Developmental Idealism and Migration: Theorizing their Relationship and an Empirical Example from Nepal.

This paper brings together both theoretically and empirically two strands of social science research: migration and developmental idealism. The paper is motivated by the fact that there are extensive bodies of research about migration and about developmental idealism, but almost no discussion in the literature about how they might be interconnected. We present theoretical arguments concerning the influence of migration in distributing developmental idealism around the world and in developmental idealism being a force influencing the migration decisions of people. We also provide an empirical investigation of how variation in developmental idealism may have been an influence on migration and choice of migration destinations in Nepal. Thus, we extend the developmental idealism literature to include migration and the migration literature to include developmental idealism.

Yoga and music intervention to reduce depression, anxiety, and stress during COVID-19 outbreak on healthcare workers.

AIM: To investigate impact of Yoga and Music Intervention on anxiety, stress, and depression levels of health care workers during the COVID-19 outbreak. METHODS: This study was conducted to assess psychological responses of 240 healthcare workers during COVID-19 outbreak. We used Yoga and Music Intervention in normal and abnormal subjects based on Depression Anxiety and Stress Scale-42 (DASS-42). RESULTS: Of all 209 participants, 105 (50.23%) had symptoms of depression (35.88%), anxiety (40.19), and stress (34.92%) alone or in combination. The data suggest that there is significant improvement in test scores after intervention. Majority of persons with abnormal score exhibited improved DASS-42 score on combined interventions of Yoga and music compared to control group. Even subjects without abnormalities on DASS-42 score also showed improved DASS-42 scores in intervention (n = 52) group compared to nonintervention (n = 52) group. CONCLUSIONS: Our findings highlighted the significance of easily available, simple, inexpensive, safe nonpharmacological interventions like Yoga and Music therapy to overcome stress, anxiety, and depression in present times.

Social Change, Out-migration, and Exit from Farming in Nepal.

Though international out-migration is widespread, little evidence exists regarding the consequences for economic change in sending countries, particularly in the densely populated agricultural areas of Asia. We examine associations between labor out-migration, remittances, and agricultural change in Nepal. Existing studies of this important population-environment relationship generally ignore the role of local community context, which is known to shape demographic behavior and likely exit from farming as well. Research offers opposing views of the consequences of out-migration for agricultural change - (1) loss of farm labor reduces engagement in agriculture, versus (2) loosening credit constraints from remittances increases engagement in agriculture - and indicates that both mechanisms likely operate simultaneously. Both of these mechanisms are likely to be shaped by changes in local context. Using multilevel dynamic models, we estimate associations between out-migration and remittances by household members and subsequent exit from farming, controlling for variations in community context. Results suggest international out-migration is associated with higher odds of exit from farming and simultaneously remittances are associated with lower odds of exit from farming. Results are robust against several key variations in model specification, including controls for household characteristics and local community context. However, local community context exerts an important independent influence on the hazard of exit from farming.

Family Obligation Attitudes, Gender, and Migration.

This study focuses on attitudes related to fulfilling family obligations and their relationships to migration behavior. We hypothesize that men who highly value fulfilling family obligations will be more likely to migrate in order to fulfill material obligations while women who highly value fulfilling family obligations will be less likely to migrate in order to fulfill care obligations. The empirical analysis examines data from the Chitwan Valley Family Study, located in south-central Nepal. We test whether variation in how much individuals value putting family needs before individual needs and caring for their adult parents matter for whether they migrate at all and if so, to which specific destinations. Our results provide only moderate support for these hypotheses but uncover patterns in how these attitudes toward family obligations are related to migration destinations. Men with strong attitudes toward family obligations are more likely to migrate internationally but especially to nearby India, sacrificing some level of economic returns for proximity. For women, the effect of attitudes is consistent: putting family needs first is negatively related to migration, while caring for adult parents is positively related to migration to India but not domestic or other international destinations. The findings suggest that our conventional typology of gendered labor and gender expectations for masculine breadwinning and feminine care might too strictly dichotomize the reality of how people actually care and provide for their families, obfuscating how they negotiate these competing demands.

