Background: Sleep is an important physiological process with many restorative functions. Insomnia defined as difficulty in falling or staying asleep which is frequent in older people. Reduced sleep quality can result in impaired daytime function which can lead to severe consequences. This study was conducted to examine sleep quality of elderly and to determine its relationship with psychosocial factors, in a rural population of Kerala. Methods: A community based cross sectional study was done by interviewing 170 people who were 60 years or above, selected by simple random sampling, after getting consent. The study tools used were Pittsburgh sleep quality index (PSQI), General anxiety disorder 7 item (GAD-7) scale, geriatric depression score (GDS 5 items) and a self designed general sociodemographic questionnaire. Data was tabulated using MS Excel and analyzed using SPSS V-20. Results: The sleep quality according to global PSQI was good for 27.6%, while it was poor for 72.4% of respondents. The mean GPSQI of the study was 8.04±4.59. Absence of toilet inside home (p=0.036), current health problems (p=0.003), multiple (>3) health problems (p=0.006), regular use of current medications (p=0.033) had a significant association with poor sleep quality. Association between general anxiety disorder and GPSQI was significant with poor sleep quality among those with severe anxiety (p=0.017). Association between GDS-5 score and GPSQI showed a significant association between symptoms suggestive of depression and poor sleep quality (p=0.014). Conclusions: Questions on sleep quality should be routinely asked by clinicians as part of general health assessment of an elderly.

ObjectivesWe sought to understand the implementation of multifaceted community plans to address opioid-related harms.DesignOur scoping review examined the extent of the literature on community plans to prevent and reduce opioid-related harms, characterise the key components, and identify gaps.Data sourcesWe searched MEDLINE, Embase, PsycINFO, CINHAL, SocINDEX and Academic Search Primer, and three search engines for English language peer-reviewed and grey literature from the past 10 years.Eligibility criteriaEligible records addressed opioid-related harms or overdose, used two or more intervention approaches (eg, prevention, treatment, harm reduction, enforcement and justice), involved two or more partners and occurred in an Organisation for Economic Co-operation and Development country.Data extraction and synthesisQualitative thematic and quantitative analysis was conducted on the charted data. Stakeholders were engaged through fourteen interviews, three focus groups and one workshop.ResultsWe identified 108 records that described 100 community plans in Canada and the USA; four had been evaluated. Most plans were provincially or state funded, led by public health and involved an average of seven partners. Commonly, plans used individual training to implement interventions. Actions focused on treatment and harm reduction, largely to increase access to addiction services and naloxone. Among specific groups, people in conflict with the law were addressed most frequently. Community plans typically engaged the public through in-person forums. Stakeholders identified three key implications to our findings: addressing equity and stigma-related barriers towards people with lived experience of substance use; improving data collection to facilitate evaluation; and enhancing community partnerships by involving people with lived experience of substance use.ConclusionCurrent understanding of the implementation and context of community opioid-related plans demonstrates a need for evaluation to advance the evidence base. Partnership with people who have lived experience of substance use is underdeveloped and may strengthen responsive public health decision making.

Background: Hepatitis B virus is transmitted by body fluids, such as blood and serum. Sexual transmission, vertical transmission, and unsafe injections, including intravenous drug use, are the most common routes of infection for Hepatitis B infection. Medical students have a very important role in preventing the disease by improving the disease knowledge among themselves and the patients they will eventually treat.Methods: A cross sectional study was conducted to assess the KAP among medical students of the first three academic years regarding hepatitis B virus infection. The sample size was 222 students. Data were collected from 230 students using a semi structured questionnaire and analyzed using SPSS v20.Results: Among 230 medical students, 79.1% students had good knowledge about hepatitis B whereas 84.3% of the respondents had the right attitude towards hepatitis B. The practice component was low with only 44.8% of the respondents having correct practice regarding hepatitis B infection.Conclusions: Although the knowledge and attitude regarding hepatitis B infection is high, the practice levels are low indicating the need to encourage proper practices among the medical students.

Background: Dengue fever is an acute infectious disease for which there are currently no specific drugs or effective vaccines available. Therefore its prevention & control solely rest on vector control strategies, for which behavioural change of the community is a requirement. Hence, the aim of our study was to implement a standardised behaviour change communication intervention strategy (BCC) and to measure its impact on the population in terms of awareness, attitude and practice regarding dengue and its vector control. Methods: This study was carried out in a ward in Njarackal Panchayath in Ernakulam district of Kerala. An initial baseline survey was conducted to assess the current awareness, attitude and practices of dengue & its vector control among the residents of the ward. This was followed by the implementation of standardized BCC Intervention strategy. A post intervention survey was carried out two months later to analyze its impact. Results: This BCC strategy resulted in increasing the awareness regarding dengue and its vector control even though it was found not to be statistically significant. However, the strategy was able to bring about a significant change in the attitude and practice of the people with regard to dengue prevention and control strategies. Conclusions: This BCC strategy was successful in this population due to community acceptance, however it requires constant reinforcement for its sustainability.