The nutrition-microcredit synergy: A case for multiple interventions and strategies

Poor diet quality is the primary determinant of the high prevalence rates of malnutrition in Ghana. In this West African country, young children’s diets primarily consist of cereals and roots which have both low energy and nutrient density and poor bioavailability of micronutrients. A 2008 national survey reported that over one-third of children consumed no nutrient-rich Animal Source Foods (ASF) on the previous day. An intervention to enhance children’s diet and nutritional status was developed based on the assumption that improving knowledge, attitudes, and beliefs of caregivers would lead to increased use of ASF for young children only if ASF availability (presence in the communities) and accessibility (families’ ability to obtain ASF through purchase, trade, hunting, or raising animals at home) were also improved. The Enhancing Child Nutrition through Animal Source Food Management (ENAM) project introduced an integrated approach of microcredit and weekly sessions of nutrition education and entrepreneurship training among rural women to increase the use of ASF in the diets of their 2- to 5-year-old children. Although the project may have not reached the poorest women in the community, the integrated activities benefited many households in diverse ways – directly through increased income and improved productivity that improved purchasing power and made foods available in the home, as well as indirectly through the empowerment of women participants. Women reported increased self-confidence, leadership skills, and social capital. Children’s diets benefited the most when caregivers were engaged in enterprises related to ASF because they facilitated sharing ASF with children and the high profits from these activities increased mothers’ ability to purchase other ASF from the market. Other family members also benefited from the project through women sharing loans for joint economic activities, improving the quality of the diet for the whole family, and sharing new knowledge. Integration of rural bank partners from an early stage of the project helped transfer activities to these permanent institutions to expand and sustain project activities. The ENAM project provided the evidence that an integrated package of microcredit and education can improve household food security and improve the diet and growth of young children living in rural communities

Agricultural informational flow in informal communication networks of farmers in Ghana

Despite the rapid growth in the use of modern communication media to improve  access to agricultural information, local information networks remain an important means of communication among rural folk. This study examined informal  communication networks of rural farmers in the Ahafo Ano south district of Ghana to determine how they can be harnessed to improve the provision of agricultural information. The objectives were two-fold, to: (i) identify local information networks and characteristics of the key communicators and (ii) determine how the structural properties of the networks affect the flow of agricultural information. Snowball sampling was used to select respondents from three purposively-selected communities in the district. Sociograms were used to reveal the ties between network actors. Key communicators of agricultural information were found to be significantly older and had higher farm output than the rest of the population and tended to occupy leadership positions in their community. Thus, extension service providers should target such key communicators when introducing new information and technology as they can serve as essential channels of information to other farmers in the community. It was also observed that network density values were generally low indicating that the networks are open to diverse sources of  information. Low degree centrality measures indicated frequent sharing of  information among several central actors rather than through one central person.Agricultural extension service providers should identify such farmers who can serve as intermediaries between actors to help disseminate information in rural communities.Keywords: key communicators, farmers, rural communities, social networks,  extension agent

Understanding why child welfare clinic attendance and growth of children in the nutrition surveillance programme is below target: lessons learnt from a mixed methods study in Ghana

