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Hand hygiene remains one of the most effective methods of preventing healthcare-associated infections. Hand drying is the end point of hand hygiene. Hand drying after hand hygiene is less explored, and the practice varies in different facilities. This explorative study was done to know the various hand-drying methods and practices of healthcare workers in Indian settings. This was a descriptive cross-sectional questionnaire-based observational study initiated from a tertiary care setup in Uttarakhand. Healthcare workers over 18 years of age directly involved in patient care were enrolled. A semi-structured questionnaire with both open-ended and close-ended questions was used with snowballing sampling technique. Statistical analysis was done using Statistical Package for Social Sciences (SPSS). Out of the eligible 395 respondents, 62.8% were female. The mean age of the respondents was 31.34 ± 8.44 years and average working hours were 8.87 ± 2.97 (range 4-24) hours. Only 72.7% did hand hygiene always before touching a patient. Nurses were more compliant about hand hygiene than doctors (P < 0.0001). A total of 82.8% were aware of appropriate hand-drying methods. Staff in the Intensive care unit Intensive care unit (ICU) setup were more aware of hand drying practices (P = 0.033). A total of 21.8% wiped their hands on their clothing to dry their hands. This was more in staff from paraclinical departments (P = 0.001). A total of 35.7% used handkerchiefs to dry hands. Resident doctors used handkerchiefs more than senior doctors or nursing staff (P = 0.01). A total of 49.9% of respondents spent less than 10 seconds in hand drying. Hand-hygiene knowledge is high among healthcare workers in India, but the knowledge of appropriate hand-drying practices is lacking. There is wide variation in the practice of hand drying. Better hand drying guidelines and incorporating hand drying as the essential endpoint of the hand hygiene ritual are warranted. [ABSTRACT FROM AUTHOR]

Community engagement is gaining prominence in global health research. But communities rarely have a say in the agendas or conduct of the very health research projects that aim to help them. This paper provides new evidence on how to share power in priority-setting in ways that seek to overcome structural constraints created by the funding environment. The five strategies were identified through case study research on the Participation for Local Action project in Karnataka, India. That project was carried out by researchers in partnership with the Zilla Budakattu Girijana Abhivrudhhi Sangha, an indigenous community development organisation representing the Solega people. The paper describes each identified strategy for sharing power in priority-setting, followed by a report of the pitfalls and challenges that arose when implementing it. Thus, the study also demonstrates that even where actions and strategies are used to address power imbalances, pitfalls will arise that need to be navigated. Given those challenges, considerations to reflect upon before employing the identified strategies are suggested. Ultimately, the paper aims to communicate strategies for sharing power during and after priority-setting and lessons on how to implement them effectively that can be used by global health researchers in the current funding environment. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyse and critically reflect on access to Assistive Technology (AT) for persons with disabilities (PWD) in Nepal, India and Bangladesh. This analysis aims to guide the development of a contextualised generic AT service delivery model suitable for these countries, based on the best practices identified. This paper is based on a comprehensive study conducted in Nepal, India and Bangladesh, observing mobility and hearing-related AT service delivery centres run by the government, as well as private and nongovernmental organisations, and interviews with key informants: policymakers (5), AT service providers (20) and AT service users (20) between December 2019 to February 2020. A descriptive, qualitative exploratory study design was followed. A quality assessment framework was used to structure the analysis and interpret the findings. AT service provisions are poorly developed in all three countries. On all quality indicators assessed, the systems show major weaknesses. AT users have very limited awareness about their rights to these services and the availability of AT services, the range of services available is very limited, and eligibility is dependent on medical criteria related to visible and severe disabilities. Lack of accessibility, eligibility, reachability and affordability are the main barriers to access AT services for PWD in Nepal, India and Bangladesh. Increased community level awareness, increased Government funding and a community based, medically informed flexible social model of AT services is a way forward to ensure access to AT services for PWD in these countries. Increased community awareness is necessary to increase access to Assistive Technology Services for Persons with Disabilities. Increased and flexible funding from the Government and philanthropists will improve rehabilitation. Establishment of community based Assistive Technology Services centres will increase access and improve rehabilitation. [ABSTRACT FROM AUTHOR]

Caregiving in the South Asian context is often assumed by family automatically for the person with cancer (PWC). In this paper, we applied the disclosure decision-making model (DD-MM) to understand the motives behind cancer prognosis disclosure (or not) by caregivers to the PWC. Fifty caregivers participated in semi-structured interviews; and data were analyzed using Framework Approach. For the disclosing caregivers, some of the themes that emerged were consistent with the DD-MM framework while others were not. In particular, the theme "recipient assessment" was part of the DD-MM framework, while others such as unmet communication needs, caregiver self-reflection, and family support were outside of the framework. In contrast, for the non-disclosing caregivers, the reasons for nondisclosure fit very concisely into the DD-MM framework, particularly with information assessment, recipient assessment, and (non) disclosure efficacy. This study has significant implications for development of communication skills trainings around holding family meetings in India. [ABSTRACT FROM AUTHOR]

This paper critically reviews and reflects on the processes for providing Assistive Technology (AT) services to Persons with Disabilities (PWD) in Bangladesh, India and Nepal. The aim is to investigate the AT service delivery systems in these countries and suggest improvements where weaknesses are identified. We carried out a descriptive qualitative exploratory study in Bangladesh, India and Nepal by conducting key informant interviews with policymakers (5), AT service providers (22) and mobility and hearing related AT service users (21). We used a directed content analysis approach guided by a seven-point AT service delivery process model to thematically analyse the existing processes for AT service delivery, from first contact through to follow-up and maintenance. AT service delivery processes are sub-optimal in all three countries, and improvements are needed. No common AT service delivery process was found, although there are common features. In general, it is easier for PWDs in India and Nepal to access AT than for those in Bangladesh, but all three countries are failing to live up to their commitments to uphold the human rights of PWDs. Although good elements of AT service delivery processes can be identified, the systems in all three countries are fragmented and generally weak. A more holistic approach of looking at the process of AT service delivery, from first contact right through to follow-up and device maintenance, with a single door service delivery system, free of cost at the point of service is recommended in these countries. Although we found significant weaknesses in AT delivery in all three countries, there are some good AT service delivery practices and opportunities for these countries to learn from one another. A systematic and stepwise approach to assessing current AT service delivery processes in the three countries – examining the delivery system as a whole, from initiation to repair and management – can help identify opportunities to improve the process for (prospective) AT users. A more coherent single door system of AT service delivery will increase the quality and efficiency of the fragmented AT service delivery practices in Bangladesh, India and Nepal. [ABSTRACT FROM AUTHOR]

Purpose: The incidents of elder victimisation and cases of victimisation, in general, are increasing fast in the society. These incidents have had negative impact on the sense of well-being and way of life of the older people. Therefore, fear of crime is being considered as a most concerning psycho-social problem amongst the older people in contemporary time. The purpose of this study is to understand the impact of crime rate on the well-being of the older people and examine the linkage between psychological factors and fear of crime amongst the older people. Design/methodology/approach: The present study is based on the mixed method approach and an exploratory research designed applied to conduct the study. The field survey has been done from October 2012 to January 2013 on a sample of 220 older people of rural and urban areas of Lucknow in the state of Uttar Pradesh through purposive sampling. For the study, researcher has interviewed 137 male older people and 83 female older people through interview schedules and case studies. The data have been analysed through descriptive and narrative analysis. Findings: The study finds that those older people have direct or indirect experience of victimisation, they have anxiety and feel insecurity that someone can victimise them. The study also finds that the happiness of older people is more affected due to anxiety and phobia and have higher level of feeling of fear of crime in their neighbourhood and home. The study also finds whenever anti-social elements are active in the neighbourhood and they commit crimes, fear of crime and anxiety grasp the older people to a large extent causing a fracture in their psychological well-being. Originality/value: This work is the original work of researcher. This paper is related to the researcher's PhD dissertation work. This paper talks about how the psychological well-being of older people affects due to nature of crime in neighbourhood, phobia of crime and anxiety due to criminal activities. [ABSTRACT FROM AUTHOR]

