Motivating knowledge agents : can incentive pay overcome social distance?

This paper studies the interaction of incentive pay and social distance in the dissemination of information. We analyse theoretically as well as empirically the e ect of incentive pay when agents have pro-social objectives, but also preferences over dealing with one social group relative to another. In a randomised eld experiment undertaken across 151 villages in South India, local agents were hired to spread information about a public health insurance programme. Relative to at pay, incentive pay improves knowledge transmission to households that are socially distant from the agent, but not to households similar to the agent

IMPLEMENTING HEALTH INSURANCE FOR THE POOR: THE ROLLOUT OF RSBY IN KARNATAKA

The National Health Insurance Scheme (Rashtriya Swasthya Bima Yojana, RSBY) aims to improve poor people's access to quality health care in India. This paper looks at the implementation of the scheme in Karnataka, drawing on a large survey of eligible households and interviews with empanelled hospitals in the state. Six months after initiation, an impressive 85% of eligible households in the sample were aware of the scheme, and 68% had been enrolled. However, the scheme was hardly operational and utilisation was virtually zero. A large proportion of beneficiaries were yet to receive their cards, and many did not know how and where to obtain treatment under the scheme. Moreover, hospitals were not ready to treat RSBY patients. Surveyed hospitals complained of a lack of training and delays in the reimbursement of their expenses. Many were refusing to treat patients under the scheme until the issues were resolved, and others were asking cardholders to pay cash. As is typical for the implementation of a government scheme, many of the problems discussed can be related to a misalignment of incentives.

PRESCRIBING PATTERN OF ANTIHYPERTENSIVE DRUGS BASED ON COMPELLING INDICATIONS WITH HYPERTENSION

Objective: The aim of the study is to assess the various prescribing patterns in hypertension with different compelling indications.Methods: It is a prospective observational study and carried out for a period of 1 y from Feb-2014 to Feb-2015. All the required data was collected from patients through personal interview and prescriptions. The data collected from the participants was entered into Microsoft excel spreadsheet and descriptive statistics were used. The mean and standard deviation (SD) were calculated.Results: A total of 394 hypertensive patients with different comorbidities were included in which 251(63.70%) males and 143(36.29%) females were present with a mean (SD) age of 59.21±1.54. The most commonly reported first three co-morbidities along with hypertension were diabetes mellitus 191 (48.47%), stroke accounts for 57 (14.46%) and coronary artery disease in 32 (8.12%). Monotherapy was given in almost 200 (50.76%) patients and dual drug therapy was indicated in 166 (42.13%) patients, triple therapy was used only in 24 (6.09%) patients in the total sample size. Quadruple therapy is the least preferred combination therapy accounts only in 4 (1.01%) patients.Conclusion: We conclude that calcium channel blockers and angiotensin II receptor blockers were the most commonly prescribed class of drugs either alone or in combination with other class of drugs for effective control of blood pressure patients with different compelling indications. Monotherapy was preferred than combination therapy.Â

Echocardiographic assessment of Left Atrial Appendage function in patients with Mitral Stenosis by Tissue Doppler Velocity Imaging.

