1,720,963 research outputs found
Factors affecting compliance of mothers/caregivers of malnourished children aged 6-59 months to an outpatient nutrition support programme in Pietermaritzburg, KwaZulu-Natal
Get PDFMagister Public Health - MPHMalnutrition continues to be a major public health problem in Africa, yet the compliance to the IMAM, a treatment protocol that began in KwaZulu-Natal and viewed as a highly efficacious approach to treat malnutrition, is very low. The Dietetics outpatient department at a regional hospital in Pietermaritzburg, KwaZulu-Natal, where the study was conducted, has about 375 children enrolled in the outpatient nutrition programme. The outpatient nutrition programme enables patients with stable Severe Acute Malnutrition and Moderate Acute Malnutrition to access nutritional supplements and to manage malnutrition outside the hospital. It is estimated that about 124 children between the age of 6 to 59 months default from the outpatient nutrition programme annually, accounting for a defaulter rate of 33%
Factors influencing breastfeeding of infants of mothers who are living with HIV at Ehlanzeni District, Mpumalanga, South Africa
Get PDFMaster of Public Health - MPHThe World Health Organisation recommendations for breastfeeding in the general population, including mothers living with HIV, emphasise breastfeeding within one hour of birth, exclusive breastfeeding (EBF) during the first six months of life, and continued breastfeeding for up to two years or beyond. However, only 34.8% of infants worldwide are exclusively breastfed for the first six months of life, and as a result, about 1.4 million infants lose their lives due to undernutrition. In South Africa, only 31.6% of infants are exclusively breastfed for the first six months. Despite the benefits of exclusive breastfeeding, many mothers living with HIV do not initiate breastfeeding or discontinue breastfeeding prematurely. It is, therefore, crucial to determine the barriers inhibiting the uptake of EBF and factors promoting mothers living with HIV to adopt exclusive breastfeeding
Cultural practices and beliefs of caregivers of malnourished children, aged 6-24 months, regarding feeding and dietary intake in Gweru, Zimbabwe
Get PDFMaster of Public Health - MPHThe burden of malnutrition continues to persist and is the major cause of morbidity and mortality in children. According to the results of the Zimbabwe Multiple indicator cluster survey in 2019, stunting remains high at (26.8%) and the leading form of malnutrition, affecting 1 in 3 children less than 5 years in Zimbabwe. Suboptimal feeding practices have been identified as one of the many causes of malnutrition. Various studies have shown that many risk factors of malnutrition can be addressed during the crucial first 1000 days of life. Cultural beliefs, values, and practices play a vital role in the pre and postnatal period. However, there is a knowledge gap in how culture influences the caregivers regarding feeding and dietary intake. Therefore, the study’s major aim was to explore the cultural beliefs and practices of caregivers of malnourished children between 6-24 months, regarding dietary intake and feeding practices in Gweru, Zimbabwe
The development of a nutrition support protocol for children with Acute Lymphoblastic Leukemia (ALL) : twenty case studies from Sheikh Khalifa Medical City, Abu Dhabi, UAE
No full textMagister Scientiae (Nutrition Management) - MSc(NM)Acute lymphocytic leukemia (ALL) is the most common type of childhood cancer accounting for approximately 25% of cancers diagnosed in children less than 20 years of age. It originates in the bone marrow and prevents the normal manufacture of red blood cells, white blood cells and platelets. A poor nutritional status is frequently observed in children with ALL at the time of diagnosis and during treatment which may result in protein energy malnutrition if nutrition intervention is delayed. This retrospective study aims to assess the nutritional status of children newly diagnosed with Acute Lymphoblastic Leukemia (ALL) using 20 case studies between 1 January 2013 and 31 December 2014 from Sheikh Khalifa Medical City (Abu Dhabi, UAE), in order to develop an appropriate nutritional support protocol for pediatric ALL patients treated at this institution. Study Design: A retrospective descriptive case study design was used. The study population consisted of 20 electronic medical records of patients aged between 1-14 years who were newly diagnosed with Acute Lymphoblastic Leukemia (ALL) and admitted to Sheikh Khalifa Medical City for treatment during the period 1 January 2012 and 31 Dec 2014. Data Collection: Identification of suitable participants began through a review of each potential study participant`s electronic medical record. Data was collected and recorded on a data collection form (Appendix III) from the electronic medical record for each suitable participant for the following at admission and during the full duration of all phases of cancer treatment namely induction, consolidation, interim maintenance, delayed intensification and maintenance. The data collected comprised of the following: age, gender, date