Fatalistic Beliefs and Migration Behaviors: A Study of Ideational Demography in Nepal.

We investigate influences of fatalistic beliefs on domestic and international migration in Nepal, positing that fatalistic beliefs may affect decisions to migrate and where to locate. Fatalism is the belief that human outcomes are preordained by forces outside of one's power and control. Because of its relationship with effort and innovation, fatalism may be an important factor in people's decision to migrate and destination choice. We expect that fatalistic beliefs encourage or discourage migration depending upon societal expectations to migrate and the relative ease of migration to different destinations. Our empirical analysis relies on migration histories of respondents from the Chitwan Valley Family Study. Results from multinomial logistic regression models provide evidence that fatalistic beliefs increase overall migration propensity and has both positive and negative destination-specific effects. Fatalistic beliefs increase Nepalis' odds of migrating to destinations that are, relatively speaking, easier to access, but decrease the odds of migrating to destinations with higher barriers to entry.

A Novel Technique in Fibrin Gluing of Intercostal Nerves: Splint and Weld.

Splint and weld technique ensures a sound coaptation of intercostal and musculocutaneous nerves with minimal introduction of synthetic suture through the neural tissue.

Ethno-Caste Influences on Migration Rates and Destinations.

While studies commonly show differences in out-migration between ethnic groups, ethnicity most often features no more than a side note in the emigration literature, and we have very little insight about why people from different ethnic groups migrate at different rates. Understanding ethnic differences in migration rates and destination choice has important implications for the present-day and future potential for either dampening or exacerbating ethnic discrimination and opportunity structures. Building on existing migration theory, we identify three possible mechanisms through which ethnicity might influence out-migration rates and destination choice: human and economic capital, contemporary discrimination, and historical legacies that are perpetuated through social networks. Our empirical investigation uses longitudinal panel survey data from Nepal and we find that all three of these mechanisms likely influence out-migration and destinations of the five major ethno-caste groups. However, we show that historical legacy and human and economic capital emerge as the key drivers of ethnic differences in out-migration here. We discuss what these results mean for migration studies as well as the potential for the institution of migration to affect patterns of ethno-caste-based disadvantage in Nepal. The theoretical basis and empirical evidence from our study also suggest ways to understand the reasoning for and consequence of ethnic and racial differentials in migration patterns in other areas of the world.

Study of Migration and Later Life Health in Nepal.

PURPOSE: This study investigates long-term consequences of individual migration experience on later life health, specifically self-rated health and functional difficulty. DESIGN/METHODOLOGY/APPROACH: The study uses multiple community-, household-, and individual-level data sets from the Chitwan Valley Family Study (CVFS) in Nepal. The CVFS selected a systematic probability sample of 151 neighborhoods in Western Chitwan and collected information on all households and individuals residing in the selected sample neighborhoods. This study uses data from multiple surveys featuring detailed migration histories of 1,373 older adults, and information on their health outcomes, households, and communities. FINDINGS: Results of the multi-level multivariate analysis show a negative association between number of years of migration experience and self-rated health, and a positive association between migration and functional difficulty. These findings suggest a negative relationship between migration experience and later life health. RESEARCH LIMITATIONS/IMPLICATIONS: Although we collected health outcome measures after the measurement of explanatory and control measures-a unique strength of this study-we were unable to control for baseline health outcomes. Also, due to the lack of time-varying measures of household socioeconomic status in the survey, this investigation was unable to control for measures associated with the economic prosperity hypothesis. Future research is necessary to develop panel data with appropriately timed measures. PRACTICAL IMPLICATIONS: The findings provide important insights that may help shape individual's and their family's migration decisions. ORIGINALITY/VALUE: This research provides important insight to individuals lured by potential short-term economic prospects in destination places, as well as to scholars and policy makers from migrant-sending settings that are grappling with skyrocketing medical expenses, rapid population aging, and old age security services.

