Checklist and coaching program in India markedly improved childbirth care but did not reduce death rates

first_imgA checklist and coaching intervention to improve facility-based childbirth care and reduce deaths of women and newborns in India achieved significant gains in the quality of care during labor and delivery, but the improvements were insufficient to reduce death rates, according to a new study.The BetterBirth study is one of the largest ever conducted in maternal-newborn health, with more than 300,000 women and newborns. It is also the first study to rigorously demonstrate large-scale, broad-based improvement in care during the 48-hour period of labor and delivery when women and newborns face the greatest risk of death and complications.The study appears in the Dec. 14, 2017 issue of the New England Journal of Medicine.The research was led by Ariadne Labs, a joint center of the Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital in Boston, in partnership with the Governments of India and Uttar Pradesh; Community Empowerment Lab in Lucknow, India; Jawaharlal Nehru Medical College in Belgaum, India; Population Services International, and the World Health Organization. It was supported by the Bill & Melinda Gates Foundation.The quality of care around the time of childbirth has been recognized globally as a major contributor to the persistently high rates of preventable maternal and infant deaths in childbirth, even though more women are delivering babies at facilities.  The WHO’s Safe Childbirth Checklist was designed to target the seven major causes of death by helping birth attendants consistently follow basic practices such as handwashing and use of clean gloves to prevent infection.In this randomized study conducted from 2014 to 2016, birth attendants and managers at 60 rural health centers in Uttar Pradesh were coached on use of the WHO’s Safe Childbirth Checklist … Sixty matched facilities that did not receive the intervention served as comparison sites … After two months of coaching, birth attendants completed 73 percent of the essential birth practices, 1.7 times better than the control arm at 42 percent … At twelve months, four months after the coaching ended, completion of checklist items persisted at 62 percent percent, 1.4 times better than control facilities, which remained unchanged. There was no difference between intervention and control sites, however, in stillbirths, seven-day newborn mortality, and seven-day maternal mortality and morbidity. Perinatal mortality, for instance, was 47 deaths per 1,000 live births in both groups.“Overall, we found that coaching birth attendants and managers to use the WHO Safe Childbirth Checklist produced greater adherence to essential birth practices, representing significant improvements in care for women and newborns,” said BetterBirth Director Dr. Katherine Semrau, an epidemiologist at Brigham and Women’s Hospital, assistant professor at Harvard Medical School, and lead author.“This was the first rigorous study of deploying checklists and coaching at large scale,” said Ariadne Labs Executive Director Dr. Atul Gawande, a Harvard Chan School professor and senior co-author, who helped lead the development of the Safe Childbirth Checklist with WHO. “The results demonstrated impressive behavior change. Now we in public health must identify the additional ingredients required to produce the complete recipe for saving lives at childbirth.” Read Full Storylast_img read more