There is a global recognition that the homeless in different clusters are isolated social groups. They are highly susceptible to loneliness and related psycho‐physical health outcomes owing to their less supportive and fragmented social networks. The conditions are worse in the case of chronic or lifetime homelessness. Beyond this popular notion, other critical perspectives are also there. This paper attempts to analyse the differences in inter‐personal social networks between the chronic and the non‐chronic homeless groups at a railway junction in India. The data have been collected through structured and semi‐structured questionnaires from 28 homeless people (15 chronically and 13 non‐chronically homeless) of Burdwan Railway Junction – a vital railway junction of West Bengal, India. The chronically homeless group displays more supportive and compact inter‐personal networks in this study than the non‐chronic homeless group. Living in the station area for a long time, they have formed a society of their own. Barring some psychological stress and social abuse, the livelihood scenario of these people is relatively stress‐free and social networks relations are more intensive and supportive. Considering the outcomes, instead of the housing‐first approach of rehabilitation, we favour the development of community shelters with minimum basic amenities close to their present location. [ABSTRACT FROM AUTHOR]

Purpose: Fear of crime is an emerging social problem in Indian society that has a significant impact on the quality of life of the elderly. In the view of this fact, the purpose of this paper is to examine the factors such as (prior victimisation, vulnerability and incivility) which contribute their role in bringing fear of crime among the elderly. Design/methodology/approach: Mixed method approach has been applied in this paper. This study has been designed as an exploratory lead-in to a planned wider study into rural–urban context as possible factors in shaping the victimisation experience. The study has been conducted from October 2012 to January 2013 on a sample of 220 elderly living in both rural and urban areas of Lucknow in the state of Uttar Pradesh, India. Findings: The study found that elderly have been victimised by known persons as compared to unknown persons. Further, the study found that immediate neighbourhood was swarming with loiters, unruly teenagers, gangs, beggars and alcoholic people walk in the society which have significantly impact on the elderly and give threat in neighbourhood. Originality/value: This is an original work of researcher. [ABSTRACT FROM AUTHOR]

Background: Quality of childcare can predict a child's emotional and behavioural adjustment throughout the life span. Furthermore, this has major implications for child development and mental health in the long-term. Parents often face major challenges while providing childcare especially during the early years of a child. Aim: This paper describes specific parental concerns in raising a toddler from a mental health developmental perspective. Methods: The study was conducted in urban Bengaluru, India under an exploratory research design using semi-structured interviews. Ten parents participated in the study. Data was analysed using thematic analysis. Results: Four major themes emerged. The first theme was related to the formation of parental beliefs about parenting which identified several sources such as parenting practices witnessed during childhood, childhood experiences and influence of culture, mass or social media. The second theme to emerge was on concerns related to toddlers which parents had difficulties in understanding as well as managing, specially navigating through sleep and feed pattern, identifying developmental needs and making a meaning of toddlers' communication styles and content. The third theme showed parental concerns which consisted of areas such as parental stress, physical exhaustion, lack of time for each other or toddler, lack of information about handling toddlers and absence of validation of parental efforts. The final theme was on their current parenting practices with their toddlers which showcased controlling styles, play time but low on quality, inappropriate responses to toddlers' emotions or behaviours and several culturally practiced measures which were not validated scientifically. Conclusion: The pre-existing belief among parents about parenting and toddlers' specific behaviours influence parenting practices. The understanding of the parental challenges is beneficial in developing an appropriate parenting programme focussing on strengthening psychological capacities of toddlers. [ABSTRACT FROM AUTHOR]

Introduction: Poor medical information transfer across healthcare visits and providers poses a potential threat to patient safety. Patient‐held health records (PHRs) may be used to facilitate informational continuity, handover communication and patient self‐management. However, there are conflicting opinions on the effectiveness of PHRs, other than in maternal and child care. Moreover, the experiences of users of PHRs in low‐ and middle‐income countries are critical in policy decisions but have rarely been researched. Aim: This study aimed to explore similarities and differences in the perspectives of patients, carers and healthcare providers (HCPs) on the current PHRs for diabetes and hypertension in Kerala. Methods: A qualitative design was used comprising semistructured interviews with patients with diabetes/hypertension (n = 20), carers (n = 15) and HCPs (n = 17) in Kerala, India. Data were analysed using thematic analysis. Results: Themes generated regarding the experiences with PHRs from each user group were compared and contrasted. The themes that arose were organized under three headings: use of PHRs in everyday practice; the perceived value of PHR and where practice and value conflict. We found that in the use of PHRs in everyday practice, multiple PHRs posed challenges for patients carrying records and for HCPs locating relevant information. Most carers carried all patients' past PHRs, while patients made decisions on which PHR to take along based on the purpose of the healthcare visit. HCPs appreciated having PHRs but documented limited details in them. The perceived value of PHRs by each group for themselves was different. While HCPs placed value on PHRs for enabling better clinical decision‐making, preventing errors and patient safety, patients perceived them as transactional tools for diabetes and hypertension medications; carers highlighted their value during emergencies. Conclusion: Our findings suggest that users find a variety of values for PHRs. However, these perceived values are different for each user group, suggesting minimal functioning of PHRs for informational continuity, handover communication and self‐management. Patient and Public Involvement: Patients and carers were involved during the pilot testing of topic guides, consent and study information sheets. Patients and carers gave their feedback on the materials to ensure clarity and appropriateness within the context. [ABSTRACT FROM AUTHOR]

Background: Recent literature, largely from Africa, shows mixed effects of own-production on diet diversity. However, the role of own-production, relative to markets, in influencing food consumption becomes more pronounced as market integration increases.Objective: This paper investigates the relative importance of two factors - production diversity and household market integration - for the intake of a nutritious diet by women and households in rural India.Methods: Data analysis is based on primary data from an extensive agriculture-nutrition survey of 3600 Indian households that was collected in 2017. Dietary diversity scores are constructed for women and households is based on 24-hour and 7-day recall periods. Household market integration is measured as monthly household expenditure on key non-staple food groups. We measure production diversity in two ways - field-level and on-farm production diversity - in order to account for the cereal centric rice-wheat cropping system found in our study locations. The analysis is based on Ordinary Least Squares regressions where we control for a variety of village, household, and individual level covariates that affect food consumption, and village fixed effects. Robustness checks are done by way of using a Poisson regression specifications and 7-day recall period.Results: Conventional measures of field-level production diversity, like the number of crops or food groups grown, have no significant association with diet diversity. In contrast, it is on-farm production diversity (the field-level cultivation of pulses and on-farm livestock management, and kitchen gardens in the longer run) that is significantly associated with improved dietary diversity scores, thus suggesting the importance of non-staples in improving both individual and household dietary diversity. Furthermore, market purchases of non-staples like pulses and dairy products are associated with a significantly higher dietary diversity. Other significant determinants of dietary diversity include women's literacy and awareness of nutrition. These results mostly remain robust to changes in the recall period of the diet diversity measure and the nature of the empirical specification.Conclusions: This study contributes to the scarce empirical evidence related to diets in India. Additionally, our results indicate some key intervention areas - promoting livestock rearing, strengthening households' market integration (for purchase of non-staples) and increasing women's awareness about nutrition. These are more impactful than raising production diversity. [ABSTRACT FROM AUTHOR]