of diagnosis, symptoms on diagnosis, the cancer diagnosis (type and subtype), anthropometric measurements (weight, length/ height, head circumference), biochemical values (visceral proteins, blood glucose levels, hemoglobin, hematocrit, lymphocyte count), clinical assessment (stomatitis, anemia, mucositis), diet history (home feeding regimes; consumption of daily requirements; food preferences – types, textures; food allergies, food intolerances; food aversions; use of oral nutritional supplements; treatment-related side-effects; systemic related side-effects (nausea; vomiting; diarrhea; anorexia; appetite changes; taste changes; physical activity level; depression), dietary requirements (age and gender related nutritional requirements for energy, protein, fat and fluids) and indications for nutritional support (oral feeding; enteral feeding; parenteral feeding). Analysis of Results: The weights and length/ heights of participants recorded in the electronic medical records were converted to z-scores on the World Health Organization growth charts. The diet prescription of nutritional intervention was interpreted in comparison to the biochemical indices, anthropometric status and dietary intake of each participant. All the data involving changes in anthropometrics, biochemistry, diet history and nutritional interventions from each case study (from diagnosis and through all stages of treatment) was screened and compared with reference values in the context of the age and sex of the child. Evidence based nutritional guidelines were used to document the outcomes of the medical nutrition treatment provided in order to develop a nutrition support protocol for children with Acute Lymphoblastic Leukemia at Sheikh Khalifa Medical City. Results: The results showed that weight loss expressed as a percentage of body weight provided a more accurate estimate of the true significance of weight loss in subjects undergoing cancer treatment (chemotherapy) for ALL. A weight loss of greater than 5% of body weight over a period of one month is considered a sign of nutritional deprivation even if the subject is not classified as undernourished by anthropometric parameters. Subjects experienced the highest weight loss during the consolidation phase and interim maintenance phases of treatment. Conclusion: It can therefore be concluded that pediatric subjects on cancer treatment for ALL at SKMC and receiving nutritional support underwent changes in nutritional status as manifest by a reduction in more than 5% of their body weight during three phases of treatment namely induction, consolidation and interim maintenance. An appropriate nutrition support protocol was developed based on the results and experience obtained from this study for pediatric ALL patients treated at SKMC
The development of a nutrition support protocol for children with Acute Lymphoblastic Leukemia (ALL) : twenty case studies from Sheikh Khalifa Medical City, Abu Dhabi, UAE
Get PDFMagister Scientiae (Nutrition Management) - MSc(NM)Acute lymphocytic leukemia (ALL) is the most common type of childhood cancer accounting for approximately 25% of cancers diagnosed in children less than 20 years of age. It originates in the bone marrow and prevents the normal manufacture of red blood cells, white blood cells and platelets. A poor nutritional status is frequently observed in children with ALL at the time of diagnosis and during treatment which may result in protein energy malnutrition if nutrition intervention is delayed. This retrospective study aims to assess the nutritional status of children newly diagnosed with Acute Lymphoblastic Leukemia (ALL) using 20 case studies between 1 January 2013 and 31 December 2014 from Sheikh Khalifa Medical City (Abu Dhabi, UAE), in order to develop an appropriate nutritional support protocol for pediatric ALL patients treated at this institution. Study Design: A retrospective descriptive case study design was used. The study population consisted of 20 electronic medical records of patients aged between 1-14 years who were newly diagnosed with Acute Lymphoblastic Leukemia (ALL) and admitted to Sheikh Khalifa Medical City for treatment during the period 1 January 2012 and 31 Dec 2014. Data Collection: Identification of suitable participants began through a review of each potential study participant`s electronic medical record. Data was collected and recorded on a data collection form (Appendix III) from the electronic medical record for each suitable participant for the following at admission and during the full duration of all phases of cancer treatment namely induction, consolidation, interim maintenance, delayed intensification and maintenance. The data collected comprised of the following: age, gender, date of diagnosis, symptoms on diagnosis, the cancer diagnosis (type and subtype), anthropometric measurements (weight, length/ height, head circumference), biochemical values (visceral proteins, blood glucose levels, hemoglobin, hematocrit, lymphocyte count), clinical assessment (stomatitis, anemia, mucositis), diet history (home feeding regimes; consumption of daily requirements; food preferences – types, textures; food allergies, food