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प्रस्तुतो लेखः नेपालस्य लुम्बिनीप्रदेशान्तर्गते गुल्मीमण्डले जातेन ‘भीमकान्तपन्थी’ इति नामकेन महाकविना विरचिते ‘जगदम्बिकावैभवम्’ महाकाव्ये द्वन्द्वविधानस्य गवेषणे केन्द्रितो वर्तते । वि. सं. २०४७ तमे वर्षे विरचितं प्रथमवारं वि. सं. २०५५ तमे वर्षे प्रकाशितं पौराणिकीं कथां गृहीत्वा रचितं महाकाव्यमिदं तन्निरूपणे उल्लेखनीयं वर्तते । अत्र तस्यैव महाकाव्यस्य परिचयेन सह गवेषणीयविषयत्वेन जगदम्बिकावैभवकाव्ये द्वन्द्वविधानं कीदृशम् ? इति समस्यामुपस्थाप्य प्रस्तुते महाकाव्ये तदन्वेषणमुद्देश्यरूपेण स्थापितं विद्यते । तस्मिन्नेव व्रmमे प्रस्तुते महाकाव्ये निरूपितमान्तरिकं बाह्यञ्च द्वन्द्वं विस्तरेण विवेचितं वर्तते । अध्ययनमिदं गुणात्मकं किल । अतोऽत्र पुस्तकालयीयया पद्धत्या सामग्रीणां सङ्कलनं विधाय निगमनात्मकेन विधिनाध्ययनं कृतं विद्यते । विषयस्य विश्लेषणे सैद्धान्तिकाधारतया पाश्चाŒयो द्वन्द्वसिद्धान्तो गृहीतोऽस्ति । गदम्बिकावैभवमहाकाव्ये प्रस्तुतं पात्रगतमान्तरिकं बाह्यमपि द्वन्द्वं समीक्ष्य तयोः काव्यस्य प्रधानफलसिद्धौ, रसाभिव्यक्तौ, कार्यावस्थायाः निर्वहणे, कथायां रोमाञ्चकतासिद्धये च साहाøयं विस्तरेण प्रदर्शितं वर्तते । कथायां कौतुकवृद्धये रोमाञ्चकतासिद्धये च सफलेन द्वन्द्वेन युक्तं महाकाव्यमिदं द्वन्द्वविधानस्य दृष्ट्या विशिष्टं वर्तते इति निष्कर्षः स्थापितो विद्यते । जगदम्बिकावैभवे द्वन्द्वविधानसम्बद्धायाः जिज्ञासायाः समाधानाय प्रकृतमध्ययनं प्राधान्येन उपयोगि वर्तते तथैव च भविष्यति काव्यान्तरेषु एतत्प्रकारकान्वेषणाय एवमेव पक्षान्तरमाश्रित्य प्रकृतमहाकाव्यस्य समीक्षणाय च सहायकं भवितुं शक्नोति ।

BACKGROUND Glasgow coma scale (GCS) and Marshall computed tomography classification of traumatic brain injury can predict the severity of the brain injury in patients following trauma. This study aims to analyse the association between two, in patients who required ICU admission or neurosurgical intervention following trauma. METHODOLOGY Retrospective study of 64 patients who underwent ICU admission or neurosurgical intervention following traumatic brain injury from September 2017 to December 2020 in Nepal Mediciti Hospital. Majority of the mild head injury where CT scan was not performed, discharged from the emergency or did not need ICU admission or admitted in ward for observation, severe polytrauma were excluded from the study. Glasgow coma Scale was categorized into mild (13-15), moderate (9-12) and severe (

