A review of infant and young child feeding practice in hospital and the home in KwaZulu-Natal Midlands

Background: Malnutrition remains a major health burden globally. To date the focus in South Africa has been on exclusive breastfeeding from birth to 6 months, with less attention on feeding of the infants beyond 6 months.Objectives: To describe infant and young child feeding practices at home and in hospital in KwaZulu-Natal Midlands, South Africa, and determine if feeding practices conform to national feeding policies. No statistical correlation was done.Methodology: A descriptive study, using structured questionnaires for mothers of infants and young children up to the age of five years, and healthcare professionals in state hospitals, was conducted in 2011 in 12 hospitals in the KwaZulu-Natal Midlands, South Africa.Results: Seventy-six percent (76%) of infants were ever exclusively breastfed with just 36% being exclusively breastfed beyond three months. Complementary feeds were commenced in 84% of infants younger than 6 months of age. Age-specific meals were provided for children below 2 years (93%) and for participants above 2 years (78%). Approximately 61% of infants and children between 6 and 24 months received more than three cups of milk per day in hospital with only 26% of children between 2 to 5 years receiving any milk. Majority of children (48%) aged 2 to 5 years received only one snack per day, which is suboptimal.Conclusion: Feeding messages focus on breastfeeding. Breastfeeding rates have improved in this region since 2003, but exclusive breastfeeding is of limited duration. Early complementary feeding is a problem in the Midlands. This study has identified that age-specific feeding of infants and young children is not recognised in state hospitals, due to the inadequate frequency of feeding. There is a discrepancy between intention and practice among healthcare professionals in feeding infants and young children. Feeding messages have to expand beyond breastfeeding and complementary feeding, with ongoing training of healthcare professionals in this field.Keywords: Infant, young child, feeding, malnutritio

<i>Schistosoma mansoni</i> cercariae experience influx of macromolecules during skin penetration

We have observed that when cercariae penetrate the skin of mice, there is influx into their tissues of Lucifer Yellow and certain labelled molecules of up to 20 kDa molecular weight. This observation was made using a variety of fluorescent membrane-impermeant compounds injected into the skin before the application of cercariae. This unexpected phenomenon was investigated further by transforming cercariae in vitro in the presence of the membrane-impermeant compounds and examining the distribution by microscopy. In schistosomula derived from this procedure, the nephridiopore and surface membrane were labelled while the pre- and post-acetabular glands were not labelled. The region associated with the oesophagus within the pharyngeal muscle clearly contained the fluorescent molecules, as did the region adjacent to the excretory tubules and the germinal mass. We used cercariae stained with carmine to aid identification of regions labelled with Lucifer Yellow. Although the mechanism of this influx is unclear, the observation is significant. From it, we can suggest an hypothesis that, during skin penetration, exposure of internal tissues of the parasite to external macromolecules represents a novel host-parasite interfac

Quadrotor multibody modelling by vehiclesim: adaptive technique for oscillations in a PVA control system

The work presented here covers the detailed modelling and trajectory control for an elastic bladed quadrotor vehicle. The benefits of using VehicleSim modelling software are also discussed. The authors present a full elastic structural and dynamical model as well as two different aerodynamic models. These two aerodynamic models differ from each other on their level of complexity and therefore, accuracy. The control methodology employed to stabilize and guide the vehicle is PVA (ProportionalVelocity-Acceleration), derived and implemented by using Simulink. As it will be shown, it stabilises and provides satisfactory quadrotor trajectory tracking. Since the control methodology feeds back the acceleration of the vehicle, and this acceleration has an oscillating nature, an adaptive process has been designed and introduced into the vehicle’s model in order to avoid the oscillations’ transmission to the control system, showing how it reduces the amplitude of the control actions oscillations. Results of simulations and discussion on them are also provided at the end of this article

