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Introduction: There is a paucity of research on conducting written formative assessment with constructive feedback for theory paper writing for postgraduates of Community Medicine in India. The concept of "Written Formative assessments with Peer-Assisted Learning Program" was implemented to improve the first 2 levels of Miller's Pyramid and assess its impact on the summative assessment. Materials and Methods: The program was conducted for 2 batches of postgraduate students in the Community Medicine enrolled for the academic session of 2016–2019 and 2017–2020. The written formative assessment was conducted every Saturday for 1 h from August to March month in 2018 and 2019. After each test, answer papers were evaluated by the peer and faculty from the department. Written and oral feedback was given by the peer. After IEC approval, we planned to assess the program's effect on level 1 and level 2 Kirkpatrick's framework. The data were analyzed using SPSS statistical package version 24 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Total 23 formative written assessments were conducted per year. The proportions of knowledge, comprehension, and analytical type of questions asked were 47%, 32%, and 21%, respectively. The mean attendance rate was 76.28% ±16.4%. There was no statistically significant difference in the average percentage of marks in formative (weekly test) and summative assessment (university final examination). There was a statistically significant positive co-relation of projected mean marks and summative assessment marks with the co-efficient of the determination being 22.6%. There was overall positive feedback of the formative and peer-assisted learning (PAL) from post graduate students. Conclusions: Written Formative Assessment with PAL program is one of the effective programs for postgraduate students to gain confidence in writing and presentation skills and to score higher in theory examination. [ABSTRACT FROM AUTHOR]

Background: Sustainable development goals (SDGs) 3.9.1 and 11.6.2 call for a reduction in deaths and illnesses from air pollution, improving the air quality of cities. The above goals motivate us to organize workshops to improve the health of traffic police, who bear the brunt of air pollution. The paper examines the effect of workshops on the health-seeking behavior of the traffic police in Bhubaneswar city. Methods: The study conducted two workshops as a quasi-experimental, single-group study at an academic institution in Bhubaneswar. It included 20 traffic police officers (11 male and 9 female). The Kirkpatrick 4-level model was used to assess the effectiveness of the workshops. A paired t-test was used to compare pre- and postworkshop scores. Results: Thirteen traffic police officers rated the workshop sessions as excellent. The score before the workshop ranged from zero to three, with a mean (standard deviation [SD]) of 2.81 (1.0). The postworkshop score had a minimum to maximum score of three to five with a mean (SD) of 4.41 (0.7) (P < 0.005). The effect size dcohen (confidence interval [CI]) was 1.87 (3.27-4.71). The mean (SD) of absolute and relative gain was 1.6 (1.0) and 0.93 (1.02), respectively. All 20 traffic police officers showed improvement in health-seeking behavior. The significant lifestyle changes after the workshops ranged between 5% and 75%. Conclusion: The test scores indicated statistically significant improvement as the P value recorded was smaller than 0.05. This concludes that the improvement in understanding of the session was statistically significant because of the training imparted. [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. Methods: This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Results: Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. Conclusions: This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers. [ABSTRACT FROM AUTHOR]

India currently hosts the largest medical education system in the world with 650 medical colleges and 98613 MBBS (undergraduate) training seats. The reasons for Indian Medical Graduate's international migration and internal distribution within India have been multifactorial. There are push factors (with India) as well as pull factors (international host countries). Almost the same reasons are implied to the distribution and availability of the medical workforce geographically within India. To address the regional disparities in medical education and the availability of human resources in health, the policy of establishing one medical college in each district in India was initiated. Impressive progress has been achieved so far. However, the policymakers must look at it critically to be able to steer this project towards meeting the public health objectives of the country in the coming century. The discussion must include arguments on the type of doctor India needs. Indian can no longer afford the policy of having many cardiologists as compared to miniscule number of trained family physicians. All specialist system is being perused at the cost of a generalist health system. This paper critically looks at the district medical college scheme and exponential growth in the number of medical seats in India. Statistical success alone cannot address the public health needs and medical care of the Indian population. The creation of the National Medical Commission (NMC) has eased the criteria for recognition of new medical colleges; however, several limitations of the Medical Council of India are being carried forward within the functioning of NMC. Unless, there is a focus on creating employment and retaining medical graduates within the health system, it is worthless producing millions of them. [ABSTRACT FROM AUTHOR]

