451 research outputs found
Influence of rotation and sources of nutrients on soil properties and productivity of finger millet (Eleusinecoracana L. Gaertn.)
A field experiment was conducted at the All India Co-ordinated Research Project for Dryland Agriculture, UAS, GKVK, Bengaluru during kharif 2013-14. The experiment was laid out with 20 treatment combinations with three factors using factorial RBD with two replications comprised of on a permanent manurial trial with 35th crop cycle. Application of FYM at 10 t ha-1 has recorded significantly higher grain yield (1.76 t ha-1), maximum water holding capacity (MWHC) of 43.85 % and dehydrogenase activity (DHA) of 357.60?g TPF g-1 24 h-1 obtained after harvest of the crop as compared to application of maize residues at 5 t ha-1 (1.37 t ha-1, 42.27 % and 193.0?g TPF g-1 24 h-1 respectively) due to improved growth and yield parameters of finger millet. However, finger millet-groundnut rotation has given significantly higher grain yield (1.78 t ha-1), MWHC (43.66 %) and DHA (298.48?g TPF g-1 24 h-1) after harvest of the crop over mono cropping of finger millet (1.34 t ha-1, 42.46% and 252.12?g TPFg-1 24 h-1respectively ). Among different nutrient sources, application of organic matter with 100 % RDF have given significantly higher grain yield (2.74 t ha-1), MWHC (45.86 %) and DHA (431.13?g TPF g-1 24 h-1) after harvest of the crop compared to absolute control (0.28 t ha-1, 41.76 % and 133.67?g TPFg-1 24 h-1 respectively). The 100 % recommended dose of fertilizer + organic matter significantly increased yield attributes because of improved soil physical and chemical properties and increased microbial activity of the soil with continued application of organic matter
Yield and weed density of Blackgram (Vignamungo (L.) Hepper) as influenced by weed control methods
The study conducted with pre-emergent herbicides alone and with sequential application of post-emergent herbicides at All India Co-ordinated Research Project (AICRP) on Weed management, Gandhi KrishiVignyan Kendra (GKVK), Bangalore in late rabi season of 2013 revealed the predominance of grasses over broad leaved weeds in blackgram. Interculture @ 20 days after sowing (DAS) and hand weeding @ 40 DAS resulted in higher yield (1182 and 5873 kg ha-1 seed and haulm yield, respectively) and least weed density of 41.33 m-2 during harvest. Uncontrolled weed growth recorded maximum population (70.00 m-2). During initial days pendimethalin 30 EC @ 0.75 kg a.i. ha-1 and alachlor 50 EC @ 1.0 kg a.i. ha-1 recorded significantly least weed population of 29.33 m-2at p< 0.05 level of significance. Uncontrolled weed growth resulted in maximum reduction in yield of 65.64 per cent
A comparison of MITS counseling and informed consent processes in Pakistan, India, Bangladesh, Kenya, and Ethiopia
Globally, more than 5 million stillbirths and neonatal deaths occur annually. For many, the cause of death (CoD) is unknown. Minimally invasive tissue sampling (MITS) has been increasingly used in postmortem examinations for ascertaining the CoD in stillbirths and neonates. Our study compared the counseling and consent methods used in MITS projects in five countries in Africa and south Asia. Key informant interviews were conducted with researchers to describe the characteristics and backgrounds of counselors, the environment and timing of consent and perceived facilitators and barriers encountered during the consent process. Counselors at all sites had backgrounds in social science, psychology and counseling or clinical expertise in obstetrics/gynecology or pediatrics. All counsellors received training about techniques for building rapport and offering emotional support to families; training duration and methods differed across sites. Counselling environments varied significantly; some sites allocated a separate room, others counselled families at the bedside or nursing stations. All counsellors had a central role in explaining the MITS procedure to families in their local languages. Most sites did not use visual aids during the process, relying solely on verbal descriptions. In most sites, parents were approached within one hour of death. The time needed for decision making by families varied from a few minutes to 24 h. In most sites, extended family took part in the decision making. Because many parents wanted burial as soon as possible, counsellors ensured that MITS would be conducted promptly after receiving consent. Barriers to consent included decreased comprehension of information due to the emotional and psychological impact of grief. Moreover, having more family members engaged in decision-making increased the complexity of counselling and achieving consensus to consent for the procedure. While each site adapted their approach to fit the context, consistencies and similarities across sites were observed
Refining the Journal Club Presentations of Postgraduate Students in Seven Clinical Departments for Better Evidence‑based Practice