Background Information on the average and incremental costs of implementing alternative strategies for treating young infants 0-59 days old in primary health facilities with signs of possible serious bacterial infection (PSBI) when a referral is not feasible is limited but valuable for policymakers. Methods Direct activity costs were calculated for outpatient treatment of PSBI and pneumonia in two districts of India: Palwal, Haryana and Lucknow, Uttar Pradesh. These included costs of staff time and consumables for initial assessment, classification, and referrals; recommended treatment of fast breathing (oral amoxicillin for seven days) and PSBI (injection gentamicin and oral amoxicillin for seven days); and daily assessments. Indirect operational costs included staff training; staff time cost for general management, supervision, and coordination; referral transport; and communication. Results The average cost per young infant treated for recommended and acceptable treatment for PSBI was 16 US dollars (US$) (95% CI=US$15.4-16.3) in 2018-19 and US$18.5 in 2022 (adjusted for inflation) when all direct and indirect operational costs were considered. The average cost of recommended treatment for pneumonia was US$10.1 (95% CI=US$9.7-10.6) or US$11.7 in 2022, per treated young infant. The incremental cost 2018-2019 for supplies, medicines, and operations (excluding staff time costs) per infant treated for PSBI was US$6.1 and US$4.3 and for pneumonia was US$3.5 and US$2.2 in Palwal and Lucknow, respectively. Operation and administrative costs were 25% in Palwal and 12% in Lucknow of the total PSBI treatment costs. The average cost per live birth for treating PSBI in each population was US$5 in Palwal and US$3 in Lucknow. Higher operation costs for social mobilisation activities in Palwal led to the empowerment of families and timely care-seeking. Conclusions Costs of treatment of PSBI with the recommended regimen in an outpatient setting, when a referral is not feasible, are under US$20 per treated child and must be budgeted to reduce deaths from neonatal sepsis. The investment must be made in activities that lead to successful identification, prompt care seeking, timely initiation of treatment and follow-up. [ABSTRACT FROM AUTHOR]

This mixed-methods, exploratory study investigates the gambling activities of street youth in Mumbai, India. Data from surveys and brief interviews of 70 youth aged 12–24, two focus groups, and ethnographic observations offer descriptive snapshots of the gambling behavior of participants. The article includes details about games played, popular venues, initiation patterns, time spent gambling, and interactions with the police. Street youth gamble for social benefits, such as group membership and fun; it is also a leisure activity enabling time to go by quickly. Individual benefits include intermittent rewards and a high after winning or being referred to as a gambler. The inability to save, the lack of recreation options, living in groups, and the environment of the streets structure and sustain gambling. This study discusses the group and social dimension of gambling among street youth, and how this dimension makes their participation different from adolescent gambling in general and General Addictions Theory. It contributes to the literature by emphasizing that for street youth the social/group aspects of gambling predominate the psychological. The paper concludes with a discussion of the implications for practice, highlighting the need to develop recreational, income-saving, and educational awareness programs. [ABSTRACT FROM AUTHOR]

Antenatal morbidities and associated malpractices are quite prevalent in slums of Delhi. This paper aims to highlight the relationship between calories intake, seasonality and gravida. It also draws attention towards inter-related aspects of antenatal practices and morbidity among women. Survey of 400 women conducted in the slums of Delhi indicated high occurrence of antenatal and post-natal malpractices. The findings indicated that discrepancies in the advice given by the medical practitioners and traditional birth attendants (TBAs). This was seen to adversely impact a majority of expectant mothers. The finding support a strong direct relationship between calories intake, seasonality morbidity and mortality patterns among women as well as their children. Although ample research has been done on homebirths and their challenges, the perspectives of TBAs (who assist in the majority of homebirths) remain unexamined. The present study sought to add to this knowledge base by uncovering various practices prevalent in low income households of a cosmopolitan city like Delhi. [ABSTRACT FROM AUTHOR]

Background: Tobacco is a public health concern at global and national levels. The state of Gujarat has 28.6% prevalence of tobacco use, 22% in males and 8% in females. Rajkot, the fourth largest and fastest growing city in Gujarat, is not free from the burden of tobacco use. Aim: The aim of this study was to assess the patterns of tobacco use and utilization of tobacco cessation services in the city of Rajkot. Methodology: This was a cross-sectional observational study conducted on adult tobacco users attending rural and urban primary healthcare centers (PHCs) in Rajkot. At least 16 participants were recruited from all 75 PHCs (a total of 1152) using probability sampling. Study instruments comprised semi-structured proforma, Fagerstrom Test for Nicotine Dependence, and readiness to change questionnaire. Responses were analyzed using SPSS version 26.0. Results: A total of 1161 participants were included. Smokeless tobacco (n = 967, 83.3%) was preferred over smoking. Mava was the most common smokeless tobacco preparation consumed. The median age of onset was 28 years (interquartile range [IQR]: 22-37), and the median duration of use was 5 years (IQR: 4-10). Males had a significantly greater duration of abstinence (U = 1218.6, P = 0.002), greater readiness to quit (χ² [df] = 35.66 [8], P = 0.001), and anticipated success (χ² [df] = 28.71 [8], P = 0.004) in abstaining. While utilization of tobacco cessation services was poor overall, counseling (32.5%) and nicotine replacement therapy (19%) were the most commonly used. Conclusion: There is a need for in-depth research on tobacco use among smaller communities, upscaling harm reduction services for tobacco use. Prevention and IEC initiatives need to be revamped considering the special needs of female tobacco users. [ABSTRACT FROM AUTHOR]

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

The Revised National Tuberculosis Control Programme (RNTCP), which incorporated the WHO DOTS strategy was introduced in India in the mid-1990s. An operational research project was conducted between 1996 and 1998 to assess the needs and perspectives of patients and providers in two chest clinics in Delhi, Moti Nagar and Nehru Nagar, during the introduction of the new strategy. This paper reports on the findings of the project, concentrating on information collected from 40 in-depth interviews with patient defaulters and from non-participant observations in clinics and directly observed treatment centres. In Moti Nagar chest clinic, 117 of 1786 (6.5%) patients and 195 of 1890 (10%) patients in Nehru Nagar left care before their treatment was complete. It was argued that the reasons for default stem from a poor correlation between patient and programme needs and priorities, and from particular characteristics of the disease and its treatment. Patient needs that were not met by the health system included convenient clinic timings, arrangements for the provision for treatment in the event of a family emergency and provision for complicated cases like alcoholics. The problems facing the provider were poor interpersonal communication with the health staff, lack of attention and support at the clinic, difficulty for patients to re-enter the system if they missed treatment and, in certain areas, long distances to the clinic. Problems related to diseases were inability of the staff to deal with drug side-effects, and patients' conception of equating well-being with cure. Simple, practical measures could improve the provision of tuberculosis (TB) treatment: more flexible hours, allowances for poor patients to reach the clinics and training health care staff for respectful communication and monitoring drug side-effects. The findings indicate a need to rethink the label of 'defaulter' often given to the patients. The important areas for future operational research is also highlighted. [ABSTRACT FROM AUTHOR]