VR 101: What Virtual Reality Looks Like Today

first_imgVirtual Reality (VR) – what does it really mean? What does it encompass? Is everyone of the same mindset when it comes down to describing exactly what VR is and, more importantly, is not?I know it is bad form to start a topic where you are looking for answers and then more questions come at you right off the bat, but in a world with a lack of definitions currently. The Association for Educational Communications and Technology has a great academic explanation for classifying VR and hopefully we can distill that down even further as we go through the musings.There are several different experiences available on the market which give a range of different experiences. Hopefully, the overview outlined here will give you a better understanding of what to expect from each device and to have the correct expectation of performance. Is it unreasonable to think that a phone encased in cardboard and held onto your face by your own hands is going to yield the same experience as a full headset with inbuilt audio and full room tracking immersion being driven by a full-fledged PC? The short answer is yes. For a longer explanation and to see the ‘working out rationale’ then please – continue reading.At this moment in time there are three ways of consuming VR content with differing levels of experience – phone-based, console-based and PC-based.Phone-Based VRPhones are ubiquitous. They are now such a part of our everyday lives that they do far more than just keep us in voice contact with the rest of the world. They now tell us what is involved in our day, traffic conditions to make sure we are on time for a meeting, ordering takeaways and filling our social calendars with suggestions and recommendations. It makes sense then that the highest volume of VR ready devices are phones. The most common example is 360 video, and this forms the gateway to VR – a user can pan around inside the video and experience more than just a limited area flat screen.For other forms of VR the phone would normally reside inside a housing using two lenses to give separation of the left and right view and immerse the user that way. This increases the load on the phone as it is now doing far more than just answer calls and so can dramatically use up precious battery life and heat up the phone considerably. To some this is a trade off of experiencing VR on the move at a low price point and without cables or wires and is a good starting point in the VR journey. However, to others, this is a half-way house to experiencing immersive VR which requires higher spec equipment.I always find it an interesting data point when it is said phone VR starts at $15 (about the price of a Google Cardboard for instance) and that VR is too expensive further up the chain as it requires a headset and PC to drive it. This makes an assumption that the user already has a phone and yet the same assumption is not made that a user already has a gaming PC that is capable of driving VR. If we compare like-to-like, then VR on a phone is the price of a phone plus a headset which significantly reduces the price differential.Console-Based VRImage courtesy Creative Commons by Marco Verch.The Playstation VR offering has been available for some time now and offers an experience above that of a phone. Increased resolution, a more immersive experience driven by better graphics and central processing unit (CPU), as well as the introduction of external controllers can increase interactivity and thus immersion.If you are already a Playstation 4 user, the addition of PlaystationVR headset, camera and controllers can be a good option if you are not looking to purchase a PC-based solution. It also has a certain family acceptance value in that you are not dedicating space in the house to a VR setup and can be accessed in the family TV space relatively easily. However, for full immersion and the ability to look, aim and shoot behind you quickly then we need to look at other solutions.PC-Based VRThe top level of VR offering is the PC-based experience and here you can have multiple different offerings, again giving some unique benefits and limitations. Windows Mixed Reality has recently been announced by Microsoft and this supports both augmented reality (Hololens) and virtual reality devices. It is important not to be confused by the name of the technology and think that anything that uses Windows Mixed Reality is indeed a device where you are overlaying graphics on your view of the real world. This assumption could be costly as family heirlooms, the TV set, and possibly the pet dog, fall foul of the thinking that the inside of the spaceship you are liberating was in fact your living room.Several PC manufacturers have announced headsets to work on Windows Mixed Reality including Dell, Acer, Asus, Lenovo and HP. These were all based off the Microsoft design and unique touches have been made by each vendor. However, remember, these are VR devices.The resolution of the Dell Visor (which I wrote about previously) is increased over console and phone based VR and also offers the six degrees of freedom controllers (up/down/left/right/forwards/backwards) for full immersion. Simple things were also taken into account to increase comfort for the wearer such as making sure the cables exit the rear of the unit to help with balance and that the visor can be lifted without removing the headset. If you are having a group VR session with friends then you also have the removable/replaceable foam surround for comfort and also an easy to use tension wheel for head adjustment.One area of VR that can cause friction in households is the placement of the cameras/lighthouses/trackers to detect movement of the user in 3D space. Whilst some may think they are a talking point of interest and fall in the same category as photos on the mantle or the artistic arrangement of twigs in a tall glass vase, then others in the household may beg to differ. The Dell Visor operates through inside out tracking by examining the environment via two cameras in the headset and mapping spatial location to fixed points in the room. This means no external cameras or sensors to clutter the environment. The controllers are also tracked via the cameras and so the whole unit is contained to the space of the user – as you turn the cameras work out the difficult stuff and ensure you have a smooth, immersive experience. The one drawback to this is that if the controllers are out of view of the headset cameras for an extended period of time then the tracking on the controllers is lost.Oculus Rift and the HTC Vive are the top devices on the market today. Offering two lighthouses, in the case of Vive, and three USB sensors for the Rift then full 360 tracking can be achieved. This comes at the expense of a dedicated space to set up the cables and play area but offers the best overall experience. The screens are based on OLED technology, rather than LCD, and this can give a better image via the refresh and latency advantages.So, in summary, every experience comes with tradeoffs and it is important to consider budget, the experience you want, and the impact to others around you. Costs and experience generally track each other – the more you spend the better the end result – seems to be an immutable fact of life. All the way from the entry level costs of a phone device as an affordable entry point, all the way up to the highest end today – the HTC Vive.How To Choose PC ConfigurationNow we come to the question of ‘You want to go with a PC experience but how do you choose which PC configuration is right for your needs?’There are lots of stickers, logos, marketing statements that basically say ‘VR Ready’ or ‘Certified’ for individual components in VR. However, the solution is only as strong as the weakest part. If you put a GPU into an underpowered system then the CPU cannot feed the pipeline quick enough to give a good experience.  This would be like putting an 800BHP engine into a small family car. Sure, it might fit, but then as soon as you press the accelerator expect it to look and feel like a clown car as the tires melt and bits and pieces fall off or break off the chassis. Not a funny experience if it is your car.At Dell we have put a lot of work behind our new ‘Ready for VR’ testing and logo and it spans both consumer and commercial products. By choosing a system that is labelled ‘Ready for VR’ then you can be assured of a great experience whether you choose a Windows Mixed Reality headset, an Oculus Rift or an HTC Vive – we are making the choice easier and eliminating confusion and doubt that the system may not be able to take full advantage of the new wave of VR functionality. The logo will be displayed on the website against all systems so buyers can purchase with confidence.The More You KnowWith all that said, then hopefully this has helped in positioning some of the key technologies available today. Ultimately it is your choice as to which experience is right for you and how much time, space and finance you want to put into it.VR is maturing and the ecosystem is growing, product offerings are continuing to increase and, as they do, so does complexity. All of the choices can lead to analysis paralysis – the fear of choosing the wrong path. At the same time, the technology is growing in the consumer space as well as the commercial and there is a FOMO effect – the fear of missing out on this new technology.My advice in all this? Try them all.There are location based experiences, stores, tech shows, friends who have already taken the plunge, VR Centers of Excellence for our commercial customers – there are places you can see and touch (and in some cases smell) various levels of VR experience and work out what is right for you. Do not believe that if you have tried a phone VR experience that that is as good as it gets and also do not run away with the notion that the entry cost for VR runs into the thousands of dollars. Dell and the market at large are working to reduce the entry costs of VR to give more access and experiences to all and we are seeing the fruit of that labor starting to appear today.Above all, whichever path you choose, have fun! It is, quite literally, a different world out there waiting to be explored and all that is missing is you.last_img read more

