Vertical transmission of HIV is still a growing concern in South Africa. Breastfed infants are still at risk as HIV is present in breast milk, leaving HIV-positive mothers unsure of the best feeding option for their infants. However, there are various infant feeding techniques that HIV-positive mothers can use to supplement breastfeeding and flash-heat is one of them. Flash-heat is heat treating expressed breast milk to deactivate HIV for infant feeding. This study explored the possibility of HIV-positive mothers to practice flash-heating method for their infants exclusively for four months as a strategy to prevent vertical transmission of HIV. A descriptive, explorative and contextual design using a mixed method was used to obtain data from mothers in a post natal ward at Tembisa hospital. The mixed method used was useful in identifying the number of HIV-positive mothers who would adopt the flash-heat technique, the characteristics of mothers whom the technique could be promoted to, the factors that influence/affect the choice of infant feeding for these mothers, as well as their feelings associated with the feeding technique. Most (74%) mothers had a positive response to the flash-heat technique compared to 10% who were uncertain. They believed that heat treating their breast milk would result in their infants being HIV-free. In addition they believed that this method was cheaper than formula feeding and expressed positive feelings about touching their breast milk while expressing with no adverse feelings of expressing into a glass jar. Furthermore, findings of this study indicated that HIV-positive mothers in a public health facility would adopt flash-heat as an alternative infant feeding method. Thus practical guidelines to promote this feeding method were proposed. The proposed draft guidelines which promote the use of the flash-heat infant feeding method for HIV-positive mothers in public sector facilities will be communicated to relevant authorities such as the National Department of Health. These guidelines support the new policy shift to exclusive breastfeeding as a child survival strategy in South Africa. / Health Studies / D.Litt. et Phil. (Health Studies)

O uso de suplementos alimentares à base de carnitina tem se tornado bastante popular dentre atletas. Nos seus possíveis efeitos biológicos, constam o emagrecimento e o melhor condicionamento aeróbio frente ao exercício físico. Embora o uso difundido também entre não-atletas, há poucas evidências científicas nestes grupos populacionais, particularmente adultos. O objetivo deste estudo foi avaliar os efeitos da suplementação de L-carnitina associada ao exercício físico aeróbio sobre a composição corporal e lipídica sanguínea, gasto energético de repouso e desempenho aeróbio de adultos clinicamente saudáveis. Foram selecionados 21 indivíduos voluntários de 40 a 58 anos de idade, de ambos os sexos (9 homens e 12 mulheres), com índice de Massa Corporal (IMC) entre 25 e 35 kg/m2, participantes de protocolo de exercícios físicos aeróbios supervisionados (80min/sessão, 3-5x/semana, 70 a 80% da freqüência cardíaca máxima para idade) há pelo menos 12 semanas. Após avaliação inicial (M0), foram divididos aleatoriamente em grupos: suplementado (G1; N=11), recebeu 1,8g/dia de L-carnitina e placebo (G2; N=10), recebeu maltodextrina, ambos mantidos nesta intervenção dietética por 30 dias consecutivos. Concluído o período dietético (M1), foram repetidas as avaliações de M0, nas situações de repouso (peso, estatura para cálculo do IMC, circunferência de abdômen, % de gordura, gasto energético de repouso, ingestão alimentar, colesterol e frações e triglicerídios) e esforço físico em esteira ergométrica (VO2máx, limiar anaeróbio, quociente respiratório e variação dos ácidos graxos livres plasmáticos). Houve ligeiro aumento do V02máx e limiar anaeróbio em ambos os grupos e reclassificação do LDL-c no grupo placebo. Os demais valores de ingestão alimentar, composição corporal, lipidemia e gasto energético não sofreram influência significativa do período de exercício ou tratamento dietético. As concentrações de ácidos graxos livres aumentaram durante o esforço físico em esteira, mas sem significância. Conclui-se que o efeito adicional da suplementação de L-carnitina em adultos exercitados regularmente é mínimo nas variações da composição corporal e sanguínea, no gasto energético, uso de substratos energéticos e no condicionamento aeróbio. / The use of nutritional supplements such as carnitine has been widely spread over among athletes. The refered advantages are related to possible weight loss and cardiorespiratory fitness. However, besides widely used in active people (non athletes) there has been little scientific based evidences in this group, specifically in adults. The purpose of the study was to investigate the additional effects of L-carnitine supplemented to exercised subjects on their body composition, blood lipid profile, resting metabolic rate and aerobic performance. Twenty-one volunteers (9 males and 12 females), 40 to 58 years old, body mass index (BMI) values between 25 and 35 kg/m2, were engaged in aerobic exercise program (80 min/session, 3-5 days/week, 70 a 80% of maximum heart rate-HRmáx) at least 12 weeks. After the first test (M0) the subjects were randomly assigned in two groups: L-carnitine (G1; N=11), receiving orally L-carnitine (1,8g/day) or placebo (G2; N=10), receiving maltodextrine during 30 consecutive days. After the dietary intervention (M 1), the assessment tests were repeated in both, resting (body mass, height, BMI calculation, resting energy expenditure, dietary intake, body fat and lipid profile) and exercised condition in a treadmill (VO2max, anaerobic threshold, respiratory exchange ratio and the variation on free fatty acids levels). VO2max and anaerobic threshold were increased in both groups and LDL-c downgraded in the placebo group. No significant changes were found due to either training or dietary supplementation in dietary intake, body composition, lipid profile and energy expenditure. Plasma free fatty acids levels increased, but not significantly, during the 30 min treadmill exercise. Thus, the additional effects of L-carnitine supplementation in moderate active adults were not enough to promote significant changes in body composition, lipid profile, energy expenditure, substrate utilization and aerobic fitness.

