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PubMedDate not supplied

Achieving health, safety, and performance improvements through enhanced cost visibility and workplace partnerships.

Reduction in the environment, safety, and occupational health (ESOH) component of operational costs requires not only a better understanding of ESOH costs and requirements, but also the formation of effective partnerships between ESOH professionals, financial analysts, and shop workers to identify viable improvements to current practices. This article presents two case studies of efforts to enhance productivity and ESOH in corrosion control facilities at Randolph Air Force Base (AFB), Texas, and Robins AFB, Ga. At each site, activity-based cost models were created to increase the visibility of ESOH-related costs and target improvement opportunities. Analysis of the strip-and-paint processes for the T-38 aircraft at Randolph and the F-15 radome and C-141 aft cowl at Robins revealed that a large proportion of operating costs were tied to ESOH requirements and practices (22 and 39%, respectively). In each case ESOH professionals teamed with shop personnel to identify potential improvements in personal protective equipment use, waste disposal, tool selection, and work methods. This approach yielded alternatives projected to reduce total shop costs by 5 to 7%. This case study demonstrates how workplaces can identify cost-saving and efficiency-enhancing practices by partnering with ESOH professionals in planning and decision-making activities.

Corrosion↗

PubMed1989

Target materials suitable for projection X-ray microscope observation of biological samples.

Trials for improving the contrast of projection X-ray images by finding better target materials than Ti (lambda K alpha: 2.75 A), which has been found to be suitable for many kinds of specimens, were carried out, considering the factors of melting point, thermal conductivity, mechanical strength, chemical stability, absorption of the X-ray, etc. Au, Ta, and Ge were found to be suitable, giving 5-10 A X-rays when low electron beam energies around 10 kV were used. In order to take advantage of the long wavelength X-rays of these targets, we tried to minimize the attenuation of the imaging X-rays in the air or to use a vacuum camera. Even in non-stained biological samples such as HeLa cells and lingual muscle section, their microstructures were visible with sufficient contrast.

Animals↗

PubMedDate not supplied

[The noninvasive study of cerebral veins and dural sinuses: comparison of two MR angiography techniques].

OBJECTIVE: To evaluate MR venography with bolus injection of intravenous contrast and elliptical filling of the K space, using three-dimensional fast spoiled gradient-echo (3D-FSPGR) sequences, and to compare it to the technique most frequently employed in the study of cerebral veins and dural sinuses, which is two-dimensional time-of-flight (2D-TOF) MR venography. MATERIAL AND METHODS: Source images, multiplanar reconstructions, and maximum intensity projections (MIP) were obtained using both 2D-TOF venography and contrasted-enhanced 3D-FSPGR venography in 20 healthy volunteers. Two radiologists independently evaluated both techniques for the visualization of twenty-one predefined venous structures, classifying the depiction as completely visible, partially visible, or not visible. RESULTS: The predefined venous structures were completely visible in 795 of 840 (94.6%) of the evaluations of contrast-enhanced 3D-FSPGR images versus 682 of 840 (81.1%) evaluations of 2D-TOF venography images. In the major dural sinuses, visualization was complete in 99.4% of the readings of contrast-enhanced 3D-FSPGR images versus 81% in the readings of the 2D-TOF images. CONCLUSION: 3D-FSPGR with elliptical filling of the K space and bolus injection of contrast material provides higher quality images of the intracranial venous system than those obtained using 2D-TOF sequences.

Adolescent↗

PubMed2000

The impact of epilepsy on the quality of life of people with epilepsy in Zimbabwe: a pilot study.

