« Nous sommes entrés dans un monde où toute figure peut se révéler n'être qu'un masque » 2 En sou... more « Nous sommes entrés dans un monde où toute figure peut se révéler n'être qu'un masque » 2 En souvenir de DD Résumé Concilier les exigences de l'action morale et les aspirations profondes d'un projet d'éducation pour la société, telle est la motivation qui a donné vie à cette contribution que nous jugeons modeste. En effet, la possibilité pour chacun de devenir meilleur dans le gouvernement de soi, la possibilité pour la société de connaitre l'harmonie, tout ceci ne va pas sans l'éducation aux valeurs. Mais qu'en est-il de l'observation des valeurs dans notre société, aujourd'hui diversement ouverte sur le monde au moyen de la mondialisation et d'internet ? Les valeurs ont-elles perdu de leur force contraignante ou s'inclinent-elles simplement devant la libre volonté de chacun à conduire sa vie à sa convenance ? Au constat, les individus sont sans cesse divisés entre l'obéissance aux valeurs et leur transgression toujours possible. Une situation paradoxale que cet article se propose d'examiner, avec pour objectif de redonner aux valeurs leur valeur de principes moraux inaliénables.
Nutritional data needed for holistic management of children with disabilities is inadequate in In... more Nutritional data needed for holistic management of children with disabilities is inadequate in India. Based on informed consent, this work examined the nutrition profile and feeding difficulties of 242 children, 2-16 years, with various disabilities. Over 80% children faced 3-15 different feeding problems, some being more pronounced in different disabilities. Mothers emerged as the main caregiver with several concerns about their child's diet. Dietary and anthropometric assessment indicated unbalanced, inadequate diets with about one third children underweight/stunted. WA, HA, BMI, MUAC, TSF, AMA and AFA emerged comparable for screening undernutrition. Knee height gave good result as a proxy measure for height across all disabilities. Children with cerebral palsy (CP) had maximum feeding problems and worst nutritional status with low energy, vitamin A and C, niacin and iron intake. Ten children with CP followed up for 6-9 months, showed positive impact of need based dietary coun...
The nurse is the hub of all activities in a hospital, centered on the patient, who makes the pati... more The nurse is the hub of all activities in a hospital, centered on the patient, who makes the patient get more individualised care. The present study was carried out in hospitals of Srinagar city (Jammu and Kashmir) to know the role of nurses in nutrition care of patients. A total of 11 hospitals registered under the Directorate of health services (Srinagar) capital of Jammu and Kashmir, India were included in the study. Hospitals were coded as (H1- H11) in order to maintain confidentiality. Data was collected using interview schedule through observation and discussion as well. The sample consisted of 62 nurses, representing 2% from each hospital. It involved gathering of both qualitative and quantitative data. A scoring pattern was formed to evaluate the nutrition care of patients by nurses. Senior staff nurses were interviewed taken from each hospital. Recommendations were developed after the conclusion was derived from the study. Results revealed that it was seen that most of the ...
Objective of the study was to assess the prevalence of food insecurity and malnutrition among you... more Objective of the study was to assess the prevalence of food insecurity and malnutrition among young children (6-36 months) in urban slums of India and its consequences on the nutritional status of the children. Household-based crosssectional study on a sample of 446 mother/child diad was conducted. Structured interview schedules were used to collect data on socio-demographic characteristics, food insecurity and household assets wealth. Height and weight were also measured. The results indicated the prevalence of child food insecurity was 38 per cent. More than 50 per cent were stunted and 36 per cent were underweight. Two-third underweight and 53 per cent stunted children were food insecure. Multivariate associations showed statistically significant inverse association of stunting and underweight with child food security status. Children from very low food secure households were 5.92 times more underweight and 4.14 times more stunted than food secure households. It was concluded tha...
Doctor’s main role and prior responsibility is medical treatment of patients. Doctors can also sh... more Doctor’s main role and prior responsibility is medical treatment of patients. Doctors can also share their expertise in nutrition care of patients in hospitals. Optimum nutrition affects both the response to medical treatments and eventually recovery. Doctors are usually perceived as the best source of information, by patients. In addition, they must provide some nutrition information to patients, in order to provide good care to patients. Doctors can motivate patients to eat healthy and also guide patients for dietary modifications to help in recovery. The present study, exploratory in nature, was carried out in Srinagar to have an insight and know the role and perspective in patient care especially in context of nutrition services, in the hospitals. The objective of the study was to investigate about if doctors were a part of nutrition care. Study sample consisted of 62 doctors, representing 2% from each hospital. Data was gathered using an interview schedule followed by observati...
