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126 result(s) for "Goel, Sonu"
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Public Health Leadership \Transformation of Dreams to Reality\
Summary This oration examines the multifaceted nature and skills of leadership in the field of public health from the eyes of public health practitioner. Through diverse examples from personal and professional experiences, the oration debunks common misconceptions surrounding leadership and underscores its capacity to motivate and steer individuals or groups towards a shared vision. It challenges the notion that leaders must possess all-encompassing knowledge, instead emphasizing the significance of traits such as courage, confidence, strategic thinking, and collaboration. Moreover, the oration also delves into the question of whether leadership is an innate quality or one that can be acquired through experience and training, recognizing that while some individuals exhibit inherent leadership qualities, others develop them over time. Throughout the article, the author shares his personal and professional journey in public health leadership, recounting formative experiences ranging from serving as a class representative to working in rural areas and marginalized communities. These encounters at various levels, encompassing departmental, institutional, national, and international, enabled the author to apply leadership attributes such as empathy, effective communication, teamwork, and change management to affect positive transformations in healthcare utilisation. The article summarises the fact that leadership is a continuous (not abstract) variable which is present in everyone, albeit, in different proportions and that, it can be acquired by persistence and perseverance.
Change in the prevalence of prehypertension and hypertension among young Indians aged 15–24 years between 2015–16 and 2019–21: Insights from nationally representative surveys
Globally, the prevalence of prehypertension and hypertension among adults in low- and middle-income countries is on the rise. However, the data on young people remains scarce. In this context, we analyzed data from two national-level cross-sectional surveys—NFHS–4, which included 272,966 individuals, and NFHS–5, which included 250,213 individuals—to assess changes in the prevalence of prehypertension and hypertension among young Indians aged 15–24 years. Between 2015–2016 and 2019–2021, the prevalence of prehypertension increased significantly (p <  0.001), rising from 38.9% to 44.5% among men and from 21.1% to 26.9% among women. While hypertension prevalence among men increased from 5.2% to 6.2%, it remained stable at approximately 4.0% among women over the same period. Most states, with a few exceptions, exhibited an increase in prehypertension prevalence across both genders, and more than two-thirds of states also showed an increase in hypertension prevalence among men. High BMI was found to be strongly associated with both prehypertension and hypertension. The rising prevalence of prehypertension and hypertension among young Indians aged 15–24 years is concerning and underscores the urgent need to develop targeted preventive strategies for this age group.
Developing a capacity building training model for public health managers of low and middle income countries
The challenges faced by the low and middle-income countries (LMIC) in the field of public health management calls for the capacity building of qualified and trained public health managers in order to improve the effectiveness and efficiency of the health care delivery system. Most of the existing training programs for public health management are based in the settings of developed countries, which hinders their application in LMIC countries. The objective of this paper is to document the process of development and evaluation of a capacity building program for public health managers of various LMICs. A training program was developed using Kern's six-step framework with several innovative learning and assessment methodologies and evaluation using Kirkpatrick training evaluation model. Delphi technique was used for program development. This five to ten-day partly/fully funded six International Public Health Management Development Programs (IPHMDP) programs was conceptualized which enrolled 178 participants from 42 countries between years 2016 and 2019. Based upon the elaborative discussion in four rounds of Delphi technique, the problem and challenges faced by public health mangers and eight key competencies (viz. Leadership and governance, Project/ program planning, financial management, supply chain management, quality management, Human Resource management, monitoring and evaluation, and communication.) were identified. The group consensually agree upon a blended teaching methodology comprising of chalk and talk approach, inquiry based learning, participatory student based learning, small group instructions, gamification, project-based learning and field-based learning. There was a significant increase in participants' knowledge score (P<0.0001) after all programs especially in the competencies of monitoring and evaluation, followed by project/ program planning, supply chain management and quality management. The majority (90%) submitted their action plan one week following the program, out of which 64% implemented their action plans within six months. A majority (54.7%) of participants were able to implement their learning once they went back by conducting similar training/ workshop/webinars in their settings. The comprehensive public health management program in LMIC settings strengthens the competencies of public health managers which can be replicated in similar settings across LMIC to mitigate diverse challenges in public health management.
