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A diagnosis of autism typically depends on clinical assessments by highly trained professionals. This high resource demand poses a challenge in low-resource settings. Digital assessment of neurodevelopmental symptoms by non-specialists provides a potential avenue to address this challenge. This cross-sectional case-control field study establishes proof of principle for such a digital assessment. We developed and tested an app, START, that can be administered by non-specialists to assess autism phenotypic domains (social, sensory, motor) through child performance and parent reports. N = 131 children (2-7 years old; 48 autistic, 43 intellectually disabled and 40 non-autistic typically developing) from low-resource settings in Delhi-NCR, India were assessed using START in home settings by non-specialist health workers. The two groups of children with neurodevelopmental disorders manifested lower social preference, greater sensory interest and lower fine-motor accuracy compared to their typically developing counterparts. Parent report further distinguished autistic from non-autistic children. Machine-learning analysis combining all START-derived measures demonstrated 78% classification accuracy for the three groups. Qualitative analysis of the interviews with health workers and families of the participants demonstrated high acceptability and feasibility of the app. These results provide feasibility, acceptability and proof of principle for START, and demonstrate the potential of a scalable, mobile tool for assessing neurodevelopmental conditions in low-resource settings.

Adult learning involves the analysis and synthesis of knowledge to become competent, which cannot be assessed only by traditional assessment tool and didactic learning methods. Stimulation of higher domains of cognitive learning needs to be inculcated to reach a better understanding of the subject rather than traditional assessment tools that relies primarily on rote learning. So, there is need for an alternative assessment tool. Hence, we conducted a study where we used case-based examination methodology. This study was conducted on 226 1st year MBBS students in Maulana Azad Medical College, New Delhi (India). Based on their compiled internal assessment marks according to monthly formative assessment, students were categorized into 3 groups (I: 0-7; II: 8-14; III: 15-20) marks out of 20 marks respectively. Two sets of question papers were set by three examiners, on the same topics carrying 50 marks each. The first set was based on traditional assessment tool (Paper-A) with recall questions and second set on case-based assessment method (Paper-B). Out of 226 students, 146 were males and 80 were females. For all groups, marks (mean ± SD) in Paper B were found to be higher (18.40 ± 4.29, 30.01 ± 4.12, and 40.33 ± 1.15) as compared to paper A (10.88 ± 4.34, 21.96 ± 7.34, and 31.50 ± 6.94) respectively. However, we found that there was significant (p < 0.001) difference in group I & II, whereas with group III, difference was found to be insignificant. Hence, we concluded that students performed better in case-based assessment rather than traditional method due to their direct involvement. Thus, for better memory and deeper learning the subjects can be assessed by case-based assessment method.

Purpose: With the advent of the COVID-19 and increased access to Internet technologies, students tend to use e-learning technologies for improved academic results, and since then, improving student engagement in a virtual space became a difficult task for educational institutions globally. The present study aims to examine the effect of key e-learning factors (i.e. perception, hedonic motivation (HM), usefulness, empowerment and attitude) on student engagement among open and distance learners (ODLs) of the central region of India. Design/methodology/approach: Simple random sampling was applied to collect data from ODLs of Chhattisgarh. ODLs who are using e-learning platforms for at least one year were chosen to be the participant in the study. The authors collected 1,137 responses using both online and offline modes of collection. Findings: The test results indicated that usefulness, HM and attitude factors were found to have a significant relationship with student engagement in e-learning, while perception and empowerment variables did not contribute to the engagement of students. Originality/value: The present study is novel in its approach. It clarifies the key factors to student engagement which might increase the students' level of involvement in e-learning technologies, if these factors are addressed tactfully by the educational institutions or concerned administration.

Purpose: Students' perception towards learning technologies in the disruptive times like coronavirus disease (2019) COVID-19 is what the educational institutes are striving to know so that the educational institutes could provide the best learning experiences to students. The present study attempts to identify the technology-enhanced learning (TEL) factors (i.e. informational quality, compatibility, resource availability, self-efficacy, subjective norms, subject interest and informational quality) with the mediation effect of perceived benefits on student satisfaction to TEL amongst non-technical students of different college/universities at Chhattisgarh state. Design/methodology/approach: Purposive sampling technique with "criterion variable" was applied to collect responses from 600 participants. Students, who are enrolled in non-technical courses at different colleges/universities, were participated in the present study. The data collection process was completed during April--November 2019. Findings: The results revealed that perceived benefits to TEL were significantly and positively mediated between all the TEL factors (i.e. information quality, compatibility, resource availability, self-efficacy, subjective norms, subject interest and institutional branding) and student satisfaction to TEL. Originality/value: The present study itself is a novel study by taking TEL factors such as informational quality, compatibility, resource availability, self-efficacy, subjective norms, subject interest and institutional branding by considering perceived benefits as mediator to examine the influence on student satisfaction to TEL.

Purpose: Technology-enhanced learning (TEL), undoubtedly, creates a big difference in higher education students' knowledge and growth, which helps them become globally competitive in the job market eventually. The present study aims to investigate the effect of various factors, i.e. informational quality, compatibility, resource availability, subjective norms, subject interest, institutional branding and self-efficacy on students' adoption intention to TEL enrolled in different government and private educational institutes in Chhattisgarh state. Design/methodology/approach: The primary data were collected from 600 students from different universities and colleges using purposive sampling technique with "criterion sampling". Hierarchical multiple regression (stepwise) analysis was used on the collected data. Findings: Results concluded that factors, i.e. compatibility, resource availability, subjective norms, subject interest and institutional branding are significantly and positively influencing students' adoption intention to TEL in Chhattisgarh, whereas self-efficacy and informational quality of TEL did not contribute significant effect for students' adoption intention. Originality/value: There is a lack of research in the knowledge domain, especially in the field of TEL, in the state of Chhattisgarh. The different variables taken in the present study, such as informational quality, self-efficacy, institutional branding, subjective norms, resource availability, compatibility and subject interest of TEL, are the first of its kind where these variables are being examined on the students' adoption intention to TEL.

Purpose: Providing quality education with the help of technologies in order to create global competitiveness among the students is the current trend in the education field. This research attempts to investigate following objectives: (1) the effect of students' perceived benefits and adoption intention of technology-enhanced learning (TEL) on their satisfaction; (2) the effect of students' perceived benefits of TEL on their adoption intention of TEL; (3) the mediating and moderating effect of students' perceived benefits of TEL in the link between students' adoption intention and satisfaction to TEL. Design/methodology/approach: The primary data were collected from 600 undergraduate and postgraduate students, particularly those who are using TEL for at least one year. The authors used purposive sampling technique with "criterion variable". Findings: Results indicated that students' perceived benefits and adoption intention of TEL have significant and positive influence on their satisfaction. Direct effect was also found between perceived benefits and adoption intention of students. Authors also concluded that mediating and moderating effect of students' perceived benefits of TEL in the link between students' adoption intention and satisfaction for TEL was found significant and positive. Originality/value: There is a huge lack of empirical studies available in the knowledge domain explaining the significance and implication of TEL in higher education in the state of Chhattisgarh, India.

