Apesar de existirem evidências suficientes sobre benefícios do aleitamento materno (AM), apenas 35% das crianças são amamentadas exclusivamente até o quarto mês de vida. Visando estender esta prática, OMS/UNICEF lançaram a Iniciativa Hospital Amigo da Criança (IHAC), que estabelece sistema de credenciamento para maternidades de acordo com grau de incentivo ao AM. Esta dissertação pretende investigar a efetividade da IHAC na duração de dois tipos de aleitamento materno: exclusivo (AME) e predominante (AMP) entre crianças usuárias de Unidades Básicas de Saúde (UBS) do Rio de Janeiro. Trata-se de estudo transversal, sendo a população de estudo constituída de 811 mães de crianças menores de 5 meses de idade, selecionadas aleatoriamente em cinco UBS na cidade do Rio de Janeiro. A variável de exposição foi categorizada em local de nascimento ocorridos em HAC, naqueles em vias de receber titulação (EVHAC) e naqueles sem titulação. Os desfechos considerados foram duração do AME e do AMP, que inclui também crianças em AME (AMEP). Na análise dos dados, optou-se pelo modelo log-log complementar, que permitiu recompor experiência longitudinal da coorte através do recordatório alimentar de 7 dias e da informação da idade das mesmas, caracterizando abordagem tipo current status data. Mesmo após controle por variáveis sociodemográficas, relativas ao estilo de vida e aos aspectos psicossociais maternos, à utilização dos serviços de saúde, idade e saúde da criança, houve maior duração do AME e AMEP em crianças nascidas em HAC e EVHAC. As taxas de AME e de AMEP são mais de duas vezes maiores entre recém-nascidos que nasceram em HAC e EVHAC. Tal efeito diminui ao longo da idade da criança, mantendo-se evidente até quatro (EVHAC) e dois (HAC) meses de vida quando se considera AME e até dois (EVHAC) e cinco (HAC) meses quando se considera AMEP. Os resultados confirmam a efetividade da IHAC nesta clientela,especialmente na manutenção de AME e AMEP nos primeiros meses de vida. Estes também sugerem necessidade de fortalecimento da IHAC e maior integração entre maternidades e UBS, visando garantir aleitamento exclusivo até seis meses de vida / Although there are sufficient evidences about breastfeeding (BF) benefits, only 35% of infants worldwide are exclusively breastfed during the first four months of life. As an effort to extend BF duration, WHO/UNICEF launched the Baby-Friendly Hospital Initiative (BFHI), which establishes hospitals accreditation as Baby-Friendly Hospitals (BFH) when it meets the Ten Steps for Successful Breastfeeding. This dissertation aims to investigate the effectiveness of the BFHI on exclusive breastfeeding (EBF) and exclusive plus predominant breastfeeding (EPBF) duration. This is a cross-sectional study with collected information throughout interviews of 811 mothers of children under 5 months old, randomly selected at five health centers in Rio de Janeiro. Exposure variable was classified according to hospitals compliance with the Ten Steps. There were three possible status: accredited hospitals (BFH), working in becoming BFH or certified hospitals (CBFH) and hospitals without BFHI accreditation or certification. Outcomes were EBF and EPBF duration. Data was analyzed by complementary log-log transformation models, which allowed capture cohort longitudinal experience through 7-day feeding recordatory and infants age (current status data). Even after adjusting analysis for sociodemographic, life style and psychological maternal factors, health services use and babies age and state of health, there was longer duration of EBF and EPBF of infants born in BFH and CBFH. EBF and EPBF rates were twice higher in newborns born in BFH and CBFH. This protective effect on EBF and EPBF decreases along childs age and its noticed until four (CBFH) and two (BFH) months of age when EBF is considered and until two (CBFH) and five (EBF) months for EPBF. The finding indicates the effectiveness of BFHI in maintaining EBF and EPBF through the first months of life in this population. In order to extend BF duration until six months of life, as recommended by WHO, it would be necessary not only to strengthen the BFHI but also to develop and encourage more actions in favor of breastfeeding, focusing on primary health care facilities

