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Objectives: The present study examines the publication output of authors from India on the topic of "Covid-19 and Psychology" using bibliometric methods. Methods: The publications as listed in Scopus database were identified by using "Covid-19" and its synonyms keywords in "Keyword" and "Title" tags. The results obtained were further restricted to subject "Psychology" under subject tag and country to India. Results: 372 publications emerged in the last 2 years on the topic of "Covid-19 and Psychology", accounting to 4.63% share of global output. About 9.95% and 25.81% share of Indian publications received external funding support and involved international collaboration, respectively. The author's from 277 organizations and 416 authors participated unevenly in the research in this area. The highest number of publications emerged from National Institute of Mental Health and Allied Sciences (NIMHANS), Bangaluru, followed by Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, All India Institute of Medical Sciences (AIIMS), New Delhi and All India Institute of Medical Sciences (AIIMS), Bhubaneswar. Authors from Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry had highest impact in terms of citations per paper and relative citation index, followed by authors from King George's Medical University (KGMU), Lucknow, and Manipal Academy of Higher Education (MAHE), Manipal. The journals that published the highest number of publications were Asian Journal of Psychiatry (158 papers), Indian Journal of Psychological Medicine (44 papers), and Frontier in Psychology (18 papers). The most commonly investigated topics in terms of frequency of appearances of keywords were mental health (93), followed by anxiety (80), mental disease (68), depression (64), mental stress (34), and social isolation. Conclusion: Over the last 2 years a large number of publications have emerged in the area of COVID-19 and psychology from India. [ABSTRACT FROM AUTHOR]

Present paper is an attempt to entangle the choice of medical education as a professional career among Indian students. The choice of career is associated not only with the higher aspirations for better economic opportunities but also seen as one of the important parameters for happiness and realisation of long term social goals. Elaborating upon the reference of world happiness report and data on higher education enrolment in India, the paper provides pecuniary and non-pecuniary aspects with special reference to medical education not only in terms of labour market but also for the gap between expectation and reality. [ABSTRACT FROM AUTHOR]

Recovery is a concept that defined a positive and empowering experience for people with Schizophrenia. Recovery is an innately personal phenomenon, but the cultural environment can influence the recovery process. The concept of recovery originated in the West. The Eastern cultures differ in various aspects from the Western cultures. Application of the Western model of recovery in an Eastern culture like India without considering the cultural differences would be misplaced. This paper discusses two cultural factors in Indian life, namely, the family and the doctrines of Karma and Fate, that can impact recovery from Schizophrenia. Understanding the impact of culture on schizophrenia recovery should also consider cultural variations between individuals and over time. Principles and practice of Recovery-oriented mental health care in India should consider the unique local cultural environment. [ABSTRACT FROM AUTHOR]

Drawing on data from a survey of 342 employees from three BPO organizations in Mumbai (India), this study examined whether cultural variables of individual cultural orientation and organizational culture, and their interaction were predictive of employees’ attitudes toward union membership in BPO organizations in India where unionization has hitherto not taken place. Using regression analysis, the researcher found that over and above the effects of demographic and job-related variable, and work stress and job satisfaction, horizontal individualism could predict union attitudes significantly and negatively whereas vertical individualism and collectivism could predict the attitudes significantly and positively. Similarly, organizational collectivism could predict employees’ attitudes toward union membership significantly and negatively. Using the univariate analysis of variance, the researcher found that the contrast between personal value and organizational culture of an individualist working in a collectivistic organizational culture or collectivist working in an individualistic culture are found to have stronger influence on union attitudes compared to the congruence of an individualist working in an individualistic culture or collectivist working in a collectivistic culture. The results and implications of findings are discussed in the paper with reference to the literature on role of cultural and attitudinal variables in relation to organizational outcomes like union membership. [ABSTRACT FROM AUTHOR]

The present article examines trauma in the multicultural context of India based on an interdisciplinary and comparative study drawing on theories from psychology, neuroscience, genetics, comparative literature, arts and cultural studies. The focus is on various forms of trauma - psychological, physical, individual, collective - and the way they shape distinct worldviews, problematic identities and conflictual selves rooted in the dialectic union of tradition and modernity that characterizes South Asian cultures in varied degrees. It is argued that these traumas get integrated into the self through a series of negotiations, emotional reverberations and transactions, yet constantly carry within them the potential of implosion/explosion in certain situations; they lead to creative and critical subversions of social norms, to the deconstruction of language and the everyday, the emergence of new discourses, as well as to processes of restructuring the self (and psyche) through dialogical interactions with the world. These interactions between the self, being and the world develop according to two significant dimensions, namely genetic and epigenetic factors, which points to the fact that trauma has a transgenerational transmission and manifests in varied degrees and forms in different contexts of development. This paper illustrates such experiences of trauma and their impact on the human psyche by comparatively analyzing (con)texts and selves from the Indian culture and the world. [ABSTRACT FROM AUTHOR]

Context: Almost 1/5th of the adolescent population suffers from mental morbidity. In older adolescents, clinical challenges are accompanied by unique psychosocial and developmental needs. Recent legislations in India - the Mental Health Care Act, 2017 and the Juvenile Justice Act, 2015 - mandate specific arrangements and provisions for evaluation and treatment of children and adolescents. A separate inpatient Adolescent Psychiatry Center (APC) was started at National Institute of Mental Health and Neurosciences, Bangalore, in 2016. Aims: (a) The aim of this study is to present the need for, development, infrastructure and workforce at APC; (b) to describe clinical profile of adolescents admitted to APC and (c) to identify clinical and psychosocial challenges in the management of older adolescents. Setting and Design: The paper covers consecutive inpatient admissions over the first 7 months of APC. Materials and Methods: Data were gathered from a review of hospital records, staff meetings, and case files. Statistical Analysis: Qualitative data, such as clinical management challenges, are summarized under major emergent themes. Quantitative data are summarized as means with standard deviations and frequencies with percentages. Results: Males, from urban, nuclear family background constituted the majority admissions. Family stressors and risk behaviors were prevalent. Unique clinical challenges included - risk behaviors, issues related to autonomy, conflict with family and conflict with the legal system. Conclusions: Older adolescents need to be treated in an environment appropriate to their age and developmental stage. Restructuring of spaces, routines, and creative inputs to interventions strategies must be made for healing environments for youngsters. APC could be a model for the development of other similar centers. [ABSTRACT FROM AUTHOR]

