54 research outputs found
Building a new master's and PhD programme in nutritional epidemiology in Kinshasa: How to face obstacles beyond the control of the project
publishedVersio
Stemming commercial milk formula marketing: Now is the time for radical transformation to build resilience for breastfeeding
One of the striking messages of the Lancet Breastfeeding
Series1â3 is that the consumption of commercial milk
formula (CMF) by infants and young children has
been normalised. More children are consuming CMF
than ever before. 2 Only 48% of the worldâs infants and
young children are breastfed as recommended,4 despite
the huge body of evidence on the lifelong benefits of
breastfeeding. This situation reflects the stranglehold the
CMF industry has on governments, health professionals,
academic institutions, and increasingly on caregivers and
families through pervasive social media
Exploring womenâs exposure to marketing of commercial formula products: A qualitative marketing study from two sites in South Africa
Regulating the marketing of commercial formula products is a long-term commitment required to protect breastfeeding. Marketing strategies of formula manufacturers, retailers and distributors evolve at a rapid rate. The aim of this research was to describe exposure of pregnant women and mothers of young children in South Africa to marketing of commercial formula products, compared to international recommendations and national legislation
An Evaluation of the Quality of IMCI Assessments among IMCI Trained Health Workers in South Africa
Integrated Management of Childhood Illness (IMCI) is a strategy to reduce mortality and morbidity in children under 5 years by improving case management of common and serious illnesses at primary health care level, and was adopted in South Africa in 1997. We report an evaluation of IMCI implementation in two provinces of South Africa.Seventy-seven IMCI trained health workers were randomly selected and observed in 74 health facilities; 1357 consultations were observed between May 2006 and January 2007. Each health worker was observed for up to 20 consultations with sick children presenting consecutively to the facility, each child was then reassessed by an IMCI expert to determine the correct findings. Observed health workers had been trained in IMCI for an average of 32.2 months, and were observed for a mean of 17.7 consultations; 50/77(65%) HW's had received a follow up visit after training. In most cases health workers used IMCI to assess presenting symptoms but did not implement IMCI comprehensively. All but one health worker referred to IMCI guidelines during the period of observation. 9(12%) observed health workers checked general danger signs in every child, and 14(18%) assessed all the main symptoms in every child. 51/109(46.8%) children with severe classifications were correctly identified. Nutritional status was not classified in 567/1357(47.5%) children.Health workers are implementing IMCI, but assessments were frequently incomplete, and children requiring urgent referral were missed. If coverage of key child survival interventions is to be improved, interventions are required to ensure competency in identifying specific signs and to encourage comprehensive assessments of children by IMCI practitioners. The role of supervision in maintaining health worker skills needs further investigation
An educational intervention to update health workers about HIV and infant feeding
Clinical guidelines are used to translate research findings into evidence-based clinical practice but are frequently not comprehensively adopted by health workers (HWs). HIV and infant feeding guidelines were revised by the World Health Organization to align feeding advice for HIV-exposed and unexposed infants, and these were adopted in South Africa in 2017. We describe an innovative, team-based, mentoring programme developed to update HWs on these guidelines. The intervention was underpinned by strong theoretical frameworks and aimed to improve HWs' attitudes, knowledge, confidence, and skills about breastfeeding in the context of HIV.10.1111/mcn.1292
Are we doing enough? Improved breastfeeding practices at 14 weeks but challenges of non-initiation and early cessation of breastfeeding remain: Findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa
Background
KwaZulu-Natal (KZN) Initiative for breastfeeding support (KIBS) was a multipronged intervention to support the initiation and sustaining of breastfeeding, implemented between 2014 and 2017. We present results of two surveys conducted before and after KIBS implementation to assess changes in infant feeding practices in KZN over this time period.
Methods
Two cross-sectional surveys were conducted in primary health care clinics. Multistage stratified random sampling was used to select clinics and participants. Sample size was calculated to provide district estimates of 14-week exclusive breastfeeding (EBF) rates at baseline (KIBS1), and provincial estimates at endpoint (KIBS2). At KIBS1 the sample required was nine participating clinics in each of 11 districts (99 clinics) with 369 participants per district (Nâ=â4059), and at KIBS2 was 30 clinics in KZN with 30 participants per clinic (Nâ=â900). All caregivers aged â„15âyears attending the clinic with infants aged 13- <â16âweeks were eligible to participate. Data was collected using structured interviews on android devices. Multi-variable logistic regression was used to adjust odds ratios for differences between time points.
