Depressive symptoms and its associated factors among secondary school adolescents of Birtamod Municipality, Jhapa, Nepal.

Depression is a rising public health concern affecting adolescents' mental health throughout the world. This cross-sectional study aimed to assess the prevalence of depressive symptoms and its associated factors among adolescents from urban Nepal. The depressive symptoms among 271 randomly selected secondary school adolescents of Britamod Municipality were assessed using Center for Epidemiologic Studies Depression Scale (CES-D). The chi-square test and multivariable logistic regression were executed to assess the statistical relationship between potential risk factors and depressive symptoms at 5% level of significance. The prevalence of depressive symptoms was 42.8% (95% CI: 37.3-49.1%). Multiple logistic regression revealed that female adolescents (aOR: 2.309, 95% CI: 1.233-4.325), adolescents enrolled in higher grades i.e. 10th grade (aOR: 4.576, 95% CI: 1.482-9.128), studying at private school (aOR: 2.302, 95% CI: 1.184-4.476), not sharing their problems with their friends (aOR: 3.022, 95% CI: 1.477-6.186), presence of perceived academic stress (aOR: 2.388, 95% CI: 1.263-4.518), dissatisfaction with current academic performance (aOR: 2.278, 95% CI: 1.141-4.518), lower perceived family support (aOR: 3.440, 95% CI: 1.276-9.275), and lower self-esteem (aOR: 2.139, 95% CI: 1.061-8.708) had higher odds of experiencing depressive symptoms. There is a high prevalence of depression among Nepalese adolescents. The findings highlight the need for health promotion interventions focusing on mental health awareness, enhancing social support systems, and implementing stress reduction strategies within schools to mitigate the burden of depression among Nepalese adolescents.

Internet Addiction and Its Associated Factors among Undergraduate Students in Kathmandu, Nepal.

Background: Internet has penetrated all processes of life and has become an unavoidable part of people's daily life. This widespread use of the Internet has resulted in significant concerns with regard to problematic Internet behaviours and related conditions. The aim of the study was to find out the prevalence of Internet addiction and its associated factors among undergraduate students in Kathmandu. Materials and Methods: We included all together 344 undergraduate students from different colleges affiliated to Pokhara University for this cross-sectional study. We used self-administered questionnaire consisting of the Internet Addiction Test scale to assess the Internet addiction. We coded the data, entered it in Epi-Data 3.1 and transferred to IBM SPSS 25 for analysis. We applied bivariate and multivariate logistic regression analysis to identify factors associated with Internet addiction, and p value <0.05 was considered as statistically significantt. Results: The prevalence of Internet addiction was found to be 29.90% (95% CI: 25.0-34.9). In the chi-squared test relationship with parents, parental control over the Internet use, perceived feeling of loneliness, and time spent on internet per day were found to be statistically associated (p < 0.05) with Internet addiction. Conclusion: This study revealed nearly one-third of the Internet addiction among undergraduate students. Relationship with parents, parental control over the internet use, perceived loneliness feelings, and time spent on internet per day were significantly associated with Internet addiction along other factors. Therefore, it is important to raise awareness among young generation, parents, and teachers towards risk of Internet addiction.

Social and mental health impact of COVID-19 pandemic among health professionals of Gandaki Province, Nepal: A mixed method study.

