Health literacy is a term employed to assess the ability of people to meet the increasing demands related to health in a rapidly evolving society. Low health literacy can affect the social determinants of health, health outcomes and the use of healthcare services. The purpose of the study was to develop a survey construct to assess health literacy within the context of regional culture. Different socioeconomic status among the Eastern and Middle Eastern countries may restrict, health information access and utilization for those with low literacy. By employing expert panel, Delphi technique, focus group methodologies, and pre-testing using participants (N = 900) from the UAE and India, a survey construct to the Eastern-Middle Eastern cultures was developed. Reliability was assessed using Cronbach’s α and validity using Factor analysis. Kiaser-Meyer-Olkin (KMO) sampling adequacy and Bartlett’s tests were used to assess the strength of the relationship among the variables. Inclusion of non-health related items were found to be critical in the authentic assessment of health literacy in the Eastern and Middle Eastern population given the influence of social desirability. Thirty-two percentage of the original 19-item construct was eliminated by the focus group for reasons of relevance and impact for the local culture. Field pretesting participants from two countries, indicated overall construct reliability (Cronbach’s α =0.85), validity and consistency (KMO value of 0.92 and Bartlett’s test of sphericity was significant). The Eastern-Middle Eastern Adult Health Literacy (EMAHL13), screening instrument is brief, simple, a useful indicator of whether or not a patient can read. It assessespatients’ ability to comprehend by distinguishing between health and non-health related items. The EMAHL13 will be a useful too for the reliable assessment of health literacy in countries, where culture plays a significant impact. This will be the first steptowards providing equitable access to healthcare for countries that have large populations with low socioeconomic status.

Background: Gulf Medical College, UAE, underwent a major curriculum change from a discipline-based to an organ-based integrated curriculum. Aim: To compare students’ perception of the educational environment in the discipline-based curriculum with that in the integrated curriculum. Methods: Data was collected from second-year students (Group 1) in the discipline-based curriculum and in the subsequent year from second year students in the integrated curriculum (Group 2). The instrument used was Dundee Ready Education Environment Measure (DREEM). Scores were compared using Wilcoxon Rank Sum test. Data from second, third and fourth year students in the discipline-based curriculum were used to determine the total DREEM score for the school. Results: The total DREEM score was significantly higher (p < 0.001) for Group 2 (135/200) when compared to Group 1(116/200). Both groups unanimously perceived a positive educational environment. Although Group 2 showed significantly more satisfaction, they perceived an over-emphasis of factual learning and a problem of cheating. Total DREEM score for the school was 120/200. Conclusion: This study shows that the organ system-based integrated curriculum is perceived to provide better educational environment than the discipline-based curriculum. However, areas like curriculum load and assessment strategies still require further fine tuning.

Body Mass Index (BMI) is a good indicator for measurements of Bone Mineral Density (BMD) which measures the density of minerals present in the bones using a special scan. This study was conducted to assess the association between BMI and status of BMD among 101 individuals who underwent Dual-Energy X-ray Absorptiometry (DEXA) scan. 39 subjects had normal and 62 had low bone mineral density. BMD was low in 82.4% of people with normal BMI, 78.1% among overweight, and 44.2% among obese. There was a statistically significant association between these two variables (

Sample size determination is one of the central tenets of medical research. If the sample size is inadequate, then the study will fail to detect a real difference between the effects of two clinical approaches. On the contrary, if the sample size is larger than what is needed, the study will become cumbersome and ethically prohibitive. Apart from this, the study will become expensive, time consuming and will have no added advantages. A study which needs a large sample size to prove any significant difference in two treatments must ensure the appropriate sample size. It is better to terminate such a study when the required sample size cannot be attained so that the funds and manpower can be conserved. When dealing with multiple sub-groups in a population the sample size should be increased the adequate level for each sub-group. To ensure the reliability of final comparison of the result, the significant level and power must be fixed before the sample size determination. Sample size determination is very important and always a difficult process to handle. It requires the collaboration of a specialist who has good scientific knowledge in the art and practice of medical statistics. A few suggestions are made in this paper regarding the methods to determine an optimum sample size in descriptive and analytical studies.Key Words: Sample size; Power analysis; Medical researchDOI: 10.3126/nje.v1i1.4100Nepal Journal of Epidemiology 2010;1 (1):4-10

Motorcycles account for a large proportion of road traffic accidents in India and the riders of these vehicles run a high risk of injuries or death. This study aims to explore the determinants of helmet use among motorcyclists in Kerala, India. A cross-sectional study conducted in Kerala, India, over a period of six months. 309 motorcyclists in Kerala were interviewed for this study using a pretested structured questionnaire. Among 309 motorcyclists, 80% were less than 40 years of age, and only 24% were females. Among the total, only 31.4% used a helmet. There was a statistically significant association between the use of helmet and gender, marital status, drunken driving, use of alcohol and attitude towards implementing legislative measures. Odds Ratios observed were 5.3 for female gender compared to male, 4.5 for those with a positive attitude towards the implementation of legislative measures on helmet use, 3.7 for those who were not drunk while driving and 2.3 for unmarried compared to married persons. The study concludes that the determinants associated with the practice of helmet use were gender, drunken driving, marital status and positive attitude towards legal measures. ‎

Adverse drug reactions (ADRs) are important public health problem associated with morbidity, mortality and financial burden on the society. Nurses play important role in medication safety surveillance through the spontaneous voluntary reporting of ADRs. Nurses' knowledge, attitude and practice towards ADR reporting and factors affecting reporting was assessed in the study. All nurses working in a tertiary care hospital, Ajman, UAE participated in this cross-sectional survey. A self administered questionnaire of four domains (knowledge, attitude, practice, factors affecting reporting) was distributed among nurses after obtaining informed consent. The knowledge and attitude components were assigned score of one for correct response. Data was analyzed using SPSS (version 19). Mann-Whitney U test was used to compare knowledge and attitude scores between subgroups; Spearman's correlation for any relationship between knowledge and attitude. Of the total participants, females constituted 92.3%; average duration of clinical experience 6.5 ± 3.3 years; mean age 28.9 ± 4.1 years. Median score for knowledge components of ADR reporting was 11(total score: 17) and for attitude components was 4(total score: 8). No difference noted in knowledge and attitude scores between gender, age group, educational qualification. A positive correlation between knowledge and attitude components was observed (r = 0.38). ADRs are important cause for morbidity and mortality was reported by (54.9%). 49.5% were aware of Pharmacovigilance centers'. Uncertainty of ADRs (49.5%); concern that the report may be wrong (46.2%) and inadequate knowledge of ADR reporting procedure were the major barriers to reporting. Training in ADR reporting as the key measure to improve reporting was suggested by (86.8%). The results of the study strongly point out the need for interventional program among nurses focusing on the importance of ADR reporting and reporting procedure to encourage their active, voluntary participation in drug safety surveillance.