Stunting among under 5-year-olds in Nepal: trends and risk factors.

INTRODUCTION: The nutritional status in the first 5 years of life has lifelong and inter-generational impacts on individual's potential and development. This study described the trend of stunting and its risk factors in children under 5 years of age between 2001 and 2016 in Nepal. METHODS: The study used datasets from the 2001, 2006, 2011 and 2016 Nepal Demographic Health Surveys to describe the trend of stunting in under 5-year children. Multiple logistic regression analysis was carried out to assess the risk factors for stunting at the time of the four surveys. RESULTS: The nutritional status of under 5-year children improved between 2001 and 2016. Babies born into poorer families had a higher risk of stunting than those born into wealthier families (AOR 1.51, CI 95% 1.23-1.87). Families residing in hill districts had less risk of stunting than those in the Terai plains (AOR 0.75, CI 95% 0.61-0.94). Babies born to uneducated women had a higher risk of stunting than those born to educated women (AOR 1.57, CI 95% 1.28-1.92). DISCUSSION: Stunting among under-5-year children decreased in the years spanning 2001-2016. This study demonstrated multiple factors that can be addressed to decrease the risk of stunting, which has important implications for neurodevelopment later in life. We add literature on risk factors for stunting in under-5-year children

The association of women's empowerment with stillbirths in Nepal.

INTRODUCTION: Globally, 2.6 million stillbirths occur each year. Empowering women can improve their overall reproductive health and help reduce stillbirths. Women empowerment has been defined as women's ability to make choices in economic decision-making, household and health care decision-making. In this paper, we aimed to evaluate if women's empowerment is associated with stillbirths. METHODS: Data from 2016 Nepal Demographic Health Surveys (NDHS) were analysed to evaluate the association between women's empowerment and stillbirths. Equiplots were generated to assess the distribution of stillbirths by wealth quintile, place of residence and level of maternal education using data from NHDS 1996, 2001, 2006, 2011 and 2016 data. For the association of women empowerment factors and stillbirths, univariate and multivariate analyses were conducted. RESULTS: A total of 88 stillbirths were reported during the survey. Univariate analysis showed age of mother, education of mother, age of husband, wealth index, head of household, decision on healthcare and decision on household purchases had significant association with stillbirths (p < 0.05). In multivariate analysis, only maternal age 35 years and above was significant (aOR 2.42; 1.22-4.80). Education of mother (aOR 1.48; 0.94-2.33), age of husband (aOR 1.54; 0.86-2.76), household head (aOR 1.51; 0.88-2.59), poor wealth index (aOR 1.62; 0.98-2.68), middle wealth index (aOR 1.37; 0.76-2.47), decision making for healthcare (aOR 1.36; 0.84-2.21) and household purchases (aOR 1.01; 0.61-1.66) had no any significant association with stillbirths. CONCLUSIONS: There are various factors linked with stillbirths. It is important to track stillbirths to improve health outcomes of mothers and newborn. Further studies are necessary to analyse women empowerment factors to understand the linkages between empowerment and stillbirths

Riding the Third Wave of SoTL

Taking stock of an enterprise can be a stimulating exercise. It is also an essential one that allows for assessment of what one has while facilitating the planning of what one wants. In this piece, we take stock of the scholarship of teaching and learning (SoTL), mapping out what we see as the first two waves of the movement, and then identifying a ‘third wave.’ We believe it is time to think bigger. Specifically, those practicing SoTL need to: infiltrate the mainstream, run interference and catalyze the use of SoTL, and work towards a grand picture of learning

RIVER ECOLOGICAL STUDY: BUILDING THE KNOWLEDGE BASE FOR VARIETY OF ASSESSMENTS SUCH AS CLIMATE CHANGE IN NEPAL

Climate change is now universally acknowledged to be taking place across the globe. It is generally presumed that the impacts of climate change would be more severe in the country like Nepal due to its location, physiography, poverty and lack of preparedness to cope with the changes. The last reason is mainly associated with knowledge, information and ability to use technologies based on science.The main objective of this research is to analyze and evaluate the effects of climate change by taking fish as an indicator. However, an even more important outcome is to prepare a solid foundation of fish-based information, which could be used in the future as a reference for a variety of purposes including the study of climate change. Two sets of examples, one in the tributaries of a glacial river and another in the tributary of a rain -fed river are compared in terms of fish ecological attributes to test for effects of climate change. In addition to fish-based information, this research also studies physico-chemical parameters and benthic fauna so as to build up an ecological profile of the rivers

Prevalence of Substance Use and Associated Factors Among High School Adolescents in Rithepani, Lekhnath-2, kaski, Nepal

