Trade liberalization and food security in Nepal

"Among South Asian countries, Nepal has liberalized most extensively during the 1980s and 1990s on both fronts, domestic and external. Nepal is a least developed country with a gross national product of US $235 per capita in 2001 and second lowest per capita wealth in the world. In South Asia, Nepal has the lowest per capita income, highest dependence of population on agriculture and second highest poverty rate. At the same time, on an average, Nepal has the lowest tariffs in South Asia and has taken several steps to downsize its public distribution system and remove a host of agricultural subsidies. This twin scenario where the lowest per capita income country is perhaps also the most liberalized makes for an interesting case for policy analysis. This paper reviews the outcomes from the liberalization policies followed by Nepal relating to food security." from Authors' Abstract

Is Economic Transition One of the Proximate Determinants of Nutrition Transition in Nepal?

Background: Historically, the process of nutrition transition begins with changes in economic structures which move away from agrarian economies to successful industrialisation, with high economic growth, urbanisation and increased real per capita income. Objective: The objective is to identify where Nepal is in economic transition and whether economic transition is considered as one of the proximate determinants of nutrition transition in Nepal. Results: Nepal’s position in the economic transition has been identified by using Popkin’s framework which is scaled from Pattern I to Pattern V. The time series trends indicated that new patterns of economic transition had been observed during 1995-2010, which was similar to the pattern IV of the Nutrition Transition as described by Popkin. The national income of Nepal increased over the past four decades. The GDP of Nepal has shown an annual increase at a rate of 3.92 per cent between 1970 and 2010. Conclusion: Economic growth and agricultural trade liberalization have induced plant fats supply in Nepal. Tourism has also transferred the taste and preferences of western foods to tourist destinations and urban centres, including potential negative health consequences related to excess consumption of fat, sugar and process foods

IsoBED: a tool for automatic calculation of biologically equivalent fractionation schedules in radiotherapy using IMRT with a simultaneous integrated boost (SIB) technique

<p>Abstract</p> <p>Background</p> <p>An advantage of the Intensity Modulated Radiotherapy (IMRT) technique is the feasibility to deliver different therapeutic dose levels to PTVs in a single treatment session using the Simultaneous Integrated Boost (SIB) technique. The paper aims to describe an automated tool to calculate the dose to be delivered with the SIB-IMRT technique in different anatomical regions that have the same Biological Equivalent Dose (BED), i.e. IsoBED, compared to the standard fractionation.</p> <p>Methods</p> <p>Based on the Linear Quadratic Model (LQM), we developed software that allows treatment schedules, biologically equivalent to standard fractionations, to be calculated. The main radiobiological parameters from literature are included in a database inside the software, which can be updated according to the clinical experience of each Institute. In particular, the BED to each target volume will be computed based on the alpha/beta ratio, total dose and the dose per fraction (generally 2 Gy for a standard fractionation). Then, after selecting the reference target, i.e. the PTV that controls the fractionation, a new total dose and dose per fraction providing the same isoBED will be calculated for each target volume.</p> <p>Results</p> <p>The IsoBED Software developed allows: 1) the calculation of new IsoBED treatment schedules derived from standard prescriptions and based on LQM, 2) the conversion of the dose-volume histograms (DVHs) for each Target and OAR to a nominal standard dose at 2Gy per fraction in order to be shown together with the DV-constraints from literature, based on the LQM and radiobiological parameters, and 3) the calculation of Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) curve versus the prescribed dose to the reference target.</p

Factors Associated With Small Size at Birth in Nepal: Further Analysis of Nepal Demographic and Health Survey 2011

Background: The global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries. LBW is a major factor associated with neonatal deaths in developing countries. The determinants of low birth weight in Nepal have rarely been studied. This study aimed to identify the factors associated with small size at birth among under-five children. Methods: Data from the 2011 Nepal Demographic and Health Survey (NDHS) were used. The association between small size at birth and explanatory variables were analysed using Chi-square tests (χ2) followed by logistic regression. Complex Sample Analysis was used to adjust for study design and sampling.Results: A total of 5240 mother- singleton under five child pairs were included in the analysis, of which 936 (16.0%) children were reported as small size at birth. Of 1922 infants whose birth weight was recorded, 235 (11.5%) infants had low birth weight (<2500 grams). The mean birth weight was 3030 grams (standard deviation: 648.249 grams). The mothers who had no antenatal visits were more likely (odds ratio (OR) 1.315; 95% confidence interval (CI) (1.042-1.661)) to have small size infants than those who had attended four or more antenatal visits. Mothers who lived in the Far-western development region were more likely to have (OR 1.698; 95% CI (1.228-2.349)) small size infants as compared to mothers from the Eastern development region. Female infants were more likely (OR 1.530; 95% CI (1.245-1.880)) to be at risk of being small than males. Conclusion: One in every six infants was reported to be small at birth. Attendance of antenatal care programs appeared to have a significant impact on birth size. Adequate antenatal care visits combined with counselling and nutritional supplementation should be a focus to reduce adverse birth outcomes such as small size at birth, especially in the geographically and economically disadvantaged areas such as Far-western region of Nepal