Background: Condom is an integral part of all interventions for female sex workers (FSWs). However, certain situations hinder them from practicing consistent condom use. This paper aims at identifying the situations that predict inconsistent condom use by FSWs of Sonagachi red-light area, Kolkata. Subjects and Methods: The cross-sectional community-based observational study was conducted among 296 brothel-based FSWs of Sonagachi. Outcome variable, that is, inconsistent condom use was said to be present if any sex act with any type of partner was not protected by condom. Association with sociodemographic, occupational, and behavioral characteristics of FSWs was examined. Results: Inconsistent condom use was present among 37.5% of the study participants, and this was predicted by the presence of a nonpaying partner (NPP) (adjusted odds ratio [AOR] [95% confidence interval (CI)]: 15.04 [7.52-30.08]), violence (AOR [95% CI]: 2.08 [1.07-4.03]) and sexual intercourse under the influence of alcohol (AOR [95% CI]: 1.86 [1.02-3.39]). The major cause behind nonuse of condom as reported by the participants was trust on partner. Conclusion: NPPs need to be given emphasis in program strategies for FSWs. The FSWs should constantly be motivated for safe sex emphasizing the fact that trust on partner may be detrimental for their health. [ABSTRACT FROM AUTHOR]

Background: Road traffic accident are by far the most common mode of death worldwide. With the increase in number of vehicles with economic development in India accompanied with congested roads, poor road infrastructure & general disregard for the safety measures result in high rate of vehicular accidents. Material & Method: Out of all cases coming to Autopsy of M.P. shah Medical college, Jamnagar, cases of Road Traffic Accidents were taken in study for the period of one year. Basic Information was obtained from police papers, inquiry accompanying police personnel & relatives. Detailed routine post-mortem examination was conducted. The data so collected was than analysed and compared with previous similar studies. Results: In superficial injuries, Abrasions were mostly found on Limbs, contusions mostly found on Head & Face. Most of the cases skeletal Injuries were seen on skull Bones with Face Bones & Mandible. Injury to chest region is more common in patients with three or four-wheeler accidents. Head injury is the leading cause of death in vehicular accidents. Conclusion: Many deaths in injury due to vehicular accidents can be prevented from increasing the awareness to the road-safety measures like Wearing Helmet while riding the two-wheelers, not over-loading the vehicles & wearing the seat-belts. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the impact of emotion management ability of leaders on employee job performance by highlighting the mediating role of employee perception of job characteristics.Design/methodology/approach Hypotheses were developed and tested using multi-source data collected from 65 dyads of heads of department and their subordinates.Findings Results show that leaders’ emotion management ability relates positively to employee job performance, and that this relationship is mediated by employees’ perception of job characteristics.Research limitations/implications Cross-sectional data were used to test the hypotheses. Generalizability of the findings is limited as the sample is taken from only one industry in India.Originality/value The findings contribute to HRM and leadership literature. The study has implications for jobs that require a high degree of interpersonal interaction with subordinates. Unique value also lies in the context of the study as this study is one of the first to explore the phenomenon in India. [ABSTRACT FROM AUTHOR]

The paper highlights the significance of Gandhian concepts in research in psychology and its related fields. To illustrate the application of Gandhian ideology, a test of non-violence is described here with its psychometric properties. Further, two unexplored research issues having a bearing on clinical psychology and psychiatry have been delineated. Firstly, a call for addressing the mental health problems of non-violent protesters numbering over one billion spread all over the world has been made. And secondly, there is a need for understanding the neurological basis of non-violent form of behavior, for example, the role of oxytocin, to increase the legitimacy of non-violence as adaptive behavior. [ABSTRACT FROM AUTHOR]

Towards the end of World War II, the morale of British units stationed in Burma and India was on a downslide. In contrast, the morale of Indian units was quite high. In fact, after the 1943 Arakan Campaign, the morale of Indian units rose slowly but steadily. The morale and discipline of Indian troops are also compared and contrasted with another colonial army: the African troops. By making a comparative study of the Commonwealth troops deployed in Burma and India, this paper attempts to show how and why the contours of morale and discipline changed among the various groups of troops at different times. The study of morale and discipline of the troops deployed in these two regions represents two extreme conditions: while Burma remained a war front, India did not experience any actual warfare except for some skirmishes with Indus tribes at the northwest frontier. In general, bad discipline is partly responsible for bad morale and vice versa, which adversely affects the fighting power of armies. This turns to the issue of ‘why do men fight’? The ‘will to war’ is directly proportional to good discipline and strong morale amongst troops. This paper will look for the causative factors shaping discipline and morale of both metropolitan and colonial soldiers, based mainly on military intelligence reports on morale. We will see that rather than grand ideas like nationalism and anti-fascism, mundane factors like the supply of good rations, access to sex and service conditions, influence the morale and discipline of soldiers, and hence their combat-worthiness. [ABSTRACT FROM AUTHOR]

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Health has been the main driver for many urban environmental interventions, particularly in cases of significant health problems linked to poor urban environmental conditions. This paper examines empirically the links between climate change mitigation and health in urban areas, when health is the main driver for improvements. The paper aims to understand how systems of urban governance can enable or prevent the creation of health outcomes via continuous improvements in the environmental conditions in a city. The research draws on cases from two Indian cities where initiatives were undertaken in different sectors: Surat (waste) and Delhi (transportation). Using the literature on network effectiveness as an analytical framework, the paper compares the cases to identify the possible ways to strengthen the governance and policy making process in the urban system so that each intervention can intentionally realize multiple impacts for both local health and climate change mitigation in the long term as well as factors that may pose a threat to long-term progress and revert back to the previous situation after initial achievements. [ABSTRACT FROM AUTHOR]

Out-of-pocket spending at out-patient departments (OPD) by households is relatively less analyzed compared to hospitalization expenses in India. This paper provides new evidence on the levels and drivers of expenditure on out-patient care, as well as choice of providers, using household survey data from 8 districts in 3 states of India. Results indicate that the economically vulnerable spend more on OPD as a proportion of per capita consumption expenditure, out-patient care remains overwhelmingly private and switches of providers—while not very prevalent—is mostly towards private providers. A key result is that choice of public providers tend to lower OPD spending significantly. It indicates that an improvement in the overall quality and accessibility of government facilities still remain an important tool that should be considered in the context of financial protection. [ABSTRACT FROM AUTHOR]

Background: In 2005-06, only 39 % of Indian women delivered in a health facility. Given that deliveries at home increase the risk of maternal mortality, it was in this context in 2005, that the Indian Government implemented the Janani Suraksha Yojana program that incentivizes poor women to give birth in a health facility by providing them with a cash transfer upon discharge. JSY helped raise institutional delivery to 74 % in the eight years since its implementation. Despite the success of the JSY in raising institutional delivery proportions, the large number of beneficiaries (105 million), and the cost of the program, there have been few qualitative studies exploring why women participate (or not) in the program. The objective of this paper was to explore this.Methods: In March 2013, we conducted 24 individual in-depth interviews with women who delivered within the previous 12 months in two districts of Madhya Pradesh, India. Qualitative framework analysis was used to analyze the data.Results: Our findings suggest that women's increased participation in the program reflect a shift in the social norm. Drivers of the shift include social pressure from the Accredited Social Health Activist (ASHA) to deliver in a health facility, and a growing individual perception of the importance for 'safe' and 'easy' delivery which was most likely an expression of the new social norm. While the incentive was an important influence on many women's choices, others did not perceive it as an important consideration in their decision to deliver in a health facility. Many women reported procedural difficulties to receive the benefit. Retaining the cash incentive was also an issue due to out-of-pocket expenditures incurred at the facility. Non-participation was often unintentional and caused by personal circumstances, poor geographic access or driven by a perception of poor quality of care provided in program facilities.Conclusions: In summary, while the cash incentive was important for some women in facilitating an institutional birth, the shift in social norm (possibly in part facilitated by the program) and therefore their own perceptions has played a major role in them giving birth in facilities. [ABSTRACT FROM AUTHOR]

