Perception and Acceptance of the Newly Introduced COVID-19 Precaution (THIRD) Vaccination Dose among Health Workers at an Indian Medical College.

INTRODUCTION: India has run a nationwide vaccination campaign against COVID-19, which has recently introduced a precaution (third) dose for health workers. This study assessed the perception and attitude of health workers toward the Indian vaccination campaign against COVID-19, with an emphasis on this major change. MATERIALS AND METHODS: A printed questionnaire was distributed among health-care workers at the Medical College of West Bengal. The completed forms were analyzed. RESULTS: Most of the participants were doctors (83.7%). Although all had received two doses of vaccine before, 44.4% were unwilling to be vaccinated with the third dose in the present scenario. The majority (63.8%) of the patients were concerned about side effects. The emergence of new COVID strains (65.6%) was viewed as a threat to the effectiveness of the vaccines. Participants with higher age, comorbidities, and those with the perception that the third dose was being introduced appropriately and would be effective against newer strains of the vaccine tended to be more willing to get vaccinated with the precaution dose compared to their counterparts. CONCLUSION: A dilemma regarding the acceptance of precaution doses was noted among health workers. This warrants the availability of more comprehensive information to increase acceptance of these vaccines.

Home-Isolation Care in Newly COVID-19-Positive Elderly Patients: A Caregiver-Centric Explanatory Framework.

Objectives: This community-based study aimed to identify the effect of different behavioral factors of family caregivers on the decision for home-isolation-based treatment of a new COVID-19-diagnosed elderly individual. It also explored the facilitators and barriers contributing to the decision-making process. Methods: A mixed-methods design was adopted to study the role of behavioral constructs such as risk tolerance, risk aversion, regret aversion, loss aversion, self-efficacy, and risk perception in healthcare-seeking decisions. By integrating the findings from the quantitative and qualitative parts, a framework was developed. Results: Self-efficacy, risk perception, and risk tolerance related to different issues were crucial factors behind the healthcare decision. However, regarding the various issues under consideration, risk perception followed by risk tolerance were the significant predictors for decision-making. Conclusion: To enhance appropriateness and equity in emergency healthcare-seeking, interventions should target risk tolerance and risk perception, taking into account the awareness levels of caregivers and the target population's risk and regret aversion. Such integrated approaches can improve the quality of care for elderly patients in home-based settings.

School-based intervention on behavioral intention of adolescents regarding healthy diet in India.

Introduction: Adolescence is a distinctive period of life when intense physical, psychological, and cognitive development occurs. A healthy diet helps prevent various forms of malnutrition and non-communicable diseases (NCDs) like diabetes, heart disease, stroke, and cancer. The current study aimed to assess the change in behavioral intentions (measured based on the TPB) toward healthy dietary practices through health promotion intervention among adolescents studying in selected schools in an urban area of West Bengal, India. Methods: The current study was a non-randomized controlled interventional study conducted among adolescents in either seventh, eighth, ninth, or tenth grades and aged between 12 and 16 years. Two-step cluster analysis with maximum likelihood estimation identified the intenders of a healthy diet. The intervention effect was measured using Relative Risk (RR) for being in the higher intention cluster through Generalized Linear Model (GLM) with a log-linear link under Poisson distribution assumptions and robust standard errors. A P-value of 0.05 or lesser was considered statistically significant. Results: There was no statistically significant difference in the mean score of "Attitude" in both groups. The mean score of "Subjective Norm" among the intervention group increased after intervention, and the difference was statistically significant. The mean score of "Perceived behavioral control" in the intervention group increased after the intervention, but the difference was statistically not significant. The intervention group's post-intervention proportion of intenders increased, and the difference was statistically significant. The relative risk of becoming an intender for healthy diet consumption in the Intervention group compared to the Control group was 2.07 (1.44-2.97). Conclusions: The intervention package effectively brought about a positive change in behavioral intention toward healthy dietary practices among adolescents. Model-based and construct-oriented intervention packages can be adopted in school-setting to promote behavioral intention toward a healthy diet.

