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Sample records for enteral feeding program

  1. Enteral feeding without pancreatic stimulation

    DEFF Research Database (Denmark)

    Kaushik, Neeraj; Pietraszewski, Marie; Holst, Jens Juul

    2005-01-01

    OBJECTIVE: All forms of commonly practiced enteral feeding techniques stimulate pancreatic secretion, and only intravenous feeding avoids it. In this study, we explored the possibility of more distal enteral infusions of tube feeds to see whether activation of the ileal brake mechanism can result...... in plasma glucagon-like peptide-1 and peptide YY concentrations. CONCLUSIONS: Our results suggest that enteral feeding can be given without stimulating pancreatic trypsin secretion provided it is delivered into the mid-distal jejunum. The mechanism may involve activation of the ileal brake mechanism....

  2. Improved Outcomes with an Outpatient Multidisciplinary Intensive Feeding Therapy Program Compared with Weekly Feeding Therapy to Reduce Enteral Tube Feeding Dependence in Medically Complex Young Children.

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    Williams, Caitlin; VanDahm, Kelly; Stevens, Lindsay M; Khan, Soofia; Urich, Jennifer; Iurilli, Janet; Linos, Elizabeth; Williams, Dana I

    2017-07-01

    The prevalence of feeding disorders in medically complex children is estimated to be as high as 80%. Enteral tube nutrition (ETN) is commonly used for nutritional support in children with feeding disorders. Adverse consequences of ETN include medical complications, psychosocial problems, and higher healthcare costs. We used a retrospective cohort controlled study design to compare outcomes of our outpatient multidisciplinary intensive feeding therapy (IFT) program to our traditional therapy (TT) of single-discipline, once weekly feeding therapy to reduce ETN dependence in medically complex young children. Children in the IFT cohort experienced a median reduction in ETN dependence of 49% (34.5-58.5%) compared with a median reduction of 0% (0-25%) for TT (p > 0.0001). Almost half of the IFT cohort no longer required ETN by the conclusion of the 5-week program. Medically complex young children (median age 26 months) successfully reduce or eliminate ETN in an outpatient multidisciplinary intensive feeding program.

  3. EARLY ENTERAL FEEDING AND DELAYED ENTERAL FEEDING- A COMPARATIVE STUDY

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    Alli Muthiah

    2017-03-01

    Full Text Available BACKGROUND Nutrients form the fuel for the body, which comes in the form of carbohydrates, proteins and lipids. The body is intended to burn fuels in order to perform work. Starvation with malnutrition affects the postoperative patients and patients with acute pancreatitis. There is an increased risk of nosocomial infections and a delay in the wound healing may be noted. They are more prone for respiratory tract infections. Enteral Nutrition (EN delivers nutrition to the body through gastrointestinal tract. This also includes the oral feeding. This study will review the administration, rationale and assess the pros and cons associated with the early initiation of enteral feeding. The aim of this study is to evaluate if early commencement of enteral nutrition compared to traditional management (delayed enteral feeding is associated with fewer complications and improved outcome-  In patients undergoing elective/emergency gastrointestinal surgery.  In patients with acute pancreatitis. It is also used to determine whether a period of starvation (nil by mouth after gastrointestinal surgery or in the early days of acute pancreatitis is beneficial in terms of specific outcomes. MATERIALS AND METHODS A prospective cohort interventional study was conducted using 100 patients from July 2012 to November 2012. Patients satisfying the inclusion and exclusion criteria were included in the study. Patients admitted in my unit for GIT surgeries or acute pancreatitis constituted the test group, while patients admitted in other units for similar disease processes constituted the control group. RESULTS Our study concluded that early enteral feeding resulted in reduced incidence of surgical site infections. When the decreased length of stay, shorter convalescent period and the lesser post-interventional fatigue were taken into account, early enteral feeding has a definite cost benefit.CONCLUSION Early enteral feeding was beneficial associated with fewer

  4. Enteral feeding without pancreatic stimulation

    DEFF Research Database (Denmark)

    Kaushik, Neeraj; Pietraszewski, Marie; Holst, Jens Juul

    2005-01-01

    .5 g protein/kg ideal body weight/d. Plasma gut peptide responses were monitored in 15 subjects. RESULTS: In comparison with basal fasting trypsin secretion rates (mean = 134 [standard error = 22] U/h), duodenal feeding with the polymeric and elemental formulae stimulated trypsin secretion (mean = 408...... in enteral feeding without pancreatic stimulation, with particular reference to trypsin, because the avoidance of trypsin stimulation may optimize enteral feeding in acute pancreatitis. METHODS: The pancreatic secretory responses to feeding were studied in 36 healthy volunteers by standard double...... [standard error = 51] U/h; P standard error = 34] U/h) and mid-distal jejunal (mean = 119 [standard error = 16] U/h) did not. Stimulation was associated with an increase in plasma cholecystokinin, whereas distal jejunal feeding resulted in an increase...

  5. Nutritional support of bone marrow transplant recipients: a prospective, randomized clinical trial comparing total parental nutrition to an enteral feeding program

    Energy Technology Data Exchange (ETDEWEB)

    Szeluga, D.J.

    1985-01-01

    Allogeneic and autologous bone marrow transplantation (BMT) have been associated with nutritionally-depleting side effects. Total parental nutrition (TPN) has become the standard, but it has not been demonstrated that TPN is the appropriate method of nutritional support. Therefore, in a prospective, randomized clinical trial TPN and enteral feeding were compared for their effectiveness in maintaining the nutritional status of patients through the first 29 post-transplant days. Nutritional assessment included measurement of serum proteins, body weight, anthropometry and isotope dilution analysis of body composition. Total body water (TBW) and extracellular fluid (ECF) were quantified by standard radioisotope dilution techniques using tritiated water and /sup 169/ytterbium-diethylenetriaminepentaacetate, respectively as the tracers. Consenting patients 10-58 years of age were stratified by type of BMT (autologous or allogeneic) and randomized to either TPN plus ad libitum oral feeding or the individualized enteral feeding program (EFP), which included one-on-one counseling, meal-by-meal menu selection, special snacks and tube feeding. There were no differences in the rate of hematologic recovery, incidence of graft-versus-host disease, organ toxicity, length of hospitalization or survival. Therefore, the observed changes in body composition were not clinically significant. Even allowing for increased dietary service, the EFP was only half as expensive as TPN. It was concluded that TPN is not superior to the EFP and therefore, TPN should be reserved for patients who demonstrate intolerance to enteral feeding.

  6. Enteral tube feeding for cystic fibrosis.

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    Morton, Alison; Wolfe, Susan

    2015-04-09

    Enteral tube feeding is routinely used in many cystic fibrosis centres when oral dietary and supplement intake has failed to achieve an adequate nutritional status. The use of this method of feeding is assessed on an individual basis taking into consideration the patients age and clinical status. To examine the evidence that in people with cystic fibrosis, supplemental enteral tube feeding improves nutritional status, respiratory function, and quality of life without significant adverse effects. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also contacted the companies that market enteral feeds and reviewed their databases.Date of the most recent search of the Group's Cystic Fibrosis Trials Register: 13 February 2015.Date of the most recent hand search of PubMed and conference abstract books: 13 February 2015. All randomised controlled trials comparing supplemental enteral tube feeding for one month or longer with no specific intervention in people with cystic fibrosis. The searches identified 38 trials; however, none were eligible for inclusion in this review. There are no trials included in this review. Supplemental enteral tube feeding is widely used throughout the world to improve nutritional status in people with cystic fibrosis. The methods mostly used, nasogastric or gastrostomy feeding, are expensive and may have a negative effect on self-esteem and body image. Reported use of enteral tube feeding suggests that it results in nutritional and respiratory improvement; but, efficacy has not been fully assessed by randomised controlled trials. It is acknowledged, however, that performing a randomised controlled trial would be difficult due to the ethics of withholding an intervention in a group of patients whose nutritional status necessitates it.

  7. A Program for Weaning Children from Enteral Feeding in a General Pediatric Unit: How, for Whom, and with What Results?

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    Justine Mirete

    2018-01-01

    Full Text Available ObjectiveTo describe a series of children who were hospitalized for a tube-weaning program in the general pediatric ward of a pediatric tertiary university hospital: describe our method, to determine the success rate of our inpatient pediatric tube weaning program, and search for relevant factors linked to its success or failure.MethodWe analyzed the medical files of consecutive children who were hospitalized for gastric-tube weaning over an 8-year period. We analyzed outcomes in terms of feeding and growth with at least 2 years of data. Success (weaning within 3 months and failure were compared by characteristics of children.ResultsWe included 37 children (29 females with mean (SD age 31.4 (21 months. Most had a severe medical history (30% prematurity; 50% intrauterine growth restriction, 50% neurological and genetic anomalies. The weaning program was successful for half of the children. Factors linked to success of the program were female sex (p = 0.0188, normal neurodevelopment (p = 0.0016, nasogastric tube (p = 0.0098, and with <24 months on EF before the stay (p = 0.0309.DiscussionComparing the efficiency of various methods and results among teams was difficult, which indicates the need to establish consensus about the outcome criteria. We confirm the need for these types of stays and programs.

  8. Compounded Apixaban Suspensions for Enteral Feeding Tubes.

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    Caraballo, Maria L; Donmez, Seda; Nathan, Kobi; Zhao, Fang

    2017-07-01

    Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of 7 days. Methods: Apixaban suspensions were prepared from commercially available 5-mg Eliquis tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride, with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A 7-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40% to 60% Ora-Plus in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus:water, was compatible with both tubing types, retaining >98% drug in posttube samples. The stability study also confirmed that this formulation was stable physically and chemically over 7 days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus:water. The stability study results supported a beyond-use date of 7 days at room temperature.

  9. Enteral Feeding in Abdominal Compartment Syndrome

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    Ye. V Grigoryev

    2009-01-01

    Full Text Available Objective: to substantiate the choice of a gastrointestinal tract (GIT function support regimen as a mode for correction of the abdominal compartment syndrome (ACS. Subjects and methods. Forty-three patients with different causes of inadequate GIT function of various origin and ACS (disseminated peritonitis (45%, pancreatitis (24%, and severe concomitant injury (31% were examined. Group 1 (control received complete parenteral nutritional feeding (n=23; APACHE II scores, 21±4; calculated probability of fatal outcome, 33.5%. In Group II (study, complete parenteral feeding in the first 24 hours after stabilization was supplemented with GIT function support with Pepsisorb (Nutricia in doses of 500, 1000, and 1500 ml on days 1, 2, and 3, respectively (n=20; APACHE II scores, 20±6; calculated probability of fatal outcome, 37.1%. During early enteral nutritional support, the SOFA score was significantly less than that in Group 1 on days 2—3; the oxygenation index significantly increased on day 3; the value of intra-abdominal hypertension decreased to the control values. The positive effect of the GIT function support regimen on regression of the multiple organ dysfunction syndrome (MODS was confirmed by the lowered levels of biological markers (von Willebrand factor (WF and endothelin-1 as markers of endothelial damage of MODS. Correlation analysis showed a direct correlation between the markers of endothelial damage and the SOFA scores (r=0.34; p=0.05 for WF and r=0.49;p=0.03 for endothelin. Conclusion. The GIT function support regimen via early enteral alimentation with Peptisorb, which was initiated in the first 24 hours after admission, is able to level off the manifestations of the early stages of the abdominal compartment syndrome, with the acceptable values of oxygen balance and water-electrolyte and osmotic homeostasis being achieved. Key words: abdominal compartment syndrome, nutritional support, biological markers, oxygenation index

  10. Enteral feeding pumps: efficacy, safety, and patient acceptability

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    White H

    2014-08-01

    Full Text Available Helen White, Linsey King Nutrition and Dietetic Group, School of Health and Wellbeing, Faculty Health and Social Science, Leeds Metropolitan University, Leeds, United Kingdom Abstract: Enteral feeding is a long established practice across pediatric and adult populations, to enhance nutritional intake and prevent malnutrition. Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered is more limited. The accuracy, safety, and consistency with which enteral feed pump systems dispense nutritional formulae are important determinants of their use and acceptability. Enteral feed pump safety has received increased interest in recent years as enteral pumps are used across hospital and home settings. Four areas of enteral feed pump safety have emerged: the consistent and accurate delivery of formula; the minimization of errors associated with tube misconnection; the impact of continuous feed delivery itself (via an enteral feed pump; and the chemical composition of the casing used in enteral feed pump manufacture. The daily use of pumps in delivery of enteral feeds in a home setting predominantly falls to the hands of parents and caregivers. Their understanding of the use and function of their pump is necessary to ensure appropriate, safe, and accurate delivery of enteral nutrition; their experience with this is important in informing clinicians and manufacturers of the emerging needs and requirements of this diverse patient population. The review highlights current practice and areas of concern and establishes our current knowledge in this field. Keywords: nutrition, perceptions, experience

  11. Clinical Aspects of Postoperative Enteral Feeding in the Surgical Patient

    NARCIS (Netherlands)

    I.J.M. Han-Geurts

    2006-01-01

    textabstractIn this thesis clinical aspects of perioperative feeding in gastrointestinal surgery are discussed in several clinical studies. The main goal is to obtain insight in the influence of enteral feeding and

  12. [Postoperative enteral feeding in digestive anastomosis with proximal oesophageal partner].

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    Vasile, I; Mirea, C; Vîlcea, I D; Calotă, F; Paşalega, M; Meşină, C; Cheie, M; Mogoanţă, S; Dumitrescu, T; Grecu, C; Radu, V; Moraru, E

    2010-01-01

    This paper aim is to discuss the advantages of enteral postoperative feeding on patients submitted to surgery finalized through an eso-digestive anastomosis; in these cases enteral feeding is often delayed 5-8 days after the surgery, and in case of an anastomotic dehiscence may be even impossible. Also, the paper promotes duodenostomy as an important enteral feeding way, and discusses the indications and contraindications of different enteral nutrition pathways in such cases. There were studied 230 cases, 149 cases submitted to cancer surgery and 81 cases with benign condition surgery followed by an eso-digestive anastomosis, in which the following enteral nutrition pathways was practiced: nasogastric or naso-esojejunal feeding tube (55 cases); Witzel jejunostomy (28 cases); gastrostomy (79 cases); duodenostomy (68 cases). Postoperative morbidity induced exclusively by the enteral nutrition pathway was encountered in 36% of patients. On patients with an eso-gastric cervical anastomosis or esogastric thoracic anastomosis we used jejunostomy as enteral feeding path and a gastric tube passed by pyloric canal for gastric decompression. In cases of esophageal reconstruction for benign esophageal strictures gastrostomy remains the best feeding method. Duodenostomy was practiced as a feeding pathway in cases of total gastrectomy with esojejunal anastomosis, with closure of the duodenal stump.

  13. Parenteral and Early Enteral Feeding in Patients with Colonic Tumor

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    O. A. Malkov

    2008-01-01

    Full Text Available Objective: to provide evidence whether it is expedient to use an early enteral feeding protocol in patients with colonic malignancies in the postoperative period to prevent and to correct hemodynamic disorders, oxygen imbalance, and malnutrition. Subjects and methods. A hundred patients (61 males and 39 females aged 66.2±5.0 years, who had Stages 2—3 colonic malignancies, were examined. Two algorithms of postoperative management were analyzed using the traditional diet and early enteral feeding. Results. The early enteral feeding protocol improves central hemodynamics and oxygen and nutritional status, prevents moderate protein-energy deficiency in the early postoperative period and reduces the number of complications and fatal outcomes in patients with colonic malignancies. Key words: malignancies, malnutrition, hemo-dynamics, oxygen status, enteral feeding.

  14. Nurses' Competency and Challenges in Enteral feeding in the ...

    African Journals Online (AJOL)

    Nurses' Competency and Challenges in Enteral feeding in the Intensive Care Unit (ICU) and High Dependency ... the American Association of Critical Care Nurses (AACN). Synergy Model for Patient Care. This model .... shortage as a common challenge, followed by patients'/guardians' refusal of tube feeding (18, 35.3%).

  15. Enteral feeding practices in preterm infants in South Africa

    African Journals Online (AJOL)

    Background. Optimal feeding regimens in babies weighing <1 000 g have not been established, and wide variations occur. In South Africa. (SA) this situation is complicated by varied resource constraints. Objective. To determine the preterm enteral feeding practices of paediatricians in SA. Methods. We invited 288 ...

  16. Pediatric Enteric Feeding Techniques: Insertion, Maintenance, and Management of Problems

    International Nuclear Information System (INIS)

    Nijs, Els L. F.; Cahill, Anne Marie

    2010-01-01

    Enteral feeding is considered a widespread, well-accepted means of delivering nutrition to adults and children who are unable to consume food by mouth or who need support in maintaining adequate nutrition for a variety of reasons, including acute and chronic disease states. Delivery of enteral feeding to nutritionally deprived patients may be achieved by several means. In this article, the indications and insertion of enteral access in children will be reviewed. In addition, common complications and management of problems will be discussed.

  17. Temporary feed restriction partially protects broilers from necrotic enteritis.

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    Tsiouris, V; Georgopoulou, I; Batzios, Chr; Pappaioannou, N; Ducatelle, R; Fortomaris, P

    2014-01-01

    The objective of this study was to investigate the effect of feed restriction on the intestinal ecosystem and on the pathogenesis of experimental necrotic enteritis in broiler chicks. To induce subclinical necrotic enteritis, an experimental challenge model using a specific diet formulation, Gumboro vaccination, oral inoculation of broilers with a 10-fold dose of attenuated anticoccidial vaccine and multiple oral inoculations with a specific strain of Clostridium perfringens was adopted. Two hundred and forty 1-day-old Cobb 500 broilers were randomly allocated to four groups: feed restricted, challenged, both feed restricted and challenged, and negative control. At 21, 22, 23 and 24 days of age, the intestines, gizzard and liver were collected from 15 birds in each group and scored for gross lesions. The intestinal digesta was collected for pH and viscosity determination. One caecum from each bird was taken for microbiological analysis. The application of feed restriction in birds challenged with C. perfringens reduced the necrotic enteritis lesion score significantly (P ≤ 0.05) and feed restriction significantly reduced (P ≤ 0.05) pH in the small intestine, the viscosity of the jejunum digesta as well as the C. perfringens counts in the caeca compared with the controls. In conclusion, feed restriction of broilers has a positive effect on the intestinal ecosystem and a significant protective effect against necrotic enteritis in the subclinical experimental model.

  18. Implementation of enteral feeding protocol in an intensive care unit

    DEFF Research Database (Denmark)

    Padar, Martin; Uusvel, Gerli; Starkopf, Liis

    2017-01-01

    AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013......, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population...... the groups. Patients in the After group had a lower 90-d (P = 0.026) and 120-d (P = 0.033) mortality. In the After group, enteral nutrition was prescribed less frequently (P = 0.039) on day 1 but significantly more frequently on all days from day 3. Implementation of the feeding protocol resulted in a higher...

  19. Residual feed intake and breeding approaches for enteric methane mitigation

    DEFF Research Database (Denmark)

    Berry, Donagh P; Lassen, Jan; de Hass, Y

    2015-01-01

    no explicit inclusion of environmental load (and in most instances, even feed efficiency) in these goals. Heritability of feed intake-related traits in cattle is moderate to high, implying that relatively high accuracy of selection can be achieved with relatively low information content per animal; however...... in cattle are rare. No estimate of the genetic variation in enteric CH4 emissions independent of animal performance exists; it is the parameters for this trait that depict the scope for genetic improvement. The approach to the inclusion of feed intake or CH4 emissions in cattle breeding goals is not clear...

  20. In Vitro Evaluation of Eslicarbazepine Delivery via Enteral Feeding Tubes.

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    Reindel, Kristin; Zhao, Fang; Hughes, Susan; Dave, Vivek S

    2017-12-01

    Purpose: The feasibility of preparing an eslicarbazepine acetate suspension using Aptiom tablets for administration via enteral feeding tubes was evaluated. Methods: Eslicarbazepine acetate suspension (40 mg/mL) was prepared using Aptiom tablets after optimizing the tablet crushing methods and the vehicle composition. A stability-indicating high-performance liquid chromatography (HPLC) method was developed to monitor the eslicarbazepine stability in the prepared suspension. Three enteric feeding tubes of various composition and dimensions were evaluated for the delivery of the suspensions. The suspension was evaluated for the physical and chemical stability for 48 hours. Results: The reproducibility and consistency of particle size reduction was found to be best with standard mortar/pestle. The viscosity analysis and physical stability studies showed that ORA-Plus:water (50:50 v/v) was optimal for suspending ability and flowability of suspension through the tubes. The developed HPLC method was found to be stability indicating and suitable for the assay of eslicarbazepine acetate in the prepared suspension. The eslicarbazepine concentrations in separately prepared suspensions were within acceptable range (±3%), indicating accuracy and reproducibility of the procedure. The eslicarbazepine concentrations in suspensions before and after delivery through the enteric feeding tubes were within acceptable range (±4%), indicating absence of any physical/chemical interactions of eslicarbazepine with the tubes and a successful delivery of eslicarbazepine dosage via enteric feeding tubes. The stability study results showed that eslicarbazepine concentration in the suspension remained unchanged when stored at room temperature for 48 hours. Conclusion: The study presents a convenient procedure for the preparation of a stable suspension of eslicarbazepine acetate (40 mg/mL) using Aptiom tablets, for administration via enteral feeding tubes.

  1. Enteral Nutrition for Feeding Severely Underfed Patients with Anorexia Nervosa

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    Maria Gabriella Gentile

    2012-09-01

    Full Text Available Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium. In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1 to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; (2 to avoid “underfeeding” caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI of 11.2 ± 0.7 kg/m2. The mean BMI increased from 11.2 ± 0.7 kg/m2 to 17.3 ± 1.6 kg/m2 and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p < 0.0001. Caloric intake levels were established after measuring resting energy expenditure by indirect calorimetry, and nutritional support was performed with enteral feeding. Vitamins, phosphate, and potassium supplements were administered during refeeding. All patients achieved a significant modification of BMI; none developed refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.

  2. Effect of enteral feeding on gallbladder function in dogs.

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    Psáder, Roland; Sterczer, Agnes; Pápa, Kinga; Harnos, Andrea; Szilvási, Viktória; Pap, Akos

    2012-06-01

    Nutritional support in critically ill patients is a fundamental principle of patient care. Little is known about gallbladder motility during the interdigestive phase and in response to enteral feeding. The objective of this study was to investigate the effect of enteral feeding on gallbladder function in dogs. The cholagogue meal (Lipofundin infusion) was applied in four anatomical positions (jejunum, duodenojejunal junction, descending duodenum, stomach) in five healthy Beagle dogs. Gallbladder volume (GBV) was monitored by ultrasonography. Lipofundin infusion given through the feeding tube caused a maximal gallbladder contraction of 9.2% (range 3.7-13.9%) in the jejunum, 16.5% (9.1-22.1%) at the duodenojejunal junction and 26.3% (22.8-29.5%) in the descending duodenum. When the cholagogue meal was given through the mouth, it caused a mean 33.8% (28.6-46.5%) maximum gallbladder contraction in the same animals. In conclusion, we can establish that the ultrasound-guided gallbladder emptying method proved to be a useful technique for monitoring the cholagogue effect of Lipofundin meal applied in different anatomical positions of the intestine. The deeper the position of application, the smaller and shorter gallbladder contraction was evoked.

  3. Withdrawing feeds from children on long term enteral feeding: factors associated with success and failure.

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    Wright, Charlotte M; Smith, Kathryn H; Morrison, Jill

    2011-05-01

    Enteral feeding is vital for sick infants, but the transition to normal diet may be difficult. The authors describe a feeding team which provides multidisciplinary management of 'hard to wean' children within a large children's hospital, using reduction of feed volume to stimulate hunger, combined with psychological input to improve mealtime interactions and relieve parental anxiety. To assess the impact of feed reduction on growth and identify factors associated with successful feed cessation. Clinical and anthropometric data retrieved from case notes and clinic database for all 41 children referred for feed withdrawal over a 5-year period. The children were aged median 4.0 (range 0.7-15) years when first seen; 27 (66%) were male and before reduction they received a median of 3766 (range 1987-9728) kJ daily from enteral feeds. Parents were often extremely anxious about weight loss and needed considerable support to make feed reductions. After follow-up for median (range) 1.7 (0.4-5.4) years, 32 (78%) were on solely normal diet, seven were still enterally fed and two were reliant on oral supplement drinks. Those referred after age 5 years were more likely to still be on artificial feeds (OR 7.4 (1.3-42); p=0.025) or to have taken more than a year to stop (OR 6.9 (1.1-43); p=0.04). Feed reduction was commonly followed by a decline in body mass index, but this was not associated with slow growth. A majority of children eventually ceased feeds successfully, but slow and failed weaning is more likely after age 5 years.

  4. How to set up and administer an enteral feed via a nasogastric tube.

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    Best, Carolyn

    2017-07-05

    Rationale and key points Nasogastric tube feeding is a method of enteral feeding commonly administered by nurses. Feed can be administered either using a volumetric enteral feeding pump (pump feeding) or via an enteral syringe (bolus feeding). This article explains how nurses can safely undertake these two methods of nasogastric tube feed administration at the patient's bedside. » Nasogastric tube feeding can be used to provide some or all of the patient's nutrition, fluid or medication. » Nurses should be equipped with the relevant knowledge to flush a nasogastric tube before the administration of feed or medication; set up and administer an enteral feed via a volumetric enteral feeding pump; and set up and administer a feed using a bolus method. » The position of the distal tip of the nasogastric tube must be confirmed as sitting in the patient's stomach before the tube is used to administer enteral feed, fluid or medication. Reflective activity 'How to' articles can help you update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: 1. How you think this article will change your practice when setting up and administering an enteral feed via a nasogastric tube. 2. How you could use this resource to educate your colleagues about nasogastric tube feeding via an enteral feeding pump or bolus feeding.

  5. The Challenges of Home Enteral Tube Feeding: A Global Perspective

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    Omorogieva Ojo

    2015-04-01

    Full Text Available The aim of this review is to provide a global perspective of Home Enteral Tube Feeding (HETF and to outline some of the challenges of home enteral nutrition (HEN provisions. It is well established that the number of patients on HETF is on the increase worldwide due to advances in technology, development of percutaneous endoscopic gastrostomy techniques, and the shift in care provisions from acute to community settings. While the significance of home enteral nutrition in meeting the nutritional requirements of patients with poor swallowing reflexes and those with poor nutritional status is not in doubt, differences exist in terms of funding, standards, management approaches and the level of infrastructural development across the world. Strategies for alleviating some of the challenges militating against the effective delivery of HETF including the development of national and international standards, guidelines and policies for HETF, increased awareness and funding by government at all levels were discussed. Others, including development of HEN services, which should create the enabling environment for multidisciplinary team work, clinical audit and research, recruitment and retention of specialist staff, and improvement in patient outcomes have been outlined. However, more research is required to fully establish the cost effectiveness of the HEN service especially in developing countries and to compare the organization of HEN service between developing and developed countries.

  6. Comparison of Intermittent and Bolus Enteral Feeding Methods on Enteral Feeding Intolerance of Patients with Sepsis: A Triple-blind Controlled Trial in Intensive Care Units.

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    Nasiri, Morteza; Farsi, Zahra; Ahangari, Mojtaba; Dadgari, Fahimeh

    2017-10-01

    BACKGROUND Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis. METHODS This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension. RESULTS There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume ( p > 0.05). Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days ( p > 0.05). CONCLUSION As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly.

  7. Effect of minimal enteral feeding on recovery in a methotrexate-induced gastrointestinal mucositis rat model

    NARCIS (Netherlands)

    Kuiken, Nicoline S. S.; Rings, Edmond H. H. M.; Havinga, Rick; Groen, Albert K.; Tissing, Wim J. E.

    2016-01-01

    Patients suffering from gastrointestinal mucositis often receive parenteral nutrition as nutritional support. However, the absence of enteral nutrition might not be beneficial for the intestine. We aimed to determine the feasibility of minimal enteral feeding (MEF) administration in a methotrexate

  8. Effect of minimal enteral feeding on recovery in a methotrexate-induced gastrointestinal mucositis rat model

    NARCIS (Netherlands)

    Kuiken, Nicoline S. S.; Rings, Edmond H. H. M.; Havinga, Rick; Groen, Albert K.; Tissing, Wim J. E.

    Patients suffering from gastrointestinal mucositis often receive parenteral nutrition as nutritional support. However, the absence of enteral nutrition might not be beneficial for the intestine. We aimed to determine the feasibility of minimal enteral feeding (MEF) administration in a methotrexate

  9. Critical Analysis of the Factors Associated with Enteral Feeding in Preventing VAP: A Systematic Review

    OpenAIRE

    Yu-Chih Chen

    2009-01-01

    Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving a...

  10. Enteral Feeding with Human Milk Decreases Time to Discharge in Infants following Gastroschisis Repair.

    Science.gov (United States)

    Gulack, Brian C; Laughon, Matthew M; Clark, Reese H; Burgess, Terrance; Robinson, Sybil; Muhammad, Abdurrauf; Zhang, Angela; Davis, Adrienne; Morton, Robert; Chu, Vivian H; Arnold, Christopher J; Hornik, Christoph P; Smith, P Brian

    2016-03-01

    To assess the effect of enteral feeding with human milk on the time from initiation of feeds to discharge after gastroschisis repair through review of a multi-institutional database. Infants who underwent gastroschisis repair between 1997 and 2012 with data recorded in the Pediatrix Medical Group Clinical Data Warehouse were categorized into 4 groups based on the percentage of days fed human milk out of the number of days fed enterally. Cox proportional hazards regression modeling was performed to determine the adjusted effect of human milk on the time from initiation of feeds to discharge. Among 3082 infants, 659 (21%) were fed human milk on 0% of enteral feeding days, 766 (25%) were fed human milk on 1%-50% of enteral feeding days, 725 (24%) were fed human milk on 51%-99% of enteral feeding days, and 932 (30%) were fed human milk on 100% of enteral feeding days. Following adjustment, being fed human milk on 0% of enteral feeding days was associated with a significantly increased time to discharge compared with being fed human milk on 100% of enteral feeding days (hazard ratio [HR] for discharge per day, 0.46; 95% CI, 0.40-0.52). The same was found for infants fed human milk on 1%-50% of enteral feeding days (HR, 0.37; 95% CI, 0.32-0.41) and for infants fed human milk on 51%-99% of enteral feeding days (HR, 0.51; 95% CI, 0.46-0.57). The use of human milk for enteral feeding of infants following repair of gastroschisis significantly reduces the time to discharge from initiation of feeds. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Percutaneous Endoscopic Gastrostomy in the Enteral Feeding of the Elderly

    Directory of Open Access Journals (Sweden)

    Huan-Lin Chen

    2011-09-01

    Full Text Available Today we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by use of a gastrostomy. Percutaneous endoscopic gastrostomy (PEG was first introduced in 1980 as an alternative to the traditional operative procedure and rapidly became the preferred procedure. In geriatric patients, the principal indications are neurological dysphagia and malnutrition, related to an underlying disease or anorexia-cachexia in very elderly. PEG is contraindicated in the presence of respiratory distress, previous gastric resection, total esophageal obstruction, coagulation disorders and sepsis in the elderly. Common complications include wound infection, leakage, hemorrhage, and fistula in the general population, but aspiration pneumonia is the major case of death in this group. Risks and complications of PEG must be discussed with patients and their families; and the decision for percutaneous endoscopic gastrostomy insertion should only be made after careful consideration and discussion between managing physicians, allied health professionals, and the patient and/or family. Four ethical principles may help make feeding decisions: beneficence, non-maleficence, autonomy and justice. Attentive long-term care after tube replacement is mandatory. Acceptance of percutaneous endoscopic gastrostomy placement by patients and their families tends to increase once favorable outcomes are offered.

