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In India, tobacco kills 900 000 people every year though the burden of tobacco is faced disproportionately in poorer states such as Bihar. Teachers may be a particularly influential group in setting norms around tobacco use in the Indian context. However, tobacco use among teachers remains high and perceptions of tobacco-related health risks are unexplored. To qualitatively explore perceptions about tobacco use among teachers in Bihar and to examine how risk information may be communicated through a variety of message formats, 12 messages on tobacco health risks varying in formats were tested in focus groups with teachers from Bihar. Participants stated that teachers were already aware of tobacco-related health risks. To further increase awareness of these risks, the inclusion of evidence-based facts in messages was recommended. Communicating risk information using negative emotions had a great appeal to teachers and was deemed most effective for increasing risk perception. Messages using narratives of teachers' personal accounts of quitting tobacco were deemed effective for increasing knowledge about the benefits of quitting. To conclude, messages using evidence-based information, possibly with negative emotions, testimonials with role models and those messages emphasizing self-efficacy in the format of narratives appear to appeal to teachers in Bihar.

This article provides a theory-based, step-by-step approach to intervention development and illustrates its application in India to design an intervention to promote tobacco-use cessation among school personnel in Bihar. We employed a five-step approach to develop the intervention using the Social Contextual Model of Health Behavior Change (SCM) in Bihar, which involved conducting formative research, classifying factors in the social environment as mediating mechanisms and modifying conditions, developing a creative brief, designing an intervention and refining the intervention based on pilot test results. The intervention engages users and non-users of tobacco, involves teachers in implementing and monitoring school tobacco control policies and maximizes teachers' role as change agents in schools and communities. Intervention components include health educator visits, discussions led by lead teachers, cessation assistance, posters and other educational materials and is implemented over the entire academic year. The intervention is being tested in Bihar government schools as part of a randomized-controlled trial. SCM was a useful framework for developing a tobacco control intervention that responded to teachers' lives in Bihar.

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Background: India made 2 important policy statements regarding tobacco control in the past decade. First, the India Tobacco Control Act (ITCA) was signed into law in 2003 with the goal to reduce tobacco consumption and protect citizens from exposure to secondhand smoke (SHS). Second, in 2005, India ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). During this same period, India conducted the Global Youth Tobacco Survey (GYTS) in 2003 and 2006 in an effort to track tobacco use among adolescents. Methods: The GYTS is a school-based survey of students aged 13-15 years. Representative national estimates for India in 2003 and 2006 were used in this study. Results: In 2006, 3.8% of students currently smoked cigarettes and 11.9% currently used other tobacco products. These rates were not significantly different than those observed in 2003. Over the same period, exposure to SHS at home and in public places significantly decreased, whereas exposure to pro-tobacco ads on billboards and the ability to purchase cigarettes in a store did not change significantly. Conclusions: The ITCA and the WHO FCTC have had mixed impacts on the tobacco control effort for adolescents in India. The positive impacts have been the reduction in exposure to SHS, both at home and in public places. The negative impacts are seen with the lack of change in pro-tobacco advertising and ability to purchase cigarettes in stores. The Government of India needs to consider new and stronger provisions of the ITCA and include strong enforcement measures. (Contains 2 tables.)

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Copyright of Journal of Natural Fibers is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Gutka, a popular smokeless tobacco (SLT) product combining chewing tobacco, areca nut, and spices, was banned by states in India beginning in 2012. Gutka can be recreated by the user mixing twin packets of tobacco and spice mixtures. We examine the availability of premixed gutka, the sale of twin packets (chewing tobacco and spice mixture sold together but in separate packets) and whether SLT was sold without legally mandated health warning labels (HWLs), without the printed maximum retail price (MRP), and above the MRP.Aims and Methods: In October/November of 2017, unique SLT packets were purchased using a systematic protocol in 25 localities with populations under 50 000 across five Indian states. Purchase information (location, twin packets, price paid) and packaging information (SLT type, printed MRP, type of HWL) were used to assess legality.Results: Of the 240 purchases of unique SLT packets, three were premade gutka. Twin packets were half of the sample, sold in every state, and illegally sold in Maharashtra where they were banned. Over half (62%) of single packets and 27% of twin packets did not feature a legal HWL. While only 5% of packets did not have a printed MRP, 29% of single packets, and 38% of twin packets were sold illegally for more than the MRP.Conclusions: SLT without the proper HWL or sold above the MRP were common. Twin packets were widely available. India should consider a country-wide restriction to ban single serving tobacco packets that would decrease affordability.Implications: This study is the earliest and that first outside of Mumbai that we are aware of to present evidence of tobacco products being sold above the MRP in India. While finding little evidence of premade gutka being sold, we found twin packets (chewing tobacco and spice mixture packets sold together) are widely available even in Maharashtra, which has a policy in place to ban twin packets. This study also finds evidence of SLT products sold without the correct HWL and without a MRP listed which shows that implementation and enforcement of regulations are as important as passing regulations. [ABSTRACT FROM AUTHOR]

This study examined the relationship between school tobacco policies and tobacco use prevalence among school personnel. Two subsets of schools were identified in Bihar, India: Federal schools (with a tobacco policy), and State schools (without a tobacco policy). Stratified probability samples of 50 schools each were selected. The survey was conducted through an anonymous, self-administered questionnaire. School personnel from State schools (non-policy schools) reported significantly higher daily cigarette smoking and daily current smokeless tobacco use compared to personnel in Federal schools (policy schools). Teachers in State schools did not teach about health consequences of tobacco, and they had not received training for such teaching. Extent of teaching about health consequences of tobacco varied across topics for teachers in Federal schools. They received negligible training, but more than 35% reported access to teaching materials. More than one-half the personnel from Federal schools knew about their school's policy prohibiting tobacco use among students and school personnel, and about policy enforcement. Personnel in State schools did not know about tobacco control policy in their schools. All school personnel in both types of schools were near unanimous in supporting policy prohibiting tobacco use in schools. The study demonstrated an association between enacting a school policy regarding tobacco use and school personnel's use of tobacco, curricular teaching, and practical training of students. Findings suggest that more extensive introduction of comprehensive school policies may help reduce tobacco use among school personnel.

