Polypharmacy in elderly cancer patients : challenges and the way clinical pharmacists can contribute in resource-limited settings

The aim of this study was to address the problems associated with polypharmacy in elderly cancer patients and to highlight the role of pharmacists in such cases in resource‐limited settings. A narrative review of existing literature was performed to summarize the evidence regarding the impact of polypharmacy in elderly cancer patients and the pharmaceutical strategies to manage it. This review emphasizes the significance of polypharmacy, which is often ignored in real clinical practice. Polypharmacy in the elderly cancer population is mainly due to: chemotherapy with one or more neoplastic agents for cancer treatment, treatment for adverse drug reactions due to neoplastic agents, the patient's comorbid conditions, or drug interactions. The role of the clinical pharmacist in specialized oncology hospitals or oncology departments of tertiary care hospitals is well established; however, this is not the case in many developing countries. A clinical pharmacist can contribute to solving the problems associated with polypharmacy by identifying the risks associated with polypharmacy and its management in resource‐limited settings. As in many developed countries, the involvement of a clinical pharmacist in cancer care for elderly patients may play a vital role in the recognition and management of polypharmacy‐related problems. Further research can be conducted to support this role

Preparation of Lapsi (Choerospondias axillaries roxb.) pulp using IMF technology and study on storage stability

The work was carried out to study the storage stability and food safety aspects of lapsi (Choerospondias axillaries roxb.) pulp stock prepared using Intermediate Moisture Food Technology. Three recipes were designed with the TSS of 55, 60 and 65 oBx and the TSS/Acidity ratio of 20, 25 and 30 respectively so as to achieve the theoretical water activity level of 0.86 to 0.90. Further three treatments using no preservative, potassium sorbate (0.3%) as preservative and pasteurisation with hot filling were done to those recipes. All samples were found to be safe from the food poisoning organism Staphylococcus aureus. All preservative added and pasteurised samples as well as 65 oBx sample with no preservative were stable up to 5 months storage and no Mold growth were observed. Mold observed after 2 month in 55 oBx sample and after 69th day in 60 oBx sample with no preservative. Preservative added samples were faint in colour while pasteurised samples were dark due to browning reaction during heating. No preservative used sample was best in appearance. 65 oBx with no preservative sample was good design but protection from air to prevent browning and use of sorbate to further extend shelf life was found necessary

English language examination reform: International trends and a framework for Nepal

This chapter is based on desk research on examinations and their reforms globally. Although the chapter is about English language examination reforms, it draws on the literature related to general education where relevant. The chapter begins by exploring why governments reform school examinations. In particular, the chapter focuses on the external environment: political, educational and economic factors which influence the nature of school examinations in different ways (Shohamy, 2007). These factors are important because a combination of at least two of these factors or all are taken into account when a government decides to reform its school examination system. Having considered these factors, the chapter showcases case studies of examination reform in other countries from Africa (Kenya), Asia (Hong Kong SAR and Singapore) and Europe (Norway), drawing on the most current literature. How examination reforms were carried out in these countries, and their consequences and lessons learned are discussed. From these case studies, key issues for Nepal are identifi ed. In order to give the reader a perspective on the examination system in Nepal in relation to the other countries discussed, this chapter then briefly reports on the history of examination reform, particularly English language examinations in Nepal. After providing the context of the examination system in Nepal, the chapter makes a proposal for a framework of English language examination reform for Nepal based on research and current good practices. This section will specifically focus on what Nepalese education policy makers can do to reform examinations that have minimal negative consequences and how they can carry this out. Drawing on Shohamy (2007) and McNamara and Rover (2006), the proposed framework will discuss how it needs to consider the essential aspects of examination reform: stakeholder engagement, needs-basedness, links with the curriculum, intended and unintended consequences, and continuous research and development. Finally, a set of recommendations for Nepalese policy makers are made

A study of effects of low temperature stress on seed development and yield in wheat (Triticum aestivam L.) : a thesis presented in partial fulfilment of the requirements for the degree of Master of Agricultural Science in Seed Technology at Massey University

