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Background Despite the high and rising burden of chronic kidney disease (CKD) in South Asia, factors that influence access to CKD care at the community level have not been studied previously, especially in the rural areas. We conducted a mixed methods study and interviewed key stakeholders to explore the views and experiences of key stakeholders, and identify barriers and potential facilitators that influence access to CKD care at the primary care level in rural India. Methods A total of 21 stakeholders participated in the study. We conducted 15 in-depth interviews on a purposive sample of stakeholders (CKD patients, healthcare providers and health planners) and one focus group discussion with 6 community health workers. The interviews were audio-recorded and transcribed verbatim. We employed the Lévesque’s framework for access to care to base interview guides and structure the initial codes. By inductive and deductive approaches, thematic analysis was undertaken using QSR NVivo version 11. Results The major patient-level barriers to CKD care as reported by the most patients and healthcare providers was poor knowledge and awareness of CKD. Health system-level barriers included shortages of skilled healthcare professionals and medicines, fragmented referrals pathways to the specialists at the hospitals with inadequate follow up care. Many patients and healthcare providers, when asked about areas for improving access to CKD care, reported educational initiatives to increase awareness of CKD among healthcare providers and patients, provision of CKD related supplies, and a systems-level approach to care coordination including task shifting by engaging community health workers in CKD care, as potential facilitators. Conclusions We identified several barriers to access CKD care at the primary care level in rural India that need urgent attention. Targeted CKD screening programs and CKD specific educational initiatives may improve awareness of CKD. Additionally, primary care infrastructure needs to be strengthened for CKD care, ensuring trained staff, availability of essential diagnostics and medications, and creating efficient referral pathways for quality CKD care.

Floods are one of the most devastating natural disasters and cause damage worth millions of dollars every year. The research on models predicting floods and advances in the methods applied have significantly reduced risk and loss of life and allowed better suggestions for policies to reduce harm to property due to floods. Empirical approaches use historical data to predict floods that might occur on the basis of statistics. Although this approach has received tons of attention in recent years thanks to advances in supporting technology, particularly within the areas of massive data and machine learning, it lacks in modeling generalized systems. The spatial distribution of the input features like meteorological conditions and other physical parameters can be captured by using physical models. Since the physical models are dynamic, they may overcome the empirical models which are less accurate and also lack generalizability. However, these models are data intensive, difficult to build, and require expertise in the domains. This paper reviews various hydrological modeling methods and predictive models and proposes a hybrid approach which combines the two approaches to predict floods in the vicinity of the river basins.

Every year, floods cause billions of dollars' worth of damages to life, crops, and property. With a proper early flood warning system in place, decision-makers can take the necessary steps to prevent or at least mitigate the damage caused by floods. Although various flood prediction models exist, a majority of them fail to be fast, reliable, and detailed simultaneously. The proposed system presents a novel hybrid flood prediction model using Long Short Term Memory(LSTM) for multivariate time series forecasting of water depth based on meteorological conditions and Height Above Nearest Drainage(HAND) to predict river stage in real-time and map the inundated areas for the corresponding water depth using enhanced HAND. Unlike traditional flood forecasting models, this hybrid approach is resource efficient and easy to implement making it highly practicable for real-time flood inundation mapping.

The immense growth and research in modern technology have led to convenience and comfort becoming mankind’s demand and first priority in any technology presented to them. With this, automation has become the need of the hour. The use of automation in cars is one such area that is getting more and more importance and recognition around the world. Driving demands total attention from the driver in activities such as lane-keeping and lane changing, slowing down at turns, keeping a watch on traffic lights and traffic signs, and handling the car in traffic. The smallest lapse in concentration can also prove to be very dangerous. Self-driving cars aim at making use of the latest technologies in Artificial Intelligence to automate as many features as possible and leave as little as possible for the driver to do. The main motive of the research work will be to develop a model of the software part needed for the efficient working of a driver assistance system on cars on real-time data and simulate it.

