Search

Upgrading, maintenance and rehabilitation of road infrastructure is expensive, especially in view of the growing scarcity and cost of suitable road building materials. In areas with high mica content and secondary minerals such as smectite in the natural materials, stabilisation with cement is not viable. The Council for Scientific and Industrial Research of South Africa has embarked on a research programme to evaluate the performance of substandard materials improved with anionic nano-silane modified bitumen emulsions for use in base and subbase layers. This work comprises laboratory testing as well as Accelerated Pavement Testing using the Heavy Vehicle Simulator (HVS). The results of a full-scale HVS test on a light pavement as well as initial analysis on a medium traffic road are discussed. It has been shown that stabilisation of available substandard materials using an anionic nano-silane modified bitumen emulsion compared with the standard approach of importing high quality crushed aggregate can lead to savings as high as 40%–50% for equivalent performance. In addition, there was also a significant reduction in construction effort and time. [ABSTRACT FROM AUTHOR]

The purpose of this article is to provide updated information by identifying and discussing methods, measures and indicators for evaluating benefits appropriate for transportation-related research facilities/programmes. The information has been drawn from within and outside transportation research. The article discusses the sources driving the need for evaluating benefits and describes the challenges confronting the evaluation process. It reviews and compares qualitative and quantitative techniques and highlights previous published work, investigations and case studies. Many traditional challenges of determining benefits persist, contributing to the gap between the ability to identify non-technical benefits of research and the growing need to demonstrate such benefits. This article aims to stimulate dialogue and investigations to advance the development of an appropriate robust method to determine quantitative benefits stemming from specifically accelerated pavement testing (APT) type transportation research. The ultimate goal is to help better understand, demonstrate and communicate the benefits of APT research. [ABSTRACT FROM PUBLISHER]

Objectives: The objective of the study was to compare the infant-feeding practices of two subdistricts with different baby-friendly status in Mpumalanga province, South Africa. Design: This was a cross-sectional, descriptive, observational study with an analytical component. Eighteen fieldworkers assisted with the data collection, utilising two sets of interviewer-administered questionnaires -- one on socio-demographic information and the other on infant-feeding practices. Subjects: Mothers with infants from birth to six months old, attending postnatal care at public sector primary health care facilities in Emalahleni and Mbombela health subdistricts on the days of data collection were included. A total of 435 mother and infant pairs were included in the study. Outcome measures: Five infant-feeding indicators were used, namely the early initiation of breastfeeding, exclusive breastfeeding, exclusive replacement feeding and mixed feeding rates, as well as the age at which complementary food was introduced. Results: There was a significantly higher early initiation of breastfeeding (57% vs. 43%), exclusive breastfeeding rates (60% vs 48%), and a lower exclusive replacement feeding rate (18% vs. 33%) in Emalahleni subdistrict, where all the public sector maternity facilities are accredited as being baby friendly, compared to that in Mbombela subdistrict, where none of the public sector maternity facilities are baby friendly. The mixed feeding rate (19% vs. 15%) and the mean age of the introduction of complementary foods (50 days versus 35 days) did not differ significantly between the two subdistricts. Conclusion: Implementation of the Baby-Friendly Hospital Initiative (BFHI) in a health subdistrict was associated with more optimal infant-feeding practices in mothers with infants aged six months and younger. It is concluded that strengthening practices prescribed within the BFHI would improve infant-feeding practices at community level. [ABSTRACT FROM AUTHOR]

This paper aims to summarise current evidence and highlight best practices, in order to propose a paediatric food-based dietary guideline (FBDG) on exclusive breastfeeding for South Africa. A literature search was conducted to profile the current nutritional status of children and breastfeeding practices in South Africa, reflect on the commitment and capacity that has been pledged and built for exclusive and continued breastfeeding over the past five years, and highlight the action needed to improve infant and young child feeding practices in the country. From the review, it was clear that the nutritional status of children and breastfeeding practices in South Africa remain unsatisfactory. The evidence base supporting the importance of exclusive and continued breastfeeding on a global and local level has been broadened. There are comprehensive and practical international guidelines to guide the protection, promotion of, and support for breastfeeding. Comprehensive and sound national and provincial policies and guidelines have also been developed in South Africa. The political will to address infant and young child feeding has been advanced and demonstrated, and a supportive environment created through commitment and capacity building. There is a need for focused action addressing adequate monitoring and evaluation of processes during all stages of the implementation of evidence-based and theoretical planning. These actions should drastically improve exclusive and continued breastfeeding and advance the health and survival of children in South Africa. The recent momentum gained in support of improving infant and young child feeding could further be enhanced by the process of reviewing the preliminary South African paediatric FBDG and field testing the following proposed message: “Give only breast milk, and no other foods or liquids, to your baby for the first six months of life”. [ABSTRACT FROM AUTHOR]

