Predicting Response to Medial Branch Blocks: A Clinical Decision Making Tool

Chronic neck pain can lead to long-term disability and socio-economic burden. Several demographic, clinical, and psychosocial factors have been implicated in the development of neck pain disability. These factors may also influence management of neck pain. Optimal treatment often requires targeting interventions based on specific diagnosis. One of the most common cause of neck pain is cervical facet joint injury. Currently, the gold standard for diagnosing facetogenic injury is through the medial branch block (MBB) procedure. Though the procedure is relatively safe, it is still invasive and may result in adverse effects. In Canada, access to this procedure is limited through referrals to a specialist pain clinic with wait times of over six months. It is important to help reduce wait times and provide access to the MBB procedure for those likely to respond. The objective of the current study is two folds 1) to develop a comprehensive interdisciplinary regression model to better describe factors that correlate with neck pain disability (Chapter 2 and 3); and 2) to create a decision tree to help clinicians screen for facetogenic neck injury using a receiver operator curve (Chapter 4). In the first two studies of the dissertation, a model was developed using a hierarchical multiple regression. The final model which included: sex, pain duration, etiology, pain intensity, pressure pain detection threshold, number of restricted planes, Spurlings’s test, medical legal status, and pain catastrophizing, explained 62% of the variance in neck disability as measured by the Neck Disability Index (NDI). The last study provided a decision tree that included two factors, pain intensity and pain catastrophizing, to help clinicians identify those patients likely to respond to cervical MBBs. These findings have important implications for front-line clinicians to help rule out patients not likely to benefit from the cervical MBBs and potentially reducing wait times for those likely to respond. However, additional work is still warranted on both the regression model and the decision tree before endorsing it’s use in clinical practice

Seroprevalence of HIV in ANC clinic attendees and utilization of PPTCT services at a tertiary care hospital of western Rajasthan, India

Background: Human immunodeficiency virus (HIV) infection in pregnant women has an important role in its spread to paediatric population by means of vertical transmission. Effective utilization of PPTCT services can reduce this spread. This study aims to determine seroprevalence of HIV in antenatal women, demographic factors of seropositive women and utilization of PPTCT services to minimize the risk of mother to child transmission.Methods: A retrospective study was done among pregnant women attending antenatal clinic of a tertiary care hospital within a period of two years from November 2013 to October 2015. Pre-test counselling, HIV testing, and post-test counselling were done as per NACO guidelines. Antiretroviral prophylaxis was given to seropositive women and their children. Analysis of demographic data of seropositive women and assessment of utilization of PPTCT services was done.Results: Out of 40,913 new antenatal registrations 26,803 (65.58%) women attended pre test counselling and 24716(60.41%) of them accepted HIV testing. Thirty-eight women were found to be seropositive with a seroprevalence rate of 0.16%. Majority of seropositve women were young primigravida, illiterate housewives belonging to rural area. Eight out of 33 partners of seropositive women tested, were found to be seronegative. Out of the 38 seropositive women, 4(10.52%) opted for pregnancy termination, and 31(81.57%) had delivery in our institution. All mother and baby pairs received antiretroviral prophylaxis.Conclusions: Seroprevalence of HIV infection in antenatal women is relatively low in this region than the national average and acceptance of therapeutic interventions to reduce the mother to child transmission is high. There is scope to improve acceptance of counselling and testing of HIV

Othered by English. Smothered by Spanish?: A Critical Ethnography of Six Non Spanish Speaking Newcomer Immigrant Youth

Thesis advisor: Maria E. BriskDrawing on Collins' (2009) framework on domination and seeing language as a signifier (Bhaba, 1994), this critical ethnography explores the relationship between language and power within the context of a school focused on serving the needs of newcomer immigrant youth in the United States, a country that has increasingly become polarized around issues of immigration, social, and educational policy. Conducting observations in multiple social contexts and informal/semi-structured interviews, the study focuses on six non-Spanish speaking newcomer immigrant youth navigating a particular phenomenon - English and Spanish being dominant languages in their social contexts inside and outside of school. Data were analyzed using guidelines of critical ethnography (Carspecken, 1996). Salient findings include issues of assimilation, meritocracy, and invisibility at the school. The importance of transnational connection, restoration, and accessing social and cultural capital outside of school were also noteworthy. Suggested additions to theorizing work and research with this population as well as critical implications for newcomer schools are also presented.Thesis (PhD) — Boston College, 2016.Submitted to: Boston College. Lynch School of Education.Discipline: Teacher Education, Special Education, Curriculum and Instruction

Technology Dynamism: Analyses of Changing Structure of Trade in Organized Manufacturing Industries In India

The paper focuses on the impact of reforms on the industrial and trade structure in the organized manufacturing sector in India, using ASI (CSO) and UN-COMTRADE data. The period of the study is from 1980-81 to 2005-06, which is divided into the pre-reform (1980-81 to 1991-92) and post-reform (1992-93 to 2005-06) periods. The semi-logarithmic and Boyce single kinked method is used for the analyses. The results show some positive signs of structural shift within the industries, but the changes are too slow to make a dent. The slower trend growth rate of value added and exports witnessed in the post-reform period reduces the initial optimism shown while adopting these reforms. Specific policy framework for each industry concerned and investment in infrastructure, human capital and technology may lead to dynamize the export structure

