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Tesi sul tema "Malnutrition in children – Prevention"

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Autore: Grafiati
Pubblicato: 27 luglio 2024
Ultima modifica: 28 luglio 2024

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1

Gunnarsson, Hanna, e Nanci Kader. "Prevention of malnutrition for children in South Africa". Thesis, Sophiahemmet Högskola, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-1772.

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Abstract (sommario):
Background Malnutrition among children in South Africa is a huge issue, which are causing short- and long-term effects for the children suffering from it. In 64 percent of the cases where children die before the age of five, malnutrition is the underlying cause. Therefore there are non-governmental organizations who are doing preventive work to try to diminish malnutrition so all children have the same chance to a good childhood. Aim The aim of the study was to describe the prevention of malnutrition of children in South Africa. Method A qualitative design with semi-structured interviews with non governmental organzations was used for this study. Data was analysed by content analyse. Findings The findings show that one key intervention is nutritional education to empower people on how to best use the scares resources they have. Therefore the non governmental organizations put a lot of emphasis on educating families about nutrition. Furthermore the stigma and mistaken beliefs about breastfeeding is targeted through education, as it is of vital importance to solely breastfeed as a preventive intervention. Conclusion Early interventions are emphasized due to the importance of preventing malnutrition early in a child’s life. The link between HIV positive women and malnourished children is remarkable and the government of South Africa has promoted breastfeeding for all as a solution.
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2

Pettersson, Camilla, e Fanny Enström. "Prevention of malnutrition in South Africa among children". Thesis, Sophiahemmet Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2133.

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Abstract (sommario):
Background Malnutrition among children in South Africa is a substantial public health problem. Especially young children are vulnerable and exposed to malnutrition. Children suffering from malnutrition develop many short- and long-term health-consequences. Effective preventative work against this issue is crucial in order for malnutrition to diminish among the children in South Africa. Aim The aim was to describe how the preventative work against malnutrition is being performed among children aged zero to six in South Africa. Method The method used in this study was a qualitative descriptive study with six semi-structured interviews. Interviews were performed with registered nurses and researchers. The interview-data was analyzed based on a grounded theory through substantive coding where the most relevant codes where found, studied and concluded in the results. Results The results showed that both the registered nurses and researchers considered socioeconomic-factors and lack of knowledge about nutrition to be the most important causes for malnutrition among children, and also impacted heavily on the preventative work. It was found that more effective preventative work is needed, but for this to work it needs to be adapted to the social context in the country. Conclusions The preventative work against malnutrition must be able to break through socioeconomic barriers like poverty, misguided cultural beliefs about nutrition, lacking food security and the fact that many mothers to children are HIV positive, which also is strongly connected to malnutrition among young children. Education about nutrition must be further developed and reach out to more people in the country.
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3

Khatib, Ibrahim Mahmud Dib. "Role of zinc-supplemented diets in the prevention of the early linear growth deficiency in Jordanian children". Thesis, University of London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.244278.

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4

Van, Der Kam Saskia. "Does a short term nutritional supplementation prevent malnutrition in ill children? Effectiveness of nutritional supplementation (ready-to-use therapeutic food and multi micronutrients) of 2 weeks in preventing malnutrition in children 6-59 months with infection (malaria, pneumonia, diarrhoea)". Doctoral thesis, Universite Libre de Bruxelles, 2017. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/242533.

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Abstract (sommario):
It has been generally recognised that sick children have an increased risk on malnutrition. An activated immune system requires more nutrients while illness is often associated with a lower absorption and decreased consumption because of lack of appetite. When these increased needs are not balanced with an adequate availability of nutrients, the sick child is at higher risk of developing malnutrition.Médecins Sans Frontières investigated the question whether this process is mitigated by simple short term nutritional supplementation given to sick children alongside medical treatment. Three Randomised Controlled Trials (RCT’s) were conducted. The first, in Democratic Republic of Congo, was a pilot; 180 children with malaria were randomised in 2 arms: 1 group receiving 2 weeks of ready to use therapeutic food (RUTF) and a control group. The children were followed for a period of 4 weeks. Children in the RUTF group showed a higher weight gain in the first 14 days compared to the control group, at day 28 the weight gain in both groups was similar.Thereafter, 2 RCT’s were implemented in Uganda and Nigeria using a similar methodology. Children with malaria, lower respiratory tract infection or diarrhoea (sample size of 2202) were randomised in three groups: supplemented with 2 weeks of RUTF, supplemented with 2 weeks of micronutrient powder (MNP), and not receiving supplementation after each disease episode. The incidence of malnutrition was compared after an observation period of 6 months. The trial in Uganda showed a reduction in malnutrition in the RUITF group with 31%, while in Nigeria, there was no significant reduction in the RUTF group. The MNP group did not show reduction in malnutrition in any site. In the group of moderate malnourished children the RUTF and MNP supplementations were not effective in preventing deterioration to severe malnutrition. However, when the studies were combined the RUTF group showed a lower mortality compared to the MNP group.Multi-variate analysis did not show a reduction of incidence of malnutrition in the supplementation groups. A strong association with morbidity was found. A higher frequency of diarrhoea was associated with an increased incidence of malnutrition. The association with malaria episodes was mixed; it was associated with a higher incidence of malnutrition in Kaabong, but in Goronyo a higher frequency of malaria decreased the incidence of malnutrition. In addition, a more frequent monitoring of the children and treatment of their illnesses was associated with a decreased incidence of malnutrition.The difference in effectiveness of supplementation between the sites can be explained by differences in food security and level of morbidity. It is argued that the fragile food security in Kaabong limits the supply of nutrients, and therefore supplementation with RUTF was effective. In Goronyo the high frequency of morbidity limits convalescence and therefore supplementation was not effective.It is likely that malnutrition is more effectively prevented when several interventions are combined like water and sanitation to prevent diarrhoea, malaria chemoprophylaxis and preventative and curative health and nutrition interventions.This dissertation will present the background, the methods of the trials and the results, followed by a discussion on the implications for programming and research.
Doctorat en Santé Publique
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5

Mitangala-Ndeba, Prudence. "Impaludation et état nutritionnel chez les enfants au Kivu en République Démocratique du Congo". Doctoral thesis, Universite Libre de Bruxelles, 2012. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209608.

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Introduction: Le paludisme est une maladie parasitaire curable. Il sévit sous une forme endémique depuis des temps immémoriaux. Malgré le recul de l’endémie observé au cours de la dernière décennie à la suite des efforts menés à un niveau international, l’Afrique essentiellement tropicale continue encore à supporter une importante charge de morbidité et de mortalité liée au paludisme. L’Organisation Mondiale de la Santé (OMS) estime que sur les 216 millions malades et 655 000 décès survenus dans le monde en 2010, respectivement 80,6% et 91,6% l’étaient en Afrique tropicale. Au cours de cette année 2010, dans cette partie du monde, à chaque minute, un enfant de moins 5 ans est décédé des suites du paludisme. A elle seule, la République Démocratique du Congo (RDC) a supporté 13,3% de la charge mondiale de morbidité estimée en 2010.

La malnutrition est un autre fléau qui frappe le monde depuis la nuit des temps. Les pays les plus touchés sont ceux-là mêmes qui sont concernés par l’endémie palustre. En 2010, 38% d’enfants africains âgés de moins de 5 ans souffraient d’un retard de croissance et 9% étaient émaciés. Ces formes de malnutrition concernaient respectivement 43% et 9% d’enfants de la RDC.

Le paludisme et la malnutrition coexistent. Néanmoins, leur relation demeure un sujet de controverse malgré de nombreuses études menées sur le sujet. Certains auteurs affirment que la malnutrition protégerait contre le paludisme alors que d’autres soutiennent le contraire. Une troisième catégorie d’auteurs atteste qu’il n’existe aucune relation.

Ces divergences de points de vues font que, sur le terrain, dans une même localité, certains préconisent le traitement systématique du paludisme au cours de la réhabilitation nutritionnelle alors que d’autres n’administrent les médicaments que pour les cas avérés de paludisme.

Dans le but de contribuer non seulement à l’amélioration des connaissances sur cette relation entre la malnutrition et le paludisme, mais aussi à la rationalisation de la prise en charge du paludisme dans les zones de coexistence des deux entités, des études ont été menées au Kivu, dans la partie Est de la RDC.

Méthodologie:En vue d’atteindre ce but, les résultats de six analyses de données, portant sur cinq études épidémiologiques menées au Kivu en RDC, sont présentés dans cette monographie.

La monographie est composée de quatre parties. La première partie est consacrée à des généralités sur le paludisme et la malnutrition et la quatrième partie est une synthèse générale.

Les résultats des six analyses évoquées ci-haut font, chacun l’objet d’un chapitre et sont regroupés au sein de deux parties portant respectivement sur la description de la relation entre la malnutrition et le paludisme (deuxième partie) et sur le traitement antipaludéen chez l’enfant sévèrement malnutri (troisième partie).

La description de la relation entre le paludisme et la malnutrition est le résultat des analyses de données de trois études. Les deux premières études font l’objet d’analyses rétrospectives des données de routine récoltées au sein de l’hôpital pédiatrique de Lwiro. La troisième étude est prospective et réalisée en communauté.

Le traitement antipaludéen chez l’enfant sévèrement malnutri est abordé à travers deux études menées en milieu hospitalier.

La première étude de cette partie a été menée à l’hôpital pédiatrique de Lwiro. Cette étude portait sur l’efficacité de la combinaison Artésunate-Amodiaquine (AS+AQ) dans le traitement du paludisme non compliqué à Plasmodium falciparum. Elle a été réalisée suivant le protocole standard de l’OMS portant sur l’évaluation et la surveillance de l’efficacité des antipaludiques pour le traitement du paludisme à Plasmodium falciparum non compliqué. Cependant, en plus des enfants habituellement inclus dans ces études d’efficacité selon le protocole de l’OMS, cette étude a intégré les enfants souffrant de la malnutrition sévère. Cette étude a conduit à deux analyses distinctes ayant fait chacune l’objet d’un chapitre. La première analyse s’est focalisée sur l’efficacité proprement dite du traitement antipaludéen. La seconde analyse a utilisé les données individuelles des enfants inclus dans cette étude sur l’efficacité du traitement antipaludéen pour explorer la production des gamétocytes de Plasmodium falciparum chez l’enfant souffrant de Malnutrition Aigue Sévère (MAS).

La deuxième étude de cette partie consacrée au traitement antipaludéen chez l’enfant malnutri sévère porte sur l’efficacité d’une stratégie de traitement antipaludéen systématique chez l’enfant malnutri au cours de la réhabilitation nutritionnelle. Il s’est agi d’un essai clinique randomisé en double aveugle, réalisé au centre thérapeutique nutritionnel de l’hôpital général de référence de Kirotshe. Les enfants malnutris admis dans le programme de réhabilitation nutritionnelle étaient assignés dans l’un des deux groupes d’étude selon une procédure aléatoire. Le groupe d’intervention recevait systématiquement la combinaison AS+AQ à la posologie habituelle et le groupe témoin recevait un placebo composé d’avicel 97,1%, stéarate de magnésium 1,9%, aérosil 1% et de colorant.

Les quatre premières études ont eu lieu dans la zone de santé de Miti Murhesa dans la province du Sud Kivu et la dernière a été menée dans la zone de santé de Kirotshe dans la province du Nord Kivu en RDC.

Résultats: [1] \
Doctorat en Sciences de la santé publique
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6

Martinsson, Katarina, e Ida Bergqvist. "Omvårdnadsarbete vid malnutrition hos äldre : - En litteraturöversikt". Thesis, Mittuniversitetet, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-12227.

