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The study aims to find the quality of research papers published in the domain of entrepreneurship in India. This study covers 100 research papers. A standardized measurement tool developed by the earlier researchers was used to evaluate the research quality. The data compiled using the measurement tool were analyzed with the support of the SPSS. The statistical tools such as descriptive statistics, Friedman's test, factor analysis, two-sample 't' test, and ANOVA are applied to analyze the data. The study findings reported that the quality of research papers published in the field of entrepreneurship is not up to the quality standards. The quality of multiple-author papers is better than single-author papers. Similarly, the quality of papers published by foreign authors is comparatively better than Indian authors. Further, the quality of papers published with the combination of foreign and Indian authors is substantially good. The quality of papers published in foreign journals is higher as compared with Indian journals. Further, the standard of papers published under the qualitative approach was comparatively better than the quantitative approach. The authors developed a Conceptual Model of Process and Product of Research (YOVA model). This model clearly shows that the whole research process yields six levels of research products. The study recommended that the researchers need to go for international collaborations to improve the quality of the publication. The funding agencies, higher learning institutions and research institutions should focus on enhancing research infrastructure. The study examined the validity of research articles searched by novice researchers in India in Google by using keywords related to entrepreneurship and, as such this non-focused approach is a big impediment to quality research. [ABSTRACT FROM AUTHOR]

It has been found that people with disabilities remain at the margin as far as the different aspects of their lives are concerned. This paper tests the hypothesis that disability leads to lower quality of life among older adults in low and middle-income countries. The data from the Study on Global Ageing and Adult Health (SAGE) was used in this study which was conducted in Ghana, China, India, Russia, South Africa and Mexico. The disability scores have been made utilising Item Response Theory, Partial Credit Model and are centered on eight functioning and health areas. Bivariate analysis, binary logistic regression and pooled regression analysis have been used to fulfil the objectives of the paper. The findings reveal that disability acts as a hindrance in attaining a high quality of life (HQOL) amongst the older adults in the above mentioned low and middle-income countries. The older adults with disability are as much as 60% less likely to enjoy an HQOL with respect to the older adults without disability. Better socio-economic development like improved health care for disabled older adults with disability enhanced living standards for both abled and disabled, efficient pension schemes for older adults with disability and effective social service schemes would be very much essential to improve overall QOL among older adults. [ABSTRACT FROM AUTHOR]

India has approximately 23 million children without parental care, who need alternative forms of care (MOSPI, 2018). Udayan Care, an NGO, designed an innovative group care model for children and youth in need of care and protection, implementing the indigenously developed LIFE (Living in Family Environment) strategy in 17 Udayan Ghars. (Sunshine Homes). With child participation as a core pillar, Udayan Care developed a Questionnaire to Assess the Needs of Children in Care (QANCC) in 2011, which is to be filled up by children annually, as a longitudinal study. The tool is conceived to ascertain whether children in the Ghars perceived if their rights were being fulfilled and that their needs were being addressed. With "meaningful participation" of children stipulated by the United Nations Convention on the Rights of the Child (UNCRC), the objective was to develop an evidence-based tool to assess the views of children on the services meted out to them, from their standpoint, and inform actual care practices annually. The self-assessment tool consists of questions, assessing the four dimensions of basic/fundamental, emotional, educational, and interpersonal needs, on a four-point Likert rating scale. A convenient purposive sampling is done on children, aged 10 to 18 years, who receive care and protection at the Ghars, and have resided there for a minimum of 6 months. This paper has two objectives, where at one end, the deductions of the previous years' data are made (2011–12 to 2016–17) with demarcating the differences with year 2018–19 data and at the second level, there is an update on the efforts made to establish the reliability and validity of the tool and create a standardized tool that can be implemented by other child care organizations in India. The paper illustrates how listening to direct voices of children and incorporating their inputs into actual care practice, can go a long way in improving the holistic wellness of children living in an alternative care setting. The results indicate that all needs of the majority of the children in Udayan Ghars. [ABSTRACT FROM AUTHOR]

Retirement is a psycho social process. It refers to the phase of life when a person leaves his job and withdraws from active working life. Proper optimization of retirement is only possible when a person has pre planned his life with proper finances and saving or the government is providing him with a lot of social security benefits. However, such conditions rarely occur as a person is preoccupied in his pre retirement phases. But proper optimization of retirement can also take place when a person has high social intelligence which affects physical and mental health. Hence, this paper is an endeavor to look into the relevance of social intelligence which helps the people in their retirement process in the people. Thus, a survey was done to find the level of Social Intelligence in the people who are ageing and are going to be retired soon. Around 252 people between 55 to 70 years were studied from Delhi and NCR. The result indicated that middle aged and just retired people had high social intelligence as compared to older adults and the former were also able to optimize their retirement effectively for successful ageing. The older adults were not able to cope up with the various issues of retirement due to low social intelligence. Hence, further studies can be carried out to design proper training for enhancement of social intelligence in aged people for their effective optimization of retirement. [ABSTRACT FROM AUTHOR]

A global goal for early childhood education and care is to ensure universal, "quality" provision that reaches all children. Achieving this goal requires a well-prepared workforce that is equipped to adapt to and deliver early childhood programs across the vastly diverse contexts and communities where children are growing up around the world. Yet currently there is a severe shortage of early childhood workers, particularly in "low resource" and complex communities. Evidence to support appropriate training for such workers is also lacking. In response, this paper presents findings from a case study of a large-scale training program for community-based early childhood workers in central-east India. A total of 650 community-based Village Communicators were trained to deliver a responsive caregiving package to parents of young children. Data collected over 3 months highlight how the unique contextually grounded, caring and reflexive approach to training resulted in profound personal and professional change among training participants. The findings are of significance in informing policy and practice associated with global goals for early childhood. First, they challenge the technical, programmatic approaches to training that are commonly adopted for preparing this workforce. Second, they evidence the potentially transformative, long-term impact of person-centered approaches to training that facilitate knowledge-sharing to understand local needs and attitudes. Third, they provide insight into ways in which training programs can support enhanced local relevance and effectiveness of early childhood services implemented for children and families across diverse contexts. Highlights: Caring, consultative approaches to training support transformative changes in knowledge and practice among community-based early childhood workers. Community-based workers comprise a crucial yet under-researched workforce globally. Active contribution to adapting early childhood interventions for greater local relevance empowers community-based workers as well as enhancing program content. Training for community-based workers in early childhood needs to shift away from overly programmatic, technical approaches. Meeting global goals for early childhood development requires localized responses. [ABSTRACT FROM AUTHOR]

This paper analyses the performance of non-banking finance companies (NBFC) in the Indian context using data envelopment analysis (DEA). The underlying objective of this study is to fill the void in the domain of NBFC, although a lot of research has been done on the banking industry in the context of the application of DEA, but none on NBFCs. The paper takes the panel data of the last 5 years (2014–2018) to calculate super-efficiencies in the first stage and then regresses the same on exogenous factors in stage-2. Descriptive statistics are used to estimate the efficiency by carrying out the calculations using both the traditional models (OTE, PTE and SE) and super-efficiency model. A comparison is made by categorizing NBFC's based on the size of total assets and using non-parametric statistic tests to find whether the efficiency scores are significantly different across different categories. The second stage DEA analysis uses Tobit regression to find the exogenous factors which affect the model significantly. Based on traditional models, the total number of efficient DMUs are 8 out of 43 while there are 15 after considering the super-efficiency algorithm. Malmquist Indices are used to study the productivity indices of NBFCs over the last 5 years, and it gives us a maximum productivity growth of 8.53%. It was noticed that there is a significant difference in the mean efficiency values of different sized NBFC's which can be explained by the lack of standardization in the NBFC domain and the few companies which are listed on the stock market. The managers should not consider ROE as a significant indicator of efficiency and should instead focus on aspects such as ROA and income diversity. Through the Malmquist analysis, the managers can break down the productivity change into technical and efficiency shifts for further investigation. [ABSTRACT FROM AUTHOR]

