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Background: COVID-19 severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was declared Pandemic by the World Health Organization on January 30, 2020. Vaccination represents the best possibility to resolve this pandemic. The current global challenge is the immunization against the SARS-CoV-2. However, the adverse events following immunization (AEFI) of the corona vaccine remains unclear. Aim and Objectives: This observational study aims to represent an accountable data of the AEFI between Covaxin and Covishield in North Indian population. Materials and Methods: The hospital-based prospective and observational study was employed from January 2021 to December 2021 for detecting and monitoring of AEFI in adults. All population vaccinated either covishield or covaxin with both doses were enrolled in the study as targeted population. Post-vaccination vaccinated population were telephonic follow-up with prior consent. Results: A total of 1015 vaccinated individuals were included in this study for assessment of AEFI. After statistical analysis of AEFI between both vaccination at 24 h P = 0.13, 3–7 days 0.4 and complete AEFI P = 0.06 observed. There is no association that was found significant P < 0.05 with the incidence of AEFI. Conclusion: The short-term outcome has not attribute any serious AEFI. This study demonstrated that both vaccines were well-tolerated and safe in generalized population. [ FROM AUTHOR] Copyright of Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research) is the property of Journal of Cardiovascular Disease Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Stigma, discrimination, poor help seeking, dearth of mental health professionals, inadequate services and facilities all adversely impact the mental health treatment gap. Service utilization by the community is influenced by cultural beliefs and literacy levels. We conducted a situational analysis in light of the little information available on mental health related stigma, service provision and utilization in Haryana, a state in Northern India. This involved: (a) qualitative key informant interviews; (b) health facility records review; and (c) policy document review to understand the local context of Faridabad district in Northern India. Ethical approvals for the study were taken before the study commenced. Phone call in-depth interviews were carried out with a purposive sample of 13 participants (Mean = 38.07 years) during the COVID-19 pandemic, which included 4 community health workers, 4 people with mental illness, 5 service providers (primary health care doctors and mental health specialists). Data for health facility review was collected from local primary health and specialist facilities while key policy documents were critically analysed for service provision and stigma alleviation activities. Thematic analysis was used to analyse patterns within the interview data. We found poor awareness and knowledge about mental illnesses, belief in faith and traditional healers, scarcity of resources (medicines, trained professionals and mental health inpatient and outpatient clinics), poor access to appropriate mental health facilities, and high costs for seeking mental health care. There is a critical gap between mental health related provisions in policy documents and its implementation at primary and district level.
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Seed is an essential input for the potato crop. Much of the efforts and investment would be infructuous if the farmers did not get the quality seeds. Only the seed with assured purity-genetic and physical can be expected to respond to fertilizers and other inputs in a respected manner. The present study attempted to analyze the source, SRR of potato seed and assess the effect on potato crop yield by using certified seed in the Jalandhar district of Punjab. The current study was conducted on primary data collected from 120 farmers during the 2020-21 agricultural year. The data were analyzed using simple tabular analysis and other suitable statistical techniques. The study found that the most preferred source of seed was the self-retained seed which came out to be 48 per cent, the second most preferred source was private seed dealers, as 17 per cent procured seed from these dealers. The high use of self-retained seed was due to the high cost of purchased seed, and the other reason was that farmers had more confidence in the self-retained seed. The study found that large farmers' Seed Replacement Rate (SRR) was higher. It was 11.2 per cent for small farmers, 19.5 per cent for medium farmers and 27.5 per cent for large farmers. The yield of potato crop using certified seed was higher than non-certified seed. The per cent difference in yield of potato grown by certified and non-certified seed among small and medium farmers was 17 per cent, 11 per cent among large farmers and 15 per cent overall in the Jalandhar district of Punjab. The study highlighted that the primary constraint faced by potato seed growers were high prices of certified seed (69.1 per cent), high cost of pesticides and insecticides (65.8 per cent), fluctuations in the price of potato seed (55 per cent), lack of public procurement at MSP (53.3 per cent), covid related restrictions (52.5 per cent) and lack of extension facilities (48.3 per cent). The study suggested that the government should provide certified seed to the farmers at the lowest cost to increase the seed replacement rate. Awareness regarding the use of certified seed should be given to farmers through extension services. Government institutes like Central Potato Research Station (CPRS) (ICAR), the Centre of Excellence (Dogri) and the Department of Horticulture should expand the production of certified seeds as only 18 per cent of potato growers purchased seeds from these agencies in the study area. The minimum support price of potatoes should be fixed to promote the production of potatoes in the state.