In this paper, we identify factors which improve the quality of technical education using the data from World Bank's Technical Education Quality Improvement Programme (TEQIP) in India. We evaluate the success of TEQIP in improving the quality of technical education in the country. Our findings show significant impact of this intervention on the quality of the technical education. The design, strategy, and implementation of TEQIP have crucial lessons for developing countries who want to build their technical education sector for rapid economic growth.

Background: There has been little research conducted within developing nations examining the link between knowledge and diet-related perceptions and behaviors. In addition, prior investigations have rarely examined interrelationships between knowledge and other nutrition-related factors. Purpose: This study explored the relationship between nutrition knowledge, social/informational factors, and diet-related outcomes among Indian adults with multiple chronic conditions. Methods: A snowball sampling technique was employed to recruit individuals. Hierarchical regression analysis was employed to examine mediating and moderating relationships. Results: Results from a cross-sectional survey indicated that knowledge only predicted use among those reporting greater pressure/concern from close others. Furthermore, social support and social trust were found to moderate the relationship between knowledge and diet-related perceptions and behaviors. Discussion: Results suggest that social factors may play a critical role in moderating the impact of nutrition knowledge on diet-related perceptions and behaviors. Translation to Health Education Practice: Public Health Education interventions targeting developing nations should aim to maximize consumers' nutrition knowledge while identifying valued close others who can help encourage positive health action. Furthermore, Health Educators as well as government and local communities must engage in outreach efforts to reinforce or, if necessary, change public perceptions regarding the food industry.

We evaluate the impact of educational reforms starting from the mid-1990s in India on the school attendance rate of low-income rural children aged 6-14 compared to ineligible rural children, employing NSSO data from 1983 to 2004/2005. We estimate a triple difference model allowing for differential (linear) trends and find a positive causal effect of school reforms on the school attendance rate of rural low-income children, although somewhat stronger for girls than boys. For both girls and boys in these groups, the increase in attendance rate is driven by the 6-11 age category and by children of scheduled tribe or scheduled caste background.

Applies a functional perspective to examine aspects of lexical style in English-language Indian newspapers and to explore the dynamics of Indian nativization of English. Findings reveal that the sociocultural constraints of the native situation significantly affect lexicology, with variations influenced more by situations than by language competency. (21 references) (Author/CB)

Objective: In India research on health issues of transgender populations are very recent and limited though transgenders are an important sub-group of the population. Hence, this study attempts to understand the state of transgender health research in India through a systematic review of literature. Methods: A systematic literature review was conducted using bibliometric analysis. Initially, 132 studies were identified, and only 37 articles meeting selection criteria were subsequently selected for review using PRISMA 2020 guidelines. The research landscape was examined with tools such as Biblioshiny, Arc-GIS (10.1), and Vos-Viewer. Results: The review highlights that existing literature on transgender health in India mainly focuses on sexual health while neglecting their overall health status. It also emphasises the skewed geographical coverage of these studies. Based on the analysis, the interdisciplinary nature of the subject is illustrated in a three-field plot and through term co-occurrence. These indicate the need for culture-specific gender-affirmative services promoting a holistic approach to comprehend the health of transgender populations in India. Conclusion: In India research on transgender health is lopsided and at an initial stage. There is a need to develop diverse research focus on various health issues of transgenders that should also be geographically representative. Future in-depth research on this subject will enable optimizing resource allocation, developing effective gender-inclusive policies, and support holistic planning for better health status of transgender people in India, and other countries with similar socio-cultural background. [ABSTRACT FROM AUTHOR]

Recurrent aphthous stomatitis (RAS) is characterized by painful, oral mucosal ulcers with wide range of prevalence ranging from 2 to 78%. Etiology of RAS is idiopathic and multifactorial. There are numerous gaps in assessment and management of RAS and the absence of guidelines or a consensus document makes the treatment further difficult. The aim of this document is to provide an Indian expert consensus for management of RAS. Experts from different specialties such as Otorhinolaryngology, Oral Medicine/Dentistry and Internal Medicine from India were invited for face to face and online meetings. After a deliberate discussion of current literature, evidence and clinical practice during advisory meetings, experts developed a consensus for management of RAS. We identify that the prevalence of RAS may lie between 2 and 5%. In defining RAS, we advocate three or more recurrences of aphthous ulcers per year as criterion for RAS. Investigation should include basic hematological (complete blood count) and nutritional (serum vitamin B12, and iron studies) parameters. Primary aim of treatment is to reduce the pain, accelerate ulcer healing, reduce the recurrences and improve the quality of life. In treating RAS, initial choice of medications is determined by pain intensity, number and size of ulcers and previous number of recurrences. Topical and systemic agents can be used in combination for effective relief. In conclusion, this consensus will help physicians and may harmonize effective diagnosis and treatment of RAS. [ABSTRACT FROM AUTHOR]

Fourteen Indian cities, including urban and rural locations, were chosen for the present study across India, with unhealthy air quality based on National Air Quality Index (NAQI > 100). However, it was found that NAQI values over the locations are driven by the undifferentiated mass concentration of particulate matter (PM, both PM 10  and PM 2.5 ) than other criteria pollutants. The PM 2.5  and PM 10  concentration during the winter violated the National Ambient Air Quality Standards (NAAQS) of India by two to five times at six urban locations, with the mean daily PM 2.5  concentration averaged over the month; the the largest being at Patna (353 µg m − 3 ) during the winter and lowest at Bengaluru (27 µg m − 3 ) during the summer. The analysis of chemical species, in general, indicated NO 2  (SO 2 , CO) as having a 25% to 70% (16% to 50%, 16% to 85%) increase in concentration from the summer to winter, which is adequately reflected in higher fuzzy scores during the winter. Thus, to provide a realistic approach to air quality management, the present study focuses on identifying priority-based locations requiring immediate mitigation measures by developing a Prioritized Clean Air Assessment Tool (PCAT). The tool utilizes a fuzzy-based algorithm to incorporate the cumulative effect of all six criteria pollutants, taking into consideration the severity of their expected health implications. Using PCAT, Delhi and Varanasi cities are identified for prioritized mitigation considering the NAAQS of India, unlike all cities (except Bengaluru) during the winter and nine out of fourteen cities during the summer, considering the NAQI. Using more stringent WHO guideline values in PCAT, six cities out of fourteen were identified requiring immediate mitigation during the winter and summer months; locations such as Solapur and Patna are identified to need season-specific mitigation measures during the summer and winter, respectively. The tool is simplistic, user-friendly, and quickly evaluates multiple locations simultaneously to provide priority sites. [ABSTRACT FROM AUTHOR]