Objective :To assess current infant feeding practices (IFP) in a relocated slum, to identity the ... more Objective :To assess current infant feeding practices (IFP) in a relocated slum, to identity the lacunae, to outline, implement, and evaluate the gain in awareness and IFP followed by mothers. Methods. Thirty-five mothers of infants aged 5-19 months were interviewed. Based on lacunae, Nutrition Education (NE) was imparted to mothers over two months. Tools used were individual counseling, participatory learning methods, positive deviance and early adopters approach aided with existing Information education communication materials. Monthly weight and length of infants was also taken. Awareness and practices on infant feeding (IF) were reviewed at mid and post NE. Results. Areas of concem at baseline were (i) discarding colostrum (77.0%), (il) feeding prelacteals (80.0%), (iil) initiation of breast-feeding (BF) after 3 days (54.3%), (/v) absence of exclusive breast-feeding (86.3%), (v) delayed complementary feeding (CF) and (w) feeding CF grossly inadequate in quality, quantity, frequency and consistency. Post NE results revealed an improved awareness about IF amongst the mothers. An improvement was seen in variety, quantity and consistency of CF fed. Active feeding behaviours were adopted (6.6% pre-NE vs 66.6% post-NE). Early adopters (24%) served as motivators. Weight for age and weight for length showed improvement. Conclusion: NE programs of shorter duration using a 'communication mix' of channels with repeated reinforcement can bring about improvement not only in awareness but also in IFP.
International Journal of Food Science, Nutrition and Dietetics, 2015
This cross sectional pilot study was conducted in a super specialty hospital of New Delhi, India ... more This cross sectional pilot study was conducted in a super specialty hospital of New Delhi, India to assess the nutritional status of the diabetic nephropathy patients undergoing haemodialysis. Thirty such patients aged 40-75 years, who were undergoing haemodialysis for about 1-3 years were selected via purposive sampling.
Background: The study tried to identify coping strategies adopted by urban slum dwellers to preve... more Background: The study tried to identify coping strategies adopted by urban slum dwellers to prevent the situation of food insecurity. Methods: A household-based cross-sectional study on a sample of 446 households was conducted. Structured interview schedule was used to collect data on coping strategies along with group discussions. Standard univariate analysis was done using SPSS (version-16). Results: Unique coping strategies were found to be adopted by households. Strategies included relying on less expensive foods like seasonal or locally available vegetables, limiting portion size of meals and reducing numbers of meals eaten in a day. To increase short-term availability of food, households borrowed food or lend money from friends or relatives, bought food on credit from private grocery shops, used reserves, and relied on food aid. Households ate at religious places in an attempt to increase access to food, withdrew children from school to save money on the school fees and also s...
Objective :To assess current infant feeding practices (IFP) in a relocated slum, to identity the ... more Objective :To assess current infant feeding practices (IFP) in a relocated slum, to identity the lacunae, to outline, implement, and evaluate the gain in awareness and IFP followed by mothers. Methods. Thirty-five mothers of infants aged 5-19 months were interviewed. Based on lacunae, Nutrition Education (NE) was imparted to mothers over two months. Tools used were individual counseling, participatory learning methods, positive deviance and early adopters approach aided with existing Information education communication materials. Monthly weight and length of infants was also taken. Awareness and practices on infant feeding (IF) were reviewed at mid and post NE. Results. Areas of concem at baseline were (i) discarding colostrum (77.0%), (il) feeding prelacteals (80.0%), (iil) initiation of breast-feeding (BF) after 3 days (54.3%), (/v) absence of exclusive breast-feeding (86.3%), (v) delayed complementary feeding (CF) and (w) feeding CF grossly inadequate in quality, quantity, frequency and consistency. Post NE results revealed an improved awareness about IF amongst the mothers. An improvement was seen in variety, quantity and consistency of CF fed. Active feeding behaviours were adopted (6.6% pre-NE vs 66.6% post-NE). Early adopters (24%) served as motivators. Weight for age and weight for length showed improvement. Conclusion: NE programs of shorter duration using a 'communication mix' of channels with repeated reinforcement can bring about improvement not only in awareness but also in IFP.
