Evidence on physical activity and sedentary behaviour in Ghana: A rapid scoping review

In Ghana, more than four in ten deaths in 2016 resulted from non-communicable diseases (NCDs). Physical inactivity and sedentary behaviours are important risk factors for NCDs. No previous systematic reviews examining physical activity and sedentary behaviour among Ghanaians were identified. Therefore, this rapid scoping review was conducted to find and synthesise what is known about the epidemiology of physical activity and sedentary behaviour of children and adults in Ghana. MEDLINE was searched for eligible studies and a narrative synthesis was conducted based on 17 identified papers as well as the 2008 Demographic and Health Survey report. Little recent high-quality data on prevalence of physical activity or sedentary behaviour in Ghana was found. Existing nationally representative data is now more than ten years old. The data identified suggest that the majority of Ghanaian adults, aged 18+ years, are physically active, achieving or exceeding World Health Organisation (WHO) recommendations (84.3% according to data collected in 2007-2008). Studies reporting sedentary behaviour in adults further suggest that the majority of Ghanaians are minimally sedentary. The most consistent associations with physical activity were by gender (men achieved more than women), employment (the employed, particularly in skilled manual jobs, achieved more than the unemployed), urban or rural residence (rural inhabitants achieved more than urban inhabitants) and socio-economic status (lower physical activity with increasing socio-economic status). Meanwhile, the few existing studies of physical activity in children (all of which investigated children aged 12+ years) suggest that the proportion of children achieving WHO recommendations on physical activity may be lower than for adults. A similar gender trend exists for children as in the adult data, with boys achieving more physical activity than girls. Physical activity is accrued most frequently through active travel, and active occupations, while leisure time physical activity is low. This means that the Ghanaian population may be vulnerable to becoming increasingly inactive as work and travel become more frequently mechanised and sedentary.&nbsp

Meat versus meat alternatives: which is better for the environment and health? A nutritional and environmental analysis of animal-based products compared with their plant-based alternatives.

BACKGROUND: Poor diets lead to negative health outcomes, including increased risk of noncommunicable diseases. Food systems, most notably agriculture, contribute to greenhouse gas emissions (GHGE) that lead to climate change. Meat consumption plays a role in both health and environmental burden. Consumption of meat alternatives may reduce these harms. The aim was to compare meat products and their plant-based alternatives on nutritional parameters, GHGE and price to examine if it is feasible and beneficial for policymakers and health professionals to recommend meat alternatives. METHODS: Data on nutritional information and cost for 99 selected products were collected from five UK supermarkets. Estimates for GHGEs for 97 of these products were found through secondary articles. Median values for nutritional value, GHGE (kgCO2 e) and price per 100 g were calculated to allow comparisons between meat products and their alternatives. Mann-Whitney U tests were used to look for significant differences for each nutrient, emissions and price. RESULTS: Meat alternatives contained significantly more fibre and sugar and were significantly higher in price compared to the equivalent meat products. Meat alternatives had a significantly lower number of calories, saturated fat, protein and kgCO2 e than meat products. There was no significant difference in the amount of salt between meat and meat alternatives. CONCLUSIONS: Overall, this paper found that meat alternatives are likely to be better for health according to most parameters, while also being more environmentally friendly, with lower GHGEs. However, the higher price of these products may be a barrier to switching to meat alternatives for the poorest in society

Evidence on physical activity and sedentary behaviour in Ghana: A rapid scoping review

In Ghana, more than four in ten deaths in 2016 resulted from non-communicable diseases (NCDs). Physical inactivity and sedentary behaviours are important risk factors for NCDs. No previous systematic reviews examining physical activity and sedentary behaviour among Ghanaians were identified. Therefore, this rapid scoping review was conducted to find and synthesise what is known about the epidemiology of physical activity and sedentary behaviour of children and adults in Ghana. MEDLINE was searched for eligible studies and a narrative synthesis was conducted based on 17 identified papers as well as the 2008 Demographic and Health Survey report. Little recent high-quality data on prevalence of physical activity or sedentary behaviour in Ghana was found. Existing nationally representative data is now more than ten years old. The data identified suggest that the majority of Ghanaian adults, aged 18+ years, are physically active, achieving or exceeding World Health Organisation (WHO) recommendations (84.3% according to data collected in 2007-2008). Studies reporting sedentary behaviour in adults further suggest that the majority of Ghanaians are minimally sedentary. The most consistent associations with physical activity were by gender (men achieved more than women), employment (the employed, particularly in skilled manual jobs, achieved more than the unemployed), urban or rural residence (rural inhabitants achieved more than urban inhabitants) and socio-economic status (lower physical activity with increasing socio-economic status). Meanwhile, the few existing studies of physical activity in children (all of which investigated children aged 12+ years) suggest that the proportion of children achieving WHO recommendations on physical activity may be lower than for adults. A similar gender trend exists for children as in the adult data, with boys achieving more physical activity than girls. Physical activity is accrued most frequently through active travel, and active occupations, while leisure time physical activity is low. This means that the Ghanaian population may be vulnerable to becoming increasingly inactive as work and travel become more frequently mechanised and sedentary

