Transition to professional practice: Perspectives of new nursing graduates of Nepal.

BACKGROUND: Internationally, the transition from student nurse to practicing nurse is recognized as being the most stressful period. Yet very little is known about how new nursing graduates perceive this transition in Nepal. The study aimed to explore new nursing graduates' perceptions of the transition to professional practice. METHODS: A qualitative descriptive methodology was used. In-depth semi-structured interviews were conducted with 10 purposively recruited participants from two private hospitals in Nepal. Data were analyzed using inductive thematic analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used to report the findings of this study. RESULTS: New nursing graduates perceived the transition to professional practice as an intense experience. Inductive thematic analysis yielded four intrinsically linked themes that encompassed new nursing graduates' transition experiences: 'getting hit by reality', 'losing confidence', 'feeling unsupported', and 'gathering strengths.' The theme 'getting hit by reality' included three sub-themes: 'gap between theory and practice,' 'no protective shield,' and 'plethora of responsibilities', which explains nurses' initial encounter with real-world practice. The theme 'losing confidence' contained three sub-themes: 'being fearful,' 'being ignored,' and 'being accused,' which describes how nurses started losing confidence as they confronted the real side of the profession. The theme 'feeling unsupported' included two sub-themes: 'left without guidance,' and 'limited support from seniors,' which explains how nurses perceived their work environment. The theme 'gathering strength' contained two sub-themes: 'reflecting' and 'asking for help,' which describes how nurses coped with the challenges related to the transition. CONCLUSION: To facilitate the transition to practice, educational institutions must impart to students a realistic understanding of the transition process, address the theory-practice gap, and collaborate with hospitals. Similarly, hospitals should have realistic expectations from new nurses, assign work according to their capabilities, and allow them sufficient time for role integration. Likewise, well-conceived detailed orientation, mentorship or preceptorship programs, and regular professional development programs are vital to easing the transition. Furthermore, establishing and maintaining a supportive work culture, which promotes equity, respect, and safety among employees, is crucial for positive transition experiences.

Morpho-physiological and biochemical response of rice (Oryza sativa L.) to drought stress: A review.

Global food shortages are caused mainly by drought, the primary driver of yield loss in agriculture worldwide. Drought stress negatively impacts the physiological and morphological characteristics of rice (Oryza sativa L.), limiting the plant productivity and hence the economy of global rice production. Physiological changes due to drought stress in rice include constrained cell division and elongation, stomatal closure, loss of turgor adjustment, reduced photosynthesis, and lower yields. Morphological changes include inhibition of seed germination, reduced tillers, early maturity, and reduced biomass. In addition, drought stress leads to a metabolic alteration by increasing the buildup of reactive oxygen species, reactive stress metabolites, antioxidative enzymes, and abscisic acid. Rice tends to combat drought through three major phenomena; tolerance, avoidance, and escape. Several mitigation techniques are introduced and adapted to combat drought stress which includes choosing drought-tolerant cultivars, planting early types, maintaining adequate moisture levels, conventional breeding, molecular maintenance, and creating variants with high-yielding characteristics. This review attempts to evaluate the various morpho-physiological responses of the rice plant to drought, along with drought stress reduction techniques.

Rugged bialkali photocathodes encapsulated with graphene and thin metal film.

Protection of free-electron sources has been technically challenging due to lack of materials that transmit electrons while preventing corrosive gas molecules. Two-dimensional materials uniquely possess both of required properties. Here, we report three orders of magnitude increase in active pressure and factor of two enhancement in the lifetime of high quantum efficiency (QE) bialkali photocathodes (cesium potassium antimonide (CsK2Sb)) by encapsulating them in graphene and thin nickel (Ni) film. The photoelectrons were extracted through the graphene protection layer in a reflection mode, and we achieved QE of ~ 0.17% at ~ 3.4 eV, 1/e lifetime of 188 h with average current of 8.6 nA under continuous illumination, and no decrease of QE at the pressure of as high as ~ 1 × 10-3 Pa. In comparison, the QE decreased drastically at 10-6 Pa for bare, non-protected CsK2Sb photocathodes and their 1/e lifetime under continuous illumination was ~ 48 h. We attributed the improvements to the gas impermeability and photoelectron transparency of graphene.