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Purpose - COVID-19 pandemic has shattered the economic systems all around the world while creating numerous problems which were faced by all, especially international migrants. The present study offers a qualitative and quantitative perspective on the distress of international migrants and their repatriation intention during the pandemic period. Design/methodology/approach - In-depth semi-structured interviews of 30 respondents belonging to five host nations, Australia, the USA, the UK, New Zealand and Canada, revealed diverse issues. Based on qualitative study findings and past literature, 22 purposeful statements about six constructs - financial issues, social issues, mobility constraints, psychological problems, healthcare issues, and repatriation intentions - were developed. These statements were measured on a seven-point Likert scale and shared online with international migrants from India residing in the host nations. Data collected from 496 international migrants from October 2020 to July 2021 were used to analyze the influence of various determinants on the repatriation intentions by partial least square-structural equation modeling using SmartPLS software. Findings - The analysis results revealed that the role of financial, social, mobility, psychological and healthcare issues was significant in strengthening the repatriation intentions of the migrants. There is a need to create job opportunities, retrain laid-off workers and formulate migrant inclusive policies. Originality/value - Although some studies have highlighted a few problems faced by international migrants, their impact on repatriation intentions has not been studied yet. The present study fills this gap and analyzes the repatriation intention of international migrants in light of different problems they faced during the pandemic.
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BACKGROUND: Availability of mental health services in low- and middle-income countries is largely concentrated in tertiary care with limited resources and scarcity of trained professionals at the primary care level. SMART Mental Health is a strategy that combines a community anti-stigma campaign with a primary health care workforce strengthening initiative, using electronic decision support with the goal of better identifying and supporting people with common mental disorders in India. METHODS: We describe the challenges faced and lessons learnt during the pre-intervention phase of SMART Mental Health cluster Randomised Controlled Trial. Pre-intervention phase includes preliminary activities for setting-up the trial and research activities prior to delivery of the intervention. Field notes from project site visit, project team meetings and detailed follow-up discussions with members of the project team were used to document operational challenges and strategies adopted to overcome them. The socio-ecological model was used as the analytical framework to organise the findings. RESULTS: Key challenges included delays in government approvals, addressing community health worker needs, and building trust in the community. These were addressed through continuous communication, leveraging support of relevant stakeholders, and addressing concerns of community health workers and community. Issues related to use of digital platform for data collection were addressed by a dedicated technical support team. The COVID-19 pandemic and political unrest led to significant and unexpected challenges requiring important adaptations to successfully implement the project. CONCLUSION: Setting up of this trial has posed challenges at a combination of community, health system and broader socio-political levels. Successful mitigating strategies to overcome these challenges must be innovative, timely and flexibly delivered according to local context. Systematic ongoing documentation of field-level challenges and subsequent adaptations can help optimise implementation processes and support high quality trials. TRIAL REGISTRATION: The trial is registered with Clinical Trials Registry India (CTRI/2018/08/015355). Registered on 16th August 2018. http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=23254&EncHid=&userName=CTRI/2018/08/015355.