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Abstract (sommario):
Bakgrund: Malnutrition är en av de största hälsoriskerna bland äldre och det har länge varit ett problem inom sjukvården. Till följd av felnäring får patienterna komplikationer. Trots att det finns olika metoder för bedömning av nutritionsstatus är det känt att omvårdnaden kring nutrition är otillräcklig. Syfte: Syftet med litteraturöversikten var att belysa senaste rön i omvårdnadsforskningen kring malnutrition gällande äldre patienter. Metod: Artikelsökningar gjordes i databaser med sökord relaterade till ämnet. Resultatet baserades på sexton artiklar där tolv var kvantitativa, en kvalitativ och tre med både kvantitativ och kvalitativ metod. Innehållsanalysen användes för att granska artiklarna. Resultat: Vid bedömning av nutritionsstatus används flera mätinstrument och omvårdnadsinsatser. Inom sjukvården fanns god kunskap kring identifiering men rutiner och prioriteringar saknades för att avhjälpa problemet. Det fanns många olika orsaker till att patienterna drabbades av kalcium- och D-vitaminbrist. Diskussion: För att få en god bedömning och kunna åtgärda problemet malnutrition krävs många olika metoder och en individ anpassad vård. Det rådde delade meningar om osteoporospatienter behövde tillskottsbehandling av kalcium och D-vitamin. Slutsatser: Det finns brister inom nutritionsomvårdnaden som kan minskas med hjälp av preventivt arbetet, individuellt anpassad vård och ett bra teamarbete. Angående kosttillskottsbehandlingens effekt fordras ytterligare forskning på området.
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7

Martinsson, Katarina, e Bergqvist Ida. "Omvårdnadsarbete vid malnutrition hos äldre : -En litteraturöversikt". Thesis, Mittuniversitetet, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-12257.

Testo completo
Abstract (sommario):
Abstrakt Bakgrund: Malnutrition är en av de största hälsoriskerna bland äldre och det har länge varit ett problem inom sjukvården. Till följd av felnäring får patienterna komplikationer. Trots att det finns olika metoder för bedömning av nutritionsstatus är det känt att omvårdnaden kring nutrition är otillräcklig. Syfte: Syftet med litteraturöversikten var att belysa senaste rön i omvårdnadsforskningen kring malnutrition gällande äldre patienter. Metod: Artikelsökningar gjordes i databaser med sökord relaterade till ämnet. Resultatet baserades på sexton artiklar där tolv var kvantitativa, en kvalitativ och tre med både kvantitativ och kvalitativ metod. Innehållsanalysen användes för att granska artiklarna. Resultat: Vid bedömning av nutritionsstatus används flera mätinstrument och omvårdnadsinsatser. Inom sjukvården fanns god kunskap kring identifiering men rutiner och prioriteringar saknades för att avhjälpa problemet. Det fanns många olika orsaker till att patienterna drabbades av kalcium- och D-vitaminbrist. Diskussion: För att få en god bedömning och kunna åtgärda problemet malnutrition krävs många olika metoder och en individ anpassad vård. Det rådde delade meningar om osteoporospatienter behövde tillskottsbehandling av kalcium och D-vitamin. Slutsatser: Det finns brister inom nutritionsomvårdnaden som kan minskas med hjälp av preventivt arbetet, individuellt anpassad vård och ett bra teamarbete. Angående kosttillskottsbehandlingens effekt fordras ytterligare forskning på området.
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8

Blomstrand, Lena, e Magdalena Johansson. "Åtgärder för att förebygga malnutrition hos äldre : En litteraturstudie". Thesis, Örebro universitet, Hälsoakademin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-20580.

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Abstract (sommario):
Det normala åldrandet samt kroniska sjukdomar påverkar individens näringstillstån, förmågan att inta mat och kan leda till malnutrition. Malnutritionstillstånd har samband med ökad risk för funktionsnedsättning och död. Syftet med denna studie var att beskriva åtgärder för att förebygga och behandla malnutrition hos äldre. Metoden var systematisk litteraturstudie med deskriptiv design. Studien innefattade 15 kvantitativa studier genomförda på personer över 65 år. Resultatet visade att nutritionsåtgärder som att ge kosttillskott, förbättra måltidsmiljön, handleda personl och patienter i nutritionsfrågor är förebyggande och behandlande av malnutrition hos äldre personer. De flesta åtgärderna är studerade på institutioner men kan tillämpas i primärvård och hemsjukvård.
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9

Törner, Nylén Gunilla. "MALNUTRITION HOS DEMENTA PERSONER-ETT OMVÅRDNADSPROBLEM". Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26374.

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Malnutrition är vanligt förekommande hos personer med demenssjukdomar och för denna utsatta grupp är det av vikt att fokusera på nutrition och omvårdnadsåtgärder. Syftet med ddenna litteraturstudie är att belysa malnutrition och riskfaktorer ho dementa personer samt beskriva vad sjuksköterskan bör vara uppmärksam på i sitt arbete för att förebygga malnutrition och hur bättre nutritionsstatus kan uppnås. Metoden i arbetet är en litteraturstudie i vilken 9 kvantitativa artiklar och 1 kantitativ/kvalitativ studie granskats ur ett vetenskapligt perspektiv. Resultatet presenteras utifrån tre huvudområden: nutritionsproblem och tillhörande faktorer,utbildning samt interventioner. Tillsammans visar de på förekomst av malnutrition och att det via utbildning och åtgärder går att påverka nutritionsstatus hos dementa personer. Slutsats är att det är väsentligt att det i sjuksköterskans omvårdnadsarbete läggs vikt på nutritionsfrågor både vad gäller riskbedömning och interventioner. Nutritionens betydelse behöver belysas starkare både i omvårdnads arbete men också under pågående utbildning.
Malnutrition is common among elderly with dementia and it is vital to focus on nutrition and care for this exposed group of individuals. The aim of this literary review is to illustrate malnutrition and risk factors among demented patients and describe what nurses should be observant of to prevent malnutrition and how to obtain better nutrition status. The method is a literary review in which 9 quantitative articles and 1 quantitative/qualitative article has been review with regard to scientific quality. The result is presented on the basis of three themes: nutrition problem and related factors,education and interventions. Altogether these three themes show presence of malnutrition and that it is possible through education and intervention to promote better nutrition status among patients with dementia. The conclusion is that it is important in nursing care to focus on nutrition issues both with regard to risk assessment and to interventions. The significance of nutrition needs to be illuminated both in nurse caring as well during the educational period.
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Fergusson, Pamela Lynne. "Severe acute malnutrition and HIV in children in Malawi". Thesis, University of Chester, 2009. http://hdl.handle.net/10034/93477.

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Abstract (sommario):
Sub-Saharan Africa is more affected by the HIV epidemic than any other region of the world. At the same time, malnutrition remains a major public health concern. HIV and malnutrition are interlinked, both epidemiologically and physiologically, contributing to high mortality and poor growth and development of children in sub-Saharan Africa. This thesis aims to explore the impact of HIV on the treatment and care of children with severe acute malnutrition in Malawi. The thesis will investigate mortality and nutritional recovery in HIV-infected and uninfected children with SAM; HIV infection and nutritional status in carers of children with SAM; and caregiver perspectives on quality of care for children with SAM. The study is based on a prospective cohort study of 454 children with SAM and meta-analysis of 17 relevant studies; a cross sectional study of 322 carer-child pairs; and a qualitative study using a grounded theory approach.
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11

Ungphakorn, Wanchana. "Pharmacometric models of oral ciprofloxacin for children with malnutrition". Thesis, University of Strathclyde, 2012. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=18680.

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Abstract (sommario):
Children with severe malnutrition typically suffer from numerous associated complications. Among these, septicaemia, especially with Gram-negative organisms, remains the major concern because it is associated with a high mortality rate. The World Health Organization (WHO) has been releasing standard guidelines for the treatment of bacterial infections for many years; however, it has been found that the mortality rate remains high even if these guidelines are followed. Ciprofloxacin is a fluoroquinolone antimicrobial agent that has been considered as alternative treatment option. However, to date, data around the pharmacokinetics (PK) of ciprofloxacin, as well as other drugs, are limited in malnourished children. The aim of this thesis was to develop pharmacokinetic models for describing and predicting the PK of drugs in such children. A population analysis was performed by using ciprofloxacin concentration-time data obtained from 52 malnourished children. It was found that a one-compartment model, with first-order absorption and a lag, adequately described the data. The final population model included the effect of body weight, high mortality risk and serum sodium concentration on clearance (CL), and the effect of body weight and sodium concentration on volume of distribution (V). Inclusion of these factors reduced inter-individual variability in CL from 50% to 38%, and in V from 49% to 43%. Absorption rate (ka) was poorly estimated and highly variable. Internal validation techniques, including nonparametric bootstrap, a visual predictive check, normalised prediction distribution error and a jackknife analysis, were used to assess the stability and robustness of the final population model. The results of these analyses indicated that the model was stable and had a favourable predictive performance for CL and V. To develop new dosage regimens, the population model was used to perform a 10,000-patient Monte Carlo simulation. The probabilities of achieving the therapeutic target AUC0-24/MIC ratio and the expected population response were then iv determined. The results showed that PK-PD breakpoints were 0.06-0.125 mg/L and 0.25-0.5 mg/L for Gram-negative and Gram-positive organisms, respectively. The overall response with the 30 mg/kg/day dose was 80% for Escherichia coli, Klebsiella pneumoniae and Salmonella species, but <60% for Pseudomonas aeruginosa and Streptococcus pneumoniae. The results suggested that an oral dose of ciprofloxacin 10 mg/kg three times daily (30 mg/kg/day) may be appropriate for the management of septicaemia in severely malnourished children. Discrepancies of susceptibility breakpoints between reference sources were also found, i.e., PK-PD, CLSI and EUCAST, and these discrepancies were most pronounced for P. aeruginosa and S. pneumoniae. The population model was alsmpartment model, with first-order absorption and a lag, adequately described the data. The final population model included the effect of body weight, high mortality risk and serum sodium concentration on clearance (CL), and the effect of body weight and sodium concentration on volume of distribution (V). Inclusion of these factors reduced inter-individual variability in CL from 50% to 38%, and in V from 49% to 43%. Absorption rate (ka) was poorly estimated and highly variable. Internal validation techniques, including nonparametric bootstrap, a visual predictive check, normalised prediction distribution error and a jackknife analysis, were used to assess the stability and robustness of the final population model. The results of these analyses indicated that the model was stable and had a favourable predictive performance for CL and V. o used to determine optimal design for future population PK studies. A number of design options and design variables were examined. The results suggest that the optimal number of groups was three and two for three- and four-sample designs, respectively. When using two groups, it was possible to vary the number of individuals in each group. If permission was given to obtain up to five samples from each patient, one group of participants would be adequate. Only samples taken after the first dose gave sufficient information. The expected coefficient of variation (CV) of all parameters was under 10% with sample sizes of 25 and 40 for five- and four-sample designs, respectively. For three samples, the CV for ka remained above 20%, although the sample size was increased to 100. It was also found that the optimal designs were highly dependent on the prior information, so prior knowledge of drug concentration-time profiles should be used with optimal design methods when designing population PKt model, with first-order absorption and a lag, adequately described the data. The final population model included the effect of body weight, high mortality risk and serum sodium concentration on clearance (CL), and the effect of body weight and sodium concentration on volume of distribution (V). Inclusion of these factors reduced inter-individual variability in CL from 50% to 38%, and in V from 49% to 43%. Absorption rate (ka) was poorly estimated and highly variable. Internal validation techniques, including nonparametric bootstrap, a visual predictive check, normalised prediction distribution error and a jackknife analysis, were used to assess the stability and robustness of the final population model. The results of these analyses indicated that the model was stable and had a favourable predictive performance for CL and V. studies. In order to predict the disposition of other drugs in a malnourished population, whole body physiologically based pharmacokinetic (WBPBPK) models were developed by using ciprofloxacine as a model drug. The WBPBPK model was initially developed for healthy adults and then scaled to healthy and malnourished children. Kp values were calculated using the Poulin method, the Rodgers method and empirical method. The results showed that, for healthy adults and children, the predicted versus observed concentration-time profiles were well described with intravenous (IV bolus v and short infusion) models. Oral predictions were also in good agreement with the data from the literature, but peak concentrations were more rapidly achieved with a higher dose. Unlike the Poulin method, the concentration-time profiles predicted using Kp from the Rodgers method and the empirical methods were similar, and closely resembled the observed data. When models were scaled for malnutrition, inter-individual variability was higher, especially during the absorption phase. However, PK profiles were still adequately described. The models developed in this thesis are useful tools for describing and predicting drug PK in malnourished children. However, due to the scarcity of data, further studies to characterise the alteration of drug kinetics, particularly during the absorption process, might improve the performance of the models. Application of these models to other drugs and data is also required to substantiate the predictive performance of the model.
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12

Ditebo, Gaeboloke Precious. "Malnutrition in children : the perceptions of mothers in Botswana". Diss., University of Pretoria, 2010. http://hdl.handle.net/2263/31170.

