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Antimicrobials prescribed without indications can lead to antimicrobial resistance (AMR). This study aimed to develop a validated support and audit antimicrobial prescription assessment tool (AmPAT) to assess the rationality of prescriptions by generalist medical doctors in outpatient settings at primary and secondary healthcare facilities. Multiphase content validity study. AmPAT was developed in four phases. Phase 1 involved item identification and development based on literature and expert suggestions. In phase 2, the face and content validity were assessed using the Delphi technique in two rounds (16 experts in round 1 and 19 in round 2). The content validity ratio (CVR) and content validity index (CVI) were calculated. A pilot study was conducted in Phase 3 in primary and secondary-level healthcare facilities (n = 92 prescriptions) in Chandigarh, India. Five experts assessed the rationality of 30 prescriptions for inter-rater reliability. The inter-rater agreement and internal consistency were calculated using Fleiss-Kappa statistics and Cronbach's alpha, respectively. Phase 4 included a large cross-sectional study (n = 945 prescriptions) for estimating the internal consistency of AmPAT. AmPAT was developed with 19 items under three sections (patient, clinical, and treatment details). The mean CVR was 0.91 (range 0.16–1.00), and mean CVI was 0.96 (range 0.58–1.00). The kappa value was 0.91 (range 0.59–1.00) for inter-rater agreement. The Cronbach's alpha was 0.75 (95%CI 0.66–0.82) and 0.76 (0.68–0.82) in phases 3 and 4, respectively. AmPAT, with good reliability, inter-rater agreement, and internal consistency, was developed to assess the rationality of antimicrobials prescribed in outpatient departments at primary and secondary-level healthcare settings. [ABSTRACT FROM AUTHOR]

India is the largest milk producer contributing 25 % to the global production. From a mere 17 million tons (MTs) in 1951, milk production increased to an inconceivable 230 MTs in 2023. Nondescript cows and buffaloes were the main milk animals. Since 1965, nationwide programs for cross breeding native cattle with exotic milk breeds such as Jersey, Holstein Friesian (HF) and Brown Swiss (BS) and upgradation of buffalo breeds along with disease eradication, feed and fodder development and provision of veterinary and extension services were implemented. Now 75 % of the milk in India is produced by the native, exotic and crossbred cows (43 %) and native breeds of buffaloes (32 %). National Dairy Development Board (NDDB) created dairy cooperatives, an Indian innovation to connect rural milk producers to urban and semi-urban consumers. These cooperatives transformed subsistence dairy farming into a profitable rural enterprise and created millions of jobs. Due to the success of the above activities, since 1998 India continues to produce the highest volumes of milk in the world. It is envisioned to increase (i) milk production to 450 million tons (MTs) (one-third of the global production) (ii) gain a share of 15 % in global milk and milk products exports and (iii) build sustainable green practices to match global standards during the next 25 years. India is increasingly deploying artificial insemination (AI) with sex sorted-frozen semen, embryo transfer and in vitro production of embryos using sex sorted semen, progeny testing and genomic selection to improve reproduction and productivity among dairy animals. Mitigation of disease burden is undertaken through nationwide vaccination against diseases such as Foot and Mouth, TB, Brucellosis etc. Nutritious fodder crops and feed additives that support higher productivity and reduce enteric methane emissions are promoted. Management and interventional practices such as better nutrition, amelioration of summer stress, oestrus synchronisation etc., are increasingly implemented. Use of internet enabled technology services (IETS) for extension activities, mobile veterinary and animal husbandry services are rapidly becoming commonplace. All these practices portend greater achievements in milk production in the fore-seeable future. Achievements, aspirations, accosts, approaches and appraisal are presented. • 1950–70: India was milk deficit country. • 1965–98: White revolution: crossbreeding and upgradation of native bovines to become world's top milk producer. • 1998–2023: Technology supported milk production: India remains the top milk producer in the world. • 2023-50: Intensification of technology adoption: India shall remain world's top milk producer. [ABSTRACT FROM AUTHOR]