Understanding the spatial spreading patterns of plant-available sulphur (S) (AS) and plant-available micronutrients (available zinc (AZn), available iron (AFe), available copper (ACu), available manganese (AMn) and available boron (AB)) in soils, especially in coastal agricultural soils subjected to various natural and anthropogenic activities, is vital for sustainable crop production by adopting site-specific nutrient management (SSNM) strategies. We studied the spatial distribution patterns of AS, AZn, AFe, ACu, AMn, and AB in cultivated soils of coastal districts of India using geostatistical approaches. Altogether 39,097 soil samples from surface (0 to 15 cm depth) layers were gathered from farm lands of 68 coastal districts. The analysis of soil samples was carried out for soil pH, electrical conductivity (EC), soil organic carbon (SOC) and AS, AZn, AFe, ACu, AMn, and AB. Soil pH, EC and SOC varied from 3.70 to 9.90, 0.01 to 7.45 dS m-1 and 0.02 to 3.74%, respectively. The concentrations of AS, AZn, AFe, ACu, AMn, and AB varied widely in the study area with their corresponding mean values were 37.4±29.4, 1.50±1.53, 27.9±35.1, 2.14±1.74, 16.9±18.4 and 1.34±1.52 mg kg-1, respectively. The coefficient of variation values of analyzed soil parameters varied from 14.6 to 126%. The concentrations of AS, AZn, AFe, ACu, AMn, and AB were negatively and significantly correlated with soil pH and positively and significantly correlated with SOC. The geostatistical analysis indicated stable, Gaussian and exponential best-fit semivariogram models with moderate to strong spatial dependence for available nutrients. The generated spatial spreading maps revealed different distribution patterns for AS, AZn, AFe, ACu, AMn, and AB. There were variations in spatial spreading patterns of AS, AZn, AFe, ACu, AMn, and AB in east- and west-coastal area. About 62, 35, 12, 0.4, 23 and 45% of the study area had deficiency of AS, AZn, AFe, ACu, AMn, and AB, respectively. The spatial spreading maps will be highly useful for SSNM in the cultivated coastal soils of the country. This study could also be used as a base for assessing spatial spreading patterns of soil parameters in cultivated coastal areas of other parts of the world. [ABSTRACT FROM AUTHOR]

This study conducted to understand the limitations of existing wound-dressing systems. A case study on healing performance of different types of commercially available wound dressings was conducted at Madras Medical College and Government General Hospital (MMC&GH), Chennai, Tamil Nadu, India (Ethical Clearance No. 3250/ME5/2010). The study indicated that the single-layer dressing would not satisfy most of the requirements of an ideal wound-dressing system, and hence there is the need for developing a multilayer wound-dressing system with each layer satisfying different requirements of an ideal wound-dressing system. [ABSTRACT FROM AUTHOR]

In this paper, we compare Indian states in terms of infrastructure development and economic development and identify states that lag behind both in terms of infrastructure and economic development. The study also investigates the role of infrastructure in determining the level of economic development across Indian states. Considering the multidimensional nature of infrastructure and economic development, we have estimated two composite indices: a composite index of infrastructure development and a composite index of economic development. We have applied principal components analysis techniques to generate weights for the selected indicators. Our finding shows vast differences among the states in the level of infrastructure development and economic development. Further, we find that variations in the availability of basic infrastructure facilities across states largely explain the persisting inter-state differences in the level of economic development. [ABSTRACT FROM AUTHOR]

Introduction: The dual use of smoked and smokeless tobacco (SLT) poses a serious challenge to tobacco control efforts. This article examines the trends and patterns of this usage in India during the period 2009-2010 and 2016-2017.Methods: Data from two rounds of nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009-2010 and 2016-2017 have been used. Dual use was assessed based on current smokers and SLT users in both rounds.Results: Findings reveal that dual use in India has dropped from 5.3% during 2009-2010 to 3.4% during 2016-2017, a decline of nearly 10 million dual users. However, some states have added nearly 4.6 million new dual users during this period. While dual use continues to remain high in rural areas, there has been a manifold increase in urban areas. Findings revealed that intention to quit tobacco was lower among dual tobacco users as compared to single users with considerable difference between urban and rural areas.Conclusion: Easy availability and affordability of SLT products compared to smoking products and restrictions on smoking in public places may have pushed current smokers and dual users to take to or intensify their SLT consumption. Measures relating to awareness, pricing, taxation, and enforcement of tobacco control laws should focus on all forms of tobacco, especially targeting high dual burden in rural and urban settings.Implications: Dual form of tobacco users represent 12% of all tobacco users in the country. The study reveals that intention to quit tobacco among dual users is significantly lower than that among single tobacco product users. This requires improving public awareness about the morbidity and mortality that arises from the use of all forms of tobacco products. Efforts to restrict the availability of tobacco products should focus on licensing the sale of all tobacco products. Reduction in dual tobacco use will not only result in multiplied health benefits but also help in achieving the Non-Communicable Diseases targets under the United Nations Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

Introduction: Renal replacement therapy (RRT) is utilized for patients admitted with acute kidney injury and is becoming indispensable for the treatment of critically ill patients. In low middle income and developing country like India, the epidemiological date about the practices of RRT in various hospitals setups in India are lacking. Renal replacement therapy although is being widely practiced in India, however, is not uniform or standardized. Moreover, the use of RRT beyond traditional indications has not only increased but has shifted from the ambit of the nephrologist and has come under the charge of intensivists. Aims and objectives: The goal of the study was to record perceptions and current practices in RRT management among intensivists across Indian intensive care units (ICUs). Materials and methods: A questionnaire including questions about hospital and ICU settings, availability of RRT, manpower availability, and RRT management in critically ill patients was formed by an expert panel of ICU physicians. The questionnaire was circulated online to Indian Society of Critical Care Medicine (ISCCM) members in October 2019. Results: The facilities in government setups are scarce and undersupplied as compared to private or corporate setups in terms of ICU bed strength and availability of RRT. High cost of continuous renal replacement therapy (CRRT) makes their use restricted. Conclusion: Resources of RRT in our country are limited, more in government setup. Improvement of the existing resources, training of personnel, and making RRT affordable are the challenges that need to be overcome to judiciously utilize these services to benefit critically ill patients. [ABSTRACT FROM AUTHOR]

Objectives: Gutka is industrially manufactured in India and some Indian states have instituted bans on the sale of manufactured gutka as a public health initiative. We explored whether gutka was still available for purchase after the ban and also sought to observe methods of ban circumvention. Methods: We visited 5 different markets at different locations separated by at least 15-20 km around the Mumbai Metropolitan Region (MMR) area, consisting of Mumbai and its satellite towns in Maharashtra, India during August- September, 2019. In each location, purveyors were queried as to the availability of gutka. Results: Tobacco purchases were made in 5 locations/sections of MMR. At all markets, banned gutka was not displayed, and could only be purchased after requesting from the shopkeeper. Three methods of ban circumvention were observed: (1) packages marked 'export only'; (2) use of twin packaging in which pan masala and tobacco are sold together for immediate mixing to create gutka; and, (3) non-descript packaging without mention of 'gutka'. Conclusions: Although not readily displayed in shops, gutka is readily available in MMR, despite a statewide ban in Maharashtra. Marketers have used multiple methods to circumvent the statewide gutka ban. [ABSTRACT FROM AUTHOR]

