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During the last 20 years, the association between polycyclic aromatic hydrocarbons (PAHs) and health risk has become one of the hotspots in the fields of public health and the environment. A bibliometric study of 1392 research articles retrieved from the Web of Science Core Collection (WoSCC) published between 2002 and 2021 was performed to give an in-depth statistical evaluation of research progress and future trends on PAHs and health risk (PHR). According to the findings, the annual output of significant scientific papers increased exponentially. China ranked first among the 86 nations in terms of the number of publications (NP), followed by the USA and India. Logistic regression analysis showed that there was a positive relationship between the second tertile of 180-day usage count (AOR = 1.62; 95% CI: 1.16–2.26) and increased odds of open access publishing after adjustment for the confounders, indicating that open access papers on PHR were more preferred over the preceding 6 months than non-open access articles. The most popular terms were "PAHs," "risk assessment," and "source identification." According to the bibliometric study, the research hotspots that require more exploration include identifying PAH sources in media such as soil, water, dust, and food and evaluating their linkages to health hazards using appropriate risk models. Understanding the environmental behavior, bioavailability, and health concerns of PAHs and their derivatives in various media is critical for environmental and public health protection. This paper provides an overview of current research status and future perspectives for PHR research. [ABSTRACT FROM AUTHOR]

The National Sample Survey (NSS) collects reliable data on morbidity, health care, and health spending through its annual multi-subject and multi-round health surveys. Evidences from these surveys have been extensively used for research and policy. While these surveys collect comprehensive information on morbidity, hospitalisation, health expenditure, information on household consumption expenditure (which is used to explain the economic gradient in health outcomes) is collected through a single question. Literature suggests that having a single question on consumption expenditure results in measurement errors. In this paper, we examine the effect of measurement errors of household consumption expenditure on estimates of catastrophic health expenditure (CHE) in India using data from the 68th round of the consumption survey (2011–12) and the 71st round of the health survey (2014), carried out by the National Sample Survey (NSS). The consumption survey canvassed a detailed schedule on consumption and interviewed 101,651 households, whereas the health survey interviewed 65,932 households from across the country. Descriptive statistics, estimates of CHE, and logistic regression models were used in the analysis. We used both the budget share approach and the capacity-to-pay approach for estimating CHE. The NSS health survey was found to have underestimated monthly per capita consumption expenditure (MPCE) in India by 32%, with the level of underestimation being significant across the states. Using the budget share approach, the CHE of India in 2014–15 was estimated at 23.4% without adjusting for the underestimation of consumption and 21.1% after adjusting for it. Similarly, using the capacity-to-pay approach, CHE was estimated to be 13.4% without adjustment and 10.4% with adjustment. The estimates differed considerably across the states. In general, it was observed that the use of a single question on consumption overestimated CHE in India. The pattern was similar regarding the intensity of CHE. The predictors of CHE were similar using both the methods, but the unadjusted estimates of CHE showed significantly higher predicted probabilities of incurring CHE across household characteristics. It is recommended to include disaggregated questions on household consumption in the future rounds of the NSS-based health surveys. Researchers using NSS data need to be aware of the effect of measurement errors of consumption expenditure on estimates of catastrophic expenditure. Adjusting for the underestimation of MPCE may improve the estimation of CHE in India. [ABSTRACT FROM AUTHOR]

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

Using data from a survey of farm households in the Indian state of Uttar Pradesh and employing a sequential logit model, this paper has investigated the impact of farmers' participation in the Direct Benefit Transfer (DBT) subsidy scheme for micro-irrigation on crop performance. The findings show that over 91% of the farmers were aware of the scheme, 61% of them registered as potential beneficiaries and two-thirds of them actually benefitted from it. Registration is the critical transition stage for participation in the DBT scheme. Our findings show that conditional upon the ownership of tube-wells and water pumping devices, several personal and household-level factors such as age, education, access to information and membership of village-level organizations distinguish the beneficiaries of DBT from the non-beneficiaries. There appears no selection bias in the scheme as neither the farm size nor the social status of potential beneficiaries appeared significant in the sequential selection process. Further, the findings show that controlling for the farm and farmer characteristics, the DBT scheme has a positive and statistically significant impact on crop yield as well as net returns, but more on the latter implying its role in reduction in the cost of production. These findings imply the need to expand DBT scheme for its greater impact on farm income and inclusiveness. [ABSTRACT FROM AUTHOR]

Background: Maternal healthcare service utilization is a pivotal indicator of a nation's progress in safeguarding the health and well-being of its women and children. In this context, women's empowerment emerges as a critical determinant influencing the utilization of maternal healthcare services. The study aims to assess the relationship between women's level of empowerment and utilization of maternal healthcare services among currently married women in India. Data and Methods: The study uses data from the fifth round of the National Family Health Survey conducted in 2019–2021 and analyzed 26,552 (15–49 aged) currently married women who had a live birth in the last 5 years preceding the survey. Additionally, univariate and bivariate analyses, multivariate logistic regression, and the SWPER index were used for the analysis. Results: Over the years, utilization of antenatal care, skilled birth attainment, and postnatal care has increased extensively in India. However, the study found that utilization of services was higher among empowered women, and it varies across the state with the extent of empowerment. State-level analysis shows that the extent of women empowerment was higher in Goa, followed by Tamil Nadu and Kerala, and lower in Jharkhand, followed by Tripura, so as the utilization of maternal and health care services. The extent of empowerment and utilization of services also varies by level of educational attainment, employment, and socio-economic status. Conclusion: There is a need for comprehensive strategies to enhance women's empowerment through education, employment, political participation, self-awareness, and reduction in gender-based violence and child marriages, which may improve awareness demand for better public health structure, and may ensure higher utilization of maternal healthcare services. Ultimately, these strategies may converse the higher maternal death and child mortality. Significance: What is already known about this subject? Existing literature in India mostly highlights a clear connection between women's autonomy and maternal healthcare services utilization. Women with higher autonomy, decision-making power, and mobility are more likely to use these services. However, in exploring the link between women's empowerment and maternal healthcare, some studies focus on education, employment, and media access among Indian mothers, sidelining broader empowerment dimensions. What this study adds? This study is likely the first to investigate the relationship between women's empowerment and the level of maternal healthcare service utilization in India. It covers key dimensions of women's empowerment, including Attitude to Violence, Social Independence, and Decision-making Power. Moreover, it is possibly the first Indian research paper to employ a survey-based women's empowerment index in this context. Notably, the assessment highlights Social Independence as a significant dimension. [ABSTRACT FROM AUTHOR]