Results
At KIBS1 (May2014- March2015), 4172 interviews were conducted with carers, of whom 3659 (87.6%) were mothers. At KIBS2 (JanuaryâAugust 2017), 929 interviews were conducted which included 788 (84.8%) mothers. Among all carers the proportion exclusively breastfeeding was 44.6 and 50.5% (pâ=â0.1) at KIBS1 and KIBS2 respectively, but greater improvements in EBF were shown among mothers (49.9 vs 59.1: pâ=â0.02). There were reductions in mixed breastfeeding among all infants (23.2% vs 16.3%; pâ=â0.016). Although there was no change in the proportion of carers who reported not breastfeeding (31.9% vs 32.8%; pâ=â0.2), the duration of breastfeeding among mothers who had stopped breastfeeding was longer at KIBS2 compared to KIBS1 (pâ=â0.0015). Mothers who had returned to work or school were less likely to be breastfeeding (adjusted odds ratio [AOR] 3.76; 95% CI 3.1â4.6), as were HIV positive mothers (AOR 2.1; 95% CI 1.7â2.6).
Conclusion
Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.publishedVersio
Establishing a postgraduate programme in nutritional epidemiology to strengthen resource capacity, academic leadership and research in the democratic republic of Congo
Background
Low- and Middle-income countries (LMIC) face considerable health and nutrition challenges, many of which can be addressed through strong academic leadership and robust research translated into evidence-based practice. A North-South-South partnership between three universities was established to implement a masterâs programme in nutritional epidemiology at the Kinshasa School of Public Health (KSPH), Democratic Republic of Congo (DRC). The partnership aimed to develop academic leadership and research capacity in the field of nutrition in the DRC. In this article we describe the educational approach and processes used, and discuss successes, challenges, and lessons learned.
Methods
Self-administered questionnaires, which included both open and closed questions, were sent to all graduates and students on the masterâs programme to explore studentsâ experiences and perceptions of all aspects of the educational programme. Quantitative data was analysed using frequencies, and a thematic approach was used to analyse responses to open-ended questions.
Results
A two-year masterâs programme in Nutritional Epidemiology was established in 2014, and 40 students had graduated by 2020. Key elements included using principles of authentic learning, deployment of students for an internship at a rural residential research site, and support of selected students with bursaries. Academic staff from all partner universities participated in teaching and research supervision.
The curriculum and teaching approach were well received by most students, although a number of challenges were identified. Most students reported benefits from the rural internship experience but were challenged by the isolation of the rural site, and felt unsupported by their supervisors, undermining studentsâ experiences and potentially the quality of the research. Financial barriers were also reported as challenges by students, even among those who received bursaries.
Conclusion
The partnership was successful in establishing a Master Programme in Nutritional Epidemiology increasing the number of nutrition researchers in the DRC. This approach could be used in other LMIC settings to address health and nutrition challenges.publishedVersio
A North-South-South partnership in higher education to develop health research capacity in the Democratic Republic of the Congo: the challenge of finding a common language
Background
Globally, increasing numbers of higher education institutions (HEIs) in non-English-speaking countries have adopted English as a medium of instruction (EMI), because of the perception that this provides opportunities to attract high-calibre students and academic staff, and engage with the international research community. We report an evaluation of a NorthâSouth-South collaboration to develop health research capacity in the Democratic Republic of the Congo (DRC) by establishing a postgraduate programme in nutritional epidemiology at the Kinshasa School of Public Health (KSPH), where EMI was adopted. We report experiences and perceptions of stakeholders, facilitators and students about using EMI.
Methods
In-depth qualitative interviews were conducted between October and December 2019 among convenience sampled stakeholders (8), facilitators (11) and students (12) involved in the programme from all three partner institutions (University of Kinshasa; University of KwaZulu-Natal, South Africa; University of Bergen, Norway). Interviews were conducted in participantsâ language of preference (English or French), audio-recorded, transcribed verbatim and translated into English when required. Analysis employed a thematic approach.
