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The COVID-19 pandemic has had a significant impact on human health and has led to social isolation and health implications. In order to optimize public health, it is important to understand the role of social and behavioral sciences, including dietary patterns and lifestyle changes. This study aimed to identify the effect of lockdown on dietary patterns and its association with Body Mass Index (BMI) and lifestyle changes in the older Indian population (aged 60 and above).The study was conducted using an online web-based Google form and 674 participants took part over a one-month period. The k-means algorithm was used to identify non-overlapping dietary patterns and logistic regression was employed to determine the factors associated with changes in dietary patterns. Three dietary patterns were identified: pro-healthy, constant, and unhealthy.During the study, 33.1% of the participants decreased their physical activity while 61.6% increased their screen usage. 26.7% consumed a pro-healthy dietary pattern, while 61.9% consumed an unhealthy dietary pattern. Women reported lower consumption of the pro-healthy pattern (23.8%) and higher consumption of the unhealthy dietary pattern (64.5%) compared to men (30.6% and 58.3%, respectively). Adherence to the pro-healthy dietary pattern was positively associated with age. Participants with a lower BMI were less likely to consume a pro-healthy dietary pattern [AOR: 0.02; CI: 0.01, 0.2]. Those who increased their physical activity were more likely to follow the pro-healthy dietary pattern [AOR: 6.49; CI: 0.76, 55.76]. Those who had less sleep [AOR: 10.22; CI: 1.97, 52.92] and more screen time [AOR: 7.61; CI: 3.28, 17.62] had a higher risk of following an unhealthy dietary pattern.The lockdown had a significant impact on dietary patterns and was associated with unhealthy lifestyle outcomes among older Indian adults. From a public health perspective, promoting awareness of healthy dietary patterns and promoting healthy lifestyles through educational programs is a priority. [ABSTRACT FROM AUTHOR]

Objectives: The main objective of this review is to summarize the evidence on the core modelling specifications and methodology on the cost-effectiveness of TKR compared to non-surgical management. Another objective of this study is to synthesize evidence of TKR cost and compare it across countries using purchasing power parity (PPP). Methodology: The electronic databases used for this review were MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), HTAIn repository, Cost effectiveness Analysis (CEA) registry, and Google Scholar. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was used to assess the validity of the methods and transparency in reporting the results. The Quality of Health Economic Studies (QHES) was used to check the quality of economic evaluation models of the studies included. The cost of TKR surgery from high income and low- or middle-income countries were extracted and converted to single USD ($) using purchasing power parities (PPP) method. Result: Thirty-two studies were included in this review, out of which eight studies used Markov model, five used regression model, one each reported Marginal structure model, discrete simulation model, decision tree and Osteoarthritis Policy Model (OAPol) respectively to assess the cost-effectiveness of TKR. For PPP, twenty-six studies were included in the analysis of TKR cost. The average cost of TKR surgery was the lowest in developing country—India ($3457) and highest in USA ($19568). Conclusion: The findings of this review showed that the Markov model was most widely used in the analysis of the cost effectiveness of TKR. Our review also concluded that the cost of TKR was higher in the developed countries as compared to the developing countries. [ABSTRACT FROM AUTHOR]

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

Despite experiencing hot weathers, limited studies from India explored relationships between ambient heat and health. We studied associations between heat and all-cause mortality to estimate heat threshold(s) affecting health, and examine other affecting dimensions. We conducted time-series analysis with daily maximum temperature and all-cause mortality data of Bhubaneswar city (March–July, 2007–2017), and explored their interactions. Mortality risks rose when daily maximum temperatures were >36.2°C (lower threshold), and even more when >40.5°C (upper threshold). Every degree above36.2°C increased the mortality risk by 2% (mortality rate ratio: 1.02; 95% CI 1.01, 1.03). The effects of maximum temperature increased on days when minimum temperatures were >25.6°C (median). The effect of heat was immediate and lasted for 0–1 day with no lagged effect. Two temperature thresholds with varying mortality risks provided an opportunity for a graded heat warning system. The accentuation of the deleterious effects of heat by the higher minimum temperature calls for its inclusion in the heat warning system in future. [ABSTRACT FROM AUTHOR]

Purpose: This survey aimed to assess the baseline level of access to social institutions, utilisation of civil facilities and participation in empowerment schemes by people with disabilities in Amravati district of Maharashtra State, India. Method: Sixty villages from two blocks in Amravati district were randomly selected for the survey. From these villages, 522 households were sampled and 3056 individuals were surveyed. Interviews were conducted with 590 individuals with disability from among the surveyed population. The structured interview schedule consisted of demographic data, access to social organisations, utilisation of civil services, and participation in empowerment schemes. Results: Locomotor disability was the most prevalent (44.6%) type of disability in the study area. Disabilities were more often present among male adolescents and young adults than among the older population and females. Over 50% of the study participants had no occupation (including children and students) and had not been to school. Only 48% had achieved secondary education and more. The proportion of disability among people belonging to Scheduled Castes and Scheduled Tribes was considerably higher than among the general population. Access to social institutions was less than 50% for most of the items, and was even lower among females. Except for the ration card and Aadhar card, civil services were generally under-utilised by people with disability. Only 3.2% of the participants were members of self-help groups, and not a single person was a member of the Disabled People's Organisation. Conclusions: In the study area access to social institutions, utilisation of civil services and participation in empowerment schemes was very low. Limitations: Data, including general socio-demographic, access and utility data, was not collected for the general population but was limited to people with disabilities. This restricted the scope for comparison between people with and without disabilities. [ABSTRACT FROM AUTHOR]