The existing empirical studies concerning labour market rigidity associated with the labour laws in India suggest an adverse impact of rigidity on total factor productivity (TFP). In this paper, we improve upon both the measurement of spatiotemporal variation in labour market flexibility and plant-level TFP from production function estimates in the presence of institutional rigidity in labour inputs adjustment due to job security legislation based on the recent advancement in the literature. We use an unbalanced panel of manufacturing plants from the Annual Survey of Industries panel data from 1999–2000 to 2016–17 to analyse the relationship between labour market rigidity/flexibility and TFP. We find that establishments that fall under the purview of job security legislation have higher productivity than those outside the ambit of job security legislation. The results suggest that rigidity associated with job security provisions does not harm TFP, and higher flexibility is negatively associated with TFP. However, we find considerable heterogeneity in the flexibility–TFP relationship across various industry groups. The heterogeneity in the flexibility–TFP relationship suggests that flexibility-inducing labour policy may improve TFP in some industries and, at the same time, decrease it in others. [ABSTRACT FROM AUTHOR]

The de-focalisation of reporting and the focalisation of post-truth ideology is antithetical to the tenets of democracy. It reverts to the traditional centralised propagation of one truth, one reality, and one perspective while contracting, negating, or antagonising the possibility of alternative and parallel narratives. The right wing has created a narrative of suspicion, which is based on the conviction that anything deviating from the traditional cultural patterns is a contamination of the ethos of one's own native values, a deviation from the nativity, and hence an influence that needs to be disposed of. The ongoing Covid pandemic has magnified the narrative of post-truth through the use of sensationalism as an effective modus operandi. The blinding of the truth is rampant as news outlets are being guarded by right-wing gatekeepers and sensationalism is used to reflect the surging emotions of a public already gripped by a precarious reality. This paper examines the three primary and seemingly independent threats to democracy during the pandemic in India: de-focalisation of reporting, coerced homogeneity based on religion and language, and sensationalism. It addresses the question of how adversity is turned into a breeding ground for demagoguery. [ABSTRACT FROM AUTHOR]

This study using a high resolution (~ 25 km) regional coupled earth system model ROM (REMO-OASIS-MPIOM), addresses the future projections of heatwave characteristics (frequency, duration, and severity) and associated dynamics over India for the AMJ (April–May–June) season. The near-surface maximum temperature (Tmax) is used to identify the prominent regions of large fluctuations using rotated empirical orthogonal function analysis. The averaged heatwave characteristics simulated by ROM is compared against the Indian Meteorological Department (IMD) Tmax observational data for the historical period 1980–2005. The ROM simulated heatwave characteristics largely agree with observations though few deviations are also noticed. The typical synoptic features associated with the heatwave days for the identified regions show the presence of elevated geopotential height (thickness; Z) with an anomalous anticyclonic structure which forms an atmospheric blocking over each region except south east coast. The daily evolution of potential vorticity and Z suggests eastward propagation of blocks that remain persistent during heatwave days. ROM is able to simulate these features with systematic higher magnitude and minor location changes. The future projections (RCP 8.5) of heatwave characteristics show a gradual increase for different time-slices during 2020–2099. The projected frequency will be doubled, and the average duration will increase by 8–12 days per season at the end of the century. The severity will also increase by 2°–3 °C. Similarly, future dynamical features will be associated with an increase in geopotential height (thickness) in the future along with a gradual decrease in potential vorticity. The future patterns of anomalous potential vorticity indicate the presence of omega block in all-time slices with a decrease in negative magnitude. [ABSTRACT FROM AUTHOR]

African swine fever (ASF), considered as the most dreadful swine disease due to its very high mortality, emerged in India in 2020. The complete genome analysis of ASF viruses isolated during the first outbreaks in India showed a few unique non‐synonymous mutations in MGF 369‐11L, MGF 505‐4R, K205R and B263R genes. Frame shifts in the protein coding sequences were observed in DP60R, ASFV‐G_ACD 00190, MGF 110‐10‐L‐MGF110‐14L fusion, MGF 360‐14L and I267L genes of Indian ASF viruses as compared to ASFV/Georgia/2007. Complete genome based phylogenetic analysis of p72‐genotype‐II viruses showed the clustering of Indian isolates with ASFV/Wuhan/2019 in a separate clade. Phylogenetic analysis of concatenated sequences of 14 open reading frames (ORF) having single nucleotide polymorphisms (SNP) showed distinct grouping of Indian ASFVs with other Asian ASFVs. This is the first complete genome characterization of ASF viruses isolated from domestic pigs in India. The results indicate that number of Tandem Repeat Sequence (TRS) in the intergenic region between I73R and I329L genes, and the 14 ORFs with SNP reported in this study could be the genetic determinants to differentiate the closely related p72‐genotype II viruses circulating in Asia. [ABSTRACT FROM AUTHOR]

The secondary data made available in the public domain by Indian Council of Agriculture Research, National Bureau of Animal Genetic Resources, Information System on Animal Genetic Resources of India was used in the present study. Data on dispersal, production, reproduction and conformation of various indigenous cattle breeds had been collected. Data was classified as per 15 agroclimatic zones and a qualitative thematic map on dispersal of various recognized indigenous cattle breeds had been developed. Parametric data was subjected to descriptive and inferential statistics. It had been observed that agro climatic zones 3, 7 and 15 were devoid of any recognized indigenous cattle breeds. All other zones were having 3 or more breeds. The milk yield per lactation result showed significantly higher milk yield by breeds residing in zone 6, 13 and 14 compared to other zones. The states covered under these zones were Haryana, Punjab, Rajasthan and Gujarat. Breeds with significantly heavier adult body weight were observed in agro climatic zones 5, 6, 9 and 14. Significantly lower birth weight was observed in breeds of zone 12. Non significant differences were observed in reproductive traits of indigenous cattle breeds among various agro climatic zones of India. Highest average body length and heights were observed in the breeds of agro climatic zones zones 6 and 14. It can be impressed upon that Agro climatic zones had played an important factor in inculcating variation observed in production and conformation traits among various indigenous cattle breeds of India [ABSTRACT FROM AUTHOR]

Background In India, there are several malaria-endemic regions where non- falciparum species coexist with Plasmodium falciparum. Traditionally, microscopy and rapid diagnostic tests are used for the diagnosis of malaria. Nevertheless, microscopy often misses the secondary malaria parasite in mixed-infection cases due to various constraints. Misdiagnosis/misinterpretation of Plasmodium species leads to improper treatment, as the treatment for P. falciparum and Plasmodium vivax species is different, as per the national vector-borne disease control program in India. Methods Blood samples were collected from malaria-endemic regions (Jharkhand, Madhya Pradesh, Chhattisgarh, Maharashtra, Odisha, Assam, Meghalaya, Mizoram and Telangana) of India covering almost the entire country. Molecular diagnosis of Plasmodium species was carried out among microscopically confirmed P. falciparum samples collected during a therapeutic efficacy study in different years. Results The polymerase chain reaction analysis revealed a high prevalence (18%) of mixed malaria parasite infections among microscopically confirmed P. falciparum samples from malaria patients that are either missed or left out by microscopy. Conclusions Deployment of molecular tools in areas of mixed species infection may prove vital for accurate diagnosis and treatment of malaria. Further, it will help in achieving the goal of malaria elimination in India. [ABSTRACT FROM AUTHOR]

