Changing rural livelihoods and forest use transition in the middle hills of Nepal

In recent decades, out-migration has become a key livelihood strategy for many rural households in the middle hills region of Nepal. In this region, rural communities are key actors in the management of local resources such as community forests. Analysis of the link between community forests and out-migration is largely missing in the literature, even though the demographic changes associated with out-migration affect forest resource use and management. This article discusses how rural communities and traditional landscapes in the middle hills are changing following out-migration and how this process has changed the management by rural communities of local forests (including community forests). Overall, the research found a reduced dependency by households on forest products (e.g. firewood, fodder and timber) sourced from community forests. Also, the reduced demand is being supplied increasingly from trees/forests grown on private farmland, including natural regenerated forests and trees planted on abandoned farmland. The declining need for forest products and the lack of an economic incentive for active forest management coupled with a decreasing sense of community has reduced the interest in community forests, leading to less intensive and infrequent forest management. Given the prevalence of out-migration and the changing socio-economic context in the middle hills, it appears time to reconsider the management of community forests beyond a narrow range of uses to enable greater commercialization and encourage ecosystem services to be harnessed so community forests better align with contemporary rural livelihoods and landscapes

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Outmigration and Land-Use Change: A Case Study from the Middle Hills of Nepal

Outmigration has become a key livelihood strategy for an increasing number of rural households, which in turn has a profound effect on land management. Studies to date have mainly focused on migrant households, and there is limited literature on the differences in land management practices of migrant and nonmigrant households. This article drew on a current study to explore how outmigration affects land management practices in the context of rapidly changing rural communities and economics in the middle hills of Nepal. The data were collected in Lamjung District in western Nepal using a mixed-method approach. We found that underutilization of farmland is a more prominent phenomenon than land abandonment, with rural communities moving to less intensive farming. Importantly, the increasing underutilization of farmland is not just occurring among migrant households. There are a range of complex factors which influence land-use decisions and the subsequent outcomes for landscapes. A high risk of food insecurity in Nepal is likely to be exacerbated if the current trajectory of underutilization and abandonment of farmland continues. A suite of policy tools that can be selectively applied depending on the local context may be more effective than broad-brush national policies in tackling the underlying causes faced by rural communities

Outmigration and Land-Use Change: A Case Study from the Middle Hills of Nepal

Outmigration has become a key livelihood strategy for an increasing number of rural households, which in turn has a profound effect on land management. Studies to date have mainly focused on migrant households, and there is limited literature on the differences in land management practices of migrant and nonmigrant households. This article drew on a current study to explore how outmigration affects land management practices in the context of rapidly changing rural communities and economics in the middle hills of Nepal. The data were collected in Lamjung District in western Nepal using a mixed-method approach. We found that underutilization of farmland is a more prominent phenomenon than land abandonment, with rural communities moving to less intensive farming. Importantly, the increasing underutilization of farmland is not just occurring among migrant households. There are a range of complex factors which influence land-use decisions and the subsequent outcomes for landscapes. A high risk of food insecurity in Nepal is likely to be exacerbated if the current trajectory of underutilization and abandonment of farmland continues. A suite of policy tools that can be selectively applied depending on the local context may be more effective than broad-brush national policies in tackling the underlying causes faced by rural communities

Women’s approach to farming in the context of feminization of agriculture: A case study from the middle hills of Nepal

The outmigration of men has led to the feminization of rural communities where women are increasingly responsible for farming. This situation has been referred to as the ‘feminization of agriculture’. This article uses the theory of intersectionality to explore the feminization process in rural communities and to understand how women are changing their farming practices in the middle hills region of Nepal. Empirical data for this study was obtained using a mixed method approach which included a household survey, in-depth interviews, focus group discussions and field observation. The study found differential impacts of the feminization process among women, with the impacts for women largely defined by their caste/ethnicity, gender, class and socio-economic level. Outmigration was causing large changes for households, yet it was not the only factor driving change in rural communities, with women increasingly involved in decision-making in both ‘migrant’ and ‘non-migrant’ households. While new roles in farming have emerged for women, traditional gender norms still constrain how women practice farming. Farming is changing noticeably, with less focus on maximising crop production and raising livestock and more emphasis given to management of farmland closer to settlements and less intensive farming

Internal Migration and Land Use and Land Cover Changes in the Middle Mountains of Nepal

The movement of rural households from remote uplands to valley floors and to semiurban and urban areas (internal migration) is a common phenomenon in the middle mountain districts of Nepal. Understanding the causes and effects of internal migration is critical to the development and implementation of policies that promote land use planning and sustainable resource management. Using geospatial information technologies and social research methods, we investigated the causes and effects of internal migration on land use and land cover patterns in a western mountain district of Nepal between 1998 and 2013. The results show a decreasing number of households at high elevations (above 1400 m), where an increase in forest cover has been observed with a consequent decrease in agricultural land and shrub- or grassland. At lower elevations (below 1400 m), forest cover has remained constant over the last 25 years, and the agricultural land area has increased but has become geometrically complex to meet the diverse needs and living requirements of the growing population. Our findings indicate that internal migration plays an important role in shaping land use and land cover change in the middle mountains of Nepal and largely determines the resource management, utilization, and distribution patterns within a small geographic unit. Therefore, land use planning must take an integrated and interdisciplinary approach rather than considering social, environmental, and demographic information in isolation

Diagnostic Accuracy of GeneXpert MTB/RIF Assay in Comparison to Conventional Drug Susceptibility Testing Method for the Diagnosis of Multidrug-Resistant Tuberculosis.

Xpert MTB/RIF assay is regarded as a great achievement of modern medicine for the rapid diagnosis of multidrug-resistant tuberculosis (MDR-TB). The main purpose of this study was to determine the performance of Xpert MTB/RIF assay compared to conventional drug susceptibility testing (DST) method for the diagnosis of MDR-TB. A comparative cross sectional study was carried out at German-Nepal Tuberculosis Project, Kathmandu, Nepal, from April 2014 to September 2014. A total of 88 culture positive clinical samples (83 pulmonary and 5 extra-pulmonary) received during the study period were analyzed for detection of multidrug-resistant tuberculosis by both GeneXpert MTB/RIF assay and conventional DST method. McNemar chi square test was used to compare the performance of Xpert with that of DST method. A p-value of less than 0.05 was considered as statistically significant. Of total 88 culture positive samples, one was reported as invalid while 2 were found to contain nontuberculous Mycobacteria (NTM). Among remaining 85 Mycobacterium tuberculosis culture positive samples, 69 were found to be MDR-TB positive by both methods. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of GeneXpert MTB/RIF assay were found to be 98.6%, 100%, 100% and 93.8% respectively. Statistically, there was no significant difference between the diagnostic performance of Xpert and conventional DST method for detection of MDR-TB. GeneXpert MTB/RIF assay was found to be highly sensitive, specific and comparable to gold standard conventional DST method for the diagnosis of MDR-TB

Performance of GeneXpert as compared to gold standard conventional drug susceptibility test.

<p>Performance of GeneXpert as compared to gold standard conventional drug susceptibility test.</p

Summary of anti-tubercular drug susceptibility test.

<p>Summary of anti-tubercular drug susceptibility test.</p