Nutritional Habits and Interventions in Childhood

The objective of this book is to present nutritional and educational interventions for children and their families. The creation of healthy preferences is a key determinant of food choices and therefore diet quality. Food choices have important implications for health, particularly for food-related diseases, such as feeding difficulties and the development of non-communicable diseases. The first years of a child's life are fundamental for the creation of tastes, eating habits and the relationship with food. Preferences for certain foods are neither innate nor unchangeable. Eating behaviour is the result of experience and learning, and, through the repeated offering of food by parents, especially those less accepted, it is possible to promote good nutrition. Behaviour depends on the interaction of environmental factors, genetics, sex, and age. The environment in which the child is immersed, and which influences them, includes family, other children, society, media and the supply of food. Achieving an adequate intake of macro and micro-nutrients is an important objective for all ages of life and, particularly, for those of pediatric age, since it is crucial for cognitive development. Nutrition has also a therapeutic effect. Nutritional interventions tailored to specific pathologies are needed to prevent nutritional deficiencies and maintain an adequate nutritional status, since children and adolescents with chronic or inflammatory diseases are particularly vulnerable and at major risk of developing malnutrition

Antioxidant, antibacterial activity and in silico study of selected medicinal plants against pathogenic bacteria

An increase in the number of antibiotic resistant bacteria worldwide has necessitated new antibacterial agents, mainly by medicinal plants. For this, the antioxidant and antibacterial activities of four Malaysian medicinal plants; Alpinia galanga, Centella asiatica, Clinacanthus nutans and Persicaria odorata extracts were evaluated against gram-positive (Bacillus subtilis, Staphylococcus epidermidis, Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus (MRSA)) and gram-negative (Escherichia coli, Pseudomonas putida) in this study. The medicinal plants were extracted using solvents with different polarities and screened for the total phenolic contents via Folin-Ciocalteu method and antioxidant capacity by diphenyl-1-picrylhydrazyl (DPPH) activity. The antibacterial activities were conducted using disc diffusion, minimal inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) tests. The most effective plant extract was further fractionated by column chromatography and thin layer chromatography. The fractions were then characterized using antibacterial assays, Zeta potential measurements, followed by scanning electron microscopic (SEM) observations and Gas Chromatography Mass Spectrometry (GCMS) analysis. Compounds identified were docked with Penicillin binding protein (PBP) using Autodock 4.0 and simulate (MD) by Gromacs 5.0.4. The findings from this study showed that acetone plant extracts exhibited the highest antioxidant and antibacterial activities; significantly by P. odorata acetone extract. This extract was also chosen due to its comparable MIC and MBC values with both the positive controls respectively. A total of 12 fractions were separated from the extract, however only H05 fraction showed bactericidal action against all gram-positive bacteria. This fraction could also alter the magnitude of bacterial negativity, significantly against MRSA. This data was supported by morphological alterations induced in treated MRSA, through SEM images. The GCMS analysis of H05 fraction showed that the presence of seven major phenolic compounds derivatives that met the Lipinski’s Rule of Five were present in the H05 extract. Among the seven compounds, the MD trajectory analysis showed that 6- hydroxy-8-methoxyoctanoic acid (tannins derivatives) shows strongest and most stable binding with PBP protein. The present study indicates that phenolics mainly tannins present in the P. odorata acetone extract were highly responsible for its antibacterial potential, especially for MRSA infection treatment

Harsh parenting and encouragement from parents during childhood: Long-term effects on well-being, mental health, and major illness

This thesis examines long-term, negative consequences of various behaviours characteristic of negative parenting styles, specifically verbal maltreatment (insulting children), physical maltreatment (beating or hitting children), and lack of encouragement. Psychological scales were employed to explore the relationship of each of these factors to mental and physical health in adults. As a part of this research, a new questionnaire, the Arabic Parenting Style Questionnaire (APSQ), was developed and compared with existing measures. Seven separate studies were conducted with Saudi Arabian participants in order to investigate the questions put forth in this thesis. To explore the impact of harsh parenting and emotional discouragement, the relationships of these variables to mental and physical health were examined in both non-clinical and clinical samples including both men and women and a broad range of ages (19 to 60 years). Findings indicate that parents’ discouraging their children from expressing thoughts and feelings, and parents’ being verbally and physically harsh towards their children, are both powerful risk factors for a broad array of long-term health outcomes in both clinical and non-clinical samples. Various aspects of the individuals’ childhood relationships with their parents, as measured using the new APSQ, are significantly correlated with the following health- and wellness-related variables in adulthood: quality of life as assessed on the Global Quality of Life Scale (GQLS), health complaints as assessed using the Minor Health Complaints Questionnaire (MHCQ), well-being mood state, life satisfaction as assessed with the Life Satisfaction Scale (SLS), depression, Chronic Fatigue Syndrome, Borderline Personality Disorder, and specific physical diseases (asthma, cancer, heart disease).the Ministry of Higher Education in Saudi Arabi

Chemistry And Biotransformation Of Uapaca kirkiana Pulp In Development Of A Functional Food Using A Probiotic

