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2,468 result(s) for "Sharma, Rakesh"
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Agrarian distress and farmer suicides in North India
\"This volume provides a comprehensive and detailed socio-economic overview of agrarian distress in India which has manifested in the suicides of farmers and agricultural labourers. Using empirical research and field data from rural India, especially Punjab, this book examines the underlying causes of farmer suicide and steps which can mitigate the crisis. Covering nearly 1400 rural households, the research in this volume identifies the various dimensions of the deepening crisis in agriculture and farming. It categorises the factors of the problem across different regions and estimates its extent and magnitude. The authors, in this updated edition, focus on instances of political mobilization and collective movements by farmers struggling to bring the issue of agrarian distress to attention. The book also discusses the implementation of state-waivered loans and compensations and their effect on the farming community. Topical, comprehensive and rich in data, this book will be valuable to scholars and researchers of political economy, agricultural economics, South Asian politics, political sociology, and public policy\"-- Provided by publisher.
Enhancing Email Responsiveness in Mental Health Services: A Quality Improvement Initiative
Aims: Effective communication is essential in mental health services, where timely decisions can significantly impact patient outcomes. Studies have shown that delayed responses to clinical communications can compromise patient safety, lead to treatment delays, and increase stress among professionals. The absence of standardized email response protocols within the North London Mental Health Trust has resulted in varying practices, with some professionals responding promptly while others may neglect emails, particularly those concerning patient care. This project seeks to address this inconsistency and improve the overall communication framework within the Trust. Aims were to to develop and implement an email response protocol for mental health professionals in the North London Mental Health Trust, ensuring timely and consistent communication regarding patient care. Methods: Co-Production: Engage stakeholders, including clients/carers, mental health professionals, managers, and admin representatives, to co-design the email response guidelines. Conduct surveys to gather insights on current practices and barriers to timely responses. Identify and Understand: Conduct a baseline assessment of current email response times and practices using a survey distributed to all mental health professionals. Analyse the collected data to identify patterns of non-responsiveness and the reasons behind them (e.g. workload, lack of awareness of the importance of timely responses). Develop Change Strategy: Based on stakeholder feedback and data analysis, draft clear email response guidelines that outline expected response times, prioritize urgent communications, and provide examples of acceptable email etiquette. Incorporate exceptions for individuals on leave, out of office, or in emergency situations. Results: 1. Work-Related Email Volume: The majority of mental health professionals receive between 20–50 emails per day, with a significant portion being patient-care related. 2. Response Time for Patient-Care Emails: Around 60% of professionals respond to patient-related emails within 24 hours. This increases to 80% when measured within 48 hours, indicating that while delays exist, the majority eventually respond within two days. 3. Factors Influencing Response Time: High workload, email volume, and urgent clinical duties were cited as the most common barriers to quick responses. Some professionals also noted a lack of standardized email response guidelines, leading to inconsistency in practices. 4. Challenges in Email Management: Professionals expressed difficulty in managing high email volumes, particularly when dealing with urgent clinical responsibilities. Lack of training on email prioritization was another reported challenge. 5. Recommendations from Professionals for Improvement: Implementation of standardized email response guidelines. Training on email management strategies and prioritization of urgent vs. non-urgent communications. 6. Impact on Patient Care and Communication: A consensus among professionals was that delayed email responses negatively impact patient care, as they can lead to delayed decision-making and increased stress among teams. 7. Willingness to Engage in Further Training: A majority of professionals were willing to participate in training related to improving email response times, indicating strong support for a structured intervention. Conclusion: The implementation of a standardized email response protocol is vital for improving communication practices among mental health professionals in the North London Mental Health Trust. By addressing the current gaps in communication, we aim to enhance patient care and streamline inter-professional collaboration.
Green chemistry for beginners
\"With escalating concerns over the current state of our planet, the realization to work toward reducing our environmental footprint is gaining momentum. Scientists have realized that green chemistry is the key to reduce waste, rendering healthy environment, and improving human health. The 12 principles of green chemistry are the basic tenets that require understanding at the most fundamental level and implementationto promoting sustainable synthesis. This book discusses innovations in the form of greener technologies (superior green catalysts, alternate reaction media, and green energy sources) and elaborates their tremendous potential in combating the critical global challenges on the horizon. It intends to empower and educate students to grasp the key concepts of green chemistry, think out of the box and come up with new ideas, and apply the basic concepts in greening the world. It extensively covers the goals of the United Nation's 2030 Agenda of Sustainable Development, which can be successfully achieved with the aid of green chemistry. It also highlights cutting-edge greener technologies such as biomimicry, miniaturization, and continuous flow.\"--Provided by publisher.
