Malnutrition. Refugees have very limited knowledge of what is deemed as “healthy” US foods and are also overwhelmed by the many choices available, making food selection and preparation a very daunting process for them (Xxxxxxx & Xxxx, 2007). In a study reviewing the medical records of all newly arriving pediatric refugees (0-18 years) entering DeKalb County, Georgia between October 2010 and July 2011 were, the data indicated that approximately one in five refugee children were anemic or malnourished. Refugee children were grouped as African, Bhutanese, or Burmese (resettling from either Thailand or Malaysia). Other studies have revealed that pediatric refugees are at an increased risk for growth and nutritional deficits (Xxxx et al. (2014). As more refugee children are resettled to the United States, it is important to screen appropriately in order to identify any growth or nutritional issues. Vitamin Deficiency Xxxx et al. (2014) in reviewing several studies concluded that there is widespread vitamin D deficiency among immigrants and refugees. Xxxxxxx, Xxxxx, Xxxxxx, Xxxxxxx, and Xxxxxxx’x research revealed that clinicians performing routine medical examinations in the United States reported high rates of hematologic and neurologic disorders caused by vitamin B12 deficiency in resettled Bhutanese refugees. Some of these studies indicate that malnutrition continues to be a major risk factor for refugee children. In order to address this issue, culturally sensitive nutrition education and counseling should be provided after resettlement (Xxxxx, 2014). Cancer According to the CDC (2016), refugee populations are at a disproportionally increased risk for cancers that occur in the developing world, such as cancers of the liver, esophagus, and stomach. Moreover, there are no specific guidelines in the United States for screening for cancers that occur disproportionally in migrants from the developing world. Many refugees in the United States emigrated from countries where the incidence of cervical cancer is high. Refugee women are unlikely to have been screened for cervical cancer prior to resettlement in the U.S. Refugee women face many barriers in accessing preventive services and screening. These include: fear of pain (the belief that mammograms are painful) and diagnosis (anxiety about what to do next if diagnosed with cancer), modesty (not wanting to expose oneself, especially to a male physician), and work and childcare commitments (the average family has 4-5 children) ...
Malnutrition. Diabetes Mellitus, Obesity, CVD and be able to find information on specific conditions (may require prompting) - Demonstrates understanding of where to find key information e.g. drugs and supplements, food composition - Basic knowledge of commonly used nutritional supplements - Basic knowledge of commonly used drugs (laxatives, anti-emetics, anti-diarrhoeal, antibiotic re: cause diarrhoea). - Basic knowledge of biochemistry ranges, and an idea of what they relate to - Knowledge of what information to gather for basic common diseases or common therapeutic diets (e.g. diabetes, hyperlipidaemia, obesity and malnutrition) - Initiates looking up information about specific conditions/diseases - Demonstrates an understanding of the principles behind routine dietary intervention and how this can be translated into practical advice Communication C1: In all areas of dietetic practice experienced - Aware of department record keeping standards/ format - Demonstrates awareness of MDT working - Able to obtain informed consent - Appropriate verbal and non-verbal communication with patients - Able to initiate a conversation: introduce self and gather basic information etc. - With supervisor direction, is able to draft uncomplicated entries for a patient’s/client’s record and medical notes (for assessment and diagnosis) - Is further developing the ability to listen attentively to service users and carers (Active listening) - Beginning to recognise and respond to non-verbal cues - Communicates appropriately (ask appropriate questions) with other disciplines, with support - Delivers appropriate verbal feedback to supervisors about info. gathered - Demonstrates an understanding of the roles/relationships of MDT Care Process CP1: identification, collection and interpretation of relevant information and evidence to assess nutritional and dietetic need - Demonstrates an understanding of the available sources of information in the practice setting - Can collect a basic diet history (with support) but not necessarily in sufficient detail. - Able to estimate an individual’s energy and protein intake from food records using food composition tables - Understands principles of estimating nutritional requirements and deficits - Demonstrates an appreciation of different social, financial factors related to eating habits. - Demonstrates an awareness of strategies to maintain confidentiality in practice - Demonstrates awareness of limitations with clinical understanding and (with promptin...