Non suicidal self injury and suicidal behavior among adolescents: co-occurrence and associated risk factors.

BACKGROUND: Non-suicidal self-injury (NSSI) and suicidal behavior (SB) are the major public health problems in adolescents. Despite the increased focus on these phenomena, there exist no reliable data in Nepal. This study aimed to determine the prevalence of NSSI and SB among adolescents. Furthermore the study identified the relationship between these two behaviors and assessed demographic, behavioral, and psychological risk factors of NSSI and SB in Nepalese adolescents in a representative sample of the general population. METHODS: The study was conducted among 730 adolescents studying in grade 9 to 12 of public and private schools of Pokhara Metropolitan city, Nepal. Data were collected through self administered standard tools- Functional Assessment of Self Mutilation (FASM) tool, Suicidal Behaviors Questionnaire-Revised (SBQ-R), Rosenberg self-esteem scale (RSES) and Beck Depression Inventory (BDI). Descriptive statistical measures such as frequency, percentage, mean, standard deviation, range were used to assess demographic characteristics and adolescent's behavior regarding NSSI and suicide. For inferential analysis chi-square and one way ANOVA test was used. Furthermore, to determine the predictors of NSSI and SB, multiple logistic regression analysis was used. RESULTS: Regarding behavioral characteristics, nearly half of the sample 327 (44.8%) reported a history of NSSI in past 1 year. Furthermore, 25.8% (n = 188) of the overall sample engaged in minor NSSI only and 3.42% (n = 25) engaged in at least one act of moderate/severe NSSI. The mean number of type of NSSI performed was 2.63 ± 1.71. The most common type of NSSI method used were picking at wound (27.3%), biting self (20.3%), pulling hair out (11.8%), cutting self (11.1%). Boys (52.6%) were more likely to be engaged in NSSI than girls (47.4%) (χ2  =  10.298, p  =  0.002). Furthermore, among 730 adolescents who completed the SBQ-R questionnaire, 131 (17.9%) had suicidal behaviors (SB) (as defined by SBQ-R a total score ≥ 7). Regarding sex differences female were significantly higher in life time prevalence of suicidal behavior than male (χ2 = 30.26, p = 0.001). Simple Chi-square tests indicated that NSSI was significantly associated with SB (χ2 = 58.16, P < .001). Logistic regressions identified the four significant predictors of NSSI behavior: male, low-level of self-esteem (SE), moderate to severe form of depression and SB. Similarly, significant predictors of SB were: female, low-level of SE, moderate to severe form of depression and NSSI behavior. CONCLUSION: The prevalence of both NSSI and SB is high in adolescents. Despite the differences between NSSI and SB a significant number of adolescents reported a history of both behaviors. Lower level of SE and moderate to severe depression were the significant predictors of both NSSI and SB. Furthermore, male and adolescents with the history of SB were at risk of NSSI behavior whereas female sex and adolescents with the history of NSSI were at risk of SB.

Isolation and Characterization of Potential Antibiotic-Producing Actinomycetes from Water and Soil Sediments of Different Regions of Nepal.

