Rupali, can you please share a case study of how you used the Positive Deviance approach to address malnutrition in your village?
Rupali: Sure. In Mala Villa, around 30% of children under 5 years were malnourished according to government records. As an Anganwadi worker, I was concerned about this high rate of malnutrition.
I started talking to mothers in the village to understand the child feeding and care practices. I noticed that some children from poor families were well-nourished despite the difficult circumstances. These were the "Positive Deviant" children.
I observed the Positive Deviant families closely to understand what special practices they followed to nourish their children. I found that
What the heart sees at the MIDAC - openingAlfonso Caputo
The International Photographic Project "What the heart sees" at the MIDAC Museum, Palazzo Bonfranceschi, Belforte del Chienti, Italy. By Terra dell'Arte.
Photos by Ruben Almeida
Margareth Degeling at the MIDAC Museum 2015Alfonso Caputo
Solo exhibition of the Dutch artist Margareth Degeling at the MIDAC Museum, Belforte del Chienti, Italy. By Terra dell'Arte. Photos by Ruben Almeida Pinto & Rossella Sclavi
Online Marketing Summit (OMS) - The Myth of Mobile MetricsIvanti
LogMyCalls CEO, Jason Wells, gave this presentation at the Online Marketing Summit (OMS) in Silicon Valley. It discusses mobile marketing and how to gather mobile analytics.
Sustainable Nutrition Manual presentation for clearance (result = endorsed!)Stacia Nordin
Presentation to the Malawi Agriculture Technical Clearing Committee which, after discussion, resulted in Endorsement of the revised Sustainable Nutrition Manual. Coming your way soon! Publishing process now underway.
Follow www.NeverEndingFood.org for updates
What the heart sees at the MIDAC - openingAlfonso Caputo
The International Photographic Project "What the heart sees" at the MIDAC Museum, Palazzo Bonfranceschi, Belforte del Chienti, Italy. By Terra dell'Arte.
Photos by Ruben Almeida
Margareth Degeling at the MIDAC Museum 2015Alfonso Caputo
Solo exhibition of the Dutch artist Margareth Degeling at the MIDAC Museum, Belforte del Chienti, Italy. By Terra dell'Arte. Photos by Ruben Almeida Pinto & Rossella Sclavi
Online Marketing Summit (OMS) - The Myth of Mobile MetricsIvanti
LogMyCalls CEO, Jason Wells, gave this presentation at the Online Marketing Summit (OMS) in Silicon Valley. It discusses mobile marketing and how to gather mobile analytics.
Sustainable Nutrition Manual presentation for clearance (result = endorsed!)Stacia Nordin
Presentation to the Malawi Agriculture Technical Clearing Committee which, after discussion, resulted in Endorsement of the revised Sustainable Nutrition Manual. Coming your way soon! Publishing process now underway.
Follow www.NeverEndingFood.org for updates
POSHAN ABHIYAAN-Poshan 2.0 will concentrate on Maternal Nutrition, Infant and...sheeza38
A month-long celebration of the POSHAN Abhiyan mission places special attention on Severe Acute Malnourished (SAM) children. It is an umbrella scheme covering the Integrated Child Development Services (ICDS) (Anganwadi Services, Poshan Abhiyan, Scheme For Adolescent Girls, National Creche Scheme).
Poshan 2.0 will include three significant initiatives within its purview: Anganwadi Services, the Scheme for Adolescent Girls, and Poshan Abhiyaan. Moreover, Poshan 2.0 will concentrate on Maternal Nutrition, Infant and Young Child Feeding Norms, Treatment of MAM/SAM, and Wellness through AYUSH.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
1. Good DRR Practices in Health by
PRIs
Session objectives:
At the end of this session participants will be able to advocate
• Adoption of best practices in health for effective DRR
Key learning points of the session:
• There have been some useful practices undertaken in different areas
• Some of these good practices include- Institutional Delivery -Referral Transport,
Collection of Water, Keno Parbo Na, DOTS, Fever Depots
Handout for the session:
Are you aware that Rs 10000/- is allotted to your Village Health and Sanitation
Committee (VHSC) as an untied fund? How has it been spent this year? Last year?
How has it been spent in previous years?
Good Practice Need Covered Benefit
Rural Ambulance - from Referral Transport Pregnant Women
modified Van Rickshaws
Keno Parbo Na Nutrition 0-3 children
Local solutions for Water Collection All
Collection of Water
2. Oral Rehydration Therapy Diarrhoea All
(ORT) Corners
Directly Observed TB All
Treatment Shortcourse
(DOTS)
Fever Depots Malaria All
Local Life Jackets made by Drowning Flood Prone
Self Help Groups/ SHGs
Table: 1 Good Practices
Rural Ambulance converted Van Rickshaws
Modified Van Rickshaw in 24 Parganas Sunderban area- use of van-rickshaw as a rural
ambulance that could save hundreds of lives by only being able to transport patients
from the households to the local clinic, in the specific region of rural West Bengal
Figure 1: Rural Ambulance
The main feature of this conveyance is that its base/platform is at a considerably low
height from the ground level than a common rickshaw van. This arrangement is made to
create more space and reduce the vibration, which otherwise cause discomfort to the
patient in a rugged terrain of an unpaved road.
