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Purpose: Communication is the passport of success. The objective of this undertaking was to fabricate a neural network ready to group which letter of the American Sign Language (ASL) letters in order is being marked, given a picture of a marking hand. Design/Methodology/Approach: It was developed using Python programming with the help of TensorFlow for all AI-related tasks and Deep Learning. Findings/Result: This examination is an initial move towards building a potential communication via gestures interpreter, which can take correspondences in communication through signing and make an interpretation of them into composed and oral language. Such an interpreter would enormously bring down the hindrance for some hard of hearing and quiet people to have the option to more readily speak with others in everyday collaborations. This objective is additionally propelled by the seclusion that is felt inside the hard of hearing local area. Dejection and sorrow exist at higher rates among the hard of hearing populace, particularly when they are drenched in a conference world. Originality/Value: Enormous obstructions that significantly influence life quality originates from the correspondence disengagement between the hard of hearing and the conference. A few models are data hardship, impediments of social associations, and trouble coordinating in the public eye. Paper Type: Research paper

Background: While nurturing care, including adequate nutrition and responsive caregiving and early learning, is critical to early childhood development, national surveys in Nepal highlight inequalities in feeding and parental caregiving practices. This study aimed to document and analyse infant and young child feeding (IYCF) and cognitive and socio-emotional caregiving practices among caregivers of children under age five in Dhanusha district, Nepal. Methods: We used a subset of data from the MIRA Dhanusha cluster randomised controlled trial, including mother-child dyads (N=1360) when children were aged 0-12 months and a follow-up survey of the same mother-child dyads (N=1352) when children were 7-59 months. We used World Health Organization IYCF indicators and questions from the Multiple Indicator Cluster Survey-4 tool to obtain information on IYCF and cognitive and socio-emotional caregiving practices, respectively. We collected data on breastfeeding practices in a postpartum 6-week questionnaire and on complementary feeding and caregiving practices in the follow-up survey. Using multivariable logistic regression models, potential explanatory household, parental and child-level variables were tested to determine their independent associations with IYCF and caregiving indicators. Results: The prevalence of feeding indicators varied. Ever breastfed (99%), exclusive breastfeeding in past 24-hours at 0-12 months (89%), and vegetable or fruit consumption (84%) were common, and minimum dietary diversity reached 63%. Problem areas were early initiation of breastfeeding (16%), feeding of colostrum (67%), no pre-lacteal feeding (53%), timely introduction of complementary feeding (56%), and animal-source food consumption (29%). Amongst caregiving indicators, access to books (7%), early stimulation and responsive caregiving (11%), and access to early childhood education (27%) were of particular concern, while 64% had access to toys and 71% received adequate care. Only 38% of children were developmentally on track. Younger children from poor households with young mothers who had not received antenatal visits and delivered at home were at risk of poor IYCF and caregiving practices. Conclusions: Poor IYCF and cognitive and socio-emotional caregiving practices are widely prevalent in lowland Nepal, which highlights the importance of improved integrated nutrition and caregiving interventions in resource-constrained settings.

Background Nurturing care, including adequate nutrition, responsive caregiving and early learning, is critical to early childhood development. In Nepal, national surveys highlight inequity in feeding and caregiving practices for young children. Our objective was to describe infant and young child feeding (IYCF) and cognitive and socio-emotional caregiving practices among caregivers of children under five in Dhanusha district, Nepal, and to explore socio-demographic and economic factors associated with these practices. Methods We did a cross-sectional analysis of a subset of data from the MIRA Dhanusha cluster randomised controlled trial, including mother-child dyads (N = 1360), sampled when children were median age 46 days and a follow-up survey of the same mother-child dyads (N = 1352) when children were median age 38 months. We used World Health Organization IYCF indicators and questions from the Multiple Indicator Cluster Survey-4 tool to obtain information on IYCF and cognitive and socio-emotional caregiving practices. Using multivariable logistic regression models, potential explanatory household, parental and child-level variables were tested to determine their independent associations with IYCF and caregiving indicators. Results The prevalence of feeding indicators varied. IYCF indicators, including ever breastfed (99%), exclusive breastfeeding (24-hour recall) (89%), and vegetable/fruit consumption (69%) were common. Problem areas were early initiation of breastfeeding (16%), colostrum feeding (67%), no pre-lacteal feeding (53%), timely introduction of complementary feeding (56%), minimum dietary diversity (49%) and animal-source food consumption (23%). Amongst caregiving indicators, access to 3+ children’s books (7%), early stimulation and responsive caregiving (11%), and participation in early childhood education (27%) were of particular concern, while 64% had access to 2+ toys and 71% received adequate care. According to the Early Child Development Index score, only 38% of children were developmentally on track. Younger children from poor households, whose mothers were young, had not received antenatal visits and delivered at home were at higher risk of poor IYCF and caregiving practices. Conclusions Suboptimal caregiving practices, inappropriate early breastfeeding practices, delayed introduction of complementary foods, inadequate dietary diversity and low animal-source food consumption are challenges in lowland Nepal. We call for urgent integrated nutrition and caregiving interventions, especially as interventions for child development are lacking in Nepal.

