Search

Background: Despite being in temperate zone, India is endemic to nutritional rickets. However, very little has been studied on knowledge, perception and cultural practices of Indian communities, towards calcium and vitamin-D deficiency in children. Aim & Objective: The study aimed to develop and validate a questionnaire in Hindi language for the assessment of knowledge, attitude, and practices of parents towards calcium and vitamin D deficiency among children. Methodology: We searched electronic databases for item generation. The questionnaire was developed in Hindi language by five experts in the field of pediatrics, pediatric orthopaedics and community medicine using Delphi method. After language correction from Hindi language experts, a convenient sample of 30 participants filled the questionnaire and tested for internal consistency and test-retest reliability. Results: The overall Cronbach's alpha value for the finalized 46-item scale indicated an acceptable reliability (alpha = 0.91). The internal consistency reliability for six domains created was acceptable. The results revealed 'high' test-retest reliability, and there was no statistically significant difference noted between any of the first test and re-test corresponding values (p>0.05). Conclusion: The present questionnaire developed in Hindi Language to assess knowledge, attitude and practices (KAP) of parents towards Calcium & Vitamin-D deficiency in children, has a good validity and reliability. This newly developed instrument could prove its use to highlight the gaps that may exist among parents. The use of this tool may help clinicians, health educators and policy makers to identify key areas of intervention with regards to Calcium & Vitamin-D deficiency in children. [ABSTRACT FROM AUTHOR]

Introduction: Fixed orthodontic treatment has been the standard method to treat malocclusions for decades; however, the number of adults seeking more inconspicuous ways to enhance their smiles has significantly increased. This trend has led to the rising popularity of clear aligners among the general population, hailed as the 'invisible treatment' for correcting misaligned teeth. Aim: To assess the level of awareness among residents of Maharashtra regarding clear aligners. Materials and Methods: A cross-sectional study was conducted at the Department of Orthodontics and Dentofacial Orthopaedics, School of Dental Sciences, Krishna Vishwa Vidyapeeth (KVV) Karad, Maharashtra, India with a sample size of 423 participants. An online survey on awareness and perceptions of clear aligners among the general population of Maharashtra was carried out for one month through the dissemination of an online questionnaire. The questionnaire was administered using Google Forms and consisted of 12 closed-ended questions. The online data was collected and analysed while assessing its content validity. Results: The mean age of the study participants was 28.4±5.88 years. According to the survey, 203 (47.99%) participants had visited an orthodontist, with 87 (43.03%) receiving clear aligner recommendations as a treatment option. Notably, 266 (62.88%) were already familiar with clear aligners, and 268 (63.36%) considered them to be an effective treatment. Conclusion: The study findings indicated that 62.88% of participants had prior knowledge of clear aligners, while only 47.99% had visited an orthodontist. [ABSTRACT FROM AUTHOR]

Introduction: In 2019, the Central Drugs Standard Control Organization (CDSCO) introduced the New Drugs and Clinical Trials Rules 2019 (NDCTR), which separated the research guidelines for "Clinical Trials" and "Biomedical and Health Research." As a result, guidelines issued by Indian Council of Medical Research were stated to apply to academic clinical trials (ACTs). This change is important because academic studies are crucial for scientific advancement and repurposing of approved drugs in health-care industry. However, conducting an ACT can pose challenges. We assessed the level of awareness, knowledge, and challenges faced by investigators. Our aim is to overcome some of these challenges and encourage more academic studies for the betterment of healthcare and scientific knowledge in India. Methodology: The study was conducted in two phases after obtaining approval from the Institutional Ethics Committee (EC) of three tertiary care hospitals in Mumbai. In the first phase, the number of ACTs was assessed from the clinical trial registry India website, while the number of registered and re-registered ECs were assessed from the CDSCO website. The second phase involved assessing investigator awareness and knowledge about ACTs using a prevalidated questionnaire with a content validity index score of 0.93. Results: In 2020, the highest numbers of studies were registered, with the highest numbers of registered and re-registered ECs from Maharashtra. All participants completed the questionnaire and were aware of the need to follow guidelines for clinical trials. Sixty-seven percent of participants knew that the guidelines for ACTs differed from those of sponsored clinical trials, but only 58% were aware of the exact definition of an ACT as per NDCTR, 2019. Eighty-five percent of participants knew who could initiate an ACT, but only 27% knew about the applicability of results of an ACT and 33% had in-depth knowledge about the required approvals, while only 10% knew the archival period. Although 71% of participants had knowledge about serious adverse event reporting, few answered in-depth questions correctly. Only 31 participants reported facing varied challenges. Conclusion: To conduct ACTs effectively and contribute to healthcare and scientific advancement, it is crucial to enhance investigators' existing knowledge about ACTs. [ABSTRACT FROM AUTHOR]