Farm Exit among Smallhoder Farmers of Nepal: A Bayesian Logistic Regression Models Approach.

To leave or not to leave farming? This is a dilemma facing a large number of farm households in a rural agrarian setting of Nepal where nearly two-thirds of the population is small holder farmers. Using the uniquely detailed retrospective panel data collected in 2015 from farming households, we examine the influence of the access to cultivated land holding and land tenure on subsequent farm exit. We address the statistical modeling issue of complete separation by developing a robust Bayesian predictive model to predict the probability of farm exit. We use the Bayesian framework with weakly informative prior to carry out the logistic regression model and compare it with other available binary response models. Our results show that the size of cultivated land has a strong negative influence on farm exit, net of all other controls. Moreover, farmers who rented farmland from others or who rented farmland to others were significantly more likely to exit farming. We estimate that a farm household required at least 5 Katha of land (one sixth of a hectare) per year to stay in farming.

When does Social Capital Matter for Migration? A Study of Networks, Brokers, and Migrants in Nepal.

The study of social capital has been one of the strongest areas of recent advance in migration research, but there are still many questions about how it works and why it has varying effects in studies of different places. In this article, we address the contextual variation in social capital's effects on migration by considering migration brokers. We argue that destinations for which migration is logistically difficult to arrange give rise to brokerage industries and hypothesize that brokers in turn substitute for the informational capital typically provided by social networks. Our empirical tests in Nepal support this narrative, showing that social networks matter for migration to destinations where brokers are not available and have little discernible effect on migration to brokered destinations. Our results suggest that migration research should consider the growing role of brokerage agencies, that theorizations of social capital more broadly must contend with how it is delimited by brokers, and that social scientists might also consider other consequences that can arise from these migration brokers that are increasingly common in many countries and provide a marketized replacement for social capital in some cases.

Household migration and children's diet in Nepal: an exploratory study.

OBJECTIVE: Individuals from low-income countries often migrate abroad for employment. The association between such migration and investment in education as well as other societal and familial outcomes has previously been examined. However, we have a limited understanding of the association between migration and children's nutrition. We aim to determine the extent to which migration of household members influences children's diet in a semi-urban region of Nepal. RESULTS: In our study setting, children in households with a migrant had higher dietary diversity scores, 0.69 on average, than their counterparts in households without a migrant. These children were approximately 43% points more likely to meet a minimum requirement for dietary diversity. These differences originated primarily from higher consumption of meat (41% points) and eggs (20% points). Approximately 37 percent of children in the sample consumed processed food during the 24 h preceding the survey. However, we found no evidence that migration was associated with the consumption of processed foods or with reduced frequency of breastfeeding. Our finding that migration is associated with higher consumption of meat and eggs is particularly encouraging, given that the protein deficiency in Nepal is estimated to be nearly 43 percent.

Strategies for origin-based surveying of international migrants.

This paper addresses methodological challenges of investigations of international migration, including difficulties in obtaining information about representative samples of migrants and both their origin and destination location. Our project used an origin-based sample with a destination focused survey and interviewed 91% of migrants from a community in Nepal to any destination and shares techniques employed. Our procedures and high response rate constitute a significant improvement in survey methods that permit the creation of unbiased data on migrants and allow the study of migration in conjunction with origin communities.

Influences of Material Aspirations on Migration.

In this article, we investigate the influences of material aspirations on migration in Nepal, positing that material aspirations may have important influences on decisions to migrate and where to locate. We discuss a theoretical model explaining how these aspirations might be key influences in the migration decision. Using detailed continuous migration histories from the 2008-2012 Chitwan Valley Family Study, we estimate logistic and alternative-specific conditional logit models to examine how material aspirations in Nepal influence migration rates and destinations. Our empirical analyses provide strong evidence that material aspirations have large effects on overall rates of migration and affect destination-specific migration rates, particularly for relatively wealthy Western and Asian destinations. We also show an interaction effect between material aspirations and destination-specific expected earnings in influencing people's migration choices. It is the people with high aspirations who migrate to destinations with high earning potentials.

