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Purpose: This paper explored the reliability of self-reported health and the impact of the social position in determining the inconsistent health response (IHR), in late life. Reliability of self-reported health is important to evaluate, as it is the primary step for asking health-care facility. As self-reported health is a subjective measure, elderly people might have a tendency of under-reporting the health problem because of lower socioeconomic status. This incidence can cause inaccurate estimate of the health problem of the aged at the time of formulating health policy or providing health-care infrastructure. Therefore, the purpose of this study is to explore the sources of inconsistent responses of self-reported health by comparing it with the existence of chronicle ailment and to identify the vulnerable group that health care supports. Design/methodology/approach: The study uses nationally representative unit-level data from the National Sample Survey of India. Using the bi-variate probit model, joint estimation of reported health and IHRs is determined. The study compares perceived and actual health status and explores how individual characteristics and socioeconomic position contributes to IHRs among the elderly population. Findings: Major findings of this study are as follows: firstly, self-reported health has little reliability, as it is compared with the existence of chronicle ailment. Older people in the rural areas have greater tendency to under-estimate the health problem, whereas urban elders tend to over-estimate it; and secondly, the inconsistency in health response is significantly associated with social caste, economic status and attainment of education. Social implications: The results of this study from bivariate probit model offer deeper understandings about the reliability of self-reported health and provide further insights to improve policy design formulated to mitigate the health inequality among the elders. This study might be helpful to design an inexpensive and easily available health measure, which is very important for a highly populated aging country with limited health-care resources. Originality/value: To the best of author's knowledge, it is the first study that has identified the sources of inconsistent health and direction of inconsistency that is where self-reported health over- or under-estimates the actual health response among the elderly in a developing country like India, where the growth rate of population aging is faster than the world. [ABSTRACT FROM AUTHOR]

Objectives: Diabetes is a significant public health concern in India, with Kerala being labeled as the diabetes capital of the country. The study aims to evaluate the prevalence, treatment, and management of diabetes to examine the unmet need for care to propose cost-effective strategies. Design: A cross-sectional study was conducted on a geographically defined cohort population in Ernakulam. Sample: This paper presents diabetes data of adults ≥30 years enrolled from the community cohort. The interviews were conducted with 997 participants at their residence. Measurement: Random blood glucose was assessed for each participant using a finger prick test. Results: The overall prevalence of diabetes was 30.1%, of which 4.1% of participants had undiagnosed diabetes. Among those with diabetes, 86.3% were aware of their diagnosis; among those aware, 86.5% were on treatment. Among those on treatment for diabetes, 54% achieved controlled blood sugar. Conclusion: The challenge in diabetes management is controlling the blood glucose levels of people who adhere to treatment. Younger employed females from lower-income quartiles have the highest risk. The study also raises questions about quality and strategies for medication compliance. The findings inspire future research on care needs, policies, and program responses to reduce the diabetes disease burden. [ABSTRACT FROM AUTHOR]

According to census 2011, India had nearly 104 millions of 60 years and above population. The share is projected to increase from 8 per cent in 2015 to 29 per cent in 2050, which is a matter of concern as rapid population ageing is accompanied by serious social and economic implications which are often linked with different health outcomes in general and lower subjective well-being (SWB) in particular. This paper aims to focus on how socio-economic inequality affects lower SWB among older adults. Bivariate, binary logistic regression and decomposition analysis were used for carving out the results using data from the Building a Knowledge Base on Population Ageing in India (BKPAI). The effective sample size for the analysis was 9181 older adults. The value of the concentration index for lower SWB was -0.28 in India, depicting that lower SWB was concentrated among older adults with poor socio-economic status. Educational status (22%), living arrangement (13%), trust over someone (13%), self-rated health (6%), instrumental activities of daily living (6%) and cognitive ability (5%) explained significant portion of socio-economic inequality for lower SWB among older adults. Our research highlights the urgent need for more empirical exposure to socio-economic inequality and its dynamic impact on lower SWB among older adults. Moreover, the present study recommends strengthening the current government programme to focus especially on older adults from lower socio-economic status. [ABSTRACT FROM AUTHOR]

Global investment in Mergers and Acquisitions (M&A) has reached unprecedented levels in recent years (Barkema and Schijven, 2008). Against this backdrop, the objective of the paper is to explore employee performance in cases of Indo-UK and Indo-USA M&A. The focus of the study is to capture the change in employee performance at individual level, of both target and acquiring companies, in two sets of samples, Indo-UK and Indo-USA M&A. As far as methodology is concerned, employee performance is measured through self-assessment of changes in determinants of performance using the Performance Diagnosis Matrix (PDM) of Holton (Swanson and Holton, 2001). The factors determining performance are: goals, systems, capacity, motivation and expertise. On the other hand, Hofstede's cultural distance index is used to calculate the cultural distance of the countries involved in M&A. The paper then compares cultural distance between India-UK and India-USA with reported changes in determinants of performance of sampled employees who have experienced this transition. The sample contains 42 respondents from three Indo-UK merged entities and 30 respondents from two Indo-US merged entities. The study diagnoses changes in determinants of performance among these two sets of responses to arrive at inferences which may have meaningful indicators for corporate policy in case of future M&A between India-UK and India-USA. [ABSTRACT FROM AUTHOR]

The association between emotional intelligence and the ability to accurately recognize and identify different facial expressions is unexplored. The current situation of the pandemic has forced many people to face intense and complex emotions that are difficult to process or manage. Emotional intelligence affects individuals' ability to perceive and identify complex emotions through nonverbal cues such as facial expressions. This paper discusses the relationship between emotional intelligence (EQ) and the recognition of emotions accurately. The participants are 200 undergraduates from universities in India. They were administered the Schutte Self Report Emotional Intelligence Test (SSEIT) (Schutte et al., 1998) online for measuring emotional intelligence. Google Form was prepared to study participants' ability to recognize emotions via images depicting facial expressions. The result shows a significant positive correlation of 0.67 between EQ and accurate recognition of emotions. The findings reiterate that reading others' facial expressions can be a precursor to emotional intelligence. [ABSTRACT FROM AUTHOR]

Introduction: Prosocial behaviour is one of the key features of the development of school-going adolescents. Therefore, the current paper focuses on the prosocial behaviour of school-going adolescents in Kollam District, Kerala. Methodology: A cross-sectional descriptive study where 600 school-going adolescents, their parents and 60 class teachers were selected through cluster sampling method. English and Malayalam version of the Strength and Difficulties Questionnaire (SDQ) was administered among respondents. Chi-square and multiple linear regression models were used for analysing the data. Results: Self-report of prosocial behaviour predictors were significantly associated with gender (P < 0.01), urban-rural settings (P < 0.001) and government-private schools (P < 0.001). Parents' report shows highly significant relationship with gender (P < 0.001) whereas teachers' report is significantly related to urban-rural settings (P < 0.01). Conclusion: The current study found that one-fifth of school-going adolescents had borderline to abnormal (self – 17.4%; parents' – 16.9%; teachers' report – 20.8%) prosocial behaviour. School-going adolescents should involve in volunteer activities and campaigns for better development in society. [ABSTRACT FROM AUTHOR]

