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The final report of the Safe School Initiative: a commitment from both staff and students blood pressure kits at walgreens order generic zestril online. School Implications for the prevention of school attacks in the administrators need to blood pressure chart spreadsheet generic 2.5mg zestril coordinate their crisis planning United States hypertension new guidelines buy 10mg zestril with amex. Living and learning in the shadow of of literature available on the topic of school crisis arrhythmia yahoo order zestril 2.5 mg line. School psychologists need to be represented in all areas of crisis planning, including prevention activities. Suicide basis of their performance relative to a specific, prede postvention guidelines: Suggestions for dealing with the termined criterion or standard. In criterion-referenced practices in school crisis prevention and intervention assessment, it is possible that all, or none, of the exam (pp. Best practices in suicide most commonly used, educators do not agree that it is intervention. Coping with crisis: and performance or direct assessment have been used Lessons learned. Coping with crisis: Quick recently, as states and school systems have adopted reference guide. Best practices students should know and be able to do in core in crisis intervention & management. Norm-referenced Psychologist, criterion-referenced tests “depend upon interpretations have been added to tests designed for an absolute standard of quality,” while norm-referenced criterion-referenced interpretation. Most, if not all, this shift in emphasis from test type to test score instructional decisions are informed by information interpretation is captured by Popham in his 2002 edi provided through criterion-referenced assessment. In tion of Classroom Assessment: What Teachers Need to most instances, criterion-referenced test scores tell Know, in which he says “. Once an assessment domain is defined, site knowledge and skills necessary to achieve the the student’s test performance can be interpreted defined learning outcomes of a lesson or curricular according to the degree to which the domain has been unit. Since criterion Linn and Gronlund (2000) propose that criterion referenced assessment identifies what students can referenced and norm-referenced assessments should and cannot do, teachers can pinpoint areas of diffi be “viewed as ends of a continuum, rather than as culty and can help students to discover flaws and a clear-cut dichotomy” (p. Typically, criterion inconsistencies in their own thinking, thereby helping referenced tests focus on a delimited and clearly them identify gaps in their understanding. Arguably the most important use of criterion Their level of difficulty is determined by the difficulty referenced tests at the beginning of the 21st century of the task. Test items are eliminated only from the has been in the widespread compulsory testing of pool of items if they are judged not to measure the public school students. Twenty-one states indicated a use of difficulty and high discriminating power are most both norm-referenced tests and criterion-referenced likely to be included because they will yield distribu tests. For the remaining states, 18 used only criterion tions of test scores that enable educators to distinguish referenced tests and 9 used only norm-referenced performances among individuals. Most states identified multiple-choice and person’s performance, the performance is compared extended-constructed. Short-constructed response orated to take advantage of the unique benefits of both items. Publishers of the criterion-referenced–testing-only states compared Criterion-Referenced Assessment———135 to just one of the nine norm-referenced–testing-only knowledge, it is common to set a single score to states. These data again emphasize how often determine an individual student’s proficiency or criterion-referenced test items may look like deficiency. However, the use of scores” for determining who passes or fails the short-answer items on standardized state assessment test, they are often used that way. Typically, the state tests appears to be a more typical characteristic of a mandated criterion-referenced tests have a specific criterion-referenced approach. Because the essence of criterion-referenced assess It is important to ask how carefully these stan ment is its ability to duplicate the criterion tasks of dards have been set. The more important the decision interest, it is critical that the test developers define being made with criterion-referenced assessment, explicitly what skills or knowledge are being mea the more important it is that the assessment have sured. For example, have developed criterion-referenced minimum competency cut scores (criterion level of performance on a test) tests. These tests were meant to verify that students been set by experts using their best judgment of what had achieved the “basics” in reading, writing, and constitutes inadequate, solid, or advanced student arithmetic. How does the