Recent findings in the finance and consumer behaviour literature have shown that investors' investment decisions are likely to be affected by their psychological tendencies. The focus of this paper is to understand how investors' psychological tendencies influence purchase postponement of shares. Furthermore, the moderating effects of product involvement on the relationship between psychological tendencies and also purchase postponement are examined. Using a survey research design, data was collected from Indian investors to empirically test the model using moderated regression analysis. Our findings show that investor's psychological tendencies do significantly impact purchase postponement. Furthermore, a profile of Indian retail investors is presented in the paper. Our findings documents another distinct phenomenon of investors' persistent departures from rationality as posited by behavioural finance and also provides a better understanding of the nature of individual investor participation in the Indian capital market. [ABSTRACT FROM AUTHOR]

Introduction: The institutionalization of community mobilization is not well understood in literature. This paper aims to understand the role of the community-to-community learning strategy in the institutionalization of community mobilization among sex workers communities across eight districts of Andhra Pradesh, India. Materials and Methods: Data collected during baseline (March, 2010) and endline (June, 2012) under an HIV prevention project (SAKSHAM project) was used to investigate the strength (as score) of community mobilization based on two learning strategies: non-government organization (NGO)-to-community-based organization (CBO) strategy, and community-to-CBO strategy. The strength of community mobilization was assessed based on different parameters. The change in scores were computed as a percentage of the improvement to the total potential improvement from baseline to endline on specific indicators and overall. Results: Most of the CBOs considered in the pre-post assessment had been registered during 2004–2008. At baseline, the community ownership and preparedness index scores for the eight CBOs under the community-to-CBO strategy ranged between 21.5 and 27.7 while the scores for the three CBOs under the NGO-to-CBO strategy ranged between 16.3 and 21.5. By endline, the strength of community mobilization among CBOs under the community-to-CBO strategy increased 18 points (equivalent to 23% potential improvement) whereas the strength of community mobilization among CBOs under the NGO-to-CBO strategy increased only 10 points (equivalent to 13% potential improvement). The average percentage difference in improvement between the strategies was 10% (p = 0.102). Further analyses indicate that a greater improvement in community-to-CBO learning strategy was noted around managerial capacities and engagement with stakeholders than other parameters. Conclusion: The community –to- CBO learning strategy presents promising results for HIV prevention with regard to institutionalization of community mobilization among sex workers communities. Findings support the scaling-up of community mobilization initiatives within HIV prevention interventions using well trained community members in India and elsewhere. [ABSTRACT FROM AUTHOR]

This paper explores the potential for systematic scrutiny of the language of top management to reveal signals of possible deceptive conduct. The language used in letters signed by Ramalinga Raju, Chair of the Indian multi-national company Satyam, are analysed using a multi-method quantitative approach. We explore the language in Raju's annual report letters from 2002-2003 to 2007-2008; and in his letter of January 7, 2009 in which he confessed to deceptive conduct. We analyse the frequency of personal pronouns, the tone of positivity or negativity, the frequency of words of extreme emotion and aspects of the characteristics of language use indicated by the DICTION 5.0 text analysis master variable, CERTAINTY. The text of Raju's letters appears to have been influenced by his self-confessed deceptive behaviour. Raju's word choice changed noticeably in his five annual report letters prior to the collapse of Satyam as the scale and impact of his financial misstatements increased. The methods presented should be considered for adoption by auditors and regulators-as a way of assessing whether signals emerging from language use warrant closer (including audit) scrutiny of a firm's financial reporting and governance. They should also be considered for use by monitors of entity risk, such as credit rating agencies and financial analysts. [ABSTRACT FROM AUTHOR]

This paper is a qualitative study of women's well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured in-depth interview guide was used to gather women's experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women's reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women's well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community. [ABSTRACT FROM AUTHOR]

This study aimed to explore subjective well-being (SWB) in an urban Indian sample. Adults ( n = 1099) belonging to two wards in the city of Bangalore in South India, responded to a study-specific questionnaire. This paper is based on data generated as part of an ongoing larger study looking at correlates of SWB. Almost equal number of men and women responded to the study and their age ranged from 20 to 81 years (mean age 37 years). Majority of them were married, Hindus, from middle socio-economic status, had studied above pre-university level and more than half were earning. The mean scores on positive affect (40.9), negative affect (27.6) and life satisfaction (24) suggested above average levels of SWB. Higher age, being married, having higher education, higher income and working in a full time job seemed to improve life satisfaction and decrease negative affect. Religion was also significantly associated with negative affect. Step-wise regression analysis suggested that only education and income were important predictors of positive affect, while negative affect was better predicted by age, income, work status and religion. Life satisfaction was predicted by income, age and education. The important correlates of SWB for men and women were somewhat different. Overall, sociodemographic variables have minimal effect on SWB in urban India and research needs to explore other predictors of SWB. [ABSTRACT FROM AUTHOR]

This conceptual, perspective and review paper on Indian scales and inventories begins with clarification on the historical and contemporary meanings of psychometry before linking itself to the burgeoning field of clinimetrics in their applications to the practice of clinical psychology and psychiatry. Clinimetrics is explained as a changing paradigm in the design, administration, and interpretation of quantitative tests, techniques or procedures applied to measurement of clinical variables, traits and processes. As an illustrative sample, this article assembles a bibliographic survey of about 105 out of 2582 research papers (4.07%) scanned through 51 back dated volumes covering 185 issues related to clinimetry as reviewed across a span of over fifty years (1958-2009) in the Indian Journal of Psychiatry. A content analysis of the contributions across distinct categories of mental measurements is explained before linkages are proposed for future directions along these lines. [ABSTRACT FROM AUTHOR]

The articles that appeared in Indian Journal of Psychiatry were related to different areas of psychotherapy. Case reports dealt with a wide variety of cases. The review papers focused on the suitability of psychotherapy in the Indian context, different approaches in psychotherapy, psychotherapy training and supervision. Psychotherapy has been viewed very close to faith orientation. There were attempts to identify the indigenous concepts that are applicable to psychotherapy. Empirical studies are low in number. Concerted effort is needed to generate interest in psychotherapy, conduct more research on evidence-based therapies as well as on psychotherapeutic process variables. [ABSTRACT FROM AUTHOR]

