The Role of the District Public Health Nurses: A Study from Gujarat

The role of District Public Health Nurses (DPHN) and District Public Health Nurse Officers (DPHNOs) as supervisors of the Public Health nursing and midwifery staff in a district was investigated. Thirteen DPHNs and DPHNOs from six districts selected from six geographic zones of Gujarat were observed for one week using the time motion method. Their activities and time spent were noted and the DPHNs/DPHNOs and their supervisors were interviewed. The role of the DPHNs has reduced over the years because they have not been assigned new roles with change in programmes and policies. Most of the DPHNs have training for clinical work in hospitals. Their 10 month training to qualify for PHN is inadequate to develop knowledge and skills in public health. There is a gap between their training and posting due to delays in government procedures of promotion. The DPHN/DPHNOs spend majority of their time in the office (49%) where they have a limited role. Their supervisory role for nurses and midwives has lost its importance. They spend about 1/3rd of their time in field supervision mostly visiting centres accessible by public transport as they do not have an allotted government vehicle. As they do not submit any field report, there is no follow-up action from their visit. Nevertheless they seem to have an important role in solving problems of field workers as they are mediators between the district and peripheral facilities. To conclude the DPHNs are under utilized which affects the quality of maternal and child health services in the district.

Emerging Issues and Opportunities in Disaster Response Supply Chain Management

The world is facing an increasing frequency and intensity of disasters both natural and man-made that have devastating impact on life, livelihood and economy of the affected communities. In the context it is very important to plan for disaster response activities and preparedness to minimize the economic and human loss. In a post disaster situation various aid organizations and government agencies start supplying food, water, clothing, medicines and other emergency relief materials efficiently and quickly to maximize survival rate and continue normalcy. However, managing disaster response supply chain is not that straight forward. In most disasters, information is scarce (between the supplier and end users) and coordination rarely exists (Long Wood, 1995) which creates disruption in flow of supply chain. Hence disaster response supply chain operates in a level of high uncertainty and is very different from what most supply chain managers perceive. This article describes the main characteristics of disaster response supply chain, particular issues faced by the managers and the opportunities on which the future strategy could be capitalized. It also suggests a model that captures the interaction between different components of supply chain and controls the flow of the commodities from the source through the chain to reach the end users

The best-of-n problem with dynamic site qualities: Achieving adaptability with stubborn individuals

© 2018, Springer Nature Switzerland AG. Collective decision-making is one of main building blocks of swarm robotics collective behaviors. It is the ability of individuals to make a collective decision without any centralized leadership, but only via local interaction and communication. The best-of-n problem is a subclass of collective decision-making, whereby the swarm has to select the best option among a set of n possible alternatives. Recently, the best-of-n problems has gathered momentum: a number of decision-making mechanisms have been studied focusing both on cases where there is an explicit measurable difference between the two qualities, as well as on cases when there are only delay costs in the environment driving the consensus to one of the n alternatives. To the best of our knowledge, all the formal studies on the best-of-n problem have considered a site quality distribution that is stationary and does not change over time. In this paper, we perform a study of the best-of-n problems in a dynamic environment setting. We consider the situation where site qualities can be directly measured by agents, and we introduce abrupt changes to these qualities, whereby the two qualities are swapped at a given time. Using computer simulations, we show that a vanilla application of one of the most studied decision-making mechanism, the voter model, does not guarantee adaptation of the swarm consensus towards the best option after the swap occurs. Therefore, we introduce the notion of stubborn agents, which are not allowed to change their opinion. We show that the presence of the stubborn agents is enough to achieve adaptability to dynamic environments. We study the performance of the system with respect to a number of key parameters: the swarm size, the difference between the two qualities and the proportion of stubborn individuals

WASTE MANAGEMENT AND SUSTAINABLE DEVELOPMENT INITIATIVES

The River Yamuna, in Delhi has degraded and polluted because of occurrence of increasing anthropogenic activities which majorly includes interference of excess amount of domestic wastewater. Delhi itself is known to be a major polluter as it discharges 79% of total pollutants in river. It is a major challenge in front of environmentalists to restore its water quality. A pilot study in summer season during May 2017-June 2017 was performed to analyze the present quality of water of river Yamuna in which number of pollutants were anlaysed which includes dissolve oxygen (DO), biochemical oxygen demand (BOD), chemical oxygen demand (COD) etc. Samples were taken from three various stretch of river Yamuna in Delhi. This chapter deals with the brief description of the performed study