Addiction habits in a rural cohort of injection drug users and effects on serum lipid profile: Analysis of a repeated measures study from an eastern state of India.

Background Injecting drug use (IDU) is associated with several cardiometabolic risks. We aimed to measure the independent effects of IDU behaviour and related factors on serum lipid profile among people who inject drugs (PWIDs). Methods We did a longitudinal study with six follow-up measurements at an interval of 2 months among 104 PWIDs from 11 selected hotspots under two blocks in West Bengal, India. Generalized estimating equations with robust standard errors analysed the effect of addiction habits on lipid profile parameters. Results The mean (SD) age of the participants was 27.6 (5.24) years, 36.5% married and 44.3% were unemployed at the time of recruitment. At the baseline, the mean (SD) body mass index (BMI) and fasting blood sugar (FBS) were 20.0 (1.82) kg/m2 and 112.0 (15.90) mg/dl, respectively. The mean duration of drug use was 2.5 (1.20) years. While 62.5% had normal triglyceride (TG), 14.4% had high total cholesterol (TC) and 69.2% had dyslipidaemia at the baseline. Adjusted for age, BMI, FBS and other addiction-related variables, models showed that longer duration of drug use (>3 years) resulted in higher levels of TG, higher TC-to-high-density lipoprotein ratio and dyslipidaemia. Tobacco use and high FBS level were also risk factors for dyslipidaemia. Conclusions Higher duration of IDU, tobacco use and higher FBS were associated with deranged lipid profile among PWIDs.

Changing patterns of household transmission of tuberculosis in an eastern state of India: The impact of COVID19 pandemic.

BACKGROUND: The COVID-19 Pandemic has affected many components of the Tuberculosis (TB) control program. Due to lockdown and restrictions, people, including TB patients, might have spent more time in the household. There might be an increased TB transmission among the household contacts (HHC). The current study was conducted to measure the household transmission of TB and also find out the relationship with several clinico-social factors. METHODS: Contact tracing data of West Bengal, India, was extracted from Nikshay portal of Central TB Division, Government of India. The anonymized data was divided into two parts, firstly before the lockdown initiation in India and secondly during the lockdown. A modified Poisson regression model was developed to determine the statistical association between clinico-social variables and the pandemic with household-level secondary TB cases. RESULTS: There was a 30% reduction in daily TB case notification, but the proportion of HHC screened was 4% higher during the pandemic than the pre-pandemic period. The secondary attack rate of household TB disease transmission was 34% lower during the pandemic period. Index TB patients aged under ten years, microbiologically positive, Drug-Resistant TB, having three or more HHCs, treatment delay more than seven days, notified from the private sector, and diagnosis during the pre-pandemic period was found to be independently associated with a higher risk of having a secondary TB case at household. CONCLUSION: The risk of household TB transmission was significantly lower during the pandemic period compared to the pre-pandemic period, which may be due to better infection prevention and control practices.

Perceived behavioral control regarding regular physical activity and healthy diet: An observational study among school-going adolescents in an urban area of West Bengal, India.

BACKGROUND: Healthy children are the foundation for a healthy and developing nation. Perceived behavioral control (PBC), comprising control belief and perceived power, is a person's perception of the ease or difficulty of performing the behavior of interest. For facilitating regular physical activity and regular healthy dietary practices among the adolescents, PBC is an important construct to develop and implement appropriate interventions. The aim is to assess PBC to perform regular physical activity and regular healthy dietary practices and measure their statistical relationship among the school-going adolescents in an urban area in West Bengal. MATERIALS AND METHODS: A school-based cross-sectional study was conducted among 251 adolescents aged 12-16 years after taking consent and assent for participation in the study. Data were collected with self-administered questionnaire on sociodemographic variables and the two domains of PBC, i.e., control beliefs and perceived power, related to regular physical activity and regular healthy dietary practices. Each PBC total score was calculated by multiplying control belief score and perceived power score for each respondent. Partial correlation coefficient was calculated between regular healthy dietary practices and regular physical activity. RESULTS: Among the total 251 responses analyzed, 34.7% and 27.5% students belonged to age group 14 and 15, respectively. It was observed that the mean (± standard deviation) score of PBC regarding regular healthy dietary practices was 100.7 (±27.7) and for regular physical activity was 106.0 (±21.4). The correlation between PBC of regular healthy dietary practices and regular physical activity was 0.421 and was statistically significant. CONCLUSION: In case PBC score over any behavior is higher, behavioral intention and ultimately chances of performing that particular behavior increases. Designing appropriate school-based health promotion strategies can lead to healthier children fostering regular healthy dietary practices and regular physical activity in their homes and communities.