  12. The effects of enteral feeding improvement massage on premature infants: A randomised controlled trial.

    Science.gov (United States)

    Kim, Hee-Young; Bang, Kyung-Sook

    2018-01-01

    To prove the effects of an enteral feeding improvement massage for premature infants with regard to their feeding, growing and superior mesentery artery blood flow aspect by a randomised controlled trial. Premature infants have feeding-related problems related to eating and absorbing nutrition due to their immature gastrointestinal function. Studies regarding the effectiveness of premature infants' enteral feeding improvement by tactile stimulation massage are rare. The study group was composed of 55 patients. Of the 55 patients, 26 were randomised into an experimental group and 29 were randomised into a control group. They were all born group received enteral feeding improvement massage twice a day for 14 days, and infants in the control group received a sham exercise. The collected data were analysed by spss 19.0, through t test, chi-square test (Fisher's exact) and ANCOVA. (i) The experimental group had reached the day of full enteral feeding significantly faster. (ii) The experimental group had a higher superior mesentery artery peak velocity (V max ) and lower RI (resistant index). (iii) The experimental group of the feeding-intolerant subgroup had a higher superior mesentery artery V max and V min . (iv) The experimental group had a heavier weight and larger head circumference after 14 days. This study demonstrates that enteral feeding improvement massage can be helpful for achieving earlier full enteral feeding, more increased superior mesentery artery, and faster growing. In particular, it can be a therapeutic, independent and evidence-based nursing intervention for feeding-intolerant premature infants. Neonatal nurses in neonatal intensive care unit can apply enteral feeding improvement massage massage for feeding-intolerant infants. © 2017 John Wiley & Sons Ltd.

  13. [Ultrasonic study of gallbladder motility during exclusive continuous enteral feeding].

    Science.gov (United States)

    Douard, H; Cosnes, J; Sebag, A; Evard, D; Le Quintrec, Y

    1987-10-01

    Total parenteral nutrition may be responsible for gallbladder sludge and lithiasis which might possibly be related to gallbladder bile stasis. Gallbladder motility has not yet been studied during constant-rate enteral nutrition. We performed serial ultrasonographic studies of gallbladder volume and contents in ten patients receiving constant-rate enteral nutrition during 35 +/- 17 days. Each patient had two weekly examinations at 9 AM and 2 PM on the same day. None of the patients developed gallbladder sludge or lithiasis. The gallbladder was frequently seen to be contracted. Mean gallbladder volume during constant-rate enteral nutrition was not significantly different from mean gallbladder volume after Bladex. Individual gallbladder volume changed significantly from one measurement to another. This study showed that gallbladder motility is preserved during constant-rate enteral nutrition. The persistence of gallbladder contractions may prevent the development of biliary sludge ad lithiasis.

  14. Critical Analysis of the Factors Associated with Enteral Feeding in Preventing VAP: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Yu-Chih Chen

    2009-04-01

    Full Text Available Ventilator-associated pneumonia (VAP is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre–post studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent, feeding site on aspiration (gastric vs. small bowel, and the timing of enteral feeding (early vs. late. The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP

  15. Critical analysis of the factors associated with enteral feeding in preventing VAP: a systematic review.

    Science.gov (United States)

    Chen, Yu-Chih

    2009-04-01

    Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre-post) studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent), feeding site on aspiration (gastric vs. small bowel), and the timing of enteral feeding (early vs. late). The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP still need further

  16. Effect of enteral tube feeding on serum phenytoin levels.

    Science.gov (United States)

    Ozuna, J; Friel, P

    1984-12-01

    The primary purpose of the present study was to determine if altering the timing of phenytoin administration in relation to delivery of tube feedings increased serum phenytoin levels. Stopping tube feedings for two hours before and two hours after administration is a procedure that nurses could employ independently for better patient care. However, this adds an extra procedure to the nurse's already busy routine. It also requires the nurse to adjust either the tube feeding flow rate or bolus amount in order to deliver the same amount of calories per day. Based on this study, it appears that this intervention procedure is not effective for the patient and is time-consuming for the nurse. Instead, the focus for increasing phenytoin serum levels in patients receiving tube feedings should probably be on increasing the dosage.

  17. Monitoring of home safety issues in children on enteral feeds with inherited metabolic disorders.

    Science.gov (United States)

    Evans, S; Shelton, F; Holden, C; Daly, A; Hopkins, V; MacDonald, A

    2010-09-01

    To assess the safety aspects of carers' enteral feeding technique when home enteral tube feeding children with inherited metabolic disorders (IMD). 40 patients (median age, 5.1 years; range, 0.3-13.6 years) with IMD requiring pump tube feeding were recruited. 12 patients had glycogen storage disease, 11 organic acidemias, 8 fatty acid oxidation disorders, 4 urea cycle disorders, and 5 had other conditions. 50% of the patients were fed by gastrostomy and 50% nasogastric tube. A questionnaire and practical assessment of feeding process was completed with carers by a dietician and nurse in the child's home. Areas investigated included carer hygiene, feed preparation, tube care, tube changing, use of feeding pumps and equipment, and storage of enteral feeding equipment. The main issues identified were poor hygiene practices (78% unclean work surfaces; 25% no hand washing); inaccurate ingredient measuring (40%); irregular checking of tube position (40%); inadequate tube flushing (50%); poor knowledge of how to clear tube blockages (80%); incorrect priming of pump sets (50%); incorrect position of child for night feeding (63%); untrained secondary carers (43%); and poor knowledge of pump alarms, battery life, and charging time. Children commonly slept in parent's room as a safety precaution (58%). Long term follow-up of children with IMD on home enteral tube feeding suggests that regular updates on knowledge and technique for carers may be necessary to reduce risk.

  18. Efficacy and complications of enteral feeding tube insertion after liver transplantation.

    Science.gov (United States)

    Chun, J H; Ahn, J Y; Jung, H-Y; Jung Park, H; Kim, G H; Lee, J H; Choi, K-S; Jung, K W; Kim, D H; Choi, K D; Song, H J; Lee, G H; Kim, J H; Song, G W; Kim, J-H

    2015-03-01

    Adequate nutritional support for patients undergoing major surgery significantly affects postoperative recovery. Data on enteral feeding after liver transplantation (LT) are scarce. The aim of this work was to determine the efficacy and complications of feeding tubes inserted with the use of fluoroscopic assistance, endoscopic assistance, or transperitoneal jejunostomy in patients who underwent LT. From January 2008 to August 2013, 2,058 LTs were performed at Asan Medical Center, Seoul, Korea. Enteral feeding tubes were inserted in 155 patients (7.5%) after LT: with the use of fluoroscopic placement in 81 (52%), endoscopic placement in 49 (32%), and transperitoneal jejunostomy in 25 (16%). We retrospectively analyzed the efficacy and complications of enteral feeding tubes. The median age was 55 years (interquartile range [IQR] 49-60). Enteral feeding indications were a high risk of gastric aspiration (n = 90), gastric stasis (n = 27), pneumonia (n = 23), gastrointestinal bleeding (n = 12), and bowel rest (n = 3). Median enteral feeding durations were 14.5 days (IQR 8.0-30.7) for fluoroscopic placement, 20.0 days (IQR 8.0-40.0) for endoscopic placement, and 37.5 days (IQR 18.2-86.2) for transperitoneal jejunostomy. Times to establishment of oral feeding were 13.0 days (IQR 6.2-25.7) for fluoroscopic placement, 24.0 days (IQR 10.5-43.5) for endoscopic placement, and 37.0 days (IQR 17.0-64.2) for transperitoneal jejunostomy. After tube insertion, tube dislocation and blockage occurred in 34 patients (22%) and 16 patients (25%), respectively. Enteral feeding tube insertion in patients who can not maintain a nasogastric tube or start oral intake for a long time is important for nutritional support after LT. Proper feeding method selection according to patient condition can help patients by improving nutritional support after major operations such as LT. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Blended food for enteral feeding via a gastrostomy.

    Science.gov (United States)

    Brown, Suzanne

    2014-11-01

    A blended diet for enteral nutrition is defined as home-made everyday food blended to a smooth 'single cream' consistency. At present, blended food is not recommended as a first choice. However, the wishes of parents who prefer to use blended food for their child need to be respected, and hospice policy for Children's Hospice South West is to replicate home conditions as far as possible. Therefore guidelines have been created for use of a blended diet. However, benefits in physical and emotional health need to be balanced against risks of tube blockage, contamination and digestive upsets.

  20. The Importance of Pharmaceutical Dosage Forms in Administration via Enteral Feeding Tubes

    Directory of Open Access Journals (Sweden)

    Kutay Demirkan

    2016-04-01

    Full Text Available SUMMARY A caloric requirement of the patients who do not have an access for feeding through an oral route is supported by enteral or parenteral nutrition. In the patients who have suitable gastrointestinal function, enteral feeding is preferred initially. Enteral feeding is also used for administration of medications in patients who cannot swallow. However, an administration of drugs via a feeding tube is complicated; appropriate techniques should be used in order to prevent obstruction of feeding tube and thereby avoid reduction of the drug effect and to minimize the risk of toxicity of given pharmaceuticals. In the patients who are not able to take medication orally, alternative routes such as intravenous, intramuscular, subcutaneous, inhaled, transdermal, rectal, and sublingual administrations are available and should be preferred at the first place. According to the American Society for Parenteral and Enteral Nutrition, an effect of a size and the position of the feeding tube, characteristics of pharmaceutical dosage form and methods of administration should be considered when applying medication via enteral tube. The risk of the drug interactions arises in patients who have nutritional support. In order to prevent drug interactions, a pharmacist, who has an extensive education and knowledge on drugs, its characteristics and mechanism of action is required for multidisciplinary team in clinical practice.

  1. Introducing enteral feeding induces intestinal subclinical inflammation and respective chromatin changes in preterm pigs

    DEFF Research Database (Denmark)

    Willems, Rhea; Krych, Lukasz; Rybicki, Verena

    2015-01-01

    AIM: To analyze how enteral food introduction affects intestinal gene regulation and chromatin structure in preterm pigs. MATERIALS & METHODS: Preterm pigs were fed parenteral nutrition plus/minus slowly increasing volumes of enteral nutrition. Intestinal gene-expression and chromatin structure...... were analyzed 5 days after birth. RESULTS: Enteral feeding led to differential upregulation of inflammatory and pattern recognition receptor genes, including IL8 (median: 5.8, 95% CI: 3.9-7.8 for formula; median: 2.2, 95% CI: 1.3-3.3 for colostrum) and TLR4 (median: 3.7, 95% CI: 2.6-4.8 for formula...... stimulation with lipopolysaccharide (median: 7.0; interquartile range: 5.63-8.85) compared with naive cells (median 4.2; interquartile range: 2.45-6.33; p = 0.03). CONCLUSION: Enteral feeding, particular with formula, induces subclinical inflammation in the premature intestine and more open chromatin...

  2. Infection control in enteral feed and feeding systems in the community

    OpenAIRE

    Ojo, Omorogieva; Bowden, Julie

    2013-01-01

    This article examines the infection risk to adult patients receiving home enteral nutrition (HEN) and strategies for its prevention and management. Enteral nutrition was historically associated with acute care settings owing to its invasive nature. The changing landscape of community care means that it is now likely to be administered in the patient’s home or in other community settings such as nursing homes. HEN is associated with two main routes of infection risks: the risk of gastrointesti...

  3. Liver but not adipose tissue is responsive to the pattern of enteral feeding.

    Science.gov (United States)

    Otero, Yolanda F; Lundblad, Tammy M; Ford, Eric A; House, Lawrence M; McGuinness, Owen P

    2014-02-01

    Nutritional support is an important aspect of medical care, providing calories to patients with compromised nutrient intake. Metabolism has a diurnal pattern, responding to the light cycle and food intake, which in turn can drive changes in liver and adipose tissue metabolism. In this study, we assessed the response of liver and white adipose tissue (WAT) to different feeding patterns under nutritional support (total enteral nutrition or TEN). Mice received continuous isocaloric TEN for 10 days or equal calories of chow once a day (Ch). TEN was given either at a constant (CN, same infusion rate during 24 h) or variable rate (VN, 80% of calories fed at night, 20% at day). Hepatic lipogenesis and carbohydrate-responsive element-binding protein (ChREBP) expression increased in parallel with the diurnal feeding pattern. Relative to Ch, both patterns of enteral feeding increased adiposity. This increase was not associated with enhanced lipogenic gene expression in WAT; moreover, lipogenesis was unaffected by the feeding pattern. Surprisingly, leptin and adiponectin expression increased. Moreover, nutritional support markedly increased hepatic and adipose FGF21 expression in CN and VN, despite being considered a fasting hormone. In summary, liver but not WAT, respond to the pattern of feeding. While hepatic lipid metabolism adapts to the pattern of nutrient availability, WAT does not. Moreover, sustained delivery of nutrients in an isocaloric diet can cause adiposity without the proinflammatory state observed in hypercaloric feeding. Thus, the liver but not adipose tissue is responsive to the pattern of feeding behavior.

  4. Enteric methane production in lactating dairy cows with continuous feeding of essential oils or rotational feeding of essential oils and lauric acid

    NARCIS (Netherlands)

    Klop, G.; Dijkstra, Jan; Dieho, K.; Hendriks, W.H.; Bannink, A.

    2017-01-01

    The rumen microbes can adapt to feed additives, which may make the decrease in enteric CH4 production upon feeding an additive a transient response only. This study investigated alternate feeding of 2 CH4 mitigating feed additives with a different mode of action on persistency of lowering CH4

  5. Enteral feeding induces diet-dependent mucosal dysfunction, bacterial proliferation, and necrotizing enterocolitis in preterm pigs on parenteral nutrition

    DEFF Research Database (Denmark)

    Bjørnvad, Charlotte R.; Thymann, Thomas; Deutz, Nicolaas E.

    2008-01-01

    Preterm neonates have an immature gut and metabolism and may benefit from total parenteral nutrition (TPN) before enteral food is introduced. Conversely,delayed enteral feeding may inhibit gut maturation and sensitize to necrotizing enterocolitis (NEC). Intestinal mass and NEC lesions were first...... recorded in preterm pigs fed enterally (porcine colostrum, bovine colostrum, or formula for 20–40 h), with or without a preceding 2- to 3-day TPN period (n 435). Mucosal mass increased during TPN and further after enteral feeding to reach an intestinal mass similar to that in enterally fed pigs without TPN...... (60–80% relative to birth). NEC developed only after enteral feeding but more often after a preceding TPN period for both sow’s colostrum (26 vs. 5%) and formula (62 vs. 39%, both P 0.001, n 43–170). Further studies in 3-day-old TPN pigs fed enterally showed that formula feeding decreased villus...

  6. Detecting Enteral Nutrition Residues and Microorganism Proliferation in Feeding Tubes via Real-Time Imaging.

    Science.gov (United States)

    Yamaoka, Ippei; Kagawa, Tomohiro; Mizugai, Kazuya; Ebisu, Goro

    2017-04-01

    Enteral nutrition (EN) residues that persist in feeding tubes provide substrates for microorganisms to proliferate and occlude the tubes. Visible EN residues in tubes are easily identified, but smaller residues can persist. We developed a new imaging technique to visualize EN residues and proliferation of microorganisms in feeding tubes. (1) Feeding tubes containing EN labeled with fluorescent dye and either with or without various types or amounts of thickeners were flushed once with water and then seeded with Pseudomonas aeruginosa Xen05 with recombinant luciferase DNA. (2) Because EN fluoresces intrinsically, EN in the feeding tubes without fluorescent dye was repeatedly flushed until the intrinsic fluorescence levels reached background levels. Fluorescent images of EN residues and bioluminescent images of microorganisms were acquired via an optical imaging system. (1) Fluorescence images showed that the amount of EN residues increased at various sites in tubes depending on EN viscosity and the thickening agent, and bioluminescence images showed that microorganism proliferation was associated with a commensurate increase in EN residues. (2) The intrinsic fluorescence of EN also enabled the detection of EN residues in tubes even in the absence of fluorescence dye. Higher EN viscosity required more flushes to reach undetectable levels. EN residues and microorganism proliferation in enteral feeding tubes were detected on fluorescence and bioluminescence images, respectively. This simplified approach allowed the real-time visualization of EN residues and microorganisms in feeding tubes.

  7. The Family Characteristics of Youth Entering a Residential Care Program

    Science.gov (United States)

    Griffith, Annette K.; Ingram, Stephanie D.; Barth, Richard P.; Trout, Alexandra L.; Hurley, Kristin Duppong; Thompson, Ronald W.; Epstein, Michael H.

    2009-01-01

    Although much is known about the mental health and behavioral functioning of youth who enter residential care programs, very little research has focused on examining the family characteristics of this population. Knowledge about family characteristics is important, however, as it can aid in tailoring programs to meet the needs of families who are…

  8. Feeding tube-related complications and problems in patients receiving long-term home enteral nutrition

    Directory of Open Access Journals (Sweden)

    Vasileios Alivizatos

    2015-04-01

    Full Text Available Aim: The aim of this study was to evaluate the long-term complications and problems related to gastrostomy and jejunostomy feeding tubes used for home enteral nutrition support and the effect these have on health care use. Materials and Methods: The medical records of 31 patients having gastrostomy (27 patients and jejunostomy (4 feeding tubes inserted in our Department were retrospectively studied. All were discharged on long-term (>3 months enteral nutrition and followed up at regular intervals by a dedicated nurse. Any problem or complication associated with tube feeding as well as the intervention, if any, that occurred, was recorded. Data were collected and analyzed. Results: All the patients were followed up for a mean of 17.5 months (4-78. The most frequent tube-related complications included inadvertent removal of the tube (broken tube, plugged tube; 45.1%, tube leakage (6.4%, dermatitis of the stoma (6.4%, and diarrhea (6.4%. There were 92 unscheduled health care contacts, with an average rate of such 2.9 contacts over the mean follow-up time of 17.5 months. Conclusion: In patients receiving long-term home enteral nutrition, feeding tube-related complications and problems are frequent and result in significant health care use. Further studies are needed to address their optimal prevention modalities and management.

  9. Improving Nutrition Outcomes for Infants Grams With a Progressive, Evidenced-Based Enteral Feeding Protocol.

    Science.gov (United States)

    Thoene, Melissa K; Lyden, Elizabeth; Anderson-Berry, Ann

    2018-03-30

    Growth is essential for very low birth weight infants. The purpose of this retrospective chart review was to evaluate the impact of a new standardized, evidenced-based feeding protocol for infants born < 1500 g in correlation with growth and clinical outcomes. Growth and nutrition data was reviewed from 2 groups of infants born < 1500 g within a level III newborn intensive care unit (NICU). Epoch 1 infants (N = 32) received care following initial implementation of a standardized enteral feeding protocol. Epoch 2 infants (N = 32) received care following aggressive modification of this initial protocol based on newly available literature that promotes earlier initiation and advancement of enteral feedings. Epoch 2 infants weighed more at 36 weeks (2562 vs 2304 g) with higher discharge weight percentiles (32nd vs 15th percentile). Epoch 2 infants started and achieved full enteral feedings earlier (day of life 1 vs 4; 7 vs 22, P < 0.0001) and required less days of parenteral nutrition (5.5 vs 17.5 days, P < 0.0001), with indwelling central line for parenteral access (6 vs 17.5). There were no differences in retinopathy of prematurity (17% control vs 19% study), oxygen requirement at 36 weeks (22% epoch 1 vs 43%), necrotizing enterocolitis (3% epoch 1 vs 0%), intraventricular hemorrhage grade 3-4, periventricular leukomalacia, or death. In this sample of very low birth weight infants, a progressive standardized, evidence-based feeding protocol was associated with improved growth without increased risk for necrotizing enterocolitis. © 2018 American Society for Parenteral and Enteral Nutrition.

  10. Fat-Modified Enteral Formula Improves Feeding Tolerance in Critically Ill Patients: A Multicenter, Single-Blind, Randomized Controlled Trial.

    Science.gov (United States)

    Qiu, Chunfang; Chen, Chuanxi; Zhang, Weixing; Kou, Qiuye; Wu, Shengnan; Zhou, Lixin; Liu, Jiyun; Ma, Gang; Chen, Juan; Chen, Minying; Luo, Hua; Zhang, Xiaofei; Lai, Jianbo; Yu, Zhihui; Yu, Xiaochun; Liao, Wei; Guan, Xiangdong; Ouyang, Bin

    2017-07-01

    Improvement of fat digestion and absorption was supposed to relieve feeding intolerance. This trial aimed to evaluate the effect of a fat-modified enteral formula on feeding tolerance in critically ill patients. This trial was conducted in 7 hospitals in China. In total, 144 intensive care unit (ICU) patients with estimated need of enteral nutrition (EN) for at least 5 days were randomly given fat-modified enteral formula containing medium-chain triglycerides (MCT), carnitine, and taurine (interventional feed group, n = 71) or standard enteral formula (control feed group, n = 73). EN intake, feeding intolerance (diarrhea, vomiting, gastric retention, and abdominal distension) and outcomes (mechanical ventilator-free days of 28 days, length of ICU stay, length of hospital stay, and in-hospital mortality) were collected. Daily calories and protein intake were increased in the interventional feed group compared with the control feed group ( P feeding intolerance was 42.3% in the interventional feed group and 65.7% in the control feed group ( P feeding intolerance was 11.3%, 18.3%, 14.1%, 25.4%, and 26.1% in the interventional feed group and 31.5%, 32.9%, 34.2%, 34.2%, and 30.4% in the control feed group from study days 1-5 ( P = .0083). Incidence of feeding intolerance without abdominal distention was 32.9% in the interventional feed group and 49.3% in the control feed group ( P = .047), while the incidence of abdominal distension was 26.8% in the interventional feed group and 43.8% in the control feed group ( P = .03). No significant differences existed in outcomes between the 2 groups. The fat-modified enteral formula containing MCT, carnitine, and taurine may improve feeding tolerance in critically ill patients.

  11. Conversion of choledochojejunostomy stents to jejunal feeding tubes for postoperative enteral alimentation.

    Science.gov (United States)

    Burke, D R; Torosian, M H; McLean, G K; Meranze, S G; Rosato, E F

    1988-01-01

    The problem of protein calorie malnutrition following major gastrointestinal surgery can be treated with central venous or enteric alimentation, with the latter being preferred. The authors describe a simple technique for the conversion of biliary stents placed after pancreaticoduodenal surgery into jejunal feeding tubes when the stenting function is no longer needed. Three illustrative cases are presented. In each case, the procedure took less than 30 min and had no associated morbidity. This technique allows early conversion from central venous to enteric alimentation without the need to create a second surgical enterostomy.

  12. Metabolic assessment and enteral tube feeding usage in children with acute neurological diseases.

    Science.gov (United States)

    Leite, H P; Fantozzi, G

    1998-01-01

    To report on acquired experience of metabolic support for children with acute neurological diseases, emphasizing enteral tube feeding usage and metabolic assessment, and also to recommend policies aimed towards improving its implementation. Retrospective analysis. Pediatric Intensive Care Unit of Hospital do Servidor Público Estadual de São Paulo. 44 patients consecutively admitted to the Pediatric ICU over a period of 3 years who were given nutrition and metabolic support for at least 72 hours. Head trauma, CNS infections and craniotomy post-operative period following tumor exeresis were the main diagnoses. Records of protein-energy intake, nutrient supply route, nitrogen balance and length of therapy. From a total of 527 days of therapy, single parenteral nutrition was utilized for 34.3% and single enteral tube feeding for 79.1% of that period. 61.4% of the children were fed exclusively via enteral tube feeding, 9.1% via parenteral and 39.5% by both routes. The enteral tube feeding was introduced upon admission and transpyloric placement was successful in 90% of the cases. Feeding was started 48 hours after ICU admission. The caloric goal was achieved on the 7th day after admission, and thereafter parenteral nutrition was interrupted. The maximum energy supply was 104.2 +/- 23.15 kcal/kg. The median length of therapy was 11 days (range 4-38). None of the patients on tube feeding developed GI tract bleeding, pneumonia or bronchoaspiration episodes and, of the 4 patients who were given exclusive TPN, 2 developed peptic ulcer. The initial urinary urea nitrogen was 7.11 g/m2 and at discharge 6.44 g/m2. The protein supply increased from 1.49 g/kg to 3.65 g/kg (p < 0.01). The nitrogen balance increased from--7.05 to 2.2 g (p < 0.01). Children with acute neurological diseases are hypercatabolic and have high urinary nitrogen losses. The initial negative nitrogen balance can be increased by more aggressive feeding regimes than the usual ones. Early tube feeding was

  13. Metabolic assessment and enteral tube feeding usage in children with acute neurological diseases

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    Heitor Pons Leite

    Full Text Available OBJECTIVE: To report on acquired experience of metabolic support for children with acute neurological diseases, emphasizing enteral tube feeding usage and metabolic assessment, and also to recommend policies aimed towards improving its implementation. DESIGN: Retrospective analysis. SETTING: Pediatric Intensive Care Unit of Hospital do Servidor Público Estadual de São Paulo. SUBJECTS: 44 patients consecutively admitted to the Pediatric ICU over a period of 3 years who were given nutrition and metabolic support for at least 72 hours. Head trauma, CNS infections and craniotomy post-operative period following tumor exeresis were the main diagnoses. MEASUREMENTS: Records of protein-energy intake, nutrient supply route, nitrogen balance and length of therapy. RESULTS: From a total of 527 days of therapy, single parenteral nutrition was utilized for 34.3% and single enteral tube feeding for 79.1% of that period. 61.4% of the children were fed exclusively via enteral tube feeding, 9.1% via parenteral and 39.5 % by both routes. The enteral tube feeding was introduced upon admission and transpyloric placement was successful in 90% of the cases. Feeding was started 48 hours after ICU admission. The caloric goal was achieved on the 7th day after admission, and thereafter parenteral nutrition was interrupted. The maximum energy supply was 104.2 ± 23.15 kcal/kg. The median length of therapy was 11 days (range 4-38. None of the patients on tube feeding developed GI tract bleeding, pneumonia or bronchoaspiration episodes and, of the 4 patients who were given exclusive TPN, 2 developed peptic ulcer. The initial urinary urea nitrogen was 7.11 g/m2 and at discharge 6.44 g/m2. The protein supply increased from 1.49 g/kg to 3.65 g/kg (p< 0.01. The nitrogen balance increased from -7.05 to 2.2 g (p< 0.01. CONCLUSIONS: Children with acute neurological diseases are hypercatabolic and have high urinary nitrogen losses. The initial negative nitrogen balance can be

  14. THAWING PROCEDURES FOR HOSPITAL-MADE ENTERAL FEEDINGS: SURVIVAL OF COLIFORM AND MESOPHILIC AEROBIC BACTERIA

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    KATHIA ROSSI ROLIM LOPES

    2009-07-01

    Full Text Available

    ABSTRACT: This study had the purpose to observe the effect of thawing procedures on survival of coliform and mesophilic aerobic bacteria in hospital-made enteral feedings. The samples are represented by three different lots. The tests were realized in three moments: immediately after the sample preparation and after freezing during 1 or 2 months. The thawing procedures were denominated convencional and alternative. The first, used by hospital, utilizes water bath at 50ºC, considering the time spent from the total thawing to its distribution in the infirmaries. The second was the fast thawing made by microwaving. The results showed that the reduction of the mesophiles and coliform was related to the time the samples were frozen. The results obtained indicate an advantage of the alternative method, which presented lower total and fecal coliform counts than the conventional one. KEYWORDS: Enteral feedings; thawing; food microbiology.

  15. Accuracy of home enteral feed preparation for children with inherited metabolic disorders.

    Science.gov (United States)

    Evans, S; Preston, F; Daly, A; Neville, C; MacDonald, A

    2011-02-01

    Many children with rare chronic disorders require home enteral tube feeds (HETF) consisting of multiple modular ingredients. Feeds are often complex and the risk of errors during their preparation is high. The consequences of over- or under-concentration can be critical. The aim of the present prospective observation study was to assess the accuracy, skills and technique of caregivers when preparing and administering HETF. Fifty-two HETF patients (median age 7.5 years, range 0.7-18.0 years) with inherited metabolic disorders (IMD) requiring special feeds were recruited. Using observation and a structured questionnaire, a practical assessment of feed preparation and storage by the main caregiver was undertaken by an independent dietitian and nurse in the child's home, including hygiene practices, accuracy of measuring recipe ingredients, and storage of both ingredients and prepared feeds. The majority (85%; n = 44) of feeds were based on >1 ingredient (median 3; range 1-6). Almost half (48%; n = 25) of caregivers measured feed ingredients inaccurately. Of the 31% (n = 16) using scoops, 31% used incorrect measuring spoons and 25% did not level scoops appropriately. Some 45% (n = 20/44) of carers measured liquid ingredients inaccurately. Hygiene practices during feed preparation were poor, including a lack of hand washing (31%: n = 16) and incorrect storage procedures for unused feed ingredients (56%; n = 29). Practices in the preparation of modular HETF for children with IMD were not ideal. A combination of inaccuracy, poor hygiene, inappropriate storage, and long feed hanging times increases both metabolic and microbial risk. Better education, regular monitoring and the development of ready-to-use or preweighed ingredients would be beneficial. © 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd.

  16. Carers' experiences of home enteral feeding: A survey exploring medicines administration challenges and strategies.

    Science.gov (United States)

    Alsaeed, D; Furniss, D; Blandford, A; Smith, F; Orlu, M

    2018-01-19

    The use of enteral tube feeding at home is becoming more widespread, with patients ranging in age and diseases. Dysphagia and swallowing difficulties can compromise nutritional intake and the administration of oral medications, affecting therapeutic outcomes negatively. Carers' experiences of medicines administration and medicines optimization have not been explored fully. The objectives of this study were to identify issues carers experience in medicines administration; the strategies they have developed to cope; and suggestions to improve the medicines administration process. An online survey was promoted nationally; 42 carers completed it. Descriptive statistical analysis was applied, as well as thematic analysis of open-ended responses. Results were compared against the 4 principles of medicines optimization. 93% of respondents administered medications with enteral feeding tubes, but only 62% had received advice from healthcare professionals and only 8% had received written information on how to do so. Responses identified 5 medicines administration issues experienced by carers; 4 strategies they developed to cope; and 3 main areas of suggestions to improve medicines administration via enteral feeding at home. The 4 principles of medicines optimization have not previously been applied to enteral feeding. We present a novel account of carers' experiences, for example coping with ill-suited formulations and a lack of training and support, which should inform better practice (Principle 1). Carers sometimes experience suboptimal choice of medicines (Principle 2). Carers' practices are not always well-informed and may affect therapeutic outcomes and safety (Principle 3). There is scope for improvement in carer training, education and support to better support medicines optimization (Principle 4). © 2018 The Authors. Journal of Clinical Pharmacy and Therapeutics Published by John Wiley & Sons Ltd.

  17. EVALUATION OF THE MICROBIAL CONTAMINATION OF HOSPITAL-MADE ENTERAL FEEDINGS

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    KATHIA ROSSI ROLIM LOPES

    2009-07-01

    Full Text Available

    ABSTRACT: The quality of enteral feeding formulations prepared at hospital, which are intended for feeding children with malnutrition and diarrhoea, was investigated. A total of eight freshly prepared samples and ten frozen samples were analised. Five of the frozen samples were thawed in the hospital, and the other five in the laboratory, in similar conditions, i. e. in water bath at 50ºC. The freshly prepared samples showed mesophilic aerobic bacteria count varying between 10 to 104 CFU/ml. The presence of total coliform (three samples, fecal coliform (two samples and B. cereus (one sample was also detected. The samples thawed in the laboratory showed a satisfactory quality whilst the formulations thawed in hospital showed higher mesophiles counts and improper counts of S. aureus (two samples and B. cereus (one sample. These results were probably due to a erroneous manipulation of some untrained personnel and emphasize the importance to keep a permanent quality control to avoid the occurrence of contamination, specially for feeding formulations intended for populations at high risk. KEYWORDS: Enteral feeding; bacterial contamination; control.

  18. A Strategy to Reduce Critical Cardiorespiratory Alarms due to Intermittent Enteral Feeding of Preterm Neonates in Intensive Care.