Background: Growth monitoring and promotion (GMP) programmes promote not only child health but serve as a service delivery strategy to enhance coverage for other crucial nutrition-specific interventions. This study compared community-based and facility-based GMP programme with respect to attendance rates, children’s nutritional status, caregivers’ satisfaction with services received and perceptions of service providers and users on factors influencing utilization. Methods: Explanatory sequential mixed methods study conducted in Ga West municipality, Ghana. It comprised 12-month secondary data analysis using growth monitoring registers of 220 infants aged 0–3 months enrolled in two community-based (CB = 104) and two facility-based (FB = 116) child welfare clinics; cross-sectional survey (exit interview) of 232 caregiver-child pairs accessing CB (n = 104) and FB services (n = 116); and in-depth interviews with 10 health workers and 15 mothers. Quantitative data were analyzed through Fisher’s exact, unpaired t-tests, and logistic regression at 95% confidence interval (CI) using SPSS version 20. Qualitative data were analyzed by thematic content analysis using ATLAS.ti 7.0. Results: Mean annual attendance to both programmes was similar with an average of six visits per year. Only 13.6% of caregiver-child pairs attained more than nine visits in the 12-months period. At least 60% of children in both programs had improved weight-for-age z-scores (WAZ) scores during participation. Predictors for improved WAZ were being underweight at baseline (AOR:11.1, 95%CI:4.0–31.0), annual attendance of at least six visits (AOR:2.2, 95%CI:1.1–4.1) and meeting the Ghana Health Service target of nine visits (AOR:4.65, 95%CI:1.4–15.1). Compared to 31.5% CB users, significant proportion of FB caregivers (57.4%) were visited at home. Half were dissatisfied with services received (CB:55.6% vs. FB:62.0%, p = 0.437) citing long waiting times, negative staff attitude and extortions of money. Regarding perceptions on factors hindering service utilization, emerged themes included extremes of maternal age, high parity, postpartum socio-cultural beliefs and practices, financial commitments, undue delays, unprofessional staff behaviours, high premium on vaccination and general misconceptions about the programme. Conclusion: The association of increased attendance with improved growth reaffirms the need to strengthen primary healthcare systems to improve service delivery; sensitize caregivers on contribution of growth monitoring and promotion to early child development; and increase contacts through home visits

Primary Culture of Adult Rat Heart Myocytes

Cultured primary adult rodent heart cells are an important model system for cardiovascular research. Nevertheless, establishment of robust, viable cultured adult myocytes can be a technically challenging, rate-limiting step for many researchers. Here we described a protocol to obtain a high yield of adult rat heart myocytes that remain viable in culture for several days. The heart is isolated and perfused with collagenase and protease under low Ca2+ conditions to recover single myocytes. Ca2+-tolerant cells are obtained by stepwise increases in extracellular Ca2+ concentration in three subsequent wash steps. Cells are filtered, resuspended in culture medium, and plated on laminin coated slips. Cultured myocytes obtained using this protocol are viable for up to four days and are suitable for most experiments including electrophysiology, biochemistry, imaging and molecular biology

Distinct RGK GTPases Differentially Use α1- and Auxiliary β-Binding-Dependent Mechanisms to Inhibit CaV1.2/CaV2.2 Channels

CaV1/CaV2 channels, comprised of pore-forming α1 and auxiliary (β,α2δ) subunits, control diverse biological responses in excitable cells. Molecules blocking CaV1/CaV2 channel currents (ICa) profoundly regulate physiology and have many therapeutic applications. Rad/Rem/Rem2/Gem GTPases (RGKs) strongly inhibit CaV1/CaV2 channels. Understanding how RGKs block ICa is critical for insights into their physiological function, and may provide design principles for developing novel CaV1/CaV2 channel inhibitors. The RGK binding sites within CaV1/CaV2 channel complexes responsible for ICa inhibition are ambiguous, and it is unclear whether there are mechanistic differences among distinct RGKs. All RGKs bind β subunits, but it is unknown if and how this interaction contributes to ICa inhibition. We investigated the role of RGK/β interaction in Rem inhibition of recombinant CaV1.2 channels, using a mutated β (β2aTM) selectively lacking RGK binding. Rem blocked β2aTM-reconstituted channels (74% inhibition) less potently than channels containing wild-type β2a (96% inhibition), suggesting the prevalence of both β-binding-dependent and independent modes of inhibition. Two mechanistic signatures of Rem inhibition of CaV1.2 channels (decreased channel surface density and open probability), but not a third (reduced maximal gating charge), depended on Rem binding to β. We identified a novel Rem binding site in CaV1.2 α1C N-terminus that mediated β-binding-independent inhibition. The CaV2.2 α1B subunit lacks the Rem binding site in the N-terminus and displays a solely β-binding-dependent form of channel inhibition. Finally, we discovered an unexpected functional dichotomy amongst distinct RGKs— while Rem and Rad use both β-binding-dependent and independent mechanisms, Gem and Rem2 use only a β-binding-dependent method to inhibit CaV1.2 channels. The results provide new mechanistic perspectives, and reveal unexpected variations in determinants, underlying inhibition of CaV1.2/CaV2.2 channels by distinct RGK GTPases

