Working mother’s awareness and practice regarding feeding of expressed breast milk

Introductions: Expressed breast milk (EBM) is a healthy feeding option as compared to formula milk for working mothers. Awareness and practice towards EBM may be helpful towards its promotion. Methods: A cross sectional study was conducted at Patan Hospital, Patan Academy of Health Sciences, Nepal. Working mothers with breastfeeding child of less than 2 year were interviewed for and practice regarding EBM. A self-constructed open and close ended questionnaire in Nepali was used for data collection to analyze the association of mother’s age, types of family structure and number of children with EBM. Results: Out of 178 working mothers, 121 (67.9%) had awareness about EBM and 22 had practiced it. Mother’s age, types of family structure and number of children were not statistically significant with level awareness. There was positive correlation between awareness and practice of EBM. Conclusions: This study demonstrated 2/3rd of working mothers had awareness of EBM and 1/10th practiced EBM feeding, and there was positive correlation of awareness and practice.  Keywords: expressed breast milk (EBM), working mother

Nutritional Status of the Elderly Population Having Dental Problem in the Selected Community

Background: Good nutrition is the foundation for a healthy life. Malnutrition is associated with higher rates of morbidity and mortality as well as increased health care expenditures, and prolonged hospital stays. Elderly People are uniquely susceptible to malnutrition due to the association of aging with various factors that influence nutritional status. Objectives: The objectives of the study was to assess the nutritional status of the elderly population having dental problem in ward no. 29 Harisiddhi, Lalitpur, Nepal Methodology: A community based cross sectional descriptive study was undertaken at, ward no. 29 Harisiddhi, Lalitpur with one hundred fifty (N=150) elderly people by using systematic random sampling method. The MNA-SF (Mini-Nutritional Assessment – Short Form) tool was utilized for interviewing the elderly people. Results: The main findings of this study revealed that 60% of the elderly people having dental problem were at risk of malnutrition, only 22% had normal nutritional status and 18% of the respondents were malnourished. The average BMI of the elderly people was 27.1 kg/m2.There was significant association between age, educational Status, types of family, income source, type of dental problem and nutritional status of the respondents. Conclusions: More than half of the elderly people are at risk of malnutrition and only few have normal nutritional status so nutritional counselling and dental health program should be conducted among the elderly people focusing on the importance of balanced diet, activity and dental health for maintaining the nutritional status within their motivation and energy level. Keywords: Nutritional Status, Dental Problems, Elderly People

Hearing our Voices: Pathways from Oppression to Liberation through Community-Based Participatory Research

A number of qualitative-based participatory approaches have been used to analyse and address structural inequalities and intersectional gender oppression. This has been broadly evident in the academic environment and, particularly, in social work education and practice. However, more participatory aspects of social justice research, such as inviting and supporting disenfranchised and vulnerable populations to become more intimately involved in identifying their issues, together with developing remedial strategies and acting upon them, are still generally marginal, leaving both researchers and practitioners travelling on the uneven ground. In an attempt to level these troughs in social work education (and, by extension, practice), the paper will explore the transformative outcomes associated with participatory action research conducted as emancipatory and liberatory tools in research undertaken in collaboration with trafficking survivors in Nepal. The purpose of this paper is to explore the collective experiences of growing critical consciousness around social injustice and structural inequalities that contributed to survivors being “doubly victimisedâ€. Hence, in this paper, their resiliency in the face of that victimisation is not discussed. The goal of the paper is three-fold: (1) share the study process/approaches that supported an increase in the survivors’ critical thinking about their own oppression; (2) consider the impact of survivors’ solidarity in social and political action; and (3) examine the applicability of an emerging model of survivors’ liberatory practice. Overall, this paper will explore new and potentially liberatory ways to address the multiple and complex issues facing survivors upon return, and promote transformative praxis to support healthy individual and collective development

Attitude Towards Online Education During Covid-19 Pandemic Among Bachelor Level Students of Jumla