Attention to advancing engagement in social work has grown within the global discourse on community engagement in higher education. It is against this backdrop that this article sought to explore the process of engagement and the benefits of engagement for social work students at a university in Mumbai, India. The study is salient as it focuses on community engagement, particularly service learning at the interface of tribal social work. Data were collected using a qualitative approach. Semi-structured in-depth interviews and focus group discussions were held with students (n = 23) and social work educators (n = 7). The study captured the process of preparing students for engagement and found that their social work learning experiences were strengthened through immersion in a tribal community, in India. [ABSTRACT FROM AUTHOR]

Background: The unprecedented onset of coronavirus disease 2019 (COVID-19) had a huge impact on health-care facilities, leading to different psychosocial challenges among health-care workers (HCWs) during this pandemic. Aim: This study aimed to explore the impact of COVID-19 on the work, family, and personal life of HCWs engaged in COVID-19 duties during the first wave in India and gain insights on the coping strategies. Materials and Methods: The findings from 12 qualitative in-depth interviews were analyzed and presented in this article. This study is a part of a mix-method design study conducted at two hospitals and one community site in Mumbai, Maharashtra. The present qualitative sample was drawn conveniently from the randomly selected quantitative sample chosen from the three sites. Results: This study highlights that in the early stage of the COVID-19 pandemic, HCWs experienced transition in work life, burnout, disruption in family life, negative emotions such as fear, and experiences of stigma. The findings also reveal that while institutional workers faced discrimination and stigma outside their workplace, noninstitutional workers faced discrimination at multiple sites during traveling and at in their residential places and additionally faced harassment while working in the community. The findings also suggest that despite numerous challenges faced by HCWs, they were driven by a sense of responsibility and displayed resilience. Conclusion: Considering the HCWs as the backbone of the health-care system, it is crucial to boost and maintain the mental well-being of HCWs by providing timely and tailored interventions to sustain their resilience and build better responses to future pandemic. [ABSTRACT FROM AUTHOR]

Rape myths are stereotypical beliefs that excuse the rapist and hold the victim responsible for rape, leading to secondary victimization. This study attempts to grasp the nature of rape myths in the Indian context and compares them with rape myths that appear in the literature. Detailed semi‐structured interviews were conducted with members of the general public (shopkeepers, clerks, students, counselors, peons, and guards) and legal actors (police personnel and lawyers). Results are discussed regarding the rejection of or support for rape myths and additional rape myths. Interestingly, we found that Indians are not supportive of rape myths that excuse rapists when they are influenced by alcohol. In support of previously researched rape myths, we found that Indians overestimated false accusations and blamed revealing clothes, women's drinking, and going out at night. We also found additional rape myths prevalent in India that are unique but not necessarily restricted to the Indian context. These include 'western' clothes, lack of parental control, disregard for traditional norms, provoking anger in males, and going out for leisure. Our findings suggest that the nature and intensity of rape myths vary according to culture. Assessment tools and educational interventions need to be tailored according to these variations. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Being one of the most common types of life threatening diseases in Southern Assam, India, the digestive system disorders (DSD) have gained much attention in recent decades. Traditional beliefs and inadequate income of mass population result in the use of alternative phytotherapies to treat the diseases. Aim of the study The present paper documents the medicinal knowledge and utilization of plants for treatment of digestive system disorders in Southern Assam, India by Disease Consensus Index (DCI). It also determines the most suitable plant species used to treat digestive system disorders in the study area. Materials and methods The study was based on ethnomedicinal field survey covering a period of 1 year from 2014–2015. The ethnomedicinal information was collected by using semi-structured questionnaires from different traditional Bengali people having knowledge on medicinal plants. Collected data were analyzed by calculating DCI. Results During the survey, 29 informants were interviewed and a total of 49 plants under 46 genera belonging to 33 families were listed. Data analysis revealed that Litsea glutinosa , Momordica charantia , Andrographis paniculata , Lawsonia inermis , Cleome viscosa , Psidium guajava , Ageratum conyzoides , Cuscuta reflexa , Cynodon dactylon and Carica papaya are the most prominent plants among the people of Southern Assam for treating DSD. Conclusion This explorative survey emphasizes the need to preserve and document the traditional healing practices for managing DSD inviting for more imminent scientific research on the plants to determine their efficacy as well as safety. With the help of statistical analysis (DCI), we propose 10 priority plants for DSD in present work. Systematic pharmacological study with these plants may contribute significant result. [ABSTRACT FROM AUTHOR]

Background: Rastriya Kishor Swasthya Karyakram (RKSK) is a holistic approach implemented for betterment of adolescent health. Barriers in the implementation can be identified by conducting the situational analysis of any program. The present study is a part of the multi-centric study conducted at Sabarkantha district for situational analysis of RKSK. To assess the implementation of various components under RKSK at various levels of health facilities, 2) to identify the barriers faced by services providers in RKSK implementation, and 3) to identify the perception of beneficiaries regarding RKSK. Materials and Methods: A Cross-sectional study using a mixed method approach was conducted to review the implementation of the RKSK program at Sabarkantha district. In-depth interview of health personnel involved in implementation of RKSK was conducted using pre-structured and pre-tested interview guide. Ongoing sessions of Adolescent Friendly Health Clinics (AFHCs) were examined, and exit interview of adolescents was conducted. Adolescents residing within limits of the defined facility were also interviewed. Frequency and percentages were used for descriptive analysis, and a thematic qualitative analysis approach was used for qualitative aspects. Results: RKSK was implemented successfully at Primary Health Centers. Infrastructure for AFHC was inadequate particularly at higher care facilities. Weekly Iron Folic Acid Supplementation (WIFS) was successfully implemented in the district. Overall sessions conducted at AFHC were found to be satisfactory. Adolescents interviewed in the community were satisfied with the services delivered to them under RKSK. Conclusion: For better implementation of RKSK, there is a need to focus on certain issues such as inadequate infrastructure of AFHCs, the lack of trained counselors, unavailability of sanitary pads, and inadequate participation of adolescents from the community in availing RKSK services. [ABSTRACT FROM AUTHOR]

