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1.
Hampshire RD Aguayo VM Harouna H Roley JA Tarini A Baker SK 《Public health nutrition》2004,7(8):1047-1053
BACKGROUND: In sub-Saharan Africa, underweight and micronutrient deficiencies account for an estimated 25% of the burden of disease. As the coverage of national health systems expands, increased opportunities exist to address the needs of children and women, the most vulnerable to these deficiencies, through high-quality nutrition services. OBJECTIVES: To assess health providers' knowledge and practice with regard to essential nutrition services for women and children in Burkina Faso, Mozambique and Niger, in order to assist the development of a standard guide and tools to assess and monitor the quality of the nutrition services delivered through national health systems. FINDINGS: The three surveys reveal the extent of missed opportunities to deliver nutrition services during routine prenatal, postnatal and child-care consultations for the prevention and treatment of highly prevalent nutritional deficiencies. CONCLUSION: A commitment to improving the quality of facility-based nutrition services is necessary to impact on the health outcomes of women and children 'covered' by national health systems. Rigorous assessment and monitoring of the quality of nutrition services should inform health programme and policy development. Building on the lessons learned in these three assessments, Helen Keller International has developed a standard Guide and Tools to assess the quality of the nutrition services delivered through national health systems. These tools can be adapted to assess ongoing nutrition services in health facilities, provide a framework for nutrition programming, inform the development of pre-service as well as in-service nutrition training curricula for providers, and evaluate the impact of nutrition training on providers' practices. 相似文献
2.
Lemke S 《Public health nutrition》2005,8(7):844-852
OBJECTIVE: Previous research on the health transition and nutrition security in black South African households revealed the need for further research among farm workers who belong to the poorest population categories. This article gives an overview of the link between nutrition security, livelihoods and HIV/AIDS in South Africa, drawing conclusions for research among farm worker households. DESIGN AND SETTING: A literature review, observations on farms and interviews with farmers and key informants were carried out in 2003 and 2004. Peer examination was done with South African and German researchers from the natural and social sciences. RESULTS: Farm workers face poverty and nutrition insecurity and continue to be a tragically underserved population group, also in terms of research. There is furthermore a lack of in-depth research on underlying causes for nutrition security in South Africa and on the link with livelihoods, poverty and HIV/AIDS. Micro-social qualitative research from the household and gender perspective is required, as valid data on households, their internal dynamics and therefore the reflection of social realities are missing. A multidisciplinary research approach based on a new conceptual framework was developed to address the situation of farm worker households. CONCLUSION: The outlined research contributes to existing programmes on farms in the North West Province, with the findings being valid also for other parts of southern Africa facing poverty, nutrition insecurity and HIV/AIDS. 相似文献
3.
OBJECTIVE: Renewed focus on public health has brought about considerable interest in workforce development among public health nutrition professionals in Canada. The present article describes a situational assessment of public health nutrition practice in Canada that will be used to guide future workforce development efforts. METHODS: A situational assessment is a planning approach that considers strengths and opportunities as well as needs and challenges, and emphasizes stakeholder participation. This situational assessment consisted of four components: a systematic review of literature on public health nutrition workforce issues; key informant interviews; a PEEST (political, economic, environmental, social, technological) factor analysis; and a consensus meeting. FINDINGS:Information gathered from these sources identified key nutrition and health concerns of the population; the need to define public health nutrition practice, roles and functions; demand for increased training, education and leadership opportunities; inconsistent qualification requirements across the country; and the desire for a common vision among practitioners. CONCLUSIONS: Findings of the situational assessment were used to create a three-year public health nutrition workforce development strategy. Specific objectives of the strategy are to define public health nutrition practice in Canada, develop competencies, collaborate with other disciplines, and begin to establish a new professional group or leadership structure to promote and enhance public health nutrition practice. The process of conducting the situational assessment not only provided valuable information for planning purposes, but also served as an effective mechanism for engaging stakeholders and building consensus. 相似文献
4.