Background: Health science students, since long time, have been using digital technology mainly for the research purposes only. Due to global spread of corona virus disease (COVID-19), education system has changed and adopted online education which was a solution for the continuity of teaching and learning process during COVID-19 pandemic. The main objective of this study was to assess the attitude towards online education among bachelor level health science students. Methods: A descriptive cross-sectional study was carried out at Karnali Academy of Health Sciences, Jumla. Complete enumeration was done. Total 68 bachelor level students were taken for the study. A pretested self administered questionnaire was used for data collection. Data were entered and analyzed by using SPSS version 16. Frequency and percentage were also computed for demographics variables. Chi-square test was applied to assess the association between socio-demographic variables and attitude level. Results: The study illustrated that, among the 68 bachelor level students, nearly two third (63.2%) students had negative attitude towards online education during COVID-19 pandemic. There was statistically significant association of attitude level with ethnicity, type of program and strength of internet connection (p≤0.05). Conclusion: Majority of students of Karnali Academy had negative attitude towards online education; and they had faced many difficulties like internet and electricity problem etc. Administration and faculty members should take necessary measures for improving online education

Engagement of health workers and peer educators from the National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram during the COVID-19 pandemic : Findings from a situational analysis

BACKGROUND: To understand the impact of COVID-19 on implementation of the peer education programme of the National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK); repurposing of the RKSK health workers and Peer Educators (PEs) in COVID-19 response activities and effect on adolescents´ health and development issues. METHODS: Virtual in-depth interviews were conducted with stakeholders (n = 31) (aged 15 to 54 years) engaged in the implementation of the RKSK and peer education programme at state, district, block, and village levels in Madhya Pradesh and Maharashtra (India). These interviews were thematically coded and analysed to address the research objectives. RESULTS: Despite most peer education programme activities being stopped, delayed, or disrupted during the pandemic and subsequent lockdown, some communication networks previously established, helped facilitate public health communication regarding COVID-19 and RKSK, between health workers, PEs, and adolescents. There was repurposing of RKSK health workers and PEs’ role towards COVID-19 response-related activities. PEs, with support from health workers, were involved in disseminating COVID-19 information, maintaining migrant and quarantine records, conducting household surveys for recording COVID-19 active cases and providing essential items (grocery, sanitary napkins, etc.) to communities and adolescents. CONCLUSION: PEs with support from community health workers are able to play a crucial role in meeting the needs of the communities during a pandemic. There is a need to further engage, involve and build the skills of PEs to support the health system. PEs can be encouraged by granting more visibility and incorporating their role more formally by paying them within the public health system in India

Neddylation orchestrates the complex transcriptional and posttranscriptional program that drives Schwann cell myelination

Myelination is essential for neuronal function and health. In peripheral nerves, >100 causative mutations have been identified that cause Charcot-Marie-Tooth disease, a disorder that can affect myelin sheaths. Among these, a number of mutations are related to essential targets of the posttranslational modification neddylation, although how these lead to myelin defects is unclear. Here, we demonstrate that inhibiting neddylation leads to a notable absence of peripheral myelin and axonal loss both in developing and regenerating mouse nerves. Our data indicate that neddylation exerts a global influence on the complex transcriptional and posttranscriptional program by simultaneously regulating the expression and function of multiple essential myelination signals, including the master transcription factor EGR2 and the negative regulators c-Jun and Sox2, and inducing global secondary changes in downstream pathways, including the mTOR and YAP/TAZ signaling pathways. This places neddylation as a critical regulator of myelination and delineates the potential pathogenic mechanisms involved in CMT mutations related to neddylation

Neddylation orchestrates the complex transcriptional and posttranscriptional program that drives Schwann cell myelination

Myelination is essential for neuronal function and health. In peripheral nerves, >100 causative mutations have been identified that cause Charcot-Marie-Tooth disease, a disorder that can affect myelin sheaths. Among these, a number of mutations are related to essential targets of the posttranslational modification neddylation, although how these lead to myelin defects is unclear. Here, we demonstrate that inhibiting neddylation leads to a notable absence of peripheral myelin and axonal loss both in developing and regenerating mouse nerves. Our data indicate that neddylation exerts a global influence on the complex transcriptional and posttranscriptional program by simultaneously regulating the expression and function of multiple essential myelination signals, including the master transcription factor EGR2 and the negative regulators c-Jun and Sox2, and inducing global secondary changes in downstream pathways, including the mTOR and YAP/TAZ signaling pathways. This places neddylation as a critical regulator of myelination and delineates the potential pathogenic mechanisms involved in CMT mutations related to neddylation

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation