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Applying for a research grant is one of the skills new researchers need to learn. Writing a grant application can be an intimidating process. Most research funders have either an online application system or a standard application form that can be emailed to the funder. Although the length and layout of a grant application can vary between funding bodies, most ask for similar details, including a research proposal, the nature of the research team, a budget, a timeline, and often a risk assessment. This paper summarises key funding agencies in the health research field. Furthermore, it briefly outlines the general process of applying for grants related to health and health services research in the UK. To highlight some of the issues that can occur in the grant application process, we provide two examples of applications for international research grants from UK-based funding bodies, each had to be resubmitted before of it was successful in receiving funding.

Complex Innovative Trial Design (CID) offers several potential benefits for clinical research, including the use of novel statistical techniques such as adaptive designs and Bayesian methods that require computer simulation to determine operating characteristics. By leveraging these techniques, CID has the potential to increase the probability of success for clinical trials while simultaneously reducing the time and cost required for drug development.

Introduction: To date, there is no comprehensive systematic review and meta-analysis to assess the suitability of COVID-19 vaccines for mass immunization. The current systematic review and meta-analysis was conducted to evaluate the safety and immunogenicity of novel COVID-19 vaccine candidates under clinical trial evaluation and present a contemporary update on the development and implementation of a potential vaccines. Methods: For this study PubMed, MEDLINE, and Embase electronic databases were used to search for eligible studies on the interface between novel coronavirus and vaccine design until December 31, 2020. Results: We have included fourteen non-randomized and randomized controlled phase I-III trials. Implementation of a universal vaccination program with proven safety and efficacy through robust clinical evaluation is the long-term goal for preventing COVID-19. The immunization program must be cost-effective for mass production and accessibility. Despite pioneering techniques for the fast-track development of the vaccine in the current global emergency, mass production and availability of an effective COVID-19 vaccine could take some more time. Conclusions: Our findings invited a revisit to the reported solicited and unsolicited SAE for COVID-19 candidate vaccines. Hence, it is alarming to judiciously expose thousands of participants to COVID-19 candidate vaccines at Phase-3 trials that have adverse events and insufficient evidence on safety and effectiveness that necessitates further justification.

The growth in information technology and computer capacity has opened up opportunities to deal with much and much larger data sets than even a decade ago. There has been a technological revolution of big data and Artificial Intelligence (AI). Perhaps many readers would immediately think about robotic surgery or self-driving cars, but there is much more to AI. This Short Communication starts with an overview of the key terms, including AI, machine learning, deep learning and Big Data. This Short Communication highlights so developments of AI in health that could benefit a low-income country like Nepal and stresses the need for Nepal’s health and education systems to track such developments and apply them locally. Moreover, Nepal needs to start growing its own AI expertise to help develop national or South Asian solutions. This would require investing in local resources such as access to computer power/capacity as well as training young Nepali to work in AI.

The sudden outbreak of Coronavirus-19 disease (COVID-19) is transforming the psychology and interpersonal relationships of millions across the globe. In Nepal, there is a need for national mental health surveys post COVID-19. This pandemic can cause traumatic experiences to the patients, caregivers, those quarantined and frontline healthcare providers which may lead to PTSD. Special attention should be focused on high-risk individuals, including policies to implement regular screening of PTSD symptoms.

Many traditional scientific journals carry an editorial at the start of each issue or perhaps in most issues. The more recently established online journals seemed to have discontinued this tradition, for example there is no editorial in Sociological Research Online or many of the online journals in the BMC stable, such as BMC Pregnancy & Childbirth or BMC Public Health. Over the past two decades we have published close to fifty editorials between us. We would like to highlight some of their specific features to offer advice and encouragement to would-be editorial writers, and, more generally, promote the writing and publishing of editorials. This paper includes an overview of the eight most recent editorials, all focusing on the hot topic of COVID-19, published in this scientific journal.

Globally, frequent flooding causes higher magnitude of disaster among the developing and developed nations. Particularly, the Indian subcontinent is considered as highly vulnerable area for natural disaster and is affected most because of limited resources and coping strategies for post-disaster rehabilitation. Apart from the great impact on human health, floods have considerable impact on mental health. The most frequently diagnosed psychological illness in flood affected population is post-traumatic stress disorder (PTSD). In India, the incidence of PTSD in major natural disasters varies considerably depending upon the magnitude of event, with the highest rates reported of around 70%. Studies conducted during initial few months post-disaster, showed a higher occurrence of psychiatric manifestations. On the other hand, some reports suggested contrary results under similar circumstances. Notably, extreme age (children and elderly), female gender, socioeconomic status, pre-existing mental health issues and financial crisis post-disaster are the potential predisposing factors influencing the vulnerability of PTSD. In Indian context, the variability in the magnitude of psychiatric illness is mainly attributed to the ethnic diversity (vulnerable population), severity and type of flood event and social support. Still there is more to explore regarding the long-term sequelae of catastrophic floods on physical and mental trauma on disaster-affected populations.

