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The social structure of India is rapidly evolving, towards modernization. The urban population of India is projected to approach 60 crores by 2036. Urban health resilience stands for building the capacity of urban systems to withstand and adapt to health-related stresses like natural disasters, man-made disasters, and pandemics like COVID-19 and the capability to recover from them by well-equipped hospitals, efficient emergency response mechanisms, and a network of well-trained and motivated healthcare professionals. Also, the involvement of communities is central to building urban health resilience. Strong policy frameworks are required for establishing a resilient urban health ecosystem. Addressing social determinants, such as income inequality, education, and housing, is also a basis of building urban health resilience. Some examples have been instrumental in designing a resilient urban health system like Singapore’s Smart Nation Initiative, Copenhagen, Denmark’s Model for Sustainable Urban Living internationally, Ahmedabad’s Heat Action Plan and Kochi’s Waterfront Development for Climate Resilience are excellent examples from our country. The suggested strategy for an urban resilient system is a Rapid, Extensive, Sturdy, Ingenious, Lucid approach with an International collaboration for an Enthusiastic, Non-latent, Continuous Early warning system (RESILIENCE).

Introduction: Self-directed learning (SDL) is the process in which individuals take the initiative and learning environment involves all other aspects of the institute. Good SDL ability is the foundation of lifelong learning. Students’ perception of the educational environment plays a subtle role in learning and contributes to learning input and students’ achievement. Self- directed learning is integral to public health teaching. Objectives: To assess the perceptions of learning environment and self-directed learning readiness and association between the two among public health researchers and also to elicit the factors associated with SDLRS. Method: A cross-sectional study was conducted from July to December 2023 in a public health institute in Kolkata. A total of 102 participants across five courses were selected by Complete Enumeration method and their self-directed learning readiness (SDLRS) and perceptions of learning environment were assessed using a self-administered questionnaire. The data was analysed in SPSS, version 16. Ethical approval was taken. Results: The mean age of the study participants was 26.7 years and 64.7% of the study participants were from MBBS background. The median academic hours was 18 hours per week, 37.3% of the participants were studying in the institute for less than 6 months and 20.6% for more than 24 months. The overall perception of learning environment was more positive than negative. There was significant positive correlation between SDLRS and Learning Environment (Spearman’s rho=0.281, p=0.004). Age (p=0.015) and prior academic qualification (p=0.016) were significantly associated with SDLRS. Conclusion: SDLRS was associated with positive Learning Environment. The overall perception of SDLRS was average and the SDL ability improved with duration of study in the institute and deteriorated with age of the study participants.

Background: On January 16, 2021, India rolled out the COVID vaccination drive. A successful and effective vaccination campaign requires much more than the availability of a safe and effective vaccine. This includes identifying vulnerable populations with lower vaccine confidence and identifying the drivers of vaccine hesitancy. Objective: This study aims to find out vaccine hesitancy among the tribal population regarding COVID-19 vaccination. Methods: It was an observational descriptive cross-sectional study, conducted at Manindranagar and Hatinagar gram panchayat of Berhampore Block of Murshidabad district, West Bengal, from June 2021–November 2021, among tribal people aged >18 years. A total of 198 tribal people were selected by applying the probability proportional to size sampling method. Participants were interviewed using predesigned, pretested, and semi-structured schedules. Potential predictors of hesitancy were investigated using the multivariate logistic regression model. Results: Vaccine hesitancy was present among 36.9% of the study participants. Fear of side effects (78.1%) was the most common reason of vaccine hesitancy. Only 30.8% of them received at least one dose of vaccine. Vaccine hesitancy was associated with decreased family income in the last 1 year (adjusted odds ratio [AOR] = 8.23), knowledge regarding vaccine (AOR = 0.41), adherence to COVID-appropriate behavior (AOR = 0.45), and trust on the local health-care worker (AOR = 0.32). Conclusion: Vaccine hesitancy among the tribal population is driven by a lack of knowledge and awareness. Their economic status, attitudes toward the health system, and accessibility factors may also play a major role in vaccine hesitancy. Extensive information, education, and communication activity, more involvement of health-care workers in the awareness campaign, and establishment of vaccination centers in tribal villages may be helpful.

