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Purpose: School teachers had difficulty in monitoring and assessing the students during the COVID-19 lockdown. This study attempts to understand the assessment and teaching challenges during COVID-19 and how this problematic situation was reshaped by new normal teaching. Design/methodology/approach: The qualitative research included perspectives of 84 school teachers using an interview-based approach. Pedagogical assessment, societal assessment and personal assessment were considered in the study. Findings: Content switching, student involvement and individual assessment are the challenges in terms of pedagogy. Buying power of electronic equipment, digital skills, study environment and distraction are the challenges faced in terms of personal challenges. Personal connect and interaction intensity is the challenges faced in terms of social challenges. Teachers adapted to synchronous, blended, flipped and asynchronous modes of teaching. Originality/value: The authors' study will support schools in developing their institutional plans to understand teachers' apprehensions better and to check the readiness of the schools towards teaching and learning approaches.

Household air pollution from the combustion of biomass and coal is estimated to cause approximately 780,000 premature deaths a year in India. The government has responded by promoting uptake of liquefied petroleum gas (LPG) by tens of millions of poor rural families. Many poor households with new LPG stoves, however, continue to partially use traditional smoky chulhas. Our primary objective was to evaluate three strategies to transition pregnant women in rural Maharashtra to exclusive use of LPG for cooking. We also measured reductions in kitchen concentrations of PM2.5 before and after our interventions. Our core intervention was a free stove, 2 free LPG cylinders (one on loan until delivery), and repeated health messaging. We measured stove usage of both the traditional and intervention stoves until delivery. In households that received the core intervention, an average of 66% days had no indoor cooking on a chulha. In an adjacent area, we evaluated a conditional cash transfer (CCT) based on usage of LPG in addition to the core intervention. Results were less successful, due to challenges implementing the CCT. Pregnant women in a third nearby area received the core intervention plus a maximum of one 14.2 kg cylinder per month of free fuel. In their homes, 90% of days had no indoor cooking on a chulha. On average, exclusive LPG use decreased kitchen concentrations of PM2.5 by approximately 85% (from 520 to 72 μg/m3). 85% of participating households agreed to pay the deposit on the 2nd cylinder. This high purchase rate suggests they valued how the second cylinder permitted continuous LPG supply. A program to increase access to second cylinders may, thus, be a straightforward way to encourage use of clean fuels in rural areas.

Data to support the use of risk scores in screening programs to detect people with prediabetes and undiagnosed diabetes in low- and middle-income countries are limited. We evaluated a targeted screening program involving a diabetes risk score in a community setting in India in terms of its uptake, yield, and costs. In the Kerala Diabetes Prevention Program, 2586 individuals (age 30–60 years) without known diabetes were screened using a two-step procedure. Step 1: screening with the Indian Diabetes Risk Score at participants' homes by trained non-medical staff. Step 2: oral glucose tolerance test (OGTT) among those with IDRS score ≥60 ("screen-positive") at community-based clinics. Screening costs were expressed in 2013 US dollars. 96.3% of those invited for the IDRS screening consented and 79.1% of screen-positives attended clinics for an OGTT. Older age and male gender were associated with higher IDRS uptake. Female gender, higher monthly household expenditure, and higher IDRS score were associated with higher OGTT uptake. The number needed to screen (yield) to detect one person with prediabetes and undiagnosed diabetes was two and six, respectively. The average screening cost of identifying one person with prediabetes and undiagnosed diabetes was $33.8 and $116.5, respectively. This targeted screening program had a high uptake and high yield for prediabetes and undiagnosed diabetes in a community setting in India. Alternative strategies are likely required to enhance the uptake of screening in certain groups. [ABSTRACT FROM AUTHOR]

Highlights • The Tamil Postpartum Bonding Questionnaire helps screen for bonding disorders. • Three factors account for 50% of variance of the scale scores. • The factors are Mild disorders, Anxiety about care and Pathological Anger. • Mothers with bonding disorders have greater psychological distress. • Caregiver reports of mothers behaviour cannot alert to mild disorders of bonding. Abstract Background The Postpartum Bonding Questionnaire was developed in English for the purpose of screening for bonding disorders among postpartum mothers. There was a felt need for a Tamil translation of the self-rated instrument. Methods The Postpartum Bonding Questionnaire was translated into Tamil (PBQ-T). Two hundred and fifty mother-infant dyads were administered the PBQ-T along with the Stafford Interview. The Stafford Interview was studied by two independent psychiatrists to arrive at a diagnosis of bonding disorders in the mothers. The Edinburgh Postnatal Depression Scale (EPDS) and Bangalore Maternal Behaviour Scale (BMBS) were used for rating depressive symptoms and caregiver reported behaviour of the mother towards the infant. We also did a factor analysis to find the factor structure of the PBQ-T. Results A 19-item PBQ-T that has five factors grouped into three subscales. The five factors are General Bonding (F1A), Frustration (F1B), Anxiety (F2), Feeling trapped (F3A) and Aggression/ Rejection dimensions (F3B) loading onto three subscales 1, 2 and 3. Total PBQ-T scores were best used to detect 'any disorder of bonding' (cut-off 5/6). Subscale 1 (cut-off 2/3) was useful in detection of mild disorders of bonding, subscale 2 (cut-off 2/3) for infant-focused anxiety and subscale 3 (cut-off 0/1) for Anger/ Rejection. Mothers with bonding disorders had greater psychological distress. Caregiver report of mother's behaviour (BMBS) could detect anxiety and anger/ rejection but not the lack of emotional bond. Conclusion A 19-item Tamil version of the PBQ is useful in screening for disorders of mother-infant bonding among healthy postpartum mothers. [ABSTRACT FROM AUTHOR]

Abstract Background Ewing sarcoma is a malignant tumour found mainly in childhood and adolescence. The present study aims at analyzing the data on Ewing sarcoma cases of bone from the National Cancer Registry Programme, India to provide incidence, patterns, and trends in the Indian population. Materials and Methods The data of five Population Based Cancer Registries (PBCR) of Bangalore, Mumbai, Chennai, Bhopal and Delhi over 30 years period (1982– 2011) were used to calculate the Age Specific and Age Standardized Incidence Rates (ASpR and ASIR), and trends in incidence was analyzed by linear and Joinpoint Regression. Results Ewing sarcoma comprised around 15 % of all bone malignancies. Sixty-eight percent were 0–19 years, with 1.6 times risk of tumour in bones of limbs as compared to other bones. The highest incidence rate (per million) was in the 10–14 years age group (male −4.4, female −2.9) with significantly increasing trend in ASpR observed in both sexes. Pooled ASIR per million for all ages was higher in male (1.6) than female (1.0) with an increasing rate ratio of ASIR with increase in age. Trend of pooled ASIR for all ages was significantly increased in both sexes. Twelve percent cases were reported in ≥30 years of age. Conclusion This paper has described population based measurements on burden and trends in incidence of skeletal Ewing in India. These may steer further research questions on the clinical and molecular epidemiology to explain factors associated with the increasing incidence of Ewing sarcoma bone observed in India. [ABSTRACT FROM AUTHOR]

Introduction Long-term outcome studies in Takayasu arteritis (TA) are few and limited by small sample size. In this study, we analysed the outcome of treatment in a large series of TA patients with a minimum follow-up period of ≥12 months by objective instruments. Materials and methods Patients with TA satisfying the 1990 ACR, Ishikawa’s, Sharma’s or EULAR/PRESS criteria were recruited from our clinics between 1998 and 2016. Only patients with a minimum follow up of 12 months were studied. Data related to clinical presentation, disease extent (DEI.Tak score), activity [Indian Takayasu arteritis clinical activity score, that is, ITAS-A (CRP)] and damage score [Takayasu arteritis damage score (TADS)], angiography and treatment were collected for all patients. Response to treatment was categorised as complete response (CR), partial response (PR) or refractory disease. Patients with sustained CR on prednisolone dose of ≤5 mg/day were classified as having sustained inactive disease. Appropriate statistical tests were used for parametric and non-parametric data. Relapse free survival was projected by Kaplan-Meir curve. Cox proportional hazards regression plot was used to compare the efficacy of medications. Predictors of sustained response were identified by logistic regression and a prediction model was constructed. Results Among 503 TA patients examined during study period, 251 had follow-up of ≥12 months and were included in this study. Median follow-up duration was 42 months (IQR: 24–81, maximum 240 months). Patients (81.7% females, mean age of 29.2 ± 11.8 years, symptom duration of 24 [6–70] months) were treated by a uniform protocol that included high dose steroids ( n = 239) plus concurrent steroid-sparing immunosuppressant ( n = 235) with mycophenolate in majority. Biological agents ( n = 44 patients) and revascularisation procedures were used in symptomatic patients after control of disease activity. At 1st follow-up, CR (ITAS2010 = 0, CRP < 6 mg/L and non-progressive disease on angiography) was observed in 173 (68.9%), partial response (PR) in 42 (16.7%) and no response was seen in only 36 (14%) patients. CR was sustained till the last follow up in 116 (65.9%) of 173 patients with initial CR, while 87 (49.4%) of them achieved sustained inactive disease. Disease activity relapsed at a median duration of 37 (29.9–44.1) months in 56 patients. Cumulative relapse free survival was 93%, 73%, 66% and 52% at 1, 3, 5 and 10 years, respectively. Baseline CRP < 6.2, DEI.Tak < 9 and angiographic type 4 disease predicted sustained inactive disease and a model comprising these parameters showed sensitivity and specificity of 70% and 61.1%. Two fatalities were observed. New vascular lesions during follow up were observed in 50 (19.9%) patients. Overall, 92.8% had at least one period of CR or PR while 7.2% were refractory to treatment till the last follow up. Damage progression (∆TADS > 1) was arrested in 68% of patients and was lower in patients with sustained inactive disease [0 (0–1)] as compared to the rest [1 (0–2.75)], p = 0.000. Both early response as well as cumulative hazard for relapse were similar between patients initiated on 0.5 and 1 mg/kg/day steroids. Conclusions Our strategy of upfront combination immunosuppressant therapy stabilised disease activity in 92.8% of patients, while 7.2% had true refractory disease. Relapse free survival was 66% at 5 years and 52% at 10 years. Damage progression was arrested in 68% and only 2 fatalities were observed. Initial steroid dose of 0.5 mg/kg/day had similar efficacy as 1 mg/kg/day dose. [ABSTRACT FROM AUTHOR]