Nutritional status of alcoholics in Peri-urban areas of the greater Accra region of Ghana

Alcoholism is a common problem in developing countries. Epidemiological studies on the relationship among excessive alcohol consumption,  malnutrition and anaemia are inconclusive. The present study examined the association between alcohol intake and nutritional status of alcoholics in the Greater Accra Region of Ghana. The study was cross-sectional involving 107 participants (men and women) aged between 20 and 76 years. Participants were identified as alcoholics after screening with a combined, but modified CAGE and AUDIT questionnaires. Anthropometric data including weight, biceps skinfold thickness, triceps skinfold thickness, hip circumference and waist circumference were collected. Body mass index (BMI) and Waist-to-hip ratio were computed using appropriate measures. Haemoglobin levels of participants were also assessed. Dietary intakes of respondents were estimated by 24-hour recall which was further converted into nutrients and energy using ESHA food processor. A pretested  questionnaire was also used to obtain data on socio-demographic and lifestyle characteristics of participants. Differences between participants based on level of alcohol intake and correlations among variables were tested for statistical significance using ANOVA and correlation analyses, respectively. Logistic regression was performed to examine the relationship between levels of total ethanol intake and overweight and obesity factors while controlling for age, smoking status, physical activity and total energy intake. There was an inverse correlation between triceps skinfold and level of alcohol consumption irrespective of predominant type of alcoholic  beverage consumed (r= -0.213, P= 0.028). Further, there was a positive correlation between alcohol consumption and hip circumference among predominant beer consumers (r= 0.585, P= 0.046). A strong positive correlation was observed between alcohol intake and haemoglobin concentration for women (r= 0.729, P= 0.040) but not among men (r= -0.053, P= 0.722). Predominant beer consumers tend to have higher weight and BMI. Moderate level of total ethanol intake was associated with greater odds of being overweight/obese, whereas high levels of intake was associated with lower odds of being overweight/obesity although these were not statistically significant. The mechanisms for the observation of higher weight, BMI and hip circumference among predominant beer consumers in this population need further exploration.Key words: Alcoholics, alcoholic beverages, nutritional statu

Rapid review of research on dietary attitudes, beliefs and practices in Ghana 1990-2020

Food-related beliefs and attitudes influence dietary behaviors and are important drivers of nutrition outcomes. Understanding beliefs and attitudes that drive dietary behaviors, as part of the process for developing Food-based Dietary Guidelines is critical for targeting messages to motivate healthy dietary diets. This rapid review was undertaken to summarize readily available local evidence on food-related beliefs, attitudes, and associated practices in Ghana. A rapid review of 39 peer-reviewed publications and graduate-level theses on the dietary behaviors of Ghanaians was conducted between November and December 2020. The study only included articles published between 1990 and 2020 involving apparently healthy populations living in Ghana. Documents were identified through a systematic literature search of Google Scholar and PubMed. Data on food-related knowledge, beliefs, attitudes, and practices were extracted into an excel template and analyzed using thematic content analysis. The sampled research included primarily cross-sectional studies of urban, rural, peri-urban and mixed localities throughout Ghana: one was a prospective research. A range of food-related taboos were identified and classified as taboos for the general population, pregnancyrelated, or child-related. Although awareness of food-related taboos was common, they were not extensively practiced. Energy-giving and nutrient-dense foods are commonly promoted during pregnancy. Culturally prescribed pre-lacteal feeds and other infant and young child feeding (IYCF) behaviors reported in the studies were not aligned with IYCF recommendations. A 3-meals-a-day pattern was observed, commonly, across all age groups; most adult meals, particularly supper, was prepared at home. However, ready-to-eat meals were regularly purchased by adults and adolescents. Adolescents frequently reported snacking and skipping meals; breakfast was the most frequently skipped meal. Fruits and vegetables were the least consumed food groups across all age groups. Muslim faith was associated with consuming more diverse diets and greater fruit and vegetable consumption. The findings of this review provide an overview of food-related beliefs and practices of Ghanaians and can inform decisions on areas to emphasize in food-based dietary guidelines and associated nutrition education messages to promote healthy diets in the Ghanaian population. Effective nutrition education is needed to dispel harmful food beliefs and practices and promote healthy food choices across the life cycle. Dietary patterns in Ghana are linked with cultural and religious practices that are often unique to particular subgroups, although there are common strands of beliefs across ethnic groups. These beliefs can result in either adverse or beneficial outcomes, depending on what eating patterns it determines.&nbsp

