Factors influencing care-seeking behaviour for mental illness in India: a situational analysis in Tamil Nadu.

BACKGROUND: The contribution of mental illness to the total burden of disease in India nearly doubled from 1990 to 2017, increasing from 2.5% of the total disability-adjusted life years in 1990 to 4.7% in 2017. Despite efforts by the Indian government, a treatment gap of 75-85%, with heterogeneity across multiple dimensions, exists across India. We conducted a qualitative study in Tamil Nadu, India, to better understand the contextual factors affecting the care-seeking behaviour for mental illness. METHODS: Qualitative methods, including semi-structured interviews and focus groups (FGs), were conducted with stakeholders involved in the mental health care pathway in Tamil Nadu. Ten semi-structured interviews and five FGs were conducted and analysed using an inductive approach to identify codes, using Dedoose v7, related to the emerging themes and categories. RESULTS: Our analyses identified three key areas that influence care-seeking: views on what causes and/or constitutes mental illness, stigma and discrimination associated with mental illness and broader factors influencing decision-making. CONCLUSIONS: The specific contextual factors identified by our study can be used to design and implement approaches that can help to address some of the issues that influence the care-seeking behaviour and manifest in the treatment gaps seen in Tamil Nadu and in India, more generally.

A nitroenolate approach to the synthesis of 4,5-disubstituted-2-aminoimidazoles. Pilot library assembly and screening for antibiotic and antibiofilm activity.

A library of 4,5-disubstituted-2-aminoimidazoles was synthesized using a nitroenolate route and then screened for antibiofilm and antimicrobial activity. These compounds displayed notable biofilm dispersal and planktonic microbicidal activity against various Gram-positive and Gram-negative bacteria.

Fast-Track Cities: striving to end urban HIV epidemics by 2030.

PURPOSE OF REVIEW: To provide a summary of progress achieved, lessons learned, and best practices employed in select Fast-Track Cities striving to attain and surpass the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets. RECENT FINDINGS: The 90-90-90 targets have served as a catalyst to galvanize political, programmatic, and funding support for urban HIV responses, while prompting increased community engagement. More than 300 cities and municipalities have joined the Fast-Track Cities network, pledging to attain and surpass the UNAIDS 90-90-90 targets. One city has officially surpassed the 95-95-95 targets; four cities have surpassed the 90-90-90 targets; and 34 cities have achieved one or more of the 90 targets. Across the Fast-Track Cities network, upward trends have been recorded in numerous cities and municipalities using data-driven approaches to close HIV care continuum gaps through data-driven implementation planning. SUMMARY: The Fast-Track Cities initiative has served as a catalyst for leveraging accelerated and optimized urban HIV responses to scale up HIV diagnosis, treatment, and viral suppression. Key to attaining and surpassing the 90-90-90 targets is a 'calculus for success' that includes political will, public health leadership, data-driven implementation planning, and equity-based interventions facilitated by active engagement with affected communities, notably people living with HIV.