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Jeyalakshmi K,1 Mahadev Rao,2 Shashidhara YN,1 Girish Thunga,2 Ravishankar N,3 Christopher Sudhakar,4 Elsa Sanatombi Devi5 1Department of Community Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India; 2Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India; 3Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India; 4Department of Mental Health Nursing & Director - Quality, Manipal Academy of Higher Education, Manipal, Karnataka, India; 5Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, IndiaCorrespondence: Elsa Sanatombi Devi, Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India, Tel +91 8310769938, Fax +91 820 292 2572, Email elsa.sana@manipal.eduPurpose: Medication adherence is a crucial component in the management of elderly with co-morbid chronic conditions. Hence, this study aimed to investigate the determinants of medication non-adherence among rural elderly with co-morbid chronic conditions of hypertension (HTN) and type 2 diabetes mellitus (T2DM) in India.Patients and Methods: This cross-sectional study adopted the probability proportional to size (PPS) sampling technique to find the determinants of medication non-adherence among elderly residing in rural coverage areas of five randomly selected primary health centres (PHC) in Udupi district, Karnataka, India. A total of 360 elderly (72 samples from each cluster) who met the inclusion criteria and consented were interviewed using predesigned prevalidated and standardized or reliable tools. The data were coded and entered in SPSS version 16.0 and analyzed using both descriptive and inferential statistics.Results: The study found that 55.6% (n=200) of rural elderly with co-morbid conditions HTN and T2DM were non-adherent to their medications and established Spearman correlation coefficient rank (r) value between undesirable person-related factors (r=− 0.444); good family support (including financial support) (r=0.185); poor accessibility to healthcare facility (r=− 0.209); detrimental medication-related factors including high cost of medication (r=− 0.237) were found to be significant at 0.05 level of confidence (p < 0.05). Further, the study depicted that the chi-square test (χ2) was identified to be significantly associated (p< 0.05) with a variable such as education, knowledge, number of illnesses and impairments, vision, memory, and physical impairments.Conclusion: Medication adherence could be improved among rural elderly with co-morbid conditions by identifying and addressing the determinants at the earliest. Further, it is vital to identify the suitable intervention program to address these avoidable problems.Keywords: drug compliance, factors, old age people, multiple chronic conditions

Introduction: Prevalence of violent incidents-physical or verbal directed to self or others, is a serious problem in psychiatric setting1. Violent behavior in psychiatric unit affects the safety of patients and any other team member working in that particular setting. There is evidence that majority of the nurses working in psychiatric setting have been attacked by patients at least one time in their career.2 Aim: To estimate the prevalence of aggression and violence among clients admitted in psychiatric units and also to find out the factors associated with aggressive and violent behavior. Materials & method: A comprehensive search was made on ProQuest, CINAHL, PubMed, Google scholar, and Cochrane databases for published original research articles between 1990 and 2016. We included all types of studies that reported about incidence or prevalence of violent behavior and factors associated with it in psychiatric ward. Result: Twenty one studies were eligible for meta-analysis and the overall pooled prevalence of violence among patients admitted in psychiatric ward is 16% (0.13. 0.19, CI 95%, i-squared=97.9%, p=0.000). The review also examined the causes accompanying with violent behavior. Conclusion: Violent behavior in psychiatric setting appear to be extremely variable between different settings. Assessing prevalence of violent behavior and to find out factors associated with violent behavior are a vital part of developing aggression management and violence prevention training program to safeguard clients and staffs from violent behavior.

Health care associated infections are infections that patients acquire, while they are in contact with the healthcare system. Contact includes all procedures associated with diagnostics, treatment, care, and rehabilitation. Health care associated infections were formerly called hospital or nosocomial infections. Hospitals still account for the vast majority of cases; however, for practical reasons the concept has been widened to comprise infections in all parts of the health care system, because a growing part of disease management takes place outside hospitals, e.g. in out patient clinics, nursing homes and general practice. The spectrum of health care associated infections ranges from simple common colds to life threatening sepsis with multidrug resistant organisms. With the above definition, around 10 % of patients on average will become infected while they are in contact with the health care system. Health care associated infections also include occupational infectious diseases acquired by health care workers.