Epilepsy is a common cause of psychosocial disability and has been perceived to have a profound impact on the social functioning of individuals with epilepsy. In Zimbabwe a combination of developing world economic priorities (with provision of social and health services for disabled people not a major goal) and culturally mediated perceptions of epilepsy as a non-medical and feared stigma may further disadvantage people with epilepsy (PWE) in this respect. In order to assess both the level of psychosocial functioning of individuals with epilepsy and their own perception of it, three groups of people were sampled: attenders at a specialized epilepsy clinic and members of two community-based support groups. All completed a brief quality-of-life questionnaire with activities of daily living added. Those carers present completed the same questionnaire at the time of sampling. The results indicated that 36 of 38 people with epilepsy sampled, and their carers, did not perceive themselves to have sufficient cognitive impairment to interfere with social functioning, work performance or relationships with other as assessed by a subsection of the WHO SIDAM (objective evaluation of cognitive performance) interview. However, an adapted activities of daily Living Questionnaire (ADLQ) showed that three-quarters of carers (and two-thirds of PWE) felt that functioning was mildly to moderately reduced, particularly in the areas of solving daily problems and speed of thinking. One-quarter of PWE experienced problems with relationships to others, just less than one-fifth of PWE reported more than four areas of reduced functioning. Of special interest was the fact that 25 (66%) reported sexual functioning as not applicable, although only four of these were of an age group which is not sexually active (less than 15 years old). In addition one-third of the central Hospital Group reported difficulties with using public transport, but none of the Community Support Group members, implying that the use of Public transport becomes an issue when it is necessary to travel long distances and that PWE curtail their travel but do not necessarily view this as a restriction. The samples chosen were from groups which, compared with PWE as a whole, are likely to include more disabled individuals, because attenders at a specialized epilepsy clinic and members of support groups self-select for more symptomatic epilepsy and a visibility. Therefore the proportion of PWE perceived to have difficulties with ADL in this project is not representative for PWE as a whole. The implications of our study are firstly that there is a significant need for selected groups of PWE in Zimbabwe to receive attention to psychosocial abilities and secondly that there are certain specific areas such as sexual functioning and the use of transport which deserve special attention. A much more detailed inventory of neuro-psychological tests will be of value to plan treatment strategies for those selected by the crude screening instruments used in this project. An important future comparison will be a survey of ADL and psychosocial functioning amongst PWE in rural communities, because it is uncertain whether PWE in rural communities are generally more or less disabled than those in the city.

Activities of Daily Living↗

PubMed2002

Women on waves: where next for the abortion boat?

Women on Waves was founded to contribute to the prevention of unwanted pregnancy and unsafe abortions throughout the world by direct action. Because national penal laws, including those governing abortion, generally extend only as far as territorial waters (12 miles), Women on Waves made plans to provide reproductive health services on a ship with a mobile clinic, including abortions, outside the territorial waters of countries where abortion is illegal. We went to Ireland first because it was nearby and there was a dedicated pro-choice community with immediate interest in and commitment to the project. Although we encountered problems that meant we could not do abortions, we were contacted by more than 300 women in five days and provided reproductive health information, contraception, workshops and information on where to obtain legal abortions in Europe. In many parts of the world an anti-abortion backlash is taking place. To safeguard our reproductive rights in the face of anti-abortion activities, it is crucial to recapture a pro-active, pro-choice role. Women on Waves helped to make visible the need for legal abortion services in Ireland, and the extensive class and other differences between women able to access abortions abroad and those who could not. We are currently attempting to resolve our status under Dutch law, but until women everywhere have the right to reproductive freedom, we will continue to make waves.

Abortion, Induced↗

PubMed2002

FDG PET for mucosal malignant melanoma of the head and neck.

OBJECTIVES/HYPOTHESIS: To evaluate imaging findings using positron emission tomography (PET) and 18F-fluorodeoxyglucose (FDG) in mucosal malignant melanoma (MMM) of the head and neck. STUDY DESIGN: Retrospective evaluation. METHODS: Eighteen PET examinations were performed for initial staging and/or follow-up in 10 patients with MMM. Medical records of 6 male and 4 female patients (age range, 43--81 y; mean, 67 y) were reviewed retrospectively with regard to the patients' history, symptoms, and clinical course. Primary melanoma elsewhere in the body was excluded at the time of diagnosis. RESULTS: All MMM were visible in staging PET examinations, but FDG uptake depended on lesion size and anatomic site. Big lesions with a nodular growth, as seen in pathologic specimens, were better visible compared with lesions with a more superficial spread within the mucous membranes. Lesions in the anterior part of the nasal cavity were more difficult to detect than those in the posterior sinonasal complex because of possible interference with nonspecific uptake in muscles of the mouth and pronounced appearance of the skin when imaging was performed using filtered back projection without attenuation correction. CONCLUSION: We found that MMM of the head and neck can be visualized using FDG PET. Furthermore, locoregional and distant metastases can be evaluated much like those of cutaneous malignant melanoma. Therefore, PET may be suitable for the staging and/or restaging of these patients. Further studies have to elucidate the potential role of FDG PET in patient management.

