ROLE OF FAMILY IN ELDERLY CARE

Family is an integral part of everyone’s life. The purpose of thesis is to explore the roles of family and significance of their participation in elderly care. The aims are to increase awareness of nursing students, nurses and families regarding involvement of family members in elderly care and to find out experience of elderly residents when family members visit them. Research method used in this thesis is quantitative research in which questionnaires were used to collect data from elderly people. Mainly questions were about family visit and its importance, loneliness and involvement of family members in their care. Data was collected from two different elderly homes in Oulu. The research questions were: - How do elderly feel about loneliness at elderly home? How are family visits implemented? What effects do family visits have on the elderly? What expectations do the elderly have on family visits? The study included two elderly homes of Oulu and the sample of 68 residents. The findings of the research showed that most of the elderly feels loneliness in elderly home. However, there were also elderly residents who mentioned that they do not feel loneliness at all. It was identified that the difference in loneliness feelings among elderly was greatly influenced by the number of family visit and support received by them. Further, this study helps to determine that elderly preferred to be visited by their family members as frequently as possible and they think that family visit is important for their happiness and well- being. This research will help health care students, nurses and family members to understand value of regular family visit in elderly home, family roles and support needed to maintain the quality of life of elderly residents. In addition, nurses will involve family members in elderly care as well as family will be encouraged and motivated to participate actively

Metachromatic Leucodystrophy: A Case Report

Metachromatic leukodystrophy (MLD) is a rare autosomal recessive inherited disease, which is caused by a deficiency in the enzyme activity of Arylsulfatase A (ARSA). Deficiency of this enzyme results in intralysosomal storage of sphingolipid cerebroside 3-sulfates (sulfatides), which are abundant in myelin and neurons. Demyelination and neurodegeneration, causing multiple and ultimately lethal neurological symptoms is the hallmark of MLD. Though it is a rare disease of frequency 1/100,000 live birth, typical history and brain imaging is being reported here

Astrocyte GluN2C NMDA receptors control basal synaptic strengths of hippocampal CA1 pyramidal neurons in the stratum radiatum

Experience-dependent plasticity is a key feature of brain synapses for which neuronal N-Methyl-D-Aspartate receptors (NMDARs) play a major role, from developmental circuit refinement to learning and memory. Astrocytes also express NMDARs, although their exact function has remained controversial. Here, we identify in mouse hippocampus, a circuit function for GluN2C NMDAR, a subtype highly expressed in astrocytes, in layer-specific tuning of synaptic strengths in CA1 pyramidal neurons. Interfering with astrocyte NMDAR or GluN2C NMDAR activity reduces the range of presynaptic strength distribution specifically in the stratum radiatum inputs without an appreciable change in the mean presynaptic strength. Mathematical modeling shows that narrowing of the width of presynaptic release probability distribution compromises the expression of long-term synaptic plasticity. Our findings suggest a novel feedback signaling system that uses astrocyte GluN2C NMDARs to adjust basal synaptic weight distribution of Schaffer collateral inputs, which in turn impacts computations performed by the CA1 pyramidal neuron

Food insecurity and dietary diversity among lactating mothers in the urban municipality in the mountains of Nepal.

BACKGROUND:Adequate nutrition is essential during the lactation period for better maternal and child health outcomes. Although food insecurity and dietary monotony (defined as less diverse diet), two important determinants of undernutrition, are endemic in the rural mountains of Nepal, insufficiently examined and assessed for risk factors in mothers during lactation, a life stage of high nutritional demand. This study aimed to assess the status and factors associated with food insecurity and dietary diversity among lactating mothers residing in the mountains of Nepal. METHODS:A community-based cross-sectional study was conducted in an urban municipality in the mountainous Bajhang District of far-western Nepal. The sampling frame and strategy led to 417 randomly selected lactating mothers. Household Food Insecurity Access Scale (HFIAS) and the tool "Minimum Dietary Diversity for Women" developed by the Food and Agriculture Organization were used to measure food insecurity and dietary diversity, respectively. Additional information on socio-demographics and risk factors were collected. Multivariable logistics regression assessed correlates of study outcomes. RESULTS:Overall, 54% of the households were food insecure, and over half (53%) of the mothers had low dietary diversity. Food insecurity status (mild food insecurity AOR = 10.12, 95% CI = 4.21-24.34; moderate food insecurity AOR = 8.17, 95% CI = 3.24-20.59, and severe food insecurity AOR = 10.56, 95% CI = 3.92-28.43) were associated with higher odds of dietary monotony. Likewise, participants with lower dietary diversity were 8.5 times more likely to be food insecure than those with higher dietary diversity (AOR = 8.48, 95% CI = 3.76-19.14). The monthly income of the family was positively associated with food insecurity. Participants' (AOR = 3.92 95%CI = 1.76-8.71) or spouses' (AOR = 2.90, 95% CI = 1.07-7.85) unemployment was associated with higher odds of being food insecure. Likewise, owning a cultivable land (AOR = 0.49, 95% CI = 0.28-0.84) and participant's unemployment status (AOR = 5.92, 95% CI = 3.02-11.63), were significantly associated with increased odds of dietary monotony. CONCLUSION:The observed food insecurity and poor dietary diversity among lactating mothers, the correlates associated with these outcomes, may help local stakeholders to identify local health needs and subgroups for targeted interventions. Socioeconomically disadvantaged mothers should be specifically targeted for relevant programs and policies

