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Diabetes mellitus (DM), a significant public health problem across the nations, is among the top ten leading causes of death. More than 370 million indigenous people (referred to as tribal people in India) are spread across 90 countries. India has the largest tribal people of 104 million. Tribal populations are not exceptional to the threat of type 2 DM (T2DM) and other non-communicable diseases, and hence, public health programmes are addressing this problem. This paper reports the systematic review and meta-analysis of the literature on the prevalence of T2DM. We conducted a systematic review and meta-analysis of the literature to understand the prevalence of T2DM among the tribal populations of India, following the guidelines of the PRISMA Statement for Reporting Systematic Reviews and Meta-Analysis. The gender-wise prevalence was recalculated by extracting the data wherever possible. Forest plots were depicted based on the prevalence, and other analyses were performed. On initial searches from three databases, 5422 citations were identified, and ultimately 27 studies were included in the review. These studies were undertaken amongst different tribes in different parts of India. The pooled prevalence of T2DM among men, women and combined were 6.04% (95% confidence interval (CI): 5.55% to 6.57%), 6.48% (95% CI: 6.01% to 6.99%) and 4.94% (95% CI: 4.72% to 5.17%), respectively. Considerable heterogeneity was found among these studies. This systematic review provides an overview of the prevalence of T2DM among the Indian tribal population. The pooled overall prevalence is slightly lower than the general population. This situation is worrisome as the epidemic of T2DM will affect the poor tribal communities, who can least afford to bear the health care costs. Hence, the public health care services must be strengthened in all tribal areas. This review further warrants establishing surveillance of T2DM in tribal areas. [ABSTRACT FROM AUTHOR]

The global rise of populism and concomitant polarizations across disenfranchised and marginalized groups has been magnified by so-called echo chambers, and a major public health crisis like the COVID-19 pandemic has only served to fuel these intergroup tensions. Media institutions disseminating information on ways to prevent the propagation of the virus have reactivated a specific discursive phenomenon previously observed in many epidemics: the construction of a defiled 'Other'. With anthropological lenses, discourse on defilement is an interesting path to understand the continuous emergence of pseudo-scientific forms of racism. In this paper, the authors focus on 'borderline racism', that is the use of an institutionally 'impartial' discourse to reaffirm the inferiority of another race. The authors employed inductive thematic analysis of 1200 social media comments reacting to articles and videos published by six media in three different countries (France, United States and India). Results delineate four major themes structuring defilement discourses: food (and the relationship to animals), religion, nationalism and gender. Media articles and videos portrayed Western and Eastern countries through contrasting images and elicited a range of reaction in readers and viewers. The discussion reflects on how borderline racism can be an appropriate concept to understand the appearance of hygienic othering of specific subgroups on social media. Theoretical implications and recommendations on a more culturally sensitive approach of media coverage of epidemics and pandemics are discussed. [ABSTRACT FROM AUTHOR]

Mobility, access to transport and healthcare play a crucial part in healthy ageing. However, these often posechallenges for older adults in the global South. This study applies the three concepts of 'motility' (access, competence and appropriation), to explore transport inequalities and barriers to access healthcare services for older adults in Bengaluru, India. The paper draws on interviews with sixty adults, aged 50 years and over, residing in urban Bengaluru. A semi-structured in-depth interview guide was employed to explore the transport inequalities. Applying thematic analysis, we present the mobility and transport barriers to access healthcare. Restricted access to healthcare services due to unavailable and unaffordable transportation resulted in missed appointments, delayed care and deterioration of health conditions. To cope with the barriers, older adults often visited less specialised clinics for regular check-ups and those with financial constraints resorted to self-medication. These actions further deteriorated health and led to adverse health outcomes. Our findings suggest that integrated health and transport policies must be designed to ensure equitable access to transportation services. Enabling older adults to have more independent lives and improve access to preventive healthcare is essential for better health outcomes. [ABSTRACT FROM AUTHOR]

Background: Dominant occupational therapy theories assert that people choose their daily occupations, and participate in occupations as autonomous agents; yet scholars insist that choices are socially-structured and inequitably available. Aim: To critically review the concept of choice in occupational therapy theory through an exploration of patriarchy in India. Material and methods: Drawing from scholarly work that addresses patriarchy in India, we employ the commonly-used occupational categories of self-care, productivity and leisure as a framework to explore the real availability of occupational choices for women. Results: Patriarchal ideology perpetuates inequitable power dynamics within Indian society. As a consequence, women, children and non-dominant men have few opportunities to make or enact occupational choices that impact their wellbeing and their lives. Conclusions: The examples provided in this paper challenge those occupational therapy theories that portray occupational engagement as the product of individual volition and unconstrained choice. Significance: Dominant occupational therapy theories are informed by specific Western assumptions that may have little relevance to people in other contexts. Critical approaches to professional assumptions are essential to avoid the imperialistic imposition of irrelevant theories, and the development and delivery of services that may be oppressive for clients who have few opportunities to make occupational choices. [ABSTRACT FROM AUTHOR]

Objective: The present paper examined the association of physical activity and substance use with depressive symptoms among adolescents in lower socio-economic settings in India. We hypothesized that physical activity would be positively associated with lower depression levels and that the relationship would be inverse in case of substance use. Methods: We utilized data from the Understanding the lives of adolescents and young adults (UDAYA) survey. The depression level was assessed by combining nine questions on symptoms, having a higher internal validity (Cronbach alpha value: 0.86), and adopting a negative binomial regression model. Results: The study demonstrated a higher mean depression score among educated, girls, and adolescents who consumed substance and were not involved in physical activity. Adolescents who are physically inactive (IRR: 1.33; CI: 1.25–1.41) and use substance (IRR- 1.26; CI: 1.11–1.43) were more likely to have depressive symptoms compared to their counterparts. However, after controlling the effect of background variables, the incidence rate ratio (IRR) decreased for physical activities (IRR: 0.88; CI: 0.81–0.94) and increased for substance use (IRR: 1.39; CI: 1.22–1.58). Conclusion: Substance use predisposes adolescents toward depression; therefore, educating teens on the effects of substance use is important as it would control possible substance use among adolescents. [ABSTRACT FROM AUTHOR]