What motivates medical students to select medical studies: a systematic literature review
Background There is a significant shortage of health workers across and within countries. It is of utmost importance to determine the factors that motivate students to opt for medical studies. The objective of this study is to group and review all the studies that investigated the motivational factors that underpin students’ selection of medical study in recent years. Methods The literature search was carried out by two researchers independently in PubMed, Google Scholar, Wiley and IndMED databases for articles published from year 2006 till 2016. A total of 38 combinations of MeSH words were used for search purpose. Studies related to medical students and interns have been included. The application of inclusion and exclusion criteria and PRISMA guidelines for reporting systematic review led to the final selection of 24 articles. Results The majority of the studies ( n  = 16; 66.6%) were from high-income countries followed by an equal number from upper-middle and lower-middle income countries ( n  = 4,16.7%). None of the studies were from low-income countries. All of the studies were cross-sectional in nature. The main motivating factors that emerged were scientific (interest in science / medicine, social interest and academia, flexible work hours and work independence), societal (prestige, job security, financial security) and humanitarian (serving the poor and under priviledged) in high-, upper-middle and lower-middle income countries, respectively. The findings were comparable to Maslow’s hierarchy of needs theory of motivation. Conclusion This systematic review identifies the motivational factors influencing students to join medical studies in different parts of the globe. These factors vary per country depending on the level of income. This study offers cues to policy makers and educators to formulate policy in order to tackle the shortage of health workers, i.e. medical doctors. However, more research is needed to translate health policy into concrete and effective measures.
Pestilent relationship between smoking and hypertension or pulse pressure among males over 15 years in India: NFHS-5 Survey
The Global Adult Tobacco Survey conducted in India has divulged that 28.6% of the populace aged 15 years and above partakes in tobacco consumption in various modalities. Despite the availability of numerous studies on the correlation between smoking and hypertension, the nexus between tobacco smoking and hypertension remains enigmatic. Smoking has predominantly been linked to blood pressure, with scant investigations exploring the plausible association that may subsist between smoking and pulse pressure. This study is based on secondary data analysis from the fifth National Family Health Survey (NFHS-5). 17 Field Agencies gathered information from 636,699 households, 724,115 women, and 101,839 men. The data related to only men was included and analysed in this present study. Male participants had a mean age of 32.2+1.2 years, an average waist circumference of 80.4+12.2 cm, and mean systolic and diastolic blood pressure of 123.4+13.8 mmHg and 80.5+10.2 mmHg. Daily smokers had a slightly higher likelihood of hypertension compared to non-smokers (OR = 1.2, p <0.001). Male quitters had significantly lower odds of hypertension (OR = 0.9, p <0.001). Quitters had reduced odds of narrow pulse pressure but increased odds of wide pulse pressure (OR = 0.81 and 1.14, respectively). The study found that regular smoking was associated with hypertension, while factors such as age, obesity, urban dwelling, wealth, and tribal residence were linked to increased blood pressure. Male quitters had a lower likelihood of hypertension, and middle-aged men and those with central obesity showed distinct associations with deranged pulse pressure.
