Effect of Indian women’s exposure to warning messages on intention to quit smokeless tobacco

Background: Media campaigns have been shown to affect intention to quit the use of smoked tobacco and quit behaviour among men. However, despite warning messages on tobacco packages and delivered via mass media, such campaigns have had limited reach and effect on women’s use of smokeless tobacco (SLT) and SLT use among Indian women is increasing. This paper explores the association between selected warning messages conveyed through different media mechanisms and intention to quit smokeless tobacco among women of reproductive age in Mumbai.Methods: A cross-sectional community survey was conducted in a representative sample of 409 daily smokeless tobacco (SLT) women users aged 18- 40 years in a low-income community in Mumbai during 2011-2012. The paper utilizes information on socio-demographic characteristics, types of tobacco use, exposure to different types of warning messages and intention to quit collected through a researcher-administered structured questionnaire. Univariate and bivariate analysis were carried out to examine the influence of warning messages on intention to quit SLT use.Results: Half of the women correctly interpreted the image of scorpion on the SLT product as ‘causing cancer’. About 36% women were exposed to warning messages on television and 67% of women intended to quit SLT. Correct interpretation of the significance of the scorpion sign on SLT packets was not significantly associated with intention to quit SLT use. However, the likelihood of intention to quit was significantly higher among those who were exposed to warning messages on television than their counterparts.Conclusions: Since anti-tobacco campaigns on television were significantly associated with the intention to quit but warnings on package tobacco were not, expansion of anti-tobacco messaging on television targeted and tailored to women should further increase quit intentions and over time, with effective cessation programs in place, have an impact on quit behaviour

Prevalence of unmet need for contraception in urban slum communities, Mumbai

Background: Unmet need for family planning is a tool to monitor the family planning program. Hence, the objective of study is to examine the prevalence of unmet need for family planning among women living in urban slum communities, Mumbai.Methods: The cross-sectional survey was conducted among currently married women aged 18-39 years and having at least one child. A total of 2797 women were selected using systematic random sampling. Information on demographic characteristics, their contraceptive behaviour and fertility intention were collected by face to face interview using structured questionnaire. Chi square test was applied and p <0.05 was considered as significant.  Results: About 59.4% were currently using family planning methods and 40.6% have reported unmet need for family planning. Awareness of contraceptive methods among women with unmet need for family planning was universal. The prevalence of unmet need for family planning significantly decreased as the age and number of children increased. The prevalence of unmet need was significantly higher than met need for family planning among women having one child as compared to women having 2 or more children.Conclusions: A significant gap was observed between met and unmet need for family planning among younger women and having one child. The study emphasises the need for family planning programs to focus on younger couples having one child.

Husband's Alcohol Use, Intimate Partner Violence, and Family Maltreatment of Low-Income Postpartum Women in Mumbai, India.

Husbands' alcohol use has been associated with family-level stress and intimate partner violence (IPV) against women in India. Joint family systems are common in India and IPV often co-occurs with non-violent family maltreatment of wives (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care). Alcohol use increases for some parents following the birth of a child. This study examined 1,038 postpartum women's reports of their husbands' alcohol use and their own experiences of IPV (by husband) and non-violent maltreatment from husbands and/or in-laws. We analyzed cross-sectional, quantitative data collected in 2008, from women (ages 15-35) seeking immunizations for their infants &lt;6 months at three large urban health centers in Mumbai, India. Crude and adjusted logistic regression models estimated associations between the independent variable (husbands' past month use of alcohol) and two dependent variables (postpartum IPV and maltreatment). Overall, 15% of husbands used alcohol, ranging from daily drinkers (10%) to those who drank one to two times per week (54%). Prevalence of postpartum IPV and family maltreatment was 18% and 42%, respectively. Prevalence of IPV among women married to alcohol users was 27%. Most abused women's husbands always (27%) or sometimes (37%) drank during violent episodes. Risk for IPV increased with a man's increasing frequency of consumption. Women who lived with a husband who drank alcohol, relative to non-drinkers, were more likely to report postpartum IPV, aOR = 2.0, 95% confidence interval (CI) = [1.3, 3.1]. Husbands' drinking was marginally associated with increased risk for family maltreatment, aOR = 1.4, 95% CI = [1.0, 2.1]. Our findings suggest that men's alcohol use is an important risk factor for postpartum IPV and maltreatment. Targeted services for Indian women contending with these issues are implicated. Postpartum care offers an ideal opportunity to screen for IPV, household maltreatment, and other health risks, such as husband's use of alcohol. There is need to scale up proven successful interventions for reducing men's alcohol use and design strategies that provide at-risk women protection from alcohol-related IPV

CHARM, a gender equity and family planning intervention for men and couples in rural India: protocol for the cluster randomized controlled trial evaluation.

