22 research outputs found
Knowledge, attitude and practice on diet and physical activity among mothers with young children in the Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal
Source at https://doi.org/10.1371/journal.pone.0200329. The prevalence of cardiovascular diseases is increasing in low and middle-income countries; Nepalâs population shows a high prevalence of behavioral risk factors. Our cross-sectional study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS), located near the capital Kathmandu, explored knowledge, attitude, and practice (KAP) of mothers with young children regarding diet and physical activity and mothersâ perception of their childrenâs attitude and behavior toward the same issues. The purpose of our study was to assess needs of the mothers concerning cardiovascular health in general and more specifically regarding diet and physical activity, and to establish a baseline for future intervention in the community by comparing two villages of JD-HDSS. In AugustâNovember 2014, nine trained enumerators interviewed all mothers of children aged 1â7 years (N = 962). We scored responses on dietary and physical activity KAP, then categorized the scores based on the percentage obtained out of the maximum possible scores into âpoor,â âfair,â and âgood.â More highly educated mothers scored higher for KAP (all pp = 0.007). Most respondents were unfamiliar with the concept of healthy and unhealthy food. Overall, 57% of respondents in JD-HDSS had âgoodâ knowledge, 44.6% had âgoodâ attitude, and most (90%) had âpoorâ practice. We observed no significant differences between the villages regarding mothersâ knowledge and attitude or childrenâs behavior. Practice score of mothers in Jhaukhel was higher than those in Duwakot regarding diet and physical activity (p<0.001). Mothersâ perceived barriers for improving lifestyle were high cost of healthy food, taste preference of other family members, and lack of knowledge regarding healthy food. Barriers for physical activity were lack of leisure time, absence of parks and playgrounds, busy caring for children and old people, feeling lazy, and embarrassed to be physically active in front of others. Our findings suggest that a health education intervention promoting a healthy lifestyle for mothers and children might improve KAP and also improve cardiovascular health. To address mothersâ gap between knowledge and practice, a future intervention should consider perceived barriers
Diet and physical activity for childrenâs health: a qualitative study of Nepalese mothersâ perceptions
Published version, also available at http://dx.doi.org/10.1136/bmjopen-2015-008197Objectives: Non-communicable diseases account
for 50% of all deaths in Nepal and 25% result
from cardiovascular diseases. Previous studies in
Nepal indicate a high burden of behavioural
cardiovascular risk factors, suggesting a low level
of knowledge, attitude and practice/behaviour
regarding cardiovascular health. The behavioural
foundation for a healthy lifestyle begins in early
childhood, when mothers play a key role in their
childrenâs lives. This qualitative study, conducted in a
Nepalese peri-urban community, aimed to explore
mothersâ perception of their childrenâs diet and
physical activity.
Design: We notated, tape-recorded and transcribed all
data collected from six focus group discussions, and
used qualitative content analysis for evaluation and
interpretation.
Setting: The study was conducted in the Jhaukhel-
Duwakot Health Demographic Surveillance Site in the
Bhaktapur district of Nepal.
Participants: Local health workers helped recruit 61
women with children aged 5â10 years. We distributed
participants among six different groups according to
educational status.
Results: Although participants understood the
importance of healthy food, they misunderstood its
composition, perceiving it as unappetising and
appropriate only for sick people. Furthermore,
participants did not prioritise their childrenâs
physical activities. Moreover, mothers believed they
had limited control over their childrenâs dietary
habits and physical activity. Finally, they opined that
health educational programmes would help
mothers and recommended various intervention
strategies to increase knowledge regarding a healthy
lifestyle.