Differential protection of neuromuscular sensory and motor axons and their endings in Wld(S) mutant mice

Orthograde Wallerian degeneration normally brings about fragmentation of peripheral nerve axons and their sensory or motor endings within 24-48 h in mice. However, neuronal expression of the chimaeric, Wld(S) gene mutation extends survival of functioning axons and their distal endings for up to 3 weeks after nerve section. Here we studied the pattern and rate of degeneration of sensory axons and their annulospiral endings in deep lumbrical muscles of Wld(S) mice, and compared these with motor axons and their terminals, using neurone-specific transgenic expression of the fluorescent proteins yellow fluorescent protein (YFP) or cyan fluorescent protein (CFP) as morphological reporters. Surprisingly, sensory endings were preserved for up to 20 days, at least twice as long as the most resilient motor nerve terminals. Protection of sensory endings and axons was also much less sensitive to Wld(S) gene-copy number or age than motor axons and their endings. Protection of γ-motor axons and their terminals innervating the juxtaequatorial and polar regions of the spindles was less than sensory axons but greater than α-motor axons. The differences between sensory and motor axon protection persisted in electrically silent, organotypic nerve-explant cultures suggesting that residual axonal activity does not contribute to the sensory-motor axon differences in vivo. Quantitative, Wld(S)-specific immunostaining of dorsal root ganglion (DRG) neurones and motor neurones in homozygous Wld(S) mice suggested that the nuclei of large DRG neurones contain about 2.4 times as much Wld(S) protein as motor neurones. By contrast, nuclear fluorescence of DRG neurones in homozygotes was only 1.5 times brighter than in heterozygotes stained under identical conditions. Thus, differences in axonal or synaptic protection within the same Wld(S) mouse may most simply be explained by differences in expression level of Wld(S) protein between neurones. Mimicry of Wld(S)-induced protection may also have applications in treatment of neurotoxicity or peripheral neuropathies in which the integrity of sensory endings may be especially implicated

Protection of neuromuscular sensory endings by the WldS gene

The compartmental hypothesis of neurodegeneration proposes that the neurone, long recognized to consist of morphologically and functionally distinct compartments, also houses distinct degeneration mechanisms for the soma, axon and nerve endings. Support for this hypothesis is provided by the phenomenon of the WldS (for Wallerian Degeneration, slow) mouse, a mutant in which axons survive several weeks after transection, rather than degenerating within 24-48 hours as in wild type mice, by virtue of expression of a chimeric Nmnat1/Ube4b protein. In this thesis I used the WldS-mouse to re-examine and extend the theory of compartmental neurodegeneration by focusing specifically on sensory axons and endings; and finally by considering a fourth compartment, the dendrites. The first part of this thesis reports that Ia afferent axons and their annulospiral endings are robustly protected from degeneration in WldS mice. Homozygous or heterozygous WldS mice crossbred with transgenic mice expressing fluorescent protein in neurones were sacrificed at various times after sciatic nerve transection. Fluorescence microscopy of whole mount preparations of lumbrical muscles in these mice revealed excellent preservation of annulospiral endings on muscle spindles for at least 10 days after axotomy. No significant difference was detected in the protection with age or gene copy-number in contrast to the protection of motor nerve terminals, which degenerate rapidly in heterozygote and aged homozygote WldS mice. In an attempt to explain the difference in motor and sensory protection by WldS, examination of three hypotheses was undertaken: a) differences in protein expression, tested by western blot and immunohistochemistry; b) differences in the degree of neuronal branching, tested through examination of g-motor axons and endings which have a degree of branching intermediate to motor and sensory neurons; and c) differences in the activity in the disconnected stumps, through primary culture of the saphenous and phrenic nerve, selected because they comprise largely pure sensory and motor axons respectively. The data suggest that none of these hypotheses provides a sufficient explanation for the difference between sensory and motor protection by WldS. The last part of this thesis attempts to extend the theory of compartmental degeneration. I examine a system for investigation of WldS-mediated protection of dendrites. In preliminary experiments retinal explants from transgenic mice expressing YFP in a subset of retinal ganglion-cell neurones were cultured. The dendritic arbours of these cells were shown to be amenable for repeated visualization and accessible to injury and monitoring of degeneration. Overall the data in this thesis suggest that the level of WldS -mediated protection conferred to an axon or axonal endings varies between different neuronal types. This has implications for the potential applications of WldS research to clinical problems. Specifically, the data imply that sensory neuropathies may benefit more than motor neuropathies from treatments based on the protective effects of WldS. These findings in sensory neurones also challenge some of the assumptions made about WldS- mediated protection of neurones, for example the extent of the age-effect on axonal endings. Further investigation of WldS-mediated protection in the CNS could give renewed impetus to attempts to discover targets for treatment in common neurodegenerative diseases. Finally, a system for investigation of dendritic degeneration has been piloted, suggesting that molecules involved in the degeneration of dendrites or in protection from this degeneration may be amenable to investigation in this system, prospectively extending the compartmental hypothesis of neuronal degeneration

Evidence on physical activity and sedentary behaviour in Ghana : a rapid scoping review

In Ghana, more than four in ten deaths in 2016 resulted from non-communicable diseases (NCDs). Physical inactivity and sedentary behaviours are important risk factors for NCDs. No previous systematic reviews examining physical activity and sedentary behaviour among Ghanaians were identified. Therefore, this rapid scoping review was conducted to find and synthesise what is known about the epidemiology of physical activity and sedentary behaviour of children and adults in Ghana. MEDLINE was searched for eligible studies and a narrative synthesis was conducted based on 17 identified papers as well as the 2008 Demographic and Health Survey report. Little recent high-quality data on prevalence of physical activity or sedentary behaviour in Ghana was found. Existing nationally representative data is now more than ten years old. The data identified suggest that the majority of Ghanaian adults, aged 18+ years, are physically active, achieving or exceeding World Health Organisation (WHO) recommendations (84.3% according to data collected in 2007-2008). Studies reporting sedentary behaviour in adults further suggest that the majority of Ghanaians are minimally sedentary. The most consistent associations with physical activity were by gender (men achieved more than women), employment (the employed, particularly in skilled manual jobs, achieved more than the unemployed), urban or rural residence (rural inhabitants achieved more than urban inhabitants) and socio-economic status (lower physical activity with increasing socio-economic status). Meanwhile, the few existing studies of physical activity in children (all of which investigated children aged 12+ years) suggest that the proportion of children achieving WHO recommendations on physical activity may be lower than for adults. A similar gender trend exists for children as in the adult data, with boys achieving more physical activity than girls. Physical activity is accrued most frequently through active travel, and active occupations, while leisure time physical activity is low. This means that the Ghanaian population may be vulnerable to becoming increasingly inactive as work and travel become more frequently mechanised and sedentary

Effects of carotenoids on mitochondrial dysfunction

Oxidative stress, an imbalance between pro-oxidant and antioxidant status, favouring the pro-oxidant state is a result of increased production of reactive oxygen species (ROS) or inadequate antioxidant protection. ROS are produced through several mechanisms in cells including during mitochondrial oxidative phosphorylation. Increased mitochondrial-derived ROS are associated with mitochondrial dysfunction, an early event in age-related diseases such as Alzheimer’s diseases (ADs) and in metabolic disorders including diabetes. AD post-mortem investigations of affected brain regions have shown the accumulation of oxidative damage to macromolecules, and oxidative stress has been considered an important contributor to disease pathology. An increase in oxidative stress, which leads to increased levels of superoxide, hydrogen peroxide and other ROS in a potentially vicious cycle is both causative and a consequence of mitochondrial dysfunction. Mitochondrial dysfunction may be ameliorated by molecules with antioxidant capacities that accumulate in mitochondria such as carotenoids. However, the role of carotenoids in mitigating mitochondrial dysfunction is not fully understood. A better understanding of the role of antioxidants in mitochondrial function is a promising lead towards the development of novel and effective treatment strategies for age-related diseases. This review evaluates and summarises some of the latest developments and insights into the effects of carotenoids on mitochondrial dysfunction with a focus on the antioxidant properties of carotenoids. The mitochondria-protective role of carotenoids may be key in therapeutic strategies and targeting the mitochondria ROS is emerging in drug development for age-related diseases

