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Background and Aims: Highly cited papers (HCPs) can influence both research and clinical practice. They help to identify core literature and important advances in a field. This study aimed to assess the current status and prospects of South Asia COVID-19 research from the HCPs using bibliometric indicators. Methodology: COVID-19 literature from South Asia published between December 2019 and 29 November 2023 in the Scopus database was analysed. The top HCPs, having more than 200 citations, were evaluated. Information about citation counts, authors and organisations and their affiliations, year of publication, source journal, geographical origin, subject, article type, funding details, etc. were retrieved and analysed. Data and visualisation analysis was undertaken using Microsoft Excel and other bibliometric software. Results: The 298 South Asia HCPs were published from 2020 to 2023 and were cited 200–3,596 times, with a mean average of 413.9 citations per paper (CPP). Around 24.5% and 51.3% of HCPs received external funding support and were involved in international collaboration, respectively. The most productive organisations were the Postgraduate Institute of Medical Education and Research, Chandigarh, and the Indian Institute of Technology, New Delhi, while the most impactful organisations were Bai Jerbai Wadia Hospital for Children, Mumbai, and Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute, Mumbai. The most productive journals were Diabetes and Metabolic Syndrome: Clinical Research & Reviews. Conclusions: This study has identified core and significant authors, organisations, journals, subject fields and significant keywords, collaborators and funding agencies involved in South Asia's COVID-19 research. [ABSTRACT FROM AUTHOR]

Aim: This paper highlights the difficulties and lacunae in the Mental Health Care Act 2017 that hinder its implementation and use for the care and treatment of persons with mental illness in India. Methods: An online nationwide survey, involving structured questions as well as open-ended questions, to elicit the level of implementation, experience in complying with the provisions of the Act, and level of satisfaction, of practicing psychiatrists was carried out. Responses were analyzed using appropriate statistics. Results: 600 respondents answered the online questionnaire. A majority of psychiatrists were senior practitioners with over 10 years of experience. 92.5% respondents were dissatisfied with the MHCA, wherein 73.3% wanted it amended, and 19.2% asked for repeal. Procedural issues were deterrent for 66.5% from taking medically necessary or helpful decisions for patients. Non-implementation of the Act was a major finding. Major dissatisfaction was expressed regarding judicial over reach in admission and discharge procedures, inclusion of general hospital psychiatry units in the definition of mental health establishment, non-applicability of provisions like advance directive and nominated representative in Indian setting, and that all treatment should be covered under insurance. Conclusion: The Act in its present form defies the spirit of its own objectives and is unimplementable. It needs major revisions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Screening of hemoglobin (Hb) before blood donation is one among the vital tests. It is performed to select a blood donor to prevent the collection of blood from an anemic person. However, no accurate, cost-effective, reliable, and standardized method is available to estimate Hb. OBJECTIVE: The aim is to evaluate the efficacy of filter paper cyanmethemoglobin (FPCH) method with the automated hematology analyzer in the estimation of Hb concentration for screening of a suitable donor. METHODOLOGY: This was a cross-sectional study in which the blood samples of 2000 patients visiting KLE's Dr. Prabhakar Kore Charitable Hospital, Belagavi, were collected in vials and directly estimated for Hb using automated hematology analyzer. To evaluate the efficacy of FPCH, 20 μL of blood sample was transferred onto Whatman filter paper and dried at room temperature. After drying, it was placed in 5 mL of Drabkin's solution for 30 min. Optical density was estimated by measuring the absorbance. Data were analyzed using SPSS version 20. The correlation coefficient, paired t-test, and difference between the means of both the methods were calculated. RESULTS: The mean Hb estimated by FPCH was 11.25 g/dL and automated hematology analyzer gave 11.35 g/dL. The difference in the means of both the methods was 0.1 g/dL. Paired t-test was done to test the level of significance and the result was 8.151 (95% confidence interval: 0.08–0.13 g/dL, P < 0.001). The correlation coefficient was found to be 0.976 (P < 0.001). CONCLUSION: FPCH is an efficient method, which is comparable to the automated hematology analyzers for Hb estimation. It could be used as an alternative screening tool for detection of Hb in a blood donation camp. [ABSTRACT FROM AUTHOR]

Background: Every year the scientific sessions of Annual National Conference of Indian Psychiatric Society (ANCIPS) are marked by presentation of free papers, posters, and award paper sessions, which are usually meant for presentation of new research which is not yet published. Hence, it is expected that these papers will be published in near future so that the scientific literature is distributed and shared with wider audience. Aim: This paper aims to evaluate the abstract to publication rate of papers presented during ANCIPS in the years 2012–2014. Materials and Methods: For this study, all the free papers, posters, and award papers presented during the ANCIPS of 2012–2014 were listed, and electronic searches were carried out to search for published articles. In addition, one of the authors of papers not found in the electronic searches were contacted through E-mail. Results: A total of 1081 papers were presented during the ANCIPS in the 3 year period under study. Of these, 64 were award papers, 622 were free papers, and 395 were posters. Majority (n = 807; 74.6%) of these could be categorized as research data-based presentations; this was followed by case reports/series (203; 18.8%), review of literature (n = 35; 3.3%), and others (n = 36; 3.3%). Overall, only 27% of the papers were published after at least 5 years of the presentation. Of all the award papers, 69.6% of papers were published, whereas only 26.8% of free oral papers and 22.5% of free posters were published. About half (45.6%) of the papers were published in national journals. In terms of indexing, among those which were published, 62.8% were published in Medline-indexed (PubMed-listed) Journals with a mean impact factor of 1. Conclusion: The present study shows that only 27% of the abstracts presented during the ANCIPS are ultimately published as full text articles in the next 5 years. [ABSTRACT FROM AUTHOR]

The study aims to find the quality of research papers published in the domain of entrepreneurship in India. This study covers 100 research papers. A standardized measurement tool developed by the earlier researchers was used to evaluate the research quality. The data compiled using the measurement tool were analyzed with the support of the SPSS. The statistical tools such as descriptive statistics, Friedman's test, factor analysis, two-sample 't' test, and ANOVA are applied to analyze the data. The study findings reported that the quality of research papers published in the field of entrepreneurship is not up to the quality standards. The quality of multiple-author papers is better than single-author papers. Similarly, the quality of papers published by foreign authors is comparatively better than Indian authors. Further, the quality of papers published with the combination of foreign and Indian authors is substantially good. The quality of papers published in foreign journals is higher as compared with Indian journals. Further, the standard of papers published under the qualitative approach was comparatively better than the quantitative approach. The authors developed a Conceptual Model of Process and Product of Research (YOVA model). This model clearly shows that the whole research process yields six levels of research products. The study recommended that the researchers need to go for international collaborations to improve the quality of the publication. The funding agencies, higher learning institutions and research institutions should focus on enhancing research infrastructure. The study examined the validity of research articles searched by novice researchers in India in Google by using keywords related to entrepreneurship and, as such this non-focused approach is a big impediment to quality research. [ABSTRACT FROM AUTHOR]

Urban planning significantly influences the physical and health profile of urban environments. This paper explores the critical nexus between urban planning and public health, emphasizing the urgent need to integrate health considerations into the urban planning curriculum in India. Current urban planning courses often overlook public health aspects, resulting in a disconnect that could hinder the ability of urban environments to meet the health and well-being needs of their populations. Through a comprehensive review and analysis of curriculum data from selected Indian institutions of national importance—including the School of Planning and Architecture, Indian Institute of Technology Kharagpur, and National Institute of Technology, Bhopal—this study identifies significant gaps in the inclusion of health-related content in urban planning education. The analysis reveals a low occurrence of health-related themes within the planning curriculum, with essential topics like public health history, environmental health, and health impact assessments seldom addressed. To bridge these gaps, the paper suggests incorporating mandatory health-focused courses, such as Health Impact Assessments and public health fundamentals, into the curriculum. It also recommends interdisciplinary collaboration with public health professionals to enrich planning education. By restructuring the curriculum to include more comprehensive health-related education, future urban planners can be better equipped to create healthier and more sustainable urban environments, ultimately enhancing public health outcomes in rapidly urbanizing spaces. This research not only sheds light on current educational inadequacies but also proposes actionable steps towards a more holistic integration of health and urban planning disciplines. [ABSTRACT FROM AUTHOR]

Background The implementation of comprehensive smoke-free laws has been associated with reductions in second-hand smoke exposure at home in several high income countries. There is little information on whether these benefits extend to low income and middle income countries with a growing tobacco-related disease burden such as India. Methods State and individual-level analysis of cross-sectional data from the Global Adult Tobacco Survey India, 2009/2010. Associations between working in a smoke-free indoor environment and living in a smoke-free home were examined using correlation at the state level, and multivariate logistic regression at the individual level. Results The percentage of respondents employed indoors (outside the home) working in smoke-free environments who lived in a smoke-free home was 64.0% compared with 41.7% of those who worked where smoking occurred. Indian states with higher proportions of smoke-free workplaces had higher proportions of smoke-free homes (rs=0.54, p<0.005). In the individual-level analysis, working in a smoke-free workplace was associated with a significantly higher likelihood of living in a smoke-free home (adjusted OR=2.07; 95% CI 1.64 to 2.52) after adjustment for potential confounders. Conclusions Implementation of smoke-free legislation in India was associated with a higher proportion of adults reporting a smoke-free home. These findings further strengthen the case for accelerated implementation of Article 8 of the Framework Convention on Tobacco Control (FCTC) in low and middle income countries. [ABSTRACT FROM AUTHOR]