Evaluation of the rashtriya bal swasthya karyakram (RBSK): A national children healthcare program in a health district of West Bengal, India.

Background: The Rashtriya Bal Swasthya Karyakram (RBSK) was launched in 2013 to screen and manage birth defects, deficiencies, diseases, and developmental delays including disabilities in Indian children, with the help of designated mobile health teams and grassroot workers across the country. Objectives: Performance of the RBSK program in three selected blocks of a health district of a large Indian state (West Bengal) was assessed. Methods: The performance assessment was based on input, process, and output performances, using checklists based on RBSK operational guidelines. Results: While some essential evaluation tools were available in required numbers at the block level, many were unavailable. There were deficiencies in the number of health staff appointed. Although most screening camps were conducted as per microplan, some were not. Anthropometric measurements were not done in some camps; Information, Education, and Communication (IEC) materials were not used adequately. Issues with fund management were also noted. The intervention rate at higher centers (District Early Intervention Centre) was low with regard to the children referred for management. Involvement of grassroot workers such as ASHA was also found to be lacking. Conclusion: Frequent orientation training of medical officers and staff is needed along with the efforts to strengthen the referral system and the patient tracking system. Sensitizing the children and their guardians regarding the importance of the relevant health issues is also needed with the help of the proper implementation of IEC services.

Treatment adherence status of the TB patients notified from private sector and its associated factors: Findings of a secondary data analysis from West Bengal, India.

INTRODUCTION: In India, each year, estimated one million TB cases are missing from notification, most of them being diagnosed treated in private sector. The large number of patients in private sector has raised concerns about suboptimal quality of care; lack of systems for treatment adherence thus raising the risk of drug resistance. The current analysis was conducted to find out the status of TB treatment adherence in private sector & to identify the factors associated with poor TB treatment adherence. METHODS: Analysis of secondary data obtained through adherence monitoring house visit by THALI (an USAID funded project) field workers during July 2018-June 2019, was done. RESULTS: Default rate among the private patients was 5%. Among the private TB patients 81.6% & among the defaulter 87.3% were in the age bracket of 15-59 years. Reasons stated for being a defaulter were 'Medicine is not working' (30%), 'Travel' (28.6%), 'Cost involved in the treatment' (21.8%), 'Side effects of ATD' (11.6%), 'Anxiety or Depression' (7.2%) & 'Feeling of completely cured' (0.8%). Despite best of efforts only 36.9% defaulter could be retrieved. Factors associated with increased risk of lost to follow-up were 15-59 years age, male sex, earning member of the family,tobacco user, alcohol user, DR-TB, continuation phase of treatment, previous history of TB, presence of symptoms & inability to walk. CONCLUSION: Privately treated TB patients are vulnerable for non-adherence. Once defaulted, it is difficult to retrieve them. Economically productive age group is at higher risk of being defaulter. Commonest reason for lost to follow up is wrong impression about TB medicine. Program should think of extensive engagement & sensitization drive for the private providers; Strict adherence monitoring of private TB patients, extensive advocacy communication & social mobilization program in the community & workplaces/institutions.

Quality of Life, Sexual Health, and Associated Factors Among the Sexually Active Adults in a Metro City of India: An Inquiry During the COVID-19 Pandemic-Related Lockdown.