standard error of mea academic skills, test developers were able to identify surement of the assessment affect strict adherence to domains of specific language arts skills and mathemat a single cut-score value Have cut scores been set to ical skills that were consider requisites of “minimum attain a predetermined number of successful appli competency. Have developers established the predictive these domains were constructed without much contro validity of their assessments through empirical versy. While educators and their critics might argue research on the relationship between criterion about the level of students’ “minimum competency” referenced assessments and other authentic measures necessary to graduate from high school, few argued of success and failure Table 1 contains a list of impor that these tests did not assess students’ ability to do tant questions for any consumer of criterion-referenced mathematical computations, recognize standard assessment. Criterion-referenced assessment was originally In the 1990s, states expanded their criterion conceived as a way to map knowledge acquisition referenced tests to assess students’ learning with along a continuum of no proficiency to consummate respect to more rigorous state, national, and inter performance. The emphasis was now ago, criterion-referenced testing has emphasized on higher-level cognitive skills such as solving real life measurement of absolute performance rather than problems or interpreting historical events. Its essence is that it provides criterion-referenced tests to measure more complicated accurate inferences about students’ cognitive activity knowledge and skills is much harder than developing and skill performance, not just relative comparisons those to measure minimum competency skills. It is critically important that Popham, speaking at a 1993 symposium on a 30-year judgments made from criterion-referenced assessment retrospective of criterion-referenced measurement, data give valid and practical insights into students’ said, “the more lofty the assessment target, the tougher understandings and skills, especially when high stakes it is to spell out succinctly what is to be measured. How clearly does the developer state the purpose and reasons for designing the criterion-referenced assessment How well does the criterion-referenced assessment constructor understand the mental and physical operations behind the criterion tasks How well can the continuum of performance on the criterion task be described and represented as tested skills and knowledge How have the reliability and validity of the criterion-referenced assessments been determined and how are these technical test characteristics reported to the public How were the "cut scores" to determine "pass/fail" or "competency-incompetency" determined—by expert judgment or by empirical verification How well does the original purpose for developing the criterion-referenced assessment match the way it is being used How much does the criterion-referenced assessment score improve the decision-making process How confident are you that the criterion-referenced test performance is a good predictor of the real life criterion task performance What are the personal and social consequences of using the "cut scores" to make educational and employment decisions Was the criterion-referenced test in fact designed as a criterion-referenced test, or is it really a norm-referenced test used for a different purpose Instructional technology and the measure behaviors, and language that are specific to a particu ment of learning outcomes. The instructional consequences of cri other than the United States, but also to those who terion-referenced clarity. The cultural loading and linguistic demands of As the population of the United States becomes standardized, norm-referenced ability tests more diverse, the need for school psychologists to be 2. Norm sample representation and stratification competent in assessing individuals from cultures other of different cultural groups than the U. Effects of cultural differences on performance ent kinds of procedures and techniques. Cross-cultural on tests testing is the use of standardized tests of intelligence and cognitive abilities with individuals who are cultur 4. Cross-cultural dynamics involving the examiner ally different and often linguistically different as well. Intelligence and cognitive ability tests have long Recently, Flanagan and Ortiz (2001) provided clas been criticized as unfair, inappropriate, and invalid for sifications of tests along the dimensions of cultural the purpose of assessing individuals who are cultur loading and linguistic demand that assist psycholo ally different. In general, they have been attacked as gists in selecting and interpreting tests that may be being culturally biased. In general, cultural bias has more appropriate for a given individual relative to his been defined historically as being psychometrically or her background.
