1,720,982 research outputs found
The impact of different dietary patterns on nutritional status and metabolic integrity in asymptomatic people living with HIV infection in South Africa
No full textAdequate nutritional status promotes optimal structure and function. In PLWH, few studies
on the impact of dietary intake on nutritional and metabolic status have been undertaken.
This cross-sectional secondary data analysis examined how different dietary patterns
influenced nutritional and metabolic integrity in asymptomatic PLWH in the North-West
Province of South Africa. Dietary data were collected using validated QFFQ. Data analysis
was by SPSS version 14. Dietary and nutrient patterns were generated using Principal
Component Analysis. Though asymptomatic, marked biochemical differences depicting
altered metabolism and inflammation were observed in PLWH compared to the uninfected.
PLWH also showed an anthropometric profile that depicted altered body composition and
abnormal fat distribution. Four dietary patterns: animal-based, ‘recommended’, staple, and
the Carbohydrate, Vegetable and Legumes (CVL) based were observed in both PLWH
and the uninfected with slight differences. In PLWH, the animal-based similar to the CVL
pattern was associated with better overall nutrient intake (r=0.5, p<0.001) and selected
nutrients, including energy (r=0.3, p<0.001), protein (r=0.6, p<0.001), iron (r=0.5, p<0.001),
zinc (r=0.6, p<0.001) and vitamin A (r=0.5, p<0.001), compared to the other dietary
patterns. The animal based dietary pattern also predicted higher BMI (OR=2.2, 95%
CI=0.9-5.0), LBM (3.6, 1.3-10.4), serum albumin (1.5, 0.9-2.4) and lower liver enzymes
AST (0.5, 0.3-0.8) and ALT (0.6, 0.4-0.9). Using Graphical Chain Modelling, higher intake
of the animal-based but lower staple-based dietary patterns were associated with better
overall nutrient intake, serum vitamins A, E, lipid score, albumin, BMI and LBM suggesting
that intake of this diet may provide better nutrient quality, enhancing nutritional status and
metabolic proficiency, which may ultimately influence disease progression. The findings
have implications for dietary guidelines for this population but further research is required.
However, if these findings are true, then a predominantly animal-based diet may be
‘recommended’ for this population. Moreover, the longer term implications of high fat
intake associated with the animal based dietary pattern on obesity and associated risks
should be considered. This poses a challenge to imperatively weigh up the longer term
risks of the overall population profile crucial for public health
Malnutrition treatment to become a core competency
No full textThe International Pediatric Association has resolved that the identification and treatment of severe malnutrition should be a core competency for paediatricians and related health professionals worldwide. The Resolution is in response to the urgent need to reduce deaths and disability among young children. The Resolution has implications for the training of doctors, nurses and other health workers as current curricula are often insufficient to confer competency. Results of a survey of national paediatric societies suggest that training institutions need assistance in teaching about malnutrition treatment. Formation of national multidisciplinary teams for advocacy, strategic planning and action are proposed and it is anticipated that paediatricians will play a major role
Ampliación a Escala del Manejo Mejorado de la Desnutrición Aguda Grave Para Pacientes Hospitalizados: Factores Clave y Experiencias de Sudáfrica, Bolivia, Malawi, y Ghana
No full textSevere acute malnutrition (SAM) can have a high mortality, especially in very ill children treated in the hospital. Many medical and nursing schools do not adequately, if at all, teach how to manage children with SAM. There is a dearth of experienced practitioners and trainers to serve as exemplars of good practice or participate in capacity development. We consider 4 country studies of scaling up implementation of WHO guidelines for improving the inpatient management of SAM within under-resourced public sector health services in South Africa, Bolivia, Malawi, and Ghana. Drawing on implementation reports, qualitative and quantitative data from our research, prospective and retrospective data collection, self-reflection, and our shared experiences, we review our capacity-building approaches for improving quality of care, implementation effectiveness, and lessons learned. These country studies provide important evidence that improved inpatient management of SAM is scalable in routine health services and scalability is achievable within different contexts and health systems. Effectiveness in reducing inpatient SAM deaths appears to be retained at scale. The country studies show evidence of impact on mortality early in the implementation and scaling up process. However, it took many years to build workforce capacity, establish monitoring and mentoring procedures, and institutionalize the guidelines within health systems. Key features for success included collaborations to build capacity and undertake operational research and advocacy for guideline adoption; specialist teams to mentor and build confidence and competency through supportive supervision; and political commitment and administrative policies for sustainability. For frontline staff to be confident in their ability to deliver appropriate care competently, an enabling environment and supportive policies and processes are needed at all levels of the health system
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Building systemic capacity for Nutrition: Training towards a professionalised workforce for Africa.
Get PDFThis article has been published in a revised form in [Proceedings of the Nutrition Society] [http://doi.org/10.1017/S0029665115002062]. This version is published under a Creative Commons CC-BY-NC-ND licence. No commercial re-distribution or re-use allowed. Derivative works cannot be distributed. Copyright © The Authors 2015.The fundamental role played by good nutrition in enabling personal, social and economic development is now widely recognised as presenting a fundamental global challenge that has to be addressed if major national and international problems are to be resolved in the coming decades. The recent focus provided by the Millennium Development Goals and the Scaling-Up-Nutrition (SUN) Movement has been towards reducing the extent of nutrition-related malnutrition in high burden countries. This has served to emphasise that there is a problem of inadequate professional capacity in nutrition that is sufficiently widespread to severely limit all attempts at the effective delivery and sustainability of nutrition-related and nutrition-enabling interventions that have impact at scale. Many high burden countries are in sub-Saharan Africa where there is a high dependency on external technical support to address nutrition-related problems. We have sought to explore the nature and magnitude of the capacity needs with a particular focus on achieving levels of competency within standardised professional pre-service training which is fit for purpose to meet the objectives within the Scaling-Up-Nutrition movement in Africa. We review our experience of engaging with stakeholders through workshops and a gap analysis of the extent of the problem to be addressed, and a review of current efforts in Africa. We conclude that there are high aspirations but severely limited human resource and capacity for training that is fit-for-purpose at all skill levels in nutrition-related subjects in Africa. There are no structured or collaborative plans within professional groups to address the wide gap between what is currently available, the ongoing needs and the future expectations for meeting local technical and professional capability. Programmatic initiatives encouraged by agencies and other external players, will need to be matched by improved local capabilities to address the serious efforts required to meet the needs for sustained improvements related to Scaling-Up-Nutrition in high burden countries. Importantly, there are pockets of effort which need to be encouraged within a context in which experience can be shared and mutual support provided
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