Enablers and Barriers Related to Preconception Physical Activity: Insights from Women of Reproductive Age Using Mixed Methods.

Engaging in regular preconception physical activity (PA) is associated with benefits, including improved cardiovascular health and mental well-being. However, most women do not meet PA recommendations in the preconception period. This study aimed to investigate enablers and barriers related to PA in preconception women using a sequential mixed method design. An online survey was followed by Zoom interviews with women of reproductive age (aged 18-45 years). A weaving approach and the Capability Opportunity Motivation Behaviour (COM-B) model were used to integrate and present the data. Seven hundred and eighty-eight non-pregnant women from Australia, India, and the US completed the quantitative survey, and 13 Australian-based women participated in a qualitative interview. Physical activity levels were associated with having social support, a desire to improve body image, and becoming a healthier person. Women encountered barriers such as misconceptions about PA, competing priorities, financial constraints, and a lack of accessibility. Enablers for participation in PA included knowledge of its importance, a desire to be healthier, weight loss, social support, and having goals. The multifaceted and intricate nature of enablers and barriers for preconception PA lays the groundwork for developing tailored interventions and policies aimed at promoting preconception PA among women.

Preconception Health in the Workplace: An Opportunity to Support Equitable Access to Education.

Preconception health is a key determinant of pregnancy and offspring outcomes, but challenges reaching people during preconception are frequently cited by health professionals. This article highlights the workplace as an important setting for promoting equitable access to preconception health-related information and education to support optimal well-being before pregnancy. Workplaces can support equitable access to education and knowledge for preconception health: (1) due to the high engagement of reproductive-age women in the workforce and (2) by reaching vulnerable or high-risk population groups who may otherwise face barriers to accessing preconception health information. Literature that explicitly investigates workplace delivery of preconception health promotion programs is scarce. However, workplace health promotion more broadly is associated with improved corporate competitiveness, productivity, and strengthened employee-employer relationships. Workplace health promotion activities may also address social determinants of health and improve employee well-being outcomes. The opportunity for workplaces to benefit from an increase in the bottom line makes workplace health promotion programs more attractive, but organizational support and stakeholder engagement are needed to facilitate the design and delivery of successful workplace preconception health education programs. Such programs have the potential to facilitate health gains for women and their families.

Insect Herbivore Populations and Plant Damage Increase at Higher Elevations.

Elevation gradients are used as a proxy to simulate climate change effects. A field study was conducted along an elevational gradient in Nepal to understand the effects of abiotic conditions on agriculturally important insect herbivore populations (tobacco caterpillar: Spodoptera litura, tomato fruit worm: Helicoverpa armigera, and South American leaf miner, Tuta absoluta) and herbivory damage on tomatoes. Elevation ranged from 100 m to 1400 m above sea level, representing different climatic zones where tomatoes are grown. Contrary to our hypothesis, natural herbivore populations and herbivory damage significantly increased at higher elevations. Individual insect species responses were variable. Populations of S. litura and T. absoluta increased at higher elevations, whereas the H. armigera population was highest at the mid-elevational range. Temperature variations with elevation also affected insect catch numbers and the level of plant damage from herbivory. In the context of climate warming, our results demonstrate that the interactive effects of elevation and climatic factors (e.g., temperature) will play an important role in determining the changes in insect pest populations and the extent of crop losses.

Effect of Hypoxia on the Lethal Mortality Time of Adult Sitophilus oryzae L.

Sitophilus oryzae is one of the most destructive pests of stored grains. It leads to significant quantitative and qualitative losses, resulting in food and income insecurity among farmers. Chemical pesticides are the most common methods used by farmers and other grain value chain actors to manage this pest. However, pesticides are increasingly becoming unattractive for pest control due to health hazards posed to applicators, consumers, the environment, and insect resistance. Modified atmospheres have the potential to manage stored insect pests as an alternative to pesticides. There is limited understanding of when insect pests die when grain is stored in airtight containers. This experiment was conducted to assess the time required to reach mortality of adult S. oryzae when exposed to 1, 3, and 5% oxygen levels. Results revealed that the LT50 for 1, 3, and 5% of oxygen were reached after 69.7 h, 187.8 h, and 386.6 h of exposure, respectively. No adult emergence was observed on infested grains following exposure to 1 and 3% oxygen levels. This result provides vital rationale for storing grain in hermetic storage conditions for at least 39 days to achieve adult S. oryzae mortality and minimize grain reinfestation.

Enablers and barriers to women's lifestyle behavior change during the preconception period: A systematic review.