Hughes R 《Public health nutrition》2004,7(5):683-691
OBJECTIVES: To assess the level of consensus amongst an international panel of public health nutrition leaders regarding the essential competencies required for effective public health nutrition practice. DESIGN: A modified Delphi study involving three rounds of questionnaires. SUBJECTS: A panel of 20 public health nutrition experts from seven countries in the European Union, the USA and Australia. RESULTS: Expert panellists completed three rounds of the study relating to competencies. A literature review conducted as a prelude to the expert panel survey identified common competency units from the fields of public health, health promotion, nutrition and dietetics, and health education. These were categorised into seven competency areas including analytical, socio-cultural and political, public health service, communication, management and leadership, nutrition science and professional competency categories. There was strong initial agreement (> or = 90% of panellists at Round 1) that developing internationally recognised competencies for public health nutrition specialists was a priority. Twenty-six of an initial listing of 52 competency units were rated as essential competencies by > or = 80% of the panellists after Round 1. Iteration rounds resulted in the addition of five extra competency units suggested by panellists after Round 1 and an increase by 13 in the number of competencies rated as essential to consensus levels. From a total of 57 competency units rated after the final survey round, 41 competency units were rated as essential competencies by > or = 80% of the panellists (consensus), with 21 of these unanimously rated as essential competencies. CONCLUSIONS: There is strong international agreement amongst public health nutrition leaders in Europe, the USA and Australia about a range of competencies required for effective public health nutrition practice. Essential competency units identified can be used to develop and review competency standards for public health nutrition. 相似文献
5.
OBJECTIVE: It is hypothesised that mothers' social networks can positively affect child nutrition through the sharing of health knowledge and other resources. The present study describes the composition of mothers' networks, examines their association with child nutrition, and assesses whether health knowledge is shared within networks. DESIGN AND SETTING: Cross-sectional data for mothers of young children from Andhra Pradesh (south India) were combined with existing data from the Young Lives study, in which the mothers were participating (n = 282). RESULTS: The composition of social networks varied between urban and rural areas, with urban networks being larger, more female, more literate and with a greater proportion of members living outside the household and being non-family. There was a positive association between child's height-for-age Z-score and mother's network size and network literacy rate. The association with network literacy was stronger among the poorest households. Women commonly reported seeking or receiving health advice from network members.CONCLUSION: Big and literate social networks are associated with better child nutrition, especially among the poor. The dissemination of health knowledge between network members is a plausible way in which social networks benefit child nutrition in India. Further research into the underlying mechanisms is necessary to inform the development of interventions that channel health information through word of mouth to the most excluded and vulnerable families. 相似文献
6.
OBJECTIVE: A Knowledge, Attitudes and Practices (KAP) study was conducted in three villages of Bekily District in southern Madagascar prior to the implementation of a health education programme with children. The participatory learning concept of the Child-to-Child approach was followed to involve the children in the planning and implementation of the programme, which was covered by the German Agency for Technical Cooperation. DESIGN: To this effect, qualitative research methods such as Participatory Learning and Action techniques (focus group discussions, mapping and matrix ranking, etc.) were applied. SUBJECTS: The survey was conducted between August and December 1999. It involved a total of 55 school-aged children (6-14 years) along with 21 mothers and 34 fathers, representing different ethnic groups and educational backgrounds. RESULTS: The results show that children's KAP related to health and nutrition strongly reflect those of adults. They are not aware of a possible link between bad hygiene and the occurrence of diseases. According to them, diarrhoea or malaria is caused by consuming too large amounts of certain foods. Even if they know about certain elementary hygiene behaviours, they do not practise this in their everyday life. CONCLUSION: A major objective of the health education programme for children should be to tackle the discrepancy between hygiene-related knowledge and behaviour. Through the participatory study approach the children revealed their ability to contribute to the programme development. In using appropriate communication channels, the Child-to-Child health education programme is expected to influence the health behaviours of both adults and children. The health education programme should be combined with a literacy programme to address the children's desire to learn reading and writing. 相似文献
7.
8.
