Long-term solar activity influences on South American rivers

River streamflows are excellent climatic indicators since they integrate precipitation over large areas. Here we follow up on our previous study of the influence of solar activity on the flow of the Parana River, in South America. We find that the unusual minimum of solar activity in recent years have a correlation on very low levels in the Parana's flow, and we report historical evidence of low water levels during the Little Ice Age. We also study data for the streamflow of three other rivers (Colorado, San Juan and Atuel), and snow levels in the Andes. We obtained that, after eliminating the secular trends and smoothing out the solar cycle, there is a strong positive correlation between the residuals of both the Sunspot Number and the streamflows, as we obtained for the Parana. Both results put together imply that higher solar activity corresponds to larger precipitation, both in summer and in wintertime, not only in the large basin of the Parana, but also in the Andean region north of the limit with Patagonia.Comment: Accepted to publication by Journal of Atmospheric and Solar-Terrestrial Physic

Atmospheric circulation processes contributing to a multidecadal variation in reconstructed and modeled Indian monsoon precipitation

An analysis of the recently reconstructed gridded May–September total precipitation in the Indian monsoon region for the past half millennium discloses significant variations at multidecadal timescales. Meanwhile, paleo-climate modeling outputs from the National Center for Atmospheric Research Community Climate System Model 4.0 show similar multidecadal variations in the monsoon precipitation. One of those variations at the frequency of 40–50 years per cycle is examined in this study. Major results show that this variation is a product of the processes in that the meridional gradient of the atmospheric enthalpy is strengthened by radiation loss in the high-latitude and polar region. Driven by this gradient and associated baroclinicity in the atmosphere, more heat/energy is generated in the tropical and subtropical (monsoon) region and transported poleward. This transport relaxes the meridional enthalpy gradient and, subsequently, the need for heat production in the monsoon region. The multidecadal timescale of these processes results from atmospheric circulation-radiation interactions and the inefficiency in generation of kinetic energy from the potential energy in the atmosphere to drive the eddies that transport heat poleward. This inefficiency creates a time delay between the meridional gradient of the enthalpy and the poleward transport. The monsoon precipitation variation lags that in the meridional gradient of enthalpy but leads that of the poleward heat transport. This phase relationship, and underlining chasing process by the transport of heat to the need for it driven by the meridional enthalpy gradient, sustains this multidecadal variation. This mechanism suggests that atmospheric circulation processes can contribute to multidecadal timescale variations. Interactions of these processes with other forcing, such as sea surface temperature or solar irradiance anomalies, can result in resonant or suppressed variations in the Indian monsoon precipitation

A comparative study on menstrual hygiene among urban and rural adolescent girls of West Bengal

Background: Menstruation is a normal physiological process to the females but sometimes it is considered as unclean phenomenon in the society. Objectives: To compare the perceptions of different aspects of menstrual hygiene between adolescent girls of rural and urban area. Materials and Methods: A community-based cross-sectional study was conducted from April 2013 to September 2013 in urban and rural area of South 24, Paraganas, West Bengal among 541 adolescent school girls in the age group of 13-18 years. Data were collected by the predesigned and pretested questionnaires. Result: Only 37.52% girls were aware of menstruation prior to attainment of menarche. The difference in the awareness regarding menstruation in urban and rural area was highly significant. Only 36% girls in the urban and 54.88% girls in the rural area used homemade sanitary pads and reused the same in the subsequent period. Satisfactory Cleaning of external genitalia was practiced by only 47.63% of the urban and 37.96% of the rural girls. This study found differences in hygienic practices followed by adolescent girls in urban and rural area. Conclusion: Hygienic practices during menstruation were unsatisfactory in the rural area as compared to the urban area. Girls should be educated about the proper hygienic practices as well as bring them out of traditional beliefs, misconceptions, and restrictions regarding menstruation

Assessment of validity and reliability of IMNCI algorithm in comparison to provisional diagnosis of senior pediatricians in a tertiary hospital of Kolkata

Background: Integrated management of childhood illness (IMNCI) is already operational in many states of India, but there are only limited studies in Indian scenario comparing its validity and reliability with the decisions of pediatricians. Aims and Objectives: To assess the validity and reliability of the IMNCI algorithm with provisional diagnosis of senior pediatricians for each IMNCI classifications. Materials and Methods: The present study is done with all the young infants between 0-2 months presented during the study period with a fresh episode of illness to test the validity and reliability of the algorithm in comparison to provisional diagnoses of senior pediatricians. The study was done in a tertiary care hospital. Validity characteristics such as sensitivity, specificity, positive predictive value, negative predictive value, and reliability characteristics such as percent agreement and Kappa were assessed for individual IMNCI classifications. Results: The sensitivity of possible serious bacterial infection, local bacterial infection, jaundice, no dehydration and possible serious bacterial infection, not able to feed were 88.89, 14.29, 66.67, 25 and 44.44% respectively. The specificities for the same conditions were 71.72, 99.09, 99.07, 94.50 and 86.87%. Percent agreements for similar conditions were 74, 94, 97, 90 and 80% respectively and the Kappa ratios were 0.38, 0.20, 0.73, 0.19 and 0.29 respectively. Conclusion: It could be concluded that IMNCI is quite a sensitive strategy and could identify severe illnesses of young infants requiring referral to higher facility. Further studies, particularly in primary health care setting, are required

