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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Web-based Survey on the Knowledge, Attitude and Practice of COVID-19 Appropriate Behaviour among Vaccinated and Unvaccinated College Students in Puducherry, India: A Cross-sectional Study
Correspondence Address :
Dr. Subhashri Soundirarajan,
Associate Professor, Department of Physiology, Sree Lakshmi Narayana Institute of Medical Sciences, Osudu, Agaram Village, Puducherry, India.
E-mail: subhashri.dr@gmail.com
Introduction: Coronaviruses (CoVs) encompass a large group of viruses known to infect the upper respiratory tract in humans. The devastating impact of the virus has led to widespread infections among millions of individuals. Widespread disregard for ‘Coronavirus Disease-2019 (COVID-19) Appropriate Behaviour’ (CAB) by the public has significantly strained the Indian healthcare system. Despite efforts to educate the public on CAB through social media since 2020, only a minority have incorporated these practices into their daily lives. Notably, some vaccinated individuals have been hesitant to adhere to CAB despite repeated awareness efforts. This study aims to understand adherence to CAB among vaccinated and unvaccinated students not associated with the healthcare system.
Aim: To evaluate the Knowledge, Attitude and Practice (KAP) of CAB among vaccinated and unvaccinated college students.
Materials and Methods: This descriptive cross-sectional study was conducted at Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India among various engineering and arts college students of Puducherry, India from December 2021 to February 2022. A web-based data collection tool was designed using Google Forms. Data was collected through invitation letters and questionnaires distributed via WhatsApp groups and Instagram. The study included a total of 360 responses, with the questionnaire comprising 40 questions related to KAP, consisting of 17, 7, and 16 questions, respectively. The results were expressed in percentages.
Results: Among the vaccinated participants, 263 (89.7%) identified social media as the primary source of COVID-19 related information. Knowledge and attitude towards COVID-19 vaccination revealed that over 50% were aware of the safety and efficacy of vaccines and the necessity of receiving two doses as advised by the government. While knowledge and attitude were similar across vaccinated and unvaccinated college students, there was a slightly higher percentage among the vaccinated group. However, there was an increased percentage of practice among unvaccinated students, indicating greater awareness of infection prevention.
Conclusion: The study found that the knowledge, attitude, and behaviour of college students, particularly those not in medical fields, were satisfactory, likely due to the widespread availability of information on social media. These findings can be valuable for public health departments to adopt a people-centered approach to raise awareness among the public and reduce vaccine hesitancy.
Awareness, Non medical field, Public heath, Questionnaire
The global impact of COVID-19 has led to numerous fatalities, prompting the scientific community to conduct research aimed at reducing mortality (1). CAB encompasses the behavioural changes adopted by individuals to curb the spread of infection when proper treatment is not readily available. This can be influenced by government regulations, health promotion initiatives, or individual motivation. In India, key CAB during the pandemic include hand hygiene, physical distancing, mask-wearing, adherence to cough etiquette, and avoiding physical greetings (2). Widespread disregard for CAB among the public strained the Indian healthcare system during the second wave (3).
Understanding of a disease can significantly influence an individual’s attitude and intentions, which in turn directly impact their behaviour. In India, the vaccination drive commenced on January 16, 2021, focusing initially on healthcare workers and the elderly population, later extending to the adult population and college students in order to facilitate a return to in-person learning, which had shifted to online platforms during the pandemic (4),(5). Vaccination is deemed crucial in curbing the spread of COVID-19 and reinstating in-person learning environments. However, adherence to CAB remains vital even among vaccinated individuals, particularly as the virus may continue to mutate until herd immunity is achieved (6). During the vaccine campaign, clear information regarding vaccine safety, efficacy, protection against mutant variants, and prevention of reinfection was lacking due to the rapid development and distribution of vaccines (7),(8).
Systematic reviews and meta-analyses have indicated a risk of reinfection among vaccinated individuals, emphasising the continued importance of adhering to CAB post-vaccination (9). Reports have shown that healthcare workers, due to their adherence to these behaviours, experienced lower rates of reinfection compared to the general public even after vaccination (9). Medical and paramedical students, often educated extensively on CAB, have demonstrated a heightened awareness of precautionary measures to be followed (10). This study aims to evaluate KAP of CAB in daily life among vaccinated and unvaccinated college students not associated with the healthcare system.
This descriptive cross-sectional study was carried out at Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India, focusing on engineering and arts college students who were both vaccinated and unvaccinated in Puducherry, India. Scientific Research Committee and Institutional Ethics Committee Clearance No. 124/SVMCH/IEC -cert/Nov 2021 were obtained for the study. The research was conducted from December 2021 to February 2022.
A self-selected non probability sampling method was employed, including all college students not affiliated with medical and paramedical fields, aged between 18-25 years, and residing in Puducherry, irrespective of gender.
Sample size: The sample size was 385, calculated using the Open Epi, Version 3, opensource calculator-SS Propor-Sample Size for a Proportion, based on the total projected population of Puducherry in 2021 (15.55 Lacs), with a 95% confidence interval. Out of 390 responses received, 360 were complete and thus included in the study (11).