In this note, we assess the newly introduced Industrial Relations Code (IRC) 2020. First, we compare the provisions in IRC 2020 with its predecessor, Industrial Disputes Act (IDA) 1947, and the amendments to IDA 1947 in 1976 and 1982 regarding the employment protection provisions against layoffs, retrenchments, and closures. We find that IRC 2020 merely restored the factory-size threshold to the initial IDA amendment 1976 level of 300 or more workers to which IDA 1947 originally applied from 100 or more workers as notified in the 1982 IDA amendment. We calculate the effect of the threshold-size change on the workers and factories on the firms registered under the Factories Act 1948 2(m). We find from the ASI 2017–2018 data that an estimated 7.07% of the factories and 15.97% of the workers will be affected due to the change in the threshold size introduced through IRC, 2020. Finally, we conclude by discussing the current relevance of the employment protection legislation during the pandemic time and the need for discretionary usage and temporary expansion of coverage of employment protection provisions under the IRC if warranted. [ABSTRACT FROM AUTHOR]

Background: Quality management in healthcare is critical for hospitals and everyone in the loop —from physicians to support staff—needs to be aware of and involved in this process. Objectives: To assess the perception of employees about the quality management system (QMS) implemented at a tertiary care eye hospital in north India and to use it to identify scope for further improvement. Methods: This cross-sectional mixed-method study involved both questionnaire-based survey and an in-depth interview by a third party. The questionnaire had 12 questions to assess the changes in culture, infrastructure, environment, system, operation theatre and outpatient department. Employees shared their opinion about improvements brought by the QMS in eight years. Respondents were divided into five groups based on their job description: (i) doctors, (ii) technical staff (nursing/operation theatre/laboratory), (iii) optometrists/opticians/audiologists, (iv) patient care executives and (v) human resources/administration/others. Results: Of the 73 employees interviewed, 94.5% perceived an improved treatment and care process and 91.8% perceived improved treatment results. According to 83.6% of the employees, they were encouraged to report patient safety concerns and 71.2% saw improved incidence and adverse event management. The QMS has increased patient satisfaction according to 83%, while 91.8% felt it improved the profile of the hospital. The employees stated no negative effects of the QMS except a long waiting time of the patients and the duplication of paperwork. Conclusion: QMS has brought many positive changes across the hospital. Still, there is scope to reduce the patient waiting time and paperwork duplication. [ABSTRACT FROM AUTHOR]

Introduction: Moyamoya angiopathy (MMA) is a chronic, progressive intracranial vasculopathy with variation in prevalence and clinical manifestations across different populations. This study was aimed to estimate the frequency of MMA as an etiology of stroke and its epidemiological features in the largest cohort of MMA patients in India. Method: A single-centered cross-sectional observational study over a period of 5 years (2016–2021) was undertaken among consecutive stroke and transient ischemic attack (TIA) patients to look for the presence of MMA angiographically. Each patient with angiographically proven MMA was further evaluated for demographic, clinical, and radiological characteristics. Results: Among 10,250 consecutive stroke and TIA patients (ischemic = 78%, hemorrhagic = 22%), frequency of MMA was 1.56% (n = 160); 15.3% among children. Female preponderance (Male:Female = 1:1.4) was noted among 160 MMA patients, with bimodal age distribution, first peak at 3–8 years, and a shorter second peak at 41–47 years. Childhood-onset MMA was seen in 75 (46.9%) with commonest initial neurological symptom of fixed-motor-weakness (44.0%), followed by TIA (26.7%); while 85 (53.1%) had adult-onset MMA with fixed-motor-weakness (50.6%) followed by headache (24.7%) as the predominant initial neurological symptom; seizure significantly higher in children (p < 0.001) and headache in adults (p = 0.012). Transient and fixed neurological manifestations constituted 87.5 and 69.4% respectively, of symptoms throughout the disease course. Cerebral infarction (45.0%) and TIA (21.9%) were the commonest types of MMA. On brain imaging, infarction was noted in 80.6%, hemorrhage in 11.3%, significantly higher among adults (p < 0.001). Cortical infarct and Gyral pattern were commoner in children (p = 0.004), subcortical infarcts in adults (p = 0.018). Frequent Suzuki staging observed was stage 4 (31.3%), followed by stage 3 (30.0%). Involvement of posterior circulation was detected in 55.6%, brain atrophy at the time of diagnosis was seen in 65.0%. Conclusion: MMA is an important etiological consideration in patients with stroke, especially in children. It can present with a myriad of transient neurological symptoms, frequently overlooked, leading to delayed diagnosis, and contributing to socio-economic burden. Indian MMA showed aberrations in its gender predisposition, age distribution, frequency of familial cases, disease manifestation, and type of stroke, in comparison to its Japanese and Caucasian counterparts pointing to the inter- and intra-continent differences of MMA phenotype. Future development of the Indian MMA national registry is of essence. [ABSTRACT FROM AUTHOR]

More than 8% of the global population is affected by a rare disease and >50% affected are children (30% of whom will die before 5 years). There are 6,000-8,000 classified rare diseases - 80% are genetically based - with less than 500 FDA approved treatments (or <5% have therapies) available to treat them. Lack of standard definition and community-based epidemiological data in India limits the estimation of prevalence and/or disease burden; though extrapolations at 6% to 8% show 72 to 96 million affected individuals. The Government of India approved the "National Policy for Rare Diseases, 2021" on 30th March 2021. It is a step in the right direction; at the time it necessitates optimal utilization of allocated resources and timely appraisal of the policy itself. [ABSTRACT FROM AUTHOR]

Background: Rural India has a severe shortage of human resources for health (HRH). The National Rural Health Mission (NRHM) deploys HRH in the rural public health system to tackle shortages. Sanctioning under NRHM does not account for workload resulting in inadequate and inequitable HRH allocation. The Workforce Indicators of Staffing Needs (WISN) approach can identify shortages and inform appropriate sanctioning norms. India currently lacks nationally relevant WISN estimates. We used existing data and modelling techniques to synthesize such estimates.Methods: We conducted a retrospective analysis of existing survey data for 93 facilities from 5 states over 8 years to create WISN calculations for HRH cadres at primary and community health centres (PHCs and CHCs) in rural areas. We modelled nationally representative average WISN-based requirements for specialist doctors at CHCs, general doctors and nurses at PHCs and CHCs. For 2019, we calculated national and state-level overall and per-centre WISN differences and ratios to depict shortage and workload pressure. We checked correlations between WISN ratios for cadres at a given centre-type to assess joint workload pressure. We evaluated the gaps between WISN-based requirements and sanctioned posts to investigate suboptimal sanctioning through concordance analysis and difference comparisons.Results: In 2019, at the national-level, WISN differences depicted workforce shortages for all considered HRH cadres. WISN ratios showed that nurses at PHCs and CHCs, and all specialist doctors at CHCs had very high workload pressure. States with more workload on PHC-doctors also had more workload on PHC-nurses depicting an augmenting or compounding effect on workload pressure across cadres. A similar result was seen for CHC-specialist pairs-physicians and surgeons, physicians and paediatricians, and paediatricians and obstetricians-gynaecologists. We found poor concordance between current sanctioning norms and WISN-based requirements with all cadres facing under-sanctioning. We also present across-state variations in workforce problems, workload pressure and sanctioning problems.Conclusion: We demonstrate the use of WISN calculations based on available data and modelling techniques for national-level estimation. Our findings suggest prioritising nurses and specialists in the rural public health system and updating the existing sanctioning norms based on workload assessments. Workload-based rural HRH deployment can ensure adequate availability and optimal distribution. [ABSTRACT FROM AUTHOR]