Presence of confusion pulse pressure change with exercise purchase zestril online, disorientation blood pressure chart all ages buy zestril 10 mg cheap, memory disorders are behavioural or psychological disorders impairment or soft neurological signs blood pressure jadakiss generic zestril 5mg overnight delivery. Delirium is the commonest organic mental disorder Since organic brain illness can mimic any psychi seen in clinical practice blood pressure medication morning or evening generic 2.5 mg zestril otc. Five to fteen percent of atric disorder, especially in the initial stages, organic all patients in medical and surgical inpatient units mental disorder should be the rst consideration in are estimated to develop delirium at some time in 20 A Short Textbook of Psychiatry their lives. It is important to recognize delirium at the Clinical Features earliest possible as delirium often has an underlying Delirium is characterised by the following features: aetiology which may be correctable. Clouding of consciousness, characterised by permanent decits which can be irreversible. No decreased ability to respond to environmental ancillary laboratory test is diagnostic, although tests stimuli, and may help in nding the aetiology. These Marked perceptual disturbances such as illu include impairment of consciousness and attention (on sions, misinterpretations, and hallucinations also a continuum from clouding to coma; reduced ability occur. These are most commonly visual though to direct, focus, sustain, and shift attention), global other perceptual domains can also be involved. Diurnal variation is marked, usually with the onset is usually rapid, the course diurnally worsening of symptoms in the evening and night uctuating, and the total duration of the condition (called sun downing). Generalised autonomic dysfunction, speech and A history of underlying physical or brain disease, thought disturbances (such as slurring of speech, and/or evidence of cerebral dysfunction. Carphologia or occillation (picking movements Presence of certain predisposing factors lowers the at cover-sheets and clothes), threshold for the development of delirium (Table 3. Occupational delirium (elaborate pantomimes as Aetiology if continuing their usual occupation in the hospital bed), and the list of possible causes of delirium is virtually 5. Any factor which disturbs the metabolism of Organic (Including Symptomatic) Mental Disorders 21 brain sufciently can cause delirium. The aetiology of One of the important causes of delirium, namely delirium demonstrates a threshold phenomenon, with post-cardiac surgery delirium, is discussed in Chapter a combination of factors adding up to cross a threshold 12. In cases where a cause is not obvious (or other contributory causes are suspected), a battery of Table 3. Pre-existing brain damage or dementia complete blood count, urinalysis, blood glucose, 2. Extremes of age (very old or very young) blood urea, serum electrolytes, liver and renal 3. Previous history of delirium function tests, thyroid function tests, serum B and 12 4. Stroke (acute phase), Hypertensive encephalo Drugs (Both ingestion and withdrawal can cause pathy delirium) and Poisons vi. There is impairment of agitated, emergency psychiatric treatment may judgement and impulse control, and also impairment be needed. There is however usually no im zepam or diazepam) or antipsychotics (haloperi pairment of consciousness (unlike in delirium; Table dol or risperidone) may be given either orally or 3. Maintenance treatment can continue though some forms of dementia can be reversible. These There is an increased risk of stroke in elderly include: patients with dementia with prescription of 1. Emotional lability (marked variation in emotional atypical antipsychotics such as olanzapine and expression). Disorientation in time; disorientation in place and memory, especially in early stages), person may also develop in later stages. Course Usually recover in 1 week; Usually protracted, although may be reversible may take up to 1 month in some cases 3. Memory Immediate retention and Immediate retention and recall normal recall disturbed Recent memory disturbed Recent memory disturbed Remote memory disturbed only in late stages d. Perception Visual illusions and Hallucinations may occur hallucinations very common i. Other features Asterixis; multifocal myoclonus Catastrophic reaction; perseveration Organic (Including Symptomatic) Mental Disorders 23 Diagnosis 3. Depressive pseudodementia: Depression in the elderly patients may mimic dementia clinically. It Like delirium, the diagnosis of dementia is clinical is called as depressive pseudodementia (Table 3. In personal activities of daily living, memory impairment contrast, patients with dementia do not often complain (typically affecting registration, storage, and retrieval of these disturbances. In fact, when confronted with of new information though previously learned material evidence of memory impairment, they often con may also be lost particularly in later stages, impaired fabulate. As depression may often be superimposed thinking, presence of clear consciousness (conscious