Background. Inhibitors of apoptosis proteins such as cIAP-1 and cIAP-2 have recently emerged as the key mechanism in resistance to apoptosis in various cancers and lead to cell survival. Therefore, the present study aimed to evaluate the cIAP-1 and cIAP-2 expression in breast cancer patients, as well as their association with overall patient survival. Methods. Histopathologically confirmed 100 invasive ductal carcinoma patients and healthy controls were included in the present study. Total RNA extraction was done from the serum sample of the patients; further, 100 ng of total RNA was used to synthesise cDNA from patients' as well as from healthy controls' serum. Quantitative real-time PCR was performed using the maxima SYBR Green dye to study the expression of cIAP-1 and cIAP-2, and beta-actin was used as the internal control. Results. The study observed that breast cancer patients had 13.50 mean fold increased cIAP-1 mRNA and 8.76 mean fold increased cIAP-2 mRNA expression compared to the control subjects. Breast cancer patients in the TNM stages I, II, III, and IV showed 9.54, 11.80, 15.19, and 16.83 mean fold increased cIAP-1 mRNA expression (p = 0.004). Distant organ metastasis, (p = 0.008), PR status of breast cancer patients (p < 0.0001), and HER2 status of breast cancer patients (p < 0.0001) were found to be associated with cIAP-1 mRNA expression. Breast cancer patients with different TNM stages such as stages I, II, III, and IV showed 7.8, 8.09, 7.97, and 12.85 mean fold increased cIAP-2 mRNA expression (p = 0.0002). Breast cancer patients with distant organ metastases status were found to be associated with cIAP-2 mRNA expression (p < 0.0001). Breast cancer patients with <13-fold and >13-fold cIAP-1 mRNA expression showed 37.39 months and 34.70 months of overall median survival, and the difference among them was found to be significant (p = 0.0001). However, cIAP-2 mRNA expression among <8-fold and >8-fold mRNA expression groups showed 35 months and 27.90 months of overall median survival time (p < 0.0001). Higher cIAP-1 mRNA expression was linked with smoking and alcoholism among the breast cancer patients (p < 0.0001 and p < 0.0001). Significant association of higher cIAP-1 mRNA expression was found with the advancement of the disease, while higher mRNA expression of cIAP-1 was associated with distant organ metastases in ROC curve analysis. Conclusion. The present study suggested that increased cell-free cIAP-1 and cIAP-2 mRNA expression was correlated with the advancement of disease, progression of disease, and overall reduced patient survival. Cell-free cIAP-1 and cIAP-2 mRNA expression could be the predictive indicator of the disease. [ABSTRACT FROM AUTHOR]

The efficient (site-specific) management of soil nutrients is possible by understanding the spatial variability in distribution of phyto-available nutrients (here after called available nutrients) and identifying the soil management zones (MZs) of agricultural landscapes. There is need for delineating soil MZs of agricultural landscapes of the world for efficient management of soil nutrients in order to obtain sustainability in crop yield. The present study was, therefore, undertaken to understand the spatial distribution pattern of available micronutrients (zinc (Zn), boron (B), iron (Fe), manganese (Mn) and copper (Cu)), available sulphur (S), and soil properties (soil acidity (pH), electrical conductivity (EC) and organic carbon (SOC) content) in soils of intensively cultivated Indo-Gangetic Plain (IGP) of India and to delineate soil MZs for efficient management of soil nutrients. Totally, 55101 soil samples from 0–15 cm depth were obtained from 167 districts of IGP during 2014 to 2017 and were analysed for different soil parameters. Soil pH, EC and SOC content varied from 4.44 to 9.80, 0.02 to 2.13 dS m-1 and 0.10 to 1.99%, respectively. The concentration of available Zn, B, Fe, Mn, Cu and S varied from 0.01 to 3.27, 0.01 to 3.51, 0.19 to 55.7, 0.05 to 49.0, 0.01 to 5.29 and 1.01 to 108 mg kg-1, respectively. Geostatistical analysis resulted in varied distribution pattern of studied soil parameters with moderate to strong spatial dependence. The extent (% area) of nutrient deficiencies in IGP followed the order: S > Zn > B > Mn > Cu > Fe. Principal component analysis and fuzzy c-means clustering produced six distinctly different soil MZs of IGP for implementation of zone-specific soil nutrient management strategies for attaining sustainability in crop yield. The developed MZ maps could also be utilized for prioritization and rationalization of nutrients supply in IGP of India. [ABSTRACT FROM AUTHOR]

INTRODUCTION Bidis are the most commonly smoked tobacco product in India. Understanding bidi smoking is important to reducing overall tobacco smoking and health-related consequences in India. We analyzed 2009-2010 and 2016- 2017 Global Adult Tobacco Survey (GATS) India data to examine bidi smoking and its associated sociodemographic correlates and perceptions of dangers of smoking. METHODS GATS is a nationally representative household survey of adults aged =15 years, designed to measure tobacco use and tobacco control indicators. Current bidi smoking was defined as current smoking of one or more bidis during a usual week. We computed bidi smoking prevalence estimates and relative change during 2009-2010 and 2016-2017. Used pooled multilevel logistic regression to identify individual-level determinants of bidi smoking and neighborhood-level and state-level variations. RESULTS Overall, 9.2% and 7.7% of adults smoked bidis in India during 2009-2010 and 2016-2017, respectively, reflecting 16.4% significant relative decline. In pooled analysis, male, older age, rural residence, lower education level, lower wealth index, less knowledge about harms of smoking, and survey year were associated with increased odds of bidi smoking. Results also showed variance in odds of smoking bidis is associated with neighborhood (15.9%) and state (31.8%) level. CONCLUSIONS Higher odds of bidi smoking were found among males, older age groups, and among those with lower socioeconomic status. Accordingly, health education interventions designed for these groups across India and other population-level interventions, such as WHO recommendation on increasing price on tobacco products, could help reduce bidi smoking. In addition, state/neighborhood-specific interventions could also help address differential bidi smoking across India. [ABSTRACT FROM AUTHOR]

In India, there has been no attempt to measure the implementation of World Health Organization's Framework Convention on Tobacco Control Article 5.3, which provides guidelines to address tobacco industry interference (TII). This study draws on a desk review conducted to assess the frequency and severity of TIIs and the government's response, reported between January and December 2017. This study highlights that the government of India does not allow tobacco industry to participate in policy development. However, the industry interferes by collaborating with the government's allied organizations. The tobacco industry has diversified as food industry in India, and directly or indirectly supports various government programs, by investing through their corporate social responsibility schemes. In addition, there are limited legislative measures to allow transparency in adoption of Article 5.3 guidelines across the country. Hence, the findings of this study underscore an exigent need to adopt and implement Article 5.3 at the national level in India. [ABSTRACT FROM AUTHOR]

Grain discolouration is an emerging disease of rice that has potential to cause huge losses if favourable conditions are available. The disease is caused by a pathogen complex and was reported from few places of India. During rabi season in 2019, a survey was undertaken at the paddy fields of NRRI, Cuttack, and found heavy incidences of grain discolouration in the cultivated rice genotypes with symptoms in the form of brown-/black-/ash-coloured grains mostly accompanied with chaffiness. The grain discolouration incidence ranged from 25 to 92% in different rice genotypes. The high disease incidence may be due to abrupt climate change, thereby increasing the virulence of the once minor pathogen(s) to gain fitness and causing devastation in rice crop. The mean yield loss due to grain discolouration was 18.9% and ranged between 0.1 and 60.2%. All the rice genotypes examined were susceptible to the disease. However, yield loss was not very devastating because only few genotypes showed higher yield loss while the remaining genotypes have much lower values. During the investigation, the temperature ranging from 25 to 37 °C, moderate rainfall, high relative humidity of 70–76% and high wind speed were observed that played a critical role in the disease outbreak. Therefore, epidemiology and management of grain discolouration should be the current concerns in order to halt the disease from affecting rice production in the country. [ABSTRACT FROM AUTHOR]