Adult↗

PubMed2005

Time-domain scanning optical mammography: I. Recording and assessment of mammograms of 154 patients.

Using a triple wavelength (670 nm, 785 nm, 843/884 nm) scanning laser-pulse mammograph we recorded craniocaudal and mediolateral projection optical mammograms of 154 patients, suspected of having breast cancer. From distributions of times of flight of photons recorded at typically 1000-2000 scan positions, optical mammograms were derived displaying (inverse) photon counts in selected time windows, absorption and reduced scattering coefficients or total haemoglobin concentration and blood oxygen saturation. Optical mammograms were analysed by comparing them with x-ray and MR mammograms, including results of histopathology, attributing a subjective visibility score to each tumour assessed. Out of 102 histologically confirmed tumours, 72 tumours were detected retrospectively in both optical projection mammograms, in addition 20 cases in one projection only, whereas 10 tumours were not detectable in any projection. Tumour contrast and contrast-to-noise ratios of mammograms of the same breast, but derived from measured DTOFs by various methods were quantitatively compared. On average, inverse photon counts in selected time windows, including total photon counts, provide highest tumour contrast and contrast-to-noise ratios. Based on the results of the present study we developed a multi-wavelength, multi-projection scanning time-domain optical mammograph with improved spectral and spatial (angular) sampling, that allows us to record entire mammograms simultaneously at various offsets between the transmitting fibre and receiving fibre bundle and provides first results for illustration.

Breast Neoplasms↗

PubMed1975

[X-ray studies of the brain as a basis for stereotaxy (author's transl)].

All attempts to reconstruct the topography of the brain in the living from studies of animal material are handicapped by technical difficulties. The best method is to compare exact X-ray pictures, which have been taken under stereotactic conditions. From a large collection of such X-rays the authors have composed contours of the internal table of the skull and of the ventricles, which best match the brains, selected for the Schaltenbrand-Bailey sterotactic atlas. For practical purposes these contours were combined with the transparent overlays for the nomenclature and the border lines of the different parts of the basal ganglia, which have been used in the myelin sections part of the atlas. A comparison of our sagittal series with the new X-ray findings shows, that the sagittal schemata of the atlas represent an extreme variation in the position of the Meynert axis and of the contours of the 4th ventricle. We have chosen a new axis system for the hindbrain, which corresponds to the average of our brains in constructing a new set of typical overlays for the atlas. The contour of the posterior fossa had to be completed. An independent axis system dor the structures of the 4th ventricle was developed, consisting of the base of the 4th ventricle, and a tangent, to the upper contour of the pons. In sterotactic procedures the axis systems for the forebrain and the hindbrain should be used independently. The results obtained are the basis for a new series of lantern slides which can be projected against the X-ray pictures with the Würzburg stereotactic equipment. In the course of this investigation we discovered a source of error. When air enters the puncture hole of the dura, the brain may sink back, so with the patient lying on his back, all structures may shift a few millimeters towards the occipital region. When the patient is lying on his side, as during an approach to the amygdala through the planum temporale, the ventricular system may collapse, so that almost no air is visible in the ventricles and the 3rd ventricle may appear to be in the lower hemisphere, the dislocation being more than 5-8 mm. But filling the ventricle with air through the ventricular catheter is sufficient to blow up the brain and to restore the normal topography.

Brain↗

PubMed2002

Spectroscopic assessment of cutaneous hemodynamics in the presence of high epidermal melanin concentration.

