Impact of conventional retting of jute (Corchorus spp.) on the environmental quality of water: a case study.

Production of quality jute fibre primarily depends on the retting process of jute. However, the quality of retting water is of great concern because of the scarcity of available water bodies for retting. A study conducted on physico-chemical and microbiological changes in retting water (pre- and post-retting) from four intensively jute-growing districts namely Nadia, North 24 Parganas, Hooghly and South Dinajpur of West Bengal, India, during jute retting. The post-retting water samples recorded lower pH (6.22 to 7.08) and higher EC (electrical conductivity) (0.509 to 0.850 ds/m) compared with pre-retting water samples (pH 6.63 to 7.44; EC 0.197 to 0.330 ds/m) collected from all the four districts under study. The biological oxygen demand (BOD) and chemical oxygen demand (COD) increased several folds in the post-retting water samples indicating very high microbial growth and activities and depleted oxygen level compared with pre-retting water. The Ca + Mg (calcium + magnesium) content in pre-retting water was high (24.15 to 36.60 ppm) which raised further (61.30 to 103.67 ppm) in post-retting water, while the bicarbonate content also increased and ranged between 2.72 and 6.81 me/l in post-retting water compared with its status in pre-retting water (1.30 to 3.15 me/l). The post-retting water was found to be a rich source of nutrients like nitrogen (N), phosphorus (P), iron (Fe), manganese (Mn), zinc (Zn) and copper (Cu) which increased substantially because of jute retting as compared with their status in pre-retting water. The population of pectinolytic, xylanolytic, cellulolytic and ligninolytic bacterial cfu (colony forming unit) increased by 1.5 times in post-retting water as compared with pre-retting water, because these specific bacterial population were involved in the degradation of pectin, xylan, cellulose and lignin during retting of jute. Thus, post-retting water can be judiciously used as a potent source of primary, secondary and micronutrients for succeeding crops besides having higher BOD and COD as a result of higher microbial growth related to jute retting.

MAGNETOCALORIC RESPONSE OF NON-STOICHIOMETRIC Ni2MnGa ALLOYS AND THE INFLUENCE OF CRYSTALLOGRAPHIC TEXTURE.

Currently, there is significant interest in magnetocaloric materials for solid state refrigeration. In this work, polycrystalline Heusler alloys belonging to the Ni2+xMn1-xGa family, with x between 0.08 and 0.24, were evaluated for the purpose of finding composition(s) with an enhanced magnetocaloric effect (MCE) close to room temperature. Differential scanning calorimetry (DSC) was successfully used to screen alloy composition for simultaneous magnetic and structural phase transformations; this coupling needed for a giant MCE. The alloy with x = 0.16 showed an excellent match of transformation temperatures and exhibited the highest magnetic entropy change, ΔSM, in the as-annealed state. Furthermore, the MCE increased by up to 84 % with a 2 Tesla (T) field change when the samples were thermally cycled through the martensite to austenite transformation temperature while held under a constant mechanical load. The highest ΔSM measured for our x = 0.16 alloy for a 2 T magnetic field change was -18 J/kg-K. Texture measurements suggest that preferential orientation of martensite variants contributed to the enhanced MCE in the stress-assisted thermally cycled state.

Primary cutaneous histoplasmosis simulating Molluscum contagiosum.

Primary cutaneous histoplasmosis in a HIV positive patient ie isolated cutaneous involvement without any deeper structures is a very rare entity. Only a handful cases have been reported worldwide. This patient presented with cutaneous lesion simulating Molluscum but histopathology revealed Histoplasma capsulatum. The patient had no deep organ involvement. The patient was put on Itraconazole which caused rapid dissolution of the lesions. He was subsequently put on HAART and discharged.

Algorithms and heuristics for efficient medical information display in PDA.

Accessing medical information in mobile devices such as PDAs and mobile phones is becoming widespread. Since these devices do not have the same rendering capabilities as of desktop computers, it is necessary for medical information to be fragmented for proper presentation on these types of devices. In this paper, we propose an architecture for displaying medical information in PDA. In the proposed system, a server extracts the information, categorizes the information in order of its relevance for diagnosis, and dynamically generates a hierarchical view of the relevant information based on certain medical domain knowledge. Displaying image and graphics data in PDA poses several challenges. The proposed system supports an image visualization tool, which interactively displays an image or a portion of an image in user's PDA. This visualization tools increases the resource utilization of PDA by offloading a part of the computation to the server. A suitable caching scheme is incorporated for optimum utilization of communication channel bandwidth.

Study of scattered radiation for in-air calibration by a multiple-distance method using ionization chambers and an HDR 192Ir brachytherapy source.