Reports in the British media over the last 4 years have highlighted the schisms and contestations that have accompanied the reports of gender selective abortions amongst British Asian families. The position that sex-selection may be within the terms of the 1967 Abortion Act has particularly sparked controversy amongst abortion campaigners and politicians but equally among medical practitioners and the British Pregnancy Advisory Service who have hitherto tended to stay clear of such debates. In what ways has the controversy around gender-based abortion led to new framings of the entitlement to service provision and new ways of thinking about evidence in the context of reproductive rights? We reflect on these issues drawing on critiques of what constitutes best evidence, contested notions of reproductive rights and reproductive governance, comparative work in India and China as well as our involvement with different groups of campaigners including British South Asian NGOs. The aim of the paper is to situate the medical and legal provision of abortion services in Britain within current discursive practices around gender equality, ethnicity, reproductive autonomy, probable and plausible evidence, and policies of health reform. [ABSTRACT FROM AUTHOR]

In this paper, we present a framework to examine the kinds of careers that rural disadvantaged youth would like to know about in a career guidance intervention as also related findings from two different rural disadvantaged contexts in India. Differences across gender, age group, region, and participation/non-participation in youth programmes are also explored. The results validate the importance of comprehensive career needs assessment and provide specific directions for designing and adapting career guidance interventions for rural disadvantaged youth. Implications for research and practice are discussed in general as well as for the specific contexts included in this study. [ABSTRACT FROM AUTHOR]

Social work as a profession is committed to the creation of an equal and just society and thrusts its position on having a gender sensitive practicum. The current paper entails a discussion regarding the changing paradigms of gender within social work academic discourses as well as practice in India. It begins with a discourse on the sex/gender distinction as essential to feminist scholarship, and further talks about the inclusion of men and masculinities as well as the paradigm of tranfeminism in the current feminist discourse. Locating the holistic perspective in professional social work practice, it seeks to present few reflections on the contemporary field-based scenario of gender in social work practice at the grassroots in India. [ABSTRACT FROM AUTHOR]

While the topic of women and water, sanitation and hygiene is a widely accepted concern among academics and activists, it continues to be an issue in developing countries with serious consequences. Based on a qualitative research conducted in rural Uttar Pradesh, India, the paper affirms that sanitation issues for women and girls are compounded by inequitable gender norms that put them at greater risk of experiencing violence and multiple health vulnerabilities. Women, despite having a high demand for safe toilet facilities, continue to practise unsafe sanitation. The findings highlight the role of three structural constraints as the key factors influencing toilet construction and use: poverty, inadequate sanitation policy and its implementation and gender-based power dynamics at the household level. The paper concludes by emphasising the relevance of engendering sanitation programmes and policies by involving women and girls in the planning process to ensure that dignified and gender-sensitive sanitation solutions are developed. The paper also stresses the need to have measures for strengthening and effectively implementing a sanitation policy for the poor and for programmes to work with both men and women to address gender power relations which influence toilet adoption and use. [ABSTRACT FROM AUTHOR]

Background: This paper explores the heterogeneities in antenatal care (ANC) utilization in India's most populated state, Uttar Pradesh. Taking an intersectionality lens, multiple individual- and district-level factors are used to identify segments of any antenatal care usage in Uttar Pradesh Objective: This paper seeks to understand the multilevel contexts of ANC utilization. The planning and programming challenge is that such knowledge of contextual specificity is rarely known upfront at the initial stages of planning or implementing an intervention. Exploratory data analysis might be needed to identify such contextual specificity. Methods: Tree-structured regression methods are used to identify segments and interactions between factors. The results from the tree-structured regression were complemented with multilevel models that controlled for the clustering of individuals within districts. Results: Heterogeneities in utilization of any ANC were observed. The multiple segments of ANC utilization that were developed went from a low utilization of 23.7% for respondents who were not literate and did not have home ownership to a high of 82.4% for respondents who were literate and at the highest level of wealth. Key variables that helped define the segments of ANC utilization include: woman's literacy, ownership of home, wealth index, and district-level sex ratio. Based on the multilevel model of any ANC utilization, cross-level interactions also were obtained between sex ratio and ownership of home as well as between sex ratio and literacy. Increases in sex ratio increased the influence of ownership of home on any ANC, while increases in sex ratio reduced the impact of woman's literacy on receiving any ANC. Conclusion: We argue that a focus on heterogeneous segments of utilization can help build knowledge of the mechanisms that underlie inequities in maternal health utilization. Such knowledge of heterogeneity needs to be incorporated in contextualizing interventions to meet a variety of recipients' needs. [ABSTRACT FROM AUTHOR]

Abortion laws in India, like other laws, are premised on the 1861 British Penal Code. The Medical Termination of Pregnancy Act was passed in 1971 to circumvent the criminality clause around abortion. Yet the law continues to render invisible women's right to choose. Legal procedures have often hindered in permitting abortion, resulting in the death of a mother or the foetus. Despite the latest techno-medical advances, the laws have remained stagnant or rather restrictive, complicated further by selective female foetus abortions. Legal resistance to abortion-seeking after 20 weeks gestation adversely affects women, depriving them of autonomy of choice. In this paper, raising important gender, health and ethical issues are illustrated through a recent legal case in India. Feminist campaigns against the legal mindset in India are emerging. [ABSTRACT FROM AUTHOR]

In India, nurses and midwives are key to the provision of public sexual and reproductive health services. Research on impediments to their performance has primarily focused on their individual capability and systemic resource constraints. Despite emerging evidence on gender-based discrimination and low professional acceptance faced by these cadres, little has been done to link these constraints to power asymmetries within the health system. We analysed data from an ethnography conducted in two primary healthcare facilities in an eastern state in India, using Veneklasen and Miller's expressions of power framework, to explore how power and gender asymmetries constrain performance and quality of care provided by Auxiliary Nurse Midwives (ANMs). We find that ANMs' low position within the official hierarchy allows managers and doctors to exercise "power over" them, severely curtailing their expression of all other forms of power. Disempowerment of ANMs occurs at multiple levels in interlinked and interdependent ways. Our findings contribute to the empirical evidence, advancing the understanding of gender as a structurally embedded dimension of power. We illustrate how the weak positioning of ANMs reflects their lack of representation in policymaking positions, a virtual absence of gender-sensitive policies, and ultimately organisational power structures embedded in patriarchy. By deepening the understanding of empowerment, the paper suggests implementable pathways to empower ANMs for improved performance. This requires addressing entrenched gender inequities through structural and organisational changes that realign power relations, facilitate more collaborative ways of exercising power, and create the antecedents to individual empowerment. [ABSTRACT FROM AUTHOR]

