Health Action by People

Background and rationaleThe National Medical Council (NMC) introduced the District Residency Program (DRP) in 2020, mandating a three-month rotational residential work in district hospitals for postgraduate medical students with the aim of revamping the traditional postgraduate medical education system. Despite its potential benefits, the DRP has sparked debate among stakeholders. This study thus aims to evaluate the stakeholder perceptions and challenges in the implementation of the DRP in Kerala using a mixed-method approach. Unlike earlier evaluations from other Indian states, Kerala presents a unique context due to its early and comprehensive implementation of the DRP, strong public health infrastructure, and high stakeholder engagement, making it an ideal setting to generate transferable lessons for national-level policy refinement.Materials and methodsThe study was conducted at Government Medical College, Thrissur, Kerala, with participation from stakeholders across the state. A cross-sectional design was used for the quantitative part of the study, and the Delphi technique was used as a qualitative approach to identify perceptions of implementing officials and their proposed solutions to the issues identified. Informed consent was obtained from all participants before collecting information for the study. A total of 586 stakeholders participated in the study (residents n = 282; Directorate of Medical Education (DME) officials n = 180; Directorate of Health Services (DHS) officials n = 124). Quantitative data were analysed descriptively using IBM SPSS Statistics for Windows version 26, and qualitative insights were collected using a three-round Delphi process with 25 invited senior stakeholders (retention 88%).ResultsA total of 586 stakeholders participated (residents n = 282; DME officials n = 180; DHS officials n = 124). Most residents described district postings as providing diverse clinical exposure but identified gaps in infrastructure and supervision continuity. DME officials acknowledged the program’s positive impact on service delivery and training but noted the need for standardized evaluation systems. DHS officials reported improved patient care and staffing at peripheral hospitals, while emphasizing the importance of better accommodation and coordination mechanisms. The District Residency Programme (DRP) was perceived to have a positive impact on postgraduate training by enhancing residents’ clinical exposure, independent decision-making, and familiarity with peripheral health systems. However, gaps remained in infrastructure, supervision uniformity, and academic linkage between district hospitals and medical colleges.ConclusionThe study highlights that while the DRP in Kerala has enhanced postgraduate training and strengthened district-level healthcare delivery, further progress requires investment in infrastructure, specialty-specific postings, and structured monitoring mechanisms to ensure uniform academic and service outcomes across sites.

Background & Objectives: Social media has grown to be the most influential and important virtual space that has revolutionized the digital world since its inception across diverse settings, but has also increased the rate of cybercrimes committed against women. This study was aimed to estimate the prevalence of cyberbullying, types and its association with sociodemographic variables among women residing in a rural community at southern Kerala Methods: A cross-sectional study was conducted among 289 women in a rural community in Thiruvananthapuram district, Kerala using a predesigned, pretested interviewer administered questionnaire. Results: Cyberbullying was found to be prevalent (10.4%) and the most common form of cyber bullying was impersonation (40%) and (33.33%) of them reacted by deleting their accounts. Majority (52.2%) of the participants belong to the age group of (31 – 45) years, were graduates (62.3%), married (85.8%) belonging to low socioeconomic strata (70.2%) of the society. Majority (83.8%) of women have a special preference to face book among the various social media sites. There was a statistically significant association between demographic variables such as Age (p value 0.001**), Educational qualification (p value 0.038*), Occupation (p value 0.030*), Socioeconomic status (p value 0.006**) and type of family (p value 0.005**). Conclusion: Although digital revolution has been a boon, this study has revealed a vivid picture regarding cyberbullying, the hidden arena of concerns faced by women

The Internal Combustion (IC) Engine driven boats, which are commonly used, are not eco-friendly and will deplete the natural resources. A better alternative is to develop an economical, eco-friendly, and user-friendly system as a water transport system. This paper proposes design of the power circuit for a BLDC motor driven solar boat with a bidirectional converter. The proposed system can deliver power required to drive the boat with higher speed than the electric boats presently available and with better running time. The most interesting characteristic of the proposed system is that the same system can deliver AC power to charge other similar electric boats using its solar power alone through a bidirectional converter in the system, thus the system acts as an AC source. The Perturb and Observe (P & O) method is implemented for the maximum power point tracking (MPPT) of the solar panel. The photovoltaic (PV) power and rectified AC grid power are stored in the Lithium Ion (Li-Ion) battery system of the proposed electric boat. The paper provides a detailed analysis of the proposed system using MATLAB SIMULINK software. The proposed power circuit is suitable to drive a twenty five passenger capacity boat.