In the chapter dealing with education and health, the report of the influential Commission for Africa prioritises basic health systems, HIV/AIDS, malaria and tuberculosis. In contrast, nutrition is given less than half a page and is reduced to parasite control and micronutrient support. Such neglect of nutrition is hard to understand in the context of increasing hunger and malnutrition across the continent. Sub-Saharan Africa is the only region in the world where the proportion of underweight children has stagnated and the absolute numbers have actually increased in the last decade. It has been pointed out that if current trends continue sub-Saharan Africa will achieve the Millennium Development Goal for child mortality around 2115 - one century after the target date. Quite clearly those concerned with nutrition need to more powerfully advocate the role of nutrition in lifting Africa out of the spiral of poverty. The present paper argues that to achieve this requires an understanding not just of the critical role of nutrition for health and development (both individual and national), but also of how recent global changes are interacting with changes in food production and supply, other determinants of maternal and child health, and the role and capacity of the state to tackle malnutrition in Africa. It concludes by suggesting some responses that nutritionists could now be making. 相似文献
9.
Llorach R Garcia-Aloy M Tulipani S Vazquez-Fresno R Andres-Lacueva C 《Journal of agricultural and food chemistry》2012,60(36):8797-8808
Correctly assessing the metabolic status of subjects after consumption of specific diets is an important challenge for modern nutrition. Recently, metabolomics has been proposed as a powerful tool for exploring the complex relationship between nutrition and health. Nutritional metabolomics, through investigating the role that dietary components play in the maintenance of health and development of risk disease, aims to identify new biomarkers that allow the intake of these compounds to be monitored and related to their expected biological effects. This review offers an overview of the application of nutrimetabolomic strategies in the discovery of new biomarkers in human nutritional research, suggesting three main categories: (1) assessment of nutritional and dietary interventions; (2) diet exposure and food consumption monitoring; and (3) health phenotype and metabolic impact of diet. For this purpose, several examples of these applications will be used to provide evidence and to discuss the advantages and drawbacks of these nutrimetabolomic strategies. 相似文献
10.
Gómez-Marín O Fleming LE Lee DJ LeBlanc W Zheng D Ma F Jané D Pitman T Caban A 《Journal of agricultural safety and health》2004,10(4):275-285
The National Health Interview Survey (NHIS) is a multipurpose household survey of the U.S. civilian non-institutionalized population conducted annually since 1957. From 1986 to 1994, over 450,000 U.S. workers, age 18 years and older, participated in a probability sampling of the entire non-institutionalized U.S. population; variables collected included a range of measures of acute and chronic disability. The objective of the present study was to assess predictors of health status, and acute and chronic disability for farmers and pesticide applicators (pesticide-exposed workers) compared to all other U.S. workers using the 1986-1994 NHIS. After adjustment for sample weights and design effects using SUDAAN, several measures of acute and chronic disability and health status were modeled with multiple logistic regression. Farmers (n = 9576) were significantly older compared to all other U.S. workers (n = 453,219) and pesticide applicators (n = 180). Farmers and pesticide applicators had a higher proportion of males, whites, and Hispanics and were less educated. After adjusting for age, gender, race-ethnicity, and education, compared to all other workers, farmers were significantly less likely to report acute and chronic disability and health conditions, while pesticide applicators were more likely to report chronic disability, health conditions, and poor health. Given the cross-sectional nature of the data and the significant job demands of farming, both leading to a relative healthy worker effect, the present results indicate that at any point in time, farmers report less acute and chronic disability, compared to other U.S. workers, whereas pesticide applicators report similar or poorer health. 相似文献
11.
Nino M. Binns 《Cereal Chemistry》2010,87(2):162-166
Whole grain and whole grain foods enjoy recommendation as part of many national and international dietary guidelines. However, if the food industry makes claims for the health benefits of whole grain foods, then a raft of regulatory requirements must be met in the European Union (EU). Under the relatively recent EU Regulation on nutrition and health claims made on foods, any nutrition claims about the energy, nutrients, fiber, or other beneficial substances the food contains need to comply with the Annex of that Regulation. As far as health claims are concerned, until the Community list of approved so‐called Article 13 claims is published, food businesses may use any health claims that can be validated by scientific evidence, providing that they meet any specific requirements of the Regulation that are applicable prior to that date and providing they are not 1) prohibited claims or 2) claims referring to a reduction in the risk of disease or a disease risk factor or 3) referring to children's development and health or 4) claims that have been rejected by the EU regulatory procedure. Claims under 2) or 3) require submission of a dossier. Once the Community list of health Article 13 claims is published, then only those claims included in the list or those claims approved following submission of a dossier to the European Food Safety Authority may be used. Whole grain foods making nutrition and health claims will also ultimately have to respect the nutrient profiles that will be established under Article 4 of the Regulation. Various definitions of what counts as a whole grain food have been proposed but none has regulatory standing in EU. The conditions of use that will be documented as part of the EU‐approved list of health claims may in essence establish a definition. 相似文献
12.
Alderman H Ndiaye B Linnemayr S Ka A Rokx C Dieng K Mulder-Sibanda M 《Public health nutrition》2009,12(5):667-673
There are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0.83 (95% CI 0.686, 1.000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control. 相似文献
13.
OBJECTIVE: Concordance of nutritional research priorities with the related burden of disease is essential to develop cost-effective interventions to address the nutritional problems of populations. The present study aimed to evaluate whether nutrition research priorities are in agreement with the population's nutritional problems in Latin America. DESIGN: The epidemiological profile was contrasted with the research priorities and research produced by academic institutions for each country. Qualitative analysis of research production by type of contribution to problem solving was also conducted. SETTINGS: Nine Latin American countries. RESULTS: Obesity (high body mass index (BMI)) and micronutrient deficiencies (anaemia) emerged as key problems, followed by stunting, breast-feeding/lactation and low birth weight. Wasting in children and women (low BMI) was uncommon. Concordance of ranked research priorities with the epidemiological profile of the country was generally good for nutrition-related chronic diseases, micronutrients and low birth weight, but not for undernutrition, stunting and breast-feeding. Studies on the efficacy and effectiveness of interventions were uncommon. CONCLUSIONS: The present research agenda insufficiently supports the goal of public health nutrition, which is to ensure the implementation of cost-effective nutrition programmes and policies. A more rational approach to define research priorities is needed. 相似文献
14.
OBJECTIVES: To describe the US public health nutrition workforce and its future social, biological and fiscal challenges. DESIGN: Literature review primarily for the four workforce surveys conducted since 1985 by the Association of State and Territorial Public Health Nutrition Directors. SETTING: The United States. SUBJECTS: Nutrition personnel working in governmental health agencies. The 1985 and 1987 subjects were personnel in full-time budgeted positions employed in governmental health agencies providing predominantly population-based services. In 1994 and 1999 subjects were both full-time and part-time, employed in or funded by governmental health agencies, and provided both direct-care and population-based services. RESULTS: The workforce primarily focuses on direct-care services for pregnant and breast-feeding women, infants and children. The US Department of Agriculture funds 81.7 % of full-time equivalent positions, primarily through the WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children). Of those personnel working in WIC, 45 % have at least 10 years of experience compared to over 65 % of the non-WIC workforce. Continuing education needs of the WIC and non-WIC workforces differ. The workforce is increasingly more racially/ethnically diverse and with 18.2 % speaking Spanish as a second language. CONCLUSIONS: The future workforce will need to focus on increasing its diversity and cultural competence, and likely will need to address retirement within leadership positions. Little is known about the workforce's capacity to address the needs of the elderly, emergency preparedness and behavioural interventions. Fiscal challenges will require evidence-based practice demonstrating both costs and impact. Little is known about the broader public health nutrition workforce beyond governmental health agencies. 相似文献
15.
OBJECTIVE: Food-based dietary guidelines (FBDGs) are globally promoted as an important part of national food and nutrition policies. They are presented within policy as key features of the strategy to educate the public and guide policy-makers and other stakeholders about a healthy diet. This paper examines the implementation of FBDGs in four countries: Chile, Germany, New Zealand and South Africa - diverse countries chosen to explore the realities of the FBDG within policy on public health nutrition. DESIGN: A literature review was carried out, followed by interviews with representatives from the governmental, academic and private sector in all four countries. RESULTS: In all four countries the FBDG is mainly implemented via written/electronic information provided to the public through the health and/or education sector. Data about the impact of FBDGs on policy and consumers' food choice or dietary habits are incomplete; nutrition surveys do not enable assessment of how effective FBDGs are as a factor in dietary or behavioural change. Despite limitations, FBDGs are seen as being valuable by key stakeholders. CONCLUSION: FBDGs are being implemented and there is experience which should be built upon. The policy focus needs to move beyond merely disseminating FBDGs. They should be part of a wider public health nutrition strategy involving multiple sectors and policy levels. Improvements in the implementation of FBDGs are crucial given the present epidemic of chronic, non-communicable diseases. 相似文献
16.
植物健康营养理论与健康元素 总被引：1，自引：0，他引：1
白由路 《植物营养与肥料学报》2020,26(7):1360-1366
从食物链营养的角度提出植物健康营养理论,即在不影响植物正常生长发育的条件下,通过调节供给植物的营养元素而生产出符合特定需求的产品,提高植物栽培的功能性和经济价值。我们把这种同时注重植物营养和产品功能的人工栽培植物的营养理论称为植物健康营养理论,这里将不具备植物营养功能,但对整个食物链特别是对人和饲养动物有营养作用的元素称为健康元素。根据矿质元素的作用对象,可将健康元素分为营养健康元素和非营养健康元素两类。营养健康元素是指它本身是植物必需营养元素,同时又对食物链上端生物也有重要健康作用。非营养健康元素是指其对植物本身的生长发育没有营养作用,仅对食物链上端的生物有健康作用。把通过植物吸收矿质元素的方式以达到食物链促进健康的栽培管理方式称为健康栽培。本文还定义了植物健康营养理论的学科边界,指出:“奢侈吸收”与动物健康的关系研究,健康元素在植物体内的代谢,健康元素在食物链中的传递形式,植物体内健康元素的含量阈值,健康元素的高效施用与管理都是植物健康营养理论的研究范畴。 相似文献
17.
Schoeman SE Hendricks MK Hattingh SP Benadé AJ Laubscher JA Dhansay MA 《Public health nutrition》2006,9(8):1007-1012
AIM: The aim of this study was to determine the practices of primary health care (PHC) nurses in targeting nutritionally at-risk infants and children for intervention at a PHC facility in a peri-urban area of the Western Cape Province of South Africa. METHODOLOGY: Nutritional risk status of infants and children <6 years of age was based on criteria specified in standardised nutrition case management guidelines developed for PHC facilities in the province. Children were identified as being nutritionally at-risk if their weight was below the 3rd centile, their birth weight was less than 2500 g, and their growth curve showed flattening or dropping off for at least two consecutive monthly visits. The study assessed the practices of nurses in identifying children who were nutritionally at-risk and the entry of these children into the food supplementation programme (formerly the Protein-Energy Malnutrition Scheme) of the health facility. Structured interviews were conducted with nurses to determine their knowledge of the case management guidelines; interviews were also conducted with caregivers to determine their sociodemographic status. RESULTS: One hundred and thirty-four children were enrolled in the study. The mean age of their caregivers was 29.5 (standard deviation 7.5) years and only 47 (38%) were married. Of the caregivers, 77% were unemployed, 46% had poor household food security and 40% were financially dependent on non-family members. Significantly more children were nutritionally at-risk if the caregiver was unemployed (54%) compared with employed (32%) (P=0.04) and when there was household food insecurity (63%) compared with household food security (37%) (P<0.004). Significantly more children were found not to be nutritionally at-risk if the caregiver was financially self-supporting or supported by their partners (61%) compared with those who were financially dependent on non-family members (35%) (P=0.003). The weight results of the nurses and the researcher differed significantly (P<0.001), which was largely due to the different scales used and weighing methods. The researcher's weight measurements were consistently higher than the nurses' (P<0.00). The researcher identified 67 (50%) infants and children as being nutritionally at-risk compared with 14 (10%) by the nurses. The nurses' poor detection and targeting of nutritionally at-risk children were largely a result of failure to plot weights on the weight-for-age chart (55%) and poor utilisation of the Road to Health Chart. CONCLUSIONS: Problems identified in the practices of PHC nurses must be addressed in targeting children at nutritional risk so that appropriate intervention and support can be provided. More attention must be given to socio-economic criteria in identifying children who are nutritionally at-risk to ensure their access to adequate social security networks. 相似文献
18.
