bluuebunny/crossref_metadata_2025 huggingface dataset:
current recommendation for isolation in COVID-19 infection: a perspective review article
Authors: Das Sunil Kumar , Yadav Manish , Sah Sunny
Published: March 2023

Introduction: There have been multiple variants of Severe acute respiratory syndrome coronavirus 2 (SARS CoV- 2), a strain of coronavirus, that causes COVID-19, a respiratory illness responsible for the ongoing COVID-19 pandemic, since its first identified outbreak in Wuhan, China in November 2019. Since the pandemic began there have been various changes in the isolation period of the identified cases reducing from 2 to 3 weeks to the current recommendation of 5 days of isolation in symptom-free individuals in various countries. As of July 2022, only the Omicron variant has been identified as a variant of concern by the World Health Organization.

 

Method: Articles were searched in Google scholar, PubMed, CDC guidelines, NHS guidelines (UK), Indian guidelines (Ministry of Health and Family Welfare), Nepal guidelines (Ministry of Health and Population), and WHO guidelines.

 

Result: The guidelines recommend a self-isolation period of infected individuals ranging from 5 to 14 days after testing positive for the COVID-19 disease.

 

Conclusion: COVID-19 is here to stay and showing no signs of slowing down though overall fatality rate have been on decline owing to vaccination and increased immunity against the virus, it is ideal to shorten the duration of isolation and focus on protection against the virus all the times and not letting the guard down.
Tropical Pancreatitis presented as early onset Diabetes Mellitus
Authors: Shrestha R , Rajchandari A , Shrestha S , Bhattachan CL
Published: March 2023

Tropical pancreatitis (TP) is a special form of chronic pancreatitis seen in tropical countries and has been less commonly reported from Nepal. We present a young non alcoholic female with early onset Diabetes Mellitus whose further investigations revealed pancreatic duct stones and was diagnosed as a case of tropical pancreatitis and underwent modified puestowâ€™s procedure.
â€˜Radishâ€™ in the rectum
Authors: Maharjan SB , Manandhar K , Joshi A , Lamichhane D , Shah JN
Published: March 2023

A 38 years male was referred to our hospital for sigmoidoscopy and removal of foreign body from rectum. Patient gave history of insertion of â€˜radishâ€™ through his anus. He developed pain, distension, vomiting and obstipation next day. On presentation abdomen was board like rigid and distended. He underwent emergency laparotomy and removal of radish from pelvis. He had eventful post operative days. He didnâ€™t disclose why he inserted radish into his rectum!
Just another hydronephrosis?
Authors: Pradhan S , Shrestha A , Shrestha P , Verma R
Published: March 2023

Obstruction at the upper end of ureter is one of the most common surgical problems that we face in day to day life. Diagnosis of hydronephrosis due to PUJ obstruction is not difficult either. But sometimes unrecognized obstruction can lead to many problems resulting in significant morbidity and sometimes even death. Giant hydronephrosis is a rare entity and giant pyonephrosis even rarer. Here we present a case of 19 year old male who presented with abdominal distension, shortness of breath and other gastrointestinal symptoms.
Clinical Review: Managing chest pain of recent onset
Authors: Butterworth K
Published: March 2023

A patient may present with either acute chest pain (a suspected acute coronary syndrome (ACS) or stable recurrent chest pain (angina). If the patient is currently in pain, or has had pain in the last 12 hours, they may have an ACS. The first and most important part of the history is to distinguish between possible cardiac causes of chest pain and non-cardiac causes.
Analysis of presenting complaint and co morbidity of the mortality at Patan Hospital Emergency Department
Authors: Bajracharya S
Published: March 2023

Introduction: Studies in mortality are important since they help to describe the quality of service in the particular department This study is aimed to know the various causes of mortality in emergency department and other associated factors.

Method: It is a retrospective study data will be collected from the charts of mortality patients in emergency department in the year 2067 BS. The relation of death in emergency department (ED) with time, duration of stay, age, sex and their primary diagnosis was observed. We will also determined. The cause of death and the underlying disease in these patients were also analyzed.

Result: Among those who died, their most common chief complain on initial presenting complain had been shortness of breath (28.3%), followed by unresponsiveness (16.7%), altered sensorium (13.3%), poisoning (13.3%) and others. The leading underlying disease were Chronic obstructive pulmonary disease (COPD) (11.7%), head injury (11.7%), pneumonia (11.7%), aluminium phosphide poisoning (10%) and acute coronary syndrome (ACS) (8.3%). There were various causes of death found among which commonest one being respiratory failure(30%),followed by raised ICP (11.7%) septic shock (11.7%), heart failure (8.3%), hypovolemic shock (8.3%).. Most of the patient died within 6 hours of hospital entry (n=43). 10 patients died within 6 to 12 hours and 7 patients died after 12 hours.

Conclusion: This study concludes that the most common cause of death in ED were COPD, aluminum poisoning, head injury, pneumonia and ACS.
An emergency department audit
Authors: Pandey B
Published: March 2023

Introduction:Regular and well conducted clinical audit helps clinicians improve services. Clinical audit, with timely feedback to all staff, is one of the most powerful tools available to assess, and therefore to drive improvements in the quality, safety, consistency for urgent and emergency care.

