Co-authors, colleagues, and contributors: Complications in collaboration and sharing lessons on academic writing

Academic writing, especially in the health field, is usually an interdisciplinary team effort. This paper highlights some of the trials, tribulations, and benefits of working with co-authors. This includes collaborations and co-authorship between academics from different disciplines, academics of different level of careers, and authors from countries of varying economies i.e., high-income countries (HICs) and from low-and middle-income countries (LMICs). This paper also provides advice in the form of several useful tips to lead authors and co-authors to support collaborative working.

Publishing, identifiers & metrics: Playing the numbers game

The number of scientific articles published each year is rapidly growing and so is the number of academic journals. This makes it impossible for an individual practitioner or researcher to keep track of all research published in their own field or sub-discipline. With the growing amount of publications, it is also becoming more difficult to distinguish between similar papers published on the same topic, in the same journal, or by the same researchers (or research team). This perspective paper could support students and novice researchers, outlines the difference between the unique identifier for: (1) you as the researcher, (2) a specific paper; and (3) a specific journal. This paper further outlines the various numerical identifiers associated with academic publishing to help demystify academic publishing.

Kidney health risk of migrant workers: An issue we can no longer overlook

Not applicable as this is an editorial.

Sexual Risk Behavior among Youths of Nepal: Further analysis of Nepal Demographic Health Survey

Background: The period of youth is the time of major physical changes in the body that precedes psychosocial maturity. The curious mind of youths predisposes them to practice sexual risk behaviors. The aim of this study is to identify the sexual risk behavior and factors associated with sexual behaviors among youths of Nepal. Methodology: This was a retrospective analysis of 6524 youths aged 15-24 years using data obtained from the Nepal Demographic and Health Survey for the year 2016. The outcome was sexual behaviors and the determinants were socio-demographic characteristics and smoking. Statistical analysis was done using chi-square tests to assess statistically significant associations between determinants and outcome. In order to identify the most important determinants with the outcome, significant predictors in the univariate analysis were then included in logistic regression. Results: The prevalence of premarital sex among the youths was 5.2%, nearly half of them were sexually active and 5.5% had multiple sex partners. Variables that were significantly associated with premarital sex in the presence of other variables included male gender (AOR=6.3,95% CI=4.3,13.2) and smoker (AOR=2.4, 95%CI=1.8,3.16). Variables that were significantly associated with recent sexual activity in the presence of other variables included female gender (AOR=1.36,95%CI=1.18,1.58), age group (AOR=8.3,95% CI= 7.3,9.3), rural residence (AOR=1.4, 95% CI=1.26,1.62), illiterate youths (AOR=4.34,95% CI=3.27,5.76), poor wealth index (AOR=0.6, 95% CI=0.5,0.68) and smoker (AOR=3.38,95% CI=2.57,4.46). Variables that were significantly associated with multiple sexual partners in the presence of other variables included male gender (AOR=5.5, 95% CI=2.58,7.05) and smoker (AOR=2.2,95% CI=1.6,3.05). Conclusion: The male and smoker youths were more likely to practice all forms of sexual risk behaviors. This study recommends the need for further studies to understand the factors responsible for sexual risk behavior among youths. Furthermore, it is imperative to provide comprehensive sexuality education for youths.

Role of Community Medicine experts in the changing epidemiological context of Nepal

Community Medicine experts are a valuable resource for a stronger health care system in Nepal. They have made significant contributions to the health sector yet have remained largely under-utilized in the national health care system. The health system is likely to be restructured considering the current COVID-19 pandemic and this is the right opportunity to utilize this pool of experts at different levels of the health system.

PhD supervision in Public Health

Roles of PhD supervisors are diverse, ranging from providing in-depth discipline-specific Public Health knowledge and technical (e.g., methodological) support to the students, encouraging them towards publications or conference presentations, offering pastoral support for student wellbeing, and finally preparing them to defend their thesis by conducting a mock viva. Effective supervision plays a vital role in a PhD journey reflecting on the quality of the PhD work, positive PhD experience, and supervisor-student relationship. While some student-supervisors team may encounter conflicting and challenging relationships, many relationships between PhD supervisor(s) and students progress into mentorship through joint publications and grant applications, career advice, and support establishing wider collaborative networks. Drawing from the wider experiences of the authors, this article highlights the responsibilities, opportunities, and sometimes the challenging nature of being a PhD supervisor. This reflection will inform good practices for PhD supervisors in countries including Nepal, where the numbers of PhD students in the field of Public Health is steadily increasing.

Nutrient intake and dietary pattern among pregnant women visiting the tertiary level hospital of Nepal