A web-based data collection tool was designed using Google Forms. Invitation letters were distributed via WhatsApp groups and posted on community groups on Instagram, explaining the study’s aim, approximate time required for questionnaire completion, voluntary participation, anonymity and confidentiality declaration, and invigilator details.
Validation of the Questionnaire: The questionnaire underwent validation through two phases. Phase 1 involved its development through literature review, focus group discussions, expert evaluations (content validity), and pretesting. In Phase 2, the validity of the questionnaire was established by conducting a cross-sectional survey on 20 participants. Internal consistency was assessed using Cronbach’s alpha after Principal Component Analysis, resulting in a Cronbach’s alpha value of 0.67 using Microsoft Excel.
Data collection tool: The final version of KAP on CAB questionnaire, comprising 40 items (excluding demographic details), was administered in English. The questionnaire included four domains: demographic information, KAP of CAB, with 5, 17, 7, and 16 questions respectively. Participants were permitted to select more than one answer for each question. Standard demographic information encompassed items related to age, gender, and enrolled course. The items regarding KAP of CAB were developed through literature review and guidelines provided by the Ministry of Health and Family Welfare (12-illustrated guide of COVID-19 appropriate behaviour) (12). The questionnaire included items related to vaccination status, mask usage, hand washing techniques, and social distancing.
Statistical Analysis
All the data were tabulated in Microsoft Excel and analysed using Statistical Package for Social Sciences (SPSS) version 21.0 software. The responses from vaccinated and unvaccinated students were separately analysed for descriptive statistics. The demographic characteristics, KAP of CAB among the vaccinated and unvaccinated students were presented as frequencies and percentages.
In the present study, a higher percentage of students belonged to the 19 to 20 years age group and were female (Table/Fig 1).
(Table/Fig 2) describes the participants’ knowledge of CAB, focusing on signs and symptoms, and how they gathered information on the same. Among the vaccinated population, approximately 173 (59.1%) and 169 (57.6%) subjects were aware that fever and cough/cold were signs and symptoms of COVID-19, and 263 (89.7%) obtained information from social media.
(Table/Fig 3) illustrates the knowledge of CAB, including cough hygiene, social distancing, and vaccination. Around 225 (76.9%) of the vaccinated subjects covered their nose and mouth while coughing, 261 (89.1%) wore a mask while traveling, and 133 (45.3%) even wore masks in enclosed spaces with other people.
(Table/Fig 4) portrays the attitude of college students towards CAB. Overall, the participants displayed a supportive attitude towards most aspects. For instance, 221 (75.4%) reported that they would advise friends and family not to be stressed about COVID-19, and 203 (69.2%) expressed a willingness to inquire about the health of someone suffering from COVID-19.
(Table/Fig 5) depicts the practice of CAB among the study subjects. Approximately 266 (90.8%) followed hand washing and sanitisation practices, 194 (66.2%) cleaned and disinfected touched surfaces, and 253 (86.2%) adhered to social distancing measures. Moreover, 203 (69.2%) avoided close contact with high-risk individuals.
This descriptive cross-sectional study was conducted among non medical college students. By the end of 2021, approximately 81.39% of the participants were vaccinated, with 56% having received both doses. Surprisingly, the level of knowledge about COVID-19 among the participants was appreciable, despite their non medical background. This finding aligns with a previous study among students from various disciplines, which showed no significant difference in knowledge regarding COVID-19 (13).
Furthermore, students with better attitudes and practices of CAB were more likely to be vaccinated, consistent with findings from a study by Pothisa T et al., (14). The absence of a scoring system in the present study’s questionnaire notwithstanding, the satisfactory level of knowledge is indicated by the fact that over 50% of the questions were answered correctly. Specifically, regarding knowledge of COVID-19 signs and symptoms, 57.6% and 40.3% of vaccinated and unvaccinated participants, respectively, were aware that cough and cold were COVID-19 symptoms. This finding was consistent with the study by Lee M et al., (15). Additionally, less than 30% of participants were knowledgeable that COVID-19 can be asymptomatic, and diarrhoea can also be a symptom.
Moreover, present study found that 89% of vaccinated and 60% of unvaccinated participants recognised close contact with an infected person as a common mode of transmission. In contrast, Lee M et al., found that the majority of participants had misconceptions regarding the source of infection, such as eating or contact with wild animals (15). Over 65% of vaccinated and unvaccinated participants avoided contact with high-risk groups, such as the elderly and pregnant women. Adequate knowledge was found to enhance attitude and behaviour, consistent with the findings of Lau LL et al., (16).
The study also highlighted the sources of COVID-19-related information. Among vaccinated participants, 89.7% obtained information from social media, a finding in line with Zhong BL et al., (17). Television, local announcements, and local healthcare providers were also reported as significant information sources in other studies (18), emphasising the need to deliver health information and interventions tailored to the community’s needs.
Regarding practices, 75% of students covered their nose and mouth while coughing, and 46.2% of vaccinated students reported washing their hands immediately after coughing. These findings are consistent with a previous study conducted among university students in Jordan (19). Moreover, a majority of vaccinated students were found to wear masks while going out, traveling, or being in a room with other people, and recognised the preventive role of mask-wearing. Similar results were reported in studies conducted in Bhutan and China (20),(21). Adalja AA, an infectious disease expert, highlighted the efficacy of face masks in preventing the spread of respiratory infections, including COVID-19 (22),(23).