Mountains host high biological and cultural diversity, generating ecosystem services providing benefits over multiple scales but also suffering significant poverty and vulnerabilities. Case studies in two contrasting village communities in the Indian Middle Himalayas explore linkages between people and adjacent forest and river ecosystems. Interviews with local people and direct observations revealed low food availability and decreasing self-sufficiency, under the combined pressures of increasing foraging by wildlife (primarily pigs and monkeys) coupled with seasonal to permanent outmigration by younger men seeking more secure income and alternative livelihoods. Much of the income remitted by migrants to their villages was not retained locally but flowed back out of the Himalayan region through purchases of food produced and marketed in the plains. This threatens the economic viability of villages, also placing asymmetric pressures on resident female, elderly and young people who concentrate labour on local livestock production to the neglect of crop agriculture, further compounding land abandonment and wildlife foraging. Significant traditional knowledge remains, along with utilitarian, cultural and spiritual connections with the landscape. Many beneficiaries of locally produced ecosystem services are remote from village communities (particularly water flows downstream to the plains), but no recompense is paid to stewards of the forested Himalayan landscape. Although local people currently perceive high biodiversity as a constraint to agriculture and other economic activities, the Himalayan landscapes could potentially constitute an asset with appropriate institutional development through promotion of managed bioprospecting, guided ecotourism and payment for ecosystem services (PES) schemes for water supply and under REDD+. [ABSTRACT FROM AUTHOR]

Aims: A large number of workers including women are involved in the informal sector in India. A majority of them are engaged in agricultural sectors. The agricultural workers have to perform their jobs by putting manual labor and are exposed to different occupational stresses. The present study was aimed to evaluate postural stress and prevalence of musculoskeletal disorder (MSD) of women cultivators engaged in uprooting job of rice cultivation. Settings and Design: This cross-sectional study was conducted on 166 women cultivators from different districts of West Bengal state, India. Materials and Methods: Prevalence and intensity of MSDs of the cultivators were evaluated by Nordic questionnaire and 10-point body part discomfort scale. Work rest pattern and postural pattern were studied by direct observation method. Postural stress was assessed by OVAKO Working Postures Analysis System (OWAS), Rapid Entire Body Assessment (REBA), Rapid Upper Limb Assessment (RULA), and Quick Exposure Checklist (QEC) methods and as well as by measuring center of gravity. Results and Conclusions: MSD was highly prevalent among the study participants. Lower back, hip, wrist, shoulder, and knee were highly affected. Higher prevalence of MSDs among the cultivators may be because of prolonged working hours and awkward postures. The women cultivators had to start their day before dawn to finish off their household chores such as cooking, cleaning, washing clothes and dishes, etc., before they moved off to the fields, which altogether impose them under additional stress. It may be suggested that ergonomic interventions such as modifying work-rest schedules, improving work postures, and introducing new design hand tools should be considered for improving work condition of the women cultivators. [ABSTRACT FROM AUTHOR]

Background: Unlike in adults, diagnosis of TB can be challenging in children, as signs and symptoms of paediatric TB can be very non-specific and similar to other common childhood chest infections, which may lead to under or delayed diagnosis of TB disease. In spite of the increasing availability of rapid high-sensitivity diagnostics in public and private sectors, majority of paediatric TB cases are empirically diagnosed, without laboratory confirmation. To address these diagnostic challenges, World Health Organization (WHO) has recommended upfront Xpert MTB/RIF (Xpert) testing for the diagnosis of TB in paediatric presumptive pulmonary and extra-pulmonary TB (EPTB) cases. However, in spite of the increasing availability of rapid high-sensitivity diagnostics, a significant gap exists in its application with Xpert being rarely used as an upfront diagnostic among patients presumed to have TB. Under an ongoing paediatric project since April 2014, which provided free-of-cost upfront Xpert testing, several low-cost outreach and education interventions were undertaken to increase the diagnostic uptake by different providers catering to the paediatric population, thereby increasing adherence to global guidance. Methods: Providers catering to paediatric population in the project cities were systematically mapped and contacted using different outreach strategies. The focus of outreach efforts was to increase provider literacy and increase their awareness of the availability of free rapid diagnostic services with the goal of changing their diagnostic approaches. Results: From April 2014 to June 2016, more than 5,700 providers/facilities were mapped and 3,670 of them were approached. The number of providers/facilities engaged under the project increased more than 10-fold (43 in April, 2014 to 466 in June, 2016), with significant increase in project uptake, both from public and private sector. Overall 42,238 paediatric presumptive TB cases were enrolled in the project, across the four cities. Over the project period, quarterly diagnostic uptake and paediatric TB cases detection rates increased more than two-fold. TB detection rates were similar in patients from public and private sectors. Conclusions: Ongoing efforts in scaling up new rapid diagnostics involves significant investments. These efforts need to be complemented with proactive provider engagement to ensure provider-literacy and awareness, for maximizing impact of this scale-up. The current project demonstrated the usefulness of outreach and education interventions for the effective uptake of newer diagnostics. [ABSTRACT FROM AUTHOR]

Aims: The present investigation was aimed to assess the postural stress and the prevalence of musculoskeletal disorders (MSDs) of the "Jari" (golden thread) workers. Settings and Design: This cross-sectional study was carried out on 156 female workers in different areas of the Purba Medinipur, Paschim Medinipur, and Howrah districts of West Bengal, India. Materials and Methods: The MSDs of the workers were evaluated by modified Nordic questionnaire method. The postural pattern during work was assessed by direct observation method. The posture of Jari workers has been analyzed by OWAS, REBA, and RULA methods. The joint angle in normal and working posture was observed. Results and Conclusions: The prevalence of MSDs was very high among the workers. The major locations of body pains in Jari workers were lower back, upper back, neck, wrist, thigh, and shoulder. The occurrence of MSDs was higher in lower and higher age group than that of the middle age group. The total work shift of the workers was approximately 13 h including rest pause. The dominant postures adopted by the workers were sitting on the floor with stretched legs, sitting on the floor with folded knees, and kneeling posture. From the results of the postural analysis, the postures of the Jari workers had been categorized as stressful. There were a significant deviation between normal standing angles and working angles. From the overall study, it may be concluded that adoption of stressful postures for longer duration might be the cause of MSDs in different body parts of the Jari workers. [ABSTRACT FROM AUTHOR]