Studies on the association between population ageing and health spending are inconclusive. Though per capita health spending has a strong age gradient, evidence from the developed countries attributes increasing health expenditure to high spending in terminal year of life. In India, though studies have examined the level, trends and determinants of health care spending, no attempt has been made on association of population ageing and per capita health spending across the districts of India. The objective of this paper was to examine the spatial dependencies and heterogeneities of population ageing and per capita health spending across 640 districts of India. Data from the Census of India (2011) and the consumption expenditure rounds of the National Sample Survey Organisation (NSSO) (2009–10 and 2011–2012) were used in the analysis. Univariate and bivariate LISA analysis, ordinary least square regression, and spatial error model were used to decipher the spatial pattern of population ageing and health spending in the districts of India. Results suggest that per capita health expenditure is positively associated with the proportion of the older adults (aged 60 years and above) in the districts of India. Districts with less than 5% older adults have an annual per capita health expenditure of ₹629 compared to ₹2432 in districts with older adults 12% or more. Districts of India also exhibit large spatial heterogeneity in household health spending. Bivariate Moran's I statistic of proportion of older adults and per capita annual health expenditure was 0.48, suggesting spatially association of the share of the older adults and the per capita annual health expenditure in India. Results of the spatial error model confirmed that share of urban population, mean wealth score, and mean household size are significant predictors of per capita annual health expenditure in India. This study is important to monitor the progress of universal health coverage across the disadvantaged districts and to integrate age component in universal health coverage programmes. [ABSTRACT FROM AUTHOR]

Changing family structure from joint to nuclear posits a challenge among older people. Increasing prevalence of nuclear family promotes household headship among older adults but leaves them vulnerable as they have to live alone at older ages. Therefore, the study aims to estimate the trends and determine the factors associated with household headship among older adults from 1992-93 to 2015–16. The analysis of this paper is based on four rounds of the National Family Health Survey, which were conducted during the periods between 1992-93, 1998–99, 2005–06, and 2015–16, respectively. The study carried out bivariate and multivariate analysis to observe the association between outcome and independent variables. Results found that household headship among older adults had increased from 59.5% in 1992–93 to 67.8% in 2015–16. Further, the study found a rise in the proportion of nuclear families and household headship among older adults from 1992-93 to 2015–16. In older ages, household headship was more among older women than older men. The likelihood of household headship among older adults in a joint family is low as compared to household headship in a nuclear family. While the rise in household headship among older adults may be attributable to a variety of socio-economic influences, it has been noted that household headship among older adults has varied between men and women and by type of family structure. Moreover, there was a clear relationship between headship and wealth status of a household. [ABSTRACT FROM AUTHOR]

This paper proposes to investigate the Co Movement and Causal Relationship, among the three weather factors (temperature, humidity, and wind speed) and the returns of the Agriculture Commodity Index called Dhaanya, in India. The study employed the secondary daily data of weather in five sample cities (Chennai, Mumbai, Delhi, Kolkata and Hyderabad), and Agriculture Commodity Index called Dhaanya, in India. Statistical tools like Descriptive Statistics, Unit Root, Correlation Matrix, and Granger Causality Test were employed. This study found that the temperature and wind speed influenced the investors' mood in Chennai and Mumbai, in respect of Agriculture Commodity Index, namely Dhaanya. The findings of this study would help the investors in making investment decisions rationally, on the basis of weather condition. [ABSTRACT FROM AUTHOR]

Background: This paper examines two state-led public-private demand-side financial support programs aiming to raise hospital delivery rates in two neighbouring Indian states-Gujarat and Madhya Pradesh. The national Janani Suraksha Yojana (JSY) was complemented with a public-private partnership program Janani Sahayogi Yojana (JSaY) in Madhya Pradesh in which private obstetricians were paid to deliver poor women. A higher amount was paid for caesarean sections (CS) than for vaginal deliveries (VD). In Gujarat state, the state program Chiranjeevi Yojana (CY) paid private obstetricians a fixed amount for a block 100 deliveries irrespective of delivery mode. The two systems thus offered an opportunity to observe the influence of supplier-induced demand (SID) from opposite incentives related to delivery mode. Methods: The data from the two programs was sourced from the Departments of Health and Family Welfare, Governments of Gujarat and Madhya Pradesh, India. Results: In JSaY program the CS rate increased from 26.6 % (2007-2008) to 40.7 % (2010-2011), against the background rate for CS in Madhya Pradesh, of only 4.9 % (2004-2006). Meanwhile in CY program in Gujarat, the CS rate decreased to 4.3 % (2010-2011) against a background CS rate of 8.1 % (2004-2006). Conclusions: The findings from India are unique in that they not only point to a significant impact from the introduction of the financial incentives but also how disincentives have an inverse impact on the choice of delivery method. [ABSTRACT FROM AUTHOR]

This paper from India describes anxieties that pregnant and postpartum women reported to obstetricians during the COVID-19 pandemic. Of the 118 obstetricians who responded to an online survey, most had been contacted for concerns about hospital visits (72.65%), methods of protection (60.17%), the safety of the infant (52.14%), anxieties related to social media messages (40.68%) and contracting the infection (39.83%). Obstetricians felt the need for resources such as videos, websites and counselling skills to handle COVID-related anxiety among perinatal women. [ABSTRACT FROM AUTHOR]

Aim: The present paper aims to understand the fear of falling (FOF) and risk factors associated with FOF in community-dwelling individuals aged over 60 years in Pune, India. Subjects and methods: The study examined a random sample of 351 community-dwelling older adults. Data on demographic characteristics, health conditions, history of falls, and psychological factors were collected using a pre-tested, structured questionnaire. The Falls Efficacy Scale International (FES-I) was used to measure FOF. Univariate and bivariate logistic regression analyses were carried out to examine associations between various factors and FOF. Results: A high FES-I score was significantly associated with older age, females, unmarried status, education less than 6 years, living alone, unstable balance and gait, hypertension, arthritis, previous falls, self-reported loss of confidence, and depression. Adults older than 70 years of age (odds ratio, OR = 2.411), those with a history of falls (OR = 2.285), those reporting loss of confidence in the past 6 months (OR = 6.766), who had answered yes to the direct question of FOF (OR = 4.632), and had unstable balance (OR = 2.522) were also more likely to have higher FES-I values. Conclusion: A large number of older adults expressed concerns about falling and we also found several factors to be associated with developing FOF, supporting the need for screening. Thus, further research is needed in order to understand the relationship between severity of FOF and actual fall events for developing preventive measures which can be implemented before FOF becomes a problem. [ABSTRACT FROM AUTHOR]

Iodine nutrition status amongst neonates can be assessed by estimating thyroid stimulating hormone (TSH). According to WHO, if more than 3 % of the neonates have TSH levels of 5 mlU/l and more in a population, it indicates presence of iodine deficiency (ID). Iodine deficiency is an endemic health problem in Solan district, Himachal Pradesh (HP) state. ID leads to mental retardation, deaf mutism, squint, dwarfism, spastic diplegia, neurological defects and congenital anomalies. The aim is to determine iodine nutrition status of neonates of Solan district. In Solan district, six hospitals/community health centers providing obstetric services and conducting more than 100 deliveries per annum were identified and enlisted. Two hospitals were selected keeping in view of operational feasibility. A total of 683 umbilical cord blood samples of neonates were collected on filter paper and analyzed for TSH. It was found that 63.2 % of the neonates had TSH levels of more than 5 mlU/l indicating iodine deficiency in the Solan district. Iodine deficiency was a public health problem in Solan district, HP. [ABSTRACT FROM AUTHOR]