Background: India has a high prevalence of micronutrient deficiency-related health risks, which can be improved by food fortification. Objectives: To identify and analyze single or multiple micronutrient (MMN) food-fortification studies for their efficacy and effectiveness in India. Methods: Papers from searching 10 databases were independently screened by two researchers. Data were abstracted to summarize food fortification results on biological markers, anthropometry, clinical, morbidity, cognition, dietary intake, and physical performance. Results: Forty-seven papers, of which 25 were randomized controlled trials, were included for analysis. Children ≤ 12 y were the main population (n=38). Food vehicles were cereals (n=6), oils and salts (n=18), and other (e.g., school meals (n=23)). Improvements in ≥ 1 biological markers were reported in all 35 papers (22 MMN, 9 Iron, 4 Iodine) with interpretable results. More specifically, iron or hemoglobin improvements were noted in all papers fortifying with MMN or solely iron. Iodine nutriture was improved in all salt iodization papers. Eight of 14, 6 of 7, 2 of 6, 4 of 6, 1 of 4, and 1 of 1 papers with interpretable results showed ≥ 1 positive result of fortification in anthropometry, clinical signs, morbidity, cognition, dietary intake, and physical performance, respectively. Conclusion: Research in India suggests food fortification improves biological markers, particularly iron and hemoglobin when fortifying with MMN or iron. MMN fortification saw more health impacts than using single fortificants. Iodine status was improved through salt iodization. Existing government nutrition programs, especially those that target children, are good avenues for food fortification implementation. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization Astana Declaration of 2018 sees primary healthcare as key to universal health coverage and gives further support to the goal of building sustainable models of community palliative care. Yet evaluating the benefits of such models continues to pose methodological and conceptual challenges. Objective: To explore evaluation issues associated with a community-based palliative care approach in Kerala, India. Design: An illuminative case study using a rapid evaluation methodology. Methodology: Qualitative interviews, documentary analysis and observations of home care and community organising. Results: We appraise a community palliative care programme in Kerala, India, using three linked 'canvases' of enquiry: (1) 'complex' multi-factorial community-based interventions and implications for evaluation; (2) 'axiological' orientations that foreground values in any evaluation process and (3) the status of evaluative evidence in postcolonial contexts. Three values underpinning the care process were significant: heterogeneity, voice and decentralisation. We identify 'objects of interest' related to first-, second- and third-order outcomes: (1) individuals and organisations; (2) unintended targets outside the core domain and (3) indirect, distal effects within and outside the domain. Conclusion: We show how evaluation of palliative care in complex community circumstances can be successfully accomplished when attending to the significance of community care values. Plain language summary: Where are the values in evaluating palliative care? Learning from community-based palliative care provision The evaluation of any intervention or service will inevitably involve a series of decisions on what we measure, what criteria we use to judge whether the intervention has been successful (or not), what type of data we actually collect and what methods we use to do this. When evaluating a range of palliative care interventions, we suggest that these decisions have often been taken in a concealed way and tend to favour relatively narrow quantitative measures linked to end outcomes. Our paper reports on the evaluation of a community-based palliative care intervention on Kerala, India. In it, we suggest that such complex work requires a broader approach to evaluation that: makes the values being used to assess success explicit; draws on a range of data types; is interested in delivery processes; and places the voices of participants at the heart of the assessment. The paper concludes with some broader observations on how these principles might be applied more widely within palliative care. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to determine the impact of problematic mobile phone use on negative mental health outcomes among nursing students in India, highlighting the necessity for targeted interventions and support mechanisms to enhance the overall well‐being and adaptability of future healthcare professionals. Methods: A cross‐sectional survey was conducted in three randomly selected nursing colleges in South India, employing validated and standardized tools such as the Mobile Phone Problematic Use Scale, Patient Health Questionnaire, Insomnia Severity Index Scale, Satisfaction with Life Scale and Rosenberg Self‐Esteem Scale. Results: The study included 402 nursing students with an average age of 20.47 years, revealing a 39% prevalence of severe problematic mobile phone usage. Positive correlations were observed between mobile phone problematic use and age, depression and insomnia. Additionally, strong negative correlations were found between satisfaction with life and self‐esteem. Depression and satisfaction with life served as chain mediators in the impact of self‐esteem on problematic mobile phone use, and both self‐esteem and satisfaction with life negatively predicted problematic mobile phone use. Conclusion: The study highlights a prevalent issue of problematic mobile phone use among nursing students, indicating a pressing need for timely intervention, as it correlates with depression, sleep insomnia, low self‐esteem and life dissatisfaction. Summary statement: What is already known about this topic? Over the last decade, using mobile phones has been prevalent among today's children and young people, coinciding with an increase in poor mental health in this population.Problematic mobile phone use may consist of various issues, including addiction/dependence, financial troubles, risky use (i.e. while driving) and restricted use (i.e. in prohibited places).From an epidemiological standpoint, prevalence rate estimates vary widely and there is little research and understanding regarding the aetiology of problematic and addicted mobile phone usage, particularly its progression. What this paper adds? The prevalence of severe problematic mobile phone use among nursing students is very high and needs immediate attention.There is a negative impact of mobile phone use on the mental health outcomes of nursing students.Positive life satisfaction and self‐esteem are protective variables that negatively predict problematic mobile phone use, while their influence is mediated by a chain reaction involving reduced depression, emphasizing the interconnected psychological dynamics. The implications of this paper: Further research is needed on the influencing factors of problematic mobile phone use and interventions to prevent mobile phone addiction among nursing students.The influence of mobile phone use on the mental health outcomes of nursing students can affect their clinical practice and productive life therefore the appropriate policies should be implemented.Implementation of short and rapid counselling services for the nursing students by the nurse educators should incorporate into the curriculum to achieve a better quality of nurses. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence of non‐communicable disease risk factors among the nursing staff and educate them on prevention. Background: Nursing staff is integral to the Indian community healthcare systems. Recent studies report a high prevalence of non‐communicable diseases in Indian nursing staff. Therefore, data on the prevalence of non‐communicable disease risk factors among nursing staff are crucial for education on prevention. Design: A cross‐sectional digital survey‐based study. Method: We invited 4435 nursing staff to attend our online survey. We used a customized questionnaire for data collection, including a digitized version of the Community‐Based Assessment Checklist form. A score of >4 was considered high risk and warranted screening. Result: Among 682 nursing staff who attended, 70% had never undergone screening for non‐communicable diseases. The prevalence of non‐communicable disease risk factors was significantly higher in male nursing staff. In addition, logistic regression analysis showed that age, tobacco and alcohol use, increased waist circumference, physical inactivity and family history of non‐communicable diseases were significant risk factors among nursing staff. Conclusion: The study findings suggest that the nursing staff have suboptimal self‐health concerns on non‐communicable diseases. This situation warrants continued medical education, awareness campaigns on adopting a healthy lifestyle and health promotion. Summary statement: What is already known about this topic? The prevalence of non‐communicable diseases (NCDs) among Indian nursing staff is a growing concern, underscoring the need for comprehensive research and targeted interventions.Despite the significant health risks faced by this demographic, there is a notable lack of data on NCD risk factors specific to Indian nursing professionals. What this paper adds? This paper adds information on the prevalence of NCD risk factors chiefly among nursing staff in the Delhi National Capital Region.Male nursing staff have particularly high NCD risk factors. The implications of this paper: Findings may help develop routine screening programmes for nursing staff, continued nursing education and good, safe nursing practice. [ABSTRACT FROM AUTHOR]

Purpose: This study is conducted to understand an emerging public health problem in the garb of polycystic ovarian syndrome (PCOS) that affects about 6–21% of women in reproductive age from a systems perspective. Design/methodology/approach: The research is conducted in two phases. In phase 1, 15 women suffering from PCOS were interviewed to generate a knowledge map using an interpretive phenomenological research approach. The emerging themes were divided into four categories, namely individual, familial, societal, organizational, medical and systemic. In phase 2, five workshops were conducted with six invited actors to generate a causal loop diagram (CLD) of PCOS. The Standards for Reporting Qualitative Research (SRQR) are used in this study. Findings: A CLD from an individual's perspective with implications on organizational, societal and system levels. Research limitations/implications: Awareness of "lifestyle diseases" is increasing, and this research shall help future studies put PCOS in the larger psychosocial context. The geographical location of respondents can be a limitation, as the causal linkages could only be true for the research site. Practical implications: The CLD provides a comprehensive understanding of complex emerging phenomenon of PCOS. Social implications: The paper draws attention to factors such as frequently changing doctors, withdrawal from work, medication fatigue, inclination to adopt due to infertility, etc. Originality/value: This is the first such paper laying out the causal relationships between factors at the individual levels and connecting them to societal, organizational and system levels. This mapping can be useful for policymakers and industry leaders to empathize with PCOS sufferers so that their working conditions can be managed better. [ABSTRACT FROM AUTHOR]