Background: Health outcomes in India are characterized by pervasive inequities due to deeply entrenched socio-economic gradients amongst the population. Therefore, it is imperative to investigate these systematic disparities in health, however, evidence of inequities does not commensurate with its policy objectives in India. Thus, our paper aims to examine the magnitude of and trends in horizontal inequities in self-reported morbidity and untreated morbidity in India over the period of 2004 to 2017–18. Methods: The study used cross-sectional data from nationwide healthcare surveys conducted in 2004, 2014 and 2017–18 encompassing sample size of 3,85,055; 3,35,499 and 5,57,887 individuals respectively. Erreygers concentration indices were employed to discern the magnitude and trend in horizontal inequities in self-reported morbidity and untreated morbidity. Need standardized concentration indices were further used to unravel the inter-regional and intra-regional income related inequities in outcomes of interest. Additionally, regression based decomposition approach was applied to ascertain the contributions of both legitimate and illegitimate factors in the measured inequalities. Results: Estimates were indicative of profound inequities in self-reported morbidity as inequity indices were positive and significant for all study years, connoting better-off reporting more morbidity, given their needs. These inequities however, declined marginally from 2004(HI: 0.049, p< 0.01) to 2017–18(HI: 0.045, P< 0.01). Untreated morbidity exhibited pro-poor inequities with negative concentration indices. Albeit, significant reduction in horizontal inequity was found from 2004(HI= − 0.103, p< 0.01) to 2017–18(HI = − 0.048, p< 0.01) in treatment seeking over the years. The largest contribution of inequality for both outcomes stemmed from illegitimate variables in all the study years. Our findings also elucidated inter-state heterogeneities in inequities with high-income states like Andhra Pradesh, Kerala and West Bengal evincing inequities greater than all India estimates and Northeastern states divulged equity in reporting morbidity. Inequities in untreated morbidity converged for most states except in Punjab, Chhattisgarh and Himachal Pradesh where widening of inequities were observed from 2004 to 2017–18. Conclusions: Pro-rich and pro-poor inequities in reported and untreated morbidities respectively persisted from 2004 to 2017–18 despite reforms in Indian healthcare. Magnitude of these inequities declined marginally over the years. Health policy in India should strive for targeted interventions closing inequity gap. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines the relationship between timing of negotiations and idiosyncratic deals (i-deals) through the moderating effects of core self-evaluations (CSE), and between i-deals and employee reactions through the moderating effects of transformational leadership behaviour (TLB) in the Indian hospitality industry. Design/methodology/approach: A total of 275 employees working in 39 companies responded to a self-administered questionnaire. To test the research hypotheses, the methodology of structural equation models was used. Findings: The results show that the relationship between before hiring negotiations and i-deals is stronger for those individuals who had low self-worth, due to countervailing forces created by their belief that they may not be eligible for i-deals. In contrast, the relationship between after hiring negotiations and i-deals is stronger for those who had high self-worth, due to their belief that they were entitled to i-deals. Additionally, the research highlights that the relationship between i-deals and employee reactions is stronger for those organisations, which are high on TLB. Research limitations/implications: The data does not allow for investigating dynamic causal inferences, because they were collected using a questionnaire at a single point in time, and they were reported in retrospect, raising measurement concerns about recall bias. Practical implications: From a managerial point of view, the findings of this study inform that in negotiating both employment conditions and work arrangements, organisations should try to achieve i-deals that are primarily flexibility focused, and that in increasing efficiency organisations should make the employees feel well supported in order to develop more confidence in deploying skills and abilities to address a more open view of their i-deals. Originality/value: The study contributes to our understanding about the Indian hospitality industry by utilising the self-enhancement theory in examining whether individual differences moderate the relationship between the timing of negotiations and i-deals, and also by utilizing the social exchange theory to examine whether TLB moderates the relationship between i-deals and employee reactions. [ABSTRACT FROM AUTHOR]

Purpose School-based nutrition education programmes have the potential to reinforce healthy dietary behaviours in adolescents. The purpose of this paper is to understand the views of secondary school students in Kolkata, India, regarding the food and nutrition curriculum, food skill acquisition at school and home and barriers to learning food skills.Design/methodology/approach The sample of 1,026 year nine students was drawn from nine private, English-speaking secondary schools in Kolkata, India to participate in a cross-sectional, self-reported paper-based survey. Data analyses including descriptive statistics and χ2 analyses were performed.Findings The majority of the respondents (65.3 per cent) were female. Biology, Home Science and Life skills classes were the main places in which students acquired food and nutrition knowledge. Almost two-thirds of the respondents acknowledged the importance of acquiring food-related knowledge and skills. Approximately half (48.3 per cent) reported that the food and nutrition curriculum involved excessive memorisation while around the same proportion described the curriculum as interesting (47 per cent) and easy to comprehend (50.3 per cent). However, relatively few students said they enjoyed attending food and nutrition classes (38.7 per cent). Only a minority reported receiving food skills training, i.e. cooking skills (23 per cent), meal planning skills and food purchasing skills (12.3 per cent) at school. Despite some parental support received at home, time constraints (50.5 per cent) and lack of interest (26.3 per cent) were cited as prominent barriers to learning food skills.Practical implications These data underscore the need for a skills-focussed food and nutrition curriculum to improve Indian adolescents’ food-related skills, nutritional knowledge and dietary behaviours.Originality/value This is the first cross-sectional survey to investigate the delivery of nutrition education and food skills in the Indian school context. [ABSTRACT FROM AUTHOR]

This paper describes the interrelationship among men's self-reports of symptoms, unsafe sexual behavior, and biologically tested sexually transmitted infections (STIs). Data are drawn from the baseline survey of six-year (2001-2007) research and intervention project on men's sexual health and HIV/STI risk reduction conducted in three urban poor communities in Mumbai, India. The survey collected a wide range of demographic, attitudinal, knowledge, and behavioral data. In addition, men were tested for common STIs by selecting a systematic random sub-sample of 816 men (assuming 20% non-response). Data in this paper are based on 641 men who had completed the survey interview and for whom the testing of blood and urine samples was conducted. Results suggest that the self-reported STI-like symptoms and unsafe sexual behavior taken together as a predictor of confirmed STIs improve the sensitivity to a significantly greater degree (χ 2=2.83, p<0.05) as compared to the sensitivity of self-reported STI-like symptoms or unsafe sexual behavior alone as a predictor of confirmed STIs. In addition, the consistency of self-report was found to vary among socio-demographic and behaviorally defined sub-groups. These results provide preliminary support for the importance of population-based surveys, which collect all the three types of data such as reported behavior, symptoms and laboratory confirmed STIs for a full understanding of sexual risk and STIs and for identification of sub-groups within communities that vary in their ability to identify STI symptoms. [ABSTRACT FROM AUTHOR]

This paper describes overall socioeconomic gradients and the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multiple aspects of health. Cross-sectional data on 11,230 Indians aged 18 years and older from the WHO-SAGE India Wave 1, 2007 were analyzed. Multivariate logit models were estimated to examine effects of socioeconomic status (education and household wealth) and age on four health domains: self-rated health, self-reported functioning, chronic diseases, and biological health measures. Results show that socioeconomic status (SES) was negatively associated with prevalence of each health measure but with considerable heterogeneity across age groups. Results for hypertension and COPD were inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for biological markers. Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum. [ABSTRACT FROM AUTHOR]

This article focuses on the narratives of 18 adolescent boys as they engaged with issues of sex, sexuality and peer relations in their daily lives. The ethnographic research was conducted in two public secondary schools in a working-class community within KwaZulu-Natal, South Africa. Participants were boys aged between 16 and 19 years, who self-identified as either Black African or Indian. Theories of positioning are employed in this paper to delve into the complexity and intricacies of boys enacting their masculinities and sexual identities within a one-to-one interview space with one of the researchers. Identity performance in this private space is read in relation to public positions (in the company of peers), exposing the malleable nature of positioning and its subjective use in different spaces. Findings suggest that boys' struggle with the concept and social practice of 'masculinity', and that while they may not want to be seen as aspiring to certain ideals regarding male sexuality, these values remain a standard against which to evaluate self and other. In the individual interviews, authenticity as a heterosexual man is negotiated through various rhetorical strategies, namely a tendency to self-position as mature and sensible. It is argued that positionality is a useful conceptual tool for highlighting diversities in the performance of masculinities, and that intervention strategies need to pay attention to how spaces are constructed and nurtured for boys to engage with the ideological dilemmas in their identity development. [ABSTRACT FROM AUTHOR]

