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- Volume 21, Issue 2, 2008
South African Journal of Clinical Nutrition - Volume 21, Issue 2, 2008
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Volume 21, Issue 2, 2008
Author D . LabadariosSource: South African Journal of Clinical Nutrition 21 (2008)More Less
Technology is wonderful, and it is. The skeptics though will no doubt hasten to add, "when it works". Experience indicates that the latter can be argued successfully. It is therefore gratifying to be able to confirm, that, barring a few gremlins that crept in here and there, the SAJCN online system is almost fully functional.
Dietary and fluid adherence among haemodialysis patients attending public sector hospitals in the Western Cape : original researchSource: South African Journal of Clinical Nutrition 21, pp 7 –12 (2008)More Less
Objective : There has been considerable debate about the extent to which social cognitive models of health behaviour apply in developing countries. The purpose of this paper was to determine the applicability of the Theory of Planned Behaviour (TPB) in predicting dietary and fluid adherence among a sample of haemodialysis patients attending public sector hospitals in the Western Cape.
Design and methods : A sample of 62 historically disadvantaged patients undergoing haemodialysis completed a battery of psychometric instruments measuring attitudes, subjective norms, perceived behavioural control regarding dietary and fluid adherence, health literacy, perceived social support, and self-reported dietary and fluid adherence. Interdialytic weight gain (IDWG), predialytic serum potassium levels, and predialytic serum phosphate levels served as biochemical indicators of dietary and fluid adherence.
Results : Regression analyses indicated that the linear combination of attitudes and perceived behavioural control significantly accounted for 15.5% of the variance in self-reported adherence (a medium-effect size) and 11.4% of the variance in IDWG (a modest-effect size). No significant predictors were identified for predialytic serum potassium and predialytic serum phosphate levels.
Interpretation and conclusions : The results indicate that, while the TPB may not function in the same manner as it does in Western samples, it may have some nuanced applicability among haemodialysis patients attending public sector hospitals in the Western Cape.
Author M. HerselmanSource: South African Journal of Clinical Nutrition 21, pp 13 –14 (2008)More Less
Chronic kidney disease (CKD) is a common disorder affecting more than 50 million people worldwide, with approximately 430 000 people reported as suffering from end-stage renal disease in South Africa in 2003. Of equal concern is the reported increase in the prevalence of CKD from 14.5% (1988-1994 NHANES data) to 16.8% (1999-2004 NHANES data) in the United States in people 20 years of age and older. This increase is also likely to be true for other countries and might be related to the increase in the prevalence of obesity, which has recently been identified as an independent and major risk factor for CKD. The effect of obesity is thought to be related to its link with diabetes and hypertension, both known risk factors for CKD.
Are South African women willing and able to apply the new food-based dietary guidelines? Lessons for nutrition educators : original researchSource: South African Journal of Clinical Nutrition 21, pp 17 –24 (2008)More Less
Background : Consumer testing was a prime consideration in developing specific South African food-based dietary guidelines (FBDGs) which were nationally adopted in 2003.
Objectives : This study aimed to determine the consumer's ability to apply the FBDGs appropriately, in terms of identifying foods / drinks according to the FBDG food categories; perceived importance of and barriers to applying each FBDG; and planning a typical day's meals to reflect the FBDGs.
Design : A cross-sectional study of 333 women from different cultural and socio-economic backgrounds.
Setting : KwaZulu-Natal, South Africa.
Methods : Data collection comprised focus-group discussions (n = 103) and structured individual interviews (n = 230).
Results : The identification of foods / drinks according to the FBDG food categories reflected a high level of comprehension by participants of these food categories. Participants from all study samples endorsed the importance of applying the FBDGs, predominantly for health reasons. Participants cited barriers to the application of the FBDGs as affordability, availability, household taste preferences, routine food-purchasing habits, time constraints, traditional / habitual food-preparation methods, and persistent attitudes. Only three FBDGs were mentioned as difficult to apply, namely, "fruits / vegetables", "foods from animals" and "legumes". Meal plans did reflect the FBDGs, illustrating the flexibility of their use across cultural and socio-economic differences.
Conclusions : Consumer testing of the FBDGs was mainly positive. The study has highlighted areas of confusion regarding certain concepts, terminology and misconceptions, and has identified barriers to application. These concerns can be addressed through the reformulation and retesting of certain dietary guidelines, and the provision of explanatory consumer information and health-worker training materials.
Dietitians' perceptions of the continuing professional development system in South Africa : original researchSource: South African Journal of Clinical Nutrition 21, pp 27 –33 (2008)More Less
Objective : To retrospectively evaluate the South African Continuing Professional Development (CPD) system (previous and current) for dietitians, by determining their perceptions of the system's implementation and participation in CPD activities.
Design : An observational descriptive study in the quantitative and qualitative research domains.
Methods : A national survey of 1 589 dietitians was conducted using a self-administered questionnaire, followed by 3 focus group discussions (FGD) with 19 Pretoria-based dietitians. In-depth interviews were also conducted with 6 CPD / Health Professions Council of South Africa (HPCSA) administrative personnel.
Results : Twenty per cent of dietitians responded to the survey. The CPD administration fee was unreasonable to 54.5% (N = 156) of dietitians and most FGD participants. CPD activities were expensive to 55% (N=164) of respondents while 29% (N = 88) of respondents, in agreement with the FGD participants, acknowledged the availability of variably priced activities. Statistically significant cost differences were determined across practice areas, qualifications and provinces. Lectures and seminars were activities most commonly participated in, followed by conferences and articles with multiple choice questions (MCQs) from peer reviewed literature. However, conferences ranked highest as the most preferred activity. Barriers to CPD activities included costs, geographical access, obtaining leave from work, family obligations and internet access. More dietitians were satisfied with the service quality at the CPD office and the Association for Dietetics in South Africa (ADSA) than with that provided by the HPCSA, but requested simpler correspondence from all these offices. In the current system, dietitians need to keep their own CPD records, but 51.7% (N = 161) preferred not to do so.
Conclusions : Addressing factors affecting CPD participation will contribute to the acceptability of the system by dietitians.
Source: South African Journal of Clinical Nutrition 21 (2008)More Less
Infant-feeding practices of mothers and the nutritional status of infants in the Vhembe District of Limpopo Province : original researchSource: South African Journal of Clinical Nutrition 21, pp 36 –41 (2008)More Less
Objective : To determine the breast-feeding and weaning practices of mothers and the nutritional status of infants in the Vhembe District of Limpopo Province.
Design : A descriptive and exploratory study was done. A sample of 185 mothers with 185 infants 12 months and younger was selected from five primary healthcare clinics. A validated questionnaire, which consisted of questions relating to demographic data, breast-feeding and weaning practices, was used. The weight and length measurements of the infants were taken.
Results : The majority (97%) of the mothers were still breast-feeding at the time of the interviews. Only 7,6% practised exclusive breastfeeding, however, while 43,2% had introduced solid foods at three months and 15% before two months. The weaning food given by most of the mothers was maize-meal soft porridge and had been introduced before four months of age. The Z-score classification was used and showed that stunting (18,9%), underweight (7%) and wasting (7%) were present among the infants but that only wasting was found to be a disorder of public-health significance. The nutritional status of the infants was therefore not significantly influenced by the breast-feeding and weaning practices of the mothers or other demographic parameters.
Conclusion : Breast-feeding was still practised by many of the mothers but exclusive breast-feeding was rare.