1,721,124 research outputs found
Distance, transport mode, and road safety on school journeys in urban India
Full text linkBackground: A third of a billion children travel to school every day in India, yet little is
known about this journey. Increasing motorisation in India is likely to have implications for
road safety of children. This thesis develops methods to measure distance to school,
transport modes, and risk of road traffic injury, on journeys to school in Hyderabad.
Methods: Following a systematic review, a self-completion questionnaire was developed to
estimate the distance and modes of travel to school in India. Its validity and reliability was
assessed using the kappa statistic. A cross-sectional survey using a two-stage stratified
cluster sampling design was conducted in government funded, government aided, and
private schools in Hyderabad. The relationship between modes of travel and distance to
school was analysed using logistic regression, adjusting for confounders. The prevalence of
road traffic injury in the previous 12 months during school journeys was estimated, and the
impacts of alternative transport scenarios on road injury was modelled.
Results: The questionnaire provided reliable information on the usual mode of travel to
school, and road injury. Distance to school measured by asking for the nearest landmark to
a child’s home was found to be a valid measure of distance compared to a method based on
in-depth interviews with children. Forty five schools including 5,842 children aged 11-14
years participated in the survey, with a response rate of 99%. Most children in Hyderabad
walked or cycled to school. Others travelled by motorised 2-wheelers, auto-rickshaw, school
bus, public transport bus, and car. Greater distance to school was strongly associated with
the use of motorised transport. A sixth of all children reported a road injury during school
journeys, which was strongly associated with travel mode and distance to school. The
overall risk of road injury was 25/100,000 child km per year. Relative to school bus
occupants, bicyclists, pedestrians and motorcycle passengers were more likely to be injured,
for the same distance travelled. The model showed that road injuries can be prevented
under transportation scenarios that restrict distance and motorised vehicles near schools.
Conclusions: The questionnaire reliably measured mode of travel to school and estimated
distances to school in Hyderabad. Most children walked or cycled to school and if these
levels are to be maintained, there is an urgent need to ensure that walking and cycling may
be done safely
Development and Evaluation of a Smartphone-enabled, Carer-supported Educational Intervention for Management of Disabilities Following Stroke in India
Full text linkBackground
The incidence and prevalence of stroke in India has reached epidemic proportions and is
considered a major public health problem. Given the nature of the condition, affected
individuals often become disabled, with profound effects on their quality of life. This study
aimed to develop an educational intervention for management of post-stroke disability in
India and to evaluate the feasibility and acceptability of delivering this intervention using
Smartphone technology and caregiver support.
Objectives:- To systematically develop a Smartphone-enabled, carer-supported, educational
intervention that is multi-disciplinary, patient-centred and culturally-sensitive for
management of disabilities following stroke in India. -To evaluate the feasibility and acceptability of the intervention by stroke survivors
and their caregivers in the Indian context.
Methodology
The study was conducted in Chennai, India, and was implemented in three phases:
Phase 1: Development of the intervention
Phase 2: Field-testing and finalising of the intervention
Phase 3: Piloting of the intervention and assessment of feasibility and acceptability.
A mixed methods approach was used to develop and evaluate the intervention.
Results
The intervention was systematically developed and titled ‘Care for Stroke’. It was delivered
through a web-based, Smartphone-enabled application. During field-testing, key uncertainties,
such as issues with connectivity, video streaming, picture clarity, quality of the videos and
functionality of the application, were identified. The intervention was reviewed, revised and
finalised before pilot-testing. Findings from the pilot-testing showed that the ‘Care for Stroke’
intervention was feasible and acceptable in an Indian context. Over 90% of the study
participants felt that the intervention was relevant, comprehensible and useful. About 95% of
the stroke survivors and all the caregivers (100%) rated the intervention to be excellent, based
on its overall credibility, usability and user-friendliness.
Discussion
‘Care for Stroke’ is an innovative educational intervention that can empower stroke survivors
and their families to be cognisant of their disability, ways to manage it and how to make
appropriate decisions on their road to recovery. The current context for stroke rehabilitation
provides a reasonable opportunity for public health practitioners to optimise interventions
such as ‘Care for Stroke’ to efficiently bridge the gaps in accessibility of stroke rehabilitation
services and enhance the continuum of care for stroke survivors worldwide. The intervention
is specifically pertinent to India and many other Low and Middle-Income Countries (LIMCs)
where resources for improving access to stroke rehabilitation services are inadequate.