Background: Tobacco usage has been identified as a leading preventable cause of mortality and is responsible for six million fatalities per year globally. India had enacted COTPA in 2003. Tobacco vendors are one of the key stakeholders for Cigarettes and Other Tobacco Products Act (COTPA) implementation. Objective: To assess the knowledge gap on COTPA and to explore the perceived factors influencing implementation of COTPA among tobacco vendors in Puducherry. Materials and Methods: A mixed-method study was conducted among tobacco vendors from Point of Sale (PoS) around 230 educational institutions (schools and degree colleges) in Puducherry for three months. Simple random sampling was applied to select educational institutions and the tobacco vendors from PoS located around these institutions were included. Data capture was done using a pretested, face-validated questionnaire incorporated in Epicollect software 5 and data analysis by SPSSv24. Purposive sampling was employed to conduct in-depth interviews among tobacco vendors till the point of saturation and manual content analysis performed. Written informed consents were sought. Institutional Ethical Committee approval was obtained. Results: Majority (95.7%) reported that they were aware of tobacco control legislation, but only one person had heard of COTPA. Awareness about the display of signage boards at PoS was observed in 75.7% vendors. Around 41.7% reported that they should not advertise any kind of tobacco products. Three major themes were identified: facilitators, barriers, and suggested measures for COTPA implementation. Conclusion: Tobacco vendors in Puducherry were aware of tobacco control legislations but not familiar with the COTPA and its provisions. It is necessary to put forth efforts to educate these important stakeholders to be more cognizant of COTPA and to effectively include them in anti-tobacco programs. [ABSTRACT FROM AUTHOR]

Introduction: In Cerebral Palsy (CP), sensory perception is affected in addition to the motor symptoms. Now-a-days, treatment solely focuses on diagnosed motor deficiencies, often overlooking underlying sensory abnormalities and their examination. Therefore, including a clinical sensory examination in the evaluation of children with CP is crucial. Aim: To develop a validated measure for assessing sensory processing among children with CP. Materials and Methods: This study, conducted as part of a Ph.D. research project, employed an exploratory sequential research design. It commenced on March 1, 2020, and concluded on October 18, 2021, at the Physiotherapy Out Patient Department (OPD) of Swami Vivekanand Subharti University in Meerut, Uttar Pradesh, India. Validity tests, including Scale Level Content Validity Index (CVI) and Spearman rank correlation methods, were used alongside other subtests. The study consisted of two phases: Development and Validation. An extensive literature search and parent interviews were conducted to comprehensively understand and collect information on sensory issues. Based on this information, a preliminary questionnaire draft was created. Three categories of validity-content, face, and concurrent-were tested. Content validation involved employing a three-round online Delphi approach. Face validity was assessed through opinions from clinicians regarding the questionnaire's appearance. Concurrent validity was established by comparing the Sensory Outcome Measure (SOM) with the criterion measure scale, Short Sensory Profile (SSP). Results: For all items, Content Validity Ratio (CVR) and item-level CVI values ranged from 0.8 to 1. The overall Scale Level CVI (average) for the scale was 0.890625. Experts exhibited a 96% agreement regarding the appearance of the questionnaire, indicating complete agreement. The Spearman rank correlation coefficient value was 0.866, and the correlation graph indicated a positive association between the two scales in terms of concurrent validity. Conclusion: The Sensory Outcome Measure (SOM) has been developed as a valid scale with high content and face validity, along with excellent concurrent validity. SOM is the first measuring scale developed in India and used for assessing sensory deficits in children with CP. [ABSTRACT FROM AUTHOR]