    Science.gov (United States)

    Joshi, Rohan; van Pul, Carola; Sanders, Anouk; Weda, Hans; Bikker, Jan Willem; Feijs, Loe; Andriessen, Peter

    2017-10-20

    Many preterm infants require enteral feeding as they cannot coordinate sucking, swallowing, and breathing. In enteral feeding, milk feeds are delivered through a small feeding tube passed via the nose or mouth into the stomach. Intermittent milk feeds may either be administered using a syringe to gently push milk into the infant's stomach (push feed) or milk can be poured into a syringe attached to the tube and allowed to drip in by gravity (gravity feed). This practice of enteral feeding is common in neonatal intensive care units. There is, however, no evidence in the literature to recommend the use of one method of feeding over the other. The aim of this study was to investigate which of the two methods of feeding is physiologically better tolerated by infants, as measured by the incidence of critical cardiorespiratory alarms during and immediately after feeding. We conducted a prospectively designed observational study with records of all feeding episodes in infants of gestational age less than 30 weeks at birth and with a minimum enteral intake of 100 mL/kg/day. In total, 2140 enteral feeding episodes were noted from 25 infants over 308 infant-days with records for several characteristics of the infants (eg, gestational age), feeding (eg, the position of infants), and of nursing-care events before feeding (eg, diapering). Logistic regression with mixed effects was used to model cardiorespiratory alarms for the push and gravity methods of feeding. After adjustments were made for all confounding variables, the position of infants was found to be statistically significant in changing the outcome of critical alarms for the two methods of feeding (P=.02). For infants in the lateral position, push feeds led to 40% more instances of one or more critical cardiorespiratory alarms in comparison with the gravity method. Both methods of feeding created a statistically comparable number of alarms for infants in the prone position. This study provides objective data that may

  19. Identification of risk factors for enteral feeding intolerance screening in critically ill patients

    Science.gov (United States)

    Xu, Lei; Wang, Ting; Chen, Ting; Yang, Wen-Qun; Liang, Ze-Ping; Zhu, Jing-Ci

    2017-01-01

    Objectives: To identify risk factors for enteral feeding intolerance screening in critically ill patients, thereby, provide some reference for healthcare staff to assess the risk of feeding intolerance, and lay the foundation for future scale development. Methods: This study used a mixed methodology, including a literature review, semi-structured interviews, the Delphi technique, and the analytic hierarchy process. We used the literature review and semi-structured interviews (n=22) to draft a preliminarily item pool for feeding intolerance, Delphi technique (n=30) to screen and determine the items, and the analytic hierarchy process to calculate the weight of each item. The study was conducted between June 2014 and September 2015 in Daping Hospital, Third Military Medical University, Chongqing, China. Results: Twenty-three risk factors were selected for the scale, including 5 dimensions. We assigned a weight to each item according to their impact on the feeding intolerance, with a higher score indicating a greater impact. The weight of each dimension was decreasing as follows: patient conditions, weight score equals 42; general conditions, weight score equals 23; gastrointestinal functions, weight score equals 15; biochemical indexes, weight score equals 14; and treatment measures, weight score equals 6. Conclusion: Developed list of risk factors based on literature review, survey among health care professionals and expert consensus should provide a basis for future studies assessing the risk of feeding intolerance in critically ill patients. PMID:28762434

  20. Effects of early excision and aggressive enteral feeding on hypermetabolism, catabolism, and sepsis after severe burn.

    Science.gov (United States)

    Hart, David W; Wolf, Steven E; Chinkes, David L; Beauford, Robert B; Mlcak, Ronald P; Heggers, John P; Wolfe, Robert R; Herndon, David N

    2003-04-01

    Severe burn induces a systemic hypermetabolic response, which includes increased energy expenditure, protein catabolism, and diminished immunity. We hypothesized that early burn excision and aggressive enteral feeding diminish hypermetabolism. Forty-six burned children were enrolled into a cohort analytic study. Cohorts were segregated according to time from burn to transfer to our institution for excision, grafting, and nutritional support. No subject had undergone wound excision or continuous nutritional support before transfer. Resting energy expenditure, skeletal muscle protein kinetics, the degree of bacterial colonization from quantitative cultures, and the incidence of burn sepsis were measured as outcome variables. Early, aggressive treatment did not decrease energy expenditure; however, it did markedly attenuate muscle protein catabolism when compared with delay in aggressive treatment. Wound colonization and sepsis were diminished in the early treatment group as well. Early excision and concurrent aggressive feeding attenuate muscle catabolism and improve infectious outcomes after burn.

  1. Utility of Octreotide in Advancing Enteral Feeds in Children with Chronic Intestinal Pseudo-Obstruction.

    Science.gov (United States)

    Ambartsumyan, Lusine; Flores, Alejandro; Nurko, Samuel; Rodriguez, Leonel

    2016-10-01

    Chronic intestinal pseudo-obstruction (CIPO) is a challenging disorder with high morbidity and mortality due to limited effective therapies that improve enteral tolerance. We aimed to present our experience using octreotide in children with CIPO and evaluate factors predicting therapy response. The study population included total parenteral nutrition (TPN)-dependent children with CIPO receiving octreotide at a tertiary care center. Octreotide response was defined as an enteral feeding increase of ≥10 cc/kg/day. A total of 16 children were included (median age 5 years, range 1-18; 88 % female). We observed an overall feed increase in 11/16 (69 %) subjects and 7/16 (44 %) were considered responders: three tolerated >65 cc/kg/day (discontinued TPN), one tolerated >30 cc/kg/day (decreased TPN) and three patients tolerated 10-12 cc/kg/day. We found an association between therapeutic octreotide response and both the presence of octreotide-induced intestinal phase III of the migrating motor complex (MMC) as well as a higher median increase in intestinal motility index after octreotide challenge during the antroduodenal manometry (p = 0.03 and children with CIPO and the antroduodenal manometry may be helpful in predicting octreotide response. Prospective studies are needed to evaluate the safety and efficacy of octreotide in children with CIPO.

  2. Mechanisms Affecting the Gut of Preterm Infants in Enteral Feeding Trials

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    Nicholas D. Embleton

    2017-05-01

    Full Text Available Large randomized controlled trials (RCTs in preterm infants offer unique opportunities for mechanistic evaluation of the risk factors leading to serious diseases, as well as the actions of interventions designed to prevent them. Necrotizing enterocolitis (NEC a serious inflammatory gut condition and late-onset sepsis (LOS are common feeding and nutrition-related problems that may cause death or serious long-term morbidity and are key outcomes in two current UK National Institutes for Health Research (NIHR trials. Speed of increasing milk feeds trial (SIFT randomized preterm infants to different rates of increases in milk feeds with a primary outcome of survival without disability at 2 years corrected age. Enteral lactoferrin in neonates (ELFIN randomizes infants to supplemental enteral lactoferrin or placebo with a primary outcome of LOS. This is a protocol for the mechanisms affecting the gut of preterm infants in enteral feeding trials (MAGPIE study and is funded by the UK NIHR Efficacy and Mechanistic Evaluation programme. MAGPIE will recruit ~480 preterm infants who were enrolled in SIFT or ELFIN. Participation in MAGPIE does not change the main trial protocols and uses non-invasive sampling of stool and urine, along with any residual resected gut tissue if infants required surgery. Trial interventions may involve effects on gut microbes, metabolites (e.g., short-chain fatty acids, and aspects of host immune function. Current hypotheses suggest that NEC and/or LOS are due to a dysregulated immune system in the context of gut dysbiosis, but mechanisms have not been systematically studied within large RCTs. Microbiomic analysis will use next-generation sequencing, and metabolites will be assessed by mass spectrometry to detect volatile organic and other compounds produced by microbes or the host. We will explore differences between disease cases and controls, as well as exploring the actions of trial interventions. Impacts of this research

  3. Prevalence, risk factors, clinical consequences, and treatment of enteral feed intolerance during critical illness.

    Science.gov (United States)

    Gungabissoon, Usha; Hacquoil, Kimberley; Bains, Chanchal; Irizarry, Michael; Dukes, George; Williamson, Russell; Deane, Adam M; Heyland, Daren K

    2015-05-01

    We aimed to determine the incidence of enteral feed intolerance and factors associated with intolerance and to assess the influence of intolerance on nutrition and clinical outcomes. We conducted a retrospective analysis of data from an international observational cohort study of nutrition practices among 167 intensive care units (ICUs). Data were collected on nutrition adequacy, ventilator-free days (VFDs), ICU stay, and 60-day mortality. Intolerance was defined as interruption of enteral nutrition (EN) due to gastrointestinal (GI) reasons (large gastric residuals, abdominal distension, emesis, diarrhea, or subjective discomfort). Logistic regression was used to determine risk factors for intolerance and their clinical significance. A sensitivity analysis restricted to sites specifying a gastric residual volume ≥200 mL to identify intolerance was also conducted. Data from 1,888 ICU patients were included. The incidence of intolerance was 30.5% and occurred after a median 3 days from EN initiation. Patients remained intolerant for a mean (±SD) duration of 1.9 ± 1.3 days . Intolerance was associated with worse nutrition adequacy vs the tolerant (56% vs 64%, P intolerance remained associated with negative outcomes. Although mortality was greater among the intolerant patients, this was not statistically significant. Intolerance occurs frequently during EN in critically ill patients and is associated with poorer nutrition and clinical outcomes. © 2014 American Society for Parenteral and Enteral Nutrition.

  4. The nutritional intake supplied by enteral formulae used in older children (aged 7-12 years) on home tube feeds.

    Science.gov (United States)

    Evans, S; Daly, A; Davies, P; MacDonald, A

    2009-10-01

    In the UK, patients aged 6-12 years contribute more than one-third of children on home enteral tube feeds (HETF). Many enteral feeds are given to this age group. The present study aimed to investigate the formula with the best nutritional composition for children aged 7-12 years on HETF by comparing the nutrient intake of three feed types; a paediatric feed (PF) for 1-6 year olds, an adult feed (AF), and a feed for children (OCF) aged 7-12 years. Twenty-five HETF children aged 7-14 years (median 10 years) were given a 6.3 kJ mL(-1) enteral feed designed for 7-12 year olds (or weighing 21-45 kg) for 9 months. Nutrient intakes on the 7-12-year-old feed were compared with baseline feed (paediatric n = 10; or adult n = 15). At baseline, the PF failed to meet 100% of the reference nutrient intake (RNI) for three of 19 (16%) of the nutrients studied, whereas AF provided in excess of 250% of the RNI for six of 19 (32%) of the nutrients. During the trial, the nutrients on the OCF were two of 19 (11%) 250% of the RNI. Only seven of 10 (70%) children on a PF met at least 100% of the UK RNI for calcium, compared to 17 of 19 (89%) on the OCF. It is important to offer older children an enteral feed that provides an optimal level of nutrients to meet their nutritional requirements. Feeds designed for 7-12-year-old children more closely meet nutrient requirements than paediatric or adult formulae, but require further modification to fully meet the nutritional needs of this group.

  5. Enteral Feeding as a Part of Combination Treatment in a Patient after Small Intestine Transplantation

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    M. Sh. Khubutia

    2014-01-01

    Full Text Available Objective: to describe the first experience with an enteral feeding regimen used as part of combination therapy in a patient after small intestine transplantation (SIT.Materials and methods. The results of treatment in a 48year-old male after heterotopic SIT for short bowel syndrome were given. The extent of the graft was 250 cm. The combination treatment aimed  to  restore  graft  functions  and  included  immunosuppressive,  infusion,  transfusion,  antibacterial,  antiviral,  and detoxification therapies and parenteral and enteral feeding (EF. Our elaborated EF regimen was divided into 3 steps: 1 early enteral therapy (on day 1 using a monomeric saline enteral solution and a specialized formula containing pharmaconutrients (glutamine, antioxidants, and tributyrine; 2 incorporation of a semielemental formula (on day 5; 3 use of polymeric  formulas  and  clinical  nutrition.  Laboratory,  ultrasound,  radiological,  and  endoscopic  monitoring  and  biopsy were performed.Results. The combination treatment using stepwise EF could satisfy a patient's protein-energy needs. Restoration of histological structures in the graft mucosa was observed during morphological examination on day 7. At enteroscopy, the intestinal mucosa was pink with prominent villi, motility, and bile-colored chyme. On day 7, there was a 150-ml self-colored stool. Data confirmed that the intestinal graft restored absorption and parietal digestion. On day 30, the patient was switched to polymeric formulas and curative diet. By the discharge from hospital, on day 86, his body mass index was 23.1 kg/m2.Conclusion. The positive treatment results in the patient became possible after SIT due to improvement of surgical techniques, current immunosuppression, and a comprehensive approach to treating him in the postoperative period. Our elaborated stepwise EF regiment is an important component of combination therapy after SIT and facilitates  the  restoration

  6. Delayed initiation but not gradual advancement of enteral formula feeding reduces the incidence of necrotizing enterocolitis (NEC in preterm pigs.

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    Nada Ghoneim

    Full Text Available Enteral formula feeding is a risk factor for necrotizing enterocolitis (NEC in premature infants, yet studies are conflicting regarding the safest timing for introduction and advancement of feeds. Our aim was to test the effects of early vs. late initiation and abrupt vs. gradual advancement of enteral feeding of an intact vs. hydrolyzed protein formula on NEC incidence and severity in preterm pigs. In Experiment 1, preterm pigs received total parenteral nutrition (TPN at birth with abrupt initiation of enteral formula feeds (50% full intake on d of life (DOL 2 (EA or 5 (LA while PN continued. Pigs were also fed formula containing either intact or hydrolyzed protein. In Experiment 2, preterm pigs received TPN at birth with enteral, hydrolyzed-protein formula feeds introduced on DOL 2 either abruptly (EA; 50% full feeds or gradually (EG; 10-50% full feeds over 5 d while PN continued. NEC incidence and severity were assessed based on macroscopic and histological scoring. In Experiment 1, NEC incidence (41% vs. 70%, P<0.05 and severity were reduced in LA vs. EA groups and LA was associated with a higher survival rate, daily weight gain and jejunum villus height. Piglets fed hydrolyzed vs. intact protein formula had lower stomach content weights and similar NEC incidence. In Experiment 2, NEC incidence and severity were not different between pigs the EG vs. EA group. Proinflammatory gene expression (IL-1β, IL-6 and S100A9 in the ileum was lower in both LA and EG vs. EA groups. In conclusion, delayed initiation but not gradual advancement of enteral feeding is protective against NEC in preterm pigs. Feeding hydrolyzed vs. intact protein formula improved gastric transit without affecting the NEC incidence.

  7. Association between illness severity and timing of initial enteral feeding in critically ill patients: a retrospective observational study

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    Huang Hsiu-Hua

    2012-05-01

    Full Text Available Abstract Background Early enteral nutrition is recommended in cases of critical illness. It is unclear whether this recommendation is of most benefit to extremely ill patients. We aim to determine the association between illness severity and commencement of enteral feeding. Methods One hundred and eight critically ill patients were grouped as “less severe” and “more severe” for this cross-sectional, retrospective observational study. The cut off value was based on Acute Physiology and Chronic Health Evaluation II score 20. Patients who received enteral feeding within 48 h of medical intensive care unit (ICU admission were considered early feeding cases otherwise they were assessed as late feeding cases. Feeding complications (gastric retention/vomiting/diarrhea/gastrointestinal bleeding, length of ICU stay, length of hospital stay, ventilator-associated pneumonia, hospital mortality, nutritional intake, serum albumin, serum prealbumin, nitrogen balance (NB, and 24-h urinary urea nitrogen data were collected over 21 days. Results There were no differences in measured outcomes between early and late feedings for less severely ill patients. Among more severely ill patients, however, the early feeding group showed improved serum albumin (p = 0.036 and prealbumin (p = 0.014 but worsened NB (p = 0.01, more feeding complications (p = 0.005, and prolonged ICU stays (p = 0.005 compared to their late feeding counterparts. Conclusions There is a significant association between severity of illness and timing of enteral feeding initiation. In more severe illness, early feeding was associated with improved nutritional outcomes, while late feeding was associated with reduced feeding complications and length of ICU stay. However, the feeding complications of more severely ill early feeders can be handled without significantly affecting nutritional intake and there is no eventual difference in length of hospital stay or mortality

  8. Randomized Controlled Trial of Slow Versus Rapid Enteral Feeding Advancements on the Clinical Outcomes in Very Low Birth Weight Neonates.

    Science.gov (United States)

    Ahmed, F; Mannan, M A; Dey, A C; Nahar, N; Hasan, Z; Jahan, I; Dey, S K; Shahidullah, M

    2017-04-01

    Starting and advancement of feeding in very low birth weight (VLBW) infants are big challenges for the neonatal practitioners. Wide variations in volume of feed advancement have observed in earlier trials both in slow and rapid advancement groups. Volume advancement in slow advancement groups have ranged from 10ml/kg/day to 23ml/kg/day and in rapid advancement groups have ranged from 15ml/kg/day to 45ml/kg/day in earlier different studies. This randomized controlled trial was conducted in neonatal intensive care unit (NICU) of Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2013 to July 2014 to evaluate the effects of slow versus rapid rates of feeding advancements on the clinical outcomes in very low birth weight infants. A total 95 infants were enrolled into two strata according to their birth weight. Infants of each stratum were randomly allocated to either slow or rapid advancement group during initiation of feeding. After gut priming over five days, feeding was advanced daily 10ml/kg in slow and 15ml/kg in rapid advancement group for 1000 - rapid advancement group. The primary outcome variable was time taken to achieve full enteral feed. Total 82 infants completed the trial. Demographically both groups were same. Infants in the rapid feeding advancement group achieved full enteral feedings before the slow advancement group, had significantly fewer days of parenteral nutrition and regained birth weight earlier. There were no statistical differences in episodes of feed interruption, number of infants with apnea, feed intolerance or diagnosis of sepsis. Rapid enteral feeding advancements were well tolerated by very low birth weight infants.

  9. Influence of feeding crimped kernel maize silage on the course of subclinical necrotic enteritis in a broiler disease model

    DEFF Research Database (Denmark)

    Sharma, Nisha; Ranjitkar, Samir; Sharma, Nishchal K

    2017-01-01

    This experiment was carried out with 375 male broilers (Ross 308) from days 1 to 28 to evaluate the influence of crimped kernel maize silage (CKMS) on the manifestation of subclinical necrotic enteritis, microbiota counts, organic acid production and relative weights of gastrointestinal segments....... A necrotic enteritis disease model was applied. Birds were allocated into 3 different dietary treatments: a maize-based feed (MBF, control diet), and 2 diets supplemented with 15% (CKMS15) or 30% (CKMS30) of crimped ensiled kernel maize. The disease model involved a 10-time overdose of an attenuated live...... of necrotic enteritis but had potential benefits in terms of inhibition of potentially harmful microorganisms....

  10. Sanitation & Safety for Child Feeding Programs.

    Science.gov (United States)

    Florida State Dept. of Health and Rehabilitative Services, Tallahassee.

    In the interest of promoting good health, sanitation, and safety practices in the operation of child feeding programs, this bulletin discusses practices in personal grooming and wearing apparel; the purchasing, storage, handling, and serving of food; sanitizing equipment and utensils; procedures to follow in case of a food poisoning outbreak; some…

  11. Parenteral nutrition results in impaired lactose digestion and hexose absorption when enteral feeding is initiated in infant pigs

    NARCIS (Netherlands)

    Burrin, Douglas G.; Stoll, Barbara; Chang, Xiaoyan; van Goudoever, Johannes B.; Fujii, Hisao; Hutson, Susan M.; Reeds, Peter J.

    2003-01-01

    Preterm infants often receive total parenteral nutrition (TPN) before enteral feeding. Although TPN has been linked to mucosal atrophy, its effects on intestinal digestion, absorption, and metabolism are unknown. Our aim was to determine the effects of TPN on rates of intestinal nutrient absorption

  12. Feeding nitrate and docosahexaenoic acid affects enteric methane production and milk fatty acid composition in lactating dairy cows

    NARCIS (Netherlands)

    Klop, G.; Hatew, B.; Bannink, A.; Dijkstra, Jan

    2016-01-01

    An experiment was conducted to study potential interaction between the effects of feeding nitrate and docosahexaenoic acid (DHA; C22:6 n-3) on enteric CH4 production and performance of lactating dairy cows. Twenty-eight lactating Holstein dairy cows were grouped into 7 blocks of 4

  13. Medication Errors in Patients with Enteral Feeding Tubes in the Intensive Care Unit.

    Science.gov (United States)

    Sohrevardi, Seyed Mojtaba; Jarahzadeh, Mohammad Hossein; Mirzaei, Ehsan; Mirjalili, Mahtabalsadat; Tafti, Arefeh Dehghani; Heydari, Behrooz

    2017-01-01

    Most patients admitted to Intensive Care Units (ICU) have problems in using oral medication or ingesting solid forms of drugs. Selecting the most suitable dosage form in such patients is a challenge. The current study was conducted to assess the frequency and types of errors of oral medication administration in patients with enteral feeding tubes or suffering swallowing problems. A cross-sectional study was performed in the ICU of Shahid Sadoughi Hospital, Yazd, Iran. Patients were assessed for the incidence and types of medication errors occurring in the process of preparation and administration of oral medicines. Ninety-four patients were involved in this study and 10,250 administrations were observed. Totally, 4753 errors occurred among the studied patients. The most commonly used drugs were pantoprazole tablet, piracetam syrup, and losartan tablet. A total of 128 different types of drugs and nine different oral pharmaceutical preparations were prescribed for the patients. Forty-one (35.34%) out of 116 different solid drugs (except effervescent tablets and powders) could be substituted by liquid or injectable forms. The most common error was the wrong time of administration. Errors of wrong dose preparation and administration accounted for 24.04% and 25.31% of all errors, respectively. In this study, at least three-fourth of the patients experienced medication errors. The occurrence of these errors can greatly impair the quality of the patients' pharmacotherapy, and more attention should be paid to this issue.

  14. Enteral Tube Feeding Nutritional Protein Hydrolysate Production Under Different Factors By Enzymatic Hydrolysis

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    Nguyen ThiQuynhHoa

    2015-01-01

    Full Text Available Abstract Hydrolysis of proteins involves the cleavage of peptide bonds to give peptides of varying sizes and amino acid composition. There are a number of types of hydrolysis enzymatic acid or alkali hydrolysis. Chemical hydrolysis is difficult to control and reduces the nutritional quality of products destroying L-form amino acids and producing toxic substances such as lysino-alanine. Enzymatic hydrolysis works without destructing amino acids and by avoiding the extreme temperatures and pH levels required for chemical hydrolysis the nutritional properties of the protein hydrolysates remain largely unaffected. In this research we investigate the fat removal and protein hydrolysis from pork meat to produce the enteral tube feeding nutritional protein hydrolysate for patient. Our results are as follows meat moisture 75.1 protein 22.6 lipid 1.71 ash 0.5 vitamin B1 1.384mg100g n hexantreatment at 80oCin 45 minutes and drying 30 minutes in 90oC.Viscosity of the hydrolysate is very low 2.240 0.092 cPand high degree of hydrolysis 31.390 0.138 . The final protein powder has balance nutritional components and acid amines low microorganisms which are safety for human consumption.

  15. Enteral feeding and its impact on family mealtime routines for caregivers of children with cerebral palsy: A mixed method study.

    Science.gov (United States)

    Russell, Marion; Jewell, Vanessa; Poskey, Gail A; Russell, Asa

    2018-02-01

    Enteral feedings are part of the daily mealtime experience for many caregivers of children with cerebral palsy. The scope of occupational therapy practice incorporates multiple aspects of the enteral feeding process. Yet, the research in this area is very limited. The purpose of this study was to provide practitioners with better understanding of the impact enteral feedings of children with cerebral palsy have on family mealtime routines. Using a complimentary mixed method approach, data were obtained through an online survey containing the Satisfaction Questionnaire with Gastrostomy Feeding (SAGA-8) and supplementary questions, and qualitative semi-structured phone interviews. Participants were caregivers of children with cerebral palsy who receive their primary nutrition through a gastrostomy tube. This study's cohort consisted of n = 36, SAGA-8, and n = 6 in-depth interviews. The mean age of children of was 9.4 (6.94 SD) with a mean age of 3.4 (5.35 SD) when enteral feeding was introduced. While families' overall situations positively changed after the gastronomy tube placement, environmental barriers and length of feeding time continued to present a challenge to mealtime routines. The mixed methods data analysis revealed that successful adjustment to having a child with a gastronomy tube and problem solving are closely linked and a consistent part of mealtime experience. Findings highlighted the necessity of comprehensive support from health professionals in achieving positive mealtime experience. Themes in this study indicated that caregivers would benefit from a professional with knowledge in the development and integration of rituals and routines to support positive outcomes. © 2017 Occupational Therapy Australia.

  16. The Effects of Pre-Operative Enteral Nutrition from Nasal Feeding Tubes on Gastric Outlet Obstruction.

    Science.gov (United States)

    Chen, Zhi-Hua; Lin, Su-Yong; Dai, Qi-Bao; Hua, Jin; Chen, Shao-Qin

    2017-04-10

    We examined gastric outlet obstruction (GOO) patients who received two weeks of strengthening pre-operative enteral nutrition therapy (pre-EN) through a nasal-jejenal feeding tube placed under a gastroscope to evaluate the feasibility and potential benefit of pre-EN compared to parenteral nutrition (PN). In this study, 68 patients confirmed to have GOO with upper-gastrointestinal contrast and who accepted the operation were randomized into an EN group and a PN group. The differences in nutritional status, immune function, post-operative complications, weight of patients, first bowel sound and first flatus time, pull tube time, length of hospital stay (LOH), and cost of hospitalization between pre-operation and post-operation were all recorded. Statistical analyses were performed using the chi square test and t -test; statistical significance was defined as p < 0.05. The success rate of the placement was 91.18% (three out of 31 cases). After pre-EN, the levels of weight, albumin (ALB), prealbumin (PA), and transferrin (TNF) in the EN group were significantly increased by pre-operation day compared to admission day, but were not significantly increased in the PN group; the weights in the EN group were significantly increased compared to the PN group by pre-operation day and day of discharge; total protein (TP), ALB, PA, and TNF of the EN group were significantly increased compared to the PN group on pre-operation and post-operative days one and three. The levels of CD3+, CD4+/CD8+, IgA, and IgM in the EN group were higher than those of the PN group at pre-operation and post-operation; the EN group had a significantly lower incidence of poor wound healing, peritoneal cavity infection, pneumonia, and a shorter first bowel sound time, first flatus time, and post-operation hospital stay than the PN group. Pre-EN through a nasal-jejunum feeding tube and placed under a gastroscope in GOO patients was safe, feasible, and beneficial to the nutrition status, immune function

  17. Fermented liquid feed - Microbial and nutritional aspects and impact on enteric diseases in pigs

    DEFF Research Database (Denmark)

    Canibe, Nuria; Jensen, Bent Borg

    2012-01-01

    , an interesting feeding strategy; (3) the policies aiming at increasing production of renewable biofuel with a corresponding increase in liquid co-products from the bioethanol industry, suitable for liquid feeding; (4) environmental policies aiming at decreasing disposal of waste, for example, liquid co......The use of liquid feed in pig nutrition has recently gained interest due to several reasons: (1) the political wish of decreasing the use of antibiotics in pig production; (2) the current fluctuations in feed prices what makes liquid feed, with the possibility of using cheap liquid ingredients......-products from the food/pharmaceutical/biofuel industry, that can be included in liquid feeding. In order to obtain fermented liquid feed (FLF) of good microbial quality, that is, biosafe, fresh feed and water are mixed with material from a previous successful fermentation, which acts as inoculum for the new...

  18. Randomised trial of safety and efficacy of postoperative enteral feeding in patients with severe pancreatitis: preliminary report.

    Science.gov (United States)

    Pupelis, G; Austrums, E; Jansone, A; Sprucs, R; Wehbi, H

    2000-05-01

    To find out whether postoperative enteral feeding is safe and effective in patients with severe pancreatitis. Prospective randomised trial. Teaching hospital, Latvia. 29 patients who had been operated on for severe pancreatitis. They were randomised to have either enteral nutrition and conventional intravenous fluids postoperatively (n = 11), or conventional intravenous fluids only (n = 18). 17 additional patients who had had major abdominal operations for other conditions were also given enteral nutrition and intravenous fluids and comprised the control group. Nutritional intake, duration of stay in intensive care (ICU) and hospital morbidity, mortality, and outcome. 1 patient died of the 11 given enteral nutrition combined with conventional intravenous fluids, compared with 5/18 given fluids only. The pattern of bowel transit in the fed group did not differ from that in the control group. Postoperative enteral nutrition seems to be safe and effective in patients with severe pancreatitis and may improve survival. Our results suggest that enteral and parenteral nutrition may complement each other in seriously ill patients.

  19. Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

    International Nuclear Information System (INIS)

    Fietkau, R.

    1998-01-01

    Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [de

  20. The Role of the Enteral Route and the Composition of Feeds in the Nutritional Support of Malnourished Surgical Patients

    Directory of Open Access Journals (Sweden)

    Luca Gianotti

    2012-09-01

    Full Text Available In surgical patients, malnutrition is an important risk factor for post-operative complications. In undernourished patients undergoing major gastrointestinal procedures, preoperative enteral nutrition (EN should be preferred whenever feasible. It may be given either orally or by feeding tubes, depending on patient compliance. Early oral intake after surgery should be encouraged, but if an insufficient postoperative oral intake is anticipated, tube feeding should be initiated as soon as possible. The use of immunomodulating formulas offers significant advantages when compared to standard feeds and the positive results on postoperative complications seem independent from the baseline nutritional status. In malnourished patients, the optimal timing and dose of immunonutrition is unclear, but consistent data suggest that they should be treated peri-operatively for at least two weeks.

  1. Home enteral tube feeding in children with inherited metabolic disorders: a review of long-term carer knowledge and technique.

    Science.gov (United States)

    Evans, S; Preston, F; Daly, A; Ashmore, C; Holden, C; MacDonald, A

    2012-12-01

    Home enteral tube feeding (HETF) is commonly used in children with inherited metabolic disorders (IMD). It is unclear how caregiver knowledge and their safety in using tube feeding techniques changes over time. Caregivers of children with IMD on HETF from one UK IMD centre had annual interviews over 3 years using a structured questionnaire and observation to assess HETF knowledge and safety techniques. Thirty-two caregivers of IMD children (median age 5.3 years; range 0.3-13.6 years) were studied. Seventy-eight percent (n = 25) of subjects had been on HETF for >5 years. Over 3 years, many caregivers' HETF techniques deteriorated: accurate feed ingredient measurement decreased from 36% to 11%; correct flushing of tubes decreased from 56% to 44%; checking tube position as recommended decreased from 72% to 56%; and correct hand washing decreased from 38% to 25%. Despite improvements, knowledge of some aspects remained poorly understood: dangers of incorrect tube placement increased from 41% to 56%; correct position for night feeding increased from 38% to 56%; and feed ingredient storage decreased from 87% to 38%. The HETF techniques of caregivers of children with IMD declined over time. Caregivers need to understand that HETF, particularly in IMD, is a serious procedure associated with life-threatening risks. Poor HETF practices may cause feed contamination, incorrect feed concentration, feed intolerance, aspiration, peritonitis and even metabolic decompensation. HETF skills should be reassessed annually, with compulsory retraining if basic 'core' HETF competencies are not demonstrated. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

  2. Enteral Feeding Tubes in Patients Undergoing Definitive Chemoradiation Therapy for Head-and-Neck Cancer: A Critical Review

    Energy Technology Data Exchange (ETDEWEB)

    Koyfman, Shlomo A., E-mail: koyfmas@ccf.org [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Adelstein, David J. [Departments of Radiation and Solid Tumor Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States)

    2012-11-01

    Definitive chemoradiation therapy has evolved as the preferred organ preservation strategy in the treatment of locally advanced head-and-neck cancer (LA-HNC). Dry mouth and dysphagia are among the most common and most debilitating treatment-related toxicities that frequently necessitate the placement of enteral feeding tubes (FT) in these patients to help them meet their nutritional requirements. The use of either a percutaneous endoscopic gastrostomy tube or a nasogastric tube, the choice of using a prophylactic vs a reactive approach, and the effects of FTs on weight loss, hospitalization, quality of life, and long-term functional outcomes are areas of continued controversy. Considerable variations in practice patterns exist in the United States and abroad. This critical review synthesizes the current data for the use of enteral FTs in this patient population and clarifies the relative advantages of different types of FTs and the timing of their use. Recent developments in the biologic understanding and treatment approaches for LA-HNC appear to be favorably impacting the frequency and severity of treatment-related dysphagia and may reduce the need for enteral tube feeding in the future.

