Estimating the effectiveness of a hospital’s interventions in India: Impact of the choice of disability weights [Évaluation de l’efficacité des interventions pratiquées dans un hôpital indien: Impact du choix des coefficients de pondération servant au calcul des années d’incapacité] [Estimación de la eficacia de las intervenciones de un hospital de la India: Impacto de la elección de los pesos de discapacidad]
Chatterjee S.,Institutional Area |
Gosselin R.A.,University of California at San Francisco
Bulletin of the World Health Organization | Year: 2015
Objective To calculate the effect of using two diferent sets of disability weights for estimates of disability-adjusted life-years (DALYs) averted by interventions delivered in one hospital in India. Methods DALYs averted by surgical and non-surgical interventions were estimated for 3445 patients who were admitted to a 106-bed private hospital in a semi-urban area of northern India in 2012–2013. Disability weights were taken from global burden of disease (GBD) studies. We used the GBD 1990 disability weights and then repeated all of our calculations using the corresponding GBD 2010 weights. DALYs averted were estimated for surgical and non-surgical interventions using disability weight, risk of death and/or disability, and effectiveness of treatment. Findings The disability weights assigned in the GBD 1990 study to the sequelae of conditions such as cataract, cancer and injuries were substantially diferent to those assigned in the GBD 2010 study. These diferences in weights led to large diferences in estimates of DALYs averted. For all surgical interventions delivered to this patient cohort, 11 517 DALYs were averted if we used the GDB 1990 weights and 9401 DALYs were averted if we used the GDB 2010 disability weights. For non-surgical interventions 5168 DALYs were averted using the GDB 1990 disability weights and 5537 DALYS were averted using the GDB 2010 disability weights. Conclusion Estimates of the effectiveness of hospital interventions depend upon the disability weighting used. Researchers and resource allocators need to be very cautious when comparing results from studies that have used diferent sets of disability weights. © 2015, World Health Organization. All rights reserved.
Srivastava A.,Institutional Area |
Avan B.I.,London School of Hygiene and Tropical Medicine |
Rajbangshi P.,Institutional Area |
Bhattacharyya S.,Institutional Area
BMC Pregnancy and Childbirth | Year: 2015
Background: Developing countries account for 99 percent of maternal deaths annually. While increasing service availability and maintaining acceptable quality standards, it is important to assess maternal satisfaction with care in order to make it more responsive and culturally acceptable, ultimately leading to enhanced utilization and improved outcomes. At a time when global efforts to reduce maternal mortality have been stepped up, maternal satisfaction and its determinants also need to be addressed by developing country governments. This review seeks to identify determinants of women's satisfaction with maternity care in developing countries. Methods: The review followed the methodology of systematic reviews. Public health and social science databases were searched. English articles covering antenatal, intrapartum or postpartum care, for either home or institutional deliveries, reporting maternal satisfaction from developing countries (World Bank list) were included, with no year limit. Out of 154 shortlisted abstracts, 54 were included and 100 excluded. Studies were extracted onto structured formats and analyzed using the narrative synthesis approach. Results: Determinants of maternal satisfaction covered all dimensions of care across structure, process and outcome. Structural elements included good physical environment, cleanliness, and availability of adequate human resources, medicines and supplies. Process determinants included interpersonal behavior, privacy, promptness, cognitive care, perceived provider competency and emotional support. Outcome related determinants were health status of the mother and newborn. Access, cost, socio-economic status and reproductive history also influenced perceived maternal satisfaction. Process of care dominated the determinants of maternal satisfaction in developing countries. Interpersonal behavior was the most widely reported determinant, with the largest body of evidence generated around provider behavior in terms of courtesy and non-abuse. Other aspects of interpersonal behavior included therapeutic communication, staff confidence and competence and encouragement to laboring women. Conclusions: Quality improvement efforts in developing countries could focus on strengthening the process of care. Special attention is needed to improve interpersonal behavior, as evidence from the review points to the importance women attach to being treated respectfully, irrespective of socio-cultural or economic context. Further research on maternal satisfaction is required on home deliveries and relative strength of various determinants in influencing maternal satisfaction. © 2015 Srivastava et al.; licensee BioMed Central.