Vermont legislative committees to hold FairPoint hearing

first_imgThe House Commerce and Economic Development Committee, joined by members of the Senate Economic Development and Finance Committees, will hold a FairPoint Communications briefing and update on Thursday, September 24. The hearing will be an opportunity for legislators to gain a fuller understanding of the challenges facing FairPoint and explore ways in which the legislature can ensure Vermonters’ interests are protected. The House and Senate Committees will hear from the President of FairPoint Communications, the Department of Public Service, the Vermont Telecommunications Authority, and Labor representatives.The agenda for the hearing is pasted below and attached to this advisory.What: FairPoint Communications HearingWhen: Thursday, September 24. 1:00-4:30 pmWho: House Commerce and Economic Development, Senate Economic Development and Senate Finance CommitteesWhere: Room 11, State HouseAGENDARoom 11, State HouseThursday, September 24, 20091:00 p.m.    FairPoint Communications Briefing and UpdateHouse Commerce and Economic Development Committee joined by Members of the Senate Finance Committee and the Senate Economic Development, Housing and General Affairs Committee Peter Nixon, President, Fairpoint Communications David O’Brien, Commissioner, Department of Public Service Charles King, Principal, Liberty Consulting William Shuttleworth, Executive Director, Vermont Telecommunications Authority Mike Spillane, Business Manager, Local 2326, IBEW.Source: Senator Shumlin’s office. 9.18.2009last_img read more