Due to recent technological advancements, there has been a rise in digital interventions aimed at either supplementing or replacing face-to-face mental health services which include the advent of mental health chatbots, that claim to provide assistive care using a therapeutic approach. These innovations are driven by Natural Language Processing (NLP). A chatbot can be described as a computer program capable of providing smart responses to user inputs by understanding natural language using one or more NLP techniques. In this study, we discuss the application of NLP in psychotherapy and also a general analysis of existing systems was performed by comparing the responses given by the chatbot against a set of predefined user inputs pertaining to queries related to wellbeing and mental health. The general methodology involved in the creation of such chatbots includes the underlying NLP techniques like word embeddings, sentiment analysis, Models like Sequence-to-Sequence model and attention mechanism. We also propose MentalEase, a mobile application which uses NLP techniques to provide not only conversational aid but also a toolbox of helpful features to keep mental health in place. By integrating mental health assessment tools into the chatbot interface, along with regular therapy it can help patients deal with mild anxiety and depression. This can also overcome certain barriers in mental health, such as waiting lists and geographical problems that hinder attendance at face-to-face counselling appointments.

Aim: To refine and contextually adapt a postpartum lifestyle intervention for prevention of type 2 diabetes mellitus (T2DM) in women with prior gestational diabetes mellitus (GDM) in Bangladesh, India, and Sri Lanka.Materials and Methods: In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with women with current diagnosis of GDM, and health care professionals involved in their management, to understand relevant local contextual factors for intervention optimization and implementation. This paper describes facilitators and barriers as well as feedback from participants on how to improve the proposed intervention. These factors were grouped and interpreted along the axes of the three main determinants of behavior–capability, opportunity, and motivation. IDIs and FGDs were digitally recorded, transcribed, and translated. Data-driven inductive thematic analysis was undertaken to identify and analyze patterns and themes.Results: Two interrelated themes emerged from the IDIs and FGDs: (i) The lifestyle intervention was acceptable and considered to have the potential to improve the existing model of care for women with GDM; and (ii) Certain barriers such as reduced priority of self-care, and adverse societal influences postpartum need to be addressed for the improvement of GDM care. Based on the feedback, the intervention was optimized by including messages for family members in the content of the intervention, providing options for both text and voice messages as reminders, and finalizing the format of the intervention session delivery.Conclusion: This study highlights the importance of contextual factors in influencing postpartum care and support for women diagnosed with GDM in three South Asian countries. It indicates that although provision of postpartum care is complex, a group lifestyle intervention program is highly acceptable to women with GDM, as well as to health care professionals, at urban hospitals.

Companies generate their reports in the form of PDF files. For further data analysis, the statistics or quantitative data in these reports have to be converted to CSV (.csv) or Excel (.xlsx) files. This is done manually by companies. This consumes a lot of time and manual work which can be reduced for better utilization of resources. Forecomp is a web application to automatically convert the tables in the PDF to CSV files. The tables could be present in text format or as an image. The web application is built keeping flexibility in mind such that the user can select the process used to convert the PDF into CSV files based on the tables in their PDF. Different technologies used in this application include YOLO model for machine learning, Tesseract OCR, Tabula, and an inbuilt snipping tool. This paper introduces the concepts behind Forecomp focussing on the methodology employed and the various results obtained.

Background Availability of basic mental health services is limited in rural areas of India. Health system and individual level factors such as lack of mental health professionals and infrastructure, poor awareness about mental health, stigma related to help seeking, are responsible for poor awareness and use of mental health services. We implemented a mental health services delivery model that leveraged technology and task sharing to facilitate identification and treatment of common mental disorders (CMDs) such as stress, depression, anxiety and suicide risk in rural areas of the state of Andhra Pradesh, India. The intervention was delivered by lay village health workers (Accredited Social Health Activists – ASHAs) and primary care doctors. An anti-stigma campaign was implemented prior to this activity. This paper reports the process evaluation of the intervention using mixed methods. Methods A mixed methods pre-post evaluation assessed the intervention using quantitative service usage analytics from the server, and qualitative interviews with different stakeholders. Barriers and facilitators in implementing the intervention were identified. Results Health service use increased significantly at post-intervention, ASHAs could followup 78.6% of those who had screened positive, and 78.6% of the 1243 Interactive Voice Response System calls made, were successful. Most respondents were aware of the intervention. They indicated that knowledge received through the intervention empowered them to approach ASHAs and share their mental health symptoms. ASHAs and doctors opined that EDSS was useful and easy to use. Medical camps organized in villages to increase access to the doctor were received positively by all. However, some aspects or facilitators of the intervention need to be improved, including network connectivity, booster training, anti-stigma campaigns, quality of mental health services provided by doctors, provision of psychotropic medications at primary health centers and frequency of health camps. Conclusion The respondents’ views helped to understand the barriers and facilitators for improving the likely effectiveness of the intervention using Andersen’s Modified Behavioral Model of Health Services Use, and identify the mechanisms by which those factors affected mental health services uptake in the community. Trial registration The study is registered with Clinical Trials Registry India (Applied - 16/07/14-Ref2014/07/007256; registration received - 04/10/17-CTRI/2017/10/009992). Electronic supplementary material The online version of this article (10.1186/s12888-017-1525-6) contains supplementary material, which is available to authorized users.