Purpose Nearly 200m people in the world experience considerable functioning difficulties. Also, more than three-fourth of the population aged 50 years and over is suffering from some kind of disability in India, China, Ghana, Russia, Mexico and South Africa. Despite the compelling nature of this issue, evidence on socioeconomic disparity in the occurrence of disability is lacking throughout the world and particularly in the aforementioned countries. The purpose of this paper is twofold – first, to examine the socioeconomic inequalities in the prevalence of disability in the selected countries; and second, to investigate the cross-country differentials in the prevalence of disability by socioeconomic characteristics.Design/methodology/approach The authors use data from the Study on Global Ageing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia and South Africa during 2007–2010. Disability scores have been constructed using Item Response Theory Partial Credit Model based on eight health and functioning domains. Bivariate analysis, concentration curves, concentration indices and multivariate regressions have been used in the analysis presented in this paper.Findings The authors find that the prevalence of disability varied considerably across sociodemographic groups. Moreover, this variation is not uniform across all countries. Also, age, Sex, work status, years of schooling and economic status emerged out as significant predictors of disability among the studied countries.Originality/value This is perhaps the first study which examines the socioeconomic inequality in disability conceptualized in a comprehensive manner among older adults spread across low to upper middle income countries. The alarming level of prevalence of disability among sociodemographic disadvantage groups calls for immediate attention in terms of detailed study of risk factors, effective policy and timely intervention. [ABSTRACT FROM AUTHOR]

This paper examines the relationship of empowerment to women's self-reported general health status and women's self-reported health during pregnancy in low-income communities in Mumbai. The data on which this paper is based were collected in three study communities located in a marginalised area of Mumbai. We draw on two data sources: in-depth qualitative interviews conducted with 66 married women and a survey sample of 260 married women. Our analysis shows that empowerment functions differently in relation to women's reproductive status. Non-pregnant women with higher levels of empowerment experience greater general health problems, while pregnant women with higher levels of empowerment are less likely to experience pregnancy-related health problems. We explain this non-intuitive finding and suggest that a globally defined empowerment measure for women may be less useful that one that is contextually and situationally defined. [ABSTRACT FROM AUTHOR]

Background: Self-assessment (SA) is an interactive course that endorses the accomplishment of learning objectives through learners' identification of insufficiencies in their didactic knowledge and pre-clinical skills. This study was planned to determine whether there is any improvement in the faculty assessment (FA) score following the implementation of SA in the Pre-clinical Conservative Dentistry Course. Methods: Fifty-four first-semester dental students were given an introductory lecture followed by a demonstration for Class I Cavity Preparation in typhodont mandibular first molar. At the end of the demonstration, the Scoring Rubric (SR) was explained point-wise in the prepared cavities. During the next session, all students performed Class I cavity preparation and they were given an assessment sheet to enter their scores (SA1). All teeth were evaluated by the Grading Faculties in a blinded manner (FA1). Each participant was explained the difference in their respective SA1 from FA1 and their queries were resolved individually. During the next sessions, Students and Grading Faculties followed the same protocol and scores were recorded as SA2, FA2, SA3 and FA3. Results: The mean score of SA1 was significantly higher than that of FA1 (p < 0.001). However, no significant difference was obtained between SA and FA in the second (p = 0.352) and third (p = 0.434) assessments. In contrast with first assessment, mean marks obtained in FA were higher compared to SA in both second and third assessments. There was a statistically significant improvement in mean marks obtained by the students over time (p < 0.001). Conclusion: SA endorsed student-faculty communication and enhanced student's poise and technical skills in operative pre-clinical dentistry. [ABSTRACT FROM AUTHOR]

Background: User satisfaction in healthcare is an important measure of the quality of services provided to the patient and their carers. Since treatment of psychiatric patients requires long follow-up periods, and this long follow-up treatment patients depends on their initial experience with health service,therefor user satisfaction is of increasing importance in the mental health field. Aims and Objectives: Assess the user satisfaction and perceptions of the attitude of emergency health- care professionals (including paramedical staff and physicians of respective specialties) toward psychiatric and nonpsychiatric patients as experienced by the patients and carers. To compare the user satisfaction and perceived attitude of emergency staff in patients with psychiatric illness and nonpsychiatric illness. To determine the service users' decision to revisit the same health-care facility in case of the same problem. Materials and Methods: This study was done in the hospital wing of a tertiary care teaching university hospital in northern India, and ethics approval was obtained from the institutional ethics committee patients' sociodemographic details and psychiatric and other relevant medical history after obtaining informed consent. The psychiatric diagnosis was made according to the ICD-10. A self-report questionnaire, comprising 9 questions, and was designed to assess the perceived attitudes of health-care workers toward the patient of psychiatric illness. The questionnaire was designed in Hindi. Descriptive statistics for categorical variables were done. Inferential statistics were calculated using the Chi-square test. Results: Out of a total of 95 respondents, 69 patients were diagnosed with a psychiatric disorder and the remaining 26 patients had medical illness or other non-psychiatric disorders. Females were a majority in both groups. Our study majorly showed that service users perceived the attitudes of medical and paramedical staff in emergency units mostly as satisfactory or extremely satisfactory, as well as the majority of service users reported that they were satisfied with the reaction of emergency paramedical staff towards the emotional well-being of the patient. Conclusions: The major strengths of this study were the quantitative analysis of health workers' attitudes toward patients with psychiatric illnesses, which showed user-rated satisfactory attitudes. There was less stigma and more of a positive impact noted. The semi-structured questionnaire was designed in the local language and tailored to cover topics such as emotional well-being and psychoeducation that can all affect the user experience. [ABSTRACT FROM AUTHOR]

Evidence on the association between widowhood and health is widely available in the literature. However, there is a dearth of analysis on the mechanism through which widowhood affects the health status of an individual, particularly in old age, specifically whether widowhood among the elderly affects their health through their economic conditions. This paper purports to establish both the direct and indirect effects of widowhood on self-reported health status among aged Indians. We examine the mediating effect of economic factors such as income, labor force participation, extent of economic independence and other economic factors in the relationship between widowhood and health status. Structural Equation Modeling (SEM) is employed to test specific hypotheses. We use unit level 60th round data for the year 2004 surveyed by the National Sample Survey Organization (NSSO). The results confirm that poor economic conditions have a mediating effect on the relationship between widowhood and health and, therefore, any policy to reduce the effect of widowhood on health must be based on economic factors. [ABSTRACT FROM PUBLISHER]

Purpose Changing demographic trends in India have resulted in a growing ageing population, and this poses many health challenges for older people. Lack of formal care institutions and social security nets further aggravate the situation. Living arrangements are, thus, expected to play a significant role in determining the healthcare needs of older people. The purpose of this paper is to examine the association of living arrangements with health among older people in India.Design/methodology/approach Data for the study were drawn from the Building Knowledge Base on Population Ageing in India (2011). The health status of older people was measured by assessing chronic illness, self-rated health and limitations in activities of daily living. Logistic regression was used to examine the influence of living arrangements on health outcomes. Further, a structural equation model was employed to observe whether poor health preceded co-residence.Findings Older people living in co-residential arrangements report more health disadvantages and older people with poor health prefer co-residence with their offspring. Perhaps the support, care and health awareness in co-residential arrangements helps older people obtain the healthcare interventions they require for the various illnesses they have had, and enable them to improve their ongoing health status.Originality/value The present study has extended the research on the relationship between health and living arrangements, and has also addressed the case of older people with poor health who prefer to stay in co-residential arrangements which has been taken up by limited studies. [ABSTRACT FROM AUTHOR]

In this paper, we examine patterns of self-reported diagnosis of noncommunicable diseases (NCDs) and prevalences of algorithm/measured test-based, undiagnosed, and untreated NCDs in China, Ghana, India, Mexico, Russia, and South Africa. Nationally representative samples of older adults aged ≥50 years were analyzed from wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (2007-2010; n = 34,149). Analyses focused on 6 conditions: angina, arthritis, asthma, chronic lung disease, depression, and hypertension. Outcomes for these NCDs were: 1) self-reported disease, 2) algorithm/measured test-based disease, 3) undiagnosed disease, and 4) untreated disease. Algorithm/measured test-based prevalence of NCDs was much higher than self-reported prevalence in all 6 countries, indicating underestimation of NCD prevalence in low- and middle-income countries. Undiagnosed prevalence of NCDs was highest for hypertension, ranging from 19.7% (95% confidence interval (CI): 18.1, 21.3) in India to 49.6% (95% CI: 46.2, 53.0) in South Africa. The proportion untreated among all diseases was highest for depression, ranging from 69.5% (95% CI: 57.1, 81.9) in South Africa to 93.2% (95% CI: 90.1, 95.7) in India. Higher levels of education and wealth significantly reduced the odds of an undiagnosed condition and untreated morbidity. A high prevalence of undiagnosed NCDs and an even higher proportion of untreated NCDs highlights the inadequacies in diagnosis and management of NCDs in local health-care systems. [ABSTRACT FROM AUTHOR]

