Mitigation potential of urease inhibitory compounds in reducing ammonia emissions from cattle urine in dairy-grazed pasture soils : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy (PhD) in Soil Science at Massey University, Palmerston North, New Zealand

The excretal deposition by grazing animals, especially urine containing about 80% urea, and urea fertiliser use on pastoral farms are major sources of ammonia (NH3) emissions in New Zealand (NZ) agriculture. Recent intensification of dairy farming in NZ has resulted in a substantial increase in the use of nitrogen (N) fertiliser, especially urea, and the quantity of urine deposited by grazing dairy cows onto pasture soils, and as a consequence, higher NH3 emissions. These emissions represent economic and environmental losses. The urease inhibitor (UI) N-(n-butyl) thiophosphoric triamide (nBTPT) has shown effectiveness in reducing emissions when applied with fertiliser urea or cattle urine in NZ dairy-grazed pasture soils. However, the inhibitory effect of nBTPT on reducing NH3 emissions is effective for a relatively short period (7 - 14 days), during which emissions from urea fertiliser is inhibited. But, in the context of grazed pasture, to reduce the NH3 emitted from deposited urine following each grazing event, regular applications of nBTPT are required, which would be prohibitively expensive. To mitigate NH3 emissions from cattle urine deposited during more than a single grazing, in dairy-grazed pasture soils, it is necessary to identify alternative longer lasting inhibition approaches to using nBTPT. Therefore, the overall objective of this thesis was to assess the effectiveness and longevity of potentially longer-lasting non-specific inhibitors copper (Cu) and zinc (Zn), and the specific inhibitor N-(2-Nitrophenyl) phosphoric triamide (2-NPT) in reducing NH3 emissions following cattle urine applied to pasture soils. The study presented in this thesis initially examined the influence of inherent and added Cu and Zn in inhibiting soil urease activity (UA), and the role of soil organic carbon (C) and soil textural and mineralogical properties on influencing the ability of these metals at inhibiting soil UA of dairy pasture soils under laboratory incubations. The study then evaluated the effect of the recently introduced UI 2-NPT on NH3 emissions, soil microbial biomass C, pasture dry matter yield and N uptake, which was compared with the more commonly used UI nBTPT. This study involved both laboratory and field experiments. The first laboratory experiment assessed the effect of inherent and added Cu and Zn in inhibiting soil UA of dairy-grazed pasture soils. The results showed significant positive correlations between soil total C and N with soil UA for 23 soils from the Waikato region of NZ. However, there were no significant negative correlations between soil UA with inherent Cu and Zn levels. Similarly, the addition of Cu up to 20 mg kg⁻¹ soil and the combination of 5 mg Cu and 5 mg Zn kg⁻¹ soil did not significantly reduce soil UA of 4 dairy-grazed pasture soils, with contrasting organic C levels. In the second laboratory experiment, the influence of the soil C factor (soil organic C, and other related soil properties, such as clay content and cation exchange capacity (CEC)) on the effectiveness of Cu and Zn to inhibit urea hydrolysis in soil supernatants were studied. When Cu was added to 2 different soil supernatants, at rates of 5, 10, and 20 mg Cu kg⁻¹ soil, there was a significant reduction in hydrolysis of urea applied at either 120 or 600 mg urea-N kg⁻¹ soil. Additions of Zn, at a rate of 20 mg kg⁻¹ soil achieved negligible or small reductions in urea hydrolysis after either 120 or 600 mg urea-N kg⁻¹ soil applications to soil supernatants. These results suggest that Cu has a urease inhibitory effect, but its ineffectiveness in C rich pasture soils is caused by reduced bioavailability as a result of high Cu complexation. However, Zn had a negligible inhibitory effect on soil UA at the rate used in this experiment. Overall these results support the conclusion that neither metal is likely to be a practical UI for reducing NH3 emissions from NZ dairy-grazed pasture soils. The effectiveness and longevity of 2-NPT and nBTPT in reducing NH3 emissions from cattle urine applied to 2 dairy-grazed pasture soils were evaluated under laboratory conditions. The inhibitors were applied at the start of the experiment and urine was applied at 4 stages; (A) immediately before, (B) 29 days after, (C) 56 days after, and (D) 29 days after and again 60 days after inhibitor application, and NH3 emissions were