Background: The global COVID-19 pandemic has brought forth multifaceted healthcare challenges, including the emergence of COVID-19-associated mucormycosis (CAM). This study investigates demographics, clinical presentation, endoscopic grading, radiological correlations, treatment modalities, and outcomes of CAM in Central India. Methods: A retrospective analysis of 312 CAM patients (April-June 2021). Data included demographics, clinical profiles, endoscopic and radiological findings, laboratory results, and treatments. A novel endoscopic grading system was utilized to assess the severity of mucormycosis lesions. Statistical analysis, including chi-squared tests, was performed. Results: Among 312 patients, 65% were male, 82% had comorbidities, and 84% presented with facial swelling. Endoscopic grading correlated with radiological manifestations (p < 0.05) and intraoperative findings. Surgical debridement and antifungal therapy were common treatments, yielding varied clinical outcomes. Mortality was 13% in advanced grades. Conclusion: This study underscores the role of endoscopic grading in risk stratification and prognosis. Findings contribute to CAM management knowledge, underscoring tailored interventions' significance. [ABSTRACT FROM AUTHOR]

Background: India is a large and populous country where reliable data on headache disorders are relatively scarce. This study in northern India (Delhi and National Capital Territory Region [NCR], including surrounding districts in the States of Haryana, Uttar Pradesh and Rajasthan) continues the series of population-based studies within the Global Campaign against Headache and follows an earlier study, using the same protocol and questionnaire, in the southern State of Karnataka. Methods: This cross-sectional study used the Global Campaign's established methodology. Biologically unrelated Indian nationals aged 18–65 years were included through multistage random sampling in both urban and rural areas of NCR. Interviews at unannounced household visits followed the structured Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire in its original English version or in the validated Hindi version. Demographic enquiry was followed by a neutral headache screening question and diagnostic questions based on the International Classification of Headache Disorders edition 3 (ICHD-3), which focused on each respondent's most bothersome headache. Questions about headache yesterday (HY) enabled estimation of 1-day prevalence. A diagnostic algorithm first identified participants reporting headache on ≥ 15 days/month (H15+), diagnosing probable medication-overuse headache (pMOH) in those also reporting acute medication use on ≥ 15 days/month, and "other H15+" in those not. To all others, the algorithm applied ICHD-3 criteria in the order definite migraine, definite tension-type headache (TTH), probable migraine, probable TTH. Definite and probable diagnoses were combined. Results: Adjusted for age, gender and habitation, 1-year prevalences were 26.3% for migraine, 34.1% for TTH, 3.0% for pMOH and 4.5% for other H15+. Female preponderance was seen in all headache types except TTH: migraine 35.7% vs. 15.1% (aOR = 3.3; p < 0.001); pMOH 4.3% vs. 0.7% (aOR = 5.1; p < 0.001); other H15 + 5.9% vs. 2.3% (aOR = 2.5; p = 0.08). One-day prevalence of (any) headache was 12.0%, based on reported HY. One-day prevalence predicted from 1-year prevalence and mean recalled headache frequency over 3 months was slightly lower (10.5%). Conclusions: The prevalences of migraine and TTH in Delhi and NCR substantially exceed global means. They closely match those in the Karnataka study: migraine 25.2%, TTH 35.1%. We argue that these estimates can reasonably be extrapolated to all India. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) reports that Asia and Africa have the highest Chronic Liver Disease (CLD) mortality rate. Cirrhosis, responsible for 22.2 fatalities per 100,000 people, is India's 10th most common cause of mortality. The increasing prevalence of chronic liver disease necessitates a study to identify predictive factors for patients who visit the emergency department. Identifying elements that enhance the predictive value of mortality in unstable patients with CLD complications is important in emergency departments. This study aims to determine Clinical and Laboratory Parameters as mortality predictors in adult chronic liver disease patients. Methodology: The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with chronic liver disease above 18 years of age who satisfied the inclusion criteria were clinically evaluated. Clinical and demographic details were collected, and data was analyzed. Results: Two hundred thirty-six patients were enrolled. The mean age was 50.77 ± 14.26 years. 78.4% of the participants were men. Abdominal distension, affecting 59.7% of patients, was the most common presenting ailment, followed by melena and hematemesis, affecting 41.9% and 32.6%, respectively. The mean stay in the emergency department was 10.29 ± 8.10 h. Refractory septic shock, the leading cause of mortality, accounts for 69.2% of all deaths, alongside grade 4 hepatic encephalopathy and massive Upper Gastrointestinal (UGI) bleeding, as identified in our study. Factors such as altered mental sensorium, high respiratory rate, low SpO2, increased heart rate, low systolic blood pressure, low diastolic blood pressure, and low Glasgow Coma Scale (GCS) on Emergency Department (ED) arrival are significantly associated with mortality. Conclusions: Chronic liver disease, a prevalent condition in India, most commonly seen in middle aged men and lower socioeconomic groups. The parameters independently associated with mortality in our study were presence of altered mental sensorium, Glasgow coma scale, Child Pugh class and need for ICU admission. Understanding the presentation pattern, and mortality predictors can help ED physicians in managing acute events and follow-ups. [ABSTRACT FROM AUTHOR]

Background: Skill and health-related components are required for the assessment of football players' functional performance, and there is a lack of literature available to measure football players' functional performance. The study mostly focuses on developing and validating the tool for football players between the ages of 18 and 25. Methods: This study used a research methodology that focused on the development and verification of a scale. The research consisted of two distinct stages, namely tool development and validity testing. Firstly, the expert panel did a comprehensive analysis of the items and domains of the questionnaire. Subsequently, the Delphi approach was used to assess the content validity of the questionnaire. Later on, the evaluation tool was officially named the complete functional performance assessment battery (CFPA) for football players in India. Result: The CFPA's newly developed tool has excellent scale-level content validity, which was more than 0.78 for each item in the tool, i.e., 1 (indicated as extremely relevant), the content validity ratio was bigger than 0.49, and each item's kappa value was found to be 1, which is excellent. Each item's universal acceptance was found to be 1 for both the item's quality and content and Aiken's V index is also greater than 0.81. Conclusion: The CFPA is a valid tool in India that can be used to check the functional performance of football players. [ABSTRACT FROM AUTHOR]

This paper explores choice of marriage partners among individuals with visual impairment in India. The importance of marriage and the desirability of characteristics and traits in the prospective marriage partners were investigated from 42 individuals with visual impairment in the age group of 18-35 years, in Mumbai, India. Non-probabilistic sampling was used to collect data using an online pre-coded questionnaire, where 35 characteristics of the prospective partner were rated on a 4-point scale, along with ranking 16 traits in order of preference. Descriptive and inferential statistics were used for analysis of data. Marriage was considered important for the sample. Family's opinions were considered vital in marital decisions, but individual choice was important. Women preferred older partners as compared to men. More women, than men, considered visual impairment of partners an irrelevant determinant for partner selection. Statistically significant gender differences were found in the valuation of characteristics and traits with women valuing good financial prospects, chastity, good behavior towards parents, desire for home and children, and being teetotal, more than men. Men desired a physically attractive partner whereas women valued financial stability. Women valued the traits of easy going, good housekeeper and good earning capacity while men preferred a physically able spouse. There is potential for research on gendered marriage choices, specifically among various marginalized populations. Interaction of cultural practices and marriage preferences of individuals with disability could be further explored. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to track the efficacy of the Test and Treat model of human immunodeficiency virus (HIV) prevention adopted by the government of India, 2015-16, using the last two rounds of National Family Health Survey, providing community-based insights in the testing of HIV prevalence in 2005-06 and 2015-16.Methods: The survey collected information from a nationally representative sample of 69,751 men and 124,385 women in 2005-06 and 103,411 men and 121,118 women age 15-49 in 2015-16 respectively. Both descriptive and multivariate techniques have been used.Results: The 'test and treat' model of HIV in India portrays a women-centric effort to ensure HIV testing as part of their ANC, resulting in a substantial increase in ever being tested for HIV. Women who are educated, living in urban areas, and in economically better households are more prone to have ever undergone HIV testing, it is a welcome change given the existing HIV scenario, with a continuously narrowing gender gap in new HIV infections (NFHS-4). Women and men having positive attitude towards stigma and discrimination to people living with HIV (PLHIV) are in better agreement to ever being tested. Further, women and men having knowledge about antiretroviral therapy (ART) are 1.6 times (p < 0.001) and 1.8 times (p  < 0.001) more likely to have ever been tested for HIV.Conclusions: Despite an improvement in coverage of HIV testing, the existing disparities in HIV testing and treatment require policy instruments with an integrated approach. Government should work in close collaboration with communities/key stakeholders, and efficiently use their resources to provide evidence-based HIV prevention and treatment interventions. [ABSTRACT FROM AUTHOR]