Background: Sexual dysfunction (SD) and its effect on our life is an important but less studied topic especially during post-COVID era. This study examines the extent of SD and other mental health predictors and their effect on quality of life. Methods: A cross-sectional survey of sexually active adults was conducted in an Indian metro-city. Along with sociodemographic data, sexual dysfunction, depression, anxiety, stress, and quality of life were assessed by Arizona Sexual Experience Scale (ASEX), Depression Anxiety and Stress Scale (DASS), and WHOQOL-BREF, respectively. Structural equations modeling was used to understand their relationship. Results: Out of the total 1,376 respondents, 80.52% were male, 65.98% were married, and 48.54% were graduates. The mean age of the participants was 34.42 (±9.34) years. Of the participants, 27.18% had sexual dysfunction. Majority of the respondents did not have depression (59.30%), anxiety (52.33%), or stress (44.48%). Mild and moderate levels were the commonest findings among those who had depression, anxiety, or stress. Among the respondents, 27.18% had sexual dysfunction as per the ASEX instrument. Increase in age and female gender were associated with sexual dysfunction overall and also all its components. Presence of depression adversely affected ease of achieving orgasm and satisfaction from orgasm and was associated with sexual dysfunction overall. The respondents had a mean score of 73.57 (±13.50) as per the WHO-QOL. Depression and stress emerged as statistically significant factors for poor quality of life, while sexual dysfunction was not associated statistically. Conclusion: More than one-fourth of the study population reported sexual dysfunction during the first wave of the pandemic in India. The study findings highlight the role of poor mental health issues in this regard. In fact, issues like depression and stress were associated with poor quality of life as well. The current findings unequivocally warrant specific interventions to improve mental health of the respondents.

Contributing factors of willingness and hesitancy regarding acceptance of COVID-19 vaccine in primary care settings: A qualitative study in an eastern state of India.

BACKGROUND: For any effective vaccination strategy, the willingness of the beneficiaries and its contributing factors are important. This study was conducted among the health-care workers (HCWs) and community members to find the perceptions regarding the COVID-19 vaccine and understand the influencers and the barriers of vaccine acceptance. MATERIALS AND METHODS: A qualitative study was conducted from October 2020 to December 2020 in two primary care settings in an urban area. Eighteen in-depth interviews (IDIs) after taking consent were conducted with the help of IDI guide developed and validated beforehand by the experts. IDIs were done among the ten community members and eight HCWs selected conveniently. Data collection were continued till data saturation when no new information yielded from the interviews. Thematic analysis was performed. RESULTS: All the participants were hopeful about availability of the vaccine. The key influencers identified for promoting willingness to accept the vaccine among both the groups were opinion of the health-care providers, colleagues' and other people's acceptance of the vaccine, effectiveness of vaccine on other people, and perceived risk of the disease. Fear of adverse reactions was the most important barrier among all the respondents. The prevalent perception was that other preventive practices and vaccine together can only be the best solution to prevent COVID-19 illness. The HCWs perceived that acceptance of vaccine among the community members would be good overall but apprehended some initial difficulties. Mass campaign to promote COVID-19 vaccination and sensitization events are the need of the hour. CONCLUSIONS: Since opinion of health-care personnel emerged as an important influencer of vaccine acceptance, mass campaign and sensitization programs spearheaded by the health-care providers can bring about change by increasing the vaccine acceptance among the beneficiaries at large. Re-enforcement regarding practice of preventive measures should be made among the population irrespective of the vaccination status.

Cumulative Noise Exposure and Perceived Effects: A Comparative Study Among Different Occupational Groups in Kolkata.