Child mortality in South Africa: Fewer deaths, but better data are needed

South Africa is committed to reducing under-5 mortality rates in line with the Sustainable Development Goal (SDG) targets. Policymakers and healthcare service managers require accurate and complete data on the number and causes of child deaths to plan and monitor healthcare service delivery and health outcomes. This study aimed to review nationally representative data on under-5 mortality and the cause of deaths among children under 5 years of age. We also reviewed systems that are currently used for generating these data. Child mortality has declined substantially in the past decade. Under-5 mortality in 2015 is estimated at 37 - 40 deaths per 1 000 live births, with an estimated infant mortality rate of 27 - 33 deaths per 1 000 live births. Approximately one-third of under-5 deaths occur during the newborn period, while diarrhoea, pneumonia and HIV infection remain the most important causes of death outside of the newborn period. The proportion of deaths owing to non-natural causes, congenital disorders and non-communicable diseases has increased. However, many discrepancies in data collected through different systems are noted, especially at the sub-national level. There is a need to improve the completeness and accuracy of existing data systems and to strengthen reconciliation and triangulation of data

Assessing sedation need and managing referred dentally anxious patients:is there a role for the Index of Sedation Need?

Aim: To conduct an exploratory investigation of public dental service (PDS) practitioners' planned sedation modality using a structural equation modelling approach, in order to identify the explanatory value of using the Index of Sedation Need (IOSN), or its component parts, to predict sedation modality in patients referred with dental anxiety. Methods: A convenience sample of patients referred to the PDS for dental anxiety management was invited to take part. The IOSN was completed for each patient (patient dental anxiety, medical and behavioural indicators and dental treatment complexity) as well as the American Society of Anesthesiologists Physical Status Classification System and the Case Mix Tool. The practitioners completed details of their planned sedation modality and identified normative dental treatment need. The data were entered onto an SPSS v21 database and subjected to frequency distributions, t-tests, correlation analysis and exploratory partial structural equation modelling (SEM). Results: Ninety-five percent of patients were ranked as MDAS 3 or 4, indicating high dental anxiety; 69% had a medical condition, which might impact on dental treatment and 82% had a dental treatment need, which was classified as intermediate/complex according to the IOSN. Eighty-eight percent of the patients in accordance with the IOSN required sedation: 62% of patients were assessed as requiring intravenous sedation. The IOSN discriminated between patients who were assessed as requiring more complex sedation modalities and had a greater normative treatment need. The SEM showed that the patient dental anxiety (P &lt;0.02) and dental treatment complexity (P &lt;0.02) predicted planned sedation modality. Functional morbidity was less strong, as a predictor, and was significant at the ten percent level. Conclusions: The IOSN is a useful and valid assessment of sedation need and predicted sedation modality for patients referred with high dental anxiety states and secondly, that component parts of the IOSN add explanatory value in practitioners' choice of planned sedation modality

Select pyrimidinones inhibit the propagation of the malarial parasite, Plasmodium falciparum

Plasmodium falciparum, the Apicomplexan parasite that is responsible for the most lethal forms of human malaria, is exposed to radically different environments and stress factors during its complex lifecycle. In any organism, Hsp70 chaperones are typically associated with tolerance to stress. We therefore reasoned that inhibition of P. falciparum Hsp70 chaperones would adversely affect parasite homeostasis. To test this hypothesis, we measured whether pyrimidinone-amides, a new class of Hsp70 modulators, could inhibit the replication of the pathogenic P. falciparum stages in human red blood cells. Nine compounds with IC50 values from 30 nM to 1.6 μM were identified. Each compound also altered the ATPase activity of purified P. falciparum Hsp70 in single-turnover assays, although higher concentrations of agents were required than was necessary to inhibit P. falciparum replication. Varying effects of these compounds on Hsp70s from other organisms were also observed. Together, our data indicate that pyrimidinone-amides constitute a novel class of anti-malarial agents. © 2009 Elsevier Ltd. All rights reserved