BACKGROUND: For individuals with lightly pigmented skin, early stage pressure ulcers appear as areas of redness, which have compromised microcirculation and do not blanch in response to pressure. The lack of a visible blanch (hemodynamic response) to pressure is a convenient diagnostic test for stage I sores. However, the blanch response is not visually apparent in people with highly pigmented skin color due to the overwhelming contribution of melanin to the reflectance of skin. METHODS: A simple least squares projection operator method is described, which can separate the reflectance contributions from melanin and hemoglobin. The methodology was tested in a study population of 20 subjects with healthy skin. The study population was evenly divided into a lightly pigmented skin group (visible blanch response) and a highly pigmented skin group (no visible blanch response). RESULTS: The hemodynamic response to pressure being applied to the skin could clearly be distinguished spectroscopically in both groups at a high level of statistical significance. CONCLUSION: The specific aim of this work was directed towards developing a spectroscopic basis for distinguishing the healthy blanch response in a manner that was independent of skin pigmentation. However, the technique has a general application when optical hemodynamic measurements are being made over a diverse patient population or under conditions of varying pigmentation such as the seasonal changes in skin color.

Adult↗

PubMed2003

Polylactic acid implants (New-Fill) to correct facial lipoatrophy in HIV-infected patients: results of the open-label study VEGA.

BACKGROUND: In the absence of currently available therapy to manage facial lipoatrophy, strategies used to compensate for facial fat loss warrant clinical evaluation. METHODS: The goal of this open-label, single-arm, pilot study was to evaluate the efficacy and safety of facial injections of poly-L-lactic acid (PLA) (New-Fill) in HIV-infected patients with severe facial lipoatrophy. Patients received four sets of injection at day 0 and then every 2 weeks for 6 weeks. Patients were evaluated by clinical examination, facial ultrasonography, and photography at screening and at weeks 6, 24, 48, 72, and 96. RESULTS: Fifty patients were enrolled. At entry, the median facial fat thickness was equal to zero (range, 0.0-2.1 mm). The median total cutaneous thickness (TCT) increased significantly from baseline : +5.1 mm (range, 2.2-8.6 mm) at week 6, +6.4 mm (range, 3.1-9.1 mm) at week 24, +7.2 mm (range, 4.2-9.6 mm) at week 48, +7.2 mm (range, 3.5-9.6 mm) at week 72 and +6.8 mm (range, 3.9-10.1 mm) at week 96 (P < 0.001). The proportion of patients with TCT > 10 mm was observed in 19% at week 6, 41% at week 24, 61% at week 48, 52% at week 72 and 43% at week 96. In 22 (44%) patients, palpable but non-visible subcutaneous micronodules were observed with a spontaneous resolution in six patients at week 96. CONCLUSION: The benefit of PLA for the correction of the facial lipoatrophy in HIV-infected patients was clearly demonstrated, with an evident aesthetic and quality of life improvement. The efficacy, safety profile, and the simplicity of the injection schedule of PLA make this filling material a potentially attractive treatment.

Adipose Tissue↗

PubMed1988

Analysis of thallium-201 "washout" from parametric color coded images.

We developed a parametric washout image which color codes regional washout, and blindly compared enhanced perfusion images in multiple projections with regional washout graphs and images in 25 patients. Washout images permitted true spatial and anatomic assessment of regions viewed en face as well as those seen in tangent, making possible the exclusion of non-coronary irregularities and permitting evaluation of washout over the apparent cavity. "Cavitary" washout was abnormal in 10 of 12 patients with apparent cavitary dilation on the post stress image, but in none without this finding. The distribution and rotation of washout abnormalities seen over the cavity when viewed en face, and the long delay between the termination of stress and post-exercise image acquisition, suggest that apparent cavitary dilation is often related to improved visibility of the 201T1 deficient blood pool due to relative ischemia of the overlying myocardial wall.

Color↗

PubMed2001

Egress of alphaherpesviruses: comparative ultrastructural study.

