Implications of Human Resource Practices and Other Structural Factors on Commitment of Public Medical Professionals in India

In this paper we focus on often neglected issue and inadequately studied area of commitment of public sector health professionals and some of the issues surrounding human resources as its determinants. The paper argues that success or failure of new initiatives in health sector critically hinges on the commitment of the staff. This paper is based on the questionnaire study and focused group discussion of 175 doctors working as district medical officers at district level and holding key administrative positions at state level in four states in India. These four Indian states account for nearly 22 per cent of India’s population. The findings provide some important insights that would be useful in drawing future agenda of strengthening health sector and involving all stakeholders in implementation process. The study finds critical linkage between human resource (HR) practices and commitment of doctors working in the government. Specifically, following HR practices are found critical in influencing organizational commitment: transparency in selection/postings, supportive training and capacity strengthening climate, recognition of performance and regular performance feedback. Further, results suggest that certain work environment and structural factors facilitate these practices. Health officials’ roles need to be redefined and given complexity of coordination at various levels, officials need to be allocated higher responsibilities. There is also a need to improve interpersonal relations within departments and coordination among agencies and officials at various levels. It is also observed that the structural rigidities in the system leading to obstruction in information sharing across various levels needs to be addressed to ensure effective healthcare delivery. This study highlights the criticality of administrative and structural issues for reforms of healthcare sector in India. Addressing human resources issues is critical for ensuring commitment from staff in implementing new initiatives or health reform agenda. National Rural Health Mission (NRHM) also identifies the human resources and capacities as an important challenge. Institutions that are critical vehicles to implement the NHRM would remain weak owing to low commitment of people. It would be important to focus on HR issues before any new initiative is proposed and implemented. The departments of health across states need to broaden and deepen the understanding of HR management and planning issues. For this purpose they may need to set-up HR division having appropriate competency and skill-mix to address the issues and work towards making the right changes. The papers discusses that these changes will be required at both strategic and operational levels.

Revisiting Appraisal Politics from Assessors’ Perspective

Past research on performance appraisal focusing on assessor’s ability to assess accurately has not made much progress because practitioners have not adopted most of the recommendations. One of the arguments has been that enhancing assessor’s ability to is useless unless s/he intends to appraise accurately. The focus of this paper is to understand assessor’s intention to appraise performance and it draws from political view of organisation, which considers assessor as a politician and proposes that certain contextual factors cause assessor’s to adopt goals other than accuracy. Specifically, it is proposed that, instrumentality of outcomes, ambiguity in the process/ policies, and accountability pressures shape the assessor’s perception of appraisal politics, which determine assessor’s intention to achieve specific goals through appraisal. Accountability research reveals that only specific accountability conditions have favourable affect on decision. While procedural accountability reduces assessor’s perception of appraisal politics, the outcome accountability will increase this perception and affect appraisal accuracy.

Cross-buoyancy mixed convection from a heated cylinder placed asymmetrically in a channel

Mixed convection heat transfer from a heated circular cylinder asymmetrically placed in a horizontal channel was studied for incompressible Newtonian fluid. A systematic investigation using two-dimensional numerical simulation (Ansys Fluent) was performed for the following control parameters: Reynolds number Re=50, 100, 150, Richardson number Ri=0, 1, 2, blockage ratio β=0.2, 0.3, 0.4, gap ratio γ=0.25, 0.5, 1 and Prandtl number of air Pr=0.7. Upon changing these parameters, steady and time periodic regimes were identified. The strongest influence on heat transfer (average Nusselt number) was identified when changing the Reynolds number (a 94% increase between the minimum and maximum Re investigated, with other parameters held constant), followed by Richardson number (+18%) and blockage ratio (+16%); the effect of asymmetric placement (γ) was almost negligible (+1%). The time-mean of the drag coefficient was most influenced by blockage ratio (a 150% increase), followed by Richardson number (+91%), gap ratio (+19%), and Re (+10%)

Impact Assessment of Thermal Radiation Hazard from LPG Fireball

AbstractThe failure of the pressure vessel containing pressure liquefied petroleum gas leads to Boiling Liquid Expanding Vapour Explosion (BLEVE). Further, ignition of released gas results in the formation of fireballs. In the present paper the semi-empirical equations are presented that represent the impact assessment of thermal radiation hazards from the liquefied petroleum gas fireball. Also an attempt has been made to determine the safe separation distance