Method: Data were collected over six months (1stBaisakh 2068 to 30th Asoj 2068) from medical register of department of emergency, Kathmandu medical college. Demography, emergency clinical diagnosis and management were analyzed.

Result: Total 3605 cases attended over 6 months period in emergency department of Kathmandu Medical College Teaching Hospital (KMCTH). Most cases (57%) were medical cases followed by surgical (27%), Obstetrics/Gynecology, Orthopedics, Pediatrics (3% each) and psychiatry, neurosurgery, ENT (2% each).

Conclusion: Emergency audit represents status of hospital in society. It guides Management to improve and expand faculties.
Pattern of ENT foreign bodies at Lumbini Zonal Hospital, a regional level ENT referral centre in Western Nepal
Authors: Pantha S , Sharma B
Published: March 2023

Aim: Foreign bodies in ENT account for a significant number of visits to an ENT clinic. Our study was aimed to determine the load of foreign bodies in an ENT referral centre in western Nepal.

Methods: It is a retrospective analysis of all the patients who presented with foreign bodies in the ENT department of the Lumbini Zonal Hospital over a period of 9 months from April-December 2009. Charts and outpatient register of the ENT department were retrospectively analyzed using SPSS 14.0.

Results: Foreign bodies were predominant in the paediatric age group. Aural foreign bodies were the most common followed by nasal foreign bodies. Nonliving foreign bodies were more common than living foreign bodies.

Conclusion: ENT foreign bodies can be removed safely in the outpatient clinic without much complication except for the foreign bodies in the oesophagus which require removal under general anaesthesia.
Evaluation of seasonal variation in the incidences of bacterial infection among surgical patients
Authors: Basnet RB
Published: March 2023

Introduction: Although a lot of attention has been paid to the prevention of nosocomial infections, surgical site infections (SSIs) continue to comprise a major proportion of all adverse events in surgical patients. So this study is designed to evaluate the common pathogens prevalent in surgical patients and find its seasonal trend.

Method: This is a prospective analytical study of all operated cases in General Surgery Unit III, Bir Hospital fromMarch 2010 to February 2011. Evaluation of bacteriological culture pattern among patients with wound infection 0 to 30 days after the operation was done.

Result: There were total of 564 elective and 292 emergency operations. Surgical site infection rate was 12.1%, 18.2%, 12.2% and 10.7% respectively in spring, summer, autumn and winter seasons. Staphylococcus and Enterococcus were the most common gram positive organisms isolated which were lower in colder seasons as compared to the other seasons while gram negative E coli, Acenatobacter, Pseudomonas and Enterobacter showed predominance in the warmer season.

Conclusion: If further validated, our findings could have important implications for future infection prevention intervention studies and for choice of empirical antimicrobial therapy among hospitalized adults.
Are your patients satisfied?
Authors: Acharya S , Shrestha A , Bajracharya S , Shrestha SR , Hayes B , Yadav BK , Butterworth K
Published: March 2023

Introduction: Patient Satisfaction is an important element in patient care. There is an association between satisfaction level, patient adherence and success of the treatment. This study was conducted to measure patient satisfaction in the department general Outpatient Department (OPD) and Emergency.

Method: This was a cross sectional descriptive study conducted in Patan Hospital on 18th August 2011. All patients registering in emergency or OPD were interviewed. A questionnaire based on the Press Ganey Questionnaire was used. Satisfaction was assessed on the basis of response to each domain which included patientsâ€™ details and waiting time, registration process, physical comfort and nursing care, physician care and finally overall satisfaction with the emergency and outpatient department.

Result: Total 92 patients were included from emergency. Average waiting time was 11.7 minutes with range of 2 to 35 minutes. Patientsâ€™ satisfaction was 83.6% while there was no patient whose satisfaction was below average. Patients were satisfied on behavior of staff at registration (93.5%), and unsatisfied about doctor not telling side effects of medicine (33.7%). Similarly 196 patients were included from OPD. Patientâ€™s satisfaction was 84.7%. Satisfaction level was highest with behavior of staff at pharmacy (94%). In OPD also patients were unsatisfied with doctors not telling side effect of medicine (41.8%).

Conclusion: Our study highlights importance of communication with patients, specifically about medicine side effects for satisfaction of patients in outpatient and emergency departments.
Unusual intra abdominal mass
Authors: Basnet RB
Published: March 2023

It is common for an intra - abdominal testes to be malignant. But rarely does it present as peritonitis. We present a case of a 30 year old man who presented with features of peritonitis, where laparotomy revealed a soft tissue mass arising from the small bowel, encroaching on to the mesentry with gangrenous small bowel and perforation. The intraoperative impression was a small bowel mass, most probably a GIST. However histopathological examination revealed a mixed germ cell tumor (embryonal cell carcinoma with seminoma). Post operative re â€“ examination showed absence of right testes.
Management of stable COPD â€“ a clinical review
Authors: Butterworth K
Published: March 2023

COPD is a progressive, systemic disease characterized by airflow limitation that is not fully reversible. There have been a number of recent advances in the management of COPD. 1 The purpose of this review article is to raise awareness of these advances and encourage their implementation in the context of Nepal.
Initial management of epilepsy
Authors: Yadav BK , Sharma L
Published: March 2023