measured following each urine application. There were 3 application rates of 2-NPT; 0.025, 0.050, and 0.075% of total urine-N applied at Stage-A, and one rate of nBTPT; 0.025% of total urine-N applied at Stage-A. The application depth of urine applied was 10 mm for Stages A, B and C and 7.2 mm for Stage-D. The % applied urine-N that was emitted as NH3 at the different stages ranged from 14.2 to 50.5% for the soils studied. Both UIs equally reduced total NH3 emissions (20.6 - 27.3%), from both of the soil types, when urine was applied immediately before inhibitor application. The inhibitor 2-NPT continued to reduce emissions (5.6 - 7.4%) from urine applied up to 56 days after the inhibitor application, but only for the soil with lower microbial biomass C and UA, suggesting that 2-NPT has slightly greater longevity of efficacy than nBTPT. When urine was applied immediately before inhibitor application, inhibitors had no effect on soil microbial biomass C, measured 31 days after inhibitor application, which suggest specificity of UIs on inhibiting UA. Two field experiments were conducted during summer and autumn to assess whether the differences observed between the inhibitors 2-NPT and nBTPT in the laboratory experiment are also achieved under field conditions. In the summer experiment, the inhibitors were applied at the start of the experiment and urine was applied at 3 stages; (A) 3 hrs before, (B) 28 days after, and (C) 68 days after inhibitor application, and NH3 emissions were measured following each urine application. The application rates of inhibitors to the urine treatments for all 3 stages were based on the percentage (0.025%) of total urine-N applied at Stage-A. In the autumn experiment, urine was only applied either immediately before or 3 hrs before inhibitor application, also at a rate of 0.025% of total urine-N. The application depth of urine applied in both of the summer and autumn experiments was 10 mm. The NH3-N emitted in the summer experiment was between 15.3 - 23.6% of the applied urine-N (equivalent to 111 - 142 kg N ha⁻¹), however, in autumn the emissions were only 4.5% (equivalent to 27 kg N ha⁻¹ of the total N applied. In the summer experiment, only 2-NPT significantly reduced total NH3 emissions (19.5% reduction), which was only when urine was applied 28 days after the inhibitor application (Stage B). Both inhibitors significantly reduced emissions in autumn when urine was applied either 3 hrs before or immediately before inhibitor application. However, the effectiveness was greater when urine was applied immediately before inhibitor application (52.3 - 72.7% reduction) compared to urine applied 3 hrs before inhibitor application (35.0 - 41.2% reduction). The reduction was greater with 2-NPT (72.7% reduction) compared to nBTPT (52.3% reduction) when urine was applied immediately before inhibitor application. The field study confirmed the findings of laboratory study that the effectiveness and longevity of 2-NPT, in reducing NH3 emissions from cattle urine applied to pasture soils, is greater compared to nBTPT. There was no effect of inhibitors on pasture dry matter yield and N uptake in either of the field experiments. The 2-NPT applied up to about a month prior to a grazing event in summer reduced NH3 emissions from urine patch areas at a rate equivalent to 26 kg N ha⁻¹ (based on 19.5 % reduction in summer) at the subsequent grazing. If 3 applications of 2-NPT are applied in summer (period when emissions are typically the highest) following 3 grazings that would reduce losses by 78 kg N ha⁻¹ from 3 subsequent grazings. When these reductions are extrapolated to determine the overall benefit on whole paddock basis, the total reduction in N loss (26 kg N ha⁻¹ x 3% x 3 grazings) is 2.3 kg N ha⁻¹ yr⁻¹, assuming the urine patches cover 3% of the grazed area per grazing. Thus, overall benefit from using 2-NPT is greater than nBTPT in reducing NH3 emissions from cattle urine deposited in dairy-grazed pastures. However, the size of the reduction from using 2-NPT on whole paddock was low, compared to the amount of N cycling in grazed pastures annually. To further improve the effectiveness of inhibitors, applied after urine application in summer, future research could focus on enhancing the contact between the inhibitor and urine urea by increasing the volume of inhibitor used (>800 L ha⁻¹) and/or by implementing shorter durations (<3 hrs) between urine and inhibitor application. Further changes in volume of inhibitor applied and timing of inhibitor application should consider cost involved and feasibility in dairy farms with the current technology

