Read the abstract in the section 00front of this document. / Thesis (DPhil (Food Science))--University of Pretoria, 2006. / Food Science / unrestricted

One of the overarching questions in the field of infant perceptual and cognitive development concerns how selective attention is organized during early development to facilitate learning. The following study examined how infants’ selective attention to properties of social events (i.e., prosody of speech and facial identity) changes in real time as a function of intersensory redundancy (redundant audiovisual, nonredundant unimodal visual) and exploratory time. Intersensory redundancy refers to the spatially coordinated and temporally synchronous occurrence of information across multiple senses. Real time macro- and micro-structural change in infants’ scanning patterns of dynamic faces was also examined. According to the Intersensory Redundancy Hypothesis, information presented redundantly and in temporal synchrony across two or more senses recruits infants’ selective attention and facilitates perceptual learning of highly salient amodal properties (properties that can be perceived across several sensory modalities such as the prosody of speech) at the expense of less salient modality specific properties. Conversely, information presented to only one sense facilitates infants’ learning of modality specific properties (properties that are specific to a particular sensory modality such as facial features) at the expense of amodal properties (Bahrick & Lickliter, 2000, 2002). Infants’ selective attention and discrimination of prosody of speech and facial configuration was assessed in a modified visual paired comparison paradigm. In redundant audiovisual stimulation, it was predicted infants would show discrimination of prosody of speech in the early phases of exploration and facial configuration in the later phases of exploration. Conversely, in nonredundant unimodal visual stimulation, it was predicted infants would show discrimination of facial identity in the early phases of exploration and prosody of speech in the later phases of exploration. Results provided support for the first prediction and indicated that following redundant audiovisual exposure, infants showed discrimination of prosody of speech earlier in processing time than discrimination of facial identity. Data from the nonredundant unimodal visual condition provided partial support for the second prediction and indicated that infants showed discrimination of facial identity, but not prosody of speech. The dissertation study contributes to the understanding of the nature of infants’ selective attention and processing of social events across exploratory time.

The marketing of infant feeding products is almost impossible as the infant nutrition industry is highly regulated. Despite operating under strict regulations, the infant formula manufacturing companies still generate high revenues on an annual basis. The infant formula manufacturing industry operates under a value chain which can be broken down into six sequential steps. These steps are: (1) Translational science; (2) Product development; (3) Clinical research; (4) Product notification; (5) Reimbursement granting and (6) Product marketing. Medical nutrition companies aspire to understand product requirements of healthcare professionals and medical representatives. This is to enable direct investment to acquire market share without wasting resources. The medical nutrition industry currently makes use of medical representatives to execute product marketing. Manufacturing companies invest a lot of money into developing their products, employing and training medical representatives and trust that this will be enough to persuade healthcare professionals to recommend their products to parents. This study analyses the main contributing factors that enhance prescription of specialised infant formula by healthcare professionals. This study was conducted in a positivistic paradigm by making use of a quantitative approach. Healthcare professionals from Port Elizabeth, working with paediatric patients were included in this study. The healthcare professionals were chosen by a convenience sampling method and were then interviewed. The empirical interview results were substantiated with the interpretive findings which were in the form of verbatim statements extracted directly from the research questionnaire. Linkage between the dependable variable (prescription) and independent variables (manufacturing company; product composition; cost of product; medical representative and peers) were established and analysed. The research revealed that prescription behaviour is an important construct which can be measured in medical practices. Prescription behaviour is correlated with positive business and medical outcomes and manufacturing companies are able to exert influence over it through the identified variables. Of these variables, efficacy of vii a product, trusted manufacturing company and the medical representatives were found to have direct and significant effects. Healthcare professionals tend to prescribe a specialised infant formula if they have seen results and trust the outcome of the product. It is advisable for manufacturing companies to exert great effort before appointing a medical representative, to make sure that the right candidate represents the face of the company.