Background: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India.Methods: Using national standardised data collected from adults aged 50 years and above with DM (self-reported) in China (N = 773) and India (N = 463), multivariable logistic regression describes: 1) association between respondents' socio-demographic and health behavioural characteristics and the dependent variable, DM medication use, and 2) association between DM medication use (independent variable) and household catastrophic expenditure on medications (dependent variable) (China: N = 630; India: N = 439). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010).Results: Prevalence of DM medication use was 87% in China and 71% in India. Multivariable analysis indicates that people reporting lifestyle modification were more likely to use DM medications in China (OR = 6.22) and India (OR = 8.45). Women were more likely to use DM medications in China (OR = 1.56). Respondents in poorer wealth quintiles in China were more likely to use DM medications whereas the reverse was true in India. Almost 17% of people with DM in China experienced catastrophic healthcare expenditure on medications compared with 7% in India. Diabetes medication use was not a statistically significant predictor of catastrophic healthcare expenditure on medications in either country, although the odds were 33% higher among DM medications users in China (OR = 1.33).Conclusions: The country comparison reflects major public policy differences underpinned by divergent political and ideological frameworks. The DM epidemic poses huge public health challenges for China and India. Ensuring equitable and affordable access to medications for DM is fundamental for healthy ageing cohorts, and is consistent with the global agenda for universal healthcare coverage. [ABSTRACT FROM AUTHOR]

Public health projects carried out by non-government organisations (NGOs) are considered a critical contributor in the provision of health services to rural population in India. But there is clear lack of documented evidence that describes the capacity and competency of the NGO project managers to successfully design and implement a new project. This article presents findings of an exploratory case study using outreach model of family planning service delivery as an example to understand the steps and actions taken by senior managers throughout the project's life cycle and competencies required by them to execute the project. Focus group discussion followed by paper-based survey using sections of Management Competency Assessment Tool was conducted with senior managers of the chosen NGO. The results indicate that the strategies developed by the NGO managers are consistent with the existing literature on project management. However, not all managers have the same level of confidence in demonstrating the competencies of (a) knowledge of healthcare environment; (b) evidence informed decision making; and (c) interpersonal, communication qualities and relationship management. The organisation needs to invest in human resource development using mixed approach of providing training, team building activities, mentoring, and support. [ABSTRACT FROM AUTHOR]

Background: The current global outbreak caused by COVID-19 has produced a unique situation with severe health and financial consequences. The fast and quick global impact called for an immediate response. A key public health action was the decision to amend the law to allow employees to work from home (WFH) whenever it was possible. In response to public health restrictions to stop the spread of COVID-19, organizations quickly switched to WFH without fully comprehending the effects of continued WFH on mental and physical health. Working from anywhere and at any time has made the separation between business and personal life more difficult. These modifications may cause employees' workdays to be longer and to experience greater work-life conflict. Overwork and work addiction provide a greater risk to the public's health and can harm various facets of mental and physical health, such as depression, anxiety, and sleep difficulties. There hasn't been much research on the underlying processes that link workaholism to poor mental health, especially among Indian academics. Purpose: There is a rise in the number of people who are worried about their mental health in academic settings. The primary purpose of this study is to determine whether academicians in India can potentially have a healthy work-family balance, which may mitigate the negative impacts of workaholism and poor mental health especially due to the Work from Home system. Methodology: A population-based study was conducted on academicians (n = 456) at private and public universities in Delhi NCR, India. Workaholism, work-family balance, and mental health difficulties were all measured using self-reported scales in the study. By using path analysis, the proposed mediation model was evaluated. The survey responses had an accuracy rate of 80%. Based on the conceptual research framework, PLS-SEM path modeling is used to find the causal connection between the indicators and latent components. Findings: The findings indicated that workaholism has been associated with mental health in two different ways: directly and through work-family balance. The path analysis found a statistically significant relationship between work from home and mental health through workaholism and work-family balance. Increased levels of anxiety, depression, stress, headaches, exhaustion, and reduced job satisfaction were some of the mental health consequences of Work from Home. Practical implication: This study provides real-world guidance to human resource managers on how to prioritize composite-level interventions at all levels of the university to create highly satisfied employees, provide a good working environment, and improve employees' mental health. Originality/value: Many researches have been done on the relationship between work-from-home and employee mental health, but relatively few have looked at how work-life balance and workaholism play a role in how work-from-home affects employees' mental health. This study fills a need in the academic and practitioner literature by investigating the relationship between work-from-home from home and employee mental health as well as the mediating function of work-family balance and workaholism with regard to Indian higher education institutions. [ABSTRACT FROM AUTHOR]

Introduction: The Self-Directed Learning (SDL) approach is an important component of the Competency-Based Medical Education (CBME) curriculum. However, learning independently can be challenging, even for the brightest and most motivated students. Moreover, self-evaluation is quite difficult. If SDL is used in combination with formative assessment and constructive feedback for individual topics, it would facilitate self-modulation by learners and guide them towards higher academic achievement. Aim: To compare the academic performance of first-year medical students in Anatomy Practical class using SDL with formative assessment and feedback versus conventional teaching methods. Materials and Methods: A comparative evaluation was conducted using a longitudinal study design in the Department of Anatomy, Medical College Kolkata, West Bengal, India, from November 2022 to June 2023. During Anatomy Practical classes, 250 first-year medical students, (Batch 2022-2023), were divided into two equal groups using simple random sampling through a lottery method. One group (study group) was taught by implementing SDL followed by formative assessment with immediate feedback, and the other group was taught by the traditional method (control group). Following the completion of each of the first three consecutive regions (superior extremities, inferior extremities, and thorax) during Anatomy Practical classes, summative assessments were conducted. The collected data were calculated in an Excel sheet and computed using JAMOVI software (free version). Independent t-test statistics for the three summative assessments were evaluated, and the p-value of each assessment was determined. A p-value <0.05 was considered to be statistically significant. Additionally, students' feedback was documented and analysed. Results: It was observed that there was an improvement in academic scores in both groups. However, higher academic performance was progressively attained in the group which was provided SDL sessions and formative assessment with immediate feedback. A total of 55 (80%) students passed the third summative assessment in comparison to 40 (59.7%) students of the control group who passed the same exam. Differences between the means of the control and study group were found to be statistically significant (p-value≤0.001 and 0.023 in two summative assessments). Conclusion: The present study revealed that SDL with formative assessment followed by immediate feedback during Anatomy Practical classes had a remarkable positive impact on students' academic performance compared to those students taught using conventional teaching methods and might be implemented in the future for better learning and improved academic achievement of students. [ABSTRACT FROM AUTHOR]