on dementia, it is at times necessary to undertake a ness can be impaired if delirium is also present), and therapeutic trial with antidepressants, if the clinical a duration of at least 6 months. The following conditions must be kept in mind in It is useful to differentiate dementia into cortical the differential diagnosis of dementia. Normal aging process: Although impairment of Aetiology memory and intellect are commoner in elderly, their mere presence does not justify a diagnosis A large number of conditions can cause dementia of dementia. However, a majority of cases are due to there is demonstrable evidence of memory and a few common causes such as Alzheimer’s disease other intellectual impairment which is of sufcient and multi-infarct dementia. Some clinically important severity to interfere with social and/or occupational types of dementia are briey discussed here. The normal memory impairment in Alzheimer’s Dementia old age is called as benign senescent forgetfulness. Delirium: the syndromes of delirium and demen this is the commonest cause of dementia, seen in tia may overlap. Patient rarely complains of cognitive impairment Patient usually always complains about memory impairment 2. Patient makes errors on cognitive examination ‘Do not know’ answers are more frequent 6. Recent memory impairment found on examination Recent memory impairment rarely found on examination 7. Consistently poor performance on similar tests Marked variability in performance on similar tests 9. History of depression less common Past history of manic and/or depressive episodes may be present 24 A Short Textbook of Psychiatry Table 3. Site of lesion Cortex (frontal and temporoparieto-occipital Subcortical grey matter (thalamus, basal association areas, and hippocampus) ganglia, and rostral brain stem) 2. Examples Alzheimer’s disease, Pick’s disease Huntington’ chorea, Parkinson’s disease, Progressive supranuclear palsy, Wilson’s disease 3. Motor system Usually normal Dysarthria, exed/extended posture, tremors, dystonia, chorea, ataxia, rigidity 5. Other features Simple delusions; depression uncommon; Complex delusions; depression common; severe aphasia, amnesia, agnosia, apraxia, rarely mania acalculia, slowed cognitive speed (bradyphrenia) 6. Memory decit Recall helped very little by cues Recall partially helped by cues and (Short-term) recognition tasks Table 3. Deciency dementias Alzheimer’s disease, Pick’s disease, Parkinson’s Pernicious anaemia, pellagra, folic acid deciency, disease, Huntington’s chorea, Lewy body dementia, thiamine deciency Steel Richardson syndrome (Progressive Supra G. Dementias due to infections nuclear Palsy) Creutzfeldt-Jacob disease, neurosyphilis, chronic B. Neoplastic dementias Bromide intoxication, drugs, heavy metals, alcohol, Neoplasms and other intracranial space-occupying carbon monoxide, analgesics, anticonvulsants, ben lesions zodiazepines, psychotropic drugs I. Metabolic dementias Chronic subdural haematoma, head injury Chronic hepatic or uraemic encephalopathy, dialysis J. Hydrocephalic dementia dementia, Wilson’s disease Normal pressure hydrocephalus E. Endocrine causes Thyroid, parathyroid, pituitary, adrenal dysfunction into two forms: a presenile form and a senile form. Autopsy shows macroscopic changes Now it is known that these two forms represent the such as enlarged cerebral ventricles, widened cerebral same disease clinically and pathologically. There is sulci and shrinkage of cerebral cortex, as well as some evidence to suggest that Alzheimer’s disease microscopic changes such as senile plaques, neurofimay have a genetic basis. However, these changes are exclusion of all other causes of dementia, as there are only quantitatively, and not qualitatively, different no distinct diagnostic clinical features or laboratory from a normal aged brain. The treatment of the underlying At present, Alzheimer’s dementia is not consi cause can prevent further deterioration by preventing dered a treatable disorder.
For classifcation into aberrant and accessory arteries and for detecting supernumerary veins agreement was fair blood pressure charts readings cheap zestril 2.5 mg fast delivery. It is obvious that the enhanced resolution makes it easier to arterial bleeding 10 mg zestril distinguish the two arteries to prehypertension 34 weeks pregnant cheap 2.5mg zestril visa the right kidney blood pressure medication joint pain order zestril 10 mg. Noncontrast-Enhanced Magnetic Resonance Versus Computed Tomography Angiography in Pre operative Evaluation of Potential Living Renal Donors. The exact McNe mar’s test was used when the number of positive results<5, marked by # Figure 1. Shows the imaging results when increasing the spatial resolution and how this is helpful in depicting details. Tools GmbH, Berlin, Germany *Presenting author Introduction: Kidney diseases represent an important public health problem with increasing incidence. The renal corticomedullary sodium gradient is necessary for proper function of the kidney, thus changes of the gradient indicate a malfunction. Therefore