Objective: Ex-vivo preservation of autologous bone flap for cranioplasty involves various techniques but there are no fixed guidelines as preservation time, temperature ,technique differs. It was preserved submerging in the mixture of 10% betadine and 80 % ethyl alcohol solution in an airtight container in refrigerator at constant temperature of 0 ﹾ C and was autoclaved 1 hour before reimplantation. The Primary objective of the study is to analyze Surgical site infection (SSI) ,secondary its association with dependent variables age,sex,mode of injury, number of procedure performed . Materials and methods: This is a retrospective study conducted in Nepal Mediciti hospital from September 2017 to November 2019 .Data of all patients who underwent cranioplasty was reviewed from medical record and U/L autologous bone cranioplasty preserved with this technique were included and other were excluded from the study.The primary outcome SSI was classified according to guidelines of the centers of disease control(CDC) and stablished with organism isolated in the culture. Results: Only 66 out of 78 cranioplasty was included in this study .The majority was male 83.3%.The mean age was 37.16(standard deviation [SD]±14.58).The SSI was 7.5% and was associated with number of procedures performed (p0.08).RTA was major cause of cranioplasty in 60.61%. Conclusion: Ex-vivo preservation of autologous bone flap for cranioplasty with this technique is safe to be applied in resource limited settings as it can produce similar results as other techniques.

Eliza Hamilton in her two-volume epistolary novel Translation of The Letters of A Hindoo Rajah (1819), by projecting two characters who undergo the oppositional experiences during their contact with English people, creates an ambivalent situation which neither represents England as totally positive nor India as completely negative. The two perspectives of Zaarmilla and Sheermaal exclude one another’s rendering. To unpack this contradictory narrative position, the concept of acculturation and cultural stress, especially formulated by John W. Berry is taken in interlocution. By rendering these two sorts of antithetical narratives juxtaposed together confirms the dynamics of ambivalence which does not regard Saidaian notion of Orientalism intact.

This research paper concentrates on George Orwell’s novel 1984, published in 1949. The novel explicates the ugly lifestyle of citizens under the rule of a powerful totalitarian ruler Big Brother. Being a ruler, the Big Brother has ultimate political power, and that is, in the narrative, linguistically asserted. This research paper examines how such political and social power of a character/person is imposed in the linguistic territory of a narrative in the light of Critical Discourse Analysis. Critical Discourse Analysis evaluates how the social and political agency of any person in any given discourse works in the linguistic form, theorists like Anthony Giddens elaborate on the role of agency in shaping the social structure. For the purpose of examining the agency in the narrative, with a particular focus on agency-patient role relation, this research brings in the role relations as the trope and, thus, concludes that totalitarian rulers drain out the agency of the citizens even in linguistic form, along with socio-political agency.

Ankylosing spondylitis (AS) patients are at increased risk of vertebral compression fractures (VCF). Our objective was to examine the yearly trend of VCF hospitalizations in AS patients as compared to rheumatoid arthritis (RA) and the general population. National Inpatient Sample (NIS) database (2000–2014) was used to identify adult (≥ 18 years) hospitalizations, based on validated ICD-9 diagnosis codes. The rate of VCF hospitalizations, as a primary diagnosis, was assessed in three mutually exclusive groups: AS, RA, and the general population. The prevalence of VCF hospitalization was highest in AS (2.70%), compared to 0.77% in RA and 0.35% in the general population. Over the 15-year period, VCF hospitalization in AS was noted to have an increasing trend (Annual Percent Change (APC) = 4.73, p

Objective: This studies aims to evaluate the outcome of Microvascular Decompression (MVD) using a muscle graft for interposition in Trigeminal Neuralgia (TN), Hemifacial Spasm (HFS) and Glossopharyngeal Neuralgia (GPN). All surgeries were performed by a single surgeon (G.R.S). Methods: In total, 26 patients with TN, HFS and GPN underwent MVD from September 2007 to April 2019. All the patients were either medically refractory or poor symptom tolerance. The mean follow-up period was 72 months. Results: Each MVD was performed using an autologous muscle graft with interposition of vessels. One patient (3.84%) had reoccurrence after MVD with muscle graft and two patients (7.69%) had partial relief. Conclusion: Various types of prosthesis are used for transposition and interposition of vessels in MVD surgeries. Although in our case series we didn't use any prosthesis for the comparative outcome, the use of muscle graft showed minimal reoccurrence rate with benefit of being cost effective. Therefore, we need randomized controlled trials to prove the superiority of muscle graft from other prosthesis material.

Health education interventions are more commonly evaluated in hospitals or schools but rarely in the community. The purpose of this study was to assess the effects of a community-based eye health e...

COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 has been occurring in waves due to emergence of different strains. During second wave of COVID pandemic in Nepal, largely caused by Delta variant, due to rapid rise in cases, existing hospitals and health facilities were overwhelmed. As a result, telemedicine was expanded to help reduce strain on the healthcare system and meet unusually high demands. A team of physicians with the support from the local government provided hospital level care for patients at home in rural district of Dang in Nepal. This research analyzes implementation of this model of care and outcomes based on review of patient records and treatment guidelines. Within a month, from May 5 to June 13, 2021, a total of 102 patients received care at home. While most patients had mild to moderate disease, 12.8% of patients had severe disease. Telemedicine usage was highest among the 40-59 years age group, with overall recovery rate of 85.3%. The patient satisfaction survey revealed that majority, 86.5% were happy with the medical care they received. This home hospital care model has shown excellent clinical outcomes and high patient satisfaction even in resource limited setting.

Objective: Ventriculoperitoneal (VP) shunt surgery is one of the commonly performed neurosurgical procedures. Complications due to shunt failure are associated with high morbidity and mortality. We report an analysis of risk factors for shunt failure in pediatric patients from a single institution in Nepal. Materials and Methods: A retrospective analytical study with prospective data was designed. All children younger than 15 years, with first time VP shunting, at a tertiary government hospital in Kathmandu during 2014-2017 were followed up. Association of independent variables with the primary outcome variable (complication of VP shunt) was analyzed using Chi-square test. Bivariate logistic regression was performed to identify unadjusted odds ratio (OR) with 95% confidence interval (CI). Multivariate logistic regression model was designed to calculate adjusted OR with 95% CI. Results: Of 120 patients, more than half (55.8%) of the patients were male. Mean age was 62.97 months. Maximum duration of follow-up was 30 months. Most common cause of hydrocephalus was congenital aqueductal stenosis (40.8%) followed by tumors (29.2%). Overall shunt complication was found in 26.7% (95% CI 19.0%–35.5%). Shunt infection was seen in 5% while malfunction without infection was found in 21.7%. Bivariate logistic regression showed duration of surgery more than 1 h (OR 2.67, 95% CI 1.11–6.42, P = 0.028) compared to 1 h or less, experienced surgeon (OR 0.37, 95% CI 0.16–0.89, P = 0.026) compared to residents, and emergency surgery (OR 3.97, 95% CI 1.69–9.29, P = 0.001) compared to elective surgery as significant risk factors, while emergency surgery was the only significant variable for shunt failure on multivariate regression analysis (OR 3.3, 95% CI 1.16–9.35, P = 0.025). Conclusion: Longer duration of surgery, less experience of the surgeon, and the priority of the case (emergency) were independent risk factors for shunt complications.

The edited volume, Conflict and cooperation in the Indo-Pacific, by two prominent international security experts, Ash Rossiter and Brendon J. Cannon, engages with the nature of strategic partnershi...

Craniovertebral junction (CVJ) is a complex anatomic region providing stability and mobility to the most important part of the craniospinal axis. The purpose of this study is to analyse clinical characteristics and outcome after surgical management of patients with CVJ anomalies presented to Neurosurgery department, Bir hospital Kathmandu Nepal. A retrospective analysis of 21 patients, managed surgically for craniovertebral instability between 2013 and 2017, was performed. Imaging studies were reviewed for bony and soft tissue details. Patients managed with posterior approach alone (either occipitocervical fusion or C1-2 fusion with or without bony decompression) were included in the study. Outcome was assessed by comparing pre and post operative Nurick grade. Most common causes of CVJ instability were non union of old odontoid fracture (38.1%)and OsOdontoidium (38.1%). 76.2% had intramedullary high signal intensities in T2 weighted MRI while 90% had cervicomedullary compression. Pre operatively, 52.38% had Nurick grading scale of 4 to 5 while 47.62%had 0-3 Nurick grade scale. Post operatively, 71.42% improved clinically, 23.80% remained unchanged while one patient deteriorated. Mean duration of follow up was 20.87 months (6-60 months). Pre operative Nurick grade was significantly associated with post operative outcome (p=0.042). Early surgical intervention is associated with better clinical outcome. Larger prospective study with clinical and radiological follow up is recommended.