The present paper examines the significance of remittances by the male outmigrants on socio-economic development of the receipient households in a frequently drought affected Bankura district in the Rarh region of West Bengal State of India with particular emphasis on the varied impacts with respect to differential access to landholding or lack of it. As many as 185 out of a total of 756 households were randomly selected for collection of data with the help of a structured household schedule. Logistic regression model has been fitted to analyse the relation between the size of migrant remittances and important socio-economic determinants. The study revealed that the size of the remittance depends on nature and types of work undertaken by the migrants at the destination. Only a small proportion of the recipient migrant households utilized the remittances received by them for a single purpose though the majority used it for a multiple of purposes. Majority of the migrant households utilized the remittances for food consumption as well as to repay the loans taken by them before adopting migration as a strategy to improve their living. Outmigration for a short or longer period appears to be a successful strategy for these households to withstand chronic poverty suffered by the most marginalised segment while the somewhat better-off sections manages to further improve their living conditions with the help of remittances received. [ABSTRACT FROM AUTHOR]

According to census 2011, India had nearly 104 millions of 60 years and above population. The share is projected to increase from 8 per cent in 2015 to 29 per cent in 2050, which is a matter of concern as rapid population ageing is accompanied by serious social and economic implications which are often linked with different health outcomes in general and lower subjective well-being (SWB) in particular. This paper aims to focus on how socio-economic inequality affects lower SWB among older adults. Bivariate, binary logistic regression and decomposition analysis were used for carving out the results using data from the Building a Knowledge Base on Population Ageing in India (BKPAI). The effective sample size for the analysis was 9181 older adults. The value of the concentration index for lower SWB was -0.28 in India, depicting that lower SWB was concentrated among older adults with poor socio-economic status. Educational status (22%), living arrangement (13%), trust over someone (13%), self-rated health (6%), instrumental activities of daily living (6%) and cognitive ability (5%) explained significant portion of socio-economic inequality for lower SWB among older adults. Our research highlights the urgent need for more empirical exposure to socio-economic inequality and its dynamic impact on lower SWB among older adults. Moreover, the present study recommends strengthening the current government programme to focus especially on older adults from lower socio-economic status. [ABSTRACT FROM AUTHOR]

Introduction: Infant and child mortality are considered as one of the most important indicators of social and economic development of the nation. This paper intends to shed light on the prevalence of infant and under-five death rates with special reference to differentials in SCs, STs, and non-SCs/STs population in India. In addition, to determine the factors affecting child immunization and institutional delivery by different background characteristics. Data source and methods: The present study has used Census 2001 and 2011 for estimating the infant and under-five mortality. The National Family Health Survey (2015–16) has been used to assess the gaps in institutional delivery and coverage of child full immunization between SC, ST, and other caste population and also to assess the covariates of insitutional delivery and full immunization. Results: The study observed the high infant mortality rate and under-5 mortality among Scheduled Caste and Scheduled Tribe, while it is much lower among non-SC/ST population in 2011 census. The result of logistic regression suggests that caste has significant impact on access to institutional delivery and child immunization, adjusted for other socio-economic variables. All the castes are more likely to gain access to both institutional delivery and child immunization compared to scheduled tribe population. Conclusion: The study result shows the persistent poor health outcome among the SC/ST population in India. There is need to focus on this section of the population to achieve the sustainable development goals of child health and its core agenda "No one left behind". [ABSTRACT FROM AUTHOR]

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

Purpose: Using data on over 7500 units from the World Bank Enterprise Survey (WBES) for 2014, the paper assesses the impact of political connections on SME financing obstacles in India. Methodology: Since the dependent variable has a meaningful response order and involves several categories, it is appropriate to use the ordered logit model (OLM). We employ the OLM of the STATA program for the estimation process. Findings: The findings indicate that political connections help alleviate higher-order financing obstacles. In terms of magnitude, senior managers with political connections are 2.5 percentage points less likely to state that there are no financing obstacles, and about 1 percentage point is more likely to state it as a moderate or major obstacle. As well, they are 0.6 percentage point more likely to mention it as a severe obstacle. These results differ across firm ownership type (i.e., male-versus female-owned) and firm size classes and when additional state characteristics are taken on board. Limitations: The analysis is limited to a single year based on data availability. A much richer analysis would need to assess how such political connections play out over time and its consequences for SME behaviour. Second, our measure of political connection is indirect, since no other measure is reported in the data. Originality: To the best of our understanding, this is one of the earliest studies for a leading emerging economy to assess the interlinkage between SME behaviour and their political connections. [ABSTRACT FROM AUTHOR]

This paper describes overall socioeconomic gradients and the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multiple aspects of health. Cross-sectional data on 11,230 Indians aged 18 years and older from the WHO-SAGE India Wave 1, 2007 were analyzed. Multivariate logit models were estimated to examine effects of socioeconomic status (education and household wealth) and age on four health domains: self-rated health, self-reported functioning, chronic diseases, and biological health measures. Results show that socioeconomic status (SES) was negatively associated with prevalence of each health measure but with considerable heterogeneity across age groups. Results for hypertension and COPD were inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for biological markers. Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum. [ABSTRACT FROM AUTHOR]

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

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

This paper attempts to predict food shortages in advance from the analysis of rainfall during the monsoon months along with other inputs used for crop production, such as land used for cereal production, percentage of area covered under irrigation and fertiliser use. We used six binary classification data mining models viz., logistic regression, Multilayer Perceptron, kernel lab-Support Vector Machines, linear discriminant analysis, quadratic discriminant analysis and k-Nearest Neighbors Network, and found that linear discriminant analysis and kernel lab-Support Vector Machines are equally suitable for predicting per capita food shortage with 89.69 % accuracy in overall prediction and 92.06 % accuracy in predicting food shortage ( true negative rate). Advance information of food shortage can help policy makers to take remedial measures in order to prevent devastating consequences arising out of food non-availability. [ABSTRACT FROM AUTHOR]

In India, the rising double burden of diseases and the low fiscal capacity of the government forces people to resort to hardship financing. This study aimed to examine the factors contributing to the reduction in hardship financing among inpatient households in India. The study relies on two rounds of National Sample Surveys with a sample of 34,478 households from the 71st round (2014) and 56,681 households from the 75th round (2018). We employed multivariable logistic regression and multivariate decomposition analyses to explore the factors associated with hardship financing in Indian households with hospitalized member(s) and assess the contributing factors to the reduction in hardship financing between 2014 and 2018. Notably, though hardship financing for inpatient households has decreased between 2014 and 2018, households with catastrophic health expenditure (CHE) had higher odds of hardship financing than those without CHE. While factors such as CHE, prolonged hospitalization, and private hospitals had impoverishing effects on hardship financing in 2014 and 2018, the decomposition model showed the potential of CHE (32%), length of hospitalization (32%), and private hospitals (24%) to slow down this negative impact over time. The findings showed the potential for further improvements in financial health protection for inpatient care over time, and underscore the need for continuing efforts to strengthen the implementation of public programs and schemes in India such as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY). [ABSTRACT FROM AUTHOR]