BackgroundGlobally, 41% of all pregnancies are unintended, increasing risk for unsafe abortion, miscarriage and maternal and child morbidities and mortality. One in four pregnancies in India (3.3 million pregnancies, annually) are unintended; 2/3 of these occur in the context of no modern contraceptive use. In addition, no contraceptive use until desired number and sex composition of children is achieved remains a norm in India. Research shows that globally and in India, the youngest and most newly married wives are least likely to use contraception and most likely to report husband's exclusive family planning decision-making control, suggesting that male engagement and family planning support is important for this group. Thus, the Counseling Husbands to Achieve Reproductive Health and Marital Equity (CHARM) intervention was developed in recognition of the need for more male engagement family planning models that include gender equity counseling and focus on spacing contraception use in rural India.Methods/designFor this study, a multi-session intervention delivered to men but inclusive of their wives was developed and evaluated as a two-armed cluster randomized controlled design study conducted across 50 mapped clusters in rural Maharashtra, India. Eligible rural young husbands and their wives (N = 1081) participated in a three session gender-equity focused family planning program delivered to the men (Sessions 1 and 2) and their wives (Session 3) by village health providers in rural India. Survey assessments were conducted at baseline and 9&amp;18 month follow-ups with eligible men and their wives, and pregnancy tests were obtained from wives at baseline and 18-month follow-up. Additional in-depth understanding of how intervention impact occurred was assessed via in-depth interviews at 18 month follow-up with VHPs and a subsample of couples (n = 50, 2 couples per intervention cluster). Process evaluation was conducted to collect feedback from husbands, wives, and VHPs on program quality and to ascertain whether program elements were implemented according to curriculum protocols. Fidelity to intervention protocol was assessed via review of clinical records.DiscussionAll study procedures were completed in February 2015. Findings from this work offer important contributions to the growing field of male engagement in family planning, globally.Trial registrationClinicalTrial.gov, NCT01593943

Maternal morbidity associated with violence and maltreatment from husbands and in-laws: findings from Indian slum communities.

BackgroundIntimate partner violence (IPV) victimization is linked to a broad range of negative maternal health outcomes. However, it is unclear whether IPV is directly related to poor maternal outcomes or whether IPV is a marker for other forms of chronic, mundane maltreatment of women that stem from the culture of gender inequity that also gives rise to IPV. To determine the prevalence of non-violent forms of gender-based household maltreatment by husbands and in-laws (GBHM), and violence from in-laws (ILV) and husbands (IPV) against women during the peripregnancy period (during and in the year prior to pregnancy); to assess relative associations of GBHM, ILV and IPV with maternal health.MethodsCross-sectional data were collected from women &lt;6 months postpartum (n = 1,039, ages 15-35 years) seeking child immunization in Mumbai, India. Associations of IPV, ILV and GBHM during the peripregnancy period with maternal health (prenatal care in first trimester, no weight gain, pain during intercourse, high blood pressure, vaginal bleeding, premature rupture of membranes, premature birth) were evaluated.ResultsOne in three women (34.0 %) reported IPV, 4.8 % reported ILV, and 48.5 % reported GBHM during the peripregnancy period. After adjusting for other forms of abuse, IPV related to pain during intercourse (AOR = 1.79); ILV related to not receiving first trimester antenatal care (AOR = 0.49), and GBHM remained associated with premature rupture of membranes (AOR = 2.28), pain during intercourse (AOR = 1.60), and vaginal bleeding (AOR = 1.80).ConclusionAfter adjusting for ILV and IPV, peripregnancy GBHM remained significantly associated with multiple forms of maternal morbidity, suggesting that GBHM is a prevalent and reliable indicator of maternal health risk

