State-wise variation and inequalities in caesarean delivery rates in India: analysis of the National Family Health Survey-5 (2019-2021) data.

Background: India's caesarean delivery (CD) rate of 21.5% suggests adequate national access to CD but may mask significant disparities. We examined variation in CD rates across states (geography), wealth, and health care sector (public versus private).

Factors associated with help-seeking by women facing intimate partner violence in India: findings from National Family Health Survey-5 (2019-2021).

Background: Intimate partner violence (IPV) against women has harmful effects on their psychological and physical health. However, help-seeking for IPV is significantly low among women in the Indian context. This study examines the different factors that influence help-seeking behaviour among women in India.

Acoustic radiation characteristics of shark skin inspired surface modified plates.

This paper aims to evaluate the acoustic radiation characteristics of thin plates featuring a layer of small-scale biomimetic shark skin type additive surface treatment. The shark skin dermal denticles are modelled as point masses arranged in a bi-directional pattern on both the upper and lower surfaces of the plate. The governing equations are obtained through a variational approach, incorporating the Dirac Delta function in the derivation of the proposed semi-analytical model for the shark skin layer.

A method for consistent cavitation bubble generation at different voltages.

A study of the dynamics of a single cavitation bubble is fundamental for understanding a wide range of applications in science and engineering. Underwater electrical discharge is a widely used method for generating cavitation bubbles to study their inception, subsequent dynamics, and collapse. In this work, an existing underwater low-voltage discharge circuit for generating cavitation bubbles is improved further to get a wider range of maximum bubble radius.

Does women empowerment associate with reduced risks of intimate partner violence in India? evidence from National Family Health Survey-5.

Background: Women empowerment is commonly believed to be an important factor affecting a woman's likelihood of facing violence from her intimate partner. Even as countries invest in policies that aim to strengthen women empowerment, studies show that increase in women empowerment does not necessarily decrease intimate partner violence (IPV) against them. Against this paradox, the present study seeks to understand the specific empowerment components that associate with IPV against women in India.

Piezoelectric energy extraction from a cylinder undergoing vortex-induced vibration using internal resonance.

A novel concept of utilizing the kinetic energy from ocean currents/wind by means of internal resonance is proposed to address the increasing global energy demand by generating clean and sustainable power. In this work, a non-linear rotative gravity pendulum is employed to autoparametrically excite the elastically mounted cylinder for a wide range of flow velocities. This concept is adopted to increase the oscillation amplitude of the cylinder due to vortex-induced vibration (VIV) in the de-synchronized region for energy harvesting.

Maternal Referral Delays and a Culture of Downstream Blaming Among Healthcare Providers: Causes and Solutions.

Patient referral management is an integral part of clinical practice. However, in low-resource settings, referrals are often delayed. The World Health Organization categorizes three types of referral delays; delay in seeking care, in reaching care and in receiving care.

Does women's empowerment and their socioeconomic condition affect the uptake of breast cancer screening? Findings from NFHS-5, India.

Background: Screening for breast cancer results in early diagnosis of the disease and improves survival. However, increasing participation of women in screening programs is challenging since it is influenced by socioeconomic and cultural factors. This study explores the relationship of socioeconomic and women empowerment factors with breast cancer screening uptakes in the states and union territories of India.

The Spiral.

Episodes of domestic violence are incredibly more common than what is documented. While we have had a law against it in India since 2005, the prevalence of domestic violence is high in India at close to 30 percent (as per National Family Health Survey, 2015-16). Yet, with interventions such as Dilaasa in Maharashtra, Bhoomika in Kerala, and Sukoon in Haryana - among others - visibility has increased; and so has support seeking behaviour.

Mapping the health systems response to violence against women: key learnings from five LMIC settings (2015-2020).

Background: Violence against women (VAW) is a global challenge, and the health sector is a key entry point for survivors to receive care. The World Health Organization adopted an earlier framework for health systems response to survivors. However, documentation on the programmatic rollout of health system response to violence against women is lacking in low and middle-income countries.

Baseline Optical Coherence Tomography Parameters That May Influence 6 Months Treatment Outcome of Polypoidal Choroidal Vasculopathy Eyes with Combination Therapy: A Short-Term Pilot Study.

Although optical coherence tomography (OCT) parameters have assisted in the diagnosis of polypoidal choroidal vasculopathy (PCV), its potential to evaluate treatment outcomes has not been established. The purpose of this pilot study was to evaluate baseline OCT parameters that may influence treatment outcome in PCV eyes with combination therapy. In this single-centered, prospective study, patients were recruited with at least one treatment-naïve PCV eye and treated with combination therapy of intravitreal anti-vascular endothelial growth factor and photodynamic therapy.

Visual Parameters and Retinal Morphology for Polypoidal Choroidal Vasculopathy Pre- and Post-Intravitreal Ranibizumab with or without Photodynamic Therapy: A Short-Term Prospective Study.