we designed a quadrature birdcage coil tai lored for sodium imaging of small rodents at 9. Birdcage Builder [3] was used in order to estimate the initial values of distributed capacitors. The bench mea surements were performed on a saline phantom (V=200mL,[NaCl]=600mM, =0. Each channel of the bird cage coil was tuned to the resonant frequency of sodium at 9. For using the circularly-polarized mode of the coil an additional Tx/Rx switch and hybrid combiner was design and built. The refection coeffcients of both chan nels (S11 and S22) were measured to be lower than -49dB and the transmission coeffcient (S12) was lower than -20dB (Fig. Figure 2D shows the simulated transmit feld (B +) for the phantom and the measured B +-feld. Our bench measure ments showed very good agreement with the results derived from the simulations. After having achieved our frst sodium images, we are now looking forward to optimize the sequences and to improve the image quality. Methods: Thirty one children aged 3-18 years (30 girls), with acute pyelonephritis were examined. Control examinations were performed in 31 patients after six months with both methods. A growing body of evidence supports the key role of hemodynamics in stenosis formation, there fore longitudinal studies with repeated evaluations of local hemodynamic conditions and vas cular structural changes over time are needed to investigate the relationship between disturbed fow and stenosis development. We obtained meshes of 1’055’000 cells with dominant-hexahedral core cells, and we generated two thin boundary layers to capture the sharp gradients of velocity near the wall (Figure 1). Three cardiac cycles were solved to avoid start-up transients and only the third cycle was saved for post-processing. This achievement, besides entailing a reduction in medical costs, may signifcantly improve the quality of life of patients. Scanning was performed on a 3T Philips Ingenia scanner (Multi-Transmit, d-Stream). Data Analysis: Kidney volumes were computed from localiser images using Analyze9 software. All values reported are the mode of histogram analysis of these multi-parametric maps. To assess reproducibility, the coeffcient of variance (CoV) of measures was computed between sessions. In 2013 renal function started worsening and renal biopsy revealed signifcant glomerulosclerosis with stripped interstitial fbrosis and tubular lesions, typical of cyclosporine-toxicity. They were than quantifed within the kidney regions, by ftting a segmented biexponential model. Current results, albeit promising, should be considered as preliminary, as this was a single case study. Results showed no statistical differences between the two groups (+/ water intake). Preferably, segmentation is performed on the functional scan itself, instead of adding an ana tomical scan for this purpose. This overcomes the need of coregistration of kidney masks and possible misalignment. Since manual segmentation is laborious, multiple approaches for kid ney segmentation have been developed. During k-means clustering, voxels are partitioned into a user de fned number of clusters based on the similarity of the R2* decay curve. Next, the cluster contain ing the kidney was identifed by a mouseclick of the user. Erosion and dilation of the mask was used to delete, for example, the renal artery and to smooth the edge of the mask. Sometimes, the spleen had to be deleted manually because it was contained in the initial mask and connected to the kidney. The convex hull of this mask was used as region of interest, since a tool to eliminate the collecting system already was available. For comparison, also manual segmentation was performed, where the collecting system was included for consistency. To quantify similarity between the manually segmented mask and the clustered mask, the Jaccard index was used, the size of the intersection divided by the size of the union of both masks, which approaches 1 in case of perfect agreement. The R2* value was calculated with a mono-exponential ft to the signal change over the echoes. Extraction of R2* values separate for cortex and medulla was performed by ftting a Gaussian and gamma function to the histogram of the R2* values (3) using an in-house developed Matlab tool. Thresholding was used to eliminate the collecting system, as published earlier (4). Clustering took on average 41s for one scan (including cropping and excluding the spleen, if necessary), while manual delineation took on average 103s. A drawback is the need for manual elimination of the spleen in a quarter of the scans. In future implementations, this possibly can be automated by incorpo ration of shape information, which probably also would overcome the need for manual image cropping. Further research must elucidate whether the algorithm also works for other functional imaging modalities. Methods Fifteen subjects were scanned twice with an interval of at least one week. Using a 2D multi-echo gradient echo sequence, 20 echoes were acquired, the frst at 4. The collecting system was eliminated using