3. A stretcher is placed on one side, with proper shock absorbing arrangements. This
helps in avoiding jerks due to bad road conditions. The stretcher can be removed while
using the conveyance for a purpose other than carrying ailing patients.
Just opposite to the stretcher, the sitting arrangement is made for at least two
attendants.
An oxygen cylinder is kept at one corner so as to meet the exigencies.
Likewise, a first-aid-box is also kept at one corner.
A wash basin is placed beside the stretcher.
Arrangements for saline, drinking water, adequate lighting, are made.
Battery operated hand mike set is fitted on the top of the vehicle.
Provisions for life jacket, life line, stuff, small tent, extra rope, folding ladder, blankets,
etc. are there for using the vehicle during calamities.
The top of the vehicle is tin-roofed and the sides are also fenced with tin sheets and
nets are placed in between to ensure adequate ventilation.
It can be used both for delivery patients AND OTHER TYPES OF PATIENTS
Hand washing
4.
5. Nutrition - Keno Parbo Na programme
Figure 1: Positive Deviance Mascot
Monitoring is done by mothers using the Mascot. Each limb represents a step in
protecting the child- such as Measles Immunization
6. Figure 2: Community Map
A positive deviant child is a healthy and developed child in a poor, disadvantaged
and distressed family. A positive deviant family is a family which has PD children
The special practices of a PD family which enables a child to grow and develop well
7. inspite of poor socioeconomic conditions are called PD practices
The attempt is to find out these practices in the community and formulate strategies and
activities which motivate all families with children to adopt these best practices through
participatory learning.
Making Malnutrition Visible to the families and community through weighing of children
and using colour-coded charts, maps and other tools
Finding out prevalent child care and feeding practices in the area – both good and bad
and identifying young children who have good (normal nutrition) or bad (severe acute
malnutrition) nutritional status as a result of these practices
Bringing the moderate to severe malnourished young children (0-3 years) and their
care-givers regularly to the AWCs (Angan Wadi Centres) for the Nutrition Counseling
and Child Care Session-NCCS. AWWs (Angan Wadi Workers) along with community,
positive deviant mothers & SHGs and teach them the correct feeding and care practices
through hands-on demonstration and urge them to follow the same care practices at
home
Close monitoring and follow up
Monitoring is done by mothers using the Mascot. Each limb represents a step in
protecting the child- such as Measles Immunization
Local solutions for Collection of Water
Collection of Rain Water by community in jars/ kolshi and using filters of sari cloth have
saved many lives. These are local practices that need to be copied and propagated.
Scientific studies have shown how many bacteria are trapped when plankton get stuck
in the cloth.
8. Figure 3:
Post Aila Water Collection
ORT Corners
At Gosaba Ghat we saw a newly literate man poring over a little booklet on what to do
in emergencies. He was reading very slowly- dis..in..fect…….ten…litres..of…water
with…a 40…milligram ta…blet..of Hala…zone.
Figure 4: ORT Corner Gosaba
9. A little further on, at the ticket office we found Swapna Barman explaining how to make
Oral Rehydration Solution to a man with a small child. After she had finished a
government Male Health Worker checked that the man had understood exactly what
she had said. Meanwhile Dipankar Dalui gave them the ORS he had just made in a
bottle they provided.
At the local Primary Health Centre Indrajit Hazra was also preparing stock solution to
disinfect water. He and Sanjeeb John Makhal had talked to 79 in patients, out patients
th
and visitors on 10 July. Saturday is a busy day in Gosaba- it is Market Day and there
are people here from as far away as Choto Mollakhali. Mollakhali is three hours ride by
launch from Gosaba.
Swapna is a local volunteer from Manmathanagar working with Anwesha, a local NGO.
Dipankar from Satjelia and Sanjeeb from Bali are with Palli Unnayan Samiti (Rural
Development Society). Indrajit has been working in West Bengal’s Nadia District for the
Catholic Charities there and has been deputed to Gosaba to take part in the relief work
beside the local volunteers after the devastating cyclone Aila that struck West Bengal
th
on 25 May 2009. They are all literate young people from rural areas.
Figure 5: ORT Corner Sarberia
Gosaba is a block town and administrative headquarters for 11 inhabited islands in the
th
Sunderbans. It was first settled in the 19 century by a man called Daniel Hamilton, who
10. bought three islands and turned them into an estate. He brought settlers from
neighbouring districts and they started the first agriculture here. Now Gosaba is a
bustling town of around 50000 people. The islanders also cultivate prawns and catch
th
fish for a living. The cyclone on 25 May broke the protective embankments around the
islands. Sea water has flowed into the fields and fresh water ponds and many have lost
their homes and farms. The storm also destroyed the water pipeline to Gosaba. Many
th
were forced to drink contaminated water and a diarrhoeal outbreak started around 30
May and continued for over a fortnight. There are still a few diarrhea patients coming in
from the further off islands.