Gigawatt-sized Cultana Solar Farm takes shape in South Australia

first_img FacebookTwitterLinkedInEmailPrint分享The Guardian:Billionaire UK industrialist Sanjeev Gupta has launched a $1bn, one-gigawatt renewable energy plan based in South Australia’s mid-north that he says will lead Australian industry’s transition to more competitive power.In the first of a number of projects slated for the upper Spencer Gulf region, which will also include a lithium-ion battery bigger than Elon Musk’s, Gupta’s energy company Simec Zen has released details of its Cultana Solar Farm.The project will produce 280 megawatts of power and feature 780,000 solar panels, generating enough electricity for 96,000 homes.Other projects in Gupta’s energy blueprint include the lithium-ion battery, expanded solar farms, a co-generation scheme to power his Whyalla steelworks using waste gas, and pumped hydro projects earmarked for the Middleback Ranges.Gupta said while coal and other fossil-fuels would play an important role in Australia’s energy transition, renewables offered the best future for energy‐intensive industries. “All of these projects will not only improve reliability and greatly reduce the cost of electricity in our own operations, they will also provide competitive sources of power for other industrial and commercial users, while at the same time playing a key role in the market’s transition towards renewables,” he said.“We have a strong conviction that traditional carbon‐intensive generation sources do not have a long‐term future as the predominant source of power in Australia and globally. We believe the world is undergoing a momentous transition to renewable power as the cost of renewables drops dramatically and quickly.”More: Sanjeev Gupta: $1bn South Australia renewable energy plan will mean cheaper power Gigawatt-sized Cultana Solar Farm takes shape in South Australialast_img read more

India’s largest oil refiner to invest $3.5 billion in renewable energy projects

first_imgIndia’s largest oil refiner to invest $3.5 billion in renewable energy projects FacebookTwitterLinkedInEmailPrint分享Clean Technica:Indian largest oil refiner and marketer is planning a large investment for a major push in renewable energy.According to media reports, Indian Oil Corporation plans to invest as much as Rs 25,000 crore (US$3.5 billion) over the next few years to set up wind, solar, and bio-fuel plants. The company is also looking to invest in alternate energy solutions.The company has an installed renewable energy capacity of 216 megawatts. The company did not share the exact details of how it plans to increase this installed capacity but did share some broad initiatives it is looking to implement or expand upon.One of those initiatives is the installation of solar power systems at Indian Oil’s fuel retail stations. The company has around 24,000 retailing stations. In 2015, we covered a story that the company was planning to install solar power systems at 10,000 of these stations. Indian Oil had announced a scheme offering a financial subsidy up to 50% for the fuel station owners to set up solar power systems, with and without battery storage. The company has reported that around 2,000 of these fuel stations have solar power systems installed.In the recent past, the company has also announced plans to set up large-scale solar power parks for self-consumption and to meet its renewable purchase obligation. Indian Oil, along with Oil India Corporation, had signed an agreement with the state government of Madhya Pradesh to develop solar power projects with a cumulative capacity of 2.7 gigawatts.More: India’s largest oil refiner plans $3.5 billion renewable energy investmentlast_img read more

Online romance leads to $1.2 million fraud

first_imgAn Ohio man allegedly used the allures of a romantic relationship to get a woman who worked at a California credit union to open nearly $3 million in fraudulent lines of credit that led to more than $1.2 million in losses, according an FBI cybercrimes investigator.Phillip Cook, 50, of South Euclid, Ohio, was arrested July 28 by U.S. Marshals and remains in federal custody on a criminal complaint filed by the FBI in California. Cook will be asking a federal judge in Cleveland next week to reconsider his detention and an order to transport him to California to face charges.In November 2014, Indira Mohabir, 41, of La Habra, Calif., was working as a business loan processor for then Western Federal Credit Union, which changed its name in 2016 to the $2.7 billion UNIFY Financial Federal Credit Union in Torrance.  Around that time, she became involved in an online relationship with Cook. Mohabir was charged last year with financial institution fraud, conspiracy to commit financial institution fraud and unauthorized issuance of credit union obligations. continue reading » 13SHARESShareShareSharePrintMailGooglePinterestDiggRedditStumbleuponDeliciousBufferTumblrlast_img read more