This paper examines the reasons for farmer suicides in India. Inability to get the right price, crop failures, and insurmountable debt are the factors that may drive the farmers to take this extreme step. A key factor for farmers being unable to get market prices is inefficient agriculture supply chain management. We find that the reasons for inefficient supply chain management include lack of reforms in the Agricultural Produce Market Committee (APMC) Act, low bargaining power due to small farm size, and lack of warehousing facilities. Crop failures happen because of poor irrigation facilities. Considering agricultural output and rainfall data from four different states in India we find evidence in favor of association between the cyclical component of agricultural output and rainfall data. Understanding this linkage is important from the perspective of formulating demand management policies (read, intervention by the government and central bank). [ABSTRACT FROM AUTHOR]

This study aims to investigate gamification-based training program through the lens of self-determination theory and in the context of corporate training programs. It integrates the self-determination theory, game elements and learning outcomes in gamified training programs to derive insights. Data is sourced from software development companies operating in the city of Bangalore in India. It applies the partial least square structural equation modeling to investigate the relationship between the self-determination learning theory and game elements and the impact it has on learning outcomes. As a precursor to the development of a game-like learning ecosystem, the authors study the perception of trainers and human resource managers toward game-based training programs in the organization. The authors find that game-based learning makes training more engaging, immersive and contextual for the learners. The study is based on a specific sector, i.e. software development companies, and so the results may lack in generalizability. Future research, therefore, may consider other industrial sectors such as manufacturing, banking and telecom to understand the relationship between the constructs. This study provides insights for the trainers, human resource managers and academicians on the effectiveness of gamification-based training programs. It also provides information on how the learning theory can be leveraged to understand gamification-based training programs. This work fulfills an identified need of the training industry to understand new methods of training with an aim to improve the learning outcomes among the learners. This study provides a deep understanding on the effectiveness of training tools such as gamified training programs in enhancing and improving the learning outcomes among the learners. [ABSTRACT FROM AUTHOR]

An abstract of the article "Mental Health Research in Indian Psychology," by Jeny Rapheal and colleagues is presented.

Background: Social inequities in early child bearing persist among young married people, especially among tribal populations in India. Rural women belonging to tribal groups and those coming from poor households are more likely to give birth before age 18. This paper explores the connection between ethnicity, gender and early fertility intention among young married people in rural India. Methods: The data is drawn from a cross sectional baseline evaluation of an intervention programme in rural India. A sample of 273 married young people was taken. Respondents were selected using systematic random sampling. Logistic Regression was used to assess the effect of being a tribal on early fertility intention and also to determine if covariates associated with early fertility intention differed by tribal status. Qualitative data was analysed using deductive content analysis approach. Results: Bivariate and logistic regression results indicated that young married people from tribal communities had higher odds of planning a child within one year of marriage than non-tribals (OR = 1.47, p-value-0.079). Findings further suggest that early fertility intention among tribals is driven by gender factors and higher education and among non-tribals, higher education and awareness on contraception are key predictors. Among tribals, the odds of planning a child within one year of marriage was strongly associated with inequitable gender norms (OR = 1.94, p-value-0.002). Higher education showed significant positive association with non-tribals (OR = 0.19, p-value-0.014) and positive association with tribals (OR = 0.56, p-value-0.416). Qualitative investigation confirms that fertility desires of young married people are strongly influenced by gender norms especially among tribal populations. Conclusion: Early child bearing was underpinned by complex ethnic factors and gender norms. Preference for early child bearing was seen most among tribal communities. Gender attitudes were a cause of concern especially among tribal groups. These results suggest that efforts to improve early child birth will require changing gender norms related to fertility among tribals as well as social equity issues including higher education among non-tribals and tribals. [ABSTRACT FROM AUTHOR]

Using data on 697 individuals from 375 rural low income households in India, we test expectations on the effects of relative income and conspicuous consumption on subjective well-being. The results of the multi-level regression analyses show that individuals who spent more on conspicuous consumption report lower levels of subjective well-being. Surprisingly an individual's relative income position does not affect feelings of well-being. Motivated by positional concerns, people do not passively accept their relative rank but instead consume conspicuous goods to keep up with the Joneses. Conspicuous consumption always comes at the account of the consumption of basic needs. Our analyses point at a positional treadmill effect of the consumption of status goods. [ABSTRACT FROM AUTHOR]

The article explores the psychology of Hindu religion and culture. It aims to identify the structural condition of particular Hindu god images. Two interpretations presented in this paper, share a common point of the new psychology of Hinduism expressed by Stanley N. Kurtz, a psychoanalytic anthropologist. A brief review of the two psychological theories, attachment theory and object relations theory, is also provided.

Background: During a commercial surrogacy arrangement, the event of embryo transfer can be seen as the formal starting point of the arrangement. However, it is common for surrogates to undergo a failed attempt at pregnancy conception or missed conception after an embryo transfer. This paper attempts to argue that such failed attempts can be understood as a loss. It aims to reconstruct the experiences of loss and grief of the surrogates and the intended parents as a consequence of their collective failure to conceive a surrogate pregnancy.Methods: Drawing on a qualitative study conducted over a period of eight months between 2014 and 2015 at two fertility clinics in Delhi and two in Kolkata, India, this paper examines the experiences of the surrogates and the intended parents when faced with missed conceptions or failed conceptions during a surrogacy arrangement.Results: We argue that while the surrogate grieves the non-arrival of a 'good news' as an uncertain loss, the intended parents experience yet another, failure in addition to the losses they might have incurred during their previous fertility treatments. The body of the surrogate becomes a site of 'a lost opportunity'. The surrogate embodies a loss in her quest to achieve social mobility and the intended parents experience a disembodied pregnancy loss. This very emotional experience stands in stark contrast to the conceptualisation of such failed attempts as non-events within the discourse of the surrogacy industry. The experience of loss of the intended parents is recognised but their grief is given no space. We argue that such ambiguity around the nature of losses resulting out of a missed or failed conception during surrogacy is an outcome of lack of interpersonal relationship between the surrogate and the intended parents.Conclusions: Since commercial surrogacy is a relational process, the only way in which the experiences of losses and failures of the actors at the preconception stage can be better addressed is through developing close sharing and understanding between each other through an ethics of care. Therefore, to nurture caring relationships, surrogacy needs to be understood as a moral commitment by -the surrogates and intended parents. To enable such a commitment, there is a need to reconsider the pre-defined and legally regulated professional duty of the doctors, agents and agencies. It cannot be a one-sided commitment, but has to have elements of mutuality. [ABSTRACT FROM AUTHOR]

The corona virus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuro-scientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the India Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the India in March, 2020. We urge India research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuro-scientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people. [ABSTRACT FROM AUTHOR]