The present paper studied the impact of educational inequality on child mortality in the states of southern region of India during the period 1991 to 2019. The study applied the Gini coefficient technique to investigate the education inequality in each state of the region. The paper observed the highest educational inequality in Andhra Pradesh while the lowest in Kerala among the states. However, such educational inequality is highest in the rural areas as compared to the urban areas in each state. The improvement of the average years of schooling contributed to the reduction of education inequality in the region. The study observed that the reduction of education inequality leads to the growth of per capita NSDP in each state of the region. Similarly, the expansion of education sector leads to reduction of child mortality rate in each state of the region. [ABSTRACT FROM AUTHOR]

Background: Teenage pregnancy is a concerning public health problem in India. Misperception and misunderstanding about pregnancy and its preventive methods lead to pregnancy when adolescents are involved in unsafe sexual intercourse. This scoping review aims to discuss the evidence on the perception, practices, and understanding related to teenage pregnancy among adolescent girls in the Indian context. Method: The Arksey and O'Malley scoping review framework and Joanna Briggs Institute Reviewers' Manual were used for the scoping review. The Population, Concept, and Context strategy (PCC) ensured the review questions, eligibility criteria, and search strategy. The Systematic Review and Meta-analysis: Extension for Scoping Review (PRISMA-ScR) was used. A literature search was done using electronic databases by specific keywords such as "teenage", "adolescences", "pregnancy", "perception", "knowledge", "awareness", etc. Relevant grey literature was identified through further searching. The review included studies that fulfil inclusion criteria having female adolescent groups aged from 10 to 19 years in the Indian context between the years 2000 and 2021. Result: We found 40 eligible studies; more than half of these were from southern (35%) and northern (27.5%) regions, and studies from the rest of India were very sporadically distributed. Most studies (72.5%) were published in the last 10 years. The relevant extracted data from individual studies were synthesized and presented in the two major sections, perception, practices, and the second one, understanding and experiences among teenage girls. The understanding of pregnancy and teenage pregnancy-related preventive methods was detailed analysis in about 72% of papers whereas other aspects, such as perception (22.5%), practices (25%), and experiences (7.5%) were discussed in the remaining papers related to pregnancy among adolescent girls. Conclusion: Evidence in the selected studies shows that understanding and practices are the major areas that were primarily explored, where perception, practices and experiences are the topics that are relatively less investigated. Literature synthesis derives misconception, lack of understanding, and practices without knowing the consequences are the key factors responsible for early pregnancies. Future interventions like increasing awareness, providing comprehensive reproductive knowledge, convenient health care aids, and proper counselling are adequate measures for minimalising the problem. The present analysis showed that studies are limited in their scope concerning various aspects of teenage pregnancy in India, so this scoping review gives essential perspectives on future research and implementation plans and policies in this field. [ABSTRACT FROM AUTHOR]

Background: Digitization of health records and health delivery processes in health care settings may have an impact on the Patient-Physician communication, wait times, that affect the overall patient satisfaction with the health care services. Aim & Objective: We ascertained the effect of digitization of medical case files on the doctor patient relationship (DPR) domain of patient satisfaction at an urban primary health center in India. Settings and Design: Comparative, cross-sectional study in primary health centres. Methods and Material: The patient satisfaction was compared between the patients attending the Public Health Dispensary (PHD) that uses digitized medical case file system and a Civil Dispensary (CD) which follows the conventional paper based medical records, using a Patient Satisfaction Questionnaire (PSQ). Statistical analysis used: Univariate analysis was done by chi-square test and adjusted analysis was done by multiple linear regression. Results: Patient satisfaction in DPR was found to be similar between the digitized medical case files based and conventional OPD (p=0.453). Significantly higher overall patient satisfaction was reported in the conventional paper based OPD than the digitized OPD (p<0.001). Conclusions: Patient satisfaction towards the doctor-patient relationship (DPR) was similar between paper based OPD and the digitized medical case files based OPD. [ABSTRACT FROM AUTHOR]

Purpose: The recommended public healthcare infrastructure and human resources are essential to deliver healthcare services, particularly in tribal areas, as the country's tribal population depends mainly on the public healthcare system for their medical needs. India has a substantial share of the tribal population, accounting for approximately 9% of the total population. The paper reviews the state of public healthcare infrastructure and human resources in tribal areas for a period that spreads over a decade. Design/methodology/approach: The paper relied on data from the Government of India's Rural Health Statistics (RHS) reports (2011–2012 and 2021–2022). From these reports, data on the physical infrastructure and human resources in the tribal areas were extracted. The extracted data were compiled and analyzed using Microsoft Excel. Findings: The analysis showed that the improvement in public healthcare infrastructure and human resource situation in tribal areas of the country was not commensurate with the tribal population growth seen in the last decade. As a result, the average population covered by a health facility was greater than the prescribed norms in the tribal-dominated geographies. The health worker-population ratio at the primary healthcare level was also higher than the national norms. However, there was a substantial improvement in the doctor-population ratio at the primary health center level. In comparison to tribal-lean states, tribal-dominated states faced the concurrent challenge of a growing population and strained healthcare facilities and human resources. As a result, the healthcare infrastructure and human resource gap continued in the tribal-dominated states of the country. The gaps in health infrastructure and human resources in tribal-dominated states must be addressed as a priority under the health infrastructure strengthening efforts to ensure that the tribal population receives and has access to quality health care from publicly funded health facilities, leading to improved health outcomes in the tribal population and the achievement of the sustainable development goals (SDGs). Originality/value: We have not come across any paper that has carried out pancountry analysis of healthcare infrastructure and human resources in tribal areas. [ABSTRACT FROM AUTHOR]

Background: This paper evaluates endoscopic stapedotomy from the perspectives of a group of 3 surgeons, each of whose experience in endoscopic and microscopic stapedotomy is 3 years and more than 12 years, respectively. Methods: Thirty-four patients clinically diagnosed with stapedial otosclerosis were alternately assigned for unilateral, microscope- and endoscope-assisted stapedotomy following the selection criteria given. Results were evaluated with predetermined epidemiologic, preoperative, perioperative, and postoperative outcome parameters. Results: The microscope group had 12 ears with otosclerosis and the endoscope-assisted group 14. Ears found to have conditions other than otosclerosis at surgery, and patients lost to follow-up were excluded. Apart from the operative time, the difference in the results of none of the parameters was statistically significant in the two groups. The average operative times for microscope- and endoscope-assisted stapedotomy were 63 minutes and 86.5 minutes, respectively, the difference being statistically significant (P <.001). Conclusions: From the perspectives of otologists in differential positions in the learning curve for microscope- and endoscope-assisted stapedotomy, there were no statistically significant differences between the two procedures in the execution of the steps to achieve "adequate surgical exposure" and in postoperative outcomes, except for operative time. [ABSTRACT FROM AUTHOR]

Background: Despite decades of a call to action to engage men in reproductive health, men are often left out of programs and interventions. In India, where half of pregnancies are reported as unintended, patriarchal gender norms and still dominant patterns of arranged marriages make engaging men in family planning and strengthening couples communication critical in increasing reproductive autonomy and helping young couples meet their reproductive goals. This study explores the feasibility and acceptability from the men's perspective of the pilot of a gender transformative intervention for newly married couples in India. Methods: A pilot study was conducted of TARANG, a 4 month intervention for newly married women, with light touch engagement of husbands (4 sessions). A total of 41 husbands participated in the pilot, and we collected baseline knowledge and endline feasibility and acceptability data from them, along with in depth qualitative interviews with 13 men. The study was conducted in June 2023-January 2024. Results: Men had low levels of knowledge about biology, family planning, with the majority of men reporting that no one had provided them information about these topics. Most men wanted to delay the first birth by at least 2 years, yet less than a quarter had discussed childbearing plans with their partner or engaged in family planning methods. While all men reported high acceptability (satisfaction and usefulness), feasibility (participation) was low, with only 43% attending 2 or more sessions. Main barriers to participation included commitments due to work and migration. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. Conclusions: Men in these rural communities are not receiving the information that they need to meet their reproductive goals, however, they greatly desire this information and ways to improve relationships with their new wives. Such an intervention appears to have the potential to help change norms and spread information in the community and provide men with positive, life affirming feelings. Providing information through technology could address barriers to in-person engagement. Trial registration clinicaltrials.gov : 03/13/24.NCT06320964 Plain language summary: Despite many years of calls to engage men in reproductive health programming, there are still a paucity of interventions that engage men. In the Indian context, with high prevalence of arranged marriages, strict gender norms, and patrilocal marriage patterns where women move into their husbands family's home, engaging men is especially important as they are critical decision-makers. With this in mind, we designed an intervention for newly married women, with an add on component for their husbands, to help young couples meet their reproductive goals. In this paper we report on the feasibility and acceptability of a 6 month pilot of this intervention with 40 newly married men in Rajasthan, India using mixed methods. We find that the intervention was highly feasibility and acceptable, and men felt that the intervention had value and should be considered. However, attendance was low due to work commitments and migration. The intervention appeared to change norms and increase knowledge about family planning and communication about childbearing. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. This suggests that engaging newly married men is possible, but interventions must be designed carefully to be sure to be able increase participation. [ABSTRACT FROM AUTHOR]