Malnutrition. Diabetes Mellitus, Obesity, CVD, Coeliac Disease and be able to find information on specific conditions (may require prompting) - Demonstrates understanding of where to find the information relevant to dietetic practice (relevant to the setting) The relevance of the below will depend upon the setting: - Basic knowledge of commonly used nutritional supplements - Basic knowledge of commonly used drugs - Basic knowledge of portion sizes, calorie and protein contents for common foods. - Knowledge of the nutritional needs of the general ‘healthy’ population - Initiates looking up information about specific conditions/diseases or processes. - Demonstrates an understanding of the principles behind dietary interaction/input/ practice in this role and how these are translated into practical advice. Communication
Malnutrition. Ensure that CBO coverage is provided for at least 80% of communities.
Malnutrition. Like diarrhea, malnutrition is another substantial contributor to disease and mortality among vulnerable populations. Its three principle constituents include: 1) protein-energy malnutrition (PEM); 2) micronutrient deficiencies; and 3) over-nutrition and xxxxxxx.xxx, xxxi As defined by Atinmo et al, “malnutrition results from the imbalance of nutrients and energy provided to the body (too low) relative to its needs (too high),” but can also be triggered and augmented by the consequences of diarrheal disease.i, ix, xxxii Although all three types of malnutrition together account for more than 50% of deaths among children under age five in developing countries, PEM and micronutrient deficiencies alone—the two forms of undernutrition—contribute to one third of all deaths among children in this age xxxxx.xxx, xxxiii, xxxiv Children affected by malnutrition at an early age become increasingly susceptible to being disadvantaged later on in life. Beginning at conception, a malnourished mother is considered to be at high risk of having a low birth-weight baby, who will be at risk of short-term and long-term morbidity and disability in the future.xxxv Close to 30 million low birth-weight babies are born annually, many as a result of having a malnourished mother.xxxv A severe consequence of maternal malnutrition is the experience of intrauterine growth retardation (IUGR), which occurs when the mother is unable to gain enough weight during pregnancy and already exhibits short stature and low xxxxxx.xx, xxxvi Consequently, IUGR infants often suffer from increased risk of diarrhea, pneumonia, and recurrent infection due to impaired immune xxxxxxxx.xx Several studies have also indicated mild to severe adversities in terms of physical, mental, and developmental ailments due to acute and chronic malnutrition experienced while in the womb and after xxxxx.xx, v, xxx, xxxii Decreased socioeconomic status, human capital and physiological capital in the future have also shown direct correlations with chronic malnutrition and tend to fall disproportionately on children living in developing countries.xxxvii Chronic malnutrition, or stunting, is characterized by low height-for-age and occurs over long periods of xxxx.xxx, xxxv As a result, the consequences of stunting are often unobserved until later on in life when the repercussions are
Malnutrition. Malaria, conflict, droughts and agricultural pests have led to significant food shortages. In 2005, malnutrition was the second highest cause of deaths and micronutrient-related anemia the fourth highest cause of death in children U5 in health facilities.20 Rural households spend 75% of monthly income on food, and urban households spend 48%.21 The number of meals per day and the number of different foods eaten are much lower in rural areas.22 41% of U5 rural children are underweight, (<-2 Z-scores, weight-for-age), and 22% of urban children. Severe malnutrition affects 14% of rural children (<-3 Z- scores, weight-for age).23 In Gitega, 7% of children are wasted, and 42% are underweight. 24 Malnutrition is reported at 14% in Kibuye.25 A national nutrition survey found that childhood malnutrition was linked to feeding practices, fever and frequent diarrhea. Some mothers withhold liquids and food when children are sick.26 The study recommends that interventions focus on behavior change and preventing and treating diseases, such as malaria, which is an important cause of anemia.27 According to the World Food Program, one-fifth of women aged 15-49 years in Burundi are underweight, contributing to low birth rates and high IMR. Gitega is one of the top 3 provinces for under-nourishment in women of reproductive age.28 Vitamin A coverage among children 6-59 months is poor; in 2006, 28% of children 6-59 months had Vitamin 19 Roll Back Malaria. World Malaria Report 2005. Available online: xxxx://xxx.xxx.xxx.xxx/wrm2005/html/2-1.htm [hereafter: RBM 2005] 20 PNDS 2005.