During the COVID-19 lockdown, India saw a major restriction in the movement of people. Patients with acute myocardial infarction (MI) required early interventions and follow-up of independent predictors like symptom-to-balloon (STB) time and door-to-balloon (DTB) time. This study aimed to determine changes in STB and DTB time before and after the COVID-19 lockdown and its associated risk factors. A hospital-based cross-sectional study of 105 patients admitted to the cardiac care units (CCU) of two tertiary care centers in a district of Southern India for six months was conducted to compare the changes in STB and DTB time before and after the COVID-19 lockdown (three months before March 2020 and three months after March 2020), and data was collected from medical records. The data collected was then entered into Microsoft Excel (Microsoft Corporation, Washington, USA), numerically coded, and analyzed using SPSS Statistics version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.). The Chi-square and Mann-Whitney U tests assessed the association between the dependent and independent variables. The STB/DTB time (before and after the COVID-19 lockdown) was the dependent variable, while the age, gender, co-morbidities, smoking status, and date of admission of patients (before and after the COVID-19 lockdown) were taken as the independent variables. A p-value of <0.05 was considered statistically significant. The predictor variables were identified using the regression method, where all variables with a significance of <0.2 were taken. The overall mean (±SD) STB time was 408.7 (±307.1) minutes, and the mean (±SD) DTB time was 161.7 (±261.6) minutes. The pre-lockdown mean STB time was 404.6 minutes, and the mean DTB time was 153 minutes, whereas the post-lockdown mean STB and DTB time were higher at 413.3 minutes and 171.6 minutes, respectively. Out of the total 105 patients, 95 (90.5%) had an STB time of ≥120 minutes, and 77 (73.3%) had an ideal DTB time of <90 minutes. There was no statistically significant variation in the STB and DTB time before and after the lockdown. Only the age group >60 years (38 (97.4%)) was found to be statistically significant with an STB time of ≥120 minutes after the lockdown (p-value=0.040), and patients referred from primary and secondary care centers (AOR (95% CI)=4.669 (1.129-19.298)) were found to be an independent factor in reducing DTB time before and after the COVID-19 lockdown. The efficiency of the health system, irrespective of the COVID-19 lockdown, was observed; nevertheless, a delay in the overall recognition of symptoms of MI was perceived. The importance of time factors in identifying the symptoms of non-communicable diseases (NCDs), especially MI and stroke, has to be ascertained among the general population.

Sasthamkotta Lake eco-region is a freshwater Ramsar site in Kerala, India. Eco-regions are ecologically and geographically defined larger land or water mass areas with a characteristic assemblage of the ecosystem and significant biodiversity. A decentralized and locally self-sustaining mechanism has been achieved in managing this eco-region by a participatory model through a joint Biodiversity Management Committee (jBMC) constitution. BMCs are custodians of the environment, and biodiversity, confined to a village/Panchayat, as per Convention on Biological Diversity (CBD) guidelines and the Indian Biodiversity Act. This jBMC constitutes a network of statutory biodiversity experts from the BMCs of three Local Self Governments (LSGs) or Panchayath administrations, where the Sasthamkotta Lake is located. It has been formed to develop strategies to manage and conserve the freshwater lake and its biodiversity. The management action plan proposed by the jBMC for the Sasthamkotta Ramsar site includes systematic and continuous assessment of the current biodiversity status, identifying and mitigating threats, appropriate use of its resources for eco-restoration and better administrative programs for biodiversity enhancement. Our case study shows that the conservation model of a Ramsar site Eco-region is successful and could be replicated in other damaged natural ecosystems which need attention, for a sustainable future.