Association between health insurance literacy and avoidance of health care services owing to cost

Importance: Navigating health insurance and health care choices requires considerable health insurance literacy. Although recommended preventive services are exempt from out-of-pocket costs under the Affordable Care Act, many people may remain unaware of this provision and its effect on their required payment. Little is known about the association between individuals\u27 health insurance literacy and their use of preventive or nonpreventive health care services. Objective: To assess the association between health insurance literacy and self-reported avoidance of health care services owing to cost. Design, Setting, and Participants: In this survey study, a US national, geographically diverse, nonprobability sample of 506 US residents aged 18 years or older with current health insurance coverage was recruited to participate in an online survey between February 22 and 23, 2016. Main Outcomes and Measures: The validated 21-item Health Insurance Literacy Measure (HILM) assessed individuals\u27 self-rated confidence in selecting and using health insurance (score range, 0-84, with higher scores indicating greater levels of health insurance literacy). Dependent variables included delayed or foregone preventive and nonpreventive services in the past 12 months owing to perceived costs, and preventive and nonpreventive use of services. Covariates included age, sex, race/ethnicity, income, educational level, high-deductible health insurance plan, health literacy, numeracy, and chronic health conditions. Analyses included descriptive statistics and bivariate and multivariable logistic regression. Results: A total of 506 of 511 participants who began the survey completed it (participation rate, 99.0%). Of the 506 participants, 339 (67.0%) were younger than 35 years (mean [SD] age, 34 [10.4] years), 228 (45.1%) were women, 406 of 504 who reported race (80.6%) were white, and 245 (48.4%) attended college for 4 or more years. A total of 228 participants (45.1%) had 1 or more chronic health condition, 361 of 500 (72.2%) who responded to the survey item had seen a physician in the outpatient setting in the past 12 months, and 446 of the 501 (89.0%) who responded to the survey item had their health insurance plan for 12 or more months. One hundred fifty respondents (29.6%) reported having delayed or foregone care because of cost. The mean (SD) HILM score was 63.5 (12.3). In multivariable logistic regression, each 12-point increase in HILM score was associated with a lower likelihood of both delayed or foregone preventive care (adjusted odds ratio [aOR], 0.61; 95% CI, 0.48-0.78) and delayed or foregone nonpreventive care (aOR, 0.71; 95% CI, 0.55-0.91). Conclusions and Relevance: This study\u27s findings suggest that lower health insurance literacy may be associated with greater avoidance of both preventive and nonpreventive services. It appears that to improve appropriate use of recommended health care services, including preventive health services, clinicians, health plans, and policymakers may need to communicate health insurance concepts in accessible ways regardless of individuals\u27 health insurance literacy. Plain language communication may be able to improve patients\u27 understanding of services exempt from out-of-pocket costs

Assessment of prevalence of domestic violence and mental health profile of adolescents exposed to domestic violence in an urban slum in Mumbai

Background: Domestic violence in adolescent age group with prevalence of 22.5% is a major cause for causing depression and other behavioral changes. These changes caused due to domestic violence in adolescent age group may persist or worsen in later life as adult resulting in substance abuse or criminal mentality or depression or phobias. Purpose of current study was to assess the prevalence of domestic violence among the adolescents and to compare the mental health in terms of behavior, self-identity & depression among those with and without domestic violence and assessment of the contributory factors fueling domestic violence in the family.Methods: The study was conducted in Cheetah camp, an urban slum of Mumbai during Jan-March, 13. Study population includes subjects aged from 15-19 years fulfilling inclusion/exclusion criteria, a sample size of 74 (99% CL) was derived, using EPI Info software. Subjects were selected by random sampling & 7 households were visited for data collection from each sector. Scales such as AAMR-ABS, Hamilton depression scale and memory recall of the subjects were used in the study. Results: The prevalence of domestic violence in adolescence in cheetah camp urban slum was found to be 38.15% with various reasons. As the maladaptive behavior in the adolescent population increased the emotional violence against them also increased and was found to be statistically significant.Conclusions: Domestic violence is a major causal factor for causing depression of varying degree from mild to severe in adolescents. This depression or behavioural changes occurred during adolescent age group may persist life long and affects their life as adult resulting in failure for social and economic growth of them and of their family.