There is limited research in India to understand young people's decision-making processes about intimate relationships before marriage. This paper, adopting a life course perspective, explains relationship choices and diachronic trajectories of relationships from adolescence to young adulthood. Retrospective data were collected from 1240 never married 20–29-year-old men and women living in Pune using a relationships history calendar. All the relationships from 10 years of age onwards were plotted on the calendar, and information on predictor variables was collected through structured questionnaires. Data were analysed using descriptive statistics. Sequence analysis approach was used to identify different typologies. Overall, 76% of the participants reported having at least one relationship. More women compared to men (84% vs 70%) ever had a relationship. The median age of starting the first relationship was 17 years for women and 18 for men. Different relationship types were reported, such as "serious", casual, "friends with benefit", and "exploring". The level of emotional involvement, commitment, and physical intimacy significantly differed in different relationship types with significant gender differences. Four typologies of relationships were observed, labelled as (1) Commitment–No sex (N = 187); (2) Commitment–Sex-Some exploration (N = 189); (3) No commitment–Exploration (N = 281), and (4) No relationship (N = 583). Compared to men, women were more likely to follow the trajectory of "Commitment-No sex" (RR 2.13, CI 1.5–3.03). Family environment was significantly related to young people's relationship choices. The findings strongly suggest the need to adopt a developmental perspective towards intimate relationships to understand and address the vulnerabilities of young people across the life course. [ABSTRACT FROM AUTHOR]

At the foundation of most inequalities in expression of sexuality lie social constructions of gender. In this paper, sex education is considered as a possibility to challenge sexism and promote healthy and self-affirmative sex lives. In the past decade, the discourse of sex education in India has become a ‘battle of morality’ where concerned citizens condemn sex education on the grounds it may encourage sexual activity and immoral conduct (e.g. promiscuity or infidelity). The work of non-governmental organisations (NGOs) is an alternative to the governmental national curriculum plan. This paper discusses NGO potential in terms of sexual empowerment by examining beliefs and understanding, choices of information, strategies and methods, and approaches apparent in sex education programmes and projects. Through qualitative data, findings were analysed by constructing a sexual empowerment model that divides components of sex education into four parts and utilises theories of empowerment. The main findings include that all four components of sex education – foundation, content, strategies and approaches – show great potential to challenge gender inequalities in regard to sexuality. Sexual health programmes and projects are seen to be highly participatory, deliberative and encouraging of critical thinking. Some concerns are highlighted: the strong focus on girls as the main actors of change, and external limitations such as parents and institutions. [ABSTRACT FROM PUBLISHER]

The HIV epidemic has had a widespread impact on global scientific and cultural discourses related to gender, sexuality, and identity. ‘Male sex workers’ have been identified as a ‘key population’ in the global HIV epidemic; however, there are methodological and conceptual challenges for defining inclusion and exclusion of transgender women within this group. To assess these potential implications, this study employs self-critique and reflection to grapple with the empiric and conceptual implications of shifting understandings of sexuality and gender within the externally re-created etic category of ‘MSM’ and ‘transgender women’ in epidemiologic HIV research. We conducted a sensitivity analysis of our previously published meta-analysis which aimed to identify the scope of peer-reviewed articles assessing HIV prevalence among male sex workers globally between 2004 and 2013. The inclusion of four studies previously excluded due to non-differentiation of cisgender male from transgender women participants (studies from Spain, Thailand, India, and Brazil: 421 total participants) increased the overall estimate of global HIV prevalence among ‘men’ who engage in sex work from 10.5% (95% CI 9.4–11.5%) to 10.8% (95% CI 9.8–11.8%). The combination of social science critique with empiric epidemiologic analysis represents a first step in defining and operationalising ‘reflexive epidemiology’. Grounded in the context of sex work and HIV prevention, this paper highlights the multiplicity of genders and sexualities across a range of social and cultural settings, limitations of existing categories (i.e. ‘MSM’, ‘transgender’), and their global implications for epidemiologic estimates of HIV prevalence. [ABSTRACT FROM AUTHOR]

Considering the high burden of injuries, the Health Authority - Abu Dhabi developed a draft electronic and paper-based injury and poisoning notification system (IPNS) to generate better data on the nature and severity of injuries. The pilot testing and evaluation of IPNS was conducted with the specific objectives to (1) identify the characteristics of injury cases, (2) explore potential risk factors, (3) illustrate the nature and type of data, and (4) the working mechanism of data collection. Data were collected from selected hospitals on patient demographics, injury information and clinical assessment. Descriptive, bivariate and multivariate analyses were conducted. Of 4226 injury cases, nearly three-fourths were male, majority were non-UAE nationals, and the mean age was 21.9. Multivariate findings suggested that compared to UAE nationals, non-UAE nationals were 27% more likely to experience fatal, severe or moderate injuries (p= 0.01). Individuals with health insurance were 31% less likely to suffer a fatal, severe or moderate injury compared to those having no health insurance (p< 0.001). This is the first systematically standardised collection of injury data across three facilities in Abu Dhabi, and provides initial information on characteristics and injury risk factors that will help identify the need for evidence-based intervention for injury prevention and control. [ABSTRACT FROM PUBLISHER]

HIV infection poses a serious threat to the economy of a household. Out of pocket (OOP) health spending can be prohibitive and can drag households below poverty level. Based on the data collected from a cross-sectional survey of 401 households with HIV+ members in Pune city, India, this paper examines the consumption levels and patterns among households, and comments on the economic impoverishment resulting from OOP medical spending. Analysis reveals that households with HIV members spend a major portion of their monthly consumption expenditure on food items. Medical expenditure constitutes a large portion of their total consumption spending. Expenditure on children's education constitutes a minor proportion of total monthly spending. A high proportion of medical expenditure has a bearing on the economic condition of households with HIV members. Poverty increases by 20% among the studied HIV households when OOP health spending is adjusted. It increases 18% among male-headed households and 26% among female-headed households. The results reiterate the need of greater support from the government in terms of accessibility and affordability of health care to save households with HIV members from economic catastrophe. [ABSTRACT FROM AUTHOR]