Despite the rapidly increasing burden of tobacco-related morbidity and mortality in low- and middle-income countries, tobacco control initiatives – especially cessation – receive little emphasis. This is true despite low-cost methods that have potential for widespread dissemination. The purpose of this paper is to provide a case study example of how lay interventionists may be trained and supported to facilitate tobacco use cessation, based on the successful Tobacco-Free Teachers–Tobacco-Free Society program (TFT–TFS) implemented in Bihar, India. This school-based program included multiple components, with lay interventionists having a crucial role. The lay interventionists included health educators and lead teachers, both of whom were selected based on formative research, underwent extensive training and received continuing support. We emphasized encouraging and supporting teachers to quit tobacco use and engaging both tobacco users and nonusers to create a supportive environment for cessation. We also stressed that neither the health educators nor lead teachers were being trained as counselors or as cessation experts. We focused on the importance of respecting teachers as individuals and identifying locally relevant methods of cessation. Although we cannot isolate the precise contribution of the lay interventionists to the successful TFT–TFS intervention, the abstinence findings in favor of the intervention at follow-up are highly encouraging. Teachers have been neglected as lay interventionists for tobacco cessation despite the fact that they tend to be highly respected and credible. The approach used for TFT–TFS could be disseminable in multiple low- and middle-income country contexts through train-the-trainer programs targeted to teachers. [ABSTRACT FROM AUTHOR]

Objective To examine the perceived effectiveness of text and pictorial smokeless tobacco health warnings in India and Bangladesh, including different types of message content. Methods An experimental study was conducted in Navi Mumbai, India (n=1002), and Dhaka, Bangladesh (n=1081). Face-to-face interviews were conducted on tablets with adult (≥19 years) smokeless tobacco users and youth (16-18 years) users and non-users. Respondents viewed warnings depicting five health effects, within one of the four randomly assigned warning label conditions (or message themes): (1) text-only, (2) symbolic pictorial, (3) graphic pictorial or (4) personal testimonial pictorial messages. Results Text-only warnings were perceived as less effective than all of the pictorial styles (p<0.001 for all). Graphic warnings were given higher effectiveness ratings than symbolic or testimonial warnings ( p<0.001). No differences were observed in levels of agreement with negative attitudes and beliefs across message themes, after respondents had viewed warnings. Conclusions Pictorial warnings are more effective than text-only messages. Pictorial warnings depicting graphic health effects may have the greatest impact, consistent with research from high-income countries on cigarette warnings. [ABSTRACT FROM AUTHOR]

Objectives: In India, a 2003 law ("COPTA") banned tobacco advertising with the exception of "point of sale" and "on-pack" advertising. Given substantial evidence regarding the impact of point of sale advertising (PoS), we analyzed the prevalence of encountering such advertising in Mumbai, India. Methods: A survey was conducted of 199 current and recent former tobacco users recruited at the Tata Memorial Hospital (Mumbai). Enrollees were queried regarding their exposure to tobacco advertising in the last 30 days through multiple media sources. Descriptive epidemiologic techniques were used to characterize the data. Results: Overall, 95% of participants were men and 5% were women (mean age=49 years). All were current tobacco users or quit using all forms of tobacco in the last 60 days. Participants' responses revealed that PoS tobacco advertising had been encountered in the last 30 days for cigarettes (61%), bidis (54%), and smokeless tobacco (59%). Other forms of tobacco advertising were virtually non-existent. Conclusions: PoS tobacco advertising remains prominent and highly visible to consumers in Mumbai, India, indicating corporate exploitation of a loophole in the COPTA legislation. Given the observed compliance with the currently imposed bans, revisions of COPTA to include all forms of tobacco promotion and advertising would be impactful. [ABSTRACT FROM AUTHOR]

Introduction Recently, a tobacco product, Chaini Khaini, identified as snus appeared in India. The product marketing emphasises its discreet nature and explicitly claims safety by referring to the existing evidence on Swedish snus. We analysed tobacco-specific nitrosamines and nicotine in 12 samples of Chaini Khaini purchased in 2013 at open markets in India. Methods Samples were purchased twice: in March 2013 from Mumbai and in November 2013 from Mumbai and Ahmedabad. Chemical constituents were measured by our routine validated methods. Results Levels of carcinogenic nitrosamines NNN, NNK and NNAL averaged 22.9 (±4.9), 2.6 (±1.0) and 3.1 (±1.5) µg/g tobacco (wet weight), respectively. The levels of NAB, which is normally present in trace levels in tobacco products, ranged from 3.9 to 12.9 µg/g tobacco. Total nicotine levels in all samples averaged 10.0 mg/g tobacco and unprotonated nicotine accounted for an average 95.4% of the total nicotine content. Conclusions Chaini Khaini, which is labelled as snus and is marketed as a safe alternative to other tobacco products contains very high levels of carcinogenic nitrosamines and biologically available nicotine. Interventions are urgently needed to educate current and potential consumers of this product. [ABSTRACT FROM AUTHOR]

Areca nut is widely used in India and the consumption has increased over the past two decades, with availability in new dry packaged forms (pan masala, gutka, mawa). Recent reports of increasing mouth cancer incidence have suggested an association with areca nut consumption. Here we have reviewed the evidence for carcinogenicity of areca nut, including epidemiological studies, several animal studies and mechanistic evidence. Studies primarily from India, providing odds ratios (ORs) or relative risks for precancers or cancer with use of areca nut without inclusion of tobacco is the focus of the review. Six casecontrol studies on oral submucous fibrosis (OSF) had significantly elevated ORs for use of areca nut in various forms. Six case-control studies on head and neck cancers, primarily oral cancer reported elevated ORs for chewing of betel quid without tobacco. Eight case control studies on oral cancer have reported elevated and significant ORs for betel quid with tobacco. A significant risk in oral cancer was noted in gutka users. Animal studies confirmed correlation between development of precancers or cancers and exposure to areca nut or pan masala without tobacco. Mechanistic evidence shows a role for areca nut alkaloids, polyphenols and copper in promoting carcinogenesis. Our review emphasizes control policies on areca nut products and appropriate mass communication programs for awareness of hazards of areca nut with emphasis on areca nut per se. [ABSTRACT FROM AUTHOR]

Seabuckthorn (Hippophae rhamnoides L.), an important plant species of Indian Himalayas, is well known for its immense medicinal and nutritional value. The plant has the ability to sustain growth in harsh environments of extreme temperatures, drought and salinity. We employed DeepSAGE, a tag based approach, to identify differentially expressed genes under cold and freeze stress in seabuckthorn. In total 36.2 million raw tags including 13.9 million distinct tags were generated using Illumina sequencing platform for three leaf tissue libraries including control (CON), cold stress (CS) and freeze stress (FS). After discarding low quality tags, 35.5 million clean tags including 7 million distinct clean tags were obtained. In all, 11922 differentially expressed genes (DEGs) including 6539 up regulated and 5383 down regulated genes were identified in three comparative setups i.e. CON vs CS, CON vs FS and CS vs FS. Gene ontology and KEGG pathway analysis were performed to assign gene ontology term to DEGs and ascertain their biological functions. DEGs were mapped back to our existing seabuckthorn transcriptome assembly comprising of 88,297 putative unigenes leading to the identification of 428 cold and freeze stress responsive genes. Expression of randomly selected 22 DEGs was validated using qRT-PCR that further supported our DeepSAGE results. The present study provided a comprehensive view of global gene expression profile of seabuckthorn under cold and freeze stresses. The DeepSAGE data could also serve as a valuable resource for further functional genomics studies aiming selection of candidate genes for development of abiotic stress tolerant transgenic plants. [ABSTRACT FROM AUTHOR]