Background: Human Resources for Health (HRH) are crucial for improving health services coverage and population health outcomes. The World Health Organisation (WHO) promotes countries to formulate holistic policies that focus on four HRH dimensions-availability, accessibility, acceptability, and quality (AAAQ). The status of these dimensions and their incorporation in the National Health Policies of India (NHPIs) are not well known.Methods: We created a multilevel framework of strategies and actions directed to improve AAAQ HRH dimensions. HRH-related recommendations of NHPI-1983, 2002, and 2017 were classified according to targeted dimensions and cadres using the framework. We identified the dimensions and cadres focussed by NHPIs using the number of mentions. Furthermore, we introduce a family of dimensionwise deficit indices formulated to assess situational HRH deficiencies for census years (1981, 2001, and 2011) and over-year trends. Finally, we evaluated whether or not the HRH recommendations in NHPIs addressed the deficient cadres and dimensions of the pre-NHPI census years.Results: NHPIs focused more on HRH availability and quality compared to accessibility and acceptability. Doctors were prioritized over auxiliary nurses-midwives and pharmacists in terms of total recommendations. AAAQ indices showed deficits in all dimensions for almost all HRH cadres over the years. All deficit indices show a general decreasing trend from 1981 to 2011 except for the accessibility deficit. The recommendations in NHPIs did not correspond to the situational deficits in many instances indicating a policy priority mismatch.Conclusion: India needs to incorporate AAAQ dimensions in its policies and monitor their progress. The framework and indices-based approach can help identify the gaps between targeted and needed dimensions and cadres for effective HRH strengthening. At the global level, the application of framework and indices will allow a comparison of the strengths and weaknesses of HRH-related policies of various nations. [ABSTRACT FROM AUTHOR]

Background: With visceral leishmaniasis (VL) incidence at its lowest level since the 1960s, increasing attention has turned to early detection and investigation of outbreaks. Methods: Outbreak investigations were triggered by recognition of case clusters in the VL surveillance system established for the elimination program. Investigations included ascertainment of all VL cases by date of fever onset, household mapping and structured collection of risk factor data. Results: VL outbreaks were investigated in 13 villages in 10 blocks of 7 districts. Data were collected for 20,670 individuals, of whom 272 were diagnosed with VL between 2012 and 2019. Risk was significantly higher among 10–19 year-olds and adults 35 or older compared to children younger than 10 years. Outbreak confirmation triggered vector control activities and heightened surveillance. VL cases strongly clustered in tolas (hamlets within villages) in which > 66% of residents self-identified as scheduled caste or scheduled tribe (SC/ST); 79.8% of VL cases occurred in SC/ST tolas whereas only 24.2% of the population resided in them. Other significant risk factors included being an unskilled non-agricultural laborer, migration for work in a brick kiln, living in a kuccha (mud brick) house, household crowding, habitually sleeping outside or on the ground, and open defecation. Conclusions: Our data highlight the importance of sensitive surveillance with triggers for case cluster detection and rapid, careful outbreak investigations to better respond to ongoing and new transmission. The strong association with SC/ST tolas suggests that efforts should focus on enhanced surveillance in these disadvantaged communities. [ABSTRACT FROM AUTHOR]

In recent years, the export baskets of developing economies have undergone a structural shift away from traditional exports towards more technology-intensive exports. The case of India, in particular, is important as the performance of Indian exports in terms of their productivity is now at par with that of developed countries. Since trade integration has significant implications for output comovements, we analyse whether this phenomenon of a structural shift in India's intra-industry trade composition has had any impact on its business cycle synchronisation with its developing and developed trade partners. Using a panel threshold regression model, our estimates reveal that intra-industry trade in technology leads to a convergence in business cycle of India with only its developing country trade partners. Further, when the GDP per capita of the partner country is greater than the threshold estimate, we find a negative relationship between technology-intensive trade and output comovements. [ABSTRACT FROM AUTHOR]

African swine fever (ASF) is the most dreaded disease of pigs, which can cause mortality of up to 100%. Following disease outbreaks with high mortality in pigs in two states of north‐east India, namely Arunachal Pradesh and Assam in early 2020, we confirmed the first occurrence of African swine fever (ASF) in domestic pigs in India by real‐time PCR, virus isolation and nucleotide sequencing. Genetic analyses in three independent genomic regions (B646L gene encoding the p72 protein, E183L gene encoding the p54 protein and the central variable region (CVR) of B602L gene) showed that the Indian ASF viruses are similar to the post‐2007‐p72‐genotype II viruses reported from Asia and Europe, suggesting the transboundary expansion of ongoing ASF outbreaks in the region. [ABSTRACT FROM AUTHOR]

Monthly mean precipitation estimates of seven products (TerraClimate, TRMM, CHIRPS, PERSIANN‐CDR, GPM‐IMERG, ERA5 and CFSR) available on Google earth engine (GEE) are evaluated against gridded gauge‐based precipitation product available from Indian Meteorological Department (IMD) for their skills and presence of systematic biases (during 2001–2018). All these products represent the climatological features reasonably well. Presence of systematic biases in these products is also observed from their evaluation. Biases across the periphery of the country are relatively on the higher side in comparison to the central regions. The magnitude of spatial variability is represented better for winter precipitation in comparison to summer precipitation. During both winter and summer, ensemble mean of various products outperforms individual products in terms of both RMSE and correlation. Performance of these products is also assessed across various Indian states, elevation bands and climate zones. The ability of these products to represent the seasonality was observed to be highest for the states with mid‐ranged peaks (10–20 mm·day−1) which tend to decrease with both increasing and decreasing peaks. Ability of the precipitation products to resemble the annual cycle does not vary with the amount of precipitation, although individual disparity among the products exists. Additionally, an alternative approach for data evaluation using Multiple Triple Collocation (MTC) was performed for the period 2001–2015 using an additional dataset obtained from soil‐moisture‐based rainfall estimates (SM2RAIN). Results from MTC convey that ERA5 performs relatively poor in comparison to the other products for central India followed by CFSR. In brief, the comprehensive evaluation of precipitation products reported herein will act a valuable reference for the researchers as well as decision makers to select the optimal product for their intended application and will inform the users about the various uncertainties in the foundations and specification of these products. [ABSTRACT FROM AUTHOR]