Healthy lifestyle behaviors during the preconception period are important to optimize maternal and child outcomes, including weight. However, the majority of women do not have optimal preconception lifestyle behaviors. This systematic review explored enablers and barriers to women's preconception lifestyle behaviors using the Capability, Opportunity, Motivation, Behaviour (COM-B) model and Theoretical Domains Framework (TDF). Preconception was defined as the time before conception, capturing planned and unplanned pregnancies. Medline Complete, EMBASE, PsycINFO, and CINAHL were searched for peer-reviewed, quantitative and qualitative primary studies (English, 2006-2020) that explored enablers and barriers to lifestyle behaviors (diet, physical activity, smoking, alcohol use, supplement intake). Forty-two studies (of 3406) were included, assessing supplement use (n = 37), diet (n = 10), smoking (n = 10), alcohol use (n = 8), and physical activity (n = 5). All three COM-B components were identified only for diet and supplement use. Of the 14 TDF domains, 7 were identified: knowledge, beliefs about capabilities, beliefs about consequences, goals, intentions, social support, and environmental context and resources. The presence/absence of knowledge on healthy behaviors was the most commonly assessed enabler/barrier. Future studies should explore a wider range of factors influencing preconception women's capability, opportunity, and motivation to modify their lifestyle behaviors.

Practice nurses and providing preconception care to women in Australia: a qualitative study.

The aims of this study were to explore women's and health professionals' perspectives of preconception care and whether expanding the role of practice nurses (PNs) to provide preconception care is acceptable. In a descriptive qualitative approach, 23 semistructured interviews and three focus groups were conducted with women (n=14), PNs (n=8), GPs (n=10) and practice managers (n=2) in the state of Victoria, Australia, between September and December 2019. An inductive process of thematic analysis identified five themes and 12 subthemes. Women and health professionals viewed preconception to be when a woman is planning a pregnancy. Women wanted personalised preconception care, and receiving this from a PN was considered to be acceptable. If the role of PNs is expanded, PNs would require training and professional recognition of their role to provide preconception care. Funding barriers were discussed by PNs, GPs and practice managers, along with potential solutions, such as Medicare item numbers and checklists to streamline consultations. Other resources in the wider community, such as schools, were identified as important aspects of a coordinated approach. Overall, expanding the role of PNs to provide preconception care was acceptable to women and health professionals to increase women's awareness and uptake of preconception care.

Depression and anxiety among war-widows of Nepal: a post-civil war cross-sectional study.

Thousands of Nepalese women were widowed as a consequence of a decade (1996-2006) long civil war in Nepal. These women are at grave risk of mental health problems due to both traumatic experiences and violation of natural order of widowhood. The present study explores the depression and anxiety among war-widows. In 2012, a cross-sectional study was designed to interview 358 war-widows using validitated Beck Depression Inventory and Beck Anxiety Inventory in four districts of Nepal - Bardiya, Surkhet, Sindhupalchowk and Kavrepalanchowk with history of high conflict intensity. The prevalence of depression and anxiety was 53% and 63% respectively. Financial stress was significantly associated with depression (2.67, 95% CI: 1.40-5.07) and anxiety (2.37, 95% CI: 1.19-4.72). High autonomy of women as compared to low autonomy, high social support as compared to low social support and literacy as opposed to illiteracy was associated with less likelihood of depression and anxiety. Our results suggest high magnitude of depression and anxiety among war-widows in Nepal. Future policy efforts should be directed at providing mental health services to identify mental health issues among conflict affected individuals with focus on education, employment and activities to promote social support and autonomy at community.

Extent of Fecal Contamination of Household Drinking Water in Nepal: Further Analysis of Nepal Multiple Indicator Cluster Survey 2014.

Water sources classified as "improved" may not necessarily provide safe drinking water for householders. We analyzed data from Nepal Multiple Indicator Cluster Survey 2014 to explore the extent of fecal contamination of household drinking water. Fecal contamination was detected in 81.2% (95% confidence interval [CI]: 77.9-84.2) household drinking water from improved sources and 89.6% (95% CI: 80.4-94.7) in water samples from unimproved sources. In adjusted analysis, there was no difference in odds of fecal contamination of household drinking water between improved and unimproved sources. We observed significantly lower odds of fecal contamination of drinking water in households in higher wealth quintiles, where soap and water were available for handwashing and in households employing water treatment. The extent of contamination of drinking water as observed in this study highlights the huge amount of effort required to ensure the provision of safely managed water in Nepal by 2030 as aimed in sustainable development goals.