BACKGROUND: In India varieties of hand tools have been used to cut the vegetables. Traditional vegetable cutter is a commonly used hand tool which has been used for years in the kitchen. The tool may have some design related problems. The present study was undertaken to reduce those problems. OBJECTIVE: The study objective was to evaluate a new design of traditional vegetable cutters for use in the Indian kitchen. PARTICIPANTS: One hundred and fifty Indian women who regularly used a vegetable cutter for cooking purposes participated in this study. METHODS: The design of the vegetable cutter was modified based on the postural preference of the users and other anthropometric factors including the blade angle, length, breadth and width of the sitting area. The prevalence of musculoskeletal disorders was assessed by means of a questionnaire for subjects' feedback. New concepts of the design were proposed and a few prototypes were made and were tested by paired comparison using the EMG system. RESULTS: A large number of subjects (61%) used the vegetable cutter while sitting on the floor with folded knees and the prevalence of MSD in most of the body parts was comparatively lower in this posture than that in squatting posture. In the new design, a broad platform was suggested to provide a more comfortable sitting when a subject sits on it with folded knees. For the vegetable cutter, the blade angle was made at 120° with a broad folded wooden base as the final prototype of the cutter. The length, breadth, and thickness of the base were selected based on the results of the anthropometric measurements among the prototypes of the cutters. The selected vegetable cutter showed the least myoelectric activity among the prototypes during cutting vegetables. CONCLUSION: The modified vegetable cutter appeared to be ergonomically effective, less prone to muscular stress, and compatible for preferred posture of the users. [ABSTRACT FROM AUTHOR]

The article discusses the high risk of cardiovascular diseases among the urban middle class in India. It examines the impact of several factors to the prevalence of the disease including low physical activity, smoking, hypertension and metabolic syndrome. It also notes that the cardiovascular diseases can cause morbidity and mortality in low and middle income countries.

Background: This study examined a PERIOD3 (PER3) gene variable number tandem repeat polymorphism and chronotype as potential BrCA risk factors among Indian women. Methods: This case-control study included sporadic, histologically confirmed BrCA cases ( n = 255) and controls ( n = 249) from India with data collection from 2010-2012. Results: Women with the 4/5 or 5/5 PER3 genotype had a nonstatistically significant 33% increased odds of BrCA. Cases were more likely to have a morning (OR = 2.43, 95% CI = 1.23-4.81) or evening (OR = 2.55, 95% CI = 1.19-5.47) chronotype. Conclusions: Findings are consistent with the possibility that extremes in chronotype may elicit circadian desynchronization, resulting in increased BrCA susceptibility. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking and binge alcohol drinking are two of the leading risk factors for premature mortality worldwide. In India, studies have examined the geographic distributions of tobacco smoking and alcohol drinking only at the state-level; sub-state variations and the spatial association between the two consumptions are poorly understood. Methodology: We used data from the Special Fertility and Mortality Survey conducted in 1998 to examine the geographic distributions of tobacco smoking and alcohol drinking at the district and postal code levels. We used kriging interpolation to generate smoking and drinking distributions at the postal code level. We also examined spatial autocorrelations and identified spatial clusters of high and low prevalence of smoking and drinking. Finally, we used bivariate analyses to examine the spatial correlations between smoking and drinking, and between cigarette and bidi smoking. Results: There was a high prevalence of any smoking in the central and northeastern states, and a high prevalence of any drinking in Himachal Pradesh, Arunachal Pradesh, and eastern Madhya Pradesh. Spatial clusters of early smoking (started smoking before age 20) were identified in the central states. Cigarette and bidi smoking showed distinctly different geographic patterns, with high levels of cigarette smoking in the northeastern states and high levels of bidi smoking in the central states. The geographic pattern of bidi smoking was similar to early smoking. Cigarette smoking was spatially associated with any drinking. Smoking prevalences in 1998 were correlated with prevalences in 2004 at the district level and 2010 at the state level. Conclusion: These results along with earlier evidence on the complementarities between tobacco smoking and alcohol drinking suggest that local public health action on smoking might also help to reduce alcohol consumption, and vice versa. Surveys that properly represent tobacco and alcohol consumptions at the district level are recommended. [ABSTRACT FROM AUTHOR]

Objectives. We assessed a school-based intervention designed to promote tobacco control among teachers in the Indian state of Bihar. Methods. We used a cluster-randomized design to test the intervention, which comprised educational efforts, tobacco control policies, and cessation support and was tailored to the local social context. In 2009 to 2011, we randomly selected 72 schools from participating school districts and randomly assigned them in blocks (rural or urban) to intervention or delayed-intervention control conditions. Results. Immediately after the intervention, the 30-day quit rate was 50% in the intervention and 15% in the control group (P = .001). At the 9-month post-intervention survey, the adjusted 6-month quit rate was 19% in the intervention and 7% in the control group (P = .06). Among teachers employed for the entire academic year of the intervention, the adjusted 6-month abstinence rates were 20% and 5%, respectively, for the intervention and control groups (P = .04). Conclusions. These findings demonstrate the potent impact of an intervention that took advantage of social resources among teachers, who can serve as role models for tobacco control in their communities. [ABSTRACT FROM AUTHOR]

In India, tobacco kills 900 000 people every year though the burden of tobacco is faced disproportionately in poorer states such as Bihar. Teachers may be a particularly influential group in setting norms around tobacco use in the Indian context. However, tobacco use among teachers remains high and perceptions of tobacco-related health risks are unexplored. To qualitatively explore perceptions about tobacco use among teachers in Bihar and to examine how risk information may be communicated through a variety of message formats, 12 messages on tobacco health risks varying in formats were tested in focus groups with teachers from Bihar. Participants stated that teachers were already aware of tobacco-related health risks. To further increase awareness of these risks, the inclusion of evidence-based facts in messages was recommended. Communicating risk information using negative emotions had a great appeal to teachers and was deemed most effective for increasing risk perception. Messages using narratives of teachers’ personal accounts of quitting tobacco were deemed effective for increasing knowledge about the benefits of quitting. To conclude, messages using evidence-based information, possibly with negative emotions, testimonials with role models and those messages emphasizing self-efficacy in the format of narratives appear to appeal to teachers in Bihar. [ABSTRACT FROM PUBLISHER]

