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Abstract: Objectives: To examine trends in hospitalization and inpatient deaths of neonates, and infectious diseases (IDs) between 2005-2014; and severe acute malnutrition (SAM) between 2010 and 2014 in Yemen. Method: It was a retrospective descriptive study. Data were extracted from the clinical records of the patients admitted from 2005 to 2014 for neonates and cases aged 1-59 months with IDs. For cases with SAM data were available from 2010 to 2014. Data were analyzed using SPSS version 20. Results: Between 2005 and 2014, 39282 under-5 hospitalized and 33.6% were neonates. Of 26069 aged 1-59 months, 15224(58.4%) hospitalized with IDs. Pneumonia (44.6%), diarrhea (29.9%), and meningitis (10.6%) were the main subgroups. During the study period, there were 4183 under-5 deaths. Neonatal deaths accounting for 3671 (87.8%). Deaths aged 1-59 month were 512(12.2%) and IDs contributing 440(85.9%). Compared to 2005/06, neonatal hospitalization and death declined by 9.2% and 18.1% in 2013/14, and IDs by 56.8% and 79.2%, respectively. Pneumonia reductions were 65.4% and 83.7%, diarrhea 42% and 95.5%, and meningitis 73% and 83%, respectively. Between 2010-2014, SAM cases were 1781 of 13689 total hospitalization [13% (95%CI 12.5-13.6)] and 53 SAM deaths of 224 total deaths [23.7 % (18.6-29.6)]. SAM hospitalization rate increased from 8.5% in 2010, to 18.4% in 2014 and death rate increased from 27% (17.6-39.0) to 57.5% (42.2-71.5), respectively. Conclusion: Despite significant decline in IDs and vaccine preventable diseases, this study showed 87.8% of under-5 mortality were neonates. The increasing trends in SAM hospitalization and death are alarming. Interventions to improve neonatal survival and to reduce SAM morbidity and mortality are urgently needed. Keywords: Infectious diseases, SAM, neonates, under-5, Yemen. |
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Abstract: This paper presents a longitudinal study of breastfeeding at two private hospitals in Jeddah, Saudi Arabia. Soliman Fakeeh (SF) follows the WHO's baby-friendly hospital initiative (BFHI), Saudi Germany Hospital (SGH) does not. Participants were 102 women in both hospitals (52 BFHI, 50 non-BFHI). Two semi-quantitative questionnaires, translated into Arabic, were used at baseline and one month postpartum. Results showed that most women in the study have initiated breastfeeding but turned to mixed feedings after one month. We also found that self-efficacy has the biggest influence on breastfeeding practice at one month, measured by the Breastfeeding Self-Efficacy Scale (BSES) and regardless of other variables. The BFHI made breast milk the first nutritive substance infants received and had a higher percentage of early initiation of breastfeeding than the non-BFHI. The BFHI hospital supported women to breastfeed practically and educationally. Support was provided by books, internet, and educational sessions. Yet, any effects no longer existed at one month postpartum, at which point most women had shifted to mixed feeding. There was no relationship between the BSES and BFHI status. Thus, we recommend developing breastfeeding promotion programs before delivery and at least a six-months follow-up after delivery, in addition to peer counselling approaches. Keywords: Breastfeeding practice, Baby-Friendly Hospital Initiative (BFHI), self-efficacy, attitude towards infant feeding. |
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Abstract: Background: Although it is widely acknowledged that hospitalized children are at greater risk of malnutrition, the available paediatric Nutritional Risk Screening (NRS) tools have not yet become universally used to identify those children at greater risk. Furthermore, the utility of one NRS tool over another remains unclear. Materials and Methods:The utility of a recently developed tool, the Paediatric Nutritional Screening Tool (PNST), was evaluated using data previously collected in the assessment of three other NRS tools in 281 children from Iran and New Zealand. The sensitivity and specificity of each tool was then assessed based on the WHO criteria for malnutrition. Results: The PNST recognized about half of the malnourished patients while the other three tools identified at least 85% of these children. The sensitivity of PNST for moderate (BMI-z < 2) and severe malnutrition (BMI-z <-3) was 37% and 46% respectively, while the sensitivity for other three NRS tools ranged from 82-100%. Conclusion: In this data set, the PNST tool did not perform as well as the three more established NRS tools. Further work is required to provide optimal tools for the identification of hospitalized children at risk of malnutrition.Keywords: Malnutrition, Nutritional risk screening, paediatrics, children, hospital admission. |
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Abstract: Photovoice is a community-based participatory research method where participants can showcase their life experiences through photography. The objective of this study was to have adolescent girls attending an after-school program use photovoice to represent their perceptions of physical activity practices. Photovoice was used to allow adolescent girls to express their perspectives, through photographs and narratives, of their personal and community strengths and concerns related to their involvement in physical activity. The phenomenological methodology was used as a framework for the study. Qualitative analyses were conducted throughout the research process. Constant comparison was used to analyze the focus group, scrapbook data, and notes recorded by the author to determine key themes and ideas. Participants for the study included 14 girls attending a school in an urban area. Benefits of physical activity as provided by the girls in their personal lives and the community included: understanding activity contributed to wellness, increased social opportunities, and the school as a hub of activities. Personal and community barriers to physical activity included: lack of neighbourhood safety, being involved in other sedentary activities, parental rules restricting outside play, outside conditions, personal choices to not exercise, and a lack of opportunity to exercise. Potential ways to increase physical activity among these participants are to create more group games and activities at the after-school program daily. Involving parents in activities with the girls at home may increase physical activity levels while at home. Keywords: Photovoice, physical activity, urban, elementary, girls. |
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Abstract: Background: School lunches that are part of the National School Lunch Program must meet specific nutrition requirements. It is unknown whether students eat school lunches in a balanced manner. This study examined which lunch food items children eat/toss, and consumption differences between sexes, and between students at a Non-Title 1 school where most students purchase school lunches and a Title 1 school where most students receive free or reduced-priced lunches. Methods:Students in both schools were observed unobtrusively for five consecutive days. Trained observers recorded the discarded food items on a checklist listing the menu items for the day. The final analyses (t- tests, z tests) included data from 2,826 student-meals. Results:Entrees similar to those offered in fast food restaurants (i.e., chicken nuggets, pizza, nachos, corndogs) were favored by most students. Fresh fruits and vegetables were not selected or consumed frequently. Boys consumed more food in the fast food, starches, and dessert categories, while girls consumed more soup, salads, and vegetables. Title 1 school students consumed more food in all categories except bread, pasta, and sandwiches than Non-Title 1 school students. Conclusions:Students’ preference of unhealthy lunch items may decrease the health benefits that school lunches attempt to provide. Keywords: Elementary school student, National School Lunch Program (NSLP), school lunch consumption, food preference, economically disadvantaged student. |