ROAD TRAFFIC ACCIDENTS IN INDIA: AN OVERVIEW

Road traffic accidents claim over a million lives every year in the world. As per World Health Organization (WHO) it is one of the leading cause of death. India, being a rapidly developing country with expanding economy has its own issues as regarding road traffic accidents due to rapid proliferation of motorization. Road traffic accidents causes enormous morbidity and mortality and at the same time, the toll on the economy of the country as a result of it is quite heavy. Road traffic accident is a result of an interaction among different factors which include the environment, vehicle and the human being. Traditionally it is considered that road traffic accidents are accidents which are unpredictable, inevitable and not preventable. But road traffic accidents are indeed predictable and preventable in majority of the cases. This require the knowledge of factors contributing and leading to road traffic accidents. There are certain preventive measures which if adopted can lead to decrease in morbidity and mortality resulting from RTA. Hence, it is the responsibility of all to contribute in reducing road traffic accidents. Keywords: Road traffic accidents; Road traffic injuries; Roads in India; Road safety; Vehicular registration

ROAD TRAFFIC ACCIDENTS IN INDIA: AN OVERVIEW

Road traffic accidents claim over a million lives every year in the world. As per World Health Organization (WHO) it is one of the leading cause of death. India, being a rapidly developing country with expanding economy has its own issues as regarding road traffic accidents due to rapid proliferation of motorization. Road traffic accidents causes enormous morbidity and mortality and at the same time, the toll on the economy of the country as a result of it is quite heavy. Road traffic accident is a result of an interaction among different factors which include the environment, vehicle and the human being. Traditionally it is considered that road traffic accidents are accidents which are unpredictable, inevitable and not preventable. But road traffic accidents are indeed predictable and preventable in majority of the cases. This require the knowledge of factors contributing and leading to road traffic accidents. There are certain preventive measures which if adopted can lead to decrease in morbidity and mortality resulting from RTA. Hence, it is the responsibility of all to contribute in reducing road traffic accidents. Keywords: Road traffic accidents; Road traffic injuries; Roads in India; Road safety; Vehicular registration

Analysis of Travel Behavior in Khulna Metropolitan City, Bangladesh

In modeling travel demand and analyzing travel behavior, it is important to know the behavior of a large number of individuals. How the individuals choose an alternative among others given in the choice set, and how they assess and consider the different alternatives, must be a function of several factors including their need, task, socio-economic, environmental and the level of service offered by the various alternatives. A qualitative analysis of travel behavior was done with a number of individuals as the samples. To provide the required data, a field survey as direct home interview survey and travel time survey were conducted and given a number of 233 households and 871 respondents obtained as the samples. Meanwhile, the socio-economic data were obtained directly from the institution concerned. . The collected data were analyzed by using the Statistical Package for Social Science (SPSS) Software.The results of the analysis show that people with higher income and more automobile availability make more travel than people with low income and less automobile availability. The home-based trips take the largest percentage (50%) of people in the study area. The result also indicates that the shopping trips (15%) contribute higher among different trip purpose. The results also show that about 57% of individuals are between 20-50 years. The number of trips generated from each zone is strongly related to the amount of households, population, active workers and students of that zone. By considering a significant level of 5% four trip generation models have been developed. By using these models future trip generation from each zone can be determined. By applying the Gravity Model and the Fratar Method, the trip distribution models have been developed. Three basic models have been introduced by using travel time, road distance and straight distance as the resistance index. From these models the future travel pattern of Khulna Metropolitan city, Bangladesh can be predicted. Keywords: Khulna Metropolitan City, Household survey, Travel behavior, Trip Distribution Models, Trip Generation Models

Does Digitally Enabling Frontline Health Workers Improve Coverage and Quality of Maternal and Child Health Services? Findings From a Mixed Methods Evaluation of TECHO+ in Gujarat