Ensuring Comprehensive Care: An Audit on Physical Parameter Monitoring in Children and Adolescents With ADHD on Medication
Aims: In child and adolescent psychiatry, particularly within Child and Adolescent Mental Health Services (CAMHS), monitoring the physical health of patients on ADHD medications is of paramount importance. Medications such as stimulants can have significant impacts on physiological processes, including cardiovascular health. This audit aims to assess current practices in monitoring physical parameters in children and adolescents prescribed ADHD medication at St Ann’s Hospital (Haringey), identify gaps in practice, and recommend improvements based on recent research. Methods: Study design: Retrospective audit. Sample: Medical records of children and adolescents diagnosed with ADHD and currently on medication. Data Collection: Frequency and documentation of weight, height, blood pressure, and heart rate measurements over the past year. Analysis: Descriptive statistics will be used to compare current practices against established standards. Ethical considerations: Ensured patient confidentiality throughout the audit. Literature review. Results: Of the 50 clients reviewed: 46 clients had their blood pressure, pulse rate, height, and weight measured at every appointment. 2 clients were referred for shared care, impacting tracking of their monitoring. 1 client’s height was not checked at appointments, though other parameters were monitored. 1 client did not have blood pressure and pulse rate monitored during follow-up. Conclusion: The audit highlighted significant adherence to monitoring standards but identified gaps in certain areas. Implementing the recommendations and maintaining a strong commitment to regular audits will enhance the quality of care provided to children and adolescents with ADHD in CAMHS. A re-audit will be planned to evaluate the impact of changes made from this audit.
A Retrospective Analysis of Non-Attendance (DNA) in Haringey CAMHS: Addressing Barriers to Care and Improving Engagement
Aims: To evaluate DNA rates and contributory factors within CAMHS to propose interventions that improve appointment adherence and service delivery. Methods: A retrospective review of appointment data and patient records. Data sources: RiO (electronic patient records). Appointment scheduling logs. Communication records (e.g. letters, SMS). Audit Period: October 2024–December 2024. Inclusion criteria: All scheduled CAMHS appointments during the audit period. Patients aged [5–18 years]. Exclusion criteria: Appointments cancelled in advance by patients or clinicians. Patients discharged prior to the scheduled appointment date. Results: The high DNA rates, especially in the Generic Team (77–97 across three months), underline the wasted resources and delayed care. This validates the need to identify and address the root causes of DNAs. Findings: Generic team has consistently higher DNA rates. ADHD and Adolescent Outreach teams also show engagement challenges. Conclusion: The audit highlights significant DNA challenges in CAMHS. Addressing these issues through improved communication, flexible scheduling, and robust follow-ups can enhance patient engagement and resource efficiency. Future re-audits will track improvements and refine interventions.
Investigating the relationship of government revenue and expenditure on economic growth using a generalized method of moments: Does state-level panel ensure sustainable growth?
The current research project investigates the correlation between economic growth, government spending, and public revenue in seventeen Indian states spanning the years 1990 to 2020. An analysis of the relationship between key fiscal policy variables and economic growth was conducted utilising a panel data approach, the Generalised Method of Moments (GMM), and fully modified Ordinary Least Squares (FMOLS & DOLS) estimation. In our investigation, we assessed the impacts of non-tax revenue, development plan expenditure, tax revenue, and development non-plan expenditure on (i) the net state domestic product (NSDP) and (ii) the NSDP per capita. The findings indicate that the selected fiscal variables are significantly related. The results indicate that expeditious expansion of the fiscal sector is obligatory to stimulate economic growth in India and advance the actual development of the economies of these states.
Enlightening the critical factors affecting the solvency of Indian construction industry: An empirical analysis using multivariate discriminant analysis and logistic regression
The present research work aimed to examine the vital factors that affect the solvency of the Indian construction sector. The two different parameters of solvency, namely, debt to total assets (DTA) and cash flow to total liabilities (CFTL), were used in the present study. These two solvency indicators were categorized using zero and one numerical values. One indicates financially sound companies, and zero indicates weak companies with poor solvency ratios. The different financial ratios, namely, profitability, liquidity, leverages, and turnovers, were used as predictors or explanatory variables of insolvency of Indian construction companies. The study employs multivariate discriminant analysis (MDA) and binary logistic regression to predict the factors accountable for the insolvency of the Indian construction sector. The empirical findings of MDA and logistic regression show significant discrimination in the solvency position of construction companies according to their different financial performance parameters, namely, profitability, liquidity, and leverage. The empirical findings suggest that in the first case, the critical indicators predicting solvency are turnover, liquidity, and leverage ratios. In the second measure of solvency (CFTL), profitability significantly discriminates solvency of companies. Overall, the findings of MDA and logistic regression are consistent with each other. The outcomes of the study will be helpful to policymakers' different stakeholders.