BackgroundPoor mental health and illness among the working population have serious socio-economic and public health consequences for both the individual and society/country. With a dramatic increase in work migration over the past decades, there is recent concern about the health and wellbeing of migrant workers and their accessibility to healthcare services in destination countries. This study aimed to explore the mental health and wellbeing experiences of Nepali returnee-migrants and non-migrant workers, and identify their perception on the risk factors for poor health and health service accessibility for them.MethodsThis qualitative study was conducted among Nepali migrant and non-migrant workers in February 2020. Four focus group discussions (n=25) and 15 in-depth interviews were conducted with male non-migrant and returnee migrant workers from Gulf countries and Malaysia. The discussions and interviews were audio-recorded, transcribed, translated into English and analysed thematically.ResultMigrant workers reported a higher risk of developing adverse mental health conditions than non-migrant workers. In addition, fever, upper respiratory infection, abdominal pain, ulcer, and occupational injuries were common health problems among both migrant and non-migrant workers. Other major illnesses reported by the migrant workers were heat burns and rashes, snake-bites, dengue, malaria, gallstone, kidney failure, and sexually transmitted diseases, while non-migrants reported hypertension, diabetes, and heart diseases. Adverse living and working conditions including exploitation and abuse by employers, lack of privacy and congested accommodation, language barriers, long hours’ hard physical work without breaks, and unhealthy lifestyles were the contributing factors to migrant workers’ poor mental and physical health. Both migrant and non-migrants reported poor compliance of job conditions and labor protection by their employers such as application of safety measures at work, provision of insurance and healthcare facilities that affected for their wellbeing negatively. Family problems compounded by constant financial burdens and unmet expectations were the most important factors linked with migrant workers’ poor mental health condition.ConclusionBoth migrant and non-migrant workers experienced poor mental and physical health condition largely affected by their adverse living and working conditions, unmet familial and financial needs and adherence to unhealthy life styles. It is needed to ensure the compliance of work agreement by employers and promotion of labor rights in relation to worker’s health and safety. In addition, policy interventions on raising awareness on occupational health risk and effective safety training to all migrant and non-migrant workers are recommended.

Background Poor mental health and illness among the working population have serious socioeconomic and public health consequences for both the individual and society/country. With a dramatic increase in work migration over the past decades, there is recent concern about the health and wellbeing of migrant workers and their accessibility to healthcare services in destination countries. This study aimed to explore the mental health and wellbeing experiences of Nepali male returnee-migrants and non-migrant workers, and their perceptions about risk factors for poor health and health service accessibility. Methods This qualitative study was conducted among Nepali migrant and non-migrant workers in February 2020. Four focus group discussions comprising 25 men and a total of 15 in-depth interviews were conducted with male non-migrant and returnee migrant workers from Gulf countries and Malaysia. The discussions and interviews were audio-recorded, transcribed, translated into English and analysed thematically. Result Migrant workers reported a higher risk of developing adverse mental health conditions than non-migrant workers. In addition, fever, upper respiratory infection, abdominal pain, ulcer, and occupational injuries were common health problems among both migrant and non-migrant workers. Other major illnesses reported by the migrant workers were heat burns and rashes, snake-bites, dengue, malaria, gallstone, kidney failure, and sexually transmitted diseases, while non-migrants reported hypertension, diabetes, and heart diseases. Adverse living and working conditions including exploitation and abuse by employers, lack of privacy and congested accommodation, language barriers, long hours’ hard physical work without breaks, and unhealthy lifestyles were the contributing factors to migrant workers’ poor mental and physical health. Both migrant and non-migrants reported poor compliance of job conditions and labor protection by their employers such as application of safety measures at work, provision of insurance and healthcare facilities that affected for their wellbeing negatively. Family problems compounded by constant financial burdens and unmet expectations were the most important factors linked with migrant workers’ poor mental health. Conclusion Both migrant and non-migrant workers experienced poor mental and physical health, largely affected by their adverse living and working conditions, unmet familial and financial needs and unhealthy life styles. Greater compliance is needed by employers of work agreements and the promotion of labor rights for worker's health and safety. In addition, policy interventions to raise awareness about occupational health risks and effective safety training for all workers (migrant and non-migrant) are recommended.