BACKGROUND: The frontline health workers are the key players in the fight against the COVID-19 pandemic, however, several incidences of attacks, stigmatization, and discrimination towards them have been reported throughout the world during the peak of infection. The social impact experienced by health professionals can alter their efficiency and also lead to mental distress. This study aimed to examine the extent of social impact experienced by health professionals currently working in Gandaki Province, Nepal along with the factors associated with their depression status. METHODS: This was a mixed-method study where a cross-sectional online survey was executed among 418 health professionals followed by in-depth interviews with 14 health professionals of Gandaki Province. The bivariate analysis and multivariate logistic regression were performed to identify the factors associated with depression at 5% level of significance. The information collected from the in-depth interviews was clustered into themes by the researchers. RESULTS: Out of 418 health professionals, 304 (72.7%) expressed that COVID-19 has impacted their family relationships, whereas 293 (70.1%) expressed that it impacted their relationships with friends and relatives, and 282 (68.1%) expressed it impacted their relationships with community people. The prevalence of depression among health professionals was noted at 39.0%. Being a female (aOR:1.425,95% CI:1.220-2.410), job dissatisfaction (aOR:1.826, 95% CI:1.105-3.016), COVID-19 impact on family relation (aOR:2.080, 95% CI:1.081-4.002), COVID-19 impact on relationship with friends and relatives (aOR:3.765, 95% CI:1.989-7.177), being badly treated (aOR:2.169, 95% CI:1.303-3.610) and experiencing moderate (aOR:1.655, 95% CI:1.036-2.645) and severe fear (aOR:2.395, 95% CI:1.116-5.137) of COVID-19 were found to the independent predictors of depression. It was noted that the pandemic has an effect on the social relations of health professionals in multiple ways. CONCLUSION: This study noted that there is a significant impact of COVID-19 on health professionals in terms of their social and mental health aspects. The social impact experienced by health professionals is an important predictor of their mental health. The mental health and well-being of these vital workforces can be enhanced by focusing on the social aspect during the pandemic.

Anxiety and depression among people with type 2 diabetes visiting diabetes clinics of Pokhara Metropolitan, Nepal: a cross-sectional study.

OBJECTIVES: To estimate the prevalence of anxiety and depression and identify the associated factors among people with type 2 diabetes mellitus (T2DM) visiting diabetes clinics of Pokhara Metropolitan, Nepal. DESIGN: Cross-sectional study. SETTING: Three diabetes clinics in Pokhara Metropolitan, Nepal, from May to July 2021. PARTICIPANTS: 283 people with T2DM visiting selected diabetes centres of Pokhara Metropolitan. OUTCOME MEASURES: Anxiety and depression were the outcome measures. Face-to-face interviews were conducted using a structured questionnaire comprising information related to participants' sociodemographic profile and several factors along with Hospital Anxiety and Depression-Anxiety subscale and Patient Health Questionnaire-9 to assess the levels of anxiety and depression, respectively. Pearson's Χ2 tests and binary logistic regression were performed to examine association between dependent and independent variables at 5% level of significance. RESULTS: The prevalence of anxiety and depression was 31.4% (95% CI 26.2% to 37.5%) and 36.4% (95% CI 30.8% to 42.0%), respectively. Anxiety was found to be associated with a lower level of perceived social support (adjusted OR (AOR) 2.442, 95% CI 1.020 to 5.845), multiple complications (AOR 2.758, 95% CI 1.015 to 7.334) and comorbidities (AOR 2.110, 95% CI 1.004 to 4.436), severe COVID-19 fear (AOR 2.343, 95% CI 1.123 to 4.887) and sleep dissatisfaction (AOR 1.912, 95% CI 1.073 to 3.047). Economical dependency (AOR 1.890, 95% CI 1.026 to 3.482), no insurance (AOR 2.973, 95% CI 1.134 to 7.093), lower perceived social support (AOR 2.883, 95% CI 1.158 to 7.181), multiple complications (AOR 2.308, 95% CI 1.585 to 6.422) and comorbidities (AOR 2.575, 95% CI 1.180 to 5.617), severe COVID-19 fear (AOR 2.117, 95% CI 1.009 to 4.573), alcohol use (AOR 2.401, 95% CI 1.199 to 4.806) and sleep dissatisfaction (AOR 1.995, 95% CI 1.093 to 3.644) were found to be associated with depression. CONCLUSION: This study showed high prevalence levels of anxiety and depression among people with T2DM. Strengthening social support and focusing on people with diabetes suffering from comorbidity and complications could help to reduce their risk of mental health problems.

