Priya T Nandimath

Introduction: Consanguineous marriages are more common in south India primarily because of social and cultural factors. Possibility of a child of consanguineous married couple, suffering from genetic diseases, congenital deformities and auto recessive disorder is more than offspring of non-consanguineous married couple. Consanguineous marriages are more prevalent in rural area because of lack of awareness about consequences. Hence the aim of the study was to educate adolescents regarding consanguineous marriage and its consequences and also to assess their knowledge before and after the intervention. Methodology: Interventional cross-sectional study was conducted using self-administered questionnaires to assess the knowledge before and after the intervention. Complete enumeration of the students studying in selected schools was done. Lecture method was used with power point presentation to educate the children. Immediate post-test and after two months of intervention follow up test was conducted to assess the retained knowledge. Results: Total 121 students participated in the study. Initially the students had no knowledge about consanguineous marriage and its effect on pregnancy outcome. Increase in knowledge was found to significant immediately after intervention (P=0). After two months of intervention significance was found with increase in the knowledge regarding effects of consanguineous marriage on women’s health (P Conclusion: Knowledge regarding consanguineous marriage and its effect on pregnancy outcome was poor among the school students. Structured teaching program about consanguineous marriage and its consequences increased the student’s knowledge.   Keywords: Consanguineous marriage, Pregnancy, Knowledge.

Health care concept is increasingly moving away from medical, task oriented and professional driven model towards a holistic model of health care which values the needs of the persons and centred on the needs of the patients. This shift is described as person centred care. Despite the wide availability of literature, philosophy and evidence on the outcomes of the person centred care, barely it is an ideal in reality. This present article throws light on the philosophy and challenges of person centred care and tries to raise the awareness and understanding about person centred care for people with dementia and explores on the challenges underpinning person-centred care in dementia.Person centred care means, being “respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions”. Each individual has unique history, personality, values, right to dignity, respect and right to participation. PCC framework emphasises on the assumptions made about the people with dementia, care givers attitude, models and care practices, factors at organisational level, cultural factors as well as structural elements such as lighting and flooring. It is a holistic philosophy across the continuum of services which takes into account the specific needs of each person. The philosophy of person centred care focuses on “the abilities and strength of the person than the losses” and on “the person than on the condition”. Challenges Underpinning Person Care: Lack of clarity in understanding person centred care in dementia, lack of research evidence, not valuing the views and needs of people with dementia, organisational culture, task centred care culture, lack of resources. Conclusion: To improve quality of life of people with dementia and for the better functioning of the people with dementia there is a need for greater implementation of person centred care. However the challenges in the implementation of person centred care are masking the achievements and positive aspects of the person centred care approach. The challenge ahead for dementia experts is to advocate and raise the awareness and understanding and to provide evidence based solutions in practically implementing person centred care and making it more real in practice than keeping it ideal in literature. Keywords: Person Centred Care, Dementia

Introduction: Anaemia is a serious concern for the young children as it affects the cognitive performance, development (cognitive and behavioral), coordination, language development and scholastic achievement. Various interventions have been undertaken during last 50 years such as green revolution, PDS, ICDS, etc. Nutritional deficiencies remain with the same burden and nutritional anemia being one of the major concerns in India. Hence it becomes quite evident hat alternative strategies should be tried to improve the nutritional anemia and reduce the morbidity associated with it, such as use of locally available, traditional food to increase the bioavailability of iron and to improve the nutritional behavior through nutritional education. The present study was proposed with an aim to assess the role of Moringa Olifera powder in improving haemoglobin level among the anaemic children. Materials and Methods: A case control study was conducted at a village, Chikaballapur district of Karnataka. 312 school children were screened for Haemoglobin level; Out of 312 students 124 school children fulfilled the inclusion criteria. 66 children were recruited to control group and interventional group respectively. The children in the interventional group were administered with 3gms per day (1/2 a tea spoon) of Moringa Olifera powder along with their food for 3 months and regular supplements provided at school. Control group was advised to continue with the regular meal and regular supplements provided at the school. Haemoglobin levels were estimated before and 3 months after the intervention. Results: Out of 58 children in the interventional group 33 (56.9%) were females and 25 (43.1%) were males and out of 66 children in the control group 34 (51.55) were females and 32(48.5%) were males. The mean Haemoglobin level of the children in the interventional group before the intervention was 10.332 which increased to 10.967 after the intervention. Similarly the mean Haemoglobin level of children in the control group before the intervention was 9.950 which remained 9.873 after the intervention. The increase in the mean haemoglobin level in the interventional group was significant with the p value of 0.045. After the intervention the children with moderate anaemia decreased from 38(65.5%) to 23(39.7%) and 13 (22.4%) children turned normal in the experimental group and in the control group the children with moderate anaemia increased from 52(78.8%) to 55(81.8%). Conclusion: There a statistically significant marginal improvement in haemoglobin level in the interventional group after three months. Keywords: Anaemia, Moringa olifera.