INTRODUCTION: The actinomycetes are diversely distributed microorganisms in nature. The geographical diversity of Nepal is suitable for adaptation of various species of actinomycetes. The distribution of the actinomycetes is dependent upon the altitude and nature of the soil and water. METHODS: A total of 22 water and soil samples were collected from different regions of Nepal and were processed. Different isolates were characterized by observing colony characteristics and microscopic characteristics. Screening of the antimicrobial property was based upon perpendicular line streaking and submerged-state fermentation for antibiotic production. RESULTS: From the identification tool used, 12 were found to be Micromonospora, 9 were Nocardia, and 7 were Streptomyces. Out of total samples, 8 isolates of actinomycetes were tested effective against the tested bacteria by primary screening using the well diffusion method. Among the primarily screened, all isolates were subjected to submerged-state fermentation methods to produce crude extracts and 4 were found to be effective against the tested bacterial group. The actinomycetes identified from a water source showed better antimicrobial property towards the tested bacteria than the soil sample. Most isolates were found to be Micromonospora followed by Nocardia and Streptomyces with higher antimicrobial activities. CONCLUSION: The water source and soil sediments of Nepal provide suitable environments for actinomycetes towards obtaining a novel antimicrobial agent. The study of actinomycetes from various unexploited areas of Nepal is necessary. Thus, exploitation of various regions of Nepal for the discovery of an effective antimicrobial agent is helpful in providing a solution to the cost-effective therapy and action against antibiotic resistance.

Perceived social support and psychological wellbeing among Nepalese adolescents: the mediating role of self-esteem.

BACKGROUND: Adolescence is characterized by unique, multiple physical, psychological and social development. Understanding the well-being of adolescents and the factors that contribute to it will help towards clarifying and defining ways to better help adolescents prepare for adult life. Therefore, the present study aims to find out the relationship between Perceived Social Support (PSS) and Psychological Well-Being (PWB) among Nepalese adolescence based on mediating role of Self-esteem (SE). METHODS: The study was conducted among 348 adolescents studying in grade 9 and 10 of government secondary level schools of Pokhara Metropolitan city, Nepal. Data were collected through self-administered standard tools-Multidimensional Scale of Perceived Social Support (MSPSS), Rosenberg self-esteem scale (RSES) and General Health Questionnaire (GHQ-12). For statistical analysis descriptive statistics, correlation, regression and mediation analyses were used. The statistical significance of mediating effect of the tested model was examined through a path proposed by Baron and Kenny and Bootstrap method. RESULTS: Overall, the finding suggests that PSS indirectly affects PWB of adolescents through mediating variable SE. Adolescents who perceive good social support had higher SE, which in turn contributed to their PWB. Furthermore, the study found no significant gender difference for PSS, SE and PWB. Also among various sources of PSS, both boys and girls were more oriented towards family for social support than friends and others. CONCLUSION: Adolescents who experience higher social support are likely to have higher SE and are more likely to have better PWB. The findings of the study will be useful to the parents, teachers, counselors, psychologist and researchers to develop strategies to enhance adolescent's mental health.

Age of onset of substance use and psychosocial problems among individuals with substance use disorders.

BACKGROUND: Substance use is generally initiated in adolescence or early adulthood and is commonly associated with several physical, psychological, emotional and social problems. The objective of this study is to assess the age of onset of substance use differences on psychosocial problems among individuals with substance use disorders (SUDs) residing in drug rehabilitation centers. METHODS: A descriptive cross sectional research design was carried out. Probability Proportional to Size (PPS) sampling technique was used to select the drug rehabilitation centers and all the respondents meeting the inclusion criteria of the selected seven rehabilitation centers were taken as a sample and comprised of 221 diagnosed individuals with SUDs. A semi structured self administered questionnaires were used to collect the information regarding demographic and substance use related characteristics. A standard tool Drug Use Screening Inventory-Revised (DUSI-R) was used to assess the psychosocial problems among individuals with SUDs. Data were analyzed using both descriptive and inferential statistics. Multivariate general linear model (MANOVA and MANCOVA) was used to evaluate differences in psychosocial problems between early vs late onset substance users. RESULT: The age of onset of substance use was significantly associated with psychosocial problems. The mean psychosocial problem scores were higher in early onset substance user (17 years or younger) than late onset substance user (18 years or higher) in various domains of DUSI-R even after controlling confounding factors. The two groups (early vs late) differed significantly in relation to age, gender, occupational status, current types of substance use, frequency of use, mode of substance use and relapse history. CONCLUSION: The study indicated that early onset substance users are at higher risk for psychosocial problems in various areas of life such as Behavior Pattern, Psychiatric disorder, Family system, Peer relationship, Leisure/Recreation and Work adjustment compared to late onset substance users. It highlights the need for early prevention, screening, and timely intervention among those individuals.

