Hematopoietic stem cell transplantation in Switzerland: a comprehensive quality control report on centre effect.

Interest groups advocate centre-specific outcome data as a useful tool for patients in choosing a hospital for their treatment and for decision-making by politicians and the insurance industry. Haematopoietic stem cell transplantation (HSCT) requires significant infrastructure and represents a cost-intensive procedure. It therefore qualifies as a prime target for such a policy. We made use of the comprehensive database of the Swiss Blood Stem Cells Transplant Group (SBST) to evaluate potential use of mortality rates. Nine institutions reported a total of 4717 HSCT - 1427 allogeneic (30.3%), 3290 autologous (69.7%) - in 3808 patients between the years 1997 and 2008. Data were analysed for survival- and transplantation-related mortality (TRM) at day 100 and at 5 years. The data showed marked and significant differences between centres in unadjusted analyses. These differences were absent or marginal when the results were adjusted for disease, year of transplant and the EBMT risk score (a score incorporating patient age, disease stage, time interval between diagnosis and transplantation, and, for allogeneic transplants, donor type and donor-recipient gender combination) in a multivariable analysis. These data indicate comparable quality among centres in Switzerland. They show that comparison of crude centre-specific outcome data without adjustment for the patient mix may be misleading. Mandatory data collection and systematic review of all cases within a comprehensive quality management system might, in contrast, serve as a model to ascertain the quality of other cost-intensive therapies in Switzerland.

Comprehensive school health : an ethnographic case study

The purpose of this ethnographic case study was to describe the characteristics of one school's Comprehensive School Health (CSH) initiative and to explore the experiences of school community members in order to gain an understanding of how one school embraced a Comprehensive School Health approach. An elementary school (grades Junior Kindergarten to six) in Burlington, Ontario was the research site for this study. Multiple methods of data collection (observations, document analysis, interviews) were used in keeping with the ethnographic and case study approach. The data were coded using both a deductive and then inductive process (Merriam, 1998). From a deductive perspective, the coding system and the subsequent identification of categories were based on a priori categories identified by using the elements of CSH based on the Comprehensive School Health Consensus Statement prepared by the Canadian Association of School Health and the research questions. Findings included the role that various school community members as well as the implementation of different programs and policies played in applying a CSH approach. The impact ofthe physical environment was described as well as successes and challenges related to the school's experience in implementing CSH. Three main themes emerged that characterized this school's experience. The first theme relates to the fundamental question about CSH which is the school community's understanding o/the concept. The second theme focused on positive school culture and the third and most diverse theme was that of capacity. Engaging in CSH is a complex and long-term undertaking involving both the school and greater community. Based on the experiences of this school's community members, recommendations address the different levels of influence on the health of children.

Unveiling Shi’i Religious Identities: Case Studies of Hijab in Culturally Homogeneous Canadian Schools

This qualitative case study explored 10 young female Shi’i Muslim Arabic-Canadian students’ experiences associated with wearing the Hijab (headscarf) within their home, community, and predominantly White Canadian public elementary school environments. The study integrated several bodies of scholarly theories in order to examine the data under a set of comprehensive lenses that more fully articulates and theorizes on the diversity of female Shi’i Muslim Canadian students’ experiences. These theories are: identity theories with a focus on religious identity and negative stereotypes associated with Muslims; feminism and the Hijab discourses; research pertaining to Muslims in school settings; and critical race theory. In order to readdress the dearth of information about Shi’is’ experiences in schools, this study provides an in-depth case study analysis in which the methodology strategies included 10 semi-structured in-depth interviews, 2 focus-group meetings, and the incorporation of the researcher’s fieldnotes. Data analysis revealed the following themes corresponding to participants’ experiences and values in their social worlds of home, community, and schools: (a) martyrdom and self-sacrifice as a means for social justice; (b) transformational meaning of the Hijab; (c) intersectionality between culture, religion, and gender; and (d) effects of visits “back home” on participants’ religious identities. Additional themes related to participants’ school experiences included: (a) “us versus them” mentality; (b) religious and complex secular dialogues; (c) absence of Muslim representations in monocultural schools; (d) discrimination; (e) remaining silent versus speaking out; and (f) participants’ strategies for preserving their identities. Recommendations are made to integrate Shi’i Muslim females’ identity within the context of Islam and the West, most notably in relation to: (a) the role of Muslim community in nondiverse settings as a space that advances and nurtures Shi’i Muslim identity; and (b) holistic and culturally responsive teaching that fosters respect of others’ religiosity and spirituality. This study makes new inroads into feminist theorizing by drawing conceptual links between these previously unknown connections such as the impact of the historical female exemplary role model and the ritual stories on the experiences of Muslim females wearing the Hijab.

