behaviors like orientation (ES 1.13, 95% CI: 0.82-1.44, P < 0.0001) and habituation (ES 1.05, 95% CI: 0.53-1.57, P = 0.0001). The risk of bias was unclear in most of the studies. Conclusions: Listening to classical music during the perinatal period may be an effective non-pharmacological intervention for reducing anxiety and pain and improving sleep quality and newborn behaviors. There is a need to conduct further interventional studies on the types of music provided and their effects on perinatal health outcomes. Registration of the Protocol: The review was prospectively registered in PROSPERO 2021 CRD42021256806.

Effectiveness of a peanut ball device during labour on maternal and neonatal outcomes: protocol for a randomised controlled trial.

Frequent positional changes and movements during labour is one of the recommendations by the World Health Organization (WHO) to prevent prolonged labour, thereby avoiding cesarean sections. However, labour induction, continuous fetal monitoring in supine position and immobilising the women during labour are standard practices in most private hospitals. To combat these problems and to implement WHO recommendations, the peanut ball is an effective device through which frequent positional changes will be achieved without disrupting the labour procedures. The current study aims to evaluate the effectiveness of the peanut ball device during labour on maternal and neonatal outcomes and assess the stress response induced by labour in terms of maternal and neonatal cortisol in low-risk primigravid women. The study is a prospective, block randomised controlled trial with parallel arms. A total of 768 study participants will be randomised to the peanut-ball group (intervention) and standard care group (control). The intervention group will receive different peanut ball positions during labour at or after 4 cm of cervical dilatation. The primary outcomes of the study are maternal outcome that includes measurement of duration of the active and the second stage of labour, stress level as measured by serum cortisol level at 3-4 cm and at 10 cm of cervical dilatation, mode of delivery, perception of pain, behavioural response during the active stage of labour and neonatal outcomes, which includes the pattern of fetal heart rate, APGAR score, birth injuries, and umbilical serum and salivary cortisol level. The collected data will be compared between the intervention and control groups.  Trial Registration: This research is registered under the CTRI (Clinical Trials Registry of India) ( CTRI/2019/08/020802) (21/8/2019).

Burden of Osteopenia and Osteoporosis Among Postmenopausal Women in India: A Systematic Review and Meta-Analysis.

Aim: Postmenopausal osteoporosis is a major public health problem around the world. The objective of this systematic review is to determine the prevalence of osteoporosis in postmenopausal women in India. Materials and Methods: This review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We identified relevant studies through a search of literature published from 2010 to January 2021 in the databases PubMed, Web of Science, ProQuest, CINHAL, and PEDro databases. We searched for cross-sectional studies involving India that were published in English. Results: There was a total of 1631 hits in the initial search and out of which 60 studies were selected for full-text review. Twelve studies were selected for qualitative analysis. Excluded studies were 48 with reasons: 20 studies had included other diseases such as knee arthritis, celiac diseases, diabetes mellitus, and kidney diseases. Eleven studies included premenopausal women, young adults, and men. Ten studies outcomes were different, and seven studies were excluded as they have done retrospective analysis and were commentaries. The pooled prevalence of osteoporosis at the lumbar spine region was 29%, the hip region was 6% and the femoral neck region was 29% whereas the pooled prevalence of osteopenia at the lumbar spine region was 37%, the hip was 6%, and femoral neck region was 37%. Conclusion: This systematic review found that postmenopausal women are at significant risk of developing low bone mineral density, and the prevalence of osteoporosis and osteopenia was high in the lumbar area.

Effectiveness of antepartum breathing exercises on the outcome of labour: A randomized controlled trial.