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Abstract (sommario):
Malnutrition is one of the serious childhood problems that affect children under five (5) years of age, and is common in developing countries Botswana included. The aim of this study was to explore the perceptions of mothers of children diagnosed with malnutrition in Botswana, specifically at Sekgoma Memorial Hospital, Serowe. The said hospital is a district hospital which renders services to Serowe community and the surrounding villages, as such; participants in this study were from Serowe and other surrounding villages like Mabou, Tshimoyapula, Mmashoro and Mogorosi. Applied research was used as a type of research because it is associated with the researcher’s motivation to assist in solving a particular problem facing a particular community. Collective case study was used as a research design. The researcher explored the perceptions of mothers regarding child malnutrition; through the use of semi-structured interviews. Twelve (12) mothers of children with malnutrition were interviewed using systematic random sampling method and subsequently data was analysed according to Creswell’s model. Literature study was done and the following aspects were discussed: Child malnutrition in developing countries; child malnutrition in Botswana; description of child malnutrition; causes of child malnutrition; symptoms of child malnutrition; treatment of child malnutrition; prevention of child malnutrition; psychosocial implications of child malnutrition on the patient, family and community and social work intervention (therapy and prevention). Literature was also compared with research findings when analysing data. The study revealed that mothers had limited knowledge on malnutrition as a condition, the signs and symptoms thereof; causes; prevention and treatment of child malnutrition. This lack of knowledge made mothers to have wrong perceptions about child malnutrition. It was revealed that mothers did not perceive malnutrition as a serious problem that can result in admission for treatment in a hospital, they expected a different diagnosis. They perceive malnutrition as a secondary diagnosis. The majority of mothers had a Setswana diagnosis for their children’s condition. Mothers perceived the signs and symptoms of malnutrition as those of Thibamo, Phogwana (fontanel), or Ntsana. They interpret malnutrition as a Setswana ailment that can be treated traditionally. Factors that were identified to be contributing to malnutrition among children at Sekgoma Memorial Hospital in Serowe were found to be; lack of knowledge about malnutrition, wrong perceptions of malnutrition by mothers, illiteracy and unemployment, and cultural factors like taking a child to a traditional healer instead of a medical health facility. The study shows that mothers’ social functioning is disrupted by their children’s illness and hospitalization and thus a need for support from the hospital multi-disciplinary team, especially the social worker who is a trained counselor. The social worker should provide ongoing supportive counseling during the process of the child’s illness.
Dissertation (MSW)--University of Pretoria, 2010.
Social Work and Criminology
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13

Larsson, Pamela, e Sofia Schiller. "Att förebygga malnutrition hos äldre - en sjuksköterskeuppgift". Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25913.

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Abstract (sommario):
Malnutrition är ett stort problem hos äldre patienter, och leder till ett antal följdsjukdomar, förlängda vårdtider samt en ökad dödlighet. Syftet med denna litteraturstudie var att beskriva sjuksköterskans arbete med att förebygga malnutrition hos äldre patienter på sjukhus eller äldreboenden, samt att beskriva de olika tillvägagångssätt som finns för att identifiera riskpatienter. Metoden var litteraturstudier där tio kvantitativa artiklar granskats med avseende på vetenskaplig kvalitet. Resultatet visar att sjuksköterskors arbete med att förebygga malnutrition främst bör inriktas på två områden; omvårdnadsåtgärder och screening. Resultatet presenteras utifrån sex teman. Slutsatsen är att sjuksköterskor behöver inse vikten av nutrition redan under utbildningen. Nutritionens betydelse måste belysas starkare för att sjuksköterskans preventiva arbete ska bli effektivt.
Malnutrition is a significant issue for the elderly, and it leads to a number of diseases, prolonged stays in hospital and an increase in mortality. The aim of this literary review was to describe the nurse’s task of preventing malnutrition in elderly patients in hospitals or nursing homes, and to describe the different courses of action available to identify patients at nutritional risk. The methods were literary review, and ten quantitative articles have been reviewed with regard to scientific quality. The results show that nurses preventive measures should be focused on two areas; nursing care and screening. The results are presented on the basis of six themes. The conclusion is that nurses need to acknowledge the importance of nutrition during their training. The importance of nutrition needs to be strongly highlighted in order to make the preventive measures of nurses efficient.
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14

Aheto, Justice Moses Kwaku. "Modelling malnutrition among under-five-year-old children in Ghana". Thesis, Lancaster University, 2016. http://eprints.lancs.ac.uk/82143/.

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Abstract (sommario):
Childhood malnutrition is a real-life and a chronic problem and one of the global major public health challenges, especially in developing countries like Ghana. Several attempts from governmental and non-governmental organizations to address the problem have fallen below expectation. It is recognised that the existing studies and nutrition intervention strategies are inadequate and hence not working to expectation. This thesis examines childhood malnutrition in Ghana using appropriate and advanced statistical methods to help improve the understanding of childhood nutrition and to better inform targeted public health nutrition interventions in the country. In this thesis, we provided solutions to five main problems: (1) investigated the major risk factors for malnutrition; (2) investigated household level variations in nutritional outcomes of children; (3) explored, modelled and illustrated spatial variations in the risk of childhood malnutrition over Ghana; (4) explored, modelled, forecasted and illustrated spatio-temporal variations in the risk of childhood malnutrition over Ghana; (5) jointly modelled weight-for-age Z-score (WAZ) and height-for-age Z-score (HAZ) to improve accuracy and reliability in estimates. To answer the first and the second problems, multilevel models were considered. The results showed strong residual household-level variations in under-fives nutritional outcomes and that child’s age, type of birth, child’s experience of diarrhoeal episodes, size of child at birth and months of breast feeding, mother’s education, current age, BMI and national health insurance status, household toilet facility ownership and wealth status were predictive of under-fives nutrition. To answer the third problem, spatial models were employed. The study found substantial spatial variation in the predicted risk of under-fives malnutrition over Ghana and also showed that Normalised Difference Vegetation Index (a marker for vegetation cover), elevation and rural/urban residence status were predictive of under-fives nutritional outcomes. The study considered spatio-temporal models to answer the fourth problem. The results showed substantial spatio-temporal variation in the risk of under-fives chronic malnutrition over Ghana. Our forecasted map of chronic malnutrition showed substantial spatial variation with children from parts of Northern and Western regions being at the highest risk of malnutrition compared to children from other regions of the country. In our forecast maps, the effect of increasing the level of maternal education was shown to reduce the prevalence of malnutrition throughout Ghana. To answer the fifth problem, multivariate response multilevel models were considered. The study found that the residual household effects for WAZ and HAZ are very strongly correlated and that the correlation was stronger for the residual household effects than the residual child effects. This also suggests that after adjusting for risk factors in our model, it is the same as-yet unidentified factors at household level that influence both WAZ and HAZ. The results also showed that there was more accuracy and reliability in estimates from the multivariate response multilevel model over separate multilevel models and showed that the effect of some important risk factors differed substantially across WAZ and HAZ. The findings from this thesis are intended to help policymakers responsible for the health and nutrition of children to design efficient public health policies and targeted nutrition interventions amidst scarce public health resources available in Ghana to better understand, target and to reduce childhood malnutrition prevalence closer to the level expected in a healthy, well-fed population of children under-fives.
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15

Kellerhals, Sarah. "Understanding Severe Acute Malnutrition in Children Globally: A Systematic Review". Thesis, The University of Arizona, 2017. http://hdl.handle.net/10150/624202.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
Severe acute malnutrition (SAM) affects 13 million children under the age of 5 worldwide, and contributes to 1‐2 million preventable deaths each year. Malnutrition is a significant factor in approximately one third of the nearly 8 million deaths in children who are under 5 years of age worldwide. There have been many revolutions in treatment of SAM over time; however, the exact etiology of this preventable condition is not well understood. This review serves to identify the most common risk factors for the development of SAM in children and to identify the most effective treatment for the disease. There are many factors that contribute to developing and surviving SAM as a child, and this systematic review serves to highlight the most common variables that lead to this cause of mortality. An exhaustive review of PubMed was conducted to complete this review. The literature review demonstrates that the most common risk factor for the development of SAM is low maternal literacy.
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16

Mahmod, Hawar, e Asha Namutebi. "Malnutrition hos äldre : Orsak och verkan - En litteraturstudie". Thesis, Röda Korsets Högskola, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-806.

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Abstract (sommario):
Bakgrund: Sveriges äldre befolkning ökar samtidigt som medellivslängden bland äldre människor stiger. Forskning visar att malnutrition hos äldre har ökat och fler ligger i riskzonen för att drabbas av malnutrition. Som en konsekvens är det därför troligt att malnutrition som fenomen och problem kommer att öka hos äldre. Malnutrition diagnostiseras inte ofta och uppmärksammas inte tillräckligt inom vården, vilket kan ge negativa effekter hos de äldre. Syfte: Syftet med denna litteraturstudie är att belysa orsaker till malnutrition och konsekvenser av malnutrition hos äldre från sextiofem år. Metod: Studien är en litteraturöversikt baserad på sexton vetenskapliga artiklar med kvantitativ design. Resultat: Samtliga artiklar berör vad som orsakar malnutrition samt vilka konsekvenser det kan få för äldre. Resultatet i denna studie redovisas i två delar; orsaker till malnutrition (genus, ålder, medicinering och demens) och konsekvenser av malnutrition (försämrad livskvalité, depression (psykisk ohälsa), högre mortalitetsrisk, högre infektionsrisk samt långa sjukhusvistelser). Slutsats: Studien visar att orsaker och konsekvenser av malnutrition hos äldre inte har uppmärksammats tillräckligt då prevalensen av malnutrition är hög och stiger. Klinisk betydelse: Trots att det forskas mycket om malnutrition hos äldre stiger antalet som drabbas av malnutrition. Det är därför av högsta prioritet att sätta in åtgärder som är anpassade till dagens vårdarbete och behov för att minska antalet som ligger i riskzonen att drabbas.
Background: Sweden's elderly population is increasing while the average life expectancy of older people increases. Research shows that malnutrition in the elderly increases and more are at risk of suffering from malnutrition. As a consequence, it is likely that malnutrition as a phenomena and problem will increase in the elderly. Malnutrition is often miss diagnosed and receives insufficient attention in health care, which can have negative effects in the elderly. Aim: The aim of this study is to illustrate the causes and consequences of malnutrition in elderly from sixty-five years old. Method: A literature study with sixteen articles with quantitative deign. Results: All articles are related to the causes of malnutrition and the impact it can have on the elderly. The results of this study are presented in two parts: the causes of malnutrition (gender, age, medication and dementia), and impacts of malnutrition (impaired quality of life, depression (mental health), higher mortality risk, higher risk of infection and long hospital stays). Conclusion: The study shows that the causes and consequences of malnutrition in the elderly has not been acknowledged enough because the prevalance of malnutrition is high and still rising. Clinical significance: Although malnutrition in the elderly is a widely researched topic the numbers of elderly suffering from malnutrition are still increasing. It is therefore of the highest priority to put in measures suited to today's health care work to reduce the number of elderly that are at risk of being affected.
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17

Alexandersson, Sandra, e Andersson Maria Roos. "Att förebygga och behandla malnutrition i sjukvården : En litteraturstudie". Thesis, University of Skövde, School of Life Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-918.