Background: Adverse short-term and long-term health effects following a high level of noise have been established. The current study aims to find the relationship of these effects with an environment-specific level of noise exposure. Materials and Methods: A comparative cross-sectional study was conducted among 50 auto-rickshaw drivers and 51 age-matched service-sector employees. The peak average noise exposure in decibels (dB) was measured. The duration of exposure and response regarding perceptions following noise exposure was assessed through a pre-designed pre-tested semi-structured questionnaire. Results: The mean age of the participants was 42.24 (±13.72) years. Among the auto-rickshaw drivers, 82% perceived stress, 64% had hearing difficulty, and 74% complained of lack of sleep following exposure to a high level of noise. However, the perceptions were comparable among the comparison group and the differences were not statistically significant. The mean average peak level of noise exposure among drivers and their comparison group was 91.64 (±7.37) dB and 91.98 (± 8.06) dB, respectively, but were not different statistically. Around 52.94% of the service-sector respondents and 48% of the drivers were exposed to the lower cumulative noise levels. Those having a higher level of cumulative noise exposure, had a higher odds of feeling irritated (Odds ratio [OR]: 2.182, 95% confidence interval [CI]: 0.845-5.636), feeling stressed (OR: 5.805, 95% CI: 1.552-21.708), having palpitation (OR: 3.694, 95% CI: 1.264-10.793), and lack of sleep (OR: 3.020, 95% CI: 1.006-9.066). Conclusion: Stress and lack of sleep were the most important perceived effects of noise exposure. The exposures to the higher cumulative noise level in specified groups were more important in relation to quantifying perceived symptoms than the average peak noise level.

Realistic personal exposure assessment of air pollutants and health outcomes - A cross-sectional study among Kolkata slum dwellers.

Background: Rapid, unplanned, and unsustainable patterns of urban development can result in many emerging environmental and health hazards. One of the important public health problems of urban environment is regular exposure to dust and pollutants and consequence of such exposure in the form of changes in the pulmonary function. Being the immediate environment, indoor pollution poses a higher risk to human health than the ambient environment. Realistic personal exposure assessment gives the actual idea about the exposure status. Objectives: This study determined the household principal environmental exposures (Dust, SO2, NO2, and total volatile organic compound) among urban slum dwellers and assessment of the respiratory function to determine any possible relationship between those exposures and outcomes. The study also described the knowledge, attitude, and practice of these urban slum people regarding air pollution and its effect. Methods: A cross-sectional study was carried out among 442 urban slum people residing in the slums of the Kolkata Municipal area. Household environmental exposures were collected by standardized methods and outcome was observed by conducting a pulmonary function test. Finally, knowledge, attitude, and practice regarding air pollution were carried out with the help of a questionnaire-based survey. Results and Discussion: Almost all the pollutants exposure was associated with impairment of lung function. Younger age and female gender were statistically associated protective factors for the development of any lung disease. Those who had an overall good awareness regarding the means and effects of air pollution were found to be protected from developing lung disease. Using exhaust ventilation, relocation to inner side of slums, using personal protective measures, and adequate pollution awareness can help the slum citizens to overcome the problem.

Role of Threat and Coping Appraisal in Protection Motivation for Adoption of Preventive Behavior During COVID-19 Pandemic.

With more than 100 million cases and over 2 million deaths globally, the COVID-19 pandemic continues to remain a major threat. Identifying the behavioral factors influencing preventive behaviors for COVID-19 are crucial in devising public health policies to promote essential strategies to combat the pandemic in an efficient manner. The current study was therefore conducted to estimate the prevalence of COVID-19 preventive behaviors and measure their association with behavioral constructs like threat perception, response efficacy, and self-efficacy, as per socio-demographic background. A region-stratified online survey focusing on the constructs of protection motivation theory, for example, threat and coping appraisal for preventive health practices against COVID-19, was carried out among adult users of social media in India. Generalized linear models with cluster-adjusted-robust standard errors were used to analyze the responses and model the preventive practices among the study population. Analysis of a total 2,646 responses revealed that proper perceptions regarding cause, symptoms, and transmission of COVID-19 were prevalent in the majority of the respondents. The majority of the participants reported frequent use of face masks (93.20%), followed by frequent washing of hands with soap and water (84.90%). The majority of the respondents affirmed that, though not frequently but sometimes, they avoid touching the face with unclean hands. Frequently covering mouth with the crook of the elbow while sneezing and coughing, and maintaining physical distance when outside was noted among 74.14 and 83.84%, respectively. The proportion of participants frequently using sanitizers to clean hands and those infrequently practicing the same were comparable. Self-efficacy for preventive practices and threat-appraisal of COVID-19 illness were identified as important determinants of the selected COVID-19 preventive behaviors, independently. The analysis confirmed that practices of the behaviors were mostly synergistic to each other. Current findings highlight that formulation of precise risk communication strategies to improve perceptions regarding threat appraisal and self-efficacy could facilitate desirable practices, which are also effective in the prevention of airborne infections and, hence, may contribute toward broader policy directions. The evidence urges the implementation of precision-driven risk communication and diffusion of these practices to attain behavioral herd immunity.