Additionally, a good number of students in both groups followed proper hand hygiene practices, consistent with findings from similar studies (20). It is noteworthy that individuals with higher levels of education tend to adhere to preventive measures against COVID-19 due to their understanding of associated risks (20).
The psychosocial health of young adults during the COVID-19 pandemic was also affected due to sudden restrictions and lockdowns. The knowledge (Q-14,15,17) (Table/Fig 3), attitude (Q-16) (Table/Fig 4), and behaviour (Q-7) (Table/Fig 5) of students about psychosocial health during the COVID-19 pandemic found that many participants opted to spend time with family and friends. A notable fact is that very few students were aware of consulting or talking to a professional counsellor as an appropriate measure to overcome the signs of anxiety. Even the awareness about the presence of the National Psychosocial helpline number (08046110007) was very low (<20-30%) among the students. Since the awareness itself is very low about seeking psychiatric consultation for oneself, the chance of recommending their family and friends to seek a psychiatrist’s opinion was found to be very low. During the COVID-19 lockdown, there was a strict limitation on social activities for a long period of time, leading to anxiety, fear, social isolation, and economic disturbance, which altogether affected the mental well-being and physical health of the people (24). It was found that the COVID-19 pandemic lead to a significant reduction in mental health and multiple behavioural changes like increased sedentary lifestyle and phone usage, in turn leading to increased levels of anxiety and depression (25). The attitude and knowledge about psychosocial health among college students imply that proper awareness regarding mental health problems and various red flags for seeking appropriate medical advice is necessary. Since WhatsApp and Facebook were the most used virtual platforms to connect with family and friends to alleviate stress (93.8% n=275 among vaccinated and 94.5% n=63 among unvaccinated students), these social media can be used to create mental health awareness. It can be used as an effective initiative to reach several people over a short time period (26).
Attitude (Q-4) (Table/Fig 4) and practice (8,9,10,11) (Table/Fig 5) on social distancing shows that they were not strictly complying with practicing social distancing. The effectiveness of social distancing not only depends on governmental policies but mainly depends on the compliance of the public to those measures. The Ministry of Health and Family Welfare defines social distancing as avoiding mass gatherings and maintaining a distance of 6 feet or 2 meters away from other people. In a study done in Egypt, 95% of the participants were aware of the importance of social distancing in preventing infection (27). It was found that participants failed to maintain social distance either because of overcrowding or lack of space (28). As India is a well-populated country, this can be one of the reasons which lead to failure to maintain social distancing.
Knowledge (Q16) (Table/Fig 3) and attitude (Q5) (Table/Fig 4) towards COVID-19 vaccination among the vaccinated participants showed that more than 56.9% are aware that the vaccine prevents the spread of infection, and more than 50% are aware that vaccines are safe and effective and it is mandatory to put two doses as per advice given by the government. This might be due to uncertainty among the general public on the safety and efficacy of vaccines and multiple reinfections that occurred even after vaccination (29). Around 60% of the unvaccinated individuals are not ready to take up the vaccination as they believe that vaccination is not necessary for healthy individuals. This was similar to previous studies that reluctance, conflicting ideas, and a lack of understanding of the efficacy and effects of vaccines have influenced people’s decisions on whether or not to receive vaccines against COVID-19 (30). Among unvaccinated groups, 40.5% believe vaccination has side-effects, they doubt the safety and efficacy of the vaccine. So, they are not willing to recommend vaccination. As said by McKee C and Bohannon K, there could also be religious and personal beliefs, safety concerns, and fear of any health-related complications in the future due to the vaccines (31). It was proposed that in order to prevent the occurrence of another wave of COVID-19, proper preventive measures should be followed by all individuals irrespective of their vaccination status. Every individual in the community should be responsible in following the precautions for these kinds of communicable diseases so that it doesn’t become a pandemic causing distress on mental, physical and financial situations.
Limitation(s)
The present study’s questionnaire does not have a scoring system, which may affect the accuracy of the results. Further studies with a proper scoring system could yield more reliable results. Additionally, the results are limited to Puducherry, and conducting studies in larger areas would allow for generalising the findings on a broader scale.
The study helped pinpoint students’ misunderstandings and associated reasons regarding CAB and the impact of vaccination. It was found that the knowledge, attitude, and behaviour of college students, even those in non medical fields, were satisfactory, likely due to the availability of social media. Given that today’s youth are tomorrow’s future, providing proper education to college students regarding appropriate behaviour during COVID-19 infection can help prevent the rapid spread of the disease and other contagious diseases in the future. The results of the study could benefit the public health department in implementing a people-centered approach to create awareness about adhering to CAB and reducing vaccine hesitancy.
DOI: 10.7860/JCDR/2024/66010.19041
Date of Submission: Jun 14, 2023
Date of Peer Review: Aug 18, 2023
Date of Acceptance: Dec 12, 2023
Date of Publishing: Feb 01, 2024
Author declaration:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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