This article addresses the rights, roles and responsibilities of Healthcare Workers (HCW) who are front line warriors in any pandemic outbreak. Coronaviruses 2019 (COVID-19) pandemic has emerged as international public health emergency in March 2020, and exposed the weak/failed health care system preparedness to respond to the pandemic threat and controlling the community spread. In India, huge population, poor economic growth and unacceptable doctor to patient ratio made swift response to emergence of pandemic, safeguarding HCWs, ability to provide care without mental and physical burn out challenging. This review emphasises the need for safety of HCW and patients, infection control, security to the family, psychosocial and mental well-being, proper allocation of medical supplies, medical ethics and communication. [ABSTRACT FROM AUTHOR]

Background: In the absence of treatment and unclear prognosis, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) itself, and public health measures like lockdown enforced by the government to limit the spread of the virus poses a threat to the psychological health of the general population. Aim: To assess the psychological status of the Indian population during the initial phase of lockdown. Method: It was a cross-sectional online survey where the questionnaire was disbursed by snowballing. The link to the survey was shared in different social networking platforms between 6th and 22nd of April 2020. The questionnaire collected responses related to the sociodemographic variables, exposure history, precautionary measures used, and the Depression, Anxiety, and Stress Scale (DASS-21) score. Results: A total of 541 participants responded to the questionnaire. Only 422 respondents' responses from 23 states of India who completed the questionnaire were included for assessment. The mean age of the participants was 30.5 (SD=10.9) years. Female constituted 60.4% (n=255) of the respondents. The pre-existing medical illness that the respondents had were diabetes mellitus, four per cent (n=17), hypertension, five per cent (n=21), thyroid dysfunction, nine per cent (n=38), and mental illness, five per cent (n=21). The median (IQR) of the DASS-21 item scale was found to be 16 (4-32). The percentage of the respondents who reported stress was 35.5% (n=149), anxiety, 32% (n=135), and depression, 34.7% (n=146). Respondents with sociodemographic variables like being single, student status, competed education till graduation, homemakers, working in public sector, and history of mental illness were more likely to experience stress, anxiety, and depression. A majority of the respondents were practicing hand hygiene and social distancing. Respondents who were unaware of their exposure status were more likely to have depression. Conclusion: The Indian population is experiencing the psychological impact of the coronavirus disease 2019 (COVID-19), which may increase with the spread of the infection. India needs to gear up to face mental health consequences. People with a pre-existing physical and psychological illness needs extra care and precaution to prevent any relapse or development of complications. [ABSTRACT FROM AUTHOR]

Background: With India preparing for the next decennial Census in 2021, we compared the disability estimates and data collection methodology between the Census 2011 and the most recent population-level survey for India and its states, to highlight the issues to be addressed to improve robustness of the disability estimates in the upcoming Census. Methods: Data from the Census 2011 and from two complementary nationally representative household surveys that covered all Indian states with the same methodology and survey instruments–the District-Level Household Survey-4 (DLHS-4, 2012–2013) and the Annual Health Surveys (AHS three rounds, 2010–11, 2011–12 and 2012–13) were used. Data from DLHS-4 and AHS 2012–13 round were pooled to generate estimates for the year 2012–13. Data collection methodology between the sources was compared, including the review of definitions of each type of disability. The overall, mental, visual, hearing, speech, and movement disability rate (DR) per 100,000 population were compared between the sources for India and for each state, and the percent difference in the respective rates was calculated. We explored the reliability of these estimates comparing yearly data from the AHS for three successive rounds. Results: Survey data were collected through proxy reporting, however, it is not entirely clear whether the data were proxy- or self-reported or a mix of both in the Census. The overall DR was 25.1% higher in the Census (2,242; 95% CI 2,241–2,243) than the survey (1,791; 95% CI 1,786–1,797) per 100,000 population, with the state-level difference ranging from -64% in Tamil Nadu to 107% in Sikkim state. Despite both sources using nearly similar definitions for overall disability and disability by type, the difference in DR was 125.5%, 54.2%, -25.7%, -19.7%, and 21.9% for hearing, speech, mental, movement, and visual DR, respectively. At the state-level, the difference in disability-specific estimates ranged from -84% to 450%. The extent of variations in the disability-specific estimates in AHS successive rounds ranged from -25% to 929% at the state-level. Conclusions: There is momentum globally towards building disability measurement that is consistent with the data required for monitoring of the Sustainable Development Goals to ensure robust estimation of disability. The current estimates from the Census and surveys seem much lower than would be expected at the population level. We make recommendations that India needs to take serious note of in order to improve the validity and reliability of India’s disability estimates. [ABSTRACT FROM AUTHOR]

Background: Low birth weight is an important predictor of maternal and child health. Birth weight is likely to be affected by maternal health, socioeconomic status and quality of health care facilities. Objective: To assess trends in the birth weight, the proportion of low birth weight, maternal factors and health care facilities for delivery in villages of Western Maharashtra from the year 2004 to 2016 and to analyze factors associated with low birth weight for total birth data of 2004–2016. Methods: Data collected for 19244 births from 22 villages in Vadu Health and Demographic Surveillance System (HDSS), Pune, Maharashtra, India from the year 2004 to 2016 were used for this analysis. Results: There was an overall increase in the annual mean birth weight from 2640.12 gram [95% CI 2602.21–2686.84] in the year 2004 to 2781.19 gram [95% CI 2749.49–2797.95] in the year 2016. There was no secular trend to show increase or decrease in the proportion of low weight at birth. Increasing maternal age (>18 years) compounded with better education, reduced parity and increasing number of institutional deliveries were significant trends observed during the past decade. Low birth weight was found to be associated with female gender, first birth order, poor maternal education and occupation as cultivation. Conclusion: Changes in maternal age, education, occupation, and increased institutionalized deliveries contributed in to increasing birth weights in rural Maharashtra. Female gender, first birth order, poor maternal education and occupation of cultivation are associated with increased risk of low birth weight. [ABSTRACT FROM AUTHOR]

Background: Activities of daily living (ADLs) refer to the ongoing behaviors that occur on a daily basis. Such behaviors include eating, cooking, bathing, social interactions (such as leisure activities, attending school or work, or assisting with chores), and other activities that one might routinely expect an individual to perform or participate in. Some of the major ADL tasks include personal hygiene, toileting, dressing, and eating. Researchers have documented delayed self-care performance in children with autism spectrum disorder (ASD). Parents report their child to have difficulties with feeding and toileting in particular. Objective: This qualitative pilot study endeavored to understand the difficulties faced by the parents of children with ASD in conducting their children's ADL. Study Design: Qualitative descriptive study was chosen for the research. Methods: The qualitative descriptive study included participants (n = 20) whose children were primarily diagnosed as ASD. Convenient sampling method was used for study sample calculation. The study included parents of children of age group between 5 and 9 years (mean ± standard deviation [SD]: 6.9 ± 1.57 months) with intelligence quotient of ≥80%. The study was conducted in a tertiary care hospital. The parents (fathers = 9 and mothers = 11) were given a semistructured questionnaire to understand difficulties faced by the parents of children with ASD (mean ± SD: 5.56 ± 33.6 months). Results: According to the study, it was observed that most of the parents have reported that their child had maximum difficulties in eating, followed by brushing and grooming and least for toileting. This study also found the priority list of difficulties in ADL. It was noted that early and proper training of the child gives good results in managing a child with ASD. Many parents reported that early training is beneficial. Conclusion: The outcome of this study shows the hierarchy of difficulties in ADL reported by the parents of children with ASD. This study also found that early ADL training gives good results in managing child with ASD. [ABSTRACT FROM AUTHOR]

