Obstetric anesthesia for the obese and morbidly obese patient: an ounce of prevention is worth more than a pound of treatment

Background: The incidence of obesity has been dramatically increasing across the globe. Anesthesiologists, are increasingly faced with the care for these patients. Obesity in the pregnant woman is associated with a broad spectrum of problems, including dramatically increased risk for cesarean delivery, diabetes, hypertension and pre-eclampsia. A thorough understanding of the physiology, associated conditions and morbidity, available options for anesthesia and possible complications is therefore important for today's anesthesiologist. Methods: This is a personal review in which different aspects of obesity in the pregnant woman, that are relevant to the anesthesiologist, are discussed. An overview of maternal and fetal morbidity and physiologic changes associated with pregnancy and obesity is provided and different options for labor analgesia, the anesthetic management for cesarean delivery and potential post-partum complications are discussed in detail. Results and Conclusion: The anesthetic management of the morbidly obese parturient is associated with special hazards. The risk for difficult or failed intubation is exceedingly high. The early placement of an epidural or intrathecal catheter may overcome the need for general anesthesia, however, the high initial failure rate necessitates critical block assessment and catheter replacement when indicated

Economic Value of Climate Variability Impacts on Coconut Production in Sri Lanka

This paper assesses the economic value of climate variability, employing a percentile analysis on an array of 31-years national annual coconut production data from 1971 to 2001. Of the production array, 10% and 90% percentiles have been considered respectively as lower and upper production extremes. The 60% of production departures of each year of extremes with respect to the mean production of 10% to 90% percentile were attributed to climate variability because studies show that the 60% of the variation of coconut production is explained by climate. These production deviations were then valued multiplying by free-on-board (FOB) prices of fresh coconuts. Results show that the foregone income from coconuts due to low rainfall varied between US$32 million to US$ 73 million while the incremental coconut income in crop glut extremes due to high rainfall varied between US$42 million and US$ 87 million. Results show that the climate variability causes income losses to the economy estimated at US$32 million to US$ 73 million in years of extreme crop shortage. And in years of extreme crop surplus, the economy realises income gains of US$42 million to US$ 87 million. These indicate the potential for significant economic benefits from investments in adaptations that would reduce variability in nut production which is caused by variations in climate. Further work is however needed to estimate the effectiveness and economic benefits that might be achieved from investments in adaptation

Smart hoist: An assistive robot to aid carers

© 2014 IEEE. Assistive Robotics(AR) is a rapidly expanding field, implementing advanced intelligent machines capable of working collaboratively with a range of human users; as assistants, tools and as companions. These AR devices can provide assistance to stretched carers when transferring non-ambulatory patients safely. This paper presents the preliminary outcomes of the design, development and implementation of a patient lifting AR device, Smart Hoist. This device, an enhanced conventional patient lifter (standard hoist), is fitted with several sensors capable of interacting with the device operator and its environment, and a set of powered wheels. The assisted manoeuvring functionality of the Smart Hoist may help reduce prevailing lower back injuries among the carers while improving the safety of carers and patients. Results collected from an evaluation of the preliminary version of the Smart Hoist conducted at the premises of IRT Woonona residential care facility confirms the system is easy to use and it reduces the effort of the operator, which may help in reducing lower back injuries

A Study on the Trends of Rainfall Patterns in the Intermediate and Dry Zones of Sri Lanka A Comparative Study for the Periods Ranging from 1941-1970 and 1971-2000

Since Sri Lanka is a tropical island unstable nature of the tropics has madeseveral temporal and spatial variations in rainfall throughout the island. Rainfall is oneof the principal factors that has been used to identify the three broad climatic zones inSri Lanka, namely the Wet zone, Intermediate zone and Dry zone. Much of thescientific researches on the rainfall pattern in Sri Lanka have revealed that most of themeteorological stations had recorded decreasing trends of rainfall during the past 100years. The present study attempts to ascertain the validity of these findings withreference to the study area of Intermediate and Dry zones of Sri Lanka (hereafterreferred to as the Intermediate and Dry zones). Considering the agricultural economy,the Dry and the Intermediate zones have been contributing towards more than 90% ofthe islands paddy. However, these two climatic zones show water surpluses in onlythree months (October to December) of the year. With this brief background, the presentstudy aims to identify the trends in rainfall in the Intermediate and the Dry Zones.Micro level framework is used for the selection of rainfall reporting stations andagro-ecological regions of these two zones. Accordigly 14 rainfall reporting stationshave selected for the study. Further, this is a comparative study of two 30 year periodsranging from 1941-1970 (1st period) and 1971-2000 (2nd period) and its seasons (FirstInter Monsoon (FIM), South West Monsoon (SEM), Second Inter Monsoon (SIM) andNorth East Monsoon (NEM). Time series analysis is employed for the identification ofany positive or negative trends of rainfall and the analysis is done on annual andseasonal basis.The results obtained from the analysis revealed that the highest and the lowestpositive trends belong to the 2nd period. It is clear that both highest and lowest negativetrends are apparent in the 1st period. All positive trends of the FIM in the 1st period havechanged into negative trends in the 2nd period. During the SWM, the highest positivetrend is showed in the 2nd period.Keywords: Rainfall Pattern, Intermediate Zone, Dry Zone, Positive Trend, NegativeTren

POTENTIAL OF AGROFORESTRY IN SUSTAINABLE DEVELOPMENT IN SRI LANKA

In order to meet the increasing demand of a growing population andincreased aspirations, Sri Lanka has to increase and sustainproduction/procurement of essential items including food, energy, resourcesfor shelter, apparels etc. Agroforestry which is a method of integration oftrees and agricultural crops and/or animals can be considered an appropriateand useful method for achieving economic, environmental and socialsustainability. There is an age-old agro forestry traditions in the country andnumerous examples of its practices are to be found in all climatic zones. Inaddition to these, development of new management strategies using scientificand systematic management strategies for wider adoption have been arelatively recent approach.This paper reviews the agroforestry interventions such as home gardens,farmers' woodlots, use of agro forestry for management of watersheds,intercropping under coconut, energy plantations under coconut and alleycropping. Physical factors and government! institutional variables areconsidered as external determinants while socio-economic factors ofindividual farm families contribute as inputs to the operation.Recommendations are also given to further develop their systems forsustainable development

COMMUNITY BASED NATURAL RESOURCE MANAGEMENT IN SRI LANKA -A REVIEW OF SOME PROJECTS

Community participation is an approach that is receiving attention across theglobe and one that marks a departure from the 'top down' orientation, whichcharacterized the cultural dimension of the modernist perspective ofdevelopment.This paper reviews two projects, which had been formulated to conserve thecountry's natural resources and to empower people and rural communities tomanage and protect them in a sustainable manner while reaping economicbenefits. The projects that are discussed are' Akkaraseeya' site of the UpperWatershed Management Project of the Ministry of Environment and NaturalResources and Participatory Forestry Project of the Forest Department. Ineach of these projects, the degree/level of community participation, thepresence of collaborative decision making and co-management, the keystakeholders and interest of each stakeholder group, the managementstrategies adopted, the extent to which these have been able to address theneeds of the community and the degree of sustainability are being discussed