Antenatal depression and its associated factors among women of Godawari Municipality, Lalitpur, Nepal: a cross-sectional study.

OBJECTIVES: To estimate the prevalence of antenatal depression and identify its associated factors among pregnant women of Godawari Municipality, Lalitpur, Nepal. DESIGN: Community-based cross-sectional study. SETTING: Godawari Municipality, Lalitpur, Nepal, between September and November 2021. PARTICIPANTS: 250 randomly selected pregnant women of Godawari Municipality, Lalitpur, Nepal. MAIN OUTCOME MEASURES: The level of antenatal depression was assessed using Edinburgh Postnatal Depression Scale. χ2 test and multivariate logistic regression analysis were applied to determine the association between antenatal depression and related variables at 95% level of confidence. RESULTS: The prevalence of antenatal depression was found to be 24.8% (95% CI: 19.2 to 30.7). Multigravida (AOR: 2.219, 95% CI: 1.113 to 4.423), unintended pregnancy (AOR: 2.547, 95% CI: 1.204 to 5.388), male sex preference of child by family (AOR: 2.531, 95% CI: 1.204 to 5.321) and intimate partner violence (AOR: 2.276, 95% CI: 1.116 to 4.640) were found to be the positive predictors of antenatal depression. CONCLUSION: This study showed a high prevalence of depression among pregnant women. The results suggest a need for mental health assessment during pregnancy. Screening for depression should be part of routine antenatal checkups for early detection and management of mental health concerns during this vulnerable period.

The Coronavirus Pandemic: What Does the Evidence Show?

Coronavirus disease 2019 (COVID-19) is a newly emerged disease that has become a global public health concern as it rapidly spread around the world. The etiologic agent responsible for this disease has been named as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses as it shows similar genomic features to that of SARS-CoV which caused a pandemic in 2002. This disease first appeared in Hubei province of China and it follows human-to-human transmission but the path this virus took to set up human infection remains a mystery. By 17 April 2020, globally there have been 2,074,529 confirmed cases with 139,378 deaths because of COVID-19. SARS-CoV-2 shows several similarities with SARS?CoV, and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) with its clinical presentations. This can vary from asymptomatic infection to severe disease and mortality. Real-time reverse-transcription polymerase chain reaction (rRT-PCR) screening is considered as the standard laboratory test for the diagnosis of COVID-19. There is no proven antiviral agent against SARS-CoV-2 so the treatment for COVID-19 is symptomatic, aiming for the management of the symptoms and prevention of the complications. The outbreak of COVID-19 has led to the implementation of extraordinary public health measures throughout the world. Numerous antiviral compounds used to treat other infections are being clinically researched to find possible treatment. Similarly, the traditional public health outbreak response strategy of isolation, quarantine, social distancing and community containment has been implemented in multiple countries and has played an important role in the prevention of new outbreaks. This review aims to enhance our understanding of COVID 19. Keywords: Coronavirus disease 2019; COVID-19; SARS-CoV-2; novel coronavirus 2019; severe acute respiratory syndrome-2.

Depression, Anxiety and Stress among the Undergraduate Students of Pokhara Metropolitan, Nepal.

BACKGROUND: The university period is taken as a risk period for the onset of several mental disorders as this period is stressful and most of the lifetime mental disorders start typically during this young age. The present study aimed to assess the prevalence and risk factors associated with depression, anxiety, and stress among undergraduates residing at Pokhara Metropolitan, Nepal. METHODS: A cross-sectional study was conducted among 681 undergraduates from different academic institutions of Pokhara Metropolitan using DASS-21 to assess the level of depression, anxiety, and stress. RESULTS: The overall prevalence of depression, anxiety, and stress among the participants was found to be 38.2%, 46.9%, and 24.1% respectively. The level of depression and stress was not associated with the academic discipline but the higher prevalence was noted among the students from the non-technical group. The major risk factors associated with depression, anxiety and stress were parental education, family history of psychiatric disorders, self-esteem, and academic performance. CONCLUSIONS: The prevalence of mental disorders is high among the undergraduates. Further assessment of these disorders targeting students from different academic disciplines is recommended.

