Which is false regarding nutritional surveillance Done in all children less than 5 years

Question 56

Which is false regarding nutritional surveillance

a.       It is a Diagnostic Method

b.      Precise weight reading required

c.       Done in all children less than 5 years

d.      Done by a trained worker

Answer

c. Done in all children less than 5 years

Reference

Park 18^th Edition Page 473

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The concept of nutritional surveillance ahs been derived from disease surveillance. Nutritional surveillance ahs been defined as “keeping watch over nutrition, in order to make decisions that will lead to improvement in nutrition in population”

Explanation

a.       It is a Diagnostic – Interventional Method

b.      Weight card has Precise nutritional status

c.       Representative sample is done for enrolment

d.      Done by a trained worker

Comments

a.       To aid long term planning in health and development

b.      To provide input for programme management and evaluation and

c.       To give timely warning and intervention to prevent short tem food consumption crises ,

Tips

Refer to Table 38 Page 473 In Park 18^th Edition for the differences between Growth Monitoring and Nutritional Surveillance

About Delphi method Formation of a team to undertake and monitor a Delphi on a given subject.

Question 55

About Delphi method

a.       Formation of a team to undertake and monitor a Delphi on a given subject.

b.      Selection of one or more panels to participate in the exercise. Customarily, the panelists are experts in the area to be investigated.

c.       Development of the first round Delphi questionnaire

d.      All are true

Answer

d. All are true

Reference

http://en.wikipedia.org/wiki/Delphi_method

http://www.iit.edu/~it/delphi.html

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The Delphi method is a systematic interactive forecasting method for obtaining forecasts from a panel of independent experts. The carefully selected experts answer questionnaires in two or more rounds. After each round, a facilitator provides an anonymous summary of the experts’ forecasts from the previous round as well as the reasons they provided for their judgments. Thus, participants are encouraged to revise their earlier answers in light of the replies of other members of the group. It is believed that during this process the range of the answers will decrease and the group will converge towards the "correct" answer. Finally, the process is stopped after a pre-defined stop criterion (e.g. number of rounds, achievement of consensus, stability of results) and the mean or median scores of the final rounds determine the results.

Delphi  is based on well-researched principles and provides forecasts that are more accurate than those from unstructured groups. The technique can be adapted for use in face-to-face meetings, and is then called mini-Delphi or Estimate-Talk-Estimate (ETE). Delphi has been widely used for business forecasting and has certain advantages over another structured forecasting approach: prediction markets.

Explanation

Fowles (1978) describes the following ten steps for the Delphi method:

1. Formation of a team to undertake and monitor a Delphi on a given subject.
2. Selection of one or more panels to participate in the exercise. Customarily, the panelists are experts in the area to be investigated.
3. Development of the first round Delphi questionnaire
4. Testing the questionnaire for proper wording (e.g., ambiguities, vagueness)
5. Transmission of the first questionnaires to the panelists
6. Analysis of the first round responses
7. Preparation of the second round questionnaires (and possible testing)
8. Transmission of the second round questionnaires to the panelists
9. Analysis of the second round responses (Steps 7 to 9 are reiterated as long as desired or necessary to achieve stability in the results.)
10. Preparation of a report by the analysis team to present the conclusions of the exercise

Comments

The most important issue in this process is the understanding of the aim of the Delphi exercise by all participants. Otherwise the panelists may answer inappropriately or become frustrated and lose interest. The respondents to the questionnaire should be well informed in the appropriate area but the literature suggest that a high degree of expertise is not necessary. The minimum number of participants to ensure a good group performance is somewhat dependent on the study design. Experiments by Brockhoff  suggest that under ideal circumstances, groups as small as four can perform well.