The main aim of this paper was to identify job stressors, gender responses and association of psychosocial work stressors with prevalence of work related musculoskeletal disorders (MSDs) among foundry workers. The data were obtained with ergonomics checklist using Likert scale. The results of this study showed a high prevalence of MSDs among workers. The male workers were more prone to pain in neck while the female workers were more prone to MSDs in upper back and shoulders. Correlation analysis showed significant relationship of dimensions of work aspects with pain and discomfort. It proved that the work-related MSDs are the results of interaction of multiple stressors associated with work and work environment, and other personal factors. ANOVA indicated that the perception of work aspects as stressors differed significantly between male and female workers. [ABSTRACT FROM AUTHOR]

Approximately 2.4 million people in India are living with HIV. Gender inequality affects HIV prevention, detection, and management. The purpose of this paper was to describe gender differences in the experience of living with HIV in Bengaluru, India. A subsample ofn= 313 (159 men and 154 women) from a larger cohort was used for these analyses. Participants were recruited through AIDS service organizations. They completed an interviewer-administered survey assessing HIV testing experience, types of stigma, and perceived consequences of stigmatization. The majority of men (67%) reported getting HIV tested because of illness, while women were more likely to be tested after learning their spouse's HIV-positive status (42%). More men (59%) than women (45%,p<0.05) were tested in private care settings. Men reported significantly higher mean levels of internalized stigma (men:M=0.71, SD = 0.63; women:M=0.46, SD = 0.55;p<0.001), whereas the women reported significantly higher scores for enacted stigma (men:M=1.30, SD = 1.69; women:M=2.10, SD = 2.17;p<0.001). These differences remained significant after controlling for potential socio-demographic covariates. Following their diagnosis, more women reported moving out of their homes (men: 16%; women: 26%;p<0.05). More men (89%) than women (66%;p<0.001) reported to have modified their sexual behavior after being diagnosed. These findings suggest that the experience of living with HIV and HIV stigma varies by gender in this population. Suggestions for a gender-based approach to HIV prevention and stigma reduction are provided. [ABSTRACT FROM PUBLISHER]

Background: During the last century, Kerala witnessed drastic mortality reduction and high improvement in longevity. This achievement is often compared with that of developed countries. However, how far the early advantages in mortality reduction have further enhanced in Kerala remains unknown. In most developed countries, advanced stage of mortality reduction and further increase in longevity was achieved mainly due to the mortality shift from adult and older ages to oldest ages (Olshansky and Ault 1986). Objectives: Considering the lack of comprehensive study on the change in longevity in Kerala, this study focuses on discovering (i) the historical time-periods that provided the biggest gain to life expectancy and also the beneficiaries (by age group and sex) and (ii) the contributions of major groups of causes of death in mortality reduction and consequent improvement in longevity. Methodology and data: The study uses the methodology proposed by Olshansky and Ault in 1986. It used methods such as Temporary Life Expectancy (TLE), Annual Relative Change in TLE, Decomposition of changes in longevity among different age groups (gender and spatial) and causes of deaths, for the analysis. It used data from various sources such as Census, Civil Registration System (CRS) and Directorate of Health Services (DHS), as well as survey data from Sample Registration System (SRS) and Medically Certified Causes of Deaths (MCCD) for this study. Finding and conclusion: The study found that overall mortality dramatically declined in the state in the recent decades. Younger ages have contributed the most for this reduction. Therefore, further mortality reduction is possible in adult and early old ages. However, the contribution of these ages to life expectancy was lower than that of youngsters until 1991-2000 especially among males. This may indicate a slow progress towards the advanced stage of epidemiological transition characterized by high prevalence of non-communicable diseases. The paper concludes that although the health issues of infants, children, and mothers in the reproductive age group, are effectively addressed through various policies in Kerala, the state needs to focus more on the health problems of adults, especially males. [ABSTRACT FROM AUTHOR]

Background: Millennium Development Goal (MDG) 5 is focused on reducing maternal mortality and achieving universal access to reproductive health care. India has made extensive efforts to achieve MDG 5 and in some regions much progress has been achieved. Progress has been uneven and inequitable however, and many women still lack access to maternal and reproductive health care. Objective: In this review, a framework developed by the Commission on Social Determinants of Health (CSDH) is used to categorize and explain determinants of inequity in maternal and reproductive health in India. Design: A review of peer-reviewed, published literature was conducted using the electronic databases PubMed and Popline. The search was performed using a carefully developed list of search terms designed to capture published papers from India on: 1) maternal and reproductive health, and 2) equity, including disadvantaged populations. A matrix was developed to sort the relevant information, which was extracted and categorized based on the CSDH framework. In this way, the main sources of inequity in maternal and reproductive health in India and their inter-relationships were determined. Results: Five main structural determinants emerged from the analysis as important in understanding equity in India: economic status, gender, education, social status (registered caste or tribe), and age (adolescents). These five determinants were found to be closely interrelated, a feature which was reflected in the literature. Conclusion: In India, economic status, gender, and social status are all closely interrelated when influencing use of and access to maternal and reproductive health care. Appropriate attention should be given to how these social determinants interplay in generating and sustaining inequity when designing policies and programs to reach equitable progress toward improved maternal and reproductive health. [ABSTRACT FROM AUTHOR]

Existing historical understandings of disability are dominated by European and American experience and tend to assume Judeo-Christian ideas of stigma and exclusion are universal norms. This paper emphasises the unique experience of disability in India and the role of poverty, gender, caste and community in compounding the marginalisation felt by people with disabilities. It argues, with Kudlick, that 'disability' is as important as 'race' or 'gender' as an analytic tool in the historical understanding of oppression and disempowerment. Moreover, the paper sees reclaiming history and insisting on inclusion of the experience of disability in the writing of Indian history as a critical factor in affirming the right of Indians with disabilities to full social and economic participation. Finally it emphasises the need for 'disability history' to look beyond colonial and post-colonial welfare paradigms and to investigate disability as an aspect of rights based history. [ABSTRACT FROM AUTHOR]