Psychosocial problems among individuals with substance use disorders in drug rehabilitation centers, Nepal.

BACKGROUND: Substance use is associated with numerous undesirable short and long term consequences. The individual not only suffer from physical and psychological problems but also loses the ability to interact with family, peers and society. The present study aims to identify the psychosocial problems and associated factors among individuals with substance use disorders. METHODS: The study was conducted using descriptive cross sectional research design in different drug rehabilitation centers of Nepal. Probability proportional to size sampling technique was used to select the drug rehabilitation centers and individuals diagnosed with substance use disorder but free from any substance withdrawal features, admitted in rehabilitation centers within 3 months and clients above 15 years of age were included in the study (N = 204). A standard tool Drug Use Screening Inventory-Revised was used to assess the psychosocial problems and the scores ranged from 0 to 100. The data were analyzed using descriptive and inferential statistics. Linear regression analysis was conducted to identify the predictors of psychosocial problems. RESULTS: The mean and standard deviation of overall psychosocial problems scores was 60.42 ± 19.44. Among different domains, more problems were found in substance use domain (75.00 ± 21.43) followed by school performance (64.60 ± 25.53), behavior pattern (64.53 ± 24.44), peer relationship (64.49 ± 24.91), social competence (61.30 ± 22.60), psychiatric disorder (56.83 ± 23.39), family system (48.28 ± 23.72) and work adjustment (45.90 ± 29.88) domains. Types of substance use, mode of substance use and age of initiation of substance use were the significant predictors of overall and most of the domains of psychosocial problems. CONCLUSION: Substance use poses significant impact on individual's psychological and social wellbeing. Individuals using injecting drugs, initiating substances early in life, using substances many times in a day and using both licit and illicit substances had more psychosocial problems. Hence, treatment centers should take this into account.

Effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy.

BACKGROUND: Stoma can pose extensive challenges for colorectal cancer survivors. Identifying the psychological and social adjustment among them and how it differs by gender will aid in identifying those particularly at risk of having poor adjustment and in planning programs to improve their adjustment. The purpose of this study was to determine the effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy. METHODS: A descriptive cross sectional study was carried out in the stoma clinic of B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal. A purposive sample of 122 patients with ostomy was taken from the above mentioned setting. Selection criteria included colorectal cancer survivors having ostomy for at least 6 months. Data on socio-demographic and clinical variables were collected. Psychosocial adjustment was measured using Ostomy Adjustment Inventory-23 (OAI-23). RESULTS: A total of 122 patients were included in the study. Mean time since ostomy surgery was 2.53 and 1.98 years for men and women respectively. Both men and women had significant impairment in the psychosocial adjustment, however, men had significantly lower psychosocial adjustment score (37.68±12.96 vs. 43.45±12.81, t=-2.47, P=0.015) at 95% CI as compared to women and they reported more negative emotions. Furthermore, men significantly predicted low acceptance {ß=-3.078, P=0.023, ΔR2=0.036, F [4,117] =7.90, P<0.001} and social engagement score {ß=-2.501, P<0.001, ΔR2=0.098, F [4,117] =6.03, P<0.001}. CONCLUSIONS: Colorectal cancer survivors with ostomy should be monitored for psychosocial concerns in regular basis and health care providers should tailor care based on their need. Approaches of survivorship care and psychosocial interventions in colorectal cancer survivors with ostomy should take into account gender specific concerns and requirements to aid adjustment.