Determinants of Complementary Feeding Practices Among Nepalese Children Aged 6-23 Months: Findings From Demographic and Health Survey 2011

Background: The adoption of inappropriate feeding practices is one of the reasons for under nutrition in Nepal and elsewhere. The objective of this study was to describe the rate of and identify the factors associated with providing the World Health Organization (WHO) recommended infant feeding practices of minimum dietary diversity, minimum meal frequency and minimum acceptable diet in Nepal amongst young children between 6–23 months in 2011. Methods: Data from Nepal Demographic and Health Survey (NDHS) 2011 was used. Prevalence of minimum dietary diversity, minimum meal frequency and minimum acceptable diet was obtained by using descriptive statistics. A Chi-square test (χ2) followed by multiple logistic regression analyses were used to determine the adjusted effect of potential factors on the outcome variables. Results: Of the 698 children aged 6–23 months; while 535 (76.6%) received the minimum meal frequency, only 212 (30.4%) children received the minimum dietary diversity, and 185 (26.5%) received an acceptable diet. Children of older mothers (>35 years); educated mothers and fathers; and mothers from all the development regions except the Mid-western region were more likely to have been provided with the recommended dietary diversity. Children of mothers who had attended ≥4 antenatal visits and who lived in the Eastern region were more likely to provide their child with the recommended meal frequency. Children of mothers, who attended ≥ 4 antenatal visits, were educated and whose fathers had at least a secondary education were more likely to meet the recommended acceptable diet standards.Conclusion: Young children aged less than two years in Nepal are at risk for not meeting the WHO recommended infant feeding standards given that only about one in three children were provided with the recommended dietary diversity and acceptable diet. This finding suggests that the majority of children are at risk of under nutrition. An appropriate mix of health education and food supplements could be a feasible option for Nepal to improve the number of children who meet the recommended infant feeding guidelines, reduce under nutrition and improve the survival rates of young children

The Issue Of National Integration in Nepal: An Ethnoregional Approach

Occasional Papers in Sociology and Anthropology - Volume 5, 199

SU-E-T-816: Application of the Histogram Analysis in Radiation Therapy (HART): An Open Source Software System

Purpose: Histogram Analysis in Radiation Therapy (HART) is an efficient dose‐volume histogram (DVH) computational tool in radiation therapy and radiation oncology research. Various applications of the software were also presented and published earlier in different journals (Med Phys 37(6), p.3217, 2010; J Appl Clin Med Phys 11(1), p.3013, 2010). The main objective of this work was to review the important applications of the program. Method and Materials:MATLAB based codes were primarily designed to read and write a simpler HART format of the DVH statistics, from the standard RTOG data formats exported from the Pinnacle3 treatment planning system (TPS; Philips Healthcare, Best, Netherlands). Various applications such as conventional DVH (cDVH) analysis, and spatial DVH (sDVH; x‐,y‐, and z‐DVHs respectively) analysis, universal‐plan indices (UPI) evaluation, biological modeling based outcome analyses (BMOA), radiobiological dose‐response modeling (DRM), and physical parameterization (PP) modules have been incorporated in the program. The fundamental results obtained in these applications, were thoroughly validated using the primary data derived from the DVH statistics extracted from the Pinnacle3 system. The program also comprises the simple computational mechanism, the graphical simulations, and the flexible interactive modules. Results: HART offers cDVH and sDVH computational modules, UPI evaluations, BMOA features, DRM simulations, and PP modules respectively for the radiotherapy plans. The cDVH and BMOA were the most applicable features among the HART users in the past year. Nearly 50% of the users (N=91) have found the program useful around the globe. The program is also available freely online. Conclusions: Several applications have been upgraded into a simpler, user‐friendly, and automated software package, HART. The program is useful to the medical physics and radiation oncology communities. We further expect to develop HART for various applications in radiotherapy research, and its expansion to other TPSs that utilize DICOM‐RT objects. © 2011, American Association of Physicists in Medicine. All rights reserved