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Diasporas are organized groups motivated by common cultural, ideological, political and religious values and common concerns for their countries of origin. Diaspora diplomacy has gained prominence worldwide, particularly in India, spurred by harrowing images of deaths and devastation due to the COVID-19 pandemic. A new generation of diaspora professionals modeled as social entrepreneurs uses collaborative and non-profit models to establish relationships with their counterparts to facilitate medical services and research. Teleradiology and telepsychiatry facilitate communication between diaspora members and their counterparts. We propose a common telehealth platform to standardize advice given by the Indian diaspora in the Global North as protocols change rapidly in acute pandemics. Consideration should be given to the well-known digital divide in India and other low- and middle-income countries. We advocate for diaspora members to train themselves in the art of global health diplomacy, to promote transparency and accountability in the collection of funds and a mandatory provision of outcome measurement by independent monitors rather than through social media. In the long run, Indian-Americans should play an active role in strengthening the domain of public health, which has historically been neglected in India, by focusing on the country's long-term infrastructure needs. The lessons learned from various diaspora efforts should be independently evaluated and recorded as best practice for future pandemics and humanitarian crises., (© The Author(s) 2022. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Objectives: We carried out a mixed method study to understand why patients did not avail of surgical care in an urban slum in India. Methods: In our earlier study, we found that out of 10,330 people, 3.46% needed surgery; 42% did not avail of surgery (unmet needs). We conducted a follow-up study to understand reasons for not availing surgery, 141 in met needs, 91 in unmet needs. We administered 2 instruments, 16 in-depth interviews and 1 focused group discussion. Results: Responses from the 2 groups for "the Socio-culturally Competent Trust in Physician Scale for a Developing Country Setting" scale did not have significant difference except for, prescription of medicines, patients with unmet needs were less likely to agree ( p = 0.076). Results between 2 groups regarding "Patient perceptions of quality" did not show significant difference except for doctors answering questions where a higher proportion of unmet need group agreed ( p = 0.064). Similar observations were made in the in depth interviews and focus group. Conclusion: There is a need for understanding trust issues with health service delivery related to surgical care for marginalized populations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Vora, Saiyed, Mavalankar, Baines and Jindal.)

The science of global health diplomacy (GHD) consists of cross-disciplinary, multistakeholder credentials comprised of national security, public health, international affairs, management, law, economics and trade policy. GHD is well placed to bring about better and improved multilateral stakeholder leverage and outcomes in the prevention and control of cancer. It is important to create an evidence base that provides clear and specific guidance for health practitioners in low- and middle-income countries (LMICs) through involvement of all stakeholders. GHD can assist LMICs to negotiate across multilateral stakeholders to integrate prevention, treatment and palliative care of cancer into their commercial and trade policies., (© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: Recipients of kidney transplant have been shown to develop emotional problems. These have been associated with medical noncompliance, compromised quality of life, and difficulty integrating the newly acquired transplant into their sense of self. In general, group psychotherapy has been shown to be more cost effective than individual therapy. We have compared the efficacy of two modalities of therapy in recipients of kidney transplants with control patients who did not receive therapy., Methods: Recipients of first cadaver kidney transplants were randomized into two groups to receive a 12-week course of group or individual psychotherapy. The control arm of the study was composed of 37 consecutive patients who had received a first cadaver kidney. Recipients of live kidney transplants, and patients who received more than one kidney transplant, were excluded because these patients have different emotional issues. The Beck Depression Inventory (BDI) was used as a measure of change in emotional state, pretherapy, at 3, 6, 9, and 12 months. A higher score on BDI was suggestive of psychologic dysfunction., Results: We recruited 89 recipients of first cadaver kidney transplants into the study. They were randomly allocated into the two study groups, 49 for individual therapy, and 40 for group therapy. Of these, 82 patients completed 12 weeks of therapy (45 patients from the individual treatment arm, and 37 from the group therapy arm). Fifty-five patients completed one-year follow-up (33 in individual therapy, and 32 in the group therapy). The mean score was 26.3 +/- 7.9 before and 18.9 +/- 9.0 after therapy in the individual treatment group (P= 0.001). This was in comparison with a mean score of 30.2 +/- 3.8 before and 26.0 +/- 4.2 after therapy for the group therapy arm (P= 0.01). Improvement appeared to be more significant in the individual therapy compared with group therapy (P= 0.01). Lowering of scores was progressive and sustained (P= 0.01). In the control arm, mean score was 9.4 +/- 5.4 before and 20.5 +/- 5.5 at the end of the first year (P= 0.005), suggesting a significant worsening of BDI scores. Multivariate analysis of age, gender, employment status, duration of dialysis, etiology of kidney failure, diabetes mellitus, and psychotherapy received at any time before transplantation did not affect results., Conclusion: We conclude that both individual and group psychotherapy were beneficial to our patients; however, individual therapy was found to result in lower BDI scores versus group therapy at the end of treatment period.

There is a chronic shortage of organs for transplantation in the UK. This problem is particularly acute amongst Asians living within the UK. The Transplant Unit, University of Glasgow, joined forces with local businessmen to initiate a public meeting to promote awareness of transplant issues affecting Asians in the greater Glasgow area. During the Forum, we conducted a survey to determine the level of knowledge about organ transplantation, donation and willingness to donate, in relationship to the age, gender, marital status and religious affiliation amongst the attendees. The Forum was conducted at a public hall after publicity in the local press and Asian shops. The meeting was attended by over 300 people of Asian origin. Of the 90 survey forms handed out, 80 were returned fully completed. There was almost no opposition to organ donation, and many of the respondents were aware that religious leaders in the UK had endorsed organ donation. However, favourable disposition to these issues was not accompanied by carrying of the organ donor card, despite an awareness of the National Donor Register. The majority of the respondents were willing to undergo live organ donation, but were undecided about cadaveric donation. The issue of presumed consent drew mixed responses. Asians in the Glasgow region are not sympathetic to the matter of organ transplantation and donation, despite their recognition of the issues of organ shortage. We suggest that the matter needs to be further integrated into Asian culture by religious leaders and business persons. Our findings indicate that women over the age of 30 and based in the home may be in a unique position of influence by virtue of their position of centrality within the social network. This approach may also be suitable in other areas of the UK and the world with a large number of ethnic minorities.