Background: Pregnancy demands adequate nutritional requirements for foetal growth, good health of pregnant women and to avoid adverse effects during pregnancy. Women from developing countries with limited resources have inadequate consumption of nutritional diets. This paper assesses the nutrient intake and dietary pattern of Nepalese pregnant women compared with recommended nutrient intake. This paper also observes trimester wise nutrient intake among pregnant women in Nepal.Methodology: A descriptive cross-sectional study was conducted among 323 pregnant women who visited Gynaecology and Obstetrics Out-Patient Department (OPD) at Tribhuvan University Teaching Hospital (TUTH) for regular Antenatal Care (ANC) check-ups. Systematic random sampling methods were followed and data were collected from September 2016 to October 2016. Nutrient intake was evaluated with a 24-hour dietary recall method and compared with the Nepalese Food Composition Table 2017 for available nutrients. Face-to-face structured interviews were conducted to assess the nutrient intake of the respondents. The data were entered in Microsoft Excel 2007 and statistical analysis was carried out in SPSS v26. The descriptive analysis was done to identify the distribution of socio-demographic variables of pregnant women. The one-way Analysis of Variance (ANOVA) was used to compare the mean of nutrient intake distribution while Tukey’s post-hoc test was done to compare trimester-wise nutrient intakes.Results: Except for fat, the intake of nutrients were below the Nepalese Recommended Nutrient Intake. Carbohydrate and energy intake in the second and third trimester was significantly different from that in the first trimester (p = 0.006 and 0.004 respectively for carbohydrates and p = 0.009 and 0.002 respectively for energy intake). However, riboflavin intake was significantly lower only in the third trimester as compared to the first (p = 0.025) while there were no significant intake differences between the first and second trimester and second and third trimester. No significant trimester wise differences were observed for intake distribution of other nutrients. Cereal intake was found to be abundant in the diet of pregnant women followed by pulses, legumes, and other vegetables.Conclusion: The research concludes inadequate nutrient intake among pregnant women as compared to the national Recommended Nutrient Intake.

Attitude of Nurses towards Care of Elderly People in TU Affiliated Teaching Hospitals of Kathmandu Valley

Nurses play an essential role in the provision of health services and health promotion for the elderly people. This study aims to find out the attitude of nurses towards care of elderly people in Tribhuvan University affiliated teaching hospitals of Kathmandu valley, Nepal. A descriptive cross-sectional study was conducted among 236 nurses working in TU affiliated teaching hospitals in Kathmandu. Data was collected proportionately from four hospitals using semi structured questionnaire and “Multifactor Attitudes Questionnaires (MAQ)” for assessing attitude of nurses towards care of elderly. Data was entered in EpiData 3.1 and analyzed using SPSS version 16. Descriptive as well as inferential statistics namely Kruskal-Wallis and Man-Whitney test were used for analyzing data. The overall response rate was 98% (236 out of 240 nurses). The mean age of respondents was 28.74 ±7.43 years. The overall prevalence of attitude below than median value of the scale was 2.5% and more than half (51.3%) of respondents had knowledge below median value regarding care of elderly. Attitude towards elderly was found to be associated with age, working hour and qualification of the respondent. So these factors should be considered in nursing education and to improve attitude towards care of elderly people. Keywords: Attitude, Nurse, Care, Elderly, Kathmandu

Open defecation free: where do we need to focus ?

BackgroundDespite major national and international efforts, many households in Nepal (as in other low-income and middle-income countries) still lack toilets. This paper assesses various determinants that act as main contributing factors because of which households in Nepal still do not have toilets. MethodsData from the Nepal Demographic and Health Survey (NDHS) 2016 was used for this study. Bivariate analysis was done to assess the association between dependent variables (toilet status- having and not having toilets in the household) and independent variables (demographic, socio-economic and geographical characteristics) using Chi-square test. Then, a multi variate logistic regression model was used to assess significant predictors for a household not having a toilet after controlling other variables. ResultsOut of the total number of sampled households (11040), nearly a fifth (18%) belonged to province no. 2, where nearly half of the households (49%) did not have toilet facilities. Similarly, households in rural areas were found to be less likely to have toilets than households in urban areas (aOR=1.56, CI1.35-1.80). In the Terai, households were almost ten times as likely not to have toilets (aOR=9.65, CI6.56-14.19) as compared to households in the mountain region. Furthermore, there is a strong positive association between households with toilets and their economic status. Poorest (aOR=15.19, CI11.26-20.47), poorer (aOR=8.75, CI6.89-11.11) and middle income (aOR=5.12, CI4.15-6.32) households were less likely to have a toilet than richer or richest households. ConclusionsDespite some real achievements and progress in Open Defecation Free (ODF) status, Nepal still has a large number of residences without a toilet. Thus, it is crucial to address all the multifaceted factors such as geographical, provincial and economic when considering sustainable ODF programming.

Parents’ and teachers’ perspectives on children’s sexual health education: a qualitative study in Makwanpur Nepal

Sex education is taught to secondary school students in Nepal. Nevertheless, there are concerns that the school-based sexual health education is not effective and adequate to address young people’s necessities. We carried out a qualitative study comprising key informant interviews with teachers (n=8) and parents (n=6) in Makwanpur district in Nepal. Interviews were recorded, transcribed and translated into English. Thematic analysis was performed to identify patterns or themes within the qualitative data. Most participants (both teachers and parents) had thought of delivering sex education preferably from grade seven to avoid the effects of globalised mass media and the internet. The practical aspects of school sex education programme and the importance of parent-child communication were of major concerns. Comprehensive training to health teachers, an informal approach to teaching sex education and seeking outside health professionals, such as health facilitators were the frequently reported issues. There is a need to offer sexual health services along with sex education to protect young people from potential dangers of STIs including HIV infection. Particularly, health teachers should be trained properly to mitigate the social and cultural impacts, and to allow a smooth sex education discussion in the classroom. The curriculum for sex education should be relevant, engaging and developmentally suitable with clear progressive avenues for learning experience.