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Background: National Family Health Surveys in India have not included nutritional status of the crucial age group of 10-14 years, when pubertal growth spurt typically occurs. BMI-for-age is commonly used to assess adolescent nutritional status which may misclassify stunted adolescents as normal or overweight. Objectives: To estimate prevalence and determinants of stunting among adolescents (10 to 19 years) in Bangalore city and to estimate the proportion of adolescents who are stunted, but otherwise assessed as normal or overweight using BMI-for-age. Methods: Cross sectional study conducted in four schools of Bangalore city using a self-administered questionnaire to capture socio-demographic details, dietary patterns and physical activity. WHO Anthroplus software was used to classify nutritional status based on height-for-age and BMI-for- age. Multiple logistic regression analysis was done to calculate adjusted odds ratios of independent co-variates associated with stunting. Results: Overall prevalence of stunting was 14% (95%CI:11.5-16.5%); 14.3% among females (95%CI:10.7-17.9%) and 13.6% among males (95%CI: 10.2-17.0%). Determinants of stunting were late adolescence [AOR=1.90(1.24-2.90),P=0.03], lower socio-economic class [AOR=2.75(1.39-5.41),P=0.03] and not taking weekly iron and folic acid supplements [AOR=2.78(1.48-5.21),P=0.001] Four of every five stunted children (81%) were classified as normal/ overweight/ obese using BMI-for-age. Conclusion: Stunting is a problem among urban adolescents in Bangalore. Height-for-age is a vital metric for assessing nutritional status of adolescents along with other metrics. We recommend strengthening of weekly iron and folic acid supplementation in schools and culturally specific targeted nutritional interventions for adolescents from economically weaker sections of society using a multi-sectoral and participatory approach. [ABSTRACT FROM AUTHOR]

Background: Ancillary health services are those supplemental services other than room, board, and medical/nursing services provided to hospital patients in the course of care. Ancillary department staff forms an integral part in the smooth functioning of a hospital. There is a need to focus on the health of these individuals to ensure their well-being and in turn, productivity at the workplace. Objective: To study the morbidity profile of the staff working at ancillary departments of a tertiary care hospital in Bengaluru, Karnataka, India. Materials and Methods: We conducted our study in a 1,200-bedded tertiary care hospital in Bengaluru, Karnataka, India. Annual medical checkup (AMC) for all the staff working at the ancillary departments has been started in recent years and is provided free of cost and during working hours. A total of 150 employees from ancillary departments underwent AMC in the year 2013. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0. Spearman's correlation and Chi-square test were used. Results: Of the 150 employees, the majority was male (72%); the mean age was 38 ± 11 years. The most common morbidities were diabetes mellitus (11%), hypertension (10.6%), musculoskeletal disorders (9.3%), surgical problems (8.6%, hemorrhoids, varicose veins), and dental caries (6.6%). On stool microscopy, 12% of the dietary workers showed ova/cyst. There was a significant positive correlation between age and the number of chronic morbidities (P < 0.01). Conclusion: Lifestyle disorders such as diabetes mellitus and hypertension were the major morbidities among the staff in the ancillary departments of the hospital. We ensured regular follow-up, adherence to medication, and lifestyle modifications in terms of diet and exercise. [ABSTRACT FROM AUTHOR]

Background: Body image refers to an individual's emotional attitudes, perceptions and beliefs regarding their own body and has a bearing on their nutritional status, which can have far-reaching consequences on their health as adults. Aim: To document body image perception and assess nutritional status among adolescents in a rural school in India. Methods: A cross sectional study was conducted among students at a government high school in Ramnagara District of Karnataka State in India. A self-administered validated questionnaire was used to document body image perceptions, self- estimation of body size and body image dissatisfaction. Height and weight were recorded and WHO BMIfor- age Growth Charts (5-19years) were used to determine nutritional status. Results: A total of 118 subjects were studied, two thirds of whom were girls. The median age was 14 years. 63% of subjects had normal BMI for age, 32% were under-nourished and 5% were overweight and obese. 53% of subjects wished they were thinner and 52% taller. 79% were found to have body image dissatisfaction. 70.3% of undernourished adolescents perceived themselves to be normal, while 66.7% of overweight adolescents perceived themselves to be normal. Adolescents who were malnourished were 7.2 times more likely to have an erroneous body size estimation compared to those who were normally nourished. Conclusion: Dual Burden of under-nutrition and over-nutrition exists among these adolescents. Proportion of adolescents with negative body image perceptions and body image dissatisfaction was high. School health programs need to incorporate counseling for those with negative body image perceptions, while emphasizing healthful nutrition for adolescents. [ABSTRACT FROM AUTHOR]