Rapid review of research on dietary attitudes, beliefs and practices in Ghana 1990-2020

Food-related beliefs and attitudes influence dietary behaviors and are important drivers of nutrition outcomes. Understanding beliefs and attitudes  that drive dietary behaviors, as part of the process for developing Food-based Dietary Guidelines is critical for targeting messages to motivate  healthy dietary diets. This rapid review was undertaken to summarize readily available local evidence on food-related beliefs, attitudes, and  associated practices in Ghana. A rapid review of 39 peer-reviewed publications and graduate-level theses on the dietary behaviors of Ghanaians was  conducted between November and December 2020. The study only included articles published between 1990 and 2020 involving apparently healthy  populations living in Ghana. Documents were identified through a systematic literature search of Google Scholar and PubMed. Data on  food-related knowledge, beliefs, attitudes, and practices were extracted into an excel template and analyzed using thematic content analysis. The  sampled research included primarily cross-sectional studies of urban, rural, peri-urban and mixed localities throughout Ghana: one was a  prospective research. A range of food-related taboos were identified and classified as taboos for the general population, pregnancyrelated, or child-  related. Although awareness of food-related taboos was common, they were not extensively practiced. Energy-giving and nutrient-dense foods are  commonly promoted during pregnancy. Culturally prescribed pre-lacteal feeds and other infant and young child feeding (IYCF) behaviors reported  in the studies were not aligned with IYCF recommendations. A 3-meals-a-day pattern was observed, commonly, across all age groups; most adult  meals, particularly supper, was prepared at home. However, ready-to-eat meals were regularly purchased by adults and adolescents. Adolescents  frequently reported snacking and skipping meals; breakfast was the most frequently skipped meal. Fruits and vegetables were the least consumed  food groups across all age groups. Muslim faith was associated with consuming more diverse diets and greater fruit and vegetable consumption.  The findings of this review provide an overview of food-related beliefs and practices of Ghanaians and can inform decisions on areas to emphasize  in food-based dietary guidelines and associated nutrition education messages to promote healthy diets in the Ghanaian population. Effective  nutrition education is needed to dispel harmful food beliefs and practices and promote healthy food choices across the life cycle. Dietary patterns in  Ghana are linked with cultural and religious practices that are often unique to particular subgroups, although there are common strands of  beliefs across ethnic groups. These beliefs can result in either adverse or beneficial outcomes, depending on what eating patterns it determines.&nbsp

Sculpting ion channel functional expression with engineered ubiquitin ligases

The functional repertoire of surface ion channels is sustained by dynamic processes of trafficking, sorting, and degradation. Dysregulation of these processes underlies diverse ion channelopathies including cardiac arrhythmias and cystic fibrosis. Ubiquitination powerfully regulates multiple steps in the channel lifecycle, yet basic mechanistic understanding is confounded by promiscuity among E3 ligase/substrate interactions and ubiquitin code complexity. Here we targeted the catalytic domain of E3 ligase, CHIP, to YFP-tagged KCNQ1 ± KCNE1 subunits with a GFP-nanobody to selectively manipulate this channel complex in heterologous cells and adult rat cardiomyocytes. Engineered CHIP enhanced KCNQ1 ubiquitination, eliminated KCNQ1 surface-density, and abolished reconstituted K+ currents without affecting protein expression. A chemo-genetic variation enabling chemical control of ubiquitination revealed KCNQ1 surface-density declined with a ~ 3.5 hr t1/2 by impaired forward trafficking. The results illustrate utility of engineered E3 ligases to elucidate mechanisms underlying ubiquitin regulation of membrane proteins, and to achieve effective post-translational functional knockdown of ion channels