A comparative study of the management decisions by IMNCI algorithm and by pediatricians of a teaching hospital for the children between 2 months to 5 years

Background: Integrated management of neonatal and childhood illness (IMNCI) is already operational in many states of India, but there are very few studies in Indian scenario comparing its validity and reliability with the pediatricians′ decisions. Objectives: 1) To compare the IMNCI decision with the decision of pediatricians; 2) to assess the significance of multiple presenting symptoms in the IMNCI algorithm. Materials and Methods : The study was conducted among the sick children between 2 months to 5 years presented in pediatric department from January to March 2009. The IMNCI decision was compared with pediatrician′s decisions by percent agreement, Kappa and weighted Kappa with the aids of SPSS version 10. Results: The overall diagnostic agreement between IMNCI algorithm and pediatrician′s decisions was 36.64%, (Kappa 0.16 and weighted Kappa 0.29) with 51.15% over diagnosis and 12.21% under diagnosis. The importance given by IMNCI algorithm in cases of multiple presenting symptoms was also reflected as it was evident that 37.50% children presented with three symptoms were categorized as red, whereas it was 28.57% and 11.67% for those presented with two and one symptom, respectively, (P < 0.0001). Pediatricians also gave importance for presence of multiple symptoms by considering 50% as admissible in the group presented with three symptoms, 30.16% in the group presented with two symptoms, and 16.67% in the group presented with only one symptom. The association was also statistically significant (P = 0.018). Conclusion: Diagnostic discordance is seen mainly due to over diagnosis of all fever cases as malaria. Importance of presence of comorbidities was also reflected

Study comparing the management decisions by IMNCI algorithm and pediatricians in a teaching hospital for the young infants between 0 to 2 months

Integrated management of neonatal and childhood illness (IMNCI) was already operational in many states of India, but there were very few studies in Indian scenario comparing its validity and reliability with the decisions of pediatricians. The general objective of the study is to compare the IMNCI decisions with the decisions of pediatricians and the specific objectives are to assess the agreement between IMNCI decisions and the decisions of pediatricians, to assess the under diagnosis and over diagnosis in IMNCI algorithm in comparison to the decisions of pediatricians and to assess the significance of multiple presenting symptoms in IMNCI algorithm. The study was conducted among the sick young infants presenting in pediatric department from January to March 2009. The IMNCI decision was compared with pediatrician′s decisions by percent agreement, Kappa and weighted Kappa with the aids of SPSS version 10. The overall diagnostic agreement between IMNCI algorithm and pediatrician′s decisions was 55.56%, (Kappa 0.32 and weighted Kappa 0.41) with 33.33% over diagnosis, and 11.11% under diagnosis. 71.88% young infants with multiple symptoms and 40% with single symptom were classified as red by IMNCI algorithm, which is statistically significant (P=0.004) whereas 56.25% young infants with multiple and 31.76% with single symptom were considered admissible by pediatricians, which is not statistically significant (P=0.052)

Knowledge and Practice of Standard Precautions and Awareness Regarding Post-Exposure Prophylaxis for HIV among Interns of a Medical College in West Bengal, India

Objectives: To assess the knowledge of interns on standard precautions and post-exposure prophylaxis for HIV, and identify the gap between knowledge and practice relating to standard precautions, as well as determining the perceived barriers against adherence to standard precautions.Methods: The study was conducted on 130 interns of 2010-11 batch from a government-run medical college in Kolkata, India. All participants completed a self-administered questionnaire with items relating to basic components of standard precautions and post-exposure prophylaxis for HIV. The questionnaire also included open ended questions relating to reasons for non-adherence to the practice of standard precautions along with additional space for specific comments, if any.Results: Poor adherence in the use of personal protective equipment, hand washing, safe handling and disposal of needles and sharp objects were found to be among the practices for which the interns expressed correct knowledge. While the main reasons for non-adherence were found to be clumsiness in handling needles, wearing gloves, feeling uncomfortable when wearing aprons, impracticality of regular hand-washing and non-availability of equipment. Although the majority of the respondents (84.6%) expressed awareness of washing sites of injured with soap and water, approximately 32.3% did not know that antiseptics could cause more damage. Also, only 63.8% expressed awareness of reporting any incidence of occupational exposure, while knowledge on post-exposure prophylaxis regimens was generally found to be poor.Conclusion: The considerable gap between knowledge and practice of standard precautions and inadequate knowledge of post-exposure prophylaxis emphasizes the need for continuous onsite training of interns with supportive supervision and monitoring of their activities