11 research outputs found
Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial
Of Land and Spirit: Reciprocity and Ritual in Land Stewardship
Across the U.S., queer and trans Black, Indigenous, and people of color are choosing to live communally in sub-rural landscapes. In doing so they are divesting from limiting socio-political and economic structures and modeling a liberatory existence, not limited to surviving the present but intending to thrive generations to come.
This thesis builds on their vision and considers how to design residential and retreat spaces rooted in an interdependence with the land and other species. It considers human-non-human entanglements as a key to living in right relationship to the lands we occupy and understanding our sacred roles as land stewards. And further invites the sacred into our dwellings, imbibing ritual, cosmology, and symbolism into our daily lives that keeps us thriving.
It uses the precedents of maroons and community land trusts as models of land stewardship that co-created futures in symbiotic relationships with the land and other species. And offers a thoughtful design tailored for an existing Afro-Indigenous land stewardship in the Blue Ridge mountains of Appalachia to be in reciprocity with plant, animal, and mineral species. The design will focus on the adaptive reuse of two barns on the site, new emergent structures, and new housing
Die Bedeutung informeller Institutionen für die Leistungsfähigkeit der Wasserpolitik: Ungleichheit und Korruption in der Megacity Delhi, Indien
Delhi, which is known as a city of migrants has suffered from non-uniform
water distribution. The poor have been hit the hardest by this situation. A
significant percentage of the population in Delhi is not served with an
adequate supply of water on a regular basis. The water distribution system of
Delhi is characterized by a high degree of inequality. This is tied to the
country’s caste system which was established thousands of years ago. The power
structure that resides in the caste system can be seen in economics and
politics. The wealthy and politically strong are the most influential. The
exclusion of members of the lower caste by the so-called upper castes produces
exploitative institutions and a maldistribution of resources, and feeds
corruption in society. This study is based on a comprehensive examination of
the class structure of the city and analyses urban water governance
performance in Delhi. The research question guiding the study is: Why has
water governance in Delhi not been effective in providing basic water services
to the inhabitants of Delhi? The dissertation argues that for decades water
governance policy was not working effectively because of its failure to
identify and address various risks. These risks are caused by a combination of
various factors, including haphazard urban planning, the authorities’ lack of
capabilities to cope with the changes caused by this haphazard planning, old
and outdated laws, lack of clarity among various laws and lack of political
will to achieve the goals prescribed in policies. The study is based on the
theoretical concepts of historical institutionalism and path-dependence. The
influence and stickiness of informal institutions and their significance for
water governance in the city were examined. The informal institutional
analysis undertaken for this research is conducted from a historical
dependency perspective. Old religious values and social norms have great
influence on water governance. These religious values and social norms shape
societal patterns and cultural traditions. As they are deeply embedded in the
social system, new and independent institutional patterns are slow to emerge.