Background Childbirth is a life-transforming intense event to a woman and her family. Even though a variety of non-pharmacological techniques are readily available to alleviate the distress of women in labour, the majority of women are unaware of its benefits. The objective of the study was to explore the impact of a simple non-pharmacological technique i.e., antepartum breathing exercises on maternal outcomes of labour among primigravid women. Methods A single centre prospective, single-blinded, randomized controlled trial was conducted at the antenatal outpatient clinic of a secondary healthcare institution. Eligible primigravid women were randomized into intervention and standard care groups. Both groups received standard obstetrical care. In addition, the intervention group were taught antepartum breathing exercises and were advised to practise daily and also during the active stage of labour. The primary outcome of the trial was the maternal outcome of labour measured in terms of onset of labour, nature of delivery, duration of labour, and need for augmentation of labour. Data was collected using World Health Organization (WHO) partograph, structured observational record on the outcome of labour. Results A total of 98 (70%) primigravid women who practised antepartum breathing exercises had spontaneous onset of labour. The odds of spontaneous onset of labour after randomization in the intervention group was 2.192 times more when compared to standard care at a (95% confidence interval 1.31-3.36, p<.001). Also, the requirement for augmentation of labour was minimal and there was a reduction in the rate of caesarean deliveries ( p <.05) based on the χ2 test. The overall mean duration of labour was less compared to standard care group F(1)= 133.800, p <.001. Conclusion Antepartum breathing exercises during labour can facilitate spontaneous vaginal birth, shorten the duration of labour, and reduce the need for operative interference.

Effectiveness of an Evidence-Based Practice Training Program for Nurse Educators: A Cluster-Randomized Controlled Trial.

BACKGROUND: Evidence-based practice (EBP) endeavors to integrate the best available evidence with clinical expertise and patient preference to enhance clinical outcomes. For nurses to effectively demonstrate EBP, the concepts of EBP should be systematically incorporated into the nursing curriculum, with nurse educators playing a pivotal role in execution. However, the effect of EBP training programs on nurse educators remains largely unexplored. AIM: To evaluate the effectiveness of an EBP training program on the knowledge, attitude, practice, and competency of nurse educators. METHODS: A pragmatic randomized controlled trial was conducted at a nursing education institution. Fifty-one nurse educators were cluster randomized into intervention and control groups. A 30-hour EBP training intervention was provided for nurse educators in the intervention group. The outcome variables were knowledge, attitude, practice, and competency regarding EBP. These outcomes were evaluated using the EBP knowledge and practice questionnaire, EBP attitude scale, and Fresno test. Data were collected at baseline, the end of 5 months, and the end of 10 months. RESULTS: Fifty-one eligible participants were enrolled in the study. The intervention and control group had three clusters each with 27 and 24 participants, respectively. Participants in both groups were comparable for variables such as age, years of experience, and educational background (p > .05). Between groups, outcome variables were compared using mixed linear multi-level modeling. Nurse educators who received the EBP training program demonstrated significant differences in knowledge (p < .05), attitude (p < .05), practice (p < .05), and competency scores (p < .05), than that of the control group, indicating the intervention effectiveness. LINKING EVIDENCE TO ACTION: EBP training programs are effective in improving the knowledge, attitude, practice, and competency of nurse educators.

Effectiveness of self-care educational programme on clinical outcomes and self-care behaviour among heart failure peoples-A randomized controlled trial: Study protocol.

AIM: To evaluate the effectiveness of a self-care education programme on clinical outcomes, self-care behaviour and knowledge on heart failure (HF) among peoples with HF. DESIGN: Randomized controlled trial. METHODS: The participants (N = 160) will be randomly assigned (1:1) to the intervention and the control arms using block randomization. The participants assigned to the intervention arm will receive educational intervention on HF self-care comprising video-assisted teaching with teach-back technique, tailored teaching at discharge and a guide on self-care followed by telephonic calls and text messages after discharge for 6 months along with standard care. The participants in the control arm will receive only a guide on self-care with standard care. The clinical outcomes such as health-related quality of life, hospital readmissions, N-terminal pro-brain natriuretic peptide levels, symptom perception, functional status, left ventricular ejection fraction, Seattle HF score, self-care behaviour and knowledge on HF will be measured at the baseline, after 1 and 6 months of the intervention. DISCUSSION: Several studies conducted on self-care education interventions have shown positive effects, whereas few studies have shown no effect on the people outcomes. Providing the printed self-care guide alone may not improve behaviour associated with self-care and clinical outcomes. These peoples need continuous reinforcement on self-care. If this self-care educational intervention shows beneficial effects, it will contribute to the clinical practice and improve clinical outcomes. IMPACT: This research will contribute to the evidence on the effectiveness of an educational intervention on self-care among peoples with HF. The results would assist the nurses caring for peoples with HF. They can also implement this intervention for improving the peoples' self-care behaviour. TRIAL REGISTRATION: The trial is registered with the Clinical Trial Registry India and the reference ID number CTRI/2019/10/021724.

Qualitative Methods in Health Care Research.

