Burden of mental health disorders and synthesis of community-based mental health intervention measures among adolescents during COVID-19 pandemic in low middle-income countries: A systematic review and meta-analysis.

BACKGROUND: COVID-19 pandemic and the resultant lockdown could have negatively impacted adolescent mental health. The synthesised burden of mental health illness among adolescents during or after the pandemic is unknown in Low Middle-Income Countries (LMICs). The objective was to ascertain the pooled prevalence of mental health disorders among adolescents aged 10 - 19 years and to systematically review & conduct a descriptive synthesis of community-based mental health intervention measures in addressing adolescent mental health disorders during the COVID-19 pandemic in LMICs. METHODS: The literature was searched in Embase, PubMed, and Scopus and selected the relevant studies. The data was extracted from the selected studies, and its quality was assessed using adapted Newcastle-Ottawa Quality Assessment Scales. Meta-analysis was performed using random effects model to pool the prevalence of mental health disorders. Statistical heterogeneity was evaluated through Cochran's Q test & I2 statistic. RESULTS: Thirty-five studies were selected out of 7955 identified studies. Most of the studies (n = 7, each) were from India and Iran. The majority of research works were community-based (n = 18), conducted in 2020 (23 articles), and participant interviews were conducted through online mode (n = 21). Varied instruments were used to measure the burden of mental health in different settings. Pooled prevalence (95% confidence intervals) of anxiety, depression and stress was found to be 43.69 (18.58-68.80)%, 47.02 (31.72-62.32)% and 39.97 (30.53-49.40)%, respectively, with high heterogeneity between the studies. No studies reported community-based mental health interventions. CONCLUSION: There has been a higher prevalence of anxiety, depression, stress, and other mental health illnesses, among adolescents in LMICs during the COVID-19 pandemic. It is important to note that no existing literature directly addresses community-based interventions for these common mental health illnesses. It is imperative to prepare the health system for early identification and management of common mental health illness among the adolescent age group in the event of any future disaster.

Facilitators and barriers to the uptake of COVID-19 vaccine precaution dose among adult population: qualitative analysis across six different states of India.

Introduction: India launched the COVID-19 vaccination drive on 16th January 2021 by vaccinating the adult population above 18 years of age. This was followed by the introduction of an additional precaution dose. As on 18th October 2022, 1,02,66,96,808 (1.02 Billion) first dose and 94, 95, 39,516 (949 Million) second doses of COVID-19 vaccine were administered. However, when compared to the uptake of the primary doses, the precaution dose uptake lagged behind with only 21,75, 12,721 (217 million) doses administered. Even though, the uptake of the primary doses remained optimal, irrespective of different interventions by the Government of India, the uptake of the precaution dose remained poor. In this context, the Ministry of Health & Family Welfare wanted to understand the facilitators and Barriers for precaution dose uptake among adults so that future immunization campaigns could address these issues. Methods: An exploratory qualitative study was conducted to assess the facilitators and barriers for COVID-19 precaution dose uptake at community level across 6 different states in India. From each of the states, two districts with the highest and lowest rates of COVID-19 vaccine precaution dose uptake were selected. In each of these districts, 2 block Primary Healthcare Centres (PHCs), one with high and one with low uptake were identified. Within these block PHCs, a PHC field area with high and low precaution dose uptakes was identified. From the identified sites a minimum of four IDIs, four FGDs were conducted among the community members. KIIs of the State Immunization Officers, District Immunisation Officers, PHC Medical Officers, healthcare workers like Accredited Social Health Activist/Auxiliary Nurse Midwife were also conducted. The data was audio recorded and it was transcribed, translated and analysed using framework approach. Results: It was observed that rise in COVID-19 cases prompted the community to take the precaution dose, this along with the cost of hospitalization and the number of productive days being lost as a result of being infected resulted in vaccine uptake. The fear of non-availability of COVID-19 vaccines latter on also prompted people for vaccine uptake. While the barriers were, poor accessibility to vaccination centers, long hours of travel, poor road connectivity and lack of transportation facilities. However, the most prominent barriers observed across all study sites was that a sense of pandemic fatigue and complacency had developed both among the providers as well as the beneficiaries. Other barriers include differences in vaccination schedules and longer duration between the primary doses of some vaccines. Media was identified to be both a barrier and facilitator for Covid-19 Precaution dose uptake. Even though media played an important role in disseminating information in the beginning of the campaign, it was soon followed by the circulation of both misinformation and disinformation. Discussion: The study identified that dissemination of accurate information and community involvement at each stage of planning and implementation are crucial for the success of any campaign. Efforts should be constantly made to address and re-invent strategies that will be most suitable for the needs of the community. Therefore, in order to ensure successful vaccination campaigns, it is crucial that along with political will it is also important to have a decentralized approach with inter-sectoral coordination with different stakeholders such as healthcare workers, community members and the different departments such as the local self-governments, education department, law & order department etc. These lessons learnt from COVID-19 vaccination campaigns must not be forgotten and must be applied in future vaccination campaigns and while framing public health policies.