Background & objectives: Assessing healthcare seeking behaviour (HSB), healthcare utilization and related out-of-pocket expenditures of Particularly Vulnerable Tribal Groups (PVTGs) of India through a prism of the health system may help to achieve equitable health outcomes. Therefore, this comprehensive study was envisaged to examine these issues among PVTGs of Odisha, India. However, there exists no validated questionnaire to measure these variables among PVTGs. Therefore, a study questionnaire was developed for this purpose and validated. Methods: Questionnaire was constructed in four phases: questionnaire development, validity assessment, pilot testing and reliability assessment. Nine domain experts face validated questionnaire in two rounds, followed by a single round of quantitative content validity. Next, the questionnaire was pretested in three rounds using cognitive interviews and pilot-tested among 335 and 100 eligible individuals for the two sections healthcare seeking behaviour (HSB-Q) and maternal and child healthcare service utilization (MCHSU-Q). Internal consistency reliability was assessed for de novo HSB-Q. Results: On two rounds of expert-driven face validity, 55 items were eliminated from 200 items. Questionnaire showed moderate to high content validity (item-level content validity index range: 0.78 to 1, scale-level content validity index/universal agreement: 0.73; scale-level content validity index/average: 0.96 and multirater kappa statistics range: 0.6 to 1). During the pre-test, items were altered until saturation was achieved. Pilot testing helped to refine interview modalities. The Cronbach alpha and McDonald’s omega assessing internal consistency of HSB-Q were 0.8 and 0.85, respectively. Interpretation & conclusions: The questionnaire was found to be valid and reliable to explore healthcare seeking behaviour, maternal and child healthcare utilization and related out-of-pocket expenditure incurred by PVTGs of Odisha, India. [ABSTRACT FROM AUTHOR]

Background: Disordered eating behaviors (DEBs) among persons with schizophrenia (PwS) have been reported widely in the literature, with very few studies in India. Robust tools to assess DEB are needed in the vernacular language to capture symptoms of disordered eating accurately. No such tools are available in the Tamil language. Globally, the Eating Attitudes Test (EAT-26) is widely used to assess DEB among PwS. Aim: This study aimed to translate and study the factor structure and reliability of EAT-26 among Tamil-speaking PwS. Materials and Methods: EAT-26 was translated into Tamil following the Oxford linguistic validation process. Experts evaluated its face validity and content validity. One hundred and fifty PwS, aged between 18 and 65 years, who attended the outpatient department of a psychiatric facility, and consented to participate, completed the Tamil version of EAT-26. Test-retest reliability of EAT-26 was assessed by readministering the tool to 30 PwS after two weeks. Data were analyzed using Stata 16.1. Internal consistency and test-retest reliability were computed using Cronbach's alpha and intraclass coefficients, respectively. The factor structure of EAT-26 was explored using principal component analysis (PCA). Spearman's rho was calculated to understand the correlation between the factors. Results: EAT-26 had an internal consistency of 0.71 and test-retest reliability of 0.896. Factor analysis revealed nine latent factors consisting of 21 of the original 26 items on EAT-26. These 21 items could explain a variance of 63.63%. Conclusions: The Tamil version of the EAT-26 is a reliable tool to assess DEB among Tamil-speaking PwS. It can be used to screen PwS for eating disorder risk. [ABSTRACT FROM AUTHOR]