Studies on the systematics and biology of the fisheries of the Vembanad lake

The thesis documents a comprehensive systematic account of Vembenad lake fishes and to study the effect of physico-chemical parameters on the distribution and abundance of fishes in the lake. This study is expected to advance the knowledge on the biological aspects of two commercially important fishes of the lake which are very desirable for brackish water fish farming. Additionally, the results of the studies on the ecology as habitat, occurrence, season and abundance of all the recorded fishes of the lake end the commercially important fish species of the lake are also incorporated. A general appraisal on the detrimental factors which are adversely affecting the fisheries resources of the lake are presented and some measures of conservation are also suggested. The results of the present study are helpful in formulating suitable schemes for management of parts of the Vembenad lake for capture and culture fisheries

Some studies on the reproductive endocrinology of tiger prawn Penaeus monodon Fabricius

The growing demand for quality prawn seed from the farmers‘ and entrepreneurs, coupled with uncertainity of their availability from nature at the appropriate time in required quantities has prompted‘ research on problems connected with prawn seed production. Endocrine control of reproduction in the penaeid shrimp _P_. monodon has been investigated in detail by adopting a comprehensive approach to the problem. The major aspects of the study included in depth investigations of the cytological details of the reproductive and neuroendocrine organs in correlation with the process of gonadal maturation. Based on the conclusions drawn from such ultrastructural studies various endocrine manipulations were carried out to see their effects on gonadal maturation. Besides that studies on the reproductive quality of male P_. monodon and the cryopreservation of spermatophores form a part of the present investigation. The shrimp 3; Inonodon used in the present study were collected from the offshore waters of Cochin, Madras and Mandapam and from the culture ponds of Vypeen Island near Cochin (Kerala) . The entire investigation on the cytological aspects were carried out using standard histological and electron-microscopic methods. Endocrine manipulations and cryopreservation studies is also carried out using the standard methods.

Studies on the Dynamics of Cochin Estuary

The thesis entitled Studies on the Dynamics of Cochin Estuary. This thesis is addressed to an investigation on the tidal, seasonal and spatial variations of the hydrographic parameters, circulation and mixing processes of the Cochin estuary. The present programme of study is aimed at obtaining a comprehensive picture of the tidal characteristics, hydrography, circulation and mixing present in this estuarine system during different seasons. The studies have been carried out through field collection of data on salinity, temperature and water currents to get a picture of their spatial and temporal variations. The hydrographic data have been analysed in relation to tide, rainfall and river discharges. From the findings it is seen that at the Cochin inlet, the estuarine features vary annually. During July and August, the estuary is characterised as almost saltwedge type; during June, September, October, December and January it shows appreciabie stratification, and during the rest of the months the estuary shows almost well mixed nature. Seasonal variations are well reflected in water temperature in the Cochin estuary, where the temperature reaches its maximum during the dry pre monsoon period with very weak thermal gradients indicating strong vertical mixing

