Knowledge, attitude and practice on cervical cancer screening and human papillomavirus vaccination among adolescent girls residing in a slum of Kolkata

Background: Cervical cancer has emerged as an important public health concern among Indian women as it contributes to significant mortality.  Early diagnosis and its prevention are thus of vital importance in the current scenario. This study assessed the knowledge, attitude, and practice regarding screening and human papillomavirus vaccination among adolescent girls in a slum area of Kolkata. Methods: This cross-sectional study was conducted among 227 adolescent girls (aged 14–19 years) at Arpuli Lane, Kolkata. A pre-designed questionnaire was used for data collection. Chi-square test and binary logistic regression analysis were done to findout the factors associated with knowledge, attitude and practice. Results:  Approximately 91% had inadequate knowledge regarding the prevention of cervical cancer, 47% had an unfavourable attitude towards the prevention of cervical cancer, and 22% had undergone a Pap smear examination/HPV test, while only 13% had received HPV vaccination. The educational status of the participants and their mothers was significantly associated with knowledge, attitude, and practice regarding cervical cancer screening and HPV vaccination. Conclusion:  Appropriate behaviour change communications should be initiated considering the propensity for high-risk behaviour and poor knowledge and attitude. Future studies should reveal the causes of their poor behaviour to ensure timely screening and adequate vaccine coverage

Smartphone Addiction, Daytime Sleepiness and Depression among Undergraduate Medical Students: A Cross-sectional Study in a Medical College of Kolkata, India

Objective: Smartphone addiction has become an emerging problem among the youth, especially among medical students in India. It has the potential to hamper their sleep quality as well act as a precipitating factor for depression. This study thus assessed the magnitude of smartphone addiction, excessive daytime sleepiness and depression among undergraduate medical students in Kolkata and elicited its determinants. Materials and Methods: This cross-sectional study was conducted among 204 undergraduate medical students in a selected medical college of Kolkata from March to June 2023. Smartphone addiction, daytime sleepiness and depression was assessed using the SAS-SV, EPSS and PHQ-9 questionnaires. Logistic regression analysis was undertaken to determine the associated factors of smartphone addiction, while Spearman’s correlation coefficient was estimated to find the relationship of smartphone addiction with depression and daytime sleepiness. Results: Approximately 29.4% participants were addicted to smartphone, 45.5% were suffering from excessive daytime sleepiness. The depression scores on the PHQ-9 scale showed a mean value of 8.15 (±4.72). Factors significantly associated with smartphone addiction were increasing age (AOR=1.23, 95%CI=1.12-2.21), male gender (AOR=2.12, 95% CI=1.36-3.45) and duration of smart phone usage >6 hours per day (AOR=1.92, 95%CI=1.23-2.45). Smartphone addiction showed positive correlation with both daytime sleepiness (ρ =0.5, p-value<0.05) and depression (ρ=0.23, p-value=0.001) Conclusion: Utmost care should be taken for promoting good mental health and wellbeing among medical students. Motivation and counselling sessions along with peer support groups can help in combating this addictive behaviour and depressive symptoms

Chronic musculoskeletal pain among elderly individuals in a rural area of West Bengal: A mixed-method study

Introduction: The high prevalence among elderly individuals and potential adverse impact on their overall life quality make chronic musculoskeletal pain a significant public health concern. Chronic musculoskeletal pain is an important cause of self-medication, which must be addressed to avoid various side effects and improve elderly health. This study aimed to determine the prevalence of chronic musculoskeletal pain and its associated factors among individuals (age ≥60 years) in rural West Bengal and explore their perspectives and perceived barriers regarding pain and its management. Methods: This mixed-method study was conducted in rural West Bengal from December 2021 to June 2022. The quantitative strand was conducted by interviewing 255 elderly participants (age ≥60 years) using a structured questionnaire. The qualitative strand was conducted via in-depth interviews of 10 patients with chronic pain. Quantitative data were analyzed using SPSS version 16, and chronic pain-related factors were analyzed using logistic regression models. Qualitative data were analyzed thematically. Results: Among the participants, 56.8% reported chronic musculoskeletal pain. The most frequently affected site was the knee joint. Comorbidity (adjusted odds ratio [aOR]=7.47, 95% confidence interval [CI]=3.2–17.5), age (aOR=5.16, 95% CI=2.2–13.5), depression (aOR=2.96, 95% CI=1.2–6.7) and over-the-counter drug usage (aOR=2.51, 95% CI=1.1–6.4) were significantly associated with chronic pain. Analgesic dependency, lack of motivation to adopt lifestyle modifications, lack of knowledge on analgesic side effects were considered pain management barriers. Conclusion: Managing comorbidities, providing mental support, generating awareness of analgesic side effects, strengthening healthcare facilities should be prioritized for holistic chronic musculoskeletal pain management

Utilisation of adolescent reproductive and sexual health services in a rural area of West Bengal: A mixed-method study