Results
Most participants viewed EMI positively, reporting that studying in English created opportunities to access relevant literature, improve interactions with the scientific community and advance their careers. As a result of adopting EMI, some students had opportunities to present research findings at international conferences and publish their research in English. English-speaking researchers from partner institutions were able to participate in supervision of studentsâ research. However, inadequate English competency, particularly among students, was challenging, with some students reporting being unable to understand or interact in class, which negatively affected their academic performance. Further, EMI created barriers at KSPH among academic staff who were not proficient in English, leading to poor participation among non-English-speaking staff and lack of integration with other postgraduate programmes. Participants suggested additional English language support for EMI.
Conclusion
Partnerships between HEIs could be a powerful tool to develop research capacity in low-income countries in line with United Nations Sustainable Development Goals. EMI could be a solution to language barriers faced by many such partnerships, but wide-ranging support to develop English proficiency among staff and students is essential to ensure that the challenges do not outweigh the benefits.publishedVersio
âI am not only beneficial to the community but to the entire country, I am trained as a researcher nowâ: Developing health research skills in low-income countries
Partnerships between Higher Education Institutions in the global South and North have potential for building capacity in public health research in low-resource countries. We present experiences of partners involved in a NorthâSouthâSouth partnership between universities in Norway, the Democratic Republic of Congo (DRC) and South Africa. The partnership aimed to establish a postgraduate programme in nutritional epidemiology at the University of Kinshasa, DRC, and develop a cadre of researchers and academic leaders to provide locally generated health research to inform policy. In-depth interviews were conducted with 31 purposively selected stakeholders, facilitators, and students from partner institutions. All participants expressed positive experiences, indicating that the partnership provided excellent opportunities to network, enriched participantsâ learning and enhanced academic growth, with benefits at individual, institutional, and country levels. Participants suggested that maintaining a common vision was important for success, facilitated by joint planning of project activities, focussing strongly on building research and academic capacity at Kinshasa School of Public Health and addressing local nutrition problems. Important challenges highlighted for future partnerships included failures of co-facilitation and co-supervision, poor research dissemination and policy impact, and concerns about sustainability. Notwithstanding, NorthâSouthâSouth partnerships can address skills shortages in public health research with significant benefits to all partner institutions.publishedVersio
TelegestĂŁo de rede de rega em aproveitamentos hidroagrĂcolas
Dissertação de mestrado, Engenharia ElĂ©ctrica e ElectrĂłnica, Instituto Superior de Engenharia, Universidade do Algarve, 2016O apoio ao desenvolvimento da agroindĂșstria estĂĄ na gĂ©nese do Grupo Hubel, quer na
vertente agronĂłmica quer nas vertentes tecnolĂłgicas, como por exemplo
telecomunicaçÔes, tecnologias de informação e automação.
A agroindĂșstria carece de tecnologias fiĂĄveis, eficientes, inovadoras e competitivas de
modo a dar resposta Ă s crescentes necessidades desta indĂșstria para possibilitar um
aumento de eficiĂȘncia e rentabilidade.
Dentro da agroindĂșstria, a agricultura estĂĄ a assistir a uma revolução tecnologia
denominada âAgricultura de PrecisĂŁoâ, esta agricultura assenta na premissa que Ă©
possĂvel medir, prever e actuar em todos os factores que interfiram com o bom
desenvolvimento das culturas de modo a minimizar os riscos de perdas de capitais e
racionalização dos recursos naturais disponĂveis.
Para melhor gerir, armazenar, contabilizar e racionalizar a ĂĄgua para a rega, foram
criados em Portugal diversos aproveitamentos hidroagrĂcolas, com especial incidĂȘncia
na zona de influĂȘncia da barragem do Alqueva.
Enquanto colaborador do Grupo Hubel, tive o privilégio de participar no projecto e na
construção de vĂĄrios destes aproveitamentos, ao nĂvel da automatização das redes de
rega e no desenvolvimento de sistemas de informação para o seu controlo e gestão.
No presente relatĂłrio descrevo essencialmente as actividades, enquanto profissional de
engenharia, que desenvolvi na concepção e instalação dos sistemas de automatização
acima referidos. Dando especial enfoque ao projecto, à anålise de soluçÔes e de
arquiteturas de comunicação e de automação, realçando os aspectos de aquisição e
comunicação de dados.
Por Ășltimo, efectuo uma pequena abordagem Ă s redes LPWAN em que assentam a
maioria das soluçÔes IoT
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