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Structural competency is a new curricular framework for training health professionals to recognise and respond to disease and its unequal distribution as the outcome of social structures, such as economic and legal systems, healthcare and taxation policies, and international institutions. While extensive global health research has linked social structures to the disproportionate burden of disease in the Global South, formal attempts to incorporate the structural competency framework into US-based global health education have not been described in the literature. This paper fills this gap by articulating five sub-competencies for structurally competent global health instruction. Authors drew on their experiences developing global health and structural competency curricula-and consulted relevant structural competency, global health, social science, social theory, and social determinants of health literatures. The five sub-competencies include: (1) Describe the role of social structures in producing and maintaining health inequities globally, (2) Identify the ways that structural inequalities are naturalised within the field of global health, (3) Discuss the impact of structures on the practice of global health, (4) Recognise structural interventions for addressing global health inequities, and (5) Apply the concept of structural humility in the context of global health.

Structural competency is a new curricular framework for training health professionals to recognise and respond to disease and its unequal distribution as the outcome of social structures, such as economic and legal systems, healthcare and taxation policies, and international institutions. While extensive global health research has linked social structures to the disproportionate burden of disease in the Global South, formal attempts to incorporate the structural competency framework into US-based global health education have not been described in the literature. This paper fills this gap by articulating five sub-competencies for structurally competent global health instruction. Authors drew on their experiences developing global health and structural competency curricula-and consulted relevant structural competency, global health, social science, social theory, and social determinants of health literatures. The five sub-competencies include: (1) Describe the role of social structures in producing and maintaining health inequities globally, (2) Identify the ways that structural inequalities are naturalised within the field of global health, (3) Discuss the impact of structures on the practice of global health, (4) Recognise structural interventions for addressing global health inequities, and (5) Apply the concept of structural humility in the context of global health.

Introduction Indian cigarillos (bidi) are low-cost alternatives to cigarettes with only 22% imposed taxes, and turnover of up to INR 4 million per annum exempted from taxation. Aims and Methods This paper estimates revenue implications and potential loss of life years (YLLs) averted if the bidi industry is subjected to increased regulations and taxation. Revenue estimates at 10% increased regulation and 100% regulation were calculated, followed by estimates at taxes equivalent to cigarettes and World Health Organization–Framework Convention on Tobacco Control (WHO–FCTC) recommendation. Price elasticity was considered to assess demand. Price changes in separate fractions (previously regulated and unregulated) were calculated to obtain potential YLLs averted. Results Current revenue of USD 59.25 million is projected to increase to USD 179.25 million with 695 159 averted YLLs at cigarette equivalent taxes and 10% increased regulation; USD 639.38 million with 4 527 597 averted YLLs with 100% regulation; USD 54.75 million, at WHO recommended taxes with 2 233 740 YLLs averted at 10% increased regulation, and 10 486 192 YLLs at 100% regulation. Conclusions Proposed estimates are in line with WHO recommendations as they consider price elasticity and suggest a substantial increase in revenue while averting YLLs. A national action is needed to drive the policy decisions towards increased regulation and taxation and revision of India's tobacco control legislation. Implications Our study presented empirical evidence of how the currently underutilized tool of taxation, as proposed in the WHO–FCTC, can be utilized to decrease bidi smoking prevalence and save measurable life years while generating government revenue simultaneously. While the revenue statistics counter the misleading tobacco industry narratives, the projected reduction in mortality will be seen as an irrefutable driving force for policy reforms, targeted at the strategic increase in regulation and taxation of the traditional Indian cigarillos industry. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: Cancer is one of the major public health concerns leading to high trends of mortality and morbidity in India. Health-related quality of life (HRQoL) is an indicator of the sense of well-being applicable, which includes all the domains of physical, social, emotional, and functional well-being. The inferences can strengthen the palliative care needs of patients. This study was conducted to assess the HRQoL of patients on anticancer therapy and to measure the perceived palliative care needs amongst diagnosed patients on cancer therapy. Methodology: Mixed method approach was used to assess the objectives of the study. FACT-G questionnaire was used to assess the HRQoL of patients among a sample size of 290 participants for quantitative analysis and 9 for in-depth interviews. Data were generated and analyzed in SPSS version 23. Spearman correlation coefficient was used to test the association between the well-being score and demographic factors. Results: The mean age of the study population was 52.46 ± 13.83 years with 65% females. The mean FACT-G score was 61.1 ± 17.1 with mean domain values of 14.97 (physical well-being), 16.55 (social well-being), 16.21 (emotional well-being) and 13.35 (functional well-being). FACT-G score was significantly associated with education level, type of cancer and type of anticancer therapy. Qualitative themes described pertaining to delayed diagnosis, financial distress, side effects, social isolation (factors worsening QoL) and support, and attitude (factors improving QoL). Conclusion: HRQOL scores were found low in all types of cancer and early referral for palliative care might have a positive effect on the quality of life of cancer patients. Cancer is the leading cause of morbidity and mortality with its profound social and economic consequences leading to impoverishment and societal inequity. [ABSTRACT FROM AUTHOR]