Undiagnosed hypertension and its associated factors in India: A rural-urban contrast from the National Family Health Survey (2019-21)
Undiagnosed hypertension extracts significant social cost, with money spent on complications already accounting for one-fifths of total health expenditure. Widespread socioeconomic disparities and inequity in health care access between rural and urban areas is expected. It is important to identify the different factors associated with undiagnosed hypertension in the working age population (15–49-years) residing in urban and rural areas, both of whom are vital to the economic development of our country. Data from the National Family Health Survey-5 (2019–21) for men and women aged 15–49 years was extracted and analysed. Operational definitions were prepared to identify known and undiagnosed hypertension. Distribution of undiagnosed hypertension according to sociodemographic, anthropometric and health-related behaviour was studied using frequencies and weighted proportions. Choropleth maps were used to depict state-wise distribution of undiagnosed hypertension. Multivariable logistic regression was used to find risk factors and protective factors for undiagnosed hypertension for men and women in rural and urban areas. The prevalence of undiagnosed hypertension was 11.7%. among men and 7.2% among women. The proportion of men with undiagnosed hypertension (66.3%) was significantly higher than the proportion of women (41.4%). Urban-rural differences were noted in various states. Education and empowerment of rural women through provision of means of socioeconomic enhancement and strengthening of community-based screening and referral under the national programme were some of the major policy implications of our findings. Future research is warranted in areas such as health insurance coverage, working away from home, owning a mobile telephone and other interventions to improve health-seeking behaviour in the rural areas.
Debunking Claims and Prioritizing Public Health: India's Bold Stand against Tobacco Imagery on OTT Platforms
Abstract India has taken a ground-breaking step in public health by mandating anti-tobacco warnings and disclaimers on over-the-top (OTT) platforms. Concerns over the prevalence of tobacco imagery in media, including OTT platforms, prompted this decision due to its role in normalizing and glamorizing smoking, particularly among the youth. The Indian government aims to comprehensively address this issue and protect public health. This article reviews recent news articles on the developments in the 2023 amendments to Cigarette and other tobacco products act COTPA 2004 and relevant studies on the ill effects of tobacco imagery to form the viewpoint. To effectively implement the new order, clear guidelines, and standards need to be established. Additionally, comprehensive awareness and education campaigns should be launched, while strict monitoring and enforcement mechanisms must be implemented. Supporting research initiatives should evaluate the impact of the warnings, and multiple stakeholders should be involved in the decision-making process. India's commitment to protecting public health and curbing tobacco advertisements on OTT platforms necessitates clear guidelines, awareness campaigns, monitoring and enforcement mechanisms, research initiatives, and stakeholder engagement. This government order aligns with international public health frameworks and can serve as a precedent for other countries. By implementing these measures, we can counter the normalization and glamorization of tobacco use and create a healthier future.
WHO Framework Convention on Tobacco Control Articles 9 and 10 implementation for sustainable tobacco control—a scoping review protocol
Introduction Tobacco consumption continues to pose a substantial global public health threat, resulting in more than 8 million preventable deaths annually. The WHO Framework Convention on Tobacco Control (FCTC) negotiated as the first global public health treaty under the auspices of the WHO, which serves as a critical instrument in combating the global tobacco epidemic. The WHO FCTC prioritizes a comprehensive approach that addresses both the demand for and supply side interventions for curbing tobacco epidemic globally. Strong evidence demonstrates the efficacy of these measures in safeguarding individuals, regardless of age, from tobacco initiation, and the associated harms. WHO FCTC Article 9 and 10 emphasizes upon testing and disclosure of tobacco product contents. This scoping review aims to explore the Implementation Landscape of WHO FCTC Articles 9 and 10 globally by adopting Consolidated Framework for Implementation Research (CFIR) framework. Methods The planned scoping review will adhere to the methodology outlined by “Arksey and O’Malley and Levac et al.” Through an exhaustive search strategy, relevant literature published from 2013 onwards will be sourced from databases including PubMed, CINAHL, EMBASE, Web of Science, Scopus, government websites, and reports. A predetermined set of criteria for study inclusion and exclusion will be applied independently by four reviewers to assess study eligibility. The findings will be synthesized narratively and qualitatively analyzed, incorporating the Consolidated Framework for Implementation Research (CFIR) framework for discussion and outlining. The review will adhere to the reporting standards outlined in the “Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Review (PRISMA-ScR)” guidelines. Conclusions/discussion Analyzing the implementation of FCTC Articles 9 and 10 across global contexts is expected to offer valuable insights into the need for context-specific adjustments and customized interventions. Understanding regional variations in efforts to regulate tobacco products is crucial for formulating specific strategies that effectively address cultural, economic, and regulatory challenges. This comparative examination has the potential to guide policymakers, public health professionals, and researchers in optimizing tobacco control initiatives to expedite progress toward effective implementation of Articles 9 and 10 in both the WHO-SEAR region and globally. Ethics approval This review will identify the landscape of the implementation of WHO FCTC Article 9 and 10. This review will also identify the best practices, policies, and strategies across the globe. An ethics committee approval was not sought for this since this involve secondary data.