This paper reconstructs the trend in the population sex ratio in India between 1971 and 1996 from available information on changes in sex differentials in mortality in the country since the beginning of the century. It is estimated that, although the mortality of females relative to that of males in India has improved since 1968, the population sex ratio increased between 1971 and 1981, stayed constant between 1981 and 1991, and started to decrease only after 1991. This implies that the recorded decrease and increase in the periods 1971-81 and 1981-91 respectively were both spurious and were the results of undercounts of females in 1971 and 1991. Another implication of this finding is that, owing to the lagged effect of past mortality on current trends in the population sex ratio, this ratio is a bad proxy for use in the study of changes in differential mortality by sex. [ABSTRACT FROM AUTHOR]

Young adults (21-to-35-years) from six rural coastal villages in South India described their past and current careers and means of livelihood; an intergenerational comparison was also made. Sixty-eight young men and women engaged in paid work were interviewed; supplementary data was obtained about 224 young adults co-residing with the 68 interviewed participants. The careers and livelihoods of these young adults were marked by intersectionality of rural community, geography and gender. The geography of a coastal region privileged men in having coastal/marine careers whereas many women played supportive roles in their spouse's/brother's coastal livelihood. The fewer women engaged in paid work were employed in education, banking/finance, and nursing sectors. Implications for career guidance programmes for the rural population are discussed. [ABSTRACT FROM AUTHOR]

Caregivers of people with disability experience difficulties in a variety of care domains. Understanding the predictive factors of caregiver strain is important in developing and implementing evidence-based intervention to reduce the difficulties experienced by the carers. The current study is a cross sectional comprehensive one-phase survey conducted in randomly selected sub-districts (taluks) of the Ernakulam district in Kerala. Primary caregivers (n = 851) for persons with different kinds of disability were identified with the help of ASHAs (Accredited Social Health Activities) from the selected geographical locations and were interviewed in a house-to-house survey after obtaining written informed consent. Validated tools measuring caregiver strain, financial burden, access to services and wellbeing were used to study the population. Majority of the caregivers were females (77.3%) and spouses (35.2%). Of the caregivers 27% reported high levels of caregiver strain. The major factors associated with caregiver strain were female gender (B = 1.379, p = 0.000), financial issues (B = 0.105, p = 0.000), the general health of caregivers (B = 0.467, p = 0.000) and issues relating to employment (B = 0.956, p = 0.000) and the availability of government welfare services (B = 1.138, p = 0.000). High caregiver burden and strain is experienced by almost a third of people caring for a person with a disability. Comprehensive interventions to reduce caregiver strain should be developed. The rehabilitation sector needs to be made aware of the high levels of caregiver strain (especially in carers who were female, unemployed, have health issues and lack formal support). To improve wellbeing for people with disability we firstly need to promote social inclusion and support schemes for caregiver. Co-designed systems are needed to assist carers to access formal and informal support resources, and increase social connectedness. [ABSTRACT FROM AUTHOR]

. Indian subcontinent exhibits considerable degree of ethnic heterogeneity in cardiovascular disease (CVD) risks. Given the importance of ethnicity, the present multi-ethnic study was conducted to find out the differences in body composition patterning and its influence on CVD risk variables.. Owing to considerable ethnic heterogeneity among Asian Indians the study was performed to determine the association of variability between body composition and CVD risk factors at the micro-level among different tribes by sex, province, and generation Nine tribes from three different states (provinces) were considered. Anthropometric measurements, body composition, adiposity, blood pressure, and fasting blood glucose was measured using standard technique. Body composition was measured using BIA method by means of body fat monitor. Mean differences of the body composition measures were analysed by ANOVA. Stepwise multiple regressions were done with CVD risk variables as dependent and body composition profiles as independent variables to find out the significant predictors. Those were then loaded for principal component factor analyses (PCFA).. Tribal subjects of both sexes and from both younger and older generations in Gujarat had significantly higher percentage body fat, subcutaneous fat-whole body, and subcutaneous fat-trunk as compared to tribal subjects of Odisha, and West Bengal, as well as significantly lower skeletal mass-whole body and skeletal mass-trunk. PCFA showed two components: (i) percentage body fat with muscle mass; and (ii) visceral fat with resting metabolism. These two components cumulatively explained 80–90% of the total variance associated with CVD risk variables, across the nine tribes.. Tribal subjects of Gujarat had higher CVD risks with significantly higher fat mass and lower muscle mass followed by the tribal subjects of Odisha, and West Bengal respectively. The younger generation are equally at risk as their older counterparts. The CVD risks are developing at a much faster rate resulting in a serious public health threat, even in traditional societies. Body composition measures could be considered as a better non-invasive technique for early intervention and proper risk management among the Asian Indians in general and tribal populations in particular. [ABSTRACT FROM AUTHOR]

There are an estimated 7 million burn injuries in India annually, of which 700,000 require hospital admission and 140,000 are fatal. According to the National Burns Programme, 91,000 of these deaths are women; a figure higher than that for maternal mortality. Women of child bearing age are on average three times more likely than men to die of burn injuries. This paper reviews the existing literature on burn injuries in India and raises pertinent issues about prevalence, causes and gaps in recognising the gendered factors leading to a high number of women dying due to burns. The work of various women’s groups and health researchers with burns victims raises several questions about the categorisation of burn deaths as accident, suicide and homicide and the failure of the health system to recognise underlying violence. Despite compelling evidence, the health system has not recognised this as a priority. Considering the substantial cost of burns care, prevention is the key which requires health systems to recognise the linkages between burn injuries and domestic violence. Health systems need to integrate awareness programmes about domestic violence and train health professionals to identify signs and symptoms of violence. This would contribute to early identification of abuse so that survivors are able to access support services at an early stage. [ABSTRACT FROM AUTHOR]

This study attempts to comprehend the reading habits of faculty members of the higher education sector in India during the lockdown period and a comparative analysis of the reading habits of faculty members prior to the lockdown and during the lockdown. The study used an online survey approach to gather information using a Google form. The study population was composed of teachers from the higher education sectors in India. The study revealed the change and the impact of the COVID-19 lockdown state on faculty members' reading habits in India's higher education sector. An online survey was conducted of the unknown population using WhatsApp received 734 responses. The responses were analyzed by the study's objectives and tested a simple null hypothesis, i.e., "There is no significant change in the reading habits of the faculty members of the higher education sector in India during the lockdown period." The study discovered that faculty members had spent more time for reading, reading habits have considerably increased, a positive impact on reading habits, utilized their lockdown time to satisfy their information needs, the change in reading habits is observable, and there is an inclination towards the utilization of digital and online information. The study would be helpful for librarians, libraries, and information centres to prepare future strategic plans, develop a system for crisis management in libraries, and provide better information services after knowing the opinion of faculty members of higher education. The study is original since no study combining variables such as teachers, higher education sector, India, and reading habits has been undertaken. This study would also guide future studies in this field. [ABSTRACT FROM AUTHOR]