Predicting Kudzu (Pueraria montana) spread and its economic impacts in timber industry: A case study from Oklahoma.

Quantifying the economic impacts of invasive species is an essential step in developing and prioritizing invasive species management. In particular, kudzu, Pueraria montana (Lour.) Merr. is an aggressive and non-native vine that not only causes ecological damage and reduces biodiversity, but can have multiple economic consequences such as loss of timber value and volume. Using current infestation locations in Oklahoma, southcentral USA, a Monte Carlo simulation was run to estimate the natural as well as anthropogenic spread rate of kudzu in the next five years. Simulations were supplemented with an economic impact analysis within the Impact Analysis for PLANing (IMPLAN) platform. To account for economic loss in the forest product industry, a replacement cost approach with a sensitivity analysis was conducted. Occurrence data collections revealed that current kudzu populations are already established in Oklahoma forests. The results demonstrate that by year five, total industry output could be reduced by $167.9 million, which will influence 780 jobs in the most extreme case scenario. The predicted economic loss due to kudzu expansion could act as an incentive for appropriate management practices and plans to be implemented.

Prevalence of Hypertension in a Community.

INTRODUCTION: Hypertension is one of the leading risk factors for the global burden of disease and is of rising public health concerns in the developing world including Nepal. However, few studies have focused on awareness, treatment, and control of hypertension among people living with this condition. In this scenario, this study aimed to find out the prevalence of hypertension and its awareness, treatment, and control among hypertensive patients residing in different parts of Kaski district, Nepal. METHODS: A descriptive cross-sectional study was performed among 977 family members of 290 households from August to December 2017. Ethical approval was taken from the Institutional Review Committee (reference number:73/074/75) of the Pokhara University Research Center. Simple random sampling was done. Hypertension screening was performed through averaging three values obtained by standardized aneroid sphygmomanometer in three observations. Primary data was collected through self-administered questionnaires and face-to-face interviews based on the participant's preferences. Collected data were analyzed using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out Of total 997 family members screened, 294 (29.49%) (26.66-32.32 at 95% confidence interval) had hypertension whereas only 127 (43.2%) were completely aware of their disease condition. 279 (94.9%) were taking antihypertensive medication and 201 (68.4%) had their blood pressure controlled. CONCLUSIONS: We found that almost one-fourth of the adult population in the community suffered from hypertension but less than half of the hypertensive patients are aware of their conditions.

Prevalence and factors associated with depression among higher secondary school adolescents of Pokhara Metropolitan, Nepal: a cross-sectional study.

OBJECTIVE: This study examined the prevalence and factors associated with depression among adolescents attending higher secondary schools in the Pokhara Metropolitan City of Nepal. DESIGN: A cross-sectional study design was adopted. SETTING: Four randomly selected higher secondary schools of Pokhara Metropolitan, Nepal. PARTICIPANTS: 312 randomly sampled higher secondary school students. METHODS: The Center for Epidemiologic Studies Depression Scale was used to assess the level of depression among students. The data collected through a self-administered questionnaire were analysed using descriptive statistical methods such as frequency and percentage. χ2 test and unadjusted OR (UOR) were calculated to assess the statistical relationship between depression and various variables at 95% CI, with level of significance at p<0.05. RESULTS: The study found a high prevalence of depression among high school students, with more than two-fifths (44.2%) of students having depression. Furthermore, almost a quarter (25.3%) of the students were noted to have mild depression and 18.9% of the students expressed major depression. Students who had low perceived social support (UOR: 3.604; 95% CI 2.088 to 6.220), did not share their problems with anyone (UOR: 1.931; 95% CI 1.228 to 3.038) and had low self-esteem (UOR: 5.282; 95% CI 2.994 to 9.319) were at higher odds of being depressed. CONCLUSION: A high prevalence of depression was observed among high school students. It was also observed that students' level of perceived social support, self-esteem and help-seeking behaviour are somehow related to their mental well-being. Hence, improving social support and self-esteem may alleviate depression and mental distress among these adolescents.