Malnutrition. Malnutrition has been and remains a constant problem throughout Cameroon, especially in the rural areas. It is primarily due to inappropriate or non-use of locally available foods rich in vitamins, minerals and protein. Results of a recent study by Plan revealed up to 30% malnutrition among children under three years old. Growth monitoring and community-based nutrition rehabilitation, nutrition education and IEC are the primary components of this intervention. Scales and other equipment were supplied by the project, as was refresher training of staff. However, in spite of these efforts, this intervention has not demonstrated significant results. For this reason, the project decided to switch to using the PD/Hearth approach instead. This change has only recently begun and is not yet being fully implemented. In the next scale up project, it will be a major focus of the nutrition component. Children who attended growth-monitoring sessions during the last 4 months and whose weights were plotted on the road to health growth monitoring card increased from 11% to 44.4%, which exceeded the targeted 40%. Since this indicator was measured using children’s cards we believe that the actual value is higher because many children did not have their cards with them for various reasons, e.g. mothers relocate and the cards are left behind. CBO members in their respective communities conduct growth monitoring and nutrition rehabilitation sessions. During these monthly sessions children are weighed and the information is recorded both in the community register as well as plotted on the child’s card. This is followed by a nutrition demonstration session where all the mothers of U-5 children participate. For children who were identified with malnutrition, the CBO members follow them through home visits where they ensure that mothers are putting into practice what they learned at the demonstration sessions. Emphasis is placed on using locally available foods to prepare balanced meals for the children. In spite of this regular exercise conducted by the community members, the malnutrition rate decrease is not significant, from 19.1% baseline value to 16.4%, missing the targeted 10%. Even though this is partially explained by the fact that nutrition rehabilitation did not start until after the MTE, it also confirms that there is need to adopt innovative approaches like PD/Hearth, which has shown its worth in a pilot project carried out by Plan Cameroon with funding from the Japan N...
Malnutrition. Quantifying the health impact at national and local levels. WHO Environmental Burden of Disease Series, No. 12. Retrieved from xxx.xxx.xxx/xxxxxxxxxxx_xxxxxxxxx/xxxxxxxxxxxx/XxxxxxxxxxxxXXX00.xxx
Malnutrition. Retrieved from xxxxx://xxx.xxx.xxx/news-room/fact-sheets/detail/malnutrition
Malnutrition. The absence of immune-promoting nutrients, like vitamin A and zinc, has also been hypothesized as a source of decreased RV vaccine protection in developing nations. Studies have demonstrated that vitamin A metabolites, like retinoic acid, promote T and B cell homing to the gut and a balance of gut regulatory to inflammatory T cells (20). Like vitamin A, zinc has also been shown to enhance immunity. Zinc supplementation increases T and B cell activity, enhances antibody responses, and also stimulates oxidative bursts and phagocytosis in macrophages during bacterial infection (21-23). One could imagine that vaccination in the absence of these nutrients could prevent macrophage functioning, inhibit immune cell homing and activity, encourage an inflammatory environment, and potentially, hinder RV vaccine seroconversion. A vitamin newly recognized to regulate immunity and modulate infection is vitamin D. Like supplementation with vitamin A and zinc, vitamin D supplementation may increase protection against infection and promote antiviral immunity. In fact, vitamin D supplementation among Mongolian school children reduced the risk for acute respiratory diseases (24). Moreover, low vitamin D levels have long been associated with the susceptibility to Mycobacterium tuberculosis infection, and vitamin D was once used to treat such infections before the development of antibiotics (25). It is unclear if vitamin D deficiencies are common in children from developing countries and if those deficiencies would affect RV vaccine seroconversion; however, in light of the study in Mongolian children, further studies addressing the prevalence of vitamin D deficiencies and the mechanisms behind vitamin D-mediated immune cell functioning are clearly warranted.