Background India’s Cigarettes and Other Tobacco Products Act bans tobacco sales and advertisements within 100 yards of educational institutions. In schooladjacent neighbourhoods in Mumbai, we assessed adherence to these policies and whether tobacco vendor and advertisement densities were associated with students' tobacco use. Methods High school students' tobacco use was measured using a multistage cluster sampling survey (n=1533). Field geographic information systems data were obtained for all tobacco vendors and advertisements within 500 m of schools (n=26). Random-effects multilevel logistic regression was used to estimate associations of tobacco vendor and advertisement densities with ever tobacco use, current smokeless tobacco use and current tobacco use. Results There were 1741 tobacco vendors and 424 advertisements within 500 m of schools, with 221 vendors (13%) and 42 advertisements (10%) located within 100 m. School-adjacent tobacco vendor density within 100 m was not associated with the tobacco use outcomes, but tobacco advertisement density within 100 m was associated with all outcomes when comparing highest to lowest density tertiles: ever use (OR: 2.01; 95% CI 1.00 to 4.07), current use (2.23; 1.16, 4.28) and current smokeless tobacco use (2.01; 1.02, 3.98). Tobacco vendor density within 200, 300, 400 and 500 m of schools was associated with current tobacco use and current smokeless tobacco use, but not ever use. Conclusions The tobacco sales ban near educational institutions could be expanded beyond 100 m. Greater enforcement is needed regarding the current bans, particularly because advertisement density within 100 m of schools was associated with all students' tobacco use outcomes. [ABSTRACT FROM AUTHOR]

This article provides a theory-based, step-by-step approach to intervention development and illustrates its application in India to design an intervention to promote tobacco-use cessation among school personnel in Bihar. We employed a five-step approach to develop the intervention using the Social Contextual Model of Health Behavior Change (SCM) in Bihar, which involved conducting formative research, classifying factors in the social environment as mediating mechanisms and modifying conditions, developing a creative brief, designing an intervention and refining the intervention based on pilot test results. The intervention engages users and non-users of tobacco, involves teachers in implementing and monitoring school tobacco control policies and maximizes teachers’ role as change agents in schools and communities. Intervention components include health educator visits, discussions led by lead teachers, cessation assistance, posters and other educational materials and is implemented over the entire academic year. The intervention is being tested in Bihar government schools as part of a randomized-controlled trial. SCM was a useful framework for developing a tobacco control intervention that responded to teachers’ lives in Bihar. [ABSTRACT FROM PUBLISHER]

OBJECTIVE We conducted a multisite study to determine the prevalence and determinants of normotension, prehypertension, and hypertension, and awareness, treatment, and control of hypertension among urban middle-class subjects in India. METHODS We evaluated 6,106 middle-class urban subjects (men 3,371; women, 2,735; response rate, 62%) in 11 cities for sociodemographic and biological factors. The subjects were classified as having normotension (BP < 120/80), prehypertension (BP 120–139/80–89), and hypertension (documented or BP ≥ 140/90). The prevalence of other cardiovascular risk factors was determined and associations evaluated through logistic regression analysis. RESULTS The age-adjusted prevalences in men and women of normotension were 26.7% and 39.1%, of prehypertension 40.2% and 30.1%, and of hypertension 32.5% and 30.4%, respectively. The prevalence of normotension declined with age whereas that of hypertension increased (P-trend < 0.01). A significant association of normotension was found with younger age, low dietary fat intake, lower use of tobacco, and low obesity (P < 0.05). The prevalence of hypercholesterolemia, diabetes, and metabolic syndrome was higher in the groups with prehypertension and hypertension than in the group with normotension (age-adjusted odds ratios (ORs) 2.0–5.0, P < 0.001). The prevalences in men and women, respectively, of two or more risk factors were 11.1% and 6.4% in the group with normotension, 25.1% and 23.3% in the group with prehypertension, and 38.3% and 39.1% in the group with hypertension (P < 0.01). Awareness of hypertension in the study population was in 55.3%; 36.5% of the hypertensive group were receiving treatment for hypertension, and 28.2% of this group had a controlled BP (< 140/90mm Hg). CONCLUSIONS The study found a low prevalence of normotension and high prevalence of hypertension in middle-class urban Asian Indians. Significant associations of hypertension were found with age, dietary fat, consumption of fruits and vegetables, smoking, and obesity. Normotensive individuals had a lower prevalence of cardiometabolic risk factors than did members of the prehypertensive or hypertensive groups. Half of the hypertensive group were aware of having hypertension, a third were receiving treatment for it, and quarter had a controlled BP. [ABSTRACT FROM PUBLISHER]

Background: To determine correlation of multiple parameters of socioeconomic status with cardiovascular risk factors in India. Methods: The study was performed at eleven cities using cluster sampling. Subjects (n = 6198, men 3426, women 2772) were evaluated for socioeconomic, demographic, biophysical and biochemical factors. They were classified into low, medium and high socioeconomic groups based on educational level (<10, 10-15 and >15yr formal education), occupational class and socioeconomic scale. Risk factor differences were evaluated using multivariate logistic regression. Results: Age-adjusted prevalence (%) of risk factors in men and women was overweight or obesity in 41.1 and 45.2, obesity 8.3 and 15.8, high waist circumference 35.7 and 57.5, high waist-hip ratio 69.0 and 83.8, hypertension 32.5 and 30.4, hypercholesterolemia 24.8 and 25.3, low HDL cholesterol 34.1 and 35.1, high triglycerides 41.2 and 31.5, diabetes 16.7 and 14.4 and metabolic syndrome in 32.2 and 40.4 percent. Lifestyle factors were smoking 12.0 and 0.5, other tobacco use 12.7 and 6.3, high fat intake 51.2 and 48.2, low fruits/vegetables intake 25.3 and 28.9, and physical inactivity in 38.8 and 46.1%. Prevalence of > = 3 risk factors was significantly greater in low (28.0%) vs. middle (23.9%) or high (22.1%) educational groups (p<0.01). In low vs. high educational groups there was greater prevalence of high waist-hip ratio (odds ratio 2.18, confidence interval 1.65-2.71), low HDL cholesterol (1.51, 1.27-1.80), hypertriglyceridemia (1.16, 0.99-1.37), smoking/ tobacco use (3.27, 2.66-4.01), and low physical activity (1.15, 0.97-1.37); and lower prevalence of high fat diet (0.47, 0.38-0.57),overweight/obesity (0.68, 0.58-0.80) and hypercholesterolemia (0.79, 0.66-0.94). Similar associations were observed with occupational and socioeconomic status. Conclusions: Low educational, occupational and socioeconomic status Asian Indians have greater prevalence of truncal obesity, low HDL cholesterol, hypertriglyceridemia, smoking or tobacco use and low physical activity and clustering of > = 3 major cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Tobacco use and under-nutrition are major public health concerns and tuberculosis is a major cause of morbidity and mortality in India. Using a cohort of 148,173 persons (recruited 1991-1997 and followed-up 1997-2003) the joint effects of tobacco use and BMI on tuberculosis mortality was studied. Tobacco use in any form and low-BMI had joint effect on tuberculosis mortality and the interaction effect was synergistic in men and antagonistic in women. Self-reported tuberculosis was associated with increased risk of tuberculosis mortality. In contrast, no such association was observed for self-reported diabetes persons. The risk pattern remained unchanged even after excluding tuberculosis deaths occurred within 1st two years of follow-up. This study highlights importance of age consideration of individual while excluding early deaths. Around 27% male tuberculosis deaths were attributable to their being underweight and smoker, while 22% male and 37% female deaths were attributable to their being underweight and smokeless tobacco user. [ABSTRACT FROM AUTHOR]

The article presents a study on the cancers which caused death in India in 2001 to 2003. The study analyzed the causes of 122,429 deaths assigned by 130 trained physicians which happened in 6671 areas in the country. Results revealed the cancers that caused mortality in India including lung, stomach, and oral in men and breast, stomach, and cervical in women.