There is no sufficient evidence to prove one anti epileptic drug to be superior to another, so selection of antiepileptic drugs should be individualized according to the patient. Monotherapy should be the goal when anti epileptic drug treatment is instituted for epilepsy.
Review of the management of acute alcohol withdrawal
Authors: Butterworth K
Published: March 2023

NICE is a British organization, the National Institute for Health and Clinical Excellence, which reviews the evidence for the diagnosis and management of many different clinical conditions. The guidelines produced are based on the evidence found in the international literature and are used in the UK as a baseline for excellent clinical practice.In this journal we will give summaries of topics covered by NICE, together with some tips on how you may need to adjust them based on the local realities in Nepal. You can access the full guidelines yourself by going to: www.nice. org.uk
Screening for diabetes in a local population of Patan, Nepal
Authors: Maharjan BR , Shakya PR , Bhandary S
Published: March 2023

Introduction: Diabetes is increasing worldwide. Earlier detection and treatment of the diabetes slowed the complications associated with diabetes. Unfortunately, 30-50% of diabetes remains undiagnosed. This study is designed to estimate the prevalence of diabetes and diabetes risk group i.e. person with impaired fasting glucose (IFG) in the Patan.

Methods: We, therefore, carried out a community based cross-sectional study for the diabetes screening using fasting plasma glucose.

Results: The result showed 3.3% screen-detected and overall prevalence of 16% diabetes showing alarming picture of diabetes status in the study population. It showed significant correlation between waist circumference (WC) and WaistHip Ratio (WHR) with fasting plasma glucose (FPG) and mean arterial pressure (MAP).

Conclusion: It pointed out the need of health education and promotion to the patients for prevention and progression of the disease.
Post appendectomy incisional hernia: a case report
Authors: Mishra Abhishek , KC Arjun , Harris Matthew , Thapa Samir
Published: March 2023

A 31-year-old man presented to the outpatient clinic at United Mission Hospital with colicky abdominal pain and bulge over the incision site which was more prominent on coughing. There was no fever. The abdomen was soft with no tenderness over the incision site and an expansive though reducible swelling was present over the right iliac fossa. The patient had undergone open appendectomy recently for acute appendicitis twenty days back. Ultrasonography revealed a 2.21cm muscle defect- findings consistent with interstitial incisional hernia. The patient underwent exploration through the same incision site electively. The subcutaneous tissue was found to be healthy. Anatomical repair with mesh placement was done. The postoperative period was uneventful and he was discharged on third postoperative day with instructions regarding dressing, removal of sutures on tenth postoperative day and avoidance of heavy weight lifting or straining and to follow up after a month.
Use of interrupted Time Series Design in COVID-19 data of Nepal
Authors: Sharma Saraswati , Bhandary Shital , Nepal Shraddha
Published: March 2023

Introduction: Nepal was hit hard by COVID-19 pandemic and is still struggling with its implications for individuals, societies, and health systems. We applied Interrupted Time Series (ITS) analysis to see if the government's decision to end two nationwide lockdowns had an impact on the average daily new cases of COVID-19 reported in Nepal.

 

Method: ITS analysis on daily new cases of COVID-19 was performed for first and second nationwide lockdown on data of Nepal from data depository for 2019 Novel Coronavirus Visual Dashboard operated by Johns Hopkins University Center for Systems Science and Engineering. Impact of ''ending nationwide lockdown'' and possible associated factors were investigated.

Result: The impact of removing first nationwide lockdown contributed to statistically significant rise of an average difference of 899 daily new cases due to community transmission of COVID-19. During second lockdown, even after imposing lockdown, cases overwhelmed existing healthcare system due to high infectivity of new Delta variant followed by a lack of adherence to public health measures and delayed decision to impose lockdown due to economic reasons. Whereas significant decline of cases was observed with an average difference of 2970 daily new cases after ending second nationwide lockdown mostly due to vaccine acceptance.

 

Conclusion: First lockdown was imposed early due to uncertainty about progression of disease, curative measures and unavailability of vaccines. Ending of first lockdown was done untimely due to economic reasons and festive seasons.  The unusual decline in cases after ending second lockdown could be contributed to increased vaccination in the country.
Preventing Future Pandemics Using "One Health" Approach in Nepal
Authors: Dangal Binod , Khadka Man Bahadur , KC Archana , Ghimire Rajesh
Published: March 2023

Emerging and re-emerging infectious diseases are in rise due to rapid climate change, environmental changes and population increase. COVID-19 has taught us about different understanding of health. One Health is a concept that recognizes the interconnections and health interdependencies among humans, other animals and the shared environments. The concept of One Health is in embryonic stage in Nepal. With the One Health approach, implementing systematic zoonotic surveillance, regulated rational use of antibiotics, prevention strategies through wide vaccination campaigns, global collaboration, rapid control of outbreaks with containment measures, development of zoonotic registry in the country, multisector coordination can prevent future pandemics
General practitioners translating ultrasonography into clinical practice in rural Nepal: rewarding practices and challenges
Authors: Dangal Binod , Paudel Rajesh , Shrestha Pradipta
Published: March 2023

