Nepal has an agrarian-based economy where the livestock sector contributes about 12 percent to the national GDP. Rupandehi district is one of the largest dairy pocket areas in the nation, but the disease, such as leptospirosis, posed a negative impact on their production and productivity. Despite the economic importance of cattle leptospirosis, the disease is concerned for the people’s occupational risk and food safety. Although leptospirosis is a priority zoonosis in Nepal, the effective implementation of the control program lacks both in animal and human health. A cross-sectional study was conducted to estimate the prevalence and identify associated risk factors of cattle leptospirosis from March 2019 to April 2020. Altogether, 206 cattle herds located in all the sixteen local levels of the district were visited. The owners were interviewed to record the cattle management system’s information and their knowledge of the zoonotic diseases. A total of 383 cattle serum samples were collected, and an indirect antibody ELISA was performed to estimate the infection status of leptospirosis in the cattle herds. All the data were analyzed by Open epi and R software for the descriptive and analytical study. Bivariate and multivariable logistic regression was applied to assess the potential herd level and animal level risk factors. Out of seven potential herd-level risk factors, the purchased cattle herds (OR: 7.2, 95% CI: 1.24-136.5, p=0.025) and cattle with herd size >10 (OR: 14.92, 95% CI: 2.61-283.38, p=0.025) were identified as significant risk factors for leptospirosis. At the animal level, the cattle taken for grazing in pastureland accessed by the community dog was a significant risk factor (OR: 4.16, 95% CI: 1.13-14.06, p=0.034). Surprisingly, none of the farmers had heard about leptospirosis before. The outcome of this research could be an epidemiological insight in control of priority zoonosis to protect the livestock economy and reduce their negative impact on public health.

AimsCOVID-19 lockdown had reduced face-to-face interaction amongst staff with work-from-home and hybrid models adapted by most NHS organisations which had impacted team morale and reduced learning opportunities within the team. Book clubs are an effective way to enhance social process of learning especially in mental health. Our aims were to improve face-to-face interaction to boost morale within the Community Mental Health Team (CMHT) and increase the reading habit within the team around mental health fiction.MethodsA questionnaire was sent initially to gauge interest on the idea of a book club and how it should be conducted. Next, we digitalised the book club with a WhatsApp group to facilitate discussion on selection of books and the first book was selected via polling (The Fat Lady Sings by Jacqueline Roy). After 4 weeks reading time, we gathered on a selected day (30th September 2022) for moderated discussions with potluck-style lunch. Anonymous feedback was collected via surveys. The cycle was repeated on 28th October 2022 (second book was Inheritance of Loss by Kiran Desai).ResultsQuestionnaire to gauge interest and how the book club should be conducted revealed that the majority preferred a once-a-month discussion during working hours on a mental health and/or social care-related fiction of about 200-300 pages in length. The 8 respondents were made up of 6 doctors, 1 nurse and 1 social worker.Feedback surveys on the impact of the book club on interaction with colleagues showed 30% improvement after the first book club (50% to 80%) and was 100% after the second cycle. Respondents also noted 60% improvement in interest in mental health-related fiction and 60% felt that the book club and discussions generated would help them in their day-to-day work in psychiatry (this figure rose to 100% after the second cycle).ConclusionStaff well-being is paramount to ensure staff satisfaction and reduce burnout. Initiatives to address this must be tailored to specific teams. It is also essential to encourage medical education in informal settings to create a culture of learning and improvement from healthcare professionals of diverse backgrounds.

AimsOur aim was to improve service user satisfaction by increasing the interval between their depot injections where clinically feasible. By doing this, we aimed to reduce attendance at the South Kensington and Chelsea Community Mental Health Team (SK&C CMHT) depot clinic by 25% over a period of 3 months, improving the workload for nurses running the clinic.MethodsOur first baseline measure was data gathered about service user satisfaction with their depot. Our second baseline measure was the average number of service users attending the depot clinic per week between May and November 2022. The balance measure was a medical review 3 months post-interval change to ensure there were no negative impacts from this change.10 service users on 3-weekly anti-psychotic depots were identified. Our team devised criteria to select service users who were appropriate for our project. This included: a stable mental state, minimal side effects on the current dose, no breakthrough symptoms, good engagement with the depot clinic, and scope to increase the current dose. These service users were discussed with their care coordinator, consultant and depot clinic nurse. If the criteria were met, the dose and interval change was discussed with our pharmacist. Finally, service users were consented and their depot charts were amended.ResultsThe interval between depot injections for 2 service users was increased from 3 to 4 weeks on December 5th, 2022. The other 8 service users failed to meet the criteria set out in our methodology.These 2 service users were asked to fill in a questionnaire on January 23rd, 2023. They reported that “it was not comfortable having an injection” and that “having it every 4 weeks was better” and “less hassle”. Their first medical review did not raise any safety concerns.On average, 20 service users attend the SK&C CMHT depot clinic every week. There was no change in the average number of patients attending the depot clinic in the last two months as only 2 service users had their depot interval successfully altered.ConclusionService users on depot injections can benefit from increasing the interval between their injections where clinically feasible. We would like to repeat this project for service users on 2-weekly depots and reassess if that makes an impact on satisfaction levels and attendance numbers at our depot clinic.

Background Child protection is burning issues in developing countries including Nepal. Child protection is one of the key works of the school health nurses. Objective To find out about the existing knowledge and practices of child protection among the school health nurses. Method This descriptive cross-sectional study was conducted among 130 school health nurses working in different schools throughout Nepal. The participants were selected using purposive sampling technique and were invited to participate via various online networks. Self-administered questionnaire was used to collect data. Duration of data collection was 20 December 2020 to 10 February 2021. Descriptive statistics was used to analyze and interpret the data. Result Among the 130 Participants, 88.5% belonged to less than 29 years age group and 67.7% had Proficiency Certificate Level in Nursing education. None of them has received training related to child protection recognition and response and 90.8% had work experience of less than 5 years. Eighty percent and 96.9% participants had knowledge regarding the meaning of child right and child abuse respectively. But 45.4% had knowledge on meaning of child neglect; 53.1% and 72.3% had the knowledge of physical abuse and noncontact sexual abuse respectively. Majority (86.9%) of the participants reported as relatives were the abuser and 63.8% replied as home is the common place for abuse. Similarly, 85.4% had received the information regarding child protection via television radio and newspaper. Only 36.1% has already been involved in child protection. The participants who went to local government (Palika), police and Non-government Organizations for coordination for child right issues were 9(19.1%), 7(14.8%) and 8(17.0%) respectively. Conclusion Most of the school health nurses are young without having experience of childhood abuse and received any child protection training before joining the job. They have good knowledge of child right, physical, sexual abuse except child neglect and existing legal arrangements. There is gap in knowledge and practice.