CTRI/2014/06/004692.

This article criticizes recent Bottom (or, Base) of the Pyramid (BoP) approaches for 'cancelling out politics' by obscuring unequal power relations at different societal levels and painting an optimistic picture of win-win outcomes that will make (some of) the world's biggest corporations richer while simultaneously adding a few crucial pennies to the pockets of the poor. The article is thus positioned within a growing stream of literature critical of BoP ideas, but it goes further than existing critiques by arguing that the current BoP discourse serves an important ideological function for global capital, specifically producing a discursive depoliticization of its corporate interventions in the lives of the world's poor. We argue that the poverty-reduction outcome of a BoP venture is contingent on its practice on the ground, which will inevitably be shaped by local and global power relations. In particular, we point to three cultural-political issues overlooked by the BoP discourse, which are vital in understanding the practice of business ventures at the BoP: adverse power relationships within poor communities; social-epistemological hierarchies between the poor and outsiders who administer poverty-reduction interventions; and local vulnerabilities induced by global currents in products, services, information and ideologies.Recent business school writing on the Base of the Pyramid (BoP) makes the grand claim that

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The CMAC videolaryngoscope decreases the time taken to intubate and reduces the intubation difficulty when compared to the Miller laryngoscope. Therefore, the CMAC videolaryngoscope may be more useful device when intubating the trachea of infants in the lateral position.

Transformations to sustainability for addressing climate change are now more urgent than ever. This paper argues that such transformations are firstly required in modernist practices that militate against sustainability due to their constitution by the fallacy of human control. The latter points to the conceit of suppressing uncertainties in knowledge, commandeering agency from 'above', standardising governance, harming marginalised ecologies and disqualifying practices inferiorised as 'primitive', 'irrational' or 'vernacular'. Undoing the fallacy of control, by admitting uncertainties, modernist practices may become caring through transformative engagement with others. I propose four aspects of such transformative engagement: (a) egalitarian commitment to distributing epistemological privilege; (b) ontological sensitivity, by taking seriously the relational bases of others' knowing; (c) learning for divergence from others; and (d) affinity in alterity across widening divergence. These aspects are proposed not as fully formed principles, but rather as questions to be reworked in ongoing encounters and struggles for sustainability and climate justice. The aim is to nurture other-than-modern understandings of climate challenges and to help build multiple coexisting pathways of resilience, adaptation and mitigation.

Purpose:Maintaining systolic blood pressure (SBP) at 100% of baseline is best for fetal and maternal outcome. We hypothesized that irrespective of the vasopressor used, maintaining SBP at 100% of baseline with phenylephrine (P), metaraminol (M), or ephedrine (E) will produce the best fetal pH after cesarean section (LSCS) under subarachnoid block (SAB).Materials and Methods:Ninety ASA 1 women scheduled for elective LSCS were randomly allocated to receive P, M, or E. SAB was established with patient in left lateral position using 2.5 cc of 0.5% hyperbaric bupivacaine. Immediately following SAB, patients received a bolus of the study drug (E = 5 mg, M = 0.5 mg, P = 30 mcg) followed by infusion (E = 2.5 mg/min, M = 0.25 mg/min, P = 15 mcg/min) to maintain SBP at 100% baseline. Umbilical blood gases, maternal hemodynamic parameters, and complications were recorded.Results:The umbilical pH was comparable in all the three groups (P > 0.05). The mean SBP from spinal block until delivery was similar over time for all the three groups. The incidence of reactive hypertension was more in group M (P < 0.05) than in group E and group P. Total drug consumption to meet target blood pressure till delivery was 39.3 ± 14.6 mg in group E, 1.7 ± 0.9 mg in group M, and 283.6 ± 99.8 mcg in group P. The incidence of nausea and vomiting was comparable in the three groups.Conclusion:All the three vasopressors were equally effective in maintaining maternal blood pressure as well as umbilical pH during spinal anesthesia for cesarean section without any detrimental effects on fetal and maternal outcome.

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