Thesis (M.Tech.: Food and Consumer Sciences)- Durban Institute of Technology, 2004 1 v. (various pagings) / This study examines the incidence of malnutrition and the factors influencing malnutrition amongst rural black children aged 0 to 24 months in Umbumbulu, Kwa-Zulu Natal so as to formulate guidelines for the development of a nutrition intervention education programme.

Thesis (Ph.D.) -- University of Adelaide, Dept. of Physiology, 2001. / Includes bibliographical references (leaves 228-257).

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.

Early deficits in childhood growth and development contribute to long-term problems that can persist into adulthood, including poor psychosocial wellbeing and reduced adult income. According to recent estimates, more than 200 million children worldwide fail to reach their full developmental potential. Underdevelopment is particularly widespread among children in Zambia; approximately 40% of Zambian children under five years of age are stunted due, in large part, to widespread malnutrition. It is a tremendous challenge for the public health care system in the country to address this burden. In this thesis, I investigate the capacity of rural health workers in Southern Province, Zambia to treat acute malnutrition among children under 5 years of age. Data presented in this thesis were collected from several sources. Information regarding current guidelines, trainings for treatment of acute malnutrition and supply chain for supplemental nutritious and ready-to-use therapeutic foods were collected during key informant interviews performed with nutritionists (n=4) and rural health workers (n=5) in Lusaka and Southern Province, Zambia. Nutritionists working within the health care system at the national, provincial and district levels were interviewed, as were rural health workers selected from a sample of health centers. Information on child nutrition was collected using 24-hour food recall questionnaires that were administered to mothers from a sample of households (n=215) in Southern Province. Data were analyzed with qualitative and quantitative methods. Outcomes of interest included the following: capability of rural health workers to address and treat acutely malnourished children; average daily consumption of carbohydrate, protein and fruit containing meals and snacks among infants; maternal perception of child growth and development as compared to other children of the same age; and mothers’ satisfaction with nutrition information and services provided by their local health centers. The first key finding of this study was that only 40% of rural health workers had been trained in the treatment of acute malnutrition within the last five years, while 100% of nutritionists had received training within the last two years. The second key finding was that infants six to 12 month old in the study sample were reported to have low protein and high carbohydrate consumption. On average, children consumed protein 0.75 times per day and carbohydrates 3.24 times per day. The third key finding was that mothers appeared to overestimate the development of their children. Despite the high rate of childhood stunting in the study sample (38%), 76% of mothers felt their child was the same height or taller than other children of the same age and sex, and close to 75% of mothers felt their child learned at the same speed as or quicker than other children of the same age and sex. These findings suggest that there are currently inadequate resources and capabilities within the Zambian health care system to properly manage the high rate of child malnutrition and stunting in the country. In order to have a greater effect on the reduction of stunting in children, efforts to better disseminate resources from the national level to the rural health centers for the treatment of chronic and acute malnutrition should be considered. Necessary resources include better access to trainings for rural health workers, anthropometric tools to measure levels of malnutrition and supplemental nutritious foods or ready-to-use therapeutic foods to treat children who are moderately or severely malnourished should be increased.