Institutional change is a slow process. To answer the research question, a
research design based on an analysis of secondary literature and primary data
collection was followed. Data was collected from interviews and household
surveys at different locations in Delhi. The case study regions are two
economically distinct but closely situated residential colonies. In this
dissertation, the proxy indicator method is utilized to analyze the different
building blocks of good governance such as transparency, accountability and
participation. These proxies give impressions about the presence of corruption
in the water supply chain in the city. There are multiple dimensions to water,
including physical, chemical and economic. Yet, here it is concluded that
Delhi’s water problems are largely governance-related problems; that, is they
can be solved. Poor water governance leads to social crisis as poor water
quality hits the city’s poor and marginalized population the hardest. It is
the poor who can least afford water and end up paying higher prices than those
having official water connections. The discrimination against the poor in
society has created an environment in which corruption thrives, including in
the water sector. Corruption tends to expand existing inequalities. The
results from the study indicate that Delhi’s water crisis is highly influenced
by the caste system which although outlawed is de facto still in practice in
India and rampant corruption. The caste system and other religious and
cultural values are major obstacles to good water governance. The Indian
government may have plans in the form of policies and laws to address
inequality and corruption, but it fails to achieve desired outcomes because of
weak enforcement and implementation. Politicians have ignored major problems
of public interest such as resolving the issues of provision to water, housing
and electricity, as they are more interested in winning the next elections
with same promises. The study shows there is a great need to build citizen’s
capacities to understand related laws and awareness on their rights, to engage
them in the process of decision making. The study also shows need to develop
tools for better transparency and accountability to enhance coordination and
cooperation among various government departments working to address the city’s
water problems. The study suggests that one possible path to change is from
the people. If social movements were to demand equal treatment and clean and
transparent government practices, conditions in the water sector might
improve. The 2015 election in Delhi may suggest that a step in this direction
has been taken and people have voted a new party into power. Social movements
can demand more effective governance. Social movements can serve as a basis
for effective action by means of which political changes and the
implementation of constitutionally anchored equity laws can be driven forward.Delhi, bekannt für den hohen Migrantenanteil seiner Bevölkerung, leidet unter
der ungleichmäßigen Wasserverteilung. Die Armen trifft diese Situation am
härtesten. Ein signifikanter Prozentsatz der Bevölkerung Delhis erhält keine
regelmäßige adäquate Wasserversorgung. Das Wasserverteilungssystem von Delhi
kennzeichnet ein hoher Grad an Ungleichheit. Dies hängt mit dem Kastensystem
des Landes zusammen, das sich vor tausenden von Jahren etabliert hat. Die dem
Kastensystem innewohnenden Machtstrukturen zeigen sich in Wirtschaft und
Politik. Wohlhabende und politisch starke Personen sind am einflussreichsten.
Der Ausschluss von Mitgliedern der unteren Kaste seitens der sogenannten
höheren Kasten schafft ausbeuterische Institutionen und eine ungleiche
Ressourcenverteilung, und nährt die Korruption in der Gesellschaft. Diese
Studie basiert auf einer vergleichenden Untersuchung der Klassenstruktur
Delhis und analysiert die Leistung der Wasserpolitik der Stadt. Ihre Leitfrage
lautet: Warum konnte die Wasserpolitik in Delhi eine grundlegende
Wasserversorgung der Einwohner nicht sicherstellen? Diese Dissertation
argumentiert, dass die Wasserpolitik ĂĽber Jahrzehnte ineffizient blieb, weil
sie verschiedene Risiken nicht erkannte. Diese Risiken entstehen durch die
Kombination verschiedener Faktoren: willkĂĽrliche Stadtplanung, verbunden mit
dem Unvermögen der Behörden, diesen Veränderungen gerecht zu werden, alte und
unzeitgemäße Gesetze, Unklarheiten im Verhältnis verschiedener Gesetze
zueinander sowie das Fehlen des politischen Willens, die von der Politik
selbst gesetzten Ziele auch zu erreichen. Die Studie basiert auf dem
theoretischen Konzept des historischen Institutionalismus und der
Pfadabhängigkeit. Sie analysiert den Einfluss und die feste Verwurzelung
informeller Institutionen und ihre Bedeutung fĂĽr die Wasserpolitik in der
Stadt. Dabei nimmt sie die Perspektive der historischen Abhängigkeit ein.
Althergebrachte religiöse Werte und soziale Normen haben großen Einfluss auf
die Wasserpolitik. Sie prägen gesellschaftliche Mustern und kulturelle
Traditionen und sind tief im sozialen System verwurzelt. Neuere und
unabhängige Institutionen sind hingegen erst noch im Entstehen, da
institutioneller Wandel ein langsamer Prozess ist. Zur Beantwortung der
Forschungsfrage diente ein auf der Analyse von Sekundärliteratur und
Primärdatenerhebung basierendes Forschungsdesign. Die Primärdatenerhebung
umfasste Interviews und Haushaltsbefragungen an verschiedenen Orten in Delhi.