intolerances; food aversions; use of oral nutritional supplements; treatment-related side-effects; systemic related side-effects (nausea; vomiting; diarrhea; anorexia; appetite changes; taste changes; physical activity level; depression), dietary requirements (age and gender related nutritional requirements for energy, protein, fat and fluids) and indications for nutritional support (oral feeding; enteral feeding; parenteral feeding). Analysis of Results: The weights and length/ heights of participants recorded in the electronic medical records were converted to z-scores on the World Health Organization growth charts. The diet prescription of nutritional intervention was interpreted in comparison to the biochemical indices, anthropometric status and dietary intake of each participant. All the data involving changes in anthropometrics, biochemistry, diet history and nutritional interventions from each case study (from diagnosis and through all stages of treatment) was screened and compared with reference values in the context of the age and sex of the child. Evidence based nutritional guidelines were used to document the outcomes of the medical nutrition treatment provided in order to develop a nutrition support protocol for children with Acute Lymphoblastic Leukemia at Sheikh Khalifa Medical City. Results: The results showed that weight loss expressed as a percentage of body weight provided a more accurate estimate of the true significance of weight loss in subjects undergoing cancer treatment (chemotherapy) for ALL. A weight loss of greater than 5% of body weight over a period of one month is considered a sign of nutritional deprivation even if the subject is not classified as undernourished by anthropometric parameters. Subjects experienced the highest weight loss during the consolidation phase and interim maintenance phases of treatment. Conclusion: It can therefore be concluded that pediatric subjects on cancer treatment for ALL at SKMC and receiving nutritional support underwent changes in nutritional status as manifest by a reduction in more than 5% of their body weight during three phases of treatment namely induction, consolidation and interim maintenance. An appropriate nutrition support protocol was developed based on the results and experience obtained from this study for pediatric ALL patients treated at SKMC
Challenges with implementation of nutrition interventions aimed at non-communicable diseases among black urban South Africans
Get PDFPhD (Nutrition), North-West University, Potchefstroom Campus, 2018AIM - To investigate challenges to the implementation of nutrition interventions aimed at chronic non-communicable diseases (CNCDs) at government, community and individual levels in the Langa PURE study site in Cape Town, South Africa.
METHODS - This cross-sectional study was embedded in the Prospective Urban and Rural Epidemiological (PURE) Study. The PURE study is a large-scale worldwide epidemiological cohort study. The PURE study aimed to recruit approximately 150,000 participants aged between 35 and 70 years living in more than 600 communities in 17 low-, middle- and high-income countries around the world. The participating countries’ selection were based on representativeness of different economic levels and the study sites included were based on the commitment of investigators to collect good quality data over the planned 10-year period. The University of the Western Cape’s (UWC) School of Public Health (SoPH) committed itself to carry out data collection in Langa (urban community) in the Western Cape Province and Mount Frere (rural community) in the Eastern Cape Province.
The current study was conducted in the urban study site (Langa). For phase 1 of the study existing baseline information (demographic, dietary, anthropometric and blood pressure (BP)) was used for secondary data analysis, 300 participants were randomly selected. For phase 2 DoH officials were identified and interviewed using the multicriteria mapping (MCM) interviewing method. For phase 3, 47 participants were selected to participate in FDGs. Data were collected at baseline from the existing PURE Western Cape Province cohort for cross-sectional analysis. For the second part of this study, 300 male and female participants aged between 35 and 70 years, from the urban community were included. Structured interviews on challenges to the implementation of nutrition interventions aimed at chronic non-communicable diseases (CNCDs) with the study participants were conducted, using a questionnaire. The multi-criteria mapping (MCM) interviewing method was used to conduct interviews with key officers from the Department of Health (DoH), to explore best courses of action to address CNCDs. Structured interviews were also conducted with DoH officials to determine challenges to the implementation of exisiting nutrition interventions aimed at CNCDs, as well as to determine their awareness of existing CNCDs policies. The third part of the study was a qualitative analysis of focus group discussions with a subsample of the PURE participants to explore challenges and barriers to the implementation of, and adherence to, CNCDs interventions.