ThesisModern advances in understanding the relationship between nutrition and health have resulted in the development of the concept of functional foods, which is a new practical approach earmarked to promote optimal health status. Underutilised wild fruits have great potential to improve overall human nutrition and help to mitigate malnutrition related problems faced by most communities in Sub-Saharan Africa. This research focused on the chemistry and biotransformation of Uapaca kirkiana pulp in the development of a functional food using a probiotic, Lactobacillus rhamnosus yoba. Lactobacillus rhamnosus yoba is a Gram negative, lactic acid bacterium, and generic probiotic of L. rhamnosus GG. The specific objectives of the study were the following: to determine the bioactive compounds, physiochemical properties, and functional potential of a highly nutritious, but underutilized U. kirkiana Muell. Arg (wild loquat) fruit; to produce a probiotic jam; to determine the functional properties of the jam and the bioaccessibility of iron and zinc, and its sensorial qualities. Ripe fruits were obtained from the Bikita, Gokwe, and Kazangarare areas in Zimbabwe and the bioactive phytochemical constituents, physicochemical properties and functional characteristics of the fruit pulp were analysed. The total soluble sugars, individual sugars and mineral contents in the fruit pulp were determined. Ascorbic acid was determined using the 2,6-Dichlorophenolindophenol (DCPIP) titration test. The total phenolic, tannin, and flavonoid contents were analysed using the Folin-Ciocalteu test, tannin binding test, and vanillin test, respectively. A composite pulp sample was obtained and its physicochemical properties (vitamin C, total titratable acid (TTA), pH, total soluble solids (TSS), antioxidant activity (AOA), moisture, and % pectin) were analysed before jam making. A probiotic jam was developed using the formulation- 55 % (wt/vol) pulp, 46 % (wt/vol) sugar, 1.5 % (wt/vol) pectin, and 0.5 % (wt/vol) citric acid. After preparation of the jam, the probiotic, L. rhamnosus yoba was inoculated into the jam, and the control jam sample was inoculated with distilled water. The viability of L. rhamnosus yoba in the jam was determined before consumption. Functional properties (vitamin C, total titratable acid (TTA), pH, total soluble solids (TSS), antioxidant activity (AOA), and moisture) of the jam inoculated with L. rhamnosus yoba were determined. Iron and zinc bioaccessibility in the probiotic jam were analysed using the in vitro simulated digestion protocol. The sensory evaluation of the jam was conducted by trained (n = 20) and untrained (n = 130) panellists. Sensory attributes, including taste, appearance, aroma, spreadability, mouthfeel, and texture were scored using a 9 point hedonic scale. A triangle test and preference test for overall acceptance were conducted. Pulp yield ranged from 12.15 ± 0.16 g/100 g to 15.09 ± 0.27 g/100 g and was significantly different (F = 158.71, p < 0.0001) in all fruits from the three study areas, and accounted for 96 % of the variation in the fruit. The TTA (0.3–0.48 g/kg) and pH (4.3–4.6) values of the pulp were significantly different (F = 12.58; P<0.0001 and F = 15.66, P< 0.0001, respectively) in fruits obtained from the three sampling areas. Fruit properties varied amongst the three study site and this was contributed by pH (74 %) level and TTA (69 %) content. The TSS (sugar content) was significantly different (F = 4.66, P < 0.0071) and accounted for 45 % of the fruit variation. There was a strong relationship between TTA and pH (r2 = 0.79); TTA and antioxidant (r2 = 0.72); and pH and phosphorus (r2 =0.81). The iron content ranged between 11.25 ± 0.52 mg/100 g to 12.16 ± 0.54 mg/100 g. Phosphorus, sodium and iron accounted for approximately 73 %, 50 %, and 43 % of the variation, respectively. The vitamin C content accounted for 27 % of the variation. Fructose was the dominant sugar. Tannins, flavonoids, and gallotannins were present. The fruit pulp had a total phenolic content of 67.0–82.5 μg GAE/g. Principal components 1 and 2 which represented physiochemical and functional properties of the pulp had eigenvalues of 5.59 and 2.13, and a variability of 37.31 % and 14.17 %, respectively. The jam inoculated with L. rhamnosus yoba had a vitamin, TTA, brix, and moisture content of 0.34 ±0.02 mg/100 g, 2.2 ± 0.11, 68.5 ± 0.2, and 34.8 ± 1.2, respectively. The fruit pulp had an antioxidant activity of 35 ± 1.02 %. Immediately after production, the jam inoculated with L. rhamnosus yoba had an iron and zinc content of 4.13 ± 0.52 mg/100 g and 0.36 ± 0.02 mg/100 g, respectively. The jam inoculated with L. rhamnosus yoba exhibited high fructose and sucrose content of 12.84 ± 0.21 g/100 g and 24.61 ± 0.12 g/100 g, respectively. Further, the jam inoculated with L. rhamnosus yoba had a TTA content of 2.2 at d 0 (after production), 2.37 ± 0.01 at d 4, and 2.48 ± 0.02 at d 7 of storage (25 °C). The jam inoculated with L. rhamnosus yoba had an iron bioaccessibility of 6.55 ± 0.36 % and a zinc bioaccessibility of 16.1 ± 0.50 %. The use of L. rhamnosus yoba in the jam showed a 4 % and 2 % increase in the iron and zinc bioaccessibility, respectively. L. rhamnosus yoba jam had mean scores of 7.5, 7.0, 6.0, and 6.5 for spreadability, taste, appearance, and mouthfeel, respectively. The jam inoculated with L. rhamnosus yoba had an overall acceptance score of 7.5 (n = 120). The good chemical and functional properties of the fruit pulp resulted in the utilisation of the fruit pulp in producing a probiotic jam through the biotransformation of nutrients. The fruit jam was able to deliver 6.2 ± 0.2 log CFU/mL live L. rhamnosus yoba cells, which make it a good probiotic food with possible functional benefits