Introduction: Summative assessments play a major role in shaping the student's learning. There is little literature available on validity of summative assessment question papers in Forensic Medicine & Toxicology. This study analyses 30 question papers from 6 reputed universities for content validity. Methods: A retrospective cross-sectional record-based observational study was conducted where 30 university summative question papers in Forensic Medicine & Toxicology from 6 universities across India were evaluated for content validity. The learning domain assessed, the type of questions asked, and sampling of the content was compared and presented in the results. Results: From the results of the study, it was noted that 80% weightage was allotted to recall in most papers and only one paper tested for application. 70 to 80% of the marks were allotted to Forensic Pathology leading to disproportionate sampling. Core areas in Toxicology and Medical Jurisprudence were sparsely assessed. Conclusion: The content validity of the summative question papers in Forensic Medicine and Toxicology was unsatisfactory, emphasising the need for evaluation of the clarity and efficacy of the blueprints being used by the universities. Faculty training to motivate and influence a change in the mindset is necessary to bring about a course correction. [ABSTRACT FROM AUTHOR]

COVID-19 has had a serious negative impact on the mental health of people around the world. The present study analyses the psychometric properties of Fear of COVID-19 Scale (FCV-19S) in the Indian context. The study checks the one-factor and two-factor structures of the measure. Data were collected from 992 respondents from India. Structural equation modeling was performed to check the construct validity after checking the factorial validity, reliability, and model fit. Both one-factor and two-factor models had good psychometric properties. FCV-19S had significant relationships with stress and wellbeing. This study can serve as a reference to practitioners and researchers to understand and analyze fear of COVID among individuals and thus to support the mental health wellbeing during the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: As work-stress, is associated with Non Communicable Diseases, and decreased work productivity, health and economic benefits are expected from periodic work-stress screening among employees using valid and reliable tools. Tool to Assess and classify Work Stress (TAWS– 16) was developed to overcome limitations in existing work-stress assessment tools in India. This study aims to test face, content, criterion and construct validity of TAWS– 16 in a sample of managerial-supervisory employees. Methods: Nine domain experts rated face and content validity of TAWS– 16. Content validity was measured by Content Validity Indices (I-CVI, S-CVI) and Modified Kappa statistics. Empirical validity was tested by analysing data reported from 356 Information Technology (IT) professionals wherein Exploratory Factor Analysis was conducted for the assessment of Construct Validity. Self-reported data was collected in an unlinked and anonymous manner using a web-link, which was emailed to the study subjects, after initial introductory telephone or personal conversation. Criterion Validity was tested against stress sub-scale of DASS– 21. This study was approved by NIMHANS ethics committee. Results: Findings revealed that TAWS– 16 has good face validity. The content validity is acceptable (CVI = 0.829). Construct Validity is appropriate as 60.8% of the total variance was explained by the factors identified in our study. Criterion Validity was moderate (Kappa Value 0.208) due to inappropriate work-stress instrument for comparison with TAWS– 16. Conclusions: Overall, TAWS– 16 demonstrated good face, content and construct validity. It measures work-stressors, coping abilities and psycho-somatic symptoms associated with work-stress. We recommend use of TAWS– 16 for periodic screening and classification of work-stress among employees. [ABSTRACT FROM AUTHOR]

Nurses Notes (NN) is an important record maintained by nurses as part of the care provided to patients. It also serves as a legal document in the field of patient care. Generally nursing institutions in India use their own formats to maintain patient care records by their students, resulting into a variety of different NN formats across nursing institutions in India. This scenario indicates a research gap towards a standardization of NN format across India. This research addresses identified gap through the development of a standard NN format for nursing institutions in India. Material and Methods: Researchers conducted a review of existing NN formats used by different nursing institutions across India. An initial draft of Comprehensive Nurses Notes (CNN) format was then prepared following synthesis research approach. CNN was then optimized as per feedback received from 17 experts (nursing teachers having minimum of 10 years of teaching experience) following purposive sampling method. The optimized CNN (OCNN) draft then used as a structured questionnaire administered through online method to collect feedback from 100 experts across India following random sampling method. This resulted into design of standardized NN format for nursing institutions across India. Approval was taken from institutional research review committee and informed consent was taken from the participants. Result: CNN was optimized through Content Validity Ratio (CVR) analysis with 0.42 as critical value as per the size of expert panel, resulting into OCNN. Validity of OCNN analyzed through Content Validity (S-CVI/Ave as 0.88, S-CVI/UA as 0.964 and critical values as 0.78) and Face Validity. Its reliability was tested through using test-retest method. Conclusion: The result provides a standardized Nurses Notes format for nursing institutions across India. It will help to bring uniformity in NN management leading to development of India specific NN protocol towards an electronic version of NN. [ABSTRACT FROM AUTHOR]

