Factors influencing distribution and habitat utilisation of Leptoptilos javanicus in and around Barandabhar Corridor Forest, Chitwan, Nepal

The globally Vulnerable wetland-dependent bird species Leptoptilos javanicus was once thought to avoid farmlands, but recent studies in lowland Nepal showed that the species uses farmlands extensively for foraging and breeding. Identifying whether this preference of L. javanicus to these habitats is common throughout Nepal is essential to understanding the conservation needs of the species. This study aimed to explore the seasonal distribution and habitat utilisation by L. javanicus in and around the Barandabhar Corridor Forest by using 220 randomly selected squares within a 500 × 500 m2 grid. We visited centroids of each selected square to collect data on L. javanicus distribution, habitat types, and probable causes of disturbance in two seasons (rainy: August – September 2019 and winter: December – January 2019–2020). A total of 64 observations of L. javanicus (n = 29 in winter, n = 35 in rainy) were made. Leptoptilos javanicus were seen in more squares outside the Protected Area (65.2%) during the rainy season. Variables that negatively influenced L. javanicus sightings were distance to the road (few individuals seen close to the road), distance to the village (few individuals seen close to settlement), and areas under human disturbance (only few individuals seen in areas with more livestock and people) during both seasons. The farmlands around the Barandabhar Corridor Forest hosted many individuals of L. javanicus and are a new location in lowland Nepal with a resident population of this species. Past assumptions regarding L. javanicus conservation require revision, and including a focus on farmlands is an important requirement in Nepal's conservation planning.

Helicopter emergency medical service for time critical interfacility transfers of patients with cardiovascular emergencies

Background The goal of improving quality through centralisation of specialised medical services must be balanced against potential harm caused by delayed access to emergency treatments in rural areas. This study aims to assess the duration of transfers of critically ill patients with cardiovascular emergencies from smaller hospitals to major medical centres by a helicopter emergency medical service (HEMS) in Switzerland. Methods This retrospective observational cohort study includes all consecutive emergency interfacility transfers (IFTs) conducted by Switzerland’s largest HEMS provider between July 3rd, 2019, and March 31st, 2021. All patients with acute myocardial infarction, non-traumatic strokes, ruptured aortic aneurysms, and other acute vascular emergencies were included. The duration and distance of each HEMS IFT were compared to calculated distances and duration of travel for the same missions using ground-based transportation (GEMS). The ground-based mission distance beyond which the total mission duration of HEMS is expected to be faster than GEMS was calculated. Findings A total of 645 patients were transferred for stroke (n = 364), myocardial infarction (n = 252) and other acute vascular emergencies (n = 29). The median total mission duration from emergency call to landing at the destination was 59.9 (IQR 51.5 to 70.5) minutes. The median road distance for the same missions was 60 (IQR 43 to 72) km. Regression analysis revealed that HEMS is expected to be faster if the road distance is more than 51.3 km. Interpretation Centralisation of specialised medical services should be accompanied by a comprehensive and specialised rescue chain. HEMS in Switzerland ensures time-sensitive IFT in medical emergencies, even in topographically challenging terrain. Graphical Abstract

Factors affecting loan repayment rate among smallholder farmers got loans from the Amhara Credit and Saving Institution: In the case of Habru District, Amhara Regional State, Ethiopia

The aim of this paper was to examine factors affecting loan repayment rate among smallholder farmers in the Habru District, Ethiopia, who had taken loans from the Amhara Credit and Saving Institution. In this study, both primary and secondary sources were used. The study employed a combination of multi-stage purposive and stratified sampling techniques in the selection of 384 borrowers from smallholder farmers in the study area. The Tobit model result found that a total of 10 out of the total 15 explanatory variables involved in the model were found to be statistically significant. According to the result demographic factors (age and household size), socio-economic factors (educational level, land size, livestock size, nonfarm income, purpose of borrowing), and institutional factors (road distance, contact with development agents, training received on loan use) were among the factors that influenced loan repayment rate of smallholder borrowers in the study area. Education level, land size, livestock size in tropical livestock unit, nonfarm income, purpose of borrowing, contact with agricultural extension agents, and training received on loan use were found to determine loan repayment rate of borrowers positively and significantly, while age, family size, and road distance were found to negatively and significantly determine loan repayment rate in the study area. Therefore, the overall results of this study underlined the great importance of the significant factors to profoundly achieve high repayment rate on borrowed funds from the Amhara Credit and Saving Institution in the studied area.