Arora, M., Tewari, A., Bassi, S., Chauhan, K., Bhasin, S., Bakshi, A., & Andreasson, S. (2017). Exploring perceptions of alcohol use in two Indian states: A qualitative study from Delhi and Haryana, India. The International Journal Of Alcohol And Drug Research, 6 (1), 1-6. doi: http://dx.doi.org/10.7895/ijadr.v6i1.238 Aims: To explore perceptions and determinants influencing alcohol consumption, with a view to inform development of suitable policies to control alcohol consumption. Methodology: Focus group discussions (FGDs) ( n =24) were conducted in two Indian states among the rural Haryana ( n =8 FGDs; 58 participants) and urban Delhi ( n =16 FGDs; 113 participants) populations. Purposive sampling was used to recruit the participants, who were from high and low socioeconomic status (SES) groups and in the age group of 18–58 years. Results: Different factors influence alcohol consumption in high and low SES groups. The age of initiation is now as low as 10–12 years, attributable to the recent trend of increased accessibility. The participants agreed that alcohol consumption has now become a more acceptable part of daily living, whereas earlier it was limited to special occasions and festivals. This has contributed to an increase in drinking. Drinking among women was earlier a taboo, but now women (mainly of high SES), are often seen drinking at social gatherings. The respondents mentioned weak enforcement of regulatory policies related to alcohol consumption and sales. Conclusions: A shift in attitudes was observed towards drinking. Drinking is increasingly seen as a part of daily life. The availability of alcohol is perceived to be increasing and restrictions on sale are not effectively enforced. There is an urgent need to re-evaluate the alcohol policy from a public health perspective in India.

Background and Objectives As a measure of nicotine dependence among adolescent smokers, the modified Fagerstrom Tolerance Questionnaire (mFTQ; seven items), has been successfully used in the United States (USA). Nonetheless, the validity and reliability of mFTQ at the international level is still needed. The current study is the first to test the validity and reliability of mFTQ in four countries: Thailand, Spain, the USA, and Russia. Methods In a cross-sectional survey, mFTQ, risk factors of nicotine dependence, and sociodemographic characteristics were assessed. Risk factors included age of first cigarette, frequency of alcohol use, frequency of marijuana use, and number of cigarettes smoked yesterday. Salivary cotinine was also obtained in Thailand and Spain. Results For all four countries, mFTQ exhibited a single factor structure, as supported by previous work in the USA. For all studied countries except Thailand, mFTQ presented acceptable internal reliability. Overall, risk factors of nicotine dependence have predicted mFTQ scores across countries. Frequency of alcohol use in the USA and frequency of marijuana use in Thailand and Spain were not associated with mFTQ scores. Discussion and Conclusions mFTQ is a single-factor measure of nicotine dependence that shows acceptable internal consistency and validity across countries. Further work can advance the scale and tailor it to different cultures. Scientific Significance mFTQ can be a clinically practical international measure of nicotine dependence. This study provides initial support for the utility of the mFTQ among Thai, Spanish, American, and Russian adolescents. Further research is needed to test and advance mFTQ across cultures. (Am J Addict 2017;XX:1–8)

Mental disorders impose an enormous burden on society. In developing countries like India, there is a lack of adequate number of trained mental health professionals to provide specialized care and 75-85 % of affected individuals do not have access to appropriate mental health services. The National Mental Health Programme (NMHP) is being implemented by the Government of India to support state governments in providing mental health services in the country. The Urban Mental Health Programme (UMHP) is a pilot initiative that has attempted the integration of mental health services in primary health care settings in two municipal wards in Kolkata, West Bengal, India. The overarching aim of this paper is to describe the methodology used for the evaluation of the community based mental health programme and to understand the processes of the programme in terms of barriers and facilitators. The current evaluation is based on a concurrent nested design, where qualitative and quantitative data are both collected at the same time but analysed separately and priority was given to qualitative data. This experience will contribute in helping other researchers to make some evaluations more effective, useful and manageable. Ethics approval was obtained from an institutional ethics committee of an organization (Ekjut) based in Ranchi, Jharkhand, India. The evaluation was undertaken by the George Institute for Global Health, New Delhi from February- June 2016.

