Evaluation of Sigma-Metric and Application of Quality Tools in Clinical Laboratory of a Tertiary Care Hospital

Variability in analytical performance of some analyte indicated the need of evaluation of quality plan of our laboratory. We tried to put the same degree of effort into our quality metrics as we put into the laboratory processes themselves. Application of six sigma methodologies improve the quality by focusing on the root causes of the problems in performance and analyzing by flowcharts, fishbone diagrams and other quality tools. Sigma metric was calculated for laboratory parameters for a period of 8 months during 2018–19. The analytes with poor sigma metric were free Thyroxine (FT3, FT4), Sodium, Calcium and Magnesium. Sigma metric of free Thyroxine (FT3, FT4), Sodium, Calcium and Magnesium were below 3. A road map for process improvement was designed with DMAIC (Define-Measure-Analyze-Improve-Control) model to solve the issue. Possible causes for low analytical performance of the particular analytes were depicted in Fishbone diagram. The Fishbone analysis identified the water quality issues with electrolyte analysis while high ambient temperature was culprit for poor assay performance of free Thyroxine. Sigma metric of the analytical performance was assessed once again after root cause analysis. Sigmametric showed marked improvement in control phase. Identification of problems led to reduction in non value added work leading to adequate resource utilization by addressing the priority issue. Therefore, DMAIC tool with Fish bone model analysis can be recommended as a well suited method for troubleshooting in poor performance of laboratory parameter.     

Appropriateness of recommended agricultural water-management technologies as perceived by the personnel of research and extension system: A study in the eastern region of India

The key to agricultural development in the eastern region of India, where problems of excess water and water scarcity coexist, is the scientific management of water resources with the adoption of recommended water-management technologies. A vast networking of infrastructure for the development and dissemination of water- management technologies have been designed since the very inception of planned economic change. Despite these concerted efforts, a large number of recommended technologies are either being adopted in piece-meal or not at all. The research and extension systems have been generating and disseminating technologies, therefore, it was felt worthwhile to assess the feasibility and appropriateness of recommended tecnologies as perceived in the first instance by the personnel of the research system and followed by the extension personnel. These steps were felt to be a precursor to screen the recommended technologies for their dissemination and evaluation in different farming systems. The assessment of recommended water-management technologies was performed after their documentation from different organisations working in the field of water management in two eastern India states viz. Orissa and West Bengal. The perception of 30 personnel members of the research system regarding the feasibility of these technologies elucidated that out of 86 documented recommended water-management technologies, 40 were having feasibility scores of ≥ 4.0; 8 technologies with score £ 3.0 and the rest of the 38 technologies with a score between 3.0 and 4.0 on a feasibility continuum range from 1.0 (not feasible) to 5.0 (highly feasible). Out of 40 recommended technologies (already assessed as highly feasible by the research personnel), extension personnel have perceived 16 and 10 technologies as highly appropriate and feasible, respectively. While six and four technologies were found to be less appropriate and feasible, respectively. Correlation of all nine indicators of appropriateness with feasibility of technologies was significant. Five indicators of appropriateness viz. simplicity, physical compatibility, production sustainability, cultural compatibility and cost together constituted 36.8 per cent of the total variation in feasibility with the ‘t’ values and ‘F’ values being significant. It indicates that not appropriateness of technologies alone but other factors influence the feasibility of technologies.     

Futility1 of Log‐Linear Smoothing when Equating with Unrepresentative Small Samples

The impact of log‐linear presmoothing on the accuracy of small sample chained equipercentile equating was evaluated under two conditions . In the first condition the small samples differed randomly in ability from the target population. In the second condition the small samples were systematically different from the target population. Results showed that equating with small samples (e.g., N < 25 or 50) using either raw or smoothed score distributions led to considerable large random equating error (although smoothing reduced random equating error). Moreover, when the small samples were not representative of the target population, the amount of equating bias also was quite large. It is concluded that although presmoothing can reduce random equating error, it is not likely to reduce equating bias caused by using an unrepresentative sample. Other alternatives to the small sample equating problem (e.g., the SiGNET design) which focus more on improving data collection are discussed.     

Tide–surge interaction model including air bubble effects for the coast of Bangladesh

An estimate of water levels due to the interaction of tide and surge associated with a storm including air bubble effects is made along the coastal region of Bangladesh. For this purpose, a vertically integrated shallow water model in Cartesian coordinate system is developed introducing air bubbles and is solved using nested finite difference schemes. A fine grid model covering the region between 21°15′N to 23°N and 89°E to 92° E has been nested into a coarse grid model covering the region between 15°N to 23°N and 85°E to 95°E in the Bay of Bengal to incorporate all the major islands and coastal bending accurately. By applying tidal forcing through the southern open boundary of the coarse grid model appropriate tidal conditions are generated in the problem domain. Numerical experiments are performed with the help of the model to simulate water levels due to tide and surge interaction including air bubble effects associated with the tropical storm of April 1991. The model results are found to be reasonable and the model can be found to simulate higher water levels in the presence of air bubbles.     

