Water carrying in hills of Nepal-associations with women's musculoskeletal disorders, uterine prolapse, and spontaneous abortions.

More than a third of women in Nepal have to carry water from source to home to satisfy their families' daily needs. A cross-sectional study was carried out in a hilly area in Nepal to assess water-carrying practices and their association with women's health. Quantitative interviews were conducted with 1001 women of reproductive age and were complemented with health surveys carried out by health professionals and structured observations of water carrying. Multivariate mixed logistic regression models were used to assess the associations between water-carrying-related risk factors and health issues for women. Around 46% of women faced considerably increased to excessive physical stress due to water carrying during the dry season. Women suffered from a disproportionately high prevalence of back pain (61%), with about 18% of this pain being horrible to excruciating; pain in the knees (34%); uterine prolapse (11.3%); and at least one spontaneous abortion (9%). The risk category of water carrying was significantly associated with uterine prolapse (OR = 1.44, 95%CI = 1.12-1.85, p = 0.031) and pain in the hips (OR = 1.69, 95%CI = 1.27-2.26, p<0.001). Receiving help with water carrying during pregnancy and during the first three months after delivery was associated with reduced odds ratios for uterine prolapse (OR = 0.10, 95% CI = 0.01-0.87, p = 0.037), and strong back pain (OR = 0.32, 95% CI = 0.12-0.87, p = 0.026). Improvements to water supply infrastructure and the promotion of social support for carrying water during pregnancy and after delivery are recommended to reduce water-carrying-related health risks

Understanding safe water‐carrying practices during pregnancy and postpartum: A mixed‐methods study in Nepal

Daily carrying of heavy loads of domestic water, especially during pregnancy and postpartum, bears a threat to maternal health in low-income countries. Using an extended health action process approach (HAPA), we examined women's reasons for and psychosocial determinants of safe water-carrying during pregnancy and postpartum. In a mixed-methods study, trained local interviewers conducted 1001 quantitative interviews with women of reproductive age (n = 921 analyzed) and 21 qualitative interviews with women of reproductive age, in-laws, and spouses in rural Nepal. We analyzed the quantitative data with generalized estimating equations to model the HAPA-based psychosocial determinants of avoiding water-carrying during pregnancy and postpartum. Subjective perspectives were investigated with thematic analysis. Outcome expectancies (B = 0.24), self-efficacy (B = 0.20), and injunctive norms (B = 0.23) were significantly associated with the intention to avoid water-carrying. Self-efficacy (B = 0.36) and instrumental support (B = 0.05) are related to behavior (all p < 0.05). Women explained water-carrying during pregnancy by a lack of family support, a shift of health decision-making power to in-laws, and low behavioral control. Overall, the necessity of water, family decision-making structures, and low support make it difficult for women to discontinue water-carrying. Additionally to infrastructural improvements, behavioral interventions may increase women's self-efficacy for safe water-carrying (e.g. reducing weight) and social support

Interrelatedness of women's health-behaviour cognitions: A dyadic study of female family members on carrying heavy loads during pregnancy in Nepal.

OBJECTIVES Decisions about reproductive health are often influenced by women's female family members, particularly in low-resource contexts. However, previous research has focused primarily on individual behavioural determinants. We investigated the interrelatedness of female family members' reproductive health behaviour with a dyadic version of an extended health action process approach. We investigated this for carrying heavy loads during pregnancy and postpartum, a risk factor for reproductive health in many low-income countries such as Nepal. DESIGN This cross-sectional study included dyads of daughters-in-law and mothers-in-law in rural Nepal (N = 476, nested in 238 dyads). METHODS Dyads of daughters- and mothers-in-law were surveyed about avoiding carrying heavy loads during pregnancy and postpartum. The effects of a woman's cognitions and her female dyadic partner's cognitions on their intention and behaviour about avoiding carrying loads were estimated using linear mixed models. RESULTS The results showed that a mother-in-law's cognitions were related to her daughter-in-law's intentions and vice versa. The mother-in-law's cognitions were also related to the daughter-in-law's behaviour. The mother-in-law's self-efficacy and injunctive norms related to the daughter-in-law's intention and behaviour over and above the daughter-in-law's own self-efficacy and injunctive norms. CONCLUSION Female Nepali family members' cognitions about carrying heavy loads during pregnancy and postpartum are interrelated. Including female family members in interventions to help women manage their reproductive health in low-resource populations seems promising. These novel findings add to the growing body of research indicating the importance of including a dyadic perspective when understanding and changing health behaviour

