scholarly journals Breastfeeding, Relactation, and High Impact Factors in Treating Moderately and Severely Malnourished Children Under Two Years of age in Colombia: A Mixed Community Study Protocol

2021 ◽  
Author(s):  
Omaira Valencia ◽  
Paola Rueda-Guevara
Keyword(s):  
Health Service ◽  
Service Provider ◽  
Health Professionals ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Second Phase ◽  
Health Service Provider ◽  
Nutritional Recovery ◽  
Care Processes ◽  
Potential Factors

Abstract Background: The prevalence of acute malnutrition in Columbia was 1.6% in 2015, which was significantly higher than that found in 2010 (0.9%). Further, the distribution by age shows a higher prevalence of malnutrition in children under 2 years of age. Low rates (36.1%) of exclusive breastfeeding (BF) were found in these children, and adequate BF rates (45.5%) were found for children between 6 and 23 months. These percentages were low compared to the world average of 46%. The objective was to evaluate breastfeeding practices, relactation and feeding processes related to the recovery of children between 0 and 24 months of age with a diagnosis of moderate or severe acute malnutrition (SAM) treated at prioritized health service provider institutions and in the Nutritional Recovery Centers of the Instituto Colombiano de Bienestar Familiar (ICBF).Methods: This research was a mixed-type observational descriptive design in the community with a quantitative and qualitative component in three phases. The first phase characterized the practices of breastfeeding and relactation among mothers seeking help for their infants through the Nutritional Recovery Centers of the Instituto Colombiano de Bienestar Familiar ICBF and health service provider institutions during the study period. In the second phase, a technical strengthening intervention will be carried out aimed at health professionals, and in the third phase, the care processes will be reviewed before and after the intervention. In addition, anthropometric variables and practices of breastfeeding on admission and discharge from care facilities were reviewed to identify potential factors related to the nutritional recovery process.Discussion: This research aims to provide a characterization of breastfeeding and relactation in the population treated for infants with severe acute malnutrition in the CRN and IPS, improve health professionals’ care processes for children with SAM, contribute to the achievement of relactation in mothers of children with moderate and severe acute malnutrition that graduate from the IPS and CRN and identify the potential factors related to the nutritional recovery of these children.Trial registration: Not aplicable

Increased risk of acquisition and transmission of ESBL-producing Enterobacteriaceae in malnourished children exposed to amoxicillin

2019 ◽  
Vol 75 (3) ◽  
pp. 709-717 ◽  
Author(s):  
Naouale Maataoui ◽  
Céline Langendorf ◽  
Fatou Berthe ◽  
Jumamurat R Bayjanov ◽  
Willem van Schaik ◽  
...  
Keyword(s):  
Placebo Group ◽  
Severe Acute Malnutrition ◽  
Controlled Trial ◽  
Acute Malnutrition ◽  
Double Blind ◽  
Adjusted Risk ◽  
Malnourished Children ◽  
Nutritional Recovery ◽  
Adjusted Risk Ratio ◽  
Increased Risk

Abstract Objectives Routine amoxicillin for children with uncomplicated severe acute malnutrition raises concerns of increasing antibiotic resistance. We performed an ancillary study nested within a double-blind, placebo-controlled trial in Niger testing the role of routine 7 day amoxicillin therapy in nutritional recovery of children 6 to 59 months of age with uncomplicated severe acute malnutrition. Methods We screened 472 children for rectal carriage of ESBL-producing Enterobacteriaceae (ESBL-E) as well as their household siblings under 5 years old, at baseline and Week 1 (W1) and Week 4 (W4) after start of therapy, and characterized strains by WGS. ClinicalTrials.gov: NCT01613547. Results Carriage in index children at baseline was similar in the amoxicillin and the placebo groups (33.8% versus 27.9%, P = 0.17). However, acquisition of ESBL-E in index children at W1 was higher in the amoxicillin group than in the placebo group (53.7% versus 32.2%, adjusted risk ratio = 2.29, P = 0.001). Among 209 index and sibling households possibly exposed to ESBL-E transmission, 16 (7.7%) had paired strains differing by ≤10 SNPs, suggesting a high probability of transmission. This was more frequent in households from the amoxicillin group than from the placebo group [11.5% (12/104) versus 3.8% (4/105), P = 0.04]. Conclusions Among children exposed to amoxicillin, ESBL-E colonization was more frequent and the risk of transmission to siblings higher. Routine amoxicillin should be carefully balanced with the risks associated with ESBL-E colonization.

