Supplemental Program Research Articles

Iron, folic acid, and vitamin D supplementation during pregnancy: Did pregnant Chilean women meet the recommendations during the COVID pandemic?

Antenatal micronutrient supplementation has been defined as a priority for Low-and Middle-income Countries (LMICs). However, it is also relevant to assess its performance in middle-high income countries, such as Chile, particularly given the post-pandemic food insecurity context. To assess the use (frequency and doses) of daily recommended supplementation (iron (15-30 mg), folic acid (FA) (400-800 μg/day), and vitamin (VD) (400 IU)) in a sample of Chilean pregnant women. In 1, 507 pregnant women selected from public health care registries of the Southeast area of Santiago-Chile, we collected maternal, supplement use, sociodemographic, and nutritional information at the first (<15 weeks), second (24-28 weeks), and third trimesters (32-36 weeks) of gestation by using a researcher administer online questionnaire. The median (IQR) age of women was 29 (25-33) years. Pre-conceptional supplementation was rare (24%), but it reached >93% in the first trimester; thereafter supplement use decreased to 79% in the second and 84% in the third trimesters, particularly in women with lower income (p<0.05), lower education (p<0.05), and with excess weight (p<0.05). Use of iron supplements in the first trimester was rare (<21%) as well as the use of VD supplements across pregnancy (<31%). Most FA (70%) and iron (80%) supplement users, exceeded the recommended daily dose while ~40% of VD users took less than the recommended dose. In this sample of Chilean women, timely initiation of FA, iron, and VD supplementation was low and doses were not aligned with the recommendations. Strengthening adherence and quality of micronutrient supplementation programs delivered through public primary care could benefit particularly the most vulnerable women.

Evaluasi Pemberian Makanan Tambahan pada Ibu Hamil dengan Kekurangan Energi Kronis (KEK) dari Program Corporate Social Responsibility (CSR) di Wilayah Kerja Puskesmas Tegal Angus Kabupaten Tangerang Tahun 2022

The condition of pregnant women who are at risk of CED can cause a decrease in the ability of the muscles that support the birth process. This can cause prolonged labor as well as bleeding, which is dangerous for the mother. Based on this, PT. Agung Sedayu Group pays special attention to the condition of chronic energy deficiency in pregnant women by creating a supplementary food program in the form of a unique and complete menu in the hope of helping to reduce the prevalence of chronic energy deficiency in pregnant women. The aim of this research is to find out how to evaluate the provision of additional food to pregnant women with chronic energy deficiency (KEK) from the Corporate Social Responsibility (CSR) program in the Tegal Angus Community Health Center work area in 2022. This type of research applies the Mixed Methods method with a Sequential Explanatory design The design starting from the first step of the research was carried out using quantitative methods and the second step was carried out using qualitative methods. Secondary data collection techniques were taken from Community Health Center data, while primary data were collected using in-depth interviews. Data analysis was carried out using the Wilxocon test. The research results showed that there were differences in the nutritional status of KEK pregnant women seen from LiLA with a significance value of 0.000 (p

Change in Mineral Status After Bariatric Surgery: a Meta-analysis.

The risk of protein and vitamin deficiencies after bariatric surgery has been well studied, but the change in mineral status has not gotten enough attention. This study aimed to perform a meta-analysis regarding the change in mineral levels after bariatric surgery and the prevalence of postoperative mineral deficiency, with subgroup analyses of different surgical procedures, study regions, and follow-up time. CENTRAL, PubMed, and EMBASE were searched for related articles. Meta-analysis, subgroup analysis, and sensitivity analysis were performed if necessary. A total of 107 articles with 47,432 patients were included. The most severe mineral deficiency after bariatric surgery was iron (20.1%), followed by zinc (18.3%), copper (14.4%), chlorine (12.2%), phosphorus (7.5%), and calcium (7.4%). Serum concentrations of potassium, sodium, selenium, manganese, and molybdenum showed no significant change before and after surgery. Subgroup analyses revealed that SG had fewer deficiencies in serum iron, calcium, zinc, magnesium, phosphorus, copper, and selenium than RYGB. OAGB showed a higher incidence of serum iron and zinc deficiencies than RYGB. Studies conducted in different regions also found various mineral statuses after surgery. Studies with follow-up ≥ 5 years had a lower prevalence of zinc, copper, and selenium deficiencies than follow-up < 5 years. A high deficiency rate of serum iron, zinc, copper, chlorine, phosphorus, and calcium was seen after bariatric surgery. The difference in surgical procedures, study regions, and follow-up time may affect postoperative mineral status; more targeted mineral supplement programs are needed considering these influencing factors.