Background: National legislation (COTPA) in India has focused on school children with dedicated section (6a and 6b) for tobacco control at Educational Institutions. Innovative mediums like Comic offer unique and engaging medium for dissemination of health information. However, its true potential remains unexplored in tobacco control. The study was conducted to develop and validate Comic for promotion of tobacco control laws in school settings. Materials and Methods: The present cross-sectional study was conducted among school teachers in Delhi in three phases: (1) need assessment, (2) development of Comic, and (3) validation (face/content validity by experts in public health/tobacco control, and construct validity by school teachers). Ethical clearance was obtained from Institutional Ethical Review Board. Prevalidated, structured, close-ended, and self-administered Questionnaire was used for the data collection. SPSS version 21 was used for descriptive and inferential results. Results: Phase 1 showed, out of 150 school teachers, 121 participated (80.66%). Mean age and teaching experience was 41.85 ± 9.76 years and 10.35 ± 6.53 years, respectively. Overall awareness about COTPA was 47.9% (n = 58) and COTPA sections 4 and 6 were 37.2% (n = 45). Majority 59.5% (n = 72) reported lack of access to training material. Phase 2 and 3 showed overall content validity index (CVI) score of 0.84. Construct validity evaluation from pre–postintervention yield mean ± SD scores of 3.94 ± 0.99 and 7.97 ± 1.17, respectively, (P < 0.001). Conclusion: Comic was developed on sound theoretical basis with satisfactory face, content and construct validity, to raise awareness about tobacco control among school children, and teachers to promote tobacco-free school. [ABSTRACT FROM AUTHOR]

The Indian hotel industry is likely to reach USD 2.3 billion by 2020 with 28% (up from 19% in 2018) of all bookings made online. The extant research in this field has been mainly focused on the technical and esthetic aspects of hotel websites. Drawing on information richness literature, we identify and develop customer-centric informative factors (named Facilitators of Online Booking or FOB) that might facilitate online hotel booking. We deployed a two-stage mixed-method study across major tourist destinations in India. In the first stage (n1 = 202), we developed an 18-item scale to measure FOB. In the second stage (n2 = 330), we tested the construct validity of FOB and found support for its relationships with e-trust (as a mediator) and purchase intention. [ABSTRACT FROM AUTHOR]

Introduction: Vitiligo can be associated with a psychological burden, stigmatization and impaired quality of life. Tools to assess the impact of vitiligo exist; however, none were developed in line with the FDA's patient-reported outcome (PRO) Guidance for Industry. This study aimed to explore the content validity of two newly developed PRO measures to assess the impact of facial and total body vitiligo on how patients feel and function. Methods: Draft PRO measures were developed from existing literature and input from PRO experts, a patient advocate and a clinical expert. Qualitative interviews were conducted with US participants living with vitiligo and international dermatologists with vitiligo expertise. Concept elicitation methodology explored the relevance of concepts in the draft PRO, while cognitive debriefing assessed conceptual relevance and understanding/interpretation. Items were iteratively amended/added throughout the interview study. Results: The 60 participants included adults (n = 48, 63% female, 18–62 years old) and adolescents (n = 12, 67% female, 12–17 years old) with Fitzpatrick Skin Types I–VI. Expert dermatologists from the US (n = 8), EU (n = 4), India (n = 1) and Egypt (n = 1) participated. Concept elicitation was utilized to confirm the signs/symptoms of vitiligo and the associated impact on emotional/psychological wellbeing, social functioning, daily life and work/school. Conceptual saturation was achieved. Most participants reported impacts on their emotional/psychological wellbeing (n = 57, 95%), e.g. feeling self-conscious (n = 35, 58%). Participants reported impacts on social functioning (n = 53, 88%), e.g. vitiligo being noticed by others (n = 42, 70%). There was general consensus between participants and expert dermatologists. Cognitive debriefing confirmed that the items were well understood. Most items were conceptually relevant; feeling self-conscious and feeling frustrated were highly endorsed. Items were removed based on low conceptual relevance (feeling abandoned, skin roughness) and expected redundancy (four items), resulting in two measures with three proposed domain scores: Emotional/Psychological Wellbeing; Social Functioning; and Physical Sensation. No comprehension concerns were observed in relation to the 7-day recall period or the item response scale/options. Eight dermatologists reviewed the PRO measures, confirming comprehensiveness and relevance. Conclusion: The draft Vitiligo Patient Priority Outcomes (ViPPO) measures evaluate the impact of facial (ViPPO-F) and total body (ViPPO-T) vitiligo on emotional/psychological and social functioning. The ViPPO measures are well understood, comprehensive and content valid for adults and adolescents with vitiligo. [ABSTRACT FROM AUTHOR]