This paper introduces the "Protected Forest" as a new conservation approach in Nepal. Historically there were two dominant forest management approaches in Nepal: protected areas and community-based forestry. These site-based management approaches were able to contribute to protect- ing endangered wildlife species, enhancing greenery, and improving livelihoods of forest-dependent communities. However, these approaches were not suitable when applied to increasing populations of wide-ranging mobile species because, outside of protected areas, conservation activities are in their infancy. To enhance the mobility of wildlife and conserve biodiversity, the Government of Nepal de- clared particular forest patches as Protected Forests to link the existing protected areas creating their network to manage the flora and fauna, while acknowledging the reliance of local communities on the forest resources. In order to create and maintain a balance between conservation and human needs for forest resources, a zoning-based Protected Forests management plan was devised, assigning specific forest patches for specific purposes. Since local community forest user groups were enjoying full benefits from their community forests, in the initial phase of the implementation of protected forest management, local communities may have to compromise on their consumption of forest products as some sections of the area are assigned for absolute protection. In the short run, they are compensated by support provided for income-generating activities; and, in the long run, they can enjoy more benefits through ecotourism. Hence, the protected forest approach creates a win-win situation for both wildlife and local communities.

In this study, a self-organizing map (SOM) was utilized to classify habitats in the Chilika lagoon located in India, the largest lagoon ecosystem in Asia (maximum length, 64.3 km; mean width, 20.1 km). The lagoon was marginally eutrophic (nitrate, 0.25 ± 0.22 mg L−1; orthophosphate, 0.26 ± 0.22 mg L−1; n = 1,980, respectively) for six years (1999–2004), and it used to be warm, shallow, turbid and predominantly brackish. The SOM model successfully identified the changing patterns of limnology in the lagoon using the monthly limnological dataset from 30 study sites (July 1999–December 2004). Comparative re-sectoring evaluation of current monitoring sites was accomplished based on the outcome of the modeling. The new site clustering that emerged from the model was similar to conventional ones, and several sites were reorganized. Water physicochemistry was affected by freshwater inflow during monsoon and the new lagoon mouth constructed in September 2000, which resulted in variations in site characteristics in terms of limnology. The results of this study may provide information on the limnological patterns in Chilika lagoon, and they leave room for further study into functional changes in the lagoon ecology with respect to changes in climatic factor, freshwater flow and lagoon morphology.

Background: Recent research has highlighted the need for additional studies on the nutrition input required to stabilize growth. Objective: Our objective was to examine the association between dietary diversity and conditional growth in children aged 0–89 mo. Methods: We analyzed cohort data from 529 mothers and children living in a remote and food-insecure region in the mountains of Nepal. Children were aged 0–59 mo at baseline and were followed up after 9 and 29 mo. Conditional growth was calculated as the deviation from the expected height-for-age difference (HAD) trajectory based on previous measures of HAD and the pattern of growth in the population. Dietary diversity was assessed with the use of a count of the foods consumed from 7 food groups in the previous 7 d. The association between dietary diversity and conditional growth during the 2 follow-up periods (of 9 and 20 mo, respectively) was estimated with the use of ordinary least-squares regressions. Results: Prevalence of stunting and absolute height deficits was very high and increased over the course of the study. At the last measurement (age range 29–89 mo), 76.5% were stunted and the mean ± SD HAD was −11.7 ± 4.6 cm. Dietary diversity was associated positively with conditional growth in the later (May 2012–December 2013) but not the earlier (July 2011–May 2012) growth period. Children’s ages ranged from 0 to 59 mo in July 2011, 9 to 69 mo in May 2012, and 29 to 89 mo in December 2013. After adjustment, increasing the dietary diversity by one food group was associated with a 0.09 cm (95% CI: 0.00, 0.17 cm) increase in conditional growth in the second growth period. Conclusions: Increasing dietary diversity for children reduces the risk of stunting and improves growth after growth faltering. Future efforts should be directed at enabling families in food-insecure areas to feed their children a more diverse diet.

The second phase of education for a sustainable future (the widespread reorientation of educational practices, systems and structures) is not yet widespread in the Asia-Pacific region. This is a very large undertaking and one that the economically wealthy regions of the world have yet to make. Therefore it is not surprising that one of the world's economically poorer regions has yet to enact such reforms. However, there is sufficient leadership in the region (in the form of international and regional agencies and active NGOs) to indicate that if Member States can be convinced that a whole-of-government approach to sustainable development is desirable, the teacher educators, curriculum development officials and teachers of the region will have the requisite support to make the necessary reforms.