In early Infancy, limited ingestion of vitamin E, especially the α-tocopherol form, and/or a high, intake of polyunsaturated fatty acids are reflected as a low serum tocopherol level. This vitamin E deficiency state is probably responsible for the development of an anemia characterized by abnormal erythrocyte hemolysis. Edema and skin changes may also be present. In order to ascertain the tocopherol status of infant formulas available in Canada, thirty-six representative formulas were chemically analyzed for vitamin E and polyunsaturated fatty acid contents. For the tocopherol analysis, a combination of the Emmerie-Engel procedure and two-dimensional thin-layer chromatography was used. An alkaline isomerization technique was chosen for the polyunsaturated fatty acid analysis. The vitamin E status of the various formulas was assessed in relation to three criteria of tocopherol adequacy - the α-tocopherol-to-PUFA ratio, the α-tocopherol content, and the level of International Units of vitamin E. With the exception of one formula which was supplemented with vitamin E, the twenty-one formulas based on fresh or modified cow's milk often contained insufficient tocopherol to meet the various criteria of adequacy. A large per cent of the vitamin E content in these formulas was present as α-tocopherol. The polyunsaturated fatty acid content was relatively low. In general, the fifteen proprietary formulas had much higher levels of vitamin E and polyunsaturated fatty acids than the formulas based on fresh or modified cow's milk. For many of the proprietary products, α-tocopherol constituted only a small part of the vitamin E content. Four of the proprietary formulas (including three which had been fortified with vitamin E) contained sufficient amounts of vitamin E to satisfy the three standards of adequacy. On the basis of the chemical analysis results, it is recommended that all infant formulas be supplemented with sufficient amounts of vitamin E. to meet the various criteria of adequacy. In this way, the risk of vitamin E deficiency in early childhood should be minimal. The present study is also concerned with past, present, and future trends in infant feeding practices. In the 1960's, the ready-to-feed hospital feeding systems, which are usually based on a proprietary preparation,were introduced in Canada. A survey conducted among Canadian hospitals indicated that the use of such systems has become widespread. At the same time, the popularity of the hospital-prepared formula system has declined. Consequently, the use of modified cow's milk formulas has declined in Canadian hospitals. However, such formulas are frequently used for home-feeding of infants. No definite trends were noted in the frequency of breast-feeding. / Land and Food Systems, Faculty of / Graduate

This study was designed to gather information about the nature and content of post-surgical play behaviour displayed by hospitalized pre-school children. Four questions were explored: Are common themes expressed in the play behaviour of hospitalized pre-school children after major surgery? Does the quality and intensity of the play behaviour demonstrated by pre-school children follow a similar pattern? Will pre-school children use play therapy as a medium through which to express fears and concerns about their hospital experience? Do children tend to act out their perceptions of what has happened to them in hospital? The population selected for the study were four girls and one boy between the ages of three and five years, who were admitted for major surgery on the heart or great vessels. During the recovery period after surgery each child had the opportunity to take part in at least five play therapy sessions lasting approximately one hour each. Play therapy took the form of situational play using real or simulated hospital equipment and various dolls representing children and adults. Each child chose the direction and content of play. The investigator took part in play as directed by the child. Parents could join in if they wished. The verbal and non-verbal behaviour displayed by each child during play therapy was recorded by audio tape and by process recordings. Four out of five children in the study participated actively in play therapy. In the course of play they expressed five common themes: intrusive procedures; re-enactment of procedures; testing reality; autonomy: regaining control; separation from home and family; and nurturing activities. The quality and intensity of the children's play behaviour followed a pattern from intense to more relaxed and from aggressive to more gentle play. During play each child expressed some individual fears and concerns about his hospitalization. Intrusive procedures were the most frequent topic of play for all the children. Finally, each child tended to act through specific procedures so that play behaviour became a factual account of the child's hospital experience. One child, the only boy in the study, did not want to participate in play therapy. The reasons for this were not investigated. It was concluded that play therapy is a useful technique which can assist nurses understand the pre-school child's perception of his hospital experience. Play therapy also has potential as a therapeutic intervention to help a child come to terms with the traumatic events of his hospitalization. / Applied Science, Faculty of / Nursing, School of / Graduate