Background: Evidence highlights a global shortage of wheelchair service provision education and training that results in inappropriate wheelchair provision with associated health and economic consequences. Two learning methodologies, a hybrid and an in-person course, based on the World Health Organization Wheelchair Service Training Package Basic Level, currently are available to train wheelchair service providers worldwide. The effectiveness of the in-person methodology, used as the standard of practice, has never been tested. Meanwhile, the Hybrid Course, which combines online and in-person training, was developed to reduce training costs and to scale training interventions and has shown potential effectiveness in increasing basic level wheelchair service provision knowledge. The objective of this study was to compare the effectiveness of both learning methodologies based on knowledge and satisfaction among a group of wheelchair service providers in India and Mexico. Methods: We conducted a controlled quasi-experimental study to evaluate changes in basic wheelchair knowledge and levels of satisfaction between Hybrid and In-person course learners in India and Mexico. A convenience sampling method guided by local stakeholders’ input was used to recruit participants. Outcomes were assessed using self-administered online surveys, the International Society of Wheelchair Professionals Wheelchair Service Provision Basic Test (primary outcome) completed pre- and post- the learning intervention and an anonymous Satisfaction Survey (secondary outcome) completed post- intervention. Baseline characteristics were compared among groups using hypothesis tests based on their assumptions. The primary analysis was intention-to-treat. To address missing values and lost to follow-up, multiple chained imputations were conducted. The primary outcome was analyzed using linear mixed models. The secondary outcome was analyzed using a two-tailed two independent samples t-test. Results: A total of 81 participants, 43 (53.1%) in the In-person group and 38 (46.9%) in the Hybrid group, participated in the study. Mean baseline knowledge scores were below the passing cutoff of the test (53 points) in both groups. Both study groups experienced statistically significant improvements in the primary outcome when comparing pre- and post-test scores (p<0.0001) with total mean scores above the passing cutoff of the test. The in-person group experienced, on average, larger effects on the primary outcome. The difference in mean change from post-test to pre-tests between In-person groups and Hybrid was 3.6 (95% Confidence Interval: 1.7;5.4), Cohen’s d = 0.36, with a small effect size favoring the In-person training. With regards to satisfaction, the difference between the two interventions was 0.23±0.07 in favor of the In-person group (p = 0.0021). Conclusions: Both learning methodologies had a statistically significant effect in increasing wheelchair service knowledge with overall high levels of satisfaction. However, the In-person group reported overall larger effects when compared with the Hybrid methodology. This study provided recommendations on how organizations can improve blended learning interventions to enhance participants’ learning experiences and reduce potential barriers and limitations. [ABSTRACT FROM AUTHOR]

Inadequate quality of care in healthcare facilities is one of the primary causes of patient mortality in low- and middle-income countries, and understanding the behavior of healthcare providers is key to addressing it. Much of the existing research concentrates on improving resource-focused issues, such as staffing or training, but these interventions do not fully close the gaps in quality of care. By contrast, there is a lack of knowledge regarding the full contextual and internal drivers–such as social norms, beliefs, and emotions–that influence the clinical behaviors of healthcare providers. We aimed to provide two conceptual frameworks to identify such drivers, and investigate them in a facility setting where inadequate quality of care is pronounced. Using immersion interviews and a novel decision-making game incorporating concepts from behavioral science, we systematically and qualitatively identified an extensive set of contextual and internal behavioral drivers in staff nurses working in reproductive, maternal, newborn, and child health (RMNCH) in government public health facilities in Uttar Pradesh, India. We found that the nurses operate in an environment of stress, blame, and lack of control, which appears to influence their perception of their role as often significantly different from the RMNCH program’s perspective. That context influences their perceptions of risk for themselves and for their patients, as well as self-efficacy beliefs, which could lead to avoidance of responsibility, or incorrect care. A limitation of the study is its use of only qualitative methods, which provide depth, rather than prevalence estimates of findings. This exploratory study identified previously under-researched contextual and internal drivers influencing the care-related behavior of staff nurses in public facilities in Uttar Pradesh. We recommend four types of interventions to close the gap between actual and target behaviors: structural improvements, systemic changes, community-level shifts, and interventions within healthcare facilities. [ABSTRACT FROM AUTHOR]

Childhood pneumonia accounts for 17% of IMR in India, posing a major health burden. With cultural beliefs influencing care seeking behaviour and disparities existing in health infrastructure across the country, an understanding of the underlying issues merits exploration. Study assessed prevalence of probable pneumonia and examined care seeking behaviour of mothers in three states, Madhya Pradesh (MP), Uttar Pradesh (UP) and Tamil Nadu (TN). This mixed methods study involved a household survey and qualitative interviews with mothers in three districts from each state. Households with children aged 2–59 months were screened to identify those with probable pneumonia; sub-sample of mothers participated in qualitative interviews. Care seeking behaviour was explored in the context of recognition of symptoms, nature of first care provided, time when care was sought outside the home and choice of health provider. Overall 17,442 children from 13,544 households were screened, of which 729 (MP), 752 (UP) and 713 (TN) children respectively, were identified with probable pneumonia; 72 mothers participated in the qualitative interviews. Three months period prevalence was estimated in study districts at 22.2%—MP 13.3%—UP and 8.4%—TN. Most mothers in MP and UP were not perceptive to severity of illness; type of care sought was often inappropriate, delayed, with home remedies and visits to unqualified care providers being their first response. In contrast, in TN, use of home remedies was minimal, going to untrained care providers, non-existent and more than 90% mothers sought appropriate care. Private doctors were the preferred choice among all mothers but utilization of government care was highest in TN (20%). Community health workers were underutilized, with less than 10% mothers consulting them. Need for educating mothers about appropriate care seeking and development of good health infrastructure as essential to attainment of better child health indices are advocated. [ABSTRACT FROM AUTHOR]

