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Engaging hospitals to meet tuberculosis control targets in China: using the Internet as a tool to put policy into practice
Wang,Lixia; Liu,Xiaoqiu; Huang,Fei; Hennig,Cornelia; Uplekar,Mukund; Jiang,Shiwen;
Bulletin of the World Health Organization , 2010, DOI: 10.1590/S0042-96862010001200015
Abstract: tuberculosis (tb) services in china are provided through a large network of tb dispensaries. even though hospitals are not as well placed to follow recommended standards of tb care, a significant proportion of people with tb symptoms seek care from hospitals. in spite of having a policy and mandate in place, the ministry of health had little success in encouraging hospitals to refer suspected tb cases to dispensaries. following the epidemic of severe acute respiratory syndrome in 2003, the government set up a nationwide internet-based communicable diseases reporting system. this achieved productive collaboration between hospitals and tb dispensaries. from 2004 to 2007, the percentage of tb suspects and patients needing referral from hospitals who arrived in tb dispensaries increased substantially from 58.7% to 77.8% and the contribution of hospitals to diagnosing sputum smear-positive tb cases doubled from 16.3% to 32.9%. using the internet-based reporting system, hospitals in china contributed to finding about one third of all sputu m smear-positive tb cases and helped meet the global tb control target of detecting 70% of such cases. based on the data available from routine surveillance facilitated by this internet-based system, this paper details the process and outcomes of strengthening collaboration between hospitals and tb dispensaries using the internet as a tool and its potential application to other country settings.
Achieving Systemic and Scalable Private Sector Engagement in Tuberculosis Care and Prevention in Asia
William A. Wells?,Mukund Uplekar,Madhukar Pai
PLOS Medicine , 2015, DOI: 10.1371/journal.pmed.1001842
Maintaining Nursing Care Quality—Clinical Care Guidelines for Cystic Fibrosis: Outpatient and Inpatient  [PDF]
Melanie Koeller, Cornelia Meyer
Case Reports in Clinical Medicine (CRCM) , 2016, DOI: 10.4236/crcm.2016.510055
Abstract: The Care Committee of the Mukoviszidose e.V., headed by Cornelia Meyer, has drawn up a completely revised version of the German Guidelines to Care in Cystic Fibrosis. It addresses all nursing staff concerning children, adolescents or adults with cystic fibrosis (CF) either in an inpatient and outpatient setting or in rehab clinics. The guidelines evolve along with the increased life expectancy of cystic fibrosis patients and improved quality of life which is described by CF patients and can be observed by the therapeutic CF team. For example, the treatment of secondary diseases like CFDR (CF related diabetes) which comes along with an increased life expectancy has been added over the years. It is essential that within such a complex disease pattern, professional experience of care staff who worked in specialized CF care centers (50+ patients per year) for many years has to be transferred to other nursing stuff or beginners. This is especially important in the context of the heterogeneous characteristics of this disease. Often it can be seen that the quality of the care for CF patients depends on the know-how and professional experience of the interdisciplinary CF therapists team. Moreover, it depends on the knowledge which the patient has gathered by himself by experience or learning. And, of course, it depends also on the knowledge of the relatives especially parents or partner respectively.
Response Inhibition and Memory Retrieval of Emotional Target Words: Evidence from an Emotional Stop-Signal Task  [PDF]
Cornelia Herbert, Stefan Sütterlin
Journal of Behavioral and Brain Science (JBBS) , 2011, DOI: 10.4236/jbbs.2011.13020
Abstract: Previous research suggests that emotional stimuli capture attention and guide behavior often automatically. The present study investigated the relationship between emotion-driven attention capture and motor response inhibition to emotional words in the stop-signal task. By experimental variations of the onset of motor response inhibition across the time-course of emotional word processing, we show that processing of emotional information significantly interferes with motor response inhibition in an early time-window, previously related to automatic emotion-driven attention capture. Second, we found that stopping reduced memory recall for unpleasant words during a subsequent surprise free recall task supporting assumptions of a link between mechanisms of motor response inhibition and memory functions. Together, our results provide behavioral evidence for dual competition models of emotion and cognition. This study provides an important link between research focusing on different sub-processes of emotion processing (from perception to action and from action to memory).
Loss of anti-predator behaviors in cattle and the increased predation losses by wolves in the Northern Rocky Mountains  [PDF]
Cornelia Fl?rcke, Temple Grandin
Open Journal of Animal Sciences (OJAS) , 2013, DOI: 10.4236/ojas.2013.33037
Abstract: Managing livestock near Yellowstone National Park has become an increasing challenge since conservation of wolves restricts ranchers from interfering. Even though wolves are beneficial for the ecosystem, rising predation incidences on livestock (depredations) create animosity in local farmers. Temperament selection of cattle, measured by the facial hair whorl pattern (HW)1, occurred during the last 15 years and the industry prefers calmer temperament animals. Six HWs occur in cattle (high, middle, low, abnormal, multiple and none), which are mutually exclusive and can be identified by using the eye-line as a reference point. We analyzed depredation of calves near Council, ID in 2011. A herd of 588 Black Angus × Charolais crossbreds (age range: 5 - 17 years) was observed. By analyzing the HW and age of cows in relation to depredations, we could identify a connection between these three factors (P < 0.001). The HW of a cow influenced the probability of losing the calf to predation (P < 0.001). Cows without the facial HW faced an increased percentage of losses (probability of 19.6% of losing the calf) compared to other HW (probability between 0% - 6.1%). An age effect on the probability of losing the calf was also found (P = 0.023). Cows over the age of 10 years are more likely to lose their calves. Our findings suggest that behavioral differences between cows with different HWs exist. Differences in protectiveness or vigilance towards the surroundings in cows without a facial HW may lead to an increased probability of losing their calves.
