Causes and Risk Factors Associated with Ventricular Assist Device - Assignment Example

Running Header: Journal article analysis Your name: Course name: Professors’ name: Date Question 1 Causes and risk factors associated with VAD, its effects and those populations most at risk. Vitamin A deficiency is a medical condition associated with lack of vitamin A in the body of an individual and by extension lack of Vitamin A in the diet. Vitamin A is in a class of vitamins that is essential majorly for the proper functioning of the visual system but is also vital for general body growth and that of the immune system. Vitamin A deficiency is therefore classified with regard to severity to the effects of the visual system of an individual, basically the eye. Night blindness is the major illness associated with Vitamin A deficiency; others will include xerophthalmia, outright blindness, Bitot’s spot, and effects on cornea like drying, ulceration and scarring de (Benoist, Andersson, Takkouche, & Egli 2003, p.1859). Causes of Vitamin A deficiency varies depending on the age of children, in infants the condition is majorly caused by premature stoppage of breast feeding, this is because at this age the baby entirely depends on the breast milk for nutrients uptake. Vitamin A deficiency in older children is however attributed to lack of vitamin A in the diet. Sources of vitamin A include fish, meat, milk and green vegetables. Other causes for children include infectious diseases like measles which depletes the body of stored vitamin A (Hotz & Loechl, et al 2012, p.163). The main effect of Vitamin A deficiency on children is the functionality of the immune system which leaves the body vulnerable to diseases. Children with Vitamin A deficiency are likely to suffer secondary critical illnesses which may vary from measles, diarrhoea and such may lead to child mortality. Another population group at risk is the pregnant women. Vitamin A deficiency mainly occurs during the last trimester of the pregnancy and may lead to night blindness and is some cases maternal mortality. Question 2 Global approaches that have been used to control VAD and other micronutrient deficiencies Several approaches have been implemented in various parts of the world to control Vitamin A deficiency and other nutrient deficiencies with different level of success. In developed countries where such deficiencies have totally been eliminated, the main approach used was improvement of diet to incorporate the vital micronutrients. Poorer countries especially in Africa and Asia cannot achieve this in totality since it’s too costly. The major disadvantage of this approach lies in the cost factor (Sommer 1994, p.60). The second approach used is supplementation, here affected population or vulnerable groups are given supplements of the micronutrients or vitamins to supplement their normal intake. Supplementation is more of a remedial approach of dealing with micronutrients deficiencies and substantial levels of success has been achieved. According to Van (2003, p.149) studies have shown that 34-40% reduction of child mortality have been achieved through supplementation of Vitamin A. Other studies have shown that work output increased up to 17% after iron supplementation was implemented. The main advantage of supplementation as seen from the studies is that rapid results can easily be achieved (Sommer 1994, p.60). The third approach is the fortification of commonly used ingredients in households such as sugar and salt. This approach may achieve limited success compared to the other methods discuss herein as studies have shown that the magnitude of the deficiencies still remain high in areas where it has been implemented. Another approach that has achieved significant success is the introduction of pro-vitamin A rich plants in areas where VAD is prevalent. Introduction of vitamin A rich fruits, vegetables and notably OSP in Sub-Saharan region in Africa and South East Asia has achieved notable success. Studies shows that this is approach could be the best since is relatively cost effective and successful as compared to the other approaches (Sommer 1994, p.60). Question 3 Nutritional outcome measures of the study, methods used to collect data on nutritional intake. The study showed that there was big impact on average intake of vitamin A during the project. This is because the project focussed on a staple food rather than seasoned foods like fruits. Prevalence of inadequate vitamin A greatly decreased among children and women at between 32 to 55%. In younger non-breast fed children aged between 12 to 35 months, the prevalence decreased only by 7 to 16 %. This can be attributed to the small consumption portions of vitamin A rich foods as compared to their high requirements (Zimmerman, Jooste & Pandav 2008, p.1252). In this particular study the biochemical and clinical indicators of vitamin A were not included; however a previous study on OSP in the same area had indicated a success. Therefore this particular study did not focus much on the nutritional outcome but rather on large scale adoption and increased OSP intake among the targeted groups. The method used for data collection was the interactive multiple pass method. A sample of 30 individuals per each age group was targeted. The women in the sample were trained on how to recall the types of food, recipe used, and the portions consumed