Data_Sheet_1_Adopting social health insurance in Nepal: A mixed study.docx

ObjectiveThe Social Health Insurance Program (SHIP) shares a major portion of social security, and is also key to Universal Health Coverage (UHC) and health equity. The Government of Nepal launched SHIP in the Fiscal Year 2015/16 for the first phase in three districts, on the principle of financial risk protection through prepayment and risk pooling in health care. Furthermore, the adoption of the program depends on the stakeholders' behaviors, mainly, the beneficiaries and the providers. Therefore, we aimed to explore and assess their perception and experiences regarding various factors acting on SHIP enrollment and adherence.MethodsA cross-sectional, facility-based, concurrent mixed-methods study was carried out in seven health facilities in the Kailali, Baglung, and Ilam districts of Nepal. A total of 822 beneficiaries, sampled using probability proportional to size (PPS), attending health care institutions, were interviewed using a structured questionnaire for quantitative data. A total of seven focus group discussions (FGDs) and 12 in-depth interviews (IDIs), taken purposefully, were conducted with beneficiaries and service providers, using guidelines, respectively. Quantitative data were entered into Epi-data and analyzed with SPSS, MS-Excel, and Epitools, an online statistical calculator. Manual thematic analysis with predefined themes was carried out for qualitative data. Percentage, frequency, mean, and median were used to describe the variables, and the Chi-square test and binary logistic regression were used to infer the findings. We then combined the qualitative data from beneficiaries' and providers' perceptions, and experiences to explore different aspects of health insurance programs as well as to justify the quantitative findings.Results and prospectsOf a total of 822 respondents (insured-404, uninsured-418), 370 (45%) were men. Families' median income was USD $65.96 (8.30–290.43). The perception of insurance premiums did not differ between the insured and uninsured groups (p = 0.53). Similarly, service utilization (OR = 220.4; 95% CI, 123.3–393.9) and accessibility (OR = 74.4; 95% CI, 42.5–130.6) were found to have high odds among the insured as compared to the uninsured respondents. Qualitative findings showed that the coverage and service quality were poor. Enrollment was gaining momentum despite nearly a one-tenth (9.1%) dropout rate. Moreover, different aspects, including provider-beneficiary communication, benefit packages, barriers, and ways to go, are discussed. Additionally, we also argue for some alternative health insurance schemes and strategies that may have possible implications in our contexts.ConclusionAlthough enrollment is encouraging, adherence is weak, with a considerable dropout rate and poor renewal. Patient management strategies and insurance education are recommended urgently. Furthermore, some alternate schemes and strategies may be considered.</p

Data_Sheet_2_Adopting social health insurance in Nepal: A mixed study.CSV

ObjectiveThe Social Health Insurance Program (SHIP) shares a major portion of social security, and is also key to Universal Health Coverage (UHC) and health equity. The Government of Nepal launched SHIP in the Fiscal Year 2015/16 for the first phase in three districts, on the principle of financial risk protection through prepayment and risk pooling in health care. Furthermore, the adoption of the program depends on the stakeholders' behaviors, mainly, the beneficiaries and the providers. Therefore, we aimed to explore and assess their perception and experiences regarding various factors acting on SHIP enrollment and adherence.MethodsA cross-sectional, facility-based, concurrent mixed-methods study was carried out in seven health facilities in the Kailali, Baglung, and Ilam districts of Nepal. A total of 822 beneficiaries, sampled using probability proportional to size (PPS), attending health care institutions, were interviewed using a structured questionnaire for quantitative data. A total of seven focus group discussions (FGDs) and 12 in-depth interviews (IDIs), taken purposefully, were conducted with beneficiaries and service providers, using guidelines, respectively. Quantitative data were entered into Epi-data and analyzed with SPSS, MS-Excel, and Epitools, an online statistical calculator. Manual thematic analysis with predefined themes was carried out for qualitative data. Percentage, frequency, mean, and median were used to describe the variables, and the Chi-square test and binary logistic regression were used to infer the findings. We then combined the qualitative data from beneficiaries' and providers' perceptions, and experiences to explore different aspects of health insurance programs as well as to justify the quantitative findings.Results and prospectsOf a total of 822 respondents (insured-404, uninsured-418), 370 (45%) were men. Families' median income was USD $65.96 (8.30–290.43). The perception of insurance premiums did not differ between the insured and uninsured groups (p = 0.53). Similarly, service utilization (OR = 220.4; 95% CI, 123.3–393.9) and accessibility (OR = 74.4; 95% CI, 42.5–130.6) were found to have high odds among the insured as compared to the uninsured respondents. Qualitative findings showed that the coverage and service quality were poor. Enrollment was gaining momentum despite nearly a one-tenth (9.1%) dropout rate. Moreover, different aspects, including provider-beneficiary communication, benefit packages, barriers, and ways to go, are discussed. Additionally, we also argue for some alternative health insurance schemes and strategies that may have possible implications in our contexts.ConclusionAlthough enrollment is encouraging, adherence is weak, with a considerable dropout rate and poor renewal. Patient management strategies and insurance education are recommended urgently. Furthermore, some alternate schemes and strategies may be considered.</p

Experience of primary healthcare workers in using the mobile app-based WHO mhGAP intervention guide in detection and treatment of people with mental disorders: A qualitative study in Nepal