Nutritional Positive Deviant (PD) infants grow 'bigger' and 'faster' than other infants living in... more Nutritional Positive Deviant (PD) infants grow 'bigger' and 'faster' than other infants living in a similarly socioeconomically deprived environment. Certain positive feeding and care giving practices adopted by mothers of PD infants enable them rear better nourished and active infants. Limited data is available on using PD mothers as counselors encouraging appropriate and feasible infant feeding practices (IFP) in India. Hence, the present study was undertaken. The study was conducted in a slum of Delhi (India). Twenty-Five infants aged 6-12 months were weighed. Three infants with normal weight for age status (as per Gomez classification) were classified as PD infants. A PD inquiry (PDI) was conducted on current IFP in these families to identify PD behaviours adopted and determinants for the same. PD behaviours identified included: feeding modified family pot (energy dense) complementary food at least two times a day, supervised bowl feeding by the mother and father support to the mother in infant feeding and care giving. Two, of these three PD mothers volunteered to discuss the benefits of PD behaviours they had been practicing with the other 22 members of the group. The strategy promoted collective dialogue and discussion to try the PD behaviours through weekly group discussions over a period of four weeks. After four weeks, feeding modified family pot food with addition of 1 teaspoon of ghee (milk fat) in food (10/22), feeding an extra midday cereal snack (12/22) were PD behaviours adopted by other members of the group (22). It can be concluded that i) behaviours requiring least preparation time were easily adopted and ii) PD mothers can be effective counselors to encourage appropriate IFP.
India is undergoing rapid nutritional transition, resulting in excess consumption of calories, sa... more India is undergoing rapid nutritional transition, resulting in excess consumption of calories, saturated fats, trans fatty acids, simple sugars, salt and low intake of fiber. Such dietary transition and a sedentary lifestyle have led to an increase in obesity and diet-related non-communicable diseases (type 2 diabetes mellitus [T2DM], cardiovascular disease [CVD], etc.) predominantly in urban, but also in rural areas. In comparison with the previous guidelines, these consensus dietary guidelines include reduction in the intake of carbohydrates, preferential intake of complex carbohydrates and low glycemic index foods, higher intake of fiber, lower intake of saturated fats, optimal ratio of essential fatty acids, reduction in trans fatty acids, slightly higher protein intake, lower intake of salt, and restricted intake of sugar. While these guidelines are applicable to Asian Indians in any geographical setting, they are particularly applicable to those residing in urban and in semi-urban areas. Proper application of these guidelines will help curb the rising ''epidemics'' of obesity, the metabolic syndrome, hypertension, T2DM, and CVD in Asian Indians. 1 Affiliations and group members are given in Appendix 1.
« Nous sommes entrés dans un monde où toute figure peut se révéler n'être qu'un masque » 2 En sou... more « Nous sommes entrés dans un monde où toute figure peut se révéler n'être qu'un masque » 2 En souvenir de DD Résumé Concilier les exigences de l'action morale et les aspirations profondes d'un projet d'éducation pour la société, telle est la motivation qui a donné vie à cette contribution que nous jugeons modeste. En effet, la possibilité pour chacun de devenir meilleur dans le gouvernement de soi, la possibilité pour la société de connaitre l'harmonie, tout ceci ne va pas sans l'éducation aux valeurs. Mais qu'en est-il de l'observation des valeurs dans notre société, aujourd'hui diversement ouverte sur le monde au moyen de la mondialisation et d'internet ? Les valeurs ont-elles perdu de leur force contraignante ou s'inclinent-elles simplement devant la libre volonté de chacun à conduire sa vie à sa convenance ? Au constat, les individus sont sans cesse divisés entre l'obéissance aux valeurs et leur transgression toujours possible. Une situation paradoxale que cet article se propose d'examiner, avec pour objectif de redonner aux valeurs leur valeur de principes moraux inaliénables.
Nutritional data needed for holistic management of children with disabilities is inadequate in In... more Nutritional data needed for holistic management of children with disabilities is inadequate in India. Based on informed consent, this work examined the nutrition profile and feeding difficulties of 242 children, 2-16 years, with various disabilities. Over 80% children faced 3-15 different feeding problems, some being more pronounced in different disabilities. Mothers emerged as the main caregiver with several concerns about their child's diet. Dietary and anthropometric assessment indicated unbalanced, inadequate diets with about one third children underweight/stunted. WA, HA, BMI, MUAC, TSF, AMA and AFA emerged comparable for screening undernutrition. Knee height gave good result as a proxy measure for height across all disabilities. Children with cerebral palsy (CP) had maximum feeding problems and worst nutritional status with low energy, vitamin A and C, niacin and iron intake. Ten children with CP followed up for 6-9 months, showed positive impact of need based dietary coun...