Introduction Chronic kidney disease (CKD) has become a public health challenge globally, especially in lower- and middle- income countries. The implications of adverse social and economic consequences of CKD are particularly grave in a populous country like India where CKD risk factors like diabetes and hypertension are widely prevalent. Although with early detection and timely initiation of interventions CKD progression can be slowed, huge knowledge-practice gap exists. Moreover, factors that influence access to CKD care at the community level have not been studied previously. This study aimed to explore the experiences and views of key stakeholders to identify factors that influence access to CKD care in rural India. We also sought to discern the current practices and preparedness for CKD, understand the facilitators and barriers to CKD care, and feasibility and acceptability of mobile-technology based clinical decision support system (mCDSS) for CKD care in primary care.Methods Using 15 in-depth interviews and one focus group discussion (n=6), we aimed to explore the experiences and views of different stakeholdres from primary healthcare system in rural India. We employed Lévesque’s framework for access to care, and inductive and deductive approaches in the analysis. The interviews were audio-recorded and transcribed verbatim. Using QSR nVivio 11, coding and thematic analysis was undertaken.Results Our study identified barriers in relation to access to CKD care in rural India. Fore most among them was poor knowledge and lack of awareness to CKD among patients as well as primary care physicians. Health system-level barriers like shortages of skilled healthcare professionals and medicines, fragmented referrals pathways with inadequate follow up care were identified. Increasing awareness of CKD among healthcare providers and patients, provision of CKD related supplies, and a system-level approach to care coordination were key facilitators.Conclusions Lack of awareness and knowledge on CKD among primary care providers and patients, and unprepared primary care infrastructure are key barriers for access to CKD care in rural India. There is an urgent need to raise CKD awareness among primary care physicians and patients, improve supplies for diagnostics and medications, and create efficient referral pathways for CKD in primary care.

Background: The incidence of hip fractures in older adults in India is likely to increase dramatically in the coming decades as a result of an aging population and increasing life expectancy. Currently, more than 600,000 adults over 60 years of age suffer a hip fracture annually in India. This paper outlines a protocol for a qualitative study investigating the care seeking behavior of older adults with hip fractures: to determine the processes in decision making, identify causes for delay in obtaining care, and identify potential barriers and facilitators to seeking appropriate care in time. Methods and design: The planned study will consider Odisha, an eastern state in India with limited health care facility, as a suitable case study. It is proposed to conduct 30 in-depth interviews in two administrative districts of Odisha. The participants will be patient and their carers in seven health facilities- four public hospitals, two private hospitals and one traditional bone-setting facility. The study relies on a purposive sampling strategy. Ethics permission will be sought from each participating institution and participants. The participants will be adults aged 50 years or older of both sexes arriving at the recruiting centers with a history of fall or injury, pain in the hip region and inability to walk and X-ray confirmed diagnosis of proximal femoral fracture and their primary carer. Trained qualitative research team will conduct these interviews. A thematic framework approach will be used to analyze the data using NVivo 9 software. The data collected from the interviews will be analysed to explore the cause of the hip fracture, events following the injury, the experiences of patients from the time of sustaining the injury, pain relief measures, decision to seek care, understanding of the urgency for treatment, causes for delay in receiving treatment, funding sources, cost liabilities for the family, financing mechanisms for out of pocket expenditure and the burden for caring. Discussion: The findings of this study will provide an increased understanding of the care seeking behaviors of older adults with hip fracture, and inform contextually appropriate changes in healthcare program and policy aimed at improving health outcomes.