General health and functional improvement among patients with unstable extracapsular proximal femoral fractures managed with proximal femoral nail by using SF-36 score

Background: Proximal femoral nail is emerging as the treatment of choice for unstable extra capsular proximal femoral fractures. This study comprises of functional evaluation of the treated patients by using SF 36 score.Methods: This was a prospective hospital-based study done on 54 patients with unstable proximal femoral fractures classified according to the AO/ASIF classification system and were treated by using PFN in the department of Orthopaedics DRPGMC, Tanda. Functional outcome was assessed by using SF-36 score on, 14th postoperative day, at three months and six months.Results: Our study has mean scores of short form-36 subscales as physical function 70.6, role limitation due to physical health 68.1, role limitation due to emotional health 90, energy/fatigue 66, emotional wellbeing 78, social functioning 67.7, pain 75 and general health 73.3.Conclusions: The results of this study confirm that intramedullary nailing with the use of a PFN in unstable proximal femoral fractures is a safe method. A significant change was seen in quality of life postoperatively as evidenced by various scores used in present study. Weaknesses of this study include a short follow-up period and the inclusion of a small study group

Fluid flow and heat transfer around a confined semi-circular cylinder: Onset of vortex shedding and effects of Reynolds and Prandtl numbers

Flow and heat transfer characteristics around a semi-circular cylinder placed in a confined channel are investigated in the unsteady regime. The two-dimensional simulations are carried out for varying values of control parameters: Reynolds number (Re) = 50–200 and Prandtl number (Pr) = 0.7, 10 and 100 at a fixed blockage ratio of 25% for Newtonian constant-property fluid. Continuity, Navier–Stokes and energy equations with appropriate boundary conditions are solved using the commercial computational fluid dynamics solver Ansys Fluent. The transition from steady to time-periodic flow occurs between Re = 69 and 70. The effect of Prandtl number on Nusselt number is pronounced; the ratio of Nusselt number values belonging to Pr = 100 and those belonging to Pr = 0.7 ranges from 6.3 to 6.5 over the Reynolds number domain investigated. Finally, the present numerical results are used to develop drag coefficient, Strouhal number and Nusselt number correlations

CFD analysis of power-law fluid flow and heat transfer around a confined semi-circular cylinder

A numerical analysis using Ansys Fluent was carried out to investigate the forced convection of powerlaw fluids (power-law index varying from 0.2 to 1.8) around a heated semi-circular cylinder with wall confinement (or blockage ratio) of 25%, Prandtl number of 50, and Reynolds numbers 1–40. Flow and thermal fields were found to be steady for Re up to 40. The shear-thickening behavior was found to have a higher value of drag coefficient, whereas the shear-thinning behavior had a smaller value of drag coefficient when compared with Newtonian fluids in the steady regime. The wake size was found shorter in shear-thickening fluids than Newtonian and shear-thinning fluids. An overall heat transfer rate was calculated and found to increase with the rise in Reynolds number. The average Nusselt numbers were observed higher for shear-thinning fluids than Newtonian and shear-thickening fluids; and the maximum enhancement in the heat transfer was achieved approximately 47% as compared to Newtonian fluids. The present results have also been correlated in terms of wake length, drag coefficient and average Nusselt number expressions for various Reynolds numbers and power-law indices studied. In addition, the effects of blockage ratios ranging from 16.67% to 50% on the engineering output parameters with varying powerlaw index at Re = 40 were reported

Laminar flow of non-Newtonian shear-thinning fluids in a T-channel

Flow characteristics of non-Newtonian power-law fluids in a right-angled horizontal T-channel are studied in the laminar regime. In particular, the two-dimensional numerical computations are performed using Ansys Fluent for the following range of physical parameters: Reynolds number (Re) = 5–200 andpower-law index (n) = 0.2–1 (covering shear-thinning, n < 1 and Newtonian, n = 1 fluids). The flow fields have been explained by streamline contours. The engineering parameters such as wake/recirculation length, critical Reynolds number for the onset of flow separation and the variation of viscosity alongthe lower wall of side branch are calculated for the above range of settings by using constant density and non-Newtonian power-law viscosity model. The results showed that for a particular n, the length of recirculation zone increases in the side branch with increasing Re. Also, it increases with decreasingn for a fixed Re. The critical Reynolds number for the onset of flow separation decreases with decreasing n. A simple wake-length correlation is also established at different values of Re and n for the range of parameters