Separation Behavior for Parturition of Red Angus Beef Cows  [PDF]
Cornelia Fl?rcke, Temple Grandin
Open Journal of Animal Sciences (OJAS) , 2014, DOI: 10.4236/ojas.2014.42007
Abstract: Increased predation losses in beef cattle in the Northern Rocky Mountains raise the importance of research concerning maternal behavior around the time of parturition. Separation behavior of multiparous cows at parturition was studied by measuring the distance (m) between the birth place and the main herd with a GPS device. Age of cows and forehead hair whorl pattern (HW) were analyzed as possible factors affecting separation distance. A total of 333 cows (95% Red Angus and 5% Angus × Hereford commercial crossbreds; age range: 3 - 6 yrs) were studied. Separation distance was determined by approaching the cow-calf pair with a utility vehicle that gradually decreased the distance to the pair. The geographic coordinates per pair were recorded and the separation distance was calculated as a straight line between each pair and the main herd. The HW on the forehead of each animal was used as a measure of individual differences in temperament. Age and HW were collected when the animals were held in a squeeze chute. HW was classified into one of six groups: high, middle, low, abnormal, multiple HWs and no HW. The age of a cow influenced the separation distance for parturition (P < 0.001). Four-year-old cows were on average about 150 m further away than other aged cows when calving. Eighty-eight percent of cows separated more than 100 m from the herd. The hair whorl position had no influence on the separation distance (P = 0.405). Distinct separation behavior for parturition was observed in this herd which appears to be an innate behavior that is influenced by the individual temperament of the cow.
Tuberculosis Management by Private Practitioners in Mumbai, India: Has Anything Changed in Two Decades?
Zarir F. Udwadia,Lancelot M. Pinto,Mukund W. Uplekar
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0012023
Abstract: Mumbai, India. A study conducted in Mumbai two decades ago revealed the extent of inappropriate tuberculosis (TB) management practices of private practitioners. Over the years, India's national TB programme has made significant progress in TB control. Efforts to engage private practitioners have also been made with several successful documented public-private mix initiatives in place.
Hard gains through soft contracts: productive engagement of private providers in tuberculosis control
L?nnroth,Knut; Uplekar,Mukund; Blanc,Léopold;
Bulletin of the World Health Organization , 2006, DOI: 10.1590/S0042-96862006001100012
Abstract: over the past decade, there has been a rapid increase in the number of initiatives involving "for-profit" private health care providers in national tuberculosis (tb) control efforts. we reviewed 15 such initiatives with respect to contractual arrangements, quality of care and success achieved in tb control. in seven initiatives, the national tb programme (ntp) interacted directly with for-profit providers; while in the remaining eight, the ntp collaborated with for-profit providers through intermediary not-for-profit nongovernmental organizations. all but one of the initiatives used relational "drugs-for-performance contracts" to engage for-profit providers, i.e. drugs were provided free of charge by the ntp emphasizing that providers dispense them free of charge to patients and follow national guidelines for diagnosis and treatment. we found that 90% (range 61-96%) of new smear-positive pulmonary tb cases were successfully treated across all initiatives and tb case detection rates increased between 10% and 36%. we conclude that for-profit providers can be effectively involved in tb control through informal, but well defined drugs-for-performance contracts. the contracting party should be able to reach a common understanding concerning goals and role division with for-profit providers and monitor them for content and quality. relational drugs-for-performance contracts minimize the need for handling the legal and financial aspects of classical contracting. we opine that further analysis is required to assess if such "soft" contracts are sufficient to scale up private for-profit provider involvement in tb control and other priority health interventions.
History, Morphology and Perfect Proportions of Mughal Tombs: The Secret to Creation of Taj Mahal
Krupali Uplekar Krusche,Danny Aijian,Selena Anders,Iva Dokonal
Archnet-IJAR : International Journal of Architectural Research , 2010,
Spaces of Sobolev type with positive smoothness on ?n, embeddings and growth envelopes
Cornelia Schneider
Journal of Function Spaces and Applications , 2009, DOI: 10.1155/2009/815676
Abstract: We characterize Triebel-Lizorkin spaces with positive smoothness on ℝn, obtained by different approaches. First we present three settings Fp,qs(ℝn),Fp,qs(ℝn),ℑp,qs(ℝn) associated to definitions by differences, Fourier-analytical methods and subatomic decompositions. We study their connections and diversity, as well as embeddings between these spaces and into Lorentz spaces. Secondly, relying on previous results obtained for Besov spaces 𝔅p,qs(ℝn), we determine their growth envelopes 𝔈G(Fp,qs(ℝn)) for 0≺p≺∞, 0≺q≤∞, s≻0, and finally discuss some applications.
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