Master of Science

thesisIn today's fast growing world of health care, the volume of drug information needed to provide competent care to patients is overwhelming. On average, health care professionals have two informational needs for every three patients seen which are either related to diagnosis or treatment. Therefore, seeking appropriate drug information to answer these informational needs is an important and valuable element of health care. Drug information can be obtained from different sources. Traditional sources like books, journals, meeting with colleagues, physicians' desk reference (PDR) or modern sources like the Internet (Google, Wikipedia), medical databases and medical literature indices. The information so obtained from these sources helps health care professionals to fill the gap in knowledge on new drugs and improve patient care. Therefore, the purpose of this study is (1) to identify health care professionals (HCPs) reported frequencies of use for different drug information sources in the University of Utah Community Clinics to obtain drug information (2) to descriptively find out of if there existed a difference between clinicians and pharmacists in their drug information seeking behaviors. The study design was cross-sectional and utilized a survey questionnaire to capture the drug information-seeking behaviors among health care professionals The Mission Based Survey Management tool was used to send out the surveys. iv The survey response rate was 55%. Clinicians most frequently reported to use drug information databases (46%) followed by personal digital assistants (PDAs) (23%) and electronic sources (18%) while pharmacists most frequently reported to use drug information databases (78%) followed by electronic sources (28%) and medical literature indices (19%). Clinicians were more likely to use PDAs to access drug information than pharmacists which could be due to portability and easier access to drug information via PDAs at point of care. Based on the results obtained from the study, it is reasonable to conclude that when clinicians and pharmacists were given a wide range of sources to choose from to seek drug information, most clinicians and pharmacist preferred to use drug information databases to obtain new drug information as compared to the traditional sources like books, journals and colleagues. Modern and improved technological sources of drug information have taken the place of traditional sources of drug information, reducing health care professionals' trips to the library or to the printed medical journals and books, eventually improving patient care

What do we perceive in a glance of a real-world scene?

What do we see when we glance at a natural scene and how does it change as the glance becomes longer? We asked naive subjects to report in a free-form format what they saw when looking at briefly presented real-life photographs. Our subjects received no specific information as to the content of each stimulus. Thus, our paradigm differs from previous studies where subjects were cued before a picture was presented and/or were probed with multiple-choice questions. In the first stage, 90 novel grayscale photographs were foveally shown to a group of 22 native-English-speaking subjects. The presentation time was chosen at random from a set of seven possible times (from 27 to 500 ms). A perceptual mask followed each photograph immediately. After each presentation, subjects reported what they had just seen as completely and truthfully as possible. In the second stage, another group of naive individuals was instructed to score each of the descriptions produced by the subjects in the first stage. Individual scores were assigned to more than a hundred different attributes. We show that within a single glance, much object- and scene-level information is perceived by human subjects. The richness of our perception, though, seems asymmetrical. Subjects tend to have a propensity toward perceiving natural scenes as being outdoor rather than indoor. The reporting of sensory- or feature-level information of a scene (such as shading and shape) consistently precedes the reporting of the semantic-level information. But once subjects recognize more semantic-level components of a scene, there is little evidence suggesting any bias toward either scene-level or object-level recognition

Human Posterior Parietal Cortex Plans Where to Reach and What to Avoid

In this time-resolved functional magnetic resonance imaging (fMRI) study, we aimed to trace the neuronal correlates of covert planning processes that precede visually guided motor behavior. Specifically, we asked whether human posterior parietal cortex has prospective planning activity that can be distinguished from activity related to retrospective visual memory and attention. Although various electrophysiological studies in monkeys have demonstrated such motor planning at the level of parietal neurons, comparatively little support is provided by recent human imaging experiments. Rather, a majority of experiments highlights a role of human posterior parietal cortex in visual working memory and attention. We thus sought to establish a clear separation of visual memory and attention from processes related to the planning of goal-directed motor behaviors. To this end, we compared delayed-response tasks with identical mnemonic and attentional demands but varying degrees of motor planning. Subjects memorized multiple target locations, and in a random subset of trials targets additionally instructed (1) desired goals or (2) undesired goals for upcoming finger reaches. Compared with the memory/attention-only conditions, both latter situations led to a specific increase of preparatory fMRI activity in posterior parietal and dorsal premotor cortex. Thus, posterior parietal cortex has prospective plans for upcoming behaviors while considering both types of targets relevant for action: those to be acquired and those to be avoided