India is committed to Millennium Development Goals regarding prenatal health but still the utilization of quality source of prenatal-care is lacking. In this paper an attempt has been made to examine the socioeconomic determinants of utilization of quality source of prenatal-care by the women in the age group of 15-49 years. Micro data having 25,896 observations from Indian Demographic Health Survey 2006 has been used. Binary logistic regression analysis is utilized to determine the association between the utilization of quality source of prenatal-care and explanatory variables categorized into demographic, socioeconomic, health and regional characteristics. Quality source of prenatal-care is defined as the prenatal-care taken from medical expert. The results have shown that age of woman at first marriage, husband's age, woman's education, husband's education, final say on woman's health-care by woman and husband collectively and husband alone, wealth index, female head of household, ever terminated pregnancy, household covered by insurance and husband's presence during prenatal visits increase the probability of utilization of quality source of prenatal-care. However, the combined family structure, birth-order of the child and living of the household in the town as compared the capital and large city decrease the probability of utilization of quality source of prenatal-care by Indian women. The implementation of law of minimum age for marriage, expansion in maternal health insurance, participation of husband in prenatal-care are proposed for enhancing the utilization of quality source of prenatal-care. [ABSTRACT FROM AUTHOR]

Objectives Few Indian studies have examined the relationship between birth size and stunting in children. Studies on recovery from stunting in India are even fewer. This study, thus, investigates the relationship between birth size and stunting in Andhra Pradesh, India. This study further examines the factors associated with recovery from stunting using a longitudinal data. Methods We used data from the three waves of Young Lives Study (YLS) conducted in Andhra Pradesh in the years 2002, 2006-2007, and 2009 respectively. We used data from 1965 children in wave 1 to examine the association between birth size and stunting. For examining the factors associated with recovery from stunting between 1 and 5 years of age, and between 5 and 8 years, we use data from 582 and 670 children who were stunted at age 1 and age 5 respectively. We use multivariable logistic regression models to fulfil the objectives of the paper. Results The children who were of average- or large- size at birth were significantly less likely to be stunted than children who were of small size at birth (OR 0.61 and 0.47 respectively). Children of average/tall mothers were 0.41 times less likely to be stunted than children of shorter mothers. Severely stunted children were less likely than other stunted children to recover from stunting between 1 and 5 years of age, and between 5 and 8 years. Mother's height was statistically associated with recovery. Change in wealth status of the household was statistically associated with recovery between 1 and 5 years of age. In comparison, child immunization was associated with recovery between 5 and 8 years. Conclusions for Practice This study contributes to the understanding of the impact of birth size on childhood stunting, and to the extent of recovery from stunting in India. Further follow-up is necessary to demonstrate the impact during adolescence and adulthood. [ABSTRACT FROM AUTHOR]

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

The first two years of life is a critical window for good nutrition. Promoting infant and young child feeding (IYCF) practices in the first two years can help improve child survival and promote healthy growth and development. Assessment of IYCF practices is important, especially in developing countries like India where optimal IYCF practices can potentially prevent 12% of all deaths under 5 years of age, to promote awareness and intervene appropriately. The objective of our study is to generate evidence for the association between different types of mass media and appropriate IYCF practices in India, including optimal breastfeeding and appropriate complementary feeding practices. A positive association between them can point to intervention at scale. We analyzed data from India's National Family Health Survey 5 (NFHS-5), 2019–2021. Multivariable logistic regression was used to examine the association of appropriate IYCF practices with mass media exposure. After controlling for demographics and socioeconomic status, the analyses showed that, overall, women who had exposure to television followed by newspaper and movies, had higher odds of adopting the recommended IYCF practices. The results also showed that the association of media exposure varied for different IYCF practices by geography. For instance, in the rural areas, television exposure was positively associated with all the IYCF practices, but in the urban areas, television exposure was positively associated with only early initiation of breastfeeding [OR 1.25; (95% CI 1.1–1.42)]. The study strengthens our understanding that an appropriate selection of mass media channels for intervention programs can promote IYCF practices at scale. Appropriately selecting the type of mass media to create awareness about different IYCF practices, in specific urban–rural settings, could help customize intervention programs to successfully influence IYCF behaviors. [ABSTRACT FROM AUTHOR]

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

Purpose: VISHRAM is a community-based mental health program to address psycho-social distress and risk factors for suicide in a predominantly rural population in Central India, through targeted interventions for the prevention and management of Depression and Alcohol Use Disorders (AUD). The evaluation was designed to assess the impact of program on the contact coverage of evidence-based treatments for depression and AUD through a repeated survey design. This paper describes the baseline prevalence of depression among adults in rural community, association of various demographic and socio-economic factors with depression and estimates contact coverage and costs of care for depression.Methods: Population-based cross-sectional survey of adults in 30 villages of Amravati district in Vidarbha region of Central India. The outcome of interest was a probable diagnosis of depression which was measured using the Patient Health Questionnaire (PHQ-9). Data were analyzed using simple and multiple logistic regression.Results: The outcome of current depression (PHQ-9 ≥ 10) was observed in 14.6 % of the sample (95 % CI 12.8-16.4 %). The contact coverage for current depression was only 4.3 % (95 % CI 1.5-7.1 %). Prevalence of depression varied greatly between the two sites of the study; higher age, female gender, lower education, economic status below poverty line and indebtedness were associated with depression; and while a contact coverage with formal health care was very low, a large proportion of affected persons had consulted family members.Conclusions: Our findings clearly indicate that psycho-social distress in rural communities in Maharashtra is strongly associated with social determinants such as gender, poverty and indebtedness and affects the entire population and not just farmers. [ABSTRACT FROM AUTHOR]

This paper examines the trends in economic inequality in infant mortality across urban-rural residence in India over last 14 years. We analysed data from the three successive rounds of the National Family Health Survey conducted in India during 1992-1993, 1998-1999, and 2005-2006. Asset-based household wealth index was used as the economic indicator for the study. Concentration index and pooled logistic regression analysis were applied to measure the extent of economic inequality in infant mortality in urban and rural India. Infant mortality rate differs considerably by urban-rural residence: infant mortality in rural India being substantially higher than that in urban India. The findings suggest that economic inequalities are higher in urban than in rural India in each of the three survey rounds. Pooled logistic regression results suggest that, in urban areas, infant mortality has declined by 22 % in poorest and 43 % in richest. In comparison, the decline is 29 and 32 % respectively in rural India. Economic inequality in infant mortality has widened more in urban than in rural India in the last two decades. [ABSTRACT FROM AUTHOR]