Efficacy of hyperbaric oxygen therapy for diabetic foot ulcer, a systematic review and meta-analysis of controlled clinical trials
Studies have suggested that hyperbaric oxygen therapy (HBOT) is effective in the healing of diabetic foot ulcer (DFU); however, there is a lack of consensus. Therefore, to assess the efficacy of HBOT on diabetic foot ulcer among diabetic patients, controlled clinical trials were searched through PubMed, EMBASE, Clinical key, Ovid Discovery, ERMED, Clinical Trials.gov databases for randomized controlled trials (RCTs) and other sources until 15 September 2020. Studies that evaluated the effect of HBOT on diabetic foot ulcer, complete healing, amputation, adverse events, ulcer reduction area, and mortality rate were included. Of 1984 study records screened, 14 studies (768 participants) including twelve RCTs, and two CCTs were included as per inclusion criteria. The results with pooled analysis have shown that HBOT was significantly effective in complete healing of diabetic foot ulcer (OR = 0.29; 95% CI 0.14–0.61; I 2  = 62%) and reduction of major amputation (RR = 0.60; 95% CI 0.39–0.92; I 2  = 24%). Although, it was not effective for minor amputations (RR = 0.82; 95% CI 0.34–1.97; I 2  = 79%); however, less adverse events were reported in standard treatment group (RR = 1.68; 95% CI 1.07–2.65; I 2  = 0%). Nevertheless, reduction in mean percentage of ulcer area and mortality rate did not differ in HBOT and control groups. This review provides an evidence that hyperbaric oxygen therapy is effective as an adjunct treatment measure for the diabetes foot ulcers. These findings could be generalized cautiously by considering methodological flaws within all studies.
Observation and rationalization of nitrogen oxidation enabled only by coupled plasma and catalyst
Heterogeneous catalysts coupled with non-thermal plasmas (NTP) are known to achieve reaction yields that exceed the contributions of the individual components. Rationalization of the enhancing potential of catalysts, however, remains challenging because the background contributions from NTP or catalysts are often non-negligible. Here, we first demonstrate platinum (Pt)-catalyzed nitrogen (N 2 ) oxidation in a radio frequency plasma afterglow at conditions at which neither catalyst nor plasma alone produces significant concentrations of nitric oxide (NO). We then develop reactor models based on reduced NTP- and surface-microkinetic mechanisms to identify the features of each that lead to the synergy between NTP and Pt. At experimental conditions, NTP and thermal catalytic NO production are suppressed by radical reactions and high N 2 dissociation barrier, respectively. Pt catalyzes NTP-generated radicals and vibrationally excited molecules to produce NO. The model construction further illustrates that the optimization of productivity and energy efficiency involves tuning of plasma species, catalysts properties, and the reactor configurations to couple plasma and catalysts. These results provide unambiguous evidence of synergism between plasma and catalyst, the origins of that synergy for N 2 oxidation, and a modeling approach to guide material selection and system optimization. Heterogeneous catalysts coupled with non-thermal plasma are known to achieve higher reaction yields, but disentangling the gain achieved by the individual components remains challenging. Here, NO is produced from N 2 and O 2 in a plasma-catalytic reactor at conditions at which neither catalyst nor plasma alone is productive, providing unambiguous evidence of plasma-catalyst synergy.
Ligninolytic Fungal Laccases and Their Biotechnological Applications
Lignin is amorphous in nature, lacks stereoregularity, and is not susceptible to hydrolytic attack. Despite its resistant nature, it is however degraded by various microorganisms, particularly, white-rot fungi. Such fungi are capable of extracellular production of lignin peroxidase, manganese peroxidase, and laccase, the three major enzymes associated with ligninolysis. Though all white-rot fungi do not produce all the three enzymes, laccase occupies an important place in ligninolysis. Laccase belongs to a diverse group of enzymes called oxidoreductases and is also known as benzenediol: oxygen oxidoreductase. They have low substrate specificity. The copper-containing enzyme laccase has been detected in a variety of organisms such as bacteria, fungi, plants, and insects. Mostly, these are extracellular proteins, although intracellular laccases have also been detected in some fungi and insects. Fungal laccases are believed to play a variety of roles, such as, morphogenesis, pathogenesis, and lignin degradation. As an oxidase, laccase is used in many agricultural, industrial, and medicinal applications. Current investigations are focused on laccase-based biooxidation, biotransformation, biosensor, and enzymatic synthesis of organic compounds. By enhancing laccase production using different physiochemical parameters, better understanding of the mechanism for the reactions of interest, and optimizing the catalytic activity of laccase, it can be used in a better way in diverse fields of biotechnology.