Efficiency of Health Care Sector at Sub-State Level in India: A Case of Punjab

In recent years, WHO and other individual researchers have advocated estimation of health system performance through stochastic frontier models. It provides an idealized yardstick to evaluate economic performance of health system. So far attempts in India have remained focused at state level analysis. This paper attempts a sub-state level analysis for an affluent Indian state, namely Punjab, by using stochastic frontier technique. Our results provide pertinent insight into state health system and facilitate health facility planning at the sub-state level. Carried out in two stages of estimation, our results suggest that life expectancy in the Indian state could be enhanced considerably by correcting the factors that are adversely influencing the sub-state level health system efficiency. A higher budgetary allocation for health manpower is recommended by us to improve efficiency in poorly performing districts. This may be supported by policy initiatives outside the health system by empowering women through better education and work participatio

Accommodating disability in higher education: a closer look at the evidence for a mainstream framework of learning support

In a recently published research article in this journal, Avramidis & Skidmore (2004) argued that it is time we placed issues of disability provision more in the context of provision for the generic student. They presented a study based on the Learning for All Questionnaire (LfAQ), which investigated certain implied issues. Findings indicated a need for improved educational provision for all students. No differences were found between disabled and non-disabled students in perceived level of needs or support for university, tutoring and lecturing systems. This null finding was the same for the learning support needs of disabled versus non-disabled students, with both groups wanting identical changes to the way the university's central learning support service responds to learning needs. These findings were taken as calling for a move away from a ‘specialist’ framework of disability provision and towards a ‘mainstream’ framework instead, in which the needs of disabled students are accommodated within improvements made in learning for all. Further, the Disabled Students' Allowance should be given over to departments in order to help fund this change in ‘institutional habitus’. In this article, four serious failings of the study and analyses are outlined. When these are addressed in a disability-theoretic reanalysis of the LfAQ data, every main finding is reversed. It is concluded that educational provisions are generally adequate. Students would welcome changes but these are more to do with increasing levels of convenience rather than learning support issues. Furthermore, the LfAQ data actually refute rather than support a mainstream framework of disability provision

Developmental disorders of vision

This review of developmental disorders of vision focuses on a few of the many disorders that disrupt visual development. Given the enormity of the human visual system in the primate brain and complexity of visual development, however, there are likely hundreds or thousands of potential types of disorders affecting high-level vision. The rapid progress seen in developmental dyslexia and Williams syndrome demonstrates the possibilities and difficulties inherent in researching such disorders, and the authors hope that similar progress will be made for congenital prosopagnosia and other disorders in the near future

A system dynamics-based simulation study for managing clinical governance and pathways in a hospital

This paper examines the development of clinical pathways in a hospital in Australia based on empirical clinical data of patient episodes. A system dynamics (SD)-based decision support system (DSS) is developed and analyzed for this purpose. System dynamics was used as the simulation modeling tool because of its rigorous approach in capturing interrelationships among variables and in handling dynamic aspects of the system behavior in managing healthcare. The study highlights the scenarios that will help hospital administrators to redistribute caseloads amongst admitting clinicians with a focus on multiple Diagnostic Related Groups (DRG’s) as the means to improve the patient turnaround and hospital throughput without compromising quality patient care. DRG’s are the best known classification system used in a casemix funding model. The classification system groups inpatient stays into clinically meaningful categories of similar levels of complexity that consume similar amounts of resources. Policy explorations reveal various combinations of the dominant policies that hospital management can adopt. The analyses act as a scratch pad for the executives as they understand what can be feasibly achieved by the implementation of clinical pathways given a number of constraints. With the use of visual interfaces, executives can manipulate the DSS to test various scenarios. Experimental evidence based on focus groups demonstrated that the DSS can enhance group learning processes and improve decision making. The simulation model findings support recent studies of CP implementation on various DRG’s published in the medical literature. These studies showed substantial reductions in length of stay, costs and resource utilization

Getting one step closer to deduction: Introducing an alternative paradigm for transitive inference

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2008 Psychology Press.Transitive inference is claimed to be “deductive”. Yet every group/species ever reported apparently uses it. We asked 58 adults to solve five-term transitive tasks, requiring neither training nor premise learning. A computer-based procedure ensured all premises were continually visible. Response accuracy and RT (non-discriminative nRT) were measured as is typically done. We also measured RT confined to correct responses (cRT). Overall, very few typical transitive phenomena emerged. The symbolic distance effect never extended to premise recall and was not at all evident for nRT; suggesting the use of non-deductive end-anchor strategies. For overall performance, and particularly the critical B?D inference, our findings indicate that deductive transitive inference is far more intellectually challenging than previously thought. Contrasts of our present findings against previous findings suggest at least two distinct transitive inference modes, with most research and most computational models to date targeting an associative mode rather than their desired deductive mode. This conclusion fits well with the growing number of theories embracing a “dual process” conception of reasoning. Finally, our differing findings for nRT versus cRT suggest that researchers should give closer consideration to matching the RT measure they use to the particular conception of transitive inference they pre-held

Clinical solutions: not always what they seem?

Brenner and colleagues, in their article published in Critical Care, showed elevated levels of the reactive carbonyl species (RCS) methylglyoxal (MG) in the circulation of patients with septic shock. We commend the authors’ bravery in launching this molecule into a field well-populated with biomarkers and where clinical diagnosis persists as the ‘gold standard’

Transitivity for height versus speed: To what extent do the under-7s really have a transitive capacity?

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2011 Psychology Press.Transitive inference underpins many human reasoning competencies. The dominant task (the “extensive training paradigm”) employs many items and large amounts of training, instilling an ordered series in the reasoner's mind. But findings from an alternative “three-term paradigm” suggest transitivity is not present until 7 + years. Interestingly, a second alternative paradigm (the “spatial task”), using simultaneously displayed height relationships to form premise pairs, can uphold the 4-year estimate. However, this paradigm risks cueing children and hence is problematic. We investigated whether a height-task variant might correspond to a more ecologically valid three-term task. A total of 222 4–6-year-olds either completed a modified height task, including an increased familiarisation phase, or a computer-animated task about cartoon characters running a race in pairs. Findings confirmed that both tasks were functionally identical. Crucially, 4-year-olds were at chance on both, whereas 6-year-olds performed competently. These findings contrast with estimates from all three paradigms considered. A theoretical evaluation of our tasks and procedures against previous ones, leads us to two conclusions. First, our estimate slightly amends the 7-year estimate offered by the three-term paradigm, with the difference explained in terms of its greater relevance to child experiences. Second, our estimate can coexist alongside the 4-year estimate from the extensive training paradigm. This is because, applying a recently developed “dual-process” conception of reasoning, anticipates that extensive training benefits a species-general associative system, while the spatial paradigm and three-term paradigm can potentially index a genuinely deductive system, which has always been the target of transitive research

Frequency Restoration Reserve Control Scheme with Participation of Industrial Loads

In order to accommodate larger amounts of renewable energy resources, whose power output is inherently unpredictable, there is an increasing need for frequency control power reserves. Loads are already used to provide replacement reserves, i.e. the slowest kind of reserves, in several power systems. This paper proposes a control scheme for frequency restoration reserves with participation of industrial loads. Frequency restoration reserves are required to change their active power within a time frame of tens of seconds to tens of minutes in response to a regulation signal. Industrial loads in many cases already have the capacity and capability to participate in this service. A mapping of their process constraints to power and energy demand is proposed in order to integrate industrial loads in existing control schemes. The proposed control scheme has been implemented in a 74-bus test system. Dynamic simulations show that industrial loads can be successfully integrated into the power system as frequency restoration reserves. © 2013 IEEE