Impact of the first phase of COVID-19 pandemic on childhood routine immunisation services in Nepal : a qualitative study on the perspectives of service providers and users

Abstract: Background: The COVID-19 pandemic has disproportionately affected all essential healthcare services delivery in low-resource settings. This study aimed to explore the challenges and experiences of providers and users of childhood immunisation services in Nepal during the COVID-19 pandemic. Methods: Semi-structured qualitative interviews were conducted with childhood immunisation service providers and users (i.e., parents of children) from Kathmandu valley, Nepal. All interviews were conducted through phone or internet-based tools, such as Zoom, WhatsApp, and messenger. All interviews were audio-recorded, transcribed verbatim, and analysed using theme-based content analysis in an Excel spreadsheet. Results: A total of 15 participants (n = 7 service providers and n = 8 service users) participated. Six themes were identified, namely: (1) impact of COVID-19 and lockdown on childhood immunisation services; (2) motivation and resilience for childhood immunisation; (3) Biosafety practices and Personal Protective Equipment (PPE) availability during the COVID-19 pandemic; (4) service adjustments and guidelines during pandemic; (5) availability of vaccines; and (6) immunisation program resilience in view of COVID-19. Service providers mentioned facing disruptions in services and some parents had decided to delay scheduled immunisation. However, most service providers showed determinations to deliver the services with high morale, while most service users reported taking their children for immunisation. Families migrating from urban to rural areas during the pandemic led to service providers having no means to confirm complete immunisation of migrating children. Service providers also experienced lack of adequate guidance to deal with the pandemic and personal protective equipment to protect themselves and service users. Conclusion: Despite experiencing disruptions in childhood immunisation service due to the COVID-19 pandemic, service users and providers were determined to vaccinate the children. There is an urgent need for effective preparedness plans to be in place to address the observed barriers and to ensure resilient immunisation services during ongoing and future pandemics

Global aspects of entrepreneurship : Comparative Analysis of Nepal and Finland

Youth entrepreneurship is one of the topics of global interest for study and research. The mission to eliminate unemployment and foster employment opportunities has increased the need of entrepreneurs thus creating the need to motivate youth entrepreneurs as they are the future economic drivers. The main aim of this study was to understand the encouraging and motivating aspects of the youths to become entrepreneurs. It also aimed at recognising their challenges and opportunistic characteristics to operate a successful business in a globally challenged environment. The theoretical part explained about entrepreneurship and its types, common characteristics of successful entrepreneurs and their need and importance for society and themselves. The global prospects and challenges for future entrepreneurs were also considered. The study also enlightened the youth need and perception towards entrepreneurship from different countries Nepal and Finland in different aspects. Qualitative analysis was taken as part of research method. The potential participants were interviewed by preparing a semi-structured questionnaire to gain insights of their experiences and how they decided entrepreneurship as career and how they have appreciated and utilised the globalized opportunities. The findings showed more common aspects of the entrepreneurs despite of their differences of operating in separate environment. The current study revealed that freedom, independence and passion were the common motivating factors while lack of funding, lack of business management skills, lack of reliable resources, start-up capital and limited networking were the common obstacles encountered by the young entrepreneurs. However, their hardworking characteristics, enthusiasm and ready to learn attitude helped to operate a successful business in a globally challenged world. After analyzing the challenges and prospects of youth entrepreneurs from two different countries recommendations to improve the present situation were made. Thus, the involvement and empowerment programs operated by the government of Nepal were found to be ineffective in comparison to Finland and suggestions to work actively with potential entrepreneurs were made in order to develop youth entrepreneurship in this country

Quantitative and Qualitative Correlation of Mandibular Lingual Bone with Risk Factors for Third Molar Using Cone Beam Computed Tomography

Mehuli Halder,1 Yogesh Chhaparwal,1 Vathsala Patil,1 Komal Smriti,1 Shubha Chhaparwal,2 Kalyana C Pentapati3 1Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; 2Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; 3Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaCorrespondence: Yogesh Chhaparwal, Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India, Tel +91 9986454730, Email [email protected]: Lingual plate thickness, density, and proximity to the tooth are linked as risk factors for various complications associated with third molar extraction. The present study aimed to assess the lingual plate thickness, and density in the mandibular third molar region using cone beam computed tomography and to estimate its correlation with type and level of impaction, number of roots, age, and gender as the risk factorsMethods: This was a retrospective study on CBCT images of 648 mandibular third molars. The lingual plate thickness at three different root levels – cervical, mid-root, and apex along with the position of the tooth, number of roots, density of lingual plate, age, and gender were evaluated. The measurements were done on Invivo 5-Anatomage software. Statistical comparison of the categorical variables was done by Chi-square test, and Fisher’s exact test, and univariate and multivariate analysis were done using binomial logistic regression.Results: Lingual plate thickness of the third molars at the cervical, mid root, and apex were 1.28 mm, 1.42 mm and .01 mm (mean). A significantly higher proportion of subjects with thin lingual plates at mid-root (p-value=0.01) and apex (p-value=0.05) were in the 21– 30 age group. Lingual bone density was significantly associated with the thickness of the lingual plate at the mid-root. A significantly higher proportion of thinner lingual plates at the mid-root level were associated with mesioangularly placed third molars (p-value=0.002).Conclusion: Our study presented that lingual plate thickness has a strong association with age, angulation, and the number of roots. Knowledge about these risk factors is imperative during the management of third molar impactions.Keywords: lingual plate, third molar, bone density, mandible, cone-beam computed tomograph