An aerodynamic analysis is conducted for morphing winglets on a regional aircraft. The optimum drag, bending moment, stall angle and maximum lift coeffcient are evaluated for various mission segments by varying winglet design parameters. Aero-elastic studies are conducted in order to incorporate wing deformation effects in addition to exploring maneuver load alleviation capability of the morphing winglet. The results show drag benefit up to 1% in cruise and wing bending moment and winglet bending moment benefits of 2.4% and 63% at 2.5g symmetric maneuver conditions. The total aircraft drag benefit translates to additional allowable structural weight that can be applied to the design of winglet actuation system. The morphing winglet shows superior stall behavior and attenuates high wing loads. The estimated wing-winglet loads will help in proper selection of actuators. This study is also expected to help in elevating technology readiness level of the morphing winglet technology.

Ankylosing spondylitis (AS) patients are at increased risk of vertebral compression fractures (VCF). Our objective was to examine the yearly trend of VCF hospitalizations in AS patients as compared to rheumatoid arthritis (RA) and the general population. National Inpatient Sample (NIS) database (2000-2014) was used to identify adult (≥ 18 years) hospitalizations, based on validated ICD-9 diagnosis codes. The rate of VCF hospitalizations, as a primary diagnosis, was assessed in three mutually exclusive groups: AS, RA, and the general population. The prevalence of VCF hospitalization was highest in AS (2.70%), compared to 0.77% in RA and 0.35% in the general population. Over the 15-year period, VCF hospitalization in AS was noted to have an increasing trend (Annual Percent Change (APC) = 4.73, p 0.05) in contrast to the stable trend in the general population (APC = 0.34, p = NS) and a declining trend in RA (APC -3.61, p 0.05). VCF related to AS was also associated with a longer hospital stay as compared to the general population (8.1 days vs. 5.1 days, p 0.05) and higher inpatient mortality (3.4% vs. 1.0%, p 0.05). A higher rate of VCF hospitalization along with an increasing trend was noted in AS as compared to RA and compared to the general population. Better screening approaches and treatment strategies for AS patients with VCF risk are urgently needed to reduce hospitalizations and related complications. Key Points • An increasing trend of VCF hospitalization was noted in AS, in contrast to a declining trend in RA and a stable trend in the general population. • VCF in AS was associated with longer hospital stay and higher inpatient mortality than in RA and the general population.

Uncorrected refractive error is the largest cause of global vision loss in 2020; 161 million people have distance vision impairment or blindness and 570 million people suffer from near vision impairment. Cataract (100 million people), age-related macular degeneration (8.1 million people), glaucoma (7.8 million people), and diabetic retinopathy (4.4 million people) are other leading causes of vision loss (Fig. 10.1). Uncorrected refractive error in South-East Asia (adjusted from the relevant Global Burden of Disease-defined regions to the World Health Organization (WHO)-defined South-East Asia Region, SEAR) accounted for 46.1% (95% CI: 42.19–49.51) of moderate to severe vision impairment (MSVI) and 12.6% (95% CI: 10.79–14.33%) of blindness [1]. Given that these data are for adults aged 50 years and above, the relative burden of vision impairment due to uncorrected refractive error is likely to be higher when data on younger adults and children are added.

Smallholder farmers dominate agriculture in Nepal. These farmers have poor knowledge about agriculture and lack of support for soil management and integrated plant-nutrient systems. Focusing on the importance and need for soil-fertility management, a soil-testing mobile van program has recently been introduced in Nepal by Soil Management Directorate, Hariharbhawan. With the introduction of the mobile lab, famers can get their soil tested for nutrient deficiencies and fertilizer requirements at their doorsteps. Using mobile lab, spatial distributions of chemical properties, including pH, organic matter (OM), total nitrogen (N), available phosphorus (as P2O5), and available potassium (as K2O) were examined in soil samples taken from the 0 to 15 cm depth from selected agricultural fields in eight different districts in the mid-hills and Terai regions of Nepal. Tests conducted on 1,479 soil samples in the soil-testing mobile van revealed the following: the mean soil OM ranged from 0.01 to 1.77%; total...