The aim of this study is to estimate the room-scatter correction when measuring air kerma rate of an HDR 192Ir brachytherapy source by in-air calibration. The variation in scattered radiation due to the specially designed jig and from the room walls was also studied. Two therapy ion chambers of volume 0.1 cm3 and 0.6 cm3 were used in the present study. Air kerma was measured by placing the source at several distances between 10 cm and 20 cm from the chamber. The scatter radiation was determined by superimposing the theoretically derived model curve of known scatter (based on the inverse square law) over the plot of measured air kerma strength values. The scatter radiation was estimated in terms of percentage of the primary radiation at 10 cm measurement distance. The scatter estimated by the 0.6 cm3 chamber at two positions was 0.33% and 0.59%, respectively. Similarly the scatter estimated at two other positions by the 0.1 cm3 chamber was 0.58% and 1.11%. This variation in scatter with position as well as with the chamber was due to the varying scatter contribution from components of the measurement set-up. The scatter radiation becomes constant at a distance greater than 100 cm from the walls of the room. We conclude that a fixed chamber with changing source positions should be used in multiple-distance measurement of air kerma rate when using a measurement jig.

The use of PHC clinic-based women's groups for financial empowerment in a rural area.

The article is based on a four-year project during which Primary Health Care (PHC) nurses worked with women's groups in their areas. The aim of the study was to explore the involvement of PHC nurses in economic empowerment, both in terms of health promotion and in terms of the PHC approach. In particular the objectives were to establish whether nurses could lead economic empowerment groups, whether such groups could establish adequate external links and become financially viable. Eleven groups were used as case studies, and a cross-case analysis was done in terms of the three objectives. It was found that between the women and the nurses, adequate leadership existed for the groups to function well. Very limited external linkages were established, notwithstanding efforts in this regard. Nine out of 11 groups contributed to financial welfare of their members after 18 months, but a range of problems with regard to financial viability are identified.

Management of family and workplace stress experienced by women of colour from various cultural backgrounds.

Minority women identify finances and maintaining cultural values as their most commonly experienced stressors at home and in the work-place. A before and after study of ethnic minority women in focus group sessions led by a trained ethnic minority facilitator examined how social and workplace supports, or lack thereof, impact on the individuals' ability to manage daily life. Creative, effective solutions to stressors were identified by the participants. Outcomes were evaluated in terms of the impact of changes on the participants' coping styles in family and work life. Results indicate that a large percentage of women in this study felt discriminated against based on their culture/race, however, this perceived discrimination decreased after the focus groups. The predominant stress management techniques were prayer and music. Family support was the most influential factor in decreasing stress. The family is a major source of support for the working women, acting as a buffer to workplace pressures.

The prevalence of multicultural groups receiving in-home service from three community agencies in southern Ontario: implications for cultural sensitivity training.

This survey assessed the ethnocultural proportion of clients (largely seniors) receiving services from three home care health agencies in Southern Ontario. Providers from the three agencies were asked to recall clients served in the previous two weeks and to describe them in terms of race, language, sex, age and disability status. White, English-speaking clients comprised 88.3% of the sample (N = 931). The remaining 11.7% of clients were white, non-English-speaking (7.8%), visible minority (2.8%), francophone (0.77%), indigenous (0.22%) and Hispanic (0.11%). Sixty-three percent of clients were women and 34% men. The majority (66.6%) of clients were over 65 years. The 11.7% of clients who were identified as multicultural in three home care agencies are an under-representation of the multicultural mix of population in the Southern Ontario region, which is 24%. Some recommendations have been offered for a system for ethnocultural data collection for the region and provision of cultural sensitivity training programs to enhance staff knowledge and skills.

Economic evaluations of community-based care: lessons from twelve studies in Ontario.

A series of 12 studies (five historic cohort and seven randomized trials) examined clients in community settings in Southern Ontario suffering from a variety of chronic physical and mental health conditions. These studies are appraised using a framework for evaluating possible outcomes of economic evaluation. In the 12 studies, sample composition and size varied. Each study was designed to quantify the well-being outcomes and expenditures associated with different community-based approaches to care provided in the context of a system of national health insurance. As a collective, these studies represent increasing methodological rigour. Multiple-perspective client well-being outcome measures were used. In two studies, caregiver burden also was analysed. A common approach to quantification and evaluation of expenditures for service consumption was used in all 12 studies. The nature of community-based health services (health vs. disease care orientation) was found to have direct and measurable impact on total expenditures for health service utilization and client well-being outcomes. In most cases, a recurring pattern of equal or better client outcomes, yet lower expenditures for use of community based health services, was associated with well-integrated health oriented services. Integrated services aimed at factors which determine health are superior when compared to individual, fragmented, disease oriented, and focused approaches to care. The main lessons from the 12 studies are that it is as or more effective and as or less expensive to offer complete, proactive, community health services to persons living with chronic circumstance than to provide focused, on-demand, piecemeal services. Complete services would have a psychosocial and mental health focus included with the physical care approach. Furthermore, people with coexisting risk factors (age, living arrangements, mental distress and problem-solving ability) are the ones who most benefit at lower expense from health oriented, proactive interventions.

