Survey of policy for MRSA screening in English cataract surgical units and changes to practice after updated National guidelines

National guidelines on MRSA (methicillin-resistant Staphylococcus aureus) screening policy in England have changed on a number of occasions, but there is limited data on its influence at a local level. The aim of this study was to determine if changes in National policy influenced preoperative screening of cataract patients for MRSA

Occupational health in small scale and household industries in Nepal: A situation analysis

Abstract Introduction: Making working conditions safe and healthy is the interest of workers, employers and the Government. Although it seems simple and obvious, this idea has not yet gained meaningful recognition in Nepal. Methods: The study was conducted in ten small scale industries of Kathmandu valley. Altogether 545 questionnaires on socioeconomic and occupational history were fi lled up. Similarly, Workplace Occupational Health Assessment was done in all ten industries. A thorough medical examination of 135 child workers was done using a structured questionnaire to fi nd out the health effects due to occupational hazards. Results: Out of the total 545 workers present in the industries under study, 135 (24.8%) were child workers. Higher proportion of child workers (97%) was illiterate compared to 3% of children with primary level education. Among the child workers, 23 (17%) were girls. The majority of the child labourers were suffering from conditions like otitis externa, otitis media, scabies, anaemia, upper respiratory diseases, nasal problems, abdominal pain etc. Conclusion: The occupational health and safety practices in small scale industries in Kathmandu have been found to be unsatisfactory. Child labour is a serious problem. Out of ten industries, six have employed child workers and the working conditions range from bad to terrible. Health and welfare of the child workers was also not satisfactory

Integrated Parametric Graph Closure and Branch-and-Cut Algorithm for Open Pit Mine Scheduling under Uncertainty

Open pit mine production scheduling is a computationally expensive large-scale mixed-integer linear programming problem. This research develops a computationally efficient algorithm to solve open pit production scheduling problems under uncertain geological parameters. The proposed solution approach for production scheduling is a two-stage process. The stochastic production scheduling problem is iteratively solved in the first stage after relaxing resource constraints using a parametric graph closure algorithm. Finally, the branch-and-cut algorithm is applied to respect the resource constraints, which might be violated during the first stage of the algorithm. Six small-scale production scheduling problems from iron and copper mines were used to validate the proposed stochastic production scheduling model. The results demonstrated that the proposed method could significantly improve the computational time with a reasonable optimality gap (the maximum gap is 4%). In addition, the proposed stochastic method is tested using industrial-scale copper data and compared with its deterministic model. The results show that the net present value for the stochastic model improved by 6% compared to the deterministic model

Impact of vegetation on the simulation of seasonal monsoon rainfall over the Indian subcontinent using a regional model

The change in the type of vegetation fraction can induce major changes in the local effects such as local evaporation, surface radiation, etc., that in turn induces changes in the model simulated outputs. The present study deals with the effects of vegetation in climate modeling over the Indian region using the MM5 mesoscale model. The main objective of the present study is to investigate the impact of vegetation dataset derived from SPOT satellite by ISRO (Indian Space Research Organization) versus that of USGS (United States Geological Survey) vegetation dataset on the simulation of the Indian summer monsoon. The present study has been conducted for five monsoon seasons (1998-2002), giving emphasis over the two contrasting southwest monsoon seasons of 1998 (normal) and 2002 (deficient). The study reveals mixed results on the impact of vegetation datasets generated by ISRO and USGS on the simulations of the monsoon. Results indicate that the ISRO data has a positive impact on the simulations of the monsoon over northeastern India and along the western coast. The MM5- USGS has greater tendency of overestimation of rainfall. It has higher standard deviation indicating that it induces a dispersive effect on the rainfall simulation. Among the five years of study, it is seen that the RMSE of July and JJAS (June-July-August-September) for All India Rainfall is mostly lower for MM5-ISRO. Also, the bias of July and JJAS rainfall is mostly closer to unity for MM5-ISRO. The wind fields at 850 hPa and 200 hPa are also better simulated by MM5 using ISRO vegetation. The synoptic features like Somali jet and Tibetan anticyclone are simulated closer to the verification analysis by ISRO vegetation. The 2 m air temperature is also better simulated by ISRO vegetation over the northeastern India, showing greater spatial variability over the region. However, the JJAS total rainfall over north India and Deccan coast is better simulated using the USGS vegetation. Sensible heat flux over north-west India is also better simulated by MM5-USGS