A field experiment was conducted to study the effect of different weed management practices on weed dynamics, yield and economics of soybean (Glycine max L.var. JS-335) production. Experiment was carried out in randomized block design consisting of thirteen weed management practices replicated thrice (pre-emergence and post- emergence application of herbicides, cultural and mechanical weed management practices). Experimental field was mostly dominated by grassy weeds namely; Sorghum halepense, Cynodon dactylon, Digitaria sanguinallis with broad leaf weeds and sedges. Total weed population and weed dry matter production was significantly highest in weedy check plot. Two hand weeding at 20 and 40 Days after sowing (DAS) with highest weed control efficiency (84.29 %) recorded lowest weed population and weed dry matter accumulation with highest values of growth and yield attributes, seed and stalk yield. Pre-emergence (PE) application of pendimethalin 1.0 kg ha-1 supplemented by hand weeding at 40 DAS was next best treatment to record lower weed population, weed dry matter accumulation and higher seed yield with the weed control efficiency of 80.83 %. Pendimethalin 1.0 kg ha-1 as pre-emergence followed by (fb) quizalofop-p-ethyl 50 g ha-1 at 20 DAS highly efficient for dominating grassy weed; Sorghum halepense produced comparable seed and stalk yield with lower cost of cultivation and recorded highest net return (711.22 $ ha-1) and benefit: cost ratio (1.51) over all other treatments with mean that 1 $ investment can fetch 1.51 $ net return thus proving more economical and profitable weed management practice among all treatments.

The aim of this study was to investigate the current situation of low vision services and barriers to low vision service delivery in Papua New Guinea (PNG).An exploratory study was undertaken to assess the situation of available services, human resources, training, equipment and assistive devices, supportive policies, needs of people with low vision and community attitudes toward people with low vision. In-depth interviews with 50 key informants were conducted in-country. Key informants included eye-care practitioners (n = 13), special education teachers (n = 10), community-based rehabilitation workers (n = 3), other stakeholders providing disability-related services (n = 8), and people with low vision (n = 14) and their family members (n = 2). Interview transcripts were analysed inductively and deductively using thematic analysis.Barriers were identified at systems and community levels. The barriers at the systems level were: low vision not a priority area for eye care and rehabilitation programs, limited availability of low vision services, trained personnel and low vision devices; low vision not included in training programs of eye-care practitioners and lack of awareness of available referral services among service providers. The barriers identified at the community level were lack of awareness of services, distance, costs and limited transport to access services and negative community attitudes.This study has identified barriers from the perspectives of different stakeholders, including service providers and people with low vision and their families. Knowledge of these barriers can now guide the development of future low vision services in PNG.

Systemic lupus erythematosus (SLE) is a multisystem disorder. While several studies have outlined risk factors for hospitalization and mortality in SLE; the frequency of hospitalizations from various causes has varied among studies and over the years. We aimed to assess the causes of SLE hospitalizations and inpatient mortality compared to those without SLE in the United States in a recent year (2016) using a large national inpatient database. We used National Inpatient Sample (NIS) to identify hospitalizations with SLE using the ICD-10 code M32. Among hospitalizations with SLE as secondary diagnosis, we used ICD-10 codes to assess the primary diagnoses associated with hospitalizations and mortality. Our study included 174,105 SLE hospitalizations matched to controls (similar age, sex, and NIS stratum) in the year 2016. Mean age of hospitalization with SLE was 51.82 years, and 89% of hospitalized SLE patients were females. Mean length of stay, cost and mortality for SLE were 5.6 ± 7.2 days, US $ 14,450 and 1.96%, respectively. SLE was the primary diagnosis in 10,185 (5.85%) of all SLE related hospitalizations. Among SLE hospitalizations, infection was the most common primary diagnosis (15.80%) followed by cardiac and renal manifestations (7.03% and 4.91% respectively). Infection was the leading cause of mortality (38.18%) followed by cardiac manifestations (12.04%). Infections and cardiac involvement were the leading causes of hospitalizations and in-hospital mortality in SLE. Whether this is related to the disease itself, its associated comorbidities or immunosuppressive agents would require further studies.