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Malnutrition är ett välkänt problem i den patientrelaterade vården både i Europa och i resten av världen. Trots detta är malnutrition något som fortfarande förekommer. Vad kan det bero på? Det är viktigt att man bedömer patientens nutritionsstatus rutinmässigt för att kunna förebygga malnutrition. Effekterna av malnutrition kostar samhället mycket pengar och orsakar mänskligt lidande. Syftet med denna studie var att belysa sjuksköterskans ansvar för att förebygga och behandla malnutrition. För att besvara syftet blev valet av metod en litteratur studie. Med hänsyn till vetenskaplig kvalitet granskades tio artiklar. Resultatet av denna studie visar att bedömning, åtgärder, dokumentation och interaktion mellan sjuksköterska och patient är viktig i arbetet med att förebygga och behandla malnutrition. Slutsatsen visar att det är nödvändigt för sjuksköterskorna att få mer utbildning inom malnutrition för att kunna identifiera riskpatienter. Interaktionen mellan sjuksköterska och patient är också en mycket viktig del och måste fungera fullt ut.


Malnutrition is a well known problem in the patient related care in Europe as well as in the rest of the world. Despite this is malnutrition something that still exists. What can that depend on? It is important to judge the patients nutrition status as a routine to be able to prevent malnutrition. The effects of malnutrition cost the community a lot of money and human suffering. The aim of this study was to see the nurse’s responsibility when it comes to prevent and treat malnutrition in his/her daily work. Our choice of method to answer this aim was a literature review. With regard to scientific quality we elected to review ten articles. The results of this study are showing that judging, preventing measures, documentation and interaction between the nurse and patient are important in the work of preventing and treating of malnutrition. The conclusion is that it’s necessary for the nurses to have more education in malnutrition to be able to identify risk patients. The interaction between the nurse and patient is also very important and has to work correctly

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18

Piniel, Abigail. "Factors contributing to severe acute malnutrition among the under five children in Francistown-Botswana". Thesis, University of the Western Cape, 2016. http://hdl.handle.net/11394/5253.

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Abstract (sommario):
Magister Artium (Child and Family Studies) - MA(CFS)
Introduction: Malnutrition is the immediate result of inadequate dietary intake, the presence of disease or the interaction between these two factors. It is a complicated problem, an outcome of several etiologies. SAM is one of the leading causes of morbidity and mortality among children under the age of five in developing countries. Although studies in Botswana show some improvement in child malnutrition since the 1980s, severe acute malnutrition still remains a cause for concern in many parts of the country. There is little information on undernourishment situation of children under the age of five years in the urban areas of the country. Aim: The purpose of this study was to determine the risk factors to severe acute malnutrition among children under the age of five years in Francistown, Botswana. The UNICEF conceptual framework was used as a guide in assessing and analysing the causes of the nutrition problem in children and assisted in the identification of appropriate solutions. Methods: The study was conducted on cases who had been admitted and referred at any time between March and July 2015. A quantitative research methodology was used to conduct the study. A case-control study design was utilised. Random selection of cases and controls was done on a ratio of 1:2 case per control. Cases included children under the age of five years admitted to Nyangabgwe Referral Hospital and those referred to the Nutritional Rehabilitation Centre within the hospital in Francistown-Botswana with a diagnosis of severe acute malnutrition. Controls were children of the same age, gender and attending the same Child welfare clinic as the case and with good nutritional status. Data was collected through face-to-face standardised interviews with care-givers. Results: Data collection was done using a combination of a review of records (child welfare clinic registers, and child welfare clinic cards) and structured questionnaires. 52 cases and 104 controls were selected with the primary or secondary care-giver as the respondent. (N=156). Data was collected using a self-developed structured questionnaire and the review of documents. Of all the cases 36.5% (n=19) were diagnosed with MAM, 46.2% (n=24) with SAM, 1.9% (n=1) with moderate PEM and 7.7% (n=4) each for PEM and Severe PEM. All the cases had presented with clinical signs and symptoms of severe acute malnutrition and/or the weight-for-height Z-score of ≤ -3 SD. Following placement of the data in regression models, the factors that were found to be significantly associated with child malnutrition were low birth weight (AOR = 0.437; 95% CI = 0.155-1.231) , exclusive breastfeeding (AOR = 2.741; 95% CI = 0.955-7.866), child illness (AOR = 0.383; 95% CI = 0.137-1.075), growth chart status (AOR =7.680; 95% CI = 1.631-36.157), level of care-giver’s education (AOR = 0.953; 95% CI = 0.277-3.280), breadwinner's work status (AOR = 1.579; 95% CI = 0.293-8.511), mother’s HIV status (AOR = 0.777; 95% CI = 0.279-2.165), alcohol consumption (AOR = 0.127; 95% CI = 0.044-0.369), household having more than one child under the age of five (AOR = 0.244; 95% CI = 0.087-0.682), household food availability (AOR = 0.823; 95% CI = 0.058-11.712), living in a brick type of house (AOR = 13.649; 95% CI = 3.736-49.858), owning a tap (AOR = 1.269; 95% CI = 0.277-5.809) and refuse removed by the relevant authority (AOR= 2.095; 95% CI = 0.353-12.445) were all statistically significantly associated with severe acute malnutrition (p < 0.05). Therefore, all these variables were included in the binary stepwise regression where living in a mud house type was the most significant factor and not being breastfed for at least three months was the least significant. Conclusion: The findings of this study suggested that immediate determinants to SAM were; child born with a low birth weight, appetite and child illness. Underlying contributing factors were; the child not exclusively breastfed for at least three months, growth chart not up to date, care-givers education level, employment status, alcohol consumption, household food availability, type of housing, owning a tap and number of children under the age of five year. Therefore, increasing household food security and strengthening educational interventions for women could contribute to a reduction in the prevalence of SAM in Francistown, Botswana.
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19

Nyberg, Sofi, e Lisbet Pallin. "Faktorer som kan vara av betydelse för att förebygga malnutrition : en litteraturstudie". Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-11480.

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Abstract (sommario):
Bakgrund: En förutsättning för människans hälsa och välbefinnande är ett adekvat näringsintag. Malnutrition har visat sig vara ett stort problem i vården. Syfte: Belysa faktorer som kan vara av betydelse för att förebygga malnutrition. Metod: Litteraturstudie som bygger på femton vetenskapliga artiklar som granskades och kvalitetsbedömdes. Resultat: Artiklarna visade att faktorer som kunde vara av betydelse var sjuksköterskans grad av kunskap, attityder till omvårdnadsåtgärder, tidsaspekten samt användandet av screeningmetoder. Diskussion: Sjuksköterskors bristande kunskap om malnutrition försvårade adekvat handläggning av patienterna. Utarbetade screeningmetoder fanns för att upptäcka malnutrition men de användes inte i tillräcklig utsträckning. Sjuksköterskor hade god attityd till nutritionens betydelse men det fanns faktorer som utgjorde hinder för att specifika omvårdnadsåtgärder utfördes. Slutsats: Studier visade att sjuksköterskor hade behov av mer kunskap inom området. Åtgärder för att förebygga malnutrition behövdes.
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20

Dale, Anne. "Helicobacter pylori infection and growth in rural Gambian children". Thesis, University of Newcastle Upon Tyne, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366583.

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21

Polaki, Busisiwe. "Caregivers perceptions on factors contributing to their children’s malnutrition". University of the Western Cape, 2018. http://hdl.handle.net/11394/6654.

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Abstract (sommario):
Magister Artium (Social Work) - MA(SW)
Complex factors contribute to child malnutrition. These include various factors for example stress, trauma, cognitive abilities and education, poverty, environmental and cultural practices. Caregivers’ situations and perceptions regarding these factors are of utmost importance in child malnutrition. Lesotho has a high incidence of malnourished children irrespective of various interventions to address the problem. The research question that the researcher wanted to answer is: What are caregivers’ perceptions on factors contributing to their children’s malnutrition? This was the question as caregivers’ environments and perceptions influence child malnutrition and they are the ones that accompany the children to the hospital where this research was done. The research goal was to get an understanding of caregivers’ perceptions on factors contributing to malnutrition. In order to reach the goal. the objectives were: To explore the factors contributing to malnutrition; to describe the factors contributing to malnutrition and to give recommendations to social workers and the multi-disciplinary team in order to address the factors contributing to malnutrition as preventative measures.
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22

Ngianga-Bakwin, Kandala. "Spatial modelling of socio-economic and demographic determinants of childhood undernutrition and mortality in Africa /". Aachen : Shaker, 2002. http://www.loc.gov/catdir/toc/fy0702/2006485828.html.

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23

Khanum, Parveen A. Gray Alan Noel. "Nutritional status of children in Khulna and Sylhet divisions in Bangladesh : a comparative analysis from the Bangladesh demographic and health survey 1996-97 /". Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-ParveenA.pdf.

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24

Carey, Aoife. "An investigation into the prevalence and identification of malnutrition in hospitalised children". Thesis, Ulster University, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.673814.

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Abstract (sommario):
Malnutrition can be defined as a state of deficiency, excess or imbalance of nutrition which has an adverse effect on bodily function, composition or clinical outcome. Despite justifiable concerns regarding the increasing prevalence of over-nutrition in children, under-nutrition remains an underlying issue in paediatric hospitals. Under-nutrition is commonly seen in hospitalised patients as a result of decreased dietary intake, an inability to absorb nutrients or increased metabolic requirements. Apart from the well-recognised detrimental metabolic and clinical consequences, the long term effects of under-nutrition on foetal, infant and childhood growth have been acknowledged to predispose a child to an increased risk of chronic disease in adulthood. General estimates suggest that 9-47% of hospitalised children are at risk of under nutrition. Apart from certain disease states known to predispose to under-nutrition, such as cystic fibrosis, cardiology and oncology conditions, prevalence estimates are highly dependent on the indices used to define under-nutrition. Suggested indices for the assessment of acute under-nutrition include weight-for-height, weight-for-age and BMI-forage, while height-for-age is suggested for the assessment of chronic under-nutrition. At present, there is a lack of universally acceptable criteria by which to define under-nutrition. The recent emergence of paediatric specific nutrition screening tools for use in hospitals, including STAMp© and PYMS in the UK and Strongkids in the Netherlands, has increased interest in under-nutrition in hospitalised children. These tools aim to identify under nutrition in order to initiate effective referral for treatment and thus potentially reduce the detrimental effects on growth and clinical outcomes. Their use in infants, however, has been largely overlooked. This thesis considers the identification and prevalence of malnutrition in hospitalised children.
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25

Sarr, Sallah Mariama. "Pharmacology of artemether in children with protein energy malnutrition in The Gambia". Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/2008886/.

