Psychometric evaluation of a new questionnaire measuring treatment satisfaction in hypothyroidism: The ThyTSQ

Objective: To demonstrate the application of a Bayesian mixed treatment comparison (MTC) model to synthesize data from clinical trials to inform decisions based on all relevant evidence. Methods: The value of an MTC model is demonstrated using a probabilistic decision-analytic model developed to assess the cost-effectiveness of second-line chemotherapy in ovarian cancer. Three clinical trials were found that each made a different pair-wise comparison of three treatments of interest in the overall patient population. As no common comparator existed between the three trials, an MTC model was used to assess the combined weight of evidence on survival from all three trials simultaneously. This analysis was compared to an alternative approach that combined two of the trials to make the same comparison of all three treatments using a common comparator, and an informal approach that did not synthesize the available evidence. Results: By including all three trials using an MTC model, the credible intervals around estimated overall survival were reduced compared with making the same comparison using only two trials and a common comparator. Nevertheless, the survival estimates from the MTC model result in greater uncertainty around the optimal treatment strategy at a cost-effectiveness threshold of £30,000 per quality-adjusted life-year. Conclusions: MTC models can be used to combine more data than would typically be included in a traditional meta-analysis that relies on a common comparator. They can formally quantify the combined uncertainty from all available evidence, and can be conducted using the same analytical approaches as standard meta-analyses

Sustainable Quality Fodder Production under Temperate Mountain Agriculture in Kashmir

Inadequate supply of quality feed and fodder is the primary cause of lower productivity of milch animals in India. Oats (Avena sativa L.) is an important fodder crop in J&K. Jammu and Kashmir state the fodder requirement is about 4.31 million tonnes against the available 3.26 million tonnes (Anonymous, 2008). Kashmir valley experiences a long lean period of winter, resulting in scarcity of green and quality fodder which results in drastic decrease in milk production. Therefore, to meet the need of animal products, there is a great importance of fodder cultivation to compensate fodder scarcity during lean period (Rabi crops remain dormant due to snow/ freezing temperatures). The best measure related to forage quality is animal productivity, which can be affected by nutrient intake, digestibility and utilization efficiency. Quality forage must have high intake, digestibility and efficient utilization. Physiological characteristics have significant impacts on growth and development of plants grown in production systems. Keeping the above facts in view, the present investigation was undertaken to identify the parents and their crosses for physiological and forage quality traits which are economically sustainable for forage yield and quality for sustainable consumption in hill agriculture

Fodder Yield, Nutrient Uptake and Quality of Oats (\u3cem\u3eAvena sativa\u3c/em\u3e L.) as Influenced by Different Agronomic Practices

The green fodder requirement and availability in India does not match and leaves a shortfall of about 63%. There is a little possibility of any tangible increase in fodder area due to competition from other economically competitive agricultural crops (Aulakh et al., 2012). Therefore, there is urgent need to maximize the tonnage and quality of fodder within the existing farming systems. Multicut nature of the crop ensures continuous supply of fodder. Kashmir valley possesses temperate type of climate, with snowfall and harsh conditions in the winter. Behaviour of crop under these conditions is entirely different from rest of country, which can be modified through different agronomic manipulations to derive maximum benefits. Sowing time has great impact on fodder yield. In agronomic techniques fertilizer management is the most important aspect. To improve supply of fodder over a period best cutting management needs to be evaluated. In view of these an experiment was undertaken to study the response of fodder oat to different sowing dates, fertility levels and cutting managements