Introduction: Health care utilization is the measure of the population’s use of the health care services. Health care utilization is used to assess how efficiently a health care system is providing healthcare services. Aim: With this context a study was carried out to evaluate health care utilization and health expenditure among people of Kumta taluk and to analyze health care utilization and health expenditure by household’s socio economic status, geographical location and other key variables. Materials and Methods: Multistage sampling was used to select 160 households. A pre-tested questionnaire was used to interview household heads. Findings: The study covered a population of 569 persons out of 160 households of Kumta taluk. Overall males fell sick more than females. Fever was highest (31.6%) reported sickness. 51.9% people utilized private facility due to good care provided and 39.5% used government facility as it is easy to access. The maximum expenditure on treatment of morbidities was Rs.16500 with the mean expenditure of Rs.1006.3. There was no association between age group, sex and type of health facility utilized. There was no difference in the type of health facility used by middle class and upper class. Data on hospitalization revealed that, majority of the people used private facility. The total minimum expenditure on hospitalization was Rs.4000 and maximum Rs.200000 with the mean expenditure of Rs.34900. Regarding immunization, 75% used PHC for immunization and 25% used private health facility. The maximum amount spent on immunization was Rs.3000 with the mean expenditure of Rs.333.33. Conclusion: Fever was highest reported sickness among all age groups irrespective of sex. Private facility was utilized by majority as the care was good and Government facility was used as it was easy to access Utilization of the health care facility showed no relationship with their age, sex, socio economic status. Majority preferred private facility for hospitalization. Keywords: Health care utilization,Health expenditure.

Introduction: Breast cancer has emerged as a major public health problem and early detection helps in bringing down the burden. Even thoughMammography is the best choice for screening, it is expensive and requires skilled personnel. Breast Self-Examination (BSE) is important in early detection and for mass awareness especially in resource poor countries. Nurses and midwives constitute major contributors in delivering health care and education and if these are empowered and trained they can convince women to perform BSE. Various studies conducted on nurses BSE practice show that the nurses are generally ineffective practitioners of BSE and that their frequency of BSE teaching is low. Aim and Methods: To assess the knowledge and practice of effective BSE among female nurses. A descriptive cross sectional study was conducted among 90 female nurses working in a tertiary care hospital. A self-administered questionnaire was used to assess the knowledge and practice of BSE. Written consent was taken from the participants. Data was collected on the socio demographic information, knowledge and practice of BSE. Data was analysed using SPSS version 16. Results: Knowledge: 55.6% of the nurses said that BSE should be performed once in 6 months, 18.9% felt that it should be performed monthly. 42.2% of the nurses said that BSE has no relation to menstrual cycle. 86.7% of nurses said that BSE should be performed in standing up position and the first source of information was BSE awareness programmes. Practice 75.6% nurses practiced BSE but only 33.3% were effectively practicing BSE. 50% of the nurses said that they were confident in performing BSE. The major reasons for practicing were, early detection has a great value and fear of Breast cancer. The major reasons for not practicing BSE were, afraid I will find something 54.5%. Conclusion: The study indicates that nurses had inadequate knowledge about BSE. Practice of BSE was high but very few practiced it effectively. Keywords: Breast self examination, Knowledge and practice.

Palliative care and end of life care are relatively new concepts in dementia care. The provision of end of life care and palliative care in the recent past has been emphasised for people with dementia rather than focusing only on cancer. There are now a huge number of strategies and policies that support and highlight the need for person cantered, high quality care for the people with dementia approaching towards the end of life. Despite this there are numerous challenges and hurdles in improving and providing palliative and end of life care. This is basically due to the fact that dementia is still not considered as terminal illness and also because of the fact that the practitioners and the carers are still not certain on when to initiate end of life care plan. Physical, psychological, emotional, spiritual, nutritional, environmental, pain controls are the aspects to be supported in end of life care. Decision making in provision of care plan during the end of life is very much essential in order to provide a personhood care but in practice a little application is seen. Advanced care planning for end of life care for people with dementia is still not practiced. Cultural diversity and beliefs towards the death are to be considered as important aspects in provision of end of life care. The practitioners should be adequately informed about the cultural beliefs. There is also a considerable lack of training among the care staff regarding the cultural belief and communication skills. Spiritual integrity is also important for provision of end of life care. Promotion of palliative and end of life care along with changing the attitude towards looking at death is very essential for people with dementia. Keywords: Palliative care end of life care.

According to the estimates in the World Alzheimer Report 2015, there are 46.8 million people living with dementia worldwide in 2015. The number of older people living in higher income countries is projected to increase by just 56%, 138% in upper middle income countries, and 185% in lower middle income countries and by 239% in low income countries, during 2015-2050. Ensuring early diagnosis becomes a priority strategy which benefits the person with dementia and their caregiver. Despite the improvements, currently in England approximately two thirds of the people with dementia do not have a formal diagnosis. In contrast there are no clear strategies and priorities in developing and low income countries where the burden is quite high. Everybody has a “right to know” about the diagnosis, condition, information, and advice available to the people with dementia. There are associated risks and benefits of disclosing a diagnosis of dementia, both to the person with dementia and their carer. This paper aims to critically examine risks and benefits of disclosing the diagnosis of dementia. A relevant literature search was conducted to critically discuss the benefits and risks of disclosure of diagnosis. The present paper has categorised and critically discussed the benefits and risks of disclosure. The author concludes that the benefits of disclosure outweigh the risks of disclosure. Disclosure of diagnosis can improve the quality of life of people with dementia. Keywords: Risks, Benefits, Dementia, Disclosure.