Relation between Stochastic Resonance and Synchronization of Passages in a Double-Well System

We calculate, numerically, the residence times (and their distribution) of a Brownian particle in a two-well system under the action of a periodic, saw-tooth type, external field. We define hysteresis in the system. The hysteresis loop area is shown to be a good measure of synchronization of passages from one well to the other. We establish connection between this stochastic synchronization and stochastic resonance in the system.Comment: To appear in PRE May 1997, figures available on reques

Access to free health-care services for the poor in tertiary hospitals of western Nepal: a descriptive study

Background: Nepal is an underdeveloped country in which half of the total health expenditure is from out-of-pocket payments. Thus, the Government of Nepal introduced universal free health-care services up to the level of district hospitals, and targeted these services to poor and marginalized people in regional and subregional hospitals. The aim of this descriptive study was to explore the implementation and utilization of free health-care services by the target population (poor and marginalized people) in two tertiary-care hospitals in western Nepal, one with a social care unit (Western Regional Hospital) and one without a social care unit (Lumbini Zonal Hospital). Methods: Medical records maintained by the two hospitals for one Nepali calendar year were collected and analysed, along with information from key informant interviews with staff from each hospital and patient exit interviews. Results: Utilization of free health-care services by poor and marginalized people in the two tertiary-care hospitals was suboptimal: only 8.4% of patients using services were exempted from payment in Western Regional Hospital, whereas it was even fewer, at 2.7%, in Lumbini Zonal Hospital. There was also unintended use of services by nontarget people. Qualitative analysis indicated a lack of awareness of free health-care services among clients, and lack of awareness regarding target groups among staff at the hospitals. Importantly, many services were utilized by people from rural areas adjoining the district in which the hospital was situated. Conclusion: Utilization of free health-care services by the target population in the two tertiary-care hospitals was very low. This was the result of poor dissemination of information about the free health-care programme by the hospitals to the target population, and also a lack of knowledge regarding free services and target groups among staff working in these hospitals. Thus, it is imperative to implement educational programmes for hospital staff and for poor and marginalized people. Unintended use of free services was also seen by nontarget groups; this suggests that there should further simplification of the process to identify target groups

Voluntary Counseling and Testing (VCT) services and its role in HIV/AIDS prevention and management in Nepal

HIV/AIDS has emerged as a serious epidemic in Nepal, concentrated amongst the most-at-risk populations. Volun-tary Counseling and Testing (VCT) is a proven strategy for the prevention and management of HIV/AIDS especially in developing countries. Given that the utilization of VCT is low in Nepal, it is important to understand the barriers and challenges that Nepal is facing in the provision and utilization of these services. This study aimed to provide recommendations for policy makers to improve the utilization of VCT services in Nepal. A qualitative study of VCT health service providers and government officials was undertaken in 4 cities of Nepal. Sixteen interviews, three joint interviews and one focus group discussion were conducted, audio recorded and transcribed verbatim. Data were then analyzed using a thematic analysis framework and major themes were identified. Various barriers including socio-cultural issues, geography, the presence of stigma and discrimination faced by people with HIV/AIDS and a lack of knowledge and awareness were identified as important factors limiting the utilization of VCT services. Current gov-ernment efforts to improve VCT service provision, although promising, require ongoing development. Systemic barriers included the sustainability of the temporary NGO VCT services, lack of staff and training, inadequate moni-toring and evaluation and limited access to services for people living in rural areas. To increase the sustainability and utilization of VCT services, the Government can intervene in a number of areas including the integration of VCT services with existing primary health care services and addressing ongoing education and quality assurance

Awareness of order of blood draw among nurses in tertiary care hospital

Background: Phlebotomy or drawing of blood sample is one of the initial steps in processing of samples for various investigations of the patients in clinical laboratory. The sample for various investigation has to follow certain protocol or order of blood draw into different vacutainers by phlebotomist or the clinical person drawing the blood to avoid errors in test results. Hence awareness of order of blood draw among them is very essential.Methods: It is a cross sectional and observational study. Based on CLSI H3-A6 (clinical and laboratory standards institute) guidelines, a questionnaire consisting of 13 multiple choice questions was prepared after validation and distributed amongst the nurses, who were on duty during the study. The answers to the questionnaire were analysed using SPSS version 23. Descriptive statistics was done for all the data collected.Results: Total 120 nurses participated in this study in a tertiary care hospital. Nurses who were able to identify Color of the vacutainer with respective to additives (90%), correct order of draw (52%), volume of blood sample collected in vacutainer (62.9%), sample collected directly into vacutainer with vacuum suction (61.7%) was incomplete. Nurses also had wrong practices, where sample was transferred from one vacutainer to other (3.3%), collected the blood sample from the arm which had IV line (28%).Conclusions: In this study, it was found that awareness on the level of order of blood draw among nurses was found unsatisfactory. Frequent training and monitoring of work practices should be developed for nurses to reduce the errors in sample collection

Aperiodic tumbling of microrods advected in a microchannel flow

We report on an experimental investigation of the tumbling of microrods in the shear flow of a microchannel (40 x 2.5 x 0.4 mm). The rods are 20 to 30 microns long and their diameters are of the order of 1 micron. Images of the centre-of-mass motion and the orientational dynamics of the rods are recorded using a microscope equipped with a CCD camera. A motorised microscope stage is used to track individual rods as they move along the channel. Automated image analysis determines the position and orientation of a tracked rods in each video frame. We find different behaviours, depending on the particle shape, its initial position, and orientation. First, we observe periodic as well as aperiodic tumbling. Second, the data show that different tumbling trajectories exhibit different sensitivities to external perturbations. These observations can be explained by slight asymmetries of the rods. Third we observe that after some time, initially periodic trajectories lose their phase. We attribute this to drift of the centre of mass of the rod from one to another stream line of the channel flow.Comment: 14 pages, 8 figures, as accepted for publicatio

An assessment of mechanical behavior of environmentally conditioned fibre reinforced polymer composites

Fibre reinforced polymer(FRP) composites are one of the most commonly used materials due to their adaptability to diverse environmental conditions and the comparative ease of combination with different materials to perform definite purposes and reveal advantageous properties. The components made up of fibre reinforced polymeric composites are exposed to temperature variations (thermal shock, thermal spike, low temperature environment, high temperature environment, freeze thaw), humidity variations, UV radiation and often the combined exposure of these environments leads to more detrimental effect on the performance of the composites during fabrication, in-service time and storage. Further, rate of loading can significantly change the mode of failure. The present experimental investigation deals with the mechanical behavior of FRP composites exposed at low temperature and thermal spiking conditioning with different loading rate and holding time. The glass/epoxy samples are exposed to ambient temperature, -20 °C, -40 °C and -60 °C temperatures and tested in 3-point bending test at 1, 10, 100, 300, 600, 1000 mm/min loading rates. Also, the thermal spike conditioning of glass/epoxy and carbon/epoxy samples were carried out at 50 °C, 100 °C, 150 °C, and 200 °C temperatures for a holding time of 5, 10, 15 and 20 minutes respectively and then tested for the interlaminar shear strength (ILSS) assessment in short beam shear (SBS) test at 1,100, 200, 700 and 1000 mm/min loading rates. Scanning electron microscopy (SEM) analysis was performed to identify various degradation mechanisms in fractured samples. Also, DSC measurement have been done to evaluate the glass transition temperature (Tg) is very important because it calculates the critical service temperature of the polymer composites. From FTIR analysis it is further confirmed that these environmental conditionings affects the bonding characteristics of the polymeric composites