Background: The burden of chronic conditions is growing in Australia with people in remote areas experiencing high rates of disease, especially kidney disease. Health care in remote areas of the Northern Territory (NT) is complicated by a mobile population, high staff turnover, poor communication between health services and complex comorbid health conditions requiring multidisciplinary care. Aim: This paper aims to describe the collaborative process between research, government and non-government health services to develop an integrated clinical decision support system to improve patient care. Methods: Building on established partnerships in the government and Aboriginal Community-Controlled Health Service (ACCHS) sectors, we developed a novel digital clinical decision support system for people at risk of developing kidney disease (due to hypertension, diabetes, cardiovascular disease) or with kidney disease. A cross-organisational and multidisciplinary Steering Committee has overseen the design, development and implementation stages. Further, the system's design and functionality were strongly informed by experts (Clinical Reference Group and Technical Working Group), health service providers, and end-user feedback through a formative evaluation. Results: We established data sharing agreements with 11 ACCHS to link patient level data with 56 government primary health services and six hospitals. Electronic Health Record (EHR) data, based on agreed criteria, is automatically and securely transferred from 15 existing EHR platforms. Through clinician-determined algorithms, the system assists clinicians to diagnose, monitor and provide guideline-based care for individuals, as well as service-level risk stratification and alerts for clinically significant events. Conclusion: Disconnected health services and separate EHRs result in information gaps and a health and safety risk, particularly for patients who access multiple health services. However, barriers to clinical data sharing between health services still exist. In this first phase, we report how robust partnerships and effective governance processes can overcome these barriers to support clinical decision making and contribute to holistic care. [ABSTRACT FROM AUTHOR]

Post-operative management of chronic rhinosinusitis is very crucial for outcomes following surgery, Normal saline nasal irrigation and steroid spray form the standard treatment of care in this period. However nasal irrigation may not be adequate and spray is usually started after 2 weeks of surgery which in any case does not deliver optimum dosage of drug to the paranasal sinus mucosa. Budesonide nasal irrigation in a high-volume low-pressure system could be the solution for a better outcome. A double blinded randomized control trial with 88 patients in 2 groups of 44 each received normal saline or Budesonide nasal irrigation (0.5 mg in 200 ml) twice daily. Patients were followed up at 2 weeks post-operatively and 3 months, a SNOT 22 and Lund Kennedy Endoscopic scores were assessed for subjective and objective assessment. Subset analysis of only CRS patients (55) were done, and results presented. Patient reported subjective score at 3 months post operatively, SNOT22 was significantly (p < 0.0001) improved with the use of Budesonide irrigation (26.69 ± 2.92) as compared to Normal saline (30.54 ± 2.81) and objective assessment score, LKES was significantly (p = 0.0031) better in Budesonide group (4.06 + 0.74) in comparison to Normal saline in the saline (4.50 + 0.67) respectively. The mean scores 3 months post op visit was significantly lower for both subjective SNOT (p < 0.001) and objective score LKES (p < 0.0001) in Budesonide groups. Budesonide nasal irrigation with positive pressure high volume device has better patient benefits and wound healing when compared to normal saline irrigation in the post-operative management of chronic rhinosinusitis. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "Developing an integrated clinical decision support system for the early identification and management of kidney disease—building cross-sectoral partnerships." The correction addresses a spelling error in the surname of one of the authors, Louise Maple-Brown. The original article has been corrected, and the corrected version can be found online. The publisher, Springer Nature, remains neutral regarding jurisdictional claims and institutional affiliations. The article was authored by Gillian Gorham, Asanga Abeyaratne, Sam Heard, Liz Moore, Pratish George, Paul Kamler, Sandawana William Majoni, Winnie Chen, Bhavya Balasubramanya, Mohammad Radwanur Talukder, Sophie Pascoe, Adam Whitehead, Cherian Sajiv, Louise Maple-Brown, Nadarajah Kangaharan, and Alan Cass. [Extracted from the article]

Objective: To identify the needs of rural elders (> 60 yrs) and to assess the challenges faced by their caregivers in providing care for the elders, in rural Southern India Methodology: The study was a community based cross-sectional study, conducted in a rural block in Tamil Nadu, India in 2016. First part of the study consisted of conducting four focussed group discussions (FGDs) with male and female elders and caregivers respectively. Based on the themes from the FGDs, a structured questionnaire for the quantitative study (part two of the study) was designed. We could interview 158 elders and 96 caregivers. Results: The needs of the elders were found mainly to be in the areas of food, finances and emotional aspects. Study revealed 83 (52.5%) of the elders reported having to cook for themselves, 69 (43.6%) reported that they did not receive old age pension. The caregivers did not perceive taking care of elders as a burden. [ABSTRACT FROM AUTHOR]