Background: Interactive teaching methods aid post graduate students in learning qualitative research. Four academic researchers from the United Kingdom had an opportunity to teach qualitative research methods, specifically consensus methods, to the Master of Public Health students (MPH) during a visit to India. This teaching formed part of a work package with All India Institute of Medical Sciences Rishikesh, India exploring the concept of family resilience among families with children under 6 years. Aims: To use the experiences of the MPH students to gain knowledge and create meaning about using the consensus methods. Participants: The participants were the MPH students. Methods: We used the workshop method to introduce the concept of family resilience by using the question, ‘What will be the three top public health priorities in India to support family resilience in the 21st century?’ as a central theme for all the workshops. Furthermore, we introduced qualitative research methods and hands on experience of consensus methods to the students. The students were introduced to Delphi and Group Concept Mapping (GCM) methods during workshop 1. Workshop 2 introduced Nominal Group Technique (NGT) through a short presentation followed by a practical hands on session using GCM data from workshop 1. The last workshop (3) focused on the World Café method. Results: The students evaluated the workshops highly and asked for online sessions on GCM, NGT, and World Café which will be planned in the future. Conclusion: We concluded that the post graduate curriculum for master’s in public health studies would benefit from teaching using interactive research methods which will enhance their critical thinking and autonomy. Second, although the MPH curriculum had quantitative methods in place, introducing qualitative consensus methods will open new avenues into future research. Finally, teaching using practical demonstration gives students a voice and makes learning effective and enjoyable. [ABSTRACT FROM AUTHOR]

Background: Patient education is an essential component of improving public health as it empowers individuals with the knowledge and skills necessary for making informed decisions about their health and well-being. Primary care physicians play a crucial role in patients' education as they are the first contact between the patients and the healthcare system. However, they may not get adequate time to prepare educational material for their patients. An artificial intelligence-based writer like ChatGPT can help write the material for physicians. Aim: This study aimed to ascertain the capability of ChatGPT for generating patients' educational materials for common public health issues in India. Materials and Methods: This observational study was conducted on the internet using the free research version of ChatGPT, a conversational artificial intelligence that can generate human-like text output. We conversed with the program with the question - "prepare a patients' education material for X in India." In the X, we used the following words or phrases -- "air pollution," "malnutrition," "maternal and child health," "mental health," "noncommunicable diseases," "road traffic accidents," "tuberculosis," and "water-borne diseases." The textual response in the conversation was collected and stored for further analysis. The text was analyzed for readability, grammatical errors, and text similarity. Result: We generated a total of eight educational documents with a median of 26 (Q1-Q3: 21.5-34) sentences with a median of 349 (Q1-Q3: 329-450.5) words. The median Flesch Reading Ease Score was 48.2 (Q1-Q3: 39-50.65). It indicates that the text can be understood by a college student. The text was grammatically correct with very few (seven errors in 3415 words) errors. The text was very clear in the majority (8 out of 9) of documents with a median score of 85 (Q1-Q3: 82.5-85) in 100. The overall text similarity index was 18% (Q1-Q3: 7.5-26). Conclusion: The research version of the ChatGPT (January 30, 2023 version) is capable of generating patients' educational materials for common public health issues in India with a difficulty level ideal for college students with high grammatical accuracy. However, the text similarity should be checked before using it. Primary care physicians can take the help of ChatGPT for generating text for materials used for patients' education. [ABSTRACT FROM AUTHOR]

The sudden upsurge in the newly emerging COVID-19 variants acted as a catalyst for India to scale up the viral Genomic surveillance in order to understand the nature and trends of the newer variants of concern and strengthen public health interventions across the country. The Government of India has proposed the Indian SARS-CoV-2 Genomics Consortium to expand the whole-genome sequencing (WGS) of this virus. However, in a vast country like India introduction and implementation of any new strategies amidst the already existing barriers due to COVID-19 will be a herculean task. This paper talks about how the primary care physicians can play a vital role in successful implementation of the above strategy in addition to the surveillance systems in India. [ABSTRACT FROM AUTHOR]