Background: This paper aimed to explore the palliative care (PC) needs and barriers to access among cancer patients in a rural region of North India with a high cancer burden. Methods: A Participatory action research (PAR) approach was employed. Situational assessment, community sensitization workshops (CSWs) and door-to-door surveys were planned, conducted and developed over three PAR cycles. A parallel convergent mixed-methods approach was adopted wherein the quantitative data from door-to-door surveys and qualitative data from CSWs and investigator field notes were collected and analyzed to provide a comprehensive understanding of PC needs and barriers to access. Descriptive statistics and thematic analysis were used. Results: A total of 27 CSWs involving 526 stakeholders were conducted. A total of 256 cancer patients were assessed for PC needs and symptom burden using the Supportive and Palliative Care Indicators (SPICT-4ALL) and the Edmonton Symptom Assessment System (ESAS) tool, respectively. Based on the SPICT assessment, all patients (n = 256) satisfied general and/or cancer-specific indicators for PC. The majority (56.6%) had ≥ one moderate-severe symptom, with the most common symptoms being tiredness, pain and loss of appetite. Analysis of qualitative findings generated three themes: unmet needs, burden of caregiving, and barriers and challenges. Cancer affected all domains of patients' and their families' lives, contributing to biopsychosocial suffering. Social stigma, discrimination, sympathizing attitudes and lack of emotional and material support contributed to psychosocial suffering among cancer patients and their caregivers. Lack of awareness, nearby healthcare facilities, transportation, essential medicines, trained manpower and education in PC, collusion, fear of social discrimination, faulty perceptions and misconceptions about cancer made access to PC difficult. Conclusions: The study emphasize the need for and provide a roadmap for developing context-specific and culturally appropriate CBPC services to address the identified challenges and needs. The findings point towards education of CHWs in PC; improving community awareness about cancer, PC, government support schemes; ensuring an uninterrupted supply of essential medicines; and developing active linkages within the community and with NGOs to address the financial, transportation, educational, vocational and other social needs as some of the strategies to ensure holistic CBPC services. Trial registration: Clinical Trial Registry of India (CTRI/2023/04/051357). [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate and compare the quality of work life (QWL) of nurses, in pre- and post-COVID-19 pandemic situations. Design/methodology/approach: The study adopts a descriptive research design. Data were collected during the pre- and post-pandemic periods. The target sampling unit of the study comprises nurses working in Bangalore city, Karnataka, India. The minimum sample size was determined (Bartlett et al., 2001) as 385. The scale validation is carried out. The factors for the present study were explored using exploratory factor analysis and confirmed by confirmatory factor analysis. Model fitness (proposed measurement model) is ensured by using fit indices. The linear regression method was used to measure the level of QWL of nurses. Findings: The present study noted that key factors that affects the QWL of nursing staff are work condition; work environment; work-life balance; compensation and reward; career development; job satisfaction and security; organization culture; relationship among co-workers and stress. Further, it is noticed that QWL of nurses pre-COVID-19 pandemic is 87.2%, while post-COVID-19 pandemic, it is 67%. Research limitations/implications: Present study can be extended to address the same research question by considering sampling unit such as therapist, technicians and sanitarians who have equally undergone tremendous pressure during pandemic. Practical implications: The study outcome provides references for organizations engaged in health services to understand the extreme job conditions posed by pandemic. The constructive inspiration (physio-social and organizational support) reinforces the nurses to continue in their professions by decreasing negative impact. Originality/value: The research paper extends the contributions of Hwang (2002), Nikeghbal et al. (2021), Howie–Esquivel et al. (2022) and Rania et al. (2023) and add to the existing body of the QWL literature. The outcome of the research records the prevailing conditions of pandemic and its effect on changes in work environment with specific reference to health-care sector. [ABSTRACT FROM AUTHOR]

Introduction: There is a paucity of research on conducting written formative assessment with constructive feedback for theory paper writing for postgraduates of Community Medicine in India. The concept of "Written Formative assessments with Peer-Assisted Learning Program" was implemented to improve the first 2 levels of Miller's Pyramid and assess its impact on the summative assessment. Materials and Methods: The program was conducted for 2 batches of postgraduate students in the Community Medicine enrolled for the academic session of 2016–2019 and 2017–2020. The written formative assessment was conducted every Saturday for 1 h from August to March month in 2018 and 2019. After each test, answer papers were evaluated by the peer and faculty from the department. Written and oral feedback was given by the peer. After IEC approval, we planned to assess the program's effect on level 1 and level 2 Kirkpatrick's framework. The data were analyzed using SPSS statistical package version 24 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Total 23 formative written assessments were conducted per year. The proportions of knowledge, comprehension, and analytical type of questions asked were 47%, 32%, and 21%, respectively. The mean attendance rate was 76.28% ±16.4%. There was no statistically significant difference in the average percentage of marks in formative (weekly test) and summative assessment (university final examination). There was a statistically significant positive co-relation of projected mean marks and summative assessment marks with the co-efficient of the determination being 22.6%. There was overall positive feedback of the formative and peer-assisted learning (PAL) from post graduate students. Conclusions: Written Formative Assessment with PAL program is one of the effective programs for postgraduate students to gain confidence in writing and presentation skills and to score higher in theory examination. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to reflect on how the COVID-19 pandemic has intensified the social and economic vulnerability of Indian elderly women, thereby making them prone to varied forms of abuse and denying them of the basic rights of secured existence. Design/methodology/approach: This study was conducted by analyzing primary data from government sources that dealt with the aging Indian population and the common predicaments that elderly women experienced during the pandemic. A qualitative interview was conducted in three old-age homes in India where the experiences of 26 elderly female residents were documented for understanding their experiences during the pandemic. The secondary data collected from different newspaper articles and online resources also enabled in perusing the difficulties that they faced both at home and the caregiving space at the critical juncture of COVID-19. Findings: Nearly 73% of the elderly population in the country has faced an incidence in different forms of abuse and exploitation during the subsequent waves of the pandemic. Disrespect and neglect were the most common type of mistreatment and around 23.1% reported physical assault. The elderly women were victimized further on socioeconomic grounds and their rights of living a secured and dignified life were significantly neglected. Research limitations/implications: The basic premise of this paper operates on the ground that the family as an institution has shunned taking care of the responsibilities vis-a-vis the elderly and therefore formal institutions have been introduced to aid in the conventional caretaking responsibilities in the Indian societal structure. This situation became all the more grave during the pandemic and therefore needed much intervention. This paper follows the theoretical lens of gender theory and case study method to analyze the data. Social implications: The HelpAge India report findings entail that elderly women/widows are doubly marginalized in the Indian society, and the COVID-19 pandemic has escalated the caregiver stress on manifold levels, thus exacerbating the problem. As most of the female senior citizens are economically dependent on their children and relatives, financial exploitation became one of the important premise that deprived them of a healthy living both at home and elderly caregiving institution. Despite the prevalence of certain elderly assistance schemes in the country, the older women's needs and well-being got heavily impacted and their voice gets hardly recognized in the wider spectrum of sociopolitical events. To extend the requisite help and assistance to this socially vulnerable section, the government on September, 2021, launched a pan-India, toll-free helpline number "Elder Line" to provide relevant information on elderly legal and medical aid and guidance on procuring pension. Originality/value: According to the secondary findings, a significant percentage of elderly women have been susceptible to physical and emotional abuse and factors such as widowhood, economic dependency, physical infirmity, cognitive impairment along with other stressors have aggravated their exposure to ill-treatment during the pandemic span. Thus, to recognize and mitigate the existing problems affecting the elderly subjects, the government should devise the necessary protocols and adopt essential measures to ensure the welfare of the marginalized section and protect their basic rights of a holistic existence. [ABSTRACT FROM AUTHOR]

Accurate segmentation of breast masses in mammogram images is essential for early cancer diagnosis and treatment planning. Several deep learning (DL) models have been proposed for whole mammogram segmentation and mass patch/crop segmentation. However, current DL models for breast mammogram mass segmentation face several limitations, including false positives (FPs), false negatives (FNs), and challenges with the end‐to‐end approach. This paper presents a novel two‐stage end‐to‐end cascaded breast mass segmentation framework that incorporates a saliency map of potential mass regions to guide the DL models for breast mass segmentation. The first‐stage segmentation model of the cascade framework is used to generate a saliency map to establish a coarse region of interest (ROI), effectively narrowing the focus to probable mass regions. The proposed presegmenter attention (PSA) blocks are introduced in the second‐stage segmentation model to enable dynamic adaptation to the most informative regions within the mammogram images based on the generated saliency map. Comparative analysis of the Attention U‐net model with and without the cascade framework is provided in terms of dice scores, precision, recall, FP rates (FPRs), and FN outcomes. Experimental results consistently demonstrate enhanced breast mass segmentation performance by the proposed cascade framework across all three datasets: INbreast, CSAW‐S, and DMID. The cascade framework shows superior segmentation performance by improving the dice score by about 6% for the INbreast dataset, 3% for the CSAW‐S dataset, and 2% for the DMID dataset. Similarly, the FN outcomes were reduced by 10% for the INbreast dataset, 19% for the CSAW‐S dataset, and 4% for the DMID dataset. Moreover, the proposed cascade framework's performance is validated with varying state‐of‐the‐art segmentation models such as DeepLabV3+ and Swin transformer U‐net. The presegmenter cascade framework has the potential to improve segmentation performance and mitigate FNs when integrated with any medical image segmentation framework, irrespective of the choice of the model. [ABSTRACT FROM AUTHOR]

