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The aim of the study was to explore the care-seeking pathway of rural women living with rheumatoid arthritis (RA) and attending a tertiary health-care facility in Odisha, India.
RA is the third leading chronic health condition and causes severe pain and immense psychosocial stress. The prevalence of RA is three to four times higher in women than in men. Furthermore, in India, women delay care seeking due to the prevailing sociocultural norms. Women report more severe symptoms and greater disability; however, there is a lack of information on their care-seeking pathways.
We conducted 113 in-depth interviews among RA patients those who visited specialists at the outpatients’ Department of Rheumatology, SCB Medical College Hospital, a tertiary care hospital in Cuttack, Odisha, India. The grounded theory approaches were used for data analysis.
The key findings included physical pain and psychosocial stress in relation to RA, cultural issues in relation to RA, mapping of the health-care providers for RA, the first point of cares and changes in care-seeking pathways, the perceived challenge for seeking health-care, and coping strategies of patients and social supports. This study explored that the RA patients seek care from multiple providers – untrained, trained and specialist without any gatekeeping. However, the primary health centers were the first point of care for maximum patients due to accessibility and affordability. Furthermore, follow-up care is significant to prevent complication among RA patients; the primary health centers are the gateway for keeping RA patients. Hence, the availability of RA trained providers at primary health center including interprofessional care, such as physiotherapy providers, and proper referral system is essential to convalesce care-seeking pathways.
Diamond like carbon (DLC) and composite nickel incorporated diamond-like carbon (Ni-DLC) films have been synthesized on ITO coated glass substrates using low voltage electrodeposition method. Modifications of structural and optical properties of thin films have been investigated with varying Ni concentration. Average grain size of Ni-DLC granules is found to decrease with increasing molarity of Ni in electrolytic solution. XRD pattern depicts multi-phase nature of Ni-DLC film. Incorporation of Ni nanoparticles in DLC matrix has been confirmed by TEM. Interestingly optical bandgap energy decreases from 2.31 to 1.58 eV with decrease in nickel content in the electrolytic bath. Simultaneously Urbach energy exhibits an increasing trend from 1.972 to 2.374 eV. Presence of sp2 and sp3 bonded carbons has been indicated by FTIR spectra. The number of sp2 bonding in carbon matrix is enhanced with dilution of electrolyte. The peaks in the range of ~600–750 cm−1 in Ni-DLC films have been attributed to metal incorporation into DLC matrix. Study reveals that the bandgap and the particle size of carbon nanocomposite films can be tailored by controlling the amount of nickel in the electrolyte.
We report the fabrication of a one dimensional microcavity structure embedded with colloidal CdSe/ZnS core/shell quantum dots using solution processing. The microcavity structures were fabricated by spin coating alternating layers of polymers of different refractive indices (poly-vinylcarbazole, and poly-acrylic acid) to form the distributed Bragg reflectors (DBRs). Greater than 90% reflectivity was obtained using ten periods of the structure. The one dimensional microcavity was formed by sandwiching a λ/n thick defect layer between two such DBRs. The microcavity demonstrated directionality in emission and well behaved dispersion characteristics. Room temperature time-resolved photoluminescence measurements carried out on this structure showed six fold enhancement of spontaneous emission rate. The photoluminescence decay time of the quantum dots was found to be ∼ 1 ns while for the quantum dots embedded in the microcavity it was ∼150 ps.
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