Temperature affects the growth, development, fertility and yield of cereals. The degree of sterility and subsequent yield reduction caused by extreme temperature stress depends upon the minimum level and duration of the stress temperature applied and the stage of plant development at the time of stress. An experiment was conducted in which three low temperature regimes (-4°, -2°C and +3°C) were applied at 5 different stages of plant growth (from 1 day before anthesis to 9 days after anthesis) for a period of 6 hours with pre- and post- conditioning periods of 6 and 4 hours respectively. The results showed that the minimum temperature reached determined the nature and severity of temperature injury in Karamu wheat. Complete floret sterility was evident when a -4°C temperature was imposed at the pre-anthesis or anthesis stages of plant development; florets in any position of the head being equally affected. A -4°C temperature stress applied 3 days after anthesis produced 50% and 5% seed formation in primary and secondary heads, respectively. This seed formation mainly occurred in the basal florets of the apical and central spikelets of the head, however the seeds formed did not develop after stress and subsequent viable seed yield was zero. At the later stages, 6 or 9 days after anthesis a -4°C temperature stress had no significant effect on seed numbers. However there was a substantial negative effect on seed development and viability so that subsequent viable seed yield was zero. Temperature stresses of +3°C and -2°C had no significant effects on seed formation, development and viable seed yield when stresses were applied at any of the stages of plant development tested. The percentage of seed formation was highest in the two basal florets of the central and apical portions of the head compared to that in the two basal florets of the bottom of the head and to the distal florets of all spikelets. The percentage sterility in terms of relative sterility (percentage 'D + R' type ovules) and sterility index (percentage 'D' type ovules) was also described. It was found that in 'Karamu' wheat 16% to 33% rudimentary florets were a common feature, such structures included tiny basal, sterile spikelets and the terminal florets of all spikelets. Morphological and anatomical differences in ovules harvested at different stages of development from different treatments were observed. Ovules were classified into 6 groups for assessment of seed development. (A = apparently not fertilised, B = swollen and conical shaped, C = developing, D = shrivelled and shrunken, E = shrunken with reduced conical shape, R = rudimentary). Possible pathways to seed formation and development can be estimated from the data. A probable pathway to normal seed development is A to B to C. However, in the case of unsuccessful seed formation and development, the pathway is likely to be A to D,A to B to D or A to B to C to D. Further detailed electron microscope work is needed to enable a complete description and understanding of the pathways of seed development in stressed and unstressed plants. Such knowledge is needed to provide a logical basis for the development of cultivars with increased cold tolerance, fertility and yield

Introduction

Innovation (i.e., a new beneficial idea or practice) in English language teaching (ELT) has been a constant subject of academic discussion over the last few decades. This topic continues to be a concern to all English language practitioners because, as teachers, we are constantly encouraging new challenges in our teaching context and as a result we find new ways of addressing and resolving them. Innovation in the context of ELT is, however, still under-researched (Waters, 2014) although this area of research is emerging in the fields of English for Academic Purposes (EAP) and English for Specific Purposes (ESP) (e.g., see Hyland & Wong, 2013). Despite both EAP and ESP tending to be innovative, pioneering practices are often limited to individual teachers or institutions. Therefore, there is a need for more research in this area of EAP and ESP. Such innovative practices can benefit other EAP and ESP practitioners globally. In this context, this edited volume, the fourth book from the IATEFL ESP SIG, aims to contribute by bringing together EAP and ESP practitioners from around the world to share their innovations and research on their novel practices. Innovations in EAP and ESP are generally initiated locally to meet certain needs. Innovative practices, due to their nature being small-scale and local, may not flourish if there is no institutional support or there is resistance to change (Waters, 2009). Even if the innovation is national or large-scale, implementing it may still be challenging (Hu & McGrath, 2011). Despite these barriers, if local innovative practices in EAP and ESP are shared with other practitioners, EAP and ESP learners from around the world may benefit from these innovative practices given the increasing demand of English language skills globally for various purposes. As you will see, this volume aims to showcase local innovations from a global perspective in each of the 12 chapters

Fearless: Sneha Shrestha

Sneha Shrestha ’10, a native to Kathmandu, Nepal, recently received an Advancing Leaders Fellowship from World Learning for her fearless project. With it, she aims to provide a creative outlet for art and culture among young people in Nepal through the Kathmandu Children’s Art Museum (KCAM). This project will support a creative learning space for children as well as an opportunity for them to express themselves and investigate their own culture through art. [excerpt

ELT, ESP & EAP in Nepal: whose interests are served?

This paper gives an overview of the state of English Language Teaching (ELT) in Nepal in general and draws a link between ELT and English for Academic Purposes (EAP) and English for Specific Purposes (ESP). The researcher briefly examines the current situation at primary, secondary and tertiary level. The impact of this is assessed from a critical applied-linguistics perspective, to see how the English language has affected the society as a whole, particularly the English-vernacular (Nepali) divide in the country. The study concludes that the ELT situation in the country is far from satisfactory. The factors responsible for this are ineffective teacher education, the medium of instruction, language policies, university entrance examinations and a lack of resources