Conclusions: Our data reveal that mothers of young
children in a peri-urban community of Nepal lack
adequate and accurate understanding about the impact
of a healthy diet and physical activity. Therefore, to
prevent future cardiovascular disease and other noncommunicable
diseases among children, Nepal needs
health education programmes to improve mothersâ
cardiovascular health knowledge, attitude and
behaviour
Knowledge, attitude and practice on diet and physical activity among mothers with young children in the Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal
The prevalence of cardiovascular diseases is increasing in low and middle-income countries; Nepal's population shows a high prevalence of behavioral risk factors. Our cross-sectional study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS), located near the capital Kathmandu, explored knowledge, attitude, and practice (KAP) of mothers with young children regarding diet and physical activity and mothers' perception of their children's attitude and behavior toward the same issues. The purpose of our study was to assess needs of the mothers concerning cardiovascular health in general and more specifically regarding diet and physical activity, and to establish a baseline for future intervention in the community by comparing two villages of JD-HDSS. In August-November 2014, nine trained enumerators interviewed all mothers of children aged 1-7 years (N = 962). We scored responses on dietary and physical activity KAP, then categorized the scores based on the percentage obtained out of the maximum possible scores into "poor," "fair," and "good." More highly educated mothers scored higher for KAP (all p<0.001); the children's behavior score reflected their mother's education level (p = 0.007). Most respondents were unfamiliar with the concept of healthy and unhealthy food. Overall, 57% of respondents in JD-HDSS had "good" knowledge, 44.6% had "good" attitude, and most (90%) had "poor" practice. We observed no significant differences between the villages regarding mothers' knowledge and attitude or children's behavior. Practice score of mothers in Jhaukhel was higher than those in Duwakot regarding diet and physical activity (p<0.001). Mothers' perceived barriers for improving lifestyle were high cost of healthy food, taste preference of other family members, and lack of knowledge regarding healthy food. Barriers for physical activity were lack of leisure time, absence of parks and playgrounds, busy caring for children and old people, feeling lazy, and embarrassed to be physically active in front of others. Our findings suggest that a health education intervention promoting a healthy lifestyle for mothers and children might improve KAP and also improve cardiovascular health. To address mothers' gap between knowledge and practice, a future intervention should consider perceived barriers
A Systematic Review of Glucose Transport Alterations in Alzheimer's Disease
From Frontiers via Jisc Publications RouterHistory: collection 2021, received 2021-01-12, accepted 2021-04-22, epub 2021-05-20Publication status: PublishedIntroduction: Alzheimer's disease (AD) is characterized by cerebral glucose hypometabolism. Hypometabolism may be partly due to reduced glucose transport at the blood-brain barrier (BBB) and across astrocytic and neuronal cell membranes. Glucose transporters (GLUTs) are integral membrane proteins responsible for moving glucose from the bloodstream to parenchymal cells where it is metabolized, and evidence indicates vascular and non-vascular GLUTs are altered in AD brains, a process which could starve the brain of glucose and accelerate cognitive decline. Here we review the literature on glucose transport alterations in AD from human and rodent studies. Methods: Literature published between 1st January 1946 and 1st November 2020 within EMBASE and MEDLINE databases was searched for the terms âglucose transportersâ AND âAlzheimer's diseaseâ. Human and rodent studies were included while reviews, letters, and in-vitro studies were excluded. Results: Forty-three studies fitting the inclusion criteria were identified, covering human (23 studies) and rodent (20 studies). Post-mortem studies showed consistent reductions in GLUT1 and GLUT3 in the hippocampus and cortex of AD brains, areas of the brain closely associated with AD pathology. Tracer studies in rodent models of AD and human AD also exhibit reduced uptake of glucose and glucose-analogs into the brain, supporting these findings. Longitudinal rodent studies clearly indicate that changes in GLUT1 and GLUT3 only occur after amyloid-ÎČ pathology is present, and several studies indicate amyloid-ÎČ itself may be responsible for GLUT changes. Furthermore, evidence from human and rodent studies suggest GLUT depletion has severe effects on brain function. A small number of studies show GLUT2 and GLUT12 are increased in AD. Anti-diabetic medications improved glucose transport capacity in AD subjects. Conclusions: GLUT1 and GLUT3 are reduced in hippocampal and cortical regions in patients and rodent models of AD, and may be caused by high levels of amyloid-ÎČ in these regions. GLUT3 reductions appear to precede the onset of clinical symptoms. GLUT2 and GLUT12 appear to increase and may have a compensatory role. Repurposing anti-diabetic drugs to modify glucose transport shows promising results in human studies of AD
Psychological impact of COVID-19 on healthcare workers: cross-sectional analyses from 14 countries
Abstract
Background
Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs.