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

This paper reports the use of a GIS based Probabilistic Certainty Factor method to assess the geo-environmental factors that contribute to landslide susceptibility in Tevankarai Ar sub-watershed, Kodaikkanal. Landslide occurrences are a common phenomenon in the Tevankarai Ar sub-watershed, Kodaikkanal owing to rugged terrain at high altitude, high frequency of intense rainfall and rapidly expanding urban growth. The spatial database of the factors influencing landslides are compiled primarily from topographical maps, aerial photographs and satellite images. They are relief, slope, aspect, curvature, weathering, soil, land use, proximity to road and proximity to drainage. Certainty Factor Approach is used to study the interaction between the factors and the landslide, highlighting the importance of each factor in causing landslide. The results show that slope, aspect, soil and proximity to roads play important role in landslide susceptibility. The landslide susceptibility map is classified into five susceptible classes - low, very low, uncertain, high and very high − 93.32% of the study area falls under the stable category and 6.34% falls under the highly and very highly unstable category. The relative landslide density index (R index) is used to validate the landslide susceptibility map. R index increases with the increase in the susceptibility class. This shows that the factors selected for the study and susceptibility mapping using certainty factor are appropriate for the study area. Highly unstable zones show intense anthropogenic activities like high density settlement areas, and busy roads connecting the hill town and the plains. [ABSTRACT FROM AUTHOR]

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

Indian society suffers from substantial inequalities in education, employment, and income based on caste and ethnicity. Compensatory or positive discrimination policies reserve 15% of the seats in institutions of higher education and state and central government jobs for people of the lowest caste, the Scheduled Caste; 7.5% of the seats are reserved for the Scheduled Tribe. These programs have been strengthened by improved enforcement and increased funding in the 1990s. This positive discrimination has also generated popular backlash and on-the-ground sabotage of the programs. This paper examines the changes in educational attainment between various social groups for a period of nearly 20 years to see whether educational inequalities have declined over time. We use data from a large national sample survey of over 100,000 households for each of the four survey years--1983, 1987-1988, 1993-1994, and 1999-2000--and focus on the educational attainment of children and young adults aged 6-29. Our results show a declining gap between dalits, adivasis, and others in the odds of completing primary school. Such improvement is not seen for Muslims, a minority group that does not benefit from affirmative action. We find little improvement in inequality at the college level. Further, we do not find evidence that upper-income groups, the so-called creamy layer of dalits and adivasis, disproportionately benefit from the affirmative action programs at the expense of their lower-income counterparts. [ABSTRACT FROM AUTHOR]

The living arrangement is an essential social support mechanism affecting older adults' health and well-being. As the Indian family structure changes over time, India's older population needs detailed investigation for its well-being due to living arrangements. This study investigates the association between the change in living arrangements after reaching age 60 years with subjective well-being and psychological health among older adults in India. We used the survey data "Building Knowledge Base on Population Ageing" in India conducted in 2011. The effective sample size for the study was 9231 older adults. Descriptive and bivariate analysis was done to present sample distribution and unadjusted estimates, respectively. Ordered logistic regression analysis was performed to understand the association between the living arrangements of the older adults and their psychological health. The outcome variables were ordered as 0 "best", 1 "good", and 2 "worst". The results showed that older adults with a change in living arrangement after turning 60 years had a higher prevalence of poor psychological health (27.5%) and low subjective well-being (36%). It was found that older adults with change in living arrangement after turning old had 84% and 54% higher likelihood to report worst psychological health [AOR: 1.84; CI: 1.48–2.27] and worst subjective well-being [AOR: 1.54; CI: 1.22–1.93] compared to older adults who did not change their living arrangement after turning old. A change in old-age living arrangements is associated with older adults' psychological health and subjective well-being in India. Older adults with a change in living arrangements need special policy attention. [ABSTRACT FROM AUTHOR]

Climate change has increased hydrometeorological disasters all over the world. The increase in the occurrences of hydrometeorological disasters has brought into focus the preservation and protection of the coasts. This study, thus, makes a comprehensive assessment of the Puri district on the east coast of India, which is most affected by hydrometeorological disasters. We identify the hotspots by applying the analytical hierarchical process to the integrated coastal vulnerability index in ArcGIS. Further, employing the ordered logistic regression model, we identify the household characteristics determining disaster risk perception among the vulnerable households. Results tend to indicate that the region falling in and around Puri-Konark coastal belt are the most vulnerable ones. The households, which are economically deprived, engaged in the primary sector, and having more dependent members, perceive greater risks of hydrometeorological disasters. The proximity to the sea and river also increases their perceived risks. The findings suggest risk-mitigating efforts by prioritizing the needs of the poor and vulnerable communities while guaranteeing access to opportunities. [ABSTRACT FROM AUTHOR]

Purpose: Maternal depression is a major public health problem in low- and middle-income countries including India. Very few studies have assessed association of various risk factors with antenatal depression in rural Indian women, especially the effect of marital conflict, gender disadvantage and gender preference on antenatal depression. This paper describes the prevalence of probable antenatal depression in rural Maharashtra, a state in the western part of India and specifically assesses the association of marital and gender disadvantage factors and gender preference for a male child with antenatal depression.Methods: Primary Health Centre-based cross-sectional survey of antenatal women in rural Maharashtra was carried out. The outcome of interest was a probable diagnosis of depression in antenatal women which was measured using the Edinburgh postnatal depression scale (EPDS). Data were analyzed using simple and multiple logistic regression.Results: 302 women in their antenatal period were included in this study. The outcome of antenatal depression (EPDS > 12) was found in 51 women (16.9%, 95% CI 12.6-21.1%). Feeling pressurized to deliver a male child was strongly associated with the outcome of antenatal depression (adjusted odds ratio (OR): 3.0; 95% CI 1.4-6.5). Unsatisfactory reaction of in-laws to dowry (adjusted OR 11.2; 95% CI 2.4-52.9) and difficult relationship with in-laws (adjusted OR 5.3; 95% CI 2.4-11.6) were also significantly associated with antenatal depression.Conclusions: Our findings demonstrate that antenatal depression in rural women of Western Maharashtra is associated with gender disadvantage factors, especially related to preference for a male child. The agenda to improve maternal mental health should be ultimately linked to address the broader social development goals and gender empowerment. [ABSTRACT FROM AUTHOR]

Aim: Infectious diseases continue to be a significant impediment in the attainment of sustainable development goals related to health. A lack of essential household amenities and social determinants are the primary cause behind the outbreak of infectious diseases in LMICs. The current study aimed to examine the socio-demographic determinants of infectious diseases vis-à-vis basic household amenities in India. Subject and methods: This study was based on nationally representative data of 'Key indicators of Social Consumption in India: Health' conducted by the National Sample Survey Organisation between July 2017 and June 2018. The study measured the inicidence of various infectious diseases across basic household amenities and socio-demographic variables. Multivariate logistic regression is employed to analyse the association between the likelihood of a particular infectious disease and various intersectional variables. Results: The study findings reveal that the lack of household amenities such as access to a toilet, clean drinking water, garbage disposal and socio-economic determinants such as area of residence, gender, poverty and age have a significant impact on the incidence of infectious diseases in India. Among various infectious diseases jaundice, malaria and others, including tuberculosis and typhoid, dengue fever and chikungunya, have a relatively higher incidence. Approximately 22.32% of the population do not have proper toilet facility, 45.56% have proper tap water facility, while 50% either use water from spring/well or other unprotected sources and about half of the population do not have any arrangement for garbage disposal. Among socio-demographic determinants, incidence of infections is relatively higher in rural areas, other backward classes (OBCs), males, children, and adults. Conclusions: The study findings outlined that there is a need for better government interventions towards reducing the burden of infectious diseases in India, particularly in rural areas. [ABSTRACT FROM AUTHOR]