Space representation for eye movements is more contralateral in monkeys than in humans

Contralateral hemispheric representation of sensory inputs (the right visual hemifield in the left hemisphere and vice versa) is a fundamental feature of primate sensorimotor organization, in particular the visuomotor system. However, many higher-order cognitive functions in humans show an asymmetric hemispheric lateralization—e.g., right brain specialization for spatial processing—necessitating a convergence of information from both hemifields. Electrophysiological studies in monkeys and functional imaging in humans have investigated space and action representations at different stages of visuospatial processing, but the transition from contralateral to unified global spatial encoding and the relationship between these encoding schemes and functional lateralization are not fully understood. Moreover, the integration of data across monkeys and humans and elucidation of interspecies homologies is hindered, because divergent findings may reflect actual species differences or arise from discrepancies in techniques and measured signals (electrophysiology vs. imaging). Here, we directly compared spatial cue and memory representations for action planning in monkeys and humans using event-related functional MRI during a working-memory oculomotor task. In monkeys, cue and memory-delay period activity in the frontal, parietal, and temporal regions was strongly contralateral. In putative human functional homologs, the contralaterality was significantly weaker, and the asymmetry between the hemispheres was stronger. These results suggest an inverse relationship between contralaterality and lateralization and elucidate similarities and differences in human and macaque cortical circuits subserving spatial awareness and oculomotor goal-directed actions

Multilingualism and bilingualism for language teachers

A language teacher, if not all teachers, can work successfully with two or even more languages. In many CBSE schools including the Kendriya Vidyalayas, English is the medium of education, therefore, it seems only pedagogically desirable and psychologically advantageous for both the students and the teachers to work with English as well as the other languages being taught in the school or represented among the children. Unless a teacher treats the languages of the children as a resource, she may not be able to understand their output, and may not be pedagogically very effective

Gendered health systems biased against maternal survival : preliminary findings from Koppal, Karnataka, India

In this paper we outline the context of pregnant women’s lives and the plural health systems they encounter in Koppal, the most deprived district in the state of Karnataka, south India. We combine preliminary survey findings with qualitative work to illustrate the dynamics involved in seeking and receiving obstetric care. Despite high levels of poverty and scarce resources supporting primary health care in the region, women with obstetric complications do access a range of health providers. Yet they still die. Although addressing the technical and managerial capacity constraints to ensuring equitable access to emergency obstetric care is essential, we argue that maternal well-being and survival cannot be effectively ensured without confronting the gender biases that also constrain health systems from supporting women’s health and saving women’s lives. We analyse these biases as failures in acknowledgement and accountability for pregnant women’s needs and conclude with strategic steps to effectively respond to the situation that encompass technical, managerial and political action. Keywords: maternal health, maternal mortality, plural health systems, gender bias, acknowledgement, accountability

Components of bottom-up gaze allocation in natural images

Recent research [Parkhurst, D., Law, K., & Niebur, E., 2002. Modeling the role of salience in the allocation of overt visual attention. Vision Research 42 (1) (2002) 107–123] showed that a model of bottom-up visual attention can account in part for the spatial locations fixated by humans while free-viewing complex natural and artificial scenes. That study used a definition of salience based on local detectors with coarse global surround inhibition. Here, we use a similar framework to investigate the roles of several types of non-linear interactions known to exist in visual cortex, and of eccentricity-dependent processing. For each of these, we added a component to the salience model, including richer interactions among orientation-tuned units, both at spatial short range (for clutter reduction) and long range (for contour facilitation), and a detailed model of eccentricity-dependent changes in visual processing. Subjects free-viewed naturalistic and artificial images while their eye movements were recorded, and the resulting fixation locations were compared with the models’ predicted salience maps. We found that the proposed interactions indeed play a significant role in the spatiotemporal deployment of attention in natural scenes; about half of the observed inter-subject variance can be explained by these different models. This suggests that attentional guidance does not depend solely on local visual features, but must also include the effects of interactions among features. As models of these interactions become more accurate in predicting behaviorally-relevant salient locations, they become useful to a range of applications in computer vision and human-machine interface design

