Background: Loneliness and depression are the noteworthy mental health issues which are prevalent among older people but only a few studies have addressed this aspect especially in developing countries. So, this study is an attempt to shed light to this aspect of older adult’s life, in order to assess the level of loneliness and depression, to identify associated factors,and to find out the correlation between loneliness and depression.Methods: A descriptive cross-sectional study design was used to collect data from 124 older peopleof age ?60 years living in a community using purposive sampling technique. A structured questionnaire, University of California, Los Angeles scale version 3 loneliness scale, and geriatric depression scale short form (GDS-15) were used to collect data. Mean, Standard deviation, frequency, percentage, chi-square test, and Spearman rank correlation was used to analyze data. Results: Older people felt loneliness either at a moderate level (38.7%) or at a severe level (16.9%). While people with (49.2%) and without depression (50.80%) were in nearly equal proportion. Age,education level, marital status,living arrangement, childlessness, perceived health status, sleep quality, and sleeping hour, and perceived economic satisfaction showed statistically significant association with both dependent variables.While the presence of disease condition was associated with the level of loneliness, the level of depression showed significant statistical association with perceived stress. Further, loneliness and depression seemed to be positively correlated.Conclusions: Older peopleexperiencing loneliness and depression is quite noteworthyand emphasis should be given towards implementation of research approaches to unleash this aspect of older people.Keywords: Community; depression; loneliness; Nepal; older people.

INTRODUCTION

Objectives: Maximizing quality of life (QoL) is the ultimate goal of long-term dementia care. However, routine QoL measurement is rare in nursing home (NH) and assisted living (AL) facilities. Routine QoL measurement might lead to improvements in resident QoL. Our objective was to assess the feasibility of using DEMQOL-CH, completed by long-term care staff in video calls with researchers, to assess healthrelated quality of life (HrQoL) of NH and AL residents with dementia or other cognitive impairment. Design: Cross-sectional study. Setting and Participants: We included a convenience sample of 5 NHs and 5 AL facilities in the Canadian province of Alberta. Forty-two care staff who had worked in the facility for !3 months completed DEMQOL-CH assessments of 183 residents who had lived in the facility for 3 months or more and were aged !65 years. Sixteen residents were assessed independently by 2 care staff to assess inter-rater reliability. Methods: We assessed HrQoL in people with dementia or other cognitive impairment using DEMQOL-CH, and assessed time to complete, inter-rater reliability, internal consistency reliability, and care staff ratings of feasibility of completing the DEMQOL-CH. Results: Average time to complete DEMQOL-CH was <5 minutes. Staff characteristics were not associated with time to complete or DEMQOL-CH scores. Inter-rater reliability [0.735, 95% confidence interval (CI): 0.712-0.780] and internal consistency reliability (0.834, 95% CI: 0.779-0.864) were high. The DEMQOL-CH score varied across residents (mean ¼ 84.8, standard deviation ¼ 11.20, 95% CI: 83.2-86.4). Care aides and managers rated use of the DEMQOL-CH as highly feasible, acceptable, and valuable. Conclusions and Implications: This study provides a proof of concept that DEMQOL-CH can be used to assess HrQoL in NH and AL residents and provides initial indications of feasibility and resources required. DEMQOL-CH may be used to support actions to improve the QoL of residents.