The control of communicable diseases in children is an important public health role. With the availability of effective vaccines, the conquest of many childhood diseases is possible. However, the success of the present immunization programs rests ultimately with the parents, who are responsible for ensuring that their children's immunization status is complete. Many factors can influence this parental compliance. The parents of kindergarten students in two suburban communities completed a questionnaire on immunizations and family characteristics. The questionnaire was constructed using items submitted from a panel of public health nurses and from the literature. A pretest was conducted.. The total' number of questionnaires returned by the deadline was 376. Data on preschool children's immunization status were also collected from health unit records. Analyses of the data included frequency distributions, contingency table analyses, factor analysis, and discriminant analysis. The major findings of the study were: 1. There was a difference between preschool children's recorded immunization status according to health unit statistics and the national standard. 2. There was a discrepancy between preschool children's immunization status as reported by parents and as recorded in health unit statistics. There was not a significant relationship between parental education level, family mobility, family socio-economic level, family composition, or parental knowledge of immunizations and preschool children's reported immunization status. 4. There was a significant relationship between a positive parental attitude toward immunization and completed preschool children's reported immunization status. 5. There was a significant relationship amongst the variables. High family mobility, a low educational level for the father, an incomplete parental immunization status, and a feeling of lack of knowledge about immunizations were discriminatory for a reported incomplete immunization status. As well mobility, education-income, family composition and attitude best accounted for the relationship amongst the variables on factor analysis Implications for nursing practise are discussed and recommendations for further research are suggested. / Applied Science, Faculty of / Nursing, School of / Graduate

Background and Significance: Pertussis infection rates have significantly increased in the United States even though pertussis is a vaccine preventable illness. Alaska has been significantly impacted by this disease and is ranked 3rd highest in the nation for infection rates per capita. Infants less than three months of age suffer the highest proportion of infections. The effects of pertussis are most severe in this age group, sometimes requiring hospitalization and causing death. One theorized contributing factor to the increased pertussis infection rates is the transition to an acellular pertussis vaccine. The acellular component of the Tdap vaccine may wane up to 42% a year, thus decreasing coverage from 10 years to approximately three to five years. The increased infection rate and decreased vaccine efficacy necessitates improved education regarding preventative measures. The cocooning vaccination strategy immunizes all eligible individuals in contact with the infant, thus creating a cocoon of protection.Purpose and Specific Aims: This Doctor of Nursing Practice (DNP) project addresses the need for improved educational material regarding infantile pertussis prevention for Alaskan families having a baby. Throughout this DNP project an educational brochure is developed, emphasizing the importance of pertussis prevention through cocooning vaccination.Methods: The educational brochure was created using the framework of the Health Belief Model (HBM). The HBM was utilized to structure the information included within the brochure to influence individual health behaviors towards immunization of pertussis through cocooning. Evaluation: Three content experts evaluated the brochure utilizing the Patent Education Materials Assessment Tool (PEMAT) auto-scoring tool. Content experts reviewed the brochure and determined the understandability and actionability of the brochure in the form of a percentage. The content expert evaluations all indicated scores of 100%. Conclusion: The brochure created within this DNP Project addresses the educational needs of Alaskan families regarding pertussis infection and the severity of these infections in the infant population. Future implications include brochure production and distribution. The brochure will have the most impact when distributed to maternity units, obstetrical, and gynecological offices in Alaska.