Introduction: Despite policy actions and strategic efforts for improving the reproductive and sexual health of adolescents by promoting the uptake of adolescent reproductive and sexual health (ARSH) services, the utilisation rate remains significantly low, especially in rural areas of India. This study aimed to assess the utilisation of these services by adolescents in rural West Bengal and its associated determinants. Methods: This mixed-method study was conducted from May to September 2021 in the Gosaba rural block of South 24 Parganas, West Bengal. Quantitative data were collected from 326 adolescents using a pre-tested structured questionnaire. Qualitative data were collected via four focus group discussions among 30 adolescents and key-informant interviews among six healthcare workers. Quantitative data were analysed using SPSS, while qualitative data were analysed thematically. Results: Ninety-six (29.4%) adolescents had utilised ARSH services at least once during adolescence. The factors associated with non-utilisation of ARSH services were younger age, female sex, increasing reproductive health stigma and decreasing parent–adolescent communication related to sexual health. Qualitative exploration revealed that unawareness regarding services, perceived lack of privacy and confidentiality at healthcare facilities and disruption of services post-emergence of the COVID-19 pandemic were some major barriers to ARSH service utilisation. Conclusion: A multi-component strategy, including promotion of adolescent-friendly health clinics, community support interventions associated with motivation and counselling of parents regarding the importance of adolescent reproductive health, is needed to improve the utilisation of ARSH services. Necessary steps to correct the deficiencies at the facility level should also be prioritised

Determinants of Modern Contraceptive Usage among Married Women: A Mixed-Methods Study in a Rural Community of India

Objective: A woman’s multifaceted feelings, knowledge, and perceptions of their intimate relations greatly influence their contraceptive behavior. In addition, women empowerment has been increasingly recognized as a key factor in family planning and reproductive health outcomes. This study aimed to assess modern contraceptive usage and its determinants among currently married women of reproductive-age (WRA) in rural Bengal. Materials and Methods: This mixed-method study was conducted in a rural area of Hooghly District, West Bengal from April to September 2021. The quantitative strand of the study was conducted by interviewing 210 currently married WRA. The qualitative strand was conducted via focussed group discussions among husbands/mothersin-law and in-depth interviews with healthcare workers. SPSS software was utilized for quantitative data analysis and factors associated with contraceptive usage were analyzed using logistic regression models. Qualitative data were analyzed thematically. Result: Currently 114 (54.8%) study participants were using modern contraceptive methods. Education (aOR=7.65, 95% CI=1.85-31.67), empowerment through freedom from family domination (aOR=5.56, 95% CI=1.30-23.66), attitude on contraception (aOR=4.67, 95% CI=1.26-17.19), and family planning counselling (aOR=4.41, 95% CI=1.12-17.33) were found to be significantly associated with modern contraceptive usage. Lack of couple counselling, family support, and knowledge gap was identified as the major barriers to contraceptive usage. Conclusion: Since a woman’s decision-making ability significantly affects their sexual and reproductive health outcomes, effective measures should be undertaken to empower them by creating awareness regarding their rights and freedom to make strategic life choices. Couple counselling should be prioritized to enhance male involvement and eliminate perceived barriers

Unsupervised Paraphrasing via Deep Reinforcement Learning

Paraphrasing is expressing the meaning of an input sentence in different wording while maintaining fluency (i.e., grammatical and syntactical correctness). Most existing work on paraphrasing use supervised models that are limited to specific domains (e.g., image captions). Such models can neither be straightforwardly transferred to other domains nor generalize well, and creating labeled training data for new domains is expensive and laborious. The need for paraphrasing across different domains and the scarcity of labeled training data in many such domains call for exploring unsupervised paraphrase generation methods. We propose Progressive Unsupervised Paraphrasing (PUP): a novel unsupervised paraphrase generation method based on deep reinforcement learning (DRL). PUP uses a variational autoencoder (trained using a non-parallel corpus) to generate a seed paraphrase that warm-starts the DRL model. Then, PUP progressively tunes the seed paraphrase guided by our novel reward function which combines semantic adequacy, language fluency, and expression diversity measures to quantify the quality of the generated paraphrases in each iteration without needing parallel sentences. Our extensive experimental evaluation shows that PUP outperforms unsupervised state-of-the-art paraphrasing techniques in terms of both automatic metrics and user studies on four real datasets. We also show that PUP outperforms domain-adapted supervised algorithms on several datasets. Our evaluation also shows that PUP achieves a great trade-off between semantic similarity and diversity of expression

Science with the Daksha High Energy Transients Mission

We present the science case for the proposed Daksha high energy transients mission. Daksha will comprise of two satellites covering the entire sky from 1~keV to $>1$~MeV. The primary objectives of the mission are to discover and characterize electromagnetic counterparts to gravitational wave source; and to study Gamma Ray Bursts (GRBs). Daksha is a versatile all-sky monitor that can address a wide variety of science cases. With its broadband spectral response, high sensitivity, and continuous all-sky coverage, it will discover fainter and rarer sources than any other existing or proposed mission. Daksha can make key strides in GRB research with polarization studies, prompt soft spectroscopy, and fine time-resolved spectral studies. Daksha will provide continuous monitoring of X-ray pulsars. It will detect magnetar outbursts and high energy counterparts to Fast Radio Bursts. Using Earth occultation to measure source fluxes, the two satellites together will obtain daily flux measurements of bright hard X-ray sources including active galactic nuclei, X-ray binaries, and slow transients like Novae. Correlation studies between the two satellites can be used to probe primordial black holes through lensing. Daksha will have a set of detectors continuously pointing towards the Sun, providing excellent hard X-ray monitoring data. Closer to home, the high sensitivity and time resolution of Daksha can be leveraged for the characterization of Terrestrial Gamma-ray Flashes.Comment: 19 pages, 7 figures. Submitted to ApJ. More details about the mission at https://www.dakshasat.in