Healthcare research is a systematic inquiry intended to generate robust evidence about important issues in the fields of medicine and healthcare. Qualitative research has ample possibilities within the arena of healthcare research. This article aims to inform healthcare professionals regarding qualitative research, its significance, and applicability in the field of healthcare. A wide variety of phenomena that cannot be explained using the quantitative approach can be explored and conveyed using a qualitative method. The major types of qualitative research designs are narrative research, phenomenological research, grounded theory research, ethnographic research, historical research, and case study research. The greatest strength of the qualitative research approach lies in the richness and depth of the healthcare exploration and description it makes. In health research, these methods are considered as the most humanistic and person-centered way of discovering and uncovering thoughts and actions of human beings.

Depression among older adults: a systematic review of South Asian countries.

The world's population has been evolving rapidly; every country in the world is facing this drastic progression in the number and the percentage of the elderly in their net population. As the chronological age advances, physiological and psychosocial decline will be evident among all older adults. The potentially relevant literature was identified using appropriate search terms in electronic databases such as PubMed MEDLINE, Scopus, ProQuest, Web of Science, CINAHL, IndMed, and Google Scholar. Articles published from 2006 to 2019, reported the prevalence and the risk factors for depression among older adults living in the community, old age homes, or hospitals of the South Asian countries. Articles were published in the languages other than English and those reporting the categorised or mean depressive scores were excluded from the review. After quality check for all the retrieved articles from different databases, 120 articles were included for the meta-analysis. The data were extracted based on a validated data extraction form, and the reviewer contacted the authors for clarification of the missing data whenever required. The estimates were pooled using the random effect model for meta-analyses. Sub-group and sensitivity analyses were also performed. The overall pooled estimate (random effect models) of the prevalence of depression among the elderly was 42.0% (95% CI: 0.38-0.46), Chi-squared P-value <0.001, and I2 99.14%. The pooled estimate of the prevalence was higher in the community settings than the old age homes (44.0%; 95% CI: 39.0-49.0 vs. 42.0%; 95% CI: 34.0-49.0). Depression is a common problem among the elderly population and the pooled estimate of depression would give directions to the healthcare providers, policymakers, and future researchers to plan some measures (either pharmacological or non-pharmacological interventions) to effectively tackle the burden of geriatric depression in the future.

Characterization of a new virulent phage ϕMC1 specific to Microbulbifer strain CMC-5.

Microbulbifer strain CMC-5, isolated from decomposing seaweeds degrades agar, alginate, carrageenan, chitin, carboxymethyl cellulose and xylan. Using bacterial strain CMC-5 as host, a novel virulent phage, designated ϕMC1 was isolated from the coast of Goa, India. Although ϕMC1 demonstrated cross infectivity with type species of Microbulbifer such as M. agarolyticus JAMBA3T and M. celer KCTC 12973T, it did not infect M. mangrovi KCTC 23483T, M. salipalidus JCM 11542T, M. elongatus DSM 6810T and M. hydrolyticus IRE-31T. The one step growth experiment of ϕMC1 infecting bacterial strain CMC-5 at a multiplicity of infection of 0.1, revealed a latent period of 60 min and a burst size of 180. TEM analysis of ϕMC1 indicated it to be a tailless phage with an icosahedral head having a diameter of 60 ± 1.42 nm. The ds DNA of ϕMC1 was restricted by EcoRI, HindIII and SmaI whereas HaeIII, BamHI, PstI, NotI did not cleave the DNA. The molecular size of ϕMC1 DNA was analyzed by restriction digestion as well as pulsed field gel electrophoresis and was estimated at 48.5 kb. The phage infectivity was adversely affected by organic solvents demonstrating the presence of a lipid membrane. The inhibition of ϕMC1 infectivity by EDTA was abolished by addition of Ca and Mg salts.

Improving the Knowledge and Attitude on 'Standard Days Method' of Family Planning Through a Promotional Program Among Indian Postgraduate Students.