Evaluation of the deficiency status of 25-hydroxyvitamin D and associated factors in Southwest China: A hospital-based retrospective cross-sectional analysis of a low-latitude, high-altitude, multiracial region.

Vitamin D deficiency is widespread in different populations and regions worldwide and has become a global health issue. The vitamin D status of the population in the Yunnan Province of Southwest China has not been evaluated to date. Therefore, in this study, we evaluated the vitamin D status according to the serum concentrations of 25-hydroxyvitamin D (25(OH)D) in individuals of Yunnan Province, a low-latitude, high-altitude and multiracial region in China. The data on 25(OH)D concentrations from October 2012 to December 2017 were retrospectively collected and assessed using the laboratory information system from 52 950 hospital-based participants (age, 1 day-96 years; females, 73.74%). The serum concentration of 25(OH)D was evaluated using a chemiluminescent immunoassay. The analysis was stratified by sex, age, sampling season, testing year, minority, residential district, latitude, altitude and meteorological factors. Vitamin D status was classified as follows: severe deficiency: <10 ng/mL; deficiency: <20 ng/mL; insufficiency: <30 ng/mL; and sufficiency: ≥30 ng/mL. The results showed that vitamin D deficiency is highly prevalent in Yunnan Province in a hospital-based cohort, with a deficiency and severe deficiency rate of 65.1% and a sufficiency rate of 5.30%. Significantly lower vitamin D levels and sufficiency rates were observed in females than in males (20.13 ± 7.22 ng/mL vs. 17.56 ± 6.66 ng/mL and 8.20% vs. 4.20%; p < 0.01, respectively); in spring and winter (16.93 ± 6.24 ng/mL; 2.97% and 16.38 ± 6.43 ng/mL; 3.06%, respectively) than in summer and autumn (20.23 ± 7.14 ng/mL; 8.02% and 19.10 ± 6.97 ng/mL; 6.61% [p < 0.01], respectively); and in older individuals (0-6 years: 28.29 ± 13.13 ng/mL vs. >60 years: 14.88 ± 8.39 ng/mL; p < 0.01). Relatively higher vitamin D levels were observed in individuals of Yi, Zhuang, Hani, Dai, Miao and Lisu minorities and lower levels in individuals of Hui and Zang minorities compared with those of the Han nationality (p < 0.01). The mean sunlight duration, mean air temperature, maximum ultraviolet value and latitude were significantly correlated with vitamin D levels (r = -0.53, 0.60, 0.31, -0.68, respectively; p < 0.05). These results suggest that vitamin D status is influenced by sex, age, minority, latitude and some meteorological factors in areas with high and low altitudes. Hence, new public health policies, such as advice on sunshine exposure, food fortification and nutrition education, as well as the implementation of vitamin D supplementation programmes must be considered to alleviate vitamin D deficiency in Yunnan province, Southwest China.

Safe and effective delivery of supplemental iron to healthy adults: a two-phase, randomized, double-blind trial - the safe iron study.