Evidence on the prevalence and determinants of smoking and smokeless tobacco (SLT), and alcohol consumption between slums and non-slums are quite limited. Using sub-samples from the National Family Health Survey (2015–16), prevalence and determinants of tobacco and alcohol use were estimated in eight Indian megacities (Chennai, Delhi, Hyderabad, Indore, Kolkata, Meerut, Mumbai, and Nagpur) by residence and sex using binary logistic regression analyses. Inter-and intra-city differences in both forms of tobacco and alcohol by residence were assessed using interaction effect analysis. Strong intra-urban disparity in tobacco and alcohol use was observed. Both forms of tobacco use were higher among men and women residing in slum areas. Despite alcohol use being higher among men from non-slum areas (33.1%) compared to those from slum areas (27.7%), the likelihood of alcohol use was higher among men residing in slums (OR = 1.37;95%CI:1.06–1.77). Higher odds of SLT use were observed among men and women from slums than in non-slum areas. Both forms of tobacco use were higher in slums from North, East, and West Indian cities, whereas alcohol use was higher among males from East and South Indian cities. Continuous monitoring of tobacco and alcohol use in slums is warranted to achieve Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

We attempt a gendered inspection of sex differentials in care following stroke in India using data from two rounds of NSSO. While almost all men and women receive allopathic care, a higher percentage of women (51.8%) were treated in public hospitals compared to men (32.6%) in 2014 and 2017–18 (45.8% vs 41.4%). Men were preponderantly treated in private hospitals (67.4%) compared to women (48.2%) in 2014 and 2017–18 (58.6% vs 54.2%). We provide evidence that for rehabilitation, at the highest decile for expenditure, men spend more than women. This preliminary exploration is indicative of a gendered dimension in care-seeking for stroke. [ABSTRACT FROM AUTHOR]

In India, the "feminization of aging" is one of the areas in which prejudice most frequently occurs. Noticeably, poverty, isolation, changes in residential care, and weak institutional support push women into several vulnerabilities. This study demonstrates that elderly women are often denied basic rights and are compelled to reside in old-age homes; the situation is worse for elderly widowed women. We examine the claims that the lives of elderly women are more precarious due to their lower literacy, limited social exposure, and monetary dependence. Being women, old, and widowed, they are affected by triple vulnerabilities that require concrete policy implications. [ABSTRACT FROM AUTHOR]

Common mental health disorders are studied extensively among adult women globally. However, they remain under-researched among young women. This study aims to determine whether gender disadvantage factors are associated with psychological distress among young women in rural India, where the child sex ratio is lower than the national average. A cross-sectional survey was conducted in rural Pune, India. A total of 229 young married women who had a live birth in the last 12 months were screened for psychological distress. The predictors of psychological distress were estimated using multivariable logistic regression analyses. Psychological distress was found among 50 respondents (21.9%). Young women who were married before 18 years had 2.19 times higher odds of distress than women who were married after 18 years. Young women who gave birth to a female infant had 2.43 times higher odds of distress than those who gave birth to a male infant. Lack of partner support and experience of postnatal health complications were other predictors. Study findings ascertain the role of gender disadvantage factors in causing psychological distress. From a public health perspective, early identification and treatment of psychological distress, is imperative, along with addressing gender inequitable practices. [ABSTRACT FROM AUTHOR]

The study aims to assess patients' preferences regarding physicians communicating bad news of COVID-19. Based on the data collected from 74 patients with COVID-19 in India, this study assesses "how" patients want bad news to be delivered. Key aspects of the physician–patient interaction were identified from the literature. Regression tests proved that three main constructs contribute significantly toward patient outcomes. Content of the message and facilitation were most crucial, however too much emotional support was not desirable by patients. Also, the patient's gender and educational background should be considered before breaking bad news. Thus, to increase patient compliance full disclosure and patient-centered methods of communication can be used. [ABSTRACT FROM AUTHOR]

The entry of COVID-19 created an unprecedented environment of fear in society. Life during lockdown may have a significant effect on the mental and physical health of human beings. The present study aims to analyze the effect of gender and age group in deciding the level of fear and stress due to COVID-19. We conducted an online survey in the Uttarakhand state of India for the present study. Chi–square test of independence has been used for establishing dependency of various factors like fear/stress on gender and age group. We find that fear of COVID-19 is independent of gender as well as age group. Stress is independent of gender but depends on age group with elder people having less stress in comparison to young people. [ABSTRACT FROM AUTHOR]

We conducted an epidemiological study to identify the demographics and pre-operative characteristics of patients undergoing primary anterior cruciate ligament (ACL) reconstruction in a multi-ethnic Asian population. A retrospective study was performed on 696 patients who registered in our ACL reconstruction registry from January 2013 to August 2016. Important inter-ethnic differences were found. Indian patients were significantly older compared to Malay and Chinese patients. Malay and Indian patients were more likely to be male, overweight, and obese compared to Chinese patients. Soccer was the predominant sport involved, although ethnic predominance in specific sports exists. Novel findings from this study include increased prevalence of concomitant chondral injuries in the Chinese population compared to Malays and Indians, and significantly higher rates of concomitant intra-articular injuries in soccer and basketball compared to netball. Identification of these high-risk subgroups would serve useful in guiding the formulation of prevention strategies within our multi-ethnic community. [ABSTRACT FROM AUTHOR]

The present research tried to find out difference in the feeling of alienation among the male and female older people. The data was collected from older people (N = 255) residing in the Urban areas of Bhopal, India. The study tried to analyse the significance difference in the feeling of alienation in male and female elderly. It was observed that females (60.33 ± 9.51) experiences more alienation than males (57.61 ± 8.85). Leven's test for equality of variance which shows [F(1,253)=.734, Sig. =.392] and t = 2.357, p=.01, (p<.05). The lower educational status of the older females makes it difficult for them to move easily along with the changing world. Also when compared to the older males, the lower degree of social contacts and activities of the older females may increase the isolation. At a time when help, care, support and presence of children, family members, friends and neighbours are most desired, the greater feelings of alienation are quite natural. [ABSTRACT FROM AUTHOR]