The private health sector in India is generally unregulated. Maharashtra is among the few states which require registration of private hospitals. This paper reports on a study of standards of care in small, private hospitals (less than 30 beds) in Maharashtra state, India, with a focus on maternity care, based on interviews with the hospitals' owners or senior staff, and observation. In the absence of reliable information on the number of private hospitals in the state, a physical listing was carried out in 11 districts and an estimate drawn up; 10% of hospitals found in each location were included in the study sample. We found poor standards of care in many cases, and few or no qualified nurses or a duty medical officer in attendance. Of the 261 hospitals visited, 146 provided maternity services yet 137 did not have a qualified midwife, and though most claimed they provided emergency care, including caesarean section, only three had a blood bank and eight had an ambulance. Government plans to promote public–private partnerships with such hospitals, including for maternity services, create concern, given our findings. The need to enforce existing regulations and collect information on health outcomes and quality of care before the state involves these hospitals further in provision of maternity care is called for. Le secteur privé est en général non réglementé en Inde. Maharashtra est l'un des rares États qui exigent l'agrément des hôpitaux privés. Cet article concerne une étude des normes de soins dans des petits hôpitaux privés (moins de 30 lits) dans l'État de Maharashtra, Inde, en particulier les soins obstétricaux, sur la base d'entretiens avec les propriétaires ou la direction de l'hôpital, et d'observations. En l'absence d'informations fiables sur le nombre d'hôpitaux privés dans l'État, une liste a été dressée dans 11 districts et une estimation a été établie ; 10% des hôpitaux recensés dans chaque site ont été inclus dans l'échantillon de l'étude. Dans beaucoup de cas, nous avons constaté des normes de soins médiocres, et peu ou pas d'infirmières qualifiées ni de médecin de garde présent. Des 261 hôpitaux visités, 146 assuraient des services de maternité, pourtant 137 n'avaient pas de sage-femme qualifiée, et même si la plupart affirmaient pratiquer des soins d'urgence, y compris des césariennes, trois seulement disposaient d'une banque du sang et huit d'une ambulance. Compte tenu de nos conclusions, la volonté du Gouvernement de promouvoir les partenariats publics-privés avec ces hôpitaux, notamment pour les services de maternité, est préoccupante. Il est nécessaire de faire appliquer la réglementation en vigueur et de recueillir des informations relatives aux effets sur la santé et à la qualité des soins avant que l'État n'implique davantage ces hôpitaux dans les soins obstétricaux. En India, el sector salud privado por lo general no es regulado. Maharashtra es uno de los pocos estados que requieren registro de hospitales privados. Este artículo informa sobre un estudio de las normas de asistencia en hospitales privados pequeños (menos de 30 camas), en el estado de Maharashtra, India, con un enfoque en la atención obstétrica, basado en entrevistas con los propietarios de los hospitales o personal de alto nivel, y en observación. En la ausencia de información fidedigna sobre el número de hospitales privados en el estado, se realizó un listado físico en 11 distritos y se calculó el número aproximado. En la muestra del estudio se incluyó el 10% de los hospitales encontrados en cada lugar. En muchos casos, se encontró calidad de atención deficiente y ninguna o pocas enfermeras calificadas o un funcionario médico de turno presente. De los 261 hospitales visitados, 146 ofrecían servicios obstétricos, pero 137 no tenían a una partera profesional calificada. Aunque la mayoría afirmaba ofrecer cuidados de emergencia, incluso cesáreas, sólo tres tenían un banco de sangre y ocho tenían ambulancia. En vista de nuestros hallazgos, los planes gubernamentales de promover alianzas entre los sectores público y privado con estos hospitales, incluso para servicios obstétricos, son preocupantes. Aún es necesario velar por el cumplimiento de los reglamentos en vigor y recopilar información sobre los resultados en salud y la calidad de la atención antes de que el estado implique aun más a estos hospitales en la prestación de servicios obstétricos. [ABSTRACT FROM AUTHOR]

Background: Palliative care has proven over time that it can help prolong life spans with the use of hospices. The literature reports that most patients with cancer are diagnosed in the later stages and since there is no cure, they will require palliative care at some point during their illness. However, most developing countries, including India, have failed to establish hospices; as a result, large numbers of cancer patients are still deprived of palliative care. To initiate better access to hospices, it is important to understand the benefits of the same. Therefore, the present study aims to explore the advantages of hospice care from the perspectives of advanced cancer patients living in hospice centres. Methods: The present study uses the method of exploratory research. Using purposive sampling, 8 participants living in a hospice in Bengaluru, India were selected and semi-structured interviews were conducted to collect data from the patients. This data was analysed using thematic analysis. Any underlying patterns were determined to identify the evident themes that emerged from the data. Results: After thematic analysis, 4 themes were identified, namely, pain management, altruism, a good death, and overall satisfaction. Within some themes, there were specific sub-themes that have been illustrated using direct quotes from the interviews. Conclusion: The findings of this study suggest that hospice centres play an important role in helping patients to come out of the trauma during the advanced stages of cancer. A sense of relief can be given to the patient by implementing palliative care. This is possible by building more hospice centres in the country where all individuals, irrespective of their financial status, can opt for the service. Having palliative care will provide dignified death to the patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: In November 2016, the government of India declared 86%of the total money in circulation as demonetized. This policy was brought into effect overnight, and it had great macro socioeconomic impact not only on the economy of the country but on the common people, especially the socioeconomically challenged. While several researchers have focused on, and continue to investigate, the effects of demonetization on the economy, its impact on the psychosocial health of workers has not yet been studied. OBJECTIVE: To provide an exploratory investigation of the psychosocial consequences of demonetization on the workers in Indian tea gardens. METHODS: A qualitative research approach was employed. Face-to-face interviews were conducted with seven key informants (clinicians and executives/managers), and 36 tea garden workers were involved in six focus groups. Collected data were analyzed using the Template Analysis technique. RESULTS: From the data analysis, five main themes emerged concerning the psychosocial factors involved in demonetization effects: socioeconomic changes, organizational consequences, workplace interpersonal relationships, work-family interface, and psychophysical symptoms. CONCLUSIONS: This preliminary study highlighted the significant impact that demonetization had on tea gardens at both the organizational and individual levels. [ABSTRACT FROM AUTHOR]

Objective: Over half of pregnant women in India are affected by anaemia, which can lead to premature birth, low birth weight and maternal and child mortality. Using formative research, we aimed to understand social and cultural factors around iron and folic acid (IFA) supplement provision and adherence to identify potential strategies for improving adherence and behaviours to prevent and treat anaemia among pregnant and lactating Indian women.Design: In-depth interviews and focus group discussions with women and key informant interviews with health officials and workers.Setting: Four districts in two Indian states: Allahabad and Bara Banki districts in Uttar Pradesh and Chikkballapura and Mandya districts in Karnataka.Participants: Pregnant and lactating women (n 65) and district officials and community health workers (n 14).Results: Most women were aware of anaemia but did not understand its seriousness and consequences. All women received IFA supplements (predominantly for free), but many were not adherent because of side effects; lack of information from healthcare providers on the causes of anaemia, its seriousness and solutions and low social support. To address anaemia, women were most confident in their ability to prepare and eat healthier foods but lacked control over resources such as appropriate food availability.Conclusions: Based on the findings, we recommend multicomponent interventions to train healthcare providers, address systemic barriers and involve family members to support IFA supplement adherence and dietary changes. Future research will determine which strategies are most effective to reduce the burden of anaemia in India among pregnant and lactating women. [ABSTRACT FROM AUTHOR]

As health advertising researchers we become involved with a variety of health and well-being issues in order to advance social marketing research. Health advertising research involves mainly face-to-face encounters with participants using qualitative methodologies. This article explores the challenges a researcher of British origin faced undertaking fieldwork in India in an effort to collect qualitative data about breast cancer awareness (BCA) and prevention, a culturally taboo subject. Key obstacles included cultural barriers, research method assumptions and researcher resilience. Reflexivity has been recognized as a crucial stage in the process of generating knowledge via qualitative research processes. Thereby applying the critical lens of reflexivity, this article reflects upon the complexities of accessing Indian women (a fiercely private demographic) to participate in discussions about the sensitive topic of breast cancer. The results are discussed and recommendations from this researcher's experience are presented as a resource to assist future qualitative health advertising inquiry [ABSTRACT FROM AUTHOR]

Joint involvement of couples is an effective strategy to increase contraceptive use and improve reproductive health of women. However, engaging couples to understand how their gender attitudes affect their personal and family health is an idea in search of practice. This mixed-methods study explores opportunities and barriers to couples' participation in health promotion in three slums of Delhi. For each couple, surveys and semi-structured interviews were conducted with husbands and wives individually to contrast self and spousal work, time, interest in health, sources of information related to health and depth of knowledge (n  = 62). Urban poverty forces men to work long hours and women to enter part-time work in the informal sector. Paid work induces lack of availability at home, lack of interest in health information and in performing household chores and a self-perception of being healthy among men. These factors inhibit men's' participation in community-based health promotion activities. Women's unpaid work in the household remains unnoticed. Women were expected to be interested in and to make time to attend community-based health-related activities. Men recalled significantly less sources of health information than their spouse. Men and their wives showed similar depth of health-related knowledge, likely due to their spousal communication, with women acting as gatekeepers. Health promotion planners must recognize time constraints, reliance on informal interpersonal communication as a source of health information and the need to portray positive masculinities that address asymmetric gender relations. Innovative, continuous and collaborative approaches may support couples to proactively care about health in low-resource settings. [ABSTRACT FROM AUTHOR]

