Osmolality of Modified Enteral Tube Feeds for Adults in Hospitals Across the Western Cape Province

Objectives: The first aim of this study was to determine the incidence of use; reasons for use; and procedures/recipes followed in modifying enteral tube feeds (ETFs) for adults in state and private hospitals across the Western Cape Province (WCP); South Africa (baseline data). The second aim was to determine the osmolality of the modified ETFs used by these hospitals (osmolality data). Design: A descriptive cross-sectional study. Setting and subjects: The study was conducted in January/February 2007. The baseline data was collected by means of a coded questionnaire sent to all state and private hospitals in the WCP (n = 111); excluding all children's hospitals. The osmolality data was obtained by means of freeze-point depression of the modified ETF recipes obtained from the participating hospitals. Results: A total response rate of 94was obtained. Of the participating hospitals (n = 104); 48were state (n = 50) and 52were private hospitals (n = 54). Sixty-two per cent of hospitals (n = 64) made use of ETFs; with 25modifying their feeds (n = 16). Twelve recipes were obtained for the osmolality testing. Eight recipes (66) were significantly lower (p 0.001); two (16) were significantly higher (p 0.001) and two of the recipes did not differ from the standard enteral product. Eight recipes (66) had a significantly higher average osmolality (p 0.001) than that of body fluid. The concentrated ETF recipe (1.43 kcal/ml) had the highest osmolality (707 mOsm/kg/H20). Conclusions: Modular ETFs had lower average osmolality than those of the semi-modular and the standard enteral products; and of body fluid (300 mOsm/kg/H20)

Measuring HIV Stigma for PLHAs and Nurses Over Time in Five African Countries

The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho; Malawi; South Africa; Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection; their adherence to medication; and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69); and 67.1(N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63); and 88.6(N=784) were females. Eighty-four per cent PLHAs reported one or more HIV-stigma events at baseline. This declined; but was still significant 1 year later; when 64.9reported experiencing at least one HIV-stigma event. At baseline; 80.3of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.71 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions; particularly focused at healthcare providers who experience HIV stigma by association