Background: While the patterns of consumption of areca nut and its by-products (ANBP) vary across South Asia and the rest of the world, all users share the probable severe outcome of oral submucous fibrosis (OSMF), and this is well reported. The role of psychosocial drivers of habit initiation and addiction is reported less. Objective: To reveal the burden of ANBP abuse, exploring the psychosocial relationship between sex, age at first exposure (AFE), the reason for initiation (RFI) with the type of habit (TOH). Methodology: Data came from the prospective hospital-based study conducted at K.M. Shah Dental College and Hospital covering years 2017 and 2018. Patients with oral lesions were assessed with complete history recording demographics, TOH, AFE, RFI, duration of habit, and clinical diagnosis of any oral and systemic diseases. Patients with a history of scleroderma, facial burns, and oral malignancy were excluded. Results: Of the 13,874 patients, 9.89% reported ANBP. We included 1000 OSMF patients. The mean age of the study cohort was 38.97 ± 14.29 years, with a range of 17–75 years. Males constituted the majority (80.1%). The most common TOH reported was regular use of gutkha (60.1%) followed by mawa (31.4%) with tension and stress (30.3%) being the most common RFI among the cohort. TOH was notably different in relation to AFE. Interestingly, mawa chewing (38.69%) was observed more in females. Importance: This study reveals the burden of ANBP abuse and reports the complex psychosocial relationships between sex, AFE, and RFI with TOH in OSMF patients in this high incidence population. [ABSTRACT FROM AUTHOR]

As more people want to register a social media presence, ineluctably, this creates a huge amount of content online. Prior research highlights that excessive information on social networking platforms leads to a usage related behavior termed as "social networking fatigue (SNF)." The present research draws from two major theories in information systems research- limited capacity model (LCM) and unified theory of acceptance and use of technology (UTAUT), to effectively understand the under-explored phenomenon of social networking fatigue. Online questionnaires were used to gather empirical data from 327 social networking users, out of which 306 samples were included in the final analysis. Structural equation modeling (SEM) techniques were employed for assessing the hypothesized relationships. This research will offer newer insights for conceptual development and assist the social media experts to formulate strategies for content modification and user engagement. [ABSTRACT FROM AUTHOR]

The aims of the present study were (1) to explore sex-related differences, (2) to estimate the associations between love of life, happiness, and religiosity, and (3) to investigate the components from the correlation matrices. A sample of Indian college students (N = 370) took part in this study. They responded to the English versions of the Love of Life Scale, the Arabic Scale of Happiness, and the Arabic Scale of Intrinsic Religiosity. Results indicated that women obtained the higher mean scores on love of life and religiosity than did men and the effect size was small. All the correlations between the scales were statistically significant and positive. Principal components analysis extracted one component and labelled: Well-being and religiosity. It was concluded that those who consider themselves as religious experienced greater love of life and happiness. [ABSTRACT FROM AUTHOR]

Indian sexual and gender minoritized (SGM) individuals face marginalization and discrimination. Objectives: This study examines stigma's effects on sexuality among SGM individuals in urban India. Methods: We conducted 5 focus group discussions and 27 interviews with SGM-identified adults connected to SGM-advocacy organizations in 3 cities (Chennai, Bangalore, Kolkata). Results: Stigma affected sexuality in the following ways: gender-specific stigma and behavioral norms, sexual identity-specific stigma, partners' stigma and buffering effects of partner, heterosexual marriage pressure, and limited sexual healthcare. Conclusions: Although there were similarities with stigma's effects in Western environments, the unique Indian context necessitates further research for more targeted interventions. [ABSTRACT FROM AUTHOR]

This study examined gender differences in patterns of smokeless tobacco (SLT) use among various socioeconomic and demographic segments in Bangladesh and India, which are home to 80 percent of global SLT users and share similar sociocultural milieus. The objective was to provide evidence of whether gender-focused interventions and policies might be helpful for SLT cessation programs. Data from the Global Adult Tobacco Survey were used for the analysis. In Bangladesh, data were collected between July and August 2009, and 9,629 individuals were successfully interviewed. In India, data were collected from June 2009 to January 2010, and 69,296 individuals were interviewed. Tests of proportions revealed that the prevalence of SLT use was highest among women in Bangladesh (27.9 percent) and among men (32.9 percent) in India. Logistic regression models revealed that the odds of SLT use was lower among Bangladeshi females in the highest age category. However, in India, a similar observation was made only for females with rural residences. In addition, the odds of SLT use was less among those with a higher level of education and wealth, irrespective of the sex or country. The present findings suggest a need for gender-specific policies and interventions for SLT control. [ABSTRACT FROM AUTHOR]

Medication non-adherence is a global health issue. Numerous factors predict it. This study is aimed to identify the association between regimen difficulty and medication non-adherence among patients with chronic conditions and testing the interaction effects of gender and age on the same. It was a cross-sectional study conducted among 479 outpatients from India. Convenience sampling method was used. Multiple regression analyses were performed to find the predictors of non-adherence and to test interaction effects. Regimen difficulty predicted medication non-adherence. The patient's gender and age have interaction effects on the relationship between regimen difficulty and medication non-adherence. [ABSTRACT FROM AUTHOR]

Objective:The study intended to see the impact of infertility on experience of emotional trauma, belief pattern and formation of psychopathology and also to explore the psychopathology with respect to degree of infertility related stress impact among male, female and unexplained factor infertility in couples suffering from primary infertility. Design:This was a clinic-based, cross-sectional comparative study based on a consecutive sampling method. Subjects:Sixty couples were studied of whom 10 couples had male-related infertility (MF), 10 had female-related infertility (FF) and 10 unexplained infertility (UF). Another 30 fertile couples were also included as comparative group (CG) after matching on certain sociodemographic variables with the clinical groups. Measures:Impact of Event Scale, Symptom Checklist-90 Revised and Irrational Belief Scale were used. Results:The impact of emotional trauma and irrational belief was greatest in the male-related infertility couples, and somatisation in the unexplained group, whereas depression and interpersonal sensitivity were higher in the female-related infertility couples. An impact of moderate to severe infertility-related stress on depression and irrational beliefs was also observed. Gender difference was evident with respect to psychopathology and types of infertility. Conclusion:The impact of infertility is evident with respect to psychopathology with differential impact of various types of infertility groups among Indian couples. [ABSTRACT FROM AUTHOR]

