A Sociocultural Perspective on Malnutrition in Children: Evidence from POSHAN Programme, Rajasthan

Integrated Management of Acute Malnutrition or POSHAN Phase 2.0 was implemented in 20 districts of Rajasthan in 2018. After 12 weeks of outpatient therapeutic care of children with Severe Acute Malnutrition (SAM), 70.4% children were cured, 12.2% defaulted and 17.4% were non-recovered and referred to Malnutrition Treatment Centres for facility treatment. The research study attempts to (a) study the sociocultural factors at the family level responsible for varying numbers of cured, defaulted and non-recovered SAM children at different localities; (b) explore the probability of the SAM children staying healthy post successful treatment at community settings without any external intervention; and (c) explore the possible approaches beyond the emergency medical response to develop a long-term strategy to address malnutrition in children. The insights and cues gained from the phenomenology of individual experiences help us understand the structural elements that undergird a healthy living. It was observed that irrespective of socio-demographic characteristics and food basket of a family, all the SAM children had a troubled medical history and/or low birth weight. The research findings also point out that a rise in income alone does not automatically lead to increased nutritional food intake. It is also important to see the issue of malnutrition in the larger context of the agrarian crisis that has cast its shadow over the rural landscape. For sustainable and lasting solutions, it is essential to shift to and promote farming practices that facilitate indigenous, locally produced and culturally acceptable nutrition from supplementary foods.

Extremity Tourniquet Training at High Seas

BackgroundFuture navy officers require unique training for emergency medical response in the isolated maritime environment. The authors issued a workshop on injury classification and extremity bleeding control, using four different commercial extremity tourniquets onboard a training sail ship. The purpose was to assess participants' perceptions of this educational experience and evaluate application simplicity while navigating on high seas.MethodsA descriptive observational study was conducted as part of a workshop issued to volunteer sailors. A post-workshop survey collected participants` perceptions about the workshops' content usefulness and adequacy, tourniquet safety, application simplicity in high seas, and device preference. The studied variables were measured on a one-to-ten Likert scale, while tourniquet preference by frequency count. Frequencies and percentages were calculated for the studied variables, and application simplicity means compared using the ANOVA test (p<0,05).ResultsFifty-one Spanish training naval officers, aged from 20-21, perceived workshop content usefulness, adequacy, and safety level in high sea use at 8.6/10, 8.7/10, and 7.5/10, respectively. As for application simplicity, CAT and SAM-XT were rated equally with a mean of 8.5, followed by SWAT (7.9) and RATS (6.9). The only statistical difference found was for the RATS (p<0.01). Windlass models were preferred by 94%, and elastic tourniquets by 6%. ConclusionsThe training sail ship extremity bleeding control workshop was perceived as useful and its content adequate by the participating midshipmen. Windlass tourniquet types were regarded as easier to apply than elastics models and were the preferred model by nine out of every ten participants.

Analysis of Emergency Medical Response Service in Peshawar through Simulation

EMRS (Emergency Medical Response Service) is the public safety system that is responsible for the initial first aid and transportation of the patient to the hospital. Providing a timely response to any emergency situation is of critical nature and needs to be addressed in the shortest possible time. Decreasing the response to an emergency site and timely pre-hospitalization care location identification and number of emergency response personnel and vehicles are some of the critical elements of EMRS. In this research, a probabilistic model is developed which incorporates the probabilistic response to any emergency situation. The developed model was applied to an actual scenario of the EMRS in the city of Peshawar, Pakistan. The EMRS has 7 locations covering 7 different regions of the city covering more than 1200 square kilometers area. The main purpose of the study is to measure the quality of EMRS on the basis of response time and queue. The study has identified that station 1 and 2 have the highest utilization; 58% each, while station 7 has the lowest utilization at 13.7%. Since the emergency care at the site of incidence is one of the primary responsibilities of the public safety organizations so this study also discusses the average instantaneous utilization of EMRS resources for that region.