Background: To facilitate healthy aging in India, it is important not only to acknowledge older people's contribution but also to understand their perception regarding their impact in the society along with society's attitude toward them. Objectives: This study aims to assess their self-perceived contribution in the society and the factors related with their contribution. Methods: It was an observational, descriptive, cross-sectional study, conducted at Amdanga block of North 24 Parganas district, West Bengal, during July 2021–June 2022. A total 0f 384 geriatrics were interviewed by the house-to-house survey with the help of a predesigned, pretested and semi-structured schedule. Potential predictors of contribution were investigated using the multivariate logistic regression model. Results: 78.9% of participants had contribution in the society. 85.9% were taking care of family members when they were sick. 93.2% were sharing their opinion with the family members. 86.5% were participating in various social works. 79.1% were suffering from at least one physical health problem. With increase in the number of health problems, chances of good contribution decreases. In case of self-perceived contribution in the society family type, employment, physical health and social participation are influencing the most. Conclusion: Elderly people are taking care of not only family members, but even relatives and neighbors also. They are sharing their knowledge and experience with family members and in the society. They are also contributing financially. Employment and proper health-care infrastructure for geriatric may be helpful to maximize their contribution.

Background: Chronic kidney disease of unknown etiology (CKDu) has been a growing concern in the Indian population causing significant morbidity and mortality in these recent years. Thus, it is vital to understand the probable risk factors associated with its manifestation. This study aims to assess the distribution of various etiologies among CKD patients, investigate all the probable risk factors associated with CKDu, and estimate the health-related quality of life (QoL) among all CKDu patients in the study area. Materials and Methods: It was an analytical, observational, cross-sectional study where one objective had a case–control study design. It was conducted at Bankura Sammilani Medical College in Bankura district, West Bengal, during July 2022–August 2022. A total of 198 patients have been studied through detailed interviews using a predesigned, pretested, semi-structured schedule. Potential risk factors and their strength of association were analyzed with the help of multivariate logistic regression. Results: It was found that the prevalence of CKDu was almost 71% in the study population, mostly affecting agricultural workers (67.17%), daily laborers (46.46%), and construction workers. Perceived heat stress, excessive daily dietary intake of salt, and drinking contaminated water are the factors that had shown the strongest association with the occurrence of CKDu in this population. The deterioration in QoL in CKDu pretty much mirrors that of CKD. Conclusion: CKDu is definitely an occupational disease, mostly affecting the wage workers and farmers spending long hours in unhealthy work environments. Environmental exposure to heavy metals must be checked and dietary modification must be done through counseling to regulate salt intake. CKDu, as a rising public health concern certainly needs special attention and immediate planning as it has a different etiopathology than CKD and the affected population, disease progression, and risk factors are markedly distinctive as well.

Background: While a smartphone can be a hugely productive tool, excessive use of this device can interfere with work, education, our physical and mental health, and productivity. Nowadays, we do not just use our smartphones, but we rely on them. Objectives: The present study aims to develop and validate an instrument measuring the problematic use of smartphones among adults in a rural area of West Bengal, India. Methods: The questionnaire on problematic use of smartphone is a self-designed tool. The items were selected by literature review. The psychometric properties of the questionnaire were assessed by content validity, construct validity, and reliability. Exploratory factor analysis was performed to identify the factors. Results: Forty-two items were generated by literature review. After final analysis, the main questionnaire contained 28 items with 5 domains, namely “impulsive use of phone,” “dependence,” “impaired control,” “denial,” “decreased productivity,” and “emotional attachment.” The Cronbach's alpha value for three domains was found to be >0.7 and >0.8 for the other three domains. Conclusion: Excessive mobile phone use is associated with various adverse consequences which is emerging as a public health problem in a large number of population in India. Problematic use of smartphone questionnaire is a valid and reliable tool to assess the pattern of mobile use among Indian population.

BACKGROUND: Student absenteeism is a major concern for undergraduate medical education training in India. Regular class attendance helps students have a proper understanding of the topic of discussion. This study explores the pattern of absenteeism among medical students and whether absenteeism is associated with their academic performances. MATERIALS AND METHODS: A record-based, cross-sectional study was done by reviewing departmental attendance registers, item cards and marks obtained in exam by 190 students in the community medicine department who had passed their 3rd professional part 1 examination in 2018. The data was entered and analyzed using SPSS version 16. A descriptive analysis summarizes the pattern of absenteeism and their marks obtained in the semester and professional exam of community medicine. The primary outcome indicator was the 3rd professional exam marks. The correlation between class absenteeism and other predictors and exam result was analyzed. Regression analysis was done to predict dependence of outcome variable on class attendance and formative examination marks. RESULTS: Overall, female students had better class attendance than male students. There was a positive correlation of lecture class attendance (r = 0.369) and marks obtained in the 6th semester exam (r = 0.717) with the final exam result. Further regression analysis showed final marks had a higher dependence on the 6th semester examination score (B = 0.669) when compared to lecture class attendance (B = 0.051). CONCLUSION: Although lecture class attendance is an important predictor of final result, this study showed that the 6th semester marks were a better predictor. This may be due to multiple factors (alternate source of learning, student's motivation, etc.) which require further exploration.