This study was undertaken primarily to investigate the plasma protein system in infants with IRDS, as compared with healthy premature infants, as it had previously been reported that the plasma protein concentration in affected infants was abnormally low. It was attempted further to establish biochemical and/or immunological criteria for diagnosis of the disease and to discover reasons for the low IgG concentrations and raised α-fetoprotein concentrations found in the sera of these infants. Maternal serum proteins were also studied during pregnancy and at and after delivery of the infant. Interrelationships between α-fetoprotein, Human Growth Hormone and other proteins, in immunochemical systems were investigated. In summary, the main conclusions reached were as follows: (i) The total serum-protein concentration in affected infants is much reduced, as compared with healthy premature infants of the same gestational age. (ii) In IRDS infants, the relative and absolute concentration, of IgG is extremely low, whereas concentrations of other immune globulins, as far as could be determined, are within normal limits. (iii) Mothers of affected infants have significantly lower concentrations both of serum IgG and of IgM, than mothers of healthy premature infants. These changes in the serum-proteins are present throughout pregnancy. By six weeks post-partum, the IgG level has returned to normal, but the IgM level remains low. Concentrations of IgA and total serum-protein are normal at all times. (iv) Examination of oedema fluid, urine, faeces and amniotic fluid for γ-globulin content, has excluded the possibility that IgG is being lost from the circulation by these routes. (v) IRDS infants have, in their serum, agglutinins of the IgM type directed against the intact maternal IgG molecule. Similar agglutinins are present in a minority of healthy premature infants. Both IRDS and healthy infants have agglutinins against IgG fragments, in approximately 50% of cases. Agglutinin titres against these are similar in the two groups, but the incidence of agglutinins against Bence Jones protein type Lis raised in IRDS. (vi) Affected infants have an elevated serum concentration of α-fetoprotein, which disappears from the serum during the: first week of post-natal life. (vii) The majority of pregnant women examined have been observed to have serum agglutinins directed against α-fetoprotein. These cross-react with albumin prepared from sera of healthy adult males α-fetoprotein has been found in the serum of many pregnant women, especially during the second trimester. (viii) Immunological interrelationships between α-fetoprotein human serum albumin, Human Growth Hormone and human IgG have been demonstrated. (ix) Infants suffering from Rh-isoimmunization exhibit a serum- protein pattern similar to that seen in IRDS. Biochemical and immunological criteria for the diagnosis of IRDS have thus been established. The data to be presented indicate the presence of an immunological factor in the aetiology of the disease.

The protein content of the only human milk fortifier available in South Africa was increased in 2017. The Original fortifier (OF) and the Reformulated fortifier (RF) provided similar energy. This study aimed to prospectively compare in-hospital growth during the intermediate stage of nutrition support of very low birth weight (VLBW) preterm infants receiving human milk fortified with these two formulations in a tertiary South African hospital. Intake of VLBW infants receiving exclusively human milk plus one of two fortifiers (OF 0.2gprotein/g powder; RF 0.4gprotein/g powder) was calculated. Change in Z-scores (Fenton, 2013) from start to end of fortification of weight, length and head circumference (HC) for age was calculated as primary outcomes. Additionally, weight gain velocity (g/kg/d) and gain in length and HC (cm/wk) were calculated. Fifty eight infants (52% female; gestational age: 30±2wk; birth weight: 1215±187g) received OF (2016 to 2017) and 59 infants (56% female; gestational age: 29±2wk; birth weight 1202±167g) received RF (2017 to 2018) for 15 days. Protein intake of RF (3.7±0.4g/kg/d) was significantly higher (p<0.001) than of OF (3.4±0.2g/kg/d). Protein-to-energy ratio of RF (2.6±0.2) was significantly higher (p<0.001) than of OF (2.3±0.1g/100kcal). No adverse effects were noted. In both groups Z-scores of weight and length dropped; Z-scores for HC showed slight improvements. There were no significant differences between the two groups in terms of Z-scores, weight gain velocity, length gain or HC gain. Analysed human milk from preterm infants’ mothers’ protein levels was higher than published values. In-hospital growth was not statistically different between groups, even though calculated protein intake and protein-to-energy ratio were significantly higher in RF group. / Thesis (PhD (Dietetics))--University of Pretoria, 2019. / Human Nutrition / PhD (Dietetics) / Unrestricted

Thesis (M.Sc.D.)--Boston University School of Graduate Dentistry, 1973. Pedodontics. / Bibliography included.