Die als Fallstudien ausgewählten Stadtviertel sind zwei wirtschaftlich
unterschiedlich situierte, aber benachbarte Wohnsiedlungen. Zur Analyse der
verschiedenen Aspekte guter RegierungsfĂĽhrung wie Transparenz, Verantwortung
und Partizipation wurde die Proxy-Indikator-Methode verwendet. Proxy-
Indikatoren geben Einblick in das Auftreten von Korruption entlang der
Wasserversorgungskette der Stadt. Wasser hat zahlreiche Dimensionen, darunter
eine physische, chemische und ökonomische. Nichtsdestoweniger schlussfolgert
die Studie, dass Delhis Wasserprobleme eigentlich Probleme der Wasserpolitik
sind, d.h. sie könnten politisch gelöst werden. Da schlechte Wasserqualität
die Armen und Marginalisierten der Stadt am härtesten trifft, führt schlechte
Wasserpolitik zur sozialen Krise. Es sind die Armen, die sich hohe
Wasserpreise am wenigsten leisten können und schlussendlich mehr zahlen müssen
als diejenigen, die über reguläre Wasseranschlüsse verfügen. Die
Diskriminierung der Armen in der Gesellschaft hat eine Umgebung geschaffen, in
der Korruption gedeiht – so auch im Wassersektor. Korruption neigt dazu,
bestehende Ungleichheiten zu vergrößern. Die Studienergebnisse zeigen, dass
Delhis Wasserkrise stark vom Kastensystem und der ungezĂĽgelten Korruption
beeinflusst ist. Das Kastensystem und andere religiöse und kulturelle Werte
sind wesentliche Hindernisse fĂĽr gute Wasserpolitik. Die indische Regierung
beabsichtigt zwar mit verschiedenen Politiken und Gesetzen, Ungleichheit und
Korruption zu verringern, aufgrund von Schwächen im Vollzug und in der
Umsetzung kann sie jedoch die erwĂĽnschten Ergebnisse nicht erreichen.
Politiker haben zentrale Probleme des öffentlichen Interesses wie
Wasserversorgung, Wohnen und Elektrizität vernachlässigt, um stattdessen den
nächsten Wahlkampf mit ebensolchen Versprechen zu bestreiten. Die Studie
zeigt, dass ein großer Bedarf besteht, die Bürger zu befähigen, die
einschlägigen Gesetze zu verstehen und sich ihrer Rechte bewusst zu werden, um
sie so auch am Entscheidungsprozess zu beteiligen. Die Studie verweist
auĂźerdem auf die Notwendigkeit, Mechanismen fĂĽr eine verbesserte Transparenz
und Rechenschaftspflicht zu entwicklen, um sow die Koordination und
Kooperation zwischen verschiedenen, an der Lösung der Wasserkrise beteiligten
Regierungsressorts zu verbessern. Der Studie zufolge könnte ein Wandel auch
von der Bevölkerung selbst ausgehen. Würden soziale Bewegungen eine
Gleichbehandlung sowie saubere und transparente Regierungspraktiken
einfordern, könnten sich die Bedingungen der Wasserversorgung verbessern. Die
Wahlen in Delhi in 2015 legen nahe, dass ein Schritt in diese Richtung getan
wurde, indem die Bevölkerung eine neue Partei in die Regierung wählte. Soziale
Bewegungen können als Basis für effektive Aktionen dienen, um politische
Veränderungen sowie die Durchsetzung verfassungsmäßig verankerter Gesetzen zur
Verteilungsgerechtigkeit voranzutreiben
Antibacterial efficacy of silver nanoparticles (AgNPs) against metallo-β-lactamase and extended spectrum β-lactamase producing clinically procured isolates of Pseudomonas aeruginosa
Abstract Resistance to carbapenems is a global threat, especially in developing countries with limited health resources. Prevalence, antibiogram, PCR detection of antibiotic resistance genes, and potency of Silver Nanoparticles (AgNPs) against multidrug-resistant (MDR) Pseudomonas aeruginosa were studied. Kirby-Bauer disc method and PCR were used to study antibiogram and drug resistance genes respectively in 255 isolates of Pseudomonas aeruginosa obtained from a tertiary care hospital. Silver nitrate (AgNO3) precursor salts were reacted with Aspergillus flavus culture filtrate to trigger the extracellular mycosynthesis of AgNPs. Mycosynthesis was first monitored