Background: Substance use among adolescents is increasing rapidly and becoming a global health concern worldwide. Because of the changing trends and rising magnitude in India, there is an urgent need to adapt and validate instruments to assess adolescents' substance use. The study translated the Teen-Addiction Severity Index (T-ASI) into Hindi and assessed the psychometric properties. Methods: The instrument (T-ASI) was translated from English to Hindi using: (a) forward translation: translation from the source language into the target one, (b) comparison and synthesis of the two translated versions, (c) blind backward translation, (d) comparison of the two back-translated versions and development of prefinal version, (e) conceptual evaluation of items and pilot study, and (f) assessing the psychometric properties. Results: The content validity of Hindi T-ASI was quite high (0.97). A significant positive correlation r = 0.439* (0.014) between the T-ASI family functioning domain and the organization scale of the Family Environment Scale (FES) demonstrated good concurrent validity. Youth self-report substance use domain correlated well with youth self-report behavior problems scale r = 0.385 (0.033) and the psychiatric status domain correlated with all three internalizing 0.606 (<0.001), externalizing 0.363 (0.045), and behavior problem scale 0.546** (0.001). Construct validity showed significant differences between two groups (substance-using and nonsubstance-using groups) in all domains except school and peer status. Cross-cultural validity shows that the two versions are equivalent. The translated version showed satisfactory reliability (Cronbach's α = 0.727). Conclusion: The translation and validation of Hindi–T-ASI show adequate psychometric properties and can be recommended for use in treatment settings across the country. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to perform a psychometric evaluation of the internal green marketing (IGM) scale in the context of consumer, industrial and service industry from a developing economy. Drawing on IGM theory, this study validates the measurement scales to operationalize IGM as green internal communication (GIC), green skill development (GSD) and green rewards (GRs). Design/methodology/approach: The sample was drawn from the consumer, industrial and service industries in Jammu and Kashmir, India, using a random sampling method. Data were collected from consumer, industrial and service industries in two phases through a self-administrated questionnaire-based survey. In total, 137 managers responded during the first phase, and 368 managers responded during the second phase. During the first phase, exploratory factor analysis (EFA) was conducted to uncover the underlying dimensions of IGM, and during the second phase, data were analyzed to test the validity of the IGM scale through confirmatory factor analysis (CFA). Findings: EFA suggested a three-dimension scale (green internal communication (GIC), green skill development (GSD), and green rewards (GR)) which was confirmed by CFA. The findings of the study demonstrate that IGM is a valid and reliable scale to capture the individual-level perception of the employees with respect to the green internal marketing of an organization. Practical implications: This paper is expected to provide valuable insights into the area of internal green marketing (IGM) about an industry that can be of immense help to domestic and international marketers in formulating human resource (HR)/marketing strategies. Further, it provides a wide-ranging scale that can act as a base for future research studies that aim to explore internal green marketing (IGM) in different organizational settings. Originality/value: IGM is embedded in three underlying elements as GIC, GSD and GRs. It is suitable to the practitioner and researchers to operationalize IGM as a second-order construct in future studies. [ABSTRACT FROM AUTHOR]