Background: Substance use is a major public health concern in global settings, and is very common during adolescence period leading to physical and/or mental health complications. This study assessed the prevalence of substance use and associated factors among high school adolescents in Rithepani 2, Lekhnath, Kaski, 2073. Objectives: The study was designed to provide estimates of substance use by school-going adolescents in Lekhnath and to identify risk factors associated with. Methods: A school based cross-sectional study was conducted from 17th October to 21st October, 2016 among eighth to 12th grade high school students in the Rithepani-2, Lekhnath. Participants were select­ed by purposive sampling techniques, and data were collected using questionnaire. Frequency, percentage, means, SD and chi-square test was performed to identify factors associated with substance use. Results: Majority of the respondents 93 (56.4%) belonged to the age group 15 - 18 years. Majority of the respondents 88 (53.3%) were males and 50 (30.3%) were studying in grade 11. Majority of the respondents 140 (84.8%) were Hindus and 104 (63%) of the respondents belonged to upper caste group. In terms of education of the respondents’ parents, majority of the respondents’ mothers 68 (41.2%) had completed their secondary education and similarly, majority of the respondents’ fathers 78 (47.3%) had completed their secondary education. Majority of the respondents’ mothers 129 (78.2%) were housewives and majority of the respondents' fathers 48 (29.1%) were businessmen. Majority of the respondents 136 (82.5%) belonged to nuclear family and 93 (56.4%) had per month family income more than Rs 15,000. Among 165 respon­dents prevalence of substance use was found to be 10 (6%). Regarding the associated factors majority of the respondents 162 (98.2%) had good relation with their parents, 101 (61.2%) respon­dents’ family members do not use substance, 128 (77.6%) respondents reported that substance use was not accepted in their culture. the prev­alence of substance use by the respondents is 6.1% in which five (50%) respondents consume alcohol, eight (80%) take cigarette, one (10%) use tobacco and two (20%) take ganja. Among the substance users, four (40%) reported imitating parents and four (40%) reported curiosity as the cause for them to initiate substance use. Regarding the accessibility of the substances among the respondents who use substances, three (30%) respondents said that it’s very difficult whereas one (10%) said that it’s very easy for them to have access to the substances. Majority of the respondents who use substances 6 (60%) avail the substance/s from their friends. Regarding the Association, there is a significant association between prevalence of substance and substance use by family members with the χ2 value of 7.61 and p-value 0.006 which is less than 0.05 significant level. There is also a significant association between the prevalence of substance use and its cultural acceptance with the χ2 value of 4.65 and p-value of 0.031 which is less than 0.05 significant level. There is a significant association between the prevalence of substance abuse and ethnicity with the χ2 value of 11.81and with the p-value 0.037 which is less than 0.05 significant level. Conclusions: The prevalence of substance use among high school ado­lescent students in selected higher secondary school was found to be 6.1%. There was significant association between prevalence of sub­stances use and cultural acceptance of participants, ethnicity and use of substances by the family members. Based on the findings of the study researcher suggests to initiate awareness and co-ordination program between the school and parents.  Journal of Gandaki Medical College Vol. 10, No. 1, 2017, Page: 43-4

A study to Assess the Knowledge Regarding Human Right of Mentally Ill Patient among Community People in Kaski, Pokhara,Nepal

Introduction: Mental health problems raise many human rights issues. People with mental illness are exposed to human rights violation within and outside the health care context. Because of lack of awareness, people with mental illness and their families do not exercise their rights. Psychiatric patients are most vulnerable groups in community. Incidence of violation of rights of mentally ill patients can be avoided if the community people become aware of them. Objective: To assess knowledge regarding human rights and myth of mental illness among community people. Method: A descriptive crosssectional study was conducted among 140 community people of Ritthepani-27, Kaski, Nepal. Non probability convenient sampling technique was adopted to collect the data. Inclusion criteria included head of the family of the selected community who were willing to participate in the study. Data was collected through face to face interview using a structured questionnaire. Results: In the present study, it was found that 46.40% of the community people had inadequate knowledge regarding human rights of mentally ill patients. There was no significant association between demographic variables and knowledge score of the respondents. The study found that more than half of the respondents (51%) had belief that mental illness is not related to physical health. Likewise 36.4% believed mental illness is caused by supernatural power and evil and 30% believed that marriage can cure mental illness. Conclusion: Based on findings, it is concluded that the level of knowledge regarding rights of mentally ill patient is inadequate and there is a high prevalence of myths and misconceptions related to mental illness among the adult population. So, there is need to conduct awareness raising activities in the community

Wheat yield forecast using detrended yield over a sub-humid climatic environment in five districts of Uttar Pradesh, India

A study was carried out to forecast the yield of the wheat crop for five districts of Uttar Pradesh namely Lucknow, Kanpur, Banda, Jhansi and Faizabad. The daily weather data on variables such as maximum temperature, rainfall, minimum temperature, and relative humidity were arranged week wise from sowing to harvesting and the relations between the weather variables and yield was worked out using statistical tools like correlation and regression. The yield has been detrended by obtaining the parameter estimates of the model and subsequently the detrended yield was used to forecast the yield of the crop using ARIMA model. The proposed method of obtaining pre-harvest forecasting of yield of crops was compared with the traditional approaches of forecasting and the proposed method was evaluated in terms of criteria’s such as goodness of fit of the model. It was observed that in all the districts the proposed model performed better as compared to the traditional method both in terms of goodness of fit as well as forecasting performance. Thus it can be concluded that the proposed approach is better and more suitable as compared to the traditional approach for forecasting the wheat yield in the five districts of Uttar Pradesh