regularly by visible ultraviolet spectroscopy that recorded AgNP peaks of approximately 400–470 nm. Confirmation by Transmission electron micrographs provided confirmation of AgNPs formed within a range of 5–30 nm. Individual and combined antibacterial activity of ten antibiotics and AgNPs was analyzed. Pearson correlation coefficients (r) were calculated for phenotypic and genotypic multidrug resistance. Data were evaluated using SPSS version 20. p-value  amikacin + AgNPs (25 mm) > aztreonam + AgNPs (23 mm) > meropenem + AgNPs (22 mm) > imipenem + AgNPs (20 mm) > gentamycin + AgNPs (17 mm) > ciprofloxacin + AgNPs (16 mm) > cefoperazone/sulbactam + AgNPs (14 mm) ≥ ceftazidime + AgNPs (14 mm). The conjugated effect of AgNPs plus antibiotics showed a 0.15–3.51 (average of 2.09) fold-area augmentation of antimicrobial activity. AgNPs conjugated with antibiotics effectively inhibited MDR Pseudomonas aeruginosa. To the best of our understanding, this is an inaugural report from Punjab Pakistan enlisting co-expression of Metallo-β-lactamases, extended-spectrum β-lactamases, and AmpC-β-lactamase plus activity of antibiotic-AgNPs
Efficacy of Sodium-Glucose Cotransporter-2 inhibitors in heart failure patients treated with dual angiotensin receptor blocker-neprilysin inhibitor: an updated meta-analysis
Background: Recent data suggest that the prevalence of heart failure has increased to approximately 23 million people globally. With increasing advancement in pharmacotherapeutics, Sodium-Glucose Cotransporter-2 inhibitors (SGLT2i) have garnered attention among clinicians to treat Heart failure with reduced ejection fraction (HFrEF) in diabetic as well as non-diabetic patients.
Methods: MEDLINE, Scopus, Embase and Cochrane CENTRAL database were searched using relevant keywords and MeSH terms. Studies were considered only if they were randomized in nature and had a sample size >1000 HF patients.
Results: Our comprehensive search strategy yielded 864 articles, of which three RCTs met the inclusion criteria with a total population of 9696. Pooled analysis revealed an association between the use of SGLT2i and decreased frequency of primary outcome irrespective of background ARNI use (HR 0.73, 95% CI [0.58-0.93], p = 0.0106; HR 0.73, 95% CI [0.66-0.81], p
Conclusion: This meta-analysis provides substantial evidence, to safely use SGLT2i atop ARNI therapy in select HF patients to further improve outcomes.</p
Bioclimatic Design: Research at Assateague State Park
Final project for ARCH600/611: Urban Studies and Planning Studio (Fall 2021). University of Maryland, College Park.Through their work with the National Center for Smart Growth at the University of Maryland (UMD), the Maryland Department of Natural Resources commissioned this report from the university’s Partnership for Action Learning in Sustainability (PALS). This research study,
conducted in a graduate level
design studio, began
with a shared vision that
people and nature can
co-exist in a mutually
beneficial relationship. Angela Baldwin, Park Manager at
Assateague State Park, and her colleagues
from NOAA, the Maryland Park Service,
the Chesapeake Coastal Service, and other
DNR offices, challenged the University
of Maryland team to test this vision in
the design of a new day use facility for
Assateague State Park, a much-beloved,
special place that is increasingly vulnerable
to the effects of climate change.
The climate crisis requires architects to
deepen their understanding of resilient
design strategies. These range from place-based
climate-responsive knowledge rarely taught in
schools of architecture, to more technically advanced
tools such as computer energy modeling, efficient
mechanical equipment and on-site renewable energy.Maryland Department of Natural Resources (MDNR