Tips

Free software for conducting Delphi studies is available at http://armstrong.wharton.upenn.edu/delphi2/

Concurrent list does not encompass Regulation and development of Medical Profession

Question 54

Concurrent list does not encompass

a. Prevention of extension of communicable diseases from one unit to another

b. Prevention of adulteration of foodstuffs

c. Regulation and development of medical profession

d. Vital Statistics

Answer

c. Regulation and development of Medical Profession

Reference

Park 18^th Edition Page 675

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The fuctions of the Union Health Ministry are set out in the seventh schedule of Article 246 of the Constitution of India under

a)      Union List

a.       International health relations and administration of port quarantine

b.      Administration of Central Institutes such as the All India Institute of Hygiene and Public Health, Kolkata; National Institute for the Control of Communicable Diseases Delhi etc

c.       Promotion of Research through research centres and other bodies

d.      Regulation and development of medical, pharmaceutical, dental and nursing professions

e.       Establishment and maintenance of drug standards

f.        Census and Collection and publication of other statistical data

g.      Immigration and Emigration

h.      Regulation of labour in the working of mines and oil fields and

i.        Co Ordination with States and with other ministeries for promotion of health

b)     Concurrent List

a.      Prevention of extension of communicable diseases from one unit to another

b.      Prevention of adulteration of foodstuffs

c.       Control of drug and poisons

d.      Vital Statistics

e.       Labour welfare

f.        Ports other than major

g.      Economic and Social Planning

h.      Population Control and Family Planning

Explanation

Self Explanatory

Comments

The state List which became the responsibility of the state included

a)      Provision of medical care

b)     Preventive Health Services

c)      Pilgrimages within the state

Tips

Quarantine act in India was promulgated in 1825

As per RCH, the Community Health Centre is a First Referral Unit

Question 53

As per RCH, the Community Health Centre is a

a. First referral unit

b. Secondary referral Unit

c. Tertiary Referral Unit

d. Not a referral Unit

Answer

a. First Referral Unit

Reference

Guidelines For Operationalising First Referral Units

(mohfw.nic.in/dofw%20website/FRU&amp_nbsp_Guidelines_2004.pdf)

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CHAPTER XI : RECOMMENDATIONS : Reduction in fertility, mortality and population growth rate are major objectives of the Tenth Plan. These should be achieved through meeting all the felt needs for health care of women and children by

improving access to services. Approach Paper to Tenth Plan envisages reduction in IMR to 45 /1,000 by 2007 and 28/1,000 by 2012, reduction in MMR to 2/1000 live births by 2007 and 1/1,000 live births by 2012 and reduction in decadal growth rate of the population between 2001-2011 to16.2. The steep reduction in mortality and fertility envisaged are technically feasible within the existing infrastructure and manpower as has been demonstrated in several states/districts. It is imperative that the goals set are achieved within the time frame as these goals are essential prerequisites for improving the quality of life and human development.

Explanation

Self Explanatory

Comments

CHC/ FRU is the critical institution which provides emergency care and plays vital role in the referral system. Currently reported gaps in number of CHC/FRU should be filled by appropriately reorganizing the Sub-divisional hospitals, post partum centers and block level PHCs . The required number of core specialists should be posted through appropriate redeployment of the manpower; wherever adequate number of specialist are not available, bringing them on contractual basis/part time basis may be considered. In order to strengthen the capability for antenatal and intrapartum care at CHC / FRU all the states may take up training of one of the staff nurses in CHC/FRU at district hospital, so that there is a nurse specialised in midwifery is available at CHCs/FRUs to provide antenatal and intrapartum care. Over the next five years efforts should be made to improve the availability of all facilities to manage emergencies at least in selected CHCs by improving availability of anaesthetist and access to banked blood.

Tips

Planning Commission Reports can be seen at

planningcommission.nic.in/aboutus/committee/strgrp/stgp_fmlywel/13_Chapter11.doc

planningcommission.nic.in/aboutus/committee/strgrp/stgp_fmlywel/sgfw_ch11.pdf

Psychrometer is used for measuring Humidity

Question 52

Psychrometer is used for measuring -

a.         air velocity

b.         Core Temperature

c.         Humidity

d.         Height from Sea Level

Answer

Humidity

Reference

Park 18th Edition Page 557

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The sling or whirling psychrometer consists of 2 mercury thermometers (wet and dry) mounted side by side on a suitable wooden frame, and provided with a handle for rotating the instrument. The underlying principle is that by rotating the bulbs are exposed to air at definite velocity.