Analysis of Risk Factors for Incisional Hernias and its Management

Introduction: Incisional hernia is a common problem after abdominal surgery. Patients present with pain, swelling and intestinal obstruction. It may be repaired by either anatomical suturing or mesh repair. Methods: It is a prospective observational study conducted in Western Regional Hospital and Fewa City Hospital, Pokhara from 2013 to 2016. A total of consecutive 100 patients admitted in these hospitals during the study period were included. Results: Incisional hernia is more common in females (M : F = 1 : 3.8), and in 30 - 50 years age group (60%). Major risk factors were wound infection (30%), overweight (25%), and postoperative cough (10%). It is found to be more associated with gynecological (65%), than gastrointestinal operations, and more so with lower abdominal midline incision (65%). It is found to occur mostly within one year (60%) of primary surgery than later. Even 24% of the patients had first symptom within six months. Mesh repair (92%) was the preferred standard surgical treatment for incisional hernia. Conclusion: Overweight females of age range between 30 - 50 years with history of gynecological operations by lower abdominal midline incision are more prone to develop incisional hernia. This incidence increases when there is wound infection. Mesh repair is the choice of operation for incisional hernia. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 16-2

Changes in seasonal snow cover in Hindu Kush-Himalayan region

The changes in seasonal snow covered area in the Hindu Kush-Himalayan (HKH) region have been examined using Moderate-resolution Imaging Spectroradiometer (MODIS) 8-day standard snow products. The average snow covered area of the HKH region based on satellite data from 2000 to 2010 is 0.76 million km2 which is 18.23% of the total geographical area of the region. The linear trend in annual snow cover from 2000 to 2010 is −1.25±1.13%. This is in consistent with earlier reported decline of the decade from 1990 to 2001. A similar trend for western, central and eastern HKH region is 8.55±1.70%, +1.66% ± 2.26% and 0.82±2.50%, respectively. The snow covered area in spring for HKH region indicates a declining trend (−1.04±0.97%). The amount of annual snowfall is correlated with annual seasonal snow cover for the western Himalaya, indicating that changes in snow cover are primarily due to interannual variations in circulation patterns. Snow cover trends over a decade were also found to vary across seasonally and the region. Snow cover trends for western HKH are positive for all seasons. In central HKH the trend is positive (+15.53±5.69%) in autumn and negative (−03.68±3.01) in winter. In eastern HKH the trend is positive in summer (+3.35±1.62%) and autumn (+7.74±5.84%). The eastern and western region of HKH has an increasing trend of 10% to 12%, while the central region has a declining trend of 12% to 14% in the decade between 2000 and 2010. Snow cover depletion curve plotted for the hydrological year 2000-2001 reveal peaks in the month of February with subsidiary peaks observed in November and December in all three regions of the HKH

Equity and coverage in the continuum of reproductive, maternal, newborn and child health services in Nepal-projecting the estimates on death averted using the LiST tool.

INTRODUCTION: The third Sustainable Development Goal, focused on health, includes two targets related to the reduction in maternal, newborn and under-five childhood mortality. We found it imperative to examine the equity and coverage of reproductive, maternal, newborn and child health (RMNCH) interventions from 2001 to 2016 in Nepal; and the death aversion that will take place during the SDG period. METHODS: We used the datasets from the Nepal Demographic Health Surveys (NDHS) 2001, 2006, 2011 and 2016. We calculated the coverage and equity for RMNCH interventions and the composite coverage index (CCI). Based on the Annualized Rate of Change (ARC) in the coverage for selected RMNCH indicators, we projected the trend for the RMNCH interventions by 2030. We used the Lives Saved Tools (LiST) tool to estimate the maternal, newborn, under-five childhood deaths and stillbirths averted. We categorised the interventions into four different patterns based on coverage and inequity gap. RESULTS: Between 2001 and 2016, a significant improvement is seen in the overall RMNCH intervention coverage-CCI increasing from 46 to 75%. The ARC was highest for skilled attendance at birth (11.7%) followed by care seeking for pneumonia (8.2%) between the same period. In 2016, the highest inequity existed for utilization of the skilled birth attendance services (51%), followed by antenatal care (18%). The inequity gap for basic immunization services reduced significantly from 27.4% in 2001 to 5% in 2016. If the current ARC continues, then an additional 3783 maternal deaths, 36,443 neonatal deaths, 66,883 under-five childhood deaths and 24,024 stillbirths is expected to be averted by the year 2030. CONCLUSION: Nepal has experienced an improvement in the coverage and equity in RMNCH interventions. Reducing inequities will improve coverage for skilled birth attendants and antenatal care. The current annual rate of change in RMNCH coverage will further reduce the maternal, neonatal, under-five childhood deaths and stillbirths