Relationships between Childhood Fever Management of Bhutanese Parents and Their Knowledge, Attitude, and Perceived Self-efficacy

Objective: To examine parents’ management of childhood fever and its relationships with the knowledge, attitudes, and perceived self-efficacy of Bhutanese parents. Method: A convenience sampling was used to recruit a sample of 80 Bhutanese parents bringing their children with fever to the Pediatric Outpatient Unit of Jigme Dorji Wangchuck National Referral Hospital. Research instruments included 1) demographic record form, 2) parents’ childhood fever management questionnaire, 3) parents’ knowledge questionnaire, 4) parents’ attitude questionnaire, and 5) parents’ perceived self-efficacy scale. The reliabilities of questionnaires 2 - 5 were acceptable, i.e. Cronbach’s alpha coefficients = 0.79, 0.71, 0.88, and 0.86, respectively. Data were collected from March to April 2017 and analyzed using descriptive statistics and Pearson’s correlation. Results: The total mean score of parents’ childhood fever management was 39.51 (SD = 5.59). There were significantly positive relationships between the parents’ childhood fever management and their knowledge, attitudes, and perceived self-efficacy (r = 0.28, 0.24 and 0.24, respectively; P-value < 0.05 for all pairs). Conclusion: There was a room for improvement of the childhood fever management of Bhutanese parents. Healthcare providers, especially nurses, could utilize the findings to develop an intervention or a program to improve and enhance parent’s management of fever in children by focusing on an increase in knowledge, attitude, and perceived self-efficacy. Keywords: childhood fever management, Bhutanese parents, knowledge, attitude, perceived self-efficacy

Climate change, malaria and neglected tropical diseases: a scoping review

To explore the effects of climate change on malaria and 20 neglected tropical diseases (NTDs), and potential effect amelioration through mitigation and adaptation, we searched for papers published from January 2010 to October 2023. We descriptively synthesised extracted data. We analysed numbers of papers meeting our inclusion criteria by country and national disease burden, healthcare access and quality index (HAQI), as well as by climate vulnerability score. From 42 693 retrieved records, 1543 full-text papers were assessed. Of 511 papers meeting the inclusion criteria, 185 studied malaria, 181 dengue and chikungunya and 53 leishmaniasis; other NTDs were relatively understudied. Mitigation was considered in 174 papers (34%) and adaption strategies in 24 (5%). Amplitude and direction of effects of climate change on malaria and NTDs are likely to vary by disease and location, be non-linear and evolve over time. Available analyses do not allow confident prediction of the overall global impact of climate change on these diseases. For dengue and chikungunya and the group of non-vector-borne NTDs, the literature privileged consideration of current low-burden countries with a high HAQI. No leishmaniasis papers considered outcomes in East Africa. Comprehensive, collaborative and standardised modelling efforts are needed to better understand how climate change will directly and indirectly affect malaria and NTDs

Assessment of excessive vaginal discharge among women who presented to Phuentsholing General Hospital: A hospital‐based study

Abstract Introduction Excessive vaginal discharge is troublesome for females. The majority of the women seek gynecological consultation due to excessive vaginal discharge. The causes vary from physiological to pathological discharge. Unless the cause is identified and treated, women will remain in distress. The present study was thus carried out to determine the most common cause of the excessive vaginal discharge. Methods A cross‐sectional study was conducted at the Phuentsholing General Hospital, Chukha, Bhutan, from May 1 to October 31, 2021. All females aged 18 years and older, irrespective of marital status, who presented with excessive vaginal discharge were recruited for the study. With due informed consent, a sterile speculum examination was performed and a high vaginal swab was collected and subjected to various tests. The data collected were analyzed using SPSS 23 software. Descriptive statistical tests were used for frequencies, percentages, mean, and standard deviations; the χ2 test was used to determine associations, and a logistic regression test was performed to determine the effect of independent variables on dependent variables. Results A total of 400 women were recruited for the study, of whom 362 (90.5%) women had infective causes for vaginal discharge. Trichomoniasis was the most common infection identified in 162 (40.5%) women, followed by bacterial vaginosis (91, 22.8%) and vulvovaginal candidiasis (52, 13.0%). In 38 (9.5%) women, infective cause was not found and categorized as physiological vaginal discharge. Malodorous, profuse discharge, vulval itching, dyspareunia, dysuria, and lower abdominal pain were significantly associated with infectious vaginal discharge. Conclusions Excessive vaginal discharge was mainly caused by infections. The most commonly detected infection was trichomoniasis, followed by bacterial vaginosis and vulvovaginal candidiasis. Every female with vaginal discharge requires proper evaluations to identify the infection and treat it adequately