Trends and patterns of second-hand smoke exposure amongst the non-smokers in India-A secondary data analysis from the Global Adult Tobacco Survey (GATS) I & II
Objectives The primary objective of the present study was to compare the prevalence and patterns of second-hand smoke (SHS) exposure in the home, workplace, public places, and at all three places amongst the non-smoker respondents between the two rounds of Global Adult Tobacco Survey (GATS) in India. The secondary objectives were to assess the differences in various factors associated with SHS exposure among non-smokers. Study design This secondary data analysis incorporated data generated from the previous two rounds of the cross-sectional, nationally representative GATS India, which covered 69,296 and 74,037 individuals aged 15 years and above. Exposure to the SHS at home, workplace, and public places amongst the non-smokers were the primary outcome variables. Standard definitions of the surveys were used. Results The overall weighted prevalence of exposure to SHS amongst the non-smokers inside the home and public places reduced. In contrast, the prevalence in the workplace increased marginally in round II compared to I. The proportion of adults who were exposed to SHS at all three places did not change much in two rounds of surveys. A decrease in the knowledge of the respondents exposed to SHS at home and public places was observed about the harmful effects of smoking in round II. Age, gender, occupation, place, and region of respondents were found to be significant determinants of SHS exposure at all the three places on multinomial logistic regression analysis. Conclusions The study calls for focused interventions in India and stringent implementation of anti-tobacco legislation, especially in the workplaces for reducing the exposure to SHS amongst the non-smokers and to produce encouraging and motivating results by next round of the survey.
Safety, efficacy and health impact of electronic nicotine delivery systems (ENDS): an umbrella review protocol
BackgroundElectronic nicotine delivery systems (ENDS), commonly known as e-cigarettes or vapes, have witnessed a rise in popularity, particularly among the youth. Although they were initially introduced as an alternative to traditional smoking, the design and function of ENDS vary. The potential health effects of ENDS, especially in comparison to traditional cigarettes, are a matter of ongoing debate. Given the increasing number of clinical studies and systematic reviews on this topic, there exists a demand for an umbrella review that offers a comprehensive assessment. The goal of this study is to perform an umbrella review of systematic reviews and meta-analyses to assess the safety, efficacy, health implications and potential gateway effect associated with ENDS.Methods and analysisThis umbrella review will adhere to the Joanna Briggs Institute (JBI) framework and the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A planned literature search will be executed across databases such as OVID, PubMed/MEDLINE, EMBASE, Cochrane Library and Web of Science. The inclusion criteria are systematic reviews that discuss ENDS and e-liquids in the context of safety, efficacy and health outcomes. The exclusion criteria include narrative reviews, non-systematic reviews and studies not in English. Quality of the selected studies will be evaluated using the AMSTAR V.2 Scale. An overlap assessment will be done using the Corrected Covered Area, and data synthesis will be presented both narratively and in tabulated formsEthics and disseminationEthics approval is not required for this study, as it does not involve the collection of original data. The results will be disseminated through peer-reviewed publication. The findings will offer crucial insights for stakeholders, policy-makers and the general public, underlining the health implications and the role of ENDS in tobacco cessation.