Background: A gap between best practice and actual clinical care exists and this can be overcome by evidence‑based practice (EBP), which is essential to improve the clinical decision making. A strategy to reduce deficits in care provision is to train the postgraduate students in the practice of EBP in the journal clubs as evidence from medical colleges in India reveals that current format of journal club presentations is unsatisfactory. Aim: The aim of the present study was to refine the journal club presentations of postgraduate students of clinical departments and to study the effectiveness of EBP training in them for better EBP. Subjects and Methods: This study was conducted in S. Nijalingappa Medical College, Bagalkot, Karnataka, India, and it was a pre‑ and post‑trial. This study was a pre‑ and post‑trial done during the journal club presentations of postgraduate students from clinical departments. Postgraduate students’ understanding of concepts about EBP was assessed using Fresno test questionnaire in traditional journal club presentation. A hands‑on session incorporating steps of EBP was imparted to them. Soon after the session, each student was assessed. In the next journal club presentation, 1 week later, the students were assessed again with the same questionnaire by the same faculty. Scores of the postgraduate students, before and after intervention (immediate and 1 week later), were compared. Data were analyzed by paired t‑test using SPSS. Results: An increase in mean posttest scores was seen immediately and also 1 week later as compared to the pretest scores. The scores also increased significantly, when each step of EBP was considered. Conclusions: Incorporating teaching of EBP in journal club presentations improved the competencies of postgraduate students in clinical decision making.Keywords: Evidence‑based practice, Journal club, Postgraduate trainin
Guide for monitoring child development in Indian setting
A study to know the prevalence of neurobehavioral developmental delay among children aged three years residing in rural communities of India using Guide for monitoring child development (GMCD). About 530 children at three years were assessed for developmental delay. The GMCD was administered to mothers by a trained interviewer. Prevalence of neurobehavioral developmental delay was estimated and validity of GMCD screening tool was monitored in Indian children. Chi-square test was used to compare categorical variables. Differences were considered significant at
Effect of the CRADLE vital signs alert device intervention on referrals for obstetric haemorrhage in low-middle income countries: a secondary analysis of a stepped- wedge cluster-randomised control trial.
BACKGROUND: Obstetric haemorrhage is the leading cause of maternal death worldwide, 99% of which occur in low and middle income countries. The majority of deaths and adverse events are associated with delays in identifying compromise and escalating care. Management of severely compromised pregnant women may require transfer to tertiary centres for specialised treatment, therefore early recognition is vital for efficient management. The CRADLE vital signs alert device accurately measures blood pressure and heart rate, calculates the shock index (heart rate divided by systolic blood pressure) and alerts the user to compromise through a traffic light system reflecting previously validated shock index thresholds. METHODS: This is a planned secondary analysis of data from the CRADLE-3 trial from ten clusters across Africa, India and Haiti where the device and training package were randomly introduced. Referral data were prospectively collected for a 4-week period before, and a 4-week period 3 months after implementation. Referrals from primary or secondary care facilities to higher level care for any cause were recorded. The denominator was the number of women seen for maternity care in these facilities. RESULTS: Between April 1 2016 and Nov 30th, 2017 536,223 women attended maternity care facilities. Overall, 3.7% (n = 2784/74,828) of women seen in peripheral maternity facilities were referred to higher level care in the control period compared to 4.4% (n = 3212/73,371) in the intervention period (OR 0.89; 0.39-2.05) (data for nine sites that were able to collect denominator). Of these 0.29% (n = 212) pre-intervention and 0.16% (n = 120) post-intervention were referred to higher-level facilities for maternal haemorrhage. Although overall referrals did not significantly reduce there was a significant reduction in referrals for obstetric haemorrhage (OR 0.56 (0.39-0.65) following introduction of the device with homogeneity (i-squared 26.1) between sites. There was no increase in any bleeding-related morbidity (maternal death or emergency hysterectomy). CONCLUSIONS: Referrals for obstetric haemorrhage reduced following implementation of the CRADLE Vital Signs Alert Device, occurring without an increase in maternal death or emergency hysterectomy. This demonstrates the potential benefit of shock index in management pathways for obstetric haemorrhage and targeting limited resources in low- middle- income settings. TRIAL REGISTRATION: This study is registered with the ISRCTN registry, number ISRCTN41244132 (02/02/2016)
Maternal and Newborn Health in Karnataka State, India: The Community Level Interventions for Pre-Eclampsia (CLIP) Trial's Baseline Study Results.
