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Australia welcomes significant numbers of humanitarian arrivals every year. Over 24,000 South Sudanese have come to Australia in the last two decades, and most faced difficulties during the settlement process. The aim of this study was to understand the barriers and challenges that have impacts on settlement and integration experiences among South Sudanese refugees in Australia. Further, this explored the factors influencing the social and cultural integration of South Sudanese refugees living in Australia for more than five years. This study used a phenomenological approach with purposive and snowball sampling to recruit 26 participants who self-identified as South Sudanese refugees. Participants were recruited via community networks and were invited to participate in a semi-structured interview. The interviews were conducted by a bilingual interviewer and were analysed thematically. Participants' experiences portrayed the complexities of integrating into a new society and experienced multiple challenges and barriers. Despite this identity dilemma, they showed a consensus about the experiences of coming to and living in Australia with close association with a group identity. While there are positive elements of the integration experience, inter-generational conflicts require further investigation. Government and settlement organisations need to make an effort to understand the context while developing appropriate processes. [ABSTRACT FROM AUTHOR]

This study aimed to assess the utilization of health care services and its associated factors among people with type 2 diabetes mellitus (T2DM) in Nepal. Data on the utilization of health care services were assessed in 481 adults aged 30 to 70 years with T2DM in Nepal. Multiple logistic regression analysis was performed to determine the factors associated with the utilization of health care services. Over 6 months, 66.1% of participants visited health care facilities or health service providers, followed by specialist visits (3.5%), hospitalization (2.1%), and emergency department visits (1.9%). Visit to health care facilities was significantly higher among those aged 50 to 59 years old (ORA: 1.64), practicing Hinduism (ORA: 2.4), and earning NRs ≥30 000 (≥USD 226.10) (ORA: 1.82) as compared to those aged ≥60 years old, practicing other religions, and with monthly family income NRs ≤10 000 (≤USD 75.37), respectively. The utilization of health care services among people with T2DM in Nepal was reasonably low. Identifying the underlying causes of low use of health care services is of great importance to bridge the gap in using health care services for management of diabetes. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) has increased globally; with a disproportionate burden in South and Southeast Asian countries, including Nepal. There is an urgent need for clinically and cost-effective culturally adapted T2DM management programs. In this study, we aim to assess the effectiveness of community based culturally appropriate lifestyle intervention in improving the management and care of people with T2DM. Methods: We will conduct a cluster randomized control trial to evaluate the effectiveness of community based culturally appropriate lifestyle intervention in improving T2DM outcomes. The trial will be conducted in 30 randomly selected healthcare facilities from two purposively selected districts (Kavrepalanchowk and Nuwakot districts) of Bagmati province, Nepal. The selected healthcare facilities are being randomized into 15 interventions (n = 15) and usual care (n = 15) groups. Those in the intervention will receive group-based 12 an hour-long fortnightly session delivered over 6 months period. The intervention package includes 12 planned modules related to diabetes care, ongoing support, supervision and monitoring, follow-up from the trained community health workers, and educational materials on diabetes self-management. The participants in the usual care groups will receive pictorial brochure on diabetes management and they will continue receiving the usual care available from the local health facilities. The primary outcome is HbA1c level, and the secondary outcomes include quality of life, health care utilization, and practice of self-care behaviour, depression, oral health quality of life, and economic assessment of the intervention. Two points measurements will be collected by the trained research assistants at baseline and at the end of the intervention. Discussion: This study will provide tested approaches for culturally adapting T2DM interventions in the Nepalese context. The findings will also have practice and policy implications for T2DM prevention and management in Nepal. Trial registration: Australia and New Zealand Clinical Trial Registry (ACTRN12621000531819). Registered on May 6, 2021. [ABSTRACT FROM AUTHOR]

Byline: Sujan. Marahatta, Sanju. Gautam, Grish. Paudel, Uday. Yadav Background: An occupational hazard contributes to severe health problems among workers due to unhygienic conditions and lack of safety at the [...]

Background: Elder mistreatment is a well-recognized public health issue with complex underlying factors. The current study hypothesized that there is no effect of any of the following factors on any type of elder mistreatment: ethnicity, age group, education status, gender, living arrangement, concentration problems, medication for any disease, income level of caregiver, use of alcohol and tobacco products, and dependence on family or caregivers for daily activities. Materials and methods: We conducted a cross-sectional study of 339 elders adults aged 60 or above residing in a rural part of eastern Nepal between August and November 2016. Multi-stage cluster sampling was adopted to select the study subjects. Information was collected using semi-structured questionnaires administered to elderly people by a designated interviewer. Factors associated with elder mistreatment were analyzed using logistic regression. Results: Our findings revealed that 61.7% of 60+-year-olds experienced some form of mistreatment (physical 2.4%, psychological 22.4%, caregiver neglect 57.5%, financial 12.1% and stranger-inflicted 8.3%). Elder mistreatment was associated with the following characteristics of elders: dependent on family for daily living activities, illiterate, experiencing concentration problems, residing in a living arrangement with their son(s)/daughter(s)-in-law, taking regular medications, belonging to the Dalit community according to the Hindu traditional caste system, and residing with a caregiver having a monthly family income of less than NRs. 20,000 (193USD). Conclusions: Our data show that elder mistreatment is prevalent in a rural community of Nepal. Addressing the lower socio-economic or socio-cultural classes of caregivers and elders via community-focused development programs might have significant implications for improving the well-being of elders. [ABSTRACT FROM AUTHOR]

Background mistreatment of elderly people is internationally recognised as a serious public health issue. This study aimed at estimating the prevalence and risk factors associated with mistreatment in urban Nepal. Methods this was a descriptive cross-sectional study of 212 elderly people residing in Butwal sub-metropolitan city, an urban area in Nepal; the study was conducted between March and October 2015. Two-stage cluster design with simple random sampling was adopted for the study. Information was collected using an interviewer administered semi-structured questionnaire of older people. Logistic regression analysis was used to identify factors associated with elder mistreatment. Results this study found a prevalence of 49.1% for mistreatment of the elderly population. Prevalence rates of caregiver neglect, financial, psychological or physical mistreatment and other types (including sexual assault) were 47.2%, 11.8%, 10.8%, 1.42% and 3.3%, respectively. Being a dalit (untouchable backward class in the traditional Hindu caste system), unemployed, widowed, divorced or separated, problems concentrating and smoking were independent factors associated with mistreatment. Smoking was found to be consistently associated with the three most common mistreatment types. Conclusions mistreatment of older people is common in urban Nepal, with neglect, financial and psychological abuse most common. Along with standard risk factors, specific ethnic issues (membership of dalit community) are associated with increased risk. [ABSTRACT FROM AUTHOR]