The Classification and Statistical Manual of Mental Health Concerns: A Proposed Practical Scientific Alternative to the DSM and ICD

2017 ◽  
Vol 58 (1) ◽  
pp. 93-114 ◽  
Author(s):  
Jeffrey Rubin
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Disorders ◽  
Health Service ◽  
Health Services ◽  
Service Provider ◽  
Health Service Provider ◽  
Statistical Manual ◽  
Health Concerns ◽  
Mental Health Concerns

The Classification and Statistical Manual of Mental Health Concerns ( CSM) is a proposed alternative to the Diagnostic and Statistical Manual of Mental Disorders ( DSM) and International Classification of Diseases ( ICD). In contrast to the DSM/ ICD overarching concept of “mental disorders,” the CSM’s overarching concept is “mental health concerns.” A mental health concern occurs when a person seeking mental health services expresses to a mental health service provider a concern about any of these topics: behavior, emotion, mood, meaning of life, death, dying, managing chronic pain, addiction, work, relationships, education, eating, cognition, sleep, and challenging life situations. The CSM begins from the perspective of the person seeking services and that is what would be classified in its manual. In addition to classifying mental health concerns, the CSM would describe a collaborative approach between the person expressing the concern and the mental health service provider for creating a psychological formulation narrative that eschews the DSM/ ICD pathologizing jargon. Compared with the DSM/ ICD approach, the use of the CSM potentially would be less stigmatizing, as well as more practical. Moreover, it would be more consistent with principles of science, eliminate the monopoly of the DSM/ ICD mental disorder approach for accessing mental health services, provide a new choice to both mental health service users and providers, challenge old ideas, stimulate fresh perspectives, and open new avenues of research.

scholarly journals ASURANSI KESEHATAN BERDASARKAN UNDANG-UNDANG NOMOR 3 TAHUN 1992

2009 ◽  
Vol 9 (3) ◽  
Author(s):  
Arief Suryono
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Services ◽  
Service Provider ◽  
Social Insurance ◽  
Health Care Insurance ◽  
Health Service Provider ◽  
The Social ◽  
The Law ◽  
Employment Guarantee

Health insurance according to the Law No. 3/1992 obout the social employment guarantee which consist of responsiver and the addressee and health service provider is the health social insurance which is aimed to give the health care guarantee toward the addressee that is enterprenaur and worker.  The law relationship which is consisted between: Responssiver-Addressee is the insurance relationship; Responssiver-Health services provider is the user of health service belong to the health service provider toward to the addressee; Health services provider-Addressee is gives the health service to the addresse is patient.  The responsibility of the responssiver toward the addressee is to give the health care insurance to the addressee gives the health service provider for the importance of the addressee. Kata Kunci:  Asuransi Kesehatan

scholarly journals Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

2020 ◽  
Vol 42 ◽  
pp. e2020003 ◽  
Author(s):  
Mekonen Adimasu ◽  
Girum Sebsibie ◽  
Fikrtemariam Abebe ◽  
Getaneh Baye ◽  
Kerebih Abere
Keyword(s):  
Cohort Study ◽  
Weight Gain ◽  
Retrospective Cohort Study ◽  
Recovery Time ◽  
Retrospective Cohort ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Daily Weight Gain ◽  
Nutritional Recovery ◽  
Length Of Hospitalization