The study analyzes the individuals' risk management strategies and determinants of preparedness for drought in Madhya Pradesh, India. It employs the descriptive and binary logistic regression on primary data and show that more than one earning member, access to social safety schemes, migration, irrigation facilities and diversified employment are the important risk management strategies. Gender, social group, income, non-migration, employment status and the interaction of 'access to government schemes and gender' are the statistically significant determinants in order, increasing the odds of preparedness against droughts. However, in the sub-sample of farmers, the main predictor variables are gender, non-migration, social group, crop losses and income. The study is novel to generate the field evidences with respect to risk management and drought preparedness, making noteworthy contributions to the disaster literature. The results advocate to strengthen the outreach and access of the social safety schemes in the drought-affected areas. Individuals are expected to build self-resilience to cost-effectively supplement the government limited efforts and capacity. These findings are important and equally applicable to the governments, policymakers and individuals residing in the other drought-affected regions with similar socio-economic characteristics of respondents. [ABSTRACT FROM AUTHOR]

Purpose: Thyroid disorders are a major public health burden. Generally, women exhibit higher differentials in the prevalence of these disorders. This study focuses on the socio-economic and behavioural correlates of thyroid disorders along with their spatial clustering among women of reproductive age in India. Methods: The study uses dataset from the fourth National Family Health Survey (NFHS-4) carried out in 2015–16 to assess self-reported thyroid disorders. Poor–rich ratio (PRR) and concentration index (CI) were used to study the variation in thyroid disorder among women arising out of economic inequality. Moran's I statistics and bivariate local spatial autocorrelation (BiLISA) maps were used to understand spatial dependence and clustering of thyroid disorder. Spatial lag and error models were applied to examine the correlates of the disorder. Results: Thyroid disorder prevalence was higher among women from socio-economically better-off households. Adjusted effects showed that users of iodized salt were 1.14 times more likely to suffer from a thyroid disorder as compared to non-users, which is contrary to the general belief that a higher percentage of consumption of iodide salt leads to a lower prevalence of thyroid disorder. A higher autoregressive coefficient (0.71) indicated significantly higher spatial clustering in thyroid disorders. Conclusions: The prevalence of thyroid disorder in India depends appreciably on spatial and various ecological factors. Sedentary lifestyles among women may be aggravating diseases, which has strong linkage with thyroid disorders. It is strongly recommended to effectively integrate universal salt iodization with activities geared towards the elimination of iodine deficiency disorders. [ABSTRACT FROM AUTHOR]

Keeping in view the cascade of disturbances caused by the co-existence of multi-morbidity and depression among aged population, this study aims to ascertain the independent impact of multi-morbidity as a risk factor for the development of depressive symptoms among adults living in India. The present study utilizes data from the nationally representative survey "Longitudinal Ageing Study in India" (LASI, Wave-1, 2017–2018). The eligible sample size was 62,244 adults aged 45 years and above. Descriptive statistics along with bivariate analysis was used to understand the prevalence of depressive symptoms. Further, binary logistic regression and Propensity Score Matching (PSM) methods were applied to examine the independent effect of multi-morbidity on depressive symptoms while controlling the selected background characteristics. Overall, around one-third respondents had at least one chronic disease and one-fifth had multi-morbidity. The most prevalent chronic disease reported in the sampled population was hypertension followed by diabetes and joint disease. It is observed that older adults with multiple chronic diseases had 77% higher odds of having depressive symptoms as compared to those without a history of chronic disease in the multivariable logistic regression model. Results obtained from PSM indicate that the risk of having depressive symptoms was 3.7% higher for adults with multi- morbidity. Depressive symptom was identified to be associated with a wider range of multiple physical health problems and people with multi-morbidity are at a higher risk of having depressive symptoms. It is imperative that multi-morbidity can be used as a screener for identifying people with depressive symptoms. [ABSTRACT FROM AUTHOR]

Hypertension is a public health issue touted as a "silent killer" worldwide. The present study aimed to explore the sex differential in the association of anthropometric measures including body mass index, waist circumference, and waist-hip ratio with hypertension among older adults in India. The study used data from the Longitudinal Aging Study in India (LASI) conducted during 2017–18. The sample contains 15,098 males and 16,366 females aged 60 years and above. Descriptive statistics (percentages) along with bivariate analysis were presented. Multivariable binary logistic regression analyses were used to examine the associations between the outcome variable (hypertension) and putative risk or protective factors. About 33.9% of males and 38.2% of females aged 60 years and above suffered from hypertension. After adjusting for the socioeconomic, demographic and health-behavioral factors, the odds of hypertension were 1.37 times (CI: 1.27–1.47), significantly higher among older adults who were obese or overweight than those with no overweight/obese condition. Older adults with high-risk waist circumference and waist-hip ratio had 1.16 times (CI: 1.08–1.25) and 1.42 times (CI: 1.32–1.51) higher odds of suffering from hypertension, respectively compared to their counterparts with no high-risk waist circumference or waist-hip ratio. The interaction effects showed that older females with overweight/obesity [OR: 0.84; CI: 0.61–0.74], high-risk waist circumference [OR: 0.89; CI: 0.78–0.99], and high-risk waist-hip ratio [OR: 0.90; CI: 0.83–0.97] had a lower chance of suffering from hypertension than their male counterparts with the similar anthropometric status. The findings suggested a larger magnitude of the association between obesity, high-risk waist circumference, high-risk waist-hip ratio and prevalent hypertension among older males than females. The study also highlights the importance of measuring obesity and central adiposity in older individuals and using such measures as screening tools for timely identification of hypertension. [ABSTRACT FROM AUTHOR]

Aim: The high incidence of acute respiratory infection (ARI)-related morbidity and mortality is a major public health concern in developing countries. This study aimed to quantify regional inequalities and the degree of association between childhood ARI and background factors. Methods: This study utilised information of 238 945 children aged below five years extracted from the Fourth Indian National Family Health Survey conducted in 2015–16. Inter-state and regional inequality in the prevalence of ARI were quantified and presented using a map of India and forest plot. The association of background characteristics and ARI was quantified using bivariate and multivariable binary logistic regression models. Results: Significant inequalities in the prevalence of childhood ARI were observed across the six regions of India. Considering the children from north-east region as a reference, those from north, central and east regions were 0.68, 1.02 and 0.57 times more likely to suffer from ARI. Comorbidity, sex, age and nutritional status of children were significantly associated with the prevalence of ARI. Conclusions: ARI remains a significant public health concern among Indian children. The results of this study showed that significant regional disparities in the prevalence of ARI exist in India. This study adds value to the better understanding of inequality patterns and quantifies within- and intra-region inequalities in the prevalence of ARI in India. [ABSTRACT FROM AUTHOR]