The present study explored the motivation of rural-urban migrants who moved from the Himalaya foothills of Uttarakhand to its capital city, Dehradun. A survey of 100 migrant families reported their socio-economic profile before and after migration, personal and general reasons for migration, problems in the village and in the city, and perception of push- and pull factors. A remote sensing-based analysis of land cover and forest changes was conducted for two villages of the migrants’ origin, aiming to link the reasons for migration to land cover changes. This was contextualised by reported large scale changes in forest cover. Major reasons for migration mentioned in this study were education, employment opportunities with the associated income, and facilities. These were perceived as both, push and pull factors, whereas environmental factors ranked very low. Declining environment or agriculture were never mentioned spontaneously as personal reason, and only occasionally as a presumed general reason for migration, but were frequently confirmed as a major problem in the village. Thus, although such problems existed, they seemed not a major driver of rural-urban migration. For most of the respondents their migration resulted in a profound change of livelihoods and significantly improved their socio-economic situation. Land and forest cover around the chosen villages fluctuated by up to 15% with a trend to increasing forest cover in recent years. At the district and state scales, forest cover was rather stable. These results question the narrative of deforestation and environmental degradation in the Himalayas as major push-factors for rural-urban migration in Uttarakhand. Even if environmental constraints were felt, it was rather the differences in socio-economic opportunities (education, employment, facilities) that drove people to migrate to the city. Regarding the push-pull paradigm, we conclude that scenarios of external conditions under which people migrate cannot be evaluated without taking the migrants’ attitudes and choices into account. [ABSTRACT FROM AUTHOR]

Background: Use of coercive measures in mental health care is an important issue for research. There are scarce data available on perception and attitudes toward coercion among Indian psychiatrists. Aims: This study aims to study psychiatrists' attitude and perspectives on the use of coercive measure in clinical practice against the background of family and patients' opinion. Materials and Methods: The study was conducted at the Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India. Psychiatrist in charge of the inpatients was asked about their general opinion on coercion and was administered Staff Attitude to Coercion Scale questionnaire. Findings were compared to previously published studies on patients' opinion and family opinion in the same sample. Data were analyzed using descriptive statistics. Results: Coercion proved to be a common measure applied in nearly 70% of the patients studied. The 189 psychiatrists participating in the study almost all perceived coercion as care, protection and safety, and as protection from dangerous situations. About 66% of psychiatrists perceived physical and chemical restraint (sedation) as necessary and acceptable in acute emergency care. One-third of the psychiatrists felt their patients lost autonomy, dignity, and the possibility of interpersonal contact. The same amount agreed that some patients could have been treated with less restriction and fewer coercive measures. Conclusion: Psychiatrists felt that physical and chemical restraints are necessary and acceptable in acute emergencies. Most psychiatrists considered coercion as a caring protective and safety attitude but also acknowledged its potential negative impact on patient dignity and therapeutic relationships. [ABSTRACT FROM AUTHOR]

Background: Around 5.4 million under-five deaths occur globally annually. Over 2.5 million neonatal deaths and an equivalent stillbirths also occur annually worldwide. India is largest contributor to these under-five deaths and stillbirths. To meet the National Health Policy goals aligned with sustainable development targets, adoption of specific strategy and interventions based on exact causes of death and stillbirths are essential. The current cause of death (CoD) labelling process is verbal autopsy based and subject to related limitations. In view of rare diagnostic autopsies, the minimally invasive tissue sampling (MITS) has emerged as a suitable alternate with comparable efficiency to determine CoD. But there is no experience on perception and acceptance for MITS in north Indian context. This formative research is exploring the perceptions and view of families, communities and healthcare providers regarding MITS to determine the acceptability and feasibility. Methods: The cross-sectional study adopts exploratory qualitative research design. The study will be conducted in New Delhi linked to deaths and stillbirths occurring at a tertiary care hospital. The data from multiple stakeholders will be collected through 53–60 key-informant in-depth interviews (IDIs), 8 focus group discussions (FGDs) and 8–10 death or stillbirth event observations. The IDIs will be done with the parents, family members, community representatives, religious priests, burial site representatives and different health care providers. The FGDs will be conducted with the fathers, mothers, and elderly family members in the community. The data collection will focus on death, post-death rituals, religious practices, willingness to know CoD, acceptability of MITS and decision making dynamics. Data will be analysed following free listing, open coding, selective coding and theme identification. Subsequently 8–10 parents will be approached for consent to conduct MITS using the communication package to be developed using the findings. Discussion: The study will provide in-depth understanding of the cultural, social, religious practices related to child death and stillbirth and factors that potentially determine acceptance of MITS. The findings will guide development of communication and counselling package and strategies for obtaining consent for MITS. The pilot experience on obtaining consent for MITS will inform suitable refinement and future practice. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to assess the perception of the young psychiatrists (aged ≤45 years) about their training received during the postgraduate training period. Methodology: An online E-mail survey using Survey Monkey electronic platform evaluated the perception of 451 psychiatrists about their own perception of training received during the postgraduation period. Results: About two-third (n = 308; 68.3%) of the respondents reported that their overall training was 'good' or 'very good'. However, training was rated as poor/very poor in subspecialties of child and adolescent psychiatry and geriatric psychiatry by 26.2% and 26.9% of the participants, respectively. Exposure/training was rated as "poor/very poor" by more than one-fifth of the participants in areas of repetitive transcranial magnetic stimulation and deep brain stimulation (69.9%), rehabilitation psychiatry (47%), forensic psychiatry (45.5%), psychodynamics (40.5%), neuroimaging (38.1%), psychotherapy (34.8%), orientation to private practice (26.9%), statistics (34.1%), writing skills (24.4%), ethical principles of research (23.5%), women mental health (23.3%), psychosexual medicine (22.7%), and research methodology (21.5%). Regarding academic activities involving writing skills, although majority (72.5%) of the participants reported being involved in writing case reports and half (50.3%) reported involvement in writing original articles, but exposure to writing other types of article was quite low. Training in different types psychotherapies in the form of adequate exposure, carrying out and supervision to different types of psychotherapy was inadequate/low for psychodynamic psychotherapies, rational emotive therapy, dialectical behavior therapy, eclectic psychotherapy, and other kind of therapies. A high proportion of respondents reported having good competence in the administration of modified electroconvulsive therapy and making presentation in academic fora just after passing degree from their institutes and at the time of survey (current competence). When comparisons were done between the different groups of institutes, significant difference was noted across all aspects of training. Conclusions: The present survey reflects that there is a variation in the psychiatry training in India. Accordingly, it can be said that there is a need to develop a model for competency-based training program at the level of the Indian Psychiatric Society in consonance with training regulatory bodies like the Medical Council of India, which can be implemented across the country to harmonize the training. [ABSTRACT FROM AUTHOR]