Unfree markets: socially embedded informal health providers in

a b s t r a c t The dynamics of informal health markets in marginalised regions are relevant to policy discourse in India, but are poorly understood. We examine how informal health markets operate from the viewpoint of informal providers (those without any government-recognised medical degrees, otherwise known as RMPs) by drawing upon data from a household survey in 2002, a provider census in 2004 and ongoing field observations from a research site in Koppal district, Karnataka, India. We find that despite their illegality, RMPs depend on government and private providers for their training and referral networks. Buffeted by unregulated market pressures, RMPs are driven to provide allopathic commodities regardless of need, but can also be circumspect in their practice. Though motivated by profit, their socially embedded practice at community level at times undermines their ability to ensure payment of fees for their services. In addition, RMPs feel that communities can threaten them via violence or malicious rumours, leading them to seek political favour and social protection from village elites and elected representatives. RMPs operate within negotiated quid pro quo bargains that lead to tenuous reciprocity or fragile trust between them and the communities in which they practise. In the context of this 'unfree' market, some RMPs reported being more embedded in health systems, more responsive to communities and more vulnerable to unregulated market pressures than others. Understanding the heterogeneity, nuanced motivations and the embedded social relations that mark informal providers in the health systems, markets and communities they work in, is critical for health system reforms

Space representation for eye movements is more contralateral in monkeys than in humans

Contralateral hemispheric representation of sensory inputs (the right visual hemifield in the left hemisphere and vice versa) is a fundamental feature of primate sensorimotor organization, in particular the visuomotor system. However, many higher-order cognitive functions in humans show an asymmetric hemispheric lateralization—e.g., right brain specialization for spatial processing—necessitating a convergence of information from both hemifields. Electrophysiological studies in monkeys and functional imaging in humans have investigated space and action representations at different stages of visuospatial processing, but the transition from contralateral to unified global spatial encoding and the relationship between these encoding schemes and functional lateralization are not fully understood. Moreover, the integration of data across monkeys and humans and elucidation of interspecies homologies is hindered, because divergent findings may reflect actual species differences or arise from discrepancies in techniques and measured signals (electrophysiology vs. imaging). Here, we directly compared spatial cue and memory representations for action planning in monkeys and humans using event-related functional MRI during a working-memory oculomotor task. In monkeys, cue and memory-delay period activity in the frontal, parietal, and temporal regions was strongly contralateral. In putative human functional homologs, the contralaterality was significantly weaker, and the asymmetry between the hemispheres was stronger. These results suggest an inverse relationship between contralaterality and lateralization and elucidate similarities and differences in human and macaque cortical circuits subserving spatial awareness and oculomotor goal-directed actions

Motor Preparatory Activity in Posterior Parietal Cortex is Modulated by Subjective Absolute Value

For optimal response selection, the consequences associated with behavioral success or failure must be appraised. To determine how monetary consequences influence the neural representations of motor preparation, human brain activity was scanned with fMRI while subjects performed a complex spatial visuomotor task. At the beginning of each trial, reward context cues indicated the potential gain and loss imposed for correct or incorrect trial completion. FMRI-activity in canonical reward structures reflected the expected value related to the context. In contrast, motor preparatory activity in posterior parietal and premotor cortex peaked in high “absolute value” (high gain or loss) conditions: being highest for large gains in subjects who believed they performed well while being highest for large losses in those who believed they performed poorly. These results suggest that the neural activity preceding goal-directed actions incorporates the absolute value of that action, predicated upon subjective, rather than objective, estimates of one's performance