Background: Polypills, fixed-dose combinations of blood pressureelowering drug(s), and statin, with or without aspirin, improve the use of these recommended drugs in patients with or at high risk of cardiovascular disease. However, in India, there has been poor uptake of polypills despite market availability.Objectives: This study sought to assess availability and cost of polypills and explore barriers and facilitators to their use in the state of Andhra Pradesh in India.Methods: A mixed-methods study was conducted. Availability and cost of polypills as well as individual component drugs was assessed through a survey of pharmacies across urban, urban slum, and rural regions in state of Andhra Pradesh in India. In-depth interviews with stakeholders at each level of the health system explored barriers and facilitators to use of polypills.Results: Overall, 30 pharmacies were surveyed (10 in each of urban, urban slum, and rural region). In urban region, 2 pharmacies stocked polypills (without aspirin) costing 121 Indian rupees (INR) per 10 pills, and 1 other pharmacy stocked a polypill (with aspirin) costing 24 INR per 10 pills. All pharmacies stocked a wide range of component drugs as separate pills with combined cost of the cheapest angiotensin-converting enzyme inhibitor, statin, and aspirin INR 124 per 10 pills. Patients were willing to use polypills if prescribed by their doctor, and pharmacies were willing to stock polypills if there was market demand. For prescribers, key barriers included perceptions that current polypills contained outdated drugs and inadequate flexibility in prescribing.Conclusions: In a market in which polypill use is licensed, their availability and use is very low. Lack of prescription of polypills was the predominant barrier to polypill use; therefore, making polypills with drugs that are more acceptable and at different available strengths, in conjunction with broader prescriber education and training, may improve their use.HighlightsIn India, where polypills are licensed, their availability and use are very low.A major barrier to the use of polypills is the lack of prescriptions from prescribers.Polypills with evidence-based drugs that are acceptable to prescribers are likely to improve their use.

Background Worldwide hip fractures are projected to increase from 1.7 million in 1990 to 6.3 million in 2050. In India, conservative estimates suggest an annual incidence of 600,000 osteoporotic hip fractures and this is expected to increase significantly due to ageing and increase life expectancy. Protocol-based ‘care pathways’ for the management of adults, over 60 years of age, with hip fractures in high-income countries has resulted in decreased mortality rates, early hospital discharge, improved quality of life and reduction in healthcare costs. The study objectives are to determine appropriateness, acceptability and feasibility of adopting best-practice guideline or protocol-based care for the management of hip fractures among older adults in India. The study will also identify barriers and facilitators in recruiting patients and retention till the agreed follow-up period. Methods This will be a mixed-methods prospective cohort study. The quantitative data collection will involve recruitment of consecutive patients aged >50 years with an X-ray-confirmed hip fracture admitted in four tertiary care hospitals in Delhi, India, over a 2-month period. The quantitative data will be collected at three points: from patients at admission to hospital, from medical records at discharge and by telephone interviews with patients at 30 days post hip fracture. Qualitative data collection will involve key informant interviews, conducted with clinical leads and focus group discussions, conducted with groups of healthcare providers and patients and/or their carers. COM-B theoretical framework (capability, opportunity, motivation and behaviour) will be used to explore healthcare providers’ behaviour in order to facilitate development and implementation of appropriate integrated care pathway for management of older adults with hip fractures in India. Discussion The proposed study will identify gaps in best practice in the management of older people with hip fractures in tertiary care hospitals in Delhi and document barriers and facilitators to the implementation of protocol-based care through recording the contextual realities of the health systems and care-seeking behaviours. Insights into these factors will be used to facilitate the development of protocol-based management of older people with hip fractures that is appropriate, context specific and acceptable by stakeholders in a low- and middle-income country setting, such as India. Electronic supplementary material The online version of this article (doi:10.1186/s40814-016-0056-0) contains supplementary material, which is available to authorized users.

Introduction: High prevalence of chronic kidney disease (CKD) not associated with known risk factors has been reported from coastal districts of Andhra Pradesh. The Study to Test and Operationalize Preventive Approaches for Chronic Kidney Disease of Undetermined Etiology in Andhra Pradesh (STOP CKDu AP) aims to ascertain the burden (prevalence and incidence) of CKD, the risk factor profile, and the community perceptions about the disease in the Uddanam area of Andhra Pradesh. Methods: Study participants will be sampled from the Uddanam area using multistage cluster random sampling. Information will be collected on the demographic profile, occupational history, and presence of conventional as well as nonconventional risk factors. Glomerular filtration rate (GFR) will be estimated using the Chronic Kidney Disease Epidemiology Collaboration equation, and proteinuria will be measured. All abnormal values will be confirmed by repeat testing after 3 months. Cases of CKD not associated with identified etiologies will be identified. Biospecimens will be stored to explore future hypotheses. The entire cohort will be followed up every 6 months to determine the incidence of CKD and to identify risk factors for decline in kidney function. Qualitative studies will be performed to understand the community perceptions and expectations with respect to the interventions. Implications: CKD is an important public health challenge in low- and middle-income countries. This study will establish the prevalence and determine the incidence of CKD not associated with known risk factors in a reported high-burden region, and will provide insights to help design targeted health systems responses. The findings will contribute to the policy development to tackle CKD in the region and will permit international comparisons with other regions with similar high prevalence. Keywords: chronic kidney disease, CKD of uncertain etiology, risk factors