Apesar de existirem evidências suficientes sobre benefícios do aleitamento materno (AM), apenas 35% das crianças são amamentadas exclusivamente até o quarto mês de vida. Visando estender esta prática, OMS/UNICEF lançaram a Iniciativa Hospital Amigo da Criança (IHAC), que estabelece sistema de credenciamento para maternidades de acordo com grau de incentivo ao AM. Esta dissertação pretende investigar a efetividade da IHAC na duração de dois tipos de aleitamento materno: exclusivo (AME) e predominante (AMP) entre crianças usuárias de Unidades Básicas de Saúde (UBS) do Rio de Janeiro. Trata-se de estudo transversal, sendo a população de estudo constituída de 811 mães de crianças menores de 5 meses de idade, selecionadas aleatoriamente em cinco UBS na cidade do Rio de Janeiro. A variável de exposição foi categorizada em local de nascimento ocorridos em HAC, naqueles em vias de receber titulação (EVHAC) e naqueles sem titulação. Os desfechos considerados foram duração do AME e do AMP, que inclui também crianças em AME (AMEP). Na análise dos dados, optou-se pelo modelo log-log complementar, que permitiu recompor experiência longitudinal da coorte através do recordatório alimentar de 7 dias e da informação da idade das mesmas, caracterizando abordagem tipo current status data. Mesmo após controle por variáveis sociodemográficas, relativas ao estilo de vida e aos aspectos psicossociais maternos, à utilização dos serviços de saúde, idade e saúde da criança, houve maior duração do AME e AMEP em crianças nascidas em HAC e EVHAC. As taxas de AME e de AMEP são mais de duas vezes maiores entre recém-nascidos que nasceram em HAC e EVHAC. Tal efeito diminui ao longo da idade da criança, mantendo-se evidente até quatro (EVHAC) e dois (HAC) meses de vida quando se considera AME e até dois (EVHAC) e cinco (HAC) meses quando se considera AMEP. Os resultados confirmam a efetividade da IHAC nesta clientela,especialmente na manutenção de AME e AMEP nos primeiros meses de vida. Estes também sugerem necessidade de fortalecimento da IHAC e maior integração entre maternidades e UBS, visando garantir aleitamento exclusivo até seis meses de vida / Although there are sufficient evidences about breastfeeding (BF) benefits, only 35% of infants worldwide are exclusively breastfed during the first four months of life. As an effort to extend BF duration, WHO/UNICEF launched the Baby-Friendly Hospital Initiative (BFHI), which establishes hospitals accreditation as Baby-Friendly Hospitals (BFH) when it meets the Ten Steps for Successful Breastfeeding. This dissertation aims to investigate the effectiveness of the BFHI on exclusive breastfeeding (EBF) and exclusive plus predominant breastfeeding (EPBF) duration. This is a cross-sectional study with collected information throughout interviews of 811 mothers of children under 5 months old, randomly selected at five health centers in Rio de Janeiro. Exposure variable was classified according to hospitals compliance with the Ten Steps. There were three possible status: accredited hospitals (BFH), working in becoming BFH or certified hospitals (CBFH) and hospitals without BFHI accreditation or certification. Outcomes were EBF and EPBF duration. Data was analyzed by complementary log-log transformation models, which allowed capture cohort longitudinal experience through 7-day feeding recordatory and infants age (current status data). Even after adjusting analysis for sociodemographic, life style and psychological maternal factors, health services use and babies age and state of health, there was longer duration of EBF and EPBF of infants born in BFH and CBFH. EBF and EPBF rates were twice higher in newborns born in BFH and CBFH. This protective effect on EBF and EPBF decreases along childs age and its noticed until four (CBFH) and two (BFH) months of age when EBF is considered and until two (CBFH) and five (EBF) months for EPBF. The finding indicates the effectiveness of BFHI in maintaining EBF and EPBF through the first months of life in this population. In order to extend BF duration until six months of life, as recommended by WHO, it would be necessary not only to strengthen the BFHI but also to develop and encourage more actions in favor of breastfeeding, focusing on primary health care facilities

