10 research outputs found
India's Public Distribution System: Utilisation and Impact
No full textThis article studies the effectiveness of India's Public Distribution System (PDS) as a food security intervention, using field survey data collected by the author in Rajasthan. Utilisation is low, and many households purchase wheat from the market at higher prices before exhausting PDS quotas. This 'puzzle of under-purchase' is analysed by extending the dual-pricing model to account for supply-side (for example, diversion) and demand-side (for example, transaction costs) constraints. Primary and secondary data as well as field observations suggest that under-purchase is mainly due to supply constraints. I also find that the PDS affects the composition (away from more nutritious 'coarse cereals'), rather than level, of cereal consumption.
Being in grief : a teacher’s autobiographical exploration of pedagogy in postcolonial India
No full textIn this thesis, grief is explored as a way of being in teaching. Drawing on Heidegger’s concept of Dasein, meaning presence or human existence, and informed by the autobiographical approach of currere, the author explores grief as an intergenerational phenomenon that occurs as a result of traumatic historical events (Partition 1947), profound personal loss (death of close family members), and the dehumanizing impact of postcolonial education in India. By relating and reflecting on stories from lived experiences, the author illustrates the ways in which the entanglements of family grief and national history can impact a child’s educational experience and a teacher’s practice. Through memory work, grief reveals itself as burdensome, a weight to be carried; practice is revealed as a site and source of grief. Invoking curriculum as ‘a complicated conversation,’ the study contends that being in grief is a reality to be embraced and discussed because of its impact on educational relationships. The significance of the thesis lies in acknowledging the intersection of the personal and the professional dimensions of teachers’ lives and the manner in which the associated emotions of grief and loss—shame, guilt, numbness, vulnerability, fear, and denial—are lived and worked out in and through pedagogy.Education, Faculty ofCurriculum and Pedagogy (EDCP), Department ofGraduat
Research impact training and development support for doctoral students
No full textThis research-in-progress case study in one UK university setting looks at how supportive PhD supervisors are of impact work, what motivates PhD students to access impact support and whether there are barriers to PhD students from carrying out impact plans and what those barriers are.
A mixed-method approach was used to collect quantitative data on student participation in impact training and qualitative data on their thoughts on impact work, supervisory support and motivators and barriers for doing impact work.
Clinical science students found it easier to understand the direct impacts of their work compared to life science students. Over time, students developed a better understanding of the potential impacts of their work. The majority of students discussed their impact with their supervisors but did not discuss time, budget or monitoring plans for impact activities. The majority of students talked about a lack of supervisor support for impact work and a need for better supervisor training. Students identified motivators and barriers for doing impact work.
The study suggests that there is a gap in training and support for doctoral students to develop the societal impact of their research. Impact work helps students to develop skills and experience valued by employers. However, PhD students may not receive impact training as part of their degrees. Supervisors may be unsupportive of PhD students doing impact work because it may distract from core research activities. Based on the study findings, the author has made recommendations for addressing this gap
Smoke
No full textLaux weaves the warp and woof of ordinary life into extraordinary and complex tapestries.Intro -- Contents -- Smoke -- Last Words -- Books -- Death Comes To Me Again, A Girl -- Ray At 14 -- Abschied Symphony -- Stairway to Heaven -- Even Music -- Trying to Raise the Dead -- The Word -- How It Will Happen, When -- The Line -- Window -- Wing -- Prayer -- Heart -- Olympia -- The Shipfitter's Wife -- Firestarter -- The Student -- Pearl -- Figures -- Fear -- Family Stories -- Twilight -- Iceland -- Reetika Arranges My Closet -- Oh, The Water -- The Gardener -- Neon Horses -- The Orgasms of Organisms -- Life Is Beautiful -- Notes -- Acknowledgments -- About The Author -- ColophonLaux weaves the warp and woof of ordinary life into extraordinary and complex tapestries.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
Six Sigma Metrics and Quality Control in Clinical Laboratory
No full textQuality control in healthcare system is still less understood because of the relative complexity in choosing an appropriate Westgard rule .Six Sigma methodology is a manufacturing strategy first pioneered by Motorola Company in 1980s, with the goal of decreasing the defect rates in production. It has improved the production efficiency of different industries. To achieve the similar high quality and near zero defect rates in healthcare system, six sigma metrics is being used in many clinical laboratories and diagnostic industry. Six sigma metrics is used in combination with total allowable error (CLIA ’88 proficiency testing criteria), method imprecision and bias. The goal is to attain the highest possible sigma scale within the acceptable limits of total allowable error. This article reviews the different Westgard control rules and their implications in pointing towards a particular error, as well as basic principles of Six Sigma methodology & their practical utility in the clinical laboratory
Successful management of abnormal uterine bleeding from uterine arteriovenous malformations with progesterone in postabortal patients
No full textECMO: a lifesaving modality in ARDS during puerperium