IntroductionTechnology Enabled Community Health Operations (TeCHO+) is a mobile and web-based application (app) for frontline health workers. It includes features such as real-time data entry, automated generation of the work plan, and a decision support system generating alerts for high-risk cases. Since 2019, the programme is implemented across all 33 districts of Gujarat, catering to a population of over 60 million. This study aims to compare changes in the coverage, quality of data reporting maternal and child health services, and time spent in the documentation before and after the introduction of the TeCHO+ app.MethodsTo address the study aim, a mixed-method design with a realist evaluation approach was adopted. The survey was conducted with randomly selected beneficiaries from 32 sub-centers across two districts of Gujarat State in India. We surveyed 215 postpartum women and mothers of 102 children at baseline (pre) and 246 postpartum women and mothers of 119 children post 1 year of the TeCHO+ programme intervention in 2020. For qualitative data, total 29 Auxiliary Nurse Midwives, 12 Data Entry Operators and 10 Primary Health Center Medical Officers were purposively selected from 32 PHCs and interviewed to understand the pathways leading to the programme outcome.ResultsFollowing introduction of TeCHO+, the coverage of full antenatal care (ANC; 75.6% vs. 67.9%, p-value < 0.0001), consumption of at least 180 iron-folic acid tablets (93% vs. 77%, p-value < 0.001), early initiation of breastfeeding (42.7% vs. 24.2%, p-value < 0.001), five home-visits by ANM during the first month after delivery (36.2% vs. 27.9%, p-value = 0.056), HBV0 vaccination (67.2% vs. 35.3%, p-value < 0.0001) and Pentavalent 2 (100% vs. 95.1%, p-value = 0.015) improved. The overall concordance rate for routine maternal health indicators (a measure of data quality) improved from 69.1 to 80.5%, while that for routine child health indicators improved from 86.6 to 92.1%. The programme resulted in 1.7 h saving a day of ANM's productive time and 1.5 h (a day) of data entry operator's time.ConclusionsThe TeCHO+ programme has improved access to care. It impacted both coverage of maternal and child health services and data reporting quality of various maternal and child high-risk conditions. Considering the programme's success, other disease services might be added to the scope of TeCHO+ software

Ghrelin for the management of cachexia associated with cancer

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the efficacy and safety of ghrelin on improving food intake, body composition and survival in patients with cachexia associated with cancer. © 2016 The Cochrane Collaboratio

Ghrelin as a Promising Therapeutic Option for Cancer Cachexia

Cachexia is a devastating complication of cancer and an important cause of morbidity and mortality and can have a great effect on quality of life, and sense of self-esteem. Unfortunately; there is no standard cure available for cancer cachexia. Ghrelin; a 28 amino acid orexigenic gut hormone and its mimetics have shown potential benefits in reversing the breakdown of protein and weight loss in catabolic states like cancer cachexia. Ghrelin has effects on several vital pathways in the regulation of appetite, and composition of the body. It increases the secretion of growth hormone and reduces energy expenditure. It plays an important role in regulation of processes associated with cancer and antagonizing protein breakdown in catabolic conditions such as cancer cachexia. Additionally, ghrelin has anti-inflammatory, anti-apoptotic and anxiolytic effects. Administration of ghrelin for short-term has been found to be well-tolerated and safe. These versatile actions of ghrelin and its safety can render it as a potentially useful novel therapy for patients with cancer cachexia. However; there is a need to generate more evidence to support the use of ghrelin in the management of cancer cachexia

Capacity Building Initiatives for Better Response to HIV/AIDS in India

Human resource capacity building is a key strategy in the design, delivery, sustainability and scaling up of HIV treatment and prevention programmes. The review aims to present human resource capacity building initiatives undertaken by the National AIDS Control Organisation (NACO) and to discuss the available opportunities in India. There was minimal emphasis on human resource capacity building in National AIDS control programme (NACP)-I. The focus of capacity building in NACP-II was on strengthening the capacity of partners implementing various HIV/AIDS interventions. NACP-III (2007–2012) focussed on capacity building as a priority agenda. Other than short-term training programmes, NACP-III is strengthening the capacity of partners through the State Training and Resource Centre, Technical Support Unit, District AIDS Prevention Control Unit, Fellowship Programme and Network of Indian Institutions for HIV/AIDS Research.  Various opportunities to enhance and consolidate capacity building responses in HIV/AIDS in India may include mainstreaming of capacity building, appropriate management of knowledge and resources, effective delivery of training, measuring and documenting impact, accreditation of programmes and institutes, use of information technology, identifying and implementing innovations  and working for sustainability.  Growing demand for capacity-building in HIV/AIDS needs substantial efforts to ensure that these are implemented effectively and efficiently. NACO had made significant strides in these regards, but at the same time there are arduous challenges like measuring impact, quality, documentation, operational research, and sustainability. NACO is formulating Phase-IV of NACP. This review will provide feedback to the NACO for strengthening its strategic document for human resource capacity building.