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Malaria and malnutrition are causes of high morbidity and mortality in developing countries especially in sub-Saharan Africa and Asia. Malnourished children are at higher risk of developing malaria, a problem compounded by the fact that malnutrition affects the metabolism of different antimalarials including chloroquine and quinine. Emerging resistance to chloroquine, which was the drug of choice, has led to the widespread use of artemisinin combination therapy in the population including children. To date, no studies have been undertaken on the pharmacokinetics of artemisinin compounds in malnourished children. This thesis aims to fill this evidence gap by studying patients with uncomplicated malaria of different nutritional status in The Gambia. Analysis of the nutritional status of 97 children in The Gambia with uncomplicated malaria showed that 30% were both underweight and wasting, while 28% were categorised into stunting. This was much higher than the national average which has been estimated to be 17.4%, 9.5% and 23% for underweight, wasting and stunting, respectively, demonstrating a potential relationship between malaria and Protein energy malnutrition. In-vitro studies showed that although pre-treatment of HL-60 cells with the iron chelator (DFO) did not affect the bioactivation of artesunate, there was a 20% increase in cell viability with IC50 increasing from 7.0 ± 4.3 to 33.3 ± 2.9. This is believed to be as a result of DFO chelating the toxic iron generated as a result of artesunate bioactivation which increased from 0.32 ± 0.6 ng/mol in the control incubations to 0.84 ± 0.1ng/mol at 100 μmol artesunate concentration. In light of the fact that iron was important in the mechanism of action of these compounds, and the fact that iron deficiency is commonly in malnourished children, the effect of both PEM and anaemia on plasma drug levels of artemether and DHA was also studied. LC-MS/MS method was optimised and validated for the simultaneous analysis of artemether and DHA in plasma with ≥80% precision and accuracy. Plasma artemether and DHA concentration analysed 2h post first dose was 138.4 ± 80.9 ng/ml and 58.8 ± 43.7 ng/ml respectively. Severely wasted and wasted children had the highest artemether (156.5 ±69.6 ng/ml) and DHA (84.1 ±62.6) plasma concentrations respectively but values were not statistically significant. Anaemic status of children did not have an influence on drug plasma concentration with anaemic children having artemether and DHA plasma concentration of 138.5 ± 73.7 and 57.9 ± 36.6, respectively, and 138.43 ± 85.3 and 59.3 ± 46.8 for non-anaemic children respectively. However, conclusive results were limited by sample size. In conclusion, this thesis has demonstrated a relationship between malaria and Protein energy malnutrition, and highlighted the possible effects pathophysiological changes as a result of protein energy malnutrition can have on drug pharmacology and therapeutic effects in these children. There is a need for further studies in larger cohorts of children with protein energy malnutrition to determine whether therapeutic efficacy of artemisinin combination therapy is affected in an adverse manner, and whether there is a need for changes in dosing recommendations.
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26

Besili, Johanna. "Undernäring inom äldrevården : förebyggande omvårdnadsåtgärder som har effekt". Thesis, Sophiahemmet Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2092.

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Undernäring är ett stort problem bland äldre både internationellt och inom svensk hälso- och sjukvård. Inom den svenska äldrevården används verktyget Mini Nutritional Assessment (MNA), (bilaga 3) för screening av nutritionsstatus. Trots detta är var tredje patient underviktig inom den svenska äldrevården. Undernäring leder till en minskad livskvalitet, ökad risk för infektioner, ökad sjuklighet och en ökad dödlighet. Vid ett minskat intag av energi och näringsämnen, som understiger kroppens behov, förbrukar kroppen sina depåer av näringsämnen och muskulaturen bryts ner. Förutsättningen för en god hälsa och sjukdomsläkning är ett gott näringstillstånd. Enligt Virginia Henderson har alla människor vissa gemensamma egenskaper och behov, där omvårdnaden skall planeras utifrån patientens upplevda behov och bristande förmåga att tillfredsställa dessa. Sjuksköterskan har enligt International Council of Nurses [ICN], (2000) ett grundläggande ansvarsområden att främja hälsa, förebygga sjukdom, lindra lidande samt återställa hälsa. Syftet var att undersöka effekter av omvårdnadsåtgärder som syftar till att förebygga undernäring hos äldre i äldrevård. En forskningsöversikt genomfördes utifrån 14 inkluderade artiklar. Sökningen av artiklarna gjordes i databaserna PubMed, CINAHL och Psycinfo. Resultatet presenterades utifrån tre huvudteman, nutrition, kunskap och utbildning samt vikten av delaktighet och engagemang. Resultatet visade att nutritionsåtgärder som att förbättra måltidsmiljön, ge kosttillskott, arbeta utifrån en individanpassad vård där patienten engageras i sin egen näringsvård, var åtgärder som kan förebygga undernäring inom äldrevården. Åtgärderna kan tillämpas inom både äldreboende och sjukhus. Slutsatsen var att faktorer som upplevdes betydelsefulla ur patientens perspektiv var att själv få medverka i sin näringsvård. Nutritionsåtgärder som visat sig effektiva för äldre är kosttillskott och en familjelik måltidssituation.
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27

Roberts, Shelley. "A New Approach to the Prevention of Malnutrition and Pressure Injury in the Clinical Setting". Thesis, Griffith University, 2015. http://hdl.handle.net/10072/367138.

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Malnutrition is a significant problem in the hospital setting, contributing to adverse outcomes for patients, such as increased risks of complications and death, and also for the health care system, through increased hospital costs and length of stay. Malnutrition is also an identified risk factor for pressure injury. Nutritional intervention for pressure injury prevention is therefore an important consideration in the hospital setting, to avoid substantial costs and patient burden associated with pressure injury. Adopting a suitable framework for intervention planning in the clinical setting may improve the likelihood of its success. Public health nutrition, whilst having a different focus to clinical dietetics, may give new insight into nutrition intervention planning in the hospital setting. Public health nutrition focuses on the prevention of nutrition related health conditions by addressing upstream determinants of the problem at a broader population level. In contrast, clinical dietetics traditionally focuses on the treatment of established nutrition related conditions by providing individualised dietetic care. However, there is an increasing focus on preventative care in hospitals, particularly in relation to pressure injury prevention. Given a considerable proportion of pressure injuries in hospitals may be attributable to malnutrition, adopting a public health nutrition framework for intervention planning may be suitable in the clinical setting. That is, applying a nutrition intervention at a broader hospital population level, to address upstream determinants of pressure injury (i.e. malnutrition) in order for its prevention. This thesis therefore explores the utility of a public health nutrition framework, the bi-cycle model (Hughes and Margetts 2011), for intervention planning and delivery in the clinical setting.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Allied Health
Griffith Health
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28

Ceresa, Shannon Michele. "Can preschool children learn abduction prevention skills?" Scholarly Commons, 1994. https://scholarlycommons.pacific.edu/uop_etds/2765.

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The purpose of this study was to evaluate the feasibility of training children as young as 3 years old to engage in appropriate responses to potentially dangerous situations. Eighty-five children ranging in age from 3 to 5 years from various preschools were randomly assigned to one of two groups (post-test-only or pretest-post-test). Treatment involved the training package, Children Need to Know: Personal Safety Training (Kraizer, 1981). Training effectiveness was assessed by an analog measure of self-protection, in which a confederate adult approached and verbally attempted to lure the child from the setting. The results showed that (a) in comparing pretest and post-test scores of the pretest-post-test group, the post-test mean was significantly higher than the pretest mean; (b) in comparing the pretest scores from the pretest-post-test group and the post-test scores from the post-test-only group, no significant interactions or main effects were found; these results with the results in (a) support the idea of a testing effect and/or a pretest sensitization effect; and (c) in comparing the post-test scores from the pretest-post-test group and post-test scores from the post-test-only group, there were no significant interactions, however there was a significant main effect for Group. These results show that post-test scores were higher than pretest scores indicating the possibility of treatment increasing post-test means. However, the post-test-only group means were not significantly higher than the pretest means from the pretest-post-test group. Additionally, the significant difference between the post-test means from the two groups indicate there was a testing effect or possibly a pretest sensitization effect, or both. (Abstract shortened by UMI.)
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29

Hoare, Simon. "Determinants of catch-up growth following diarrhoeal disease in West African children". Thesis, University of Newcastle Upon Tyne, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.341780.

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30

Johansson, Anna, e Jeanette Norlin-Backlund. "Malnutrition hos äldre patienter på sjukhus : Metoder för bedömning av nutritionsstatus samt sjuksköterskans rutiner och attityder i samband med prevention". Thesis, Högskolan Dalarna, Omvårdnad, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:du-2816.

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Syftet med studien var att beskriva subjektiva multifaktoriella metoder som sjuksköterskor kan använda för att identifiera äldre patienter med malnutrition och patienter med risk för att utveckla malnutriion. Syftet var vidare att redogöra för vilka undersökningar som sjuksköterskor i kliniskt arbete använder för att bedöma patienters nutrionsstatus med samt att belysa sjuksköterskors attityder till prevention av malnutritionstillstånd. Studien genomfördes som en systematisk litteraturstudie. De vetenskapliga artiklar (n=17) som ingick i studiens resultat söktes i databaserna ELIN@Dalarna och CINAHL. De sökord som användes var malnutrition, nutrition, undernutrition, elderly, screening, assessment, MNA, SGA, nurses och attitudes i olika kombinationer. Genom analys och granskning av de vetenskapliga artiklarna framkom det i resultatet att SGA, MNA, Simplified Model Malnourishment och NUFFE var subjektiva multifaktoriella metoder som sjuksköterskor kan använda för identifiering av äldre patienter med malnutrition eller risk för malnutrition. Den vanligaste undersökningen som sjuksköterskor bedömde patienters nutritionsstatus med var vägning. Andra undersökningar var mätning, BMI, intervju om normal vikt och viktförlust, observation av patienten, kostregistrering samt nutritionsplan i journalen. Sjuksköterskor upplevde att sjukhusledningen inte förväntade sig att bedömning av patienters nutritionsstatus skulle ske vid inskrivning samt att ansvarsfördelningen mellan sjuksköterskor och läkare var oklar. Det förekom att sjuksköterskor var ointresserade av behandling av malnutrition, men majoriteten var mycket intresserade. Många sjuksköterskor kände att deras kunskaper inom nutrition var otillräckliga för arbetet.
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31

Larsson, Carina, e Paula Melander. "Nutrition och äldre : Distriktssköterskans/sjuksköterskans attityd till nutrition i omvårdnaden av äldre". Thesis, Mid Sweden University, Department of Health Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-310.