This study assessed perception and experience of trained primary health care workers in using a mobile app-based version of the WHO mental health gap action programme (mhGAP) Intervention Guide in the assessment and management of people with mental health conditions in primary care in Nepal. A qualitative study was conducted with primary healthcare workers who were trained in using the WHO mhGAP mobile application in Jhapa, a district in eastern Nepal. Semi-structured interviews were carried out with 15 healthcare workers (3 females and 12 males) nine months after the training. Interviews were audio recorded, transcribed and translated into English for the thematic qualitative data analysis. Health care workers (HCWs) found the mobile app helpful to verify and confirm their assessment and diagnosis. The other benefits reported by the participants were: bringing uniformity in diagnosis and management of mental health conditions across primary healthcare facilities; reminding the HCWs specific assessment questions; creating awareness on the importance of psychosocial intervention; improving the interaction between patients and service providers; and the importance of follow-up care. Despite these advantages, lack of clarity about report submission modality; lack of electricity or internet connectivity; and low technology literacy among older HCWs were some of the barriers in using the app. The major recommendation made by the HCWs for the guide included revision of the assessment process and system; inclusion of a chat function with supervisors; minimizing the amount of patients’ data to be collected in the app; and addition of conversion and anxiety disorders to the app. This study concludes that the mobile decision support application could be acceptable and feasible in primary care settings if the suggested modifications are incorporated, in addition to addressing other systemic issues facing the primary care-based delivery of mental health services

Stinging Nettle (<i>Urtica dioica</i> L.): Nutritional Composition, Bioactive Compounds, and Food Functional Properties

Stinging nettle (Urtica dioica L., Urticaceae) is commonly found in Asia, Africa, and Europe and has a long history of being used as food and traditional medicine. Recently, this plant is gaining attention as a highly nutritious food, where fresh leaves are dried and used as powder or in other forms. Leaves are rich in many bioactive compounds. This review aims to cover the traditional uses in food and medicine, as well as its nutritional composition, including its bioactive chemical constituents and reported food functional activities. Various bioactive chemical constituents have been isolated from stinging nettle to date, such as flavonoids, phenolic acids, amino acid, carotenoids, and fatty acids. Stinging nettle extracts and its compounds, such as rutin, kaempferol, and vitamin A, are also used for their nutritional properties and as anti-inflammatory and antioxidant agents. Future studies should focus on the proper formulation and stability testing of the functional foods containing stinging nettle and their detailed activities in clinical studies

Village-integrated eye workers for prevention of corneal ulcers in Nepal (VIEW study): a cluster-randomised controlled trial

BackgroundCorneal ulcers are a common cause of blindness in low-income and middle-income countries, usually resulting from traumatic corneal abrasions during agricultural work. Antimicrobial prophylaxis of corneal abrasions can help prevent corneal ulcers, but delays in the initiation of therapy are frequent. We aimed to assess whether a community-based programme for corneal ulcer prevention would reduce the incidence of corneal ulceration.MethodsA cluster-randomised trial was performed in village development committees (VDCs) in Nepal. VDCs in the catchment area of Bharatpur Eye Hospital, Nepal with less than 15 000 people were eligible for inclusion. We randomly assigned (1:1) VDCs to either an intervention group or a control group. In the intervention VDCs, existing female community health volunteers (FCHVs) were trained to diagnose corneal abrasions and provide a 3-day course of ophthalmic antimicrobials to their patients. In the control VDCs, FCHVs did not provide this intervention. Participants were not masked given the nature of the intervention. Both groups were followed up for 3 years for photographic evidence of corneal ulceration. The primary outcome was the incidence of corneal ulceration, determined by masked assessment of corneal photographs. The analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, NCT01969786.FindingsWe assessed 112 VDCs, of which 24 were enrolled. The study was performed between Feb 4, 2014, and Oct 20, 2017. 12 VDCs were randomly assigned to the intervention group and 12 to the control group. 252 539 individuals were included in the study (130 579 in the intervention group and 121 960 in the control group). FCHVs diagnosed and provided antimicrobials for 4777 corneal abrasions. The census identified 289 corneal ulcers among 246 893 person-years in the intervention group (incidence 1·21 cases [95% CI 0·85-1·74] per 1000 person-years) and 262 corneal ulcers among 239 170 person-years in the control group (incidence 1·18 cases [0·82-1·70] per 1000 person-years; incidence rate ratio 1·03 [95% CI 0·63-1·67]; p=0·93). Medication allergy was self-reported in 0·2% of participants.InterpretationWe did not detect a reduction in the incidence of corneal ulceration during the first 3 years of a community-based corneal ulcer prevention programme. Further study might be warranted in more rural areas where basic eye care facilities are not available.FundingNational Eye Institute