Exploration of meaning, motivation, and preparedness to care amongst the one-child policy generation in China

YesIn China there is a cultural expectation (Xiao, -filial piety) that offspring should provide care for their parents. However, the sustainability of this is threatened by the impact of the One-Child Policy (OCP) (1979-2015), which has resulted in a diminution in numbers of children available to care, rapid urbanisation and increase in the number of women in employment. In this context, the objective was to explore the motivations, meaning, and preparedness for future caregiving of offspring affected by the OCP. We adopted a constructivist position using a hermeneutic phenomenology approach and interviewed eight current and prospective caregivers aged 20-35 years about future caregiving responsibilities. Data were obtained through in-depth interviews, analysed using reflective Thematic Analysis. Three prominent themes: (i) Caregiving beliefs, (ii) Caregiving conditions and (iii) Contextual factors were identified under an overarching theme "Competing pressures-meanings, motivation and preparedness". Despite the inherent stress, participants envisaged providing or organising care in the future to fulfil Xiao, and most viewed long-term care settings as unviable. Ultimately, the findings suggested that the actual performance of caregiving would not always measure up to ideal expectations, resulting in 'filial discrepancy' that is, a gap between societal expectations for caregiving to older relatives and actual caregiving performance. This could adversely impact the caregivers and quality of care provided. The findings highlighted the urgent need to develop culturally attuned services, including education and training for family caregivers, health and social care professionals.This work was supported by Research England: Quality Related Global Challenge Research Fund; University of Bradford

Stressors and coping mechanisms of family care-givers of older relatives living with long-term conditions in mainland China: A scoping review of the evidence

YesAs the ageing population in China continues to grow, more people will be living with long-term health conditions and require support from family care-givers. This scoping review therefore aims to explore sources of stress and coping mechanisms adopted by care-givers of older relatives living with long-term conditions in mainland China. Literature searches were conducted in English (CINAHL, EMBASE, MEDLINE, PsycINFO and SCOPUS) and Chinese (CNKI, WANFANG DATA, CQVIP and CBM) databases between October and November 2019. The searches focused on the stressors and coping mechanisms utilised by family care-givers residing in the community. Narrative synthesis was used to identify themes within the data. Forty-six papers were included: 20 papers from English and 26 from Chinese databases. Six themes captured stressors: care-giving time (N = 22), financial resources (N = 17), role and personal strains (N = 42), preparedness (N = 4), social roles (N = 10) and lack of adequate formal support (N = 22); and one theme captured coping (N = 14). Unmet needs of care-givers of older relatives in mainland China were found to be extensive. Only a few studies had attempted to explore the causal link between stressors, coping and the influence of culture. Findings underscore the significance of adequately capturing intricacies around care-givers’ unmet needs, rather than generalising on the basis of culture. Qualitative studies are critical to providing a better understanding of the relationship between stressors, coping and resources afforded to care-givers by their cultural environment. Having such understanding is crucial to inform the development of competent care, which promotes self-efficacy and self-actualisation in care-givers in mainland China.This work was supported by Research England: Quality Related Global Challenge Research Fund (QR-GCRF)

Improving the health and welfare of people who live in slums

Summary In the first paper in this Series we assessed theoretical and empirical evidence and concluded that the health of people living in slums is a function not only of poverty but of intimately shared physical and social environments. In this paper we extend the theory of so-called neighbourhood effects. Slums offer high returns on investment because beneficial effects are shared across many people in densely populated neighbourhoods. Neighbourhood effects also help explain how and why the benefits of interventions vary between slum and non-slum spaces and between slums. We build on this spatial concept of slums to argue that, in all low-income and-middle-income countries, census tracts should henceforth be designated slum or non-slum both to inform local policy and as the basis for research surveys that build on censuses. We argue that slum health should be promoted as a topic of enquiry alongside poverty and health