Objectives This study measures the prevalence of risk factors among pregnant women and young children aged 12-24 months in a rural community in West Bengal, India. Methods Community health workers (CHWs) enrolled women and children into this 2015 cross-sectional study. Pregnant women were evaluated for underweight, anemia, and abnormal blood pressure. Children were evaluated for underweight, abnormal head and upper arm circumferences, and low scores from the Ages and Stages Questionnaire (ASQ). Data were collected on smartphones and tablets or by paper. Results More than half of the 279 women (59.9%) had a risk factor during pregnancy: 48.7% were anemic, 35.1% had low blood pressure, and 7.5% were underweight. Among the 366 children, 59.3% had a risk factor, including 24.0% with low ASQ scores and 49.7% who had abnormal anthropometric measures. Conclusions for Practice Vulnerable populations, such as pregnant women and young children, needed a greater connection to doctors in this rural community. This study demonstrated the feasibility of CHWs to listen to health concerns and connect underserved populations with health care services. [ABSTRACT FROM AUTHOR]

Medical statistics is generally considered a dry, boring, and complex subject and most doctors think that it is not required for them. There has been reluctance amongst doctors including surgeons to learn it. The knowledge of statistics amongst surgeons is poor. To know the attitude and knowledge of the surgeons, we conducted an online survey with Google form. A Google form was created (https://forms.gle/16Be3CJtnVAqtm5t9). It was shared with the heads of the department of general surgery of all medical colleges of Karnataka. We avoided asking personal details to avoid bias. Responders included 16 medical college faculty, 19 PG students in general surgery, and 18 consultant surgeons. 50.1% of responders did not read journals regularly. Only 5.9% understood the statistics part well while reading the journals. 43.1% understood statistics partly and some preferred to skip the statistics part. 88.4% of the responders agreed that statistics should be taught in the undergraduate and postgraduate curriculum. Only 43.4% felt that the medical college teachers have sufficient knowledge of statistics to guide their students. 60.4% approached a statistician and 45.3% searched Google for a solution when they came across a statistical problem. Some suggestions were given by the responders are (a) statistics should be taught in MBBS and MS/MD curriculum. It should be a compulsory subject for the examination. (b) Associations (like ASI) should conduct hands-on workshops on statistics for the benefit of the members. (c) More information on statistics should be provided in our journals etc. [ABSTRACT FROM AUTHOR]

This paper examines the association between alcohol use and HIV-related sexual risk behaviors among men who have sex with men (MSM). A cross-sectional bio-behavioral survey was conducted among 3,880 MSM, recruited using time-location cluster sampling from cruising sites in three Indian states. Nearly three-fifths of the participants reported alcohol use. Among frequent users (40 % of the sample), defined as those who consumed alcohol daily or at least once a week, 66 % were aged 25 years and above, 53 % self-identified as kothi (feminine/receptive), and 63 % consistently used condoms with male paying partners. Multivariate logistic regression demonstrated that frequent users were more likely to be aged 25 years and above, less likely to self-identify as kothi, and less likely to consistently use condoms with male paying (AOR = 0.7; 95 % CI 0.5-0.9) and male regular (AOR = 0.7; 95 % CI 0.6-0.9) partners. HIV prevention interventions for MSM need to provide tailored information on alcohol use-related sexual risk, especially for MSM in sex work and MSM with male regular partners. [ABSTRACT FROM AUTHOR]

Using the consumption expenditure data, National Sample Survey, 2009-2010, this paper test the hypothesis that the monthly per capita household health spending of elderly households is significantly higher than non-elderly households in India. The households are classified into three mutually exclusive groups; households with only elderly members (elderly households), households with elderly and non-elderly members and households without any elderly member. The health spending include the institutional (hospitalization) and non-institutional health expenditure of the households, standardized for 30 days. Descriptive statistics and a two part model are used to understand the differentials in health expenditures across households. Results indicate that the monthly per capita health spending increases with economic status, occupation, age and educational attainment of the head of the household. The monthly per capita health spending of elderly households is 3.8 times higher than that of non-elderly households. While the health spending accounts 13 % of total consumption expenditure for elderly households, it was 7 % among households with elderly and non-elderly members, and 5 % among non-elderly households. Controlling for socio-economic and demographic correlates, the per-capita household health spending among elderly households and among household with elderly and non-elderly members was significantly higher than non-elderly households. The health expenditure is catastrophic for poorer households, casual labourer and households with elderly members. Based on the finding we suggest to increased access to health insurance and public spending on geriatric care to reduce the out-of-pocket expenditure on health care in India. [ABSTRACT FROM AUTHOR]

Intellectual disability in India is substantially under-reported, especially amongst females. This study quantifies the prevalence and gender bias in household reporting of intellectual disability by estimating the age-and-gender specific prevalence of the intellectually disabled by education, Socio-Demographic Index (SDI) score, place of residence, (rural/urban) and income of household head. We estimated prevalence (per 100,000) at 179 (95% CI: 173 to 185) for males and 120 (95% CI: 115 to 125) for females. Gender differences declined sharply with increased education, was higher for lower ages and low income and varied little by state development. Under-identification and under-reporting due to stigma are two plausible reasons for the gender differences in prevalence that increase with age. [ABSTRACT FROM AUTHOR]

Background: Knowledge of the prevalence and attributable burden of headache disorders in India is sparse, with only two recent population-based studies from South and East India. These produced conflicting results. A study in North India is needed. We report the methodology of such a study using, and validating, a Hindi translation of the Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation (HARDSHIP) questionnaire developed by Lifting The Burden (LTB). Almost half of the Indian population speak Hindi or one of its dialects. Methods: The study adopted LTB's standardized protocol for population-based studies in a cross-sectional survey using multistage random sampling conducted in urban Delhi and a surrounding rural area. Trained interviewers visited households unannounced, randomly selected one adult member from each and applied the Hindi version of HARDSHIP in face-to-face interviews. The most bothersome headache reported by participants was classified algorithmically into headache on ≥ 15 days/month (H15 +), migraine (including definite and probable) or tension-type headache (including definite and probable). These diagnoses were mutually exclusive. All participants diagnosed with H15 + and a 10% subsample of all others were additionally assessed by headache specialists and classified as above. We estimated the sensitivity and specificity of HARDSHIP diagnoses by comparison with the specialists' diagnoses. Results: From 3,040 eligible households, 2,066 participants were interviewed. The participating proportions were 98.3% in rural areas but 52.9% in urban Delhi. In the validation subsample of 291 participants (149 rural, 142 urban), 61 did not report any headache (seven of those assessed by HARDSHIP, eight by headache specialists and 46 by both) [kappa = 0.83; 95% CI: 0.74-0.91]. In the remaining 230 participants who reported headache in the preceding year, sensitivity, specificity and kappa with (95% CI) were 0.73 (0.65-0.79), 0.80 (0.67-0.90) and 0.43 (0.34-0.58) for migraine; 0.71 (0.56-0.83), 0.80 (0.730.85) and 0.43 (0.37-0.62) for TTH and 0.75 (0.47-0.94), 0.93 (0.89-0.96) and 0.46 (0.34-0.58) for H15 + respectively. Conclusion: This study validates the Hindi version of HARDSHIP, finding its performance similar to those of other versions. It can be used to conduct population surveys in other Hindi-speaking regions of India. [ABSTRACT FROM AUTHOR]

