BackgroundIntimate partner violence (IPV) is a significant public health threat which causes injury and acute and chronic physical and mental health problems. In India, a high percentage of women experience IPV. The purposes of this study include 1) to describe the lifetime prevalence of IPV, and 2) to examine the association between IPV and physical and mental health well-being, among women utilizing community health services for the economically disadvantaged in India.MethodsWomen utilizing community health services (N = 219) aged between 18 and 62 years completed a self-administered survey in Gujarat, India. Standardized instruments were used to measure perceived physical and mental health well-being. In addition, participants were asked about their lifetime experience with IPV, and socio-demographic questions. Analysis was restricted to the ever-married participants who completed the questions on IPV (N = 167).ResultsParticipants with a lifetime history of IPV were more likely to have reported poorer physical and mental health compared to those without a lifetime history of IPV. More than half of the participants with an IPV history experienced multiple types of IPV (physical, sexual and/or emotional IPV). While being in the highest caste was a significant positive factor associated with better health, caste and other socio-demographic factors were not associated with IPV.ConclusionsWomen in India face risk of IPV. Yet those experiencing IPV do not seek help or rely on informal help sources. Community health organizations may take a role in IPV prevention and intervention. Diversity of intervention options would be important to encourage more women with IPV experience to seek help.

The most successful post-earthquake rehabilitation program is the one that involves the victims in their own relief, reconstruction, and rehabilitation efforts. The role of the government and NGOs is to facilitate people’s participation. This article explores the concept of coproduction in action in the 2001 post-earthquake rehabilitation in Gujarat, India.

Previous studies in India suggest high prevalence of intimate partner violence (IPV), childhood abuse, and abuse from in-laws. Yet few studies examined IPV, childhood abuse, and abuse from in-laws together. The purpose of this study is to examine the association between IPV, childhood abuse, and abuse from in-laws, and types of abuse (physical, sexual, and emotional abuse) among women utilizing community health services for the economically disadvantaged in India. This study contributes to expanding the literature on abuse experience and providing knowledge for developing intervention programs and research projects to improve health and safety of economically disadvantaged women. The data were collected from women aged 18 years old or older at 18 community health centers that are primarily for the economically disadvantaged in Gujarat, India, in October and November 2013. Of the 219 women who completed a self-administered survey, 167 participants, who had ever been married and indicated whether they had been abused by their spouse or not, were included in analysis. More than 60% of the participants experienced IPV, childhood abuse, and/or abuse from in-laws, often with multiple types of abuse. Physical abuse is a major issue for IPV, childhood abuse, and in-law abuse. Emotional abuse potentially happens along with physical and/or sexual abuse. Abuse from in-laws requires greater attention because all types of abuse from in-laws were associated with IPV. Community health centers should provide abuse prevention and intervention programs that have involvement of family members as well as women who are at risk of being abused.

Background and Objectives:Genetics and environment have both been implicated in the exponential rise in the prevalence of diabetes mellitus that affects 65.1 million people, and leads to a mortality of 1 million people every year in India. This study was devised to obtain the trends of the distribution of blood glucose, and sociodemographic characteristics in rural areas of a North Indian state.Materials and Methods:A cross-sectional study was conducted at eight centers in five districts. A camp-based approach was followed in the diabetes screening conducted in rural areas. Blood glucose measurements were obtained after informed consent by trained staff using a reflectance photometer instrument. Descriptive statistics, distribution curves, log transformations, and tests for bimodality were obtained.Results:45,318 participants consisting of 44.4% males and 55.6% females were screened. Ages ranged from 18 to 98 years with the mean age of 39.9 ± 14.44 years. 86.5% were normal (random blood sugar [RBS] <140 mg/dl), 10.6% were prediabetic (RBS 140–200 mg/dl) and 2.9% were diabetic (RBS > 200 mg/dl). The median blood glucose level steadily rose with increasing age. The prediabetic to diabetic ratio was 4:1. The distribution curve of RBS was right skewed. A log transformation was applied, and bimodality was tested using the Hartigan's dip test. The dip statistic (D) was 0.0162 with a simulated P < 0.001.Conclusion:Mass screening for diabetes provides benefits from a clinical standpoint by helping to estimate the prevalence (diabetes) and the hidden burden of the disease (prediabetes). Screening programs can strengthen healthcare system initiatives and reduce the growing burden of diabetes in India.

Objectives: Opioid Use Disorder (OUD) is a chronic brain disease that can be successfully managed with buprenorphine (BPN). Like other chronic diseases, OUD involves cycles of relapse and remission, with relapse often associated with medication treatment discontinuation. This study seeks to characterize the relationship between healthcare expenditures and OUD patient relapse and to evaluate real-world BPN treatment persistence. Methods: This retrospective observational study of patients with OUD enrolled in commercial, Medicare and Medicaid plans included claims data incurred between 01/01/2011 and 03/31/2018. Patients were required to have a minimum of two years of follow up and were split into three cohorts: OUD with relapse, OUD without relapse, and control (treated with acute opioids). A 1:1:1 propensity score match was performed. Results: 3,630 propensity matched patients from each of the cohorts qualified for the analysis with 71% enrolled in a Medicaid plan. Highest rates of anxiety, bipolar disorder, depression, and hepatitis C were found for OUD patients with relapse. OUD patients with relapse also incurred greater per member medical costs ($28,944) as compared to OUD patients without relapse ($18,252), and control ($11,880) (p=0.0203). Among patients with OUD, costs related to opioid dependence were higher for the relapsing cohort ($10,383) as compared to the non-relapsing cohort ($3,550) (p=0.0203). OUD patients demonstrated low persistence in buprenorphine treatment for both the relapsing (125 mean days in treatment episode) and non-relapsing (173 days) cohorts. Conclusions: In patients with OUD, relapse (as compared to no relapse) was associated with an increase in medical utilization that resulted in greater annual medical spend. Improved methods to identify patients with OUD in need of additional interventions and methods to prolong medication treatment duration are needed.