Research Articles (Human Ecology and Dietetics)
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Item Feature Reduction for the Classification of Bruise Damage to Apple Fruit Using a Contactless FT-NIR Spectroscopy with Machine Learning(MDPI, 202) Isingizwe, F; Hussein, E; Vaccari, M; Umezuruike, LSpectroscopy data are useful for modelling biological systems such as predicting quality parameters of horticultural products. However, using the wide spectrum of wavelengths is not practical in a production setting. Such data are of high dimensional nature and they tend to result in complex models that are not easily understood. Furthermore, collinearity between different wavelengths dictates that some of the data variables are redundant and may even contribute noise. The use of variable selection methods is one efficient way to obtain an optimal model, andthis was the aim of this work. Taking advantage of a non-contact spectrometer, near infrared spectral data in the range of 800–2500 nm were used to classify bruise damage in three apple cultivars, namely ‘Golden Delicious’, ‘Granny Smith’ and ‘Royal Gala’. Six prominent machine learning classification algorithms were employed, and two variable selection methods were used to determine the most relevant wavelengths for the problem of distinguishing between bruised and non-bruised fruit. The selected wavelengths clustered around 900 nm, 1300 nm, 1500 nm and 1900 nm. The best results were achieved using linear regression and support vector machine based on up to 40 wavelengths: these methods reached precision values in the range of 0.79–0.86, which were all comparable (within error bars) to a classifier based on the entire range of frequencies. The results also provided an open-source based framework that is useful towards the development of multi-spectral applications such as rapid grading of apples based on mechanical damage, and it can also be emulated and applied for other types of defects on fresh produce.Item The association between the body mass index of first-year female university students and their weight-related perceptions and practices, psychological health, physical activity and other physical health indicators(Cambridge University Press, 2006) Cilliers, Janetta; Senekal, Marjanne; Kunneke, ErnestaTo investigate the association between the weight status of first-year female students (FYFS) and various weight management-related characteristics to identify possible components of a weight management programme for students. Mean (^standard deviation (SD)) body mass index (BMI) of the FYFS was 21.8 ^ 2.6 kg m22 , with 7.2% being underweight, 81.9% normal-weight, 10.0% overweight and 0.8% obese. Underweight, normal-weight and overweight students differed with regard to their perception of their weight (P , 0.001), weight goals (P , 0.001) and previous weight-loss practices (P , 0.001). Mean ^ SD score on the 26-item Eating Attitudes Test (EAT-26) was 8.5 ^ 9.0 with 8.4% classified as high scorers. Mean ^ SD score on the 34-item Body Shape Questionnaire (BSQ) was 87.7 ^ 32.2, with 76.1% classified as low, 11.9% as medium and 11.9% as high scorers. The self-concept questionnaire indicated that 36.7% had a high, 43.9% a medium and 19.4% a low self-concept. Higher BMI correlated with a higher BSQ score (P , 0.001), a lower self-concept (P ¼ 0.029) and a higher EAT-26 score (P , 0.001). Smoking was prevalent amongst 13.1% of students, and 51.2% used vitamin and/or mineral supplements. Students who quitted smoking had higher (P ¼ 0.006) BMI (22.7 ^ 2.9 kg m22 ) than those who never smoked before (21.6 ^ 2.5 kg m22 ).Item Nutrition, oral health and the young child(Wiley Open Access, 2007) Naidoo, Sudeshni; Myburgh, NeilOral health is integral to general health and essential to well-being and quality of life. Socio-behavioural and environmental factors play a significant role in oral disease and oral health.Dental caries is a global disease with few populations exempt from its effects. In developingcountries, as development increases so does dental caries and children are at the forefront of thedisease disadvantage. There is a growing need to identify high caries risk groups accurately tocommence prevention from a young age.The effect of early intervention in childhood on generaland dental health with both population and high-risk approaches also needs examining. As aneducational tool, the paediatric food-based dietary guidelines may play a significant role innutrition and oral health interventions. This paper provides information on nutrition, includingaccess to fluoride and use of sugar.Oral health concerns,such as early childhood caries,which areimportant for the young child, are also discussed.Item Nutritional