Explanation :

Self Explanatory

Comments :

Other ways of measuring Humidty are

                                                  i.      Dry and wet bulb hygrometer

                                                ii.      Assmann Psychrometer

Tips :

Ä     Air velocity is measured by anerometer and kata thermometer

Ä     Wind direction is measured by Wind vane

Most common occupational cancer in India is Skin Cancer

Question 51

Most common occupational cancer in India is

a.       Skin Cancer

b.      Lung Cancer

c.       Bladder Cancer

d.      Brain Cancer

Answer

a. Skin Cancer

Reference

Park 18th Edition Page 611

Indian Journal of Industrial medicine 13-45 BHansali KN (1967)

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Statistics now show that nearly 75 percent of occupational cancers are Skin cancers

Explanation

Self Explanatory

Comments

Beware that the “Now” was 40 years ago.

Tips

The English surgeon Percivall Pott (1714-1788) was the first to establish a causal link between cancer and exposure to a substance in the environment. In 1775 he described the occurrence of cancer of the scrotum in a number of his male patients, whose common history included employment as chimney sweeps when they were young. He related the malignancy to the occupation, and concluded that their prolonged exposure to soot was the cause. Pott's description of this disease, and his concern for the plight of these "chimneyboys," sparked a series of reports by other authors and brought to light a disgrace which took another hundred years to eliminate in England. Pott may legitimately be seen as a precursor to the modern investigators who seek to prevent occupational exposure to hazardous substances.

Soft tick transmits Q Fever Relapsing Fever

Question 50

Soft tick transmits

a. Relapsing Fever

b. KFD

c. Tick Typhus

d. Tularemia

Answer

a. Relapsing Fever

Reference

Park 18^th Edition Page 574

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The diseases transmitted by various insects are

Ä     Anopheles mosquito

o       Malaria

o       Filaria (not in India)

Ä     Culex mosquito

o       Bancroftian Filariasis

o       Japanese Encephalitis

o       West Nile fever

o       Viral Arthritis (epidemic / polyarthritis)

Ä     Aedes mosquito

o       Yellow fever (not in India)

o       Dengue

o       Dengue Haemorrhagic fever

o       Chikungunya fever

o       Chikungunya haemorrhagic fever

o       Rift Valley fever

o       Filaria (not in India)

Ä     Mansonoides mosquito

o       Malayan (Brugian) filariasis

o       Chikungunya fever

Ä     Housefly

o       Typhoid and paratyphoid fever

o       Diarrhoea

o       Dysentry

o       Cholera

o       Gastro-enteritis

o       Amoebiasis

o       Helminthic infestations

o       Poliomyelitis

o       Conjucntivitis

o       Trachoma

o       Anthrax

o       Yaws

Ä     Sandfly

o       Kala-azar

o       Oriental Sore

o       Sandfly fever

o       Oraya Fever

Ä     Tsetse Fly

o       Sleeping Sickness

Ä     Louse

o       Epidemic Typhus

o       Relapsing Fever

o       Trench Fever

o       Pediculosis

Ä     Rat Flea

o       Bubonic Plague

o       Endemic Typhus

o       Chiggerosis

o       Hymenolepis diminuta

Ä     Black Fly

o       Onchocerciasis

Ä     Reduvid Bug

o       Chagas Disease

Ä     Hard Tick

o       Tick Typhus

o       Viral Encephalitis

o       Viral Fevers

o       Viral Hemorrhagic fevers (eg KFD)

o       Tularemia

o       Tick Paralysis

o       Human Babesiosis

Ä     Soft Tick

o       Q Fever

o       Relapsing Fever

Ä     Trombiculid Mite

o       Scrub Typhus

o       Rickettsial Pox

Ä     Itch-mite

o       Scabies

Ä     Cyclops

o       Guinea Worm

o       Fish Tape worm

Ä     Cockroaches

o       Enteric Pathogens

Explanation

Self Explanatory

Comments

Relapsing fever is also transmitted by Louse

Tips

Remember the Mnemonic QRS – Q Fever, Relapsing Fever, Soft Tick