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Biomedical subjects

Jayashree Ramakrishna

Publications and source records attributed to Jayashree Ramakrishna.

8 recordsLinked to original sources
PubMed2006

Cultural context and impact of alcohol use in the Sundarban Delta, West Bengal, India.

Hazardous alcohol consumption is a worldwide problem with many locally distinctive features across cultures, but studies to guide policy in developing countries are notably lacking. This community study aimed to clarify local patterns of alcohol use in six villages of West Bengal, India. It considered the variety of local alcoholic preparations, who consumed them, when, and where. It sought to determine how social changes in the region influence changing patterns of acceptable and problem use of alcohol. Ethnographic methods included participant observation and focus group discussions. The qualitative data analysis of field notes and transcripts included a review of full texts and a computer-assisted analysis of thematically coded segments with reference to a structured agenda. We found that drinking is an integral feature of the cultural landscape. Locally brewed rice beer (handia), palm wine (tadi), distilled country liquor (chullu), and so-called Indian-made foreign liquor (IMFL) are consumed in these villages. Each is identified with particular segments of society and settings in these communities. Reported effects of problem drinking included social disturbances, family discord, and domestic violence. Increasing problem alcohol use was attributed by villagers to social changes resulting from development, which were otherwise valued, such as improved transportation and communications. In a field dominated by Western and urban studies, this research clarifies features of alcohol availability, use, and acceptance in a neglected rural area of India. It illustrates the limitations of western clinical models of dependence and the importance of clarifying sociocultural conditions that define locally acceptable and problem use.

Alcohol Drinking↗
PubMed2006

Health-related stigma: rethinking concepts and interventions.

As a feature of many chronic health problems, stigma contributes to a hidden burden of illness. Health-related stigma is typically characterized by social disqualification of individuals and populations who are identified with particular health problems. Another aspect is characterized by social disqualification targeting other features of a person's identity-such as ethnicity, sexual preferences or socio-economic status-which through limited access to services and other social disadvantages result in adverse effects on health. Health professionals therefore have substantial interests in recognizing and mitigating the impact of stigma as both a feature and a cause of many health problems. Rendering historical concepts of stigma as a discrediting physical attribute obsolete, two generations of Goffman-inspired sociological studies have redefined stigma as a socially discrediting situation of individuals. Based on that formulation and to specify health research interests, a working definition of health-related stigma is proposed. It emphasizes the particular features of target health problems and the role of particular social, cultural and economic settings in developing countries. As a practical matter, it relates to various strategies for intervention, which may focus on controlling or treating target health problems with informed health and social policies, countering the disposition of perpetrators to stigmatize, and supporting those who are stigmatized to limit their vulnerability and strengthen their resilience. Our suggestions for health studies of stigma highlight needs for disease- and culture-specific research that serves the interests of international health.

Communicable Diseases↗
PubMed2005

Birth rights and rituals in rural south India: care seeking in the intrapartum period.

Maternal morbidity and mortality are high in the Indian context, but the majority of maternal deaths could be avoided by prompt and effective access to intrapartum care (WHO, 1999). Understanding the care seeking responses to intrapartum morbidities is crucial if maternal health is to be effectively improved, and maternal mortality reduced. This paper presents the results of a prospective study of 388 women followed through delivery and traditional postpartum in rural Karnataka in southern India. In this setting, few women use the existing health facilities and most deliveries occur at home. The analysis uses quantitative data, collected via questionnaires administered to women both during pregnancy and immediately after delivery. By virtue of its prospective design, the study gives a unique insight into intentions for intrapartum care during pregnancy as well as events following morbidities during labour. Routine care in the intrapartum period, both within institutions and at home, and impediments to appropriate care are also examined. The study was designed to collect information about health seeking decisions made by women and their families as pregnancies unfolded, rather than trying to capture women's experience from a retrospective instrument. The data set is therefore a rich source of quantitative information, which incorporates details of event sequences and health service utilization not previously collected in a Safe Motherhood study. Additional qualitative information was also available from concurrent in-depth interviews with pregnant women, their families, health care providers and other key informants in the area. The level of unplanned institutional care seeking during the intrapartum period within the study area was very high, increasing from 11% planning deliveries at a facility to an eventual 35% actually delivering in hospitals. In addition there was a significant move away from planned deliveries with the auxiliary nurse midwive (ANM), to births with a lay attendant or dai. The proportion of women who planned for an ANM to assist was 49%, as compared with the actual occurrence, which was less than half of this proportion. Perceived quality of care was found to be an important factor in health seeking behaviour, as was wealth, caste, education and experience of previous problems in pregnancy. Actual care given by a range of practitioners was found to contain both beneficial and undesirable elements. As a response to serious morbidities experienced within the study period, many women were able to seek care although sometimes after a long delay. Those women who experienced inadequate progression of labour pains were most likely to proceed unexpectedly to a hospital delivery.

Adolescent↗
PubMed2003

Sex, studies or strife? What to integrate in adolescent health services.

If health services for adolescents are to be successfully integrated into the existing health care system, they will need to reach out to meet the needs that adolescents themselves perceive as salient. This paper describes a study aiming to elicit the needs of adolescents in higher secondary schools in Goa, India, in 1999-2000. The objective was to generate information which could guide the development of adolescent-friendly health services by integrating the health needs identified by adolescents themselves. The study began with free-listing, followed by focus group discussions and in-depth interviews to elicit areas of concern. Then, a survey of 811 students with a self-report questionnaire was carried out. The findings demonstrate that there is clearly an unmet need for information about sexual and reproductive health, but also a large, unmet need for psychosocial support for health issues ranging from violence in schools to poor relationships with parents, stress-related health complaints and educational difficulties, which are often perceived by adolescents to be of primary importance. Integrating these issues into programmes is likely to be an essential element in developing health services and programmes which can reach out to the majority of adolescents in school settings in India.

Adolescent↗
PubMed2003

High-risk sexual behaviour & sensation seeking among heavy alcohol users.

BACKGROUND & OBJECTIVES: An association has been shown between alcohol use and high-risk sexual behaviour. One of the important variables that might mediate risky sexual behaviour among alcohol users is the sensation-seeking dimension of personality. This study was undertaken with the aim to assess the relationship between sensation seeking and sexual risk taking among heavy alcohol users admitted to a De-addiction centre. METHODS: To study the above association, sensation seeking was compared between subjects admitted for treatment of alcohol dependence with (n = 30) and without (n = 30) reported high-risk sexual behaviour. RESULTS: Subjects reporting high-risk sexual behaviour were found to have higher sensation seeking scores in all the domains of the sensation seeking scale compared to those without high-risk sexual behaviour. Scores on the subscale disinhibition, of the sensation seeking scale seemed to be associated with higher sexual risk taking. INTERPRETATION & CONCLUSION: Sensation seeking as a personality variable was significantly associated with sexual risk taking behaviour among heavy alcohol users. The study indicates the need for careful assessment of personality in these individuals and emphasizes the need for further studies on a larger sample.

Adult↗