Effectiveness of Implementing the Citizen’s Charter at a Regional Health Services Directorate in Sri Lanka

Introduction - Unacceptable delays in providing services by the Regional Director of Health Services’ Office, Kurunegala and subsequent re-visits had created customer dissatisfaction. A citizen’s charter and supplementary interventions were developed and implemented to improve providing services. The objective of this study is to assess effectiveness of implementing citizen’s charter and supplementary interventions at Establishment Branch of Regional Director of Health Services’ Office, Kurunegala.Methods - Methods involve developing process and outcome indicators to assess the effectiveness of charter and supplementary interventions, pre and post-assessments of developed indicators following implementing interventions for three months, and comparison of pre and post results for statistical significance to assess the effectiveness of implementations.Results - Following implementations, compliance of personal files with service standards significantly increased (p<0.001) from 40% to 94% while average number of visits per service to Establishment Branch had a significant reduction (p<0.001) from 2.40 to 1.09. Nursing officers’ overall satisfaction on receiving services improved significantly (p<0.001) from 11.5% to 75% as their satisfaction on all service attributes showed statistically significant improvements. Three attributes namely, awareness of place of formats, availability of contact details of responsible officer for services and courtesy exceeded expectations although the remainder showed expectation-perception gaps.Conclusion - Charter and supplementary interventions proved to be effective in improving service provision at Establishment Branch of Regional Director of Health Services’ Office, Kurunegala. It is recommended that Regional Director of Health Services’ offices implement charters and supplementary interventions at Establishment Branches in a stepwise manner to improve service provision.

Morbidity Pattern in End Stage Renal Disease Patients Before And After Renal Transplantation

Introduction: To effectively and efficiently plan programmes for prevention and control of End Stage Renal Disease (ESRD)/ chronic kidney disease, there is a need for basic epidemiological and clinical data. This hospital-based descriptive study on renal transplant patients attempted to provide some information on their morbidity pattern before and after renal transplantation. Methods: A hospital-based study was conducted at the Teaching Hospital, Kandy. The study sample consisted of 305 patients who had undergone real transplant and attended the clinic during the three month period of data collection. Interviewer administered questionnaire was used as the data collection tool. Results: Renal transplant patients are prone to infections mainly due to iatrogenic immunosuppression. Cytomegalovirus infection was the commonest. Other common infections observed were upper respiratory tract infections, gastroenteritis and urinary tract infections. All the patients who participated in the study developed at least one non-communicable disease during the follow up period. Anaemia (54%) was the most common problem encountered, followed by rejection, both acute and chronic (50%) and dyslipidaemia (44%). Almost all the participants had hypertension developed before or after the transplantation. This suggests that hypertension is leading to ESRD, resulting from ESRD or just a co-morbidity. Conclusion: Cytomegalovirus infection was the commonest infectious disease reported. Other common infections observed in this study were upper respiratory tract infections, gastroenteritis and urinary tract infections. All the patients developed at least one non-communicable disease during the follow up period. Key words: Morbidity, Renal Transplant, Non Communicable Diseas

Aetiological Factors Associated With End Stage Renal Disease; Analysis of End Stage Renal Patients in Sri Lanka

Introduction: End stage renal disease (ESRD) can be considered as one of the growing health problems as well as a public health issue in Sri Lanka. The demographic and epidemiological transition currently the country undergoes, contribute significantly to this problem. Methods: This study was conducted at the Nephrology Clinic, Kandy Teaching Hospital, a tertiary level medical institution. The study sample consisted of renal transplant patients satisfied the selection criteria. Considering the estimated sample size, no sampling techniques were used and a total of 305 patients interviewed using the study instrument, an interviewer-administered questionnaire. Results: Investigation of possible aetiology of ESRD revealed that for 69.5% cases aetiology was not well established. Among the known aetiological factors, diabetes (38%) was the commonest followed by nephrotic syndrome (19%) and hypertension (18%). This distribution pattern differs from what was observed in other countries. The differences in the aetiology of ESRD in regard to sex of patients, ethnicity, educational status, occupation and income were statistically not significant. Conclusion: Investigation of possible aetiology of ESRD revealed that for 69.5% cases aetiology was not well established. Among the known aetiological factors, diabetes (38%) was the commonest followed by nephrotic syndrome (19%) and hypertension (18%). The differences in the aetiology of ESRD in regard to sex of patients, ethnicity, educational status and occupation were statistically not significant. Key words: End Stage Renal Disease, Aetiological factors, Non Communicable Diseas

Precise quantum tomography of photon pairs with entangled orbital angular momentum