management after colonic interposition(MedPharm Publications, 2011) Basson, AbigailDuring oesophagal reconstruction adequate nutrition must be maintained. The article provides an account of the feeding programme and procedures followed in the case of a patient that had an emergency gastrectomy, splenectomy and oesophagectomy.Item Nutrition management in the adult Crohn's disease patient(MedPharm Publications, 2012) Basson, AbigailMalnutrition, nutrient deficiencies and osteoporosis are common in Crohn’s disease patients regardless of disease activity. While the role of diet in the pathogenesis of the disease remains inconclusive, upon diagnosis nutrition therapy plays an integral role throughout patient care. Successful nutrition intervention involves appropriate nutritional assessment, supplemental nutrition and individualized counseling and support.Item Challenges experienced while providing home based care: A community organisation's experience(University of the Western Cape, 2012) Erasmus, Charlene; Ramuhaheli, R. M.Introduction: Methods: Results: Conclusion: Keywords: The large and ever-growing number of people being infected with HIV/AIDS, led to health professionals being unable to cope with these increasing numbers. To combat this challenge, an alternative strategy such as home based care needed to be implemented. When attempting to attend to this need, a deeper understanding of the challenges facing community organizations when providing home based care is necessary in order to formulate these effective and relevant care services. The aim of the study was to explore the challenges faced by Umtha Welanga Community Organization in the provision of HIV/AIDS home based care. Acase study using a qualitative approach with in-depth interviews as the data collectionmethod was used. The Umtha Welanga Community Organization constituted the total population therefore no sampling was applied. All themembers of the management team and all the home-based caregivers were interviewed. Informed consent as well as consent for recording interview was obtained prior to data collection. Respondents were informed that participation is voluntary and that they can withdrew at any time. Data analysis began immediately after completion of all the interviews by transcribing and translating the audio-taped data. Thematic analysis was used in which data was coded and categorized. The main areas of concern were gender inequality, insufficient funding, lack of disclosure and trust, risk faced by caregivers and lack of recognition Finances appear to be, both for the organization and the home based carers, a specifically influential obstacle in the implementation and maintenance of the services. Lack of recognition by the government and lack of trust and disclosure towards care workers; create difficult conditions for them to perform their tasks and duties. Care services also present risks and dangers to caregivers such as being susceptible to criminal activity, feeling unsafe and vulnerable.Item Vitamin D and Crohn’s disease in the adult patient: a review(SAGE Publications, 2014) Basson, AbigailCrohn’s disease (CD) is characterized as a chronic immune-mediated inflammatory disorder of the gastrointestinal tract. Current consensus surrounding the cause of the disease suggests a complex interplay between genetic susceptibility, the intestinal microbiome and environmental factors, leading to the aberrant Th1 and Th17 cell driven autoimmune response. Vitamin D deficiency is common in CD patients, and longstanding deficiency has been associated with reduced bone mineral density (BMD). Accumulating evidence now suggests that in addition to maintaining skeletal integrity, vitamin D also plays an integral role in regulating the general immune response, a function employed via its genomic actions on the vitamin D receptor (VDR). The VDR is expressed in all immune cells and both directly and indirectly targeted by the bioactive form of vitamin D, 1,25-Dihydroxyvitamin D (1,25[OH]₂D). Impaired regulation or deficiency of the vitamin has been linked to the promotion of self-reactive T cell development, loss of immune tolerance to self-structures and experimental colitis in animal models, whilst the subsequent administration of the vitamin in these models resulted in the improvement of immune-mediated symptoms. In addition, low vitamin D has been associated with disease activity in CD patients, and supplementation appears to be beneficial in improving clinical scores and reducing inflammation. Therefore, the primary aims of this paper were to review the molecular evidence supporting the immunoregulatory roles of vitamin D and its supplementation in the CD patient, based upon existing literature. The