Ultrasound has been increasingly implemented in general practice for its diagnostic and therapeutic purposes. The recent introduction of Point of Care Ultrasound (POCUS) has changed the intended management plans reducing referrals and morbidity and mortality. Inadequate numbers and less availability of radiologists in peripheral setting is a major challenge for coverage of ultrasonography services in remote Nepal. MD General Practitioner (MDGPs) in district hospitals have performed and interpreted large variety of cases for better clinical outcome. Regular communication, coordination and collaboration meeting between MDGPs and radiologists, specific updates and training programs are needed for MDGPs to further strengthen their skills.
Point prevalence of antimicrobial prescriptions among inpatient in a tertiary level hospital in Nepal
Authors: Karki Arjun , Shrestha Anmol Purna , Shrestha Abha , Shrestha Rajeev , Shrestha Roshana
Published: March 2023

Introduction: Inappropriate use of antimicrobials increases resistance, morbidity, and mortality. Accurate information on the use of antibiotics is crucial to address the problem of antibiotic overuse and resistance. The aim of this study is to explore the antibiotic prescription pattern at inpatient departments of Dhulikhel Hospital.

Method:  This prospective point prevalence study was conducted in five inpatient departments by making 25 visits between June 2018 and March 2019. Patient planned to be discharged on the day of visit was included in the study. The details of the patients who received at least one antimicrobial for at least one clinical treatment condition or prophylaxis during the hospital stay was recorded. The data on the antimicrobials received, diagnosis, therapeutic indication according to predefined lists, and markers of prescribing quality were recorded.

Result: Out of 179 patients, 125 patients (69.8%) were prescribed one or more antibiotics. There was noticeable variation in prevalence of antibiotic prescription across the departments, ranging from 59.5%-78.9 %. The top three prescribed antibiotics were third generation cephalosporins 63 (38%), broad spectrum penicillin 49 (29.5%), and metronidazole 19 (11.4%). The patients received antibiotic for non-bacteriological proven infection 66 (52.8%) and only 8 (6.4%) patient received antibiotic for bacteriological proven infection. Culture and sensitivity testing were sent in 45(36%) patients and urine was the most frequent specimen

Conclusion:  Study concluded that there is need to further explore factors contributing to the high prevalence of antibiotic use and develop strategies for appropriate antibiotic use in the hospital.
Task shifting approach led by general practitioners to improve maternal and reproductive health care: Experience of rural Nepal.
Authors: Dangal Binod , Ghimire Rajan , Yadav Santosh
Published: March 2023

Task shifting approaches have been the key strategies around the world to reduce maternal, neonatal, and reproductive morbidity as well as mortality. In resource-limited settings, access to those care is severely constrained by the unavailability of trained human resources. General practitioners (GPs) are the cornerstone of peripheral hospitals in Nepal to deliver accessible required basic health care including life-saving surgeries. The analysis identifies task shifting activities like anesthesia, antenatal ultrasonography, safe abortion services, collaborative mental health care, and handling of complicated vaginal delivery led by GPs to midwives, doctors, and paramedics at district-level hospitals to improve maternal and reproductive care. Findings indicated improved access to maternal and reproductive health services without compromising outcomes. However, several barriers were found to better support their practice.
Is Janssen responsible for the shock?
Authors: Maharjan Kripa , Tiwary Abhishek
Published: March 2023

A 53-year-old male with no known comorbidities presented in Emergency department of Trishuli Hospital in shock with 3 daysâ€™ history of swelling of whole body and 1-day history of difficulty breathing 3 days after receiving the Janssen Ad26.COV2.S vaccine. Nepal on 19th July, 2021 started the inoculation campaign of Johnson and Johnson vaccine, the third COVID-19 shot approved for public use in the country. Twenty eight cases of cerebral venous sinus thrombi were reported after receiving the Janssen Ad26.COV2.S vaccine, out of which three cases expired.3 However no cases of shock post vaccine has been reported till date. The cause of shock in this patient was not clear. The patient could have massive pulmonary embolism leading to shock with the fact that no other septic foci was found in this patient. As there has been rising demand of the vaccine and unmet need, the general public are going to extreme extent. There should be robust public health awareness and follow up post vaccination. The government and health organizations should be focusing more on the post vaccination status of the public, so that we can prevent such adverse events in future.
Medication adherence and blood pressure control among hypertensive patients in Salyan Hospital
Authors: Sharma Pradeep , Shrestha Bikash
Published: March 2023

Introduction: Hypertension is a chronic medical condition with severe consequences and it remains inadequately managed everywhere. Medication adherence is a critical parameter for achieving strict blood pressure control in patients undergoing antihypertensive therapy. Good medication adherence is also a key factor determining the success of preventive measures for cardiovascular risk reduction. So, we aimed to study the medication adherence and blood pressure control among hypertensive patients of Salyan Hospital.

Method: A cross-sectional observational study was conducted in Salyan Hospital. Total of 110 adult hypertensive patients were enrolled in the study. A structured questionnaire i.e. Morisky medication adherence questionnaire (MMAS-8) in Nepali version was used to measure adherence. In addition, WHO validated method of measuring BP, drug type used and type of therapy were also included. Data were entered and analyzed using IBM SPSS.

