Joint regression analysis of the effect of climate risk on food security in rural Nepal: Using Copula approach

This paper analyzes the effect of climate risk on food security in rural Nepal, utilizing the Nepal Living Standard Survey data and climate risk index data. We construct two indicators for food security, caloric intake per capita and food diversity, which captures comprehensive information of food security. The copula method, which allows us to obtain flexible bivariate parametric model for the continuous-count data, is used to simultaneously estimate the caloric intake and food diversity models

On the spin-isospin decomposition of nuclear symmetry energy

The decomposition of nuclear symmetry energy into spin and isospin components is discussed to elucidate the underlying properties of the NN bare interaction. This investigation was carried out in the framework of the Brueckner-Hartree-Fock theory of asymmetric nuclear matter with consistent two and three body forces. It is shown the interplay among the various two body channels in terms of isospin singlet and triplet components as well as spin singlet and triplet ones. The broad range of baryon densities enables to study the effects of three body force moving from low to high densities.Comment: 8 pages, 4 figure

Serum KL-6 and the mortality of patients with connective tissue disease-associated interstitial lung disease: A meta-analysis

Connective tissue disease-associated interstitial lung disease (CTD-ILD) is an important underlying cause of morbidity and mortality in patients with CTD. Serum Krebs von den Lungen-6 (KL-6) is an immune factor which has been related to the severity of ILD. This systematic review and meta-analysis aimed to evaluate the association between serum KL-6 and mortality of patients with CTD-ILD. Longitudinal studies relevant to the aim of the meta-analysis were retrieved by search of electronic databases including PubMed, Web of Science, and Embase. A random-effects model was used to combine the data by incorporating the influence of between-study heterogeneity. Fifteen cohorts involving 1737 patients with CTD-ILD were included. During a mean follow-up of 35.3 months, 430 (24.8%) patients died. Compared to those with a lower KL-6 at admission, patients with a higher KL-6 were associated with a higher mortality risk during follow-up (risk ratio: 2.18, 95% confidence interval: 1.66 to 2.87, P < 0.001; I2 = 20%). Subgroup analysis showed a significant association in studies from Asian countries, but not in those from non-Asian countries; in studies with cutoff of KL-6 derived in receiver operating characteristic (ROC) curve analysis, but not in those derived from other methods; in studies with multivariate analysis, but not in those with univariate analysis (P for subgroup difference all < 0.05). The association was not significantly affected by different CTDs or methods for measuring serum KL-6. In conclusion, a high serum KL-6 may be a risk factor of increased mortality in patients with CTD-ILD

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Food Security, Climate Change, and Poverty Reduction in Rural Nepal

Smallholder famers in the developing countries, especially those who mainly depend on rain-fed agriculture, are vulnerable and sensitive to climate change because such agricultural cultivators largely depend on traditional farming techniques, and are less capable of coping with climate change (Krishnamurthy et al., 2013). Like many other developing countries, agricultural production in Nepal is largely dependent on rainfall, which causes high sensitivity to climate change for household food security. This dissertation, which is composed of three main studies, examines how serious climate change affects household food security, as well as the potential strategies households could adopt to cope with food insecurity and climate change. The first study investigates effects of temperature and rainfall trends since 1976 on individual caloric intake and household food diversity using cross-section data from Nepal Living Standard Survey 2010/2011. The analysis utilizes a Copula method to estimate the caloric intake and food diversity models simultaneously. Results show that the estimated correlation parameter between the two models is statistically significant from zero at the 1% level, confirming the validity of using the Copula method. We also find that the rainfall and temperature risk in rural Nepal negatively affects household food security (both caloric intake per capita and food diversity). Findings also highlight the importance of community social capital, coping strategies (i.e., remittance, access to credit, and government support), infrastructure, and agricultural income. The second study uses a Stochastic Frontier Production Model to examine the spatial effects of extreme climate events as well as the mean temperature and rainfall on rice production. We also analyze the factors affecting agricultural production efficiency using panel data from Nepal Living Standard Survey in 2003/2004 and 2010/2011. The results show that 1℃ increase in summer temperature causes a total loss of 4183 kg of rice in the sample. We also find that households located in the districts with more river and road systems are more efficient in rice production, and conclude that agricultural extension programs and education of the household head contribute to production efficiency. Driven by the findings, the following study investigates effects of farmers perception of climate change on their willingness to pay (WTP) for a weather index-based crop insurance. The study considers two crop insurance products: product A only insures rice and B insures both rice and livestock. We use the Biprobit method with contingent valuation data collected from a primary survey conducted in Bahunepati, Nepal. The results indicate that people who perceive the continuity of climate change or experience adverse effects of climate change are more willing to pay for the insurance products. In addition, we find that other existing mitigation strategies crowd out individuals\u27 WTP. Finally, the annually median WTPs are 1.6% and 3% of household income for product A and B, respectively

Farmers’ perception of climate change and willingness to pay for weather-index insurance in Bahunepati, Nepal

This paper is a pioneering study of investigating effects of farmers’ perception of climate change on their willingness to pay (WTP) for a weather-index crop insurance in Nepal. We use contingent valuation data collected from a primary household survey conducted in Bahunepati, Nepal to examine the topic. The research improves on the previous literature by analyzing two crop insurance products which incorporate both crop and livestock