Caregivers are the persons who provide care at the time of distress or illness. They face many stress and strain to provide the best possible medical care for their children. There are very few studies that explored the care-related quality of life (CarerQoL) of the caregivers of thalassemic children and its correlates. With this background, the current study was designed to explore the CarerQoL of the caregivers of β-Thalassemia Major (β-TM) children and its various correlates. It was a cross-sectional observational study conducted among caregivers of β-TM children attending a tertiary care health facility of Eastern India in between May 2016 and April 2017 with a structured schedule. The median CarerQoL score was found to be 5 with an interquartile range of 4–7 (range: 11). In the final multivariable logistic regression model, care receivers’ (thalassemic children) age [adjusted odds ratio (AOR): 2.2 (1.2–4.2)], spleen status [AOR: 4.1 (2.0–8.7)], blood transfusion frequency [AOR: 2.1 (1.1–3.9)], and quality of life (QoL) [AOR: 3.0 (1.6–5.5)] and caregivers’ educational level [AOR: 2.3 (1.2–4.1)], perceived social discrimination [AOR: 2.3 (1.3–4.1)], debt [AOR: 2.3 (1.2–4.3)], nongovernmental organization assistance [AOR: 2.0 (1.0–4.0)], and wage loss due to seeking treatment [AOR: 1.9 (1.1–3.4)] were significant predictors of CarerQoL of the study participants adjusted with their age, sex, working status, per-capita monthly income, knowledge level related to the disease, and care receivers’ comorbidity status. To conclude, CarerQoL of the study participants were significantly associated with QoL of their wards. Other significant associates of CarerQoL were caregivers’ education level, financial profile, patients’ age, and their clinico-therapeutic profile.

Background: The discourse of mental health is getting its due attention after all these years in India. A major threat to the mental health system is the demand side factors, namely, knowledge, attitude, and practice (KAP) of the general population toward this. In spite of growing concern regarding mental health in India, this kind of study to assess the mental health status has been very few in India, more so in West Bengal. Objectives: With this background, this study was carried out with the objectives to validate the Community Attitude to Mental Illness (CAMI), to assess the different sociodemographic factors among the study population, to assess the KAP regarding mental illness among the study population. Methods: It was an observational, descriptive study with cross-sectional design done at Amdanga Community Development Block, North 24 Parganas, West Bengal, India, in 2015-16. Questionnaire validation to assess the KAP was the primary objective with obtaining the descriptive data were the second one. CAMI questionnaire was used which was validated for the given area by validation methods such as Cronbach's alpha and structural equation modeling. The resultant questionnaire was used in the field on adult population after a single-stage survey design to collect 730 samples. Results: The test statistics showed that the questionnaire was reasonably valid after a few tweakings. SEM identified well-define domains in the attitude part. 94.9% says that they are willing to live with a people with mental illness. 14.9% has actually done so. Health-care seeking behavior shows that 19.2% will go to a GP in case of any mental illness. Furthermore, attitude toward mental illness showed mixed picture as also knowledge. This study correlated with various studies of developing countries and it was seen that these population showed markedly different attitudes for probability of the patients getting cured than many other countries. Furthermore, stigma was gradually decreasing, as evident from various other studies. Conclusion: This study will provide valuable insights into the cognitive and affective aspect of mental illness among these population and thus help in implementing better policies in this regard, as this is fast becoming the talk of the day.

BACKGROUND: Although prevention the birth of children with β-thalassemia major (β-TM) is an important health issue, it is rarely explored. With this background, the study was designed to find family planning practices and related factors of couples with children affected by β-TM. MATERIALS AND METHODS: This was a cross-sectional, observational study, conducted among 324 parents with children affected by β-TM attending a tertiary care health facility in Eastern India. Data were analyzed using univariate and multivariable logistic regression using SPSS. RESULTS: Of 324 parents, 89.5% were sexually active, 44.8% of which were currently using family planning method to prevent the birth of another child with the oral contraceptive pill most preferred (46.9%) followed by tubectomy (33.9%). Those who were sexually active, but not desirous of a child were 223, of which 41.7% had the unmet need for family planning with religious belief (41.9%) being the most predominant reason followed by unaware of methods (26.9%). In multivariable analysis, religion, caste, per capita monthly income, mothers' education level, and working status were significant predictors of unmet need for family planning adjusted with others. CONCLUSIONS: Burden of unmet need for family planning among the study population was alarmingly high. Parents of the thalassemic children should be counseled in easily comprehensible local language to increase the rate of contraception among them.