For medical fraternity, health system and policymakers to undertake effective countermeasures, a comprehensive assessment of the prevalence of anxiety among older adults is required; hence, we conducted a systematic review and meta-analysis using data pooled from surveys across the country. The search strategy was developed using medical subject headings (MeSH) terms and free-text keywords. We searched PubMed and Scopus for articles to report the prevalence of anxiety among older adults. The appraisal tool for cross-sectional studies was used for quality assessment. Prevalence from different studies was pooled together using the inverse variance heterogeneity method. Sensitivity analyses were performed to assess the impact of included studies' methodological quality on pooled results and to investigate potential causes of heterogeneity. Twenty-three studies were included in this systematic review. The overall pooled estimate of the prevalence of anxiety in older adults was 18.7% (95% CI: 2.4, 38.8). The studies had a high degree of heterogeneity. Publication bias was assessed using a Doi plot which showed an luis furuya-kanamori (LFK) index of 1.21 indicating minor asymmetry. Like other parts of the world, India has witnessed a rise in the number of elderly due to lower fertility rates, higher life expectancies and a shift in illness patterns from communicable to non-communicable. The number of elderly people suffering from diseases of mental health is expected to rise dramatically. This review consolidates the existing evidence to showcase anxiety as an upcoming public health problem requiring due focus from policymakers and health systems. [ABSTRACT FROM AUTHOR]

The article focuses on the AVENIR trial, which examines the impact of mass distribution of azithromycin on preschool-aged children in sub-Saharan Africa. Topics include the trial's findings on mortality reduction, the need for ongoing monitoring of antibiotic resistance, and the importance of assessing the long-term efficacy of the treatment.

Background. Cardiovascular diseases, including heart failure (HF), are leading causes of death and disability in India. However, most studies in India only include urban populations or rural regions with improved access and may not represent the poorest patients or regions. We studied the epidemiology of HF patients admitted to a secondary care hospital in rural Chhattisgarh, India. Methods. We did a retrospective chart review of patients hospitalized with HF in 2018 to obtain their demographic data and risk factors for developing HF. We reviewed echocardiograms to assign patients to their most probable HF category. Results. We studied 88 HF patients with a mean age of 42 years including 55 (62.5%) women. The most common categories of HF were cardiomyopathy (36.8%), rheumatic heart disease (RHD; 25.3%) and right heart failure (RHF; 18.4%). Prior tuberculosis was more prevalent in patients with RHF compared with other types of HF (43.8% v. 13.9%). Conclusions. HF patients in this study from rural central India were young and predominantly women. Cardiomyopathy, RHD and RHF due to past tuberculosis were common causes of HF in this population. Further studies are needed to expand upon these single centre findings to better understand the risk factors and outcomes of HF among the rural poor. [ABSTRACT FROM AUTHOR]