  3. Principles of feeding cancer patients via enteral or parenteral nutrition during radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fietkau, R. [Strahlentherapeutische Klinik und Poliklinik, Rostock Univ. (Germany)]|[Strahlentherapeutische Klinik und Poliklinik, Erlangen Univ. (Germany)

    1998-11-01

    Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [Deutsch] Hintergrund: Der Ernaehrungsstatus von Tumorpatienten ist haeufig bereits vor jeder antitumoroesen Therapie reduziert und kann sich durch die notwendige Radio(chemo)therapie weiter verschlechtern. Methode: Im Rahmen dieses Uebersichtsartikels werden die Moeglichkeiten und Risiken der enteralen und parenteralen Ernaehrung waehrend einer Radiotherapie besprochen. Die Indikationen der enteralen Ernaehrung werden anhand von eigenen Ergebnissen begruendet. Ergebnisse: Die Langzeiternaehrung wird am besten ueber einen enteralen Zugang durchgefuehrt. In einer prospektiven, nichtrandomisierten Studie konnten wir zeigen, dass eine enterale Ernaehrung mittels perkutaner endoskopisch kontrollierter Gastrostomie (PEG) nicht nur die anthropometrischen und biochemischen Parameter waehrend einer Radio(chemo)therapie verbessert, sondern auch die Lebensqualitaet. Eine weitere Moeglichkeit besteht in der

  4. A pilot study to assess tolerability of early enteral nutrition via esophagostomy tube feeding in dogs with severe acute pancreatitis.

    Science.gov (United States)

    Mansfield, C S; James, F E; Steiner, J M; Suchodolski, J S; Robertson, I D; Hosgood, G

    2011-01-01

    The putative role of the gut in amplification of systemic inflammation in acute pancreatitis is gaining credence, and intraluminal nutrition has been shown to decrease inflammation in experimental models of pancreatitis. Prepyloric feeding often is used in people with acute pancreatitis, but has not been evaluated in dogs. Early intervention with enteral nutrition (EN) delivered proximal to the pylorus will be well tolerated in dogs with acute pancreatitis and provide justification for further larger trials. Ten dogs with severe acute pancreatitis in an open-label, prospective pilot study. Dogs were treated with plasma transfusion and standard care, and then consecutively assigned to receive either EN via esophagostomy tube feeding or parenteral nutrition (PN). Outcome was used to determine optimal study size for future studies, and complications were compared between the 2 groups. A significantly greater number of vomiting or regurgitating episodes occurred in dogs receiving PN. The dogs receiving EN did not demonstrate any noticeable postprandial pain. There were more catheter-related complications in the PN group. There was no difference in outcome between the 2 treatments, and 43 dogs for each treatment would be required in future studies to determine a difference in outcome. Early EN delivered proximal to the pylorus is well tolerated in dogs with severe pancreatitis and resulted in fewer complications than PN. Prospective trials in a larger cohort are justified to fully establish the potential benefit of early EN, preferably compared with minimal enteral nutrition. Copyright © 2011 by the American College of Veterinary Internal Medicine.

  5. Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low-birthweight infants : a systematic review

    NARCIS (Netherlands)

    Kamphorst, Kim; Sietsma, Ydelette; Brouwer, Annemieke J; Rood, Paul J T; van den Hoogen, Agnes

    2016-01-01

    Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies

  6. The Use of an Automated System (GreenFeed) to Monitor Enteric Methane and Carbon Dioxide Emissions from Ruminant Animals.

    Science.gov (United States)

    Hristov, Alexander N; Oh, Joonpyo; Giallongo, Fabio; Frederick, Tyler; Weeks, Holley; Zimmerman, Patrick R; Harper, Michael T; Hristova, Rada A; Zimmerman, R Scott; Branco, Antonio F

    2015-09-07

    Ruminant animals (domesticated or wild) emit methane (CH4) through enteric fermentation in their digestive tract and from decomposition of manure during storage. These processes are the major sources of greenhouse gas (GHG) emissions from animal production systems. Techniques for measuring enteric CH4 vary from direct measurements (respiration chambers, which are highly accurate, but with limited applicability) to various indirect methods (sniffers, laser technology, which are practical, but with variable accuracy). The sulfur hexafluoride (SF6) tracer gas method is commonly used to measure enteric CH4 production by animal scientists and more recently, application of an Automated Head-Chamber System (AHCS) (GreenFeed, C-Lock, Inc., Rapid City, SD), which is the focus of this experiment, has been growing. AHCS is an automated system to monitor CH4 and carbon dioxide (CO2) mass fluxes from the breath of ruminant animals. In a typical AHCS operation, small quantities of baiting feed are dispensed to individual animals to lure them to AHCS multiple times daily. As the animal visits AHCS, a fan system pulls air past the animal's muzzle into an intake manifold, and through an air collection pipe where continuous airflow rates are measured. A sub-sample of air is pumped out of the pipe into non-dispersive infra-red sensors for continuous measurement of CH4 and CO2 concentrations. Field comparisons of AHCS to respiration chambers or SF6 have demonstrated that AHCS produces repeatable and accurate CH4 emission results, provided that animal visits to AHCS are sufficient so emission estimates are representative of the diurnal rhythm of rumen gas production. Here, we demonstrate the use of AHCS to measure CO2 and CH4 fluxes from dairy cows given a control diet or a diet supplemented with technical-grade cashew nut shell liquid.

  7. Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low-birthweight infants: a systematic review.

    Science.gov (United States)

    Kamphorst, Kim; Sietsma, Ydelette; Brouwer, Annemieke J; Rood, Paul J T; van den Hoogen, Agnes

    2016-11-01

    Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies published between 2007 and 2014 and covered 495 infants. Suppositories were ineffective in shortening the time to reach full enteral feeding, and the evidence on enemas was contradictory. Enemas and rectal stimulation did not shorten the time until complete meconium evacuation was reached. Further research into safe, effective interventions to accelerate meconium excretion is needed. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  8. Enteric methane production in lactating dairy cows with continuous feeding of essential oils or rotational feeding of essential oils and lauric acid.

    Science.gov (United States)

    Klop, G; Dijkstra, J; Dieho, K; Hendriks, W H; Bannink, A

    2017-05-01

    Rumen microbes can adapt to feed additives, which may make the decrease in enteric CH 4 production upon feeding an additive a transient response only. This study investigated alternate feeding of 2 CH 4 mitigating feed additives with a different mode of action on persistency of lowering CH 4 production compared with feeding a single additive over a period of 10 wk. Four pairs of cows were selected, and within pairs, cows were randomly assigned to either the control (AR-AR) or the alternating (AR-LA) concentrate treatment. The AR concentrate contained a blend of essential oils (Agolin Ruminant, Agolin SA, Bière, Switzerland; 0.17 g/kg of dry matter) and the LA concentrate contained lauric acid (C12:0; 65 g/kg of dry matter). A basal concentrate without Agolin Ruminant and lauric acid was fed during the pretreatment period (2 wk). Thereafter, the cows assigned to the AR-AR treatment received the AR concentrate during all 10 treatment weeks (5 periods of 2 wk each), whereas cows assigned to the AR-LA treatment received AR and LA concentrates rotated on a weekly basis. Methane emission was measured in climate respiration chambers during periods 1, 3, and 5. From period 3 onward, dry matter intake and milk protein concentration were reduced with the AR-LA treatment. Milk fat concentration was not affected, but the proportion of C12:0 in milk fat increased upon feeding C12:0. Molar proportions of acetate and propionate in rumen fluid were lower and higher, respectively, with the AR-LA than with the AR-AR treatment. Methane yield (g/kg of dry matter intake) and intensity (g/kg of fat- and protein-corrected milk yield) were not affected by treatment. Methane yield and intensity were significantly lower (12 and 11%, respectively) in period 1 compared with the pretreatment period, but no significant difference relative to pretreatment period was observed in period 3 (numerically 9 and 7% lower, respectively) and in period 5 (numerically 8 and 4% lower, respectively

  9. Buffalo heifers selected for lower residual feed intake have lower feed intake, better dietary nitrogen utilisation and reduced enteric methane production.

    Science.gov (United States)

    Sharma, V K; Kundu, S S; Datt, C; Prusty, S; Kumar, M; Sontakke, U B

    2018-04-01

    This study was conducted to evaluate the utilisation of the residual feed intake (RFI) as a feed efficiency selection tool and its relationship with methane emissions. Eighteen Murrah buffalo (Bubalus bubalis) heifers were fed ad libitum with total mixed ration (TMR) for 120 days. Based on linear regression models involving dry matter intake (DMI), average daily gain (ADG) and mid-test metabolic body size (MBW 0.75 ), heifers were assigned into low and high RFI groups. The RFI varied from -0.09 to +0.12 kg DM/day with average RFI of -0.05 and 0.05 kg DM/day in low and high RFI heifers respectively. Low RFI heifers ate 11.6% less DM each day, yet average daily gain (ADG) and feed utilisation were comparable among low and high RFI groups. Low RFI heifers required significantly (p  .05) among low and high RFI groups. Although the nitrogen balance was similar among heifers of low and high RFI groups, nitrogen metabolism was significantly higher (p > .05) in high RFI heifers. Comparison of data from heifers exhibiting the low (n = 9) and high (n = 9) RFI showed that the low RFI heifers have lower enteric methane production and methane losses than high RFI heifers. In conclusion, results of this study revealed that selection of more efficient buffalo heifers has multiple benefits, such as decreased feed intake and less emission of methane. © 2017 Blackwell Verlag GmbH.

  10. The institutionalization of children's feeding programs in Atlantic Canada.

    Science.gov (United States)

    McIntyre, L; Raine, K; Dayle, J B

    2001-01-01

    This study traces the evolution of children's feeding programs established in Atlantic Canada from a few months to over 15 years ago. Our qualitative analysis of nine children's feeding programs in Atlantic Canada revealed that they began as an ad hoc, community-based effort to feed hungry children. All subsequently experienced stress related to community mobilization. In order to recover from this stress, programs "routinized," often with fewer volunteers or by adopting measures that ensured efficiency and stability. While one program remained routinized, others gradually assumed more features of institutionalization as a response to externally or internally imposed crises. They did so by adopting professional management strategies and often hiring professional personnel. As the institutionalized programs continued, they became driven by the need to feed themselves, which was often greater than their mission to feed hungry children. The challenge for dietitians assisting children's feeding program operators, policy makers, children's advocates, and citizens is to reflect upon which organizational models of children's feeding programs should be supported.

  11. The metabolic activity of the enteric microflora and the pattern of sensitization in different types of feeding in healthy infants

    Directory of Open Access Journals (Sweden)

    S. V. Bogdanova

    2015-01-01

    Full Text Available Objective: to investigate the metabolic activity of the enteric microflora and the rate of milk protein sensitization during different types of feeding in healthy infants of Moscow. A total of 200 apparently healthy children were followed up. According to feeding patterns, there were 100 formula-fed babies (a study group and 100 breast-fed ones (a comparison group. Subgroup 1 of the study group included 51 infants receiving formulas based on New Zealand goat's milk with prebiotics; Subgroup 2 consisted of 49 infants having formulas based on cow's milk-serum proteins with prebiotics. The metabolic activity of the enteric microflora was investigated by gas liquid chromatography; the concentrations of allergen-specific IgE and IgG antibodies against cow's and goat's milk proteins in coprofllrates were determined by noncompetitive enzyme immunoassay using special test systems (Allergopharma, Germany before and during the ingestion of the formulas with prebiotics. The use of the formulas containing prebiotics led to increases in acetic acid and butyric acid concentrations and anaerobic index in both subgroups. However, their highest values in the coproflltrates were observed in Subgroup 1 and breast-fed infants. Analysis of allergen-specific IgE and IgC antibodies before formula indigestion showed that the level of latent sensitization to goat's milk protein was substantially lower than that to cow's milk protein (+ Class 1 and + Class 2, respectively. Subgroup 1 showed a more pronounced tendency to decrease the rate of latent sensitization to these types of protein. Thus, the most pronounced positive tendency in the examined indicators was observed in babies receiving breast milk or formulas based on New Zealand goat's milk with prebiotics.

  12. Enteral Feeding During Chemoradiotherapy for Advanced Head-and-Neck Cancer: A Single-Institution Experience Using a Reactive Approach

    International Nuclear Information System (INIS)

    Clavel, Sebastien; Fortin, Bernard; Despres, Philippe; Donath, David; Soulieres, Denis; Khaouam, Nader; Charpentier, Danielle; Belair, Manon; Guertin, Louis; Nguyen-Tan, Phuc Felix

    2011-01-01

    Purpose: The optimal method for providing enteral nutrition to patients with head-and-neck cancer is unclear. The purpose of the present study was to evaluate the safety and efficacy of our reactive policy, which consists of the installation of a nasogastric (NG) feeding tube only when required by the patient's nutritional status. Methods and Materials: The records of all patients with Stage III and IV head-and-neck cancer treated with concomitant chemotherapy and radiotherapy between January 2003 and December 2006 were reviewed. The overall and disease-free survival rates were estimated using the Kaplan-Meier method and compared with the log-rank test. Results: The present study included 253 patients, and the median follow-up was 33 months. At 3 years, the estimated overall survival and disease-free survival rate was 82.8% and 77.8%, respectively, for the whole population. No survival difference was observed when the patients were compared according to the presence and absence of a NG tube or stratified by weight loss quartile. The mean weight loss during treatment for all patients was 10.4%. The proportion of patients requiring a NG tube was 49.8%, and the NG tube remained in place for a median duration of 40 days. No major complications were associated with NG tube installation. Only 3% of the patients were still dependent on enteral feeding at 6 months. Conclusion: These results suggest that the use of a reactive NG tube with an interdisciplinary team approach is a safe and effective method to manage malnutrition in patients treated with concomitant chemotherapy and radiotherapy for head-and-neck cancer.

  13. The Correlates and Consequences of Drug Involvement among Youths Entering a Juvenile Justice Diversion Program

    Science.gov (United States)

    Dembo, Richard; Wareham, Jennifer; Poythress, Norman; Cook, Brittany; Schmeidler, James

    2006-01-01

    We report the results of the relationship of lifetime and past year drug involvement to psychosocial functioning among youths entering a Juvenile Arbitration Program (a diversion program) in the 13th Judicial Circuit, who enrolled in a Center for Substance Abuse Treatment funded study. The project is a clinical trial evaluating an innovative…

  14. An early feeding regime and a high-density amino acid diet on growth performance of broilers under subclinical necrotic enteritis challenge

    OpenAIRE

    Chake Keerqin; Shu-Biao Wu; Birger Svihus; Robert Swick; Natalie Morgan; Mingan Choct

    2017-01-01

    Broilers that have early access to feed have been shown to have enhanced immune system and gut development and heightened resilience against necrotic enteritis (NE). This study examined the effect of early feeding a high amino acid density diet on performance of broilers under a sub-clinical NE challenge model. Ross 308 broilers (n = 576) were assigned to a 2 × 2 × 2 factorial design with 2 feeding regimes (feed access either within 6 h post-hatch or after 48 h post-hatch), 2 diets (control d...

  15. Comparison of the effects of enteral feeding with continuous and intermittent parenteral nutrition on hepatic triglyceride secretion in human beings

    International Nuclear Information System (INIS)

    Isabel-Martinez, L.; Skinner, C.; Parkin, A.; Hall, R.I.

    1989-01-01

    Plasma triglyceride turnover was measured during steady-state conditions in 22 postoperative patients. Nine had received nutritional support with an enteral regimen, seven had received an equivalent regimen as continuous parenteral nutrition, and six received the same parenteral regimen as a cyclical infusion. After 5 days of nutritional support, each patient received an intravenous bolus of tritiated glycerol. Plasma radiolabeled triglyceride content was measured during the subsequent 24 hours. The data were analyzed by means of a simple deterministic model of plasma triglyceride kinetics and compared with the results obtained by stochastic analysis. The rates of hepatic triglyceride secretion obtained by deterministic analysis were higher than those obtained by the stochastic approach. However, the mode of delivery of the nutritional regimen did not affect the rate of hepatic triglyceride secretion regardless of the method of analysis. The results suggest that neither complete nutritional bypass of the gastrointestinal tract nor interruption of parenteral nutrition in an attempt to mimic normal eating has any effect on hepatic triglyceride secretion. Any beneficial effect that enteral feeding or cyclical parenteral nutrition may have on liver dysfunction associated with standard parenteral nutrition appears to be unrelated to changes in hepatic triglyceride secretion

  16. A Stepwise, Pilot Study of Bovine Colostrum to Supplement the First Enteral Feeding in Preterm Infants (Precolos)

    DEFF Research Database (Denmark)

    Li, Yanqi; Juhl, Sandra M; Ye, Xuqiang

    2017-01-01

    and gut maturation. We designed a pilot study to investigate the feasibility and tolerability of BC as the first nutrition for preterm infants. The study was designed into three phases (A, B, and C) and recruited infants with birth weights of 1,000-1,800 g (China) or gestational ages (GAs) of 27 + 0 to 32...... to full enteral feeding, serious infections/NEC, plasma amino acid profile, blood biochemistry, and intestinal functions are assessed. This paper presents the study protocol and results from phases A and B. RESULTS: Seven Danish and five Chinese infants received 22 ± 11 and 22 ± 6 ml·kg-1·day-1 BC...... enteral protein intake. Based on the safety evaluation of phases A and B, the randomized phase C has been initiated. When complete, the Precolos trial will document whether it is feasible to use BC as a novel, bioactive milk diet for preterm infants. Our trial paves the way for a larger randomized...

  17. Waste feed delivery program systems engineering implementation plan

    International Nuclear Information System (INIS)

    O'Toole, S.M.; Hendel, B.J.

    1998-01-01

    This document defines the systems engineering processes and products planned by the Waste Feed Delivery Program to develop the necessary and sufficient systems to provide waste feed to the Privatization Contractor for Phase 1. It defines roles and responsibilities for the performance of the systems engineering processes and generation of products

  18. Owner experiences and complications with home use of a replacement low profile gastrostomy device for long-term enteral feeding in dogs

    OpenAIRE

    Yoshimoto, Sean K.; Marks, Stanley L.; Struble, Andrea L.; Riel, Darlene L.

    2006-01-01

    The purpose of this study was to evaluate complications and owner impressions of a low profile gastrostomy device (LPGD) for enteral feeding in dogs. Medical records of dogs that had placement of a percutaneous endoscopic gastrostomy tube followed by a LPGD between 1995 and 2003 were reviewed. Fifteen dogs had 29 devices placed for a variety of disease states in which enteral nutritional support was indicated. The individual tubes were placed for a median duration of 212 d. Most complications...

  19. Early enteral tube feeding in optimizing treatment of hyperemesis gravidarum: the Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER) randomized controlled trial.

    Science.gov (United States)

    Grooten, Iris J; Koot, Marjette H; van der Post, Joris Am; Bais, Joke Mj; Ris-Stalpers, Carrie; Naaktgeboren, Christiana; Bremer, Henk A; van der Ham, David P; Heidema, Wieteke M; Huisjes, Anjoke; Kleiverda, Gunilla; Kuppens, Simone; van Laar, Judith Oeh; Langenveld, Josje; van der Made, Flip; van Pampus, Mariëlle G; Papatsonis, Dimitri; Pelinck, Marie-José; Pernet, Paula J; van Rheenen, Leonie; Rijnders, Robbert J; Scheepers, Hubertina Cj; Vogelvang, Tatjana E; Mol, Ben W; Roseboom, Tessa J; Painter, Rebecca C

    2017-09-01

    Background: Hyperemesis gravidarum (HG) leads to dehydration, poor nutritional intake, and weight loss. HG has been associated with adverse pregnancy outcomes such as low birth weight. Information about the potential effectiveness of treatments for HG is limited. Objective: We hypothesized that in women with HG, early enteral tube feeding in addition to standard care improves birth weight. Design: We performed a multicenter, open-label randomized controlled trial [Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER)] in 19 hospitals in the Netherlands. A total of 116 women hospitalized for HG between 5 and 20 wk of gestation were randomly allocated to enteral tube feeding for ≥7 d in addition to standard care with intravenous rehydration and antiemetic treatment or to standard care alone. Women were encouraged to continue tube feeding at home. On the basis of our power calculation, a sample size of 120 women was anticipated. Analyses were performed according to the intention-to-treat principle. Results: Between October 2014 and March 2016 we randomly allocated 59 women to enteral tube feeding and 57 women to standard care. The mean ± SD birth weight was 3160 ± 770 g in the enteral tube feeding group compared with 3200 ± 680 g in the standard care group (mean difference: -40 g, 95% CI: -230, 310 g). Secondary outcomes, including maternal weight gain, duration of hospital stay, readmission rate, nausea and vomiting symptoms, decrease in quality of life, psychological distress, prematurity, and small-for-gestational-age, also were comparable. Of the women allocated to enteral tube feeding, 28 (47%) were treated according to protocol. Enteral tube feeding was discontinued within 7 d of placement in the remaining women, primarily because of its adverse effects (34%). Conclusions: In women with HG, early enteral tube feeding does not improve birth weight or secondary outcomes. Many women discontinued tube feeding because of discomfort

  20. Food Program: The Army Field Feeding System

    Science.gov (United States)

    1990-09-24

    example, ultra-high-tem- perature ( UHT ) milk , bread, cereal, and fruit), enter the total quan- tity required (based on the actual number to be supported...days’ lead time is required for requisitioning unitized rations. (3) Order bread, UHT milk , and authorized enhancement items based on factors in...supporting MACOM. (7) Each T Ration meal served to a soldier will include a half pint of milk and 21⁄2 ounces of bread. A Ration enhancements should be added

  1. Environmental impacts of precision feeding programs applied in pig production.

    Science.gov (United States)

    Andretta, I; Hauschild, L; Kipper, M; Pires, P G S; Pomar, C

    2017-12-04

    This study was undertaken to evaluate the effect that switching from conventional to precision feeding systems during the growing-finishing phase would have on the potential environmental impact of Brazilian pig production. Standard life-cycle assessment procedures were used, with a cradle-to-farm gate boundary. The inputs and outputs of each interface of the life cycle (production of feed ingredients, processing in the feed industry, transportation and animal rearing) were organized in a model. Grain production was independently characterized in the Central-West and South regions of Brazil, whereas the pigs were raised in the South region. Three feeding programs were applied for growing-finishing pigs: conventional phase feeding by group (CON); precision daily feeding by group (PFG) (whole herd fed the same daily adjusted diet); and precision daily feeding by individual (PFI) (diets adjusted daily to match individual nutrient requirements). Raising pigs (1 t pig BW at farm gate) in South Brazil under the CON feeding program using grain cultivated in the same region led to emissions of 1840 kg of CO2-eq, 13.1 kg of PO4-eq and 32.2 kg of SO2-eq. Simulations using grain from the Central-West region showed a greater climate change impact. Compared with the previous scenario, a 17% increase in climate change impact was found when simulating with soybeans produced in Central-West Brazil, whereas a 28% increase was observed when simulating with corn and soybeans from Central-West Brazil. Compared with the CON feeding program, the PFG and PFI programs reduced the potential environmental impact. Applying the PFG program mitigated the potential climate change impact and eutrophication by up to 4%, and acidification impact by up to 3% compared with the CON program. Making a further adjustment by feeding pigs according to their individual nutrient requirements mitigated the potential climate change impact by up to 6% and the potential eutrophication and acidification impact

  2. A mathematical model to describe the diurnal pattern of enteric methane emissions from non-lactating dairy cows post-feeding

    Directory of Open Access Journals (Sweden)

    Min Wang

    2015-12-01

    Full Text Available Enteric methane emission is not only a source of energy loss in ruminants, but also a potent contributor to greenhouse gas production. To identify the nature and timing of interventions to reduce methane emissions requires knowledge of temporal kinetics of methane emissions during animal husbandry. Accordingly, a mathematical model was developed to investigate the pattern of enteric methane emissions after feeding in dairy cows. The model facilitated estimation of total enteric methane emissions (V, g produced by the residual substrate (V1, g and newly ingested feed (V2, g. The model was fitted to the 10 h methane emission patterns after morning feeding of 16 non-lactating dairy cows with various body weights (BW, and the obtained parameters were used to predict the kinetics of 24 h methane emission for each animal. The rate of methane emission (g/h reached a maximum within 1 to 2 h after feeding, followed by a gradual post-prandial decline to a basal value before the next feeding. The model satisfactorily fitted curves for each cow according to the criterion of goodness-of-fit, and provided biological descriptions for fluctuations in methane emissions based on basal V1 and feeding V2 in response to the changes in BW and dry matter intake (DMI of different dairy cows. The basal V1 and feeding V2 are probably maintained by slow- and readily-degradable substrates, respectively. The former contributed at least 0.6 of methane production. In summary, the model provides a means to separate basal V1 and feeding V2 within V, and can be used to predict 24 h emission from a single feeding period.

  3. Effects of guest feeding programs on captive giraffe behavior.

    Science.gov (United States)

    Orban, David A; Siegford, Janice M; Snider, Richard J

    2016-01-01

    Zoological institutions develop human-animal interaction opportunities for visitors to advance missions of conservation, education, and recreation; however, the animal welfare implications largely have yet to be evaluated. This behavioral study was the first to quantify impacts of guest feeding programs on captive giraffe behavior and welfare, by documenting giraffe time budgets that included both normal and stereotypic behaviors. Thirty giraffes from nine zoos (six zoos with varying guest feeding programs and three without) were observed using both instantaneous scan sampling and continuous behavioral sampling techniques. All data were collected during summer 2012 and analyzed using linear mixed models. The degree of individual giraffe participation in guest feeding programs was positively associated with increased time spent idle and marginally associated with reduced time spent ruminating. Time spent participating in guest feeding programs had no effect on performance of stereotypic behaviors. When time spent eating routine diets was combined with time spent participating in guest feeding programs, individuals that spent more time engaged in total feeding behaviors tended to perform less oral stereotypic behavior such as object-licking and tongue-rolling. By extending foraging time and complexity, guest feeding programs have the potential to act as environmental enrichment and alleviate unfulfilled foraging motivations that may underlie oral stereotypic behaviors observed in many captive giraffes. However, management strategies may need to be adjusted to mitigate idleness and other program consequences. Further studies, especially pre-and-post-program implementation comparisons, are needed to better understand the influence of human-animal interactions on zoo animal behavior and welfare. © 2016 Wiley Periodicals, Inc.

  4. Comparison of the effects of enteral feeding through the bolus and continuous methods on blood sugar and prealbumin levels in ICU inpatients.

    Science.gov (United States)

    Shahriari, Mohsen; Rezaei, Ehsaneh; Bakht, Leila Azad; Abbasi, Saeid

    2015-01-01

    Appropriate nutritional support is effective on achievement of expected outcomes in intensive care unit (ICU) patients. Although several studies have suggested different conclusions about the effectiveness of tube feeding methods, there is no specific program of nutritional support for patients who have been hospitalized. There is a possibility for complications due to an inadequate nutrition. The aim of our study is to compare the effects of enteral feeding through the bolus and continuous methods on blood sugar and prealbumin level among the ICU inpatients. Fifty subjects were selected by convenient sampling from April to Aug 2013 in the ICU wards of Alzahra Hospital, Isfahan, Iran, and randomly assigned to study and control groups in this clinical trial. The subjects in the study group received infusion pump feeding while the control group received bolus feeding for 72 h. Blood sugar was checked for every 4 h for 72 h and the prealbumin level was assessed on the first and the fourth day in two groups. In the study group, the mean blood sugar significantly decreased on the fourth day, compared with the first (P = 0.03, F = 3.85) and third (P = 0.01, F = 3.15) day. In the control group, the mean blood sugar increased from the first day. It was significantly higher in the control group on the second day (P = 0.02, F = 3.55), compared with the study group. In the study group, there was a significant difference in the mean prealbumin before and after intervention (P = 0.048, t = 1.97), but no significant difference was observed in the control group. There was a significant difference between two groups after intervention (P = 0.04, t = 2.05). The obtained results showed that supportive nutrition through a continuous method had an effect on critical patients' blood sugar control and made a better nutritional status for these patients through an increase of prealbumin level. Positive effects of this feeding method can result in appropriate outcomes for patients

  5. The Effect of an Intervention Aimed at Reducing Errors when Administering Medication through Enteral Feeding Tubes in an Institution for Individuals with Intellectual Disability

    Science.gov (United States)

    Idzinga, J. C.; de Jong, A. L.; van den Bemt, P. M. L. A.

    2009-01-01

    Background: Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to…

  6. Drug Administration via Enteral Feeding Tube in Residential Care Facilities for Individuals with Intellectual Disability: A Focus Group Study on Guideline Implementation

    Science.gov (United States)

    Joos, Elke; Van Tongelen, Inge; Wijnants, Karen; Mehuys, Els; Van Bocxlaer, Jan; Remon, Jean Paul; Grypdonck, Maria; Van Winckel, Myriam; Boussery, Koen

    2016-01-01

    People with profound intellectual disabilities often receive medication through enteral feeding tube (EFT). In a previous study, we found that current guidelines concerning medication preparation and administration through EFT are often not followed in residential care facilities (RCFs) for individuals with intellectual disabilities. The present…

  7. Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding

    NARCIS (Netherlands)

    Kraaijeveld, FM; de Roos, N.M.; Belle-van Meerkerk, Gerdien; Teding van Berkhout, F; Heijerman, HGM; van de Graaf, EA

    2017-01-01

    Abstract BACKGROUND: Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. OBJECTIVE: This

  8. Body Weight and Body Mass Index in Patients with End-Stage Cystic Fibrosis Stabilize After the Start of Enteral Tube Feeding

    NARCIS (Netherlands)

    Hollander, Francis M.; Roos, de Nicole M.; Belle-Van Meerkerk, Gerdien; Teding van Berkhout, Ferdinand; Heijerman, Harry G.M.; Graaf, van de Ed A.

    2017-01-01

    Background: Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. Objective: This study

  9. A retrospective review of enteral nutrition support practices at a tertiary pediatric hospital: A comparison of prolonged nasogastric and gastrostomy tube feeding.

    Science.gov (United States)

    Ricciuto, Amanda; Baird, Robert; Sant'Anna, Ana

    2015-08-01

    Despite the frequent use of tube-mediated enteral feeding, there is little evidence clarifying best practices pertaining to prolonged nasogastric and gastrostomy tube use in children. At the Montreal Children's Hospital, tube feeding practices are non-standardized and highly variable, with many patients remaining on protracted nasogastric feeds. We aimed to characterize enteral nutrition practices at our institution and to compare prolonged nasogastric and gastrostomy tube use, hypothesizing that earlier gastrostomy improves outcomes, particularly the development of food refusal. In this retrospective cohort study, we reviewed the charts of children beginning long-term (>3 months) nasogastric or gastrostomy feeds at our institution between January 2007 and December 2011, with follow-up until May 2013. Patient demographics, anthropometric parameters, swallowing assessment, tube feeding duration and complications were recorded. Among 166 patients, the median total tube feeding duration was 24.9 (3.0-75.6) months and varied with underlying disease and swallowing assessment. The median duration of nasogastric tube use was 7.8 (0.7-45.3) months. Food refusal was significantly associated with nasogastric tube exposure >3 months (RR 3.3, p nasogastric group. Prolonged nasogastric feeding is common at our institution. Its association with increased food refusal and less favorable anthropometric outcomes may warrant earlier gastrostomy placement. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. Feeding-dependent activation of enteric cells and sensory neurons by lymphatic fluid: evidence for a neurolymphocrine system.

    Science.gov (United States)

    Poole, Daniel P; Lee, Mike; Tso, Patrick; Bunnett, Nigel W; Yo, Sek Jin; Lieu, TinaMarie; Shiu, Amy; Wang, Jen-Chywan; Nomura, Daniel K; Aponte, Gregory W

    2014-04-15

    Lymphatic fluid is a plasma filtrate that can be viewed as having biological activity through the passive accumulation of molecules from the interstitial fluid. The possibility that lymphatic fluid is part of an active self-contained signaling process that parallels the endocrine system, through the activation of G-protein coupled receptors (GPCR), has remained unexplored. We show that the GPCR lysophosphatidic acid 5 (LPA5) is found in sensory nerve fibers expressing calcitonin gene-related peptide (CGRP) that innervate the lumen of lymphatic lacteals and enteric nerves. Using LPA5 as a model for nutrient-responsive GPCRs present on sensory nerves, we demonstrate that dietary protein hydrolysate (peptone) can induce c-Fos expression in enterocytes and nerves that express LPA5. Mesenteric lymphatic fluid (MLF) mobilizes intracellular calcium in cell models expressing LPA5 upon feeding in a time- and dose-dependent manner. Primary cultured neurons of the dorsal root ganglia expressing CGRP are activated by MLF, which is enhanced upon LPA5 overexpression. Activation is independent of the known LPA5 agonists, lysophosphatidic acid and farnesyl pyrophosphate. These data bring forth a pathway for the direct stimulation of sensory nerves by luminal contents and interstitial fluid. Thus, by activating LPA5 on sensory nerves, MLF provides a means for known and yet to be identified constituents of the interstitial fluid to act as signals to comprise a "neurolymphocrine" system.

  11. Program of gastrointestinal rehabilitation and early postoperative enteral nutrition: a prospective study.

    Science.gov (United States)

    Martos-Benítez, Frank Daniel; Gutiérrez-Noyola, Anarelys; Soto-García, Andrés; González-Martínez, Iraida; Betancourt-Plaza, Ilionanys

    2018-02-10

    Nutritional depletion is commonly observed in patients undergoing surgical treatment for a gastrointestinal malignancy. An appropriate nutritional intervention could be associated with improved postoperative outcomes. The study was aimed to determine the effect of a program of gastrointestinal rehabilitation and early postoperative enteral nutrition upon complications and clinical outcomes in patients who experienced gastrointestinal surgery for cancer. This is a prospective study (2013 January-2015 December) of 465 consecutive patients submitted to gastrointestinal surgery for cancer and admitted to an Oncological Intensive Care Unit. The program of gastrointestinal rehabilitation and early postoperative enteral nutrition consisted on: (1) general rules: pain relive, early mobilization, antibiotic prophylaxis, deep vein thrombosis prophylaxis and respiratory physiotherapy; and (2) gastrointestinal rules: gastric protection, control of postoperative nausea and vomiting, early nasogastric tube remove and early enteral nutrition. The most frequent surgical sites were colorectal (44.9%), gynecological with intestinal suturing (15.7%) and esophagus/stomach (11.0%). Emergency surgery was performed in 12.7% of patients. The program of intestinal rehabilitation and early postoperative enteral nutrition reduced major complications (19.2 vs. 10.2%; p = 0.030), respiratory complications (p = 0.040), delirium (p = 0.032), infectious complications (p = 0.047) and gastrointestinal complications (p < 0.001). Intensive care unit mortality (p = 0.018), length of intensive care unit stay (p < 0.001) and length of hospitalization (p < 0.001) were reduced as well. A program of gastrointestinal rehabilitation and early postoperative enteral nutrition is associated with reduced postoperative complications and improved clinical outcomes in patients undergoing gastrointestinal surgery for cancer.

  12. Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit.

    Science.gov (United States)

    Herich, Lena Carolin; Cuttini, Marina; Croci, Ileana; Franco, Francesco; Di Lallo, Domenico; Baronciani, Dante; Fares, Katia; Gargano, Giancarlo; Raponi, Massimiliano; Zeitlin, Jennifer

    2017-03-01

    To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units. This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect. There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers. In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Early versus Late Enteral Feeding in Preterm Intrauterine Growth Restricted Neonates with Antenatal Doppler Abnormalities: An Open-Label Randomized Trial.

    Science.gov (United States)

    Tewari, Vishal Vishnu; Dubey, Sachin Kumar; Kumar, Reema; Vardhan, Shakti; Sreedhar, C M; Gupta, Girish

    2018-02-01

    Enteral feeding in preterm neonates with intrauterine growth restriction (IUGR) and absent or reversed end diastolic flow (AREDF) on umbilical artery (UA) Doppler is delayed owing to an increased risk of necrotizing enterocolitis (NEC). Delaying enteral feeding with longer duration of parenteral nutrition (PN) carries an increased risk of sepsis. To study early versus late feeding in preterm IUGR neonates for time required to attain sufficient feed volume to discontinue PN and increased risk of NEC or feed intolerance (FI). Open-label randomized controlled trial. Tertiary care neonatal unit and fetal-maternal medicine unit in India. Preterm intrauterine growth restricted neonates' ≤32 weeks with AREDF on UA Doppler enrolled from 1 January 2014 to 31 July 2015. Randomized to receive early or late feeding using mothers own or donor breast milk as per a feed initiation and advancement protocol. Time in days required to attain sufficient feed volume allowing discontinuation of PN and incidence of NEC in neonates fed early versus late. There were 77 eligible neonates. Sixty-two neonates were included and stratified as extreme preterm (27-29 weeks) (n = 20) and very preterm (30-32 weeks) (n = 42). Ten extreme preterm and 21 very preterm neonates were randomized to each early feeding and late feeding arm. There was a significantly faster attainment of sufficient feeds in the early feeding arm of both the stratified groups [extreme preterm: median 14 days (Interquartile range IQR: 12-15) compared with 18 days (IQR: 18-20), hazard ratio (HR): 1.59, 95% CI: 0.626-4.078; very preterm: 12 days (IQR: 10-14) as compared with 16 days (IQR 15-17), HR: 1.89, 95% CI: 1.011-3.555]. There was no difference in the incidence of NEC, FI and combined outcome of NEC and FI. Early feeding in preterm IUGR neonates with AREDF on antenatal UA Doppler allowed earlier discontinuation of PN, allowing birth weight to be regained earlier and did not increase the incidence of NEC and FI.

  14. Effects of feeding level on nutrient digestibility and enteric methane production in growing goats (Capra hircus hircus) and Sika deer (Cervus nippon hortulorum).

    Science.gov (United States)

    Na, Youngjun; Li, Dong Hua; Choi, Yongjun; Kim, Kyoung Hoon; Lee, Sang Rak

    2018-03-02

    Two experiments were conducted to determine the effects of feeding level on nutrient digestibility and enteric methane (CH4) emissions in growing goats and Sika deer. Three growing male goats (initial BW of 22.4 ± 0.9 kg) and three growing male deer (initial BW of 20.2 ± 4.8 kg) were each allotted to a respiration-metabolism chamber for an adaptation period of 7 d and a data collection period of 3 d. An experimental diet was offered to each animal at one of three feeding levels (1.5, 2.0, and 2.5% of BW) in a 3 × 3 Latin square design. The chambers were used for measuring enteric CH4 emission. Nutrient digestibility decreased linearly in goats as feeding level increased, whereas Sika deer digestibility was not affected by feeding level. The enteric production of CH4 expressed as g/kg DMI, g/kg organic matter intake (OMI), and % of gross energy intake (GEI) decreased linearly with increased feeding level in goats; however, that of Sika deer was not affected by feeding level. Six equations were estimated for predicting the enteric CH4 emission from goats and Sika deer. For goat, equation 1 was found to be of the highest accuracy: CH4 (g/day) = 6.2 (± 14.1) + 10.2 (± 7.01) × DMI (kg/day) + 0.0048 (± 0.0275) × DMD (g/kg) - 0.0070 (± 0.0187) × neutral detergent fiber digestibility (NDFD; g/kg). For Sika deer, equation 4 was found to be of the highest accuracy: CH4 (g/day) = - 13.0 (± 30.8) + 29.4 (± 3.93) × DMI (kg/day) + 0.046 (± 0.094) × DMD (g/kg) - 0.0363 (± 0.0636) × NDFD (g/kg). Increasing the feeding level increased CH4 production in both goats and Sika deer, and predictive models of enteric CH4 production by goats and Sika deer were estimated.

  15. A prospective comparison of the use of nasogastric and percutaneous endoscopic gastrostomy tubes for long-term enteral feeding in older people.

    Science.gov (United States)

    Dwolatzky, T; Berezovski, S; Friedmann, R; Paz, J; Clarfield, A M; Stessman, J; Hamburger, R; Jaul, E; Friedlander, Y; Rosin, A; Sonnenblick, M

    2001-12-01

    To compare the indications for and the outcome of long-term enteral feeding by nasogastric tube (NGT) with that of percutaneous endoscopic gastrostomy (PEG) tube. A prospective, multicenter cohort study. Acute geriatric units and long-term care (LTC) hospitals in Jerusalem, Israel. 122 chronic patients aged 65 years and older for whom long-term enteral feeding was indicated as determined by the treating physician. Patients with acute medical conditions at the time of tube placement were excluded. We examined the indications for enteral feeding, nutritional status, outcome and complications in all subjects. Subjects were followed for a minimum period of six months. Although the PEG patients were older and had a higher incidence of dementia, there was an improved survival in those patients with PEG as compared to NGT (hazard ratio (HR)=0.41; 95% confidence interval (CI) 0.22-0.76; P=0.01). Also, the patients with PEG had a lower rate of aspiration (HR=0.48; 95% CI 0.26-0.89) and self-extubation (HR=0.17; 95% CI 0.05-0.58) than those with NGT. Apart from a significant improvement in the serum albumin level at the 4-week follow-up assessment in the patients with PEG compared to those with NGT (adjusted mean 3.35 compared to 3.08; F=4.982), nutritional status was otherwise similar in both groups. In long-term enteral feeding, in a selected group of non-acute patients, the use of PEG was associated with improved survival, was better tolerated by the patient and was associated with a lower incidence of aspiration. A randomized controlled study is needed to determine whether PEG is truly superior to NGT. Copyright 2001 Harcourt Publishers Ltd.

  16. Infant feeding practices in the Peruvian Amazon: implications for programs to improve feeding

    Directory of Open Access Journals (Sweden)

    Gwenyth Lee

    2014-09-01

    Full Text Available OBJECTIVE: To characterize feeding practices in a community in the Peruvian Amazon and to consider how this information could be used to strengthen programs and policies designed to improve nutrition and reduce child malnutrition in vulnerable communities METHODS: Data from three structured questionnaires were combined to produce a comprehensive depiction of feeding in a sample of 246 infants from birth through 8 months of life in the community of Santa Clara de Nanay near Iquitos, Peru. Breastfeeding initiation practices, exclusive breastfeeding in the first 180 days of life, the introduction of solids, and complementary feeding practices from 6-8 months, were described and related to maternal, infant, and household characteristics, including food insecurity RESULTS: The median duration of exclusive breastfeeding was 19 days. However, over the first 180 days of life, children were exclusively breastfed on 46.1% of days. Overall, 68.3% of infants received some semi-solid or solid food between 0-6 months and all had received semi-solids by the end of 8 months of age. The proportion of infants consuming a minimally acceptable (frequent and diverse complementary diet was 2.9%, 7.9%, and 16.1% at 6, 7, and 8 months respectively CONCLUSIONS: Although breastfeeding is nearly universal, promotion programs are needed in Santa Clara to 1 delay the introduction of plain water, other non-breast milk liquids, and semi-solid foods; 2 extend the period of exclusive breastfeeding; and 3 increase food diversity and the frequency of feeding during the period of complementary feeding. These results can be used to guide programs and policies to improve nutrition and reduce child malnutrition.

  17. Pulsatile delivery of a leucine supplement during long-term continuous enteral feeding enhances lean growth in term neonatal pigs

    Science.gov (United States)

    Neonatal pigs are used as a model to study and optimize the clinical treatment of infants who are unable to maintain oral feeding. Using this model, we have previously shown that pulsatile administration of leucine during continuous feeding over 24 h via orogastric tube enhanced protein synthesis in...

  18. O uso de nutrição enteral precoce pós-transplante hepático adulto The use of early enteral feeding post orthotopic liver transplantation in adults

    Directory of Open Access Journals (Sweden)

    Mário Reis Álvares-da-Silva

    2004-09-01

    transplant groups. AIM: To report our experience with the use of early enteral nutrition in patients undergoing orthotopic liver transplantation and also evaluate its safety. PATIENTS/METHODS: We studied 41 adults submitted to orthotopic liver transplantation. Pre- orthotopic liver transplantation nutritional assessment was accomplished by the subjective global assessment and grip strength. Enteral nutrition was begun in 12 hours. Oral feeding was initiate gradually as soon as possible. RESULTS: We studied 35 individuals, with an average of age of 45.5 years (8.93. The prevalence of malnutrition in orthotopic liver transplantation was of 77.1% determined by subjective global assessment, and 100% by grip strength. Early enteral nutrition was begun in all of the individuals in up to 12 hours, mode 10.9 hours, and maintained exclusively by medium period of 2.6 days (2.2. Oral feeding was obtained in the medium period of 9.5 days (9.7. Early enteral nutrition provided total caloric intake in 97% of the cases. Intolerance to the enteral feeding occurred in five individuals (14.2%, and in four of them it was resumed successfully after 12 hours. The prevalence of respiratory infection was of 28.6%. In only two patients (5.7% there was aspirative bronchopneumonia. CONCLUSIONS: Early enteral nutrition is an effective method in the provision of calories and safe in application to patients undergoing orthotopic liver transplantation.

  19. An early feeding regime and a high-density amino acid diet on growth performance of broilers under subclinical necrotic enteritis challenge

    Directory of Open Access Journals (Sweden)

    Chake Keerqin

    2017-03-01

    Full Text Available Broilers that have early access to feed have been shown to have enhanced immune system and gut development and heightened resilience against necrotic enteritis (NE. This study examined the effect of early feeding a high amino acid density diet on performance of broilers under a sub-clinical NE challenge model. Ross 308 broilers (n = 576 were assigned to a 2 × 2 × 2 factorial design with 2 feeding regimes (feed access either within 6 h post-hatch or after 48 h post-hatch, 2 diets (control diet or the control diet with an additional 10% digestible amino acids [HAA] and either presence or absence of NE challenge. Oral administrations of Eimeria species (d 9 and a field strain of Clostridium perfringens (d 14 were used to induce NE. Broiler performance was analysed at d 13, 23, 30 and 35. Intestinal lesion score and bacterial count were analysed on d 16. The NE challenge reduced overall bird performance and induced severe intestinal lesions, without causing notable mortality. At d 23 bird weight was significantly lower (P < 0.001 in the challenged birds compared with the unchallenged birds, but by d 30 the challenged birds had recovered and challenge no longer had an impact on bird performance. Birds fed the HAA diet had greater body weight by d 35 and heightened Lactobacillus content in the ileum at d 16 (P < 0.05. Birds that were fed the HAA diet after a period of fasting performed better in terms of feed conversion ratio (FCR under challenge. The findings from this study suggest there are beneficial effects of feeding high amino acid diets to birds in response to external stresses, such as post-hatch fasting and subclinical NE.

  20. Waste minimization program at the feed materials production center

    International Nuclear Information System (INIS)

    Blasdel, J.E.; Crotzer, M.E.; Gardner, R.L.; Kato, T.R.; Spradlin, C.N.

    1987-01-01

    A waste minimization program is being implemented at the Feed Materials Production Center to reduce the generation of uranium-contaminated wastes and to comply with existing and forthcoming regulations. Procedures and plans are described which deal with the following wastes: process and non-process trash, contaminated wood and metals, used metal drums, and major process wastes such as contaminated magnesium fluoride and neutralized raffinate. Waste minimization techniques used include segregation, source reduction, volume reduction, material substitution and waste/product recycle. The importance of training, communication, and incentives is also covered

  1. The waste minimization program at the Feed Materials Production Center

    International Nuclear Information System (INIS)

    Blasdel, J.E.; Crotzer, M.E.; Gardner, R.L.; Kato, T.R.; Spradlin, C.N.

    1987-01-01

    A waste minimization program is being implemented at the Feed Materials Production Center to reduce the generation of uranium-contaminated wastes and to comply with existing and forthcoming regulations. Procedures and plans are described which deal with process and non-process trash, contaminated wood and metals, used metal drums, and major process wastes such as contaminated magnesium fluoride and neutralized raffinate. Waste minimization techniques used include segregation, source reduction, volume reduction, material substitution and waste/product recycle. The importance of training, communication, and incentives is also covered. 5 refs., 11 figs

  2. Tourist Affiliate Program while Using Online Booking System with Possibility of Entering B2B Code

    Directory of Open Access Journals (Sweden)

    Slivar Iva

    2008-01-01

    Full Text Available Affiliate marketing programs are one of the most powerful tools for online marketing since the merchant presenting a product or a service decides on the commissioning model and the commission is granted only if the desired results have been reached. Affiliate marketing is based offline as much as tourism itself and it relies on the commission that tourist companies pay to their partners (affiliates who bring new guests. This paper will present the basics of how online affiliate programs work, benefits they bring and steps for their further implementation. It will explain in detail how to establish an affiliate program for dynamic web pages which use online booking system platforms that offer a possibility of entering a B2B code. Special attention will be paid to SEO (Search Engine Optimisation. It will also present results of a research on Croatian hotels web pages and the implementation of the online booking system and affiliate programs. Having in mind the insufficient deployment of online potentials, the aim of the paper is to stress the need for setting up an effective method of monitoring changes and updates in the online world as well as implementing new promotional possibilities, all aimed at increasing sales. The goal of the paper is to explore advantages and disadvantages of the affiliate program as a new sales channel and promote the possibility to implement it in one of the biggest Croatian hotel companies, Maistra d.d. Rovinj. Along with methods of data acquiring and different techniques of creative thinking, the following scientific research methods were also used: statistic, historic, descriptive, comparison, interview, analysis and synthesis, induction and deduction.

  3. Assessment of malnutrition and enteral feeding practices in the critically ill: A single-centre observational study

    Directory of Open Access Journals (Sweden)

    Prashant Paul Verghese

    2018-01-01

    Full Text Available Background and Aims: Early identification of malnutrition among hospitalised patients is essential to institute appropriate patient-specific nutritional strategies. This study was conducted to evaluate the nutritional status of medical patients at admission to the adult intensive care unit (ICU and to identify factors which prevent attainment of daily feeding goals in them. Methods: This was a 1 year prospective, observational study on 200 medical adult ICU patients. The study was carried out based on daily documentation. The primary outcome was the nutritional status of medical Patients at admission to the adult ICU. The tests for statistical analysis used were independent t test, Chi-square test, Fisher's exact test and multivariate logistic regression analysis. Results: Out of the 200 patients in our study, 45%, 48.5% and 9% of patients had mild, moderate and severe malnutrition, respectively, corresponding to subjective global assessment (SGA rating A,B and C, respectively. The most common reasons for non-attainment of daily feeding goals were delayed feed procurement (17.57%, and feeds being held for procedures (16.36%. The overall mean length of ICU stay was 8.63 ± 7.26 days, and the ICU mortality rate was 47.5% (95/200. Patients with SGA rating B and C at admission had higher risk of mortality in the ICU, with an adjusted odds ratio of 3.54 (95% confidence interval [CI]- 1.71–7.33, P = 0.001 and 11.11 (95% CI-2.26–54.66, P = 0.003, respectively. Conclusion: Malnutrition is commonly present at admission among medical ICU patients, and is associated with higher ICU mortality.

  4. Preparedness of Entering Pediatric Dentistry Residents: Advanced Pediatric Program Directors' and First-Year Residents' Perspectives.

    Science.gov (United States)

    Rutkauskas, John; Seale, N Sue; Casamassimo, Paul; Rutkauskas, John S

    2015-11-01

    For children to receive needed oral health care, adequate training at both the predoctoral and postdoctoral levels of dental education is required, but previous studies have found inadequacies in predoctoral education that lead to general dentists' unwillingness to treat certain young populations. As another way of assessing predoctoral preparation, the aim of this study was to determine the perspectives of first-year residents and pediatric program directors about residents' preparedness to enter advanced education programs in pediatric dentistry. Surveys were sent to all 74 U.S. program directors and 360 first-year residents. The survey focused on procedures related to prevention, behavior management, restorative procedures, pulp therapy, sedation, and surgery, as well as treating patients funded by Medicaid and with special health care needs. Among the first-year residents, 173 surveys were returned for a 48% response rate; 61 directors returned surveys for an 82% response rate. Only half of the residents (55%) reported feeling adequately prepared for their first year in residency; less than half cited adequate preparation to place stainless steel crowns (SSCs) (42%) and perform pulpotomies (45%). Far fewer felt adequately prepared to provide treatment for children six months to three years of age, including examinations (29%), infant oral exams (27%), and children with severe caries (37%). The program directors were even less positive about the adequacy of residents' preparation. Only 17% deemed them adequately prepared to place SSCs and 13% to perform pulpotomies. Approximately half reported their first-year residents were inadequately prepared to treat very young children and children with severe caries (55% each). This study found that the perceived inadequacy of predoctoral education in pediatric dentistry was consistent at both the learner and educator levels, supporting previous studies identifying inadequacies in this area.

  5. Feeding saponin-containing Yucca schidigera and Quillaja saponaria to decrease enteric methane production in dairy cows.

    Science.gov (United States)

    Holtshausen, L; Chaves, A V; Beauchemin, K A; McGinn, S M; McAllister, T A; Odongo, N E; Cheeke, P R; Benchaar, C

    2009-06-01

    An experiment was conducted in vitro to determine whether the addition of saponin-containing Yucca schidigera or Quillaja saponaria reduces methane production without impairing ruminal fermentation or fiber digestion. A slightly lower dose of saponin was then fed to lactating dairy cows to evaluate effects on ruminal fermentation, methane production, total-tract nutrient digestibility, and milk production and composition. A 24-h batch culture in vitro incubation was conducted in a completely randomized design with a control (no additive, CON) and 3 doses of either saponin source [15, 30, and 45 g/kg of substrate dry matter (DM)] using buffered ruminal fluid from 3 dairy cows. The in vivo study was conducted as a crossover design with 2 groups of cows, 3 treatments, and three 28-d periods. Six ruminally cannulated cows were used in group 1 and 6 intact cows in group 2 (627 +/- 55 kg of body weight and 155 +/- 28 d in milk). The treatments were 1) early lactation total mixed ration, no additive (control; CON); 2) CON diet supplemented with whole-plant Y. schidigera powder at 10 g/kg of DM (YS); and 3) CON diet supplemented with whole-plant Q. saponaria powder at 10 g/kg of DM (QS). Methane production was measured in environmental chambers and with the sulfur hexafluoride (SF(6)) tracer technique. In vitro, increasing levels of both saponin sources decreased methane concentration in the headspace and increased the proportion of propionate in the buffered rumen fluid. Concentration of ammonia-N, acetate proportion, and the acetate:propionate ratio in the buffered rumen fluid as well as 24-h digestible neutral detergent fiber were reduced compared with the CON treatment. Medium and high saponin levels decreased DM digestibility compared with the CON treatment. A lower feeding rate of both saponin sources (10 g/kg of DM) was used in vivo in an attempt to avoid potentially negative effects of higher saponin levels on feed digestibility. Feeding saponin did not affect milk

  6. Permissive underfeeding versus target enteral feeding in adult critically ill patients (PermiT Trial: a study protocol of a multicenter randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Arabi Yaseen M

    2012-10-01

    Full Text Available Abstract Background Nutritional support is an essential part of the management of critically ill patients. However, optimal caloric intake has not been systematically evaluated. We aim to compare two strategies of enteral feeding: permissive underfeeding versus target feeding. Method/Design This is an international multi-center randomized controlled trial in critically ill medical- surgical adult patients. Using a centralized allocation, 862 patients will be randomized to permissive underfeeding or target feeding. Patients in the permissive group receive 50% (acceptable range is 40% to 60% of the calculated caloric requirement, while those in the targeted group receive 100% (acceptable range 70% to 100% of the calculated caloric requirement. The primary outcome is 90-day all-cause mortality. Secondary outcomes include ICU and hospital mortality, 28-day, and 180-day mortality as well as health care-associated infections, organ failure, and length of stay in the ICU and hospital. The trial has 80% power to detect an 8% absolute reduction in 90-day mortality assuming a baseline risk of death of 25% at an alpha level of 0.05. Discussion Patient recruitment started in November 2009 and is currently active in five centers. The Data Monitoring Committee advised continuation of the trial after the first interim analysis. The study is expected to finish by November 2013. Trial registration Current Controlled Trials ISRCTN68144998

  7. Comparison of respiratory quotient and resting energy expenditure in two regimens of enteral feeding - continuous vs. intermittent in head-injured critically ill patients

    Directory of Open Access Journals (Sweden)

    Indubala Maurya

    2011-01-01

    Full Text Available Introduction: Measurement of respiratory quotient (RQ and resting energy expenditure (REE has been shown to be helpful in designing nutritional regimens. There is a paucity of the literature describing the impact of a feeding regimen on the energy expenditure patterns. Therefore, we studied the effect of continuous vs. intermittent feeding regimen in head-injured patients on mechanical ventilation on RQ and REE . Methods: After institutional ethical approval, this randomized study was conducted in 40 adult male patients with head injury requiring controlled mode of ventilation. Patients were randomly allocated into two groups. Group C: Feeds (30 kcal/kg/day were given for 18 h/day, with night rest for 6 h. Group I: Six bolus feeds (30 kcal/kg/day were given three hourly for 18 h with night rest for 6 h. RQ and REE were recorded every 30 min for 24 h. Blood sugar was measured 4 hourly. Other adverse effects such as feed intolerance, aspiration were noted. Results: Demographic profile and SOFA score were comparable in the two groups. Base line RQ (0.8 vs. 0.86 and REE (1527 vs. 1599 kcal/day were comparable in both the groups (P>0.05. RQ was comparable in both groups during the study period at any time of the day (P>0.05. Base line RQ was compared with all other RQ values measured every half hour and fluctuation from the base line value was insignificant in both groups (P>0.05. REE was comparable in both the groups throughout the study period (P>0.5. Adequacy of feeding as assessed by EI/MREE was 105.7% and 105.3% in group C and group I, respectively. There was no significant difference in the blood sugar levels between the two groups (P>0.05. Conclusion: We found from our study that RQ, REE, and blood sugar remain comparable with two regimens of enteral feeding - continuous vs. intermittent in neurosurgical patients on ventilator support in a ICU setup.

  8. Probiotics and Time to Achieve Full Enteral Feeding in Human Milk-Fed and Formula-Fed Preterm Infants: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Aceti, Arianna; Gori, Davide; Barone, Giovanni; Callegari, Maria Luisa; Fantini, Maria Pia; Indrio, Flavia; Maggio, Luca; Meneghin, Fabio; Morelli, Lorenzo; Zuccotti, Gianvincenzo; Corvaglia, Luigi

    2016-07-30

    Probiotics have been linked to a reduction in the incidence of necrotizing enterocolitis and late-onset sepsis in preterm infants. Recently, probiotics have also proved to reduce time to achieve full enteral feeding (FEF). However, the relationship between FEF achievement and type of feeding in infants treated with probiotics has not been explored yet. The aim of this systematic review and meta-analysis was to evaluate the effect of probiotics in reducing time to achieve FEF in preterm infants, according to type of feeding (exclusive human milk (HM) vs. formula). Randomized-controlled trials involving preterm infants receiving probiotics, and reporting on time to reach FEF were included in the systematic review. Trials reporting on outcome according to type of feeding (exclusive HM vs. formula) were included in the meta-analysis. Fixed-effect or random-effects models were used as appropriate. Results were expressed as mean difference (MD) with 95% confidence interval (CI). Twenty-five studies were included in the systematic review. In the five studies recruiting exclusively HM-fed preterm infants, those treated with probiotics reached FEF approximately 3 days before controls (MD -3.15 days (95% CI -5.25/-1.05), p = 0.003). None of the two studies reporting on exclusively formula-fed infants showed any difference between infants receiving probiotics and controls in terms of FEF achievement. The limited number of included studies did not allow testing for other subgroup differences between HM and formula-fed infants. However, if confirmed in further studies, the 3-days reduction in time to achieve FEF in exclusively HM-fed preterm infants might have significant implications for their clinical management.

  9. Nosocomial colonization of premature babies with Klebsiella oxytoca: probable role of enteral feeding procedure in transmission and control of the outbreak with the use of gloves.

    Science.gov (United States)

    Berthelot, P; Grattard, F; Patural, H; Ros, A; Jelassi-Saoudin, H; Pozzetto, B; Teyssier, G; Lucht, F

    2001-03-01

    To investigate the persistence of colonization of premature babies by Klebsiella oxytoca, with special emphasis on the mode of transmission of the bacterium and evaluation of Standard Precautions to stop the epidemic. Retrospective analysis of cases and prospective study of systematic bacteriological samples (stools and throat) from babies, healthcare workers (HCWs), and environment, with genotyping of strains by arbitrarily primed polymerase chain reaction. A premature baby unit (PBU) and a neonatal intensive care unit in the university hospital of Saint-Etienne, France. An outbreak of K oxytoca was suspected in two pediatric wards after the occurrence of a fatal bacteremia in a newborn hospitalized in the PBU and the colonization of other babies 2 months later. Retrospective analysis showed that 24 babies' digestive tract had been colonized. No environmental reservoir was recovered in the units nor in enteral feeding. No K oxytoca was isolated from HCW samples. Genotyping confirmed the presence of epidemic strains, although independent clones were responsible for infections or colonizations in each of the two units. The chronology and the site of babies' colonization (isolation of K oxytoca in stools before throat) were determined during a prospective study and suggested that enteral feeding procedures could be the source of contamination. Therefore, use of gloves during this practice by HCWs was recommended and, after readjustment of Standard Precautions, stopped the outbreak. To prevent cross-contamination among high-risk babies, careful attention must be paid to Standard Precautions. Bacteriological surveillance of the digestive tract of neonates could help to check compliance with these guidelines

  10. What Is Enteral Nutrition?

    Science.gov (United States)

    ... types of feeding tubes. Enteral Nutrition Fact Sheet Twitter Tweets by ASPENWEB ASPEN 8401 Colesville Road, Suite ... Staff Find a Clinician Press Room Career Center Advertising and Sponsorship Related Websites BPS NBNSC NBPNS Connect ...

  11. Pancreatitis, very early compared with normal start of enteral feeding (PYTHON trial: design and rationale of a randomised controlled multicenter trial

    Directory of Open Access Journals (Sweden)

    Schaapherder Alexander F

    2011-03-01

    Full Text Available Abstract Background In predicted severe acute pancreatitis, infections have a negative effect on clinical outcome. A start of enteral nutrition (EN within 24 hours of onset may reduce the number of infections as compared to the current practice of starting an oral diet and EN if necessary at 3-4 days after admission. Methods/Design The PYTHON trial is a randomised controlled, parallel-group, superiority multicenter trial. Patients with predicted severe acute pancreatitis (Imrie-score ≥ 3 or APACHE-II score ≥ 8 or CRP > 150 mg/L will be randomised to EN within 24 hours or an oral diet and EN if necessary, after 72 hours after hospital admission. During a 3-year period, 208 patients will be enrolled from 20 hospitals of the Dutch Pancreatitis Study Group. The primary endpoint is a composite of mortality or infections (bacteraemia, infected pancreatic or peripancreatic necrosis, pneumonia during hospital stay or within 6 months following randomisation. Secondary endpoints include other major morbidity (e.g. new onset organ failure, need for intervention, intolerance of enteral feeding and total costs from a societal perspective. Discussion The PYTHON trial is designed to show that a very early ( Trial Registration ISRCTN: ISRCTN18170985

  12. Enteral nutrition in surgery

    International Nuclear Information System (INIS)

    Sucha, R.; Lichvarova, I.; Duchon, R.; Dolnik, J.; Pindak, D.

    2011-01-01

    Enteral feeding provides physiologic, metabolic, safety, and cost benefits over parenteral nutrition. There are various ways enteral nutritional is administered and scheduled. The method of administration must be individualized to each patient's specific needs. Enteral nutrition is not only the supply of exogenous substrates and to prevent depletion of endogenous sources. Today the enteral nutrition becomes part of a therapeutic strategy to influence the severity of the disease to affect the function of GIT, and to modulate immune responses of the gut and the whole organism. Early enteral nutrition in the postoperative period reduces the risk of infectious complications. (author)

  13. Effect of oat hulls as a free choice feeding on broiler performance, short chain fatty acids and microflora under a mild necrotic enteritis challenge

    Directory of Open Access Journals (Sweden)

    Sarbast K. Kheravii

    2018-03-01

    Full Text Available Structure of fibre has been reported to enhance performance, intestinal function and modify the composition and quantity of the microbial population in the chicken gastrointestinal tract. It is hypothesised that insoluble fibre in oat hulls may improve gut health and reduce intestinal Clostridium perfringens number. This research assessed the effect of free choice oat hulls (OH on performance and gut microbiota in broilers during a mild (subclinical necrotic enteritis (NE challenge. A total of 240 day-old male Ross 308 broiler chickens were assigned to 24 cages in a 2 × 2 factorial arrangement of treatments. Factors were challenge − or +; and OH − or +. On d 16, challenged broilers had lower weight gain and feed intake (P < 0.05 compared with unchallenged broilers. On d 16, broilers given OH had lower feed intake (P < 0.05 and tended to have lower (P = 0.062 feed conversion ratio (FCR compared with those without access to OH. Broiler performance, however, was not affected by OH nor by challenge on d 24 and 35. The broilers given OH had heavier gizzards (P < 0.05 compared with those without OH at d 35 but not at d 13 or 16. Increased numbers of C. perfringens (P < 0.001 and reduced numbers (P < 0.05 of Lactobacillus and Salmonellae were observed in the caecal contents of challenged broilers on d 16. Challenged broilers had a lower concentration of caecal acetic acid (P < 0.01 compared with unchallenged broilers at d 16. The broilers given OH had lower concentrations of caecal acetic acid (P < 0.05, propionic acid (P < 0.05, and valeric acid (P < 0.01 compared with those without access to OH. An OH by challenge interaction on succinic acid concentration was observed on d 16 (P < 0.05. Oat hulls elevated the caecal succinic acid concentration only in the unchallenged broilers. This study indicated a positive role of OH through improved gizzard function and increased succinic acid in the gut but its role in

  14. Micosoft Excel Sensitivity Analysis for Linear and Stochastic Program Feed Formulation

    Science.gov (United States)

    Sensitivity analysis is a part of mathematical programming solutions and is used in making nutritional and economic decisions for a given feed formulation problem. The terms, shadow price and reduced cost, are familiar linear program (LP) terms to feed formulators. Because of the nonlinear nature of...

  15. FEEDING GUIDELINES FOR INFANTS AND TODDLERS (START HEALTHY PROGRAM

    Directory of Open Access Journals (Sweden)

    Nancy Butte

    2007-01-01

    Full Text Available The dietary guidelines for americans contains recommendations on diets and healthy lifestyles but it does not deal with specificities of the diet and feeding breast and small infants (to 2 years. However, parents and carecgivers need practical recommendations on feeding infants and toddlers that are necessary to ensure a normal growth and to create the basis for forming healthy food habits, which apart from other benefits might help prevent the development of obesity and other diseases in both childhood and adulthood. The feeding guidelines for infants and toddlers is aimed at providing parents and carecgivers with practical information on feeding breast and small infants. It is intendced for adding and broadening recommendations worked out by other expert groups and organizations. The article provides a substantiation of the guidelines. The methodology, results and a complete reference list used to work out the recommendations are presented in another document.Key words: infants, nutrition.

  16. Feeding the Future: The Global Emergence of School Lunch Programs

    Science.gov (United States)

    Rutledge, Jennifer Geist

    2009-01-01

    My dissertation is motivated by a puzzle of international social policy and norm emergence and diffusion. Today, children in one hundred and forty-one countries receive free or subsidized school lunches. Yet less than a century ago, no state had a national child nutrition policy. Feeding children was clearly not considered a state responsibility a…

  17. The UNAM M. Sc. program in Medical Physics enters its teen years

    Science.gov (United States)

    Brandan, María-Ester

    2010-12-01

    The M.Sc. (Medical Physics) program at the National Autonomous University of Mexico UNAM, created in 1997, has graduated a substantial number of medical physicists who constitute today about 30% of the medical physics clinical workforce in the country. Up to present date (May 2010) more than 60 students have graduated, 60% of them hold clinical jobs, 20% have completed or study a Ph.D., and 15% perform activities related to this specialization. In addition to strengthening the clinical practice of medical physics, the program has served as an incentive for medical physics research in UNAM and other centers. We report the circumstances of the program origin, the evolution of its curriculum, the main achievements, and the next challenges.

  18. A dynamic programming model for optimising feeding and slaughter decisions regarding fattening pigs

    Directory of Open Access Journals (Sweden)

    J. K. NIEMI

    2008-12-01

    Full Text Available Costs of purchasing new piglets and of feeding them until slaughter are the main variable expenditures in pig fattening. They both depend on slaughter intensity, the nature of feeding patterns and the technological constraints of pig fattening, such as genotype. Therefore, it is of interest to examine the effect of production technology and changes in input and output prices on feeding and slaughter decisions. This study examines the problem by using a dynamic programming model that links genetic characteristics of a pig to feeding decisions and the timing of slaughter and takes into account how these jointly affect the quality-adjusted value of a carcass. The state of nature and the genotype of a pig are known in the analysis. The results suggest that producer can benefit from improvements in the pig’s genotype. Animals of improved genotype can reach optimal slaughter maturity quicker and produce leaner meat than animals of poor genotype. In order to fully utilise the benefits of animal breeding, the producer must adjust feeding and slaughter patterns on the basis of genotype. The results also suggest that the producer can benefit from flexible feeding technology. Typically, such a technology provides incentives to feed piglets with protein-rich feed. When the pig approaches slaughter maturity, the share of protein-rich feed in the diet gradually decreases and the amount of energy-rich feed increases. Generally, the optimal slaughter weight is within the weight range that pays the highest price per kilogram of pig meat. The optimal feeding pattern and the optimal timing of slaughter depend on price ratios. Particularly, an increase in the price of pig meat provides incentives to increase the growth rates up to the pig’s biological maximum by increasing the amount of energy in the feed. Price changes and changes in slaughter premium can also have large income effects.;

  19. Enteric glia.

    Science.gov (United States)

    Rühl, A; Nasser, Y; Sharkey, K A

    2004-04-01

    The enteric nervous system is composed of both enteric neurones and enteric glia. Enteric glial cells were first described by Dogiel and are now known to outnumber neurones approximately 4 : 1. In the past, these cells were assumed to subserve a largely supportive role; however, recent evidence indicates that enteric glial cells may play a more active role in the control of gut function. In transgenic mouse models, where enteric glial cells are selectively ablated, the loss of glia results in intestinal inflammation and disruption of the epithelial barrier. Enteric glia are activated specifically by inflammatory insults and may contribute actively to inflammatory pathology via antigen presentation and cytokine synthesis. Enteric glia also express receptors for neurotransmitters and so may serve as intermediaries in enteric neurotransmission. Thus, enteric glia may serve as a link between the nervous and immune systems of the gut and may also have an important role in maintaining the integrity of the mucosal barrier and in other aspects of intestinal homeostasis.

  20. A Mixed Integer Programming Poultry Feed Ration Optimisation Problem Using the Bat Algorithm

    Directory of Open Access Journals (Sweden)

    Godfrey Chagwiza

    2016-01-01

    Full Text Available In this paper, a feed ration problem is presented as a mixed integer programming problem. An attempt to find the optimal quantities of Moringa oleifera inclusion into the poultry feed ration was done and the problem was solved using the Bat algorithm and the Cplex solver. The study used findings of previous research to investigate the effects of Moringa oleifera inclusion in poultry feed ration. The results show that the farmer is likely to gain US$0.89 more if Moringa oleifera is included in the feed ration. Results also show superiority of the Bat algorithm in terms of execution time and number of iterations required to find the optimum solution as compared with the results obtained by the Cplex solver. Results revealed that there is a significant economic benefit of Moringa oleifera inclusion into the poultry feed ration.

  1. Do In-School Feeding Programs Have an Impact on Academic Performance?

    Science.gov (United States)

    Adrogue, Cecilia; Orlicki, Maria Eugenia

    2013-01-01

    As Argentina presents problems of malnutrition, the federal in-school feeding program has become a key policy because it provides an important nutritional intervention during a relevant growth period. This paper estimates the effect of the program on academic performance--measured by standardized test scores--with a difference in difference model,…

  2. Evaluation of programs to improve complementary feeding in infants and young children.

    Science.gov (United States)

    Frongillo, Edward A

    2017-10-01

    Evaluation of complementary feeding programs is needed to enhance knowledge on what works, to document responsible use of resources, and for advocacy. Evaluation is done during program conceptualization and design, implementation, and determination of effectiveness. This paper explains the role of evaluation in the advancement of complementary feeding programs, presenting concepts and methods and illustrating them through examples. Planning and investments for evaluations should occur from the beginning of the project life cycle. Essential to evaluation is articulation of a program theory on how change would occur and what program actions are required for change. Analysis of program impact pathways makes explicit the dynamic connections in the program theory and accounts for contextual factors that could influence program effectiveness. Evaluating implementation functioning is done through addressing questions about needs, coverage, provision, and utilization using information obtained from process evaluation, operations research, and monitoring. Evaluating effectiveness is done through assessing impact, efficiency, coverage, process, and causality. Plausibility designs ask whether the program seemed to have an effect above and beyond external influences, often using a nonrandomized control group and baseline and end line measures. Probability designs ask whether there was an effect using a randomized control group. Evaluations may not be able to use randomization, particularly for programs implemented at a large scale. Plausibility designs, innovative designs, or innovative combinations of designs sometimes are best able to provide useful information. Further work is needed to develop practical designs for evaluation of large-scale country programs on complementary feeding. © 2017 John Wiley & Sons Ltd.

  3. Government information systems to monitor complementary feeding programs for young children.

    Science.gov (United States)

    Jefferds, Maria Elena D

    2017-10-01

    Accelerating progress to improve complementary feeding of young children is a global priority. Strengthening monitoring through government information systems may increase the quality and implementation of infant and young child feeding (IYCF) programs. Monitoring is necessary for the effective implementation of programs as it allows program managers to assess program performance, identify problems, and take corrective action. Program descriptions and conceptual models explain how program inputs and activities should lead to outputs and outcomes, and ultimately public health impact; thus, they are critical tools when designing effective IYCF programs and monitoring systems as these descriptions and conceptual models form the basis for the program and are key for developing the monitoring system, indicators, and tools. Despite their importance, many programs do not have these documented, nor monitoring plans, limiting their ability to design effective programs and monitoring systems. Once in place, it is important to periodically review the monitoring system to confirm it still appropriately meets stakeholder needs and the data are being used to inform decision-making, and to make program adjustments as the monitoring focus, resources, or capacity may change during the program lifecycle. Including priority indicators of IYCF practices and counseling indicators in the government information systems may strengthen IYCF programs when the indicators are contextualized to the government IYCF program, capacity, and setting, and the indicators are used for decision-making and program improvement. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  4. APPLICABILITY OF NON-FEED REMOVAL PROGRAMS TO INDUCE MOLTING INSTEAD OF THE CONVENTIONAL FEED WITHDRAWAL METHOD IN BROWN LAYING HENS

    Directory of Open Access Journals (Sweden)

    S Sariozkan

    Full Text Available ABSTRACT This study was conducted to compare the applicability of non-feed removal (NFR programs to induce molting in brown laying hens by feedusing alfalfa meal and barley grain on molting of instead of feed withdrawal in terms of performance, egg quality and profitability. A total of 240, 75-week-old Hy-Line brown laying hens were randomly divided into three groups as conventional feed withdrawal (CONV, and two non-feed removal programs using alfalfa meal (A+F or barley grain (B+F, each containing 80 hens with 20 replicates (4 hens x 20 replicates = 80 hens. After 10 days of the induced molting the lowest body weight loss (20.01% was found in the B+F method (p 0.05. Haugh unit of CONV group was better than NFR groups, whereas molting by NFR groups improved egg yolk color (p< 0.001. Despite higher feed cost of NFR programs, egg income and profit was better than CONV group (p< 0.001. In conclusion, molting with alfalfa meal and barley grain of brown layers may be used as non-feed removal programs, without negative effects on the performance and egg quality parameters. Besides, these non-feed removal programs have higher income and profitability.

  5. Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program.

    Science.gov (United States)

    Bozec, Alexandre; Benezery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, Olivier; Poissonnet, Gilles; Riss, Jean-Christophe; Hannoun-Lévi, Jean-Michel; Chand, Marie-Eve; Leysalle, Axel; Saada, Esma; Sudaka, Anne; Haudebourg, Juliette; Hebert, Christophe; Falewee, Marie-Noelle; Demard, François; Santini, José; Peyrade, Frédéric

    2016-09-01

    The objective of the study is to evaluate the nutritional status and determine its impact on clinical outcomes in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program without prophylactic feeding-tube placement. All patients with locally advanced (T3/4, N0-3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngolaryngectomy, treated by docetaxel, cisplatin and 5-fluorouracil (TPF)-ICT for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Patients' nutritional status was closely monitored. Enteral nutrition was used if and when a patient was unable to sustain per-oral nutrition and hydration. The impact of nutritional status on clinical outcomes was investigated in univariate and multivariate analysis. A total of 53 patients (42 men and 11 women, mean age = 58.6 ± 8.2 years) were included in this study. Six (11.3 %) patients had lost more than 10 % of their usual body weight before therapy. Compared with patients' usual weight, the mean maximum patient weight loss during therapeutic management was 8.7 ± 4.5 kg. Enteral nutrition was required in 17 patients (32 %). We found no influence of the tested nutritional status-related factors on response to ICT, toxicity of ICT, overall, cause-specific and recurrence-free survival, and on post-therapeutic swallowing outcome. Maximum weight loss was significantly associated with a higher risk of enteral tube feeding during therapy (p = 0.03) and of complications (grade ≥3, p = 0.006) during RT. Without prophylactic feeding-tube placement, approximately one-third of the patients required enteral nutrition. There was no significant impact of nutritional status on oncologic or functional outcomes.

  6. Radiation enteritis

    Science.gov (United States)

    Radiation enteropathy; Radiation-induced small bowel injury; Post-radiation enteritis ... Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells. The therapy ...

  7. Pancreatitis, very early compared with normal start of enteral feeding (PYTHON trial): design and rationale of a randomised controlled multicenter trial

    NARCIS (Netherlands)

    Bakker, O.J.; van Santvoort, H.C.; van Brunschot, S.; Ali, U.A.; Besselink, M.G.; Boermeester, M.A.; Bollen, T.L.; Bosscha, K.; Brink, M.A.; Dejong, C.H.; van Geenen, E.J.; van Goor, H.; Heisterkamp, J.; Houdijk, A.P.; Jansen, J.M.; Karsten, T.M.; Manusama, E.R.; Nieuwenhuijs, V.B.; van Ramshorst, B.; Schaapherder, A.F.; van der Schelling, G.P.; Spanier, M.B.M.; Tan, A.; Vecht, J.; Weusten, B.L.; Witteman, B.J.; Akkermans, L.M.; Gooszen, H.G.

    2011-01-01

    ABSTRACT: BACKGROUND: In predicted severe acute pancreatitis, infections have a negative effect on clinical outcome. A start of enteral nutrition (EN) within 24 hours of onset may reduce the number of infections as compared to the current practice of starting an oral diet and EN if necessary at 3-4

  8. Pancreatitis, very early compared with normal start of enteral feeding (PYTHON trial) : design and rationale of a randomised controlled multicenter trial

    NARCIS (Netherlands)

    Bakker, Olaf J.; van Santvoort, Hjalmar C.; van Brunschot, Sandra; Ali, Usama Ahmed; Besselink, Marc G.; Boermeester, Marja A.; Bollen, Thomas L.; Bosscha, Koop; Brink, Menno A.; Dejong, Cornelis H.; van Geenen, Erwin J.; van Goor, Harry; Heisterkamp, Joos; Houdijk, Alexander P.; Jansen, Jeroen M.; Karsten, Thom M.; Manusama, Eric R.; Nieuwenhuijs, Vincent B.; van Ramshorst, Bert; Schaapherder, Alexander F.; van der Schelling, George P.; Spanier, Marcel B. M.; Tan, Adriaan; Vecht, Juda; Weusten, Bas L.; Witteman, Ben J.; Akkermans, Louis M.; Gooszen, Hein G.

    2011-01-01

    Background: In predicted severe acute pancreatitis, infections have a negative effect on clinical outcome. A start of enteral nutrition (EN) within 24 hours of onset may reduce the number of infections as compared to the current practice of starting an oral diet and EN if necessary at 3-4 days after

  9. Chlamydia prevalence trends among women and men entering the National Job Training Program from 1990 through 2012.

    Science.gov (United States)

    Learner, Emily R; Torrone, Elizabeth A; Fine, Jason P; Pence, Brian W; Powers, Kimberly A; Miller, William C

    2018-01-26

    Evaluating chlamydia prevalence trends from sentinel surveillance is important for understanding population disease burden over time. However, prevalence trend estimates from surveillance data may be misleading if they do not account for changes in risk profiles of individuals who are screened (case mix) and changing performance of the screening tests used. We analyzed chlamydia screening data from a sentinel surveillance population of 389,555 young women (1990-2012) and 303,699 young men (2003-2012) entering the US National Job Training Program. This period follows the introduction of national chlamydia screening programs designed to prevent transmission and reduce population disease burden. After ruling out bias due to case mix, we used an expectation-maximization based maximum likelihood approach to account for measurement error from changing screening tests, and generated minimally-biased long-term chlamydia prevalence trend estimates among youth and young adults in this sentinel surveillance population. Adjusted chlamydia prevalence among women was high throughout the study period, but fell from 20% in 1990 to 12% in 2003, and remained between 12% and 14% through 2012. Adjusted prevalence among men was steady throughout the study period at approximately 7%. For both women and men, adjusted prevalence was highest among Black and American Indian youth and young adults, and in the Southern and Midwestern regions of the US throughout the study period. Our minimally-biased trend estimates provide support for an initial decrease in chlamydia prevalence among women soon after the introduction of national chlamydia screening programs. Constant chlamydia prevalence in more recent years suggests that screening may not be sufficient to further reduce chlamydia prevalence among high-risk youth and young adults.

  10. Disparities in the patterns and determinants of HIV risk behaviors among adolescents entering substance abuse treatment programs.

    Science.gov (United States)

    Mulatu, Mesfin S; Leonard, Kimberly Jeffries; Godette, Dionne C; Fulmore, Darren

    2008-12-01

    Black youth are disproportionately affected by the HIV/AIDS epidemic. This study examined disparities in patterns and determinants of sexual risk behaviors among black and white adolescents in substance abuse treatment programs. We used pooled clinical data collected from 4,565 sexually active 12-17-year-old black (29.7%) and white (70.3%) adolescents entering outpatient and residential substance abuse treatment programs nationally. Multivariate logistic regression analyses were used to examine racial differences in patterns of sexual risk behaviors and the associations of these behaviors with demographic, socioenvironmental and psychosocial risk factors, including substance use and abuse, symptoms of mental disorders and criminal behaviors. Blacks were significantly more likely than whites to have had sex with multiple partners, purchased or traded sex and used substances to enhance their sexual experiences, even after adjusting for demographic, socioenvironmental and psychosocial risk factors. Substance use and abuse, internalizing symptoms and drug-related crimes were significantly associated with engaging in > or =2 sexual risk behaviors in both groups. Disparities in determinants of HIV risk were also found. For instance, male gender, single-parent custody and history of criminal justice involvement were associated with having had sex with multiple partners among blacks but not among whites. Demographic, socioenvironmental and psychosocial risk factors accounted for up to 30% of the variance in sexual risk in both groups. Black adolescents with substance use problems are at greater risk for HIV infection than their white peers because of their higher rates of sexual risk behaviors. Differences in co-occurring psychosocial problems did not fully explain racial disparities in sexual risk behaviors. HIV prevention programs for black adolescents in treatment should consider both individual and broader contextual factors that co-occur with sexual risk behaviors.

  11. Feasibility of a web-based dementia feeding skills training program for nursing home staff.

    Science.gov (United States)

    Batchelor-Murphy, Melissa; Amella, Elaine J; Zapka, Jane; Mueller, Martina; Beck, Cornelia

    2015-01-01

    Nursing home (NH) staff do not receive adequate training for providing feeding assistance to residents with dementia who exhibit aversive feeding behaviors (e.g., clamping mouth shut). The result is often low meal intake for these residents. This feasibility study tested a web-based dementia feeding skills program for staff in two United States NHs. Randomly assigned, the intervention staff received web-based dementia feeding skills training with coaching. Both groups participated in web-based pre-/post-tests assessing staff knowledge and self-efficacy; and meal observations measured NH staff and resident feeding behaviors, time for meal assistance, and meal intake. Aversive feeding behaviors increased in both groups of residents; however, the intervention NH staff increased the amount of time spent providing assistance and meal intake doubled. In the control group, less time was spent providing assistance and meal intake decreased. This study suggests that training staff to use current clinical practice guidelines improves meal intake. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Enteral nutrition and quality of life in patients undergoing chemoradiotherapy for esophageal carcinoma: a comparison of nasogastric tube, esophageal stent, and ostomy tube feeding.

    Science.gov (United States)

    Yu, Fang-Jung; Shih, Hsiang-Yao; Wu, Chien-Yi; Chuang, Yun-Shiuan; Lee, Jui-Ying; Li, Hsien-Pin; Fang, Pen-Tzu; Tsai, Dong-Lin; Chou, Shah-Hwa; Wu, I-Chen

    2017-12-07

    This study prospectively recruited esophageal squamous cell carcinoma patients who received esophageal stent, nasogastric tube (NGT), or jejunostomy/gastrostomy feeding to compare the changes in nutritional status and quality of life during chemoradiation therapy (CRT). In total, 81 patients were analyzed (stent, 7; surgical ostomy, 26; NGT, 19; oral intake, 29). An NGT was inserted when, despite medication, dysphagia or pain worsened with oral feeding during CRT. Serial body weight and daily narcotic demand were recorded. Changes in serum albumin level and quality of life were also assessed. In subgroup analysis comparing NGT and prophylactic surgical ostomy feeding, 5 patients with total occlusion in the ostomy group were excluded. Patients in all groups had similar decreases in mean body weight with an overall change of -6.41% ± 5.21% at the end of CRT. The stent group had significantly worse pain, decreased albumin (-1.03 ± .9 mg/dL), and decreased quality of life across CRT compared with the other groups. In subgroup analysis the stent group had significantly higher weight loss, whereas the NGT group had higher narcotic demand and slightly worse quality of life. Two patients (7.7%) had ileus days after jejunostomy creation. Five patients (23.8%) among those received prophylactic ostomy creation and scarcely used it. These preliminary results raise concerns that use of esophageal stents may be less suitable in patients undergoing CRT. Tube feeding by means of transnasal or percutaneous routes appear to be comparably effective during CRT, but both have advantages and disadvantages. We suggest a careful endoscopic evaluation to select the population more appropriate for NGT feeding on an as-needed basis during CRT. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  13. Chlamydia prevalence among women and men entering the National Job Training Program: United States, 2003-2007.

    Science.gov (United States)

    Satterwhite, Catherine Lindsey; Tian, Lin H; Braxton, Jimmy; Weinstock, Hillard

    2010-02-01

    To analyze 5-year prevalence trends in Chlamydia trachomatis infections among high-risk young men and women aged 16 to 24 years entering the National Job Training Program, where universal screening is required. Entrance exams conducted in over 100 National Job Training Program centers from 2003 to 2007 were considered. Women provided cervical specimens tested using either a DNA hybridization probe (PACE 2, Gen-Probe, San Diego, CA) or a strand displacement amplification test (SDA, BD ProbeTec ET, Becton-Dickinson, Sparks, MD). In the absence of a pelvic exam, urine specimens were tested using SDA. PACE 2 testing was performed predominately from 2002 to 2005; from 2005 to 2007, SDA was used. All male testing was conducted using SDA on urine specimens. Chlamydia prevalence trends were assessed for women and men, using logistic regression models. Adjusted odds ratios (AOR), 95% confidence intervals (CI), and P-values were calculated. Approximately 15,000 women and 30,000 men were screened annually for chlamydia. Among both sexes, adjusted prevalence declined significantly from 2003 to 2007. In 2003, crude prevalence among women was 9.9%; in 2007, prevalence was 13.7%. However, after controlling for covariates, including increasingly sensitive tests, the model indicated a significant declining prevalence trend (AOR: 0.95, CI: 0.93-0.97, 4.6% decrease in odds per year). Among men, crude prevalence in 2003 was 8.4%; in 2007, prevalence was 8.3%; after controlling for possible confounding, a significant decline in prevalence was also detected (AOR: 0.98, CI: 0.96-0.99, 1.9% decrease in odds per year). In a relatively stable, high-risk population of young women and men, adjusted chlamydia prevalence declined from 2003 to 2007. Test technology plays a critical role in interpreting rates and should be considered whenever chlamydia rates are examined.

  14. The Performance and Incidence of Ascites in Broiler Chickens in Response to Feed Restriction and Meal Feeding Programs

    Directory of Open Access Journals (Sweden)

    Behrouz Dastar

    2014-04-01

    Full Text Available An experiment was conducted to evaluate the effect of feed restriction (FR and meal feeding (MF on performance, carcass characteristics and related parameters to ascites in Ross 308 male broiler chickens. Five dietary treatments were 1 the control (ad libo. feeding, 2 feed restriction from 7 to 14 days (FR14, 3 feed restriction from 7 to 21 days (FR21, 4 meal feeding from 7 to 14 days (MF14 and 5 meal feeding from 7 to 21days (MF21. All birds were fed adlibitum for the first week post hatch and after 21 days of age. Four replicate of 12 birds were allocated to each treatment. The results indicated FR and MF21 groups had significantly (p

  15. Preliminary Assessment of the Hanford Tank Waste Feed Acceptance and Product Qualification Programs

    Energy Technology Data Exchange (ETDEWEB)

    Herman, C. C.; Adamson, Duane J.; Herman, D. T.; Peeler, David K.; Poirier, Micheal R.; Reboul, S. H.; Stone, M. E.; Peterson, Reid A.; Chun, Jaehun; Fort, James A.; Vienna, John D.; Wells, Beric E.

    2013-04-01

    The U.S. Department of Energy Office of Environmental Management (EM) is engaging the national laboratories to provide the scientific and technological rigor to support EM program and project planning, technology development and deployment, project execution, and assessment of program outcomes. As an early demonstration of this new responsibility, Savannah River National Laboratory (SRNL) and Pacific Northwest National Laboratory (PNNL) have been chartered to implement a science and technology program addressing Hanford Tank waste feed acceptance and product qualification. As a first step, the laboratories examined the technical risks and uncertainties associated with the planned waste feed acceptance and qualification testing for Hanford tank wastes. Science and technology gaps were identified for work associated with 1) feed criteria development with emphasis on identifying the feed properties and the process requirements, 2) the Tank Waste Treatment and Immobilization Plant (WTP) process qualification program, and 3) the WTP HLW glass product qualification program. Opportunities for streamlining the accetpance and qualification programs were also considered in the gap assessment. Technical approaches to address the science and technology gaps and/or implement the opportunities were identified. These approaches will be further refined and developed as strong integrated teams of researchers from national laboratories, contractors, industry, and academia are brought together to provide the best science and technology solutions. Pursuing the identified approaches will have immediate and long-term benefits to DOE in reducing risks and uncertainties associated with tank waste removal and preparation, transfers from the tank farm to the WTP, processing within the WTP Pretreatment Facility, and in producing qualified HLW glass products. Additionally, implementation of the identified opportunities provides the potential for long-term cost savings given the anticipated

  16. The Feed Materials Program of the Manhattan Project: A Foundational Component of the Nuclear Weapons Complex

    Science.gov (United States)

    Reed, B. Cameron

    2014-12-01

    The feed materials program of the Manhattan Project was responsible for procuring uranium-bearing ores and materials and processing them into forms suitable for use as source materials for the Project's uranium-enrichment factories and plutonium-producing reactors. This aspect of the Manhattan Project has tended to be overlooked in comparison with the Project's more dramatic accomplishments, but was absolutely vital to the success of those endeavors: without appropriate raw materials and the means to process them, nuclear weapons and much of the subsequent cold war would never have come to pass. Drawing from information available in Manhattan Engineer District Documents, this paper examines the sources and processing of uranium-bearing materials used in making the first nuclear weapons and how the feed materials program became a central foundational component of the postwar nuclear weapons complex.

  17. Feeding Your Baby

    Medline Plus

    Full Text Available ... Frequently asked questions Email sign up Join our online community Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please fill in all fields. Please enter a ...

  18. Feeding Your Baby

    Medline Plus

    Full Text Available ... Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please fill in all fields. Please enter a valid e-mail address. Your information: Your recipient's information: Your ...

  19. A Review Of Nutritional Guidelines And Menu Compositions For School Feeding Programs In 12 Countries.

    Directory of Open Access Journals (Sweden)

    Ruzky eAliyar

    2015-08-01

    Full Text Available Study objectives: To analyze the nutritional guidelines and menu compositions of school meal provision in various different countries.Background: School feeding is the provision of food on-site or to take home, which aims to increase school enrolment, attendance and retention, and exist as a social safety net for households with very low income. Home-grown school feeding (HGSF, additionally, aims to stimulate local economies by providing a source of income for local smallholder farmers. Methods: Literature searches using the Ovid MEDLINE databases, gathered information from in-country stakeholders, and accessed the programme websites of various countries. Nutrient composition of these menus was calculated from nutritional guidelines and menu compositions using a nutrition linear programming tool (NUTVAL.Country comparisons: School feeding aims differ between countries of each income group. The implementation, delivery of service and nutritional content of foods also differ considerably between countries and income groups. In high-income countries, guidelines and standards have been recommended in an attempt to combat rising levels of overweight and obesity, and to model healthier lifestyle habits. In low-income countries there is a gap in terms of guidance on nutrition standards and menu composition.Conclusions: Provision of evidence-based guidance on nutrition standards to middle and low income countries who have recently established or are planning to establish school feeding has the potential to greatly enhance and improve the quality of service and improve the life of millions of children worldwide.

  20. Effects of feed-supplementation and hide-spray application of two sources of tannins on enteric and hide bacteria of feedlot cattle.

    Science.gov (United States)

    Gutierrez-Banuelos, Hector; Pinchak, William E; Min, Byeng R; Carstens, Gordon E; Anderson, Robin C; Tedeschi, Luis O; Krueger, Wimberley K; Krueger, Nathan A; Lancaster, Phillip A; Gomez, Robynne R

    2011-01-01

    Pathogenic bacteria attached to the hide or shed in the feces of cattle at slaughter can contaminate carcasses intended to be processed for human consumption. Therefore, new pre-harvest interventions are needed to prevent the carriage and excretion of foodborne pathogens in cattle presented to the processing plant. The objectives of this study were to examine the antimicrobial effects of hydrolysable tannin-rich chestnut and condensed tannin-rich mimosa extracts on bacterial indicators of foodborne pathogens when applied as a hide-intervention and as a feed additive to feedlot cattle. Water (control) or solutions (3 % wt/vol) of chestnut- and mimosa-extract treatments were sprayed (25 mL) at the left costal side of each animal to a 1000 cm² area, divided in four equal quadrants. Hide-swabs samples obtained at pre-, 2-min, 8-h, and 24-h post-spray application were cultured to enumerate Escherichia coli/total coliforms and total aerobic plate counts. In a second experiment, diets supplemented without (controls) or with (1.5 % of diet dry matter) chestnut- or mimosa-extracts were fed during a 42-day experimental feeding period. Weekly fecal samples starting on day 0, and rumen fluid obtained on days 0, 7, 21 or 42 were cultured to enumerate E.coli/total coliforms and Campylobacter. Tannin spray application showed no effect of treatment or post-application-time (P > 0.05) on measured bacterial populations, averaging 1.7/1.8, 1.5/1.6 and 1.5/1.7 (log₁₀CFU/cm²) for E. coli/total coliforms, and 4.0, 3.4 and 4.2 (log₁₀CFU/cm²) in total aerobes for control, chestnut and mimosa treatments, respectively. Mean (± SEM) ruminal E. coli and total coliform concentrations (log(10) CFU/mL) were reduced (P cattle hides. Additionally, chestnut tannin reduced E. coli and total coliforms within the rumen but the antimicrobial effect was not maintained in the lower gastrointestinal tract. Further research is necessary to elucidate the possible antimicrobial effects of tannins

  1. Caregiver- vs infant-oriented feeding: a model of infant-feeding strategies among special supplemental nutrition program for women, infants, and children participants in rural east Tennessee.

    Science.gov (United States)

    Kavanagh, Katherine F; Habibi, Mona; Anderson, Kirsten; Spence, Marsha

    2010-10-01

    The aim of this project was to collect data from focus-group participants to inform the future development of region-specific educational strategies to modify infant-feeding practices that may predispose children to obesity. Infant-feeding perceptions and practices were collected from participants of the Special Supplemental Nutrition Program for Women, Infants, and Children, through recorded focus groups, in two East Tennessee counties. Focus groups replaced the participants' required, prescheduled nutrition-education classes for participants with infants younger than 6 months of age. Twenty-nine focus groups were convened and recorded, reaching a total of 109 participants. Results of this series of focus groups indicate that the Special Supplemental Nutrition Program for Women, Infants, and Children population in rural East Tennessee was similar to populations elsewhere in terms of early solid-food introduction, frequent switching of formula, and sources of and valuation of infant-feeding advice. However, this population seemed to be different in the magnitude at which they introduce infant cereal early (primarily as an addition to the bottle). For this reason, interventions designed to reduce inappropriate infant-feeding behaviors in this population should focus on early introduction of solid food (especially infant cereal) first. In addition to these findings, a model of infant-feeding strategy development based on caregiver-orientation (framed within parenting styles) is presented and discussed. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  2. Feed-pump hydraulic performance and design improvement, Phase I: research program design. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brown, W.H.; Gopalakrishnan, S.; Fehlau, R.; Thompson, W.E.; Wilson, D.G.

    1982-03-01

    As a result of prior EPRI-sponsored studies, it was concluded that a research program should be designed and implemented to provide an improved basis for the design, procurement, testing, and operation of large feed pumps with increased reliability and stability over the full range of operating conditions. This two-volume report contains a research plan which is based on a review of the present state of the art and which defines the necessary R and D program and estimates the benefits and costs of the program. The recommended research program consists of 30 interrelated tasks. It is designed to perform the needed research; to verify the results; to develop improved components; and to publish computer-aided design methods, pump specification guidelines, and a troubleshooting manual. Most of the technology proposed in the research plan is applicable to nuclear power plants as well as to fossil-fired plants. This volume discusses the design, performance and failures of feed pumps, and recommendations for research on pump dynamics, design, and specifications.

  3. Effects of feeding ground pods of Enterolobium cyclocarpum Jacq. Griseb on dry matter intake, rumen fermentation, and enteric methane production by Pelibuey sheep fed tropical grass.

    Science.gov (United States)

    Albores-Moreno, S; Alayón-Gamboa, J A; Ayala-Burgos, A J; Solorio-Sánchez, F J; Aguilar-Pérez, C F; Olivera-Castillo, L; Ku-Vera, J C

    2017-04-01

    An experiment was carried out to determine the effect of supplementing ground pods of Enterolobium cyclocarpum in a basal ration of Pennisetum purpureum grass on feed intake, rumen volatile fatty acids (VFAs), and protozoa and methane (CH 4 ) production by hair sheep. Four male sheep (Pelibuey × Katahdin) with a mean live weight of 27.0 kg (SD ± 0.5) were supplemented with 0.00, 0.15, 0.30, and 0.45 kg of dry matter (DM) of E. cyclocarpum pods daily; equivalent to 0.00, 4.35, 8.70, and 13.05 g of crude saponins, respectively. Dry matter intake (DMI), organic matter intake (OMI), and molar proportions of propionic acid increased linearly (P sheep fed tropical grass, it is advisable to supplement the basal ration with up to 0.30 kg DM of E. cyclocarpum pods.

  4. Results and lessons learned from UMANG program: A large scale community-managed supplementary feeding program in India

    International Nuclear Information System (INIS)

    Chockalingham, David; Gnanaraj, Grana Pu Selvi; Indriani, Esther

    2014-01-01

    Full text: India’s National Family Health Survey (2005-2006) revealed that 48% children under 5 years old were stunted while 43% were underweight. Child malnutrition is the outcome of high levels of exposure to infections, inappropriate infant and young child feeding and caring practices. It has its origins almost entirely during the first two to three years of life. Child malnutrition is responsible for 22% of India’s burden of disease. According to the Lancet journal in 2013, undernutrition during pregnancy, affecting fetal growth, and the first two years of life is a major determinant of both stunting of linear growth and subsequent obesity and non-communicable diseases in adulthood. World Vision India (WVI) is a humanitarian organization working in India since 1951 and currently serving 163 districts in 25 states. The strategic directive of WVI for 2011-2014 focuses on reducing infant mortality and eliminating hunger in communities. In March 2011, a special task force Integrated Programming - Child Health (IPCH) with the key mandates to target families of malnourished children residing in program areas towards delivering fullness of life; support Government, communities and other partners in scaling up proven multisectoral interventions; leverage multi-sectoral coalitions to combat malnutrition; advocate change in system and sustainability; and set up organizational support. A generic logframe with the intervention packages was adopted by Area Development Programs (ADPs) in 96 locations, making it the biggest nutrition program ever been implemented by WVI. After doing the nutritional assessment, 83255 children were identified to be in moderate and severe malnutrition condition. Considering that even mild to moderate malnutrition greatly increases the risk of children dying from common childhood diseases, WVI decided to set up an emergency response as an ethical and critical decision to save the lives of these children. A community managed supplementary

  5. Comparative effects of different enteral feeding methods in head and neck cancer patients receiving radiotherapy or chemoradiotherapy: a network meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhang ZH

    2016-05-01

    Full Text Available Zhihong Zhang,1,2 Yu Zhu,1 Yun Ling,3 Lijuan Zhang,1 Hongwei Wan1 1Department of Nursing, Shanghai Proton and Heavy Ion Center, 2Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, 3Department of Human Resource, Shanghai Proton and Heavy Ion Center, Shanghai, People’s Republic of China Abstract: Nasogastric tube (NGT and percutaneous endoscopic gastrostomy were frequently used in the head and neck cancer patients when malnutrition was present. Nevertheless, the evidence was inclusive in terms of the choice and the time of tube placement. The aim of this network meta-analysis was to evaluate the comparative effects of prophylactic percutaneous endoscopic gastrostomy (pPEG, reactive percutaneous endoscopic gastrostomy (rPEG, and NGT in the head and neck cancer patients receiving radiotherapy or chemoradiotherapy. Databases of PubMed, Web of Science, and Elsevier were searched from inception to October 2015. Thirteen studies enrolling 1,631 participants were included in this network meta-analysis. The results indicated that both pPEG and NGT were superior to rPEG in the management of weight loss. pPEG was associated with the least rate of treatment interruption and nutrition-related hospital admission among pPEG, rPEG, and NGT. Meanwhile, there was no difference in tube-related complications. Our study suggested that pPEG might be a better choice in malnutrition management in the head and neck cancer patients undergoing radiotherapy or chemoradiotherapy. However, its effects need to be further investigated in more randomized controlled trials. Keywords: malnutrition, tube feeding, weight loss, treatment interruption, readmission, complication

  6. Fetal and neonatal programming of postnatal growth and feed efficiency in swine.

    Science.gov (United States)

    Ji, Yun; Wu, Zhenlong; Dai, Zhaolai; Wang, Xiaolong; Li, Ju; Wang, Binggen; Wu, Guoyao

    2017-01-01

    Maternal undernutrition or overnutrition during pregnancy alters organ structure, impairs prenatal and neonatal growth and development, and reduces feed efficiency for lean tissue gains in pigs. These adverse effects may be carried over to the next generation or beyond. This phenomenon of the transgenerational impacts is known as fetal programming, which is mediated by stable and heritable alterations of gene expression through covalent modifications of DNA and histones without changes in DNA sequences (namely, epigenetics). The mechanisms responsible for the epigenetic regulation of protein expression and functions include chromatin remodeling; DNA methylation (occurring at the 5´-position of cytosine residues within CpG dinucleotides); and histone modifications (acetylation, methylation, phosphorylation, and ubiquitination). Like maternal malnutrition, undernutrition during the neonatal period also reduces growth performance and feed efficiency (weight gain:feed intake; also known as weight-gain efficiency) in postweaning pigs by 5-10%, thereby increasing the days necessary to reach the market body-weight. Supplementing functional amino acids (e.g., arginine and glutamine) and vitamins (e.g., folate) play a key role in activating the mammalian target of rapamycin signaling and regulating the provision of methyl donors for DNA and protein methylation. Therefore, these nutrients are beneficial for the dietary treatment of metabolic disorders in offspring with intrauterine growth restriction or neonatal malnutrition. The mechanism-based strategies hold great promise for the improvement of the efficiency of pork production and the sustainability of the global swine industry.

  7. Feeding Tubes

    Science.gov (United States)

    ... the TPN. Tubes Used for Enteral Feeds NG (Nasogastric Tube) A flexible tube is placed via the nose, ... portion of the small intestine Naso – nose NG – Nasogastric Tube -ostomy – new opening Percutaneous – through the skin PEJ – ...

  8. Enteral stents.

    Science.gov (United States)

    Varadarajulu, Shyam; Banerjee, Subhas; Barth, Bradley; Desilets, David; Kaul, Vivek; Kethu, Sripathi; Pedrosa, Marcos; Pfau, Patrick; Tokar, Jeffrey; Wang, Amy; Song, Louis-Michel Wong Kee; Rodriguez, Sarah

    2011-09-01

    The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases, data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through August 2010 for articles related to enteral, esophageal, duodenal, and colonic stents. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  9. The effect of different feed restriction programs on reproductive performance, efficiency, frame size, and uniformity in broiler breeder hens.

    Science.gov (United States)

    de Beer, M; Coon, C N

    2007-09-01

    Two experiments were conducted to determine the effect of feed restriction programs on breeder reproductive performance. In experiment 1, every day (ED), skip-a-day (SK), 4-3, and 5-2 programs were compared. Diets did not differ, and feed intake was identical in all groups. Four hundred twenty pullets were reared on each program. At 21 wk, 80 breeders from each program were individually housed to record performance parameters. Body weight and frame size were larger in ED pullets than SK, 4-3, or 5-2 despite equal intakes. Hens fed ED reached sexual maturity at a younger age than other groups. Hens fed ED also produced more total and settable eggs than SK hens. Egg weight was heavier in 5-2 hens than in ED with 4-3 and SK intermediate. Efficiency of feed utilization was best in ED hens. In experiment 2 the same programs were tested, but pullets were reared to reach equal BW. One hundred seventy-five pullets were reared on each program, of which 60 were housed. Feed intake was greater for SK, 4-3, and 5-2 than ED pullets to reach the same BW. Frame size did not differ, indicating that BW was the cause of differences in experiment 1. In experiment 2, differences in performance were attenuated but not eliminated by feeding to reach equal BW, suggesting that metabolic factors aside from BW are altered by feeding programs. The 5-2 produced larger eggs than ED with the trend among programs being identical to that in experiment 1. These results suggest that metabolic changes such as increased lipogenesis or alterations in body composition may result in larger eggs in feeding programs that include off-feed days. Mortality, fertility, and hatchability were not affected by feeding programs in either experiment. Body composition analysis indicated the importance of total lean protein mass as a threshold for the onset of sexual maturity. Programs like SK are less efficient than ED and may result in reduced performance.

  10. Plutonium-bearing materials feed report for the DOE Fissile Materials Disposition Program alternatives

    International Nuclear Information System (INIS)

    Brough, W.G.; Boerigter, S.T.

    1995-01-01

    This report has identified all plutonium currently excess to DOE Defense Programs under current planning assumptions. A number of material categories win clearly fan within the scope of the MD (Materials Disposition) program, but the fate of the other categories are unknown at the present time. MD planning requires that estimates be made of those materials likely to be considered for disposition actions so that bounding cases for the PEIS (Programmatic Environmental Impact Statement) can be determined and so that processing which may be required can be identified in considering the various alternatives. A systematic analysis of the various alternatives in reachmg the preferred alternative requires an understanding of the possible range of values which may be taken by the various categories of feed materials. One table identifies the current total inventories excess to Defense Program planning needs and represents the bounding total of Pu which may become part of the MD disposition effort for all materials, except site return weapons. The other categories, principally irradiated fuel, rich scrap, and lean scrap, are discussed. Another table summarizes the ranges and expected quantities of Pu which could become the responsibility of the MD program. These values are to be used for assessing the impact of the various alternatives and for scaling operations to assess PEIS impact. Determination of the actual materials to be included in the disposition program will be done later

  11. Medicare program; replacement of reasonable charge methodology by fee schedules for parenteral and enteral nutrients, equipment, and supplies. Final rule.

    Science.gov (United States)

    2001-08-28

    This final rule implements fee schedules for payment of parenteral and enteral nutrition (PEN) items and services furnished under the prosthetic device benefit, defined in section 1861(s)(8) of the Social Security Act. The authority for establishing these fee schedules is provided by the Balanced Budget Act of 1997, which amended the Social Security Act at section 1842(s). Section 1842(s) of the Social Security Act specifies that statewide or other area wide fee schedules may be implemented for the following items and services still subject to the reasonable charge payment methodology: medical supplies; home dialysis supplies and equipment; therapeutic shoes; parenteral and enteral nutrients, equipment, and supplies; electromyogram devices; salivation devices; blood products; and transfusion medicine. This final rule describes changes made to the proposed fee schedule payment methodology for these items and services and provides that the fee schedules for PEN items and services are effective for all covered items and services furnished on or after January 1, 2002. Fee schedules will not be implemented for electromyogram devices and salivation devices at this time since these items are not covered by Medicare. In addition, fee schedules will not be implemented for medical supplies, home dialysis supplies and equipment, therapeutic shoes, blood products, and transfusion medicine at this time since the data required to establish these fee schedules are inadequate.

  12. Change of serum prealbumin levels and serum protein markers between egg white powder and casein protein additives in standard enteral feeding formulas in critically ill patients with acute respiratory failure.

    Science.gov (United States)

    Bhurayanontachai, Rungsun; Sa-Nguansai, Sunatee

    2016-01-01

    Protein deficiency is a major problem in critically ill patients. Egg white powder recently became a standard additive for protein supplementation in our unit. However, clinical data are not available to support egg white powder supplementation compared to standard protein casein supplementation. This study aimed to determine the change of serum prealbumin (PAB) levels of egg white powder compared to casein additive in standard enteral feeding in critically ill patients with respiratory failure. A prospective double-blind, randomized, non-inferiority study was conducted in patients with acute respiratory failure in the medical intensive care unit and respiratory care unit. These patients randomly received 1500 kcal/day of enteral nutrition support with 40 g/day of protein additives by either egg white protein powder or casein protein for 7 days. The serum PAB and C-reactive protein (CRP) levels were measured on days 1, 3, 5, and 7. Repeated-measures ANOVA determined the group effects displayed by serum PAB and CRP levels. p values egg white powder group. The clinical characteristics, baseline nutritional status, and biochemistries were not significantly different between the groups. No statistically significant differences were seen in the serum PAB and serum CRP levels between the two groups. The average mean ± SEM difference of serum PAB level between the groups was 2.3 ± 2.5 mg% (p = 0.58). The levels of PAB between the egg white protein additive and casein protein additive were not significantly different and less than the non-inferior margin. Thai Clinical Trials Registry TCTR20160126002.

  13. 40 CFR 122.23 - Concentrated animal feeding operations (applicable to State NPDES programs, see § 123.25).

    Science.gov (United States)

    2010-07-01

    ... (applicable to State NPDES programs, see § 123.25). 122.23 Section 122.23 Protection of Environment... Concentrated animal feeding operations (applicable to State NPDES programs, see § 123.25). (a) Scope... owner or operator (see § 122.21(b)); (ii) The CAFO name and address, the county name and the latitude...

  14. School Feeding Analysis in the context of a Food and Nutrition Program - doi:10.5020/18061230.2006.p164

    Directory of Open Access Journals (Sweden)

    Dixis Figueroa Pedraza

    2012-01-01

    Full Text Available The diversity of standards related to school feeding makes it a complex topic and difficult to lead with. This research aimed at reflecting on the essential aspects of the subject, in a bibliographical revision of global proposal that was based on what the term “program” represents. The School Feeding Program means a combination of projects addressed to bring meals to keep students nourished, independent of their condition. This concept implies that all School Feeding Program should consist of three stages: design, carrying out and evaluation. The design includes important controversial aspects, related to school feeding, such as: the program objectives, their relationship with starvation, malnutrition and school failure; and the distinction of treating this matter from the perspective of breeding right. There are significant differences among experiences in running School Feeding Programs in developed and in developing countries, as well as within the last ones. The evaluation stage usually is not well designed or it is not considered. This stage is really important and it is addressed to determine if the outcomes are corresponding to planned objectives. In order to complete a useful evaluation stage, the use of proper indicators is a main point. Finally, a whole analysis of the Program is carried out in order to obtain unquestionable results. The School Feeding Program is discussed as a Public Policy, into the context of Food Security and the other complementary activities included in it. The proposed view considers school feeding as a right that must be satisfied in the implementation of organized projects.

  15. Feed-pump hydraulic performance and design improvement, Phase I: research program design. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brown, W.H.; Gopalakrishnan, S.; Fehlau, R.; Thompson, W.E.; Wilson, D.G.

    1982-03-01

    As a result of prior EPRI-sponsored studies, it was concluded that a research program should be designed and implemented to provide an improved basis for the design, procurement, testing, and operation of large feed pumps with increased reliability and stability over the full range of operating conditions. This two-volume report contains a research plan which is based on a review of the present state of the art and which defines the necessary R and D program and estimates the benefits and costs of the program. The recommended research program consists of 30 interrelated tasks. It is designed to perform the needed research; to verify the results; to develop improved components; and to publish computer-aided design methods, pump specification guidelines, and a troubleshooting manual. Most of the technology proposed in the research plan is applicable to nuclear power plants as well as to fossil-fired plants. This volume contains appendixes on pump design, cavitation damage, performance testing, hydraulics, two-phase flow in pumps, flow stability, and rotor dynamics.

  16. Comparative assessment of the food purchase program and the national school feeding program's impact in Ubá, Minas Gerais, Brazil

    OpenAIRE

    Oliveira, Leandro Gomes de; Batalha, Mário Otávio; Pettan, Kleber Batista

    2016-01-01

    ABSTRACT: The Food Purchase Program (PAA) and the National School Feeding Program (PNAE) are the main trading programs of Brazil that promote a connection between the family farm and institutional markets. The case study portrayed in this article aimed to evaluate and compare the socioeconomic impacts generated by the PAA and PNAE among Ubá's family farmers in Minas Gerais. To do this, two tipes of questionnaires were applied to managers and farmers who participate in the programs and obtaine...

  17. Background and elements of the linkage between the Brazilian school feeding program and family farming.

    Science.gov (United States)

    Schwartzman, Flavia; Mora, Claudia Andrea Rodriguez; Bogus, Claudia Maria; Villar, Betzabeth Slater

    2017-12-18

    Since 2009, legislation of the National School Feeding Program of Brazil (PNAE) institutionalizes its linkage with family farming as it establishes the requirement that at least 30% out of the total financial resources allocated by the federal government to the states and municipalities for school feeding must be used in the purchase of products directly from this sector. This study analyzes the process of drafting this legislation, focusing on the elements related to the procurement from family farming, through a historical contextualization, and it also presents a graphical representation with the main elements of this linkage: its objectives, target population, actions implemented and expected results. Actors involved with the drafting of the legislation were interviewed. The analyses show that the procurement from family farming is a far-reaching initiative in terms of the concept, execution and results. It has also showed that a strong articulation between the actors and institutions of the different sectors involved is critical to its success. The education, agriculture, planning, procurement and civil society sectors should work articulately at national, state and local level. The results of this study demonstrate that initiatives like this, of institutional procurement from family farming, which are currently being implemented in several countries, constitute as an important strategy of food and nutrition security, for the fulfillment of the human right to adequate food and the promotion of long-term sustainable development.

  18. New benchmarks for costs and cost-efficiency of school-based feeding programs in food-insecure areas.

    Science.gov (United States)

    Gelli, Aulo; Cavallero, Andrea; Minervini, Licia; Mirabile, Mariana; Molinas, Luca; de la Mothe, Marc Regnault

    2011-12-01

    School feeding is a popular intervention that has been used to support the education, health and nutrition of school children. Although the benefits of school feeding are well documented, the evidence on the costs of such programs is remarkably thin. Address the need for systematic estimates of the cost of different school feeding modalities, and of the determinants of the considerable cost variation among countries. WFP project data, including expenditures and number of schoolchildren covered, were collected for 78 projects in 62 countries through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The standardized yearly average school feeding cost per child, not including school-level costs, was US$48. The yearly costs per child were lowest at US$23 for biscuit programs reaching school-going children and highest at US$75 for take-home rations programs reaching families of schoolgoing children. The average cost of programs combining on-site meals with extra take-home rations for children from vulnerable households was US$61. Commodity costs were on average 58% of total costs and were highest for biscuit and take-home rations programs (71% and 68%, respectively). Fortified biscuits provided the most cost-efficient option in terms of micronutrient delivery, whereas take-home rations were more cost-efficient in terms of food quantities delivered. Both costs and effects should be considered carefully when designing school feeding interventions. The average costs of school feeding estimated here are higher than those found in earlier studies but fall within the range of costs previously reported. Because this analysis does not include school-level costs, these

  19. Analysis of the national school feeding program in the municipality of Viçosa, state of Minas Gerais.

    Science.gov (United States)

    Rocha, Naruna Pereira; Filgueiras, Mariana De Santis; Albuquerque, Fernanda Martins de; Milagres, Luana Cupertino; Castro, Ana Paula Pereira; Silva, Mariane Alves; Costa, Glauce Dias da; Priore, Silvia Eloiza; Novaes, Juliana Farias de

    2018-01-01

    OBJECTIVE To analyze the implementation of the Brazilian National School Feeding Program as a food and nutritional security policy in public schools. METHODS This a cross-sectional study, with a quantitative and qualitative approach, carried out with 268 schoolchildren aged eight to nine years from the public school system of Viçosa, state of Minas Gerais, Brazil, in 2015. Interviews were carried out using semi-structured questionnaires with the children, parents, cooks, nutritionists, trainer of the Technical Assistance and Rural Extension Company, and president of the School Feeding Council. In order to analyze the implementation of the National School Feeding Program in Viçosa, we evaluated the direct weighing of the food served in the schools using mechanical balances with a capacity of up to 10 kg and the perception of the social players involved in the implementation of the National School Feeding Program. The children were questioned about the acceptance of and adherence to the food offered, in addition to the habit of bringing food from home. Parents reported knowledge about the School Feeding Program and Council. The qualitative analysis consisted of content analysis and quantitative analysis using the chi-square test, Fisher's exact test, and Mann-Whitney test. We adopted the statistical significance of 5% for quantitative analysis. RESULTS Children reported low adherence to the school feeding program and most of them used to bring food from home. Irregularities were identified in the implementation of the National School Feeding Program, such as: inadequate number of nutritionists, suspension of Council meetings, inadequate infrastructure in the areas of preparation and distribution of meals, lack of training of cooks, lack of nutritional adequacy of the food offered, and lack of actions on food and nutritional education. The Program complied with the recommendations for purchasing food from family farms. CONCLUSIONS The National School Feeding Program

  20. Analysis of the national school feeding program in the municipality of Viçosa, state of Minas Gerais

    Directory of Open Access Journals (Sweden)

    Naruna Pereira Rocha

    2018-02-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the implementation of the Brazilian National School Feeding Program as a food and nutritional security policy in public schools. METHODS This a cross-sectional study, with a quantitative and qualitative approach, carried out with 268 schoolchildren aged eight to nine years from the public school system of Viçosa, state of Minas Gerais, Brazil, in 2015. Interviews were carried out using semi-structured questionnaires with the children, parents, cooks, nutritionists, trainer of the Technical Assistance and Rural Extension Company, and president of the School Feeding Council. In order to analyze the implementation of the National School Feeding Program in Viçosa, we evaluated the direct weighing of the food served in the schools using mechanical balances with a capacity of up to 10 kg and the perception of the social players involved in the implementation of the National School Feeding Program. The children were questioned about the acceptance of and adherence to the food offered, in addition to the habit of bringing food from home. Parents reported knowledge about the School Feeding Program and Council. The qualitative analysis consisted of content analysis and quantitative analysis using the chi-square test, Fisher’s exact test, and Mann-Whitney test. We adopted the statistical significance of 5% for quantitative analysis. RESULTS Children reported low adherence to the school feeding program and most of them used to bring food from home. Irregularities were identified in the implementation of the National School Feeding Program, such as: inadequate number of nutritionists, suspension of Council meetings, inadequate infrastructure in the areas of preparation and distribution of meals, lack of training of cooks, lack of nutritional adequacy of the food offered, and lack of actions on food and nutritional education. The Program complied with the recommendations for purchasing food from family farms. CONCLUSIONS The

  1. Perspectives of volunteers in emergency feeding programs on hunger, its causes, and solutions.

    Science.gov (United States)

    Edlefsen, Miriam S; Olson, Christine M

    2002-01-01

    To understand the social beliefs of volunteers in emergency feeding programs (EFPs) regarding hunger and whether volunteer experiences broadened understanding of hunger. An interpretivist paradigm and qualitative methods were used. Seventeen volunteers were recruited and interviewed from three EFPs. Interviews were analyzed using the constant comparative method. Volunteering in EFPs increased volunteers' awareness of the prevalence of hunger in their communities. More involved volunteers had a greater understanding of the life situations of the hungry. The volunteers felt that increasing self-sufficiency and private responses were appropriate solutions to hunger. The volunteers' attitudes and social beliefs were similar to those of the general public. Interventions that facilitate interaction between volunteers and clients, promote reflection on volunteer experiences, and provide alternative viewpoints on poverty are needed to broaden volunteers' understanding of hunger and food insecurity.

  2. The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program follow-up.

    Science.gov (United States)

    Hesketh, Kylie D; Campbell, Karen; Salmon, Jo; McNaughton, Sarah A; McCallum, Zoe; Cameron, Adrian; Ball, Kylie; Gold, Lisa; Andrianopoulos, Nick; Crawford, David

    2013-01-01

    The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program, is a community-based, cluster-randomised controlled trial of an obesity prevention intervention delivered to first-time parents of infants from age 4-20 months. Conducted from 2008 to 2010, the program had high uptake and retention and showed positive impacts on some dietary outcomes and television viewing. Funding was secured for a follow-up study of participants two and 3.5 years post intervention (at child ages ~3.5 and 5 years). The follow-up study aims to assess intervention effects, mediators and moderators of effects, and program cost-effectiveness over the longer term. The 492 families still enrolled in the Melbourne InFANT Program at intervention conclusion will be recontacted and renewed consent sought to participate in this follow-up study. No further intervention will occur. Home visit data collections will occur approximately two and 3.5 years post intervention. Main outcomes to be assessed include child body mass index, waist circumference, diet (3 × 24-hour recalls; food frequency questionnaire), physical activity (8 days ActiGraph accelerometer data; parent reported active play) and sedentary time (8days ActiGraph accelerometer and ActivPAL inclinometer data; parent reported screen time). Follow-up of participants of the Melbourne InFANT Program at two and 3.5 years post intervention will allow assessment of longer term intervention effects, investigation of potential mediators and moderators of such effects, and economic evaluation of the longer term outcomes. This information will be valuable to researchers and policy makers in progressing the field of early childhood obesity prevention. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Evaluation of limit feeding corn and distillers dried grains with solubles in non-feed-withdrawal molt programs for laying hens.

    Science.gov (United States)

    Mejia, L; Meyer, E T; Utterback, P L; Utterback, C W; Parsons, C M; Koelkebeck, K W

    2010-03-01

    An experiment was conducted using 504 Hy-Line W-36 Single Comb White Leghorn hens (69 wk of age) randomly assigned to 1 of 7 treatments. These treatments consisted of a 47% corn:47% soy hulls diet (C:SH) fed ad libitum; a 94% corn diet fed at a rate of 36.3, 45.4, or 54.5 g/hen per day (CORN 36, CORN 45, and CORN 54, respectively); and a 94% corn distillers dried grains with solubles (DDGS) diet fed at the same rates as the previous corn diets (DDGS 36, DDGS 45, and DDGS 54, respectively) during the molt period of 28 d. The intent was to feed the DDGS diets for 28 d; however, all hens on these diets had very low feed intakes and greater than anticipated BW loss. Thus, they were switched to a 16% CP corn-soybean meal layer diet on d 19 of the molt period. At d 28, hens on all treatments were fed the same corn-soybean meal layer diet for 39 wk (73 to 112 wk of age). All DDGS diets and the CORN 36 diet resulted in total cessation of egg production during the molt period and egg production of hens fed the CORN 45, CORN 54, and C:SH diets had decreased to 3 and 4%, respectively, by d 28. Body weight loss during the 28-d molt period ranged from 14% for the CORN 54 diet to approximately 23% for the 3 DDGS diets. Postmolt egg production (5 to 43 wk) was higher for hens fed the DDGS molt diets than those fed the corn diets. There were no consistent differences in egg mass, egg-specific gravity, feed efficiency, or layer feed consumption among molt treatments for the postmolt period. These results indicate that limit feeding corn diet and DDGS diet in non-feed-withdrawal molt programs will yield long-term postmolt performance that is comparable to that observed by ad libitum feeding a C:SH diet.

  4. Enteral nutrition access devices.

    Science.gov (United States)

    Kwon, Richard S; Banerjee, Subhas; Desilets, David; Diehl, David L; Farraye, Francis A; Kaul, Vivek; Mamula, Petar; Pedrosa, Marcos C; Rodriguez, Sarah A; Varadarajulu, Shyam; Song, Louis-Michel Wong Kee; Tierney, William M

    2010-08-01

    The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but, in many cases, data from randomized, controlled trials are lacking. In such situations, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the ASGE Governing Board. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through August 2009 for articles related to endoscopy in patients requiring enteral feeding access by using the keywords "endoscopy," "percutaneous," "gastrostomy," "jejunostomy," "nasogastric," "nasoenteric," "nasojejunal," "transnasal," "feeding tube," "enteric," and "button." Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment. Copyright 2010 American Society

  5. Clinical utility of topiramate extended-release capsules (USL255): Bioequivalence of USL255 sprinkled and intact capsule in healthy adults and an in vitro evaluation of sprinkle delivery via enteral feeding tubes.