Background: Kerala has initiated many Universal Health Coverage (UHC) reforms in the last decade. The Aardram Mission launched in 2017 stands out owing to its scope, objectives, and commitments for strengthening Primary Health Care (PHC) in the State. The current study proposes to explore access and financial protection through the lens of equity in Kerala especially in the context of major UHC reforms carried out during the last decade. This paper will also highlight the key lessons from Kerala's approach towards UHC and health systems strengthening through a political economy approach. Methods: Data from the Kerala state sample of 75th Round (2017-18) National Sample Survey is used for this study. Comparison is also drawn from the 71st Round Sample Survey, 2014, to measure the state's progress in terms of access and financial protection. Logistic regression was used for the calculation. The findings were further explored through a political economy approach. Results: The share of public facilities for outpatient care is 47.5%, which is a significant increase from 34.0% (in 2014) in the state. The share of public sector for out-patient care has increased for the lower socio-economic population in the state. The share of public sector for in-patient care has also increased to 37.3% in 2017-18 from 33.9% in 2014, but not to the extent as the increase shown in outpatient care. The average out-of-pocket-expenditure during hospitalization has increased more in private facilities as compared to public for both outpatient care and hospitalization. Conclusions: Overall increase in the share of public facilities for both outpatient care and hospitalization is indicative of the enhanced trust among the people at large of the public healthcare delivery system in Kerala, post the launch of UHC reforms in the State. The insurance linked UHC reforms would be insufficient for the State to progress further towards UHC. Kerala with a long and successful history in 'public provisioning' should focus more on strengthening PHC through Aardram Mission in its journey towards pursuit of UHC. [ABSTRACT FROM AUTHOR]

The purpose of this research is to focus on the most practised Artificial Food Colourants (AFCs) creating a demand in the consumer food market and neglecting food safety by the stakeholders, as these AFCs have been proven to be harmful to human health. The problem question that has been addressed here is whether the labeling policy and the consumer awareness of AFC are in tandem with; how the Indian judiciary fared in delivering their judgements towards the prevalence of non-permitted AFCs in the Indian food market to tell them as successful for the healthier consumer food industry. The main objective is to examine the consumers's awareness on AFC on the International Numbering System for Food Additives (INS) and their mentioning on the label of food products along with the regulatory measures for approvals of AFCs in Europe, USA and India for comparison. It is revealed that consumers' awareness of INS is not very significant; FSSAI permits only eight AFCs for consumption, nevertheless, other non-permitted AFCs were also found to be used and the Indian government has acted responsibly on various occasions by entering the manufacturing premises to inspect the food, collect samples for testing the adulteration by submitting to the food analyst, thereby curbing such activities and grabbing such offenders to the court. The concept of food safety dimensions in consensus with AFC practices, the health and legal issues associated with AFC consumption, the Indian Government's policies and the response of the judiciary related to food colourants safety are discussed in this paper. A doctrinal research method is followed by analysing the legal literature such as the regulatory provisions, government policies and noteworthy cases from the Indian judiciary and drawing support from empirical research evidencing the poor knowledge of consumers on AFCs being added in the food. Therefore, a serious policy awareness among consumers with respect to AFCs, being responsible and taking ownership towards one's own health and their family members by taking steps in questioning the consumer forum, avoiding purchase of such packed food which does not adhere to the labeling standards and being consumer friendly. Stringent regulations in labeling standards of packaged food in the USA and Europe due to the import nature of their products are the need of the hour. [ABSTRACT FROM AUTHOR]

Purpose: Population ageing is a demographic transition and burdens every country's health sector. A lack of social security combined with low government health-sector spending has made health-care utilisation difficult among elderly in many developing countries like India. This makes population ageing a global phenomenon for policymakers, researchers and stakeholders to discuss and debate in 21st century. The purpose of this paper is to examine the behavioural determinants of health-care utilisation among elderly population in Punjab. Design/methodology/approach: This study examines health-care utilisation among the elderly population in Punjab. A structured questionnaire was used to collect the data in the state of Punjab, with a multi-stage stratified random sample of 385 respondents. Logit regression was used to analyse the association between several behavioural factors like age, gender, place of residence, source of livelihood, education and frequency of visits with health-care utilisation among elderly aged 60 and above. Findings: This study revealed that gender, age, place of residence, source of livelihood, education and frequency of visits were significant determinants of health-care utilisation among elderly population. Originality/value: This study directs the need to improve health-care utilisation in a country, reducing inequalities that exist among the elderly population with respect to socio-economic and demographic differences. [ABSTRACT FROM AUTHOR]

Hand hygiene remains one of the most effective methods of preventing healthcare-associated infections. Hand drying is the end point of hand hygiene. Hand drying after hand hygiene is less explored, and the practice varies in different facilities. This explorative study was done to know the various hand-drying methods and practices of healthcare workers in Indian settings. This was a descriptive cross-sectional questionnaire-based observational study initiated from a tertiary care setup in Uttarakhand. Healthcare workers over 18 years of age directly involved in patient care were enrolled. A semi-structured questionnaire with both open-ended and close-ended questions was used with snowballing sampling technique. Statistical analysis was done using Statistical Package for Social Sciences (SPSS). Out of the eligible 395 respondents, 62.8% were female. The mean age of the respondents was 31.34 ± 8.44 years and average working hours were 8.87 ± 2.97 (range 4-24) hours. Only 72.7% did hand hygiene always before touching a patient. Nurses were more compliant about hand hygiene than doctors (P < 0.0001). A total of 82.8% were aware of appropriate hand-drying methods. Staff in the Intensive care unit Intensive care unit (ICU) setup were more aware of hand drying practices (P = 0.033). A total of 21.8% wiped their hands on their clothing to dry their hands. This was more in staff from paraclinical departments (P = 0.001). A total of 35.7% used handkerchiefs to dry hands. Resident doctors used handkerchiefs more than senior doctors or nursing staff (P = 0.01). A total of 49.9% of respondents spent less than 10 seconds in hand drying. Hand-hygiene knowledge is high among healthcare workers in India, but the knowledge of appropriate hand-drying practices is lacking. There is wide variation in the practice of hand drying. Better hand drying guidelines and incorporating hand drying as the essential endpoint of the hand hygiene ritual are warranted. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to describe a response to the needs of mental health workers (MHWs) in India during COVID-19 pandemic, through an online training program on trauma-informed intervention and care. Design/methodology/approach: A four-module online training program was developed. Two modules were aimed to bridge the knowledge gap on trauma for MHWs, so that they could effectively address the associated symptoms of fear and grief. The other two modules aimed to support MHWs' self-care and create supportive connections among colleagues. In this mixed method evaluation study, needs expressed before the training and lessons derived from the training were collected through questionnaires, focus group discussion and interviews. Findings: Of the 3,168 MHWs who registered for the training, 534 completed the pre-questionnaire. Of the 125 post-questionnaire records, 38 had watched all four modules. A great need for learning to work with grief and manage the increased workload without burnout was observed. Post-training gains included skills for working with fear and grief, which increased the confidence of MHWs. The importance of self-care was an eye-opener for many. Social implications: This study indicates a way to equip MHWs to address the trauma that will continue to live in people in the aftermath of crises. Originality/value: This study examined the challenges MHWs in India faced during the COVID-19 pandemic, revealing a knowledge gap on dealing with this level of trauma. It can contribute to the knowledge on how to support MHWs in such crises. [ABSTRACT FROM AUTHOR]

Objective: The high-cited publications (HCPs) (with 50 or more citations) on orthopedic research from India were analyzed on various parameters. Methodology: The HCPs that were published between 2002 and 2021, on the Indian orthopedic research and indexed in the Scopus database were evaluated on various parameters. A network analysis was used to evaluate and visualize the collaborative interaction among the most productive organizations, authors, and keywords using VOSviewer and Biblioshyn software. Results: Of the total 4606 publications, 179 (3.88%) were HCPs, that were cited 22767 times (averaging 127.19 citations per publication). An external funding was received in 24.58% of publications and 36.87% of publications had an international collaboration. The most productive organizations were the Indian Institute of Science - Bengaluru (n = 11), All India Institute of Medical Sciences - New Delhi, and Amrita Institute of Medical Sciences - Kochi (n = 8 each) and the most impactful organizations in terms of citations per paper and relative citation index were Vellore Institute of Technology - Vellore, TIET - Patiala, and Lovely Professional University. The most productive authors were K. Chatterjee, D. Lahiri, and R. Vaishya. The most impactful authors were P. Mukherjee, S. Rajasekaran, and J. N. Babu in terms of citations per paper and relative citation index. Delhi was the epicenter of research and publications (n = 27). Material science and medicine contributed the largest number of publications (n = 77 and n = 73), followed by Engineering (n = 51). Treatment and clinical studies accounted maximally (24.58% and 8.38%) and hydroxyapatite (n = 40) was the most significant keyword appearing in the literature. Conclusion: This study provided an insight into understanding of research status including trends identified and studied the most influential contributions and performance of Indian organizations and authors and indicated broad and narrow subject fields contributing to this medical specialty. It gives some ideas about past, present, and future hotspots in research. [ABSTRACT FROM AUTHOR]