MATHEMATICS AS AN IM/PURE KNOWLEDGE SYSTEM: SYMBIOSIS, (W)HOLISM AND SYNERGY IN MATHEMATICS EDUCATION

The problem of culturally decontextualised mathematics education faced by Nepali students, teachers and teacher educators has often been oriented by the view of the nature of mathematics as a body of pure knowledge, which gives rise to an exclusive emphasis on an ideology of singularity, epistemology of objectivism, language of universality and logic of certainty whilst developing curriculum, conceiving pedagogies and implementing assessment strategies in school mathematics education and mathematics teacher education programmes. With epistemic referents of dialectical logics and performative imagination, an alternative view of the nature of mathematics as an impure knowledge is discussed with its possible disempowering features, such as essentialism, hegemony and dualisms. Finally, an inclusive view of the nature of mathematics as im/pure knowledge system is articulated with the help of various forms of dialectics.     

Supporting Online PBL: Design Considerations for Supporting Distributed Problem Solving

This study considers how four groups of education graduate students worked in a distributed problem-based learning (PBL) environment using an asynchronous threaded discussion tool. The analyses consider how the students were able to interact with each other using the tool and how they worked together to define the problem and identify key issues to explore. The outcomes include some design considerations for tools to support these activities as well as insight about how students may work together to solve a problem in a distributed environment.     

A cogenerative inquiry using postcolonial theory to envisage culturally inclusive science education

This forum constitutes a cogenerative inquiry using postcolonial theory drawn from the review paper by Zembylas and Avraamidou. Three teacher educators from African, Asian and Caribbean countries reflect on problems confronting their professional practices and consider the prospects of creating culturally inclusive science education. We learn that in Mozambique, Nepal and the Caribbean scientism patrols the borders of science education serving to exclude local epistemological beliefs and discourses and negating culturally contextualized teaching and learning. Despite the diverse cultural hybridities of these countries, science education is disconnected from the daily lives of the majority of their populations, serving inequitably the academic Western-oriented aspirations of an elite group who are “living hybridity but talking scientism.” The discussants explore their autobiographies to reveal core cultural values and beliefs grounded in their non-Western traditions and worldviews but which are in conflict with the Western Modern Worldview (WMW) and thus have no legitimate role in the standard school/college science classroom. They reflect on their hybrid cultural identities and reveal the interplay of multiple selves grounded in both the WMW and non-WMWs and existing in a dialectical tension of managed contradiction in a Third Space. They argue for dialectical logic to illuminate a Third Space wherein students of science education may be empowered to challenge hegemonies of cultural reproduction and examine reflexively their own identities, coming to recognize and reconcile their core cultural beliefs with those of Western modern science, thereby dissipating otherwise strongly delineated cultural borders.

Protective Role of <Emphasis Type="SmallCaps">l</Emphasis>-Arginine Against Free-Radical Mediated Oxidative Damage in Patients with Unstable Angina

Unstable angina is a critical condition of heart resulting from narrowing of vessels supplying blood to heart. Ischemia of the myocardium leads to oxidative stress and severe tissue damage. The objective of the present study was to determine the effect of l-arginine administration on the oxidant–antioxidant homeostasis which otherwise gets imbalanced in patients with cardiovascular diseases. The results obtained, show improvement in the oxidant–antioxidant levels of the subjects upon incorporation of l-arginine. Our findings suggest that supplementation of l-arginine along with regular anti-anginal therapy may be beneficial to the patients of unstable angina.     

Oxidative stress, α-tocopherol, ascorbic acid and reduced glutathione status in schizophrenics

A disturbance in the antioxidant defense system including α-tocopherol, ascorbic acid and reduced glutahtione metabolism due to free radical induced oxidative injury has been implicated in various neuro-psychiatric disorders. The roles of these antioxidants, changes in their blood levels and correlation with oxidative stress were studied in a common psychiatric illness Schizophrenia. Fifty-eight subjects of either sex ranging in age from 18–60 years divided into two age groups (≤40 and >40 years) diagnosed for schizophrenia, and forty age and sex-matched normal subjects as controls were included in the study. Blood samples were analyzed for malondialdehyde (MDA), α-tocopherol, total ascorbic acid (TAA), dehydro ascorbic acid (DHAA), reduced ascorbic acid (RAA), leucocyte ascorbic acid (LAA) and reduced glutathione (GSH). A decrease in the levels of α-tocopherol, total ascorbic acid and reduced glutathione was found in schizophrenics compared to normal controls. Further a significant rise in oxidative stress and decreased antioxidant status was observed in the chronic stage of schizophrenia as compared to those in acute condition. A significant rise in dehydroascorbic acid with concomitant fall in reduced ascorbic acid suggests scavenging action of ascorbic acid and its utilization with increased oxidative stress as indicated by high blood malondialdehyde levels. Leucocyte ascorbic acid, a better index of ascorbic acid status was also found to be reduced in schizophrenics, suggesting depletion of body stores of ascorbic acid and the condition worsened with advancing age.