PSB in Bhutan: Countering Foreign Invasion with Local Contents

Bhutan has been a latecomer to the world of public service broadcasting (PSB). As the global debate on whether there still is a place for PSB in the changing media landscape is continuing, Bhutan, on the contrary, is working towards strengthening its PSB. There are compelling reasons why Bhutan seeks to strengthen its PSB. As the isolated Himalayan kingdom is bombarded with over 50 international satellite TV channels, PSB is an important source of news and information for the Bhutanese audience. It plays an ever more critical role in strengthening the country’s nascent democracy by providing the public a platform to voice their concerns and debate and discuss various social, political, cultural and economic issues. Also, as the only local or national TV channel, it plays a crucial role in counterbalancing the flood of foreign programming beamed into the country and protect Bhutan’s unique Buddhist culture and nurture it for the 21st century

The Education Resilience of Out-of-school Children in Bhutan: A Methodology and Pilot Study

Accessibility and quality of education is a much-debated issue today. In Bhutan this is especially a concern for the population scattered across the extreme mountainous terrain of the country. Difficult access and spatial isolation leads to an unequal distribution of the quality services in Bhutan. It is also an issue for children in urban communities despite the easy access to schools. Poverty and disability hold children back from enrolling in and completing school. Hence, the education resilience in these vulnerable communities can differ accordingly even despite the fact that the government provides free basic education in Bhutan. We define resilience as the ability of students, education institutions, and communities to achieve positive education outcomes in spite of adversities, such as the marginalization, isolation and poverty that exist in pockets in Bhutan. This report presents the results of our pilot study. We consulted with education policy makers and implementers at the national level, and communities, parents and children themselves at the local level, to conduct an in-depth analysis of the risks and the assets (strengths, opportunities and resources), that exist in schools, homes and in communities. Accordingly, recommendations are also made in this report with a view towards filling the gaps and enhancing the relevance of education policies and programs based on the evidence collected from the field during the study

Cross-sectional imaging in cancers of the head and neck: how we review and report.

Cancer of the head and neck is the sixth most frequent cancer worldwide and associated with significant morbidity. The head and neck area is complex and divided into various anatomical and functional subunits. Imaging is performed by cross-sectional modalities like computed tomography, magnetic resonance imaging, ultrasound and positron emission tomography-computed tomography, usually with fluorine-18-deoxy-D-glucose. Therefore, knowledge of the cross-sectional anatomy is very important. This article seeks to give an overview of the various cross-sectional imaging modalities used in the evaluation of head and neck cancers. It briefly describes the anatomy of the extracranial head and neck and the role of imaging as well as the imaging appearance of tumours and their extension to lymph nodes, bone and surrounding tissue. The advantages and disadvantages as well as basic requirements of the various modalities are described along with ways of optimizing imaging quality. A general guideline for prescription of the various modalities is given. Pitfalls are many and varied and can be due to anatomical variation, due to pathology which can be misinterpreted and technical due to peculiarities of the various imaging modalities. Knowledge of these pitfalls can help to avoid misinterpretation. The important points to be mentioned while reporting are also enumerated

Acquired Resistance to Immune Checkpoint Blockade Therapies

Immune checkpoint blockade therapy (ICBT) has revolutionized the treatment and management of numerous cancers, yet a substantial proportion of patients who initially respond to ICBT subsequently develop resistance. Comprehensive genomic analysis of samples from recent clinical trials and pre-clinical investigation in mouse models of cancer provide insight into how tumors evade ICBT after an initial response to treatment. Here, we summarize our current knowledge on the development of acquired ICBT resistance, by examining the mechanisms related to tumor-intrinsic properties, T-cell function, and tumor-immune cell interactions. We discuss current and future management of ICBT resistance, and consider crucial questions remaining in this field of acquired resistance to immune checkpoint blockade therapies

Cancer of the oral cavity and oropharynx

Tumours in the oral cavity and oropharynx differ in presentation and prognosis and the detection of spread of tumour from one subsite to another is essential for the T-staging. This article reviews the anatomy and describes the pattern of spread of different cancers arising in the oral cavity and oropharynx; the imaging findings on computerized tomography and magnetic resonance imaging are also described. Brief mention is made on the role of newer imaging modalities such as [18F]fluorodeoxyglucose-positron emission tomography/computed tomography, perfusion studies and diffusion-weighted magnetic resonance imaging