DEEPAND: In-Depth Modeling of Correlated AND Gates for NLFSR-based Lightweight Block Ciphers

Automated cryptanalysis has taken center stage in the arena of cryptanalysis since the pioneering work by Mouha et al. which showcased the power of Mixed Integer Linear Programming (MILP) in solving cryptanalysis problems that otherwise, required significant effort. Since its inception, research in this area has moved in primarily two directions. One is to model more and more classical cryptanalysis tools as optimization problems to leverage the ease provided by state-of-the-art solvers. The other direction is to improve existing models to make them more efficient and/or accurate. The current work is an attempt to contribute to the latter. In this work, a general model referred to as DEEPAND has been devised to capture the correlation between AND gates in NLFSR-based lightweight block ciphers. DEEPAND builds upon and generalizes the idea of joint propagation of differences through AND gates captured using refined MILP modeling of TinyJAMBU by Saha et al. in FSE 2020. The proposed model has been applied to TinyJAMBU and KATAN and can detect correlations that were missed by earlier models. This leads to more accurate differential bounds for both ciphers. In particular, a 384-round (full-round as per earlier specification) Type-IV trail is found for TinyJAMBU with 14 active AND gates using the new model, while the refined model reported this figure to be 19. This also reaffirms the decision of the designers to increase the number of rounds from 384 to 640. Moreover, the model succeeds in searching a full round Type-IV trail of TinyJAMBU keyed permutation $\mathcal{P}_{1024}$ with probability $2^{-108} (\gg 2^{-128})$. This reveals the non-random properties of $\mathcal{P}_{1024}$ thereby showing it to be non-ideal. Hence it cannot be expected to provide the same security levels as robust block ciphers. Further, the provable security of the TinyJAMBU AEAD scheme should be carefully revisited. Similarly, for KATAN 32, DEEPAND modeling improves the 42-round trail with $2^{-11}$ probability to $2^{-7}$. Also, for KATAN 48 and KATAN 64, this model respectively improves the designer\u27s claimed 43-round and 37-round trail probabilities. Moreover, in the related key setting, the DEEPAND model can make a better 140-round boomerang distinguisher (for both the data and time complexity) compared to the previous boomerang attack by Isobe et al. in ACISP 2013. In summary, DEEPAND seems to capture the underlying correlation better when multiple AND gates are at play and can be adapted to other classes of ciphers as well

STUDY ON AGE RELATED MACULAR DEGENERATION (DRY TYPE) IN CONTEXT TO PITTA VIDAGDHA DRISHTI AND ITS AYURVEDIC MANAGEMENT

Age Related Macular Degeneration (ARMD) is the leading cause of the vision loss and blindness in people above 50 years of age. ARMD is characterised by central vision loss, distorted or blurred vision, decreased visual acuity, Central or para-central blind spot (scotoma). An almost similar clinical condition to ARMD is seen in Pitta Vidagdha Dristi. Dry ARMD is more prevalent (90%) and slower in progress than Wet ARMD. The Ayurvedic management of Pitta Vidagdha Drishti is similar to Pittaja Abhishyanda. With this background a specific line of treatment for the Pitta Vidagdha Drisht in Sushruta Samhita is adopted. In this study, total 22 patients, 12 in group A (Triphala Ghrita, Saptamrita Lauha, Rasayana Churna and Shatavari etc.) &amp; 10 in Group B (Control) were registered. The duration of therapy was of 3 months in both the groups. Group A showed better results on ARMD when compared with that of Group B especially on perception of flashes of light (72.23%) &amp; dim light adaptation problem (45.23%). So ARMD (Dry type) can be better managed by Ayurvedic treatment group than the Modern multivitamin group