Given limited resource availability in a developing nation like India, faced with high incidences of crime, it is important to optimize on the resources spent in combating crime by channelling them to proper direction. This requires an understanding of the actual and overall level of crime across India. Our paper provides a complete understanding of the various indicators of violent crime and the determinants of these crimes in India using district level data for three census years, namely, 1981, 1991 and 2001. We construct three alternative crime-burden indices. Including a variable like voter turnout in state election at the district level, we document significant impact of public awareness to reduce and combat crime. The constructed crime burden index shows that states located in northern parts of India have more incidences of crime compared to states in the south. We also find that our estimated crime-burden indices tend to report in general a higher level of crime-burden than the average based index. This suggests controlling for the factors beyond population while constructing the aggregate crime-burden index for any country is essential. Our work although is limited to the Indian data, we however, believe that this can be easily applied to various other countries. [ABSTRACT FROM AUTHOR]

Objectives In low-income settings, neonatal mortality rates (NMR) are higher among socioeconomically disadvantaged groups. Institutional deliveries have been shown to be protective against neonatal mortality. In Gujarat, India, the access of disadvantaged women to institutional deliveries has increased. However, the impact of increased institutional delivery on NMR has not been studied here. This paper examined if institutional childbirth is associated with lower NMR among disadvantaged women in Gujarat, India. Methods A community-based prospective cohort of pregnant women was followed in three districts in Gujarat, India (July 2013-November 2014). Two thousand nine hundred and nineteen live births to disadvantaged women (tribal or below poverty line) were included in the study. Data was analyzed using multivariable logistic regression. Results The overall NMR was 25 deaths per 1000 live births. Multivariable analysis showed that institutional childbirth was protective against neonatal mortality only among disadvantaged women with obstetric complications during delivery. Among mothers with obstetric complications during delivery, those who gave birth in a private or public facility had significantly lower odds of having a neonatal death than women delivering at home (AOR 0.07 95% CI 0.01-0.45 and AOR 0.03, 95% CI 0.00-0.33 respectively). Conclusions for Practice Our findings highlight the crucial role of institutional delivery to prevent neonatal deaths among those born to disadvantaged women with complications during delivery in this setting. Efforts to improve disadvantaged women's access to good quality obstetric care must continue in order to further reduce the NMR in Gujarat, India. [ABSTRACT FROM AUTHOR]

Medical students confront enormous academic, psychosocial, and existential stress throughout their training, leading to a cascade of consequences both physically and psychologically. The declined cognitive function of these students interferes in their academic performance and excellence. The purpose of this study was to examine the effectiveness of a yogic meditation technique, mind sound resonance technique (MSRT), on cognitive functions of University Medical students in a randomized, two-way crossover study. In total, 42 healthy volunteers of both genders (5 males and 37 females) with mean age of 19.44 ± 1.31 years were recruited from a medical college in South India, based on the inclusion and exclusion criteria. A 10-day orientation in the technique of MSRT was given to all the recruited subjects after which each subject underwent both MSRT and supine rest (SR) sessions. All participants were randomized in a 1:1 ratio to receive a session of either MSRT or SR. After a day of washout, participants crossed over to receive the alternative intervention. The cognitive functions were assessed using 2 paper-pencil tasks called Digit Letter Substitution Test (DLST) and Six-Letter Cancelation Task (SLCT), before and immediately after both sessions. Both the groups showed significant improvement in net attempt of both DLST and SLCT, but the magnitude of change was more in the MSRT group than in the SR group. The MSRT group demonstrated significantly enhanced net scores in both SLCT ( p < 0.001) and DLST ( p < 0.001). The result of the present study suggests that a single session of MSRT, a Mind-Body Practice, may positively impact the performance in cognitive tasks by the University Medical Students. [ABSTRACT FROM AUTHOR]

Background: Endotracheal intubation is an essential resuscitative procedure in the emergency setting. Airway assessment parameters such as the Mallampati classification are difficult to perform in an emergency setting. As point-of-care ultrasound (POCUS) assessment of airway parameters does not require patients to perform any mandatory action, ultrasound may become the potential first-line noninvasive airway assessment tool in the emergency department (ED). The use of POCUS in the ED has not been sufficiently studied. Using POCUS in airway assessment for predicting difficult intubation may be the next step in successful airway management. Methodology: The study was an observational study conducted at the ED of the All India Institute of Medical Sciences (Rishikesh). The treating emergency physician recorded the patient history and systemic examination along with an indication for intubation. The POCUS assessment of airway parameters pre-epiglottis to epiglottic vocal cord ratio (Pre-E/E-VC), tongue thickness, hyomental distance, and distance from skin to the hyoid bone was performed by the study investigator. During laryngoscopy, Cormack-Lehane (CL) grading was assessed. The data was entered and analyzed. Results: Seventy patients who required intubation in the ED were enrolled in the study. Among the study population, 48.6%, 28.6%, 14.3%, 1.4%, and 7.1% were classified with the following CL grading: 1, 2a, 2b, 3a, and 3b, respectively. At a cutoff of ≥ 1.86, Pre-E/E-VC predicts difficult laryngoscopy (AUC 0.835) with a sensitivity of 83% and a specificity of 94%. At a cutoff of ≥ 5.98 cm, tongue thickness predicts difficult laryngoscopy (AUC 0.78) with a sensitivity of 83% and a specificity of 88%. At a cutoff of hyomental distance ≤ 6 cm, it predicts difficult laryngoscopy with a sensitivity of 83% and a specificity of 88%. All parameters can act as a promising tool for predicting difficult laryngoscopy, with the single best parameter being Pre-E/E-VC. Conclusion: Assessment of the airway with POCUS may be helpful to the emergency physician when the clinical airway assessment parameters fail to predict difficult laryngoscopy as most patients requiring intubation are uncooperative. Assessment of the parameters in our study Pre-E/E-VC, tongue thickness, and hyomental distance can act as a promising tool for predicting difficult laryngoscopy in the emergency scenario. [ABSTRACT FROM AUTHOR]

Few studies in India have conducted research on cyberbullying, and the existing studies lack information about psychometric properties of cyberbullying measures. To address this gap in the literature, the current study evaluated the psychometric properties of a behavioral assessment of cyberbullying perpetration and victimization from the Problem Behavior Frequency Scales—Adolescent Revised among Indian youth. Parallel samples were recruited from the New Delhi area (N = 178; Mage = 12.47; 57.1% male) and the U.S. (N = 307; Mage = 11.79; 51.9% male). A confirmatory factor analysis indicated that a one-factor solution for both scales had good fit with the data, similar to the original validation of the scale. We found measurement equivalence for cyberbullying perpetration across demographic subgroups in India—gender, age, religion, free- or reduced-price lunch, geographic location, and type of school. Measurement equivalence was found for cyberbullying victimization across subgroups in India, except for free- or reduced-price lunch status. Invariance testing across countries resulted in strong invariance for cyberbullying perpetration (e.g., same structure, factor loadings, and intercepts). Invariance testing across countries for cyberbullying victimization was weak (e.g., same structure and factor loadings), suggesting caution against cross-cultural comparisons when using the cyberbullying victimization measure. The results build capacity for cyberbullying research in India so that risk and protective factors can be measured with validated cyberbullying scales to identify ways to reduce cyberbullying. [ABSTRACT FROM AUTHOR]