OBJECTIVE: The aim was to contribute to the nutritional well-being of young children living in Duncan Village by investigating factors that influence clinic attendance of mothers and to formulate recommendations for optimisation of accessibility of primary health care (PHC) clinics in the area. DESIGN: PHC clinic accessibility was evaluated by assessing the experiences of mothers who attended clinics in the area as well as the experiences of health care workers (HCWs) in these clinics of service delivery and its recipients (mothers/children), using the focus group technique. The ATLAS/ti program was used to analyse the data in the following steps: preparation and importing of the data, getting to know and coding the data, retrieval and examination of codes and quotations, creation of families and creation of networks. SETTING: Duncan Village, a low socio-economic urban settlement in East London, South Africa. SUBJECTS: Focus group discussions (four to seven participants per group) were conducted with four groups of mothers who do not attend PHC clinics, six with mothers who do attend the clinics (including pregnant women) and four groups of HCWs. RESULTS: Four networks that provide a summary of all the major trends in the data were created. The results clearly indicate that mothers in Duncan Village perceive and/or experience serious problems that make it difficult for them to attend clinic and even prevent them from doing so. These problems include both the way they are treated at the clinics (especially the problem of verbal abuse) as well as the actual services delivered (no medicines, no help, disorganised, long waiting periods, being turned away). The main problem experienced by the HCWs with service delivery seems to be a heavy workload, as well as the fact that many mothers do not come for follow-up visits. CONCLUSION: Efforts to increase the accessibility of PHC clinics in Duncan Village should focus on improving the relationship between mothers and HCWs and the heavy workload experienced by these workers. 相似文献
19.
The California Agricultural Workers Health Survey was a statewide cross-sectional household survey of 970 hired farm laborers. Randomly selected participants residing in randomly selected dwellings were recruited in seven communities representing all of the state's agricultural regions. Participants were interviewed in their preferred language by professional staff. The response rate was 83%. The comprehensive interview included self-reported health conditions, doctor-reported health conditions, work history, workplace health conditions, field sanitation, and work-related injuries. A farm workplace injury during the twelve-month period prior to the interview was reported by 6% of male workers (95% CI: 4% - 8%) and 2% of female workers (95% CI: 1% - 3%). Significant numbers of both male (41%) and female (40%) workers reported persistent pain (every day for more than one week) in the back, neck, knees, shoulders, hands, feet, or multiple body parts. The number of body parts in which female workers reported persistent pain correlated with increased years of U.S. hired farm work (Spearman r = 0.24, p < 0.01). Direct contact with pesticides from being sprayed or drifted upon among both male and female workers was associated with multiple workplace health conditions such as irritated, itchy, or water eyes (male: OR 2.9, 95% CI: 1.6 - 5.0; female: OR 13.8, 95% CI: 4.3 - 44.7). Persistent stomach aches among male and female participants was associated with being required to taste unwashed grapes for sweetness while picking (male: OR 4.6, 95% CI: 2.1 - 9.9; female: OR 5.8, 95% CI: 2.6 - 12.6). 相似文献
20.
Food in its many manifestations allows us to explore the global control of health and to examine the ways in which food choice is moulded by many interests. The global food market is controlled by a small number of companies who operate a system that delivers 'cheap' food to the countries of the developed world. This 'cheap' food comes at a price, which externalises costs to the nation state in terms of health consequences (diabetes, coronary heart disease and other food-related diseases) and to the environment in terms of pollution and the associated clean-up strategies. Food policy has not to any great extent dealt with these issues, opting instead for an approach based on nutrition, food choice and biomedical health. Ignoring wider elements of the food system including issues of ecology and sustainability constrains a broader understanding within public health nutrition. Here we argue that public health nutrition, through the medium of health promotion, needs to address these wider issues of who controls the food supply, and thus the influences on the food chain and the food choices of the individual and communities. Such an upstream approach to food policy (one that has been learned from work on tobacco) is necessary if we are seriously to influence food choice. 相似文献