Background There is a large burden of psychological distress in low and middle-income countries, and culturally relevant interventions must be developed to address it. This requires an understanding of how distress is experienced. We conducted a qualitative grounded theory study to understand how mothers experience and manage distress in Dhanusha, a low-resource setting in rural Nepal. We also explored how distressed mothers interact with their families and the wider community. Methods Participants were identified during a cluster-randomised controlled trial in which mothers were screened for psychological distress using the 12-item General Health Questionnaire (GHQ-12). We conducted 22 semi-structured interviews with distressed mothers (GHQ-12 score ≥5) and one with a traditional healer (dhami), as well as 12 focus group discussions with community members. Data were analysed using grounded theory methods and a model was developed to explain psychological distress in this setting. Results We found that distress was termed tension by participants and mainly described in terms of physical symptoms. Key perceived causes of distress were poor health, lack of sons, and fertility problems. Tension developed in a context of limited autonomy for women and perceived duty towards the family. Distressed mothers discussed several strategies to alleviate tension, including seeking treatment for perceived physical health problems and tension from doctors or dhamis, having repeated pregnancies until a son was delivered, manipulating social circumstances in the household, and deciding to accept their fate. Their ability to implement these strategies depended on whether they were able to negotiate with their in-laws or husbands for resources. Conclusions Vulnerability, as a consequence of gender and social disadvantage, manifests as psychological distress among mothers in Dhanusha. Screening tools incorporating physical symptoms of tension should be envisaged, along with interventions to address gender inequity, support marital relationships, and improve access to perinatal healthcare.

Background Neonatal mortality remains high in rural Nepal. Previous work suggests that local women's groups can effect significant improvement through community mobilisation. The possibility of identification and management of newborn infections by community-based workers has also arisen. Methods/Design The objective of this trial is to evaluate the effects on newborn health of two community-based interventions involving Female Community Health Volunteers. MIRA Dhanusha community groups: a participatory intervention with women's groups. MIRA Dhanusha sepsis management: training of community volunteers in the recognition and management of neonatal sepsis. The study design is a cluster randomized controlled trial involving 60 village development committee clusters allocated 1:1 to two interventions in a factorial design. MIRA Dhanusha community groups: Female Community Health Volunteers (FCHVs) are supported in convening monthly women's groups. Nine groups per cluster (270 in total) work through two action research cycles in which they (i) identify local issues around maternity, newborn health and nutrition, (ii) prioritise key problems, (iii) develop strategies to address them, (iv) implement the strategies, and (v) evaluate their success. Cycle 1 focuses on maternal and newborn health and cycle 2 on nutrition in pregnancy and infancy and associated postpartum care practices. MIRA Dhanusha sepsis management: FCHVs are trained to care for vulnerable newborn infants. They (i) identify local births, (ii) identify low birth weight infants, (iii) identify possible newborn infection, (iv) manage the process of treatment with oral antibiotics and referral to a health facility to receive parenteral gentamicin, and (v) follow up infants and support families. Primary outcome: neonatal mortality rates. Secondary outcomes: MIRA Dhanusha community group: stillbirth, infant and under-two mortality rates, care practices and health care seeking behaviour, maternal diet, breastfeeding and complementary feeding practices, maternal and under-2 anthropometric status. MIRA Dhanusha sepsis management: identification and treatment of neonatal sepsis by community health volunteers, infection-specific neonatal mortality. Trial Registration no ISRCTN: ISRCTN87820538

DOI: 10.3126/opsa.v2i0.1065Occasional Papers in Sociology and Anthropology Vol.2 1990 p.13-23

The PDF of this file is 3,547 kbytes in size and therefore will take a long time to download if you click on the PDF link below. If you would like the file to be sent to you by email, please send a request to info@nepjol.info. Please include the citation below in your request. DOI: 10.3126/opsa.v3i0.1077Occasional Papers in Sociology and Anthropology Vol.3 1993 p.69-95

Information sheet showing different paragraphs inserted for different study arms. (DOCX 24 kb)

Information sheet showing different paragraphs inserted for different study arms. (DOCX 24 kb)

Nutrient content of 150 g daily intake of WFP wheat-soya with sugar Super Cereal food supplement, in relation to the nutrients listed in the DFID TORs, FAO-WHO vitamin and mineral requirements [50]. Remarks contain notes about nutrients where appropriate. (PDF 324 kb)

Information sheet and consent form for menstrual monitoring or pregnancy follow-up. (DOCX 24 kb)