Bakgrund: Prevalensen av malnutrition bland äldre patienter på sjukhus är hög. Tillståndet är förknippat med komplikationer som ökad dödlighet, ökad infektionsrisk, försämrad sårläkning och förlängd sjukhusvistelse. Att tidigt identifiera patienter med risk för, eller pågående malnutrition är en förutsättning för att förhindra komplikationer. För att underlätta detta används ett flertal screeningverktyg. Syfte: Att kartlägga hur stor andel patienter som identifieras med risk för malnutrition vid användning av olika screeningverktyg hos äldre patienter på sjukhus. Metod: En litteraturstudie baserad på åtta kvantitativa empiriska studier. Sökningarna gjordes i databaserna Cinahl och PubMed. Kategorisering gjordes av screeningverktygens identifiering av nutritionsstatus. Resultat: Resultatet visar att screeningverktyget Mini Nutritional Assessment Short Form har det högst uppmätta värdet av identifierade patienter med risk för, eller pågående malnutrition. Screeningverktyg som har identifierat samma patienter överensstämde inte helt i kategoriseringen av nutritionsstatusen. Konklusion: En samstämmighet kring vilket screeningverktyg som har bäst identifieringsförmåga för äldre patienter på sjukhus saknas. Vidare forskning behövs för att fortsätta utvecklingen av screeningverktyg för identifiering malnutrition. I dagsläget kan utbildning inom användandet av GLIM-kriterierna bidra till en effektiv identifiering, samt implementering av adekvata nutritionsåtgärder. Detta skulle kunna minska lidande för patienter och kostnader för vården. / Background: The prevalence of malnutrition among elderly patients in hospitals is high. Malnutrition is associated with complications such as increased mortality, increased risk of infection, impaired wound healing, and prolonged hospital stay. Early identification of patients at risk, or currently experiencing malnutrition is a prerequisite for preventing these complications. To facilitate this, several screening tools are used. Aim: To investigate the proportion of patients identified at risk for malnutrition using different screening tools among elderly patients in hospitals. Methods: A literature review based on eight quantitative empirical studies. The searches were conducted in the databases Cinahl and PubMed. The screening tools identification of nutritional status were categorized. Results: The screening tool Mini Nutritional Assessment Short Form had the highest measured value in identified patients at risk, or currently experiencing malnutrition. Screening tools that identified the same patients did not completely agree on the categorization of nutritional status. Conclusion: Consensus regarding the screening tool with the best identification capability for elderly patients in hospitals is insufficient. Continuous development of screening tools for identifying malnutrition is needed. Education on the GLIM criteria can contribute to effectively identifying and implementing appropriate nutrition interventions. This could reduce suffering for patients and healthcare costs.

No description available.

Socio-economic, education, and health variables were examined to determine the primary causes of malnutrition in preschool Haitian children. A survey of 160 women and their child closest to weaning age was conducted in three regions of Haiti in January 1978. Ordinary least squares multiple regression analysis was used to determine the combined power of the socio-economic, education, and health variables and the relative power of each independent variable separately in explaining malnutrition in the sample population. Results showed that the amount of food or food money available had the greatest impact on the child's current nutritional status as, measured by weight/age. Long term malnutrition, as measured by height, age, was most affected by education. Health variables as a group were least effective in explaining malnutrition although the number of illnesses a child had had was highly related to malnutrition. A strong interaction between weaning age and months spent in a nutrition center suggested that children who were weaned early were more likely to become severely malnourished and required longer periods of nutritional rehabilitation than children who were weaned later. Recommendations were made to incorporate the findings into current nutrition center programs in Haiti. / Ph. D.

Sammanfattning Bakgrund: Malnutrition är ett vanligt problem hos äldre. Risken ökar vid hög ålder, sjukdom och andra faktorer som bidrar till undernäring. För att minska riskerna och förbättra hälsan hos äldre personer, krävs det att sjuksköterskan har förmågan att kunna identifiera, planera, och ha kunskap om nutrition samt om olika förebyggande åtgärder vid malnutrition. Syfte: Syftet med studien är att beskriva vilka faktorer som påverkar sjuksköterskans arbete vid malnutrition hos äldre.Metod: En litteraturstudie med kvalitativ ansats genomfördes och baserades på sju vetenskapliga artiklar som söktes via databasen Cinahl och PubMed med fulltext. Tolkningen av innehållsanalysen utifrån Graneheim och Lundmans användes för att analysera de vetenskapliga artiklarna.Resultat: Resultatet visade olika faktorer som påverkade sjuksköterskans arbete vid förebyggande åtgärder och behandling av malnutrition hos äldre person. Innehållsanalysen ledde fram till fem olika kategorier. Kategorierna blev Brist på kunskap om nutrition, Tid och personal brist, Attityder till nutritions relaterade problem, Avsaknad av samarbete i ett vårdteam och Planering av måltidsmiljö saknas.Slutsats: Att beskriva faktorer som påverkar sjuksköterskors arbete vid malnutrition kan ge bättre förståelse om näringsvård. Ökad kunskap ger även möjligheter för sjuksköterskor att kunna planera och utföra omvårdnadsarbetet gällande näringsvård.