• The survey study identified important psychosocial predictors of risky driving are identified, among which perceptions related to costs and benefits, societal acceptance, and personal control of risky riding behaviour. • The theory of planned behaviour proves to be a valid model to explain the intention to refrain from risky riding behaviours while riding. • Different risky riding behaviours have different psychosocial determinants, which indicates the need to delineate the concept of risky riding behaviour into specific sub-behaviours. • Risky riding behaviours in the past did not prove the be an important predictor of future intentions to adopt more safe riding practices. • The findings specify important target points at the belief and determinant level for future educational programmes to promote safe riding. Road crash injuries have emerged as a significant public health issue in many low-and middle-income countries in recent years. Annually, more than 1.35 million people lose their lives due to road crashes, making it one of the leading causes of death worldwide. In India, road crash injuries have increasingly become a major concern for motorized two-wheeler riders. It is important to understand risky riding behaviours to develop accurate and evidence-based risk reduction programmes that fit the target population well. The current study aimed to identify the psychosocial determinants of refraining from risky riding behaviour in young, motorized two-wheeler riders. A quantitative survey based on the theory of planned behaviour (TPB) complemented with questions measuring routine behaviours was conducted among 238 young riders aged 18–25 riding motorized two-wheelers in Manipal, a locality of Udupi district in Karnataka province of Southwestern India. The study tool assessed four risky riding behaviours: (1) speeding, (2) helmet non-use, (3) performing stunts, and (4) using mobile phones while riding. The results of the study indicated that the intention to refrain from risky riding behaviours can be explained by important psychosocial determinants of human behaviour, including attitude, social norms, and perceived behavioural control and their underlying belief systems with regard to perceived benefits and costs, perceptions of other's behaviours and approval, and expressions of personal control that inform these psychosocial determinants. In addition, the extent to which participants automatically behaved in risky riding practices in the past did not prove to be a strong predictor of future intentions to refrain from risky riding. It is concluded that the study resulted in an in-depth understanding of the psychosocial determinants of risky riding behaviour. Policymakers and programme developers are encouraged to use the findings in defining programme goals for future educational interventions to promote safe two-wheeler riding. [ABSTRACT FROM AUTHOR]

Stillbirth is a significant public health challenge in India, accounting for a substantial portion of the global burden. Exposure to household air pollution from solid fuel combustion during pregnancy has been associated with adverse pregnancy outcomes, including stillbirth. This study aimed to investigate the association between solid fuel use and stillbirth risk in India, utilizing data from the National Family Health Survey 5 (NFHS-5). Nationwide cross-sectional study. The study employed data from the NFHS-5, a nationally representative cross-sectional survey conducted in India from 2019 to 2021. The study sample consisted of 204,723 women aged 15–49 years who had a pregnancy in the past 5 years preceding the survey. Stillbirth was calculated using calendar data, providing robust estimates. Logistic regression analysis was performed to assess the relationship between solid fuel use and stillbirth, adjusting for various sociodemographic and maternal factors. The use of unclean cooking fuels was significantly associated with an increased risk of stillbirth (OR = 1.34, 95 % CI: 1.13–1.58, p < 0.001) compared to clean fuels. Other factors associated with higher stillbirth risk included rural residence, lower maternal education, belongingness to certain social categories, delivering at private healthcare facilities, limited antenatal visits, and undergoing caesarean delivery. The findings highlight the detrimental impact of solid fuel use on stillbirth rates in India, underscoring the need for targeted interventions to promote cleaner cooking technologies and address socioeconomic disparities. Efforts to transition households towards cleaner energy sources and improve access to quality maternal healthcare services are crucial for reducing the burden of stillbirth in India. [ABSTRACT FROM AUTHOR]

This study critically evaluates the impact of the Pradhan Mantri Ujjwala Yojana (PMUY) on LPG accessibility among poor households in India. Using Propensity Score Matching and Difference-in-Differences estimators and the National Family Health Survey (NFHS) dataset, the Average Treatment Effect on the intendedly Treated is a modest 2.1 percentage point increase in LPG consumption due to PMUY, with a parallel decrease in firewood consumption. Regional analysis reveals differential impacts, with significant progress in the North, West, and South but less pronounced effects in the East and North East. The study also underscores variance across social groups, with Scheduled Caste households showing the most substantial benefits, while Scheduled Tribes households are hardly affected. Despite the PMUY's initial success in facilitating LPG access, sustaining its usage remains challenging. Policy should emphasise targeted interventions and address regional and community-specific disparities for the sustained usage of LPG. [ABSTRACT FROM AUTHOR]