Conclusion
‘Care for Stroke’ is an innovative effort towards the global need for research to develop
interventions that bridge the barriers to the provision of stroke rehabilitation services and
meet the needs of affected individuals. This application and similar approaches that harness
the potential of current technology need to be researched further to bridge the gaps in access
to stroke services worldwide
A Feasibility Study to Develop an Integrated Diabetic Retinopathy Screening Programme in the Western Province of Sri Lanka
Full text linkBackground: Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus which can lead to sight loss, if not detected and treated in time. Objectives: This study aimed to assess the feasibility of integrating DR screening (DRS) services into free public sector health care in Sri Lanka. The objectives were to identify barriers to access DRS, to determine the most appropriate DRS modality and to assess acceptability of a health educational intervention (HEI). Methods: The study was conducted using mixed methods. The barriers were assessed through systematic literature search and qualitative studies. A systematic literature review and meta-analysis was conducted to assess the diagnostic accuracy of DRS using digital retinal imaging. Based on the results of the formative stages, a local context specific DRS modality was defined and validated at a tertiary level medical clinic by trained physician graders. Finally, a HEI was adapted and acceptability was assessed using participatory approach. Results: The formative studies revealed that lack of knowledge and awareness on DR, lack of skilled human resources and DRS imaging infrastructure as the main barriers. In the meta-analysis, highest sensitivity was observed in mydriatic more than two field strategy (92%, 95% CI 90-94%). In the validation study, sensitivity of the defined referable DR was 88.7% for grader 1 and 92.5% for grader 2, using mydriatic imaging. The specificity was 94.9% for grader 1 and 96.4% for grader 2. The overall acceptability of the HEI material was satisfactory. Conclusions: Knowing the barriers to access DRS is a pre-requisite in development of a DRS program. Non-mydriatic 2-field strategy is a more pragmatic approach in implementing DRS programs in low income non-ophthalmic settings, with dilatation of pupils of those who have ungradable images. The process of adapting HEI was not simply translation into local language, instead a tailored approach for the local context
Models for correction of myopia in the South Asia region.
Full text linkModels for correction of myopia need to target identification and correction of those with myopia on the one hand and interventions for modifiable factors to prevent onset and slow down progression on the other
Situational analysis of diabetic retinopathy screening in India: How has it changed in the last three years?
Full text linkOf all the eye conditions in the contemporary Indian context, diabetic retinopathy (DR) attracts the maximum attention not just of the eye care fraternity but the entire medical fraternity. Countries are at different stages of evolution in structured DR screening services. In most low and middle income countries, screening is opportunistic, while in most of the high income countries structured population-based DR screening is the established norm. To reduce inequities in access, it is important that all persons with diabetes are provided equal access to DR screening and management services. Such programs have been proven to reverse the magnitude of vision-threatening diabetic retinopathy in countries like England and Scotland. DR screening should not be considered an endpoint in itself but the starting point in a continuum of services for effective management of DR services so that the risk of vision loss can be mitigated. Till recently all DR screening programs in India were opportunistic models where persons with diabetes visiting an eye care facility were screened. Since 2016, with support from International funders, demonstration models integrating DR screening services in the public health system were initiated. These pilots showed that a systematic integrated structured DR screening program is possible in India and need to be scaled up across the country. Many DR screening and referral initiatives have been adversely impacted by the COVID-19 pandemic and advocacy with the government is critical to facilitate continuous sustainable services
The socioeconomic impact of human immunodeficiency virus / acquired immune deficiency syndrome in India and its relevance to eye care
No full textHuman immunodeficiency virus (HIV) infection is aptly called the modern day ′plague′ and has the potential to decimate people in the productive age group. On the other hand, the increasing life expectancy in developing countries spirals age-related blindness. One therefore reduces economic productivity while the other increases economic dependency. Both lead to increased expenditure of households though in different proportions. Human immunodeficiency virus and blindness are both associated with discrimination, stigma and long-term consequences. They impact the socioeconomic fabric of the affected individuals, communities and countries. The loss in productivity and the cost of support to the affected individuals are seen in both. Each is a potent problem on its own but together they spell disaster in geometric proportions rather than a simple additive effect. Strategies need to be evolved to provide solace and improve the quality of life of an HIV-positive blind individual
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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