INFLUENCE OF FOOD AVAILABILITY ON THE NUTRITIONAL STATUS OF CHILDREN OF 6 MONTHS TO 23 MONTHS

Purpose: The study, therefore, seeks to establish the relationship between the food availability and nutritional status of children of 6 months to 23 months. Specifically, the study will seek to determine the influence of food availability, food accessibility, food utilization and food safety on the nutritional status of children of 6 months to 23 months in Kenya.Methodology: The study will take a case study of Kenyan referral level 5 hospital. The hospital has approximately 600 mothers to children of 6 months to 23 months attending clinic in a month. This study will adopt descriptive cross sectional survey design. The study will target the mothers to the children of 6 months to 23 months. The study will also target the head nurses and Paediatricians from the nursing units in the hospital as the key informants. Stratified random sampling method will be used to select the respondents. That is, from the mothers of children of age groups 6-8 months, 9-11 months and 12-23 months. Data will be collected using self-administered structured questionnaires and the Key informant interview guides (KIIs). The study will use Fisher formula to select a sample size of 201 mothers from the total population. Pre-testing of the instruments will be conducted to determine the validity and reliability of the instrument. Data will be analysed using Statistical Package for Social Sciences (SPSS) version 20. Data will be analyzed using chi-square to test the association between the variables. Binary logistic regression (Odds ratio regression) will be used to test the multivariate relationships between various independent and dependent variables.Findings: The study finds that there is a significant impact of food availability on nutritional status of children of 6 months to 23 months. Unique contribution to theory, policy, and practice: TThe inadequacy and unavailability of healthy and nutritious food in many households especially in the Sub-Saharan Africa indicates the serious level of food insecurity. Hartman, et al. (2016) additionally, finds out that dietary intake is not different by disease status (remission or relapse) however, in the absence of nutritional supplements, food intake is inadequate for many nutrients in many children stomach problems.

FACTORS AFFECTING NURSES’ PERFORMANCE TOWARDS HEALTHCARE IMPROVEMENT: A CRITICAL REVIEW

Purpose: The study, therefore, seeks to establish the factors that influence the performance of nurses towards the overall healthcare improvement.Methodology: This study adopted a desk survey design. This involved an in-depth review of studies in relation to nurses’ performance and healthcare improvement. An in-depth search of the top keywords related to nurses’ performance and healthcare improvement was done in various databases. Thus, the seminar paper was purely qualitative, drawing its findings from secondary sources of information.Findings: The study finds that workload, payment and salaries, working conditions and leadership affect the performance of nurses towards the overall healthcare improvement. Unique contribution to theory, policy, and practice: Mismatch of human resources with workload and lack of clarity with regard to duties have maximum correlation with poor quality of care. Organizational structure and communication program categories gained the highest and lowest importance respectively. This information could be used by nursing managers and policy makers to plan programs in order to improve the quality of clinical nursing services. Clinical governance is considered as a framework for improving the quality of clinical services in nursing. Professional nursing practice standards are valid expression tasks that are expected of all nurses regardless of their roles and expertise in communities to be done with merit.

EFFECT OF HARD DRUG ADDICTION ON PSYCHOLOGICAL WELL-BEING OF PERSONS ATTENDING MAT CLINIC

Purpose: The study, therefore, seeks to establish the effect of hard drug addiction on psychological well-being of persons attending mat clinic.Methodology: This study will adopt a descriptive survey design. The study will employ a population of 450 respondents, that is the, guardians /patients, and nurses of the clinic. The population of the study will include the patients attending and nurses working with the patients at MAT clinic in Kenya. According to Kothari (2004), a sample size of between 10 and 30% is a good representation of the target population, for populations not exceeding 1000. The target sample size for this study, therefore, will be 10% of the total respondents of the clinic, i.e., 45 respondents selected by simple random sampling method. Inclusion criteria and exclusion criteria will be used where the guardians/patients who attended the clinic and the nurses working in the clinic will be included, while the patients who are mentally incapacitated to respond to the questions as well as the nurses not directly involved with the patients will be excluded. The study will use questionnaires, key information and interview guides to collect the primary data. Analysis of data will be done by use of Statistical Package for Social Sciences (SPSS) computer software.Findings: The study finds that there is a significant impact of hard drug addiction on psychological well-being of persons attending mat clinic. Unique contribution to theory, policy, and practice: Both psychological well-being and substance abuse are influenced by numerous overlapping and interacting factors and as such, any psychometric scales trying to identify adolescents at risk for psychological problems and substance abuse would have to look at them in interaction. Fortunately, it seems that the Psychological Well-Being Scale used for the purpose of this research can serve this dual purpose, namely to identify adolescents with a negative psychological well-being and consequently identify those adolescents at risk for substance abuse.

STUDY THE PREVALENCE OF MALNUTRITION AMONG CRHON'S DISEASE PATIENTS DURING CLINICAL REMISSION

Purpose: People with Crohn's disease are at risk of nutritional deficiency, especially those subject to strict diet. Aim of this study is to study the relationship between malnutrition and Crohn's disease during clinical remission.Methods: The patients were randomized from the Benghazi Medical Center. The total of the patients was 50 patients with 26 males and 24 females aged from 18 years and over was performed between the January 2017 to April 2017. Self-administered questionnaire was used to collect personal information. The questionnaire included socio-economic characteristics, anthropometry, 24hr.recall method to find out whether they are malnourished or not.Result: approximately 82% of patients had their weight within the normal range, while 8% of their weight was below the normal range among of them approximately 6% represented with men according to the BMI. As for skin fold thickness, it appeared that 36% of patients have ideal fat levels, 26% have lower fat levels, while ,22% have medium fat levels, whereas the rest (14%) have higher fat levels. Regarding the 24-hour recall method shows that most patients had their daily calories at a low rate and the maximum daily calorie consumption was 1115Kcal , while the minimum was 305Kcal.Conclusion: We conclude that the relationship between Crohn's disease and malnutrition is does not exist based on our study. Our study may lack some laboratory investigations of patients. Future studies will be needed to document the relation between malnutrition and Crohn's disease.

FIRST LINE ANTI-RETRO VIRAL DRUGS DISRUPTS THE ESTRUS CYCLE OF WISTAR RATS

Background: Patients with HIV AIDS are beginning to live longer and healthier lives due to the use of ARV therapy. The effect of long term usage of these agents on the reproductive potential of human females has not been well studied. The study of the estrus cycle in rats will give information on the possible effect of ARV's on the reproductive potential of humans.Aims: To elucidate the effects of the first-line ARV's, Efavirenz, Tenofovir and Lamivudine administered in a combined fashion, on the oestrous cycle of adult female Wistar rats.Material and Methods: Twenty-five female Wistar rats with a mean weight of 158.76g were used. A total of five groups of rats were involved in the study. Five rats were apportioned to each study group. All three ARV's were administered orally in a combined fashion to a particular group of Female Wistar rats and also administered individually to other groups while the control group received water. The estrous cycles of various groups of rats were monitored via microscopic analysis of their vaginal smearsResults: The control group had a consistently regular cycle, while the cycles of the rats in the combination therapy group and the rats that received efavirenz alone, became elongated relative to the control group. There was a 48-hour enlongated proestrous phase some of the rats.Conclusions: First-line ARV's - Tenofovir, Efavirenz, and Lamivudine- disrupt the estrous cycle of adult rats. Further investigation of the long term usage of these drugs on the menstrual cycle of human females is therefore necessary