Background: Despite the high and rising burden of chronic kidney disease (CKD) in South Asia, factors that influence access to CKD care at the community level have not been studied previously, especially in the rural areas. We conducted a mixed methods study and interviewed key stakeholders to explore the views and experiences of key stakeholders, and identify barriers and potential facilitators that influence access to CKD care at the primary care level in rural India.Methods: A total of 21 stakeholders participated in the study. We conducted 15 in-depth interviews on a purposive sample of stakeholders (CKD patients, healthcare providers and health planners) and one focus group discussion with 6 community health workers. The interviews were audio-recorded and transcribed verbatim. We employed the Lévesque's framework for access to care to base interview guides and structure the initial codes. By inductive and deductive approaches, thematic analysis was undertaken using QSR NVivo version 11.Results: The major patient-level barriers to CKD care as reported by the most patients and healthcare providers was poor knowledge and awareness of CKD. Health system-level barriers included shortages of skilled healthcare professionals and medicines, fragmented referrals pathways to the specialists at the hospitals with inadequate follow up care. Many patients and healthcare providers, when asked about areas for improving access to CKD care, reported educational initiatives to increase awareness of CKD among healthcare providers and patients, provision of CKD related supplies, and a systems-level approach to care coordination including task shifting by engaging community health workers in CKD care, as potential facilitators.Conclusions: We identified several barriers to access CKD care at the primary care level in rural India that need urgent attention. Targeted CKD screening programs and CKD specific educational initiatives may improve awareness of CKD. Additionally, primary care infrastructure needs to be strengthened for CKD care, ensuring trained staff, availability of essential diagnostics and medications, and creating efficient referral pathways for quality CKD care. [ABSTRACT FROM AUTHOR]

Aims and objectives: To compare the communication and practice experiences of migrant nurses in geographically distant, culturally dissimilar countries in Eastern and Western contexts. Background: Considerable research has focused on the experience of acculturation of migrant nurses into geographically diverse locations. However, there remains scant comparative research which considers the ways in which migrant nurses interpret their experience through making "sense" of events encountered in their practice. Design: An exploratory qualitative study was conducted using face‐to‐face interviews with 36 migrant nurses currently practising in New Zealand and 20 migrant nurses practising in the United Arab Emirates. Methods: The same question schedule was used to explore influences on communication and practice in both settings. Thematic analysis and sensemaking theory guided coding and analysis of data. COREQ guidelines informed the reporting of qualitative data. Results: Qualitative analysis resulted in five representative themes, three illustrating similarities across diverse cultures and two that demonstrate the differences migrant nurses require to navigate across contrasting cultural environments successfully. Conclusion: Cultural value‐based differences in both locales caused both systemic and interpersonal sensemaking challenges for migrant nurses that emphasise the importance of orientation and education programmes for internationally qualified nurses. However, cultural conflicts also exist within groups. Orientation programmes should address culturally patterned responses among different groups of internationally qualified nurses. Relevance to clinical practice: Findings demonstrate a need for migrant nurses to be willing to embrace ambiguity in order to acculturate into a collaborative team culture in each of the geographical locations in this study. As registered nurses (RNs) also carry their cultural imprint, orientation interventions targeting the cultural variations of nurses in less standardised orientation programmes may be more beneficial in enhancing acculturation and in turn, staff retention. [ABSTRACT FROM AUTHOR]

Background: There is no single best indicator to assess the childhood socioeconomic position (CSEP) in public health research. The aim of the study is to develop and validate a new questionnaire, with adequate psychometric properties, to measure the childhood SEP of the young adults. Methods: The first phase consisted of a qualitative phase to identify the variables to measure childhood SEP through the in-depth interviews among 15 young adults (18-45 years) of rural Kerala. The second phase was a quantitative phase to validate the questionnaire through a cross sectional survey among 200 young adults of Kerala. We did content validity, reliability tests and construct validity by using exploratory factor analysis of the questionnaire to demonstrate its psychometric properties. Results: The qualitative analysis reported 26 variables spread across 5 domains to measure the CSEP. Finally, the questionnaire has 11 questions with 3 domains named as value added through paternity, maternal occupation-related factors and parental education. The questionnaire has good reliability (Cronbach's α=0.88) also. Conclusion: We have developed a reliable and valid questionnaire to measure the childhood SEP of younger adults and can be used in various public health research. [ABSTRACT FROM AUTHOR]

This study was designed to examine the rates of HIV serostatus disclosure in a sample of HIV-infected children in the state of Karnataka in South India, their reactions to learning their HIV-positive status and the reasons for and barriers to disclosure from the point of view of their caregivers. We enrolled 233 HIV-infected children, aged 5-18 years and their caregivers between July 2011 and February 2013 at HIV clinics in three tertiary care centers. Caregiver interviews included information about demographic characteristics, medical history, type of disclosure to the child and other related factors, including disclosure barriers. Three quarters (n = 185) of the caregivers reported that there had been no disclosure to the child, 15.4% (n = 38) reported partial disclosure (e.g. telling the child he or she had a 'chronic illness') and only 9.7% (n = 24) reported full disclosure, at a mean age of 10.9 (SD: 2.5) years. Caregivers, who planned to disclose in the future, stated on average that 16 years would be the right age. Those who favored a later disclosure reported that they feared strong negative emotional reactions from the child (p = 0.03) and social isolation (p < 0.001) following disclosure. These results show that that the level of full disclosure is low among South Indian youth living with HIV, and that when disclosure occurs, it is most likely to be partial. The majority of children who learned their status had been informed by a health-care provider, possibly reflecting the difficulty for a caregiver of having this conversation. The caregivers reported multiple disadvantages of disclosure, mostly because of fears of stigma and discrimination. Despite some evidence from the literature that disclosure can have positive effects on a child's health, it is thus clear that we need to develop, implement and evaluate community-based stigma reduction programs to reduce the social barriers to disclosure. [ABSTRACT FROM AUTHOR]