Kandwal R.,Institutional Area |
Bahl T.,Specializes in Health Issues
Current HIV/AIDS Reports | Year: 2011
Stigma and discrimination have been "bed fellows" of HIV and AIDS in India. Perpetuated by lack of awareness, deep-rooted traditional beliefs, adherence to harmful practices, and a moralistic tag associated with a condition connected with sex (in India the method of HIV transmission being largely heterosexual in nature) and high-risk individuals such as sex workers, it made it difficult for the country to fight an epidemic that was hard to track, estimate, diagnose, and treat. Various interventions under India's National AIDS Control Program (NACP) have targeted stigma and discrimination among different groups. The program has been fairly successful in its outreach programs, bringing about a reduction in adult HIV prevalence and new infections. As the country transitions from NACP Phase III (2007-2012) to IV (2012-2017), making treatment and longevity its top priority, stigma is no longer such a terrifying word. This review discusses the social and cultural context of HIV/AIDS-related stigma in general and highlights various policies and intervention programs that have led India's campaign against HIV/AIDS-driven stigma into the testing, care, support, and treatment ambit. © 2011 Springer Science+Business Media, LLC.
Verma S.C.,Institutional Area |
Jain C.L.,College Uttar Pradesh |
Kumari A.,Institutional Area |
Padhi M.M.,Institutional Area |
Devalla R.B.,Institutional Area
Journal of Separation Science | Year: 2013
Ursolic acid (UA) is the most important bioactive phytoconstituent of Eucalyptus × hybrida Maiden leaves and exhibits anticancer, antimutagenic, anti-inflammatory, antioxidative, and antiprotozoal activities. In this study, microwave-assisted extraction technique was employed for rapid isolation of UA from the leaves of Eucalyptus × hybrida and simultaneously HPLC-diode array method was developed for the quantification of UA. Effects of several experimental parameters on the extraction efficiencies of UA, such as type and volume of extraction solvents, microwave power and extraction time, were evaluated. The optimal extraction conditions were found to be 20 mL of a mixture of chloroform/methanol, 60:40; liquid-to-material ratio, 4:1; preleaching time, 10 min; microwave power, 600 W; temperature, 50°C; and microwave irradiation time, 5 min. Under the optimum conditions, the yield of UA was found to be 1.95 ± 0.08% in the dry leaves of Eucalyptus × hybrida. The results showed that microwave-assisted extraction is a more rapid extraction method with higher yield and lower solvent consumptions than the conventional method. It is a faster, convenient, and appropriate method and it may be used for rapid isolation and quantification of UA and other important phytoconstituents present in the leaves of Eucalyptus × hybrida. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Kovendan K.,Bharathiar University |
Murugan K.,Bharathiar University |
Shanthakumar S.P.,Institutional Area |
Vincent S.,P.A. College |
Hwang J.-S.,National Taiwan Ocean University
Parasitology Research | Year: 2012
Morinda citrifolia leaf extract was tested for larvicidal activity against three medically important mosquito vectors such as malarial vector Anopheles stephensi, dengue vector Aedes aegypti, and filarial vector Culex quinquefasciatus. The plant material was shade dried at room temperature and powdered coarsely. From the leaf, 1-kg powder was macerated with 3.0 L of hexane, chloroform, acetone, methanol, and water sequentially for a period of 72 h each and filtered. The yield of extracts was hexane (13.56 g), chloroform (15.21 g), acetone (12.85 g), methanol (14.76 g), and water (12.92 g), respectively. The extracts were concentrated at reduced temperature on a rotary vacuum evaporator and stored at a temperature of 4°C. The M. citrifolia leaf extract at 200, 300, 400, 500, and 600 ppm caused a significant mortality of three mosquito species. Hexane, chloroform, acetone, and