Abstract: India accounts for approximately one third of the world's total population of stunted preschoolers. Addressing global undernutrition, therefore, requires an understanding of the determinants of stunting across India's diverse states and districts. We created a district‐level aggregate data set from the recently released 2015–2016 National and Family Health Survey, which covered 601,509 households in 640 districts. We used mapping and descriptive analyses to understand spatial differences in distribution of stunting. We then used population‐weighted regressions to identify stunting determinants and regression‐based decompositions to explain differences between high‐ and low‐stunting districts across India. Stunting prevalence is high (38.4%) and varies considerably across districts (range: 12.4% to 65.1%), with 239 of the 640 districts have stunting levels above 40% and 202 have prevalence of 30–40%. High‐stunting districts are heavily clustered in the north and centre of the country. Differences in stunting prevalence between low and high burden districts were explained by differences in women's low body mass index (19% of the difference), education (12%), children's adequate diet (9%), assets (7%), open defecation (7%), age at marriage (7%), antenatal care (6%), and household size (5%). The decomposition models explained 71% of the observed difference in stunting prevalence. Our findings emphasize the variability in stunting across India, reinforce the multifactorial determinants of stunting, and highlight that interdistrict differences in stunting are strongly explained by a multitude of economic, health, hygiene, and demographic factors. A nationwide focus for stunting prevention is required, while addressing critical determinants district‐by‐district to reduce inequalities and prevalence of childhood stunting. [ABSTRACT FROM AUTHOR]

Background: Improving quality of maternal healthcare services is key to reducing maternal mortality across developing nations, including India. Expanding access to institutionalized care alone has failed to address critical quality barriers to safe, effective, patient-centred, timely and equitable care. Multi-dimensional quality improvement focusing on Person Centred Care(PCC) has an important role in expanding utilization of maternal health services and reducing maternal mortality. Methods: Nine public health facilities were selected in two rural districts of Uttar Pradesh(UP), India, to understand women’s experiences of childbirth and identify quality gaps in the process of maternity care. 23 direct, non-participant observations of uncomplicated vaginal deliveries were conducted using checklists with special reference to PCC, capturing quality of care provision at five stages—admission; pre-delivery; delivery; post-delivery and discharge. Data was thematically analysed using the framework approach. Case studies, good practices and gaps were noted at each stage of delivery care. Results: Admission to maternity wards was generally prompt. All deliveries were conducted by skilled providers and at least one staff was available at all times. Study findings were discussed under two broad themes of care ‘structure’ and ‘process’. While infrastructure, supplies and human resource were available across most facilities, gaps were observed in the process of care, particularly during delivery and post-delivery stages. Key areas of concern included compromised patient safety like poor hand hygiene, usage of unsterilized instruments; inadequate clinical care like lack of routine monitoring of labour progression, inadequate postpartum care; partially compromised privacy in the labour room and postnatal ward; and few incidents of abuse and demand for informal payments. Conclusions: The study findings reflect gaps in the quality of maternity care across public health facilities in the study area and support the argument for strengthening PCC as an important effort towards quality improvement across the continuum of delivery care. [ABSTRACT FROM AUTHOR]

Background and Objective: Social networking sites (SNSs) are online platforms that provide individuals with an opportunity to manage their personal relationship and remain updated with the world. The primary objective of the present research was to find the pattern of school students' SNS usage and its influence on their academic performance. Materials and Methods: The setting was an English medium school situated in the metropolitan city of Siliguri in West Bengal. A pretested and predesigned questionnaire was self-administered anonymously by 388 randomly selected students. The data were analyzed using appropriate statistics. Results: Three hundred thirty-eight (87.1%) students used SNS and spent an increased amount of time on these networks. Addiction was seen in 70.7% and was more common in the age group of 17 years and above. Conclusion: There is a need to educate students about the ways of using SNS and the perils associated with it, to help them understand that though very much in trend, they should be used cautiously. [ABSTRACT FROM AUTHOR]

Background: Usability assessment is necessary to know how effective is the implemented Hospital Information System (HIS) integrated Electronic Medical Record (EMR). The assessment explores the factors that influence the satisfaction level of the end-user. Objective: To understand the end user attitude towards HIS integrated EMR, to assess the satisfaction level of the end-user and to analyze the challenges and limitations. Methodology: A descriptive cross-sectional study was carried out among nursing, billing, front office, medical records department and paramedical staff of a super specialty hospital in Southern India. A structured and validated questionnaire was used for the data collection. Results: The study revealed that 61.40% of staff had a moderate level of satisfaction with the present HIS integrated EMR. Post Hoc test revealed a significant difference in the attitudes of staffs towards HIS integrated EMR. The major technical challenges reported by the end users were slow network, poor integrity, difficulty in accessing data, lack of guidelines for using HIS and non-friendly user interface. The lack of training, lack of healthcare professional's support, lack of experience in using the system and scare to use the HIS integrated EMR were the human challenges expressed by the end-users. The information availability, software, and communication system were the limitations that restricted the end-users to utilize the system fully. Conclusion: The study indicated that the better acceptability of HIS integrated EMR is only possible through the; involvement of end-users in the mainstream of implementation and regular evaluation of end-user satisfaction. This approach will provide the scope for improving the system to meet the end-user requirements and lead to better sustainability. [ABSTRACT FROM AUTHOR]

Context: The mental healthcare act 2017 represents a complete overhaul of Indian mental health legislation. Aims: The aim of this study was to establish the opinions of Indian psychiatrists regarding the new act. Settings: Mental health professionals in Bihar and Jharkhand were interviewed. Design: A focus group design was utilized. Materials and Methods: Key questions explored the positive and negative aspects of the act and the management of the transitional phase. All focus groups were recorded and transcribed. Analysis: Data were coded and analyzed using an inductive approach. Results: Many positive aspects of the new legislation were identified especially relating to rights, autonomy, and the decriminalization of suicide. However, psychiatrists have significant concerns that the new legislation may negatively impact patients and increase stigma. Psychiatrists held varying views on the proposed licensing and inspection of general hospital psychiatric units. Conclusions: Careful evaluation of the new legislation is needed as the concerns raised warrant ongoing monitoring. [ABSTRACT FROM AUTHOR]

Context: Buses take up more than 90% of public transport in Indian cities and serve as a cheap and convenient mode of transport for all classes of society. However, the well-being of employees of this mode of transport is paramount in passenger and personal safety. As in any job, the person has to balance work and personal issues. Work--life balance is a concept that supports the effort from an employee in any sector to split their time and energy to balance work and personal lives. Materials and Methods: A cross-sectional study using a structured interview schedule was conducted among 103 Karnataka State Road Transport Corporation (KSRTC) workers in Anekal town, Karnataka, to determine the work--life balance among them. The total score was classified into high, medium, and low work balance categories. The scores for each domain were analyzed separately to derive at the factors which act against work--life balance. Results: Low work--life balance was found in 26 (25.2%) of all subjects. The important factors that affected work--life balance were identified to be shift work, work load, night duties, social functions, and negative attitude of family members. The reasons that motivated them to work were to support family (35%), future security (33%), and to clear personal debts (15.5%). Conclusion: Given the low work--life balance in a quarter of several individuals in this study, there is a need to address this issue to ensure necessary balance and safety and well-being of both road transport employees and passengers. [ABSTRACT FROM AUTHOR]