Socialization, legitimation and the transfer of biomedical knowledge to low- and middle-income countries: analyzing the case of emergency medicine in India

BACKGROUND: Medical specialization is a key feature of biomedicine, and is a growing, but weakly understood aspect of health systems in many low- and middle-income countries (LMICs), including India. Emergency medicine is an example of a medical specialty that has been promoted in India by several high-income country stakeholders, including the Indian diaspora, through transnational and institutional partnerships. Despite the rapid evolution of emergency medicine in comparison to other specialties, this specialty has seen fragmentation in the stakeholder network and divergent training and policy objectives. Few empirical studies have examined the influence of stakeholders from high-income countries broadly, or of diasporas specifically, in transferring knowledge of medical specialization to LMICs. Using the concepts of socialization and legitimation, our goal is to examine the transfer of medical knowledge from high-income countries to LMICs through domestic, diasporic and foreign stakeholders, and the perceived impact of this knowledge on shaping health priorities in India. METHODS: This analysis was conducted as part of a broader study on the development of emergency medicine in India. We designed a qualitative case study focused on the early 1990s until 2015, analyzing data from in-depth interviewing (n = 87), document review (n = 248), and non-participant observation of conferences and meetings (n = 6). RESULTS: From the early 1990s, domestic stakeholders with exposure to emergency medicine in high-income countries began to establish Emergency Departments and initiate specialist training in the field. Their efforts were amplified by the active legitimation of emergency medicine by diasporic and foreign stakeholders, who formed transnational partnerships with domestic stakeholders and organized conferences, training programs and other activities to promote the field in India. However, despite a broad commitment to expanding specialist training, the network of domestic, diasporic and foreign stakeholders was highly fragmented, resulting in myriad unstandardized postgraduate training programs and duplicative policy agendas. Further, the focus in this time period was largely on training specialists, resulting in more emphasis on a medicalized, tertiary-level form of care. CONCLUSIONS: This analysis reveals the complexities of the roles and dynamics of domestic, diasporic and foreign stakeholders in the evolution of emergency medicine in India. More research and critical analyses are required to explore the transfer of medical knowledge, such as other medical specialties, models of clinical care, and medical technologies, from high-income countries to India

Not Available

Not AvailableRice is an important staple food crop and primary diet source for majority of the world’s population. However, biotic stress such as Sheath blight (ShB) is one of major disease which effects 50-60% yield loss. ShB disease is mainly caused by Rhizoctonia solani, however, no rice cultivar has been found to be completely tolerance. We developed the BPT5204 mutant lines through EMS method. The mutant lines (BPT5204) were screened through detached leaf method (Dath 1987) under standard glass house conditions and the protocol was standardized in ICAR-IIRR. After 72hrs of infection, the lesion length of each cut leaf was measured and according to tolerance we scored 0-9 scale. We observed that 13 out of 40 were showed tolerance against sheath blight. ShB-1, ShB-5, ShB-11, ShB-12, ShB-13 (score-0) lines were showed highly tolerance, ShB-2 and ShB-8 (score 1-8) were moderately tolerant, wild type (BPT5204) was complete susceptible (scores up to 9). Therefore, this standardized detached leaf assay can be used to assess against sheath blight disease.Council for scientific and industrial research, Government of India, New Delh

Not Available

Not AvailableSamba Mahsuri (BPT5204) is a medium slender rice variety highly popular among the farmers in South and Eastern India. It is one of the best Rice varieties with good cooking quality. The yield of BPT 5204 is 6-6.5 tons/ha, even though it is showing maximum susceptibility to many biotic stresses and exhibits incomplete panicle emergence, this make it an ideal genotype for identifying mutational changes in traits of agronomic importance. To obtain agronomical important traits mutation breeding plays an important role. Mutagenesis plays key role among these genetic resources, mutant stocks with discrete genetic lesions are essential to determining gene function and dissecting biochemical and metabolic pathways. Chemical mutagenesis has been routinely used to generate genetic variability for breeding research and genetic studies. In rice, there are several advantages of using chemical mutagenesis to produce mutant populations suitable for both forward and reverse genetics. First, mutant populations can be produced using any genotypes. Second, because of the high density of mutations, genome-wide saturation mutagenesis can be achieved using a relatively small mutant population [1, 2]. Third, it provides a large allelic series as a complement to the knockout mutants produced by insertional mutagenesis or transformation methods (over- and under-expression) [3-6]. Morphological variations including grain types, maturity and traits contributing to yield are observed in every generation. In present study, observed the agro-morphological variations in the BPT-5204 sheath blight tolerant mutants which developed through chemical mutagen EMS (Ethyl Methane Sulfonate) [7].o Council for scientific and industrial research, Government of India, New Delh