Statistical analysis of co-occurrence patterns in microbial presence-absence datasets.

Drawing on a long history in macroecology, correlation analysis of microbiome datasets is becoming a common practice for identifying relationships or shared ecological niches among bacterial taxa. However, many of the statistical issues that plague such analyses in macroscale communities remain unresolved for microbial communities. Here, we discuss problems in the analysis of microbial species correlations based on presence-absence data. We focus on presence-absence data because this information is more readily obtainable from sequencing studies, especially for whole-genome sequencing, where abundance estimation is still in its infancy. First, we show how Pearson's correlation coefficient (r) and Jaccard's index (J)-two of the most common metrics for correlation analysis of presence-absence data-can contradict each other when applied to a typical microbiome dataset. In our dataset, for example, 14% of species-pairs predicted to be significantly correlated by r were not predicted to be significantly correlated using J, while 37.4% of species-pairs predicted to be significantly correlated by J were not predicted to be significantly correlated using r. Mismatch was particularly common among species-pairs with at least one rare species (<10% prevalence), explaining why r and J might differ more strongly in microbiome datasets, where there are large numbers of rare taxa. Indeed 74% of all species-pairs in our study had at least one rare species. Next, we show how Pearson's correlation coefficient can result in artificial inflation of positive taxon relationships and how this is a particular problem for microbiome studies. We then illustrate how Jaccard's index of similarity (J) can yield improvements over Pearson's correlation coefficient. However, the standard null model for Jaccard's index is flawed, and thus introduces its own set of spurious conclusions. We thus identify a better null model based on a hypergeometric distribution, which appropriately corrects for species prevalence. This model is available from recent statistics literature, and can be used for evaluating the significance of any value of an empirically observed Jaccard's index. The resulting simple, yet effective method for handling correlation analysis of microbial presence-absence datasets provides a robust means of testing and finding relationships and/or shared environmental responses among microbial taxa.

Belowground interactions with aboveground consequences: Invasive earthworms and arbuscular mycorrhizal fungi.

A mounting body of research suggests that invasive nonnative earthworms substantially alter microbial communities, including arbuscular mycorrhizal fungi (AMF). These changes to AMF can cascade to affect plant communities and vertebrate populations. Despite these research advances, relatively little is known about (1) the mechanisms behind earthworms' effects on AMF and (2) the factors that determine the outcomes of earthworm-AMF interactions (i.e., whether AMF abundance is increased or decreased and subsequent effects on plants). We predict that AMF-mediated effects of nonnative earthworms on ecosystems are nearly universal because (1) AMF are important components of most terrestrial ecosystems, (2) nonnative earthworms have become established in nearly every type of terrestrial ecosystem, and (3) nonnative earthworms, due to their burrowing and feeding behavior, greatly affect AMF with potentially profound concomitant effects on plant communities. We highlight the multiple direct and indirect effects of nonnative earthworms on plants and review what is currently known about the interaction between earthworms and AMF. We also illustrate how the effects of nonnative earthworms on plant-AMF mutualisms can alter the structure and stability of aboveground plant communities, as well as the vertebrate communities relying on these habitats. Integrative studies that assess the interactive effects of earthworms and AMF can provide new insights into the role that belowground ecosystem engineers play in altering aboveground ecological processes. Understanding these processes may improve our ability to predict the structure of plant and animal communities in earthworm-invaded regions and to develop management strategies that limit the numerous undesired impacts of earthworms.