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Syftet: Avsikten med denna studie var att belysa distriktssköterskans/sjuksköterskansattityd till nutrition i omvårdnad av äldre över 65 år med hemtjänst.Metod: Utifrån ostrukturerade fokusgruppsintervjuer fick sjuksköterskor i enkommun i Mellansverige diskutera nutrition som ett omvårdnadsproblem utifrån ettpatientfall. Intervjuerna analyserades med kvalitativ innehållsanalys.Resultat: Analysen resulterade i fyra teman, medvetenhet om personens behov,ansvar för den andre, kunskap om att möta behoven samt relationsetik.Sjuksköterskorna förmedlade en positiv syn på att arbeta med nutrition och de hadeen stor förståelse för vilka konsekvenser ett för dåligt energiintag har på den äldresvälbefinnande. De upplevde att de har ett stort ansvar och tillräckligt med kunskapför att möta nutritionsproblemen i omvårdnaden. De anser att alla äldre har ett egetval så hänsyn måste visas och respekt måste tas för deras vilja när det gäller nutrition,vården kring den enskilde måste vara den bästa tänkbara.Slutsats: Studien visar att sjuksköterskorna tar ett stort ansvar i nutritionsfrågorna.Allt från att tillgodose individens enskilda behov till att lära ut och stötta övrigpersonal i vården. Sjuksköterskorna upplever att de har den rätta kunskapen för attkunna hantera nutritionsproblem i vården. Kunskapen har ökat de senaste åren.Denna kunskap anser författarna ligger till grund för sjuksköterskans positiva syn tillnutrition i omvårdnaden.


Aim: The aim of this study was to illuminate the nurse’s attitudes to nutrition whencaring elderly people over 65 years of age in their homes.Method: With unstructured interviews in focus groups the nurses discussed nutritionas a care problem from a patient’s situation. The interviews were analysed withcontent analysis.Result: The analyse resulted in four subjects, awareness of the persons needs,responsibility for the other, knowledge of meeting needs and relations ethics. Thenurses had a positive attitude to work with nutrition tasks and they had a greatunderstanding for the consequences of a low energy intake and how it will influencethe wellness of the elderly. They experienced that they had a big responsibility andenough knowledge to meet the nutrition problems in the care of the elderly. Theyconsidered that the elderly had their own choice, consideration and respect must beenshown for their own wish when it comes to nutrition. The care always must be of thehighest quality for the single person.Conclusion: The study showed that the nurses had a great responsibility in nutritionquestions. That means everything from providing the individuals needs to educateand support the staff in the care. The nurses experienced they had the adequateknowledge to handle the nutrition problems in the care. The knowledge aboutnutrition among the nursing staff tends to increase in the past years. This knowledgethe authors consider be the basis of positive attitude to nutrition among the nursesinterviewed.

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Simpamba, Mica Mutuna. "Risk factors for severe malnutrition in children with cerebral palsy in Lusaka, Zambia". University of the Western Cape, 2017. http://hdl.handle.net/11394/5941.

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Magister Public Health - MPH (Public Health)
Over 80% of children with Cerebral Palsy (CP) present with feeding difficulties which consequently result in about 40-50% of them being malnourished. Many children with CP in low resource countries like Zambia, present with severe malnutrition and the extent of this problem remains unknown. The aim of this study was to identify the main risk factors associated with severe malnutrition in children with CP.
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33

Ackatia-Armah, Robert Samuel. "Community-based management of acute malnutrition in Malian children: a cluster randomized trial". Thesis, Boston University, 2013. https://hdl.handle.net/2144/12704.

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Thesis (Ph.D.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
Acute malnutrition (AM), characterized by wasting, affects 55 million children under five years of age in developing countries. In Mali, the prevalence of AM exceeds 15% in some seasons. There is currently no consensus on the most effective dietary treatment strategy for children with moderate AM (MAM). Twelve health centers in rural Mali were randomly assigned to provide children with MAM (defined as mid-upper arm circumference (MUAC) < 12.5 and ≥ 11.0 cm or weight-for-length Z-score (WLZ) <-2.0 WHO standard and >70% NCHS reference median) 1 of 4 dietary regimens: 1) lipid-based, ready-to-use supplementary food (Supplementary Plumpy, SP); 2) special corn soy blend for MAM (CSB++); 3) locally processed, fortified food (Misola, MI); or 4) locally milled flours (millet and cowpea) plus oil, sugar and micronutrient powder (HFM). 1264 non-edematous children aged 6-35 months with MAM were offered ~500 kcal/d of assigned diet in addition to their usual food intake for 12 weeks. Hemoglobin (Hb) was measured in 1154 children, and plasma ferritin and transferrin receptor were measured in a subset of 452 children. 1178 children (93.2%) completed the study and attendance at weekly/bi-weekly follow-up visits was >85% in all groups. The adjusted mean (95% CI) change in weight in kg from baseline was greater with SP and CSB++ than other regimens (1.16 (1.08, 1.24), 1.04 (0.96, 1.13), 0.91 (0.82, 0.99), 0.83 (0.74, 0.92) for the respective study groups, p<0.001 ANOVA). MUAC changes followed a similar pattern. For length, SP and CSB++ differed significantly from HFM only. Recovery from MAM (defined as WLZ>-2.0, MUAC> 12.5cm) was higher with SP than the three other regimens (73%, 68%, 61%, 58% respectively, p less than O.OOO1). Total cost per treatment based on median time to recovery was $2.20 for SP, $1.43 for CSB++, $1.83 for MI and $1.65 for HFM. Anemia rates remained high (>81 %) in all groups after treatment. SP generally provided greater improvement in iron status compared to MI while CSB++ and HFM had intermediate effects. SP was more effective than other dietary regimens for the treatment of MAM and improvement of iron status; however, the benefits must be considered in relation to product costs and availability.
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Navaratnarajah, Paramalingam Kandasamy. "Child malnutrition mortality at St Barnabas Hospital is high - is it due to practices and attitudes of staff?: a study in a rural district hospital". Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&amp.

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The case fatality rate for malnutrition at St Barnabas Hospital over the past years has been around 38%. The rates in other district hospitals in the Eastern Cape province were found to be in excess of 30%. In June 2000, the Eastern Cape Department of Health introduced a protocol for in-patient management of children with severe malnutrition, with the aim of reducing case fatality rate below 10%. St Barnabas Hospital introduced the Eastern Cape protocol in August 2003. An evaluation was done in November 2003 to assess the protocol's impact on the case fatality rate. The rate remained high, at 37.5%. This study descibed the current practices and attitudes of the nurses as St Barnabas Hospital paediatric ward, in the management of severely malnourished childen.
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Dubé, John, e University of Lethbridge Faculty of Education. "Suicidal children". Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Education, 2004, 2004. http://hdl.handle.net/10133/218.

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This study gathers the literature on suicidal children and creates guidelines designed to assist professionals with assessing the suicidality of a child. Analysis of the literature reveals that there are varying ages of children used in the research, a lack of standardization for the definition of suicide, and resistance towards a collective research approach to understanding suicidal behaviour. The literature also identifies the important risk factors, which are incorporated into guidelines for determing this sucidality of a child: family discord and violence, depression, significant loss, poor and/or dysfunctional parent/child communication and bonding, aggressive behaviour, stress, physical abuse, parental separation/divorce, hopelessness, academic difficulties, prior suicide attempts, and viewing death as a temporary state of being.
viii, 104 leaves ; 29 cm.
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36

Paukštė, Ernesta. "Organizing Children and Youth Tobacco Prevention in Community". Master's thesis, Lithuanian Academic Libraries Network (LABT), 2011. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2011~D_20110628_152837-57601.

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Aim. To assess the association of smoking prevention program with children knowledge and attitudes towards smoking as well as with their smoking behavior. Methods. Survey targeted at the 11-15 years old pupils and was carried out in four schools in Latvia and four schools in Liverpool before and after peer-to-peer pilot intervention. 931 questionnaires in Riga and 836 in Liverpool were used for data analysis. SPSS 15.0 for Windows has been utilized for processing the statistical data. The statistical significance of the data in question was tested, by using the chi-square (χ2) and Z criteria. Results. 15% of pupils in Riga (12% girls and 19% boys) and 8% in Liverpool (13% and 5%) smoked during last month, from which 3% and 1% - smoked daily. 92% of respondents in Liverpool and 94% in Riga knew that smoking is harmful for health. Before intervention 85% of pupils in Riga and 90% in Liverpool declared not smoking if one of the best friends offered a cigarette, ever smokers were less likely to resist. 35% in Liverpool and 49% Riga thought that girls and accordingly, 29% and 40% boys who smoke have less friends. Majority of population in both cities thought that smoking makes young people look less attractive. Approximately, half of the smokers were willing to quit with higher percentage of those who smoked daily. 50% of children in Riga and 44% in Liverpool schools were exposed to ETS at least one day, last week (daily, 22% and 19%), which was strongly associated with... [to full text]
Paukštė E. Vaikų ir jaunimo rūkymo prevencijos organizavimas bendruomenėje. Visuomenės sveikatos vadybos magistro baigiamasis darbas / darbo vadovas doc. Veryga A.; Lietuvos sveikatos mokslų universitetas, Medicinos akademija, Visuomenės sveikatos fakultetas, Sveikatos vadybos katedra. – Kaunas, 2011. – 98 p. Darbo tikslas. Įvertinti vaikų rūkymo prevencijos programos reikšmę vaikų žinioms, nuostatoms apie rūkymą bei jų rūkymo įpročiams. Metodai. Anoniminė 11-15 metų moksleivių apklausa atlikta keturiose Latvijos ir keturiose Liverpulio mokyklose prieš ir po bendraamžis-bendraamžiui bandomają intervenciją. Į duomenų analizę buvo įtraukta 931 anketa Rygoje ir 836 anketos Liverpulyje. Statistinė duomenų analizė buvo atlikta naudojant statistinį programinį paketą SPSS 15.0 for Windows. Surinktų duomenų skirtumų patikimumas buvo vertinamas Chi kvadrato (χ2) ir Z kriterijais. Rezultatai. Nustatyta, jog per pastarąsias 30 dienų, Rygoje rūkė 15 proc. (12 proc. mergaičių ir 19 proc. berniukų) ir Liverpulyje 8 proc. moksleivių (13 proc. ir 5 proc.) iš kurių 3 proc. ir 1 proc. rūkė kasdien. 92 proc. moksleivių Liverpulyje ir 94 proc. Rygoje žinojo, jog rūkymas yra žąlingas sveikatai. 85 proc. vaikų Rygoje ir 90 proc. Liverpulyje prieš intervenciją teigė, jog nerūkytų jeigu vienas geriausių draugų pasiūlytų cigaretę. 35 proc. apklaustųjų Liverpulyje ir 49 proc. Rygoje manė, jog mergaitės ir atitinkamai, 29 proc. ir 40 proc. berniukai, kurie rūko turi mažiau draugų. Beto, didžioji... [toliau žr. visą tekstą]
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37

Warren, Janet M. "Strategies for the prevention of obesity in children". Thesis, Oxford Brookes University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.251367.

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Schindler, Rose. "Effective Prevention for Children: Conceptual and Methodological Advances". Doctoral thesis, Universitätsbibliothek Chemnitz, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:ch1-qucosa-194396.

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This dissertation addresses various methodological and conceptual challenges of prevention programs for preschool children. It focuses on two major topics, (1) methodological guidelines for longitudinal studies in the context of prevention projects, and (2) analyses of emotional development and moral emotions. After a brief introduction to the research questions in Chapter 1, Chapters 2 and 3 address the methodological branch of my research, and Chapters 4 to 6 will analyze several aspects of moral development and moral emotions. In the final Chapter 7, all findings are summarized in view of their application to prevention work in the context of childhood development.
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Williams, Joan Marie. "Drowning prevention for children in San Bernardino County". CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2048.