Methods
A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively.
Results
A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%).
Conclusion
COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered
Effectiveness of health promotion regarding diet and physical activity among Nepalese mothers and their young children: The Heart-health Associated Research, Dissemination, and Intervention in the Community (HARDIC) trial
Background: Nepal, like many low- and middle-income countries, exhibits rising burden of cardiovascular diseases. Misconceptions, poor behavior, and a high prevalence of risk factors contribute to this development. Health promotion efforts along with primary prevention strategies, including risk factor reduction in both adults and children, are therefore critical.
Objectives: This study assessed the effectiveness of a health promotion intervention on mothersâ knowledge, attitude and practice (KAP) and their childrenâs behavior regarding diet and physical activity.
Methods: The Heart-health Associated Research, Dissemination and Intervention in the Community (HARDIC), a community-based trial, used peer education to target mothers with 1â9-year-old children in the peri-urban JhaukhelâDuwakot Health Demographic Surveillance Site, Nepal, during AugustâNovember 2016. In the intervention area, 47 peer mothers were trained to conduct four education classes for about 10 fellow mothers (N = 391). After 3 months, all eligible mothers in the intervention and control areas were interviewed and the results were compared with the KAP of all eligible mothers at baseline.
Results: Post-intervention, mothersâ KAP median scores had improved regarding heart-healthy diet and physical activity. More mothers had âgoodâ KAP (>75% of maximum possible scores), and mothers with âgoodâ knowledge increased from 50% to 81%. Corresponding control values increased only from 58% to 63%. Mothersâ attitude and practice improved. Additionally, mothers in the intervention area reported improvement in their childrenâs diet and physical activity behavior. Moreover, Difference in Differences analysis showed that the HARDIC intervention significantly increased mothersâ KAP scores and childrenâs behavior scores in the intervention area compared to the control area.
Conclusions: Our intervention improves KAP scores regarding diet and physical activity and shows potential for expansion via community health workers, volunteers, and/or local women. Moreover, HARDIC can contribute to Nepalâs Package of Essential Noncommunicable Diseases Initiative, which currently lacks a specific package for health promotion
Preference of Food-items and Physical Activity of Peri-urban Children in Bhaktapur
BACKGROUND: Though cardiovascular diseases are mostly seen in adulthood, the foundation of diet and physical activity is largely formed during childhood. The study aimed to explore children's preference for diet and physical activity in a peri-urban area of Nepal because this is an important dimension to explore in the life-course approach to combat non-communicable diseases. METHODS: We conducted a cross-sectional study to enquire young peri-urban children of Duwakot and Jhaukhel villages of Bhaktapur district, Nepal on their preferences for diet and physical activity. All eligible households with children in the age range 5-10 years as enlisted from the Jhaukhel-Duwakot Health Demographic Surveillance Site database were selected for the study. Twelve enumerators visited the selected households and facilitated the eligible children to fill in the questionnaire. We used a child-friendly photo-assisted questionnaire with face-scales that easily enabled the children to select a particular preference for each of the food item and physical activity. During analysis, food items were categorized into 'green', 'yellow' and 'red' on the basis of their nutritive values. Physical activity was categorized based on severity of the activity. RESULTS: Four hundred and thirty seven children filled up the questionnaires. Overall, median preference scores for 'red' food were higher than for healthier 'green' food (4.16 vs. 4.03), particularly, if mothers were self-employed. Likewise, the children preferred low over moderate-to-severe physical activity (4.16 vs. 3.50), and preference was affected by parents' occupation and income. CONCLUSIONS: The study objectively revealed that most of the children preferred unhealthier food-items and low physical activities. It shall be useful to consider these findings while planning health promotional activities targeted at them.CC BY 4.0</p
The heart-health associated research, dissemination and intervention in the community (HARDIC) trial for nepalese mothers regarding diet and physical activity : A process evaluation