physiological processes, accepted serum concentration values and its well-recognized role in bone health were also summarized.Item Ethical misconduct by registered physiotherapists in South Africa (2007– 2013): A mixed methods approach(PubMed, 2015) Nortje, Nico; Hoffmann, Willem ABackground: The role of ethics in a medical context is to protect the interests of patients. Thus, it is critically important to understand the guilty verdicts related to professional standard breaches and ethics misconduct of physiotherapists. Aim: To analyse the case content and penalties of all guilty verdicts related to ethics misconduct against registered physiotherapists in South Africa. Methods: A mixed methods approach was followed consisting of epidemiological data analysis and qualitative content analysis. The data documents were formal annual lists (2007–2013) of guilty verdicts related to ethical misconduct. Quantitative data analysis focused on annual frequencies of guilty verdicts, transgression categories and the imposed penalties. Qualitative data analysis focused on content analysis of the case content for each guilty verdict. Results: Relatively few physiotherapists (0.05%) are annually found guilty of ethical misconduct. The two most frequent penalties were fines of R5000.00 and fines of R8000.00 – R10 000.00. The majority of transgressions involved fraudulent conduct (70.3%), followed by performance of procedures without patient consent (10.8%). Fraudulent conduct involved issuing misleading, inaccurate or false medical statements, and false or inaccurate medical aid scheme claims.Item The influence of second-hand cigarette smoke exposure during childhood and active cigarette smoking on Crohn's Disease phenotype defined by the montreal classification scheme in a Western Cape Population, South Africa(PLoS ONE, 2015-09) Chivese, Tawanda; Basson, Abigail; Esterhuizen, TonyaSmoking may worsen the disease outcomes in patients with Crohn’s disease (CD), however the effect of exposure to second-hand cigarette smoke during childhood is unclear. In South Africa, no such literature exists. The aim of this study was to investigate whether disease phenotype, at time of diagnosis of CD, was associated with exposure to second-hand cigarette during childhood and active cigarette smoking habits.Item Seven year overview (2007-2013) of ethical transgressions by registered healthcare professionals in South Africa(AOSIS, 2016) Nortje, Nico; Hoffmann, WillemA move has taken place internationally in the delivery and "consumption" of health care where if clients and patients (health care consumers) hold the opinion that the health care professionals/providers' behaviour has had a negative effect, impact or outcome on them, they may lodge a complaint with the relevant health professional regulatory body. Ethical transgressions of health care providers can generally be clustered into the following three categories: a) Competence and conduct with clients (e.g. abandonment, sexual intimacies, dishonesty, disclosure of information); b) Business practices (e.g. billing, reports, documentation); and c) Professional practice (e.g. referral upon termination, obtaining appropriate potential employment opportunities, nonprofessional relationships). The primary objective of this study was to analyse the ethical transgressions of registered members of the twelve professional boards in the Health Professions Council of South Africa (HPCSA) in the period 2007 to 2013. A mixed methods approach was followed in this study which specifically focused on a historical research approach. The results indicate that the boards with the highest number of transgressions per the registered practitioners were firstly the Medical and Dental practitioners, closely followed by the Optometry and Dispensing Opticians Board. The predominantly complaint made against members of both these boards was for fraudulent conduct (collectively totalling to 85% of all fraudulent cases during the period) and included actions such as charging for non-rendered services, issuing false statements and submitting fraudulent medical aid claims. Cognisance needs to be taken that the South African public will increasingly demand better services and that since they are being better informed via the media of their rights and have access to a broader database of knowledge (rightly or wrongly so the internet) practitioners' opinions will not necessarily be accepted outright and that they (the public) will challenge it accordingly. This raises the concern that practitioners need to take on the responsibility to communicate with their patients/clients in order to educate them and keep them informed.Item Dietary fat intake and red blood cell