The nurse is the hub of all activities in a hospital, centered on the patient, who makes the pati... more The nurse is the hub of all activities in a hospital, centered on the patient, who makes the patient get more individualised care. The present study was carried out in hospitals of Srinagar city (Jammu and Kashmir) to know the role of nurses in nutrition care of patients. A total of 11 hospitals registered under the Directorate of health services (Srinagar) capital of Jammu and Kashmir, India were included in the study. Hospitals were coded as (H1- H11) in order to maintain confidentiality. Data was collected using interview schedule through observation and discussion as well. The sample consisted of 62 nurses, representing 2% from each hospital. It involved gathering of both qualitative and quantitative data. A scoring pattern was formed to evaluate the nutrition care of patients by nurses. Senior staff nurses were interviewed taken from each hospital. Recommendations were developed after the conclusion was derived from the study. Results revealed that it was seen that most of the ...
Objective of the study was to assess the prevalence of food insecurity and malnutrition among you... more Objective of the study was to assess the prevalence of food insecurity and malnutrition among young children (6-36 months) in urban slums of India and its consequences on the nutritional status of the children. Household-based crosssectional study on a sample of 446 mother/child diad was conducted. Structured interview schedules were used to collect data on socio-demographic characteristics, food insecurity and household assets wealth. Height and weight were also measured. The results indicated the prevalence of child food insecurity was 38 per cent. More than 50 per cent were stunted and 36 per cent were underweight. Two-third underweight and 53 per cent stunted children were food insecure. Multivariate associations showed statistically significant inverse association of stunting and underweight with child food security status. Children from very low food secure households were 5.92 times more underweight and 4.14 times more stunted than food secure households. It was concluded tha...
Doctor’s main role and prior responsibility is medical treatment of patients. Doctors can also sh... more Doctor’s main role and prior responsibility is medical treatment of patients. Doctors can also share their expertise in nutrition care of patients in hospitals. Optimum nutrition affects both the response to medical treatments and eventually recovery. Doctors are usually perceived as the best source of information, by patients. In addition, they must provide some nutrition information to patients, in order to provide good care to patients. Doctors can motivate patients to eat healthy and also guide patients for dietary modifications to help in recovery. The present study, exploratory in nature, was carried out in Srinagar to have an insight and know the role and perspective in patient care especially in context of nutrition services, in the hospitals. The objective of the study was to investigate about if doctors were a part of nutrition care. Study sample consisted of 62 doctors, representing 2% from each hospital. Data was gathered using an interview schedule followed by observati...
Objective :To assess current infant feeding practices (IFP) in a relocated slum, to identity the ... more Objective :To assess current infant feeding practices (IFP) in a relocated slum, to identity the lacunae, to outline, implement, and evaluate the gain in awareness and IFP followed by mothers. Methods. Thirty-five mothers of infants aged 5-19 months were interviewed. Based on lacunae, Nutrition Education (NE) was imparted to mothers over two months. Tools used were individual counseling, participatory learning methods, positive deviance and early adopters approach aided with existing Information education communication materials. Monthly weight and length of infants was also taken. Awareness and practices on infant feeding (IF) were reviewed at mid and post NE. Results. Areas of concem at baseline were (i) discarding colostrum (77.0%), (il) feeding prelacteals (80.0%), (iil) initiation of breast-feeding (BF) after 3 days (54.3%), (/v) absence of exclusive breast-feeding (86.3%), (v) delayed complementary feeding (CF) and (w) feeding CF grossly inadequate in quality, quantity, frequency and consistency. Post NE results revealed an improved awareness about IF amongst the mothers. An improvement was seen in variety, quantity and consistency of CF fed. Active feeding behaviours were adopted (6.6% pre-NE vs 66.6% post-NE). Early adopters (24%) served as motivators. Weight for age and weight for length showed improvement. Conclusion: NE programs of shorter duration using a 'communication mix' of channels with repeated reinforcement can bring about improvement not only in awareness but also in IFP.
International Journal of Food Science, Nutrition and Dietetics, 2015
This cross sectional pilot study was conducted in a super specialty hospital of New Delhi, India ... more This cross sectional pilot study was conducted in a super specialty hospital of New Delhi, India to assess the nutritional status of the diabetic nephropathy patients undergoing haemodialysis. Thirty such patients aged 40-75 years, who were undergoing haemodialysis for about 1-3 years were selected via purposive sampling.