The present study attempted to determine health-related quality of life in individuals with chronic suppurative otitis media (CSOM). COMOT-15 and COMQ-12 questionnaires were administered to 100 individuals with CSOM of South India. The study also attempted to determine the possible predictors (demographic and audiological results) of HRQOL based on demographic details (gender, onset and nature of hearing loss) and pure-tone average. The results of study showed that individuals with CSOM in South India exhibit poor health-related quality of life. The ear-related symptoms and emotional difficulties because of CSOM affect their HRQOL. The study also showed that scores were poorer in individuals with higher degree of loss and longer onset of CSOM. It was also found that gender and nature of hearing loss were poor predictors of HRQOL measures. Thus, it is essential to determine HRQOL measures to understand the problems from the patient’s perspective and provide appropriate management. [ABSTRACT FROM PUBLISHER]

Background:Millennium Development Goal 4, to reduce child mortality, can only be achieved by reducing stillbirths globally. A confluence of medical and sociocultural factors contribute to the high stillbirth rates in India. The psychosocial aftermath of stillbirth is a well-documented public health problem, though less is known of the experience for men, particularly outside of the Western context. Therefore, men's perceptions and knowledge regarding reproductive health, as well as maternal-child health are important.Methods:Key informant interviews (n = 5) were analyzed and 28 structured interviews were conducted using a survey based on qualitative themes.Results:Qualitative themes included men's dual burden and right to medical and reproductive decision making power. Wives were discouraged from expressing grief and pushed to conceive again. If not successful, particularly if a son was not conceived, a second wife was considered a solution. Quantitative data revealed that men with a history of stillbirths had greater anxiety and depression, perceived less social support, but had more egalitarian views towards women than men without stillbirth experience. At the same time fathers of stillbirths were more likely to be emotionally or physically abusive. Predictors of mental health, attitudes towards women, and perceived support are discussed.Conclusions:Patriarchal societal values, son preference, deficient women's autonomy, and sex-selective abortion perpetuate the risk for future poor infant outcomes, including stillbirth, and compounds the already higher risk of stillbirth for males. Grief interventions should explore and take into account men's perceptions, attitudes, and behaviors towards reproductive decision making. [ABSTRACT FROM AUTHOR]

This study examines whether concern for the long-term care of older parents is the primary reason for son preference in India. Controlling for important socioeconomic factors that are believed to affect son preference, we find that concern for long-term care is the principal cause of son preference in India. Sons serve as the primary caregivers to elderly parents, while daughters are mostly engaged in caring for parents-in-law. This trend is more acute in rural than in urban areas. Our study also finds a strong implication of the filial relationship for the long-term care of elderly parents. [ABSTRACT FROM AUTHOR]

We describe the evaluation of a participatory, garment factory-based intervention to promote gender equity. The intervention comprised four campaigns focused on gender and violence against women, alcoholism, sexual and reproductive health, and HIV/AIDS, which were implemented using information displays (standees and posters) and interactive methods (street play, one-to-one interactions, experience-sharing, and health camps). Each campaign lasted six days and the entire intervention was implemented over 10 months. We evaluated the intervention using a quasi-experimental design in which one factory served as the intervention site and a second as a delayed control. Two mobile-phone-based cross-sectional surveys were conducted at baseline and 12 months with separate systematic random samples of employees from each site. Data on socio-demographic characteristics and knowledge and attitudes related to gender equity, intimate partner violence (IPV) and alcohol use were assessed, and differences in these variables associated with the intervention were examined using difference-in-difference estimation. Analyses of data from 835 respondents revealed substantial, statistically significant improvements in attitudes related to gender equity, unacceptability of IPV, and awareness of IPV and alcohol-related support services. In conclusion, our study offers compelling evidence on the effectiveness of workplace-based interventions in advancing gender equity. [ABSTRACT FROM PUBLISHER]

This article explores the effect of store characteristics and interpersonal trust on formation of attitude and intention to purchase from online stores in the context of online social media marketing. Store Brand Knowledge, Store Reputation, Perceived Store Size, and Perceived Store Risk have been considered as antecedents of trust. Based on existing literature, a conceptual model is proposed and empirically tested with a sample (n = 424) of online social media users with the help of partial least square path modeling. This study is among the very few empirical investigations done in the context of trust in online social media marketing and focuses only on consumer-perceived store-controlled factors as antecedents of trust. [ABSTRACT FROM PUBLISHER]

Background: To analyse the presentation of ocular firecracker injuries during a festival celebration in five consecutive years. Methods: We retrospectively analysed 541 patients with cracker injuries who presented to a tertiary eye care hospital during the fortnight of Deepavali for five consecutive years. The parameters studied were the age and sex, environmental factors, type of firework, eye involved and whether the involved person was a passer-by or actively involved. Results: Children up to 15 years, males and bystanders were seen to be affected more frequently. The most common firework involved was the flower pots. Conclusions: Fire cracker related ocular injuries are an important public health problem in India where celebrations are not complete without lighting crackers. This study brings to light the importance of safety measures and emphasises the need for restrictive firework legislation which has proved to reduce such injuries in countries across the world. [ABSTRACT FROM PUBLISHER]

As the population of older adults in India grows, research is needed to plan a sustainable future for India's older adults. This article reports results from a Global Positioning System (GPS)–based pilot study that examined the mobility of middle-class, older adults living in Ahmedabad, Gujarat, India. Using mobility as a lens through which to examine the lives of older adults, we map potential research and identify policy areas of interest considering older adults in urban India. The study explores the role of life stage in mobility as well as the effects of gender and urban environment on mobility. Using this distinctive perspective on day-to-day life, we propose themes through which, using policy and planning tools, the living environments of older adults in Indian cities can be improved. These policy measures include focusing on walkability and pedestrian safety in residential areas and building on existing mixed land use to create high accessibility to goods and services in urban environments. [ABSTRACT FROM AUTHOR]