Context: Patients with chronic life-limiting conditions on palliative care (PC) prefer to be treated at home. Medical care by family physicians (FPs) reduces demand on costly and busy hospital facilities. Working of PC team in collaboration with FPs is thus helpful in home-based management of patients. Aims: This study aimed at exploring the extent of knowledge of FPs about PC and the need for additional training. Settings and Design: Semi-structured interviews were conducted with ten FPs from two suburbs of Mumbai, currently served by home care services of a tertiary cancer care center. Subjects and Methods: Data were digitally recorded, transcribed, and analyzed using exploratory analysis followed by content analysis to develop thematic codes. Results and Conclusions: FPs perceive PC as symptom control and psychological support helpful in managing patients with advanced life-limiting illnesses. Further training would help them in PC provision. Such training programs should preferably focus on symptom management and communication skills. There is a need for further research in designing a training module for FPs to get better understanding of the principles of PC. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases (NCDs) represent the largest, and fastest growing, burden of disease in India. This study aimed to quantify levels of diagnosis, treatment, and control among hypertensive and diabetic patients, and to describe demand- and supply-side barriers to hypertension and diabetes diagnosis and care in two Indian districts, Shimla and Udaipur.Methods: We conducted household and health facility surveys, as well as qualitative focus group discussions and interviews. The household survey randomly sampled individuals aged 15 and above in rural and urban areas in both districts. The survey included questions on NCD knowledge, history, and risk factors. Blood pressure, weight, height, and blood glucose measurements were obtained. The health facility survey was administered in 48 health care facilities, focusing on NCD diagnosis and treatment capacity, including staffing, equipment, and pharmaceuticals. Qualitative data was collected through semi-structured key informant interviews with health professionals and public health officials, as well as focus groups with patients and community members.Results: Among 7181 individuals, 32% either reported a history of hypertension or were found to have a systolic blood pressure ≥ 140 mmHg and/or diastolic ≥90 mmHg. Only 26% of those found to have elevated blood pressure reported a prior diagnosis, and just 42% of individuals with a prior diagnosis of hypertension were found to be normotensive. A history of diabetes or an elevated blood sugar (Random blood glucose (RBG) ≥200 mg/dl or fasting blood glucose (FBG) ≥126 mg/dl) was noted in 7% of the population. Among those with an elevated RBG/FBG, 59% had previously received a diagnosis of diabetes. Only 60% of diabetics on treatment were measured with a RBG <200 mg/dl. Lower-level health facilities were noted to have limited capacity to measure blood glucose as well as significant gaps in the availability of first-line pharmaceuticals for both hypertension and diabetes.Conclusions: We found high rates of uncontrolled diabetes and undiagnosed and uncontrolled hypertension. Lower level health facilities were constrained by capacity to test, monitor and treat diabetes and hypertension. Interventions aimed at improving patient outcomes will need to focus on the expanding access to quality care in order to accommodate the growing demand for NCD services. [ABSTRACT FROM AUTHOR]

Purpose: The risk behaviors of Hong Kong ethnic minority students are understudied. This exploratory qualitative study aimed to explore culturally nuanced factors for the development and prevention of risk behaviors among Pakistani and Indian students in Hong Kong. Method: Twenty-three students participated in four focus groups. All interviews were transcribed verbatim and analyzed using thematic analysis. Results: The participants reported bullying, delinquency, gambling, alcohol, cigarette, and drug uses as risk behaviors. Four themes emerged in the development and prevention of risk behaviors: (a) Parental and peer influence, (b) An unsafe community environment were perceived by the participants as essential factors for the development of risk behaviors, (c) Parental monitoring, and (d) Strong religious beliefs were believed as protective factors for the prevention of risk behaviors. Conclusion: Further research and practice may investigate and focus on the factors embedded in the Hong Kong ethnic minorities’ sociocultural contexts to prevent risk behaviors. [ABSTRACT FROM AUTHOR]

Background: Internal labour migration is an important and necessary livelihood strategy for millions of individuals and households in India. However, the precarious position of migrant workers within Indian society may have consequences for the health of these individuals. Previous research on the connections between health and labour mobility within India have primarily focused on the negative health outcomes associated with this practice. Thus, there is a need to better identify the determinants of internal migrant health and how these determinants shape migrant health outcomes. Methods: An exploratory mixed methods study was conducted in 26 villages in the Krishnagiri district of Tamil Nadu. Sixty-six semi-structured interviews were completed using snowball sampling, followed by 300 household surveys using multi-stage random sampling. For qualitative data, an analysis of themes and content was completed. For quantitative data, information on current participation in internal labour migration, in addition to self-reported morbidity and determinants of internal migrant health, was collected. Morbidity categories were compared between migrant and non-migrant adults (age 14-65 years) using a Fisher's exact test. Results: Of the 300 households surveyed, 137 households (45.7%) had at least one current migrant member, with 205 migrant and 1012 non-migrant adults (age 14-65 years) included in this study. The health profile of migrant and non-migrants was similar in this setting, with 53 migrants (25.9%) currently suffering from a health problem compared to 273 non-migrants (27.0%). Migrant households identified both occupational and livelihood factors that contributed to changes in the health of their migrant members. These determinants of internal migrant health were corroborated and further expanded on through the semi-structured interviews. Conclusions: Internal labour migration in and of itself is not a determinant of health, as participation in labour mobility can contribute to an improvement in health, a decline in health, or no change in health among migrant workers. Targeted public health interventions should focus on addressing the determinants of internal migrant health to enhance the contributions these individuals can make to their households and villages of origin. [ABSTRACT FROM AUTHOR]

Migrant workers are understood to be vulnerable to HIV. However, little is known about the experience of migration-based households following HIV infection. This qualitative study examined the migration-HIV relationship beyond the point of infection, looking at how it affects livelihood choices, household relationships and the economic viability of migrant families. We conducted semi-structured interviews with 33 HIV-positive migrant men and women recruited from an anti-retroviral therapy (ART) centre in north India. Following infection among the migrant men, contact with free, public-sector HIV services was often made late, after the development of debilitating symptoms, abandonment of migrant work and return to native villages. After enrolment at the ART centre participants’ health eventually stabilised but they now faced serious economic debt, an inflexible treatment regimen and reduced physical strength. Insecure migrant job markets, monthly drug collection and discriminatory employment policies impeded future migration plans. HIV-positive wives of migrants occupied an insecure position in the rural marital household that depended on their husbands’ health and presence of children. The migration-HIV relationship continued to shape the life course of migrant families beyond the point of infection, often exposing them again to the economic insecurity that migration had helped to overcome, threatening their long-term survival. [ABSTRACT FROM AUTHOR]

Background: Convergence of sectoral programs is important for scaling up essential maternal and child health and nutrition interventions. In India, these interventions are implemented by two government programs - Integrated Child Development Services (ICDS) and National Rural Health Mission (NRHM). These programs are designed to work together, but there is limited understanding of the nature and extent of coordination in place and needed at the various administrative levels. Our study examined how intersectoral convergence in nutrition programming is operationalized between ICDS and NRHM from the state to village levels in Odisha, and the factors influencing convergence in policy implementation and service delivery.Methods: Semi-structured interviews were conducted with state-level stakeholders (n = 12), district (n = 19) and block officials (n = 66), and frontline workers (FLWs, n = 48). Systematic coding and content analysis of transcripts were undertaken to elucidate themes and patterns related to the degree and mechanisms of convergence, types of actions/services, and facilitators and barriers.Results: Close collaboration at state level was observed in developing guidelines, planning, and reviewing programs, facilitated by a shared motivation and recognized leadership for coordination. However, the health department was perceived to drive the agenda, and different priorities and little data sharing presented challenges. At the district level, there were joint planning and review meetings, trainings, and data sharing, but poor participation in the intersectoral meetings and limited supervision. While the block level is the hub for planning and supervision, cooperation is limited by the lack of guidelines for coordination, heavy workload, inadequate resources, and poor communication. Strong collaboration among FLWs was facilitated by close interpersonal communication and mutual understanding of roles and responsibilities.Conclusions: Congruent or shared priorities and regularity of actions between sectors across all levels will likely improve the quality of coordination, and clear roles and leadership and accountability are imperative. As convergence is a means to achieving effective coverage and delivery of services for improved maternal and child health and nutrition, focus should be on delivering all the essential services to the mother-child dyads through mechanisms that facilitate a continuum of care approach, rather than sectorally-driven, service-specific delivery processes. [ABSTRACT FROM AUTHOR]