a thresholding approach, as published earlier (5). The compartmental method (6) was used to extract separate values for cortex and medulla. Here, a Gaussian and gamma function representing cortex and medulla are ftted to the histo gram of R2* values. In the repeatability analysis, left and right kidneys were treated as separate measurements. However, in these studies subjects were scanned either 1-2 weeks apart or on the same day. The larger time interval between scans in our study can be an explanation for the decreased repeatability of medullary R2*. The difference in repeat ability between cortex and medulla in our study might be explained by the uncontrolled water and salt intake. In future research, the infuence of post-processing on the repeatability can be investigated, for example compartmental analysis (6) compared to region of interest based approaches to extract separate R2* values for cortex and medulla. Before carrying out studies in pathological conditions it is important to gain data of a healthy population. In this study we, with a single scan protocol determine baseline values of total and regional renal blood fow, oxygenation, true and apparent diffusion and T1 in healthy volunteers. No signifcant difference between right and left kidney or between gender was found for any of the studied parameters. Signifcant interregional differences between cortex, outer and inner medulla was found for perfusion, oxygenation level, diffusion and T1.
Recent reports indicated that vitamin E deficiency is world-wide in 29 both children and adults blood pressure below 100 best 10 mg zestril. It is therefore logical to hypertension va compensation order genuine zestril on-line accept that the low plasma levels of vitamin E recorded in the present study arrhythmia update 2014 buy generic zestril pills, was mainly due to prehypertension lisinopril order 2.5 mg zestril with mastercard a low dietary intake of 29 vitamin E. It was suggested by Traber that circulating Tocopherol below the cut-off of 12mol/L is likely indicative of inadequacy if not frank vitamin E deficiency. Vitamin E has many functions in the body and is best known for its role as an anti oxidant. It is the most important chain-breaking lipid-soluble antioxidant present in body tissues and is considered the first line of defence against lipid peroxidation. It was shown that supplementation with vitamin E significantly enhances both cell mediated and humoral immune functions in humans es 2 pecially in elderly animals. It is also known that even marginal vitamin E deficiency, im 3 pairs the immune response. The relationship between vitamin E and immune function 4 was also demonstrated in Canadian 3-year olds. Those with the lowest serum vitamin E had the lowest lymphocyte proliferative response and serum IgM concentrations. The implication of the low plasma vitamin E levels is far reaching, especially in the light of recent findings from a recent study, which reported that elevated levels of To copherol and Tocotrienol forms are associated with reduced risk of cognitive impair 5 31 ment in older adults. From Table 2, it is evident that 94% of the children had plasma levels less than 20 mol/L Tocopherol and no children had plasma levels of Tocophero l levels above 30 mol/L. Vitamin E has effects on inflammatory processes due to the antioxidant func 32 tions of Tocopherol. Our results indicated that vitamin E deficiency (< 12 mol /L, Tocopherol, func tional deficiency) can exist in the absence of severe malnutrition. The prevalence of malnutrition in chil dren participating in the present study can be regarded as very low (Table 1) and yet a high prevalence of vitamin E deficiency (functional deficiency) was observed (Table 2). Statistical analysis suggested that the number of observations were proba 201 Article 6 bly too small to show any correlations between the different parameters. Based on evidence from the literature, we must conclude that the observed vitamin E deficiency found in these children has far reaching implications. Not only could the high preva lence of vitamin E deficiency have an influence on inflammation in these children, but could potentially affected their behaviour and cognitive function. A third observation of potential relevant importance in these children, is the rela tively low red blood cell n-3 fatty acid content which is indicative of a low N-3 fatty acid 35 11 intake. Currently there is important scientific data confirming the beneficial and protective effects of omega-3 fatty acids and their 37 effects against inflammation, cancer and heart disease. Recent research also indicated 12 a relationship between the Omega-3 Index and processing speeds in teenagers. Teen agers with higher blood levels of Omega-3 displayed better information processing speeds, compared with those with lower levels. The Ome ga-3 values recorded in the present study were not as low as that recorded in the study 12 reported by van der Wurff et al. Summary and conclusion Results from this study clearly showed that although these