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Blue bull is Asia’s largest antelope, a species of least concern in IUCN Red data list of 2020. In Nepal, it is vulnerable and is often considered as a problem animal for its crop raiding habit. Although, its population is restricted in India and Nepal, there are insufficient studies conducted on the distribution and threats of the species at local level. This study aimed to assess the distribution of blue bull and its conservation threats in Bardia National Park and its buffer zone. Field survey was carried out to identify the potential area with the information provided by park staff and buffer zone people and by the transect method in the selected habitat to determine the distribution of blue bull population. Additionally, six focus group discussions (1 in each of thefive sites and 1 with park staff) and a half-day workshop (involving 25 participants representing each site and park office) were organized to assess the existing threats to the species. Data were analyzed descriptively using MS Excel, while the distribution map was prepared using Arc GIS. Also, 8 major identified threats were ranked using relative threat ranking procedure and classified into four severity classes. We found that the population of blue bull was dispersed from core area of Bardia National Park towards the buffer zone area. Open grazing, invasive species, predation by tiger and flash flood were the major threats to the blue bull as perceived by the local people. Habitat management activities including control of grazing, removal of invasive plant species, plantation of palatable grass species, increase in other prey species of tiger and control of flood in blue bull’s habitats are recommended to protect the species and thus sustain their threatened population.

While the use of antibiotics for secondary infections in COVID-19 has been described in scientific literature and guidelines have been issued for their appropriate use, the importance of listening to patients in a systematic manner has often been overlooked. To highlight this issue, we spoke with patients about their experiences with antibiotics as treatment for COVID-19 and their understanding of antimicrobial resistance (AMR). We found that there is a general lack of awareness of the risks of AMR, and even when patients are knowledgeable, fear of COVID-19 and pressure from healthcare providers often override considerations for appropriate use. We present case examples of three patients’ experiences and provide recommendations for health systems, healthcare providers, and patients or caregivers on actions they can each take to reduce the risk of AMR during and beyond the COVID-19 pandemic. We also share ways that the patient community can be empowered to provide their voices to decision-making on both COVID-19 treatment protocols and prescriptions of antibiotics.

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tual equivalence to 'hassled'. CONCLUSIONS: Though not always possible to translate an English word exactly into the target language, a full translation and linguistic validation process, including creation of a concept elaboration document followed by an in-depth discussion at back-translation review stage, enables a conceptually equivalent translation to be found. The concept elaboration document should, where possible, be created in conjunction with the instrument developer.

In developing new medicines, pharmaceutical companies face the complex and challenging task of choosing comparators, in the absence of clear and consistent guidance, in order to produce evidence that best meets diverse stakeholder needs. This lack of clear and consistent guidance has led to several high-profile cases in which HTA bodies rejected products receiving regulatory approval due to a lack of evidence relative to desired comparators. Our objective was to identify key issues in comparator selection and present case studies highlighting these issues. METHODS: We conducted a comprehensive search of the published and grey literature addressing comparator selection, including formal guidelines from major regulatory, HTA, and professional organizations, as well as case studies and published opinions. Three authors independently and qualitatively assessed the identified literature, and the final list of issues was agreed upon through team discussion and consensus. RESULTS: Key challenges in the selection of appropriate comparators include: 1) lack of a standard definition for "standard of care," 2) concerns regarding off-label usage; 3) changes in requirements due to market dynamics; and 4) RCT design issues. We explore several of these challenges further with case studies. CONCLUSIONS: Due to challenges inherent in meeting diverse stakeholder needs, the selection of comparators is a complex and multi-faceted problem. The challenges we identified highlight the need for more uniformity and clarity among existing standards. In the context of ongoing external standard setting and harmonization efforts, organizations seeking to provide guidance around comparator selection should consider the issues described herein and work towards the common goal of a more transparent, harmonized process that optimizes the production of evidence that best meets the needs of all stakeholders.