Result: Out of 110 respondents enrolled, less than half of the respondents 45.45% had controlled BP. More than 4/5thwere on monotherapy. BP control in monotherapy was 47.87% and in combination therapy was 45.45%. Patient with high, medium and low adherence were 40.9%, (44.54%) and 14.54% respectively. Level of adherence to antihypertensive drugs was related to BP control (p=0.0004). Most commonly used anti hypertensives were CCBs.

Conclusion: There was high prevalence of uncontrolled BP among hypertensive patients in Salyan Hospital. Similarly higher number of patients were on monotherapy. But BP control in monotherapy and combination therapy was similar. Higher number of patients were non-adherent. The relation between BP control and medication adherence was statistically significant. So the causes of poor BP control and poor adherence should be explored and addressed in each doctor-patient encounter.

Keywords: Blood Pressure, Medication adherence, Morisky medication adherence questionnaire (MMAS-8)
Responding Second Wave of COVID-19: Experience in Lower Resource Setting of Eastern Nepal
Authors: Dangal Binod
Published: March 2023

Along with the surge of second wave, the recent global pandemic COVID-19 is increasingly alarming. Although the initial increase of cases was gradual, a recent drastic surge in the number of cases reflects the speed of transmission from person to person. Because of the uncontrollable increase in COVID-19 cases, a prompt and effective response to an apparently unknown overwhelming pandemic is very challenging and dubious. Dolakha, situated in eastern part of Nepal, has struggled to manage COVID-19 care with coordination, cooperation and significant response with limited resources. In this study, we have shared our experience at lower resource setting with limited resources regarding preparedness, responses and challenges in the management of COVID positive cases.
Role of General Practitioners in transforming surgical care in rural Nepal - A descriptive study from eastern Nepal.
Authors: Dangal Binod , Kwan Ng Jessica Yuen , Gauchan Bikash , Khadka Man Bahadur , Pathak Mandeep
Published: March 2023

Introduction: Nepal is a low-to-middle-income country (LMIC) with a predominantly rural population. Almost 10-20% of patients presenting to hospital require surgical care. The availability of skilled human resources in managing surgical care in rural areas of Nepal has to expand to meet this need. The objective of this study is to describe and demonstrate how General Practitioners (GPs) can be upskilled to provide surgical care in rural district hospitals in Nepal.

Method: It is a retrospective review of all surgical procedures performed by GPs from 1st February 2016 to 31st January 2021 at Charikot hospital. Data was collected from a prospectively maintained Electronic Health Record (EHR) system (Bahmini). Details of data collected included name of the procedure and its respective specialty. GP Task shifting and targeted surgical training programs for common orthopedic procedures and pediatric herniotomy were described in detail.

Result: A wide range of surgical procedures were performed by GPs over 5 years. This included interventions for obstetric emergencies, trauma and orthopedics, gynecological issues, general surgery of adult and childhood. A total of 2037 surgeries were performed by GPs including: Cesarean section 25%, 19.7% were orthopedics surgeries followed by 13.5% of mesh repair for abdominal hernia, 9.3% eversion of sac for Hydrocele, 8.7% appendectomy, 5.2% hysterectomy, 3% of pediatric herniotomy and others.

Conclusion: GPs can be further trained to perform important common surgical procedures to improve access to surgical care for rural communities.

Keywords: Continuing medical education, general practitioner, leadership, rural surgery
Preparedness and response plan at Lumbini Medical College and Teaching Hospital, Palpa for COVID-19 pandemic
Authors: Bom Rabin
Published: March 2023

Respiratory illness caused by novel corona virus became global pandemic. The disease is named COVID-19, meaning coronavirus disease 2019. Most of the districts of Nepal became infected with COVID-19. This COVID-19 became challenging aspect for both health personals and government. With emerging data and guidelines on COVID-19 most of health institutions in Nepal started to fight against it. We medical staffs at Lumbini Medical College and Teaching Hospital (LMCTH) realized need of early preparedness and response plan to tackle the rapidly emerging COVID-19 situation over nation.
Forecasting cesarean deliveries with robust time series models in a tertiary care hospital
Authors: Bhandary Shital , Pradhan Binita
Published: March 2023

Introduction: Caesarian section rate was 47% at Patan Hospital in 2014 despite the recommendation of keeping it below 15%. This has become a public health problem and it is debated as human right violation of childbearing women. This study aims use robust time series model to forecast caesarian deliveries to keep track of it at the hospital.

Method: Univariate time series models were used to forecast 3-year caesarean deliveries at Patan Hospital using 60-month (2010-2014) data. A robust time series model with low mean average percentage error from validation period and without autocorrelation problem was selected and used to forecast caesarean deliveries for 2015-2017 period.  

Result: Winterâ€™s additive model had lowest validation forecasting error and showed decreasing trend of caesarian deliveries but it showed autocorrelation. Quadratic regression gave similar result but is also autocorrelation problem. Artificial Neural Network â€“ Multilayer Perceptron model gave close forecasts but autocorrelation was not assessed. Best Autoregressive Integrated Moving Average (ARIMA) model gave valid forecasts without autocorrelation problem.

