Mothers’ Knowledge, Attitude and Practice Regarding Diarrhea and its Management in Morang Nepal: An Interventional Study

Purpose: To assess diarrhea-related knowledge, attitude and practice through successive educational interventions.Methods: This was an interventional study conducted at nine different locations of Morang district, Nepal from March 2010 to January 2011. Multistage random sampling approach was adopted to sample 630 subjects and they were randomly assigned to test and control groups. The subjects in the test group were provided an educational intervention designed on the basis of World Health Organization guidelines. Data collection followed by intervention was conducted at baseline, 1 month and 3 months; at 6 months, only data were taken without intervention.Results: About 90 % of the mothers were from the age group 16-30 years and most (93 %) of them were agricultural laborers. A majority (> 62%) of the mothers were not educated. Educational interventions brought about significant improvement in knowledge, attitude and practice at 1st, 2nd and 3rd follow-up. The median scores of knowledge, attitude and practice increased from 14, 7, 6 to 26, 9, 13, respectively, due to repeated interventions. Furthermore, interventions strengthened the correlationbetween knowledge, attitude and practice.Conclusion: Intervention was beneficial in improving mothers’ knowledge, attitude and practice regarding diarrhea and its management.Keywords: Attitude, Diarrhea, Intervention, Knowledge, Mothers, Practic

Student feedback on the use of paintings in Sparshanam, the Medical Humanities module at KIST Medical College, Nepal

<p>Abstract</p> <p>Background</p> <p>Paintings have been used in Medical Humanities modules in Nepal at Manipal College of Medical Sciences and KIST Medical College. Detailed participant feedback about the paintings used, the activities carried out, problems with using paintings and the role of paintings in future modules has not been previously done. Hence the present study was carried out.</p> <p>Methods</p> <p>The present module for first year medical students was conducted from February to August 2010 at KIST Medical College, Nepal. Paintings used were by Western artists and obtained from the Literature, Arts and Medicine database. The activities undertaken by the students include answering the questions 'What do you see' and 'What do you feel' about the painting, creating a story of 100 words about the scene depicted, and interpreting the painting using role plays and poems/songs. Feedback was not obtained about the last two activities. In August 2010 we obtained detailed feedback about the paintings used.</p> <p>Results</p> <p>Seventy-eight of the 100 students (78%) participated. Thirty-four students (43.6%) were male. The most common overall comments about the use of paintings were "they helped me feel what I saw" (12 respondents), "enjoyed the sessions" (12 respondents), "some paintings were hard to interpret" (10 respondents) and "were in tune with module objectives" (10 respondents). Forty-eight (61.5%) felt the use of western paintings was appropriate. Suggestions to make annotations about paintings more useful were to make them shorter and more precise, simplify the language and properly introduce the artist. Forty-one students (52.6%) had difficulty with the exercise 'what do you feel'. Seventy-four students (94.9%) wanted paintings from Nepal to be included.</p> <p>Conclusions</p> <p>Participant response was positive and they were satisfied with use of paintings in the module. Use of more paintings from Nepal and South Asia can be considered. Further studies may be required to understand whether use of paintings succeeded in fulfilling module objectives.</p

Violent video games and morality: a meta-ethical approach

This paper considers what it is about violent video games that leads one reasonably minded person to declare "That is immoral" while another denies it. Three interpretations of video game content a re discussed: reductionist, narrow, and broad. It is argued that a broad interpretation is required for a moral objection to be justified. It is further argued that understanding the meaning of moral utterances – like "x is immoral" – is important to an understanding of why there is a lack of moral consensus when it comes to the content of violent video games. Constructive ecumenical expressivism is presented as a means of explaining what it is that we are doing when we make moral pronouncements and why, when it comes to video game content, differing moral attitudes abound. Constructive ecumenical expressivism is also presented as a means of illuminating what would be required for moral consensus to be achieved

Succesful Radiofrequency Ablation of Atrial Tachycardia Arising From Within the Coronary Venous Sinus

Focal atrial tachycardia (AT) though a relatively uncommon cause of supraventricular tachycardia is difficult to control with antiarrythmic drugs. With the advent of radiofrequency ablation (RFA), this form of tachycardia can be treated with high long-term success [1]. These foci tend to cluster at specific anatomic locations. In the right atrium, these foci occur along the crista terminalis, the tricuspid annulus, the ostium of the coronary sinus and the perinodal region. In the left atrium, foci occur predominantly at the pulmonary vein ostia and less commonly at the mitral annulus, the left atrial appendage, and the left side of interatrial septum [2-6]. We report the electrophysiological characteristics and ablation procedure of a focal atrial tachycardia which was arising from deep within the coronary sinus

Knowledge and perceptions of the risks of non-steroidal anti-inflammatory drugs among orthopaedic patients in Thailand

Background There is a high incidence of adverse effects from non-steroidal antiinflammatory drugs (NSAIDs) in Thailand, but patients’ perceptions and knowledge of NSAID risks is unknown. Objective This study aims to assess patients’ perceptions and knowledge of NSAID risks and factors affecting them. Setting University hospital in North-East of Thailand. Method A Cross-sectional study conducted over 4 months, using a self-administered questionnaire. Patients prescribed NSAIDs for at least one month duration from orthopaedic clinic were recruited using systematic random sampling. Main outcome measure Patients’ perceptions on NSAID risks, knowledge on risk factors, and their associated factors. Results A total of 474 questionnaires were assessed. Overall perceptions of risks was low (scoring below five on a 0–10 visual analogue scale), with risks associated with the renal system scoring highest. Perceived risk of gastrointestinal problems differed between patients using non-selective and selective NSAIDs (3.47 ± 2.75 vs 2.06 ± 2.98; P < 0.001). Receiving side effect information from a health professional was associated with higher risk perception. Most patients (80 %) identified high doses, renal disease and gastrointestinal ulcer increased risks of NSAIDs, but fewer than half recognized that use in the elderly, multiple NSAID use, drinking, hypertension and cardiovascular disease also increased risk of adverse events. Having underlying diseases and receiving side effect information were associated with 1.6–2.0 fold increased knowledge of NSAID risks. Conclusion Perceptions and knowledge concerning NSAID risks was generally low in Thai patients, but higher in those who had received side effect information. Risk-related information should be widely provided, especially in high-risk patients

The Formation of the First Massive Black Holes

Supermassive black holes (SMBHs) are common in local galactic nuclei, and SMBHs as massive as several billion solar masses already exist at redshift z=6. These earliest SMBHs may grow by the combination of radiation-pressure-limited accretion and mergers of stellar-mass seed BHs, left behind by the first generation of metal-free stars, or may be formed by more rapid direct collapse of gas in rare special environments where dense gas can accumulate without first fragmenting into stars. This chapter offers a review of these two competing scenarios, as well as some more exotic alternative ideas. It also briefly discusses how the different models may be distinguished in the future by observations with JWST, (e)LISA and other instruments.Comment: 47 pages with 306 references; this review is a chapter in "The First Galaxies - Theoretical Predictions and Observational Clues", Springer Astrophysics and Space Science Library, Eds. T. Wiklind, V. Bromm & B. Mobasher, in pres