Purpose: Competency-based education and assessment are globally trending, also embraced by recently announced National education policy 2020, India. Medical programs are rapidly transforming to produce competent health professionals, to satisfy public health requirements. This paper describes Delphi study with a participatory approach, to develop a competency matrix required for training of eye care professionals.Methods: Scoping review of literature formulated the baseline architecture of competency framework identifying two core competencies for management of refractive error, namely, "visual function assessment" and "optical technology management." The Delphi technique was employed for the development of a competency matrix with detailed knowledge, skills, and attitude (KSA) definitions for all competency elements. A heterogeneous group including optometry practitioners, academicians, researchers, association representatives, and industry representatives accomplished the objective in four rounds.Results: Delphi study resulted in defining two competency clusters (CC): "CC1: Refraction" with 10 units and 43 elements and "CC2: Dispensing optics" with 8 units and 54 elements. KSA components of each of competency elements were identified and mapped with applied optics curriculum in the optometry program.Conclusion: Participation of all stakeholders of the educational system is essential and beneficial for nurturing of the competent workforce in healthcare. It helps build a curriculum not only having theoretical knowledge and skills but also the attitude and behavioral component of measurable competencies that satisfies the needs of the local healthcare system. This study has evolved a comprehensive competency matrix highlighting essential competencies required for the effective management of refractive error. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has become a global pandemic, prompting lockdowns in practically every country. To prevent the spread of the disease, India has enforced a rigorous nationwide lockdown that commenced in March 2020. The lockdown imposed amid the pandemic ensured that most commercial activities and vehicle transportation ceased, resulting in a significant reduction in air pollution levels. Material and Methods: The value of air pollutants PM10, PM2.5, NO2, and SO2 from January to May 2020 was obtained from the Indian Central Pollution Control Board. Before lockdown and during lockdown, relative fluctuations in ambient concentrations of four air contaminants were investigated. The Box-Jenkins approach was used to estimate future air pollution data points using time series data analysis. Results: The PM10 level reduced by 61%, 30%, 68%, 37%, and 43% in the selected cities, respectively. Comparison of other pollutant concentrations before and after the lockdown also found a reduction in ambient pollutant concentrations, resulting in improved air quality. Inference of predicted model values to observed values revealed a significant increase in the concentrations of all pollutants. The percentage increases in AQImean from predicted to observed values were 206% in Ghaziabad, 148% in Delhi, 59% in Hyderabad, and 160% in Cochin. Conclusion: The strict lockdown has resulted in a significant drop in air pollutant levels. Upgrading present technologies could help keep pollution to a minimum of 37% under control. The findings would prompt the government to consider how to strictly reduce vehicle and industrial pollution to improve air quality and maintain improved public health. [ABSTRACT FROM AUTHOR]

Childhood injuries are a major public health challenge in India and globally. This systematic review was conducted to understand the burden and spectrum of childhood injuries, with a focus on unintentional injuries, among children 5-14 years of age and to suggest approaches to prevention that can be adopted in the Indian context. This systematic review was conducted with the standard approach and use of keywords. A total of 33 studies which were found to be relevant were analyzed. Road traffic accidents (RTAs) contribute to nearly 85% of all unintentional injuries and related deaths and 90% of disability-adjusted life years (DALYs) lost in developing countries. Poor traffic regulation, heavy traffic load, and poor skill of identifying the dangerous road crossing sites make the children's age group vulnerable and prone to RTA. Children with poor skill of identification and response to dangerous road crossing sites, along with heavy unregulated traffic were found to be the major reasons for such accidents and make this age group more vulnerable. Public health-based prevention approaches need to be based upon legislation, regulation, and enforcement, as well as environmental modification, education and skill development, emergency medical care using levels of prevention, and principles of targeted prevention to effectively address child health challenges. Addressing child injuries should be a key component of all endeavors aimed at enhancing child mortality and morbidity rates, as well as the overall welfare of children, both at the national and global levels. It is imperative to prioritize policies focused on preventing unintentional injuries across all age groups, with particular attention to children. [ABSTRACT FROM AUTHOR]

Background: India has launched Ayushman Bharat Digital Mission (ABDM), to provide an integrated digital health infrastructure. The success of digital health systems lies in their ability to achieve universal healthcare and incorporate all levels of disease prevention. The objective of this study was to develop an expert consensus on how Community Medicine (Preventive and Social Medicine) can be integrated into ABDM. Methods: A total of 17 and 15 participants, who were Community Medicine professionals with more than 10 years experience in the Public Health Sector and/or Medical Education in various parts of India, participated in round 1 and 2 of this Delphi study respectively. The study explored three domains: 1. Advantages and challenges of ABDM, and possible solutions; 2. Intersectoral convergence in Unified Health Interface (UHI) and 3. Way ahead in medical education and research. Results: Participants envisaged improved accessibility, affordability, and quality of care due to ABDM. However, awareness generation, reaching out to marginalized populations, human resource constraints, financial sustainability, and data security issues were anticipated challenges. The study identified plausible solutions addressing six broad challenges of ABDM and classified them based on the priority of implementation. Participants listed out nine key roles of Community Medicine professionals in digital health. The Study identified about 95 stakeholders who play direct and indirect roles in public health and can be connected to the general public through the Unified Health Interface of ABDM. Further, the study explored the future of medical education and research in the digital era. Conclusion: The Study contributes to broadening the scope of India's digital health mission, with elements of Community Medicine in its cornerstone. [ABSTRACT FROM AUTHOR]