Association between the 2d:4d and cardiovascular risk factors: Body mass index, blood pressure and body fat.

OBJECTIVES: To examine the relationship between the cardiovascular risk factors such as obesity as measured by Body mass index (BMI), body fat and blood pressure with the second to fourth digit ratio (2d:4d); a prenatal testosterone exposure marker. METHODS: The 2d:4d for both hands were measured for the Indian male subjects' (n = 1217). Subject's anthropometric parameters such as height, weight, skinfold thicknesses at various regions and blood pressure measurements were collected in a cross-sectional study with a convenient sampling approach. The association between digit ratio and the other variables were examined using analysis of variance, Pearson's correlation test and linear regression methods. RESULTS: The study included 1193 subjects and all were males aged 19.69 ± 5.38 years (range 13 to 40 years). The subjects' body mass index (BMI) was 19.45 ± 3.82 and right and left hand 2d:4d were 0.958 ± 0.054, and 0.958 ± 0.061 respectively. The systolic blood pressure (SBP) and BMI significantly differed between the higher and lower half of right 2d:4d. The left hand 2d:4d was significantly correlated with SBP (r = 0.075, p = 0.028) and significantly differed between different hypertensive groups (p < 0.003, F = 3.552, df = 5). CONCLUSION: The study observed an association between 2d:4d with hypertension and BMI among young Indian population, emphasizing the effect of prenatal testosterone on late life cardiovascular risk factor.

Association between second to fourth digit ratio and personality among Indian men.

OBJECTIVES: To examine the relationship between the personality domains with the second to fourth digit ratio (2d:4d); a prenatal testosterone exposure marker. METHODS: The 2d:4d for both hands was measured for the Indian male subjects' (n = 994). Ten-item personality inventory and displaced aggression questionnaire data were collected in a self-reported proforma in this cross sectional study with a convenient sampling approach. RESULTS: The personality traits, namely openness to new experiences, carelessness, and self-discipline were significantly differed between lower-half and higher-half of 2d:4d by median split. The right hand 2d:4d was positively correlated with open to new experiences and negatively correlated with disorganization, carelessness, and revenge planning. The left hand 2d:4d was positively correlated with aggression. On binary logistic regression, openness was positively associated while carelessness was negatively associated with the right hand 2d:4d and self-discipline trait was negatively associated with the left hand 2d:4d. CONCLUSION: This study affirmed the link between 2d:4d and domains of Big Five personality factors among Indian men and inverse relationship between 2d:4d and more "female" hands in the domains of disorganization, carelessness, and revenge planning even in men, emphasizing the effect of prenatal testosterone exposure on human personality.

Hearing Threshold Status and Risk Estimate of Hearing Impairment among Administrative Workforce.

BACKGROUND: Administrative workers working in quieter environment workplace are considered unaffected by noise-induced hearing loss (NIHL). AIM: To create a baseline data of the administrative workers so as to monitor them with prospective years of exposure with the hypothesis that workers working in the administrative jobs may not be affected by NIHL. SETTINGS AND DESIGN: The study was conducted among men and women administrative workers working in an office in Ahmedabad city, India. The design of the study was prospective cross-sectional study. MATERIALS AND METHODS: In all, 64 men and 33 women administrative workers were recruited. Pure tone air conduction (AC) and unmasked bone conduction (BC) audiometry of both ears was performed. Pure tone averages (PTAs) and air-bone gap (ABG) were calculated. Excess risk of hearing impairment was estimated using five model equations. STATISTICAL ANALYSIS: Descriptive statistics was used for analysis. For calculation of excess risk of hearing impairment, models in online calculator were used. RESULTS: AC for men depicted 4 and 6 kHz notch, whereas 6 kHz for women, for both ears. Around three-fourth men and nine-tenth women recorded hearing threshold <25 dB (A) for PTA0.5-1-2-4. ABG was <15 dB at all frequencies except 6 kHz, for both groups. Highest values of average estimated excess risk were 4.89% and 1.21% for men and women, respectively. Estimated excess risk ranged up to 1% for 50%-77% men and 82%-91% women. CONCLUSION: Administrative workers are minimally risked of developing NIHL; however, with progressive age, hearing ability may deteriorate.

