The impact of 1995--1996 health sector reforms in the effectiveness of malaria control program in the state of Orissa, India

Malaria poses a significant public health problem worldwide. The World Health Organization indicates that approximately 40% of the world's population and almost 85% of the population from the South–East Asian region is at risk of contracting malaria. India being the most populous country in the region, contributes the highest number of malaria cases and deaths attributed to malaria. Orissa is the state that has the highest number of malaria cases and deaths attributable to malaria. A secondary data analysis was carried out to evaluate the effectiveness of the World bank-assisted Malaria Action Program in the state of Orissa under the health sector reforms of 1995-96. The secondary analysis utilized the government of India's National Anti Malaria Management Information System's (NAMMIS) surveillance data and the National Family Health Survey (NFHS–I and NFHS–II) datasets to compare the malaria mortality and morbidity in the state between 1992-93 and 1998-99. Results revealed no effect of the intervention and indicated an increase of 2.18 times in malaria mortality between 1992-1999 and an increase of 1.53 times in malaria morbidity between 1992-93 and 1998-99 in the state. The difference in the age-adjusted malaria morbidity in the state between the time periods of 1992-93 and 1998-99 proved to be highly significant (t = 4.29 df=16, p<. 0005) whereas the difference between the increase of age-adjusted malaria morbidity during 1992-93 and 1998-99 between Orissa (with intervention) and Bihar (no intervention) proved to be non significant (t=.0471 df=16, p<.50). Factors such as underutilization of World Bank funds for the malaria control program, inadequate health care infrastructure, structural adjustment problems, poor management, poor financial management, parasite resistance to anti-malarial drugs, inadequate supply of drugs and staff shortages may have contributed to the failure of the program in the state.^

The burden of parainfluenza virus infection in patients with hematological malignancy and hematopoietic stem cell transplant (HSCT) recipients in the absence of active immunization and approved therapy: The role of infection control

Background. Community respiratory viruses, mainly RSV and influenza, are significant causes of morbidity and mortality in patients with leukemia and HSCT recipients. The data on impact of PIV infections in these patients is lacking. Methods. We reviewed the records of patients with leukemia and HSCT recipients who developed PIV infection from Oct'02–Nov'07 to determine the outcome of such infections. Results. We identified 200 patients with PIV infections including 80(40%) patients with leukemia and 120 (60%) recipients of HSCT. Median age was 55 y (17-84 y). As compared to HSCT recipients, patients with leukemia had higher APACHE II score (14 vs. 10, p<0.0001); were more likely to have ANC<500 (48% vs. 10%, p<0.0001) and ALC<200 (45% vs. 23.5%, p=0.02). PIV type III was the commonest isolate (172/200, 86%). Most patients 141/200 (70%) had upper respiratory infection (URI), and 59/200 (30%) had pneumonia at presentation. Patients in leukemia group were more likely to require hospitalization due to PIV infection (77% vs. 36% p=0.0001) and were more likely to progress to pneumonia (61% vs. 39%, p=0.002). Fifty five patients received aerosolized ribavirin and/or IVIG. There were no significant differences in the duration of symptoms, length of hospitalization, progression to pneumonia or mortality between the treated verses untreated group. The clinical outcome was unknown in 13 (6%) patients. Complete resolution of symptoms was noted in 91% (171/187) patients and 9% (16/187) patients died. Mortality rate was 17% (16/95) among patients who had PIV pneumonia, with no significant difference between leukemia and HSCT group (16% vs. 17%). The cause of death was acute respiratory failure and/or multi-organ failure in (13, 81%) patients. Conclusions. Patients with leukemia and HSCT could be at high risk for serious PIV infections including PIV pneumonia. Treatment with aerosolized ribavirin and/or IVIG may not have significant effect on the outcome of PIV infection.^

The relationship between surgical residents' perception of leadership and patient safety culture

Introduction. Patient safety culture is the integration of interrelated practices that once developed is supported by both the culture and leadership of the organization (Sagan, 1993). The purpose of this study is to describe and examine the relationship between surgical residents’ perception of their leadership and the resulting organizational safety culture within their clinical setting. This assessment is important to understanding the extent that leadership style affects the perception of the safety culture.^ Methods. A secondary dataset was used which included data from 68 surgical residents from two survey instruments, Organizational Description Questionnaire (ODQ) and Patient Safety Climate In Healthcare Organizations (PSCHO) Survey. Multiple regressions followed by hierarchical regressions with the introduction of the Post Graduate Year (PGY) variable examined the association between the leadership styles, Transactional and Transformational and the organizational safety culture variables, Overall Emphasis on Safety, Senior management engagement, Organizational resources for safety. Independent t-tests were conducted to assess whether males and females differ among the organizational safety culture variables and either leadership style.^ Results. The surgical residents perceived their organizational leadership to have greater emphasis placed on transformational leadership culture style relative to transactional leadership culture style. The only significant association found was between Transformational leadership and Organizational resources for safety. PGY had no significant effect on the leadership or the safety culture perceived. No significant difference was found between females and males in regards to the safety culture or the leadership style.^ Discussion. These results have implications as they support the premise for the study which is surgical residents perceive their existing leadership and organizational culture to be more transformational in nature than transactional. Significance was found between the leadership perceived and one of the safety culture variables, Organizational resources for safety. The foundation for this association lies in the fact that surgical residents are the personnel which are a part of the organizational resources. Although PGY differentiation did not seem to play a difference in the leadership perceived this could be attributed to the small sample size. No gender difference were found which supports the assumption that within such a highly specialized group such as surgical residents there is no gender differences since the highly specialized field draws a certain type of person with distinct characteristics. In future research these survey tools can be used to gauge the survey audiences’ perception and safety interventions can be developed based on the results. ^