Background: The World Health Organization has reported more than 31,186,000 confirmed cases of coronavirus disease-19 (COVID-19), including 962,343 deaths, worldwide as on September 21, 2020. The current COVID-19 pandemic is affecting clinical research activities in most parts of the world. The focus on developing a vaccine for SARS-CoV-2 and the treatment of COVID-19 is, in fact, disrupting many upcoming and/or ongoing clinical trials on other diseases around the globe. On March 18, 2020, the United States Food and Drug Administration (FDA) issued an updated guideline for the conduct of clinical trials during the current health emergency situation. The potential challenges, such as social distancing and quarantines, result in study participants’ inaccessibility and trial personnel for in-person scheduled study visits and/or follow-up. Due to the sudden onset and wide-spread impact of COVID-19, its influence on the management of clinical trials and research necessitates urgent attention. Therefore, our systematic review of the literature aims to assess the impact of the COVID-19 pandemic on the conduction of clinical trials and research. The search for the relevant articles for review included the keywords "COVID-19” AND "clinical trial" in PubMed, MEDLINE, Embase, Google scholar and Google electronic databases. Key findings include: delaying subject enrollment and operational gaps in most ongoing clinical trials, which in turn has a negative impact on trial programmes and data integrity. Globally, most sites conducting clinical trials other than COVID-19 are experiencing a delay in timelines and a complete halt of operations in lieu of this pandemic, thus affecting clinical research outcomes.

Over the past few decades, we have seen several outbreaks of zoonotic coronavirus infections. These viruses have the potential of interspecies transmission leading to pathogenesis in humans. This particular respiratory coronavirus initially named 2019-nCOV, is known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In the current situation, abiding to the general health guidelines is utmost important to maintain stronger immunity for fighting infections and protection from other environmental hazards.

Background: Worldwide, 36.7 million people were infected with Acquired Immunodeficiency Syndrome (AIDS) by the end of 2015. Over the period 2007 to 2015, there was a declining trend in the prevalence of adult Human Immunodeficiency Virus (HIV) in the state of Kerala, India. The current study aims to find a suitable statistical modelling technique for the distribution of HIV incubation time and predict the cumulative number of AIDS cases. Materials and Methods: The requisite data were obtained from the Kerala State AIDS Control Society (KSACS) for the years 2007 to 2015. To assess the distribution of HIV incubation time, the data of 22 HIV-infected Keralite patients were retrieved from the medical records of a teaching hospital. Data included age, gender, and incubation time. The back-calculation method was utilized to predict the cumulative HIV/AIDS cases. Results: The estimated total cumulative AIDS cases in Kerala for the years 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 and 2015 were found to be 35,777, 48,944, 62,039, 45,669, 45,668, and 43,605, 42,377, 39,362, 37,617, 39,583, 25,414 respectively using back-calculation method with Weibull (2) incubation time distribution. The mean incubation time of the total HIV cases (male and female) was 4.4 years which indicates a rapid progression of the disease in the state of Kerala. Conclusion: The back-calculation method is a powerful tool to estimate the cumulative frequency of AIDS cases; which predicted a declining HIV trend among Keralites. Moreover, the Weibull distribution is the best fitted distribution for HIV incubation time in our population.

Background: The Human Papillomavirus (HPV) is strongly associated with cervical and other cancers. In women, cervical cancer is the third most common cancer. HPV infection can be largely prevented through vaccination of (adolescent) girls. At the same time, Nepal is a low-income country experiencing a cultural change in attitudes towards sex and sexual behaviour. However, in the adolescent population knowledge about HPV, factors associated with an increased risk of HPV and the existence of the vaccination is often low. Materials and Methods: This was a cross-sectional study with female students enrolled in health and non-health science courses in Pokhara, Nepal. The questionnaire included demographic details, knowledge and attitude questions related to HPV, associated risk behaviour and its vaccination. Descriptive statistics, including Chi-Square test, were used to identify statistically significant relationships. Ethical approval was granted by the relevant authority in Nepal. Results: Hindu religion (75.0 %; 95% CI: 70.9, 78.6) and Newari caste (75.5%; CI: 61.1, 86.7) were more aware about HPV, HPV vaccination. Hindus religion (55.6%; 95% CI: 51.2, 60.0) and Dalit caste (61.6%, 95% CI: 53.3, 69.4) more willing to be vaccinated than other religions and other castes, respectively. Not unsurprisingly, students on health-related courses had a greater awareness of HPV, HPV vaccination and were more willing to be vaccinated than students on other courses. Similar patterns of association arose for knowledge related to those sexually active at an early age; HPV risk and multiple sex partners; and fact that condoms cannot fully prevent the transmission of HPV. Conclusion: Knowledge about the link between HPV and (a) early sexual initiation, (b) having multiple sexual partners, and (c) the limited protection of condoms and other birth control measures was poor in our study compared to similar research conducted in other parts of the world. One key implication is the need for education campaigns in Nepal to educate young women and their parents about HPV, its risk factors and the benefits of vaccination.