This paper explores how research advisory groups can be a vehicle for youth activism. It draws on our experiences with young activists, aged 15–26 years, in India and Brazil, who were advisors on a research project focused on youth livelihoods in cities. These young people played a vital role in supporting youth researchers, identifying research themes and developing engagement and advocacy strategies. Through this paper, we explore how the Youth Expert Group advisory model evolved differently in each location and examine how these were shaped by the context, the 'adult' research team and the youth activists themselves. A critically reflexive response in intergenerational partnership is essential to support youth activists in research activities. [ABSTRACT FROM AUTHOR]

The objective of the present research paper is to evaluate the efficacy of crop insurance schemes in India, with a specific focus on their performance. The relevant statistics are collected for a period of six years, from 2018 to 2023. The descriptive statistics and CAGR are employed to evaluate the farmer's enrolment, sum insured, and premium collected from Farmers, state/UT, and GOI. Testing of hypotheses made with the help of one sample t-test, paired sample t-test, and correlation. The study found that farmers' enrollment is higher in the kharif season than in the rabi season, and the overall farmer's participation, and sum insured, premium of farmers, State/UT, and GOI in crop insurance schemes is reduced during the study period, which is evidenced by the negative CAGR. There is a consistent decline in farmers' participation in crop insurance schemes which is evidenced by negative CAGR and supported by hypotheses testing. [ABSTRACT FROM AUTHOR]

Modernization, a stressful lifestyle, attachment to a Western diet, and the use of preserved and processed foods lead to a loss of homeostasis of intestinal microbial diversity. The use of refined flour and refined sugar, which lack of micro biota-accessible carbohydrates (MAC), means dietary fiber high salt consumption, and saturated fats in fried and packaged foods cause gut microbiota dysbiosis. Microbial dysbiosis caused by high fat, salt, and lack of fiber causes several metabolic diseases, including asthma. The objective of the study is to develop a hypothetic model that "Ancient Indian diet" which is inspired by thousands of years of Indian science, including Yoga, Ayurveda, and Naturopathy may maintain the diversity of the gut microbiota and may inhibits the asthmatic symptoms by enhancing the growth of antiasthmatic bacteria. A keyword search utilizing the phrases "western diet, beneficial microbiota, asthma, gut microbial dysbiosis, Ancient Indian diet" was conducted electronically search through the SCOPUS,Science Direct, PubMed, Web of Science, and PsycINFO databases. Search criteria are divided into two arms the first one includes different full-text research papers including how Indian diet altered gut microbial composition. The second one, we included the full text including how presence of certain gut microbiota can prevents the asthmatic attack. To And publications that met the eligibility requirements, the first and third authors separately reviewed each publication's title and abstract using the previously described inclusion criteria. We have included 124 research articles, which is published between 1989 to 2024. A plant-based ancient Indian diet increases the diversity of Bacteroidetes, Actinobacteria, Prevotella, Bifidobacterium, Lactobacillus, Ruminococcus, Roseburia, Lactobacillus, Lachnospira, Akkermansia and shows inhibitory effects against Clostridium, E. coli, Staphylococcus, Haemophilus, Moraxella and Neisseria.The ancient Indian diet a low-fat lacto-vegetarian diet maintains gut microbiota homeostasis, and suppresses the growth of pathogenic asthmatic bacteria and promotes the growth of beneficial asthmatic bacteria. [ABSTRACT FROM AUTHOR]

Introduction: Data mining in healthcare is a nascent arena of research in healthcare. Heterogeneity of Diabetes Mellitus in terms of clinical presentation calls for newer methods of research to study potential risk factors. Aim: The paper aims to use clustering techniques to identify the relationship between the four variables, namely the pre-prandial and postprandial sugar level, age and sex. Methods: The data was taken from a diagnostic laboratory in Wagholi, Pune. We conducted K-mean algorithm, EM algorithm, model-based clustering and t-mixture model. Results: It is evidenced that the data was best fitted to the t-mixture model. Our 50% samples were people with diabetes, 17% had prediabetes. Trivial correlation existed between age and sugar level. Males and females were equally at risk of having diabetes. Data presented concludes that age and sex have no effect on the risk of having diabetes. Data mining can be used to deduce meaningful clusters to drive plan-based interventions in the population. Conclusion: Methods of data mining can be used to deduce meaningful clusters in a heterogeneous dataset thus providing policymakers and healthcare researchers with novel information that will potentially contribute in formulating evidence-based policies. [ABSTRACT FROM AUTHOR]

Background: Sustainable development goals (SDGs) 3.9.1 and 11.6.2 call for a reduction in deaths and illnesses from air pollution, improving the air quality of cities. The above goals motivate us to organize workshops to improve the health of traffic police, who bear the brunt of air pollution. The paper examines the effect of workshops on the health-seeking behavior of the traffic police in Bhubaneswar city. Methods: The study conducted two workshops as a quasi-experimental, single-group study at an academic institution in Bhubaneswar. It included 20 traffic police officers (11 male and 9 female). The Kirkpatrick 4-level model was used to assess the effectiveness of the workshops. A paired t-test was used to compare pre- and postworkshop scores. Results: Thirteen traffic police officers rated the workshop sessions as excellent. The score before the workshop ranged from zero to three, with a mean (standard deviation [SD]) of 2.81 (1.0). The postworkshop score had a minimum to maximum score of three to five with a mean (SD) of 4.41 (0.7) (P < 0.005). The effect size dcohen (confidence interval [CI]) was 1.87 (3.27-4.71). The mean (SD) of absolute and relative gain was 1.6 (1.0) and 0.93 (1.02), respectively. All 20 traffic police officers showed improvement in health-seeking behavior. The significant lifestyle changes after the workshops ranged between 5% and 75%. Conclusion: The test scores indicated statistically significant improvement as the P value recorded was smaller than 0.05. This concludes that the improvement in understanding of the session was statistically significant because of the training imparted. [ABSTRACT FROM AUTHOR]

Purpose: Housing policies in India (last modified in 2017) define "affordable housing" on three main parameters – income of the target group, dwelling unit size and house price to income ratio. The Covid-19 pandemic has questioned the robustness of the defining parameters of affordable housing. This paper aims to study the impact of Covid-19 pandemic on housing affordability and adequacy for the urban poor and highlights how one pandemic has directly challenged the practicality of the affordable housing criteria in urban India. Design/methodology/approach: The study is based on a pilot test conducted through interviews with the consumer group. Furthermore, the affordable housing policies of urban India were studied in conjunction with the pandemic guidelines laid down by the World Health Organization. The consumer responses were analyzed in relation to the policies and guidelines to arrive at the inferences. The secondary case examples of the Dharavi slums in Mumbai and the Savda Ghevra slum resettlement colony in Delhi, along with the findings of the primary survey in the economically weaker section category, are used to formulate the conclusions. Findings: The pilot test conducted for the target consumer group clearly indicates that (i) the pandemic has severely affected the housing purchase capacity of the target consumer, thereby questioning the "affordability" of housing; (ii) proposed housing solutions are inadequate to enable livability, thereby questioning the "adequacy" of housing; and (iii) proposed housing solutions are inept to accommodate pandemic protocols. The Covid-19 pandemic and the conditions it imposed on the built environment clearly highlight the inadequacy of affordable housing parameters being followed in urban India. Research limitations/implications: Further research may be conducted on global best practices in housing, which may advise the housing policies in India. Practical implications: The study suggests key areas that need intervention and modification to make the housing policies more robust and effective. Social implications: The study explores the social sustainability aspects of housing, which are often considered secondary in policies. Originality/value: Because housing has a direct bearing on the physical, social and mental well-being of society, it is imperative to find housing solutions that are safe and resilient for a sustainable future. This paper is an original attempt by the author to question and highlight how the current affordable housing solutions adopted in urban India will continue to fail under any external adverse conditions unless modifications are considered in the existing housing parameters. [ABSTRACT FROM AUTHOR]

Purpose: Migrants face some unique health-care challenges, which often remain unaddressed by the health system. The purpose of this study is to determine health-care access among migrants in Chhattisgarh, from a lens of health equity. Design/methodology/approach: This study was conducted in a government-built tenement under the Integrated Housing and Slum Development program in Bilaspur district of Chhattisgarh state of India. It is a mixed-methods study which used a survey method, focus group discussion, in depth-interviews, semi-structured interviews and non-participant observations of health facilities in the area. Respondents included residents (migrants) and other local stakeholders like the Chief Medical Officer of the district, elected representatives of the local government and frontline health workers. This paper focuses on the findings from the qualitative component of the study. Findings: The move to resettle the people living in the slums to the periphery of the city had a negative impact on their health-care access. They find it difficult to access public health services, given the services are concentrated in the city. Women, elderly people and disabled people grapple with additional challenges in being able to access basic reproductive health services and care for chronic illnesses. Equity in health-care access is linked to various social determinants of health including access to housing and social security. However, the authors found that the migrant community is being deprived of appropriate housing facilities and social security. Originality/value: This paper explores the health-care access of internal migrants in Chhattisgarh state of India in the larger context of urban development with a focus on health equity. [ABSTRACT FROM AUTHOR]