INTRODUCTIONNon communicable diseases (NCDs) are one of the leading causes of mortality and morbidity worldwide afflicting more in developing countries. In 2012, of the total 56 million deaths worldwide, NCD accounted for more than 50% (i.e. 38 million deaths). Of these, more than 70% (28 million deaths) of NCD deaths occurred in low and middle income countries. 1It is interesting to note that, cardiovascular diseases (CVDs) alone lead to 46.2% of NCD deaths followed by cancer, respiratory diseases and diabetes.2 Among cardiovascular diseases, the number of people with hypertension in developed countries is expected to increase by 24% from 333 million to 413 million while in developing countries by 80% from 639 million to 1.15 billion between 2000 and 2025. 3 This data depicts that almost three-quarters of the hypertensive population worldwide will be in developing countries by the year 2025 with the increment of global prevalence of hypertension by 9% in men and 13% in women between 2000 and 2015. 3 In Nepal, the scenario of hypertension is not different from other developing countries. ABSTRACTBackground: Burgeoning burden of non-communicable diseases (especially hypertension) along with communicable diseases has made the situation more worrying in an economically constraint countries like Nepal. Studies are therefore necessary to assess the actual burden of disease; however nominal studies have focused this situation especially in semi urban areas of Nepal. This study was therefore conducted with the main aim of assessing the prevalence of hypertension in suburban area of central Nepal and to find the associated risk factors. Methods: A cross sectional study was conducted in a sub urban area of Changunarayan municipality of Nepal utilizing consecutive convenience sampling method. A total of 240 consenting participants aged ≥18 were enrolled in the study. Data was collected using questionnaire and measurements of blood pressure, waist/hip circumference, height and weight were taken. Chi square test was used to assess the strength of relationship between the categorical variables with p value taken significant at ≤0.05. Only values with significant association were used to obtain the Odds Ratios (OR) via binary logistic regression. Results: The prevalence of hypertension and pre-hypertension was found to be 20.4% and 35.4% respectively. Further, study illustrates the significant association (p≤0.05) of age, gender, family type, presence of co-morbidities, smoking, alcohol intake habits, habit of adding salt, BMI and waist/hip ratio with hypertension. Conclusions: Results of high prevalence of hypertension and its association with several factors indicates the necessity for timely detection, treatment and control of hypertension using various strategies.

Background The number of research publications reporting the use of the Promoting Action on Research Implementation in Health Services (PARIHS) framework and the integrated PARIHS (i-PARIHS) framework has grown steadily. We asked how the last decade of implementation research, predicated on the (i-)PARIHS framework (referring to the PARIHS or i-PARIHS framework), has contributed to our understanding of the conceptualizations of, relationships between, and dynamics among the core framework elements/sub-elements. Building on the Helfrich et al. (2010) review of research on the PARIHS framework, we undertook a critical interpretive synthesis to: (1) identify conceptual and relational advances in the (i-)PARIHS framework and (2) identify conceptual and relational aspects of the (i-)PARIHS framework that warrant further work. Methods We performed a systematic search in PubMed/PubMed Central, Ovid MEDLINE, CINAHL, JSTOR, SCOPUS, Web of Science, and PsycInfo. Articles were eligible for synthesis if they (a) were peer-reviewed articles, written in English, and published between January 2009 and December 2021, (b) applied the (i-)PARIHS framework explicitly to guide implementation research, and (c) made conceptual (expanding the conceptualization of core elements) and/or relational contributions (elaborating relationships among elements/sub-elements, or theorizing the relationships using empirical data). We used a critical interpretive synthesis approach to synthesize conceptual-relational advances of the (i-)PARIHS framework. Results Thirty-seven articles were eligible for synthesis. Twenty-four offered conceptual contributions, and 18 offered relational contributions (5 articles contributed in both ways). We found conceptual expansion of all core (i-)PARIHS elements, with most emphasis on context (particularly outer context and leadership), facilitation, and implementation success. Articles also gave insights into the complex relationships and relational dynamism among these elements, characterized as contingent, interactive, multilevel, and temporal effects. Conclusions We observed developmental advances of the (i-)PARIHS framework and proposed several directions to further advance the framework. Conceptualization of (i-)PARIHS elements (particularly evidence/innovation and recipients) need to be further developed by specifying conceptual and operational definitions of underlying sub-elements. Relationships among (i-)PARIHS elements/sub-elements need to be further elaborated through empirical studies that consider situational contingencies and causal complexities. This will require examining necessity and sufficiency of (i-)PARIHS elements/sub-elements in relation to implementation outcomes, interactions among elements, and mechanism-based explanations.