The case of Scott Ortiz: a clash between criminal justice and public health

The criminal justice system creates particular challenges for persons with HIV and Hepatitis C, many of whom have a history of injection drug use. The case of Scott Ortiz, taken from public trial and sentencing transcripts, reveals the manner in which incarceration may delay learning of important health problems such as Hepatitis C infection. In addition, the case of Mr. Ortiz suggests the bias in sentencing that a former injection drug user may face. Collaboration between the Montefiore Medical Center residency in Social Medicine and a Bronx legal services agency, Bronx Defenders, yielded the discovery that a decade after diagnosis with HIV and after long term incarceration, Mr. Ortiz was infected with Hepatitis C. Mr. Ortiz only became aware of his advanced Hepatitis C and liver damage during his trial. The second important aspect of this case centers on the justification for lengthy sentence for a burglary conviction. The presiding Judge in Mr. Ortiz's case acknowledged that because of his advanced illness, Mr. Ortiz posed no threat to society as a burglar (the crime for which he was convicted). But the Judge elected to use his discretion to sentence Mr. Ortiz to a term of 15 years to life (as opposed to a minimum of two to four years) based on the idea that the public health would be served by preventing Mr. Ortiz from returning to the life of a street addict, sharing dirty needles with others. Mr. Ortiz reports distant injection drug use, no evidence of current or recent drug use was presented during Mr. Ortiz's trial and he reports no injection drug use for over a decade. In this case, bias against a former injection drug user, masquerading as concern for public health, is used to justify a lengthier sentence. Mr. Ortiz's lack of awareness of his Hepatitis C infection despite long term incarceration, combined with the justification for his dramatically increased sentence, provide examples of how persons within the criminal justice system may face particular challenges to their health

Drug utilization study of antihypertensive drugs used in the treatment of second and third trimester of pregnancy in tertiary care hospital

Background: Hypertensive disorders are major cause of the perinatal and maternal mortality and morbidity worldwide. Aim of study was to evaluate current trend of antihypertensive drugs and to assess frequency and distribution of antihypertensive drugs in pregnancy.Methods: A retrospective observational study was conducted in a tertiary care hospital for period of six months in collaboration with department of obstetrics and gynaecology. Patients data recorded in case report form and analysed to study prescription pattern and related information.Results: Total of 104 cases were enrolled in this study. Prescribed antihypertensive drugs in pregnancy were Labetalol, Nifedipine, MgSO4 and furosemide. Most commonly prescribed drug was labetalol. In this study, Gestational hypertension was most common diagnosis in hypertensive disorder. Majority of drug prescribed from category C and A. In present study, Single drug therapy was most commonly prescribed for hypertension in pregnancy was 64.42% whereas multiple drug therapy was 35.57%. Most common maternal complication was anaemia i.e. 54.05% followed by placental abruption in 24.3%. Neonatal outcome was low birth weight i.e.36% followed by preterm birth i.e.24%.Conclusions: Labetalol found to be most common prescribed drug. Single drug therapy prescription was high as compared to multiple drug therapy prescription in hypertensive disorders in pregnancy. Gestational hypertension was most common cause of hypertensive disorder. Anaemia was found to be most common maternal complication encountered in hypertensive disorders in pregnancy. Most common adverse neonatal outcome was low birth weight

A multilateral design methodology for development contexts : a framework for the Dharavi potters

Thesis (M.Arch.)--Massachusetts Institute of Technology, Dept. of Architecture, 2002.Page 83 blank.Includes bibliographical references (p. 80-82).The migration from rural areas to urban environments, and the continuous growth of the current population has caused an increasing shortage of low-in come urban housing in developing countries. In addition, the high cost of available housing has driven many in the lower income groups into squatter settlements in and along the periphery of urban developments. These squatter settlements are often the result of ineffectual and dysfunctional social and economic policy, compromised structures of governance, corrupt land markets, lack of equitable and humane regulation, and improper and inefficient finance scenarios. While poverty has many dimensions, urban poverty often has a broader meaning of cumulative deprivation, characterized by: squalid living conditions; risks to life and health from poor sanitation, air pollution, crime and violence, traffic accidents, and natural disasters; and the breakdown of traditional family and community safety nets. Rapid population increases within urban areas, crumbling infrastructure, growing inequalities between rich and poor, and insufficient urban services point to the need for a reevaluation of current models of urban development. Through an investigation of a multi-disciplinary approach to development, this project will identify the difficulties and potentials within the context of development in order to augment current design, planning, financing, and construction knowledge towards the creation of viable and sustainable architecture. The Khumbar Wada potters' community in Dharavi, Mumbai will be utilized to illustrate the potential for multi lateral approaches to go beyond the rhetoric that has compromised the discussion of architecture and its relationship to development work. The design will address development strategies and construction processes that express local conditions within the urban, architectural, and tectonic scales. Through the investigation and implementation of architectural infrastructure, the design will alleviate environmental, economic, and political constraints while accommodating local values. A potters' workshop will serve to illustrate the potential of a multi lateral design methodology. This thesis aims to suggest a framework for decision-making that can be used across various sectors and at multiple scales and the physical implementation of infrastructure that allows for the creation of more humane environments.by Amina S. Razvi.M.Arch