This paper aims to propose evidence-based, paediatric food-based dietary guidelines on the complementary feeding period, from six to 24 months, of South Africa. A growing body of evidence supports the World Health Organization recommendation that, following six months of exclusive breastfeeding, appropriate and adequate complementary foods should be introduced, with continued breastfeeding for up to two years of age and beyond. A literature search was done by searching electronic databases (PubMed, the Cochrane Library and Sabinet) and hand searching key reference lists from January 2004 to April 2012, including studies published prior to 2004. Relevant international and national documents from normative bodies, global health and infant feeding authorities, professional and scientific societies and government were identified. It has been established that, in South Africa, high levels of stunting, growing concerns about overweight and obesity and the poor intake of certain micronutrients in the critical six- to 24-month period are, in part, a consequence of poor breastfeeding and complementary feeding practices, as well as the poor quality of the complementary diet. The introduction of semi-solid foods before four months of age is a common practice. The typical maize-based feeding pattern is low in food sourced from animals, vegetables and fruit and omega-3 fatty acids. Efforts by mothers to improve the quality of their children’s diets by adding energy-rich food to maize meal improves energy intake, but not micronutrient intake. Low nutrient-dense liquid, such as tea and coffee, energy-dense sugar-sweetened drinks, an excessive intake of fruit juice and high-fat and salty snacks exacerbate poor nutrient intake and displace nutrient-dense food in the diet. Healthcare workers should provide consistent, evidence-based messages and guidelines to caregivers of future generations. Interventions must be implemented and strengthened at a programme level. These could include nutrition education to improve caregiver practices, the use of high-quality, locally available foods, the use of enriched complementary foods, and exceptional support of food-insecure populations. [ABSTRACT FROM AUTHOR]

The Baby-Friendly Hospital Initiative (BFHI) is a global effort to improve the role of maternity services and to enable mothers to breastfeed their infants, thus ensuring the best start in life for their infants. The foundation for the BFHI is the Ten Steps to Successful Breastfeeding (BF). It has been shown, however, that the selective implementation of only some of the steps may be ineffective and discouraging to successful BF practices. An initial study was therefore conducted to assess the extent of the implementation of the Ten Steps in both public and private maternity facilities. Poor performance for some steps led to a follow-up study to investigate the knowledge and attitudes of health care workers (HCWs) and mothers alike and to evaluate the exclusive BF (EBF) practices of mothers attending private BF clinics. Both studies followed descriptive, cross-sectional designs and were set in the Cape Metropole in the Western Cape. Twenty-six maternity facilities participated in the initial study, for which observation lists were completed and verified by interviewer-administered questionnaires to both HCWs and mothers. Eighteen private BF clinics participated in the follow-up study, which included observations and interviewer-administered questionnaires to 25 HCWs and 64 mothers. During the initial study, lower mean scores were noted for Steps 1, 2, 6 and 10. The overall implementation of the Ten Steps was average. The findings highlighted the importance of the establishment and implementation of BF policies, of appropriate and continuous BF training and better referral systems to ensure initiation and establishment of early BF, EBF practices and support on an ongoing basis to ensure the best start in life for infants. [ABSTRACT FROM AUTHOR]

A great need exists for ongoing breastfeeding training. Students of today relate well to computers in the learning environment. In this study, computer-based learning (CBL) was explored in the context of breastfeeding training for undergraduate Dietetic students. Aim: To adapt and validate an Indian computer-based undergraduate breastfeeding training module for use by South African undergraduate Dietetic students. Methods and materials: The Indian module was adapted to suit the South African scenario and converted into low-bandwidth, interactive computer-based material. It was assessed for face and content validity by 19 peer reviewers and 17 third-year Stellenbosch University (SU) Dietetic student reviewers by means of self-administered questionnaires. Impact of the adapted module on knowledge was evaluated on second-year SU (n = 14) and University of the Western Cape (UWC) (n = 15) Dietetic students by means of pre- and post-knowledge tests. Results: All reviewers rated their information technology (IT) skills as sufficient and enjoyed the presentation mode of the adapted module. Student reviewers indicated that CBL was a "nice way of learning", but requested that it should not be used as the sole source of instruction. Fifty three per cent (n = 19) of the reviewers rated CBL to be equally effective compared to conventional lectures, 36% (n = 13) rated it as being more effective and 11% (n = 4) as less effective. Pre- and post-knowledge test scores showed a significant increase (SU p < 0.0001 and UWC p < 0.00115). Conclusion: It is recommended that validated computer-based breastfeeding training modules be integrated as part of multi-media methods to increase coverage and enhance breastfeeding learning for undergraduate Dietetic students. Other students of health care professions and health care workers may also benefit from such modules. [ABSTRACT FROM AUTHOR]

The authors reflect on the role of access to nutrient and food intake data on the struggle against malnutrition in South Africa. They argue that nutrition interventions depend on food intake data, which has limitations including the daily variation of food intake, incorrect reporting, and coding errors. They mention that supplementation provides short-term measure but does not address the cause of malnutrition. The creation of a working committee for data accessibility is also suggested.