SAMMANFATTNING Bakgrund: Undernäring leder till förlängd vårdtid och andra komplikationer. En nutritionsmätning på ett Universitetssjukhus i Mellansverige visade att 44 % av alla inneliggande patienter led av undernäring vid mätningstillfället. Syfte: Att undersöka hur stor andel av patienterna på en intensivvårdsavdelning (IVA) i ett universitetssjukhus i Mellansverige som erhöll det av Socialstyrelsen rekommenderade kravet på 25 Kcal/kg/dygn under behandlingsdag 1 till 7. Ett annat syfte var att undersöka hur korrelationen mellan energiintaget och energibehovet påverkar den totala sjukhusvistelsen på IVA samt hur energiintaget påverkas av confounding variabler såsom kön och diagnosgrupp. Metod: En kvantitativ, retrospektiv studie där 63 journaler, granskades. En systematisk urval användes från 2013 till 2015. Data analyserades med icke-parametriska test, med hjälp av korrelationer och signifikanstester vid jämförelser mellan grupper. Resultat: Inga patienter erhöll det rekommenderade energibehov från dag 1-7. Korrelationer fanns med energiintag efter behov. Män och kvinnor behandlas ej likvärdigt utifrån energiintag efter energibehov. Majoriteten av de patienter som drabbats av någon av de diagnosgrupper med högst prevalens hade sämre följsamhet till sitt energibehov jämfört med patienter som inte led av diagnosgruppen. Slutsats: Studien visar stora brister i att tillgodose energibehovet hos patienter på IVA. Detta resultat kommer förhoppningsvis att leda till förbättrade rutiner och lägga en grund för förbättrade lokala riktlinjer om följsamhet till näringsintag på IVA. Kvinnor och män behandlas inte likvärdigt och att drabbas av någon av de sjukdomsgrupper som har den högsta prevalensen ledde till att patienten behandlades sämre i fråga om näring.

Bakgrund Undernäring är vanligt bland personer bosatta på vårdhem, närmare bestämt 15-40% av dem är undernärda. Det finns olika sätt att undersöka om en person är undernärd, en modell är Mini Nutritional Assessment (MNA). Studier som använts sig av MNA-modellen visar att undernäringen minskat från 36 % 1999 till 18 % 2008. Att matsedelsplaneringen utgår från vårdtagarnas behov är viktigt. Även om antalet välnärda ökat inom äldreomsorgen är undernäring fortfarande ett stort problem, därför känns det angeläget att belysa detta område. Syfte Syftet med undersökningen är att skapa en överblick hur måltidsrutinerna samt undernäring ser ut och hur den kan förbättras inom äldreomsorgen i Piteå kommun. Metod Studien gjordes enligt en kvantitativ metod med strukturerade intervjuer. En enkät utformades, denna fylldes i samtidigt som intervjun skedde över telefon. Tjugo personer intervjuades, dessa representerade var sin avdelning på ett äldreboende. En sammanställande analys gjordes i statistikprogrammet SPSS 21.0 som presenterades med beskrivande statistik. Resultat Vanligast var att de äldre åt i matsalen, enstaka individer åt inne på sitt rum. Knappt en tredjedel av respondenterna svarade att de tyckte att det doftade mat i matsalen. På samtliga boenden kunde nattfastan överstiga elva timmar. Oftast serverades kvällsmålet 1,5 timme efter middagen som serverades av 13 boenden klockan 16.30. Till lunch samt middag serverades två alternativ. Dessert serverades två till tre gånger per vecka. En regelbunden kontakt med dietist var sällsynt för samtliga boenden. På 55 % av boendena förekom undernäring. Slutsats Det uppmärksammades en nattfasta som kunde bli alltför lång. Att senarelägga middag och kvällsmål skulle kunna vara en lösning. Andelen som befann sig i riskzon till undernäring var alltför stor. Matsedeln stämde generellt väl överens med rådande riktlinjer.