India's traditional kinship behavior have undergone certain fundamental changes due to recent development and functioning of Indian society. Of all, the most dominant change is in the form of co-residence of children with their parents in old age. Without familial support, falling or no income and poor health, today, older adults are the most vulnerable population sub-group in the total population. Therefore, by using the India Human Development Survey-II, 2011-12 data we study the relevant association of living arrangement on health status of the older adults. Our results indicate that older adults living alone have significant and strong association with adverse health conditions such as Cataract, Hypertension, and Heart Disease. On the backdrop of health variations of older adults, it is understood that among other socio-economic conditions, living arrangement have serious implications on the health status of the older adults. Thus, we strongly support the notion that older adults with proper family care and support are more likely to be in a better health position as compared to those deprived of it. [ABSTRACT FROM AUTHOR]

Background: Masseter vestibular-evoked myogenic potentials (mVEMP) are vestibular-dependent inhibitory reflex recorded using acoustic stimulus. mVEMP can assess important brainstem regions. mVEMP abnormalities have been reported in patients with multiple sclerosis, Parkinson's disease, and idiopathic random eye movement disorder. The objective of the study was to record mVEMP using tone-burst stimulus at different frequencies in young healthy individuals. Method: The study used normative study design. Thirty-two participants, aged 18–28 years with normal hearing and balance function, were recruited for the study. Simple random sampling was used for selection of participants. Data collection and analysis: mVEMP was recorded for all the individuals at 500 Hz,750 Hz,1000 Hz, 2000 Hz, and 4000 Hz tone burst stimuli. The p11 and n21 peaks were identified. The latency of the p11 and n21 peaks and the rectified amplitude of the p11-n21 peak complex were measured for all the participants. Wilcoxson signed-rank test was used for statistical anlysis. Results: The study found a 100% response rate and higher amplitude for 500 Hz and 750 Hz tone burst stimuli. However, Wilcoxson signed-rank test with Bonferroni correction showed no significant difference in amplitude (p = 0.92) between 500 and 750 Hz. Conclusion: The study recommends 500 Hz/750 Hz tone burst stimuli as an optimal frequency for recording mVEMP in young, healthy individuals. However, seeing the frequency-tuning characteristics of mVEMP in other peripheral vestibular pathologies would be interesting. [ABSTRACT FROM AUTHOR]

Background: While extensive research exists on physical frailty, including in low- and middle-income countries like India, studies have yet to appraise whether perceived social standing is associated with physical frailty. As such, this study examines (1) the association between subjective social status (SSS) and physical frailty among older adults in India; and (2) whether this association is mediated and moderated by perceived discrimination and experiences of III-treatment. Methods: Data came from the Longitudinal Aging Study in India with a sample of 31,464 older adults aged 60 and above. Physical frailty was assessed using an adapted version of the frailty phenotype developed by Fried and colleagues. SSS was assessed using the Macarthur scale. Multivariable logistic regression models along with Karlson–Holm–Breen (KHB) methodology were employed to examine the direct association, mediational pathways, and the interactions. Results: The prevalence of frailty was 30.65% and those with lowest SSS reported higher prevalence of frailty (42.06%). After adjusting for several confounders, odds of frailty were lower among persons with high SSS relative to those with low SSS, and the variance explained by the SSS was higher than that explained by household consumption quintiles. Moreover, the association between SSS and frailty was mediated and moderated by perceived discrimination and III-treatment. Conclusions: Our findings underscore that when examining the association between socioeconomic status (SES) and physical frailty, it is important to consider SSS given that perceived social status likely reflects the less apparent psychosocial components associated with SES, and that perceived discrimination and III-treatment both mediate and moderate the association between SSS and physical frailty is critical to identifying those older Indians most susceptible to the functional health implications of lower SSS. [ABSTRACT FROM AUTHOR]

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The loss of family-based support services along with the preference of the older adults to age-in-place, have increased the importance of neighbourhood and community based support services for the older adults in India. This study first proposes a framework for identification of the neighbourhood-based support services, which are perceived by the older adults to contribute to their overall QoL, by understanding the concerns and perception of overall QoL of older adults living in Kolkata, India. The quality and type of available services also vary considerably based on the different classes of cities in India. This study, through analysis of data collected from structured interviews with older adults living in Kolkata and Midnapore in India, also proposes a framework that can help in exploring if living in different classes of cities impacts upon on the prioritisation of the support services by the older adults. In the process of identification of the support services, the initial list was first identified from literature and interviews with caregivers and beneficiaries of non-governmental organizations providing older adults care services, and the final list of support services were selected on the basis of researchers' judgement. The importance or prioritisation of support services was determined using RIDIT analysis. Considering the limitations of funds for social support services in a developing country like India, the proposed framework of identification and prioritisation can be utilised by future policy makers for formulation of policies and programs catering to essential support services, based on the class of city and the socio-economic and cultural background of the city residents. [ABSTRACT FROM AUTHOR]

Indian population is ageing at a higher pace coupled with the increase in life expectancy, and the prevalence of cognitive impairment, dementia, and comorbidities increase dramatically with age. Such cognitive and physical changes are intimately linked with declines in everyday functioning that include loss of decision-making skills. The present study explored the relationship between socioeconomic and health status of older adults and their role in household decision making. The study used data from the "Building a Knowledge Base of Population Ageing in India" (BKPAI) survey conducted in 2011 (n = 9181). Descriptive statistics along with multivariate negative binomial and binary logistic regression analyses were conducted. A proportion of 29.7% of older adults had no or partial involvement in household decision making and 26.5% of older adults reported that they had witnessed a decline in their role as decision-maker. The involvement of older adults in household decision making was 1.51 times lower among those who did not contribute money in household expenditure (incidence rate tatio (IRR):1.51; 95% confidence interval (CI): 1.24, 1.84) than those who contributed. Respondents who had low cognitive ability (IRR: 1.22; 95% CI: 1.09, 1.37) or had more than one disability (IRR: 1.27; 95%CI: 1.09, 1.47) were significantly 1.22 and 1.27 times less likely to have involvement in household decision making, respecctively. Older adults who reported low self-rated health (adjusted odds rati (aOR): 1.4; 95% CI: 1.21, 1.61), low general health (aOR: 2.85; 95% CI: 2.46, 3.31), low subjective wellbeing (aOR: 2.29; 95% CI: 1.99, 2.64) and low IADL (aOR: 1.49; 95% CI: 1.31, 1.69) were significantly more likely to report a decline in the role as a decision maker compared to their healthy counterparts. Along with the poor socioeconomic characteristics, the negative effects of cognitive and health markers of ageing further diminish the role of older adults in household decision making. Further research in the field of familial role and importance of older adults in different family settings is required in tackling a wide range of issues related to the wellbeing of the aged population. [ABSTRACT FROM AUTHOR]

The aim of this study is to examine the influence of antenatal factors such as anxiety, depression, perceived stress, marital satisfaction, maternal antenatal attachment, and social support on postnatal maternal attachment and competence in women who received assisted reproductive treatment. A prospective longitudinal cohort design was adopted with two groups—50 women who received assisted reproductive treatment and 50 women who had natural conception. Both the groups were assessed using self-report measures over three time points: T1, 7th month of pregnancy; T2, 2 weeks postpartum; and T3, 3 months postpartum. A final sample of 44 women who had assisted conception and 47 women who had natural conception completed assessments across all three time points. Descriptive, bivariate analyses, and stepwise multiple linear regression analyses were carried out. In the assisted conception group, maternal antenatal attachment, depression, and marital satisfaction significantly predicted postnatal maternal-infant attachment. Perceived social support, depression, and duration of marriage significantly predicted postnatal maternal competence. In the naturally conceived group, maternal antenatal attachment and social support significantly predicted postnatal maternal-infant attachment; perceived stress significantly predicted postnatal maternal competence. Antenatal depressive symptoms and relational factors significantly influenced postnatal maternal attachment and competence highlighting the need for screening and targeted psychological interventions during pregnancy. [ABSTRACT FROM AUTHOR]

