Nurses are managing huge number of patients infected with human immunodeficiency virus (HIV), which made them highly vulnerable to HIV infection through occupational exposure such as needle stick injuries and splashing of blood/bodily fluids on mucosal surface. This made the practice of post exposure prophylaxis (PEP) for HIV crucial among nurses. Therefore, our study aimed to assess knowledge, attitude and practice of PEP for HIV among nurses in Bhutan. A cross-sectional study was conducted among 221 registered nurses working at Jigme Dorji Wangchuck National Referral Hospital, Bhutan between April and June 2017. A structured self-administered questionnaire was used to collect data and analysed using SPSS version 21. Majority (80.1%) of our participants had poor knowledge regarding PEP for HIV. Although half (51.1%) of our participants had heard about PEP, only 3 (1.4%) attended a formal training on PEP for HIV. However, a significant proportion of nurses (92.3%) had positive attitude towards PEP for HIV. Out of 221 respondents, 95(43%) had been exposed to needle stick injuries and splashing of blood/bodily fluids while managing patients. Despite significant number of exposures, only 2 (2.1%) of them took PEP and completed 28 days of prophylaxis. Lack of protective barriers at work place (56.8%) and poor knowledge on personal protective equipment (14.7%) were major perceived causes of exposure among study participants. No PEP service (30.2%) and lack of support to report incidents (22.6%) were two major reasons leading to failure of PEP practice among exposed individuals. Despite positive attitude exhibited by majority of our respondents, the level of knowledge and practice of PEP for HIV among nurses was very low. Therefore, a formal training on PEP and 24 hours accessible PEP service with proper guidelines are recommended to improve the overall knowledge and practice of PEP against HIV among nurses.

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The authors report a study in which they examined how the principals utilize to analyze the level and contrast of principals’ discernments towards instructional leadership practices based on individual and institutional factors along with identification of hindrances to leadership practice in Bhutan. The quantitative and qualitative approaches were deployed for this research. Three instructional leadership dimensions of, managing instructional programs, defining the school mission and promoting a positive school learning environment were used as measurement of criteria. The data were collected through Principals Instructional Management Rating Scale questionnaires and semi-structured interviews and analyzed using mean, standard deviation, t-test, and content analysis. The respondents consisted of 31 principals. These 31 principals are the representative of Instructional leadership from one of the districts in Bhutan. The findings of this study revealed principals’ high-level practices of instructional leadership and consistency among the personal and institutional factors. The result showed that all the 10 instructional leadership functions (Principals Instructional Management Rating Scale) almost at high level and overall mean generated was also high (3:58). Distinguished obstacles to instructional leadership were various roles, time limitations, work over-burden, lacking guidelines resources, shortages of teacher, restricted bolster for professional advancement, jumble between expectations and priorities. Within the light of the above findings, researcher would like to conclude that building learning culture not only depends on individual academic qualification but also the working environment and attitude of the academic committee towards student centered learning beneath the supervision of effective instructional leadership.

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The Himalayan Birch (Betula utilis D. Don) an essential tree species due to its ecological and social importance in the himalayan region.  The study assessed  the effect of environmental factors on habitat, growth, and regeneration patterns of the Himalayan Birch at the Royal Botanical Park, Lampelri, Bhutan . Two vertical transects with a spacing of 75 m were laid across the altitudinal gradient. A total of 10 circular sample plots were laid on each transect with a plot size of 12.62 m for trees, 3.57 m for regeneration, and 0.57 m for ground cover vegetation. A total of 119 vascular plant species under 45 families were recorded in 20 survey plots. The Spearman rho’s correlation showed strong negative correlation between the species abundance and temperature (rs=- .83) and positive correlation with the species count and altitude (rs = .83). The species richness in the study area showed an initial increase up to certain with elevation and then  decreased with further increase in elevation. The importance value index (IVI) of tree species showed Tsuga dumosa as the most dominant species.  Betula utilis indicated an increasing density with an increase in elevation. The regeneration of Betula utilis was poor as it was mostly found in a sapling stage. From a total of 43 tree species regenerating,  13.95% showed good regeneration, 34.88% fair, 23.25% poor, and 4.65% without regeneration. The remaining 23.25% seems  to be either reappearing or immigrating.