TB- DOTS
Raiganj- A Panchayat Prodhan followed up a [patient who had been treated under
RNTCP. After 2 courses of treatment the man was declared resistant to TB. The
Prodhan followed up and filled in a form that was sent to Swasthya Bhavan, The patient
was admitted to the Jawaharlal Nehru Hospital in Kalyani for DOTS Plus treatment.
Fever Treatment Depots
Dooars- Indian Tea Association has set up Malaria clinics in the remote gardens. These
are a support to the Fever Treatment Depots where ICDS workers keep Malaria
medicines and can take blood for tests
Local Life Jackets made by SHGs
During the CBDP programme in Uttar Dinajpur Self Help Groups learnt how to make
cost effective life jackets using commonly available materials.
Source of the Reference material:
Skills That Save Lives ASHA Module 6 NRHM
Keno Parbo Na- http://www.positivedeviance.org/from_the_field/voices-nutrition.html
http://www.unicef.org/india/nutrition_1557.html
11. Van Ambulance-
http://wn.com/InnoAid__Rural_Ambulance_Project__Sunderbans__the_local_rickshawm4v
ORT Corners UNICEF Press Report
Session plan:
Start the session with explaining objectives of the session and the significance of the
session for the entire training programme.
Running time Description of specific activities of the session
First 10 mins Brain Storming/ Listing. Ask- What are the good practices you
have seen?
11-50 mins Presentations (6 mins each): either of their own success stories
or of examples provided
51 to 60 mins Discussion on good practices by PRIs.
Methods:
Handouts, Presentation of case studies of good practices highlighting the scope of DRR
in Health sector and the role played by PRIs
Material required:
Pre-designed visual aids on Case Studies. White board, white board markers, flip charts
Annexure-
Case Study on Positive Deviance/ Keno Parbo Na
12. PD Practitioner: Rupali Haldar (Anganwadi worker)
Location: Mala Village, West Bengal
Date: February 2005
My name is Rupali Haldar. Initially when I started my work as an AWW (Anganwadi
Worker), and used to weigh children, then many mothers refused to allow me to weigh
their children. Many used to make faces, many used to say if you weigh my child the
weight will go down but I still didn’t lose hope. Whenever I used to go to the village, the
villagers used to snub me by saying, “There she goes, once again she will try to weigh
our children.” Many used to comment, “She gets money so she comes here, she must
have some purpose.” Again, some used to say, “Even though some people get money
they don’t work, they don’t come to advise us”.
Slowly, I became much closer to them. My first session started at 1.6.02. There were 14
children then. The programme was not initiated in the centre but in a mothers’ house. It
takes 10 minutes from the centre to reach that house. The programme stopped for a
month due to heavy rains. By 28.8.02, a number of Grade IV, III, and II malnourished
children moved to Grade I and Normal. Their mothers were so happy. They started
feeding the meal at home as well.
Another aspect of joy was that the grandmothers used to bring the children to the
centre. If the mothers did not want to come the grandmothers used to persuade them to
attend. The grandmothers also reported the cases of mothers who did not prepare the
meal at home. In the PD programme, the Hindu and Muslim mothers prepared the meal
together. The programme started in a Hindu family, but then it also took place in the
Muslim families. Even the mothers of the normal children have supported and
participated in the programme wholeheartedly. Once I asked a normal child’s mother,
“Why do you want to attend regularly?” She said, “I want my child to remain healthy and
not lose weight and besides my child loves to eat with all the children.”
Initially the Panchayat people did not help me. They wouldn’t even behave properly. I
supplied the fuel till the 8th session. From the 9th session, the mothers’ contributed the
13. fuel. One of the fathers refused to give polio drops to the child but the grandmother
came to me to give the child the drops secretly. I was so happy.
My CDPO and Supervisor told me to work well to get good results. Today I am very
happy. Now even the Panchayat have come forward. Earlier they wouldn’t listen to me,
now they do. Earlier those who would make faces and wouldn’t talk to me, now
consider me as their own. This is my biggest gift. My work is for mothers and children,
and to reduce child deaths. If I am aware, then I can create awareness in others. I feel
AWWs should have a mentality of maternal love and affection. I feel even if there is a
VHC (Village Health Committee), to back up the AWW, she has to give her best effort.
Whenever there is a problem the mothers must be consulted, this helps in
understanding what each mother wants to say. Once while facing the fuel problem, I
said I don’t get any money for fuel, how long can I keep arranging for it? The mothers
were quick to answer “Didi, these are our children who have the food, so we will arrange
the fuel, don’t worry.”