Low dose amiodarone in refractory tachyarrhythmias.

Fifty patients with drug resistant tachyarrhythmias were treated with amiodarone for 6-22 months; 16 for recurrent ventricular tachycardia (VT), 2 for VT followed by ventricular fibrillation (VF), 14 for complex ventricular ectopics, and 18 for supraventricular tachyarrhythmias (SVT). Amiodarone was administered in a dose much lower than that used in western trials. The actual incidence of successful amiodarone therapy was 81.2% at 22 months for patients with VT. Among the patients with SVT, 88.6% patients were successfully treated for 22 months (range 3-22 months). Amiodarone toxicity appeared in 22 of 50 patients (44%) treated for more than 12 weeks. Withdrawal of therapy was required in 4 patients. Despite the lower dose, clinical efficacy and onset of action were comparable to the western experience.

Spontaneously regressing nodular fasciitis of the neck.

Nodular fasciitis, a rare but definite clinico-pathological entity, has been described as a tumourous nodule which occurs predominantly in the subcutaneous fat and fascia, but may also rarely involve the deep fascia and contiguous muscle. It has been called subcutaneous fibromatosis, pseudosarcomatous fasciitis, proliferative fasciitis, infiltrative fasciitis, etc. Konwaler and his associates were the first to describe this condition in the name of 'pseudosarcomatous fasciitis' in 1955. Stout (1961) thinks that this term is most appropriate because the lesion simulates the appearance of sarcoma histologically, although it is not malignant, and because it usually shows some inflammatory stigmata. The term 'nodular fasciitis' was first used by Shuman (1961) and since then has been used by most authors, and therefore is used here. This paper describes a case of nodular fasciitis of the neck, unusual for its size and site, which spontaneously regressed; and it also reviews the cases described in the English Literature. We feel it is important to bring to the attention of otolaryngologists the existence of this pseudosarcomatous soft-tissue lesion (which may present in the neck), in order that it and malignant lesions may be properly differentiated and treated.

Inverted papilloma of the nose. Some aspects of aetiology.

A study of 43 cases of inverted papilloma of the nose has been made. These cases, arising from a moderately well-defined geographical area, were seen between 1955 and 1980. A detailed clinical and histological review was made in each case. No correlation has been found between any of the variable histological features and the potential of a particular papilloma to recur. The overall incidence of transformation to carcinoma is low, even after multiple recurrences. The findings suggests that there may be an extrinsic factor contributing to the causation of these tumours.

Metastatic tumours in the maxillary sinus. A report of two cases and a review of the literature.

We present two further cases of metastasis in the antrum. A review of the literature reveals renal carcinoma as the commonest primary tumour. When an adenocarcinoma of the antrum is diagnosed, an intravenous pyelogram should be performed to exclude a renal primary. This investigation, if negative, should be repeated during follow-up. The possibility of a bronchial tumour should be investigated in patients with an anaplastic tumour in the antrum.

Experiential learning: an approach to transcultural education for nursing.

Delivery of culturally appropriate health care in our pluralistic society demands that practitioners develop special attitudes, knowledge, and skills. Experimental learning is a powerful methodology for addressing the affective, as well as the cognitive, domain of learning. The exploration of personal values is an essential first step in developing cultural awareness in order to move learners beyond ethnocentrism through awareness, understanding, acceptance, and appreciation of other cultures if learners are to truly adopt a multicultural approach to their professional practice. The nursing curriculum at McMaster University School of Nursing is based on the principles of adult education and self-directed learning. A series of guided experiences have been undertaken with a variety of health sciences learners, both students and faculty members, to foster an increased appreciation of (their) own values preliminary to embarking on knowledge and skill acquisition for transcultural health care.

Examination of student learning about dimensions of health and illness using Stewart's conceptual framework for primary health care.