Background Mothers with young children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance site of Bhaktapur district have misconceptions and poor behavioural practice regarding diet and physical activity. We developed the Heart-health Associated Research, Dissemination and Intervention in the Community trial - a health promotion intervention for mothers. Objective The objective of this study was to evaluate the interventionâs feasibility, acceptability, potential for transferability and scaling up, and to determine its immediate outcome. Method Duwakot and Jhaukhel were randomly selected as the intervention and control communities, respectively. We trained 47 peer mothers from Duwakot, each of whom gave classes with 10 fellow mothers of their neighbourhood. The process evaluation was carried out on a continuous basis at different points of the intervention held from August to November 2016. Result In round one, the participation and completion rates were both > 90% for peer mothers; and 85% and 70%, respectively, for the fellow mothers. However, the participation rates fell in the round two of the intervention. On the whole, the mothers expressed satisfaction and acceptance of the course content and training modality. Immediate evaluation of the intervention showed improvement of knowledge, attitude and practice of diet and physical activity among both groups of mothers. Conclusion The successful implementation of the intervention targeting diet and physical activity clearly demonstrates the feasibility of health promotional activities in the Nepalese community for improvement of cardiovascular health. © 2017, Kathmandu University. All rights reserved.© Copyright 2020</p
The heart-health associated research, dissemination and intervention in the community (HARDIC) trial for nepalese mothers regarding diet and physical activity : A process evaluation
Background Mothers with young children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance site of Bhaktapur district have misconceptions and poor behavioural practice regarding diet and physical activity. We developed the Heart-health Associated Research, Dissemination and Intervention in the Community trial - a health promotion intervention for mothers. Objective The objective of this study was to evaluate the interventionâs feasibility, acceptability, potential for transferability and scaling up, and to determine its immediate outcome. Method Duwakot and Jhaukhel were randomly selected as the intervention and control communities, respectively. We trained 47 peer mothers from Duwakot, each of whom gave classes with 10 fellow mothers of their neighbourhood. The process evaluation was carried out on a continuous basis at different points of the intervention held from August to November 2016. Result In round one, the participation and completion rates were both > 90% for peer mothers; and 85% and 70%, respectively, for the fellow mothers. However, the participation rates fell in the round two of the intervention. On the whole, the mothers expressed satisfaction and acceptance of the course content and training modality. Immediate evaluation of the intervention showed improvement of knowledge, attitude and practice of diet and physical activity among both groups of mothers. Conclusion The successful implementation of the intervention targeting diet and physical activity clearly demonstrates the feasibility of health promotional activities in the Nepalese community for improvement of cardiovascular health. © 2017, Kathmandu University. All rights reserved.© Copyright 2020</p
Changes in childrenâs diet and physical activity as perceived by their mothers : Impact of a health promotion intervention for mothers in a sub-urban area of Nepal
Background: Unhealthy diet and physical inactivity contribute to the growing burden of cardiovascular diseases in Nepal. Lifestyle is formed in childhood and in the Nepalese context influenced mainly by mothers, it is to date unknown how influential mothers are. Objectives: To assess changes in childrenâs diet and physical activity as perceived by their mothers after a health promotion intervention. Methodology: The Heart-Health Associated Research, Dissemination and Intervention in the Community is a community trial conducted in the Jhaukhel-Duwakot Health Demographic Surveillance site, in Bhaktapur district of Nepal. We conducted a health promotion intervention on diet and physical activity targeted at mothers with children aged one to nine years old in August-November 2016. Duwakot was randomized as the intervention site and Jhaukhel as the control. We conducted a follow-up study after three months to determine the outcome of the intervention. Nine trained enumerators conducted door-to-door visits to all households with eligible mothers. We calculated mean, frequency and percent changes for childrenâs behavior. Results: As responded by mothers, children in Duwakot consumed more healthy snacks after the intervention compared to Jhaukhel. Children in Duwakot increased consumption of water and milk. Childrenâs consumption of packet juices and soft drinks was decreased by 30% and 4% respectively. There was 21% increment in the duration of outdoor playing among the children at Duwakot during follow-up. Conclusion: The Heart-Health Associated Research, Dissemination and Intervention in the Community that focused on mothers showed indirect positive impact on their young childrenâs diet and physical activity behavior. In future, the longterm effects of such intervention should be assessed.Vol. 7, No. 4, Issue 26</p