Studies on the meteriological aspects of air pollution over Cochin

Pollutants that once enter into the earth’s atmosphere become part of the atmosphere and hence their dispersion, dilution, direction of transportation etc. are governed by the meteorological conditions. The thesis deals with the study of the atmospheric dispersion capacity, wind climatology, atmospheric stability, pollutant distribution by means of a model and the suggestions for a comprehensive planning for the industrially developing city, Cochin. The definition, sources, types and effects of air pollution have been dealt with briefly. The influence of various meteorological parameters such as vector wind, temperature and its vertical structure and atmospheric stability in relation to pollutant dispersal have been studied. The importance of inversions, mixing heights, ventilation coefficients were brought out. The spatial variation of mixing heights studies for the first time on a microscale region, serves to delineate the regions of good and poor dispersal capacity. A study of wind direction fluctuation, σθ and its relation to stability and mixing heights were shown to be much useful. It was shown that there is a necessity to look into the method of σθ computation. The development of Gausssian Plume Model along with the application for multiple sources was presented. The pollutant chosen was sulphur dioxide and industrial sources alone were considered. The percentage frequency of occurrence of inversions and isothermals are found to be low in all months during the year. The spatial variation of mixing heights revealed that a single mixing height cannot be taken as a representative for the whole city have low mixing heights and monsoonal months showed lowest mixing heights. The study of ventilation co-efficients showed values less than the required optimum value 6000m2/5. However, the low values may be due to the consideration of surface wind alone instead of the vertically averaged wind. Relatively more calm conditions and light winds during night and strong winds during day time were observed. During the most of the year westerlies during day time and northeasterlies during night time are the dominant winds. Unstable conditions with high values of σθ during day time and stable conditions with lower values of σθ during night time are the prominent features. Monsoonal months showed neutral stability for most of the time. A study σθ of and Pasquill Stability category has revealed the difficulty in giving a unique value of for each stability category. For the first time regression equations have been developed relating mixing heights and σθ. A closer examination of σθ revealed that half of the range of wind direction fluctuations is to be taken, instead of one by sixth, to compute σθ. The spatial distribution of SO2 showed a more or less uniform distribution with a slight intrusion towards south. Winter months showed low concentrations contrary to the expectations. The variations of the concentration is found to be influenced more by the mixing height and the stack height rather than wind speed. In the densely populated areas the concentration is more than the threshold limit value. However, the values reported appear to be high, because no depletion of the material is assumed through dry or wet depositions and also because of the inclusion of calm conditions with a very light wind speed. A reduction of emission during night time with a consequent rise during day time would bring down the levels of pollution. The probable locations for the new industries could be the extreme southeast parts because the concentration towards the north falls off very quickly resulting low concentrations. In such a case pollutant spread would be towards south and west, thus keeping the city interior relatively free from pollution. A more detailed examination of the pollutant spread by means of models that would take the dry and wet depositions may be necessary. Nevertheless, the present model serves to give the trend of the distribution of pollutant concentration with which one can suggest the optimum locations for the new industries

Studies on Thermal structure in the seas around in India

The thesis entitled Studies on Thermal Structure in the Seas Around India. An attempt is made in this study to document the observed variability of thermal structure, both on seasonal and short-term scales, in the eastern Arabian Sea and southwestern Bay of Bengal, from the spatial and time series data sets from a reasonably strong data base. The present study has certain limitations. The mean temperatures are based on an uneven distribution of data in space and time. Some of the areas, although having a ‘full annual coverage, do not have adequate data for some months. Some portions in the area under study are having data gaps. The consistency and the coherence in the internal wave characteristics could not be examined due to non-availability of adequate data sets. The influence of generating mechanisms; other than winds and tides on the observed internal wave fields could not be ascertained due to lack of data. However, a comprehensive and intensive data collection can overcome these limitations. The deployment of moored buoys with arrays of sensors at different depths at some important locations for about 5 to 10 years can provide intensive and extensive data sets. This strong data base can afford to address the short-term and seasonal variability of thermal field and understand in detail the individual and collective influences of various physical and dynamical mechanisms responsible for such variability.

Studies on the systematics, biology and fishery of rainbow sardines, dussumieria spp., from Indian waters

Rainbow sardines of the genus belonging to the family Dueenaieriidae. are small pelagic fishes forming a fairly good, though not abundant. seasonal fishery all along the coasts of India inhabiting the coastal waters. There have been some earlier reports on such individual aspects as their systematic, distribution, abundance. Ostecology and a few biological factors but no attempt has been made towards a comprehensive study on this group. Two species of rainbow sardines are known to occur in the Indian seas and while a knowledge about their biology would be useful from the fishery point of view. it was also thought a study of their systematic position, especially regarding the identity or the two species which had raised doubts among earlier workers would lead to a better understanding or the group as a whole. This thesis is mainly based on studies during the period from April 1969 to march 1971 with a continued investigation of fishhery aspects till December 1975. from the Gulf of manar: and the Palk Bay around mandapam area. on the south-east coast of India. Thus the work deals with the systemtics, biology and fishery of rainbow sardines of Indian seas.

Studies On Chitinoclastic Bacteria In Coastal Zone

The thesis is proposed to study the occurrence and distribution of chitinoclasts in water, sediment and fauna as related to site characteristics such as temperature, salinity, depth of water, pH, etc. Since no information is available on the chitinolytic properties of coastal strains, it is also proposed to study the chitinolytic activity of the bacterial isolates in relation to various environmental conditions. It is also planned to work out the taxonomy of some of the representative isolates and certain kinetic properties of their chitinases. It is expected that the results of the study would yield a comprehensive information-on the chitinoclastic bacteria in the southern coastal zone of west coast of India.

Studies on Larval Nutrition in The Pearl Oyster Pinctada Pucata (Gould)

The present study has yielded a great deal of information on nutrition of pearl oyster larvae. T he formulae presented may be used effectively and with advantage in improving the larval rearing system with specific reference to nutritional aspects. It is also hoped that this is the first comprehensive study on pearl oyster larval nutrition would stimulate further detailed investigations on many of the other finer aspects of tropical bivalve larval nutrition.

Studies on the female reproductive physiology of the prawn, Macrobrachium idella (Hilgendorf, 1898)

’l‘he reproductive physiology of the female palaemonid prawn M. idella has been investigated by adopting a comprehensive approach to the problem. The major aspects of the study included investigations on breeding biology and process of oogenesis, variations in the biochemical components in relation to maturation, neuroendocrine relations and control over reproduction, and artificial insemination. The prawns used in the present study were procured from Vembanad Lake at Panavally village - a place nearly 20 km. away from Cochin. The studies were carried out using standard histological and biochemical methods. The modern technique of electroejaculation was adopted for extrusion of spermatophores in artificial insemination experiment.

Rashtriya Swasthya Bhima Yojana-Comprehensive Health Insurance Scheme (Rsby-Chis) In Kerala: A Study On The Effectiveness And Utilization Of The Scheme With Special Reference To Ernakulam And Wayanad Districts

Health insurance has become a necessity for the common man, next to food, clothing and shelter. The financing of health expense is either catastrophic or sometimes even frequently contracted illnesses, is a major cause of mental agony for the common man. The cost of care may sometimes result in the complete erosion of the family savings or may even lead to indebtedness as many studies on causes of rural indebtedness bear testimony (Jayalakshmi, 2006). A suitable cover by way of health insurance is all that is required to cope with such situations. Health care insurance rightly provides the mechanism for both individuals and families to mitigate the financial burden of medical expenses in the present context. Hence a well designed affordable health insurance policy is the need of the hour.Therefore, it is very significant to study the extent to which the beneficiaries in Kerala make use of the benefits provided by a social health insurance scheme like RSBY-CHIS. Based on the above pertinent points, this study assumes national relevance even though the geographical area of the study is limited to two districts of Kerala. The findings of the study will bring forth valuable inputs on the services availed by the beneficiaries of RSBYCHIS and take appropriate measures to improve the effectiveness of the scheme whereby maximum quality benefit could be availed by the poorest of the poor and develop the scheme as a real dawn of the new era of health for them

Comprehensive evaluation of the WaterGAP3 model across climatic, physiographic, and anthropogenic gradients

In den letzten Jahrzehnten haben sich makroskalige hydrologische Modelle als wichtige Werkzeuge etabliert um den Zustand der globalen erneuerbaren Süßwasserressourcen flächendeckend bewerten können. Sie werden heutzutage eingesetzt um eine große Bandbreite wissenschaftlicher Fragestellungen zu beantworten, insbesondere hinsichtlich der Auswirkungen anthropogener Einflüsse auf das natürliche Abflussregime oder der Auswirkungen des globalen Wandels und Klimawandels auf die Ressource Wasser. Diese Auswirkungen lassen sich durch verschiedenste wasserbezogene Kenngrößen abschätzen, wie z.B. erneuerbare (Grund-)Wasserressourcen, Hochwasserrisiko, Dürren, Wasserstress und Wasserknappheit. Die Weiterentwicklung makroskaliger hydrologischer Modelle wurde insbesondere durch stetig steigende Rechenkapazitäten begünstigt, aber auch durch die zunehmende Verfügbarkeit von Fernerkundungsdaten und abgeleiteten Datenprodukten, die genutzt werden können, um die Modelle anzutreiben und zu verbessern. Wie alle makro- bis globalskaligen Modellierungsansätze unterliegen makroskalige hydrologische Simulationen erheblichen Unsicherheiten, die (i) auf räumliche Eingabedatensätze, wie z.B. meteorologische Größen oder Landoberflächenparameter, und (ii) im Besonderen auf die (oftmals) vereinfachte Abbildung physikalischer Prozesse im Modell zurückzuführen sind. Angesichts dieser Unsicherheiten ist es unabdingbar, die tatsächliche Anwendbarkeit und Prognosefähigkeit der Modelle unter diversen klimatischen und physiographischen Bedingungen zu überprüfen. Bisher wurden die meisten Evaluierungsstudien jedoch lediglich in wenigen, großen Flusseinzugsgebieten durchgeführt oder fokussierten auf kontinentalen Wasserflüssen. Dies steht im Kontrast zu vielen Anwendungsstudien, deren Analysen und Aussagen auf simulierten Zustandsgrößen und Flüssen in deutlich feinerer räumlicher Auflösung (Gridzelle) basieren. Den Kern der Dissertation bildet eine umfangreiche Evaluierung der generellen Anwendbarkeit des globalen hydrologischen Modells WaterGAP3 für die Simulation von monatlichen Abflussregimen und Niedrig- und Hochwasserabflüssen auf Basis von mehr als 2400 Durchflussmessreihen für den Zeitraum 1958-2010. Die betrachteten Flusseinzugsgebiete repräsentieren ein breites Spektrum klimatischer und physiographischer Bedingungen, die Einzugsgebietsgröße reicht von 3000 bis zu mehreren Millionen Quadratkilometern. Die Modellevaluierung hat dabei zwei Zielsetzungen: Erstens soll die erzielte Modellgüte als Bezugswert dienen gegen den jegliche weiteren Modellverbesserungen verglichen werden können. Zweitens soll eine Methode zur diagnostischen Modellevaluierung entwickelt und getestet werden, die eindeutige Ansatzpunkte zur Modellverbesserung aufzeigen soll, falls die Modellgüte unzureichend ist. Hierzu werden komplementäre Modellgütemaße mit neun Gebietsparametern verknüpft, welche die klimatischen und physiographischen Bedingungen sowie den Grad anthropogener Beeinflussung in den einzelnen Einzugsgebieten quantifizieren. WaterGAP3 erzielt eine mittlere bis hohe Modellgüte für die Simulation von sowohl monatlichen Abflussregimen als auch Niedrig- und Hochwasserabflüssen, jedoch sind für alle betrachteten Modellgütemaße deutliche räumliche Muster erkennbar. Von den neun betrachteten Gebietseigenschaften weisen insbesondere der Ariditätsgrad und die mittlere Gebietsneigung einen starken Einfluss auf die Modellgüte auf. Das Modell tendiert zur Überschätzung des jährlichen Abflussvolumens mit steigender Aridität. Dieses Verhalten ist charakteristisch für makroskalige hydrologische Modelle und ist auf die unzureichende Abbildung von Prozessen der Abflussbildung und –konzentration in wasserlimitierten Gebieten zurückzuführen. In steilen Einzugsgebieten wird eine geringe Modellgüte hinsichtlich der Abbildung von monatlicher Abflussvariabilität und zeitlicher Dynamik festgestellt, die sich auch in der Güte der Niedrig- und Hochwassersimulation widerspiegelt. Diese Beobachtung weist auf notwendige Modellverbesserungen in Bezug auf (i) die Aufteilung des Gesamtabflusses in schnelle und verzögerte Abflusskomponente und (ii) die Berechnung der Fließgeschwindigkeit im Gerinne hin. Die im Rahmen der Dissertation entwickelte Methode zur diagnostischen Modellevaluierung durch Verknüpfung von komplementären Modellgütemaßen und Einzugsgebietseigenschaften wurde exemplarisch am Beispiel des WaterGAP3 Modells erprobt. Die Methode hat sich als effizientes Werkzeug erwiesen, um räumliche Muster in der Modellgüte zu erklären und Defizite in der Modellstruktur zu identifizieren. Die entwickelte Methode ist generell für jedes hydrologische Modell anwendbar. Sie ist jedoch insbesondere für makroskalige Modelle und multi-basin Studien relevant, da sie das Fehlen von feldspezifischen Kenntnissen und gezielten Messkampagnen, auf die üblicherweise in der Einzugsgebietsmodellierung zurückgegriffen wird, teilweise ausgleichen kann.

Evaluating and re-developing a more comprehensive and useful needs based assessment tool for parents and teachers of newly-diagnosed deaf and hard of hearing children

The purpose of this study was to redevelop a needs assessment inventory for use by caregivers and professionals engaging in educational services for children who are newly-diagnosed as deaf or hard of hearing.