In view of the increasing emphasis on community-based primary health care, nursing education programs need to identify creative learning strategies to prepare nurses capable of promoting, maintaining and restoring health in diverse populations. The purpose of this descriptive study was to identify the learning outcomes acknowledged by junior baccalaureate nursing students in non-traditional community settings. Data were gathered through semi-structured interviews with the students, through journals kept daily by the students, and from the faculty tutor's anecdotal notes. Analysis of data illustrated concepts from Stewart's conceptual framework for primary health care. Students gained an appreciation of the influence of the social-cultural-political and physical environments on health. They also came to understand the significance of collaborative modes of interaction with recipients of nursing care. Thus, non-traditional community experiences demonstrated effectiveness in enhancing students' understanding of the multiple dimensions of health as well as the necessity for mutuality in nurse-person interactions. Providing varied learning environments in undergraduate nursing programs will produce practitioners who are more responsive to present and future primary health care issues.

Self-directed learning in the context of a nursing curriculum: development of a learning plan.

The rapid pace at which biological health breakthroughs and advancements in technology occur is creating unique challenges to health care programmes. The curricula of all health care programmes will need to be set in learning environments where students will be able to develop learning skills that are transportable across situations, over a whole lifetime. This article attempts to focus on self-directed learning (SDL) concepts and the development of a learning contract/plan, including the roles of both the student and faculty in self-learning approaches and contractual development.

Empowerment through self-directed learning.

In the 1970s, McMaster University, Hamilton, introduced self-directed learning (SDL) to its undergraduate nursing program. This innovation was prompted by a fundamental belief in the importance of nurse empowerment and the link between empowerment and SDL. The empowerment of nurses, it was believed, was critical to the improved health and welfare of patients. In the 1990s, faculty and alumni have perceived another benefit to SDL: the ability of McMaster graduates to persevere and excel in the face of health care system change.

Pakistan's community health workers.

Pakistan's health characteristics are worse than those of other Asian countries at similar stages of development. Its mortality rate for children under five is 139 per 1,000, and its maternal mortality is 60 per 10,000. Malnutrition in women and children is widespread; 50 per cent of children under five are stunted. Pakistan's population growth rate of 3.1 per cent per year is among the highest in Asia. The high population growth rate and poor health status of many people call for extensive health care services, but, unfortunately, health services do not reach most of the people of Pakistan. Partly because the training of doctors and nurses is lengthy and expensive, there is an acute shortage of health care providers, especially women. Although female health professionals are preferred for caring for women, cultural constraints inhibit women from seeking education. Such is the multifaceted dilemma in the provision of primary health care in Pakistan.

PIP: In Pakistan, the mortality rate for children under age 5 is 139/1000 live births, and the maternal mortality rate is 60/10,000. 50% of the children under 5 are stunted as a result of malnutrition. There is an acute shortage of health care providers; therefore, the Medical College and School of Nursing at Aga Khan University, Karachi, developed a community health service model that proposes a primary health care field team composed of community health nurses and doctors, lady health visitors, and community health workers (CHWs). Most community health nurses are graduates of a 3-year nursing program at the Aga Khan University School of Nursing followed by 1 year of midwifery training. In addition, graduates of the newly established BScN program are entering the system as community health nurses. Community health doctors are medical graduates whose education has emphasized clinical and theoretical knowledge of primary health care. Lady health visitors are the mid-level health care providers who deliver health care to mothers and children under age 5. They are high school graduates whose 2-year training includes midwifery, covering prenatal care, delivery care, postnatal care, and newborn care. CHWs have attended the CHW Training Program at Aga Khan University in order to provide preventive and promotive maternal and child care in their communities. The role of the CHW is to be an essential and permanent member of the health care system. The CHW encourages collection, storage, and use of clean water and garbage disposal; offers information about prenatal and postnatal care; refers women with pregnancy complications; encourages breast feeding; demonstrates food preparation for infants and toddlers; explains the management of diarrhea and vomiting; instructs about adequate prenatal nutrition; encourages immunization of pregnant women and children; and monitors the growth of children under age 5.

Comparative dosimetry of GammaMed Plus high-dose rate Ir brachytherapy source.

The comparative dosimetry of GammaMed (GM) Plus high-dose rate brachytherapy source was performed by an experiment using 0.1-cc thimble ionization chamber and simulation-based study using EGSnrc code. In-water dose measurements were performed with 0.1-cc chamber to derive the radial dose function (r = 0.8 to 20.0 cm) and anisotropy function (r = 5.0 cm with polar angle from 10° to 170°). The nonuniformity correction factor for 0.1-cc chamber was applied for in-water measurements at shorter distances from the source. The EGSnrc code was used to derive the dose rate constant (Λ), radial dose function g(L)(r) and anisotropy function F(r, θ) of GM Plus source. The dosimetric data derived using EGSnrc code in our study were in very good agreement relative to published data for GM Plus source. The radial dose function up to 12 cm derived from measured dose using 0.1-cc chamber was in agreement within ±3% of data derived by the simulation study.