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Background: There could be several possible mechanisms on how chronic conditions relate to sleep problems in older persons; for instance, pain and sleep have a strong link and depressive symptoms are similarly associated with sleep problems. The present study explored whether pain and depressive symptoms are mediators in the relationship between multi-morbidity and sleep problems among older adults. Methods: Study utilized data from the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults age 60 years and above. Multivariable logistic regression along with mediation analysis using Karlson–Holm–Breen (KHB) method was conducted. Results: A proportion of 14.8% of the participants suffered from sleep problems, whereas, 22.5% and 8.7% of older adults had multi-morbidity and had depressive symptoms, respectively. Also, around 10.3% of older adults reported pain and received no medication for the relief of pain, whereas 29.3% of older adults reported pain and received some type of medication for the relief of pain. Older adults with multi-morbidity had higher odds of suffering from sleep problems [adjusted odds ratio (aOR):1.26, confidence interval (CI):1.10–1.45] than those who had no multi-morbidity. Older adults who reported pain but received no medication for the relief of pain [aOR: 1.90, CI: 1.64–2.22] or reported pain and received medication for the relief of pain [aOR: 1.82, CI:1.62–2.04] and those who had depressive symptoms [aOR: 2.21, CI:1.89–2.57%] had higher odds of suffering from sleep problems compared to those who did not report pain and had no depressive symptoms, respectively. Around 11.2% of the association of multi-morbidity with sleep problems was mediated by pain and 4.3% of such association was mediated by depressive symptoms. Conclusion: Pain and depressive symptoms were found to mediate the association between multi-morbidity and sleep problems; therefore, reducing pain and depressive symptoms may be considered to improve sleep in older multi-morbid patients. [ABSTRACT FROM AUTHOR]

Introduction: The continuum of care (CoC) throughout pregnancy, delivery and post-delivery has recently been highlighted as an integrated intervention programme for maternal, new-born, and child health. Existing literature suggests the importance of continuum of care (CoC) for improved maternal and child health outcomes. However due to unavailability of data at the lowest administrative levels, literature on spatial pattern of uptake of full CoC is lacking. The present study attempts to focus on the spatial analysis of CoC in maternal health care in India. Data and methods: The study is based on the fourth round of National Family Health Survey data conducted in 2015–16 in India. The outcome variable used is maternal health continuum of care which includes- at least 4 ANC visits, delivery through skilled birth attendant and postnatal check-up within 48 hours of delivery. Univariate and bivariate Local Indicator of Spatial Association (LISA) maps have been generated to show the spatial pattern of CoC across 640 districts in India. We also employed spatial regression techniques to explore the determinants of CoC. Findings: Percentage of women who followed full CoC was observed to be least for East Kameng (0.0%) district of Arunachal Pradesh and highest in North Goa district (90.4%). Majority of districts where uptake of full CoC was more than 80 percent were found concentrated in southern region on India. Equivalently, findings indicated a strong spatial clustering of full CoC with high-high clusters mostly concentrated in southern districts. Low-low district clusters are concentrated in the states of Uttar Pradesh, Bihar and Madhya Pradesh. For complete CoC the global Moran's I is 0.73 indicating the spatial dependence. The spatial regression analysis suggested that modern contraceptive use, meeting with health worker, urbanization and secondary or above education for women have positive impact on the utilisation of CoC. Conclusion: The spatial pattern indicates district level clustering in uptake of CoC among women. The study suggests policymakers and stakeholders to implement comprehensive interventions at sub-regional levels for ensuring the completion of CoC for women which acts as a preventive measure for adverse outcomes such as-maternal and child mortality. [ABSTRACT FROM AUTHOR]

Food consumption data in terms of dietary diversity is a vital source for examining the nutrition status of mothers. Diversity in diet is a reliable proxy indicator for quality and quantity of diet in different geographic settings. This study attempts to assess, the regional pattern of dietary diversity among mothers, its determinants and link with their nutritional status in the states of Gujarat and Maharashtra. It uses the CNSM and CNSG data, collected from 2,809 mothers of under two years and 4,828 mothers of under-five children in the year 2012 and 2014 respectively. The regional level socio-economic and cultural diversity reflects on diet diversities. Gujarat is predominantly a vegetarian state where milk and fruits are consumed universally across all the regions. While in Maharashtra, more than two-third consume non-vegetarian food. The consumption of milk and fruits differ across the regions and classes. The dietary score indicates that 37% of women from Gujarat consume more diversified food compared to 23% from Maharashtra. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies have found positive associations between higher geographical altitude and increased risk of stunting in children under 5 years old, but little evidence exists on this relationship in the Indian context specifically. Chronic exposure to high altitudes can impair food security, healthcare access, oxygen delivery and nutrient absorption, potentially increasing malnutrition., Objective: To investigate the association between geographical altitude and stunting among children aged under 5 years in India., Methods: Using data from the 2015-2016 National Family Health Survey, logistic regression was conducted to estimate the relationship between altitude and stunting, adjusting for child, maternal and household characteristics. The analysis included over 167 555 children under 5 years old., Results: Children at higher altitudes had a significantly greater risk of stunting. Those at >2000+ metres had 40% higher adjusted odds of stunting than children below 1000 metres. The altitude-stunting association was stronger among rural children., Conclusions: This study provides robust evidence that higher geographical altitude is an important risk factor for stunting among young children in India, especially those in rural areas. Targeted interventions to improve food security, healthcare access and nutrition in high-altitude regions could help to mitigate the higher burden of stunting in these areas., Competing Interests: Competing interests: None., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)