Introduction Rheumatic heart disease is one of the commonest cardiac conditions in India in both children and adults, accounting for 30 - 40% of cardiac cases admitted in hospital. Approximately 25% of all patients with rheumatic heart disease have pure or predominant mitral stenosis (MS). Thromboembolism develops in atleast 20% of mitral stenosis patients, at sometime during the course of their disease. Thromboembolism remains an important cause of morbidity and mortality in rheumatic MS. Echocardiography is the widely used method for detecting left atrial and left atrial appendage thrombi. Trans thoracic echocardiography (TTE) is only 50% sensitive in detecting LA and LAA thrombi.Transesophageal echocardiography (TEE) is 99% sensitive and specific in detecting LA and LAA thrombi. Echocardiography when combined with spectral and colour flow Doppler is well established as a safe, non-invasive, and versatile diagnostic modality in cardiology, and is now the predominant technique used for evaluation of left ventricular function and for the assessment and quantification of valvar heart lesions. When combined with physiological or pharmacological stress, echocardiography also enables the identification of reversible myocardial ischaemia and myocardial contractile reserve. However, assessment of regional cardiac dysfunction at rest and during stress remains subjective and semiquantitative, with high interobserver variability. Doppler measurement of myocardial motion,using pulsed wave Doppler, was first proposed in 1989 but this technique allowed realtime visualisation of only a single myocardial segment and its potential was not realised.Only later, with the development of colour flow algorithms to visualise myocardial motion,did the technique begin to gain clinical acceptability. TDI can be performed in pulsed-wave and color modes. Pulsed-wave TDI is used to measure peak myocardial velocities and is particularly well suited to the measurement of long-axis ventricular motion because the longitudinally oriented endocardial fibers are most parallel to the ultrasound beam in the apical views. Because the apex remains relatively stationary throughout the cardiac cycle, mitral annular motion is a good surrogate measure of overall longitudinal left ventricular (LV) contraction and relaxation. AIM OF THE STUDY: The most widely accepted method for assessing the left atrial appendage (LAA) function is the measurement of left atrial appendage late peak emptying velocity (LAAEV) by using pulse wave Doppler (PWD) on Transesophageal echocardiography (TEE) and reduced left atrial appendage late peak emptying velocity represents left atrial appendage dysfunction. The magnitude and pattern of left atrial appendage flow velocities are dependent on acute changes in loading conditions. Left atrial appendage flow velocities may also be affected by left atrial appendage size and morphology which are highly variable. Myocardial velocities obtained by Tissue Doppler imaging (TDI) are less dependent on preload and left atrial appendage (LAA) tissue velocities may help in more accurate risk prediction. CONCLUSION: Left Atrial Appendage function is depressed in patients with mitral stenosis as assessed by Left Atrial Appendage late peak Emptying Velocity and Left Atrial Appendage late peak Systolic velocity. The deterioration of Left Atrial Appendage function is more prominent among patients with Atrial fibrillation and those with embolic events. Left Atrial Appendage late peak Systolic velocity as assessed by Tissue Doppler imaging seems to be more reliable than Left Atrial Appendage late peak Emptying Velocity assessed with Pulse Doppler imaging in assessing Left Atrial Appendage function. Left Atrial Appendage late peak Systolic velocity is a useful parameter in evaluating Left Atrial Appendage function in patients with mitral stenosis

Effect of Chemicals and Growth Regulators on Post-Harvest Shelf-Life and Quality in Papaya (Carica papaya L.) Cv. Red Lady

The present investigation on papaya (Carica papaya L.) cv. Red Lady was carried out at Horticultural College and Research Institute, Venkataramannagudem, West Godavari district of Andhra Pradesh, during the year 2010-11. The study was carried out using 9 different treatments involving two chemicals calcium nitrate and calcium chloride at 1, 2, 3 and 4% concentration and two growth regulators, viz., GA3 at 75, 100, 150 and 200mg/l, and BA at 100, 125, 150 and 175mg/l concentration conducted separately in a factorial concept of completely randomized design (CRD), with three replications, under laboratory conditions. Physical parameters studied were per cent fruit ripening, physiological loss in weight (PLW), fruit firmness, shelf-life, and, physic-chemical properties studied were: total soluble solids (TSS), total sugars, reducing sugars, acidity, ascorbic acid and Brix:acid ratio. Fruits treated with CaCl2 @ 4% showed significantly low PLW, per cent fruit ripening, and the highest fruit-firmness, shelf-life, lowest total soluble solids, total sugars, reducing sugars, Brix:acid ratio, and highest acidity and ascorbic acid content, which were on par with CaCl2 @ 2% application. Fruits treated with GA3 @ 100mg/l also exhibited similar results for these parameters. It was concluded that CaCl2 @ 4 % had a beneficial impact on shelf-life of papaya fruits upto 10.67 days without any loss in either physical or physic-chemical properties. Similarly, application of growth regulators such as GA3 and BA @100mg/l significantly increased shelf-life of papaya fruits upto 12 days and 11 days, respectively, while showing the best physical and physico-chemical properties

Implementing health insurance for the poor: the rollout of RSBY in Karnataka

The National Health Insurance Scheme (Rashtriya Swasthya Bima Yojana, RSBY) aims to improve poor people’s access to quality health care in India. This paper looks at the implementation of the scheme in Karnataka, drawing on a large survey of eligible households and interviews with empanelled hospitals in the state. Six months after initiation, an impressive 85% of eligible households in the sample were aware of the scheme, and 68% had been enrolled. However, the scheme was hardly operational and utilisation was virtually zero. A large proportion of beneficiaries were yet to receive their cards, and many did not know how and where to obtain treatment under the scheme. Moreover, hospitals were not ready to treat RSBY patients. Surveyed hospitals complained of a lack of training and delays in the reimbursement of their expenses. Many were refusing to treat patients under the scheme until the issues were resolved, and others were asking cardholders to pay cash. As is typical for the implementation of a government scheme, many of the problems discussed can be related to a misalignment of incentives