fatty acid composition of children and women from three different geographical areas in South Africa(Elsevier, 2016) Ford, Rosalyn; Faber, Mieke; Kunneke, Ernesta; Smuts, Cornelius M.Dietary fat intake, particularly the type of fat, is reflected in the red blood cell (RBC) fatty acid (FA) profile and is vital in growth, development and health maintenance. The FA profile (%wt/wt) of RBC membrane phospholipids (as determined by gas chromatography) and dietary intake (as determined by 24 h recall) was assessed in 2–6 y old South African children and their caregivers randomly selected from three communities, i.e. an urban Northern Cape community (urban-NC; n = 104), an urban coastal Western Cape community (urban-WC; n = 93) and a rural Limpopo Province community (rural-LP; n = 102). Mean RBC FA values across groups were compared using ANOVA and Bonferroni post-hoc test while controlling for age and gender (children); median dietary intake values were compared using a Kruskal–Wallis test. Dietary intakes for total fat, saturated FAs and polyunsaturated FAs were higher in the two urban areas compared to the rural area. Total fat intake in rural-LP, and omega-3 FA dietary intake in all three areas were lower than the South African adopted guidelines. Dietary SFA intake in both urban areas was higher than recommended by South African guidelines; this was reflected in the RBC membrane FA profile. Rural-LP children had the lowest intake of omega-3 and omega-6 FAs yet presented with the highest RBC docosahexaenoic acid (DHA) profile and highest arachidonic acid percentage. Although differences observed in dietary fat intake between the two urban and the rural area were reflected in the RBC membrane total phospholipid FA profile, the lowest total fat and α-linolenic acid (ALA) intake by rural children that presented with the highest RBC DHA profile warrants further investigation.Item Household consumption of orange-fleshed sweet potato and its associated factors in Chipata District, Eastern Province Zambia(SAGE Publications, 2017) Sakala, Patricia; Kunneke, Ernesta; Faber, MiekeBACKGROUND: The Integrating Orange Project promotes production and consumption of orange-fleshed sweet potato (OFSP) to address vitamin A deficiency among rural populations of Zambia since 2011. OBJECTIVE: This study assessed household production and consumption of OFSP and identified factors associated with consumption thereof in Integrating Orange Project areas in Chipata district, Zambia. METHODS: Respondents of 295 randomly selected households were interviewed using a structured questionnaire during the sweet potato harvest season. Associations between OFSP consumption and household factors were assessed using w2 tests. RESULTS: Frequency of OFSP consumption was categorized as 4 days during the last 7 days (30.2%), 1 to 3 days during the last 7 days (49.5%), eats OFSP but not during the last 7 days (7.1%), and never (13.2%). In total, 60.3% of households planted OFSP, and 40.0% bought OFSP, mostly from farmers within the community. Orange-fleshed sweet potato consumption was associated with the presence of children aged less than 5 years in the household (P ¼ .018), production of OFSP (P < .001), purchasing of OFSP (P < .001), and respondent having knowledge on health benefits of OFSP (P ¼ .014). Age and sex of the household head and household size had no association with OFSP consumption (P > .05). CONCLUSION: A high percentage of households consumed OFSP during the harvesting season in Integrating Orange Project areas. Programs promoting OFSP consumption should thus focus on OFSP production and sensitizing households on nutritional benefits of OFSP and target households with children aged less than 5 years as entry point.Item School tuck shops in South Africa—an ethical appraisal(MedPharm Publications, 2017) Nortje, Nico; Faber, Mieke; De Villiers, AnnizaIt can be postulated that schools have an ethical responsibility to protect children from an unhealthy food environment. Against the backdrop of stunting, overweight and micronutrient deficiencies prevalent in South African children, the aim of this scoping study is to review information available on foods sold to school children within an ethical framework. While some schools have a formal tuck shop, at other schools, food vendors sell food either on or outside the school premises. Ten studies, of which two were national, fit the selection criteria for this study. Available data show that mostly unhealthy food options are sold to South African school children; with low-nutrient energy-dense foods (e.g. chips, sweets) and sugar sweetened beverages being the most popular. The Integrated School Health Policy provide a policy framework for