Background: This is the first detailed Indian electronic medical record (EMR)-based real-world observational study to understand the clinical characteristics, associated comorbidities/risk factors and treatment(s) of CAD patients across India.Methods: EMR data of adult Indians (aged ≥ 18 years) diagnosed with CAD was retrospectively analyzed.Results: The majority of the participants had stable IHD (93%), were men (68.5% in ACS, 59.8% in stable IHD), most common age group was 40–64 years in ACS (56.6%) and stable IHD (51.4%). Both are common in metros (ACS 52%, 62% stable IHD). There is a high frequency of hypertension (38.2% in ACS, 59% in stable IHD) and diabetes mellitus (32.3% in ACS, 57.6% in stable IHD). Most common treatments are antiplatelet drugs and lipid-lowering drugs (96%).Conclusions: In India, stable IHD is the most prevalent form in vast majority of patients. The patients with CAD are mostly males, are mainly located in metros and majority fall between the age group of 40–64. The major comorbidities are hypertension and diabetes mellitus. Sociodemographic and clinical characteristics for CAD in India may not be similar to what is reported from the west. There is a significant difference in drug usage and adherence to guidelines in India for CAD. [ABSTRACT FROM AUTHOR]

More than 8% of the global population is affected by a rare disease and >50% affected are children (30% of whom will die before 5 years). There are 6,000-8,000 classified rare diseases - 80% are genetically based - with less than 500 FDA approved treatments (or <5% have therapies) available to treat them. Lack of standard definition and community-based epidemiological data in India limits the estimation of prevalence and/or disease burden; though extrapolations at 6% to 8% show 72 to 96 million affected individuals. The Government of India approved the "National Policy for Rare Diseases, 2021" on 30th March 2021. It is a step in the right direction; at the time it necessitates optimal utilization of allocated resources and timely appraisal of the policy itself. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to create a hierarchy of critical success factors affecting the higher technical education institutions, taking a case study of India. Using total interpretive structural modeling (TISM), the paper attempts to establish the inter-linkages among ten critical success factors for enhancing the performance of these institutions. Design/methodology/approach: The paper employs Total Interpretive Structural Modeling (TISM) to understand the hierarchy of the factors and their interplay using response from 18 experts in the domain. Findings: The findings reveal that autonomy and accountability coupled with availability of sustainable funds are the driving factors for the success of the institutions. Infrastructural facilities and establishment of centers of excellence act as amplification factors. Introduction of new programs and their accreditation, improvement in faculty quality, research output and improvement in performance of academically weak students emerge as process factors that drive the output factors, namely, academic performance and student placement. Research limitations/implications: The major limitation of this study is the scope that was limited to 191 institutions, as mandated in the project. Practical implications: This study has important implications for the institutions as well as the policy makers to channelize their focus and efforts on driving and amplification factors that would ultimately lead to enhanced performance of the next generation higher technical education institutions. Originality/value: This paper is a part of pan India project carried out to assess the performance of higher technical education institutions in India. [ABSTRACT FROM AUTHOR]

The sustainable development goals (SDGs) were result of extensive stakeholder participation and global consensus. Despite large promises, there is an increasing concern among the member states whether SDGs address real problems of nations, particularly the developing world. This study discusses key issues raised by developing countries with respect to the SDGs. Using opinion of experts on SDGs regarding its implications and future, a case study for India is presented. The study with its findings and policy recommendations intend to benefit SDG implementation efforts and planning at the national and sub-national level in India and other developing countries, helping them redesign and investigate their national SDG implementation strategies on similar lines as India to improve its reach and effectiveness. [ABSTRACT FROM AUTHOR]

As India moves toward the elimination of visceral leishmaniasis (VL) as a public health problem, comprehensive timely case detection has become increasingly important, in order to reduce the period of infectivity and control outbreaks. During the 2000s, localized research studies suggested that a large percentage of VL cases were never reported in government data. However, assessments conducted from 2013 to 2015 indicated that 85% or more of confirmed cases were eventually captured and reported in surveillance data, albeit with significant delays before diagnosis. Based on methods developed during these assessments, the CARE India team evolved new strategies for active case detection (ACD), applicable at large scale while being sufficiently effective in reducing time to diagnosis. Active case searches are triggered by the report of a confirmed VL case, and comprise two major search mechanisms: 1) case identification based on the index case's knowledge of other known VL cases and searches in nearby houses (snowballing); and 2) sustained contact over time with a range of private providers, both formal and informal. Simultaneously, house-to-house searches were conducted in 142 villages of 47 blocks during this period. We analyzed data from 5030 VL patients reported in Bihar from January 2018 through July 2019. Of these 3033 were detected passively and 1997 via ACD (15 (0.8%) via house-to-house and 1982 (99.2%) by light touch ACD methods). We constructed multinomial logistic regression models comparing time intervals to diagnosis (30-59, 60-89 and ≥90 days with <30 days as the referent). ACD and younger age were associated with shorter time to diagnosis, while male sex and HIV infection were associated with longer illness durations. The advantage of ACD over PCD was more marked for longer illness durations: the adjusted odds ratios for having illness durations of 30-59, 60-89 and >=90 days compared to the referent of <30 days for ACD vs PCD were 0.88, 0.56 and 0.42 respectively. These ACD strategies not only reduce time to diagnosis, and thus risk of transmission, but also ensure that there is a double check on the proportion of cases actually getting captured. Such a process can supplement passive case detection efforts that must go on, possibly perpetually, even after elimination as a public health problem is achieved. [ABSTRACT FROM AUTHOR]

Puparia and third instar of a new diminutive whitefly, Regiominutus ventralis gen. et sp. nov. found infesting underside leaves of Aglaia elaeagnoides (A. Juss) (Meliaceae) on the Andaman Islands, India, are diagnosed, described and discussed. Regiominutus gen. nov. differs from allied genera, Aleuroclava Singh, Aericerus Dubey, Aleuroparvus Dubey, Aleuropleurocelus Drews and Sampson and Tetralicia Harrison in having a submarginal ventral groove, from the former two in having a deflexed submargin and smaller ventral surface and from the latter two in having a caudal furrow. Affinities and differences of the new genus shared with related genera are discussed. Puparium characters observed in slide mounts versus scanning electron microscope (SEM) images are presented. Line drawings, habitus images and SEM, microphotographs of the type specimens are given for the new taxa. This is the first whitefly species to be recorded from this host plant. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) is an autoimmune disease with varied articular and extra‐articular manifestations. In developing countries such as India patients with RA often delay seeking medical advice which may impact prognosis and disease burden. Aim: To explore perceptions and experiences of patients living in India in seeking medical help for their RA symptoms. Methods: Clinician‐diagnosed RA participants from different socioeconomic backgrounds were interviewed using a semi‐structured topic guide. Participants were purposively selected and interviewed following an iterative approach. All interviews were recorded and transcribed by an independent company and analyzed using a thematic framework. Findings were reported in accordance with consolidated criteria for reporting qualitative research guidelines. Results: Twenty participants (13 male, 7 female) with median age 40 years (35.7‐46.5) were recruited. Three overarching themes demonstrating participants' experiences and reasons for delay in seeking medical help were identified. (1) "Symptoms perspectives and delay in participants' journey" narrated participants' experiences of having RA symptoms, how these were perceived, rationalized and led to delay. (2) "Participants' experience of the healthcare system" illustrated delay in referral, reaching diagnosis and treatment initiation highlighting their experiences with the health system. (3) "Recommendations for improving care" where participants made recommendations for reducing the delay at local and national levels. Conclusion: This is the first qualitative study which explored perceptions and experiences of RA patients in India resulting in delay. Improved provision of rheumatology care, effective referral system and greater involvement of government at local and national levels are needed to improve the delay in seeking medical help for Indian patients. [ABSTRACT FROM AUTHOR]

