Browsing by Author "Solomons, Nasheetah"

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    Addressing non-communicable diseases in the Western Cape, South Africa
    (PAGEpress, 2019) Solomons, Nasheetah; Kruger, Salome; Pouane, Thandi
    Chronic non-communicable diseases (CNCDs) are increasing with grave consequences to countries’ development. The purpose of this study was three-fold: (1) to determine challenges PURE study participants faced regarding CNCD interventions and what they required from a CNCD intervention programme, and (2) to explore courses of action Department of Health (DoH) officials thought would perform best, as well as (3) to determine what DoH officials perceive to be obstacles in addressing the CNCD epidemic.
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    Adherence challenges encountered in an intervention programme to combat chronic non-communicable diseases in an urban black community, Cape Town
    (AOSIS OpenJournals Publishing AOSIS (Pty) Ltd, 2017) Solomons, Nasheetah; Kruger, Herculina Salome; Puoane, Thandi
    Background: Chronic non-communicable diseases (CNCD) have become the greatest contributor to the mortality rate worldwide. Despite attempts by Governments and various non-governmental organisations to prevent and control the epidemic with various intervention strategies, the number of people suffering from CNCD is increasing at an alarming rate in South Africa and worldwide. Objectives: Study's objectives were to explore perceived challenges with implementation of, and adherence to health messages disseminated as part of a CNCD intervention programme; to gain an understanding of participants' expectations of CNCD intervention programmes;, and to explore the acceptability and preference of health message dissemination methods. In addition, participants' awareness of, and willingness to participate in CNCDs intervention programmes in their community was explored. Methods: Participants were recruited from the existing urban Prospective Urban Rural Epidemiology study site in Langa, Cape Town. Focus group discussions were conducted with 47 participants using a question guide. Summative content analysis was used to analyse the data. Results: Four themes emerged from the data analysis: practical aspects of implementation and adherence to intervention programmes; participants' expectations of intervention programmes; aspects influencing participants' acceptance of interventions; and their preferences for health message dissemination. The results of this study will be used to inform CNCDs intervention programmes. Conclusions: Our findings revealed that although participants found current methods of health message dissemination in CNCDs intervention acceptable, they faced real challenges with implementing and adhering to CNCDs to these messages.
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    Association between dietary adherence, anthropometric measurements and blood pressure in an urban black population, South Africa
    (Taylor & Francis, 2018) Solomons, Nasheetah; Kruger, H Salome; Puoane, Thandi
    Objectives: The aim was to determine participants’ dietary adherence by calculating a diet adherence score based on the Dietary Approaches to Stop Hypertension (DASH)-style diet; (2) to determine if there was an association between dietary adherence score, anthropometric measurements (waist circumference, body mass index (BMI), waist–hip ratio, waist-toheight- ratio) and blood pressure (BP) in a South African urban black population. Design: Cross-sectional secondary analysis of data collected for the PURE study was undertaken. Setting: Langa, the urban PURE study site in the Western Cape province, South Africa. Subjects: The PURE study Western Cape urban cohort, 454 participants, aged 32–81 years was utilised. Outcome measures: Dietary adherence scores were calculated and the BP and anthropometric measurements, respectively, of participants in the lowest and highest tertiles of dietary adherence scores were compared. Results: Positive correlations were found between age, for both men and women, and systolic and diastolic BP. A significant positive correlation between added sugar intake and systolic blood pressure (SBP) was present only in the women. A significant positive correlation was found between BMI, diastolic BP and SBP in men only. No significant differences existed between BP of men or women in the lowest and top tertile groups according to dietary adherence score, but a significant inverse correlation between the dietary adherence score and SBP was found in women. Conclusions: BMI was positively associated with BP in men, while dietary adherence score was negatively correlated with SBP in women. Summary: Non-adherence to dietary guidelines presenting overconsumption of unhealthy foods may be associated with high blood pressure.