achieving healthy school food environments in South Africa, and several guidelines are available in South African to assist school tuck shops to sell healthier options. Children’s preference for unhealthy foods, the cost of healthier food options and a lack of proper facilities may however be barriers for implementing healthy tuck shops. An action stronger than merely providing guidelines may therefore be needed. Cognisance needs to be taken of conflicting value based arguments within ethical perspectives. Given these conflicts, the authors argue that an Ethics of Responsibility contributes to the debate of the best and supports the notion that society at large has a responsibility to protect vulnerable communities of which school children are part. Presently an ethical vacuum exists in terms of rights and responsibilities which this study hopes to address.Item Dietary patterns and colorectal cancer risk in Zimbabwe: A population based case-control study(Elsevier, 2018) Katsidzira, Leolin; Laubscher, Ria; Gangaidzo, Innocent T.; Swart, Rina; Makunike-Mutasa, Rudo; Manyanga, Tadios; Thomson, Sandie; Ramesar, Raj; Matenga, Jonathan A.; Rusakaniko, SimbarasheBACKGROUND: The rising incidence of colorectal cancer in sub-Saharan Africa may be partly caused by changing dietary patterns. We sought to establish the association between dietary patterns and colorectal cancer in Zimbabwe. METHODS: One hundred colorectal cancer cases and 200 community-based controls were recruited. Data were collected using a food frequency questionnaire, and dietary patterns derived by principal component analysis. Generalised linear and logistic regression models were used to assess the associations between dietary patterns, participant characteristics and colorectal cancer. RESULTS: Three main dietary patterns were identified: traditional African, urbanised and processed food. The traditional African diet appeared protective against colorectal cancer (Odds Ratio (OR) 0.35; 95% Confidence Interval (CI), 0.21 – 0.58), which had no association with the urban (OR 0.68; 95% CI, 0.43–1.08), or processed food (OR 0.91; 0.58–1.41) patterns. The traditional African diet was associated with rural domicile, (OR 1.26; 95% CI, 1.00–1.59), and a low income (OR1.48; 95% CI, 1.06–2.08). The urbanised diet was associated with urban domicile (OR 1.70; 95% CI, 1.38–2.10), secondary (OR 1.30; 95% CI, 1.07–1.59) or tertiary education (OR 1.48; 95% CI, 1.11–1.97), and monthly incomes of $201–500 (OR 1.30; 95% CI, 1.05–1.62), and the processed food pattern with tertiary education (OR 1.42; 95% CI, 1.05–1.92), and income > $1000/month (OR 1.48; 95% CI, 1.02–2.15). CONCLUSION: A shift away from protective, traditional African dietary patterns may partly explain the rising incidence of colorectal cancer in sub-Saharan Africa.Item Exploring the affordances of e-learning technologies for dietetics education and training(South African Medical Association, 2019) Wilkenson, JillLecturers in health science education programmes wear many hats. Their undergraduate training prepares them to deliver healthcare services as clinicians. They may enter academia as clinical educators and then advance to become classroom-based teachers. It is frequently assumed that they are equipped to fulfil the role of teacher. This was certainly the route that I followed. As a digital immigrant, my standard teaching tools were lectures supported by text-laden PowerPoint presentations. The realisation dawned that this approach was failing to meet the expectations of digital-age students – it not only favoured student passivity, but was also a missed opportunity to demonstrate responsible use of technology for communicating information to colleagues and clients in the workplace.Item Resituating Africa’s urban informal food sector(Spinger, 2019) Crush, Jonathan; Young, GraemeThe complex dynamics of the informal food sector in urban Africa are poorly understood. Urban informal food systems are beginning to receive attention from scholars and policymakers, but the notable absence of detailed empirical information and necessary theoretical engagement with their emergence, structure, and operation has thus far limited efforts to understand the central role that they play in urban development processes. This Special Issue brings together a diverse collection of case studies from seven countries across the Global South—China, Jamaica, Mozambique, Namibia, Nigeria, South Africa, and Uganda—to explore these dynamics by placing Africa’s urban informal food sector in comparative international context.Item Persistence of the inverse care law in maternal health service utilization: An examination of antenatal care and hospital delivery in Ghana(PAGEpress, 