Background: The study tried to identify coping strategies adopted by urban slum dwellers to preve... more Background: The study tried to identify coping strategies adopted by urban slum dwellers to prevent the situation of food insecurity. Methods: A household-based cross-sectional study on a sample of 446 households was conducted. Structured interview schedule was used to collect data on coping strategies along with group discussions. Standard univariate analysis was done using SPSS (version-16). Results: Unique coping strategies were found to be adopted by households. Strategies included relying on less expensive foods like seasonal or locally available vegetables, limiting portion size of meals and reducing numbers of meals eaten in a day. To increase short-term availability of food, households borrowed food or lend money from friends or relatives, bought food on credit from private grocery shops, used reserves, and relied on food aid. Households ate at religious places in an attempt to increase access to food, withdrew children from school to save money on the school fees and also s...
Objective :To assess current infant feeding practices (IFP) in a relocated slum, to identity the ... more Objective :To assess current infant feeding practices (IFP) in a relocated slum, to identity the lacunae, to outline, implement, and evaluate the gain in awareness and IFP followed by mothers. Methods. Thirty-five mothers of infants aged 5-19 months were interviewed. Based on lacunae, Nutrition Education (NE) was imparted to mothers over two months. Tools used were individual counseling, participatory learning methods, positive deviance and early adopters approach aided with existing Information education communication materials. Monthly weight and length of infants was also taken. Awareness and practices on infant feeding (IF) were reviewed at mid and post NE. Results. Areas of concem at baseline were (i) discarding colostrum (77.0%), (il) feeding prelacteals (80.0%), (iil) initiation of breast-feeding (BF) after 3 days (54.3%), (/v) absence of exclusive breast-feeding (86.3%), (v) delayed complementary feeding (CF) and (w) feeding CF grossly inadequate in quality, quantity, frequency and consistency. Post NE results revealed an improved awareness about IF amongst the mothers. An improvement was seen in variety, quantity and consistency of CF fed. Active feeding behaviours were adopted (6.6% pre-NE vs 66.6% post-NE). Early adopters (24%) served as motivators. Weight for age and weight for length showed improvement. Conclusion: NE programs of shorter duration using a 'communication mix' of channels with repeated reinforcement can bring about improvement not only in awareness but also in IFP.
Nutritional Positive Deviant (PD) infants grow 'bigger' and 'faster' than other infants living in... more Nutritional Positive Deviant (PD) infants grow 'bigger' and 'faster' than other infants living in a similarly socioeconomically deprived environment. Certain positive feeding and care giving practices adopted by mothers of PD infants enable them rear better nourished and active infants. Limited data is available on using PD mothers as counselors encouraging appropriate and feasible infant feeding practices (IFP) in India. Hence, the present study was undertaken. The study was conducted in a slum of Delhi (India). Twenty-Five infants aged 6-12 months were weighed. Three infants with normal weight for age status (as per Gomez classification) were classified as PD infants. A PD inquiry (PDI) was conducted on current IFP in these families to identify PD behaviours adopted and determinants for the same. PD behaviours identified included: feeding modified family pot (energy dense) complementary food at least two times a day, supervised bowl feeding by the mother and father support to the mother in infant feeding and care giving. Two, of these three PD mothers volunteered to discuss the benefits of PD behaviours they had been practicing with the other 22 members of the group. The strategy promoted collective dialogue and discussion to try the PD behaviours through weekly group discussions over a period of four weeks. After four weeks, feeding modified family pot food with addition of 1 teaspoon of ghee (milk fat) in food (10/22), feeding an extra midday cereal snack (12/22) were PD behaviours adopted by other members of the group (22). It can be concluded that i) behaviours requiring least preparation time were easily adopted and ii) PD mothers can be effective counselors to encourage appropriate IFP.
India is undergoing rapid nutritional transition, resulting in excess consumption of calories, sa... more India is undergoing rapid nutritional transition, resulting in excess consumption of calories, saturated fats, trans fatty acids, simple sugars, salt and low intake of fiber. Such dietary transition and a sedentary lifestyle have led to an increase in obesity and diet-related non-communicable diseases (type 2 diabetes mellitus [T2DM], cardiovascular disease [CVD], etc.) predominantly in urban, but also in rural areas. In comparison with the previous guidelines, these consensus dietary guidelines include reduction in the intake of carbohydrates, preferential intake of complex carbohydrates and low glycemic index foods, higher intake of fiber, lower intake of saturated fats, optimal ratio of essential fatty acids, reduction in trans fatty acids, slightly higher protein intake, lower intake of salt, and restricted intake of sugar. While these guidelines are applicable to Asian Indians in any geographical setting, they are particularly applicable to those residing in urban and in semi-urban areas. Proper application of these guidelines will help curb the rising ''epidemics'' of obesity, the metabolic syndrome, hypertension, T2DM, and CVD in Asian Indians. 1 Affiliations and group members are given in Appendix 1.
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