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Drowning and near drowning is a significant problem nationwide and in San Bernardino County. Drowning in and around the home is the leading cause of accidental death of children under 5 years of age. In the United States, drowning is cited as the second most common cause of death for adolescents. This project was undertaken to help establish a funding source to develop a drowning prevention program in San Bernardino County. A request for assistance was obtained from the California Center for Childhood Injury Prevention and the California Kids' Plates Program.
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40

Muwalo, Blessings Gandalale Chale. "Risk factors for malnutrition in children aged 0 to 5 Years in Lilongwe district, Malawi". University of the Western Cape, 2013. http://hdl.handle.net/11394/4273.

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>Magister Scientiae - MSc
The Malawi Multiple Indicator Cluster Survey (MICS) in 2007 indicated that the prevalence of underweight in Lilongwe District was 29%, stunting was 49% and Global Acute Malnutrition was 11%. The aim of the study therefore was to determine the risk factors for malnutrition amongst children aged 0 to 5 years in Lilongwe district in Malawi. Study design It was a case-control study, conducted in randomly selected Community Therapeutic Care (CTC) Sites (Nutrition Rehabilitation Units (NRUs)) and Under-five Clinics at health facilities of the district. The study sample was comprised of 50 underweightfor- age children (25 girls and 25 boys) aged 0 to 5 years from NRUs of the district selected randomly. The controls were comprised of 44 normal weight-for-age children (22 girls and 22 boys) randomly selected within the same age group, routinely attending under-five growth monitoring and immunization sessions during the same period as the cases. The cases and controls were identified using the NRU and under-five clinic registers respectively. Data Collection There was a face to face interview with the mother/guardians of the children, conducted by trained NRU nurse specialists, the researcher and a research assistant, using a structured questionnaire. Questions about socio-economic status of the mother/caregiver, child feeding practices, nutritional status and diseases of the child were asked. Analysis of results Data was analyzed using EpiInfo 2002 software. Ethical approval for the study was requested from the Ethical committee of the University of the Western Cape. Informed written consent was obtained from all the participants.
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41

Sellström, Eva. "Studies in safety promotion for preschool children /". Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4271-4/.

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James, Kulanathan, e Emma Lindberg. "Caring for Children Who Suffer from Malnutrition Nurses‟ experiences in the highlands of Papua". Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-16417.

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This study was carried out during the spring of 2009 in the highlands of Papua, Indonesia on a Minor Field Study (MFS) scholarship funded by the Swedish International Development Cooperation Agency (SIDA). Indonesia is a developing country with Papua as a province in the most eastern part of the country. Mountains and jungles cover Papua, which makes health care hard for people to reach. Half of the child deaths in the world are connected to malnutrition and most of the suffering children live in developing countries. The authors had been informed about the high rate of malnutrition and child diseases among Papuans in the highlands and that the nurses who work in the highlands were faced with challenges when working to improve the health among children who suffer from malnutrition and their families. The aim of the study is to describe nurses‟ experience of working with children who suffer from malnutrition.A qualitative approach was chosen for the study and by using an open-ended interviewing method seven interviews were collected. Seven nurses were asked about their experience working with children who suffer from malnutrition. The interviews were collected at one specific hospital in the highlands of Papua and the respondents were of both gender. The interviews were transcribed and analyzed according to the qualitative content analysis. The result was presented in themes and sub-themes, where these three main areas were found: “Hindrance of health”, “Improving health”, and “Challenges”. The result shows that Papuans belief in spirits and traditional treatment and also lack of trust in the western medicine is a major problem for nurses who give care to the children suffering from malnutrition. The result is discussed in relation to background where relevant literature is referred to.
Program: Sjuksköterskeutbildning
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43

Jensen, Kayla Camille. "Malnutrition and Handgrip Strength in Hospitalized and Non-Hospitalized Children 6-14 Years Old". BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6307.

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Malnutrition is concerning in children because it effects proper growth and development. Handgrip Strength (HGS) has been identified as a diagnostic indicator for identifying pediatric malnutrition but normal reference ranges have not yet been established; therefore, HGS can be used to identify malnutrition but not quantify the degree of malnutrition: mild, moderate, or severe. The aim of this study was to determine if HGS differed between hospitalized and non-hospitalized children and to describe the association between HGS and several parameters including height, weight, body mass index (BMI), and mid-upper arm circumference (MUAC). One hundred nine hospitalized and 110 non-hospitalized pediatric patients ages 6-14 years participated in this cross sectional, nonequivalent control group design study. Nutrition status was evaluated using BMI z scores and MUAC z scores, and HGS was evaluated within 48 hours of hospital admission or at a well-child appointment. According to BMI z scores, 24.8% of hospitalized and 18.3% of non-hospitalized participants were malnourished. Mean HGS of hospitalized participants was not significantly different from non-hospitalized participants (p=.2053). HGS was found to be associated with age, height, dominant hand, and MUAC z scores in all participants. The difference in HGS measurements was not statistically significant between hospitalized and non-hospitalized children using a one-time HGS measurement. Further research examining HGS measurements over time as well as comparing HGS measurements to the degree of malnutrition deficit in pediatrics is needed.
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Pettersson, Hanna, e Soffía Stephensen. "Nursing interventions to prevent and treat malnutrition in older adults : a literature review". Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3859.

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Background World Health Organization reports that there are no exact statistics of how many older adults worldwide suffer from malnutrition, but available data suggest that about 15–60 percent of older adults cared for in hospitals, nursing homes and home-care programmes are suffering from malnutrition. It is important that the registered nurse is aware of different interventions and how they can be implemented in order to improve the nutritional status of the older adult. Aim The aim of this study was to examine nursing interventions used to treat and prevent malnutrition in older adults at hospitals and nursing homes. Method The study design was a literature review with 15 scientific articles included. The data collection was done in the databases PubMed and CINAHL. The result articles were a mix of both qualitative- and quantitative studies. Intergraded data analysis was used to compile the 15 articles. Results The interventions had an overall positive effect on the nutritional status of the older adults. Oral nutritional supplements were the most common intervention. Both environmental and social factors had effect on the mealtime experience. The older adult was not often involved in the nutritional care and the evaluation of the outcome of the interventions was scarce. The teamwork between health professionals, relatives and the older adult was inadequate. Conclusions Malnutrition in older adults is a prevalent problem and is often de-prioritized in nursing care. The most common intervention used was oral nutritional supplements but there are other interventions that also provide positive results and provide more individual care and are often disregarded by the RN’s. The older adults’ involvement in the nutritional care can be increased and improved as well as involvement of relatives. The importance of treating and preventing malnutrition is a topic that could be emphasized more within the geriatric care.
Bakgrund Världshälsoorganisationen rapporterar att det inte finns någon exakt statistik över hur många äldre personer över hela världen som lider av undernäring, men tillgängliga data tyder på att cirka 15–60 procent av de äldre personer som vårdas på sjukhus, särskilt boende och inom hemsjukvården lider av undernäring. Det är viktigt att den legitimerade sjuksköterskan är medveten om olika omvårdnadsåtgärder och hur de kan genomföras för att förbättra den äldre personens näringsstatus. Syfte Syftet med denna studie var att undersöka tillämpade omvårdnadsåtgärder för att förebygga och behandla undernäring hos äldre personer på sjukhus och särskilt boende. Metod Studiedesignen var en litteraturöversikt med 15 vetenskapliga artiklar inkluderade. Datainsamlingen gjordes i databaserna PubMed och CINAHL. Resultatartiklarna var en blandning av både kvalitativa och kvantitativa artiklar. En integrerad analys utfördes för att sammanställa de 15 artiklarna. Resultat Omvårdnadsåtgärderna hade en övergripande positiv effekt på de äldre personernas näringsstatus. Näringsdrycker var den vanligaste åtgärden. Både miljömässiga och sociala faktorer påverkade matupplevelsen. Den äldre personen var sällan involverad i sin nutritionsvård och utvärdering av omvårdnadsåtgärderna var sällsynt. Samarbetet mellan vårdpersonal, anhöriga och den äldre personen var otillräckligt. Slutsats Undernäring hos äldre personer är ett vanligt förekommande problem som ofta bortprioriteras inom vården. Den vanligaste åtgärden var insättande av näringsdryck men det finns andra åtgärder som ger goda resultat och är mer individanpassade som ofta förbises av sjuksköterskan. Den äldre personens medverkan i sin vård gällande nutrition kan ökas och förbättras, såväl som medverkan av anhöriga. Vikten av att behandla och förebygga undernäring är ett ämne som skulle kunna betonas mer inom geriatrisk vård.
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Leung, Ho-kin Vincent, e 梁浩堅. "The effectiveness of the use of "ready-to-use" therapeutic food (RUTF) in treating malnourished children in developing countries and the way forward". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193780.

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WHO and UNICEF recommend the use of “ready-to-use therapeutic food” (RUTF) in the treatment of severely acute malnourished (SAM) children with no complicated medical background. This research paper aims to review the evidence on the use of RUTF in the treatment of SAM children, explore the potential issues with the use of RUTF, and provide suggestions for future research. A total of 7 studies were included for the review on the effectiveness of RUTF treatment. Evidences showed a general improvement in the health outcomes of SAM children, yet failed to yield high-quality evidences to prove its benefits. Potential problems with the reliance on RUTF were identified, further research on the use of RUTF are required.
published_or_final_version
Public Health
Master
Master of Public Health
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46

Åhlén, Johan. "Universal prevention of anxiety and depression in school children". Doctoral thesis, Uppsala universitet, Institutionen för psykologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-333033.

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Anxiety and depression are common in children and adolescents, and involve individual suffering, risk of future psychiatric problems, and high costs to society. However, only a limited number of children experiencing debilitating anxiety and depression are identified and receive professional help. One approach that could possibly reduce the prevalence of these conditions is universal school-based prevention aimed at reducing the impact of risk factors and strengthening protective factors involved in the development of anxiety and depression. The current thesis aimed to contribute to the literature on universal prevention of anxiety and depression in children. Study I involved a meta-analysis of earlier randomized, and cluster-randomized trials of universal prevention of anxiety and depression. Overall, the meta-analysis showed small but significant effects of universal preventive interventions, meaning that lower levels of anxiety and depression were evident after intervention completion and partially evident at follow-up assessments. No variables were found to significantly enhance the effects, however, there was a tendency for larger effects to be associated with mental health professionals delivering the interventions. In Study II, a widely adopted prevention program called Friends for Life was evaluated in a large school-based cluster-randomized effectiveness trial. The results showed no evidence of an intervention effect for the whole sample. However, children with elevated depressive symptoms at baseline and children with teachers who highly participated in supervision, seemed to benefit from the intervention in the short term. Study III involved a 3-year follow-up of Study II and an examination of the effects of sample attrition. The results showed no long-term effects for the whole sample and no maintenance of the short-term subgroup effects observed in Study II. Finally, to increase our understanding of the development of anxiety in children and to assist future improvements of universal prevention, Study IV evaluated different trajectories of overall anxiety together with related patterns of disorder-specific symptoms in a school-based sample over 39 months. Evidence favored a model of three different developmental trajectories across age. One trajectory was characterized by increasing levels of overall anxiety, but fluctuating disorder-specific symptoms arguably related to the normal challenges of children’s developmental level, which warrants an increased focus on age-relevant challenges in universal prevention. The four studies provide further understanding of the overall effectiveness of universal prevention of anxiety and depression in children, the short- and long-term effects of universal prevention in a Swedish context, and ideas for further development of preventive interventions.
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47

Baset, M. U. "Road traffic injury prevention in children in rural Bangladesh". Thesis, University of the West of England, Bristol, 2013. http://eprints.uwe.ac.uk/22643/.