The safety of novel forms of iron in healthy, iron-replete adults as might occur if used in population-based iron supplementation programs was examined. We tested the hypotheses that supplementation with nanoparticulate iron hydroxide adipate tartrate (IHAT), an iron-enriched Aspergillus oryzae product (ASP), or ferrous sulphate heptahydrate (FS) are safe as indicated by erythrocyte susceptibility to malarial infection, bacterial proliferation, and gut inflammation. Responses to FS administered daily or weekly, and with or without other micronutrients were compared. Two phases of randomized, double-blinded trials were conducted in Boston, MA. Phase I randomized 160 volunteers to six treatments: placebo, IHAT, ASP, FS, and FS plus a micronutrient powder (MNP) administrated daily at 60 mg Fe/day; and FS administered as a single weekly dose of 420 mg Fe. Phase II randomized 86 volunteers to IHAT, ASP, or FS administered at 120 mg Fe/day. Completing these phases were 151 and 77 participants, respectively. The study was powered to detect effects on primary endpoints: susceptibility of participant erythrocytes to infection by Plasmodium falciparum, the proliferation potential of selected pathogenic bacteria in sera, and markers of gut inflammation. Secondary endpoints for which the study was not powered included indicators of iron status and gastrointestinal symptoms. Supplementation with any form of iron did not affect any primary endpoint. In Phase I, the frequency of gastrointestinal symptoms associated with FS was unaffected by dosing with MNP or weekly administration; but participants taking IHAT more frequently reported abdominal pain (27%, p < 0.008) and nausea (4%, p = 0.009) than those taking FS, while those taking ASP more frequently reported nausea (8%, p = 0.009). Surprisingly, only 9% of participants taking IHAT at 120 mg Fe/day (Phase II) reported abdominal pain and no other group reported that symptom. With respect to the primary endpoints, few differences were found when comparing these forms of iron, indicating that 28 days of 60 or 120 mg/day of IHAT, ASP, or FS may be safe for healthy, iron-replete adults. With respect to other endpoints, subjects receiving IHAT more frequently reported abdominal pain and nausea, suggesting the need for further study. ClinicalTrials.gov, NCT03212677; registered: 11 July 2017.

Correlation between Knowledge and Attitude with Compliance with Blood Supplement Tablet Consumption in SMAN 10 Students in the Working Area of Puskesmas Andalas, Padang City

The high incidence of anemia occurs in the adolescent age group and female sex. In preventing anemia and reducing the incidence of anemia in Indonesia, the government is holding a blood-added tablet supplementation program for young girls at school. To support the program, this research was carried out with the aim of knowing the relationship between knowledge and attitude with adherence to blood supplement consumption by female students of SMAN 10 in the working area of the Andalas Health Center, Padang City. This research was conducted from March to June 2023. The method used was an observational analytic design, the sampling technique used was purposive sampling which met the inclusion and exclusion criteria. The sample used in this study was female students of SMAN 10 in the working area of the Andalas Public Health Center, Padang City. The results of the univariate test of SMAN 10 female students in the work area of the Andalas Health Center, Padang City, most of them had high knowledge (66.5%), negative attitudes (55.7%), low compliance (74.3%). Then the results of the chi square test obtained that the relationship between knowledge and attitudes did not have a significant relationship with a P value of 0.542 (≥ 0.05), and the relationship between attitude and adherence to consumption of iron tablets had a significant relationship with a P value (≤ 0.05).

Effect of community based nutritional education on knowledge, attitude and compliance to IFA supplementation among pregnant women in rural areas of southwest Ethiopia: a quasi experimental study

BackgroundCompliance with the iron folic acid supplementation is low and not at the required level to prevent anaemia during pregnancy in many countries, including Ethiopia, even though an iron-folic acid supplementation program is being implemented. The aims of this study were to determine the effect of community-based nutritional education on knowledge, attitude, and compliance to IFA supplementation in Ilu Aba Bor zone of southwest Ethiopia.MethodA pretest–posttest quasi-experimental study design consisting of intervention and control group was conducted among pregnant women. The total sample size of 472, therefore, 236 pregnant women for each interventional and control group from 16 kebeles were randomly selected in two districts. A multi-stage sampling technique was used to select the study participants. Then, individual study units were selected using a simple random sampling technique and followed until the end of the study period. Effect of community-based nutritional education on knowledge, attitude, and compliance to IFA supplementation among pregnant women in rural areas were measured.ResultsA total of 472 pregnant women participated in the study during the baseline and 437 (92.6%) were in the study until the end. The majority (49.2%) of respondents were 21–25 years of age, with a mean age of 23.4 (SD = 3.7) years. Community-based nutrition has resulted in a statistically significant increase in levels of maternal knowledge of IFAS by 15.2% in the intervention group compared to 5.1% in the control group. Similarly, the intervention group had odds of developing a positive attitude toward IFA 5.6 (4.01, 7.85) times higher than the control group. Moreover, in this study, the odds of compliance towards IFA supplementation were 3.9 (2.67, 5.57) times higher among those who received nutrition education than those women who did not.ConclusionThis study revealed that community-based nutritional education can result in a significant change in knowledge, attitude, and compliance towards IFA supplementation and supports the literature suggesting the importance of the intervention to overcome the problem of poor compliance and its associated consequences.