Egress of four important alphaherpesviruses, equine herpesvirus 1 (EHV-1), herpes simplex virus type 1 (HSV-1), infectious laryngotracheitis virus (ILTV), and pseudorabies virus (PrV), was investigated by electron microscopy of infected cell lines of different origins. In all virus-cell systems analyzed, similar observations were made concerning the different stages of virion morphogenesis. After intranuclear assembly, nucleocapsids bud at the inner leaflet of the nuclear membrane, resulting in enveloped particles in the perinuclear space that contain a sharply bordered rim of tegument and a smooth envelope surface. Egress from the perinuclear cisterna primarily occurs by fusion of the primary envelope with the outer leaflet of the nuclear membrane, which has been visualized for HSV-1 and EHV-1 for the first time. The resulting intracytoplasmic naked nucleocapsids are enveloped at membranes of the trans-Golgi network (TGN), as shown by immunogold labeling with a TGN-specific antiserum. Virions containing their final envelope differ in morphology from particles within the perinuclear cisterna by visible surface projections and a diffuse tegument. Particularly striking was the addition of a large amount of tegument material to ILTV capsids in the cytoplasm. Extracellular virions were morphologically identical to virions within Golgi-derived vesicles, but distinct from virions in the perinuclear space. Studies with gB- and gH-deleted PrV mutants indicated that these two glycoproteins, which are essential for virus entry and direct cell-to-cell spread, are dispensable for egress. Taken together, our studies indicate that the deenvelopment-reenvelopment process of herpesvirus maturation also occurs in EHV-1, HSV-1, and ILTV and that membrane fusion processes occurring during egress are substantially different from those during entry and direct viral cell-to-cell spread.

Alphaherpesvirinae↗

PubMed2006

Developing visibility for aging in social work: the first NGSWC.

In March 2001, the Council on Social Work Education's (CSWE) Strengthening Aging and Gerontology Education for Social Work (SAGE-SW) project published an action agenda for social work and aging (CSWE/SAGE-SW, 2001). CSWE SAGE-SW, funded by the John A. Hartford Foundation from 1998 to 2004, had several charges in the first phase of funding, including the gathering of data through a thorough review of literature, focus groups, surveys and a variety of activities to garner expert input. This agenda, often referred to as the Blueprint, identified a number of serious issues regarding the lack of attention, preparation, leadership and interest in aging within the social work profession. It also provided some recommended actions to address these issues and help set the stage for the creation of the National Gerontological Social Work Conference. What were the issues at hand and why might a National Gerontological Social Work Conference (NGSWC) address some of these issues?

Aged↗

PubMed2002

Calcium-binding proteins in the human developing brain.