Background: General hospital psychiatric units (GHPUs) are one of the major service and training providers in the field of mental health in India. However, there has not been any systematic attempt at their contributions toward research. Aim: The present paper reports on contributions of the GHPUs toward the psychiatric research based on analysis of publications in the Indian Journal of Psychiatry (IJP). Materials and Methods: All the issues of IJP of the last 25 years (1989-2013) were manually searched for original research papers, brief reports, and case reports. A semi-structured performa was used to collect information on various parameters. Results: About two-thirds of the papers were contributed by the GHPUs, most being multi-authored and from tertiary care centers. The research covered a variety of psychiatric disorders including schizophrenia, mood disorders, and common mental disorders. Most of the research reported was self-funded. Conclusion: GHPUs have contributed significantly to psychiatric research in India in the last 25 years. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM), a significant public health problem across the nations, is among the top ten leading causes of death. More than 370 million indigenous people (referred to as tribal people in India) are spread across 90 countries. India has the largest tribal people of 104 million. Tribal populations are not exceptional to the threat of type 2 DM (T2DM) and other non-communicable diseases, and hence, public health programmes are addressing this problem. This paper reports the systematic review and meta-analysis of the literature on the prevalence of T2DM. We conducted a systematic review and meta-analysis of the literature to understand the prevalence of T2DM among the tribal populations of India, following the guidelines of the PRISMA Statement for Reporting Systematic Reviews and Meta-Analysis. The gender-wise prevalence was recalculated by extracting the data wherever possible. Forest plots were depicted based on the prevalence, and other analyses were performed. On initial searches from three databases, 5422 citations were identified, and ultimately 27 studies were included in the review. These studies were undertaken amongst different tribes in different parts of India. The pooled prevalence of T2DM among men, women and combined were 6.04% (95% confidence interval (CI): 5.55% to 6.57%), 6.48% (95% CI: 6.01% to 6.99%) and 4.94% (95% CI: 4.72% to 5.17%), respectively. Considerable heterogeneity was found among these studies. This systematic review provides an overview of the prevalence of T2DM among the Indian tribal population. The pooled overall prevalence is slightly lower than the general population. This situation is worrisome as the epidemic of T2DM will affect the poor tribal communities, who can least afford to bear the health care costs. Hence, the public health care services must be strengthened in all tribal areas. This review further warrants establishing surveillance of T2DM in tribal areas. [ABSTRACT FROM AUTHOR]

Fluency Assessment and Benchmarking for Literacy in Education (FABLe) is the first mobile application being developed for the assessment of foundational literacy skills in India. FABLe passages are currently available in English for Grades 2, 3 and 4, with plans to expand to other Indian languages. FABLe is designed to administer curriculum-based measures for reading (R-CBMs) that have been validated in the Indian context. This paper describes the preliminary benchmarking procedures being undertaken for the Indian student population and how FABLe screens for students at-risk for reading difficulties. Student performance data based on initial FABLe results are compared with international benchmarks and teacher perception data. Overall, FABLe scores are lower than international benchmarks. FABLe was able to accurately identify students needing additional support, with the majority of students identified at-risk falling below the 19th percentile in FABLe. [ABSTRACT FROM AUTHOR]

Purpose: Verbal abuse of the aged people in later life is a matter of grave concern in contemporary times. Aged people are abused by family members, relatives and neighbors in the form of yelling, taunting, swearing and threats, among other things. These abusive behaviors have the greatest influence on their social standing and well-being, and they cause society and families to dismantle their social networks as a result. This study aims to understand the nature of verbal elder abuse as a social phenomenon under the theoretical framework of sociocultural paradigm and examines the causes. Design/methodology/approach: The descriptive phenomenology method has been applied in this study. The study has been conducted on a sample of 60 elderly living in Kanpur district of Uttar Pradesh. The concern of using descriptive phenomenology in the present study is to understand the nature of verbal abuse against the elderly systematically by exploring cultural, situational and social aspects of verbal abuse in Indian society. This method analyzes the reality behind the verbal elder abuse as a social phenomenon and relationship between elderly and their abusers. Findings: The study finds an increase in verbal elder abuse in Indian families, which can range from psychological torture to physical torture, and includes insults, humiliation and neglecting the needs of the elderly for food, clothing, shelter and medical attention. The study also points out that reduction in attachment is as a responsible factor for verbal abuse with the elderly in modern times. Originality/value: This is an original paper. This paper talks about the most concerning issue of verbal abuse which is faced by aged people in their family and society. Basically, this paper has applied the descriptive phenomenological method for the analysis of verbal elder abuse as a social phenomenon in the sociocultural context of Indian society. [ABSTRACT FROM AUTHOR]

Background: In 2018, it was found that only a quarter of Grade 3 children in India were reading at grade level. A growing demand for English education has further limited children's literacy achievement. Despite a strong evidence base in favour of using systematic phonics for building English literacy skills, many teachers in India continue to use rote‐methods of literacy instruction. Objectives: We aimed to examine the efficacy of GraphoLearn (GL) English Rime, a computer‐assisted reading intervention, in improving the foundational literacy skills of 1st and 2nd grade students who were attending an English medium school in India. Methods: A total of 136 students across 6 classrooms were randomly allocated to play either GL or a control math game over a 5‐week intervention period. Students were pre‐ and post‐tested on various English literacy skills using tasks built into the GL software as well as through oral and paper‐based tasks. Results and Conclusions: Students who played GL showed significantly greater and faster development on in‐game measures of letter‐sound knowledge, rime unit recognition, and word recognition as compared to students who did not play GL. In addition, GL resulted in greater effects on these measures for students with stronger English literacy skills prior to the start of the intervention. No differences were found between groups on the oral and paper‐based tasks. Implications: GL was able to quickly and effectively teach critical sub‐skills for reading. However, a lack of effects on the out‐of‐game measures opens the door for further discussion on the successful implementation of such interventions. Lay Description: What is already known about this topic:India has an ongoing literacy crisis with many children failing to acquire functional literacy skills.Under‐resourced schools,outdated pedagogical methods, and a demand for English‐medium education are partially to blame.Globally, technology is being increasingly looked at to help improve student learning levels across all subject areas.There are a lack of studies examining the efficacy of various ed‐tech tools to improve literacy in the context of India.What this paper adds:The study aimed to test GraphoLearn English (GL), a mobile game designed to teach and practice early reading skills through phonics with first and second graders.Results showed that children who played GL outperformed those who did not play on critical literacy skills such as letter‐sound knowledge and word recognition.In addition, GL was more effective for those who had higher pre‐existing English literacy skills.However, improvements were only seen on measures assessed in the game and not on measures assessed orally or on paper.Implications for practice and/or policy:GL and other educational technologies can be extremely effective tools which allow for an individualized learning experience.However, it is important that for any educational game, learning moves beyond the game itself.Teachers are critical players in this process and must ensure that tech‐based instruction is integrated with teacher‐led instruction.Policy makers and school administration must ensure that teachers are adequately trained on when, with whom, and how to use such technologies before they are introduced. [ABSTRACT FROM AUTHOR]

Background: Depression is a major public health concern among Indian adolescents. Pre- and post-natal depression can often alter fetal development and have negative consequences on the physical and mental health of the mother. This paper aims to draw attention to the prevalence of depression and its correlates among currently married, ever-pregnant adolescents from two Indian States, i.e. Uttar Pradesh and Bihar. Methods: This study utilizes data from a subsample (n = 3116) of the prospective cohort study Understanding the Lives of Adolescents and Young Adults (UDAYA) among 10 to 19 year-old adolescents. Bivariate analysis was performed to assess the prevalence of depression by sociodemographic and behavioral characteristics. To further access the predictors associated with depression a logistic regression model was applied. Results: Around one-tenth (9%) of pregnant adolescents had depression. Regression analysis indicated that substance use, religion, autonomy, considering attempting suicide, premarital relationship, violence, dowry, adverse pregnancy outcome, menstrual problem, and parental pressure for the child immediately after marriage were significantly associated with depression. Conclusions: This study confirms the pre-existing annotation that teen pregnancy is linked with depression. Findings indicate that Adolescent mothers experiencing violence, and a history of adverse pregnancy outcomes are at increased risk of developing depression. These study findings call for an urgent need to address depression among adolescent mothers. [ABSTRACT FROM AUTHOR]