Magister Public Health - MPH / Promotion of exclusive breastfeeding (EBF), (giving breast milk only without any solids or liquids), has proved to be very challenging in the South African context, although this infant feeding practice has been found to protect babies against diarrhoea and respiratory tract infections and to carry a lower risk of HIV infection than mixed feeding (breastfeeding combined with formula or solids). Study design: The PROMISE-EBF study is a multi-country cluster randomised trial to examine peer support to promote exclusive breastfeeding in Africa. For the South African site in the PROMISE-EBF study, three sites, Paarl, Rietvlei and Umlazi, were selected because of their different geographic settings and each site operated as a separate stratum for cluster selection and randomisation purposes. The clusters were then randomised into intervention and control arms making a total of 17 clusters in each arm. HIV positive and negative women in the intervention arm received support on their choice of infant feeding from the peer supporters who visited them at their homes while the women in the control group only received the standard infant feeding counselling and support provided by health care workers at health facilities. Data collection: Mothers were interviewed at recruitment during the antepartum period to establish eligibility, obtain informed consent and data on socio-economic status. Home visits were scheduled for data collection by trained data collectors at 3, 6, 12 and 24 weeks after birth. Analysis of results: This mini-thesis was a secondary analysis of the PROMISE-EBF data focusing on the South African data only. The data was adjusted for clustering and analysed using SAS. Comparison of variables between the intervention and control groups within sites was done. Results: A significant difference, regarding counselling and infant feeding practices, was observed among all women who received peer support compared to those who received the standard antenatal counselling, with more women in the intervention group (20.5%) practising EBF than those in the control group (12.8%) by Week 3. When the women's HIV status was considered, more than 65% of HIV positive and 40% of HIV negative women practised MF and EFF (giving formula milk only with no breast milk) throughout the study, respectively, regardless of the group they were in. For women who hadintended to practise EBF at recruitment, 33% in the control group and 20% in the intervention group actually practised EBF by Week 3. Regarding disclosure and feeding choice, 77.4% of women who had disclosed their HIV status actually practised MF versus 8.6% who practised EBF by Week 3.Conclusion: Community peer counselling should be strengthened as the results from this study showed that a high percentage of women who practised EBF were those who had received counselling, irrespective of their HIV status. The high percentage of HIV positive women who practised high risk feeding, despite receiving infant counselling, is of concern. Disclosure of the women's HIV status did not translate to them practising low risk infant feeding methods, which may suggest that there are other issues that determine the women's choice of infant feeding. / South Africa

Thesis( M.Ed.) -- University of Limpopo, 2022 / The purpose of this study was to explore translanguaging patterns in Xitsonga classrooms at high schools in Mkhuhlu, specifically M.L Nkuna High School. In this study, translanguaging patterns were tracked at M.L Nkuna high school, whereby some learners almost have little or no exposure to Xitsonga at home, but they enroll for Xitsonga as Home Language (HL). The language policy of the school provides for Xitsonga as an official HL, yet there are those who speak SiSwati and other languages as their Home Languages. There is high failure rate of Xitsonga Home Language as a subject. The researcher observed lessons and conducted interviews on teachers and learners to develop the case, which may be used to enrich an understanding of other cases that include translanguaging as a pedagogic tool. The study was qualitative within transformative paradigm. The researcher observed that translanguaging was not adequately used within Xitsonga classrooms at M.L Nkuna high school. Moreover, the researcher acknowledge the view that if translanguaging was used properly in classrooms, improvement of learning experience would be realized. Moreover, the researcher views translanguaging as an integral part of the environment of M.L Nkuna High School, in order to bridge the gap between learners in multilingual classrooms. Lastly, there is a need to conduct a survey on language policies in schools