Conclusion: ARIMA (0,1,1),(0,0,0) model with one difference and one level of moving error correction gave valid forecasts for Patan Hospital. Advanced univariate and multivariate time series models with large samples can be used to get precise forecasts of caesarean deliveries in Nepal.
Diarrheal disease outbreak in Muskkot, Gulmi, Nepal â€“ 2019
Authors: Pachya Uttam
Published: March 2023

Introduction: Diarrhea outbreak was observed in Dajakot, Musikot Municipality, Gulmi, Nepal on April 2019. This study analyzes the data that were collected during this outbreak.

Method: This is a descriptive, cross sectional study defining the diarrheal outbreak at Gulmi in time, place and person.

Result: There were 188 patients presenting with symptom of diarrhea between April 23 to 29, 2019. There were 108 (57.4%) female and 80 (42.5%) male. Maximum (69) number of patients were on day 3 of outbreak.

Conclusion: The outbreak observed at Musikot in 2019 was due to contaminated source of water.
A história que Bacurau nos ensina a ensinar para ser “gente”
Authors: Melo Francisco Egberto de
Published: March 2023

O artigo tem o filme “Bacurau” como possibilidade de uso para o ensino de História partindo de um tempo distópico para pensar uma história do tempo presente, não desvinculado de seu passado. Entendemos que essas dimensões de tempo que se intercruzam podem ser trabalhadas nas práticas de ensino e de aprendizagem a partir do conceito de letramento histórico. Compreendendo-se a trama do filme como um artefato cultural, entende-se que, a partir de suas diversas narrativas, tempos e espaços interseccionados pelos habitantes e forasteiros de Bacurau, é possível identificar e problematizar os fios que conduzem a uma compreensão de conceitos historiográficos que favoreçam uma aprendizagem histórica fundada na complexidade do pensamento e da consciência histórica para estudantes da Educação Básica. Entendemos esses estudantes como parceiros de sala de aula que podem partilhar entre si e com o professor conhecimentos prévios identificados na vida prática dos personagens do filme e refletir sobre suas próprias identidades, sobre o exercício de cidadania e sobre as experiências cotidianas historicamente constituídas para construir novas estratégias de vida e resistência ao pensamento histórico eurocêntrico que continua a nos colonizar os corpos, mentes e hábitos. Espera-se que, ao trabalhar com o filme, professores e seus parceiros de sala de aula assumam uma condição de investigadores da história com vistas a elaboração de um conhecimento histórico próprio relacionado à cognição histórica.
Legende tværprofessionel uddannelse
Authors: Holflod Kim
Published: March 2023

Denne artikels formål er at undersøge og diskutere legende samarbejde i tværprofessionel uddannelse – og hvilke muligheder, udfordringer og implikationer det har at udvikle og praktisere tværprofessionel uddannelse med legende pædagogik og didaktik. Artiklen er metodologisk informeret af designbaseret forskning og baseret på empirisk materiale fra studerendes refleksionstekster, interviews med undervisere og observationer fra legende interventioner ved pædagog‐ og læreruddannelsen. I artiklen udfoldes to analytiske temaer om 1) kommunikative strategier og håndteringer af forskelle samt 2) kollaborative muligheder og begrænsninger i udforskninger af relationer og forskellighed. Analyserne viser, at studerende i legende og tværprofessionelt samarbejde mellem uddannelser oplever at udvikle kommunikative strategier, nærværende og relationelle deltagelsesformer samt at skabe perspektiver til at udforske og forstå hinandens forskellighed. Analyserne viser endvidere, at det er didaktisk meningsfuldt, når en pointe med tværprofessionel uddannelse er at forberede til en tværprofessionel praksis præget af faglig og professionel forskellighed og kompleksitet. Endelig viser analyserne, at samarbejdet ikke er uden udfordringer, når forforståelser og stereotyper sættes i spil. Til sidst i artiklen diskuteres muligheder og implikationer for legende tværprofessionelle uddannelsesformer, som perspektiveres til en relationel pædagogik.
Skulking and spying then telling tales
Authors: Wright Hazel R.
Published: March 2023

I share a different way of writing about research by doing and discussing it. First, the restrictions of the Covid-19 pandemic forced me to adapt my methods of researching, to catch snippets of data when and where I could, by email, phone, and family chats and then by observing and eavesdropping on passers-by on my daily walks in rural England. Then, to protect identities I adapted my way of writing, crafting partly fictionalised composite stories. I use my short vignettes, Living in Lockdown, to show how I wrote as ‘others’, and changed roles to fully examine my processes-in-action. Writing narratively and ‘telling’ stories to engage my audience, led me to parallels within the theatrical tradition, especially the Method Acting approach of Stella Adler. I also found that the archetypal figure of the flâneur (particularly as conceived by Baudelaire and Walter Benjamin) provided a conceptual framework for my walking/watching practices. He, too, simply wandered, seeing what there was to see, but usually in a city. I use these frameworks to reflect on my own work, drawing on parallel methodologies to show how it constitutes research, and explore the role that writing plays overall.
Children Who Write ’Off the Beaten track’ and What We Can Learn from Them
Authors: Heger Stine
Published: March 2023