Exploring Barriers to Vitamin A Supplementation Uptake and Program Implementation Among Children Aged 6-59Months in Ethiopia: A Qualitative Approach.

Background: Children in Ethiopia do not receive the recommended dose of vitamin A supplementation (VAS). Objective: This study aimed to explore the barriers to VAS uptake and program implementation among children aged 6-59months in Ethiopia. Methods: Data were collected qualitatively using focus group discussions and in-depth interviews. The data were audio-recorded, transcribed, and inductively coded. The results were displayed using thematic analysis and the well-spoken verbatim of the respondents. Results: The barriers to VAS uptake were low parental awareness of the program and low interest or motivation, low promotion of the program among health professionals, an excessive workload for health extension workers, and low professional attention to VAS compared to other health services. Conclusion: Both client-side and supply-side issues posed significant obstacles to the uptake of VAS. It is important to educate mothers about VAS. Health workers should receive refresher training to raise their level of concern about VAS's importance and its schedule. It's crucial to initiate outreach programs for remote communities. The departmentalization of health extension packages will improve service and access.

Study on the impact of the COVID-19 pandemic on stunting program implementation (sensitive and specific programs) in Sleman Regency

The COVID-19 pandemic is a new challenge for the implementation of stunting intervention in Indonesia. Therefore, monitoring the stunting program implementation during a pandemic is crucial to achieving the target of stunting reduction. This research aims to examine the pandemic’s impacts on the implementation of specific and sensitive programs, especially posyandu, iron supplementation, PMT, and Sustainable Food Program(SFG). Method, qualitative research uses a Case-Study with 17 informants selected by purposive sampling, including the stakeholders and program’s target in the working area of Tempel 2 Health Center. Data in the form of interview transcripts and other documents were collected using in-depth interviews and documentation studies in November-December 2021 and were analyzed in 3 stages: reduction, presentation, and conclusion. Result, the COVID-19 pandemic has affected specific nutrition interventions, especially in the planning, implementation, and scope of activities. It relates to social difficulties and concerns over the spread of COVID-19. In the implementation of SFG program, the pandemic does not have a significant impact. It can be interpreted that COVID-19 pandemic affects several aspect of the stunting program’s implementation. This study suggests the stakelhoders and communities to optimize the implementation of stunting intervention so it can run sustainably to reduce stunting prevalences.

Effects of a phonics intervention in a randomized controlled study in Swedish second-grade students at risk of reading difficulties.

Teaching phoneme awareness to children at risk for early reading difficulties has been recognized as successful in several studies. In this randomized controlled trial (RCT)-study, we add to this research by optimizing core procedural as well as teaching components in a phonics-directed intervention and extend the RCT reading intervention research into a semi-transparent language context. The aim of the present study was to evaluate the effects of a novel Swedish intensive phonics program. This randomized controlled pre-test and post-test intervention study targeted second-grade students with early reading difficulties. Students were identified by a repeated screening procedure and allocated to intervention (n = 34) and control (n = 34) conditions. A 9-week intensive phonics-based program was administrated one-to-one, by special education teachers in Swedish mainstream elementary schools. Results show an improvement in the intervention group, compared with the controls on all outcome measures. Findings indicate that the supplementary phonics program, delivered with high intensity, can significantly increase word reading skills and reading comprehension in second-grade students with early reading difficulties.

Using a customized board game to improve English learning’s experience and effectiveness

English language learning is an integral part of basic education in Indonesia today. However, not all students have equal opportunities to learn English. Elementary school children in Kucur village, in particular, are among those who lack sufficient access to learning English outside the classroom due to their family circumstances. Fortunately, there is a Learning Center called Cakrawangsa managed by the local youth organization (Karang Taruna) in Krajan hamlet, Kucur village. This center provides educational assistance to students. However, the center lacks permanent human resources to support students in learning English. In 2021, the community engagement team from Ma Chung University conducted once-a-week fun English learning sessions. Based on the evaluation results of the program, the participants greatly enjoyed the fun learning approach delivered by the Ma Chung University community engagement team. However, some students still struggled to memorize English vocabulary and pronounce it accurately. Therefore, the proposing team suggests a supplementary English learning program using an enjoyable method that has the potential to enhance vocabulary mastery. Based on conducted studies, the proposing team has developed a relevant board game tailored to the students' environment as an engaging and effective tool to support English language teaching.