Background: Adolescents are at risk of various psychosocial problems, due to pressure from parents, educational agencies, peers, and society. Often, it is not recognized and goes unnoticed. There is an immense need to screen this group for early detection and proper management. Aim: The aim of this study was to assess the prevalence of psychosocial problems among adolescents and to determine their risk factors. Methodology: The study employed a nonexperimental, exploratory, cross-sectional research design with a quantitative approach. Using a two-stage random sampling technique, a total of 2030 adolescents from 37 schools were chosen. The data collection tool for study participants consisted of three parts: (a) A sociodemographic proforma, (b) a pediatric symptom checklist-youth report, and (c) a checklist for assessing determinants of psychosocial problems. Results: Three hundred five (15.02%) of the 2030 respondents had significant impairment to internalizing problems, 350 (17.24%) to attention deficit problems, and 378 (18.62%) to externalizing problems. Pediatric symptom checklist scores and academic performance showed a moderately positive correlation. There is a significant association between psychosocial problems and adolescent characteristics at a P = 0.05 level of significance. Conclusion: Adolescents have a high prevalence of psychosocial problems such as anxiety and attention deficit. Periodic screening, counseling, and referral to psychotherapy can help to lessen the severity of the condition and improve psychosocial well-being. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to assess the prevalence and socio-economic determinants of common mental disorders among youth in India. Design/methodology/approach - The study utilizes data from "Youth in India: Situation and Needs 2006-2007". One-way analysis of variance is used to compare different groups. Poisson regression models are used to test the relationship of household, parental, and individual factors with mental health problems. Findings - An estimated 11-31 million youth suffer from reported mental health problems in India. Results suggest that the household and individual factors like place of residence, wealth quintile, age, education, and occupation are the most important determinants of mental health problems among Indian youth. Parental factors lose their statistical significance once individual factors are controlled. Research limitations/implications - Little is known about correlates of mental health among youth. Strengthening on-going programmes and creating awareness about mental health issues through various programmes may help improve scenario. The two limitations of the study are: first, data covering all the states would have given a broader and clear picture of the issue; and second, due to cross-sectional nature of the data the study is not able to look into the cause-effect relationship. Originality/value - There are few studies which have explored mental health problems covering smaller areas in India. This is the first and the largest study conducted on a representative population of Indian youth to determine the correlates of reported mental health problems using General Health Questionnaire-12. [ABSTRACT FROM AUTHOR]

Background: Although some 300 million Indian children travel to school every day, little is known about how they get there. This information is important for transport planners and public health authorities. This paper presents the development of a self-administered questionnaire and examines its reliability and validity in estimating distance and mode of travel to school in a low resource urban setting.Methods: We developed a questionnaire on children's travel to school. We assessed test re-test reliability by repeating the questionnaire one week later (n = 61). The questionnaire was improved and re-tested (n = 68). We examined the convergent validity of distance estimates by comparing estimates based on the nearest landmark to children's homes with a 'gold standard' based on one-to-one interviews with children using detailed maps (n = 50).Results: Most questions showed fair to almost perfect agreement. Questions on usual mode of travel (κ 0.73- 0.84) and road injury (κ 0.61- 0.72) were found to be more reliable than those on parental permissions (κ 0.18- 0.30), perception of safety (κ 0.00- 0.54), and physical activity (κ -0.01- 0.07). The distance estimated by the nearest landmark method was not significantly different than the in-depth method for walking , 52 m [95 % CI -32 m to 135 m], 10 % of the mean difference, and for walking and cycling combined, 65 m [95 % CI -30 m to 159 m], 11 % of the mean difference. For children who used motorized transport (excluding private school bus), the nearest landmark method under-estimated distance by an average of 325 metres [95 % CI -664 m to 1314 m], 15 % of the mean difference.Conclusions: A self-administered questionnaire was found to provide reliable information on the usual mode of travel to school, and road injury, in a small sample of children in Hyderabad, India. The 'nearest landmark' method can be applied in similar low-resource settings, for a reasonably accurate estimate of the distance from a child's home to school. [ABSTRACT FROM AUTHOR]

Background: There are 600 million girls in low and middle income countries (LMICs), many of whom are at great risk for poor health and education. There is thus great need for programs that can effectively improve wellbeing for these girls. Although many interventions have been developed to address these issues, most focus on health and education without integrating attention to social and emotional factors. This omission is unfortunate, as nascent evidence indicates that these factors are closely related to health and education. This paper describes the methods of a 4-arm randomized controlled trial among 3,560 adolescent girls in rural Bihar, India that tested whether adding an intervention targeting social-emotional issues (based on a "resilience framework") to an adolescent health intervention would improve emotional, social, physical, and educational wellbeing to a greater extent than its components and a control group. Study arms were: (1) Girls First, a combination of the Girls First Resilience Curriculum (RC) and the Girls First Health Curriculum (HC); (2) Girls First Resilience Curriculum (RC) alone; (3) Girls First Health Curriculum (HC) alone; and (4) a school-as-usual control group (SC).Methods: Seventy-six schools were randomized (19 per condition) and 74 local women with a tenth grade education were trained and monitored to facilitate the program. Quantitative data were collected from 3,560 girls over 4 assessment points with very low rates of participant attrition. Qualitative assessments were conducted with a subset of 99 girls and 27 facilitators.Results and Conclusions: In this article, we discuss guiding principles that facilitated trial implementation, including integrating diverse local and non-local sources of knowledge, focusing on flexibility of planning and implementation, prioritizing systematic measurement selection, and striking a balance between scientific rigor and real-world feasibility.Trial Registration: Clinicaltrials.gov NCT02429661 . Registered 24 April 2015. [ABSTRACT FROM AUTHOR]

India's traditional kinship behavior have undergone certain fundamental changes due to recent development and functioning of Indian society. Of all, the most dominant change is in the form of co-residence of children with their parents in old age. Without familial support, falling or no income and poor health, today, older adults are the most vulnerable population sub-group in the total population. Therefore, by using the India Human Development Survey-II, 2011-12 data we study the relevant association of living arrangement on health status of the older adults. Our results indicate that older adults living alone have significant and strong association with adverse health conditions such as Cataract, Hypertension, and Heart Disease. On the backdrop of health variations of older adults, it is understood that among other socio-economic conditions, living arrangement have serious implications on the health status of the older adults. Thus, we strongly support the notion that older adults with proper family care and support are more likely to be in a better health position as compared to those deprived of it. [ABSTRACT FROM AUTHOR]

Intervention programs aimed at preventing tobacco use among youth have been shown to be effective in curbing tobacco use onset and progression. However, the effects of even very successful tobacco prevention programs may not always impress policy-makers and lay audiences. Economic analysis potentially strengthens the case. In this paper, we evaluate the cost-effectiveness of a youth tobacco use prevention program which has been translated and implemented in India, a developing country. Although programs like these are inexpensive to implement in the USA, they are even less expensive in India due to low labor costs. Our results show that the costs per quality-adjusted life-year added, due to averted smoking, was $2057, even without including averted medical costs. If we ignore student time, cost-effectiveness improves by roughly 10%. To put the cost-effectiveness of this smoking prevention program into context, it is over 24 times more cost-effective than dialysis in the USA, which costs $50 000 for a life-year. [ABSTRACT FROM PUBLISHER]

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Background: Evidence of hysterectomy in India is limited mainly due to lack of information in large-scale nationally representative health surveys. In 2015–16, the fourth National Family Health Survey (NFHS-4) – a cross-sectional survey – collected for the first time direct information on hysterectomy and self-reported reasons for undergoing the procedure among women in the reproductive age group. This paper examines the prevalence and determinants of hysterectomy in India among women aged 30–49 years in 29 states and seven union territories (UTs) of India using the NFHS-4 dataset. Methods: Percentage weighted by sampling weights was used for estimating the prevalence of hysterectomy. The paper used crosstabulations and percentage distributions to estimate the prevalence of hysterectomy across different socioeconomic backgrounds and reasons for undergoing hysterectomy respectively. A multivariate binary logistic regression model was also used to find statistically significant determinants of hysterectomy. Results: In India as a whole, 6 % of women aged 30–49 years had undergone a hysterectomy. The percentage of women who had undergone the procedure was found to vary considerably across the states and the UTs (from a minimum of 2% in Lakshadweep to a maximum of 16% in Andhra Pradesh). A noticeable fact that emerged was that the majority of the hysterectomies were performed in the private sector except in the northeast region. Years of schooling, caste, religion, geographic region, place of residence, wealth quintiles, age, parity, age at first cohabitation, marital status, and body mass index of women were found to be the sociodemographic determinants statistically associated with hysterectomy in India. The reasons reported frequently for hysterectomy were excessive menstrual bleeding/pain (56%), followed by fibroids/cysts (20%). Conclusion: The percentage and likelihood of undergoing hysterectomy are relatively high among women from older age groups (45–49), those who reside in rural areas, those without schooling, those who are obese, those having high parity, those with a low age at first marriage, and those who reside in the eastern and southern parts of India. The policy implication of these findings is that the reproductive health program managers should ensure regular screening and timely treatment of the problems resulting in hysterectomy. [ABSTRACT FROM AUTHOR]

The article presents a research paper which examines reliability and validity of Indian Migration Study Physical Activity Questionnaire (IMS-PAQ) in urban and rural groups in India. Study is based on examination of a sub-sample of IMS participants. Findings reveal that IMS-PAQ reliability and validity are similar to comparable self-reported instruments and is appropriate tool for ranking PA of individuals in India but requires refinements for sedentary population and women in India.