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INTRODUCTION: In India about 95% of individuals who need treatment for common mental disorders like depression, stress and anxiety and substance use are unable to access care. Stigma associated with help seeking and lack of trained mental health professionals are important barriers in accessing mental healthcare. Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health integrates a community-level stigma reduction campaign and task sharing with the help of a mobile-enabled electronic decision support system (EDSS)-to reduce psychiatric morbidity due to stress, depression and self-harm in high-risk individuals. This paper presents and discusses the protocol for process evaluation of SMART Mental Health. METHODS AND ANALYSIS: The process evaluation will use mixed quantitative and qualitative methods to evaluate implementation fidelity and identify facilitators of and barriers to implementation of the intervention. Case studies of six intervention and two control clusters will be used. Quantitative data sources will include usage analytics extracted from the mHealth platform for the trial. Qualitative data sources will include focus group discussions and interviews with recruited participants, primary health centre doctors, community health workers (Accredited Social Health Activits) who participated in the project and local community leaders. The design and analysis will be guided by Medical Research Council framework for process evaluations, the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, and the normalisation process theory. ETHICS AND DISSEMINATION: The study has been approved by the ethics committee of the George Institute for Global Health, India and the Institutional Ethics Committee, All India Institute of Medical Sciences (AIIMS), New Delhi. Findings of the study will be disseminated through peer-reviewed publications, stakeholder meetings, digital and social media platforms. TRIAL REGISTRATION NUMBER: CTRI/2018/08/015355.
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Mental Disorders , Mental Health , Community Health Workers , Humans , India , Mental Disorders/psychology , Mental Disorders/therapy , Randomized Controlled Trials as Topic , Referral and ConsultationABSTRACT
PURPOSE: We report findings from a survey on the mental health impact of COVID-19 factoring environmental adversities among older adolescents (15-19 years) living in urban slums in India. METHODS: We report survey results of 3490 older adolescents. Patient Health Questionnaire-9 was used to assess depression, slum adversity questionnaire for slum conditions, and for COVID-19 infection we recorded self-reported positivity status. Sociodemographic details were also collected. Additional sub-group analyses of sample who had depression and tested positive for COVID-19 infection was conducted. We used univariate and multivariate logistic regression models to identify factors and COVID-19 infection that were associated with depression. RESULTS: Adolescents with adversities were three times more likely to report depression. Adolescents who reported COVID-19 infection were about two times more likely to have depression. Sub-group analyses showed that adolescents having experienced adversities and girls were more likely to report depression following COVID-19 infection. CONCLUSIONS: There is a need for an intersectional research framework that incorporates stress arising out of a pandemic, social disadvantage, and systemic inequities. Such a framework will help to assess mental health issues of developmentally vulnerable groups residing in disadvantageous conditions.
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COVID-19 , Poverty Areas , Adolescent , COVID-19/epidemiology , Depression/epidemiology , Female , Humans , India/epidemiology , Mental HealthABSTRACT
The COVID-19 pandemic has seen a significant rise in the demand for mental health services. Technology advancement and pandemic restrictions have revolutionised the mental health field with mental health professionals adapting and shifting towards online platforms. Recent research suggests that online therapy can be as effective as in-person therapy for various mental health conditions. Online psychotherapy isn’t a new practice, rather it has been used during pre-covid times with caution. Several studies have proven the effectiveness of telemental health indicating that both clients and providers who use telehealth generally view it favourably. Online psychotherapy and telemedicine could be more approachable, convenient while increasing access to out-of-state professionals. Online therapy and tele-consultation have its strengths as well as challenges including flexibility in scheduling, convenience, saving time from commuting to and from appointments, enhancing vulnerability and disclosure. However, it has its own set of challenges and ethical concerns, particularly revolving around privacy and confidentiality in the digital space. This symposium will highlight the strengths and challenges of telemental health based on empirical researches and personal experiences of psychotherapists and psychiatrists. With increasing onus over the providers, it becomes important to discuss and address the new demands. It will enable the mental health practitioners to be more equipped and competent to continue offering telehealth as demand for mental health services grows, particularly services offered virtually. Finally, the symposium glances at the future of tele mental healthcare in the light of the recent guidelines and what it possibly holds for service providers. TableName of the sub-topicSpeakerTelemental healthcare: A contemporary overviewMs. Padmaja Mushahary and Ms.Angana Mukherjee SharmaOnline psychotherapy: Scope and challengesDr Amanpreet KaurThe 'New Normal' of Telepsychiatry: Where do we stand?Dr. Debanjan BanerjeeEthics in tele-mental health and the curve aheadDr. Ananya Sinha