Evaluation of a results-based financing nutrition intervention for tuberculosis patients in Madhya Pradesh, India, implemented during the COVID-19 pandemic

BackgroundReducing malnutrition through food supplementation is a critical component of the WHO End Tuberculosis (TB) strategy. A results-based financing (RBF) initiative in Madhya Pradesh, India—called Mukti—introduced an intensive nutrition intervention, including home visits, counseling, food basket distribution, and assistance in obtaining government benefits. Phase 1 of the program (Dhar District), implemented by ChildFund India (ChildFund) and funded by USAID, coincided with the COVID-19 lockdown in 2020. Under an RBF reimbursement scheme, ChildFund was paid based on treatment retention for 6 months and weight gain of 6 kg for adults.MethodsThe evaluation used a mixed methods approach. Qualitative components included interviews with key informants and focus groups with program participants. Quantitative components included an analysis of program data (i.e., patient demographics, receipt of program services, and weight gain). An impact analysis of retention in treatment used data from a government database. A difference-in-differences model was used to compare results from baseline data and the program period for Dhar District to similar data for the adjacent Jhabua District.ResultsThe program was well implemented and appreciated by patients and providers. Patients received an average of 10.2 home visits and 6.2 food baskets. While all age and sex groups gained weight significantly over their 6-month treatment period, there was no program impact on treatment retention. Seventy-six percent of patients achieved both outcome goals. And though average program costs were under budget, ChildFund experienced a loss in the results-based financing scheme, which was covered by USAID to continue program expansion.ConclusionsImplementing a nutrition supplementation and education program for TB patients in India is feasible. The intervention improved weight gain despite COVID-19-related lockdowns. The Mukti program did not impact treatment retention, which was already high at baseline. Program costs were modest, but the results-based financing reimbursement scheme resulted in a loss for the implementer. Overall, the RBF model led to an increased focus on outcomes for program staff and other stakeholders, which led to more efficient service delivery. Future research should examine total costs (including donated staff time) more extensively to determine the cost-effectiveness of Mukti and similar interventions.

FOOD SUPPLEMENTATION INCREASES MULE DEER (Odocoileus hemionus eremicus) RETENTION AT THE RANCHO SAN HUBERTO WILDLIFE CONSERVATION MANAGEMENT UNIT, SONORA, MEXICO

Artificial food and water supplementation programs are common in Wildlife Conservation Management Units (UMAs) in arid northern Mexico to attract and retain mule deer as quality trophies. However, implementing these actions represents a high economic cost, and there is no convincing evidence of their effectiveness. This study evaluated the effect of food and water supplementation by capture-mark-recapture using camera traps at the UMA San Huberto, Sonora, Mexico. During the winter of 2015-2016, male mule deer counts and detection histories were collected at 62 photo-trapping stations spread across four supplementation treatments: 1) water and food, 2) water, 3) food, and 4) no supplementation. In addition, to assess the impact of natural vegetation on trough and feeder utilization on the ranch, the Normalized Difference Vegetation Index was calculated using Landsat 8 satellite images. A log-Poisson regression model for deer counts per photo-trapping station found that food supplementation increased mule deer numbers by 42 % when compared to stations without food supplementation. Vegetation biomass had no effect on the frequency of use of feeders and waterers in any of the treatments. According to the multistate model for detection histories, male mule deer at waterers receiving food-only supplementation are more likely to remain in that treatment than to move to either of the other two treatments (water and feed or water). This finding suggests that food-only supplementation is more effective in retaining male mule deer.