Has loneliness and poor resilient coping influenced the magnitude of psychological distress among apparently healthy Indian adults during the lockdown? Evidence from a rapid online nation-wide cross-sectional survey.

BACKGROUND: The burden of psychological distress is increasing with the spread of the pandemic and also with the enforcement of its containment measures. The aim of this research was to determine the proportion of self-reported psychological distress, loneliness and degrees of resilient coping, and to also investigate the relationship of loneliness, coping and other variables with psychological distress among apparently healthy Indians during nation-wide lockdown period. METHODS: A cross-sectional, region-stratified survey using pre-designed pre-tested Google form disseminated via different social media platforms was conducted. A total of 1249 responses were analysed all over India. The form enquired about Socio-demographic profile, awareness on COVID pandemic and cases in the surroundings. UCLA Loneliness scale, Brief resilience and coping scale (BRCS) and Psychological distress scale (K6) assessed self-reported loneliness, coping and psychological distress, respectively. Special regressor technique adjusting for endogeneity and heteroskedasticity was used to extract the average marginal effects. RESULTS: Majority of the respondents were 18-35 years old, male, single and urban residents. News media, social media mostly acted as sources of information regarding COVID related news. Overall, 54.47% (95% CI: 51.39-57.53%) and 38.39% (95% CI: 35.57-41.29%) were reported to be lonely and had low resilient coping ability respectively. Around 44.68% had high risk of developing psychological distress. Being a student (average marginal effect coefficient (AMECoef).: -0.07, 95% CI: [-0.12, -0.01]) and perceiving lockdown as an effective measure (AMECoef: -0.11, 95% CI: [-0.19, -0.03]) were protective against psychological distress. Psychological distress was associated with male respondents (AMECoef 0.07, 95% CI: [0.02, 0.11]), low or medium resilient copers (AMECoef 0.89, 95% CI: [0.17, 1.61]), and perceiving a serious impact of social distancing measures (AMECoef 0.17, 95% CI: [0.09, 0.26]). CONCLUSIONS: Psychological distress among Indian population during lockdown was prevalent. Poor coping ability and perceiving social distancing to have a serious impact was found to be significantly contributing to psychological distress. Appropriate measures to address these issues would be beneficial for the community mental health.

Correlates of insomnia among the adults during COVID19 pandemic: evidence from an online survey in India.

BACKGROUND: Psychosocial distresses are often associated with sleep disorders. This is found as a common population level observation during natural calamities or emergency situations like a pandemic. The current study was conducted to determine the magnitude of self-reported insomnia, and to identify its associated factors among the apparently healthy Indian adult population having access to social media during the lockdown period of COVID 19 pandemic. METHODS: A cross-sectional, region-stratified survey was conducted from April 20 - May 19, 2020 in India using online questionnaire comprising Perceived Stress Scale, Generalized Anxiety Disorder Scale, Insomnia Severity Index, variables related to concern, fear and apprehension about COVID19 pandemic, and different socio-clinical variables. The questionnaire was disseminated via different social media platforms and responses from 1081 respondents were included in the analysis. RESULTS: Moderate clinical insomnia was present in 13.32% (95% confidence interval [CI]: 12.23%-14.50%), and severe clinical insomnia was present in 1.85% (95% CI: 1.08%-3.14%). For higher levels of insomnia mild anxiety was associated with a proportional odds ratio (OR) of 1.83 (95% CI: 1.24-2.71), and moderate and severe anxiety had an OR of 4.01 (95% CI: 2.57-6.25). Factors associated with higher severity of insomnia were middle age group (36-50 years), being a professional, living alone, perceiving COVID as serious disease, urban residence and those having comorbidity. The OR for being concerned for staying indoors was 5.09 (95% CI: 4.09-5.33), whereas the OR for fear of scarcity in availability of masks and sanitizers was 1.48 (95% CI: 1.26-1.75); and the OR for fear of unavailability of essential goods was 3.20 (95% CI: 2.06-4.98). CONCLUSIONS: Psychosocial factors like generalized anxiety, higher age, higher perceived severity, and various concerns related to COVID19 pandemic were identified to be associated with higher degrees of insomnia. Necessary psychosocial interventions, may be required to address the burden of insomnia in a timely and long-term mode.