The Physical Burden of Water Carrying and Women’s Psychosocial Well-Being: Evidence from Rural Nepal

Many women in low-income countries carry heavy loads of drinking water for their families in difficult terrain. This can adversely affect their health and well-being. The present study is the first to investigate the physical burden of water carrying and women’s psychosocial well-being, and how this relationship is moderated by environmental and health conditions. Trained local interviewers conducted interviews with 1001 women across five rural communities in Nepal. In addition, objective measurement was used to assess the weight carried and distance from the water source. The physical burden of water carrying was calculated from weight, distance, and frequency of trips. Its association with psychosocial well-being was modeled using generalized estimating equations. Two additional models included the terrain and uterine prolapse as moderators. The physical burden of water carrying is directly related to higher emotional distress and reduced daily functioning. This correlation was exacerbated for women carrying in hilly versus flat terrain, and for those who had uterine prolapse. Our results underline the importance of adequate water access for women’s psychosocial well-being, especially for vulnerable populations such as women with impaired health (e.g., uterine prolapse) or those living in hilly terrain. The results further highlight the interconnectedness of the Sustainable Development Goal (SDG) 6: water access, SDG 3: health and well-being, and SDG 5: gender equality

Environmental features around roost sites drive species-specific roost preferences for boreal bats

Bats and their reproductive roost sites are strictly protected by legislation in Europe. Although knowledge on foraging habitats of boreal bats has increased vastly over the last decades, little is known on how habitat surrounding the roosts influences the selection of roost sites. We combined citizen science and molecular methods to determine the most critical environmental features within different radiuses around roost sites of bats inhabiting human settlements at the northernmost edge of their distribution range in Finland. We compared six different land-use types around the roost sites to randomly selected points for each species to determine at which radiuses around the roost are land-use types most critical. We found that for the northern bat (Eptesicus nilssonii), built environment, open areas, and water within the 200 m radius were the most important in roost site selection. The Brandt’s myotis (Myotis brandtii) favored roost sites in landscape not affected by human disturbance within 5 km radius. Based on our results, the surrounding habitat around a roost plays a vital role for bat species, and it should be protected along with the roost and considered in land-use planning. Furthermore, species-specific variation in roost site selection should be considered in conservation planning.Bats and their reproductive roost sites are strictly protected by legislation in Europe. Although knowledge on foraging habitats of boreal bats has increased vastly over the last decades, little is known on how habitat surrounding the roosts influences the selection of roost sites. We combined citizen science and molecular methods to determine the most critical environmental features within different radiuses around roost sites of bats inhabiting human settlements at the northernmost edge of their distribution range in Finland. We compared six different land-use types around the roost sites to randomly selected points for each species to determine at which radiuses around the roost are land-use types most critical. We found that for the northern bat (Eptesicus nilssonii), built environment, open areas, and water within the 200 m radius were the most important in roost site selection. The Brandt’s myotis (Myotis brandtii) favored roost sites in landscape not affected by human disturbance within 5 km radius. Based on our results, the surrounding habitat around a roost plays a vital role for bat species, and it should be protected along with the roost and considered in land-use planning. Furthermore, species-specific variation in roost site selection should be considered in conservation planning.Peer reviewe

Defective metabolic programming impairs early neuronal morphogenesis in neural cultures and an organoid model of Leigh syndrome

Leigh syndrome (LS) is a severe manifestation of mitochondrial disease in children and is currently incurable. The lack of effective models hampers our understanding of the mechanisms underlying the neuronal pathology of LS. Using patient-derived induced pluripotent stem cells and CRISPR/Cas9 engineering, we developed a human model of LS caused by mutations in the complex IV assembly gene SURF1. Single-cell RNA-sequencing and multi-omics analysis revealed compromised neuronal morphogenesis in mutant neural cultures and brain organoids. The defects emerged at the level of neural progenitor cells (NPCs), which retained a glycolytic proliferative state that failed to instruct neuronal morphogenesis. LS NPCs carrying mutations in the complex I gene NDUFS4 recapitulated morphogenesis defects. SURF1 gene augmentation and PGC1A induction via bezafibrate treatment supported the metabolic programming of LSNPCs, leading to restored neuronal morphogenesis. Our findings provide mechanistic insights and suggest potential interventional strategies for a rare mitochondrial disease