A mixed-methods study on risk perception and safety practices among unorganized construction workers in a municipal area of West Bengal.

BACKGROUND: The construction industry in India heavily relies on unorganized workers, who often lack adequate access to safety measures, placing them at significant risk of accidents and injuries. The objective was to determine risk perceptions of construction workers, and explore their safety practices, facilitators, and barriers. METHODS: A mixed-methods approach with a convergent parallel design (QUAN + qual) was undertaken. Quantitative strand included face-to-face interviews with 203 randomly selected building construction workers from 10 construction sites in five selected municipal wards in Kolkata. Questions pertained to socio-demographics, occupational characteristics, risk perception, and safety practices. The qualitative arm involved key informant interviews to unravel the facilitators and barriers affecting safety practices and nonparticipant observation. RESULTS: The perceived risk for respiratory problems due to dust, pain from carrying loads, slips, trips or falls, and heat-related illnesses was in the medium- to high category for 64.0%, 58.6%, 39.9%, and 36.5% of the study participants, respectively. However, the safety practices for these respective domains were in the good practice category for 6.9%, 4.9%, 54.2%, and 34.5% of the workers. From the qualitative arm, it was evident that availability of PPE, a conducive environment, and availability of worker-friendly technology could be important predictors of safety practices. Barriers such as time constraints and feasibility due to discomfort and expenditure were also identified. CONCLUSION: Despite high-risk perception, safety practices were not consistently good among construction workers. Further research is crucial to enhance the health and safety of unorganized workers in India.

Readiness to manage domestic violence among medical interns - an observational study in a medical college and hospital in India.

BACKGROUND: Domestic violence is a deeply entrenched issue in Indian society, with global implications, especially for women's physical and mental health. Healthcare providers play important role in early identification and support of the victims. Medical interns, the future generation of Health care professionals, often acting as primary caregivers are uniquely positioned and expected to recognize and assist victims. This study aims to evaluate their knowledge, attitudes, practices, and readiness to manage domestic violence and its associating factors. METHODS: This cross-sectional study was conducted among 157 medical interns at a Medical college and hospital in West Bengal, India, from December 2022 to February 2023. Simple random sampling was done. Data were collected using a semi-structured questionnaire, Medical Intern Readiness to manage domestic violence scale (MIREDS), validated after adoption from Physician Readiness to manage Intimate partner violence scale (PREMIS). Ethical approval was obtained, and participants gave informed written consent for inclusion. Satisfactory threshold was determined to be more than 50 percent. Data analysis was performed using MS Excel and SPSS software, including descriptive and inferential statistics, with a significance level of p less than 0.05, along with logistic regression analysis. RESULTS: Only 45.2% of medical interns demonstrated satisfactory knowledge, 54.8% had a satisfactory attitude. Most interns (91.7%) exhibited poor practice in dealing with domestic violence cases, only 31.2% considered themselves ready to manage domestic violence cases. Interns who attend more patients was found to have better attitude. Positive associations were found between knowledge, attitude, and readiness to manage domestic violence cases among doctors . CONCLUSIONS: A substantial proportion of medical interns demonstrated inadequate knowledge, negative attitudes, and poor practice and inadequate readiness to manage domestic violence. Comprehensive training and education with cultural sensitivity training along with more practical exposures are in need to address this issue properly.

Twin studies as an innovative approach to address research questions in cancer care within primary care settings.

This paper proposes the utilisation of twin studies as a novel and powerful methodological approach to investigate critical research questions pertaining to cancer prevention, screening, diagnosis, treatment and survivorship within primary care contexts. The inherent genetic similarity between monozygotic (MZ) (identical) twins provides a unique opportunity to disentangle genetic and environmental influences on cancer-related outcomes. MZ twins share virtually identical genetic makeup, offering a unique opportunity to discern the relative contributions of genetic and environmental factors to cancer-related outcomes. In contrast, dizygotic (DZ) twins, also known as fraternal twins, develop from two separate eggs fertilised by two different sperm and share on average 50% of their genetic material, the same level of genetic similarity found in non-twin siblings. Comparisons between MZ and DZ twins enable researchers to disentangle hereditary factors from shared environmental influences. This methodology has the potential to advance our understanding of the multifaceted interplay between genetic predisposition, lifestyle factors and healthcare interventions in the context of cancer care. This paper outlines the rationale, design considerations and potential applications of twin studies in primary care-based cancer research.

Proportion, Pattern, and Predictors of Falls in Older Adults - A Community-based Observational Study in Rural West Bengal.

Introduction: In spite of falls being a major public health problem, where most of the falls are preventable, there is a lack of epidemiological investigation among those aged 50 and above, especially in developing countries. Hence, we investigate the proportion, pattern, and predictors of falls in this age group. Materials and Methods: This cross-sectional community-based study was done in the Uluberia-II block of Howrah district, West Bengal, from February to July 2021. A multistage cluster sampling method was used to meet the sample size. Data were collected with the help of a structured interview schedule. Predictors were estimated by the SPSS version 16 and defined in adjusted odds ratio (AOR) with a 95% confidence interval. Results: Among 170 study participants, 34.7% (59/170) experienced at least one episode of fall, while 20.6% (35/170) experienced recurrent falls in 12 months. Most (78%; 46/59) falls occurred in the home environment and due to slippage (67.8%; 40/59) on the floor. 84.7% (50/59) sustained any type of injuries, 47.5% (28/59) required either consultation of a physician or medication, and 6.8% (4/59) required hospitalization. Safety Checklist Score measured 75.3% (128/170) had a poor household environment, within that 30.6% (52/170) had a seriously poor household environment, which was an important predictor of falls ([AOR] = 3.59 [1.24-10.38]). Fear of fall (AOR = 6.18 [1.77-21.53]) measured by shortfall efficacy scale and nonformal education (AOR = 5.05 [1.33-19.07]) were also predictors of falls. Conclusion: Considerable proportion of falls occurred in the past year, which can be preventable by improving modifiable environmental factors and detection of fear of fall in persons at different levels of health-care facilities.