Background: Article 5.3 of the World Health Organization's Framework Convention on Tobacco Control necessitates the governments to take measures to protect health policy from the commercial and other vested interests of the tobacco industry (TI). Considering the vast geographical area and diversity between states within India, it is necessary to evaluate the level of implementation of Article 5.3 at the sub-national level. Hence, this study was conducted to assess the implementation of Article 5.3 in the Karnataka state of southern India. Materials and Method: Southeast Asia Tobacco Control Alliance Tobacco Industry Interference index was adopted and used for the study. A desk review was conducted for 2018. Publicly available evidence of tobacco industry interference was scored based on its frequency, severity, and the government's response to it. Lower the score, effective the level of governance against the TI interference, which predicts well for the state. Results: The study demonstrates a score of 46 out of 95 in the implementation of Article 5.3 in Karnataka, which is lower when compared to the national score of 69 out of 100 for 2018. Corporate social responsibility, conflict of interest, and unnecessary interactions with TI are the major areas that need focus to comply with the provisions of Article 5.3. Conclusion: Overall, Karnataka needs to strengthen the implementation of Article 5.3 and develop a strategy in line with the global best practices. This assessment can help in identifying areas requiring enhanced vigilance to avoid industry interference. [ABSTRACT FROM AUTHOR]

Mucormycosis emerged as a major public health challenge during the second wave of the COVID-19 pandemic in India in mid-2021. The disease, colloquially known as the Black fungus, was declared epidemic by the government. This review describes the epidemiological pattern and the determinants of mucormycosis. The review also proposes evidence based public health strategies for the prevention and control of mucormycosis. The rationale use of steroids in clinical management, formulation of evidence-based standard treatment guidelines and adherence to those guidelines by physicians, the strengthening of primary healthcare services to facilitate early care; compliance with infection prevention and control measures at all the health facilities; and early diagnosis and case management are the key strategies to prevent future emergence of mucormycosis. The article concludes that it is not enough that we tackle a health challenge at hand, in crisis mode. It is equally important that we derive learnings and take measures prevent any future. Effective control of mucormycosis and prevention of future outbreaks of disease is possible through coordinated actions of health policy makers, public health experts and clinicians. The entire episode is also a reminder for strengthening India's health systems at all levels – primary, secondary and tertiary – as well as in both public and private sector. [ABSTRACT FROM AUTHOR]

Background and Objective: The translational research objective is to produce meaningful and applicable results that directly benefit the community. The objective of translational research is to move from traditional research discoveries rapidly and efficiently into practice. Translational research encourages and promotes multidisciplinary collaboration among clinicians, researchers, industry, policy makers, and other related stakeholders. It further incorporates the needs of the general public with communities being engaged to determine their requirements for health invention. It identifies and supports medical and health practices. Translational research is frequently classified by which stage of restatement (from beginning exploration to societal operation and impact) it falls into. Translational research is the process of turning compliances in the laboratory, clinic, and community into interventions that apply to the health of individualities, public from diagnostics, and to medical procedures as well as behavioral changes. Methods: This study adopted a qualitative research methodology based on Hill et al. consensual qualitative research (CQR) to build multiple case studies to acquire the information. We ion.opted to apply a modified method of CQR based on multiple case studies. This is an emerging methodological approach in research. Results: Based on the 24 semistructured interviews, these interviews were directly with researchers who carry out the research. Twenty-four voluntary researchers participated in the research and these semi-structured interviews were made into 24 case studies to be analyzed. Each case study was built based on the questions on methods of research. These were used to identify and build the tools for practicing translational research. Conclusion: There is a huge untapped potential for India in the area of translational research. [ABSTRACT FROM AUTHOR]