Industry experts criticise German plan to allow Dutch-style pensions

first_imgGermany’s Ministry for Labour and Social Affairs (BMAS) has taken many in the industry by surprise after taking up a proposal by the metal union to broaden the reach of occupational pensions.Just weeks after IG Metall first recommended the creation of industry-wide pension funds, similar to the Dutch model, the BMAS endorsed the proposal in a paper that has yet to be made public.IG Metall was the union behind MetallRente, one of the more recent industry-wide schemes launched in Germany.The banking industry also offers industry-wide provision through the €24bn BVV, while Soka Bau offers pensions and other benefits to those in the building industry. Additionally, countries including the Netherlands and Denmark provide collective schemes.PFZW, the Dutch healthcare sector fund, is among Europe’s largest schemes, with more than €150bn in assets.Denmark, meanwhile, has a handful of pension providers targeting the healthcare, white and blue-collar industry, providing them with a scale that would otherwise be almost impossible to achieve.Despite the German government’s support for IG Metall’s plan, the industry’s response has been lukewarm at best.Speaking at the German pension association’s (aba) annual conference in Cologne, Peter Hadasch, a board member at Nestlé Germany, rejected the idea outright.“We do not need yet another pensions vehicle,” he said.“Germany already has enough in the occupational pension segment.”According to the BMAS’s proposal, different industries would set up a Pensionskasse or a Pensionsfonds, into which each employer – either voluntarily or through compulsion – could make contributions on behalf of employees.Additionally, new protection funds, or ‘safety’ funds, should be created to ensure the security of assets in the new pension funds, even in case of insolvency.But Hadasch argued that this would mean employers could no longer use individual pension plans to attract prospective employees, or retain current ones. He also argued that the German way of “insuring all the risks in advance” was like “pulling all teeth to prevent tooth decay”.“We have to define the risks employers have to take in a funded pension system and not release them from this responsibility because this would sever the tie to the employee – and this would be the end of occupational pensions,” he said.Hadasch also warned that the new proposed system had been the brainchild of unions and the government – “two parties that fear nothing more than the capital markets”.“If you hedge away all risks,” he added, “it will be more expensive than taking a bit of risk.”Michael Hessling, a board member at Allianz, also criticised the BMAS’s proposal.He said he feared Germany’s “major pensions vehicle” – direct insurance contracts – would be left out in a new system, which he said would “increase complexity” and “damage the existing system”.“It would create uncertainty, and employers would stop setting up pension plans while waiting for the new system,” he said.But Peter Görgen, head of BMAS’s supplementary pension department, said it would be good to “plant new seeds” with the proposed vehicles.At the conference, aba chairman Heribert Karch read out a previous statement by the IG Metall union, which kicked off the debate in the first place but has now rejected the BMAS proposal.Karch noted that the union criticises the fact it would be mandatory to have a pension scheme that would fall under the IORP II regime, and that it does not want employers to be able to “buy themselves out” of their funding responsibilities.As for the aba itself, Karch said the association would not take any position on the matter, but merely “help think matters through”.Andrea Nahles, federal minister for Labour and Social Affairs, has previously said provisions within collective labour agreements should pave the way for greater occupational coverage – with a clause now included in the country’s new minimum wage law, a campaign promise of Nahles’s Social Democratic Party.A BMAS study on the expansion of occupational coverage earlier this year also attempted to highlight the main hurdles preventing small and medium-sized enterprises from offering provision.last_img read more

Batesville to celebrate Statehood Day Sunday

first_imgBATESVILLE, Ind. – Indiana will officially mark 200 years of statehood on December 11.The City of Batesville will celebrate the Bicentennial by hosting an event at the Memorial Building on Sunday, December 11 at 11:30 a.m.Mayor Mike Bettice will officiate the ceremony and raise the official Bicentennial flag.Mayor Bettice will also recognize the Torchbearers who were locally nominated to participate in the Bicentennial Torch Relay in September.The city recently received a five-foot fiberglass bison sculpture from Duke Energy as part of the statewide public art project in conjunction with Indiana’s Bicentennial Celebration.The bison was painted by Batesville High School art teachers Mary K Cambron and Kyle Hunteman.Chris Fledderman of Enneking Auto Body oversaw the donated services of priming, base coating and sealing the bison.Tim Weberding led the effort of Weberding Carving Shop, to make the custom Indiana State Seals.During Sunday’s event, the name of Bicentennial Bison will also be unveiled.Community members submitted names to the Batesville Bicentennial Committee during the Tree Lighting Ceremony on December 1.last_img read more