Postmarital Living Arrangements in Historically Patrilocal Settings: Integrating Household Fission and Migration Perspectives.

This study integrates theory and research on household fission (or partition) and migration to better understand living arrangements following marriage, especially in historically patrilocal and primarily agricultural settings. Using panel data from the Chitwan Valley Family Study to analyze the sequential decision-making process that influences men's living arrangements subsequent to first marriage, we demonstrate the importance of distinguishing among extended family living, temporary migration, and the establishment of an independent household. We find that community economic characteristics, such as access to markets or employment, as well as household wealth affect the initial decision to leave the natal home. Household resources and use of farmland, along with the young men's own education, media exposure, travel, and marital behavior, influence the decision to make the departure from the natal home permanent. Our findings explain why previous results regarding household fission and those focused on migration have provided such mixed results, and we establish a new framework for thinking about how families and individuals manage living situations.

A calendar method of collecting remittance use data in a remittance dependent setting of Nepal1.

This methodological paper describes the design and refinement of a calendar method of collecting data on remittance receipt and remittance use and its piloting in a rural remittance dependent setting of Nepal. Much of the previous national surveys collected remittance receipt and remittance use cross-sectional data that used a time frame ranging from 12 - 24 months. These surveys collected remittance receipt data by asking, 'How much money has he/she sent in the past 12 months or 2 years?' We believe that the long time frame of one to two years adds burden to respondents for unnecessary calculations and is prone to re-call bias. Moreover, these surveys used vague words such as 'capital formation' or 'daily consumption' to measure the uses of remittances. Thus, the instrument per se is unreliable posing threats to collecting valid responses. Considering these flaws, in 2013, we designed a calendar with shorter timing cues and simple words for collecting longitudinal data on remittance receipt and remittance use. First, we describe the calendar design process. Next, we provide descriptive results of household responses on the amount of remittance received and the remittance used on various socio-economic and cultural dimensions of household activities. The implications of the insights gained from this study are discussed.

Negative Pressure Wound Therapy in the Management of Combat Wounds: A Critical Review.

Significance: Wounds sustained in a combat trauma often result in a composite tissue loss. Combat injuries, due to high energy transfer to tissues, lead to trauma at multiple anatomical sites. An early wound cover is associated with lower rate of infections and a faster wound healing. The concept of negative pressure wound therapy (NPWT) in the management of combat-related wounds has evolved from the civilian trauma and the wounds from nontraumatic etiologies. Recent Advances: Encouraged by the results of NPWT in noncombat-related wounds, the military surgeons during Operation Iraqi Freedom and Operation Enduring Freedom used this novel method in a large percentage of combat wounds, with gratifying results. The mechanism of NPWT in wound healing is multifactorial and often complex reconstructive procedure can be avoided in a combat trauma setting. Critical Issues: Wounds sustained in military trauma are heavily contaminated with dirt, patient clothing, and frequently associated with extensive soft tissue loss and osseous destruction. Delay in evacuation during an ongoing conflict carries the risk of systemic infection. Early debridement is indicated followed by delayed closure of wounds. NPWT helps to provide temporary wound cover during the interim period of debridement and wound closure. Future Directions: Future area of research in combat wounds is related to abdominal trauma with loss of abdominal wall. The concept of negative pressure incisional management system in patients with a high risk of wound breakdown following surgery is under review, and may be of relevance in combat wounds.

Use of contralateral spinal accessory nerve for ipsilateral suprascapular neurotization in global brachial plexus injury: a new technique.

