Relationship between health-related quality of life and respiratory health status among coal-based sponge iron plant workers in Barjora, India

Background: Many coal-based sponge iron plant workers have poor health-related quality of life in general, and specifically a poor respiratory health status. However, the relationship between their health-related quality of life and respiratory health status is unknown. Aim: This study investigated the relationship between health related quality of life, measured using the EuroQol- 5D (EQ5D), and respiratory health status, measured using the St. George’s Respiratory Questionnaire (SGRQ), among coal-based sponge iron plant workers in Barjora, India. Method: A cross-sectional study was conducted among coalbased sponge iron plant workers in Barjora, and complete data were available on 252 participants. Spearman’s rank correlation coefficients were reported to show the strength of relationship between health-related quality of life and respiratory health status. Results and conclusion: Significant correlations were found between all EQ5D dimensions/visual analogue scale (VAS) and all SGRQ scores except between EQ5D-VAS and SGRQ-activity. A range of correlations was found. They were moderate between EQ5D-anxiety/depression and SGRQ-symptom, EQ5D-VAS and SGRQ-symptom, and EQ5D-anxiety/depression and SGRQ-total, but weak between all the other factors

Challenges to the surveillance of non-communicable diseases – a review of selected approaches

Background: The rising global burden of non-communicable diseases (NCDs) necessitates the institutionalization of surveillance systems to track trends and evaluate interventions. However, NCD surveillance capacities vary across high- and low- and middle-income countries. The objective of the review was to analyse existing literature with respect to structures of health facility-based NCD surveillance systems and the lessons low- and middle-income countries can learn in setting up and running these systems. Methods: A literature review was conducted using Pub Med, Web of Knowledge and WHOLIS databases to identify citations published in English language between 1993 and 2013. In total, 20 manuscripts met inclusion criteria: 12 studies were analysed in respect to the surveillance approach, eight supporting documents in respect to general and regional challenges in NCD surveillance. Results: Eleven of the 12 studies identified were conducted in high-income countries. Five studies had a single disease focus, three a multiple NCD focus and three covered communicable as well as non-communicable diseases. Nine studies were passive assisted sentinel surveillance systems, of which six focused on the primary care level and three had additional active surveillance components, i.e., population-based surveys. The supporting documents reveal that NCD surveillance is rather limited in most low- and middle-income countries despite the increasing disease burden and its socioeconomic impact. Major barriers include institutional surveillance capacities and hence data availability. Conclusions: The review suggests that given the complex system requirements, multiple surveillance approaches are necessary to collect comprehensive information for effective NCD surveillance. Sentinel augmented facility-based surveillance, preferably supported by population-based surveys, can provide improved evidence and help budget scarce resources. Electronic supplementary material: The online version of this article (doi:10.1186/s12889-015-2570-z) contains supplementary material, which is available to authorized users

Assisted reproductive technologies in India: the views of practitioners.

BACKGROUND: This article documents the context of Assisted Reproductive Technology/ies (ART) services and providers' perceptions regarding services offered in India. The objective is to facilitate understanding of critical issues and relevant concerns. METHODS: A postal survey conducted with a sample of 470 gynaecologists and in-depth interviews with 39 gynaecologists in four cities. RESULTS: ART clinics have proliferated in cities and towns; they are commercialised and the quality of treatment is variable. Most providers perceived that patients lack knowledge about infertility and ART, costs are high, investigations unnecessarily repeated and success rates low. ART providers do not have clear selection criteria, some lack rigorous specialised training and infrastructure and most are deficient in record-keeping and counselling and lack transparency. Monitoring and regulation by appropriate authorities are also lacking. CONCLUSION: Both providers and regulatory authorities need to look critically at exploitation of patients and commercialisation, excessive costs, lack of information, informed consent, and transparency, counselling, unethical practices, variations in quality of treatment and ensuring proper monitoring and regulation

Placebo use in vaccine trials: recommendations of a WHO expert panel.

Vaccines are among the most cost-effective interventions against infectious diseases. Many candidate vaccines targeting neglected diseases in low- and middle-income countries are now progressing to large-scale clinical testing. However, controversy surrounds the appropriate design of vaccine trials and, in particular, the use of unvaccinated controls (with or without placebo) when an efficacious vaccine already exists. This paper specifies four situations in which placebo use may be acceptable, provided that the study question cannot be answered in an active-controlled trial design; the risks of delaying or foregoing an efficacious vaccine are mitigated; the risks of using a placebo control are justified by the social and public health value of the research; and the research is responsive to local health needs. The four situations are: (1) developing a locally affordable vaccine, (2) evaluating the local safety and efficacy of an existing vaccine, (3) testing a new vaccine when an existing vaccine is considered inappropriate for local use (e.g. based on epidemiologic or demographic factors), and (4) determining the local burden of disease