Bellbirds (Anthornis melanura) are one of two endemic honeyeaters in New Zealand. They are still common in many parts of the country, but also rare and absent in some areas where they were abundant before. Together with tui (Prosthemadera novaeseelandia) bellbirds are responsible for avian pollination of several native plants in New Zealand. Habitat fragmentation and geographical constraints prevent bellbirds from re-occupying formerly inhabited areas. After translocations birds often disperse; some just disappear, some are thought to fly back to their source site and probably many die. Supplementary feeding provides energy rich food, which helps to ensure birds are well-nourished until they can discover natural food sources at the release sites. Conspecific song playback as an attractant for many bird species can be used as public information about high habitat value and additionally lure birds to good food sources and nest sites. Artificial feeding stations were set up at 18 locations in Kennedy's Bush, Port Hills, Canterbury, New Zealand. Feeders filled with sugar water were available for five to six consecutive days and during observation hours the effect of song playback was tested. Variation in bird numbers resulting from experimental treatments was recorded using five-minute bird counts prior to treatments and additional counts every minute of observation time. Bellbird numbers varied strongly with habitat types, showing highest numbers for dense and tall bush areas and close to creeks and lowest for open areas besides pasture and in post-flowering flax fields. Bellbird numbers increased when song was broadcast, with the strongest effect in areas where bellbird numbers were moderate or low, but not in areas where bellbirds were absent. Feeding stations were not observed to be used by bellbirds. The strong response in bellbird numbers to conspecific song playback proved the attractiveness of song for bellbirds. Nevertheless, its function as a lure for bellbirds to artificial feeding stations was not shown. This contrasting result indicates that the use of bellbird song as an enticement for bellbirds has to be investigated further.

Vertical transmission of HIV is still a growing concern in South Africa. Breastfed infants are still at risk as HIV is present in breast milk, leaving HIV-positive mothers unsure of the best feeding option for their infants. However, there are various infant feeding techniques that HIV-positive mothers can use to supplement breastfeeding and flash-heat is one of them. Flash-heat is heat treating expressed breast milk to deactivate HIV for infant feeding. This study explored the possibility of HIV-positive mothers to practice flash-heating method for their infants exclusively for four months as a strategy to prevent vertical transmission of HIV. A descriptive, explorative and contextual design using a mixed method was used to obtain data from mothers in a post natal ward at Tembisa hospital. The mixed method used was useful in identifying the number of HIV-positive mothers who would adopt the flash-heat technique, the characteristics of mothers whom the technique could be promoted to, the factors that influence/affect the choice of infant feeding for these mothers, as well as their feelings associated with the feeding technique. Most (74%) mothers had a positive response to the flash-heat technique compared to 10% who were uncertain. They believed that heat treating their breast milk would result in their infants being HIV-free. In addition they believed that this method was cheaper than formula feeding and expressed positive feelings about touching their breast milk while expressing with no adverse feelings of expressing into a glass jar. Furthermore, findings of this study indicated that HIV-positive mothers in a public health facility would adopt flash-heat as an alternative infant feeding method. Thus practical guidelines to promote this feeding method were proposed. The proposed draft guidelines which promote the use of the flash-heat infant feeding method for HIV-positive mothers in public sector facilities will be communicated to relevant authorities such as the National Department of Health. These guidelines support the new policy shift to exclusive breastfeeding as a child survival strategy in South Africa. / Health Studies / D.Litt. et Phil. (Health Studies)