Prevalence of stunting among under-five children in refugee and internally displaced communities: a systematic review and meta-analysis

BackgroundA pooled estimate of stunting prevalence in refugee and internally displaced under-five children can help quantify the problem and focus on the nutritional needs of these marginalized groups. We aimed to assess the pooled prevalence of stunting in refugees and internally displaced under-five children from different parts of the globe.MethodsIn this systematic review and meta-analysis, seven databases (Cochrane, EBSCOHost, EMBASE, ProQuest, PubMed, Scopus, and Web of Science) along with “preprint servers” were searched systematically from the earliest available date to 14 February 2023. Refugee and internally displaced (IDP) under-five children were included, and study quality was assessed using “National Heart, Lung, and Blood Institute (NHLBI)” tools.ResultsA total of 776 abstracts (PubMed = 208, Scopus = 192, Cochrane = 1, Web of Science = 27, Embase = 8, EBSCOHost = 123, ProQuest = 5, Google Scholar = 209, and Preprints = 3) were retrieved, duplicates removed, and screened, among which 30 studies were found eligible for qualitative and quantitative synthesis. The pooled prevalence of stunting was 26% [95% confidence interval (CI): 21–31]. Heterogeneity was high (I2 = 99%, p < 0.01). A subgroup analysis of the type of study subjects revealed a pooled stunting prevalence of 37% (95% CI: 23–53) in internally displaced populations and 22% (95% CI: 18–28) among refugee children. Based on geographical distribution, the stunting was 32% (95% CI: 24–40) in the African region, 34% (95% CI: 24–46) in the South-East Asian region, and 14% (95% CI: 11–19) in Eastern Mediterranean region.ConclusionThe stunting rate is more in the internally displaced population than the refugee population and more in the South-East Asian and African regions. Our recommendation is to conduct further research to evaluate the determinants of undernutrition among under-five children of refugees and internally displaced populations from different regions so that international organizations and responsible stakeholders of that region can take effective remedial actions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387156, PROSPERO [CRD42023387156]

Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study

Background To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990–2020, and forecasts for 2050. Methods We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. Only studies with samples representative of the population and with clearly defined visual acuity testing protocols were included. We fitted hierarchical models to estimate 2020 prevalence (with 95% uncertainty intervals [UIs]) of mild vision impairment (presenting visual acuity ≥6/18 and <6/12), moderate and severe vision impairment (<6/18 to 3/60), and blindness (<3/60 or less than 10° visual field around central fixation); and vision impairment from uncorrected presbyopia (presenting near vision <N6 or <N8 at 40 cm where best-corrected distance visual acuity is ≥6/12). We forecast estimates of vision loss up to 2050. Findings In 2020, an estimated 43·3 million (95% UI 37·6–48·4) people were blind, of whom 23·9 million (55%; 20·8–26·8) were estimated to be female. We estimated 295 million (267–325) people to have moderate and severe vision impairment, of whom 163 million (55%; 147–179) were female; 258 million (233–285) to have mild vision impairment, of whom 142 million (55%; 128–157) were female; and 510 million (371–667) to have visual impairment from uncorrected presbyopia, of whom 280 million (55%; 205–365) were female. Globally, between 1990 and 2020, among adults aged 50 years or older, age-standardised prevalence of blindness decreased by 28·5% (–29·4 to −27·7) and prevalence of mild vision impairment decreased slightly (–0·3%, −0·8 to −0·2), whereas prevalence of moderate and severe vision impairment increased slightly (2·5%, 1·9 to 3·2; insufficient data were available to calculate this statistic for vision impairment from uncorrected presbyopia). In this period, the number of people who were blind increased by 50·6% (47·8 to 53·4) and the number with moderate and severe vision impairment increased by 91·7% (87·6 to 95·8). By 2050, we predict 61·0 million (52·9 to 69·3) people will be blind, 474 million (428 to 518) will have moderate and severe vision impairment, 360 million (322 to 400) will have mild vision impairment, and 866 million (629 to 1150) will have uncorrected presbyopia. Interpretation Age-adjusted prevalence of blindness has reduced over the past three decades, yet due to population growth, progress is not keeping pace with needs. We face enormous challenges in avoiding vision impairment as the global population grows and ages