children appeared to be nutritionally in a good state, based, on their weight and heights, certain blood biochem ical parameters indicated specific deficiencies that can potentially have far reaching cognitive and future health implications. Although the application of the various indices to this age group I can be questioned, it however points to an early condition that can have serious health consequences in later life. Plasma levels of Carotenes, vitamin E and a relatively low red blood cell Omega 3 index, indicated a low fruit and vegetable intake as well as a low intake of fish. Low intakes of these foods are known to have negative effects on inflammation, cognitive function and general health of the consumer. Serum levels of vitamin E forms and risk of cognitive impairment in a Finnish cohort of older adults. The occurrence and effects of human vitamin E deficiency: a study in patients with cystic fibrosis. Six carotenoids in plasma used to assess recommended intake of fruits and vegetables in a controlled feeding study. Omega-3 fatty acids and cardiovascular disease: A case for omega-3 index as a new risk factor. Association between Blood Omega-3 Index and Cognition in Typically Developing Dutch Adolescents. Determination of carotenoid pigments, retinol, and alpha-tocophero l in feeds, tissues and blood serum by normal phase high performance liquid chromatography. Indicators for assessing vitamin A deficiency and their application in monitoring and evaluation intervention programmes. Status of Carotenoids, Vitamin A, and Vitamin E in the Mother-Infant Dyad and Anthropometric Status of Infants in Malawi. Vitamin A, carotenoid and vitamin E plasma concen trations in children from Lagos in relation to sex and growth failure. A 4-wk intervention with a high intake of carotenoid-rich vegetables and fruit reduces plasma C reactive protein in healthy, non-smoking men. A Systematic Review of Global Alpha-Tocopherol Status as Assessed by Nutritional Intake Levels and Blood Serum Concentrations. Cognitive Function of Children with Cystic Fibrosis: Deleteri ous Effect of Early Malnutrition. Vitamin E deficiency and associated neurological deficits in children with protein-energy malnutrition. Red blood cell 15N: a novel biomarker of dietary eicosapentaenoic acid and docosahexaenoic acid intake. South African Nutritional Journal, 2017 *equal contribution 205 Article 7 Abstract Objective To determine the effects of consuming biscuits baked with Red Palm Oil on the vitamin A, and Carotene status of pre-school children attending an informal creche. After 1 base-line observations on anthropometry and blood sampling supplementation was initiated under the supervision of a trained field worker who kept a record of attend ance and biscuit consumption of each child. Not withstanding the fact that flour was fortified in South Africa, there is evidence of vita min A deficiency in South Africa. Baseline observations were repeated after three and six months of supplementation and again six months after supplementation ended. The study was approved by the Faculty of Applied Sciences Ethics Committee of the Cape Peninsula University of Technology. Methodolgy A blood sample (last meal at least 12 hours before) was drawn from a fore arm vein, while the child was in the supine position. Samples were then air-freighted to our laboratories in Bellville and stored at -40C until analysis of, and Carotenes and Retinol. Blood could not be analysed for Iron, Zinc and Selenium because the amount of blood drawn was inadequate for these analy sis. Results from the A and B groups during the course of the study were compared with baseline values and statistically analysed. For ty-seven participants – twenty-five in the A group and twenty-two in the B group at tended all four blood collection sessions and were included in the final analysis. During supplementation, mean plasma a-Carotene levels increased seven-fold from base-line values in the A group whilst only small non-significant changes from base-line 206 Effects of consumption of biscuits baked with Red Palm Oil levels were observed in the B group. After supplementation was stopped, group A, Carotene levels declined to base-line levels. After six-months supplementation, values returned to base-line levels six months after supplementation was terminated. Again only small insignificant changes from baseline were observed in the B group. No significant difference was found in the response to biscuit supplementation between the two groups. Key words: Red Palm Oil biscuits, Blood Carotene, Vitamin A, Informal creche children. Micronutrient malnutrition, also known as “hidden” hunger has serious consequences. For example, vitamin A deficiency is associated with an im 4 paired immune response with lowered resistance against infection. Although earlier studies demonstrated the ability of dietary carotenes to prevent infections, the belief was that the action of these Carotenoids may be through their prior conversion to 16 vitamin A.
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