The current global pandemic caused by COVID-19 has brought about an immense effect on the mental health of the general public. Considering the escalation in number of cases, mankind is facing a myriad of psychological problems, ranging from those related to taking precautions and maintaining safety to the ones caused by separation and bereavement. The current study aims to explore whether there is a significant difference between individuals with excellent, good, fair and vague knowledge of COVID-19 with respect to depression, anxiety, stress, level of mindfulness, specific cognitive emotion regulation strategies and psychological flexibility; to find out whether there is any significant relationship among these variables; and to determine whether knowledge of COVID-19, level of mindfulness, specific cognitive emotion regulation strategies and psychological flexibility are significant predictors of depression, anxiety and stress in the sample of the current study. The sample consisted of 402 individuals selected from the community following the research criteria. Data was collected using digital consent form, information schedule and questionnaires, from 3rd May to 13th May, 2020. The questionnaires consisted of a semi-structured interview schedule to assess knowledge of COVID-19, Depression, Anxiety and Stress Scale – 21, Five Facet Mindfulness Questionnaire-Short Form, Cognitive Emotion Regulation Questionnaire-Short version and Acceptance and Action Questionnaire-II. The data was statistically analyzed using analysis of variance test, correlational analysis and linear regression. The findings show that significant differences were present among individuals having varying degrees of knowledge of COVID-19 with respect to anxiety, level of mindfulness and psychological flexibility. Significant relationships were found to be present among the variables of the present study, having differing trends brought forward by the COVID-19 crisis. Certain socio-demographic characteristics and study variables were found to significantly predict the existing levels of depression, anxiety and stress in the current sample. The study suggests the necessity to formulate and implement appropriate mindfulness-based therapeutic interventions to address the mental health concerns arising as a result of the pandemic. [ABSTRACT FROM AUTHOR]

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Objective: Despite a reduction in maternal mortality in recent years, a high rate of anaemia and other nutrient inadequacies during pregnancy pose a serious threat to mothers and their children in the Global South. Using the framework of the WHO–Commission on Social Determinants of Health, this study examines the socioeconomic, programmatic and contextual factors associated with the consumption of iron and folic acid (IFA) tablets/syrup for at least 100 d (IFA100) and receiving supplementary food (SF) by pregnant women in India. Design: We analysed a nationally representative cross-sectional survey of over 190 898 ever-married women aged 15–49 years who were interviewed as part of the National Family Health Survey (NFHS) conducted during 2015–16, who had at least one live birth preceding 5 years of the survey. Setting: All twenty-nine states and seven union territories of India. Participants: Ever-married women aged 15–49 years. Results: Less than one-third of women were found to be consuming IFA100, and a little over half received SF during their last pregnancy. The consumption of IFA100 was likely to improve with women's education, household wealth, early and more prenatal visits, and in a community with high pregnancy registration. Higher parity, early and more prenatal visits, contact with community health workers during pregnancy, belonging to a poor household and living in an aggregated poor community and rural area positively determine whether a woman might receive SF during pregnancy. Conclusions: Continuous monitoring and evaluation of provisioning IFA and SF in targeted groups and communities is a key to expanding the coverage and reducing the burden of undernutrition during pregnancy. [ABSTRACT FROM AUTHOR]

Studies on host-pathogen interaction have identified human ACE2 as a host cell receptor responsible for mediating infection by coronavirus (COVID-19). Subsequent studies have shown striking difference of allele frequency among Europeans and Asians for a polymorphism rs2285666, present in ACE2. It has been revealed that the alternate allele (TT-plus strand or AA-minus strand) of rs2285666 elevate the expression level of this gene upto 50%, hence may play a significant role in SARS-CoV-2 susceptibility. Therefore, we have first looked the phylogenetic structure of rs2285666 derived haplotypes in worldwide populations and compared the spatial frequency of this particular allele with respect to the COVID-19 infection as well as case-fatality rate in India. For the first time, we ascertained a significant positive correlation for alternate allele (T or A) of rs2285666, with the lower infection as well as case-fatality rate among Indian populations. We trust that this information will be useful to understand the role of ACE2 in COVID-19 susceptibility. [ABSTRACT FROM AUTHOR]

Polyhouse cultivation enables year-round production of bell pepper (Capsicum annuum L.). Maintaining a favorable micro-climate inside a polyhouse is mostly through manual operation of environmental control systems in developing countries, and to varying degrees, with automation in developed countries. In this study automation of micro-climate control through sensors and controllers was examined. Soil moisture, relative humidity, and air temperature sensors were installed at different locations inside a polyhouse for the operation of irrigation, foggers, and fan-pad cooling systems. Threshold values of these parameterswere set as input to the programmable logic controller and systems. Bell pepper is an economically important crop rich in nutrients. The efficacy of the use of an automated system to control the growing environment for this crop needs to be clarified. The experiment was conducted using cv. Swarna, grown under open-field and polyhouse culture, at irrigation levels of 80% or 100% of crop evapotranspiration. Type of growing environment affected yield and fruit size, with production in the polyhouse being better, but irrigation level did not. The programmable logic controller-based automation system worked well for micro-climate control leading to 93% and 53% higher yield and fruit weight, respectively, in the polyhouse than open-field cultivation. The programmable logic controller-based automation can aid in maintaining a favorable microclimate inside a greenhouse leading to better bell pepper yield. [ABSTRACT FROM AUTHOR]

Bovine ephemeral fever virus (BEFV) is an evolving arbovirus reported across tropical, subtropical and temperate climatic zones globally. This study reveals prominent BEFV outbreaks in India, emerging annually during monsoons in subtropical areas accompanied by a congenial abundance of the vector population. PCR‐based detection of viral genomic RNA in the blood samples collected during outbreaks of 2018–2019 for the first time confirmed the presence of BEFV in India. Phylogenetic analysis based on the glycoprotein gene of BEFV showed the current isolates to have high sequence homology with Middle Eastern lineage with nearly 97%, identity to Turkey (BEFV Ad12/TUR) and Israel (Israel 2006) isolates. [ABSTRACT FROM AUTHOR]

In May 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in Asiatic lions in a zoological park in India. Sequence and phylogenetic analyses showed the SARS-CoV-2 strains were the B.1.617.2 (Delta) variant. To reduce transmission of variants of concern, surveillance of SARS-CoV-2 in wild animal populations should be increased. [ABSTRACT FROM AUTHOR]