The objective of this study was to compare visual parameters and retinal layers' morphology pre-treatment (baseline) and 6 months post-treatment in polypoidal choroidal vasculopathy (PCV) eyes. A single centre, longitudinal, prospective study was conducted at a public tertiary hospital of Malaysia. Visual parameters including distance and near visual acuity (DVA and NVA), contrast sensitivity (CS), reading speed (RS), and different qualitative and quantitative optical coherence tomography (OCT) parameters were evaluated pre- and 6 months post-treatment.

Correlation between Visual Functions and Retinal Morphology in Eyes with Early and Intermediate Age-Related Macular Degeneration.

In early and intermediate age related macular degeneration (ARMD), visual acuity alone has failed to explain the complete variation of vision. The aim of the present study was to determine correlation between different visual functions and retinal morphology in eyes with early and intermediate ARMD. In this single center cross sectional study, patients diagnosed as early or intermediate ARMD in at least one eye were recruited.

Patient-Perceived Benefit of Treatment in Polypoidal Choroidal Vasculopathy: A Pilot Study.

Polypoidal choroidal vasculopathy (PCV), a subtype of neovascular age-related macular degeneration, requires repeated treatment. The objective of this pilot study was to evaluate and compare vision-targeted quality of life (QOL) at baseline and after 6 months of treatment in patients with PCV. Naive PCV patients were recruited.

Twin public health emergencies: Covid-19 and domestic violence.

While a virus is hardly "choosy" in finding a host, the consequences of government responses to a pandemic, such as to Covid-19, have deep implications for those already-marginalised, such as women and girls. In the absence of a systematic database examining the details of the impact, this comment synthesises existing opinions, reviews and the limited available data to show how, not only the outbreak, but particularly our response to it, are increasing the incidence of domestic violence (DV) across the globe, including in India. Despite tackling a much higher Covid caseload and mortality rate than India has, countries such as France and Spain have prioritised responding to DV in their respective societies, working out contingent mitigation mechanisms.

Between participation and signature: a response to "Autonomy and risk in HPSR studies".

Health Policy and Systems Research (HPSR) is defined as the "production of new knowledge to improve how societies organise themselves to achieve health goals" (1: p 4); the focus of HPSR studies is on generating, using and disseminating research to strengthen health systems, particularly in low-and middle-income countries. There has been an increasing focus on defining HPSR clearly and on its ethical components and challenges, especially as this domain, is fundamentally different from biomedical /clinical research. One of the imperatives of HPSR is the "co-production of knowledge" (1: p 4) by the researcher, the communities involved, and healthcare providers; and this calls for shared responsibility and ownership, which is not an essential aspect of biomedical research.

Searching for a Roommate: A Correspondence Audit Examining Racial/Ethnic and Immigrant Discrimination among Millennials.

Survey research finds that millennials have less prejudiced views of racial/ethnic minorities than other generations, leading some to label millennials as postracial. However, attitudinal survey research may be subject to social desirability bias because it documents statements or beliefs instead of actions. Moreover, most audit studies focus on people who make hiring decisions or own rental property and are therefore often older than millennials.

Identifying disrespect and abuse in organisational culture: a study of two hospitals in Mumbai, India.

This paper draws on findings from a qualitative study of two government hospitals in Mumbai, India, which aimed to provide a better understanding of the institutional drivers of disrespect and abuse (D&A) in childbirth. The paper describes the structural context, in which government hospital providers can exercise considerable power over patients, yet may be themselves vulnerable to violence and external influence. Decisions that affect care are made by a bureaucracy, which does not perceive problems with the same intensity as providers who are directly attending to patients.

When fiduciary duty clashes with duty to the state.

In their case study Cash and Castro discuss a situation where a physician's duties to the laws of her land stand in conflict with her fiduciary duties to her patient. This present commentary is a response to the situation they describe, and it engages with the issue of conscientious objection in medicine, to argue that the ethical responsibility of the physician should be tilted in favour of the patient, especially when the laws of the land are regressive and harmful.

Assisted reproductive technologies: Conundrums and challenges.

A few weeks ago, a leading multi-city IVF clinic published an advertisement in a leading news daily. The advertisement sounded ominous, "The longer you wait, the lower your chances" - it referred to one's chances of getting pregnant. The subtext was far too easy to decipher: the content was thoroughly gendered and directed solely at women, particularly at career-oriented women who delay their marriages and childbearing plans far too long, supposedly lowering their fertility in the process.

The social value of research: interrogating the paradoxes.

The relation between science and society is, simply put, very complex. In the history of global bioethics, it is the Code of Nuremberg which foregrounded the acute ways in which biomedical/scientific research could (negatively) impact society; this 1947 Code became the point of reference for subsequent research concerning humans. The Code "required that medical experiments on human beings must have the potential to yield fruitful results for the good of society".