In a recently initiated research project, I explore children’s voluntary creative writing and its possible significance for their motivation, engagement, writer identity and capacity to work with other types of writing. In this article I share some preliminary insights from my current field work among these children who write “off the beaten track” in the sense that they spend their free time outside of school writing together and being taught by professional authors. I argue that we can learn a great deal about some basic characteristics of writing, craft, community, and enjoyment in writing from these children and their writing practices. I also share some of my own (human) writing experiences (with reference to Badley, 2019), and I present a thought of not post-, but pre-academic writing: writing that is built on learning the craft of writing, becoming a writer, and working with story and voice early on and throughout education.
Crafting Future Memories
Authors: Aluko-Kpotie Bukola
Published: March 2023

Myths of gendered labour and specifically the masculinisation of certain forms of artisanship are bothsteeped in Victorian colonial ideals of female respectability that serve to exclude unemployed, educatedwomen from market relevant, lucrative jobs in carpentry trades, in the city of Lagos, West Africa. Thesehist orically situated dynamics of social exclusion expose an increasing number of educated women topoverty in one of Africa's primary economic hubs. Utilising the linguistic devices of rich descriptionsand first person accounts in this reflective paper, and drawing data from culturally groundedethnographic research on a female carpentry training project in the city, I examine how the communitieswhich emerged from the project negotiate socio economic, familial, and historical constraints in aneffort to buil d new, inclusive training pathways and craft alternative future narratives of gendered labourpractices in Lagos.Keywords
there, not there
Authors: Carter Cee , Rashid Mariam , Scherrer Benjamin D. , Jocson Korina M.
Published: March 2023

For us, “writing off the beaten track” has been propelled by collaborative study of ontoepistemological contributions that break the constraints of western knowledge-making. Black studies and women of color feminisms prompt us to pause long enough to breathe … to interrogate the ellipsis … to sit in the space between words or the dangling punctuation. What’s there (or not there) creatively points to ideas, questions, and methods that subvert the primacy of the western colonial imagination. Our collective writing has often come to us by being worked and reworked, fused and refused in an iterative process, this time with fahima ife’s Maroon Choreography. From homonyms to a wordplay on tracks/tracts, we discuss a writing praxis that has been contoured by radical study and scholarship “actively straying from” disciplined/disciplining conventions. There is always more to knowing and articulating subjects, contexts, and the pursuit of justice.
Impact of Rural Out-Migration on Agricultural Technology Adoption of Rural Households in Southern Ethiopia
Authors: Eshetu Fassil , Haji Jema , Ketema Mengistu , Mehare Abule
Published: March 2023

Using the new economics labor migration theory as a theoretical framework and the multinomial treatment effects negative binomial regression as an analytical model in southern Ethiopia, this study investigated the effects of rural out-migration on the intensity of agricultural technology adoption. In the year 2021, data were collected from 415 sample houses using stratified random sampling. Regression analysis showed that while the influence of migration from rural to urban areas is negligible, participation in international migration greatly increases the likelihood of technology adoption in rural families by 38.9%. The intensity of agricultural technology adoption by rural households is negatively and significantly correlated with male-headed households and household age, while the frequency of extension visits, non-farm participation, saving, membership in cooperatives, sales of livestock, and tropical livestock unit are positively and significantly related to the intensity of agricultural technology adoption. The outcome is consistent with the labor migration theory's risk and credit hypotheses. To encourage the adoption of agricultural technology and stop the recent surge of rural out-migration in southern Ethiopia, policymakers should provide access to capital, public services, and viable off-farm employment in rural areas.
The Relationship Between Digital Performance and Production of Greenhouse Gas Emissions in EU Countries: Correlation Analysis and ANOVA Method
Authors: Hornungová Jana , Petrová Kateřina
Published: March 2023

Agricultural activities produce the significant amounts of greenhouse gas emission. The importance of an ever-changing climate means that digital technologies and their environmental impact are more frequently discussed in the context of the 5th Industrial Revolution. It is important to minimize environmental threats and reduce production waste on the way to a sustainable path. The main scientific aim of the paper is to examine, based on correlation analysis and ANOVA method, the relationship between two variables, digital performance of individual EU countries expressed by the indicator Digital Economy and Society Index and production of Greenhouse Gas Emissions, specifically how digital technologies affect the environment and how to transform digital technologies to supporting the European Green Deal and accelerate sustainable growth. The reasons are that digital technologies can play an important role in reducing greenhouse gas emissions. According to the results, it has been proven that exists a positive correlation between two variables regarding as a weak correlation between DESI and GHG emissions. Analysis of variance indicates the highly significant differences between variables. Countries with the higher DESI index produce more Greenhouse gas emissions as well but in a weak manner.
Development of Organic Production in Ukraine: Potential, Current Threats and Consequences for Global Food Security
Authors: Irtyshcheva Inna , Kramarenko Iryna , Stehnei Marianna , Pavlenko Olena , Boiko Yevheniia , Voit Oleksiy , Hryshyna Natalia , Ishchenko Olena , Archybisova Dariya , Molodan Maryna
Published: March 2023