In South Asia, the monsoon brings life to vegetation, but at the same time has potential to cause public health problems. Notably, the climate change due to global warming is affecting the extent of monsoon rainfall in the region causing flooding which increases the risks of major disease outbreaks. Flooding and standing water after heavy rainfall increases the risk of vector-borne diseases such as dengue, malaria, plague, chikungunya, typhoid, cholera and Leptospirosis. Worldwide, Leptospirosis is one of the most common and emerging zoonoses, except on the North and South Poles. Rat fever or leptospirosis is a bacterial infection caused by the spiral-shaped bacteria (spirochete) of the genus Leptospira. This infection is mainly seen in wild and even domesticated species of rodents. It is mainly transmitted to humans by exposure of the mucous membranes (oral, nasal & eye) and skin abrasions or cuts to the urine or tissues of infected rodents or soil contaminated by their urine. Rats are the primary reservoir of leptospirosis, although farm animals and livestock, such as horses, pigs, dogs or cattle, and even wild animals can also be a reservoir for the bacteria. However, human-to-human transmission seems to occur occasionally. It is also an occupational hazard with potential risk of exposure among outdoors workers such as farmers, cleaners, veterinarians, agricultural workers. Moreover, there exists an increased chance of a recreational hazard to those who swims and wades in contaminated waters .

This paper reports on a consultation meeting that discussed two emerging health issues of Nepali migrant workers in Malaysia and the ways they can be addressed. Primarily, it focused on the issue of sudden cardiac deaths of Nepali migrant workers in Malaysia. This issue has been raised internationally by both scientific and media in the recent years. Secondly, it discussed kidney health related problem among Nepali migrant workers which has caught the attention of Nepali media recently. The meeting was organized in Kuala Lumpur, Malaysia on 19th April, 2019 where twenty people including health researchers, representatives of migrant related national and international organizations, and Nepali migrant workers participated. The meeting concluded that three types of data collection are needed: (1) good record of deaths, if at possible proper post-mortems; (2) a verbal autopsy tool to help identify underlying causes ; and qualitative research into kidney related problems.

Public Health professionals and researchers always need to be on their toes as the pool of viruses is forever changing. One recent example of this change is the Nipah virus (NiV). This infection is a type of zoonosis, emerging from the family of Paramyxoviridae, genus Henipavirus (RNA virus) and the natural host is Pteropus fruit bat. For Public Health surveillance and multidisciplinary approaches on investigations and therapy and development of vaccines are vital. As with all emerging viruses harmful to humans, an effective system for the detection of infectious diseases as well as for the identification for new causes, risk factors and characteristics in challenged settings is crucial to reduce the disease burden in the population.

On too many occasions researchers conduct public health and/or epidemiological studies in low-income countries without the appropriate in-country ethical approval. This article reflects on some of the underlying reasons for not applying for ethical approval. The piece concludes that we need to start by educating our (junior) researchers and research students about the importance of research ethics. We conclude with a number of recommendations for researchers, scientific journal editors and reviewers and ethical committees in high-income countries to bring the message home to researchers that ethical approval should be sought in low-income countries if and when required!

It is clear that academic dissemination has a system of checks and balances which authors may experience as barriers. We all want to be sure that scientific information disseminated in academic journals is based on solid data, ethically collected and correctly interpreted. The process of peer reviewing helps to prevent bad science and/or poor scientific papers being published. Many published scientific papers differ from the original submitted manuscript since papers go through a process of peer-review, editing and rewriting. However, there are other potential obstacles in the field of academic publishing. This paper is a case-study of one methods paper which stumbled upon a number of barriers related to the viability and continued existence of a number of academic journals in Nepal. Finally, we offer some advice to help health journals to survive when their editors leave.DOI: http://dx.doi.org/10.3126/nje.v2i4.7093Nepal Journal of Epidemiology Vol.2(4) 2012 pp.213-215

Nepal has a great opportunity to learn from, and collaborate with, non-governmental development partners and private sectors, and from other governments and organizations around the world, but we must move promptly.