Upper Extremity Muscular Strength in Push-Pull Tasks: Model Approach Towards Task Design.

BACKGROUND: Pushing and pulling in workplaces are common actions. Repetitive forceful exertions in long-duration works lead to increased risk of musculoskeletal disorders and injuries. AIM: To investigate the upper extremity strength in generic push-pull modes while using hand tools and forecasting the limits of the workers while frequent or continuous operation. SETTINGS AND DESIGN: The study was conducted among men workers in Ahmedabad city, India, and the design was cross-sectional study. MATERIALS AND METHODS: In all, 100 men were recruited (Group 1: 18-39 years and Group 2: 40-60 years). Upper extremity muscular strength (isometric mode) testing of the preferred hand during push-pull type of manual hand-tool operations was carried out for 60 s. Forecasting of strength to generate predictions for future events (120 s) based on known past events (measured 60 s) was carried out using Holt-Winters time-series model. STATISTICAL ANALYSIS: Descriptive statistics was used for analysis. For prediction model evaluation, WEKA 3.8.2 was used. RESULTS: Anthropometric parameters of both groups were similar, having no effect on generated strength. Largely, pull strength was recorded to be higher than push strength, wherein Group 2 men generated slightly higher strength. Seated strength was also higher than standing exertion. Forecasting reveals steady strength values for Group 1 men, whereas steep decline among Group 2 men with increasing duration of trial. CONCLUSION: The strength data generated would aid in work schedule design. Strength forecasting model would assist in developing engineering guidelines in the design of tools at workplace.

Task distribution, work environment, and perceived health discomforts among Indian ceramic workers.

BACKGROUND: The study examined the work environment of Indian ceramics workers and assessed associations between work hazards, work category, and self-reported symptoms. METHODS: The multi-method ergonomic review technique (MMERT) checkpoints was used for work analysis and prevalence of self-reported symptoms among 329 male workers. RESULTS: Ambient temperature and relative humidity in ceramic industries were 39.9°C and 17.4% respectively. Musculoskeletal discomfort was observed as a primary complaint; especially lower extremity pain (45%). Load handlers and machine operators had the highest levels of work hazards, including high skill requirement, strenuous work posture, poor commitment by the organization. Poor job autonomy, task clarity, hot workplace, inappropriate workplace design, inadequate auxiliary support, and mental overload were significantly associated with self-reported symptoms (P < 0.001). CONCLUSION: Work categories are associated with work hazards and may lead to various health symptoms among ceramic workers. Control of workplace hazards may lower rates of symptoms and thus may lead to improved health, productivity, and well-being. Am. J. Ind. Med. 59:1145-1155, 2016. © 2016 Wiley Periodicals, Inc.

Comparison of workers' perceptions toward work climate and health symptoms between ceramic and iron foundry workers.

BACKGROUND: Workers exposed to heavy manual material handling (MMH) in a hot working environment succumb to severe physical stress and psychological stress. AIMS: (1) Recognize the heat load at workplaces of ceramic industry and iron industry, and (2) comparatively examine the characteristics of self-reported physiological responses and heat-health perception among these workers. SETTINGS AND DESIGN: Cross-sectional prospective study. MATERIALS AND METHODS: Workplace microclimate in the ceramic industry and iron industry was monitored. An ergonomic checklist and a questionnaire was used to record self-reported workers' perceptions toward heat stress at workplace (ceramic workers N = 321, iron foundry workers N = 253). The prevalence rates of subjective symptoms among workers of both the industries were compared. STATISTICAL ANALYSIS: Chi-square test was used to examine the association between stressors and health complaints at a significance level set at P < 0.05. RESULTS: Iron foundries recorded higher mean ambient temperature (43.4 ± 3.7°C) and wet-bulb globe temperature (WGBT) index (31.5 ± 0.7°C) as compared to ceramic industries (39.9 ± 3.3°C and 28 ± 1.5°C, respectively). Heavy sweating, elevated body temperature, sleeplessness, excessive thirst, muscular discomforts, and fatigue were prime symptoms recorded among workers of both industries. Skin-related disorders (red face, dry skin, bumps, itching) were significantly higher among iron foundry workers, whereas sleeplessness, high blood pressure, heavy sweating, kidney stone, decreased urination, muscular discomforts, and fatigue were significantly more among ceramic workers. Young workers reported more sweating and fatigue than older workers. CONCLUSIONS: A hot work climate and heavy manual labor designate ceramic and iron industries as arduous. Direct contact with hot surface and continuous MMH in tandem with the mechanical pace of production process makes work in ceramic industries more difficult than iron foundries.