Study the Electronic and Spectroscopic Characteristics of p-n Heterojunction Hybrid (Sn10O16/C24O6) via Density Functional Theory (DFT)

The electronic characteristics, including the density of state and bond length, in addition to the spectroscopic properties such as IR spectrum and Raman scattering, as a function of the frequency of Sn10O16, C24O6, and hybrid junction (Sn10O16/C24O6) were studied. The methodology uses DFT for all electron levels with the hybrid function B3-LYP (Becke level, 3-parameters, Lee–Yang-Parr), with 6-311G (p,d) basis set, and Stuttgart/Dresden (SDD) basis set, using Gaussian 09 theoretical calculations. The geometrical structures were calculated by Gaussian view 05 as a supplementary program. The band gap was calculated and compared to the measured values. The density of state of the hybrid junction (Sn10O16/C24O6) increased because of the increased number of degeneracy states. Theoretical values of bonds for C=C, C=O, and Sn-O are equal to 1.33, 1.20 and 2.27 Å respectively, these bonds values are in good agreement with experimental values of bond length of 1.34 for the C=C bond, 1.23 for the C=O bond, and 2.3 for the Sn-O bond. . The spectroscopic properties, such as IR spectra have shown a peak which is comparable to longitudinal modes of GO and tin dioxide SnO2 at (1582 and 690) cm-1, respectively.

Improving Nutritional Status of School Going Children Through School-based Nutrition Program in Rajasthan, India

This case control research was conducted in the tribal block of Sirohi district of Rajasthan, India to assess the impact of the food supplementation program on the nutritional status of school-going children. With 1:1 matching using parameters of sex and age of children from six villages each, data of 430 1st to 8th grade children, 215 cases and controls each, were analysed. World Health Organization (WHO) Anthro plus tool was used to determine the Weight for Age, Height for Age and Body Mass Index (BMI) for age indicators. Results showed that children who were on the intervention of milk were found to be 1.7 times more active as compare to those not receiving milk. It was also found that the proportion of children with severe malnutrition- in terms of wasting, stunting and underweight – was less among cases as compare to the controls. However, the difference was found significant only for wasting and underweight respectively. Therefore, it was concluded that milk-based interventions have been proved to be successful strategy in combating acute malnutrition among school-going children. More research is needed to evaluate the impact of such interventions on stunting, and to improve the program planning for scaling up and replication.

Vitamin A Program for Giving Toddlers in Posyandu Neighborhoods Ledeng with CIPP Model

This study aims to evaluate the facilities of the Posyandu (Integrated Health Service Post) in the vitamin A supplementation program for toddlers at Posyandu Ledeng. The vitamin A supplementation program at Posyandu Ledeng was evaluated using the CIPP (Context, Input, Process, Product) model to assess the program's context, resources utilized, program implementation, and achieved outcomes. The evaluation results showed that although the vitamin A supplementation program was implemented successfully, there are still deficiencies in the available facilities. The measuring equipment for body weight and height and the storage facilities for vitamin A are inadequate, and there is a need to replenish the vitamin A stock. These facility shortcomings can impact the program's effectiveness and the quality of healthcare services at Posyandu Ledeng. Therefore, it is necessary to update and improve the facilities and inventory management to enhance the effectiveness of this program, ensuring its sustainability and success in providing vitamin A supplementation to toddlers at Posyandu Ledeng.

Risk factors for late (28+ weeks' gestation) stillbirth in the United States, 2014-2015.

In the United States (US) late stillbirth (at 28 weeks or more of gestation) occurs in 3/1000 births. We examined risk factors for late stillbirth with the specific goal of identifying modifiable factors that contribute substantially to stillbirth burden. All singleton births in the US for 2014-2015. We used a retrospective population-based design to assess the effects of multiple factors on the risk of late stillbirth in the US. Data were drawn from the US Centers for Disease Control and Prevention live birth and fetal death data files. There were 6,732,157 live and 18,334 stillbirths available for analysis (late stillbirth rate = 2.72/1000 births). The importance of sociodemographic determinants was shown by higher risks for Black and Native Hawaiian and Other Pacific Islander mothers compared with White mothers, mothers with low educational attainment, and older mothers. Among modifiable risk factors, delayed/absent prenatal care, diabetes, hypertension, and maternal smoking were associated with increased risk, though they accounted for only 3-6% of stillbirths each. Two factors accounted for the largest proportion of late stillbirths: high maternal body mass index (BMI; 15%) and infants who were small for gestational age (38%). Participation in the supplemental nutrition for women, infants and children program was associated with a 28% reduction in overall stillbirth burden. This study provides population-based evidence for stillbirth risk in the US. A high proportion of late stillbirths was associated with high maternal BMI and small for gestational age, whereas participation in supplemental nutrition programs was associated with a large reduction in stillbirth burden. Addressing obesity and fetal growth restriction, as well as broadening participation in nutritional supplementation programs could reduce late stillbirths.