O uso de suplementos alimentares à base de carnitina tem se tornado bastante popular dentre atletas. Nos seus possíveis efeitos biológicos, constam o emagrecimento e o melhor condicionamento aeróbio frente ao exercício físico. Embora o uso difundido também entre não-atletas, há poucas evidências científicas nestes grupos populacionais, particularmente adultos. O objetivo deste estudo foi avaliar os efeitos da suplementação de L-carnitina associada ao exercício físico aeróbio sobre a composição corporal e lipídica sanguínea, gasto energético de repouso e desempenho aeróbio de adultos clinicamente saudáveis. Foram selecionados 21 indivíduos voluntários de 40 a 58 anos de idade, de ambos os sexos (9 homens e 12 mulheres), com índice de Massa Corporal (IMC) entre 25 e 35 kg/m2, participantes de protocolo de exercícios físicos aeróbios supervisionados (80min/sessão, 3-5x/semana, 70 a 80% da freqüência cardíaca máxima para idade) há pelo menos 12 semanas. Após avaliação inicial (M0), foram divididos aleatoriamente em grupos: suplementado (G1; N=11), recebeu 1,8g/dia de L-carnitina e placebo (G2; N=10), recebeu maltodextrina, ambos mantidos nesta intervenção dietética por 30 dias consecutivos. Concluído o período dietético (M1), foram repetidas as avaliações de M0, nas situações de repouso (peso, estatura para cálculo do IMC, circunferência de abdômen, % de gordura, gasto energético de repouso, ingestão alimentar, colesterol e frações e triglicerídios) e esforço físico em esteira ergométrica (VO2máx, limiar anaeróbio, quociente respiratório e variação dos ácidos graxos livres plasmáticos). Houve ligeiro aumento do V02máx e limiar anaeróbio em ambos os grupos e reclassificação do LDL-c no grupo placebo. Os demais valores de ingestão alimentar, composição corporal, lipidemia e gasto energético não sofreram influência significativa do período de exercício ou tratamento dietético. As concentrações de ácidos graxos livres aumentaram durante o esforço físico em esteira, mas sem significância. Conclui-se que o efeito adicional da suplementação de L-carnitina em adultos exercitados regularmente é mínimo nas variações da composição corporal e sanguínea, no gasto energético, uso de substratos energéticos e no condicionamento aeróbio. / The use of nutritional supplements such as carnitine has been widely spread over among athletes. The refered advantages are related to possible weight loss and cardiorespiratory fitness. However, besides widely used in active people (non athletes) there has been little scientific based evidences in this group, specifically in adults. The purpose of the study was to investigate the additional effects of L-carnitine supplemented to exercised subjects on their body composition, blood lipid profile, resting metabolic rate and aerobic performance. Twenty-one volunteers (9 males and 12 females), 40 to 58 years old, body mass index (BMI) values between 25 and 35 kg/m2, were engaged in aerobic exercise program (80 min/session, 3-5 days/week, 70 a 80% of maximum heart rate-HRmáx) at least 12 weeks. After the first test (M0) the subjects were randomly assigned in two groups: L-carnitine (G1; N=11), receiving orally L-carnitine (1,8g/day) or placebo (G2; N=10), receiving maltodextrine during 30 consecutive days. After the dietary intervention (M 1), the assessment tests were repeated in both, resting (body mass, height, BMI calculation, resting energy expenditure, dietary intake, body fat and lipid profile) and exercised condition in a treadmill (VO2max, anaerobic threshold, respiratory exchange ratio and the variation on free fatty acids levels). VO2max and anaerobic threshold were increased in both groups and LDL-c downgraded in the placebo group. No significant changes were found due to either training or dietary supplementation in dietary intake, body composition, lipid profile and energy expenditure. Plasma free fatty acids levels increased, but not significantly, during the 30 min treadmill exercise. Thus, the additional effects of L-carnitine supplementation in moderate active adults were not enough to promote significant changes in body composition, lipid profile, energy expenditure, substrate utilization and aerobic fitness.