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    The development of a nutrition support protocol for children with Acute Lymphoblastic Leukemia (ALL) : twenty case studies from Sheikh Khalifa Medical City, Abu Dhabi, UAE
    (University of the Western Cape, 2017) Pillay, Looventharee; Kunneke, Ernesta; Solomons, Nasheetah
    Acute lymphocytic leukemia (ALL) is the most common type of childhood cancer accounting for approximately 25% of cancers diagnosed in children less than 20 years of age. It originates in the bone marrow and prevents the normal manufacture of red blood cells, white blood cells and platelets. A poor nutritional status is frequently observed in children with ALL at the time of diagnosis and during treatment which may result in protein energy malnutrition if nutrition intervention is delayed. This retrospective study aims to assess the nutritional status of children newly diagnosed with Acute Lymphoblastic Leukemia (ALL) using 20 case studies between 1 January 2013 and 31 December 2014 from Sheikh Khalifa Medical City (Abu Dhabi, UAE), in order to develop an appropriate nutritional support protocol for pediatric ALL patients treated at this institution. Study Design: A retrospective descriptive case study design was used. The study population consisted of 20 electronic medical records of patients aged between 1-14 years who were newly diagnosed with Acute Lymphoblastic Leukemia (ALL) and admitted to Sheikh Khalifa Medical City for treatment during the period 1 January 2012 and 31 Dec 2014. Data Collection: Identification of suitable participants began through a review of each potential study participant`s electronic medical record. Data was collected and recorded on a data collection form (Appendix III) from the electronic medical record for each suitable participant for the following at admission and during the full duration of all phases of cancer treatment namely induction, consolidation, interim maintenance, delayed intensification and maintenance. The data collected comprised of the following: age, gender, date of diagnosis, symptoms on diagnosis, the cancer diagnosis (type and subtype), anthropometric measurements (weight, length/ height, head circumference), biochemical values (visceral proteins, blood glucose levels, hemoglobin, hematocrit, lymphocyte count), clinical assessment (stomatitis, anemia, mucositis), diet history (home feeding regimes; consumption of daily requirements; food preferences – types, textures; food allergies, food intolerances; food aversions; use of oral nutritional supplements; treatment-related side-effects; systemic related side-effects (nausea; vomiting; diarrhea; anorexia; appetite changes; taste changes; physical activity level; depression), dietary requirements (age and gender related nutritional requirements for energy, protein, fat and fluids) and indications for nutritional support (oral feeding; enteral feeding; parenteral feeding). Analysis of Results: The weights and length/ heights of participants recorded in the electronic medical records were converted to z-scores on the World Health Organization growth charts. The diet prescription of nutritional intervention was interpreted in comparison to the biochemical indices, anthropometric status and dietary intake of each participant. All the data involving changes in anthropometrics, biochemistry, diet history and nutritional interventions from each case study (from diagnosis and through all stages of treatment) was screened and compared with reference values in the context of the age and sex of the child. Evidence based nutritional guidelines were used to document the outcomes of the medical nutrition treatment provided in order to develop a nutrition support protocol for children with Acute Lymphoblastic Leukemia at Sheikh Khalifa Medical City. Results: The results showed that weight loss expressed as a percentage of body weight provided a more accurate estimate of the true significance of weight loss in subjects undergoing cancer treatment (chemotherapy) for ALL. A weight loss of greater than 5% of body weight over a period of one month is considered a sign of nutritional deprivation even if the subject is not classified as undernourished by anthropometric parameters. Subjects experienced the highest weight loss during the consolidation phase and interim maintenance phases of treatment. Conclusion: It can therefore be concluded that pediatric subjects on cancer treatment for ALL at SKMC and receiving nutritional support underwent changes in nutritional status as manifest by a reduction in more than 5% of their body weight during three phases of treatment namely induction, consolidation and interim maintenance. An appropriate nutrition support protocol was developed based on the results and experience obtained from this study for pediatric ALL patients treated at SKMC.
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    Treating an intervention level 1 patient: futile or brave?
    (Medpharm Publications (Pty) Ltd, 2013) Solomons, Nasheetah; Nortje, Nico
    An ethical dilemma describes conflicting opinions by different members of the care team. This article focuses on AJ, a five-year-old child with cerebral palsy, who was born deaf and blind as a result of having contracted rubella in utero. The case is examined against Sokol’s four-quadrant analysis of ethical issues, giving a framework designed to facilitate the systematic identification and analysis of clinical ethical problems. The issue is whether the medical team should have palliated AJ, or continued with invasive therapy and feeding. The conclusion is that paediatric palliative care is often difficult, but that the dietitian has a duty to contribute his or her knowledge to benefit the patient.