Measuring Impact of Climate Change on Indigenous Health in the Background of Multiple Disadvantages: A Scoping Review for Equitable Public Health Policy Formulation.

How climate change is uniquely affecting Indigenous health remains a very less explored area in the existing research literature. The imperative of inclusive climate action to protect indigenous health multiplies manifolds due to their unique vulnerabilities owing to predominant dependence on natural resources and multiple disadvantages faced. The current article attempted to add to the evidence pool regarding climate change impacts on the indigenous population by systematically collecting, processing, and interpreting data as a scoping literature review for effective and inclusive climate policymaking. Twenty-Nine articles of varied study designs were identified employing a systematically organized search strategy using PubMed (Field, MeSH, and advanced search) and Google scholar; relevant data were extracted for further analysis. The Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews (PRISMA-ScR) guidelines were followed. Changing climate scenarios had both direct and indirect health-related impacts on indigenous health, and altered the epidemiological triad for various health-related events, causing the emergence and re-emergence of infectious diseases, and increased prevalence of chronic diseases and mental disorders. An expanded framework was developed showcasing the variability of climate change events, multiple disadvantages, and its impacts on indigenous populations. Few studies also reported a wide range of adaptation responses of indigenous peoples towards climate change. It was substantiated that any climate-change mitigation policy must take into account the trials and tribulations of indigenous communities. Also, due to the complexity and large variability of the impacts and differences in mitigation capabilities, policies should be contextualized locally and tailored to meet the climate need of the indigenous community.

Determinants of Treatment Adherence Among Patients Living With Noncommunicable Diseases: A Mixed-Method Study in a Rural Area of West Bengal.

The multisectoral impact of the COVID-19 pandemic can impair treatment adherence of patients with noncommunicable diseases (NCDs). This mixed-method study, conducted from November 2020 to January 2021, assessed the quantum of their treatment adherence and its determinants in rural West Bengal. Quantitative data were collected from 213 NCD patients while qualitative exploration for barriers of treatment adherence was conducted as 6 in-depth Interviews. Treatment adherence was assessed by "Medication Compliance Questionnaire" and "Adherence to Healthy Lifestyle and Follow-up Advice" Questionnaire. A total of 39.4% were nonadherent to medications while 67.1% had nonadherence to healthy lifestyle and follow-up advice. Significant predictors associated with nonadherence were increasing age, female gender, lower socioeconomic status, decreasing patient empowerment, and decreasing trust in the medical profession. Economic crisis, fear of contagion, and nonavailability of investigation facilities were some new emerging barriers in addition to preexisting barriers of treatment adherence. Therefore, measures for improving patient empowerment and patient-provider relationship by motivation and counseling, taking proper care of vulnerable patients affected by the pandemic, and correcting deficiencies at the health-system level should be given utmost priority.

Knowledge and Parity: Perspectives of Usage of Emergency Contraceptive Pills among Women of a Rural Area of Delhi.

CONTEXT: Correct use of emergency contraceptive pills (ECPs) may prevent up to 95% of unwanted pregnancies which may significantly decrease unsafe abortions and maternal mortality. AIMS: Assessment of knowledge and use of ECPs among women and to explore factors associated with them. MATERIALS AND METHODS: This was a facility-based cross-sectional study. Data were collected using a prestructured, pretested questionnaire from 381 reproductive age women (15-49 years) selected by systematic random sampling. Statistical Package for the Social Sciences version 16 and Epi info (version 7.0.) were used for all statistical analyses. Descriptive analysis was performed, and results were expressed in terms of frequencies and percentages. The Chi-square and Fisher's exact test were used as tests of significance in univariate analysis. Determinants of use of ECPs were identified using logistic regression. RESULTS: Of 381 women interviewed, awareness level of ECPs (ever heard about ECPs) was found to be 34% (n = 128). Ever use of emergency contraception was reported by 38 (9.7%). Age (odds ratio [OR] = 3.02, 95% confidence interval [CI] [1.88-4.87]), education (OR = 0.086, 95% CI [0.047-0.158]), husband's education (OR = 0.11, 95% CI [0.067-0.187]), socioeconomic status (OR = 6.14, 95% CI [3.28-11.51]), and family status (OR = 2.6, 95% CI [1.59-4.24]) were found to be significantly associated with the use of emergency contraceptives. CONCLUSIONS: The study identified that most respondents lack adequate knowledge about ECPs, and ever use of ECPs was very low. Factors that were associated with the use of ECPs were age, literacy, socioeconomic status, and knowledge about the method. Creating a sustainable awareness on ECPs and their use may serve them with power to control their parity.

Twin Studies: A Unique Epidemiological Tool.

Twin studies are a special type of epidemiological studies designed to measure the contribution of genetics as opposed to the environment, to a given trait. Despite the facts that the classical twin studies are still being guided by assumptions made back in the 1920s and that the inherent limitation lies in the study design itself, the results suggested by earlier twin studies have often been confirmed by molecular genetic studies later. Use of twin registries and various innovative yet complex software packages such as the (SAS) and their extensions (e.g., SAS PROC GENMOD and SAS PROC PHREG) has increased the potential of this epidemiological tool toward contributing significantly to the field of genetics and other life sciences.