Background: Musculoskeletal (MS) pain is responsible for poor quality of life and decreased productivity. Objective information about the burden of musculoskeletal disorders among the general community in India is scanty, and the few reports that exist are based on a small sample size. Materials and Methods: This paper examines the issue of MS pain and its associated risk factors in a cross-sectional study of 2086 subjects from National Capital Region (NCR). Results: Overall prevalence of MS pain was found to be 25.9%. Pain was found to be more frequent among females (31.3%) as compared with males (20.9%). Significant association of pain in joints/limbs/knee/lower legs with obesity (OR = 2.1, P < 0.001) and high body fat (OR = 2.2, P < 0.001) was established. More than 50% of the subjects complained of backache. Conclusions: Our findings confirm that MS pain is a significant burden of disease among the residents of NCR. Women and subjects doing heavy work load, like agriculture and dairy farming, constitute the chief demographic groups. It is high time that a policy is framed to reduce this load of sickness. [ABSTRACT FROM AUTHOR]

Introduction: Burnout, which occurs as a prolonged response to chronic interpersonal pressures on the job, is becoming more common in human service professions such as teaching. All of these human service jobs have one thing in common: continuous interpersonal contact. This direct contact with people leads to the performance of emotional labor, which is defined as the regulation of feelings in the workplace in order to conform to organizational regulations, which contributes to employee burnout. Perceived organizational support, according to Job Demands and Resources Theory, can be a protective factor for employees by acting as a job resource that buffers the negative effects of numerous job demands, such as emotional labor, and minimizes burnout. Objective: To study emotional labor, burnout, and the mediating role of perceived organizational support among teachers. Method: The descriptive, correlational, cross-sectional study was conducted among 101 school teachers, from Mangaluru between the age groups of 25-45 years, including both men and women. The study was done using a questionnaire approach and the scales used were the Emotional Labor Scale, Oldenburg Burnout Inventory, and Survey of Perceived Organizational Support. Results: The result of the study suggests that there is a significant negative relationship between deep acting and burnout among teachers (r = 0.202; p-value = 0.043) and between surface acting and burnout (r = -0.211; p-value = 0.034). Perceived organizational support is partially mediated between surface acting and burnout as well as deep acting and burnout among teachers. No significant differences in the usage of surface acting or deep acting emerged with respect to work experience and gender. Conclusion: This study sought to bring awareness to emotional labor as an integral part of teaching and how it can contribute to burnout. It aids in understanding the antecedents of burnout and how school management can mobilize organizational resources to improve employees’ perceptions of organizational support, which will help in dampening the negative impact of burnout. [ABSTRACT FROM AUTHOR]

Introduction: There is a dearth of data on common multimorbidity clusters and the healthcare costs for individuals with mental health disorders. This study aimed to identify clinically meaningful physical-mental multimorbidity clusters, frequently occurring clusters of conditions, and healthcare utilization patterns and expenditure among patients attending a psychiatric outpatient clinic. Materials and Methods: Data were collected in the psychiatric outpatient department among patients aged 18 years and above in February-July 2019 (n = 500); follow-up data on non-communicable disease incidence were collected after 18 months. For analysis, morbidity clusters were defined using two approaches: 1) agglomerative hierarchical clustering method to identify clusters of diseases; and 2) non-hierarchical cluster k mean analysis to identify clusters of patients. Self-reported healthcare costs in these clusters were also calculated. Result: Two disease clusters were identified: using the 1st approach were; 1) hypertension, diabetes, and mood disorder; 2) Neurotic, stress-related, and somatoform disorders, and acid peptic disease. Three clusters of patients identified using the 2nd approach were identified: 1) those with mood disorders and cardiometabolic, musculoskeletal, and thyroid diseases; 2) those with neurotic, substance use, and organic mental disorders, cancer, and epilepsy; and 3) those with Schizophrenia. Patients in Cluster 1 were taking more than six medicines and had more hospital visits. Within 18 months, 41 participants developed either one or two chronic conditions, most commonly diabetes, hypertension, or thyroid disease. Conclusion: Cardiometabolic diseases are most commonly clustered with mood disorders. There is a need for blood pressure and sugar measurement in psychiatric clinics and mood disorder screening in cardiac, endocrinology, and primary care clinics. [ABSTRACT FROM AUTHOR]

Stroke is a major public health problem all over the globe, especially in low and middle-income countries like India. In the urban areas of India, the disease has grown to epidemic proportions. The underprivileged residents in urban slum areas have poor health literacy, usually resulting in poor health-seeking behaviours. Hence, efforts towards stroke prevention and risk factor control are critical in urban slum areas. The objective of the study was to assess the awareness about stroke among adults residing in the urban slum area of Bangalore, India. A cross-sectional survey was conducted using a mixedmethods approach, where data were collected from 490 adults using selfreported questionnaires. Over half of the participants (52%) did not know that the brain is the primary organ affected by stroke. Hypertension (44.9%) and diabetes mellitus (23.6%) were the most cited risk factors by participants. In binary logistic regression analysis, higher education was a predictor of stroke awareness (OR 0.65, p=0.02). Several misconceptions about stroke risk factors were identified among the participants. Poor awareness about stroke and its risk factors among the underprivileged urban population is demonstrated in this study. The study highlights the need to develop and implement strategies and programmes to improve awareness about stroke for the whole community. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to examine the relationship of pain with suicidal ideation and suicide attempts with depressive symptoms among adults aged ≥50 years from six low‐ and middle‐income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa). Methods: Cross‐sectional, community‐based, nationally representative data from the WHO Study on global AGEing and adult health were analyzed. Self‐reported information on past 12‐month suicidal ideation and suicide attempts among people with depressive symptoms was collected. Pain was assessed with the question "Overall in the last 30 days, how much of bodily aches or pain did you have?" With answer options: "none", "mild", "moderate", "severe/extreme". Multivariable logistic regression was done to assess associations. Results: Data on 34,129 adults aged ≥50 years (mean [SD] age 62.4 [16.0] years; males 47.9%) were analyzed. Compared to no pain, mild, moderate, and severe/extreme pain were associated with 2.83 (95% CI = 1.51–5.28), 4.01 (95% CI = 2.38–6.76), and 12.26 (95% CI = 6.44–23.36) times higher odds for suicidal ideation. For suicide attempt, only severe/extreme pain was associated with significantly increased odds (OR = 4.68; 95% CI = 1.67–13.08). Conclusions: In this large sample of older adults from multiple LMICs, pain was strongly associated with suicidal thoughts and suicide attempts with depressive symptoms. Future studies should assess whether addressing pain among older people in LMICs may lead to reduction in suicidal thoughts and behaviors. Key points: Thirty‐four thousand one hundred twenty‐nine adults aged ≥50 years (mean [SD] age 62.4 [16.0] years; males 47.9%).Pain was strongly associated with suicidal thoughts.Pain was strongly associated with suicide attempts.Future studies should assess whether addressing pain may reduce suicide. [ABSTRACT FROM AUTHOR]