Summary: 'Indigenous peoples' across the globe suffer a disproportionate burden of mental illness. However, this burden is not fully explored in India despite having the second largest absolute concentration of indigenous peoples in the world. We did a secondary analysis of data from a cross-sectional survey in indigenous populations from the Nilgiri Biosphere Reserve in South India. Symptoms suggestive of psychological distress were reported by 39.9% participants. Being alone, tobacco use, hypertension, hypertension in family member, and violent conflict in household were independently associated with psychological distress. More epidemiological studies need to be conducted to map the burden and elaborate the relationships between mental health problems and socio-cultural factors in indigenous populations in India. [ABSTRACT FROM AUTHOR]

Background: India is undergoing a huge demographic and epidemiological change, resulting in an increase in population ageing. With this, the number of people with co-existence of multiple chronic diseases is also set to rise. The present study aims to identify gender differential in the most prevalent combinations of chronic conditions among the elderly living with multimorbidity in India. This study also examines the factors affecting multimorbidity status among the Indian elderly. This study used the data from Building a Knowledge Base on Population Ageing in India (BKPAI), conducted in 2011. The presence or not of multimorbidity was considered as the outcome variable. The bivariate and logistic regression analysis was done to access the pattern and predictors of multimorbidity among the elderly. The relative risk of having different chronic conditions were calculated among the population with multimorbidity. The prevalence of most prevalent disease combinations among the overall population and multimorbidity group was also calculated. The overall prevalence of multimorbidity among the elderly was 32.96% and higher among women (34.69%). The most prevalent diseases among respondents with multimorbidity conditions were arthritis or rheumatism (54.75%), hypertension (45.79%), loss of all-natural teeth (32.94%), cataract (31.34%), diabetes (23.01%) and asthma (21.06%). The prevalence of arthritis or rheumatism, diabetes and hypertension were higher among women in the multimorbidity group than men of the same group. The relative risks for conditions like dementia, loss of all-natural teeth, depression, cerebral embolism, stroke or thrombosis and osteoporosis are higher in the multimorbidity group. Hence these conditions have a higher possibility to co-exist with other chronic conditions. The most prevalent combination of diseases in the multimorbidity group was arthritis, rheumatism or osteoarthritis, hypertension, and cataract (4.68%). The prevalence of this combination is higher among women than men (women: 5.79%, men: 3.30%). Age, gender, religion, wealth quintile, current working status, smoking, alcohol were significant determinants of multimorbidity among the elderly. Multimorbidity is an emerging issue and highly associated with ageing. There lie gender differences in the combination of diseases and their prevalence. Therefore, there is a need to strengthen healthcare services for both men and women using gender-specific analysis as both genders have different priorities regarding healthcare utilisation. One of the relevant implications based on our findings is that researchers and policymakers need to work together to develop effective intervention strategies separately for men and women, which will help to reduce the burden of multimorbidity in the population. [ABSTRACT FROM AUTHOR]

The modernization and shift towards urbanized lifestyles have triggered several diseases, and the context of aging varies in urban and rural settings in India. The study aimed to investigate the urban–rural differences in successful ageing among older adults in India and the contributing factors in those differences. The study utilizes data from nationally representative Longitudinal Ageing Study in India (LASI, 2017–18). The analytical sample size for the study was 31,464 older adults aged 60 years and above. Descriptive statistics and bivariate analysis were carried out to present the initial results. Multivariable logistic regression and decomposition analysis was used to find the associations between explanatory variables and successful aging and to identify the contributions of covariates that explain the rural–urban differences in successful ageing. A proportion of 32% and 24% of older adults from rural and urban areas were successful agers with an urban disadvantage. Urban-dwelling older adults had 0.67 times [95% confidence interval (CI): (0.64, 0.71)] lower unadjusted odds of successful ageing than rural older adults. Again, after adjusting for the effect of other explanatory variables, urban older adults had 0.92 times [CI: (0.87, 0.98)] lower odds of being successful agers than their rural counterparts. The major contributors to the rural–urban inequality in successful aging were differences in regional distribution (17% contribution), waist circumference (16%), working status (16%), body mass index (13%) and physical activity (8%) among rural and urban older adults. The urban disadvantage in aging successfully may reflect the higher prevalence of adverse lifestyle behaviours in urban dwellers and under-diagnosis and under-reporting of many diseases in rural areas, particularly non-communicable diseases, suggesting the need for further investigation. [ABSTRACT FROM AUTHOR]

Aims: Healthcare utilization is a major challenge for low- and middle-income countries, especially for the publicly funded facilities. The study has tried to explore the women's opinion behind the non-utilization of public healthcare facilities in India. Subjects and methods: This was a cross-sectional study using nationally representative samples of 351,625 women of reproductive age (15–49 years) from the 29 States and seven Union Territories. Indian National Family Health Surveys NFHS-4 (2015–2016) was the data source. The respondents were asked why the members of their households do not utilize public healthcare facilities when members of their households are sick. They have options to respond either 'yes' or 'no'. Five reasons for non-utilization of public healthcare were asked: (i) 'there is no nearby facility'; (ii) 'facility timing is not convenient'; (iii) 'health personnel are often absent'; (iv) 'waiting time is too long'; and (v) 'poor quality of care'. Results: The majority of the women in India (88%) said that their family members did not use public healthcare facilities. The reasons behind this were 'no nearby facilities' (42.4%), 'inconvenient facility timing' (29.6%), 'poor quality of care' (52.3%), 'health personnel often absent' (16.8%) and 'long waiting time' (39.9%). Conclusions: importantly, during the last 10 years, the utilization of public health care facilities has dropped significantly, which should be taken seriously as the Indian Parliament has been placing emphasis on equity. [ABSTRACT FROM AUTHOR]

The market for corporate control offers a rich framework to study the interaction between investment and financing decisions. Do corporations have specific preferences for the means of financing acquisitions, such using cash or equity to pay the claims of the target firm's shareholders? This study builds a unique sample of 1041 corporate acquisitions over the period 2000–2018 in India, a major emerging economy with fast-growing capital markets. The study investigates separately corporate preferences for the means of payment and the financing sources for acquisitions, using multinomial logit and nested logit models. First, we find that different factors explain the payment and financing decisions. Second, the cash payment decision is best explained by the target's relative size, greater tender offers, cross-border deals, and cash reserves. Third, the findings are most aligned with pecking order theory and cost of capital considerations. [ABSTRACT FROM AUTHOR]