Social networking websites are used by millions of people around the world. People express their views, opinions and share current topics. Millions of data generated every day. It’s a good platform to connect with the people. Now a day’s spammers used this platform to advertise spam content on the social networking websites. The proposed system used to classify tweets into different groups as spam and non spam tweets .The system will use 120 character tweets for analysis purpose. Various active and verified twitter accounts would be chosen to extract the tweets. Each tweet is to be classified into 2 category-spam and non-spam. These classified tweets then are used to train the various machine learning techniques. Words of each tweet considered as features and a feature vector was created using bag-of-words approach in order to create the instances. The data will be trained using SVM (Support Vector Machine). General Terms Classification, Spam Filtering methods

BackgroundStigma related to mental health is a major barrier to help-seeking resulting in a large treatment gap in low- and middle-income countries (LMIC). This study assessed changes in knowledge, attitude and behaviour, and stigma related to help-seeking among participants exposed to an anti-stigma campaign.MethodThe campaign, using multi-media interventions, was part of the SMART Mental Health Project, conducted for 3 months, across 42 villages in rural Andhra Pradesh, in South India. Mixed-methods evaluation was conducted in two villages using a pre-post design.ResultsA total of 1576 and 2100 participants were interviewed, at pre- and post-intervention phases of the campaign. Knowledge was not increased. Attitudes and behaviours improved significantly (p < 0.01). Stigma related to help-seeking reduced significantly (p < 0.05). Social contact and drama were the most beneficial interventions identified during qualitative interviews.ConclusionThe results showed that the campaign was beneficial and led to improvement of attitude and behaviours related to mental health and reduction in stigma related to help-seeking. Social contact was the most effective intervention. The study had implications for future research in LMIC.

Tobacco use experimentation is most frequent between the ages of 15–24 in India. Therefore, programming to counteract tobacco use among adolescents is needed. There is a lack of evidence-based teen tobacco use prevention and cessation programs. The current study provides an outcome evaluation of the Project EX tobacco use prevention and cessation program among Indian adolescents (16–18 years). An eight-session classroom-based curriculum was adapted to the Indian context and translated from English to Hindi (local language). Next, it was tested using a quasi-experimental design with 624 Indian students at baseline, involving two program and two control schools, with a three-month post-program follow-up. Project EX involves motivation-enhancement (e.g., talk shows and games) and coping skills (e.g., complementary and alternative medicine) components. Program participants rated complementary and alternative medicine (CAM) activities like meditation, yoga and healthy breathing higher than talk shows and games. Compared to the standard care control condition, the program condition revealed a prevention effect, but not a cessation effect. Implications for prevention/cessation programming among Indian teens are discussed. This study was approved by the Independent Ethics Committee, Mumbai.

This paper proposes a smart driver assistant system that will help drivers avoid accidents during lane departures by providing prompt and quick markings of road lanes. This paper also proposes a novel system for the automatic detection and recognition of traffic signs. It detects the blobs using MSER i.e Maximally Stable Extremal Regions which provides similar results under different lighting conditions. Recognition is based on a cascade of Convolutional Neural Networks (CNN) that were trained using histogram of oriented gradient (HOG) features.

An air fryer is a kitchen appliance that works by using high speed hot air circulation. When the fryer is working, it begins to produce hot air and a mechanical fan begins to circulate it very fast around the food, which fries the food and produces a crispy layer. Most hot air fryers come with adjustable temperature and timer knobs that allow for more precise cooking. Food is cooked in the cooking basket that sits on a drip tray. There are various brands of air fryers that claim to fry the food with 80% less oil in general. Air fryer technology is based on "Rapid air technology" that uses the hot air to fry and cook the food which causes the use of less oil frying food. Which food needs what amount of cooking time. Time is a business which has not been dealt with properly. In most of the cases the user is compelled with a restricted amount of control. Most of the people wouldn’t have noticed (but can reason out very well) different type of food need different amount of cooking time which depends directly on the air temperature and fan speed etc.