2019) Jonah, Coretta M.P.The gap in maternal health outcomes, access and utilization between the haves and have-nots continues to be a challenge globally despite improvements over the past decade. Though Ghana has experienced steady gains in maternal health access and utilization over the years, maternal outcomes, on the other hand, remain poor. In this regard, it is essential to know how various groups in the population achieved improvements and whether some women continue to be disproportionately disadvantaged. The paper performs an analysis of cross-sectional data from the 2017 Ghana maternal health survey to examine the existence of the inverse care law in maternal health services in Ghana. Using descriptive techniques and multivariate logistic regression models the study reveals a pro-rich and pro-urban gradient in the use of hospital facilities for delivery and antenatal care attendance — also, regions known for their high levels of poverty feature significantly lower rates of hospital deliveries. The paper concludes by stressing that unless policies are changed to accommodate these groups, overall gains in maternal health will continue to be incremental.Item The informal food sector and cohabitation with supermarkets in Windhoek, Namibia(Spinger, 2019) Nickanor, Ndeyapo; Crush, Jonathan; Kazembe, LawrenceMuch of the literature on urban food systems has focused on supermarket expansion and their ability to reach urban consumers. However, the current pace of urbanisation and rising urban poverty has been accompanied by a major upsurge in informality and a growing role for the informal food sector. One of the persistent arguments in the supermarkets literature is that the expansion of modern retail undermines the informal food sector. Critics of this argument suggest that there are two conditions under which this may not occur: first, when there is spatial differentiation with supermarkets servicing higher income areas and the informal sector targeting low-income areas. And second, when there is market segmentation when the formal and informal sectors focus on the sale of different product types. This paper examines the case of Windhoek, Namibia, which has undergone a major supermarket revolution in the last two decades.Item Social grants, remittances, and food security: Does the source of income matter?(Spinger, 2019) Waidler, Jennifer; Devereux, StephenLarge numbers of South Africans receive social grants (public transfers) or remittances (private transfers), and yet one in four South Africans is food insecure. The purpose of this paper is to address two questions: do social grants and remittances improve food security and nutritional outcomes? If so, do these impacts differ between public and private transfers? Drawing on the National Income Dynamic Survey (NIDS), South Africa’s first nationally representative survey that follows more than 28,000 individuals over time, we found significant and positive impacts of the Older Person’s Grant and of remittances on the dietary diversity index, but not of the Child Support Grant. Moreover, we found no effect on food expenditure or on anthropometry (BMI) by the Older Person’s Grant, or remittances. However, some positive effects were found on children’s BMI from the Child Support Grant. We discuss why we observe different effects from different transfers, as well as giving several reasons why income transfers are failing to close the nutritional deficits in South Africa.Item Intersectoral (in)activity: Towards an understanding of public sector department links between water, sanitation and hygiene (WASH) and childhood undernutrition in South Africa(Oxford University Press, 2020) Momberg, Douglas J.; Mahlangu, Pinky; Ngandu, Bwangandu C.Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), contribute to poor child health, nutritional status and physical growth. The primary responsibility for the provision of water and sanitation, as a basic service and human right, lies with the State, as such, a number of stakeholders are involved. Despite relatively high levels of WASH infrastructure coverage in South Africa, enteric infections and stunting remain high for a middle-income country. The aim of this study is to elucidate the landscape of WASH in South Africa in relation to nutritional status of children under the age of 5 years in the South African, Gauteng and City of Johannesburg contexts. The authors detailed the national and provincial public sector departments and through purposive sampling proceeded to map the various departments and associated policies that are responsible for the provision of WASH facilities, as well the nutritional status of children.
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