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Background: Mental health and other health professionals working in mental health care may contribute to the experiences of stigma and discrimination among mental health service users, but can also help reduce the impact of stigma on service users. However the few studies of interventions to equip such professionals to be anti-stigma agents those took place in High-Income Countries. This study assesses the feasibility, potential effectiveness and costs of Responding to Experienced and Anticipated Discrimination training for health professionals working in mental health care (READ-MH) across Low- and Middle-Income Countries (LMICs). Methods: This is an uncontrolled pre-post mixed methods feasibility study of READ-MH training at seven sites across five LMICs (China, Ethiopia, India, Nepal, and Tunisia). Outcome measures: knowledge based on course content; attitudes to working to address the impact of stigma on service users; and skills in responding constructively to service users' reports of discrimination. The training draws upon the evidence bases for stigma reduction, health advocacy and medical education and is tailored to sites through situational analyses. Its content, delivery methods and intensity were agreed through a consensus exercise with site research teams. READ-MH will be delivered to health professionals working in mental health care immediately after baseline data collection; outcome measures will be collected post-training and three months post-baseline, followed by qualitative data collection. Fidelity will be rated during delivery of READ-MH, and data on training costs will be collected. Quantitative data will be assessed using generalised linear mixed models. Qualitative data will be evaluated by thematic analysis to identify feedback about the training methods and content, including the implementability of the knowledge and skills learned. Pooled and site-specific training costs per trainee and per session will be reported. Conclusions: The training development used a participatory and contextualized approach. Evaluation design strengths include the diversity of settings; the use of mixed methods; the use of a skills-based measure; and knowledge and attitude measures aligned to the target population and training. Limitations are the uncertain generalisability of skills performance to routine care, and the impact of COVID-19 restrictions at several sites limiting qualitative data collection for situational analyses.
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There is a decline in revenue and occupancy rates in the hotels during the pandemic. For the sustainable and long-term recovery of the hotel industry, the guests need to be analyzed for their stay preferences. This study attempts to find the preferred attributes of the travelers visiting the Indian luxury hotels during the COVID-19 pandemic. The research investigated the post-visit experiences from the online reviews published by tourists on TripAdvisor.com. Thematic salience valence analysis and lexical salience valence analysis was used to identify the vital attributes of the hotel industry. The study revealed staff, location, food, hygiene, and rooms as the preferred hotel attributes, in which the coastal locations were highly considered for location based marketing of luxury hotels, and non-compliance of COVID-19 standards and complaints for upgradations in the rooms were the non-recommenders for the luxury hotels. The dashboard-based salience valence zone analysis was used to provide suggestions to the hotel authorities by revealing the significant and critical hotel attributes simultaneously for prompt handling of the issues during the COVID-19 pandemic.
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There have been several measures adopt to manage the increase of COVID-19 in India. To combat the COVID-19 Pandemic faced by the nation, Govt. of India has in employ gigantic amount of procedures like Lockdown, aggressive testing, infusing funds to improve the financial system, present incentives to various sectors, promoting digital dealings, e-learning, etc. The challenge remains the acceptance and adoption of these by people of India. The need will be to educate people about this epidemic and increase their knowledge in the direction of it so that extend of the same can be slowed down. Majority people have not only to change their practices but also their attitude towards life. The lifestyles are bound to be affected due to COVID-19 across India. Through this study we will try to gauge on these aspects. For this a survey on people of Tricity (Chandigarh/ Mohali/ Panchkula) was conducted. The questionnaire included 20 questions to assess the understanding of the residents on the measures adopted for the prevention of disease and what they are doing on their own to come out of this. The study is based on their confidence level, knowledge level and the practices they are adopting towards this epidemic. The study found not too high levels of knowledge scores of the respondents. However, the results showed high levels of confidence and practices followed in such situation. The results of the demographic analysis revealed the knowledge scores showed significant differences existed between the groups based on gender and age. However, no significant differences are found for attitude and practices across the groups based on gender and age.