We report a high fidelity tomographic reconstruction of the quantum state of photon pairs generated by parametric down-conversion with orbital angular momentum (OAM) entanglement. Our tomography method allows us to estimate an upper and lower bound for the entanglement between the down-converted photons. We investigate the two-dimensional state subspace defined by the OAM states ± and superpositions thereof, with =1, 2, ..., 30. We find that the reconstructed density matrix, even for OAMs up to around =20, is close to that of a maximally entangled Bell state with a fidelity in the range between F=0.979 and F=0.814. This demonstrates that, although the single count-rate diminishes with increasing , entanglement persists in a large dimensional state space

Accuracy of gastrocnemius muscles forces in walking and running goats predicted by one-element and two-element Hill-type models

Hill-type models are commonly used to estimate muscle forces during human and animal movement —yet the accuracy of the forces estimated during walking, running, and other tasks remains largely unknown. Further, most Hill-type models assume a single contractile element, despite evidence that faster and slower motor units, which have different activation-deactivation dynamics, may be independently or collectively excited. This study evaluated a novel, two-element Hill-type model with “differential” activation of fast and slow contractile elements. Model performance was assessed using a comprehensive data set (including measures of EMG intensity, fascicle length, and tendon force) collected from the gastrocnemius muscles of goats during locomotor experiments. Muscle forces predicted by the new two-element model were compared to the forces estimated using traditional one-element models and to the forces measured in vivo using tendon buckle transducers. Overall, the two-element model resulted in the best predictions of in vivo gastrocnemius force. The coefficient of determination, r2, was up to 26.9% higher and the root mean square error, RMSE, was up to 37.4% lower for the two-element model than for the one-element models tested. All models captured salient features of the measured muscle force during walking, trotting, and galloping (r2 = 0.26 to 0.51), and all exhibited some errors (RMSE = 9.63 to 32.2% of the maximum in vivo force). These comparisons provide important insight into the accuracy of Hill-type models. The results also show that incorporation of fast and slow contractile elements within muscle models can improve estimates of time-varying, whole muscle force during locomotor tasks.Organismic and Evolutionary Biolog

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Towards a framework for architecting heterogeneous teams of humans and robots for space exploration

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Aeronautics and Astronautics, 2006.Includes bibliographical references (p. 113-121).Human-robotic systems will play a critical role in space exploration, should NASA embark on missions to the Moon and Mars. A unified framework to optimally leverage the capabilities of humans and robots in space exploration will be an invaluable tool for mission planning. Although there is a growing body of literature on human robotic interactions (HRI), there is not yet a framework that lends itself both to a formal representation of heterogeneous teams of humans and robots, and to an evaluation of such teams across a series of common, task-based metrics. My objective in this thesis is to lay the foundations of a unified framework for architecting human-robotic systems for optimal task performance given a set of metrics. First, I review literature from different fields including HRI and human-computer interaction, and synthesize multiple considerations for architecting heterogeneous teams of humans and robots. I then present methods to systematically and formally capture the characteristics that describe a human-robotic system to provide a basis for evaluating human-robotic systems against a common set of metrics.(cont.) I propose an analytical formulation of common metrics to guide the design and evaluate the performance of human-robot systems, and I then apply the analytical formulation to a case study of a multi-agent human-robot system developed at NASA. Finally, I discuss directions for further research aimed at developing this framework.by Julie Ann Arnold.S.M

Bounds and optimisation of orbital angular momentum bandwidths within parametric down-conversion systems

The measurement of high-dimensional entangled states of orbital angular momentum prepared by spontaneous parametric down-conversion can be considered in two separate stages: a generation stage and a detection stage. Given a certain number of generated modes, the number of measured modes is determined by the measurement apparatus. We derive a simple relationship between the generation and detection parameters and the number of measured entangled modes.Comment: 6 pages, 4 figure

Relativistic Description of Exclusive Deuteron Breakup Reactions

The exclusive deuteron break-up reaction is analyzed within a covariant approach based on the Bethe-Salpeter equation with realistic meson-exchange interaction. Relativistic effects in the cross section, tensor analyzing power and polarization transfer are investigated in explicit form. Results of numerical calculations are presented for kinematical conditions in forthcoming p + D reactions at COSY.Comment: 10 LaTeX pages, 4 eps-figure

The Process " Pbar P -> E- E+ " with Polarized Initial Particles and Proton Form Factors in Time-Like Region

The discussion on the asymptotical behaviour of the form factors in the space-like and time-like regions have been corrected and clarified. Fig.3 has been replaced by an improved analysis of the data.Comment: DFTT 13/93. LaTeX file, 11 pages + 3 figures (included