Over the counter (OTC) sell of sex enhancer drugs: an emerging public health issue in India

Background: As a result of lack of skilled service providers/doctors, there is increasing trend of over the counter (OTC) sell of medicine in India. Among these OTC drugs, sell of sex enhancer medicine is an emerging problem as these medicines are being advertised on large scale using mass media like Television, newspapers and Radio without any approval from drug controlling authority ‘Central Drugs and Standards Control Organization’. Purpose of current study was to study the trend of over the counter sell of sex enhancer drugs in India & to study health seeking behavior of patients with self-diagnosed ED in terms of self-medication.Methods: This cross-sectional study include interview schedule of 74 patients coming on 10 medical stores selected randomly in Jodhpur city in September 2013.Results: So 10% were found to buying sex enhancer drugs. Thirty eight percent among those buying sex enhancer medicines were Unmarried and 62% were married.92% buying sex enhancer medicine were Hindu and 8% were Muslim patients. Only 9.46% patients had consulted allopathic doctors and 12.16% consulted to Ayurveda Vaidya, 4.05% consulted local Quack and 8.11% consulted to friends but 66.22 % patients had not consulted anybody for Medication; but they are buying by self for self-diagnosed EDConclusions: This study therefor confirms that there is significant association between self-diagnosed ED and OTC sell of sex enhancer medicine in India. TV & newspapers, poster/banners are significantly important in providing information of sex enhancer medicines to self-diagnosed patients of ED.

Antimicrobial Peptides from Insects: An Overview

Bacteria are exceptionally adept at acquiring resistance to antibiotics and antiseptic agents, hence new antibiotics and strategies are therefore needed to deal with this threat. Several authors have reported the inhibitory effect of anti microbial peptides of animal origin on bacteria and research is on the rise about insect antimicrobial peptides. An attempt has been made to have a comprehensive review of the research work carried out on antimicrobial peptides from insects

Review Paper on Zigbee based Secured Wireless Communication by using DES Encryption

IEEE 802.15.4(Zigbee)[1] standard is low data rate,low power consumption and low cost wireless personal area network.In order to transmit large amount of information that require high data such as video, image and audio and its encryption and decryption is considered.Zigbee in general uses a single channel for data transmission.In this paper we proposeddata transmission (pdf,image) over zigbee networks with DES encryption,which aims to improve total throughput of networks and secure transmission of data

Incidence of umbilical cord around the neck and its effects on mode of delivery and fetal outcome at tertiary care hospital

Background: Umbilical cord is one of the fetal membranes. It is developed from the yolk sac. Umbilical cord is tubular structure. Approximate length of the cord is 50 cm. Umbilical cord around the neck is called as the nuchal cord. The aim of the study is to find out the incidence of umbilical cord around the neck at the time of delivery and its fetal outcomes.Methods: It is a retrospective observational study. This study was conducted in the department of obstetrics and gynecology at a tertiary care hospital over a period of 6 months (Feb-Jul 2020). Out of 542 patients, 388 were enrolled in this study after the inclusion and exclusion criteria, of which 101 were delivered with umbilical cord and the remaining were 287 patients in control group.Results: Present study showed 38.4% incidence of umbilical cord at the time of delivery. Incidence is more among the primigravida and it is statistically significant. Both intrapartum and postpartum risks are not related to umbilical cord around the neck. Mean length of the cord in patients delivered with cord around the neck is more when compared to the control group and has significant p value.Conclusions: This study concludes that the presence of umbilical cord, alone is not an indication for caesarean section. Umbilical cord with 3 loops was associated with increased operative delivery and low Apgar score, proper intrapartum surveillance and portogram leads to good fetal outcome

Weed seed bank and weed population as influenced by weed management practices in rice var Co 54

Weed seed bank in soil serves as the reservoir of weed seeds which emerge whenever conditions become conducive and affects crop growth.  In the present study, a field experiment was performed at Agricultural College and Research Institute, Tamil Nadu Agricultural University, Madurai, India, during Kharif 2021 and Rabi 2022 to determine weed seed bank present in soil by direct seed extraction using the sieving method at discrete depths of 0-5 cm, 5-10 cm and 10-15 cm after rice harvest with reference to different weed management practices imposed and its effect on weed population in succeeding crop. The average proportion of weeds that emerged in the field ranged from 9 to 38 % of the total weed seed bank. Weed management practices followed during the preceding crop greatly influenced weed seed germination. The higher weed seed reserve (1384 m-2) and consequent weed population (528 no’s m-2) were found at a depth of 0-5 cm in unweeded plots. The lower weed seed density (536 m-2) and weed population (94 no’s m-2) were found in pre emergence application of Pyrazosulfuron + Pretilachlor and early post emergence application of Bispyripac sodium. The results from the present study confirmed that herbicide treatment considerably minimized the weed seed density and population, which will assist in predicting weed infestation and appropriate timing of weed control