water caused moderate considerable mortality; however, the highest larval mortality was methanolic extract, observed in three mosquito vectors. The larval mortality was observed after 24-h exposure. No mortality was observed in the control. The third larvae of Anopheles stephensi had values of LC500 345.10, 324.26, 299.97, 261.96, and 284.59 ppm and LC900 653.00, 626.58, 571.89, 505.06, and 549.51 ppm, respectively. The Aedes aegypti had values of LC500361.75, 343.22, 315.40, 277.92, and 306.98 ppm and LC900687.39, 659.02, 611.35, 568.18, and 613.25 ppm, respectively. The Culex quinquefasciatus had values of LC500382.96, 369.85, 344.34, 330.42, and 324.64 ppm and LC900726.18, 706.57, 669.28, 619.63, and 644.47 ppm, respectively. The results of the leaf extract of M. citrifolia are promising as good larvicidal activity against the mosquito vector Anopheles stephensi, Aedes aegypti, and Culex quinquefasciatus. This is a new eco-friendly approach for the control of vector control programs. Therefore, this study provides first report on the larvicidal activities against three species of mosquito vectors of this plant extracts from India. © Springer-Verlag 2012.
Swaminathan M.S.,Institutional Area
Resonance | Year: 2014
Swami Vivekananda, whose 150th birth anniversary is being celebrated this year, used to say, "This life is short; its vanities are transient. He alone lives who lives for others". Norman Borlaug was one such person, who lived and worked for the cause of ensuring food for all. As a scientist, he helped to breed outstanding varieties of dwarf wheat, which could help to triple the average yield. As a humanist, he placed faces before figures, and helped to highlight the fact that the persistence of hunger, in the midst of opportunities to increase food production through synergy between technology and public policy, is inexcusable. Dr Borlaug was not satisfied with scientific know-how alone. He wanted to convert scientific know-how into field level do - how. On the last day of his life, a scientist showed him a new equipment to trace soil fertility. Dr Borlaug's last words before his death were, "Take the tracer to the farmer". On the occasion of his birth centenary on March 25, 2014 we should all follow his advice and accelerate progress in linking the lab with land. His life and work will be eternal sources of inspiration and lead us to convert his vision of a hunger-free world into reality. Borlaug's Approach to Increasing Wheat Yield © 2014 Indian Academy of Sciences.
Rao P.S.S.,Institutional Area |
John A.S.,Institutional Area
Indian Journal of Leprosy | Year: 2012
A cross-sectional epidemiological study was carried out at a Leprosy Referral Hospital in Delhi to assess the nutritional status of multibacillary leprosy patients in comparison to the general population using BMI. 150 people affected with multibacillary leprosy were included in the study, of whom 108 (72%) had WHO Grade 2 disability. 100 non leprosy patients were also included as a control group. Socio-demographic and clinical details as well as their height and weight were measured and the BMI computed. The findings clearly showed that under-nutrition (BMI < 18.5) was more common in people affected by leprosy than in those without leprosy, regardless of age or sex. Presence of disability made the incidence of under-nutrition more likely. The duration of disease, number of lesions or bacterial index had no impact on the level of nutrition. There may be multiple factors working together to lead to this under-nutrition and these are discussed briefly. If, we aim to provide high quality services with a holistic approach, a mandatory BMI should be calculated for every patient and if under nourished, a qualitative diet summary should be done and suitable nutritional advice given. Further, studies are needed for a better understanding of the occurrence and progression of under-nutrition in leprosy to find efficient ways to combat this problem. © Hind Kusht Nivaran Sangh, New Delhi.