Recent studies have demonstrated that antibodies against the calcium-binding proteins (CaBPs) parvalbumin (PV), calbindin (CB), and calretinin (CR) are appropriate tools for demonstrating transient features and developmental changes of human fetal brain organization as well as for detecting specific alterations in pathologically altered specimens. CB and CR are abundantly expressed in various nerve cell types of the subplate in the second half of gestation. The subplate being an outstandingly wide zone subjacent to the cortical plate, it is a "waiting compartment" for various cortical afferents that reside here prior to entering the cortical plate. The cortical plate (future layers II-VI of the cerebral cortex) contains only CR-ir neurons until the 6th gestational month. In the 7th and 8th month, cortical CB- and PV-ir interneurons are observed in deeper portions of the cortical plate. Cajal-Retzius cells of layer I are CR-immunolabeled from the 4th month onwards. Fetal hydrocephalus causes severe alterations of CB- and PV-ir neurons in the subplate and the cortical plate: shrinkage of ir neurons, loss of process labeling and in most severe cases, entire loss of immunolabeling. Such alterations, which cannot be detected in Nissl-stained sections, indicate distinct impairment of neuronal function. The ganglionic eminence being a prominent part of the telencephalic proliferative zone persists nearly throughout the entire fetal period. Between 16 and 24 weeks of gestation, CR-ir cells are found in the center and, in a higher number, in the periphery, i.e., the mantle zone, of the ganglionic eminence. The mantle zone also exhibits CB-ir cells. These observations support experimental data showing that CR-ir precursor cells leave the ganglionic eminence to migrate towards the cerebral cortex. The CR- and CB-ir neurons of the mantle zone most probably represent an intermediate target for outgrowing axons. This notion is supported by the observation that SNAP (synaptosomal associated protein) 25-ir fibers coming from the intermediate zone terminate upon CR-ir cells in the mantle zone. Within the amygdaloid complex, immature, migrating CR- or CB-ir neurons are observed in the 5th and 6th gestational month. In the 8th and 9th month, anti-CR and anti-CB mark different subsets of interneurons as well as a small proportion of pyramidal projection neurons. The different subsets of interneurons are likely to be functionally different with regard to their connectivities. Considering studies in the literature, it is obvious that CR is transiently expressed in pyramidal cells. Moreover, diffuse (neuropil) CB and CR immunolabeling, which is found in different intensities in the various amygdaloid subdivisions, displays distinct redistribution during development, an observation indicating reorganization of afferent inputs. The sequential arrival of various afferent fiber systems in the two compartments of the striatum (patch and matrix compartment) is reflected by changing patterns of diffuse CB immunolabeling: During the second half of gestation, the patches are labeled and postnatally a changeover to matrix labeling is seen. The thalamic reticular complex reveals prominent transient features seen in PV and CR immunopreparations. Four subdivisions become obvious: the main portion, the perireticular nucleus, the medial subnucleus, and the pregeniculate nucleus. The PV- and CR-ir perireticular nucleus, not visible in the mature brain, is a distinct fetal entity located within the internal capsule. The main portion of the reticular complex is much more prominent in the fetus than in the adult and displays transitory CR expression. The most probable developmental role of the reticular complex is to provide guiding cues for outgrowing axons from or into the dorsal thalamus. The basal nucleus of Meynert and the hypothalamic tuberomamillary nucleus both provide extrathalamic projections to the cerebral cortex. The sequential differentiation of the two nuclei can be demonstrated using anti-CB and anti-PV. The basal nucleus strongly expresses CB and appears to be mature distinctly earlier than the PV-ir tuberomamillary nucleus. Antisera against CaBPs clearly demonstrate that the magnocellular part of the red nucleus located in the mesencephalic tegmentum is outstanding in the fetal and perinatal brain and inconspicuous in the adult. In particular, CB is the most abundant CaBP in this portion of the red nucleus. The dominance of the magnocellular part over the parvocellular part may be a substrate for a specific transitory pattern of motor behavior. On the whole, CaBPs mark the transient architectonic organization of the brain, which is involved in the establishment of transitory neuronal circuitries. The latter are essential for the formation of mature projections. Detailed data on the normal organization of the transient structures are required for the evaluation of alterations occurring in the fetal and perinatal brain. The transient structures are sites of predilection for alteration caused by hypoxia-ischemia, hemorrhage, or hydrocephalus.

Brain↗

PubMedDate not supplied

Vessel enhancement filtering in three-dimensional MR angiography.

For a variety of reasons, small vessels have low signal intensity in magnetic resonance angiography. When the vessel signal intensity is lower than the signal intensity of background tissues, these vessels tend not to be visible on maximum-intensity-projection images. The authors developed a nonlinear second-difference spatial filtering technique that enhances the details of small vessels while suppressing both noise and uniform background tissue. Two similar nonlinear second-difference filters are presented and compared with the linear Laplacian second-difference filter. To evaluate the performance of these filters, they were applied to intracranial three-dimensional time-of-flight MR angiographic data and the results compared with the vessel enhancement obtained with a simple second-difference Laplacian filter and with magnetization transfer contrast (MTC) techniques. The comparisons demonstrated that nonlinear filtering and MTC techniques result in similar improvement in small-vessel visibility and apparent continuity. A quantitative comparison demonstrated that the improvement in the contrast-to-noise ratio is much greater with the nonlinear filters than the Laplacian filter.

Circle of Willis↗

PubMed1996

Dynamic planar myocardial perfusion imaging in patients with one-vessel disease with intracoronary injection of technetium 99m teboroxime during papaverine-induced coronary hyperemia.