Vultures and people: Local perceptions of a low-density vulture population in the eastern mid-hills of Nepal

The cause for rapid decline of the South Asian vulture population in 1990s was unknown for many years until diclofenac was proved to be the main reason for such decline in 2004.  The vulture populations from Nepal has also undergone rapid decline that causes low awareness among people about its ecological importance.  For declining species that have large range and are mostly associated with humans, people’s attitudes can have direct effects on their survival because of the multiple linkages and potential for both positive and negative impacts of human behaviour for these large scavengers.  However, little is known about vultures in the eastern mid-hills of Nepal.  Therefore, we conducted a study in Ramechhap, a district in the eastern mid-hills of Nepal, to assess the vultures’ status and human relations using transect and questionnaire surveys respectively.  Himalayan Griffons Gyps himalayensis and Egyptian Vultures Neophron percnopterus were found in the area, and the majority of respondents interviewed had a positive attitude towards vultures (58.8%) and their conservation (47.3%).  Although neglected in previous studies, a neutral attitude (20% towards vultures and 15.8% towards vulture conservation) can be significant (largely related to ignorance) and can be readily turned to negative due to the vulture’s carcass consuming behaviour and lack of conventional appeal to many people, with implications for the success of a conservation programme.  In our study, carcass scarcity appeared to be an increasing concern with about 90% of the respondents reporting burying cattle carcasses, and that this practice has recently increased.  In the course of the study period, however, two (unburied) carcasses were observed.  Our study found that nimesulide, a potentially toxic NSAID for vultures, was used for veterinary purpose in the study area, which could be a serious threat to vultures.  Other human activities such as carcass poisoning pose threats to vultures in the study area.  Therefore, for long term vulture conservation, local attitudes and behaviour should be considered along with ecological aspects of vultures. </div

Second and third generation voltage-sensitive fluorescent proteins for monitoring membrane potential

Over the last decade, optical neuroimaging methods have been enriched by engineered biosensors derived from fluorescent protein (FP) reporters fused to protein detectors that convert physiological signals into changes of intrinsic FP fluorescence. These FP-based indicators are genetically encoded, and hence targetable to specific cell populations within networks of heterologous cell types. Among this class of biosensors, the development of optical probes for membrane potential is both highly desirable and challenging. A suitable FP voltage sensor would indeed be a valuable tool for monitoring the activity of thousands of individual neurons simultaneously in a non-invasive manner. Previous prototypic genetically-encoded FP voltage indicators achieved a proof of principle but also highlighted several difficulties such as poor cell surface targeting and slow kinetics. Recently, we developed a new series of FRET-based Voltage-Sensitive Fluorescent Proteins (VSFPs), referred to as VSFP2s, with efficient targeting to the plasma membrane and high responsiveness to membrane potential signaling in excitable cells. In addition to these FRET-based voltage sensors, we also generated a third series of probes consisting of single FPs with response kinetics suitable for the optical imaging of fast neuronal signals. These newly available genetically-encoded reporters for membrane potential will be instrumental for future experimental approaches directed toward the understanding of neuronal network dynamics and information processing in the brain. Here, we review the development and current status of these novel fluorescent probes

Effect of the 2015 earthquake on pediatric inpatient pattern at a tertiary care hospital in Nepal

Abstract Background Earthquakes impact child health in many ways. Diseases occurring immediately following an earthquake have been studied in field based hospitals but studies on the inpatient disease pattern among children without trauma in a permanent hospital setup is lacking. Methods We examined the diagnoses of all children without trauma, admitted to Kanti Children’s Hospital, Kathmandu for fifteen-week duration (from 4th week to end of the 18th week) following the 7.8 magnitude Nepal earthquake on 25th April 2015. The admitted children were grouped based on direct effect of earthquake on their family (house damaged or family member injured or dead) and on whether their place of residence was located in an earthquake affected district. Most common diagnoses were identified and their distribution between the aforementioned groups analyzed to examine differences, if any, in disease occurrence or presentation. The fifteen weeks study duration was divided into three parts of five weeks each, to study trends in illness presentation. Variables were compared among various groups using appropriate statistical tests (p < 0.05). Results A total of 1057 patients were admitted. The proportion of patients requiring admission for pneumonia, acute gastroenteritis and acute or poststreptococcal glomerulonephritis (AGN/PSGN) was significantly higher among children belonging to earthquake affected districts. Proportion of patients with any infective condition was also significantly higher in this group. Acute gastroenteritis and any infective condition were significantly higher among children from substantially affected families. The proportion of AGN/PSGN among admitted patients increased in successive time categories among patients from affected districts and from substantially affected families. Urinary Tract Infection, bronchiolitis, tuberculosis, pleural effusion, protein energy malnutrition/failure to thrive, nephrotic syndrome, meningitis/meningoencephalitis, epilepsy or seizure disorders, leukemia/malignancies, enteric fever, infective hepatitis and congenital heart disease were not significantly different among children from affected and not affected districts or between substantially affected and not affected families. Patients from substantially affected families were admitted to semi-intensive care ward or ICU in significantly higher proportions (12.6% vs 7.8%, p = 0.014). Conclusion Children seeking care for certain diseases were more likely to be from earthquake affected families and districts. Those from affected families required critical care more often

Astrocytes regulate heterogeneity of presynaptic strengths in hippocampal networks

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