LEVEL OF UNDERSTANDING IN ASSOCIATIVE SEMANTICS AMONG AB-ENGLISH STUDENTS: BASIS FOR INTERVENTION PROGRAM

The presented study aims to check the level of understanding in associative semantics among AB-English students as basis for an intervention program to further improve comprehension as English major student. The framework of this study is supported by the mind of Noam Chomsky with his work in innateness theory. Moreover, this study used a descriptive-evaluative method designed to determine the level of understanding in associative semantics of fifty (50) students under the AB-English program of Ramon Magsaysay Memorial Colleges-Marbel, Inc. (RMMC-MI) who were selected purposively. A test questionnaire of fourty (40) items was used to determine the levels of understanding of the respondents in denotative and connotative, with twenty items for each level for the creation of an intervention program suited to enhance their ability to understand context words, and multiple lexicalities. Finally, the findings stated that out of twenty (20) item each test, students averaged a score of ranging to “Good” in denotative part of test, while still a “Good” range in connotative part. The results revealed that among the fifty (50) students who partake the test, their combine score average is interpreted as “Good”. Thus, a recommended supplemental intervention program is needed to enforce understanding in associative semantics through refresher and engaging activities for the AB-English students of RMMC-MI.

Evaluation of iron prophylaxis in children aged 4-24 months

Aim: The aim of this study is to assess the current status of the national iron supplementation program and the utilization of iron prophylaxis in the society, taking into account factors such as education, socioeconomic status, and the recommendations provided by healthcare professionals. Materials and Methods: A total of 540 patients Children aged 4-24 months admitted to the Pediatrics Outpatient Clinic were evaluated and a total of 540 patients were surveyed. The children were asked whether they used or not regular iron prophylaxis between 4 and 12 months. The data were analyzed using the SPSS 22 software package program Results: In our study, it was found that 50.8% of children did not use iron prophylaxis or used it irregularly. The most common side effects reported were constipation, diarrhea, and vomiting. Significantly higher rates of supplement use were observed among children with parents who had higher education and income levels. (Mother's education; p=0.026, father's education; p&amp;lt;0.001, income level; p=0.015) Conclusion: The fact that more than half of the participants in the study did not use iron supplementation or used it irregularly highlights the inadequate access to adequate iron prophylaxis for children. Healthcare professionals should allocate time to families and provide information about iron supplementation.

Justification of Universal Iron Supplementation for Infants 6-12 months in Regions with a High Prevalence of Thalassemia.

Many clinicians hesitate to adopt a universal infant iron supplementation program due to the risk of increased iron absorption for those with thalassemia. We aimed to determine thalassemia prevalence in 6- to 12-month-old infants, along with the iron status of those with and without thalassemia. We performed a cross-sectional descriptive study of infants attending the Well Baby Clinic at Thammasat University Hospital for routine checkups. Complete blood count, hemoglobin electrophoresis, iron parameters, and molecular genetics for common α- and β-thalassemia were evaluated. Overall, 97 of 206 (47%) participants had thalassemia minor, the majority having Hb E traits. None had thalassemia intermedia or major. Familial history of anemia or thalassemia presented an increased risk of detecting thalassemia minor in offspring (OR 5.18; 95% CI 2.60-10.33, p=0.001). There were no statistical differences in transferrin saturation, serum ferritin and hepcidin between iron-replete infants with thalassemia minor and those without. However, one-third of infants with thalassemia minor (31/97) also had iron deficiency anemia (IDA), with a similar risk of having iron deficiency to infants without thalassemia. There was no hepcidin suppression in our infants with thalassemia minor as compared to controls. Both thalassemia and IDA are endemic to Southeast Asia. Infants with thalassemia minor, particularly with Hb E and α-thalassemia traits, are at risk of IDA. Our short-term universal iron supplementation program for 6- to 12-month-old infants does not appear to increase the risk of those with thalassemia minor developing iron overload in the future.