Introduction: Triage is a dynamic and complex decision-making process to determine fair access to medical care in mass casualty situations. Triage takes place through healthcare settings including Intensive Care Units (ICUs). Triage governing principles have been subject to ethical debates for a long time specifically with the recent global pandemic of COVID-19. This study aims to revisit the ethical principles guiding patient prioritisation during recent COVID-19 disaster triage in the Indian subcontinent and attempts to look for principles with consideration of social justice. Methods: Key electronic databases such as WHO, EMBASE, and DOAJ were used to access published literature relating to ICU triage in the Indian subcontinent. Literature on and from 2015–2022 were included in this study. The SPICE framework was used to identify the literature. The Inclusion criteria were as follows: Literature with ethical connotations focusing on India and neighbouring countries, and in an ICU setting during pandemics. The Exclusion criteria were as follows: Literature focusing on other countries, without ethical foundations, hospital admissions, and non-COVID-19 ICU admissions. The PRISMA standard was applied to screen the appropriate literature. The BOOLEAN operator "OR" was used to enhance the literature search. Finally, six papers were found suitable for this study and thus were included in the literature review. Additionally, for the second time, the frequency of certain ethical phrases was reassessed in the plans and guidelines to check the changed awareness of ethical pandemic planning, if any. A thematic analysis was applied to analyse the data and generate findings and new knowledge. Results: The findings highlight gaps in knowledge around ICU triaging in the region which indicates the scope of better ethical pandemic preparation at the regional level. The findings show that there is a debate between researchers on prioritisation from available resources and ethical perspectives and principles associated with fair access to healthcare even during pandemic times. The literature also highlights enhancing the regional capacity and building equitable approaches to reduce existing health inequities and the need of the social justice framework for ICU triaging during a pandemic. Conclusions: ICU triaging in five South Asian neighbour nations was studied for the presence of a guided ethical framework. Additionally, for the second time, certain ethical phrases were reassessed in the plans and guidelines; however, usage of those terms was found to be significantly low. The discussion shows that the plans and guidelines have the scope to improve ethical ICU triaging in these countries and in the specific region. After analysing different ethical guidelines, this study emphasises that there is a need for a just and fair framework, specifically a social justice framework in ICU triage in the subcontinent to address the underlying health inequities. [ABSTRACT FROM AUTHOR]

Covid-induced lockdowns have increased the importance of technology in education. Though access to technology as well as availability of the internet remain a major concern for a lot of children in the global south, children with intellectual disabilities are disadvantaged even more as most of the e-content is developed keeping in mind the average learner. Unstructured interviews were conducted with children with intellectual disabilities studying in government schools in Haryana as well as their teachers and parents. Thematic analysis of the interviews was conducted to understand the use-patterns of mobile phones by children with intellectual disabilities. Findings suggest that these children are learning to use mobile phones on their own or with some support and are able to navigate the complexities of these smartphones quite well. They use these devices mostly for their entertainment. This paper then reflects on the need and strategies to develop these technologies in ways that they can be used as effective tools for teaching children with intellectual disabilities, especially in the inclusive education system in developing countries. The paper reflects on the need to develop technology and tools using flexible and exploratory designs to enhance the learning processes for children with intellectual disabilities from the lower income strata. This study highlights the importance of being able to use mobile phones by children with intellectual disabilities belonging to low income families. Following this, the article argues for designing of mobile phones suitable for use by children with intellectual disabilities using playfulness and explorations, and Building e-content keeping the elements of playfulness and exploration which can enhance the learnings of this group of students which is often ignored. [ABSTRACT FROM AUTHOR]

Background: Road traffic accidents are preventable public health issues and are becoming more common. These accidents can be linked to a number of factors, including an increase in the number of vehicles on the roads, changes in daily life, a nasty habit of breaking traffic laws, anarchic traffic systems, and risky driving practices. Thoraco-abdominal injury in different forms is one of the major causes of mortality in the victims of fatal road traffic accidents. The aim of this study was to know the pattern of thoraco-abdominal injuries in victims of fatal road traffic accident cases. Material & Method: The present study was conducted at the tertiary healthcare centre in southern Haryana. Total of 75 cases of fatal road traffic accident cases were enrolled during one year of study period. The basic information about the deceased like age, gender, mode of travel of the victim was obtained from investigating officer narration and inquest papers. During autopsy, detailed examination of injuries was carried out and the autopsy findings were recorded and analyzed. Results: It was observed that out of 75 cases male outnumbered females in ratio 5.25:1. Majority of the victims belonged to the age group 21-30 years. The commonest injury of the thoracic region was rib fracture (41.3%). It was also observed that 17.3% of victims had pelvic fracture. Conclusion: Human error is a major contributing factor to fatal RTAs, which can be avoided in many cases. A more stringent licensing policy, particularly for four-wheelers, increased knowledge of traffic laws, the reduction of drug abuse and an appropriate road network that is in line with traffic volume can help to reduce the number of fatal road traffic accidents. [ABSTRACT FROM AUTHOR]

Background: Given India's high patient load on the existing healthcare setup, as well as political, social, and organizational challenges, the nursing sector is facing various problems, therefore leading to substandard nursing experiences leading to poor patient care at the parallel healthcare setups, specifically homecare. This paper presents self-managed organizations (SMOs) characterized by a horizontal management structure as an effective alternative to existing hierarchical management structures overladen with bureaucracy. Therefore, we are exploring the strategies at self-managed homecare organizations that can make nursing a better and more productive experience. Method: This study utilized Constructivist Grounded Theory (CGT), employing semi-structured interviews to explore nursing dynamics in horizontal organizational structures. It delved into crucial aspects like finances, organizational structure, value systems, information flow, and conflict resolution within SMOs. The methodology involved theoretical sampling, prioritizing expert self-management knowledge over mere representativeness. Seven nurses, twelve management members, and fifteen patients from self-managed homecare organizations contributed to the examination of nursing experiences. Constant comparative analysis of data led to the identification of the Qualitative Success Enablers (QSEs), revealing three themes: Insightfulness, Enhancing Nursing Experience through Job Enrichment, and Autonomy-Enabled Intrapreneurship. Results: The findings indicate that the horizontal management structure represented by the studied organization in India has shown considerable success in times laden with uncertainties during the COVID-19 pandemic, especially during the delta wave, which revealed the frailty of existing healthcare infrastructure. The organization successfully maintained a better nursing experience and gained patient and employee satisfaction, as revealed by in-depth semi-structured interviews and constant comparative analysis. Conclusion: In a world of unique challenges, we stand on the brink of significant transformations. SMOs are vital in India's homecare sector for enhancing nursing experiences and overall organizational performance. Fostering a trust-based environment within SMOs is integral to delivering effective services. The autonomy to design nursing jobs, insightfulness, and innovativeness in the nursing job through suitable training activities, various job enrichment methods, and finding meaningfulness in a job through softer aspects of caregiving result in an enhanced nursing experience at SMOs. This groundbreaking approach can be extended to other homecare organizations in India, relieving the strain on the existing healthcare system. [ABSTRACT FROM AUTHOR]

Background: The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis. Methods: This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies. Results: In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article. Conclusion: Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat. Registration: Open Science Framework (DOI: 10.17605/OSF.IO/74GHM). [ABSTRACT FROM AUTHOR]

According to the Center for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program, the cervical cancer screening rate dropped by 84% soon after the declaration of the COVID-19 pandemic. The challenges facing cervical cancer screening were largely attributed to the required in-person nature of the screening process and the measures implemented to control the spread of the virus. While the impact of the COVID-19 pandemic on cancer screening is well-documented in high-income countries, less is known about the low- and middle-income countries that bear 90% of the global burden of cervical cancer deaths. In this paper, we aim to offer a comprehensive view of the impact of COVID-19 on cervical cancer screening in LMICs. Using our study, "Prevention of Cervical Cancer in India through Self-Sampling" (PCCIS), as a case example, we present the challenges COVID-19 has exerted on patients, healthcare practitioners, and health systems, as well as potential opportunities to mitigate these challenges. [ABSTRACT FROM AUTHOR]

Background: This research adds to the growing body of work demonstrating the vital role of image categorization in the medical sector. The efficiency of illness diagnosis is being greatly enhanced using image classification. A brain tumor is a collection of abnormal cells in the brain. Diagnostic precision is required when looking for a tumor in the brain because even the smallest error in human judgement can have disastrous results. To get around this problem, the medical community has implemented an automated brain tumor segmentation system. A variety of methods are employed to segment a brain tumor, but the results are inconsistent. To improve the quality of MRI images, we present our findings in this paper. Deep learning methods for image segmentation and classification are discussed in this paper. Methods: In this paper we a very robust deep learning method for image segmentation and classification. For image classification, we are employing the enhanced faster R-CNN method. The ResNet50 model is used to differentiate between tumor and non-tumor images. The next step in this framework is to use Deep Residual UNET for segmentation. RESUNET is an FCNN that maximizes efficiency. The proposed method works well in terms of its ability to find and classify things accurately. Results: The accuracy rate for identifying tumours in MRI scans using the proposed technique is 94.23%. Using transfer learning with Resnet50 as the base model and the use of discriminative learning rates, our model achieved superior results than other recent models. Conclusion: Within the scope of this study, we have integrated the residual networks with the U-Net to make the network stronger. This strategy improves the efficiency of classification and segmentation tools. To achieve a higher level of accuracy, the model may be trained further, or additional data may be applied in the training process. [ABSTRACT FROM AUTHOR]