With the presence of western nations in India, a change started appearing in the medical scenario. The civilians and soldiers had to suffer from many endemic diseases like fever, cholera, plague, small pox etc. prevalent in India and it caused great loss to the new comers. To protect the life and properties and to gain a firm ground in the Indian soil, Europeans established various medical institutions that provided western medical care. In the course of time British got hold of the power in most part of this country. As the administrators were more engaged with the fatal endemic diseases, cutaneous disorders with lower mortality got less importance. Tilbury Fox, a distinguished British physician accompanied the Earl of Hopetoun in a tour to the East and reached India in 1864. Fox noticed the chaotic situation in the systematic study of dermatological disorders. He proposed a scheme to study the proper situation in this country which laid the beginning of systematic study of dermatology in India. Though his study was the steppingstone of Indian dermatology, but Fox got little attention in the history of dermatology in India. This article discusses about a brief overview of the scheme and the contribution of Tilbury fox. [ABSTRACT FROM AUTHOR]

India has been witnessing an epidemic of diabetes for several years now. A large proportion of patients with undiagnosed and poorly controlled diabetes are at great risk of developing diabetic retinopathy (DR) and irreversible blindness. The goal of DR screening is to identify people with sight-threatening DR early so that prompt treatment can be initiated, and blindness can be prevented. Systematic DR screening is essential to identify disease early, and a national effort for the same is required. We adopt a health system approach to outline the actions that need to take place for effective DR screening in the public sector in India. We discuss the role of national leadership, needs assessment, finalization of DR screening and referral pathway, trainings, strategies to improve the uptake, allocation of roles and responsibilities, public-private partnerships, quality control, and financing. [ABSTRACT FROM AUTHOR]

Context: As social position rises, health improves. Alma Ata set the stage for community-oriented primary care (COPC), and family medicine is perfectly positioned to integrate Social Determinants of Health. India presents a unique environment for innovations in family medicine. Aims: This study aimed to (1) assess the ability of different primary care practices to address the social determinants of health (SDoH); (2) identify key obstacles and supports; and (3) provide practical insights to family physicians and other primary care providers (PCPs) for the integration of SDoH and clinical primary care. Settings and Design: A diverse sample of primary healthcare practices were selected in southern India for investigation. Data collection involved observation and informal interviews. Methods and Material: The researchers used general observation and informal interviews to collect data. Investigators used a basic interview guide to structure conversations and formal journal entries were recorded immediately following each visit. Statistical Analysis Used: Thematic analysis was conducted with NVIVO software to categorize major themes. Results: Seventeen primary healthcare practices were observed; eleven were formally enrolled for interviews. Four inputs and three outputs of socially oriented primary care practices were identified. The inputs include leadership style, appropriate staffing, funding structures, and patient panels. Social interventions, community contact, and treasuring community empowerment were the major outputs. Conclusions: Community health lies at the heart of strengthening primary healthcare. Establishing practices that bridge the gap between clinical primary care and SDoH initiatives need to be prioritized. This study fosters agency for family physicians and PCPs to engage with local communities and lead the path toward this integration. [ABSTRACT FROM AUTHOR]

Background: Hardcore smokers are of significant public health concern having a greater risk of developing tobacco-related diseases. Objective: This study aimed to identify burden of hardcore smokers, its distribution, and determinants in India. Subjects and Methods: Analysis of Global Adult Tobacco Survey India 2016-2017 data was carried out. Hardcore smoking was defined when the following criteria were fulfilled -- current daily cigarette smoking for at least 5 years, no quit attempt in past 12 months, no intention to quit in next 12 months, and time to first smoke within 30 min of waking up. Independent variables included sociodemographic, knowledge of side effects, indoor smoking policy, and age of smoking initiation. Multivariable logistic regression was carried out, with adjustment for clustering, stratification, and sampling weight. Results: Proportion of hardcore smoking among the general population and current daily smokers were 3.43% and 32.3%, respectively. In the adjusted model, it was found to be significantly associated with increasing age, earlier initiation of daily smoking, tribal caste, and unfavorable indoor smoking policy. Conclusion: Tobacco control strategies should be modified to tackle these issues, especially early age of initiation of daily smoking and indoor smoking policy. [ABSTRACT FROM AUTHOR]

The recommendation of a Rural Indemnity Bond after MBBS aims to address the rural-urban disparity in the Indian healthcare system. It is a radical reform in medical education curriculum and generates searching questions: How to affect the attitudes of medical graduates? Are there other successful models we can learn from? Do the healthcare challenges need a more integrated action? A policy enforcing the shunting of doctors needs to take the apprehensions of all the stakeholders into consideration. The broader issue of Rural Health Iniquity, that plagues the country requires interventions at multiple levels with a properly financed healthcare system at its foundation. [ABSTRACT FROM AUTHOR]