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J Healthc Qual Res ; 34(4): 167-175, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31713527


OBJECTIVE: To report various components of health system responsiveness among poor internal migrants who availed the government health facilities in 13 Indian cities. MATERIALS AND METHODS: Cluster random sampling was used to select 50,806 migrant households, of which 14,263 households avail the government health facility in last six months. In addition, 5072 women, who sought antenatal care and 3946 women who had delivery in government health facility during last six months were also included. Data on different domains of health system responsiveness were collected using an interviewer-administered questionnaire, developed based on the World Health Survey of WHO. RESULTS: Of the eight domains of responsiveness, namely, autonomy, communication, confidentiality, dignity, choice, quality of basic facilities, prompt attention and access to family and community, seven domains, except the 'choice', are assessed, and they are moderate. Only about 30% of participants said that doctor discussed on treatment options (autonomy). And 50-60% of participants said positively for questions of clarity of communication. About 59% of participants acknowledged the confidentiality. Not more than 40% of participants said they were treated with dignity, and privacy is respected (dignity). The responses to quality basic amenities, prompt attention and access to family and community domains are fairly satisfactory. CONCLUSIONS: This study has implications as many urban poor, including migrants do not utilize the services of public healthcare facilities. Hence, a responsive health system is required. There should be a policy in place to train and orient healthcare workers on some of the domains of health system responsiveness.

Semin Immunopathol ; 40(6): 605-615, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30209546


Recent studies of molecular mobility in the plasma membrane have revealed that diffusion is restricted by cytoskeletal networks or fences. Transmembrane protein "pickets" that reversibly associate with the membrane-associated skeleton and with the pericellular coat impede the movement of unattached bystander molecules. While membrane picket-fences were originally described as barriers to free diffusion in more passive cell types such as fibroblasts, they have particularly important functions in the more dynamic immune cells. In phagocytes, such fences curtail spontaneous activation and their disassembly facilitates stimulation by target particles, fostering receptor clustering and the exclusion of phosphatases from the phagocytic cup. In this review, we describe the nature of the cellular cytoskeleton and of the exoskeleton created by the pericellular coat, their association with transmembrane pickets, and the modulation of molecular mobility during phagocytosis.

Membrana Celular/metabolismo , Fagócitos/metabolismo , Fagocitose/fisiologia , Animais , Humanos
Front Cell Neurosci ; 12: 278, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30210302


The hippocampal circuitry is widely recognized as susceptible to ischemic injury and seizure generation. However, hippocampal contribution to acute non-convulsive seizures (NCS) in models involving middle cerebral artery occlusion (MCAO) remains to be determined. To address this, we occluded the middle cerebral artery in adult C57 black mice and monitored electroencephalographic (EEG) discharges from hippocampal and neocortical areas. Electrographic discharges in the absence of convulsive motor behaviors were observed within 90 min following occlusion of the middle cerebral artery. Hippocampal discharges were more robust than corresponding cortical discharges in all seizure events examined, and hippocampal discharges alone or with minimal cortical involvement were also observed in some seizure events. Seizure development was associated with ipsilateral hippocampal injuries as determined by subsequent histological examinations. We also introduced hypoxia-hypoglycemia episodes in mouse brain slices and examined regional hyperexcitable responses ex vivo. Extracellular recordings showed that the hippocampal CA3 region had a greater propensity for exhibiting single/multiunit activities or epileptiform field potentials following hypoxic-hypoglycemic (HH) episodes compared to the CA1, dentate gyrus, entorhinal cortical (EC) or neocortical regions. Whole-cell recordings revealed that CA3 pyramidal neurons exhibited excessive excitatory postsynaptic currents, attenuated inhibitory postsynaptic currents and intermittent or repetitive spikes in response to HH challenge. Together, these observations suggest that hippocampal discharges, possibly as a result of CA3 circuitry hyperexcitability, are a major component of acute NCS in a mouse model of MCAO.

BMJ Open ; 6(3): e010290, 2016 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-26936906


OBJECTIVES: To assess the status of menstrual hygiene management (MHM) among adolescent girls in India to determine unmet needs. DESIGN: Systematic review and meta-analysis. We searched PubMed, The Global Health Database, Google Scholar and references for studies published from 2000 to September 2015 on girls' MHM. SETTING: India. PARTICIPANTS: Adolescent girls. OUTCOME MEASURES: Information on menarche awareness, type of absorbent used, disposal, hygiene, restrictions and school absenteeism was extracted from eligible materials; a quality score was applied. Meta-analysis was used to estimate pooled prevalence (PP), and meta-regression to examine the effect of setting, region and time. RESULTS: Data from 138 studies involving 193 subpopulations and 97,070 girls were extracted. In 88 studies, half of the girls reported being informed prior to menarche (PP 48%, 95% CI 43% to 53%, I(2) 98.6%). Commercial pad use was more common among urban (PP 67%, 57% to 76%, I(2) 99.3%, n=38) than rural girls (PP 32%, 25% to 38%, I(2) 98.6%, n=56, p<0.0001), with use increasing over time (p<0.0001). Inappropriate disposal was common (PP 23%, 16% to 31%, I(2) 99.0%, n=34). Menstruating girls experienced many restrictions, especially for religious activities (PP 0.77, 0.71 to 0.83, I(2) 99.1%, n=67). A quarter (PP 24%, 19% to 30%, I(2) 98.5%, n=64) reported missing school during periods. A lower prevalence of absenteeism was associated with higher commercial pad use in univariate (p=0.023) but not in multivariate analysis when adjusted for region (p=0.232, n=53). Approximately a third of girls changed their absorbents in school facilities (PP 37%, 29% to 46%, I(2) 97.8%, n=17). Half of the girls' homes had a toilet (PP 51%, 36% to 67%, I(2) 99.4%, n=21). The quality of studies imposed limitations on analyses and the interpretation of results (mean score 3 on a scale of 0-7). CONCLUSIONS: Strengthening of MHM programmes in India is needed. Education on awareness, access to hygienic absorbents and disposal of MHM items need to be addressed. TRIAL REGISTRATION NUMBER: CRD42015019197.

Absenteísmo , Conhecimentos, Atitudes e Prática em Saúde , Higiene/normas , Menarca , Menstruação , Adolescente , Feminino , Humanos , Índia , População Rural , Instituições Acadêmicas , População Urbana
Int J Biol Macromol ; 57: 204-12, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23500442


Chitosan nanorod with minimum particle size of <100 nm was prepared by crosslinking low molecular weight chitosan with polyanion sodium tripolyphosphate and physicochemically characterized (FT-IR, XRD, SEM, AFM, TGA and DSC) for waste water treatment. Its sorption capacity and sorption isotherms for chromium (Cr) were studied. The effect of initial concentration of Cr ions, sorbent amount, agitation period and pH of solution that influence sorption capacity were also investigated. It was found that nanochitosan in the solid state was rod shaped which could sorb Cr (VI) to Cr (III) ions effectively. Based on the Langmuir, the Freundlich and the Temkin sorption isotherms, the sorption capacity of chitosan nanoparticles is very high and the adsorbent favors multilayer adsorption. The kinetics studies show that the adsorption follows the pseudo-second-order kinetics, which infers the transformation of Cr (VI) to Cr (III). From the results it was concluded that nanochitosan is an excellent material as a biosorbent for Cr removal from water.

Quitosana/química , Cromo/química , Nanotubos/química , Águas Residuárias/química , Poluentes Químicos da Água/química , Purificação da Água/métodos , Nanotubos/ultraestrutura , Polifosfatos/química