Factors Affecting Loan Repayment Rate from ACSI among Smallholder Farmers: In the case of Habru District, Eastern Amara Regional State, Ethiopia

This paper aims to examine factors affecting loan repayment rate from Amhara Credit and Saving Institutions (ACSI) among smallholder farmers in Habru district, Ethiopia. In this study, both primary and secondary data sources were used. The study employed a combination of multi-stage purposive and stratified sampling techniques in the selection of 384 borrowers from small-holder farmers in the study area. The Tobit model result found that a total of 10 out of the total 15 explanatory variables involved in the model were found to be statistically significant. According to the result demographic factors (age and household size), socio-economic factors (educational level, land size, livestock size, non-farm income, purpose of borrowing), and institutional factors (road distance, contact with development agents, training received on loan use) were among the factors that influenced loan repayment rate of small-holder borrowers in the study area. Education level, land size, livestock size in TLU, non-farm income, purpose of borrowing, contact with agricultural extension agents, and training received on loan use were found to determine loan repayment rate of borrowers positively and significantly, while age, family size, and road distance were found negatively and significantly determine loan repayment rate in the study area. Therefore, the overall result of this study underlined the great importance of the significant factors to profoundly achieve high repayment rate on borrowed funds from ACSI in the study area.

Après-ski: The spread of coronavirus from Ischgl through Germany

The Austrian ski resort of Ischgl is commonly claimed to be ground zero for the diffusion of the SARS-CoV-2 virus in the first wave of infections experienced by Germany. Drawing on data for 401 German counties, we find that conditional on geographical latitude and testing behavior by health authorities, road distance to Ischgl is indeed an important predictor of infection cases, but – in line with expectations – not of fatality rates. Were all German counties located as far from Ischgl as the most distant county of Vorpommern-Rügen, Germany would have seen about 45 % fewer COVID-19 cases. A simple diffusion model predicts that the absolute value of the distance-to-Ischgl elasticity should fall over time when inter- and intra-county mobility are unrestricted. We test this hypothesis and conclude that the German lockdown measures have halted the spread of the virus.

The use of geographical analysis in assessing the impact of patients’ home addresses on their participation in outpatient cardiac rehabilitation: a prospective cohort study

Purpose Geographical analysis is becoming a powerful tool for evaluating the quality of medical services and acquiring fundamental data for medical decision-making. Using geographical analysis, we evaluated the impact of the distance from patients’ homes to the hospital on their participation in outpatient cardiac rehabilitation (OCR). Methods All patients hospitalized for percutaneous coronary intervention, coronary artery bypass grafting, valvular surgery, congestive heart failure, and aortic diseases were advised to participate in an OCR program after discharge. Using the dataset of our cohort study of OCR from 2004 to 2015 (n = 9,019), we used geographical analysis to investigate the impact of the distance from patients’ homes to hospital on their participation in our OCR program. Results Patients whose road distance from home to hospital was 0–10 km, 10–20 km, and 20–30 km participated more in OCR than those whose road distance was ≧ 30 km (OR 4.34, 95% CI 3.80–4.96; OR 2.98, 95% CI 2.61–3.40; and OR 1.90, 95% CI 1.61–2.23, respectively). Especially in patients with heart failure, the longer the distance, the lesser the participation rate (P < .001). Conclusions Using geographical analysis, we successfully evaluated the factors influencing patients’ participation in OCR. This illustrates the importance of using geographical analysis in future epidemiological and clinical studies. Trial registration UMIN000028435.

Abstract 13727: Mapping Analysis Clarifies the Correlation Between Distribution of Patient’s Home Address and Participation in Outpatient Cardiac Rehabilitation

Introduction: Geographical analysis is developing as a powerful tool for evaluating the quality of medical service and acquiring the fundamental data for medical decision-making. Using a geographical analysis, we can evaluate the impact of the distance from patient’s home to the hospital on the participation in outpatient cardiac rehabilitation (CR). Methods: All patients hospitalized for percutaneous coronary intervention, coronary artery bypass grafting, valvular surgery, congestive heart failure and aortic diseases were recommended to participate in outpatient-CR program after discharge. In the dataset of prospective cohort study of CR from 2004 to 2015 (n=9,019), we investigated the impact of the distance from patient’s home to hospital on the participation in outpatient-CR program using the geographical analysis. Results: The total participation rate of outpatient-CR was 47% in our study population. The participation rate of outpatient-CR was highest (62%) in patients with road distance from home to hospital < 10 km as compared with those with road distance of 10-20 km, 20-30 km and >30km to hospital (51%, 39%, and 23%, respectively, p<0.001). Patients whose road distance from home to hospital was < 30 km more participated in outpatient-CR as compared with patients whose road distance was ≧30 km (Odds ratio 4.41, 95%CI 3.86 - 5.04). Expecially in patients with heart failure, the longer distance-the less participation rate relationship was menifest (p<0.01). Conclusions: Using the geographical analysis, we could successfully evaluate the impact of road distance from patient’s home to hospital on the participation in outpatient-CR after discharge in patients with cardiovascular diseases. Especially in patients with heart failure, “the longer distance, the less participation” relationship was manifest. This geographical analysis will provide us with essential information for future epidemiological and clinical studies as well as medical decision-making, improving the healthcare service.