Gender Equity Perceptions Among School-Going Adolescents: A Mixed-Methods Comparison Amongst Tribal and Non-Tribal Rural Areas of an Eastern State in India.

Introduction: Gender equity is an important social determinant of population health. There are very few studies in the Indian context in this regard, and even less regarding the diversity in tribal-dominated and non-tribal regions. The current study was conducted to assess and compare the perceptions of adolescents going to selected schools of tribal-dominated and non-tribal rural areas in West Bengal, India, regarding gender equity. It also explored the teacher's perceptions on gender equity in an attempt to contextualize the students' perceptions. Methods: A mixed-methods study was conducted with a convergent parallel design in two co-education schools, each from tribal-dominated and non-tribal rural areas. In the quantitative survey total of 828 adolescents aged 14-19 years participated. The qualitative component involved 26 in-depth interviews (IDIs) with the selected teachers. Results: Overall, the respondents from tribal area had a better perception regarding the equitable privilege of independence among genders, equity in decision roles, and especially financial decision roles of women. Perceptions related to girls access to education were better among the boys from non-tribal area than their counterparts from tribal area. The non-tribal respondents had a more inadequate perception regarding women's limited role. In general, the respondents perceived favorably against gender dominance. The teacher's perceptions in the context were mostly concordant, with some exceptions, e.g., regarding dominance and violence-related issues, the teachers perceived differently, contrasting the better perceptions exhibited by the students. Conclusion: The teachers' perceptions showed strict reliance on the deep-rooted social norms that can be taken up for behavior change interventions. Better perceptions from the tribal areas are an opportunity to further enhance on gender equity. The boys' perceptions can still be improved more in favor of gender equity.

Domestic migrant workers in India returning to their homes: emerging socioeconomic and health challenges during the COVID-19 pandemic.

Domestic migrant workers were stranded far from home when India declared nationwide lockdown to combat the pandemic of novel coronavirus (COVID-19). A large number of these workers were left with no economic support, no food and in many cases nowhere to live. The pandemic posed a serious health threat to these people, and the socioeconomic insecurity pushed them towards the edge of sustainability. Many of the migrants began walking home and accepted an uncertain fate if they could not return back home. The Government of India initiated efforts to provide transport support with special train services from the beginning of May 2020. While the migrants have started to return to their villages and towns, the states are facing the challenges of preventing the spread of COVID-19. The point-of-entry screening, quarantine and isolation facilities have increased substantially in capacity, although the quality of care remains a point of concern. Back at their homes, the migrants are enduring stigma, discrimination and poor social security. In order to avert the brewing humanitarian crisis, empathetic administration combined with political will is a must. Prudent, evidence-based decision-making in the economic and health sectors is also necessary.

Elders suffering recurrent injurious falls: causal analysis from a rural tribal community in the eastern part of India.