Karst groundwater is one of the primary water resources in most provinces of Southwestern China where karst topography is strongly featured. In Guizhou Province, a prominent geologic sedimentary formation is the dolomite stratum which exists as the restricted platform facies and potentially provides a large reservoir for drinking water. A proper understanding and evaluation of its hydrogeochemical characteristics and water quality is the key to ensuring the drinking water safety. In the present study, groundwater samples were collected from 25 locations of the dolomite aquifer across Guizhou to determine their major chemical compounds, including the cations (K+, Na+, Ca2+, Mg2+) and the anions (HCO3&minus, F&minus, Cl&minus, NO3&minus, SO42&minus, ), as well as the pH, total hardness, and total dissolved solids. HCO3&minus, and Ca2+ were found to be the dominant anion and cation, respectively, which is characteristic of typical karst groundwater and supports the overall observation of a slightly weak acid to weak alkaline environment in the studied groundwater, as the pH measurements ranged from 6.80 to 8.37. Fuzzy comprehensive evaluation method is used to evaluate the groundwater quality based on typical drinking water safety standard. The results show that the groundwater in most of the studied aquifers is of reasonably good quality. However, in some aquifers, concentrations of NO3&minus, and/or SO42&minus, were found to be excessively high. Overall, the studied dolomite aquifer in its natural environment as investigated in the present study can be considered as a potential geological stratum for water resources exploitation in Guizhou.

Background Venous thromboembolism (VTE) is 3rd commonest cause of cardiovascular deaths and encompasses deep-venous thrombosis (DVT) and pulmonary embolism (PE). Rheumatologic diseases have been found to be associated with an increased risk of VTE among hospitalised patients. Objectives To describe the trend of VTE among select rheumatologic diseases over 15 years. Methods We used National Inpatient Sample (NIS) database for years 2000–2014 to identify adults≥18 years with select rheumatologic diseases and VTE based on ICD-9 codes. Prevalence was age-sex adjusted against US census population data. STATA was used for querying database and Joinpoint regression was used to analyse annual trends of prevalence in terms of annual percentage change (APC). Logistic regression with survey command was used to derive adjusted odds of VTE association for all years combined. Results We included a total of 461,089,203 hospitalizations among which 8,822,456 (1.91%) had VTE (table 1). An upward trend in the prevalence of VTE (APCs 2.45–4.16) (and PE subset) was noted in most of the rheumatologic disease groups (figure 1). DVT, however, had a decreasing or non-significant increasing trend among most disease groups (data for DVT and PE not shown). The adjusted odds of VTE association was highest among SLE group (aOR=2.2, CI=2.17–2.3) followed by DM/PM (aOR=2.0, CI=1.9–2.2) (table 1). Table 1 Frequency counts of rheumatologic diseases and controls; prevalence of VTE and adjusted regression analysis of VTE association Conclusions Inflammatory rheumatologic diseases seem to be associated with higher prevalence and odds of having VTE among hospitalised patients and the overall trend is rising. This might indicate some lag in following of guidelines for VTE prophylaxis. Closer look into the implications of stricter prophylaxis among rheumatologic patients is a matter of further studies. Disclosure of Interest None declared

To assess clinical competency of 1-year trained vision technicians (VTs) in detecting and referring causes of visual impairment in India.Eye examination results and management plans for 328 patients examined by 24 VTs in 24 vision centers of LV Prasad Eye Institute in Andhra Pradesh were compared with those of a standard optometrist who examined the same patients. Eye examinations included retinoscopy and subjective refraction, slit lamp examination, applanation tonometry and undilated direct ophthalmoscopy. Data were analyzed for level of concordance in retinoscopy, spectacle prescription, disease detection and referral.VTs demonstrated moderate to good levels of agreement in refraction, disease detection and referral. Sensitivity and specificity for ocular pathology identification were 77.4% (95% confidence interval, CI, 69.4-84.2%) and 86.6% (95% CI 81.1-91.1%), respectively. The highest sensitivity was demonstrated in detecting significant cataract (91.5%) and refractive error (83.0%). VT spectacle prescriptions were accurate 76% of the time for mean spherical equivalent and 65% of the time for astigmatism. VT sensitivity in detecting posterior segment abnormalities was low (18.5%) resulting in failure to detect retinal conditions such as diabetic retinopathy and maculopathy. Despite lack of recognition of the specific pathology, referral decisions were correct in 78.4% of cases.VTs in India competently detect and manage or refer the two most common causes of visual impairment; uncorrected refractive error and cataract. Over two-thirds of patients received accurate and appropriate services from VTs, suggesting that they are a useful and competent cadre for rural and remote eye care.