Basu S.,Institutional Area
Proceedings of SPIE - The International Society for Optical Engineering | Year: 2014
Satellite data is very important for model initialization and verification. A large number of satellite observations are currently assimilated into the Numerical Weather Prediction (NWP) systems at the National Centre for Medium Range Weather Forecasting (NCMRWF). Apart from Global meteorological observations from GTS, near-real time satellite observations are received at NCMRWF from other operational centres like ISRO, NOAA/NESDIS, EUMETCAST, etc. Recently India has become member of Asia-Pacific Regional ATOVS Retransmission Service (APRARS) for faster access to high resolution global satellite data useful for high resolution regional models. Indian HRPT at Chennai covers the APRARS data gap region over South East Asia. A robust data monitoring system has been implemented at NCMRWF to assess the quantity and quality of the data as well as the satellite sensor strength, before getting assimilated in the models. Validation of new satellite observations, especially from Indian satellites are being carried out against insitu observations and similar space borne platforms. After establishing the quality of the data, Observation System Experiments (OSEs) are being conducted to study their impact in the assimilation and forecast systems. OSEs have been carried out with the Oceansat-2 scatterometer winds and radiance data from Megha-Tropiques SAPHIR sensor. Daily rainfall analysis dataset is being generated by merging satellite estimates and in-situ observations. ASCAT soil wetness measurements from METOP satellite is being assimilated into the global model. Land surface parameters (LuLc and albedo) retrieved from Indian satellites are being explored for its possible usage in the global and regional models. OLR from Indian satellites are used for validating model outputs. This paper reviews the efforts made at NCMRWF in (i) assimilating the data from Indian/International satellites and (ii) generating useful products from the satellite data. © 2014 SPIE.
Das Gupta M.,Institutional Area |
Rani S.I.,Institutional Area
International Journal of Remote Sensing | Year: 2013
Validation of Kalpana-1 atmospheric motion vectors (AMVs) against upper air radiosonde (RS) winds and numerical model-derived winds (National Centre for Medium Range Weather Forecasting's (NCMRWF's) T382L64 first guess) during the monsoon season of 2011 was attempted in this study. This was the first attempt to compare Kalpana-1 AMVs with model-derived winds. An AMV validation against RS winds showed that the mean AMV speed is always higher than that of the mean RS speed, except in high-level cloud motion vectors (CMVs). In the southwest monsoon season of 2011, the maximum speed bias in Kalpana-1 AMV with respect to RS winds was observed in the middle level (~5 m s-1). The root mean square vector difference (RMSVD) of Kalpana-1 AMV with respect to the collocated RS winds (~5-7 m s-1) has been found to be in the same range as those of other geostationary satellites, especially over the northern hemisphere and the tropics. The validation of Kalpana-1 AMVs against first guess revealed more erroneous low-level and middle-level AMVs, but the vector difference in the high-level winds was found to be smaller than the same in the low- and middle-level winds. The uncertainty in the empirical genetic algorithm (GA) used to derive the Kalpana-1 AMVs, which does not use model background fields, may be the reason for the high RMSVD of Kalpana-1 AMVs with respect to RS winds and high bias with respect to first guess. The mean observed AMV clearly depicted monsoonal features such as low-level westerly jet (LLWJ) and tropical easterly jet (TEJ). The speed bias density plots of Kalpana-1 high-level CMVs (400-100 hPa) and water vapour channel winds (WVWs) (above ~500 hPa) with respect to first guess showed that the bias was higher for WVWs; however, the standard deviations of high-level CMVs and WVWs are comparable. © 2013 Copyright Taylor and Francis Group, LLC.
Narayan J.,Institutional Area
Journal of Ayurveda and Integrative Medicine | Year: 2010
This article concerns the 20th century saga of Ayurvedic Education up to the current situation, based on a general appreciation of knowledge in Ayurveda. In this light, it considers how to improve quality of teaching and teachers. This is most important, because in education, teachers are the custodians of tradition and knowledge. As those most responsible for maintaining or restoring quality, teachers have very important roles to play. The article also treats 'learning and teaching': who should learn Ayurveda, and how to teach Ayurveda so that it continues from generation to generation, leading to the final area of onsideration, reforms in teaching Ayurveda, and future prospects.