State of Post-injury First Response Systems in Nepal—A Nationwide Survey

Copyright © 2021 Banstola, Smart, Raut, Ghimire, Pant, Joshi, Joshi and Mytton. Injuries account for 9.2% of all deaths and 9.9% of the total disability-adjusted life years in Nepal. To date, there has not been a systematic assessment of the status of first response systems in Nepal. An online survey was cascaded through government, non-governmental organisations and academic networks to identify first response providers across Nepal. Identified organisations were invited to complete a questionnaire to explore the services, personnel, equipment, and resources in these organisations, their first aid training activities and whether the organisation evaluated their first response services and training. Of 28 organisations identified, 17 (61%) completed the questionnaire. The range of services offered varied considerably; 15 (88.2%) provided first aid training, 9 (52.9%) provided treatment at the scene and 5 (29.4%) provided full emergency medical services with assessment, treatment and transport to a health facility. Only 8 (47.1%) of providers had an ambulance, with 6 (35.3%) offering transportation without an ambulance. Of 13 first aid training providers, 7 (53.8%) evaluated skill retention and 6 (46.2%) assessed health outcomes of patients. The length of a training course varied from 1 to 16 days and costs from US$4.0 to 430.0 per participant. There was a variation among training providers in who they train, how they train, and whether they evaluate that training. No standardisation existed for either first aid training or provision of care at the scene of an injury. This survey suggests that coordination and leadership will be required to develop an effective first response system across the country.National Institute for Health Research (NIHR) Global Health Research Programme (Project ref 16/137/49) using UK aid from the UK Government

Agenda setting and framing of gender-based violence in Nepal: how it became a health issue.

: Gender-based violence (GBV) has been addressed as a policy issue in Nepal since the mid 1990s, yet it was only in 2010 that Nepal developed a legal and policy framework to combat GBV. This article draws on the concepts of agenda setting and framing to analyse the historical processes by which GBV became legitimized as a health policy issue in Nepal and explored factors that facilitated and constrained the opening and closing of windows of opportunity. The results presented are based on a document analysis of the policy and regulatory framework around GBV in Nepal. A content analysis was undertaken. Agenda setting for GBV policies in Nepal evolved over many years and was characterized by the interplay of political context factors, actors and multiple frames. The way the issue was depicted at different times and by different actors played a key role in the delay in bringing health onto the policy agenda. Women's groups and less powerful Ministries developed gender equity and development frames, but it was only when the more powerful human rights frame was promoted by the country's new Constitution and the Office of the Prime Minister that legislation on GBV was achieved and a domestic violence bill was adopted, followed by a National Plan of Action. This eventually enabled the health frame to converge around the development of implementation policies that incorporated health service responses. Our explicit incorporation of framing within the Kindgon model has illustrated how important it is for understanding the emergence of policy issues, and the subsequent debates about their resolution. The framing of a policy problem by certain policy actors, affects the development of each of the three policy streams, and may facilitate or constrain their convergence. The concept of framing therefore lends an additional depth of understanding to the Kindgon agenda setting model.<br/

Plasmodium vivax lineages: geographical distribution, tandem repeat polymorphism, and phylogenetic relationship

<p>Abstract</p> <p>Background</p> <p>Multi-drug resistance and severe/complicated cases are the emerging phenotypes of vivax malaria, which may deteriorate current anti-malarial control measures. The emergence of these phenotypes could be associated with either of the two <it>Plasmodium vivax </it>lineages. The two lineages had been categorized as Old World and New World, based on geographical sub-division and genetic and phenotypical markers. This study revisited the lineage hypothesis of <it>P. vivax </it>by typing the distribution of lineages among global isolates and evaluated their genetic relatedness using a panel of new mini-satellite markers.</p> <p>Methods</p> <p><it>18S SSU rRNA S-type </it>gene was amplified from 420 <it>Plasmodium vivax </it>field isolates collected from different geographical regions of India, Thailand and Colombia as well as four strains each of <it>P. vivax </it>originating from Nicaragua, Panama, Thailand (Pak Chang), and Vietnam (ONG). A mini-satellite marker panel was then developed to understand the population genetic parameters and tested on a sample subset of both lineages.</p> <p>Results</p> <p><it>18S SSU rRNA S-type </it>gene typing revealed the distribution of both lineages (Old World and New World) in all geographical regions. However, distribution of <it>Plasmodium vivax </it>lineages was highly variable in every geographical region. The lack of geographical sub-division between lineages suggests that both lineages are globally distributed. Ten mini-satellites were scanned from the <it>P. vivax </it>genome sequence; these tandem repeats were located in eight of the chromosomes. Mini-satellites revealed substantial allelic diversity (7-21, <it>AE </it>= 14.6 ± 2.0) and heterozygosity (<it>He </it>= 0.697-0.924, <it>AE </it>= 0.857 ± 0.033) per locus. Mini-satellite comparison between the two lineages revealed high but similar pattern of genetic diversity, allele frequency, and high degree of allele sharing. A Neighbour-Joining phylogenetic tree derived from genetic distance data obtained from ten mini-satellites also placed both lineages together in every cluster.</p> <p>Conclusions</p> <p>The global lineage distribution, lack of genetic distance, similar pattern of genetic diversity, and allele sharing strongly suggested that both lineages are a single species and thus new emerging phenotypes associated with vivax malaria could not be clearly classified as belonging to a particular lineage on basis of their geographical origin.</p