No full textAcute respiratory distress syndrome (ARDS) is an uncommon condition encountered in pregnancy. The incidence of ARDS in pregnancy has been reported to be 1 in 6229 deliveries with mortality rates to range from 24% to 39% in pregnant patients. An essential component in management of ARDS involves good communication between the obstetrics team and critical care specialist and a fundamental understanding of mechanical ventilatory support. In critically ill patients where both cardiorespiratory support is required, Extracorporeal Membrane Oxygenation (ECMO) can be used to help maintain the vital functions. ECMO is a temporary cardio respiratory or respiratory support in critically ill patients who are unresponsive to conventional management. In present case a young female with post-partum ARDS was successfully managed with extra corporeal membrane oxygenation (ECMO)
Assessment of Enterovirus Excretion and Identification of VDPVs in Patients with Primary Immunodeficiency in India: Outcome of ICMR–WHO Collaborative Study Phase-I
No full textThe emergence of vaccine-derived polioviruses (VDPVs) in patients with Primary Immunodeficiency (PID) is a threat to the polio-eradication program. In a first of its kind pilot study for successful screening and identification of VDPV excretion among patients with PID in India, enteroviruses were assessed in stool specimens of 154 PID patients across India in a period of two years. A total of 21.42% of patients were tested positive for enteroviruses, 2.59% tested positive for polioviruses (PV), whereas 18.83% of patients were positive for non-polio enteroviruses (NPEV). A male child of 3 years and 6 months of age diagnosed with Hyper IgM syndrome was detected positive for type1 VDPV (iVDPV1) with 1.6% nucleotide divergence from the parent Sabin strain. E21 (19.4%), E14 (9%), E11 (9%), E16 (7.5%), and CVA2 (7.5%) were the five most frequently observed NPEV types in PID patients. Patients with combined immunodeficiency were at a higher risk for enterovirus infection as compared to antibody deficiency. The high susceptibility of PID patients to enterovirus infection emphasizes the need for enhanced surveillance of these patients until the use of OPV is stopped. The expansion of PID surveillance and integration with a national program will facilitate early detection and follow-up of iVDPV excretion to mitigate the risk for iVDPV spread
Clinical and Molecular Findings in Mendelian Susceptibility to Mycobacterial Diseases: Experience From India
No full textMendelian Susceptibility to Mycobacterial diseases (MSMD) are a group of innate immune defects with more than 17 genes and 32 clinical phenotypes identified. Defects in the IFN-γ mediated immunity lead to an increased susceptibility to intracellular pathogens like mycobacteria including attenuated Mycobacterium bovis-Bacillus Calmette-Guérin (BCG) vaccine strains and non-tuberculous environmental mycobacteria (NTM), Salmonella, fungi, parasites like Leishmania and some viruses, in otherwise healthy individuals. Mutations in the IL12RB1 gene are the commonest genetic defects identified. This retrospective study reports the clinical, immunological, and molecular characteristics of a cohort of 55 MSMD patients from 10 centers across India. Mycobacterial infection was confirmed by GeneXpert, Histopathology, and acid fast bacilli staining. Immunological workup included lymphocyte subset analysis, Nitro blue tetrazolium (NBT) test, immunoglobulin levels, and flow-cytometric evaluation of the IFN-γ mediated immunity. Genetic analysis was done by next generation sequencing (NGS). Disseminated BCG-osis was the commonest presenting manifestation (82%) with a median age of presentation of 6 months due to the practice of BCG vaccination at birth. This was followed by infection with Salmonella and non-typhi Salmonella (13%), Cytomegalovirus (CMV) (11%), Candida (7%), NTM (4%), and Histoplasma (2%). Thirty-six percent of patients in cohort were infected by more than one organism. This study is the largest cohort of MSMD patients reported from India to the best of our knowledge and we highlight the importance of work up for IL-12/IL-23/ISG15/IFN-γ circuit in all patients with BCG-osis and suspected MSMD irrespective of age
The Spectrum of Clinical, Immunological, and Molecular Findings in Familial Hemophagocytic Lymphohistiocytosis: Experience From India
No full textHemophagocytic lymphohistiocytosis (HLH) is a syndrome of immune dysregulation characterized by hyperactivation of the immune system, excessive cytokine secretion and severe systemic inflammation. HLH is classified as familial (FHL) when associated with mutations in PRF1, UNC13D, STX11, and STXBP2 genes. There is limited information available about the clinical and mutational spectrum of FHL patients in Indian population. This study is a retrospective analysis of 101 molecularly characterized FHL patients over the last 10 years from 20 different referral centers in India. FHL2 and FHL3 together accounted for 84% of cases of FHL in our cohort. Patients belonging to different FHL subtypes were indistinguishable based on clinical and biochemical parameters. However, flow cytometry-based assays viz. perforin expression and degranulation assay were found to be specific and sensitive in diagnosis and classification of FHL patients. Molecular characterization of respective genes revealed 76 different disease-causing mutations including 39 (51%) novel mutations in PRF1, UNC13D, STX11, and STXBP2 genes. Overall, survival was poor (28%) irrespective of the age of onset or the type of mutation in our cohort. Altogether, this article sheds light on the current scenario of FHL in India. Our data reveal a wide genetic heterogeneity of FHL in the Indian population and confirms the poor prognosis of FHL. This study also emphasizes that though mutational analysis is important for diagnostic confirmation of FHL, flow cytometry based assays help significantly in rapid diagnosis and functional validation of novel variants identified