Background: In response to India's growing tobacco epidemic, strategies are needed to decrease tobacco use among Indian youth, particularly among those who are economically disadvantaged. The objective of this study was to assess the effectiveness of a school-based life-skills tobacco control program for youth of low socio-economic status in Mumbai and the surrounding state of Maharashtra. We hypothesized that compared to youth in control schools, youth exposed to the program would have greater knowledge of effects of tobacco use; be more likely to take action to prevent others from using tobacco; demonstrate more positive life skills and attitudes; and be less likely to report tobacco use. Methods/Findings: Using a quasi-experimental design, we assessed program effectiveness by comparing 8th and 9th grade students in intervention schools to 8th grade students in comparable schools that did not receive the program. Across all schools, 1851 students completed a survey that assessed core program components in early 2010. The program consisted of activities focused on building awareness about the hazards of tobacco, developing life skills, and advocacy development. The primary outcome measure was self-reported tobacco use in the last 30 days. Findings indicate that 4.1% of 8th grade intervention students (OR = 0.51) and 3.6% of 9th grade intervention students (OR = 0.33) reported using tobacco at least once in the last 30 days, compared to 8.7% of students in the control schools. Intervention group students were also significantly more knowledgeable about tobacco and related legislation, reported more efforts to prevent tobacco use among others, and reported stronger life skills and self-efficacy than students in control schools. Limitations to the study include schools not being randomly assigned to condition and tobacco use being measured by self-report. Conclusions: This program represents an effective model of school-based tobacco use prevention that low-income schools in India and other low- and middle-income countries can replicate. [ABSTRACT FROM AUTHOR]

Background: Tobacco use has been identified as the single biggest cause of inequality in morbidity. The objective of this study is to examine the role of social determinants on current tobacco use in thirteen low-and-middle income countries. Methodology/Principal Findings: We used nationally representative data from the Global Adult Tobacco Survey (GATS) conducted during 2008-2010 in 13 low-and-middle income countries: Bangladesh, China, Egypt, India, Mexico, Philippines, Poland, Russian Federation, Thailand, Turkey, Ukraine, Uruguay, and Viet Nam. These surveys provided information on 209,027 respondent's aged 15 years and above and the country datasets were analyzed individually for estimating current tobacco use across various socio-demographic factors (gender, age, place of residence, education, wealth index, and knowledge on harmful effects of smoking). Multiple logistic regression analysis was used to predict the impact of these determinants on current tobacco use status. Current tobacco use was defined as current smoking or use of smokeless tobacco, either daily or occasionally. Former smokers were excluded from the analysis. Adjusted odds ratios for current tobacco use after controlling other cofactors, was significantly higher for males across all countries and for urban areas in eight of the 13 countries. For educational level, the trend was significant in Bangladesh, Egypt, India, Philippines and Thailand demonstrating decreasing prevalence of tobacco use with increasing levels of education. For wealth index, the trend of decreasing prevalence of tobacco use with increasing wealth was significant for Bangladesh, India, Philippines, Thailand, Turkey, Ukraine, Uruguay and Viet Nam. The trend of decreasing prevalence with increasing levels of knowledge on harmful effects of smoking was significant in China, India, Philippines, Poland, Russian Federation, Thailand, Ukraine and Viet Nam. Conclusions/Significance: These findings demonstrate a significant but varied role of social determinants on current tobacco use within and across countries. [ABSTRACT FROM AUTHOR]

Objective Smokeless tobacco consumption in India is a significant source of morbidity and mortality. In order to educate smokeless tobacco users about the health harms of smokeless tobacco and to denormalise tobacco usage and encourage quitting, a national television and radio mass media campaign targeted at smokeless tobacco users was aired for 6 weeks during November and December 2009. Methods The campaign was evaluated with a nationally representative household survey of smokeless tobacco users (n=2898). The effect of campaign awareness was assessed with logistic regression analysis. Results The campaign affected smokeless tobacco users as intended: 63% of smokeless-only users and 72% of dual users (ie, those who consumed both smoking and smokeless forms) recalled the campaign advertisement, primarily through television delivery. The vast majority (over 70%) of those aware of the campaign said that it made them stop and think, was relevant to their lives and provided new information. 75% of smokeless-only users and 77% of dual users said that it made them feel concerned about their habit. Campaign awareness was associated with better knowledge, more negative attitudes towards smokeless tobacco and greater cessation-oriented intentions and behaviours among smokeless tobacco users. Conclusions Social marketing campaigns that utilise mass media are feasible and efficacious interventions for tobacco control in India. Implications for future mass media tobacco control programming in India are discussed. [ABSTRACT FROM AUTHOR]

This investigation was aimed to assess age and sex related variation in the index finger flexion and extension strength and its association with some anthropometric characteristics. A total of 400 subjects (200 male and 200 female), 18-60 years were selected at random and divided into three age groups: 18-34, 35-50 and 51-60 years. Strength was measured using a dedicated device. Results revealed that finger flexion and extension strength was significantly greater (p < 0.001) in men than in women. Irrespective of gender the right hand was significantly stronger (p< 0.001) than that of left hand. A significant variation in finger extension strength with age was noted for both genders. Positive correlations between strength and some anthropometry were indicated only in case of male subjects. [ABSTRACT FROM AUTHOR]

Background: Second-hand smoke contains several toxic chemicals that are known to pollute the air and harm people's health. In India, smoking in public places has been prohibited since October 2008 as a way to reduce second-hand smoke (SHS) exposure. The purpose of the present study was to assess the implementation of smoke-free policies and its impact on indoor air quality by measuring the PM2.5 levels in bars and restaurants, restaurants, country liquor bars, hookah restaurants and pubs in Mumbai. Materials and Methods: Air quality measurements at 50 venues were conducted by using a "SIDEPAK™ AM510 Personal Aerosol Monitor" during April to May 2009. Average concentration of PM2.5 (µg/m3) particles was calculated separately for each venue. Results: Smoking was observed in 36% of the surveyed venues during an hour of data collection. The PM2.5 levels ranged from 16.97 to 1101.76 µg/m3. The average level of PM2.5 among non-smoking venues was 97.19 µg/m3 and among smoking venues was 363.04 µg/m3. Conclusion: Considerable scope for improvement in implementation of smoke-free policies exists. The PM2.5 levels were exceedingly high in venues where smoking was observed. [ABSTRACT FROM AUTHOR]