Self-Care Practices and Health-Seeking Behaviors Among Older Adults in Urban Indian Slums: A Mixed Methods Study.

Background Effective self-care is crucial for maintaining health among older adults in resource-constrained communities. This study examined self-care practices, health-seeking behaviors, and associated factors among older adults in urban slums in India. Materials and methods A mixed methods study was conducted among 432 adults aged ≥65 years. Participants were selected through multistage random sampling from five slum areas. Self-care practices, health-seeking behaviors, demographic information, chronic conditions, self-efficacy, and health literacy were assessed through interviews. The qualitative data was explored through in-depth interviews with 30 participants. Results Inadequate health literacy (194, 45%) and low self-efficacy (162, 37.5%) were common. While 324 (75%) had an adequate diet and 378 (87.5%) took medications properly, only 86 (20%) monitored diabetes complications. Only 194 (45%) of the patients underwent recommended cancer screening, and 324 (75%) of the patients saw doctors ≥twice a year. Age, sex, education, income, comorbidities, self-efficacy, and health literacy had significant associations. Alongside facilitators such as social support, barriers such as limited healthcare access and suboptimal prevention orientation emerged. Conclusion Suboptimal prevention orientation and overreliance on secondary care instead of self-care among elderly people are problematic given the limited use of geriatric services. Grassroots health workers can improve health literacy and self-efficacy through home visits to enable self-care. Healthcare access inequities for vulnerable groups merit policy attention.

Knowledge, Attitudes, and Preventive Practices Regarding Tuberculosis Among Healthcare Workers and Patients in India: A Mixed-Method Study.

BACKGROUND: Tuberculosis (TB) remains a major public health challenge in India. Healthcare workers (HCWs) and TB patients are critical to disease transmission and prevention. This study evaluated and compared knowledge, attitudes, and practices related to TB infection control. MATERIALS AND METHODS: This was a mixed-method study that included a cross-sectional survey conducted among 167 HCWs and 346 patients with TB at tertiary hospitals in western Gujarat using a validated questionnaire. Additionally, 20 HCWs and 20 patients were interviewed to gain qualitative insights. Between-group analyses were performed, and multivariate regressions identified predictors of knowledge and compliance, while thematic analysis explored qualitative insights. RESULTS: A total of 142/167 (85.0%) HCWs had good knowledge, whereas 208/346 (60.1%) patients had good knowledge. A total of 151/167 (90.4%) HCWs had positive attitudes, whereas 242/346 (69.9%) patients had positive attitudes. A total of 159/167 (95.2%) HCWs practiced good preventive behaviors, whereas 225/346 (65.0%) patients did. HCWs demonstrated significantly higher mean knowledge scores (9.2 vs. 7.1, p<0.001) and higher median attitude scores (ranging from 5 with IQR 4-5 to 5 with IQR 5-5) compared to patients (ranging from 4 with IQR 3-5 to 5 with IQR 4-5) across all attitude statements assessed using the Likert scale (p<0.001). Being an HCW was associated with good knowledge (adjusted odds ratio (AOR) 2.5, 95% CI 1.5-4.1), positive attitudes (AOR 2.2, 95% CI 1.4-3.6), and good practices (AOR 3.1, 95% CI 1.8-5.2). The qualitative themes highlighted the need for accessible education, clear communication, adequate resourcing, and personal responsibility. CONCLUSION: This study identified gaps in TB prevention knowledge and practices among patients compared to those among HCWs in India. Tailored educational initiatives, optimized health communication, improved infrastructure, and accessible messaging can help individuals assimilate appropriate infection control behaviors among healthcare system actors and communities toward ending TB.

Secretory phospholipase A2 deposition on contact lenses and its effect on bacterial adhesion.

PURPOSE: Secretory phospholipase A2 (sPLA2) is a potent antibacterial enzyme in tears and has been found to kill Staphylococcus aureus rapidly in vitro. The purpose was to determine whether sPLA2 deposition is associated with contact lens (CL) type, if sPLA2 remains active on CLs, and if this has an effect on bacterial adhesion. METHODS: Ionic (etafilcon A) and nonionic (Polymacon) high-water, soft CLs were used. CLs were worn for 6 hours (daily wear, n = 39) or 6 nights on an extended-wear schedule (n = 25). Tears were collected from patients and worn contact lenses were removed and protein and active enzymes extracted for estimation of their levels. The number of S. aureus adhering to sPLA2-soaked CLs in vitro was also quantified. RESULTS: There was no significant difference in the concentration of sPLA2 in tears between groups of daily CL wearers. Significantly less sPLA2 was recovered from Polymacon CLs for both daily and extended wear compared with etafilcon A CLs (daily wear: 3 vs. 5 ng/lens; extended wear: 3 vs. 6 ng/lens; P < 0.05). sPLA2 activity correlated with protein amounts from lenses. Relatively less active sPLA2 was recovered from Polymacon contact lenses. sPLA2 reduced adhesion of Staphylococcus to contact lenses in vitro. CONCLUSIONS: Etafilcon A CLs absorb more active sPLA2 than Polymacon CLs, which increases with length of CL wear. The sequestering of sPLA2 onto CLs did not affect amounts of the enzyme in tears. sPLA2 adsorbed to a CL can reduce the viable Staphylococcus adhering to the CL, which may protect the eye from colonization by this pathogen.

Bisintercalating threading diacridines: relationships between DNA binding, cytotoxicity, and cell cycle arrest.

We have synthesized a series of bis(9-aminoacridine-4-carboxamides) linked via the 9-position with neutral flexible alkyl chains, charged flexible polyamine chains, and a semirigid charged piperazine-containing chain. The carboxamide side chains comprise N,N-dimethylaminoethyl and ethylmorpholino groups. The compounds are designed to bisintercalate into DNA by a threading mode, in which the side chains are intended to form hydrogen-bonding contacts with the O6/N7 atoms of guanine in the major groove, and the linkers are intended to lie in the minor groove. By this means, we anticipate that they will dissociate slowly from DNA, and be cytotoxic as a consequence of template inhibition of transcription. The dimers remove and reverse the supercoiling of closed circular DNA with helix unwinding angles ranging from 26 degrees to 46 degrees, confirming bifunctional intercalation in all cases, and the DNA complexes of representative members dissociate many orders of magnitude more slowly than simple aminoacridines. Cytotoxicity for human leukemic CCRF-CEM cells was determined, the most active agents having IC(50) values of 35-50 nM in a range extending over 20-fold, with neither the dimethylaminoethyl nor the ethylmorpholino series being intrinsically more toxic. In common with established transcription inhibitors, the morpholino series, with one exception, have no effect on cell cycle distribution in randomly dividing CCRF-CEM populations. By contrast, the dimethylaminoethyl series, with two exceptions, cause G2/M arrest in the manner of topoisomerase poisons, consistent with possible involvement of topoisomerases in their mode of action. Thus, the cellular response to these bisintercalating threading agents is complex and appears to be determined by both their side chain and linker structures. There are no simple relationships between structure, cytotoxicity, and cell cycle arrest, and the origins of this complexity are unclear given that the compounds bind to DNA by a common mechanism.