Equine glanders is an infectious and notifiable bacterial disease caused by Burkholderia mallei. The disease has been reported in South American, African and Asian countries including India. Here, we present the outcome of glanders serosurveillance carried out between January 2015 and December 2018 to know the status of equine glanders among different states in India. A total of 102,071 equid sera from 299 districts of twenty‐one states and one union territory were tested for glanders. Samples were screened with Hcp1 indirect ELISA followed by confirmatory diagnosis by CFT. During this four‐year surveillance, a total of 932 glanders‐positive cases were detected from 120 districts of 12 states. The study also revealed increasing trend of glanders from 2016 onwards with maximum occurrence in northern India. Overall seroprevalence ranged between 0.62% (95% CI, 0.52–0.72) and 1.145% (95% CI, 1.03–1.25). Seasonal shifting from winter to summer (March to June) coincided with highest number glanders incidence with corresponding seroprevalences of 1.2% (95% CI, 1.09–1.30). The present surveillance unveils territorial ingression of glanders to six states like Jammu & Kashmir, Gujarat, Rajasthan, Madhya Pradesh, Delhi and Tamil Nadu. In addition, re‐emerging cases have been reported in Maharashtra, Haryana and Punjab after a gap of 10 years. Lack of awareness, little veterinary care and unrestricted movement of equids across state borders might have led to the introduction and establishment of the infection to these states. We believe that information from this study will provide a baseline data on glanders for devising surveillance and control strategies in India. Being a zoonotic disease, the persistence of glanders poses a potential threat to occupationally exposed humans especially equine handlers and veterinarians. Therefore, targeted surveillance of human population from each glanders outbreak is also recommended. [ABSTRACT FROM AUTHOR]

This paper delves into the debates concerning labour market flexibility in India and suggests an improved measure of labour market flexibility to overcome the shortcomings of the existing measures. A state-wise time-variant composite index considering both de jure and de facto indicators of flexibility is constructed to account for the stringency of regulation of hiring and firing practices that affect labour adjustment mechanism of organised manufacturing sector firms in India. The newly built index reaffirms the criticism and limitations of the existing measures which solely rely on de jure indicators by pointing out that de jure measures alone are highly misleading and insufficient to identify a state's labour market flexibility status. The index has been put to application in examining the role of spatial variation in labour market flexibility in explaining the difference in employment growth in India's organised manufacturing sector. The paper finds no evidence in support of a statistically significant effect of spatial variation in flexibility in explaining the variation in employment growth. Interestingly, the paper demonstrates that employment elasticity of growth was lower in "flexible" states as compared to the "rigid" states, indicating that greater flexibility is associated with a weaker employment performance. [ABSTRACT FROM AUTHOR]

Background: To fulfil the objective of fast-tracking the accessibility of new drugs and promoting clinical research in India, the Union Ministry of Health and Family Welfare, India has notified the "New Drugs and Clinical trials Rules, 2019" on 25th March 2019. The prime objective of the new rule is to initiate unambiguous, foreseeable and effective regulations for the clinical trials in India. Drugs Controller General of India (DCGI) affirmed that the new rules would apply to all new drugs, investigational new drugs, bioequivalence and bioavailability study (BA/BE) and ethics committees. The new rules would replace part XA and schedule Y of drugs; however, the existing rules (Drugs and Cosmetics Act, 1940; Drug and Cosmetics Rules, 1945) and licenses, orders or directions will remain valid. Purpose: This brief review aims at presenting the key highlights of the "New Drugs and Clinical Trials Rules, 2019" of India. Methods: Literature review in existing and new clinical trials rules in India was conducted by referring the articles published in the indexed journals and official websites and compared. Conclusion: The clinical trials approval timeline has moved down to 30 days for the domestic trials and 90 days for the approval of global clinical trials. This faster approval timelines in the newly amended rules have enabled approval of more number of clinical trials and as a result, India may again turn out to be the preferred centre for conducting the trials. [ABSTRACT FROM AUTHOR]

Background: Media forms an important part of the lives of adolescents in as much as the shows they watch on television, playing video games, as well as visiting the various websites. There is a growing concern of the influence of media on every aspect of health of children and adolescents. About 95% of the population in India has availability of television. India has limited studies which have explored the use of screen‑based media (SBM) and its effect on child health. This study was conducted to assess the pattern of SBM use. Methods: A community‑based cross‑sectional study was conducted in an Urban Resettlement Colony, New Delhi. The study included 550 adolescents of age group from 10 to 19 years of age selected through simple random sampling from a list of adolescents residing in the area. A semi‑structured interview schedule was used. Results: About 98% of the adolescents used SBM. Television formed the maximum used media (96.5%). The mean (standard deviation) of the screen time was found to be 3.8 (2.77) h/day. Out of the total screen time, time contributed by television is 2.8 h/day followed by other SBM. About 68% of adolescents reported having screen time more than the recommended (>2 h). Significant association was observed between screen time and watching television while eating [odds ratio (95% confidence interval) = 0.35 (0.22, 0.55)]. Conclusion: High proportion of adolescents use SBM for more than the recommended screen time. We should have a recommendation for maximum screen time separately for developing countries. [ABSTRACT FROM AUTHOR]

Aims: This study was undertaken to determine the prevalence of active epilepsy, assess the sociodemographic profile, and psychological aspects of epilepsy in the Jaipur district of Rajasthan, India. Methods: We conducted a community-based, cross-sectional observational study covering both rural (n = 165,660) and urban (n = 179,142) populations of Jaipur district using a house-to-house survey. An adapted, pre-designed World Health Organization screening questionnaire was used to identify the cases. Those confirmed by neurologists as true seizures were included in the study. Cases were classified as per the International League against Epilepsy recommendation. Global Mental Health Assessment Tool electronic questionnaire was used to analyze psychological aspects of cases. The caregivers of the patients participated in the knowledge, attitude, and practice (KAP) survey. Results: A total of 380 patients (258 men, 122 women) were identified with active epilepsy. The estimated prevalence of active epilepsy was 1.1/1,000 population and 71% of cases belonged to low socioeconomic classes. Primary treatment gap was documented in 18.8% of cases in our study, 38% of cases were non-compliant to treatment with poorer compliance in those on pol-therapy, 76% had some psychiatric disorder, anxiety and depression being the commonest, and positive family history of epilepsy was found in 4.7%. KAP survey revealed that only 15% of the respondents believed that epilepsy is non-curable, 74% denied its infectious nature, 26% believed that epilepsy occurs due to past sins, and 81% said that they would not marry persons with epilepsy. Conclusion: A relatively low prevalence (1.1/1,000) of active epilepsy and a smaller primary treatment gap (18.8%) was found in our study population. Almost three-fourth of cases had an associated psychological problem, Though caregivers were aware of the nature of disease, majority would not prefer to marry a person suffering from epilepsy. [ABSTRACT FROM AUTHOR]

The global agenda of sustainable development (SD) will get a major boost from the successful implementation of the Sustainable Development Goals (SDGs) in developing countries. This requires effective planning and understanding of the SDGs at the national level and developing sound SDG indicators that account for country priorities. Currently, there is no formal SDG indicator set in India, but the process for it is underway. This paper has attempted to propose a unique technique for identifying the most representative indicator set for SD measurement in India based on the SDGs. Considering the needs and preferences of the country, a three‐stage process is proposed to develop the priority indicator set. The application of the approach has been presented for SDG 7, which relates to energy. This is supported with a background on India's SD progress. The proposed technique is simple yet effective, and can be easily replicated by other developing countries. [ABSTRACT FROM AUTHOR]