INTRODUCTION: The 'Standard Days Method' is a fertility awareness-based method of family planning that identifies day 8 through day 19 of the menstrual cycle as fertile days during which a woman is likely to conceive with unprotected intercourse. OBJECTIVE: The study was aimed to determine the effectiveness of a promotional program on the 'Standard Days Method' in terms of improving the knowledge scores and attitude scores. DESIGN: A pre-experimental one-group pretest-posttest research design was adopted. The samples included 365 female postgraduate students from selected colleges of Udupi Taluk, Karnataka. The data was collected using self-administered questionnaires. The plan for the promotional program was also established. RESULTS: The findings of the study were analyzed using the descriptive and inferential statistics. The mean pretest and posttest knowledge scores were computed, and it was found that there was an increase in the mean knowledge score from 8.96 ± 3.84 to 32.64 ± 5.59, respectively. It was observed that the promotional program on 'Standard Days Method' was effective in improving the knowledge (p < 0.001) and attitude (p < 0.001) of the postgraduate students. CONCLUSION: The promotional program on Standard Days Method of family planning was effective in improving the knowledge and attitude of the postgraduate female students. This will enable the women to adopt this method and plan their pregnancies naturally and reduce the side effects of using oral contraceptives.

Evidence-Based Practice: Knowledge, attitudes, practice and perceived barriers among nurses in Oman.

OBJECTIVES: The aim of this study was to describe nurses' practices, attitudes, knowledge/skills and perceived barriers in relation to evidence-based practice (EBP) in Oman. METHODS: This descriptive cross-sectional study was conducted between February and November 2012. A self-reported 24-item questionnaire was used to measure EBP practices, attitudes and knowledge/skills among a convenience sample of 600 nurses working in four governmental hospitals in Muscat, Oman. Responses were scored on a one to seven rating scale. Barriers to EBP were measured on a five-point Likert scale using two subscales. Descriptive statistics and general linear regression were used to analyse the data. RESULTS: A total of 414 nurses were included in the study. The greatest barriers to developing EBP among nurses were insufficient time for research (3.51 ± 0.97) and insufficient resources to change practices (3.64 ± 0.99). Nurses with more years of experience reported increased use of EBP (P <0.01), more positive attitudes towards EBP (P <0.001) and fewer barriers to research (P <0.01). Significant positive correlations were found between years of experience and practice (r = 0.16) and attitudes (r = 0.20). Nurses with a baccalaureate degree reported fewer barriers to research than those qualified at a diploma level (P <0.001). Nurses who perceived more barriers to research reported less use of EBP (P <0.001), less positive attitudes towards EBP (P <0.001) and limited EBP knowledge/skills (P <0.001). CONCLUSION: These findings provide a basis for enhancing nursing practices, knowledge and skills. Continuing education for nurses and minimising barriers is crucial to increasing the use of EBP in Oman.

Dysfunctional glutamatergic and γ-aminobutyric acidergic activities in prefrontal cortex of mice in social defeat model of depression.

BACKGROUND: Depression is a complex neuropsychiatric syndrome that is often very severe and life threatening. In spite of the remarkable progress in understanding the neural biology, the etiopathophysiology of depression is still elusive. In this study, we have investigated molecular mechanisms in the prefrontal cortex of mice showing depression-like phenotype induced by chronic defeat stress. METHODS: Depression-like phenotype was induced in C57BL/6 mice by subjecting them to a 10-day social defeat paradigm. The metabolic activity of excitatory (glutamatergic) and inhibitory (γ-aminobutyric acid [GABA]ergic) neurons of the prefrontal cortex was measured by (1)H-[(13)C]-nuclear magnetic resonance spectroscopy together with infusion of [1,6-(13)C2]glucose. In addition, the expression level of genes associated with glutamatergic and GABAergic pathways was monitored by quantitative polymerase chain reaction. RESULTS: Mice showing depression-like phenotype exhibit significant reduction in the levels of glutamate, glutamine, N-acetyl aspartate, and taurine in the prefrontal cortex. Most importantly, findings of reduced (13)C labeling of glutamate-C4, glutamate-C3, and GABA-C2 from [1,6-(13)C2]glucose indicate decreased glutamatergic and GABAergic neuronal metabolism and neurotransmitter cycling in the depressed mice. The reduced glutamine-C4 labeling suggests decreased neurotransmitter cycling in depression. Quantitative polymerase chain reaction analysis revealed reduced transcripts of Gad1 and Eaat2 genes, which code for enzymes involved in the synthesis of GABA and the clearance of glutamate from synapses, respectively. CONCLUSIONS: These data indicate that the activities of glutamatergic and GABAergic neurons are reduced in mice showing a depression-like phenotype, which is supported by molecular data for the expression of genes involved in glutamate and GABA pathways.