Suchergebnisse

Excessive fiscal spending is commonly cited as a root of the current European debt crisis. This article suggests, like others, that the rise of competitiveness imbalances contributing to national imbalances in total borrowing is a better explanation for systemic differences toward Economic and Monetary Union (EMU) countries' exposure to market speculation. We identify one driver of this divergence: a country's capacity to limit sheltered sector wage growth, relative to wage growth in the manufacturing sector. Corporatist institutions that linked sectoral wage developments together in the surplus countries provided those with a comparative wage advantage vis-à-vis EMU's debtor nations, which helps explain why the EMU core has emerged relatively unscathed from market speculation during the crisis despite the poor fiscal performance of some of the core countries during EMU's early years. Using a panel regression analysis, we demonstrate that rising differentials between public and manufacturing sector wage growth, and wage-governance institutions that weakly coordinate exposed and sheltered sectors, are significantly correlated with export decline. We also find that weak-governance institutions are significantly associated with more prominent export decline inside as opposed to outside a monetary union.

Health research activities have advanced considerably in Nepal over the past several years. However, stakeholders' confidence on scientific community is shaken as the latter failed occasionally in adhering to ethical principles. Nepal Health Research Council has exercised regulatory authority to control and support research works. However, much more is needed given the scale at which studies are being carried out. It is high time to conduct an analysis of the current situation followed by the development of an overarching framework to strengthen health research that facilitates a range of actions along the continuum of identifying information needs to translation of knowledge into policies and practices for ultimately improving people's health. Keywords: Ethics; health research systems; knowledge management; research regulation

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the strain of coronavirus that causes coronavirus disease 2019 (COVID-19), a respiratory illness. COVID-19 has now become a global public health crisis causing alarming numbers of morbidity and mortality. Ever since the COVID-19 pandemic started scientists, researchers, universities, companies, and institutions all around the world have been endeavoring to discover a potential treatment for COVID-19. Numerous studies and clinical trials on vaccines and drugs for the prevention and treatment of COVID-19 are underway across the world. However, the uncertainty around the efficacy and safety of various treatment regimens have become one of the biggest challenges in the battle against the SARS-CoV-2. This paper is a narrative review of articles regarding the various treatments and vaccines being tested for the SARS-CoV-2, available in the PubMed database along with Google Scholar. There are ongoing clinical trials on potential drugs such as remdesivir, favipiravir, lopinavir/ritonavir, chloroquine, and hydroxychloroquine, corticosteroids tocilizumab, azithromycin, anakinra, etc. and other therapeutic modalities like convalescent plasma therapy. Likewise, vaccines against SARS-CoV-2 are being developed and tested, including mRNA, non-replicating viral vector, DNA, protein subunit candidate vaccines, etc. Although some early-stage clinical trials and studies on these drugs and vaccines have shown positive results, definitive and conclusive results are yet to be obtained.
Keywords: COVID-19; antiviral drugs; COVID-19 treatment; COVID-19 vaccine; SARS-CoV-2

Background: Frontline Health Care Workers are at risk of developing mental and psychological distress during Corona virus disease 2019 pandemic. This study aimed to assess level of stress, anxiety, depression and their associated factors among health care workers during Corona virus disease 2019 pandemic in Nepal.Methods: This is a web based cross-sectional survey conducted among 404 Health Care Workers during early phase of Corona virus disease 2019 pandemic. The participants were selected using convenience sampling technique and were invited to participate via various online networks. Depression, anxiety and stress were assessed using the Depression Anxiety Stress Scale-21 (DASS-21) and their associated factors were measured using structured questionnaires. Multivariable logistic regression was carried out to determine the associated factors.Results: The symptoms of stress, anxiety and depression among health care workers were found to be 28.9%, 35.6% and 17.0% respectively. Females were found to be 2 fold more likely to have anxiety and depression than male. Nurses were found to be two times more likely to have anxiety than doctors. Laboratory personnel were almost three folds more likely to have anxiety than doctors. Health care workers with insufficient/ no PPE were almost three fold more likely to have depression. health care workers working in high-risk areas had almost 2 fold higher odds of having depression.Conclusions: Health care workers experienced symptoms of stress, anxiety and depression in varied level of severity. This experience was higher among the nurses and laboratory workers than doctors. Pandemic preparedness assuring PPE and appropriate psychological interventions may be beneficial to promote mental health and well-being of health care workers.Keywords: Anxiety; associated factors; depression; health workers; stress

Novel coronavirus disease 2019 (COVID-19) is a growing public health crisis. Despite initial focus on the elderly population with comorbidities, it seems that large studies from the worst affected countries follow a sex-disaggregation pattern. Analysis of available data showed marked variations in reported cases between males and females among different countries with higher mortality in males. At this early stage of the pandemic, medical datasets at the individual level are not available; therefore, it is challenging to conclude how different factors have impacted COVID-19 susceptibility. Thus, in the absence of patients' level data, we attempted to provide a theoretical description of how other determinants have affected COVID-19 susceptibility in males compared to females. In this article, we have identified and discussed possible biological and behavioral factors that could be responsible for the increased male susceptibility. Biological factors include - an absence of X-chromosomes (a powerhouse for immune-related genes), a high level of testosterone that inhibits antibody production, and the presence of Angiotensin-converting enzyme 2 (ACE2) receptors that facilitate viral replication. Similarly, behavioral factors constitute - higher smoking and alcohol consumptions, low level of handwashing practices, and high-risk behavior like non-adherence to health services and reluctance to follow public health measures in males.
Keywords: COVID-19; gender; males; sex disaggregation; susceptibility

Background: Preparedness, readiness, and response status of any country is integral in identifying, managing, and preventing COVID-19 pandemic. The objective of this study is to assess the status of the Government of Nepal designated COVID hospitals and COVID clinics to respond against COVID-19. Methods: A cross sectional study was conducted with the focal persons of COVID hospitals and COVID clinics using a semi-structured questionnaire from April 26, 2020 to May 27, 2020 via face to face interview with onsite observation and telephonic interview in few unreachable health facilities. Results: Government of Nepal designated COVID hospitals and COVID clinics demonstrated efforts in establishing preparedness plans and committees such as COVID management core team (96.7% and 86%), provision of coordination with the government authority (both 100% ), preparedness response plan (93.3% and 84%), and infection prevention and control committee (63.3% and 65.6%) to respond to COVID-19 respectively. The participants reported differences in training provided to their health care workers with maximum COVID hospitals (80%) providing training on use of personal protective equipment and least (43.3%) on handling dead bodies. Only half of the COVID clinics (49.5%) had provision of triage systems.Conclusions: COVID hospitals and COVID clinics in Nepal demonstrated different status of COVID pandemic preparedness and readiness. In case of surge, Nepalese hospitals would struggle due to lack of trained workforce and infrastructure. Interdisciplinary, multi-sectoral collaboration with various focused strategies, including in-service training to staff, is paramount to increase preparedness and readiness. Keywords: COVID-19; Nepal; preparedness; readiness