Positive Impact of Aachar-Rasayana on Health

The first and foremost aim of Ayurveda - “Swasthasya Swasthya Rakshanam Aaturasya Vikara Prashamanam Cha”  is to maintain a healthy state of life and to remain free from the burden of diseases and sufferings so as to accomplish the ultimate goal of human life. To achieve this objective, Ayurveda has advocated certain percepts and rules which can ensure the normal functioning of human body without any hindrance. Ayurveda has suggested schedules of Swasthvritta including Dincharya, Ratricharya, Ritucharya, Rasayana, and Sadvritta as some of the practices and methods that leads to a happy, healthy and long life. In Ayurveda general principles to prevent psychic disturbances, practices preventing psychosomatic disturbances, practices regarding codes of general ethics in diet, behaviour, study, self-control etc. are explained as parts of Sadvritta. True efforts made for the observation of these schedules and conduct give rise to the effects of rejuvenation therapy called Aachar Rasayana that promotes longevity without any attack of diseases. Rasayana is one of the comprehensive disciplines of Ayurveda, which comprises a specialized use of herbs, herbo-mineral formulations, food articles and lifestyle along with self-discipline with social etiquette to achieve the optimum state of tissues that there is least effect of etiological factors on body. A careful analysis of qualities of Aachar Rasayana reveals that most of them are related to Mana, Dhi, Dhriti, along with good conduct. It inculcates the discipline related to mind, character, social, religious and personal life, so as to accord with the happiness and good of the individual and the society as a whole

The Role of the District Public Health Nurses: A Study from Gujarat

The role of the DPHNs has reduced over the years because they have not been assigned new roles with change in programmes and policies. Most of the DPHNs have training for clinical work in hospitals. Their 10 month training to qualify for PHN is inadequate to develop knowledge and skills in public health. There is a gap between their training and posting due to delays in government procedures of promotion. The DPHN/DPHNOs spend majority of their time in the office (49%) where they have a limited role. Their supervisory role for nurses and midwives has lost its importance. They spend about 1/3rd of their time in field supervision mostly visiting centres accessible by public transport as they do not have an allotted government vehicle. As they do not submit any field report, there is no follow-up action from their visit. Nevertheless they seem to have an important role in solving problems of field workers as they are mediators between the district and peripheral facilities. To conclude the DPHNs are under utilized which affects the quality of maternal and child health services in the district. [Working Paper No. 2010-02-04]District Programme Management Unit, clinical work, supervisory role, child health services

Utility of VExUS score in the peri-operative care unit, intensive care unit, and emergency setting - A systematic review

Background and Aims: The venous excess ultrasound (VExUS) score presents a prospect of valuable clinical utility. The study aimed to systematically review the effectiveness of the VExUS score in detecting venous congestion across emergency, critical care, and peri-operative contexts; assessing its utility in improved patient outcomes; and exploring its relationship with established parameters. Methods: This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD42023421034). A comprehensive literature search, employing pre-defined search terms related to the VExUS score in diverse clinical contexts, was conducted on articles published between 2000 and 15 May 2023 across databases- PubMed, PubMed Central, Cochrane, Scopus, Elsevier Clinical Key, and Google Scholar. Bias risk assessment was carried out using the Risk of Bias in Non-Randomised Studies tool. Given the significant heterogeneity across studies concerning participants, interventions, outcomes, and study designs, data pooling for a meaningful meta-analysis was not feasible. Results: The review included 15 articles comprising observational studies, case series, and case reports. Most patients exhibited moderate-to-severe venous congestion based on their baseline VExUS scores. Higher VExUS scores correlated with a greater risk of acute kidney injury (AKI) in post-operative patients. The VExUS score strongly correlated with central venous pressure; specific components, such as the intra-renal monophasic pattern, portal-pulsatility, and inferior vena cava diameter, exhibited robust predictive value for venous congestion. Conclusion: VExUS score is valuable in assessing and predicting venous congestion, especially regarding AKI prediction risk and guiding interventions. However, its utility in predicting outcomes in acute heart failure patients appears less certain