El objetivo de este estudio fue encontrar los factores de riesgo para la baja adherencia a la suplementación con multimicronutrientes (MMN) en niños de 6 a 35 meses de edad. Se analizó una base de datos secundaria de la vigilancia centinela realizada durante los años 2009-2011 en las regiones de Apurímac, Ayacucho y Huancavelica por el Centro Nacional de Epidemiologia, Prevención y Control de Enfermedades del Perú (CDC). Se incluyeron los datos demográficos además de otras variables que se recogieron mes a mes durante la vigilancia. Estas son si recibió consejería nutricional, si asistió a la sesión demostrativa de preparación de alimentos con MMN, si percibió alguna mejoría en el niño, si el niño presentó algún evento adverso relacionado al consumo de MMN, si recibió visitas domiciliarias, y el alimento en el que se agregó los MMN. Para el análisis estadístico se usó la regresión de ecuaciones de estimación generalizadas (GEE). Los resultados que se encontraron son que asistir a la sesión demostrativa (p=0.005), que el niño presente eventos adversos relacionados a la ingesta de MMN durante los seis primeros meses de suplementación (p<0.001) y agregar los MMN en alimentos líquidos (p=0.001) disminuyen la adherencia a la suplementación en 1.27%, 17.00% y 1.51% respectivamente. Residir en Huancavelica (p<0.001) y que la madre note a su niño más despierto (p=0.039) incrementan la adherencia en 2.51% y 0.95% respectivamente. Concluimos que se deben realizar intervenciones que aborden estos factores de riesgo, y recomendamos que se realicen más estudios en esta área. / The objective of this study was to find the risk factors for poor adherence to multimicronutrient supplementation (MMN) in children 6 to 35 months of age. A secondary database of sentinel surveillance carried out during the years 2009-2011 in the regions of Apurímac, Ayacucho and Huancavelica by the National Center for Epidemiology, Prevention and Disease Control of Perú (CDC) was analyzed. Demographic data was included in addition to other variables that were collected month by month during the surveillance. These are if they received nutritional counseling, if they attended the food preparation demonstration session with MMN, if they perceive any improvement in the child, if the child presented any adverse event related to MMN consumption, if they received home visits, and the food in which the MMNs were added. Regression of generalized estimating equations (GEE) was used for statistical analysis. The results that were found are that attending the demonstration session (p = 0.005), that the child presents adverse events related to the ingestion of MMN during the first six months of supplementation (p <0.001) and adding MMN in liquid foods (p = 0.001) decrease adherence to supplementation by 1.27%, 17.00% and 1.51% respectively. Residing in Huancavelica (p <0.001) and having the mother notice the child more awake (p = 0.039) increases adherence by 2.51% and 0.95% respectively. We conclude that interventions that address these risk factors should be performed, and we recommend that further studies be conducted in this area. / Tesis

The prevalence of Protein-Energy Malnutrition (PEM) in South Africa has been welldescribed in previous research studies and yet little is known about the nutritional status of toddlers in the Vosloorus Township. Using the research questions as the conceptual framework for the study, an exploratory descriptive survey was conducted to determine. • What factors give rise to malnutrition in the Vosloorus Township? • Why do toddlers on the PEM Programme fail to achieve their expected target weight? Data was collected by means of structured interviews from a sample of 50 mothers in the Vosloorus Township whose toddlers were on the PEM Programme. The fmdings indicated that the poor socio-economic conditions of the majority of households, especially unemployment, low levels of education and ignorance, contributed towards the development of malnutrition amongst toddlers and their failure to thrive on the PEM Programme. Recommendations to reduce levels of malnutrition and transform existing nutrition programmes were made. / Health Studies / M.A. (Nursing Science)

Made available in DSpace on 2016-01-26T12:51:12Z (GMT). No. of bitstreams: 1 rosicleryagi_dissert.pdf: 414700 bytes, checksum: 16f9a0fd1dd26383f4b843678eec9dd6 (MD5) Previous issue date: 2005-07-14 / Brazilian government policy of public health aims to promote and support breastfeeding; consequently reducing the infant mortality as well as improving the children´s quality of life. The objectives of this study were: a) to observe the diet of premature and full-term babies aged under two years, assessing the breastfeeding indicators of the World Health Organization (WHO): exclusive breastfeeding, predominant breastfeeding, complementary proper foods, continued breastfeeding and milk bottle feeding; b) to compare standardized diets among premature and full-term newborns. Casuistics: Two hundred of mothers of newborns and infants participated the study. They were divided into four groups (50 