Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china

<p>Abstract</p> <p>Background</p> <p>In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs) to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified as a unique case of further decentralisation of tuberculosis (TB) treatment services in township hospitals. The study evaluated the impact of the MC policy on providers and patients in Gansu Province. The second objective was to assess the unique case of Ganzhou County compared with other counties in the province.</p> <p>Methods</p> <p>Both quantitative and qualitative methods were used. All 523 MCs in the province completed an institutional survey regarding their performance. Four counties were selected for in-depth investigation, where 169 TB suspects were randomly selected from the MC and county TB dispensary registers for questionnaire surveys. Informant interviews were conducted with 38 health staff at the township and county levels in the four counties.</p> <p>Results</p> <p>Gansu established MCs in 39% of its township hospitals. From January 2006 to June 2007, 8% of MCs identified more than 10 TB sputum smear positive patients while 54% did not find any. MCs identified 1546 TB sputum smear positive patients, accounting for 9% of the total in the province. The throughputs of MCs in Ganzhou County were eight times of those in other counties. Interviews identified several barriers to implement the MC policy, such as inadequate health financing, low laboratory capacity, lack of human resources, poor treatment and management capacities, and lack of supervisions from county TB dispensaries.</p> <p>Conclusion</p> <p>Microscopy centre throughputs were generally low in Gansu Province, and the contribution of MCs to TB case detection was insignificant taking account the number of MCs established. As a unique case of full decentralisation of TB service, Ganzhou County presented better results. However, standards and quality of TB care needed to be improved. The MC policy needs to be reviewed in light of evidence from this study.</p

Effects of nutrient addition and soil drainage on germination of N-fixing and non-N-fixing tropical dry forest tree species

To develop generalised predictions regarding the effects of atmospheric nitrogen (N) and phosphorus (P) deposition on vegetation communities, it is necessary to account for the impacts of increased nutrient availability on the early life history stages of plants. Additionally, it is important to determine if these responses (a) differ between plant functional groups and (b) are modulated by soil drainage, which may affect the persistence of added nutrients. We experimentally assessed seed germination responses (germination proportion and germination energy, i.e. time to germination) of commonly occurring N-fixing and non-N-fixing tropical dry forest tree species found in India to simulated N and P deposition in well-drained soils, as well as soils with impeded drainage. When soils were not allowed to drain, germination proportion declined with nutrient addition, while germination energy remained unchanged. Stronger declines in germination proportion were observed for N-fixing species. In free-draining soils, nutrient addition did not affect germination proportion in either functional group. However, we detected a trend of delayed germination with nutrient addition, especially in N-fixers. Our results suggest that nutrient deposition can lead to potential shifts in functional dominance and tree community composition of tropical dry forests in the long term through its effects on early life stages of trees, although the mechanisms underlying the observed germination responses remain unclear. Further, such effects are likely to be spatially variable across the geographic range in which tropical dry forests occur depending on soil drainage properties

Long-range superconducting proximity effect in nickel nanowires

When a ferromagnet is placed in contact with a superconductor owing to incompatible spin order, the Cooper pairs from the superconductor cannot survive more than 1 or 2 nm inside the ferromagnet. This is confirmed in the measurements of ferromagnetic nickel (Ni) nanowires contacted by superconducting niobium (Nb) leads. However, when a 3 nm thick copper oxide (CuO) buffer layer made by exposing an evaporated or a sputtered 3 nm Cu film to air is inserted between the Nb electrodes and the Ni wire, the spatial extent of the superconducting proximity range is dramatically increased from 2 to a few tens of nanometers. A scanning transmission electron microscope study confirms the formation of a 3 nm thick CuO layer when an evaporated Cu film is exposed to air. Magnetization measurements of such a 3 nm CuO film on a SiO_{2}/Si substrate and on Nb/SiO_{2}/Si show clear evidence of ferromagnetism. One way to understand the long-range proximity effect in the Ni nanowire is that the CuO buffer layer with ferromagnetism facilitates the conversion of singlet superconductivity in Nb into triplet supercurrent along the Ni nanowires