Existing vital health statistics registries in India have been unable to provide reliable estimates of maternal and newborn mortality and morbidity, and region-specific health estimates are essential to the planning and monitoring of health interventions. This study was designed to assess baseline rates as the precursor to a community-based cluster randomized control trial (cRCT)-Community Level Interventions for Pre-eclampsia (CLIP) Trial (NCT01911494; CTRI/2014/01/004352). The objective was to describe baseline demographics and health outcomes prior to initiation of the CLIP trial and to improve knowledge of population-level health, in particular of maternal and neonatal outcomes related to hypertensive disorders of pregnancy, in northern districts the state of Karnataka, India. The prospective population-based survey was conducted in eight clusters in Belgaum and Bagalkot districts in Karnataka State from 2013-2014. Data collection was undertaken by adapting the Maternal and Newborn Health registry platform, developed by the Global Network for Women's and Child Health Studies. Descriptive statistics were completed using SAS and R. During the period of 2013-2014, prospective data was collected on 5,469 pregnant women with an average age of 23.2 (+/-3.3) years. Delivery outcomes were collected from 5,448 completed pregnancies. A majority of the women reported institutional deliveries (96.0%), largely attended by skilled birth attendants. The maternal mortality ratio of 103 (per 100,000 livebirths) was observed during this study, neonatal mortality ratio was 25 per 1,000 livebirths, and perinatal mortality ratio was 50 per 1,000 livebirths. Despite a high number of institutional deliveries, rates of stillbirth were 2.86%. Early enrollment and close follow-up and monitoring procedures established by the Maternal and Newborn Health registry allowed for negligible lost to follow-up. This population-level study provides regional rates of maternal and newborn health in Belgaum and Bagalkot in Karnataka over 2013-14. The mortality ratios and morbidity information can be used in planning interventions and monitoring indicators of effectiveness to inform policy and practice. Comprehensive regional epidemiologic data, such as that provided here, is essential to gauge improvements and challenges in maternal health, as well as track disparities found in rural areas
Looking beyond the numbers: Quality assurance procedures in the global network for women\u27s and children\u27s health research maternal newborn health registry
Background: Quality assurance (QA) is a process that should be an integral part of research to protect the rights and safety of study participants and to reduce the likelihood that the results are affected by bias in data collection. Most QA plans include processes related to study preparation and regulatory compliance, data collection, data analysis and publication of study results. However, little detailed information is available on the specific procedures associated with QA processes to ensure high-quality data in multi-site studies.Methods: The Global Network for Women\u27s and Children\u27s Health Maternal Newborn Health Registy (MNHR) is a prospective population-based registry of pregnancies and deliveries that is carried out in 8 international sites. Since its inception, QA procedures have been utilized to ensure the quality of the data. More recently, a training and certification process was developed to ensure that standardized, scientifically accurate clinical definitions are used consistently across sites. Staff complete a web-based training module that reviews the MNHR study protocol, study forms and clinical definitions developed by MNHR investigators and are certified through a multiple choice examination prior to initiating study activities and every six months thereafter. A standardized procedure for supervision and evaluation of field staff is carried out to ensure that research activites are conducted according to the protocol across all the MNHR sites.Conclusions: We developed standardized QA processes for training, certification and supervision of the MNHR, a multisite research registry. It is expected that these activities, together with ongoing QA processes, will help to further optimize data quality for this protocol
A prospective study of maternal, fetal and neonatal deaths in low- and middle-income countries
Objective: To quantify maternal, fetal and neonatal mortality in low- and middle-income countries, to identify when deaths occur and to identify relationships between maternal deaths and stillbirths and neonatal deaths.Methods: A prospective study of pregnancy outcomes was performed in 106 communities at seven sites in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. Pregnant women were enrolled and followed until six weeks postpartum.Findings: Between 2010 and 2012, 214,070 of 220,235 enrolled women (97.2%) completed follow-up. The maternal mortality ratio was 168 per 100,000 live births, ranging from 69 per 100,000 in Argentina to 316 per 100,000 in Pakistan. Overall, 29% (98/336) of maternal deaths occurred around the time of delivery: most were attributed to haemorrhage (86/336), pre-eclampsia or eclampsia (55/336) or sepsis (39/336). Around 70% (4349/6213) of stillbirths were probably intrapartum; 34% (1804/5230) of neonates died on the day of delivery and 14% (755/5230) died the day after. Stillbirths were more common in women who died than in those alive six weeks postpartum (risk ratio, RR: 9.48; 95% confidence interval, CI: 7.97-11.27), as were perinatal deaths (RR: 4.30; 95% CI: 3.26-5.67) and 7-day (RR: 3.94; 95% CI: 2.74-5.65) and 28-day neonatal deaths (RR: 7.36; 95% CI: 5.54-9.77).Conclusions: Most maternal, fetal and neonatal deaths occurred at or around delivery and were attributed to preventable causes. Maternal death increased the risk of perinatal and neonatal death. Improving obstetric and neonatal care around the time of birth offers the greatest chance of reducing mortality
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