A morphing wing is designed to morph to different wing profiles required for different flight regimes. Such a design is based on modules, and discretization of different wing profiles will yield different sets of modules. In this paper, a novel wing module consolidation methodology is developed to consolidate different sets of modules to a common set of modules for a unified modular morphing wing design. Initial wing profiles are created for different flight regimes using an optimization algorithm coupled with a fluid solver. These wing profiles are then smoothened, and used as reference geometries for module discretization. The results of discretized wings are then consolidated using a sensitivity analysis and a weighting function that allows the designer to assign a higher priority to a specific flight regime. A case study, showing the implementation of this methodology for climb, cruise, and descent flight regimes, reveals that the consolidated wing can be morphed to approximate the original wing profi...

Health promotion intervention in schools is a useful strategy to improve students' health awareness. The purpose of this study was to assess the effect of eye health promotion interventions on eye health literacy in school children in Vietnam. A piloted questionnaire was administered to 300 children from five secondary schools in Ba Ria-Vung Tau, Vietnam at baseline and re-administered after the eye health promotion interventions. McNemar chi-square and logistic regression were used for statistical analysis. A total of 300 children aged 12-15 years (mean, 13.3 ± 1.3 years; 60% female) participated in the baseline survey. The participation rate in the post-health promotion survey was 94.7%. After the health promotion interventions, number of children who had correct eye health knowledge increased by 10-20% (60-75% to 70-95%), more children reported having had an eye examination (63.3% to 84.7%; p < 0.001) and more reported wearing spectacles (36.1% to 43.4%; p = 0.04). Children in urban schools were twice as likely to have improved knowledge of vision loss compared with children in rural schools (odds ratio, 2.1-4.1; p = 0.01 to p < 0.001). Children from rural schools had significantly higher odds of visiting doctor after the eye problems worsened (odds ratio, 4.5; p < 0.001). These results imply that eye health promotion interventions significantly improve eye health knowledge, attitudes and practices of school children. Additionally, participation of parents and teachers as change agents may further improve children's health literacy.

Background Travellers are at risk of acquiring infectious diseases during travel, with risks differing by destination, travel and traveller characteristics. A pre-travel health consultation may minimize this risk. However, uptake of pre-travel health advice remains low. We investigated pre-travel health preparations and disease-specific risk behaviours among notified cases of selected travel-associated infectious diseases imported into Australia. Methods Prospective enhanced surveillance of notified cases of typhoid, paratyphoid, measles, hepatitis A, hepatitis E, malaria and chikungunya was conducted in two Australian states between February 2013 and January 2014. Details of pre-travel health preparation and disease-specific risk behaviours were collected. Results Among 180 cases associated with international travel, 28% were

Purpose: The aim was to develop and validate an instrument to measure job satisfaction in eye‐care personnel and assess the job satisfaction of one‐year trained vision technicians in India. Methods: A pilot instrument for assessing job satisfaction was developed, based on a literature review and input from a public health expert panel. Rasch analysis was used to assess psychometric properties and to undertake an iterative item reduction. The instrument was then administered to vision technicians in vision centres of Andhra Pradesh in India. Associations between vision technicians’ job satisfaction and factors such as age, gender and experience were analysed using t‐test and one‐way analysis of variance. Results: Rasch analysis confirmed that the 15‐item job satisfaction in eye‐care personnel (JSEP) was a unidimensional instrument with good fit statistics, measurement precisions and absence of differential item functioning. Overall, vision technicians reported high rates of job satisfaction (0.46 logits). Age, gender and experience were not associated with high job satisfaction score. Item score analysis showed non‐financial incentives, salary and workload were the most important determinants of job satisfaction. Conclusions: The 15‐item JSEP instrument is a valid instrument for assessing job satisfaction among eye‐care personnel. Overall, vision technicians in India demonstrated high rates of job satisfaction. Refereed/Peer-reviewed