Unimanual and Bimanual Weight Perception of Virtual Objects with a new Multi-finger Haptic Interface

Accurate weight perception is important particularly in tasks where the user has to apply vertical forces to ensure safe landing of a fragile object or precise penetration of a surface with a probe. Moreover, depending on physical properties of objects such as weight and size we may switch between unimanual and bimanual manipulation during a task. Research has shown that bimanual manipulation of real objects results in a misperception of their weight: they tend to feel lighter than similarly heavy objects which are handled with one hand only [8]. Effective simulation of bimanual manipulation with desktop haptic interfaces should be able to replicate this effect of bimanual manipulation on weight perception. Here, we present the MasterFinger-2, a new multi-finger haptic interface allowing bimanual manipulation of virtual objects with precision grip and we conduct weight discrimination experiments to evaluate its capacity to simulate unimanual and bimanual weight. We found that the bimanual ‘lighter’ bias is also observed with the MasterFinger-2 but the sensitivity to changes of virtual weights deteriorated.

Digital Control Implementation to Reduce the Cost and Improve the Performance of the Control Stage of an Industrial Switched-Mode Power Supply

The main objective of this work is the design and implementation of the digital control stage of a 280W AC/DC industrial power supply in a single low-cost microcontroller to replace the analog control stage. The switch-mode power supply (SMPS) consists of a PFC boost converter with fixed frequency operation and a variable frequency LLC series resonant DC/DC converter. Input voltage range is 85VRMS-550VRMS and the output voltage range is 24V-28V. A digital controller is especially suitable for this kind of SMPS to implement its multiple functionalities and to keep the efficiency and the performance high over the wide range of input voltages. Additional advantages of the digital control are reliability and size. The optimized design and implementation of the digital control stage it is presented. Experimental results show the stable operation of the controlled system and an estimation of the cost reduction achieved with the digital control stage.

Perception of employers and employees regarding the attitude of businesses toward the environment: a qualitative analysis

Commitment and involvement from the different members of an organization are two key elements for an organization to achieve its environmental excellence. Firstly, businesses are aware of the close relationship between their activities and the environment, for they are not only polluting agents but also agents with the capacity to reduce adverse environmental impacts. Secondly, the fact that employees can play a relevant role in terms of the socially responsible measures to be taken by organizations has started to become an irrefutably important issue. This piece of research is intended to help gain knowledge concerning the attitude of the two main actors in productive activity toward the environmental, that is, employers and employees; as well, this research intends to identify factors determining behaviour towards the environmental. For this, we have gathered the ideas and assessments contained in the discourse of a group of small and medium-sized businesses, large company owners and officers, employees, and work related risk prevention representatives. Qualitative work consisted of in-depth interviews and the creation of discussion groups.

Performance of pressure control valves and flow meters precision in operational irrigation-water balance accuracy

In pressure irrigation-water distribution networks, pressure regulating devices for controlling the discharged flow rate by irrigation units are needed due to the variability of flow rate. In addition, applied water volume is used controlled operating the valve during a calculated time interval, and assuming constant flow rate. In general, a pressure regulating valve PRV is the commonly used pressure regulating device in a hydrant, which, also, executes the open and close function. A hydrant feeds several irrigation units, requiring a wide range in flow rate. In addition, some flow meters are also available, one as a component of the hydrant and the rest are placed downstream. Every land owner has one flow meter for each group of field plots downstream the hydrant. Its lecture could be used for refining the water balance but its accuracy must be taken into account. Ideal PRV performance would maintain a constant downstream pressure. However, the true performance depends on both upstream pressure and the discharged flow rate. The objective of this work is to asses the influence of the performance on the applied volume during the whole irrigation events in a year. The results of the study have been obtained introducing the flow rate into a PRV model. Variations on flow rate are simulated by taking into account the consequences of variations on climate conditions and also decisions in irrigation operation, such us duration and frequency application. The model comprises continuity, dynamic and energy equations of the components of the PRV.