INTRODUCTION: Falls among the elderly are prevalent but preventable. There is a knowledge gap regarding the factors causing recurrent injurious falls among the elderly, especially in tribal areas. The aim of the present study was to find out the incidence of injurious falls among elderly participants and measure the effect of selected predictors on recurrent injurious falls. METHODS: A longitudinal observational study was conducted among 536 community-dwelling elderly individuals residing in 16 tribal dominated villages under two community development blocks of North 24-Parganas, West Bengal, India from December 2017 to January 2019. Participants were followed up for 1 year. The predictors of recurrent injurious falls were assessed through Prentice, Williams and Peterson Gap Time hazard model. RESULTS: The mean age of the participants at the baseline was 69.16 (±2.95) years. The majority were male (55.60%), with sedentary physical activity (49.63%). At baseline, history of injurious fall in the preceding 1 year was present in 37.69% of participants. At baseline, 53.17% had malnutrition and 54.29% were dependent on caregivers for activities of daily living. During the follow-up period there were 153 episodes of injurious falls. The incidence of fall was 29.88 episodes per 100 person-years. History of fall had a hazard ratio of 2.33 (95% confidence interval (CI): 1.01-5.38). The hazard ratios for malnutrition, impaired balance and faster walking speed respectively were 1.20 (95%CI: 1.01-3.60), 5.96 (95%CI: 3.52-6.34) and 3.23 (95%CI: 2.12-5.26), and were statistically significant. CONCLUSION: Physical status indicators such as nutritional status, balance and walking speed appeared to be key factors contributing to recurrent injurious falls. Proper nutrition, and regular check-up and rehabilitative measures, are needed to reduce recurrent falls.

Effect of light pollution on self-reported sleep quality and its components: Comparative assessment among healthy adult populations in a rural and an Urban area of West Bengal, India.

BACKGROUND: Light pollution is inappropriate or excessive use of artificial light. Nighttime sky radiance is an effective measure to study its effects on individual sleep quality. OBJECTIVES: The study is aimed to measure the effect of light pollution on the sleep quality and compare among people residing in selected rural and urban areas of West Bengal, India. METHODS: A comparative cross-sectional study was conducted during September-October 2018 in 10 villages of Barasat II block and 10 wards of Kolkata Municipal Corporation. Two hundred and sixty-three participants from urban and 249 participants from rural areas were selected through multi-stage sampling. Data regarding sleep quality and other selected factors were geotagged along with the radiance data. Multi-level linear regression models were built. RESULTS: The mean age of the participants from rural and urban areas were respectively 37.65 (±10.77) years and 38.10 (±11.02) years. Gender-wise the participants were distributed almost evenly in urban and rural areas. Among the urban and rural population, the observed mean global Pittsburgh Sleep Quality Index scores were 12.63 (±3.04) and 9.23 (±2.27), respectively. Poorer sleep quality was observed to be statistically significant with increasing level of exposure. Multi-level models show that, at an exposure of >40.0 nW/cm2/sr the adjusted coefficient was 11.52 (95% confidence interval [CI]: 9.65, 13.40) in the overall model and 12.84 (95% CI: 12.31, 13.37) for urban participants. CONCLUSION: The disturbance in sleep is associated with higher levels of night-time radiance of the sky strongly observed among the urban population.

Effectiveness of preventive measures against COVID-19: A systematic review of In Silico modeling studies in indian context.

BACKGROUND: In the absence of any approved treatment or vaccine against novel Severe Acute Respiratory Syndrome Coronavirus -2 (SARS-CoV-2) infection, Non-Pharmaceutical Interventions (NPIs) are the cornerstone to prevent the disease, especially in a populous country like India. OBJECTIVES: To understand the effectiveness of NPIs reported in the contemporary literatures describing prediction models for prevention of the ongoing pandemic of SARS-CoV-2 specifically in Indian population. METHODS: Original research articles in English obtained through keyword search in PubMed, WHO Global Database for COVID19, and pre-print servers were included in the review. Thematic synthesis of extracted data from articles were done. RESULTS: Twenty-four articles were found eligible for the review - four published articles and twenty pre-print articles. Compartmental model was found to be the most commonly used mathematical model; along with exponential, time varying, neural network and cluster kinetic models. Social distancing, specifically lockdown, was the most commonly modelled intervention strategy. Additionally, contact tracing using smartphone application, international travel restriction, increasing hospital/ICU beds, changes in testing strategy were also dealt with. Social distancing along with increasing testing seemed to be effective in delaying the peak of the epidemic and reducing the peak prevalence. CONCLUSION: Although there is mathematical rationality behind implementation of social distancing measures including lockdown, this study also emphasised the importance of other associated measures like increasing tests and increasing the number of hospital and ICU beds. The later components are particularly important during the social mixing period to be observed after lifting of lockdown.