An exploratory study was conducted on 23 consecutive treatment-seeking adolescent inhalant users at a tertiary drug dependence treatment center in India. Sociodemographic, clinical parameters and neuropsychological functioning were assessed using semi-structured interview, Composite International Diagnostic Interview (CIDI 3.0) for diagnosis, checklist for health damage and withdrawal symptoms, Malin's Intelligence Scale for Indian Children (MISIC), Memory for Design test and Stroop test. Routine biochemical testing and urinary hippuric acid level for recent inhalant use, measured using Gas Liquid Chromatography with Nitrogen Phosphorous Detector (GLC-NPD) was conducted. All participants were urban males (mean age 16 [SD = 1.8] years), who used either ink eraser fluid (87%) or glue (13%). Most participants experienced inhalant withdrawal (80%) and revealed high prevalence of psychiatric co-morbidity (52%), behavioral problems (43.5%), and neuropsychological deficits. Biochemical analysis validated recent (1–3 days) toluene exposure in 69.6% of participants, consistent with self-report. Management plans should take these issues into consideration. [ABSTRACT FROM AUTHOR]

Background: There is growing interest in the ethics of cluster trials, but no literature on the uncertainties in defining communities in relation to the scientific notion of the cluster in collaborative biomedical research.Methods: The views of participants in a community-based cluster randomised trial (CRT) in Mumbai, India, were solicited regarding their understanding and views on community. We conducted two focus group discussions with local residents and 20 semi-structured interviews with different respondent groups. On average, ten participants took part in each focus group, most of them women aged 18-55. We conducted semi-structured interviews with ten residents (nine women and one man) lasting approximately an hour each and seven individuals (five men and two women) identified by residents as local leaders or decision-makers. In addition, we interviewed two Municipal Corporators (locally elected government officials involved in urban planning and development) and one representative of a political party located in a slum community.Results: Residents' sense of community largely matched the scientific notion of the cluster, defined by the investigators as a geographic area, but their perceived needs were not entirely met by the trial.Conclusion: We examined whether the possibility of a conceptual mismatch between 'clusters' and 'communities' is likely to have methodological implications for a study or to lead to potential social disharmony because of the research interventions, arguing that it is important to take social factors into account as well as statistical efficiency when choosing the size and type of clusters and designing a trial. One method of informing such a design would be to use existing forums for community engagement to explore individuals' primary sense of community or social group and, where possible, to fit clusters around them.Trial Registration: ISRCTN Register: ISRCTN56183183 Clinical Trials Registry of India: CTRI/2012/09/003004 . [ABSTRACT FROM AUTHOR]

Objectives: This exploratory study attempted to assess a range of sexual behaviors, relationships, and related factors among a sample of bisexual men in Mumbai, India. Methods: Data collection occurred in two separate phases. First, focus group discussions were facilitated with local community members in order to finalize an interviewer-administered questionnaire. Afterward, structured interviews were conducted with a sample of 50 bisexual men using this questionnaire. Results: Participants reported a wide range of sexual behaviors and relationships with male and female partners. Conclusions: Findings have implications for future research and practice focusing on bisexual men in India,as well as their partners of all genders. [ABSTRACT FROM AUTHOR]

Background: Noncommunicable disease (NCDs), psychological, substance use disorders, and stress-related issues have been less understood in Indian industrial settings. Systems for screening and early identification of the above have not been integrated in workplaces, nor there is a strong regulatory backing for the same. Aim: To explore the feasibility of integrating mental health and select NCD risk factor screening with the periodical medical examination of employees. To identify proportion of employees with select NCD risk factors and symptoms suggestive of mental health problems. Settings and Design: Around 10% of employees from a leading motor industry in Bangalore, (706) participated in this cross-sectional voluntary screening program. Materials and Methods: This screening was conducted as a part of their annual medical examination. A mixed method of self-report and interview administered technique was adopted for the same. Statistical Analysis: Descriptive statistical methods (proportions, median, mean, and standard deviation (SD)) and Chi-square test of significance. Results and Conclusions: Screening revealed the following; tobacco use (18%), alcohol use (57%), perceived work stress (10%), and obesity (3%). Nearly 23% screened positive for psychological distress. Time consumed for this assessment was 1-5 min. Initial attempts point out that it is feasible to integrate screening for mental health, substance use, and NCD risk factors in periodic medical examination using a combination of self-report and interview-administered method, though further detailed assessments for confirmation is necessary. [ABSTRACT FROM AUTHOR]

We explored knowledge, attitudes, and practices associated with the menopause transition particular to women in the multi-ethnic cultural context of Singapore. Fifty-eight Chinese, Malay, and Indian Singaporean women participated in interviews that were audiorecorded, transcribed verbatim, and analyzed using thematic analysis. Women from all three ethnicities described an attitude of acceptance surrounding menopause and the changes associated with it. While they thought it was important to be informed, they did not seek out information about menopause and did not view health professionals as useful sources of information. Management practices were diverse and rarely involved accessing health professionals. [ABSTRACT FROM PUBLISHER]

Smaller health care facilities especially clinics though believed to generate lesser quantum/categories of medical waste, the number of clinics/small health care settings are considerable. The movement to manage biomedical waste in a safe and scientific manner has gathered momentum among the medium and large hospitals in Bangalore, but there has been a little understanding and focus on the smaller health care facilities/clinics in this aspect. It is important to gather evidence regarding the current situation of bio-medical waste (BMW) management and issues in smaller health care settings, so as to expand the safe management to all points of generation in Bangalore and will also help to plan relevant interventional strategies for the same. Hence an exploratory study was conducted to assess the current situation and issues in management of BMW among small health care facilities (sHCF). This cross sectional study was conducted in T. Dasarahalli (ward number 15) under Bruhat Bengaluru Mahanagar Palike (BBMP) of Bangalore. Data was collected from a convenient sample of 35 nursing homes (<50 beds) and clinics in December 2011. The results of this study indicate that 3 (20 %) of nursing homes had a Policy for Health Care Waste Management, though committees for Infection control and Hospital waste management were absent. Recording system like injury and waste management registers were non-existent. In our study the Common Bio-medical Waste Treatment Facility operator collected waste from 28 (80 %) of the sHCF. Segregation at the point of generation was present in 22 (62.9 %) of the sHCF. Segregation process was compliant as per BMW rules 1998 among 5 (16.1 %) of the sHCF. 18 sHCF workers were vaccinated with hepatitis B and tetanus. Deficiencies were observed in areas of containment, sharps management and disinfection. It was observed that though the quantum and category of waste generated was limited there exist deficiencies which warrant initiation of system development measures including capacity building. [ABSTRACT FROM AUTHOR]

The article discusses a study of a group of epilepsy patients in India. The aim of the study was to understand the patients' pathway to care to be able to target appropriate services to them. It was noted that most patients had contacted a health-care provider for their first episode. Meanwhile, secondary level government hospitals were the most common first link of care for the patients.

The article presents a study on aggressive driving behavior on roads in India. The study showed that factors such as excessive honking, overtaking, and loud music in one's car increased the risk of anger among high-angry drivers on Indian roads. The high-angry driver was found to be more likely to express anger directly, compared to the low-angry driver, and the low-angry driver was more likely to express anger passively. Implications for law enforcement agencies and government are discussed.

ABSTRACT Sikhs constitute a high proportion of the ethnic minority population in Britain. Yet, social psychologists have largely neglected this demographically important religious group, leaving much of the theorising to anthropologists and sociologists. The present study explores how a group of British-born Sikhs understood and defined their Sikh identities, focussing upon strategies for safeguarding the continuity and distinctiveness of this identity. Ten individuals were interviewed. Informed by identity process theory, the transcripts were subjected to thematic analysis. Three superordinate themes are reported, namely (i) 'Freedom and gender equality': the 'essence' of Sikh identity; (ii) Continuing the legacy of the Gurus; and (iii) Maintaining group continuity and distinctiveness in a threatening social context. Theoretical and practical implications of the research are discussed, particularly in relation to intergroup relations. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]