Background: Rising obesity epidemic and dyslipidemia majorly contribute to cardiovascular disease burden. Emerging evidence has reported an increasing trend of metabolic disorders among rural tribal populations in developing countries. Hence, the present study attempts to estimate the prevalence of obesity and dyslipidemia and explore their association among Bhil tribal population from India. Materials and methods: This was a cross-sectional study consisting of 277 adults recruited through household survey. Data on socio-demographic and lifestyle variables were collected and obesity was determined using anthropometric measurements. Biochemical assay was done using fasting blood samples. Logistic regression was employed to identify obesity variables associated with dyslipidemia. Results: Almost 40% of the population had generalized obesity (high BMI) while abdominal obesity was found to be relatively higher in terms of WHR (76.9%) followed by WHtR (59.2%) and WC (44.8%). Dyslipidemia in form of low HDL-C was found to be highest (52.3%) followed by high TG (40.8%), TC (7.9%), and LDL-C (6.5%). Sex-wise distribution of obesity and dyslipidemia variables revealed women were significantly more obese and dyslipidemic (low HDL-C) as compared to men. Logistic regression analysis after controlling for confounders revealed a significant association of abdominal obesity with all abnormal lipids except for high TG. Conclusion: The observed high prevalence of obesity and dyslipidemia, particularly low HDL-C and hypertriglyceridemia, warrants a public health concern. This study emphasizes the need for population-specific disease documentation to highlight underlying mechanisms of risk factors and to set forth a targeted approach to disease treatment and management. [ABSTRACT FROM AUTHOR]

Purpose: Our objective is to identify the predictive factors and predict hospital length of stay (LOS) in dengue patients, for efficient utilization of hospital resources. Methods: We collected 1360 medical patient records of confirmed dengue infection from 2012 to 2017 at Max group of hospitals in India. We applied two different data mining algorithms, logistic regression (LR) with elastic-net, and random forest to extract predictive factors and predict the LOS. We used an area under the curve (AUC), sensitivity, and specificity to evaluate the performance of the classifiers. Results: The classifiers performed well, with logistic regression (LR) with elastic-net providing an AUC score of 0.75 and random forest providing a score of 0.72. Out of 1148 patients, 364 (32%) patients had prolonged length of stay (LOS) (> 5 days) and overall hospitalization mean was 4.03 ± 2.44 days (median ± IQR). The highest number of dengue cases belonged to the age group of 10-20 years (21.1%) with a male predominance. Moreover, the study showed that blood transfusion, emergency admission, assisted ventilation, low haemoglobin, high total leucocyte count (TLC), low or high haematocrit, and low lymphocytes have a significant correlation with prolonged LOS. Conclusion: Our findings demonstrated that the logistic regression with elastic-net was the best fit with an AUC of 0.75 and there is a significant association between LOS greater than five days and identified patient-specific variables. This method can identify the patients at highest risks and help focus time and resources. [ABSTRACT FROM AUTHOR]

Background: Communication in emergency departments (ED) in India is complicated by the country's immense language diversity. Prior research has revealed challenges in language and communication as barriers to care. Our objective was to quantify language diversity among clinicians in Indian EDs and better understand issues related to clinician-clinician and clinician-patient communication. Methodology: A cross-sectional survey of ED clinicians was conducted. Survey participants were recruited in-person and through email at six partner sites in India. ANOVA and binary logistic regression were used for subgroup analysis. Semi-structured interviews were conducted with ED clinicians. Interview data was analyzed using the rapid assessment process to determine predominant themes. Results: 106 clinicians completed the survey. On average, clinicians spoke 3.75 languages. Seventy-one percent used a non-English language to speak to fellow clinicians most of the time, and 53% reported at least one critical incident over the last year where poor communication played a part. Interviews revealed challenges including low health literacy, high patient volume, and workplace hierarchy. Conclusions: This study is the first to document the impact of language diversity and communication barriers in Indian EDs. The results highlight the need for effective strategies to improve communication between the multiple languages spoken by clinicians and patients. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the impact of COVID-19 on sexual, mental and physical health. There were 262 respondents included in this study (38% female and 62% male) above 18 years of age from India. Statistical analysis was performed using Ordinary Least Squares (OLS) based on multivariate logistic regression analysis. The numerical tests were performed by using Python 3 engine and R-squared (coefficient of multiple determinations for multiple regressions) for prediction and P value > 0.5 is considered to be statistically significant. The study outcomes were obtained using a study-specific questionnaire to assess the quality of sex life, changes in sexual behavior and mental health. Frequency of sexual intercourse, frequency of watching porn, sexual hygiene, frequency of physical activity, depression, desire for parenthood in female respondents have more significant R2 (0.903, 0.976, 0.973, 0.989, 0.985, 0.862) value respectively as compared to male respondents. Financial anxiety, Smoking and drinking habits in male respondents have more significant R2 (0.917, 0.964) value respectively as compared to female respondents. The aim of this study is to understand quality of sex life, sexual behavior, reproductive planning, mental health, physical health and adult coping during the COVID-19 pandemic, as well as how past experiences have affected. Many respondents had a broad variety of problems concerning their sexual and reproductive well being. Measures should be set in order to safeguard the mental and sexual health of people during the pandemic. [ABSTRACT FROM AUTHOR]

Geogenic arsenic contamination in groundwaters poses a severe health risk to hundreds of millions of people globally. Notwithstanding the particular risks to exposed populations in the Indian sub-continent, at the time of writing, there was a paucity of geostatistically based models of the spatial distribution of groundwater hazard in India. In this study, we used logistic regression models of secondary groundwater arsenic data with research-informed secondary soil, climate and topographic variables as principal predictors generate hazard and risk maps of groundwater arsenic at a resolution of 1 km across Gujarat State. By combining models based on different arsenic concentrations, we have generated a pseudo-contour map of groundwater arsenic concentrations, which indicates greater arsenic hazard (> 10 μg/L) in the northwest, northeast and south-east parts of Kachchh District as well as northwest and southwest Banas Kantha District. The total number of people living in areas in Gujarat with groundwater arsenic concentration exceeding 10 μg/L is estimated to be around 122,000, of which we estimate approximately 49,000 people consume groundwater exceeding 10 µg/L. Using simple previously published dose–response relationships, this is estimated to have given rise to 700 (prevalence) cases of skin cancer and around 10 cases of premature avoidable mortality/annum from internal (lung, liver, bladder) cancers—that latter value is on the order of just 0.001% of internal cancers in Gujarat, reflecting the relative low groundwater arsenic hazard in Gujarat State. [ABSTRACT FROM AUTHOR]