Background Frontline doctors managing the current novel coronavirus 2019 (COVID-19) pandemic work under stressful conditions due to change in workload, working pattern, and worries about the infection to themselves and families with frequently changing treatment protocols. Their psychological well-being is necessary for the effective management of the health crisis. Objectives This study aims to assess the psychological state and worries of frontline doctors while dealing with the COVID-19 pandemic, the various coping skills employed by them for maintaining their mental health, and the knowledge about illness and related myths and misinformation among them. A further objective is to compare the above between two groups of frontline doctors: the consultants and the junior residents (JR) working in the hospital. Materials and Methods A total of 164 participants (76 consultants and 88 JRs) were cross-sectionally evaluated online using a prevalidated questionnaire within a period of 3 months after obtaining institutional ethics approval Statistical Analysis The study sample and results were described using descriptive analysis. The association between the categorical variables was measured using chi-squared test. Results Most participants frequently updated themselves through reliable sources (consultants = 92%, JR = 73.9%) predominantly from the hospital task force and university. Overall, 71% of consultants and 58% of JRs were worried about being infected. JRs were significantly more worried about the spread of infection due to faulty sterilization of the protective equipment as compared to the consultants (p = 0.031). Most participants were worried about their families getting infected (consultants = 79%, JR =89.8%). Both consultants (18.4%) and JRs (35.2%) had sleep disturbances. Although most did not have syndromal depressive features and COVID-19-related anxiety, tiredness (45.1%) and worrying too much (47.5%) were the most common psychological symptoms. Almost all participants (consultants = 76.3%, JR = 80.7%) used multiple coping styles, such as avoiding thinking about COVID-19, listening to music, and physical activities. Conclusion Frontline doctors overall reported higher worries regarding their family being infected and protective equipment-related issues, whereas they had less core depressive and anxiety symptoms. They had adequate COVID-19-related awareness and used multiple coping skills. [ABSTRACT FROM AUTHOR]

Objective This systematic review aimed to evaluate the scientific evidence on the efficacy of desensitizing mouthwashes for the treatment of dentin hypersensitivity ( DH) and root sensitivity ( RS). Material and methods A thorough search in MEDLINE, PubMed and Cochrane Plus Library was conducted up to February 2015. Randomized clinical trials, parallel, double-blinded and placebo-controlled, with a follow-up of at least 6 weeks, reporting changes on response to tactile stimuli, thermal/evaporative stimuli or patients' subjective assessment of the pain experienced during their daily life after the home use of desensitizing mouthwashes were considered for inclusion. Results The screening of titles and abstracts resulted in seven publications meeting the eligibility criteria. The desensitizing agents evaluated were potassium nitrate ( n = 5), aluminium lactate ( n = 1) and sodium fluoride ( n = 1). A meta-analysis for each of the hypersensitivity stimuli was performed. Results demonstrated statistically significant reduction in sensitivity scores favouring test group when DH was assessed by means of patients' self-reported pain experience ( SMD at 8 weeks = 0.77; 95% CI [0.23; 1.31]; P = 0.005). No significant effects were detected in response to tactile or thermal/evaporative stimuli. Meta-regression analysis demonstrated a tendency towards an increased effect favouring test group for the patients' subjective perception, whereas tactile and thermal/evaporative stimuli showed a slight tendency towards a reduction in the efficacy of the test mouthwash. Conclusions There exists a tendency towards a decrease in DH or RS scores with time in both treatment groups, with significant differences in favour of test group when sensitivity is evaluated in terms of patients' self-reported sensitivity symptoms. [ABSTRACT FROM AUTHOR]

This study examines the relationship between abusive supervision and fear based silence and turnover intentions and how emotional intelligence (EI) dimensions mediate this relationship. Using "relationship theory" in high power distance work context of India, the authors predicted that abusive supervision is positively related to EI and also positively related to fear based silence and turnover intention. Data were collected from 347 employees from Indian manufacturing and retail industry in two stages. Results have supported the mediating impact of others' emotional appraisal on the relationship of abusive supervision and fear based silence. However other EI dimensions (self emotional appraisal, regulation of emotions and use of emotions) did not produce a significant mediating effect. Furthermore, abusive supervision had a negative relationship with self emotional appraisal and a positive relationship with others' emotional appraisal. The implications are discussed for understanding the relevance of others' emotional appraisal in diminishing the fear based silence among the employees. The study advances the use of relationship theory and its practices in Indian work context. [ABSTRACT FROM AUTHOR]

Background: Cement dust is a significant source of occupational exposure affecting lung function and respiratory health. A higher burden of respiratory morbidity is known among factory workers involved in cement production. Globally or from India, there are no estimates of this burden from informal workers exposed to cement dust. Objective: To assess difference in lung function and respiratory symptoms among informal workers exposed to cement and those unexposed, using a comparative community based cross-sectional study from purposively selected areas in Delhi, India. Methods: Using a portable spirometer we measured lung function and collected respiratory symptoms from conveniently sampled informal workers (n = 100) exposed to cement dust, 50 indoor informal workers (tailors), and 50 outdoor (vegetable) vendors. Regression analyses were performed to compare respiratory symptom score and lung function parameters, adjusted for age, body mass index, smoking, socioeconomic status, and years of occupational exposure. Findings: Exposed workers had significantly lower lung function (PEF = –750 ml/s and –810 ml/s and FEV1/FVC (%) = –3.87 and –2.11) compared to indoor and outdoor groups, with three times higher chronic respiratory symptoms when compared to the unexposed groups. The cement dust exposure was observed to be associated with PEF (mean difference (MD) = –0.75L, 95%CI = –1.36 to –0.15, p = 0.01), %FEV1/FVC (MD = –3.87, 95%CI = –6.77 to –0.96, p = 0.03) and respiratory symptoms (p < 0.001). Conclusion: This study generates evidence regarding the respiratory burden of occupational exposure among vulnerable informal workers. There is an urgent need for policy reforms to safeguard health from occupational exposures, especially among informal workers. [ABSTRACT FROM AUTHOR]

Background and Aim: A questionnaire-based study was conducted to assess the knowledge, understanding, and perception of dental undergraduate students toward child abuse and neglect in an Indian setup. Materials and Methods: The data were collected through a 38-item questionnaire to investigate the self-reported knowledge, understanding, and perception in relation to child abuse among 3rd, final-year, and interns among private and government dental colleges in India. There were 1277 responses to the questionnaire. Results: The responses were obtained from all regions of India, including both government and private dental institutes. 10% each of all government and private institutes in India participated in this survey. It was observed that the level of knowledge and awareness of BDS students increased from BDS 3rd year through the final year and internship. The amount of awareness regarding child abuse is better among the interns. Although 50.9% of the respondents were aware of nongovernmental organizations working actively for victims of child abuse and neglect in India. Conclusion: There is a restricted level of knowledge and awareness regarding child abuse and neglect among BDS students, wherein BDS interns were comparatively familiar with the facts. Although the majority of dental students were aware of organizations working for child abuse victims but were still confined to approaching legally and ethically. [ABSTRACT FROM AUTHOR]

Purpose: Thyroid disorders are a major public health burden. Generally, women exhibit higher differentials in the prevalence of these disorders. This study focuses on the socio-economic and behavioural correlates of thyroid disorders along with their spatial clustering among women of reproductive age in India. Methods: The study uses dataset from the fourth National Family Health Survey (NFHS-4) carried out in 2015–16 to assess self-reported thyroid disorders. Poor–rich ratio (PRR) and concentration index (CI) were used to study the variation in thyroid disorder among women arising out of economic inequality. Moran's I statistics and bivariate local spatial autocorrelation (BiLISA) maps were used to understand spatial dependence and clustering of thyroid disorder. Spatial lag and error models were applied to examine the correlates of the disorder. Results: Thyroid disorder prevalence was higher among women from socio-economically better-off households. Adjusted effects showed that users of iodized salt were 1.14 times more likely to suffer from a thyroid disorder as compared to non-users, which is contrary to the general belief that a higher percentage of consumption of iodide salt leads to a lower prevalence of thyroid disorder. A higher autoregressive coefficient (0.71) indicated significantly higher spatial clustering in thyroid disorders. Conclusions: The prevalence of thyroid disorder in India depends appreciably on spatial and various ecological factors. Sedentary lifestyles among women may be aggravating diseases, which has strong linkage with thyroid disorders. It is strongly recommended to effectively integrate universal salt iodization with activities geared towards the elimination of iodine deficiency disorders. [ABSTRACT FROM AUTHOR]