The purpose of this study was to examine the self-perception of leadership styles of practicing female superintendents in Texas and how their preferred leadership style affected their performance. The study posed the following questions:(1) What are the preferred leadership styles of the practicing female superintendents in Texas as measured by Bolman & Deal’s (2003) four frames of leadership? (2) What are the predominant behaviors that female superintendents in Texas identify within each frame of leadership? (3) How do the preferred leadership styles and behaviors influence the superintendents’ every day performance? This study was relied on a mixed method approach, quantitative and qualitative. The quantitative component involved surveying 50 female superintendents, using the Leadership Orientations (Self-Report) survey (Bolman & Deal, 1990). The qualitative component included a semi-structured interview which asked follow up questions with six selected female superintendents (two from rural, two from suburban, and two from urban districts) who consented to the interview regarding the influence of their leadership preferences. The findings suggest participants’ preferred leadership style relates to the Human Resource frame which include: being an inspirational leader, utilizing interpersonal skills, making good decisions; as well as, coaching and developing people. Findings also suggest that predominant behaviors include: supporting others, building trusting relationships through collaboration, and being participative. The preferred leadership styles and behaviors’ influence on female superintendents’ everyday performance resulted in embracing collaboration, being transparent, sharing a vision, being passionate, and building trusting relationships. Additionally, beliefs and behaviors that lead to success include: being honest, depersonalize the situations, education makes a difference, adopt flexibility, and power to make decisions. The characteristics that lead to success are: being spiritual, being organized, being committed, and willing to help others. Furthermore, the following advice was offered: learn to cope with high level of visibility, become knowledgeable of the district’s needs and characteristics, and develop a professional image. Finally, implications for aspiring female superintendents, superintendent preparation programs and school boards members are also presented. / text

The contamination of street vended vegetables may occur through the usage of manure and contaminated irrigation water, and the consumption of these vegetables, such as ready-to-eat salads, can cause foodborne diseases in consumers. The objective of this study was to investigate the Enterobacteriaceae diversity in vegetables sold at informal markets in the Johannesburg Metropolis. A total of 201 vegetable samples were purchased from randomly selected street vendors from different regions in the Johannesburg Metropolis and analysed for aerobic growth count and Enterobacteriaceae contamination using Plate Count Agar (PCA), and violet red bile glucose agar (VRBGA), respectively. The diversity of bacterial isolates was analysed using sequencing and phylogenetic analysis. The aerobic bacterial growth counts of vegetables from all the regions ranged from 7.66(±0.759) to 8.37(±0.347) log10 cfu/g and the mean aerobic growth counts of vegetables from Soweto and Yeoville were significantly different (p ≤ 0.05) from those of the other regions, but were not significantly (p > 0.05) different across different vegetable types. The Enterobacteriaceae growth counts in vegetables from all the regions ranged from 5.05 (±0.647) to 5.45 (±0.693) log10 cfu/g. The mean Enterobacteriaceae growth counts of vegetables were not significantly (p > 0.05) across each region and different vegetables types. The predominant Enterobacteria genera were Serratia (35%), followed by Hafnia (21%), Aeromonas (17%), and Pseudomonas (5%). In conclusion, this study shows that the vegetables sold at the informal markets in the Johannesburg Metropolis have high aerobic bacterial growth and Enterobacteriaceae contamination due to poor hygiene practices. The dominant Enterobacteriaceae genera isolated are Aeromonas, Hafnia, Serratia, and Pseudomonas, which could be opportunistic pathogens. It is recommended that the Department of Health improves vending and sanitation facilities, to prevent cross contamination. / Life and Consumer Sciences / M. Sc. (Life Sciences)

科学研究費補助金 研究種目:基盤研究(B)(2) 課題番号:08455251 研究代表者:福和 伸夫 研究期間:1996-1998年度