Soil erosion is one of the major environmental hazards causing severe land degradation in the sub-tropical monsoon dominated Mayurakshi river basin (MRB) of Eastern India. Hence, this study aims to delineate the areas with severe soil erosion probability (SEP) using logistic regression (LR), decision tree (DT), and Random forest (RF). A soil erosion inventory map was prepared using 150 rill and gully erosion prone sites, out of which 70% sample points were randomly chosen for modelling and remaining 30% sites were used for model validation. Alongside, 12 conditioning factors including elevation, curvature, aspect, runoff, TWI, slope, geology, stream frequency, rainfall erosivity, NDVI, LS-factor, and LULC were selected as spatial data base for model building. Multicollinearity among conditioning factors were performed using tolerance (TOL) and variance inflation factor (VIF). The analysis concludes that the possibility of soil erosion is very high in the undulating western parts of Mayurakshi river basin as compared to other sectors. The validation results obtained from ROC curve and kappa statistics is showing that DT and RF reached a higher prediction accuracy than LR model. [ABSTRACT FROM AUTHOR]

In the tribal region, risk of death among neonates is influenced to a great extent by factors related to the mother such as situation of the mother prior to and post pregnancy, care received before, during and after pregnancy, birth order, and care received by the child during the first few years of his/her life. There is paucity of basic epidemiological data on reproductive health outcomes of displaced people (Hynes et al. in JAMA 288(5):595–603, 2002). Therefore, this study aims to examine the social factors responsible for neonatal deaths among displaced tribal communities in India. Sequential exploratory study design was used to collect data from displaced tribal communities in the state of Odisha and Chhattisgarh during 2016–2017. A purposive sampling method was used to select the sample from the definite population. Results indicate that in total 115 (59.3%) women had experienced at least one child deaths. Analysis of neonatal deaths suggests that about 39.2% women experienced at least one or more neonatal death during the last 5 years. Women who chose to deliver at home experience higher neonatal deaths (47.1%) in comparison to the women who delivered at the health facility (26.0%). The logistic regression analysis indicate that mothers education, place of delivery, utilization of the services, possession of Below Poverty Line (BPL) card and Particularly Vulnerable Tribal Group (PVTG) status are significant predictors of neonatal mortality. The probability of occurrence of neonatal mortality is 60% lower for literate women as compared to the illiterate women. Findings of the study identified three phases of delay that affect displaced tribal women in accessing and receiving health care services. Displaced tribal women are late in recognizing health problems of neonates and delay in seeking medical care due to rooted cultural barriers. Women who participated in this study had low levels of risk perception about delivering children at home and visiting traditional healer for the treatment. This is mainly due to their personal experiences of uneventful deliveries conducted by mothers-in-law or Traditional Birth Attendants (TBA) and sociocultural beliefs. There is need for provision of culturally sensitive instruction to service providers. This would further motivate service providers to sensitize the displaced tribal communities on various free healthcare services available to them. [ABSTRACT FROM AUTHOR]

India is the home of more than 253 million adolescents, which account for almost 21% of the country's population. In the recent past, there has been a rise in the prevalence of mental illness and maladaptive behaviours among adolescents living in slum populations, which are increasing at an alarming rate in many developing countries, mainly due to rural–urban migration, are characterized by poverty, poor housing, overcrowding, poor environment, and high prevalence of communicable diseases. This neglected population has become a major reservoir for a broad spectrum of adverse health conditions. Studies on the mental health status among adolescents in India are relatively scarce. The main objective of the study was to estimate the prevalence of mental health disorder and its determinants among adolescents in slum settings in Lucknow, India; by using GHQ-12. The study used cross-sectional primary data which was collected in 2015–2016 from the adolescents living in various slums of Lucknow city. About 590 adolescents whose parents gave consent to participate were included in the study. Descriptive statistics, Chi square test and ordered logistic regression analysis (OLR) technique were used to assess the mental health. Reliability of GHQ-12 was assessed before performing the analysis which was found to be 0.79. Approximately, 33% of adolescents were found to suffer from severe level of mental disorder. The results of this study depicts that adolescents of age 12–15 years had more severe mental health problems compares to 16–19 years of adolescents. Females were more likely to suffer from severe mental health problems compared to moderate/normal mental health problems (OR 1.72; p < 0.001). Odds of severe mental health problems was significantly higher among Muslims (OR 1.66; p < 0.001) than Hindus. Thus, it was found that age, gender, education, caste, household economic status, media exposure and religion to be significantly associated with mental health problem. Government should provide a wide range of adolescent friendly health services (clinical, mental, nutritional, including counselling) in these slums for a better adolescent health outcome. [ABSTRACT FROM AUTHOR]

The present study assessed the extent to which the gully erosion susceptibility could be successfully modeled in Mayurakshi river basin as a function of four gully controlling factor clusters (topographical, erosivity, erodibility, and resisting). Gully erosion zones have been identified through two different models (correlation matrix and logistic regression) incorporating 15 conditioning indicators. Both the models have generated quite identical result regarding gully erosion susceptibility. It illustrates that extreme erosion-susceptible zones cover almost 16% of the basin area followed by high susceptibility with almost 28% areal coverage. This susceptibility is dominantly confined within the upper catchment. Older and newer alluvial plains of the lower catchment belong to low susceptibility to relatively safe situation. Models are validated by constructing ROC curve and calculating Kappa statistics. Both the approaches certified the validity of the models. The factor clustering shows that the positively influencing clusters like erosivity factors and erodibility factors are playing a dominant role with, respectively, 76 and 75% correlation with gully erosion susceptibility, whereas the resistant factors achieved only 32% correlation which denotes week significance due to containing sparse vegetation cover having low canopy density as well as poor crop management and conservation practice. [ABSTRACT FROM AUTHOR]

Purpose: To assess the dietary inadequacies of micronutrients and the associated factors among the apparently healthy urban adults. Methods: This community-based cross-sectional study involved 300 urban adults (distributed into age groups: 21–40, 41–60, and > 60 years) residing in Hyderabad city, South India. Hemoglobin in whole blood, ferritin, folate, and vitamin B12 (B12) in plasma was estimated. Dietary intakes were assessed by three 24-h dietary recalls and calculated the probability of adequacy (PA) using estimated average requirement. Results: The prevalence of anemia (30%), iron deficiency (ID, 23%), and iron deficiency anemia (IDA, 14.3%) was independent of age but higher in women. While folate deficiency (32.2%) was independent of age and gender, B12 deficiency (35.5%) varied by both age and gender. The PA of iron (89%) was higher, while that of folate, B12, and zinc (1–11%) were noticeably low. The mean PA (MPA) across the ten micronutrients was 38%, independent of age and gender, but associated with the educational status. Energy intake was a strong predictor of the MPA. Cereals and millets predominantly contributed to the intake of thiamine, niacin, zinc, and iron; green leafy vegetables and fruits to vitamins A, C, folate, and iron; animal foods to B12; and milk and milk products to calcium, vitamin A, riboflavin, and B12. The unadjusted and adjusted logistic regression models revealed that micronutrient inadequacy was associated with greater risk of IDA and folate deficiency. Conclusions: These results indicate a higher prevalence of micronutrient deficiencies among the healthy urban adults possibly due to the inadequacy of multiple micronutrients. [ABSTRACT FROM AUTHOR]