Large scale investment in the National Rural Health Mission is expected to increase the utilization and reduce the cost of maternal care in public health centres in India. The objective of this paper is to examine recent trends in the utilization and cost of hospital based delivery care in the Empowered Action Group (EAG) states of India. The unit data from the District Level Household Survey 3, 2007-2008 is used in the analyses. The coverage and the cost of hospital based delivery at constant price is analyzed for five consecutive years preceding the survey. Descriptive and multivariate analyses are used to understand the socio-economic differentials in cost and utilization of delivery care. During 2004-2008, the utilization of delivery care from public health centres has increased in all the eight EAG states. Adjusting for inflation, the household cost of delivery care has declined for the poor, less educated and in public health centres in the EAG states. The cost of delivery care in private health centres has not shown any significant changes across the states. Results of the multivariate analyses suggest that time, state, place of residence, economic status; educational attainment and delivery characteristics of mother are significant predictors of hospital based delivery care in India. The study demonstrates the utility of public spending on health care and provides a thrust to the ongoing debate on universal health coverage in India. [ABSTRACT FROM AUTHOR]

Female sex workers (FSWs) were recruited for a 4-month placebo vaginal gel trial in Nellore, India. Two experiments explored if prior knowledge of biomarkers for unprotected sex and insertion of gel applicators would yield more accurate self-reports. A third experiment compared self-reports of gel use and adherence levels between FSWs randomly assigned to interactive voice response survey (IVRS) and those assigned to paper diaries. Prior knowledge of biomarkers did not improve accuracy of self-reported condom or gel use, nor did it affect actual adherence. Of those who tested positive for the presence of semenogelin in the vagina, 76 % reported no unprotected sex in the previous 48 h. Overall, women reported using gel on 90 % of days whereas the biomarker indicated gel use on fewer than 50 % of days. Compliance to IVRS was low, despite familiarity with mobile phone technology. Additional explorations with other populations are needed. [ABSTRACT FROM AUTHOR]

This paper examines the impact of three components of an HIV prevention program (mid-media, interpersonal communication, and project-run clinics) on consistent condom use by long distance truckers with paid and non-paid female partners in India. Data from 2,723 long distance truckers were analyzed using the propensity score matching approach. Based on utilization of services, the following categories of intervention exposure were derived: no exposure, exposure only to mid-media, exposure only to mid-media and interpersonal communication, exposure only to mid-media and project-run clinics, and exposure to all three intervention components. Compared to those who were not exposed to any intervention, exposure to mid-media alone increased consistent condom use with paid female partners by about ten percent. Exposure to mid-media and visits to project-run clinics increased consistent condom use with non-paid female partners by 26 %. These findings suggest that mid-media events and clinics were the most effective package of services to increase consistent condom use among the long distance truckers. [ABSTRACT FROM AUTHOR]

This paper examines the associations between male migration and mobility with HIV among married couples in India. Cross-sectional analyses of a nationally representative household survey conducted across all 29 states of India from 2005 to 2006 via the National Family Health Survey-3 (NFHS-3) included a subsample of 27,771 married couples who were tested for HIV as a part of their participation. Both bi-variate and multi-variate analyses were conducted. About 0.5% of the total married couples in the current study included an HIV-infected partner; 0.11% were HIV concordant and 0.38% were HIV serodiscordant couples. Adjusted logistic regression analyses demonstrated that HIV infection in couples (seroconcordant or serodiscordant) was significantly more likely among those couples where the man was migrant but not mobile and those couples where the man was migrant as well as mobile, relative to those couples where the man was neither migrant nor mobile. Male migration increases the risk for HIV among married couples in India, largely in the form of serodiscordance in which men are HIV infected. These findings document the need for not only primary prevention efforts to reduce HIV acquisition among migrant male workers, particularly more mobile migrants, but also efforts are needed to reduce subsequent transmission to their wives. [ABSTRACT FROM AUTHOR]

The School Mental Health (SMH) services play critical roles fostering positive mental health and helping children with psychological problems. Despite its proven value, SMH services remain less developed in India. In this context, sensitizing teachers about child mental health issues could be considered as an important step in SMH promotion. Towards this goal, a large scale sensitization program for school teachers on SMH issues was carried out in an Indian city. This paper reports the process and the outcome of this sensitization program. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between indicators of mobility, socio-economic vulnerabilities, and HIV risk behaviours among 5,498 mobile female sex workers (FSWs) living in the four high HIV prevalence states in India. Female sex workers with greater degree of mobility reported significantly more often than the FSWs with lesser degree of mobility that they experienced physical violence, and consumed alcohol prior to sex. Further, FSWs with greater degree of mobility reported significantly more often than the FSWs with lesser degree of mobility that they had inconsistent condom use in sex with clients, even after controlling for several demographic characteristics and socio-economic vulnerabilities including experiences of violence. Additionally, short duration visits and visit to the Jatra (religious fairs) places found to have significant association with their inconsistent condom use in sex with clients as well as continuation of sex despite having STI symptoms. These findings suggest the need for screening FSWs for higher degree of mobility and to mobilize them to form community networks so as to deal with violence, reduce alcohol use and promote consistent condom use along the routes of mobility. HIV prevention interventions aimed at FSWs require an increased attention to address the socio-economic vulnerabilities including alcohol use, with particular emphasis on those FSWs who are on the move in India and elsewhere. [ABSTRACT FROM AUTHOR]

Introduction: Maternal and child under-nutrition is particularly widespread in low and middle-income nations, increasing the overall disease burden due to poor nutritional status. The aim of this study was to develop nutrition intervention for the prevention and control of anaemia among women of reproductive age. Methods: Community-based intervention study was conducted among 443 women of reproductive age group (15–49 years) to determine the effectiveness of a 6-month nutrition intervention package. The nutrition intervention was developed by using Precede-Proceed model and the trans-theoretical model of behavior change. Multi-channel communication approach was adopted and nutrition intervention package was provided. Assessment of haemoglobin, red blood cells, platelet, ferritin, folate, vitamin B12, haematocrit test, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width and total leucocyte count was compared at the baseline and endline after the intervention among the participants. The chi-square test of independence and t-test were performed. Results: The only mean ferritin level shows significant improvement (p < 0.001). A significant decrease (~ 15%, p = 0.027) in anaemia was observed after the intervention. Conclusions: Improvement in anaemic status of women was observed. National schemes and programs require a more robust strategical implementation like food fortification/bio fortification and behaviour change communication at village level to enhance the availability and accessibility of fortified food. Significance: What is already known on this subject? Anaemia is highly prevalent among women and child in India. In reproductive aged women, there is some evidence of a link between nutrition and anaemia. What this study adds? The study recommends that trans-theoretical model of behaviour construct was an effective way to reduce the prevalence of anaemia among reproductive aged women of India. Multi-channel communication and household level interaction can be considered for significant implementation of nutrition intervention. [ABSTRACT FROM AUTHOR]