Medians and frequencies were calculated for demographic data, anthropometric measurements, smoking habits, alcohol use and BP of men and women. The dietary data was analysed using the MRC Foodfinder III software package. Furthermore, diet adherence was determined by calculating a dietary adherence score which was based on a combination of the Dietary Approaches to Stop Hypertension (DASH) guidelines and the South African Food-Based Dietary Guidelines (SAFBDG). The dietary adherence score was calculated using an adaptation of the DASH score. Correlations were calculated between continuous variables (dietary intakes, anthropometric variables and BP) for men and women. A comparison between anthropometric variables and BP, by diet quality (adherence group) was determined using the Mann-Whitney U test. The presence of associations between diet adherence category and body mass index (BMI) (overweight/obese vs normal weight), waist-height ratio (WtHR) (0.5), waist-hip ratio (WHR) and waist circumference (WC) ( cut-points), were determined by means of the chi square test (two-by-two tables). Logistic regression and odds ratios were used to determine associations between BP as the dependent variable and dietary adherence score, age, smoking and physical activity as covariates. Data analysis was done using the Statistical Package for Social Studies (SPSS) version 23 (SPSS Inc., Chicago, IL, USA) software programme. The MCM data was analysed using the MCM software package 2016 version (University of Sussex).
The responses of the participants to the structured interviews were presented as frequencies. The results of the MCM interviews were summarised. The focus group discussions were analysed using content analysis.
RESULTS AND CONCLUSION OF MANUSCRIPTS - Three manuscripts were written to meet the aims of this thesis. In the first manuscript, the association between dietary adherence score and blood pressure, as well as anthropometric measurements were investigated. Positive relationships were found between age, for both men and women and systolic and diastolic BP. A significant positive relationship between added sugar intake and systolic blood pressure (SBP) was only present in the women’s group. A significant positive relationship was found between SBP, diastolic blood pressure (DBP) and BMI for men only. No significant differences existed between blood pressure of men or women in the lowest and top tertile groups, according to dietary adherence score, but a significant inverse correlation between the dietary adherence score and SBP in women was found. The findings revealed that there were no significant differences between anthropometric measurements or blood pressure in the three groups according to dietary adherence, but women with the highest adherence scores had the lowest SBP.
In the second manuscript, the aim was to determine the challenges that participants had regarding CNCDs interventions and their needs from intervention programmes were explored. In addition, the strategies that the Department of Health officials viewed as the best options to address the CNCDs epidemic were also investigated. Participants sought education on foods associated with weight gain, what food and drinks to purchase and how to prepare healthy food and recipes as part of CNCDs intervention programmes. Department of Health officials regarded the integration of health services, community participation, improved inter-sectoral partnerships and food taxation as the most favourable options to address the CNCDs epidemic. The findings revealed that current CNCDs interventions should be adapted to include context-based needs of community members.
In the third manuscript, perceived challenges with the implementation of, and adherence to, CNCDs intervention health messages were explored. The study attempted to gain an understanding of participants’ expectations of CNCDs intervention programmes and explored the acceptability and preference of health message dissemination. In addition, preferred modes of health message dissemination were explored. Four themes emerged from the data analysis: practical aspects of implementation and adherence to intervention programmes; participants’ expectations of intervention programmes; aspects influencing participants’ acceptance of interventions and their preferences for health message dissemination. The findings revealed that, although participants found current methods of health message dissemination in CNCD interventions acceptable, they faced real challenges with implementing and adhering to these messages.
GENERAL CONCLUSION - The study revealed that the challenges faced with the implementation of and adherence to CNCDs health messages are multifactorial and that current CNCDs intervention programmes do not necessarily meet participants’ expectations and perceived needs. This indicates the need for culturally-sensitive health messages and dietary recommendations that are context-based. By including the community members from the onset when planning CNCDs intervention programmes, possible gaps between the planned interventions of the Department of Health and the expectations about intervention programmes of target groups could be addressedNational Research Foundation (NRF)Doctora
Treating an intervention level 1 patient: futile or brave?
No full textAn ethical dilemma describes conflicting opinions by different members of the care team. This article focuses on AJ, a five-year-old child
with cerebral palsy, who was born deaf and blind as a result of having contracted rubella in utero. The case is examined against Sokol’s
four-quadrant analysis of ethical issues, giving a framework designed to facilitate the systematic identification and analysis of clinical ethical
problems. The issue is whether the medical team should have palliated AJ, or continued with invasive therapy and feeding. The conclusion is
that paediatric palliative care is often difficult, but that the dietitian has a duty to contribute his or her knowledge to benefit the patient.Department of HE and Training approved lis
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
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