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In the state of Punjab, the heart of the green revolution in India, a large fraction of agricultural labour is expended by migrant workers. The unplanned lockdown imposed by the Indian government affected paddy transplantation, a labour-intensive activity in Punjab primarily due to interstate restrictions on movement. Drawing on a primary survey in a village from the Malwa region of Punjab, the paper examines the changes in agrarian relations in rural Punjab due to the Covid-19 pandemic by critically analysing the dynamics of capital labour relations. The restriction on labour movement and unilateral imposition of transplantation wage rates by a few Panchayats in Punjab (dominated by capitalist landlords and rich peasants) has intensified class conflict in the state. The Punjab government's policies, which are driven by the capitalist landlords and rich peasants, have played a significant role in the increased exploitation of workers. The paper concludes with a brief evaluation of the changes induced by Covid-19 in the agrarian political economy of Punjab.
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With the exponential growth of COVID-19 cases, medical practitioners are searching for accurate and quick automated detection methods to prevent Covid from spreading while trying to reduce the computational requirement of devices. In this research article, a deep learning Convolutional Neural Network (CNN) based accurate and efficient ensemble model using deep learning is being proposed with 2161 COVID-19, 2022 pneumonia, and 5863 normal chest X-ray images that has been collected from previous publications and other online resources. To improve the detection accuracy contrast enhancement and image normalization have been done to produce better quality images at the pre-processing level. Further data augmentation methods are used by creating modified versions of images in the dataset to train the four efficient CNN models (Inceptionv3, DenseNet121, Xception, InceptionResNetv2) Experimental results provide 98.33% accuracy for binary class and 92.36% for multiclass. The performance evaluation metrics reveal that this tool can be very helpful for early disease diagnosis.
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BACKGROUND: Few observational studies have shown a beneficial effect of dipeptidyl peptidase-4 inhibitors (DPP4i) in patients with coronavirus disease 2019 (COVID-19), although results are not consistent. The present systematic review and meta-analysis was undertaken to provide a precise summary of the effect of DPP4i use (preadmission or in-hospital) and mortality in COVID-19 patients with diabetes mellitus (DM). METHODS: PubMed and Google Scholar databases were systematically searched using appropriate keywords to 4 January 2021, to identify observational studies reporting mortality in COVID-19 patients with DM using DPP4i versus those not using DPP4i. Preadmission and in-hospital use of DPP4i were considered. Study quality was assessed using the Newcastle-Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% confidence intervals (CIs) were calculated. Subgroup analysis was performed for studies reporting preadmission and in-hospital use of DPP4i. RESULTS: We identified nine observational studies of high quality pooling data retrieved from 7008 COVID-19 patients with DM. The pooled analysis of unadjusted and adjusted data did not show any significant association between DPP4i use and mortality in COVID-19 patients with DM. However, on subgroup analysis, we found that in-hospital (and not preadmission) DPP4i use was associated with reduced mortality (unadjusted OR 0.37, 95% CI 0.23, 0.58, p < 0.0001, I 2 = 0% and adjusted OR 0.27, 95% CI 0.13, 0.55, p = 0.0003, I 2 = 12%). CONCLUSIONS: In-hospital use of DPP4i is associated with a significant reduction in COVID-19 mortality. Hence, it would be prudent to initiate or continue DPP4i in COVID-19 patients with DM if not contraindicated.