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Some of the problems encountered by field investigators like nutritionist / dietician/ social scientist during the process may include: Memory lapse virus 34 compression order suprax without a prescription. Errors arising from crude local measures(inventory method) Inaccurate weighing of food stuffs(weighment method) Seasonal variations and improper selection of reporting period treatment for dogs false pregnancy order 200 mg suprax free shipping. Response error arising as a result of deviation from normal food consumption pattern during the survey period. In order to overcome the above problems the following points should be taken into consideration: A pilot survey is needed. Proper communication and transport facilities to the area of survey should be ensured. Sample size for diet and nutritional survey should be in the ratio of 1:4 or 1:5 depending on the objective of the survey. Erstwhile knowledge of field situation will help in formulatingquestionnaires, checklist and guidelines. So far, we learnt about the methods of dietary assessment, the advantages and its limitations in nutritional assessment. Thenutritional sufficiency of the cells, tissues, organs and anatomical systemstoaccomplish their biological functions is assessed by this method. Functional indices of nutritional status include cognitive ability, disease response, reproductive competence, and physical activity, and work performance, social and behavioural performance. Functional indices, which have many potential advantages over static indices in respect to validity of information related to nutritional status are described below: Submaximal test, using tread mill, which asses cardiac efficiency, work performance and respiratory capacity might be useful as an adjunct to biochemical and anthropometric measures in the assessment of nutritional status. Fertility rate and birth weight of the infant, reflects nutritional status at the population level. Milk volume, fat and total energy content of milk is reduced in malnourished women. Prenatally undernourished infants show several behavioral impairments that could negatively affect the development of social competence including reduced activity and less interaction with caretakers. The Functional assessment of nutritional status: Principles practice and potential, Nutrition, Reviews, 41. They help in retrospective studies and the results obtained helps to enrich other methods of nutritional survey. As we know, the indirect methods used frequently are vital statistics and Ecological factors assessment. A wide range of vital statistics may be considered as indirect indicators of nutritional status of the community are discussed in the following pages. Parameters used under vital statistics are Measures of Morbidity Measures of Mortality Let us converse each one in detail. Measures of Morbidity Morbidity relates to types and varieties of disease one faces or experience affecting the day to day activity. Total number of new cases Of a specific disease during the year Incidence rate = - x k Midyear population Total number of old cases existing at a point of time Prevalence rate = -x k Total population at that point of time Where k can be, 100 or 1,000, 10,000 or 1, 00,000. This rate gives an index of maternal nutrition through many other factors like genetic make-up of mother and child, the degree of exposure to infections and the standard of medical care available. The manifestations and effects of malnutrition are well known to be severe in toddlers. Under the indirect methods, next in turn comes the assessment of ecological factors, which encompass several parameters. The ecological factors related to the aetiology and prevention of malnutrition include: a) Conditioning Infections: Nutrition and infection is a vicious cycle that will be studied in detail in unit- 4. B, whooping cough, diarrhoeal diseases and dysentery Viral: Measles Parasitic: Malaria, Ascariasis Protozoal: Amoebiasis b) Cultural Influences: Food attitudes, meal pattern, and local concepts on causation, prevention and cure of diseases all significantly contribute to nutritional status. Also, the number of schools, number of students` enrolment, attendance, literacy rate, mass media availability and usage also indirectly help to assess the nutritional status. Though the indirect assessment methods are available they are less reliable than the direct methods. The results of nutritional prevalence survey vary greatly in complexity, depending on the type and number of staff, the time available, purpose of investigation and on the quality of information sought from the respondent. Hence, it can be concluded that the direct methods of nutritional assessment can be used primarily and the indirect methods can support to enhance the validity of assessment. Direct methods- Anthropometry, Biochemical and Self-Insturctional Material 48 Laboratory estimation, Biophysical or radiological examination, Clinical examination, Dietary survey, Functional assessment. Tests like serum proteins, serum amino acid ratio, urinary hydroxyproline index, urinary creatinine height index, urea-creatinine ratio are used to assess protein nutritional status.
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