This study examined the imaging results and kinetics of technetium 99m teboroxime after its intracoronary injection during papaverine-induced coronary hyperemia in patients with one-vessel disease before and after coronary angioplasty. Thirteen patients with > or = 90% diameter stenosis of either the left anterior descending or the left circumflex coronary artery were included. Two patients were excluded because of ventricular tachycardia during papaverine injection in one patient and unsuccessful angioplasty in the second patient. One mCi of technetium 99m teboroxime was injected into the left main coronary artery during coronary hyperemia induced by intracoronary injection of papaverine. Dynamic acquisition in a frame mode (20 sec/frame) was performed for 5 minutes in the left anterior oblique projection with a multicrystal gamma camera before and after successful angioplasty. Ischemic:normal count ratio increased from 0.75 +/- 0.4 before to 1.00 +/- 0.50 after angioplasty (p < 0.1). The T 1/2 of teboroxime was 6.5 +/- 1.5 min in the normal zone and 7.2 +/- 1.9 min in the ischemic zone (p, NS). Perfusion defects were visible in the territory of the stenosed coronary artery in 9 of 11 patients before angioplasty and in 7 of 11 patients after angioplasty. The image quality was excellent in all studies. Thus this study shows that performing dynamic imaging with intracoronary injection of technetium 99m teboroxime is feasible. This technique may be useful to study the impact of angioplasty on coronary flow and tracer kinetics.

Aged↗

PubMedDate not supplied

Positive deviance--the West Bengal experience.

There are 11.1 million children in the age group 0-6 years in West Bengal. Of these, every second child under 3 years of age is underweight, more than four out of ten are stunted, and one out of eight are wasted. The Integrated Child Development Services (ICDS) programme in West Bengal has 355 operational projects covering 53,064 operational anganwadi centers reaching out to more than four million beneficiaries--approximately half of whom are children in the age group 0-3 years. The Department of Women and Child Development (DWCD) is trying to identify and replicate innovative, community-based, sustainable approaches. One such innovative initiative has been the "Keno Parbo Na" project based on the Positive Deviance (PD) approach which aims to reduce and prevent malnutrition among children under 3 years of age by focusing on local solutions and resources, local behaviors and practices. Behavior change is emphasized through participatory learning and community mobilization. The pilot phase of the project has been completed in two districts [Four blocks (2 in each District) and 32 villages/AWCs (8 in each block)] of West Bengal (Murshidabad and South 24 Parganas). The analysis of the project activities so far reveals that the issue of malnutrition and its prevention is now visible in the villages covered. Acceptance of desirable behavioral practices is observed within the community. A steady reduction in the moderate and severe level of malnutrition was noted across four districts. A general preponderance of girl children was noted at the entry stage indicating higher levels of severe and moderate malnutrition among girl children to begin with but also suggesting PD as an important strategy in reducing the gender gap in malnutrition. The boys gain in terms of nutritional status faster than the girls so in the intermediate phase malnourished girls are more in number. However, by the sixth / ninth round, as the malnutrition levels decline substantially, the gender gap tends to close.

Breast Feeding↗

PubMed1994

[Femoral neck fractures: position of the implant, unrecognized articular penetration and its consequences].

INTRODUCTION: Only two dimensions of a three dimensional object are visible on plain roentgenograms. Therefore, on gross inspection of antero-posterior and lateral roentgenograms, a screw may project as being safely within the head of the femur even though penetration has occurred. This region may be referred to as a "blind zone". MATERIAL AND METHODS: Unrecognized screw penetration into the hip joint during internal fixation of femoral neck fractures was researched on intra operative roentgenograms of 30 patients. Unrecognized pin penetration through the posterior part of the neck was also analyzed on the same X Rays. RESULTS: Unrecognized screw penetration into the hip joint was observed in 20 per cent and penetration at the posterior part of the neck was observed in 10 per cent of cases. DISCUSSION: Several methods of determining screw position are described and discussed in this study.

Bone Nails↗