Comparison of V2IC control with voltage mode and current mode controls for high frequency (MHz) and very fast response applications

High switching frequencies (several MHz) allow the integration of low power DC/DC converters. Although, in theory, a high switching frequency would make possible to implement a conventional Voltage Mode control (VMC) or Peak Current Mode control (PCMC) with very high bandwidth, in practice, parasitic effects and robustness limits the applicability of these control techniques. This paper compares VMC and CMC techniques with the V2IC control. This control is based on two loops. The fast internal loop has information of the output capacitor current and the error voltage, providing fast dynamic response under load and voltage reference steps, while the slow external voltage loop provides accurate steady state regulation. This paper shows the fast dynamic response of the V2IC control under load and output voltage reference steps and its robustness operating with additional output capacitors added by the customer.

A new method to analyse the perception of size

In living bodies, the correct perceptual representation of size constancy requires that an object's size appear the same when it changes its location with respect to the observer. At the same time, it is necessary that objects at different locations appear to be the same size if they are. In order to do that, the perceptual system must recover from the stimuli impinging on the individual, from the light falling on the retina, a representation of the relative sizes of objects in the environment. Moreover, at the same time, image perception is related to another type of phenomena. It corresponds to the well known perceptual illusions. To analyze this facts, we propose a system based on a particular arrays of receptive points composed by optical fibers and dummy fibers. The structure is based on the first layers of the mammalians primary visual cortex. At that part of the brain, the neurons located at certain columns, respond to particular directions. This orientation changes in a systematic way as one moves across the cortical surface. In our case, the signals from the above-mentioned array are analyzed and information concerning orientation and size of a particular line is obtained. With this system, the Muelle-Lyer illusion has been studied and some rules to interpret why equal length objects give rise to different interpretations are presented.

Self perception of decision making competence in spanish football players

Background: It is known that competence to make decisions is a fundamental aspect of sport competition. Objective: This study has analyzed the decision profile of a sample of Spanish football players of different levels of expertise. Methods: 690 Spanish football players of national and international level completed the decision making questionnaire, which cover three dimensions ? perceived decision competence, decision anxiety and commitment with decision learning. MANCOVA and ANOVA analysis were carried out to analyse the differences in each dimension based on the level of expertise. Results: Results showed that perception of decision making competence increased and the anxiety decreased with the level of expertise. Conclusions: This study confirmed the usefulness of this questionnaire in the process of training for coaches and sport psychologists.

Perception of the sport events held in a permanent facility: the case of the Madrid Sports Palace

The aims of this study were to analyse perceptions regarding the sporting events held in the Madrid Sports Palace and to analyse whether those perceptions vary by age or gender. One hundred and ninetyfive residents answered the Ntloko and Swart (2008) questionnaire. The dimensions most highly rated were economic benefits (3.9±0.8), the event as a regional showcase (3.6±0.7), and the event as entertainment (3.4±0.6). However, the respondents did not agree with the negative environmental impact (2.0±0.8). Men rated the use of public money (z=2.4; pmenor que.05) and the regional showcase (z=2.0 pmenor que.05) more positively than women. Finally, women rated the increase in prices (z=2.0; pmenor que.05) more highly than men. The age groups differed significantly only regarding the promotion of community pride. Seniors and middle-aged adults rated it more positively than young adults (?2(2)=9.9; pmenor que.01). The fact that in an urban sports facility regular sporting events take place on a regular basis means that there are diverse perceptions, though mainly positive, and those perceptions differ from the perceptions about mega events that take place once in a life time at temporary sports facilities.

Assessing the passengers’ perception of implemented advanced management measures in bus service

The aim of this investigation is to evaluate the passenger?s perception of some attributes related to quality of bus services, and how this perception changes with the implementation of different measures. Surveys to passengers riding different bus lines were conducted in two scenarios: before the implementation of the measures and after the measures were implemented. The results of the passenger surveys were statistically analysed; then, an ordered logit model was used to analyse the differences between surveys thanks to the implemented measures. Finally, a factor analysis was done to identify the underlying unobserved factors (latent variables) that the respondents perceived

New QR Survey Methodologies to Analyze User Perception of Service Quality in Public Transport: The Experience of Madrid

Customer Satisfaction Surveys (CSS) have become an important tool for public transport planners, as improvements in the perceived quality of service lead to greater use of public transport and lower traffic pollution. Until now, Intelligent Transportation System (ITS) enhancements in public transport have traditionally included fleet management systems based on Automatic Vehicle Location (AVL) technologies, which can be used to optimize routing and scheduling, and to feed real-time information into passenger information channels. However, surveys of public transport users could also benefit from the new information technologies. As most customers carry their smartphones when traveling, Quick Response (QR) codes open up the possibility of conducting these surveys at a lower cost.This paper contributes to the limited existing literature by developing the analysis of QR codes applied to CSS in public transport and highlighting their importance in reducing the cost of data collection and processing. The added value of this research is that it provides the first assessment of a real case study in Madrid (Spain) using QR codes for this purpose. This pilot experience was part of a research project analyzing bus service quality in the same case study, so the QR code survey (155 valid questionnaires) was validated using a conventional face-to-face survey (520 valid questionnaires). The results show clearly that, after overcoming a few teething troubles, this QR code application will ultimately provide transport management with a useful tool to reduce survey costs