The article aims to analyze the potential of organic production in Ukraine in war conditions and determine its consequences for world food security. Methodological approaches based on cluster and rating analysis of regions based on their potential in the field of organic production are proposed and provide an appropriate evaluation algorithm, mathematical tools, and strategic alternatives for all variants of data obtained in the calculation process. With the help of the given methodological approaches, the development of strategies for organic production for the primary clustering of regions, namely in Kyiv, Odesa, and Cherkasy oblasts, is proved. The system of forming a regional model of organically oriented multidisciplinary agriculture is appropriate for these regions. This will create the preconditions for organic food production, organic livestock, and related sectors of environmentally oriented economic activities. The development of an innovative component for implementing SMART-specialization projects is possible. It is substantiated that the most affected regions (Kharkiv, Luhansk, Donetsk, Kherson, Mykolaiv, Zaporizhia) from hostilities and occupation are potential for organic production and have significant areas for agricultural production. It is projected that the other war in Ukraine will reduce the production of farm products, including organic, which will lead to food security in most countries.
What is Inside the Bottle? - Factors Influencing Pálinka Consumption
Authors: Maró Zalán Márk , Török Áron , Balogh Péter , Czine Péter
Published: March 2023

Pálinka is the national spirit of Hungary and is in possession of the geographical indication of the European Union, but it used to be listed as a poor-quality product for a long time. The turnaround in this field began in the early 2000s. The aim of this study is to analyse the behaviour and attitudes regarding the purchase and consumption of pálinka and, to assess the product-related awareness of Hungarian consumers who like this particular spirit. Based on the literature, the knowledge of Hungarian consumers about pálinka is rather low, which is confirmed by the results of our questionnaire survey of 1,000 people. Furthermore, based on the results obtained, participants in the pálinka sector are more likely to understand how important certain product attributes that are perceived by consumers when purchasing pálinka. In order to increase the awareness of the spirit, it is essential to get to know the consumers, which can be followed by a well-positioned marketing strategy from both the government and corporate side.
The Context Relevance of ICT, Freshwater Management Activity and Sustainability Goal: A Proposed Encapsulated Conceptual Framework
Authors: Mongi Hector John
Published: March 2023

This study proposes an Encapsulated Conceptual Framework (ECF) for understanding the links between Information and Communication Technologies (ICTs), water resource management activities, and Sustainable Development Goals (SDGs). The study aims to contribute to national, regional, and global debates on the potential of ICTs in achieving sustainability goals. A combination of two socio-technical theories - Relevance Theory (RT) and Technology Acceptance Model (TAM) was adopted to inform the study. The literature review further informed the construction of the ECF. The framework testing involved sampling participants and collecting and analyzing the data. A sample of 251 (n = 251) individuals from formal and informal water user groups on the Tanzanian side of the Lake Victoria Basin participated in testing the framework. The study adopted the cross-sectional design to a mixed research approach. Furthermore, it used three quantitative and qualitative data collection techniques: Focus Group Discussions (FGDs), Key Informant Interviews (KIIs), and Questionnaire Administration (QA). Each FGDs session accommodated a group of participants with 9 – 12 members across the selected sites. KIIs targeted groups network leaders, water resource managers at various levels, and other individuals with potential information. Gathered dataset was cleaned, summarized, and analyzed using descriptive, correlation, and content analytical methods. The study capitalized on the strength of Tableau and R statistics to produce the visualizations that support the descriptive analysis of the data. Furthermore, the study used R and MS Excel software to establish the relationships among the variables. Results indicated the prominent use of mobile as ICTs for freshwater management activities. Furthermore, mobile-based tools such as SMS, voice call, image and video supported these activities to attain some indicators of SDGs related to water resource management. The study concludes that the framework contributes to understanding the contextual issues on ICT, freshwater management and SDGs.
Análise de risco x princípio da precaução: análise de caso nas nanotecnologias
Authors: Contipelli Ernani , Nagao Menezes Daniel Francisco
Published: March 2023

O artigo analisa a regulação das nanotecnologias no contexto de produtos e processos químicos. O objetivo foi identificar as forças histórico-econômicas que impulsionaram as duas principais abordagens de regulação de substâncias químicas. O procedimento metodológico consistiu em uma análise histórica e de conteúdo do que juridicamente culminou como os dois principais instrumentos regulatórios: a análise regulatória de risco e o princípio da precaução. As forças histórico-econômicas são, por um lado, as forças de mercado, que se expressam na política de análise de risco regulatório em relação a riscos, saúde e sustentabilidade, e que tendem a estimular o desenvolvimento comercial e procuram individualizar as relações técnicas e os efeitos potenciais de processos, tecnologias e produtos. Por outro lado, existem as forças da vida, aquelas que privilegiam a proteção da saúde das pessoas e dos ecossistemas, e que se expressam na política do princípio da precaução. Embora à primeira vista não pareçam abordagens contraditórias, pois possuem diferentes âmbitos intrínsecos, tanto temporais e espaciais quanto sociais, na prática essas abordagens e os conceitos e metodologias que promovem representam forças sociais que eventualmente podem se enfrentar. Ambas as tendências são exemplificadas no caso das nanotecnologias. A análise mostra, como resultado, que a expressão jurídica dessas forças representa interesses de diferentes origens: em um caso aqueles que privilegiam o mercado; de outro, aqueles que privilegiam a defesa da vida e da saúde.