This paper studies systematic reporting heterogeneity in self-assessed health in India using World Health Survey (WHS)-SAGE survey that has subjective assessments on own health and hypothetical vignettes as well as objective measures like measured anthropometrics and performance tests on a range of health domains. The study implicitly tests and validates the assumption of response consistency in a developing country setting, thus lending support to the use of vignettes. Additionally, we are able to control for unobservable heterogeneities of reporting behavior at the individual level by employing individual fixed-effects estimation using multiple ratings on a set of vignettes by the same person. The study confirms identical pattern of systematic bias by the socioeconomic subgroups as is indicated by vignette technique. It further highlights that substantial amount of reporting heterogeneity remains unexplained after controlling for the usual socioeconomic control variables. The finding has potentially broader implications for research based on self-reported data in a developing country. JEL Classification: C83, D91, I12, I18, I15, I32, J10 [ABSTRACT FROM AUTHOR]

The present study was conducted to determine the extent of exposure to and use of mobile devices by children (aged 0–60 months) with a diagnosed neurodevelopmental disability. A self-report survey-based design was employed. Questionnaires were administered at a tertiary care hospital in Mumbai, India The study included a convenience sample of 423 children with a neurodevelopmental disability (aged 0–60 months). The self-report survey was administered to the parents of the children. Analyses showed that 92.7% (n = 392) of all respondents have smartphones. 61% (n = 258) of the respondents stated that their children used mobile devices before 2 years of age. 58% (n = 246) of the parents gave children devices while feeding. A statistically significant difference was found in the mobile media usage between groups of children with different diagnoses (p < 0.001). Children diagnosed with ASD appeared to spend the largest amount of time on mobile media (m = 180.44 mins), as compared to children included with other diagnoses. Of the diagnosed children, only 13.4% (n = 57) of parents were informed about the possible negative effects of media use by their paediatricians. The results suggest premature mobile media habits, frequent use and lack of awareness about the effects of mobile media usage among children diagnosed with a neurodevelopmental disability. We suggest there is a need to update recommendations for caregivers on the use of mobile media by young children with disability. The usage and consequences of mobile media use differ based on the type of neurodevelopmental disorder diagnosis. Parents of children with neurodevelopmental disorders often use mobile media as a distraction while engaging in various activities themselves, this information helps identify times at which mobile media might be purposefully used by parents as distractors There is an urgent need for clinical guidelines regarding mobile media usage among young children with neurodevelopmental disorders [ABSTRACT FROM AUTHOR]

The Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) is regularly used to measure spirituality and religiosity in U.S. Christian populations, although it has not been used for making comparisons with non-Western groups. This study compared BMMRS results for 109 individuals (60 in the U.S. and 49 in India) with traumatic brain injury (TBI) from different cultures (U.S., India), ethnic groups (African American, Caucasian, South Asian), and religions (Christian, Hindu, Muslim). In general, the results indicated that U.S. African Americans and Christians reported being the most spiritual, South Asians and Hindus the least. Groups differed significantly in self-reported spiritual experiences, but less in frequency of religious activities. Results suggest using caution when applying Western-based measures of religion and spirituality in non-Western, non-Christian populations. [ABSTRACT FROM AUTHOR]

Music therapy (MT) services for children with special needs in India are limited. Understanding the current level of parental knowledge of music therapy and their willingness to include it in a child's habilitation program may ascertain the need for parent education and could help to make music therapy feasible and accessible to Indian parents. Hence, a preliminary survey was undertaken to investigate various aspects of parental awareness about music therapy. Twenty-one item self-report questionnaire was developed and validated. The questionnaire was administered to 80 parents residing in various cities of Maharashtra who had children with special needs who were being administered therapies other than music therapy. The parents had a minimum education of 10th grade with proficiency in English. Statistical analysis revealed that parents had some level of pre-existing knowledge about music therapy and were willing to include music therapy in their child's treatment. Parents with higher educational levels and annual family income were significantly more aware of the term music therapy. Parents who had heard of music therapy were more likely to include music therapy in their child's habilitation. Motivations that drew parents' willingness have been described in detail. Parents of children with special needs in urban parts of Maharashtra are positively inclined towards music therapy. They are willing to include music therapy in their child's habilitation provided the structure of these services to complement their needs. Nevertheless, there remains a need for increasing awareness about the versatility and the scope of music therapy. [ABSTRACT FROM AUTHOR]

Persons with mental illnesses in India and rest of developing world continue to consult religious/spiritual (R/S) healers or traditional, complementary and alternative medicine (TCAM) professionals prior to seeking psychiatric services that are devoid of spiritual components of care. We aim to understand TCAM and allopathic professionals' perspectives on patients' R/S needs within mental health services, cross-sectional study was conducted at five TCAM and two allopathic tertiary care hospitals in three different Indian states; 393 participants completed RSMPP, a self-administered, semi-structured survey questionnaire. Perspectives of TCAM and allopathic health professionals on role of spirituality in mental health care were compared. Substantial percentage, 43.7 % TCAM and 41.3 % allopathic, of participants believe that their patients approach R/S or TCAM practitioners for severe mental illness; 91.2 % of TCAM and 69.7 % of allopaths were satisfied with R/S healers ( p = 0.0019). Furthermore, 91.1 % TCAM and 73.1 % allopaths ( p = 0.000) believe that mental health stigma can be minimized by integrating with spiritual care services. Overall, 87 % of TCAM and 73 % of allopaths agreed to primary criterion variable: 'spiritual healing is beneficial and complementary to psychiatric care.' A quarter of allopaths (24.4 %) and 38 % of TCAM physicians reportedly cross-refer their grieving patients to religious/TCAM healer and psychiatrist/psychologist, respectively; on logistic regression, significant ( p < 0.05) predictors were clinical interactions/references to r/s healers. Providing spiritual care within the setup of psychiatric institution will not only complement psychiatric care but also alleviate stigma against mental health services. Implications on developing spiritual care services like clinical chaplaincy are discussed. [ABSTRACT FROM AUTHOR]

Globally, elder abuse/mistreatment is a common form of violence against the elderly. This study examines the association between multimorbidity and abuse/mistreatment among the elderly population (60+) in India. Cross-sectional data from the United Nations Population Fund (UNFPA)'s "Building Knowledge Base on Population Aging in India" (BKPAI, 2011) was analyzed. We generated a multimorbidity variable by combining 20 self-reported diagnosed chronic diseases. Bivariate analysis was used to understand the sample distribution and prevalence estimation of elder abuse/mistreatment by multimorbidity and state. Furthermore, multilevel mixed-effect logistic regression was used to examine the association between multimorbidity and elder abuse/mistreatment. The overall prevalence of elder abuse/mistreatment in the study population is 11.4%. The prevalence of elder abuse/mistreatment among elderly with no chronic diseases is 6.01% which increases to 22.7% among elderly with four or more chronic diseases. Furthermore, the result from the multilevel mixed-effect logistic regression showed a close association between multimorbidity and elder abuse. Elderly with two, three, and four or more chronic diseases are 3.02 (CI = 2.33, 3.91, p <.000), 4.16 (CI = 3.02, 5.74, p <.000), and 5.06 (CI = 3.50, 7.31, p <.000) times more likely to experience abuse/mistreatment than elderly with no chronic diseases, respectively. In specific, this association is stronger for the elderly population residing in the urban areas. Furthermore, economic status and educational attainment have a protective role in determining elder abuse/mistreatment in India. In conclusion, multimorbidity has emerged as a significant risk factor of elder abuse/mistreatment in India. Measures to prevent elder abuse should consider the role of multimorbidity. [ABSTRACT FROM AUTHOR]