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Background: Childhood road traffic injuries (RTIs) are a major public health problem internationally; little research has been conducted on preventing childhood RTIs in Bangladesh. Aim and Objectives: Aim: to develop a pilot intervention to reduce childhood RTIs in rural Bangladesh. Objectives - to: • determine the epidemiology of and risk factors for childhood RTIs • explore community perceptions of childhood RTIs and their prevention • develop a pilot package of preventive interventions and evaluate the package to assess its feasibility and acceptability Methods: Five studies were conducted using mixed methods. Study A examined the epidemiology of childhood RTIs using three data sources. Study B explored community perceptions through focus groups. Study C (school survey) investigated exposure to the road environment. A pilot intervention developed and implemented (study D), was evaluated for its feasibility and acceptability in rural communities (study E). Results: Studies A-C showed that RTIs are a growing problem, especially for rural child pedestrians. The rate of childhood RTIs mortality was three times higher in rural than urban areas (9.1 versus 2.7 per 100,000 children years). Pedestrians (42%) were the main victims in rural areas, with children aged 5-9 particularly vulnerable. Seven focus groups were conducted which provided insights into the causes of RTIs, e.g. Problems finding safe places to cross, poor supervision. The school survey showed that children lacked knowledge and skills about road crossing. Risk factors included gender, age, accompanying person, and travel mode. The “Safe Child Pedestrian” pilot programme was developed and implemented in six schools, 36 school children aged 7-9 years were trained at the roadside by volunteers. The programme was feasible and acceptable for rural communities. Conclusion: The expansion of Bangladesh’s rural road network continues, with child pedestrian injuries increasing. Practical child pedestrian training is an initial step in engaging communities to reduce RTIs. Achievement: This is the first attempt to explore the situation of childhood RTIs in rural Bangladesh and develop, implement and evaluate a programme for child pedestrians.
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48

Bates, Katie. "Double or divergent? : stuntingoverweightness among children and the 'burden' of malnutrition : a study of Albania". Thesis, London School of Economics and Political Science (University of London), 2014. http://etheses.lse.ac.uk/998/.

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Today, researchers and policy makers alike are increasingly concerned about the “double burden of malnutrition” in low and middle income countries (LMICs). This ‘double burden’ is understood to be the coexistence of under- and overnutrition within one population. The definition of a ‘double burden’ relies upon the existence of chronic undernutrition among children (indicated by stunting – where children are shorter than expected for their age) and the existence of overnutrition in children or adults (child overweightness as indicated by a greater weight than expected for a given height and adult overweightness/obesity as indicated by a greater weight than height). However, research has failed to consider that children can be concurrently stunted and overweight – known here as ‘stuntingoverweightness’. In failing to consider stuntingoverweightness, the prevalence of stunting and overweightness among children has been overestimated at the population level. Stuntedoverweight children have been ‘double counted’ – once as stunted and once as overweight. This has severe implications for our understanding of malnutrition in LMICs today. The polarisation of malnutrition among children of under- and overnutrition has been exaggerated and a whole group of children have become hidden – the stuntedoverweight. This research addresses this issue. Recalculating stunting and overweightness prevalence accounting for stuntingoverweightness this research shows that, today in LMICs, up to 10.42% of children under-five are stuntedoverweight – yet no policies or programmes exist to understand the determinants of stuntingoverweightness, its effects or how to alleviate them. An individual level analysis of Albania shows stuntedoverweight children are a separate socioeconomic group and should thus be targeted for interventions separately from their stunted and overweight peers. Furthermore, failing to recognise stuntingoverweightness has led to overestimations of the burden of stunting by up to 88.54% (in Albania) and of overweight by up to 295.26% (in Benin) and skewing our understanding of the ‘burden of malnutrition’ in LMICs. The thesis shows that for nutritional strategies to be effective – research needs to consider the diverse burden of malnutrition observed in LMICs today.
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49

SILVA, Carolina Bastos Gasparinho Antero da. "Malnutrition and enteric infections in children in Bengo province, Angola-a four-arm experimental study". Doctoral thesis, Instituto de Higiene e Medicina Tropical, 2019. http://hdl.handle.net/10362/82951.

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Introdução: À semelhança de outros países de baixo-médio rendimento, em Angola, a malnutrição e a doença diarreica estão entre as principais causas de mortes em crianças menores de cinco anos, nomeadamente na província do Bengo. Objectivos: i) identificar a etiologia da diarreia e fatores associados em crianças menores de cinco anos atendidas no Hospital Geral do Bengo (HGB); ii) fornecer informações sobre a caracterização molecular de rotavírus, antes da introdução da vacina; iii) fornecer uma caracterização molecular de Giardia lamblia; e iv) investigar se o tratamento de parasitas intestinais (com ou sem diagnóstico prévio) em dois níveis diferentes (individual ou a nível do agregado familiar) tem impacto sobre o estado nutricional de crianças de 2-5 anos, após seguimento de dois anos no Bengo. Métodos: Um estudo transversal (ET) foi implementado para investigar a presença de vírus, bactérias e parasitas nas fezes diarreicas de 344 crianças atendidas no HGB (2012- 2013), recolhendo dados sociodemográficos, nutricionais e clínicos, explorados por modelos de regressão logística simples e múltipla. Posteriormente, realizaram-se métodos moleculares para identificação dos genótipos circulantes de rotavírus e genótipos e subgenótipos de G. lamblia. Entre 2013 e 2017, um estudo longitudinal e experimental (RCT) com quatro braços em paralelo foi realizado em crianças infetadas com pelo menos um parasita intestinal patogénico (ISRCTN-72928001). As 121 crianças com critérios de inclusão foram distribuídas aleatoriamente (1:1:1:1) - Braço1: albendazol anual a nível individual; Braço2: albendazol anual ao agregado familiar; Braço3: diagnóstico e tratamento quadrimestral de parasitas intestinais a nível individual; Braço4: diagnóstico e tratamento quadrimestral de parasitas intestinais ao nível do agregado familiar. No início do estudo, aos 4, 8, 12, 16, 20 e 24 meses de acompanhamento avaliou-se: a altura, o peso, estatura-para-idade, peso-para-altura e peso-para-idade em Z-score. A análise por intenção-de-tratar foi realizada seguindo as diretrizes CONSORT, após a análise de valores omissos (IBM SPSS). Dada a falha dos pressupostos da análise paramétrica de medidas repetidas, uma abordagem não paramétrica (nparLD) e os modelos LMM e GEE foram explorados no programa R. Resultados: Nos dois estudos, as crianças viviam principalmente em áreas urbanas (>90%) e mais de 20% não tinha latrina. A água mais usada para beber provinha do rio, da torneira no quintal e de tanques. A desnutrição crónica ocorreu em 38% (ET) e 31% (RCT) das crianças. No ET, 67% das crianças estavam infetadas por um agente enteropatogénico, principalmente por Cryptosporidium spp. (30%), rotavírus (25%) e G. lamblia (22%). Cryptosporidium spp. e rotavírus foram mais frequentes em menores de 12 meses. Os principais genótipos circulantes de rotavírus foram: G1P [8] (47%), G1P [6] (29%) e G2P [4] (13%). O genótipo B de G. lamblia foi predominante em relação ao genótipo A. No RCT, no início do estudo, as crianças estavam infetadas principalmente com G. lamblia (57%) e Ascaris lumbricoides (26%). Diferentes modelos não forneceram nenhuma evidência ou fraca evidência do efeito das intervenções nas medições antropométricas, embora tenha ocorrido uma evolução temporal significativa. Contudo, nota-se uma redução da desnutrição ligeira ao longo do estudo, apesar de, em média, as crianças permaneceram com valores padronizados (z-scores) negativos para os índices antropométricos.Conclusão: Várias infeções entéricas foram identificados nos dois estudos. No RCT, nenhuma das estratégias de tratamento de parasitoses intestinais se destacou com efeito significativo nos indicadores antropométricos estudados. A duração do RCT e o tamanho da amostra podem não ter sido suficientes para observar diferenças significativas. Por outro lado, realça-se a importância de uma abordagem multifatorial integrada com vista à melhoria do estado nutricional (e.g., WASH, educação, alimentação adequada e acesso a cuidados de saúde).
Background: Similar to other low- and middle-income countries, in Angola, malnutrition and diarrhoeal disease are among the major causes of deaths in children under-five, namely in Bengo province. Aims: i) identify the aetiology of diarrhoea and associated factors in under-five children attending the Bengo General Hospital (HGB); ii) provide information on the molecular characterization of rotavirus, before the vaccine introduction; iii) provide a molecular characterization of Giardia lamblia; and iv) investigate if treatment of intestinal parasites (with or without previous diagnosis) in two different levels (individual or household) impacts on nutritional status of children 2-5 years, after a two-year follow-up in Bengo. Methods: A cross-sectional study (CSS) was conducted to investigate the presence of virus, bacteria and parasites in diarrhoeal stools of 344 children attending HGB (2012-2013), collecting sociodemographic, nutritional and clinical data, analysed by simple and multiple logistic regression models. Then, molecular methods were performed for the identification of rotavirus circulating genotypes and G. lamblia assemblages and subassemblages. Between 2013 and 2017, a four-arm randomised controlled trial (RCT, registration ISRCTN-72928001) was conducted longitudinally in children infected with at least one pathogenic intestinal parasite. 121 children meeting inclusion criteria were randomly assigned (1:1:1:1) - Arm1: annual albendazole at individual level; Arm2: annual albendazole at household level; Arm3: four-monthly screening and treatment of intestinal parasites at individual level; Arm4: four-monthly screening and treatment of intestinal parasites at household level. Height, weight, height-for-age, weight-for-height, and weight-for-age Z-score were assessed at baseline, 4, 8, 12, 16, 20, and 24 months of follow-up. Intention-to-treat analysis was performed following CONSORT guidelines, after a missing value analysis (IBM SPSS). Given the failure of assumptions for parametric repeated measurements, nonparametric rank-based method (nparLD), LMM and GEE models were performed in R program. Results: In both studies, children lived mainly in urban areas (>90%) and more than 20% did not have a latrine. The most commonly drinking water sources were the river, the tap in the yard and tank. Near 38% (CSS) and 31% (RCT) of children were stunted. In the CSS, 67% of children were infected with an enteropathogen, mostly with Cryptosporidium spp. (30%), rotavirus (25%) and G. lamblia (22%). Cryptosporidium spp. and rotavirus were more frequent in children under 12 months. The main rotavirus circulating genotypes were: G1P[8] (47%), G1P[6] (29%) and G2P[4] (13%). G. lamblia assemblage B was predominant compared with assemblage A. In the RCT, at baseline, children were mainly infected with G. lamblia (57%) and Ascaris lumbricoides (26%). Different models provided no evidence or weak evidence of the effect of interventions on anthropometric measurements, although a significant temporal effect occurred. A reduction in mild malnutrition occurred throughout the study, although, on average, children remained with negative z-scores for anthropometric indices. Conclusion: Several enteric infections were identified in both studies. In the RCT, none of the treatment strategies targeting intestinal parasites stood out with significant effect on the anthropometric indices studied. The duration of the RCT and the sample size may not have been sufficient to observe significant differences. On the other hand, it highlights the importance of an integrated multifactorial approach to improving nutritional status (eg, WASH, education, adequate food and access to health care).
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Ross, Scott W. "Bully prevention in positive behavior support /". Connect to title online (Scholars' Bank) Connect to title online (ProQuest), 2009. http://hdl.handle.net/1794/10240.

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