Summary Evidence-based management can reduce deaths and suffering of older adults with hip fractures. This study investigates the evidence-practice gaps in hip fracture care in three major hospitals in Delhi, potential barriers and facilitators to improving care, and consequently, identifies contextually appropriate interventions for implementing best practice for management of older adults with hip fractures in India. Purpose Hip fracture in older adults is a significant public health issue in India. The current study sought to document current practices, identify barriers and facilitators to adopting best practice guidelines and recommend improvements in the management of older adults with hip fractures in Delhi, India. Methods This mixed methods observational study collected data from healthcare providers, patients, carers and medical records from three major public tertiary care hospitals in Delhi, India. All patients aged ≥50 years with an X-ray confirmed hip fracture that were admitted to these hospitals over a 10-week period were recruited. Patients’ data were collected at admission, discharge and 30 days post-injury. Eleven key informant interviews and four focus group discussions were conducted with healthcare providers. Descriptive data for key quantitative variables were computed. The qualitative data were analysed and interpreted using a behaviour change wheel framework. Results A total of 136 patients, 74 (54%) men and 62 women, with hip fracture were identified in the three participating hospitals during the recruitment period and only 85 (63%) were admitted for treatment with a mean age of 66.5 years (SD 11.9). Of these, 30% received surgery within 48 h of hospital admission, 95% received surgery within 39 days of hospital admission and two (3%) had died by 30 days of injury. According to the healthcare providers, inadequate resources and overcrowding prevent adequate caring of the hip fracture patients. They unanimously felt the need for protocol-based management of hip fracture in India. Conclusion The development and implementation of national guidelines and standardized protocols of care for older people with hip fractures in India has the potential to improve both care and patient-related outcomes. Electronic supplementary material The online version of this article (doi:10.1007/s11657-017-0344-1) contains supplementary material, which is available to authorized users.

Background: Hip fractures among older adults is a serious public health issue in India due to increase in ageing population. Availability and timely access to surgical care is essential for reduction of mortality and morbidity from hip fractures and thereby decreasing inequalities among older adults. The notion of access to care is multi-dimensional and the “three-delay” framework can be applied to understand the causes for delay between sustaining a hip fracture and receipt of appropriate care. The aim of this study is to determine the processes in decision-making, identify cause for delays in obtaining care, and the potential barriers and facilitators to seeking appropriate care in time. Methods: A qualitative study was conducted (30 in-depth interviews) in seven healthcare facilities (4 public; 2 private and 1 alternative care center) in two administrative district of Odisha, India. The study was undertaken by George Institute for Global Health, India, in collaboration with Indian Institute of Public Health-Bhubaneswar from July 2014 to January 2015.Participants were aged 50 years or older with hip fracture including males and females. Data was categorized using NVIVO software and analyzed by thematic analysis. Results: Majority of participants perceived hip fracture injury will heal on its own and does not require surgery. They were not aware of the consequences of such an injury, comorbid conditions and available healthcare facilities. Family/community members played a significant role in the choice of surgeon and in accessing health care facility. Participants who had an injury outside their home were taken immediately to the hospital whereas those who fell inside home get delayed in reaching hospital. The delay from time of injury till access of care varied from few hours to months. People with a hip fracture and their relatives had strong faith and belief in traditional health care system, i.e. Traditional bonesetters within their local community. Conclusion: Our study findings emphasize on the need for quick decision- making to access nearest health facility with the provision of surgical care. We recommended further research studies to be conducted in varied settings to widen our knowledge in care pathways for the management of hip fractures in India.

Project Advancing Cessation of Tobacco in Vulnerable Indian Tobacco Consuming Youth (ACTIVITY) is a community-based group randomized intervention trial focused on disadvantaged youth (aged 10-19 years) residing in 14 low-income communities (slums and resettlement colonies) in Delhi, India. This article discusses the findings of Focus Group Discussions (FGDs) conducted to inform the development and test the appropriateness of Project ACTIVITY's intervention model. The findings of the FGDs facilitated the understanding of factors contributing to increased tobacco uptake and cessation (both smoking and smokeless tobacco) among youth in this setting. Twenty-two FGDs were conducted with youth (10-19 years) and adults in two urban slums in Delhi. Key findings revealed: (i) youth and adults had limited knowledge about long-term health consequences of tobacco use; (ii) socio-environmental determinants and peer pressure were important variables influencing initiation of tobacco use; (iii) lack of motivation, support and sufficient skills hinder tobacco cessation and (iv) active involvement of community, family, religious leaders, local policy makers and health professionals is important in creating and reinforcing tobacco-free norms. The results of these FGDs aided in finalizing the intervention model for Project ACTIVITY and guided its intervention development.