Benefits of the Mediterranean Diet—Wine Association: Role of Components

The Mediterranean diet is a model of eating based on the traditional foods and drinks of the countries surrounding the Mediterranean Sea. The cultural and the nutritional aspects of the multisecular Mediterranean civilization include diet as a central element of health and wellbeing, including wine, if it is consumed in moderation. In recent decades, it has been promoted worldwide (UNESCO 2010) as one of the healthiest dietary patterns. The objective of this book is to bring the role of wine as part of the Mediterranean diet to light, especially through policy makers, the medical world, and vectors of images

Patient and Doctor Perceptions of Hypertension and its Treatment: a Qualitative Study in Urban Hospitals of Pakistan

Hypertension (HTN) is a chronic disease that has become a growing public health problem in countries around the world, including Pakistan. Successful HTN control is an essential cornerstone in the prevention of morbidity and mortality associated with uncontrolled HTN. However, patients’ beliefs about their disease, treatment and control are related to the outcome of successful HTN control and management. Likewise, doctors’ understanding of HTN and its treatment is equally important and can affect their practice and HTN management. There is little qualitative research considering patients’ and doctors’ understanding of HTN, its treatment and how it influences HTN management in Pakistan. Therefore, the current study aimed to elicit patients’ and doctors’ perceptions, attitudes and beliefs about HTN and its treatment in urban areas of Pakistan. A qualitative study that drew on grounded theory principles was undertaken in two public hospitals of Pakistan. Thirty in-depth semi-structured interviews with hypertensive patients and thirty interviews with doctors were conducted in two hospitals. Interviews were translated and transcribed from Urdu into English and NVivo was used to organise the data in a systematic way. Data were analysed using a constant comparative approach based on the principles of grounded theory. The study revealed that patients’ (n=30) beliefs were complex, deep-rooted and influenced their attitude towards HTN treatment. Patients’ beliefs were informed by understanding gleaned from the socio-cultural environment (local norms, social relations, religion), individual factors (e.g. income, co-morbidities) and interactions with doctors. In contrast, doctors’ (n=30) own understandings on what constitutes successful HTN management often contradicted patients’ beliefs. Doctors’ reported that time restraints and work burden affected their approach to treatment and the provision of information to patients. Findings also revealed an overlap between patients’ and doctors’ beliefs, however, in relation to adopting lifestyle changes for management of HTN. In general, though doctors paid less consideration to patients’ beliefs in routine clinical practice and evaluated patients through the filter of their own beliefs. The findings suggest that doctors could provide a better service care by aligning with their patients on a common understanding about HTN management and providing culturally appropriate information. Doctors should be aware of the understanding hypertensive patients attach to HTN and avoid providing treatment based on their own beliefs. Doctors must engage with patients’ beliefs and identify their particular healthcare needs in order to achieve control of HTN in Pakistan

How does virtual simulation impact on nursing students’ knowledge and self-efficacy for recognising and responding to deteriorating patients? A mixed methods study.

Background: Preparing undergraduate nursing students effectively for safe clinical practice continues to present significant challenges due to the impact of the Covid-19 pandemic, global nursing shortages, greater competition for quality clinical placements, and no guarantee that nursing students will have exposure to a deteriorating patient during their clinical placements. This is a concern because early warning signs of clinical deterioration are often not detected by nurses in a timely manner, and recognition and response to deteriorating patients is recognised globally as a major safety challenge (Haddeland et al., 2018). Aim: To explore the impact of using interactive virtual simulation case studies with facilitated debriefing (Eppich and Cheng, 2015) on nursing students’ knowledge and self-efficacy for recognising and responding to early signs of clinical deterioration in patients. Design & Methods: Mixed methods study with quasi-experimental pre/post design and focus groups. A convenience sample (n=88) final year undergraduate nursing students with half the sample at each sites randomly allocated to a treatment or control group. The treatment group received a virtual simulation intervention, debriefing, and participated in a focus group. Results: The treatment group had statistically significant higher levels of clinical self-efficacy from pre to post survey scores (65.34 and 80.12) compared to the control group (62.59 and 70.73) and significantly increased levels of knowledge in recognizing and responding to the deteriorating patient scores from pre to post survey (11.30 to 13.1) in comparison to the control group (10.33 and 9.92). Conclusions: study findings demonstrated the positive impact of a the virtual simulation intervention on knowledge and confidence of undergraduate nursing students from geographically diverse areas