Technology Dynamism: Analyses of Changing Structure of Trade in Organized Manufacturing Industries In India

The paper focuses on the impact of reforms on the industrial and trade structure in the organized manufacturing sector in India, using ASI (CSO) and UN-COMTRADE data. The period of the study is from 1980-81 to 2005-06, which is divided into the pre-reform (1980-81 to 1991-92) and post-reform (1992-93 to 2005-06) periods. The semi-logarithmic and Boyce single kinked method is used for the analyses. The results show some positive signs of structural shift within the industries, but the changes are too slow to make a dent. The slower trend growth rate of value added and exports witnessed in the post-reform period reduces the initial optimism shown while adopting these reforms. Specific policy framework for each industry concerned and investment in infrastructure, human capital and technology may lead to dynamize the export structure

Economic reforms, technological intensity and industrial development in India

The impact of the 1991 reforms on the Indian manufacturing sector has been a subject of much debate. The reforms were expected to result in a high growth rate coupled with a structural change towards high technology industries. This paper analyses data on 60 three-digit industries, reclassified into four technology-intensive subgroups, for the period 1980-81 to 2005-06. Dividing this period into the pre-reform (1980-81 to 1991-92) and the post-reform (1992-93 to 2005-06), the paper uses the single kinked model to reveal a slower trend growth rate of value added for about 77% of the industries in the post-reform period. Further, the study does not find any significant structural transformations within the organised manufacturing sector, which is still dominated by relatively low technology industries. The results thus refute the neo-liberal optimism regarding reforms. In an increasingly technology-driven world, promoting industrialisation is a multidimensional complex task that requires a constructive role of the government

Tilting Towards South: Pattern and Determinants of Global Value Chains

Geographical fragmentation of production process reoriented the attention of scholars towards the issues concerning international trade. From trade in goods the world is increasingly experiencing trade in tasks. The concerns of the countries are largely shifting towards increasing their share in global value-chains (GVC) for enhancing growth and employment opportunities. Therefore, it becomes important to examine the changing pattern of world production process. For the same, manufacturing sector of various developed and emerging economies is examined. It was found that the share from emerging countries in terms of value-added and domestic value-added content in gross exports has increased over the years as compared to G7 and other European Union (EU) countries. The paper also tried to econometrically examine the determinants of such change. It was also found that developed countries benefitted relatively more because of openness as compared to the manufactures belonging to emerging economies. The paper also discusses policy implications based upon systems of innovation approach

Global Value Chains and Innovation Systems : Exploring the Inter-relations

Advances in transportation sector have shrunk the world in a matter of few hours while the inventions in information and communication technologies is giving time a miss. These together have transformed the structure of world production process. The nations are increasingly concerned about entering the global value chains (GVC) and subsequently to upgrade into higher valueadded activities, largely being determined by the structure of their innovation systems (IS). Therefore, an attempt is made to examine the relationship between participation in Global value chains (GVC) and Innovation Systems (IS) of different developed, Asian and developing countries depicting different stages of development. For the purpose, seemingly unrelated regression equation model is estimated for the manufacturing industries and it was found that in the initial stages of development, low-skilled labour, mediumskilled labour, process innovation and price level have significant impact on participation in global value chains (GVC) followed by the role of skilled labour and innovations in the advanced stages of development. It was also found that for building innovation systems (IS), the role of high-skilled labour predominates in the initial stages. However, in the later stages, participation in GVC with backward linkages also has a positive impact on building their innovation systems (IS). Specifically for South Korea with proximity in hightechnology intensive industries, the impact of high skilled labour, product and process innovation are significant in determining global value chain participation while the high-skilled labour and backward linkages played important role for building its innovation systems (IS). For Indias low-technology intensive industries, low skilled labour and price level have significant impact on its participation in global value chains whereas human capital have positive impact on its innovation systems (IS)

Economic reforms, technological intensity and industrial development in India

The impact of the 1991 reforms on the Indian manufacturing sector has been a subject of much debate. The reforms were expected to result in a high growth rate coupled with a structural change towards high technology industries. This paper analyses data on 60 three-digit industries, reclassified into four technology-intensive subgroups, for the period 1980-81 to 2005-06. Dividing this period into the pre-reform (1980-81 to 1991-92) and the post-reform (1992-93 to 2005-06), the paper uses the single kinked model to reveal a slower trend growth rate of value added for about 77% of the industries in the post-reform period. Further, the study does not find any significant structural transformations within the organised manufacturing sector, which is still dominated by relatively low technology industries. The results thus refute the neo-liberal optimism regarding reforms. In an increasingly technology-driven world, promoting industrialisation is a multidimensional complex task that requires a constructive role of the government

VIRTUAL REALITY IN BIOMEDICAL

Virtual reality (VR) encompasses a number of surgical research topics, including computer graphics, imaging, visualization, simulation, data fusion and telemedicine. In this paper we define virtual reality and each of these areas, focusing on a state-of-the-art review of the research and recent accomplishments. .Virtual reality is a powerful technology for solving today’s real-world problems. Virtual reality refers to computer-generated, interactive, three-dimensional (3-D) environments into which patients are immersed. It provides a way for surgeon to visualize, manipulate and interact with simulated environments through the use of computers and extremely complex data