each): Group I (< 4 months); Group II ( between 6 and <10 months); Group III ( between 12 and < 16 months); Group IV ( between 20 and <24 months). Method: At first the project was approved by the Ethics Committee of Research. Afterwards, before the routinely consulting, the mothers answered a questionnaire based on a methodology standardized by WHO about information of diet during the last 24 hours. Results: The majority of mothers was adult (lesser than 20% of adolescents), able to read and write (97%; IC:93 to 99%), living with a partner (estimative of 79.5%; IC:73 to 85%), minority worked outside (27%; IC:21 to 34%). Average of 70.5% (IC:64 to 77%) of cesarean labor and 50.5% (IC:43 to 57%) of premature labor. The minority performed the first breastfeeding in the labor room (estimative of 18%; IC:13 to 25%). In Group I, the rate of exclusive breastfeeding was 40% (IC:26 to 55%), and predominant breastfeeding 28% (IC:16 to 42%). In Group II, the rate of breastfeeding with complementary proper foods was 46% (IC:32 to 61%). In Group III, the rate of continued breastfeeding up to one year was 30% (IC:18 to 45%); and in Group IV, the rate of continued breastfeeding up to two years was 32% (IC:20 to 47%). The rate of milk bottle feeding for babies under one year was 57% (IC:47 to 67%). Conclusions: The characteristics of the groups of mothers and babies were almost homogeneous, both have been following partially the facilitator routines of breastfeeding. As the age of babies increased, breastfeeding diminished, with the early introduction of liquids and complementary diet. The standardized diet of full-term and premature babies was similar. / O Brasil adota uma política de saúde voltada para a promoção, proteção e apoio ao aleitamento materno, como forma de reduzir a mortalidade infantil e melhorar a qualidade de vida das crianças. Os objetivos deste estudo foram; a) caracterizar a amostra e verificar a alimentação de bebês com idade inferior a dois anos, prematuros e a termo, avaliando os indicadores de aleitamento materno propostos pela Organização Mundial de Saúde (OMS): amamentação exclusiva, amamentação predominante, alimentação complementar oportuna, amamentação continuada e alimentação por mamadeira; b) comparar padrões alimentares entre bebês prematuros e a termo. Casuística: participaram do estudo 200 mães de recém-nascidos e lactentes divididas em quatro grupos de 50 mães; Grupo 1 (<4 meses); Grupo II (entre 6 e <10 meses); Grupo III (entre 12 e <16 meses); Grupo IV (entre 20 e <24 meses). Método; O projeto foi aprovado pelo Comitê de Ética em Pesquisa. Antes da consulta rotineira, as mães responderam a um questionário, fundamentado em metodologia padronizada pela OMS, sobre informações alimentares relativas as últimas 24 horas. Resultados: A maioria das mães encontrava-se na fase adulta (menos de 20% de adolescentes), alfabetizadas (97%; lC:93 a 99%), com parceiros (estimativa de 79,5%; 10:73 a 85%), minoria trabalhava fora (27%; 10:21 a 34%). Estimativa de 70,5% (lC:64 a 77%) de parto cesárea e 50,5% (lC:43 a 57%) de prematuridade. A minoria realizou a primeira mamada na sala de parto (estimativa de 18%; lC:13 a 25%). No Grupo 1 a taxa de aleitamento materno exclusivo foi 40% (lC:26 a 55%) e de aleitamento materno predominante 28% (10:16 a 42%). No Grupo II a taxa de aleitamento materno com alimentação complementar oportuna de 46% (10:32 a 61%). Para o Grupo III, a taxa de aleitamento materno continuado até um ano foi de 30% (10:18 a 45%) e para o Grupo IV a taxa de aleitamento materno continuado até dois anos foi de 32% (10:20 a 47%). Nota de Resumo A taxa de alimentação por mamadeira para menores de um ano foi de 57% (10:47 a 67%). Conclusões: As características dos grupos de mães e crianças foram quase homogêneas; ambos seguiam parcialmente rotinas facilitadoras da amamentação. O aleitamento materno diminui com o aumento da idade, havendo a introdução precoce de líquidos e alimentação complementar. O padrão alimentar dos bebês a termo e prematuros foi semelhante.

The prevalence of Protein-Energy Malnutrition (PEM) in South Africa has been welldescribed in previous research studies and yet little is known about the nutritional status of toddlers in the Vosloorus Township. Using the research questions as the conceptual framework for the study, an exploratory descriptive survey was conducted to determine. • What factors give rise to malnutrition in the Vosloorus Township? • Why do toddlers on the PEM Programme fail to achieve their expected target weight? Data was collected by means of structured interviews from a sample of 50 mothers in the Vosloorus Township whose toddlers were on the PEM Programme. The fmdings indicated that the poor socio-economic conditions of the majority of households, especially unemployment, low levels of education and ignorance, contributed towards the development of malnutrition amongst toddlers and their failure to thrive on the PEM Programme. Recommendations to reduce levels of malnutrition and transform existing nutrition programmes were made. / Health Studies / M.A. (Nursing Science)