Background: India has 66 million people with diabetes, of which a large proportion do not receive adequate care. The primary health centres can serve as platforms for early detection of diabetes and continuum of care. Objectives: This project evaluates a community-level technology-enabled system-level intervention based around the community health workers and primary-care physicians. We hypothesize that incorporation of a mobile clinical decision support system, with other process-level changes will improve identification and management of individuals with diabetes in primary care settings. Methods: A cluster-randomized trial in sixteen villages/peri-urban areas in Andhra Pradesh and Haryana will test the feasibility and preliminary effectiveness of this intervention. The effectiveness of the extended care intervention will be evaluated by the difference in HbA1c (glycosylated hemoglobin) measured at baseline and end-line between the two study arms. Qualitative interviews of physicians, ASHA, and community members will ascertain the intervention acceptability and feasibility. Results: A total of 1785 adults (females: 53.2%; median age: 50 years) were screened. ASHAs achieved 100% completeness of data for anthropometric, blood-pressure, and blood-glucose measures. At baseline, 63% of the participants were overweight/obese, 27.8% had elevated blood pressure, 20.3% were at high-risk for cardiovascular disease (CVD), and 21.3% had elevated blood glucose. Half of the individuals with diabetes were newly diagnosed. Conclusion: Technology enabled transfer of simple clinical procedures from physicians to nonphysician health workers can support the provision of healthcare in under-served communities. Community health workers can successfully screen and refer patients with diabetes and/or CVD to physicians in primary healthcare system. [ABSTRACT FROM AUTHOR]

Amidst a rapidly aging population, living alone is considered as a living arrangement with various disadvantages. The study aimed to assess the association between older adults living in one-person-households (OPH) and their socio-economic status along with associated inequalities. The data for the present study was utilized from National Family Health Survey, 2015–16 (n = 146, 657). Descriptive, bivariate along with multivariable analysis was used to fulfil the aim of the present study. For assessing socio-economic differentials in OPH, concentration index along with Wagstaff decomposition analysis was used. It was revealed that poor older adults had a higher proportion of OPH (12.7%) than older adults from the non-poor category (3.8%). The value of concentration index was -0.38 indicating the concentration of OPH among poor older adults. Manipur had the highest value of concentration index (-0.614). The highest percentage of poor OPH among older adults was in Kerala (30.7%) and whereas it was lowest among older adults in Bihar (5.9%). About 33.6% of socio-economic status related-inequality was explained by the marital status of older adults followed by older adults' place of residence (30.9%) and gender (29.3%). Older adults who are poor, women, never married, and living in rural areas need greater attention from both governmental and non-governmental organizations. In addition, policies should be designed by differentiating between older adults who live alone by choice and those who are forced by circumstances to map the vulnerabilities effectively. [ABSTRACT FROM AUTHOR]

This study was undertaken to test the validity of the Spirituality and Spiritual Care Rating Scale (SSCRS) by McSherry et al. (IJNS 39:723–734, 2002) in an Indian context. The study was conducted in a tertiary care teaching hospital with a convenience sample of 200 nurses. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were completed to assess the reliability and validity of the tool. The results of the present study were similar to but differed from the McSherry et al's (IJNS 39:723–734, 2002) study which identified 17 items on the scale. Only 15 items loaded on three factors. [ABSTRACT FROM AUTHOR]

Background: Despite its utility, uncertainty exists on the feasibility of acute peritoneal dialysis (PD) and optimal PD catheter type for very low birth weight (VLBW < 1500 g) and extremely low birth weight (ELBW < 1000 g) infants. We hereby report our experience of acute PD among these high-risk infants and compare the outcome between stylet-based rigid catheter (SRC) and Cook Mac-Loc Multipurpose Drainage catheters® (CMMDC). Methods: Case notes of infants < 1500 g undergoing PD between 2012 and 2021 in a network of five participating neonatal units supported by a tertiary paediatric nephrology centre in Kolkata, India, were retrospectively reviewed. PD was conducted either with SRC or after 2018 with CMMDC. Outcome parameters included complications, survival during PD, and survival to discharge. Results: 24 infants (VLBW: n = 13 and ELBW: n = 11) underwent PD at median age 4.5 days (IQR 3–6) with either CMMDC (n = 14) or SRC (n = 10). Significant improvement in biochemical parameters and fluid removal was seen in both ELBW and VLBW infants. CMMDC was associated with significantly fewer PD-related complications 7/14 (50%) vs. 9/10 (90%) (p = 0.04) and higher survival during PD 13/14 (93%) vs. 5/10 (50%) (p = 0.02), without significant difference in survival to hospital discharge 8/14 (57%) vs. 3/10 (30%) (p = 0.25). CMMDC also enabled longer duration of PD, higher ultrafiltration, and better control of acidosis. Consumable cost was higher for CMMDC (USD$60) than SRC (USD$14). Conclusions: In a low resource setting, CMMDC had lower PD complications and superior short-term survival among ELBW/VLBW infants. A higher resolution version of the Graphical abstract is available as Supplementary information [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases are the most serious public health threat of the twenty-first century. Diabetes is becoming a major public health issue worldwide and is associated with a slew of potentially fatal comorbidities. Aim: Based on the available literature, our systematic review and meta-analysis aimed to understand the prevalence of diabetes mellitus in the Indian tribal community. Materials and methods: Following PRISMA guidelines, studies reporting the prevalence of diabetes mellitus among tribes in India were retrieved by independent investigators who electronically conducted a literature search by exploiting searches conducted in PubMed, Science Direct, and Google Scholar. We estimated pooled prevalence with 95% confidence intervals using the R Studio statistical tool in a random-effects model. This review includes twenty-three studies from 2000 to 2020 conducted in all five regions of India. Results: The pooled prevalence rate across the twenty-three studies of 35,985 participants was 6% (95% confidence intervals [CI] = 5–7%). High heterogeneity was observed in prevalence estimates. The prevalence of diabetes mellitus in different subgroups ranged from 4% (95% CI = 0.00, 0.05%) to 10% (95% CI = 0.00, 0.19) (North, 5%; South, 5%; East, 10%; West, 4%; and Central, 7%). Conclusion: As a result, concentrated efforts aimed at filling awareness gaps as well as operational research or other data gaps would aid in the prevention and control of diabetes, as well as filling these gaps in tribal areas. [ABSTRACT FROM AUTHOR]

Background: Blood gas analysis is integral to assessing emergency department (ED) patients with acute respiratory or metabolic disease. Arterial blood gas (ABG) is the gold standard for oxygenation, ventilation, and acid–base status but is painful to obtain. Peripheral venous blood gas (VBG) is a valuable alternative as it is less painful and easy to collect. The comparability of ABG and VBG was studied in various conditions. But in hypotension, previous findings were inconsistent. So, we studied the correlation and agreement between ABG and VBG in hypotensive patients. Methodology: The study was conducted at the emergency department of a tertiary healthcare center in Northern India. Patients with hypotension above 18 years who satisfied the inclusion criteria were clinically evaluated. Patients who require ABG as a part of routine care were sampled. ABG was collected from the radial artery. VBG was obtained from the cubital or dorsal hand veins. Both samples were collected within 10 min and were analyzed. All ABG and VBG variables were entered in premade proforma. The patient was then treated and disposed of according to institutional protocol. Results: A total of 250 patients were enrolled. The mean age was 53.25 ± 15.71 years. 56.8% were male. The study included 45.6% septic, 34.4% hypovolemic, 18% cardiogenic, and 2% obstructive shock patients. The study found a strong correlation and agreement for ABG and VBG pH, pCO2, HCO3, lactate, sodium, potassium, chloride, ionized calcium, blood urea nitrogen, base excess, and arterial/alveolar oxygen ratio. Hence, regression equations were made for the aforementioned. There was no correlation observed between ABG and VBG pO2 and SpO2. Our study concluded that VBG could be a reasonable alternative for ABG in hypotensive patients. We can also mathematically predict values of ABG from VBG using regression equations derived. Conclusions: ABG sampling causes most unpleasant experiences to patients and is associated with complications like arterial injury, thrombosis, air or clotted-blood embolism, arterial occlusion, hematoma, aneurysm formation, and reflex sympathetic dystrophy. The study has shown strong correlations and agreements for most ABG and VBG parameters and can predict ABG mathematically using regression formulas formulated from VBG. This will decrease needle stick injury, consume less time, and make blood gas evaluation easy in hypotensive settings. [ABSTRACT FROM AUTHOR]