In India, 57% of men between 15 and 54 years and 10.8% of women between 15 and 49 years use tobacco. A wide variety of tobacco gets used and the poor and the underprivileged are the dominant victims of tobacco and its adverse consequences. Project MYTRI (Mobilizing Youth for Tobacco-Related Initiatives in India) was a tobacco prevention intervention program, a cluster-randomized trial in 32 Indian schools which aimed to decrease susceptibility to tobacco use among sixth- to ninth-grade students in urban settings in India. This culture-specific intervention, which addressed both smokeless and smoked forms of tobacco, was Indian in content and communication. We qualitatively developed indicators which would help accurately measure the dose of the intervention given, received and reached. A multi-staged process evaluation was done through both subjective and objective measures. Training the teachers critically contributed toward a rigorous implementation and also correlated with the outcomes, as did a higher proportion of students participating in the classroom discussions and better peer–leader–student communication. A sizeable proportion of subjective responses were ‘socially desirable’, making objective assessment a preferred methodology even for ‘dose received’. The peer-led health activism was successful. Teachers' manuals need to be concise.

Tobacco consumption in multiple forms presents an emerging, significant and growing threat to the health of Indian adolescents, especially those from low socio-economic communities. Research in two phases was undertaken among economically disadvantaged adolescents in two urban slums of Delhi. In phase I, qualitative research methods such as focus group discussions and in-depth interviews were used to explore and understand the determinants influencing tobacco use among these adolescents. Prevalence of tobacco use was higher among boys than girls. Adolescents reported using tobacco in multiple forms, chewing tobacco being the most popular. Peer pressure, easy availability and affordability were important reasons associated with tobacco initiation and continued use. Though they had some knowledge about the harmful effects of tobacco, this was not sufficient to motivate them to abstain or quit. The community-based intervention model developed on the basis of the results of phase I was evaluated in phase II in a demonstration study with two slum communities. One was treated as the intervention and the other as control. A significant difference in current use of tobacco was observed between the study groups (p = 0.048), with the intervention group showing a reduction in use, compared with an increase in use among the control group. Post-intervention, the intervention group reported significantly lower fresh uptake (0.3%) of tobacco use compared with the control group (1.7%). No significant change was found for quit rate (p = 0.282) in the two groups. Community-based interventions can be effective in preventing adolescents from initiating tobacco use in a low-resource setting such as India.

Childhood obesity has recently been reported as a growing problem in low- and middle-income countries. One potential prevention strategy is to apply effective obesity prevention approaches from the United States and/or other Western countries into programs that can be implemented in developing countries such as India. The purpose of this study was to explore Indian students’ perceptions of social–contextual factors related to obesity and whether they perceived a role for school-based obesity prevention. This study was conducted as a first step in a model to translate interventions from one culture to another. A total of 183 fourth- and fifth-grade students of middle socioeconomic status participated in focus group discussions. Analyses were guided by the essential principles of qualitative research and informed by social cognitive and social ecological theories. Results yielded five relevant themes: (a) student health behavior knowledge, (b) parental influence on health behavior, (c) school influence on health behavior, (d) media influence on health behavior, and (e) contexts for health promotion intervention. We found that students had moderate knowledge related to health behaviors (i.e., food intake and physical activity); that parents, schools, and the media are all important contributors to healthy and unhealthy behavior; and that schools can play an important role in the prevention of obesity. Results suggest that Indian middle socioeconomic status students are already moderately aware of the health benefits to nutritious food intake and physical activity, but parents, schools, and the media can influence unhealthy behaviors.

Pictorial warnings are effective in promoting smoking cessation as shown by research in the developed countries. This study aims to determine perceptions of Indians about the effectiveness of pictorial health warnings on tobacco packs which existed from May 31, 2009, to December 1, 2011. A cross-sectional survey was undertaken in five states of India with 1897 participants (56% males; 54% tobacco users). More tobacco users expressed that the pictorial warnings are inadequate to convey the health impact of tobacco use when compared with nonusers (71.50% vs. 62.75%; P < 0.001). More illiterates when compared with literates expressed their concern that the current pictorial warnings will not motivate them to quit (61.17% vs. 51.01%; P < 0.001). The new warnings implemented from December 1, 2011, in India are also not field-tested. Field testing and assessment of effectiveness of health warnings should be a mandatory requirement for Parties reporting on Article 11 of Framework Convention on Tobacco Control (FCTC).