by the individuals sampled. In some households the amount of food consumed and the portion sizes was recorded using photographs. Actual cooked foods were also used as part of the sample. The interviews conducted captured the list of foods consumed, the state at which they were consumed, ingredients added and how the foods were processed. The actual foods or clay modelled potions were then weighed of measured volumetrically (Hotz & Loechl, C et al 2012, p.164). The weighed foods were converted into energy and vitamin intakes using a food composition table that was designed for the project. Question 4 Anthropometric indices used in this study, Growth monitoring. The anthropometric indices used in the study were weight against height, height against age and weight against age both in children and women. Both groups were weighed at the baseline of the study and at the end of the study and BMI calculated for comparison purposes. As noted by Hotz & Loechl, C et al (2012, p.164) at the baseline of the study, it was noted that there was a high prevalence in stunting among children, it was also noted that prevalence of underweight children was between moderate and high indicating general malnutrition among the group as per the standards of WHO. This is a pointer that lack of vitamin A in the diet inhibits growth of children. Pregnant women recorded better BMI measurements indicating low underweight prevalence in this target group. Studies have shown that lack of iodine in the body could lead to impaired mental functionality and general poor physical development in children. In adults goiter and impaired functionality can also be attributed to lack of iodine. In the study of iron deficiency anemia, it was noted that women in developing countries are likely to be adversely affected as compared to those in industrialized countries. The same studies also showed that individual suffering from anemia have lower throughput in a physical work environment. As seen from the research, in households where a community level volunteer resided, the outcome was significantly different as compared to the individuals where a volunteer did not reside. This indicates that when monitoring is done closely the results obtained are better. Growth monitoring allows researchers and policy implementers to follow through the study and implementation progress so that the success or failure of the project can be measured. This will allow the implementers to either improve on the approach used or to revert to a new approach as the implementation progresses (Hotz & Loechl, C et al 2012, p.164). Question 5 Main components of the intervention The primary objective of the project was to improve the intake of orange sweet potatoes in the selected region through a large scale intervention for a period of 3 years. This was approached through 3 major components for effective intervention. 1. Agricultural component; this involved distribution of the planting material i.e. OSP vines, training on farming of the vines, pest and disease control (Hotz & Loechl, C et al 2012, p.163). 2. Demand creation/behavior change component; This was done through road shows and radio programs and focused on general education to sensitize the pubic on the benefits of the orange sweet potatoes as a vital source of vitamin A. The component target group was the women participating in the study. 3. Marketing and product development component; this involved training of a small group of targeted traders, medium scale growers and business owners on the sale of the orange sweet potatoes. It also involved establishment of stall which were to be used for sale of the orange sweet potatoes and for general information dissemination. Implementation Implementation was done in 2 models, in the first model; participating groups in the community received agricultural, health and nutritional training from agricultural and nutrition extensionists and supported through refresher courses in the subsequent 2 years. In the second model, training was only conducted in the first year to vary the intensity of the two models (Hotz & Loechl et al 2012, p.167). The extensionists trained community based volunteers who in turn supported the community participants through group sessions. Findings of the study After the 3 years of the project intervention, the households that participated in the study had successfully incorporated orange sweet potatoes in their diets. The general acceptance of the crop by the community to incorporate orange sweet potatoes in the regular production would be a boost to their food security since it had proven to be a vital source of vitamin A (Hotz & Loechl et al 2012, p.164). References de Benoist, B, Andersson, M, Takkouche, B. & Egli, I 2003, Prevalence of iodine deficiency worldwide. The Lancet, vol. 362, no.9398, pp.1859--‐1860. Hotz, C & Loechl, C et al 2012, A large-scale intervention to introduce orange sweet potato in rural Mozambique increases vitamin A intakes among children and women, British Journal of Nutrition, vol.108, no.1, pp. 163–176. Sommer, A 1994, Vitamin A: its effect on childhood sight and life, Nutrition Reviews, vol. 52, no.2, pp. 60-66. Van DN 2003, Anaemia and micronutrients deficiencies, British Medical Bulletin, vol. 67, no.1, pp. 149-160. Zimmerman, MB, Jooste, PL & Pandav, CV 2008, Iodine-deficiency disorders, The Lancet, vol.372, no. 9645, pp.1251-1262. Read More