Homeless man arrested after attacking dog and lifeguard at beach

first_imgAuthorities in California have arrested a homeless man who reportedly randomly attacked a small dog and a lifeguard at a beach.The incident occurred on August 9th at Ormond Beach in Port Hueneme.Authorities say lifeguards witnessed the suspect, Dylan McTaggert approach a beachgoer and her dog from behind, pick up the dog and punt it in the air.The dog reportedly went into shock and lost consciousness.When the lifeguards intervened in the situation, McTaggert then became violent and punched at least one of them.Authorities eventually located McTaggert and took him into custody.He has since been charged with fighting in public, assault on a lifeguard, and felony animal cruelty.According to the report, the dog was kicked so hard that she was “diagnosed with having a collapsed lung and displaced heart.”She is recovering at home under the care of her owner.last_img read more

India-Sri Lanka first Test starts tomorrow

first_img… Shastri on mission to keep India at No.1NEW India head coach Ravi Shastri will tomorrow look to prove his team remain the world’s best Test side when they take on Sri Lanka in the first of three matches.Shastri, who took over the demanding role after Anil Kumble’s acrimonious exit last month, has backed India to continue the “fearless brand of cricket” that helped them regain the No.1 position last year from Pakistan.While India lost the Champions Trophy final to their arch-rivals, the Virat Kohli-led side are on a roll after winning 10 of the past 13 Tests, overcoming top sides like New Zealand, England and, narrowly, Australia.“They know their job. They are professional cricketers. Once they step on the field they take over. That is how it should be,” said Shastri, who became head coach after Kumble quit over his “untenable” relationship with Kohli.“My role will be to get the guys (to) express themselves and play (a) fearless brand of cricket,” the former all-rounder added.While India start as overwhelming favourites after the seventh-ranked Sri Lanka scraped past Zimbabwe in a one-off Test last week, Shastri has warned against complacency.“Sri Lanka can’t be taken lightly at home. Their track record playing at home is as good as any other team. We would look to improve in the series,” said the 55-year-old.The visitors have played a two-day warm-up game in Colombo with returning batsman Shikhar Dhawan among the scorers.India could start with three spinners and use left-arm wrist-spinner Kuldeep Yadav with the experienced Ravichandran Ashwin and Ravindra Jadeja.Ashwin said Shastri’s presence has always had a “postive influence” on the team, adding that the players were looking to work together with the coach for some amazing results.“Ravi has been a fabulous person to have in the dressing room. Even when he was here last time, we lost that Test in Galle and (he) really picked us up from that low point in our careers,” Ashwin told reporters yesterday.Sri Lanka, whose new Test skipper Dinesh Chandimal has been ruled out after being hospitalised for pneumonia, will need all the experience of stand-in-captain Rangana Herath.The left-arm spinner, who took 11 wickets against Zimbabwe and his 31st five-wicket haul in 81 Tests, is key for Sri Lanka.Sri Lanka’s pace lineup has been bolstered by the return of veteran Nuwan Pradeep, who is likely to start at Galle International Stadium.Dhananjaya de Silva adds muscle to their strong batting arsenal, comprising former captain Angelo Mathews, Upul Tharanga and Niroshan Dickwella.Sri Lanka’s interim coach Nic Pothas said the team should take inspiration from Kohli’s men who overcame a 1-0 deficit to beat the islanders in a three-Test series in 2015.The triumph resurrected India’s fortunes as they registered their first series win in Sri Lanka for 23 years and went on to become the No.1 Test side again a year later.“I think we probably are in the same situation that Virat was talking about the Indian team being in a few years ago. We are in that rebuilding phase,” said Pothas.The South African, who took charge after Graham Ford’s exit last month, added he was focused on changing the team’s culture and unleashing their potential.last_img read more