PROPRANOLOL HYDROCHLORIDE TOPICAL GEL FOR THE TREATMENT OF INFANTILE HEMANGIOMA

Objective: To formulate and evaluate propranolol hydrochloride topical gel for overcoming the limitations and low oral bioavailability associated with conventional therapy. Methods: The propranolol hydrochloride topical gels were prepared by the cold mechanical method. The preliminary evaluation and further characterisation studies was conducted to find the optimised formulation. The in vitro release and ex vivo permeation studies were investigated. The histopathological studies and stability studies was also assessed. Results: The propranolol hydrochloride topical gel was successfully prepared. The in vitro release of optimized topical propranolol hydrochloride gel formulation (G2) showed the highest cumulative percentage drug release that is, 95.55%±0.15 after 7.5 h. (G2) the formulation showed a higher flux value of 4.61μg/cm2/h. The histopathological study using pig skin revealed that the optimized formulation was found to be safe for topical application. Conclusion: The formulated topical gel containing propranolol Hydrochloride seems to be a promising dosage form for enhanced skin delivery of propranolol hydrochloride in treating Infantile Hemangioma

Spousal discordance on reports of contraceptive communication, contraceptive use, and ideal family size in rural India: a cross-sectional study

Background Persistent low rates of spacing contraceptive use among young wives in rural India have been implicated in ongoing negative maternal, infant and child health outcomes throughout the country. Gender inequity has been found to consistently predict low rates of contraception. An issue around contraceptive reporting however is that when reporting on contraceptive use, spouses in rural India often provide discordant reports. While discordant reports of contraceptive use potentially impede promotion of contraceptive use, little research has investigated the predictors of discordant reporting. Methods Using data we collected from 867 couples in rural Maharashtra India as part of a men-focused family planning randomized controlled trial. We categorized couples on discordance of men’s and women’s reports of current contraceptive use, communication with their spouse regarding contraception, and ideal family size, and assessed the levels of discordance for each category. We then ran multinomial regression analyses to determine predictors of discordance categories with a focus on women’s empowerment (household and fertility decision-making, women’s education, and women’s knowledge of contraception). Results When individuals reported communicating about contraception and their spouses did not, those individuals were also more likely to report using contraception when their spouses did not. Women’s empowerment was higher in couples in which both couples reported contraception communication or use or in couples in which only wives reported contraception communication or use. There were couple-level characteristics that predicted husbands reporting either contraception use or contraception communication when their wives did not: husband’s education, husband’s familiarity with contraception, and number of children. Conclusions Overall there were clear patterns to differential reporting. Associations with women’s empowerment and contraceptive communication and use suggest a strategy of women’s empowerment to improve reproductive health. Discordant women-only reports suggest that even when programs interact with empowered women, the inclusion of husbands is essential. Husband-only discordant reports highlight the characteristics of men who may be more receptive to family planning messages than are their wives. Family planning programs may be most effective when working with couples rather than just with women, and should focus on improving communication between couples, and supporting them in achieving concordance in their reproductive preferences. Trial registration Clinical Trials Number: NCT01593943, registered May 4, 2012 at clinicaltrials.gov

Ultrafast carrier phonon dynamics in NaOH-reacted graphite oxide film

NaOH-reacted graphite oxide film was prepared by decomposing epoxy groups in graphite oxide into hydroxyl and -ONa groups with NaOH solution. Ultrafast carrier dynamics of the sample were studied by time-resolved transient differential reflection (\DeltaR/R). The data show two exponential relaxation processes. The slow relaxation process (\sim2ps) is ascribed to low energy acoustic phonon mediated scattering. The electron-phonon coupling and first-principles calculation results demonstrate that - OH and -ONa groups in the sample are strongly coupled. Thus, we attribute the fast relaxation process (\sim0.17ps) to the coupling of hydroxyl and -ONa groups in the sample

Ultrafast carrier dynamics in pristine and FeCl3-intercalated bilayer graphene

Ultrafast carrier dynamics of pristine bilayer graphene (BLG) and bilayer graphene intercalated with FeCl3 (FeCl3-G), were studied using time-resolved transient differential reflection (delta R/R). Compared to BLG, the FeCl3-G data showed an opposite sign of delta R/R, a slower rise time, and a single (instead of double) exponential relaxation. We attribute these differences in dynamics to the down-shifting of the Fermi level in FeCl3-G, as well as the formation of numerous horizontal bands arising from the d-orbitals of Fe. Our work shows that intercalation can dramatically change the electronic structure of graphene, and its associated carrier dynamics.Comment: 14 pages, 4 figure