OBJECTIVES: Recovery time from severe acute malnutrition (SAM) is often a neglected topic despite its clinical impact. Although a few studies have examined nutritional recovery time, the length of hospitalization in those studies varied greatly. Therefore, the aim of this study was to determine the recovery time from SAM and to identify predictors of length of hospitalization among under-5 children.METHODS: A retrospective cohort study was conducted among 423 under-5 children with SAM who had been admitted to Yekatit 12 Hospital. Kaplan-Meier analysis was used to estimate time to nutritional recovery, and Cox proportional hazard regression analysis was performed to determine independent predictors.RESULTS: The nutritional recovery rate was 81.3%, and the median recovery time was 15.00 days (95% confidence interval [CI], 13.61 to 16.39). Age, daily weight gain per kilogram of body weight, vaccination status, and the existence of at least 1 comorbidity (e.g., pneumonia, stunting, shock, and deworming) were found to be significant independent predictors of nutritional recovery time. The adjusted hazard ratio (aHR) for nutritional recovery decreased by 1.9% for every 1-month increase in child age (aHR, 0.98; 95% CI, 0.97 to 0.99).CONCLUSIONS: The overall nutritional recovery time in this study was within the Sphere standards. However, approximately 13.0% of children stayed in the hospital for more than 28.00 days, which is an unacceptably large proportion. Daily weight gain of ≥8 g/kg, full vaccination, and deworming with albendazole or mebendazole reduced nutritional recovery time. Conversely, older age, pneumonia, stunting, and shock increased nutritional recovery time.

scholarly journals The Role of Organizational Trauma on Silence and Organizational Cynicism in a Health Service Provider Center

2019 ◽  
Vol 7 (3) ◽  
pp. 51-60
Author(s):  
Abbas Ebrahimi ◽  
Hooshmand Bagheri Gara Bollagh ◽  
Mohsen Eynali ◽  
Mohammad Mehdi Baki Hashemi ◽  
◽  
...  
Keyword(s):  
Health Service ◽  
Service Provider ◽  
Health Service Provider ◽  
Organizational Cynicism ◽  
Organizational Trauma

scholarly journals The Effectiveness of the Malnutrition eLearning Course for Global Capacity Building in the Management of Malnutrition: A Prospective Empirical Study (Preprint)

2018 ◽  
Author(s):  
Sunhea Choi ◽  
Ho Ming Yuen ◽  
Reginald Annan ◽  
Trevor Pickup ◽  
Andrew Pulman ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Health Professionals ◽  
Severe Acute Malnutrition ◽  
Scale Up ◽  
Health Sector ◽  
Nutrition Intervention ◽  
Acute Malnutrition ◽  
World Health ◽  
Knowledge Gain ◽  
Prospective Longitudinal

BACKGROUND Scaling-up improved management of severe acute malnutrition has been identified as the nutrition intervention with the largest potential to reduce child mortality but lack of operational capacity at all levels of the health system constrains scale-up. We therefore developed an interactive Malnutrition eLearning course that is accessible at scale to build capacity of the health sector workforce to manage severely malnourished children according to guidelines of the World Health Organization (WHO). OBJECTIVE The study aim was to test whether the Malnutrition eLearning course improves knowledge and skills of in-service and pre-service health professionals in managing children with severe acute malnutrition. METHODS This 2-year prospective, longitudinal, empirical research study took place in Ghana, Guatemala, El Salvador and Colombia between January 2015 and February 2017. A subset of 354 in-service health personnel from 12 hospitals and 2 Ministries of Health, 703 pre-service trainees from 9 academic institutions, and 204 online users participated. Knowledge gain after training and retention over time were measured through pre- and post-assessments, comprising questions pertaining to screening, diagnosis, pathophysiology, and treatment and prevention of malnutrition. Comprehension, application and integration of knowledge were tested. Changes in perception, confidence, and clinical practice were assessed through questionnaires and interviews. RESULTS Before the course, awareness of the WHO guidelines was 36.7% (389/1059) overall and 26.3% (94/358) among in-service professionals. The mean score gain in knowledge after access to the course of 606 participants who had pre-and post-assessment data was 11.8 (95% CI 10.8, 12.9 P<.001) – a relative increase of 41.5%. The proportion who achieved above the pass mark post-training was 58.7% (356/606), compared with 18.2% (110/606) pre-training. Of the in-service professionals, 86% (128/149) reported applying their knowledge by changing their clinical practice in screening, assessment, diagnosis and/or management. This group demonstrated significantly increased, retained knowledge 6-months after training (mean difference (SD) from pre-assessment:12.1 (11.8)), retaining 65.8% (12.1/18.4) of gained knowledge from the training. Changes in the management of malnutrition were reported by trained participants, and institutional operational and policy changes were also found. CONCLUSIONS The Malnutrition eLearning course improved knowledge, understanding and skills of health professionals in the diagnosis and management of children with severe acute malnutrition, and changes in clinical practice and confidence were reported following completion of the course.

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