Introduction: The Menopause-specific Quality of Life (MENQOL) questionnaire was developed in 1996 to assess the health-related quality of life (QOL) in the menopausal transition and it addresses the degree to which menopausal symptoms had bothered women. The objective of this study was to translate the MENQOL questionnaire in the Odia- regional language of India and validate it for usage in the Odia-speaking menopausal women. Methods: The original English questionnaire MENQOL with 1-month recall period was translated by the researchers. According to instructions by Mapi Research Trust, the questionnaire was forward and backward translated, followed by participant testing and proofreading. Validity and reliability were evaluated by the following tests: internal consistency (reliability), stability (test-retest reliability) with Cronbach's alpha correlations, Pearson's correlation coefficients, and content validity index. Results: A total of 80 postmenopausal women participated in the study. The ICC score and Cronbach's alpha value of all the four domains such as vasomotor, psychosocial, physical, and sexual of both MENQOL English and Odia (MENQOL-E and MENQOL-O) versions recommended excellent homogeneity. The internal consistency using the Cronbach's alpha showed high reliability (0.993) between the MENQOL-E and MENQOL-O questionnaires. Conclusion: The MENQOL-O questionnaire will be used at the individual to community health-care settings to measure QOL and those identified with lower menopause-related QOL, they may get support and care. [ABSTRACT FROM AUTHOR]

Context: COVID-19 has led to a spate of rhino-orbital-cerebral mucormycosis cases in India, the epidemiology of which was least understood before. Only a few case series and case reports discuss the symptomatology of mucormycosis. Aims: The primary objective of our study was to estimate the prevalence of pain in patients with mucormycosis. The secondary objectives include the type, regional distribution, characteristics and determinants of pain in patients with mucormycosis. Settings and Design: A cross-sectional study was conducted on consecutive adult patients with mucormycosis in our hospital. Materials and Methods: Following recruitment, a preplanned written questionnaire that was tested for validity with peers, with closed-ended queries was filled on a sole visit by an anesthesia postgraduate based on the response by the patient. Statistical analysis used: Categorical variables were summarized as proportion and percentage. To compare quantitative variables, Chi-square test was used. Results: A total of 69 out of the 80 patients recruited complained of pain (P value = 0.468). A total of 76.8% of patients had pain in the supraorbital region with 84% of the patients complaining of throbbing pain and 98.6% needing analgesics. Gender, pre-existing diabetes mellitus, organs affected due to mucormycosis, prior steroid usage, prior COVID illness, surgical intervention, and previous experience of pain in the same region had no influence on the presence or severity of pain. Conclusions: Pain is one of the presenting symptoms in patients with mucormycosis which is usually in the supraorbital and maxillary region, nociceptive type and throbbing in nature, and moderate to severe in intensity usually managed with simple analgesics. [ABSTRACT FROM AUTHOR]

The present study aims to develop, measure and validate an instrument for barriers to the adoption of circular economy practices in Micro, Small and Medium Enterprises (MSMEs). Using both inductive and deductive approaches, a scale was developed to assess barriers to the adoption of the circular economy practices. Then a structured and rigorous procedure was followed using the survey data of 269 participants selected from different industries in India. The measurement scales were tested and validated using exploratory factor analysis and structural equation modelling using IBM SPSS 26 and AMOS 26 tools. A competing model strategy was used to explore the most parsimonious measurement model that best fits the data. The results confirmed the existence of seven dimensions of barriers to the adoption of circular economy practices. The final instrument demonstrated a satisfactory level of reliability, convergent, discriminant and nomological validity. The instrument offers significant theoretical and managerial implications and is expected to assist scholars and practitioners in future empirical research. [ABSTRACT FROM AUTHOR]