Nerve transfer between the spinal accessory nerve (SAN) and the suprascapular nerve (SSN) is a standard technique in shoulder reanimation. In cases of global brachial plexus injury, donor nerves are few and at times severely traumatized owing to extensive traction forces. This precludes the application of standard nerve transfer techniques. The authors offer the use of the contralateral SAN as an additional option in the reinnervation of an injured SSN in such circumstances. To the best of their knowledge, this is the first successful attempt of this technique to be reported in the literature.

Management of Isolated Musculocutaneous Injury: Comparing Double Fascicular Nerve Transfer With Conventional Nerve Grafting.

PURPOSE: To compare the functional outcomes of nerve grafts and nerve transfers in the management of isolated musculocutaneous nerve (MCN) injuries. METHODS: We performed a retrospective case-control study of isolated MCN injury managed at a tertiary care center. The study group was composed of 12 patients managed with double nerve transfer whereas the 8 patients in the grafted group constituted the control group. RESULTS: In the study group, stab and missile injuries constituted most cases with a denervation period ranging between 3 and 9 months. Eleven patients in this group experienced a full range of active elbow flexion whereas one had antigravity flexion of 120°. Electromyography revealed the first sign of reinnervation of biceps at 10 ± 2 weeks, compared with 20 ± 2 weeks in the grafted group. The overall trend was for patients in the study group to have earlier return of active elbow flexion and better restoration of elbow flexion strength and range of (presumably active) elbow motion than those treated with grafting, although none of these measures reached statistical significance. CONCLUSIONS: We found that distal nerve transfer was a superior method of managing isolated MCN injury compared with conventional nerve grafting.

Factors affecting institutional delivery in rural Chitwan district of Nepal: a community-based cross-sectional study.

BACKGROUND: Health facility delivery is considered a critical strategy to improve maternal health. The Government of Nepal is promoting institutional delivery through different incentive programmes and the establishment of birthing centres. This study aimed to identify the socio-demographic, socio-cultural, and health service-related factors influencing institutional delivery uptake in rural areas of Chitwan district, where high rates of institutional deliveries co-exist with a significant proportion of home deliveries. METHODS: This community-based cross-sectional study was conducted in six rural Village Development Committees of Chitwan district, which are characterised by relatively low institutional delivery rates and the availability of birthing centres. The study area represents both hilly and plain areas of Chitwan. A total of 673 mothers who had given birth during a one-year-period were interviewed using a structured questionnaire. Univariate and multivariable logistic regression analysis using stepwise backward elimination was performed to identify key factors affecting institutional delivery. RESULTS: Adjusting for all other factors in the final model, advantaged caste/ethnicity [aOR: 1.98; 95% CI: 1.15-3.42], support for institutional delivery by the husband [aOR: 19.85; 95% CI: 8.53-46.21], the decision on place of delivery taken jointly by women and family members [aOR: 5.43; 95% CI: 2.91-10.16] or by family members alone [aOR: 4.61; 95% CI: 2.56-8.28], birth preparations [aOR: 1.75; 95% CI: 1.04-2.92], complications during the most recent pregnancy/delivery [aOR: 2.88; 95% CI: 1.67-4.98], a perception that skilled health workers are always available [aOR: 2.70; 95% CI: 1.20-6.07] and a birthing facility located within one hour's travelling distance [aOR: 2.15; 95% CI: 1.26-3.69] significantly increased the likelihood of institutional delivery. On the other hand, not knowing about the adequacy of physical facilities significantly decreased the likelihood of institutional delivery [aOR: 0.14; 95% CI: 0.05-0.41]. CONCLUSION: With multiple incentives present, the decision to deliver in a health facility is affected by a complex interplay of socio-demographic, socio-cultural, and health service-related factors. Family decision-making roles and a husband's support for institutional delivery exert a particularly strong influence on the place of delivery, and this should be emphasized in the health policy as well as development and implementation of maternal health programmes in Nepal.