    Science.gov (United States)

    Clark, Annie M; Pellock, John M; Holmay, Mary; Anders, Bob; Cloyd, James

    2016-04-01

    The objectives of these two studies were to determine if beads from extended-release topiramate capsules sprinkled onto soft food are bioequivalent to the intact capsule and if beads from the capsule can be passed through enteral gastrostomy (G-) and jejunostomy (J-) feeding tubes. Bioequivalence of 200-mg USL255 (Qudexy XR [topiramate] extended-release capsules) sprinkled onto soft food (applesauce) versus the intact capsule was evaluated in a phase 1, randomized, single-dose, crossover study (N=36). Pharmacokinetic evaluations included area under the curve (AUC), maximum plasma concentration (Cmax), time to Cmax (Tmax), and terminal elimination half-life (t1/2). If 90% confidence intervals (CI) of the ratio of geometric least-squares means were between 0.80 and 1.25, AUC and Cmax were considered bioequivalent. In separate in vitro experiments, 100-mg USL255 beads were passed through feeding tubes using gentle syringe pressure to develop a clog-free bead-delivery method. Multiple tube sizes (14- to 18-French [Fr] tubes), dilutions (5 mg/15 mL-25 mg/15 mL), and diluents (deionized water, apple juice, Ketocal, sparkling water) were tested. Area under the curve and Cmax for USL255 beads sprinkled onto applesauce were bioequivalent to the intact capsule (GLSM [90% CI]: AUC0-t 1.01 [0.97-1.04], AUC0-∞ 1.02 [0.98-1.05]; Cmax 1.09 [1.03-1.14]). Median Tmax was 4h earlier for USL255 sprinkled versus the intact capsule (10 vs 14 h; p=0.0018), and t1/2 was similar (84 vs 82 h, respectively). In 14-Fr G-tubes, USL255 beads diluted in Ketocal minimized bead clogging versus deionized water. Recovery of USL255 beads diluted in deionized water was nearly 100% in 16-Fr G-, 18-Fr G-, and 18-Fr J-tubes. For patients with difficulty swallowing pills, USL255 sprinkled onto applesauce offers a useful once-daily option for taking topiramate. USL255 beads were also successfully delivered in vitro through ≥14-Fr G- or J-tubes, with tube clogging minimized by portioning the dose and

  6. Enteral alimentation: administration and complications.

    Science.gov (United States)

    Benya, R; Mobarhan, S

    1991-06-01

    Tube feeding is commonly used for providing essential calories and nutrients to the patient otherwise unable to eat. In the last two decades there has been significant expansion in the number and quality of enteral formulas. In this review, we evaluate the indications for each major class of formula, and survey complications associated with formulas and devices that deliver formula. Recommendations for future research are listed.

  7. GeoFORCE Texas: An Outreach Program that is Increasing the Number and Diversity of Students Completing STEM Degrees and Entering the Workforce

    Science.gov (United States)

    Snow, E.; Moore, S. L.

    2014-12-01

    GeoFORCE Texas is an outreach program of the Jackson School of Geosciences, University of Texas at Austin. Established in 2005 with the goal of increasing the number and diversity of students studying geosciences and engineering and entering the high-tech workforce, GeoFORCE has been highly successful. Key elements to that success will be presented here. GeoFORCE targets bright students in rural and inner-city schools where they are generally not academically challenged. Every summer throughout high school we take them on geologic field trips all over the country. In 2014, GeoFORCE led 15 field academies for about 600 students. The program is rigorous and academic. We emphasize college-level thinking skills. Because it is a 4-year program, they have a pretty good grounding in physical geology by the time they graduate. More importantly, they develop confidence in their ability to handle college, and a strong motivation to earn a college degree. GeoFORCE students are mostly minority (85%) and more than half will be the first in their family to graduate from college. GeoFORCE students exceed national averages in rates of going to college (97%), majoring in STEM fields (66%), majoring in geosciences (15%) and engineering (13%), and graduating from college (~85%). GeoFORCE is a public/private partnership and a workforce-focused program. The Jackson School funds staff and operating expenses (37%). Money for student programs comes from private industry (44%), state and federal grants (14%), and foundations and individual donors (5%). Our corporate partners are in the energy sector. In addition to funding, corporate sponsors attend the summer field programs, mentor GeoFORCE students, and provide opportunities for the students to visit the companies. As our students move toward college graduation, our industry and government partners have begun to hire them as interns. GeoFORCE graduates are now entering the workforce. Our first two cohorts are 4 and 5 years past high

  8. The development of a bismuth feed system for the very high Isp thruster with anode layer VHITAL program

    Science.gov (United States)

    Marrese-Reading, Colleen; Markusic, Tom; Polzin, Kurt; Knowles, Timothy; Mueller, Juergen

    2005-01-01

    A bismuth feed system was developed for the VHITAL Program to deliver 8-12 mg/s of bismuth vapor at a few Torr to the VHITAL-160. A carbon vaporizer developed to control vapor flow rates to the thruster.

  9. Integrated Blanket Supplementary Feeding Program Reduces Levels of Stunting in Yenangyaung, Myanmar

    International Nuclear Information System (INIS)

    Aung, Thet; Baik, Diane

    2014-01-01

    were seen in the underweight and wasting levels. However, significant improvements in the median height-for-age z-score (HAZ) were found in levels of stunting on Day-1 (-2.37 SD, n = 381) vs. 6-month follow-up (-1.99 SD, n = 314)(Z = -7.683, p<0.0001). Unfortunately, there were significant increases in the levels of stunting on Day-1 (-2.37 SD, n = 381) vs. 1-Year follow-up (-2.70 SD, n = 242)(Z = -2.21, p = 0.027). CONCLUSION: An integrated blanket supplementary feeding program could possibly reduce levels of stunting in just 6-months, but continued monitoring is required of the children even if the children are discharged from the program to ensure their rehabilitation is sustained at home. The increase in levels of stunting at 1-Year follow-up may have been due to the fact that many of the rehabilitated children were discharged and not followed up for the study. Thus, further research is needed to assess the effects of integrated blanket supplementary feeding programs on reducing levels of stunting. (author)

  10. Impact of skip-a-day and every-day feeding programs for broiler breeder pullets on the recovery of salmonella and campylobacter following challenge

    Science.gov (United States)

    The impact of restrictive feeding programs on Salmonella and Campylobacter colonization and persistence after challenge was investigated for broiler breeder pullets housed in an experimental rearing facility. Pullet-chicks were placed on litter in 3 feeding program rooms and each room contained dup...

  11. Internal Medicine Residency Program Directors' Views of the Core Entrustable Professional Activities for Entering Residency: An Opportunity to Enhance Communication of Competency Along the Continuum.

    Science.gov (United States)

    Angus, Steven V; Vu, T Robert; Willett, Lisa L; Call, Stephanie; Halvorsen, Andrew J; Chaudhry, Saima

    2017-06-01

    To examine internal medicine (IM) residency program directors' (PDs') perspectives on the Core Entrustable Professional Activities for Entering Residency (Core EPAs)-introduced into undergraduate medical education to further competency-based assessment-and on communicating competency-based information during transitions. A spring 2015 Association of Program Directors in Internal Medicine survey asked PDs of U.S. IM residency programs for their perspectives on which Core EPAs new interns must or should possess on day 1, which are most essential, and which have the largest gap between expected and observed performance. Their views and preferences were also requested regarding communicating competency-based information at transitions from medical school to residency and residency to fellowship/employment. The response rate was 57% (204/361 programs). The majority of PDs felt new interns must/should possess 12 of the 13 Core EPAs. PDs' rankings of Core EPAs by relative importance were more varied than their rankings by the largest gaps in performance. Although preferred timing varied, most PDs (82%) considered it important for medical schools to communicate Core EPA-based information to PDs; nearly three-quarters (71%) would prefer a checklist format. Many (60%) would be willing to provide competency-based evaluations to fellowship directors/employers. Most (> 80%) agreed that there should be a bidirectional communication mechanism for programs/employers to provide feedback on competency assessments. The gaps identified in Core EPA performance may help guide medical schools' curricular and assessment tool design. Sharing competency-based information at transitions along the medical education continuum could help ensure production of competent, practice-ready physicians.

  12. Meat-based enteral nutrition

    Science.gov (United States)

    Derevitskay, O. K.; Dydykin, A. S.

    2017-09-01

    Enteral nutrition is widely used in hospitals as a means of nutritional support and therapy for different diseases. Enteral nutrition must fulfil the energy needs of the body, be balanced by the nutrient composition and meet patient’s nutritional needs. Meat is a source of full-value animal protein, vitamins and minerals. On the basis of this research, recipes and technology for a meat-based enteral nutrition product were developed. The product is a ready-to-eat sterilised mixture in the form of a liquid homogeneous mass, which is of full value in terms of composition and enriched with vitamins and minerals, consists of particles with a size of not more than 0.3 mm and has the modified fat composition and rheological characteristics that are necessary for passage through enteral feeding tubes. The study presents experimental data on the content of the main macro- and micro-nutrients in the developed product. The new product is characterised by a balanced fatty acid composition, which plays an important role in correction of lipid metabolism disorders and protein-energy deficiency, and it is capable of satisfying patients’ daily requirements for vitamins and the main macro- and microelements when consuming 1500-2000 ml. Meat-based enteral nutrition can be used in diets as a standard mixture for effective correction of the energy and anabolic requirements of the body and support of the nutritional status of patients, including those with operated stomach syndrome.

  13. Improving the Process of Enteral Nutrition Preparation With Milk Technicians: Perceptions of Cost, Time, and Quality.

    Science.gov (United States)

    Brock, Whitney W; Cunningham, Craig A; Brandon, Debra H; Hoehn, Valerie; Carter, Brigit

    2016-04-01

    Neonatal intensive care nurses have historically been responsible for preparing enteral feedings--a costly and time-consuming process that may require leaving the bedside. To address these concerns, the Milk Technician Program was implemented at a major military treatment facility. Milk technicians were specially trained and responsible for handling, storing, and preparing enteral feeds. To determine effectiveness of the Milk Technician Program, changes in length of time required to first attain full feeds, cost of feeding preparation, adherence to feeding preparation procedures, and nurse and milk technician role variables were evaluated. A pre-/postdesign was used to compare length of time to full enteral feedings and cost. A plan-do-study-act design was used to evaluate protocol adherence and to identify and evaluate nurse and milk technician role variables. Data were collected via surveys, direct observations, and retrospective chart reviews to determine the overall effectiveness of this intervention. The average time for extremely and very preterm infants (milk technician adherence to preparation procedures was 95.5%. Most nurses reported that the program saved time (97%) and all milk technicians reported improved job satisfaction. Nurses expressed concerns about accuracy and safety of preparation. Milk technicians reported concerns with communication, supplies, and lack of perceived support. Milk technicians offer significant benefit to infants and nurses in the neonatal intensive care unit, including reducing time for infants to reach full feeds, saving nurses' time, and reducing costs. Further research is needed to identify ideal educational backgrounds for milk technicians and to directly measure the effect of milk technicians on hospital length of stay and infant growth parameters.

  14. Impacts of Nutrition and Feeding Programs on Farmers’ Management Decisions Affecting the Success of Dairy Farms with Culture Breed Cattle

    OpenAIRE

    Yavuz Topcu; Mehmet Toparlak; Muhlis Macit

    2016-01-01

    The aim of the study is to evaluate all the factors determining the milk production and yield decisions with regard to the nutrition and feeding programs affecting the integrated management strategies on the success of the dairy farms with culture breed cattle under the pasture-based and indoor barn-based production systems. For these aims, data obtained from the individual interviews conducted at the dairy farms with 100 culture breed cattle were used for Principal Component and Multiple Reg...

  15. Diarrhea in enterally fed patients: blame the diet?

    Science.gov (United States)

    Chang, Sue-Joan; Huang, Hsiu-Hua

    2013-09-01

    Diarrhea has great impact on enteral nutrition. The purpose of this review is to identify the factors leading to diarrhea during enteral nutrition and to provide the published updates on diarrhea prevention through nutritional intervention. Diarrhea in enteral fed patients is attributed to multiple factors, including medications (major contributor), infections, bacterial contamination, underlying disease, and enteral feeding. Diet management can alleviate diarrhea in enteral feeding. High content of fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) in enteral formula is postulated to induce diarrhea and lower FODMAPs formula may reduce the likelihood of diarrhea in enterally fed patients. Fiber-enriched formula can reduce the incidence of diarrhea and produce short-chain fatty acids for colonocytes. Ingesting prebiotics, nonviable probiotics or probiotic derivatives, and human lactoferrin may provide alternatives for reducing/preventing diarrhea. Enteral feeding is not generally considered the primary cause of diarrhea, which is frequently linked to prescribed medications. When diarrhea is apparent, healthcare members should evaluate the possible risk factors and systematically attempt to eliminate the underlying causes of diarrhea before reducing or suspending enteral feeding. Lower FODMAPs formula, prebiotics, probiotic derivatives, and lactoferrin may be used to manage enteral feeding-related diarrhea.

  16. Feed Forward Programming of Car Drivers’ Eye Movement Behavior. A System Theoretical Approach. Volume 1

    Science.gov (United States)

    1980-02-01

    an interaction between the human being (or animal) with his environment. The environ- ment, on the other hand, includea objects and/or other people (or...always consider the possibility of some sudden entering their path of driving, especially children and eldery "RT .55 蚌 ii1 -4 ) 4. -- 4 . .,- W 0 0

  17. Effects of a “step-up” ractopamine feeding program, sex and social rank on growth performance, hoof lesions, and Enterobacteriaceae shedding in finishing pigs

    Science.gov (United States)

    Increasing concern for animal well-being and food safety has driven the investigation of feed additives such as ractopamine (RAC), a ß-agonist widely used to improve production performance of finishing pigs. The objective of this study was to determine the effects of a “step-up” RAC feeding program ...

  18. Evolving trends in enteral alimentation.

    Science.gov (United States)

    Ponsky, J L

    1986-01-01

    Nutrition has become a cornerstone of surgical patient care. With better understanding of metabolic and compositional requirements, great advances have been made in the area of total parenteral nutrition. Recent attention to full utilization of alimentary tract function has prompted a resurgence of interest in dietary formulas and methods of delivery. Three new approaches to the alimentary tract provide better access for feeding. Needle catheter jejunostomy allows early alimentary tract utilization following operations, while percutaneous endoscopic gastrostomy and jejunostomy provide long-term solutions to the provision of enteral alimentation. Future utilization of these techniques will certainly lead to better patient care.

  19. Multitalented EspB of enteropathogenic Escherichia coli (EPEC) enters cells autonomously and induces programmed cell death in human monocytic THP-1 cells.

    Science.gov (United States)

    Baumann, Doreen; Salia, Helen; Greune, Lilo; Norkowski, Stephanie; Körner, Britta; Uckeley, Zina M; Frankel, Gad; Guenot, Marianne; Rüter, Christian; Schmidt, M Alexander

    2018-03-12

    Enteropathogenic Escherichia coli (EPEC) subvert host cell signaling pathways by injecting effector proteins via a Type 3 Secretion System (T3SS). The T3SS-dependent EspB protein is a multi-functional effector protein, which contributes to adherence and translocator pore formation and after injection exhibits several intracellular activities. In addition, EspB is also secreted into the environment. Effects of secreted EspB have not been reported thus far. As a surrogate for secreted EspB we employed recombinant EspB (rEspB) derived from the prototype EPEC strain E2348/69 and investigated the interactions of the purified protein with different human epithelial and immune cells including monocytic THP-1 cells, macrophages, dendritic cells, U-937, epithelial T84, Caco-2, and HeLa cells. To assess whether these proteins might exert a cytotoxic effect we monitored the release of lactate dehydrogenase (LDH) as well as propidium iodide (PI) uptake. For comparison, we also investigated several homologs of EspB such as IpaD of Shigella, and SipC, SipD, SseB, and SseD of Salmonella as purified recombinant proteins. Interestingly, cytotoxicity was only observed in THP-1 cells and macrophages, whereas epithelial cells remained unaffected. Cell fractionation and immune fluorescence experiments showed that rEspB enters cells autonomously, which suggests that EspB might qualify as a novel cell-penetrating effector protein (CPE). Using specific organelle tracers and inhibitors of signaling pathways we found that rEspB destroys the mitochondrial membrane potential - an indication of programmed cell death induction in THP-1 cells. Here we show that EspB not only constitutes an essential part of the T3SS-nanomachine and contributes to the arsenal of injected effector proteins but, furthermore, that secreted (recombinant) EspB autonomously enters host cells and selectively induces cell death in immune cells. Copyright © 2018 Elsevier GmbH. All rights reserved.

  20. Effects of early neonatal development and delayed feeding immediately post-hatch on the hepatic lipogenic program in broiler chicks.

    Science.gov (United States)

    Richards, Mark P; Proszkowiec-Weglarz, Monika; Rosebrough, Robert W; McMurtry, John P; Angel, Roselina

    2010-12-01

    The embryo to neonate transition is a critical period of development that has significant impact on broiler production. During this time important genetic programs governing metabolism and growth are established. The goal of this work was to study the effects of early post-hatch (PH) development and the time of initiation of feeding on activation of the genetic program regulating hepatic lipogenesis. A comparison of liver total RNA samples at hatch and 7 days PH was performed using oligonucleotide-based (Affymetrix GeneChip®) chicken genome microarrays. During the first week PH there was significant up-regulation of key lipogenic genes including: ATP citrate lyase (ACL), malic enzyme (ME), fatty acid synthase (FAS), acetyl-CoA carboxylase alpha (ACCα), stearoyl-CoA desaturase-1 (SCD-1), sterol regulatory element binding protein-2 (SREBP-2) and thyroid hormone responsive spot 14α (Spot 14α) among others. These findings were confirmed using gene-specific RT-PCR assays. In a follow-up study, we investigated the effects of withholding feed for the first 48 h PH (delayed feeding, DF) on lipogenic gene expression through 8 days PH. Body weight gain was significantly depressed by DF. Plasma levels of the major metabolic hormones that regulate lipogenic gene expression (insulin, glucagon and T(3)) changed significantly during PH development, but were largely unaffected by DF. Plasma glucose was significantly lower in the DF group at 24h PH but recovered thereafter. In general, DF inhibited the up-regulation of lipogenic genes until feeding was initiated. Delayed up-regulation was also observed for the lipogenic transcription factor genes, SREBP-1, SREBP-2 and peroxisome proliferator-activated receptor gamma (PPARγ), but not for carbohydrate response element binding protein (ChREB) or liver X receptor (LXR). Our results offer additional insight into the transcriptional programming of hepatic lipogenesis in response to the transition from high fat (yolk) to high

  1. Enteric Neurobiology: Discoveries and Directions.

    Science.gov (United States)

    Wood, Jackie D

    Discovery and documentation of noncholinergic-nonadrenergic neurotransmission in the enteric nervous system started a revolution in mechanisms of neural control of the digestive tract that continues into a twenty-first century era of translational gastroenterology, which is now firmly embedded in the term, neurogastroenterology. This chapter, on Enteric Neurobiology: Discoveries and Directions, tracks the step-by-step advances in enteric neuronal electrophysiology and synaptic behavior and progresses to the higher order functions of central pattern generators, hard wired synaptic circuits and libraries of neural programs in the brain-in-the-gut that underlie the several different patterns of motility and secretory behaviors that occur in the specialized, serially-connected compartments extending from the esophagus to the anus.

  2. Prevalence of Neisseria gonorrhoeae infections among men and women entering the National Job Training Program--United States, 2004-2009.

    Science.gov (United States)

    Bradley, Heather; Satterwhite, Catherine Lindsey

    2012-01-01

    National notifiable disease data indicate that there were 99 cases of gonorrhea for every 100,000 persons in the United States in 2009, the lowest recorded gonorrhea rate in US history. However, the extent to which declining case reports signify a reduction in prevalence is unknown. Gonorrhea prevalence was estimated among 16- to 24-year-old men and women entering the National Job Training Program (NJTP) between 2004 and 2009. Multivariate logistic regression was used to assess the probability of testing positive for gonorrhea over time. A total of 95,184 men and 91,697 women were screened for gonorrhea upon entry to the NJTP between 2004 and 2009. For women, gonorrhea prevalence increased from 2004 (2.6%) to 2006 (2.9%), then decreased steadily through 2009 (1.8%). For men, prevalence increased from 2004 (1.3%) to 2005 (1.6%), then decreased through 2009 (0.9%). Gonorrhea prevalence among black women decreased from 3.6% in 2004 to 2.5% in 2009 and was 2 to 4 times higher than prevalence among white women. Likewise, prevalence among black men decreased from 2.0% to 1.5% and was 8 to 22 times higher than prevalence among white men. After adjusting for gonorrhea risk factors, the odds of women and men testing positive for gonorrhea decreased by 50% and 40%, respectively, from 2004 to 2009. Declining trends in gonorrhea infection among NJTP entrants are similar to those observed in gonorrhea case report data, suggesting that the decrease in case reports is due to a decrease in prevalence. However, targeted interventions are needed to reduce gonorrhea infections in populations with disproportionate risk.

  3. Virological failure and HIV-1 drug resistance mutations among naive and antiretroviral pre-treated patients entering the ESTHER program of Calmette Hospital in Cambodia.

    Directory of Open Access Journals (Sweden)

    Hubert Barennes

    Full Text Available INTRODUCTION: In resource limited settings, patients entering an antiretroviral therapy (ART program comprise ART naive and ART pre-treated patients who may show differential virological outcomes. METHODS: This retrospective study, conducted in 2010-2012 in the HIV clinic of Calmette Hospital located in Phnom Penh (Cambodia assessed virological failure (VF rates and patterns of drug resistance of naive and pre-treated patients. Naive and ART pre-treated patients were included when a Viral Load (VL was performed during the first year of ART for naive subjects or at the first consultation for pre-treated individuals. Patients showing Virological failure (VF (>1,000 copies/ml underwent HIV DR genotyping testing. Interpretation of drug resistance mutations was done according to 2013 version 23 ANRS algorithms. RESULTS: On a total of 209 patients, 164 (78.4% were naive and 45 (21.5% were ART pre-treated. Their median initial CD4 counts were 74 cells/mm3 (IQR: 30-194 and 279 cells/mm3 (IQR: 103-455 (p<0.001, respectively. Twenty seven patients (12.9% exhibited VF (95% CI: 8.6-18.2%, including 10 naive (10/164, 6.0% and 17 pre-treated (17/45, 37.8% patients (p<0.001. Among these viremic patients, twenty-two (81.4% were sequenced in reverse transcriptase and protease coding regions. Overall, 19 (86.3% harbored ≥1 drug resistance mutations (DRMs whereas 3 (all belonging to pre-treated patients harbored wild-types viruses. The most frequent DRMs were M184V (86.3%, K103N (45.5% and thymidine analog mutations (TAMs (40.9%. Two (13.3% pre-treated patients harbored viruses that showed a multi-nucleos(tide resistance including Q151M, K65R, E33A/D, E44A/D mutations. CONCLUSION: In Cambodia, VF rates were low for naive patients but the emergence of DRMs to NNRTI and 3TC occurred relatively quickly in this subgroup. In pre-treated patients, VF rates were much higher and TAMs were relatively common. HIV genotypic assays before ART initiation and for ART pre

  4. Immediate preoperative enteral nutrition (preoperative enteral nutrition

    Directory of Open Access Journals (Sweden)

    Lađević Nebojša

    2017-01-01

    Full Text Available Nutritional support of surgical patients is a necessary part of the treatment. It alone cannot cure the disease but it significantly affects the recovery of patients and supports surgical interventions. Patients in malnutrition have shown to have significantly more postoperative infectious and non-infectious complications. This significantly prolongs treatment time and increases costs. However, there is one fact that cannot be expressed in money, which is the patient's impression of the surgical intervention. Adequate preoperative patient support, based on the intake of liquid nutritive solutions, reduces preoperative stress and deflects the metabolic response. Now, it is recommended for adults and children older than one year to drink clear liquid up to 2 hours before induction in anesthesia. Appropriate enteral nutrition has a significant place in the postoperative recovery of patients. Enteral nutrition is reducing complications, mainly infectious complications because the function of the digestive system as one large immune system is preserved. Perioperative enteral nutrition is a necessary part of the modern treatment of surgical patients. In addition to the significant effect on the occurrence of postoperative complications, it is also important that this type of diet improves the psychological status of patients.

  5. Roswell Park Cancer Institute/Howard University Prostate Cancer Scholars Program

    Science.gov (United States)

    2017-10-01

    Prostate Cancer Scholars Program is designed to encourage students from under-represented minority groups to enter graduate training and ultimately...Howard University Prostate Cancer Scholars Program (RHPCS) aims to encourage students from under-represented minority groups to enter graduate training...developing healthcare and research professionals by feeding the pipeline of subsequent college science graduates poised to enter graduate training in the

  6. Enteric neurodegeneration in ageing.

    Science.gov (United States)

    Camilleri, M; Cowen, T; Koch, T R

    2008-04-01

    The objective of this article is to review the clinical presentation and neurobiology of degeneration of the enteric nervous system with emphasis on human data where available. Constipation, incontinence and evacuation disorders are frequently encountered in the ageing population. Healthy lower gastrointestinal function is essential for successful ageing as it is critical to maintaining independence and autonomy to pursue further activity. One clinical expression of enteric neurodegeneration is constipation. However, the aetiology may be multifactorial as disturbances of epithelial, muscle or neural function may all result from neurodegeneration. There is evidence of loss of excitatory (e.g. cholinergic) enteric neurons and interstitial cells of Cajal, whereas inhibitory (including nitrergic) neurons appear unaffected. Understanding neurodegeneration in the enteric nervous system is key to developing treatments to reverse it. Neurotrophins have been shown to accelerate colonic transit and relieve constipation in the medium term; they are also implicated in maintenance programmes in adult enteric neurons through a role in antioxidant defence. However, their effects in ageing colon require further study. There is evidence that 5-HT(2) and 5-HT(4) mechanisms are involved in development, maintenance and survival of enteric neurons. Further research is needed to understand and potentially reverse enteric neurodegeneration.

  7. Complications relating to enteral and parenteral nutrition in trauma ...

    African Journals Online (AJOL)

    Objectives: The aim of the study was to compare the incidence of complications in patients receiving enteral and parenteral nutrition (PN), and review how the early initiation of enteral feeding and early achievement of caloric goal would affect the incidence of complications. Design: The design was a retrospective audit of ...

  8. Online Database Allows for Quick and Easy Monitoring and Reporting of Supplementary Feeding Program Performance: An Analysis of World Vision CMAM Programs (2006-2013)

    International Nuclear Information System (INIS)

    Emary, Colleen; Aidam, Bridget; Roberton, Tim

    2014-01-01

    Full text: Background: Despite the widespread implementation of interventions to address moderate acute malnutrition (MAM), lack of robust monitoring systems have hindered evaluation of the effectiveness of approaches to prevent and treat MAM. Since 2006, World Vision (WV) has provided supplementary feeding to 280,518 children 6-59 months of age (U5) and 105,949 pregnant and lactating women (PLW) as part of Community Based Management of Acute Malnutrition (CMAM) programming. The Excel-based system initially used for monitoring individual site programs faced numerous challenges. It was time consuming, prone to human error, lost data as a result of staff turnover and hence use of data to inform program performance was limited. In 2010, World Vision International (WVI)’s Nutrition Centre of Expertise (NCOE) established an online database to overcome these limitations. The aim of the database was to improve monitoring and reporting of WV’s CMAM programs. As of December 2013, the database has been rolled out in 14 countries Burundi, Chad, DRC, Ethiopia, Kenya, Mali, Mauritania, Niger, Sudan, Pakistan, South Sudan, Somalia, Zimbabwe and Zambia. Methods: The database includes data on admissions (mid-upper arm circumference, weight for height, oedema, referral) and discharge outcomes (recovered, died, defaulted, non-recovered, referral) for Supplementary Feeding Programs (SFPs) for children U5 as well as PLWs. A quantitative analysis of the data sets available was conducted to identify issues with data quality and draw findings from the data itself. Variations in program performance as compared to Sphere standards were determined by country and aggregated over the 14 countries. In addition, time trend analyses were conducted to determine significant different and seasonality effects. Results: Most data was related to program admissions from 2010 to July 2013, though some retrospective program data was available from 2006 to 2009. The countries with the largest number

  9. Educational intervention to modify bottle-feeding behaviors among formula-feeding mothers in the WIC program: impact on infant formula intake and weight gain.

    Science.gov (United States)

    Kavanagh, Katherine F; Cohen, Roberta J; Heinig, M Jane; Dewey, Kathryn G

    2008-01-01

    Formula-fed infants gain weight faster than breastfed infants. This study evaluated whether encouraging formula-feeding caregivers to be sensitive to infant satiety cues would alter feeding practices and reduce infant formula intake and weight gain. Double-blind, randomized educational intervention, with intake and growth measured before (at 1 to 2 months) and after (4 to 5 months) the intervention. Women, Infants, and Children (WIC) clinics in Sacramento, California. 836 caregivers of young infants were screened; 214 were eligible, and 104 agreed to participate. Intervention subjects received education promoting awareness of satiety cues and discouraging bottles containing more than 6 ounces before 4 months of age; intervention and control groups received education regarding introduction and feeding of solid food after 4 months of age. Formula intake (mL/24 hours) and weight gain (g/week). Differences between groups evaluated using 2-way analysis of covariance (ANCOVA). Sixty-one subjects completed baseline records, 44 attended class, and 38 completed the study. Despite a positive response to the educational intervention, there was no change in bottle-feeding behaviors (formula intake at 4 to 5 months was more than 1100 mL/day in both groups). Infant growth in the intervention group was greater than in the control group (P intervention improved knowledge of the key messages, but further research is needed to understand barriers to modifying bottle-feeding behaviors.

  10. Infant Feeding Policy and Programming During the 2014–2015 Ebola Virus Disease Outbreak in Sierra Leone

    Science.gov (United States)

    Brandt, Amelia; Serrano Oria, Óscar; Kallon, Mustapha; Bazzano, Alessandra N.

    2017-01-01

    ABSTRACT Optimal breastfeeding is of vital importance to infant and child health and has been adopted by countries as a standard recommendation. However, in the context of an infectious disease outbreak, especially when the disease is poorly understood, policy makers must balance the benefits of breastfeeding against the risk of disease transmission through breastfeeding. During the 2014–2015 Ebola Virus Disease (EVD) outbreak in Sierra Leone, the development of correct and consistent messaging about infant feeding and nutrition programming was considerably delayed by numerous challenges. These challenges included a lack of sufficient information about the risk of transmission through human milk, numerous stakeholders, limited communication between coordination pillars, inconsistent and evolving messages from various stakeholders, and the public's distrust of the health system and international actors. For improved response to future disease outbreaks, research on vertical transmission of EVD should be prioritized, infant and young child feeding experts should be integrated into outbreak response collaboration, and a digital repository of potential and appropriately tailored messages should be created. PMID:28963177

  11. Analysis of tank 4 (FTF-4-15-22, 23) surface and subsurface supernatant samples in support of enrichment control, corrosion control and evaporator feed qualification programs

    Energy Technology Data Exchange (ETDEWEB)

    Oji, L. N. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2015-09-09

    This report provides the results of analyses on Savannah River Site Tank 4 surface and subsurface supernatant liquid samples in support of the Enrichment Control Program (ECP), the Corrosion Control Program (CCP) and the Evaporator Feed Qualification (EFQ) Program. The purpose of the ECP sample taken from Tank 4 in August 2015 was to determine if the supernatant liquid would be “acceptable feed” to the 2H and 3H evaporator systems.

  12. Positive impact of child feeding training program for primary care health professionals: a cluster randomized field trial

    Directory of Open Access Journals (Sweden)

    Márcia Regina Vitolo

    2014-12-01

    Full Text Available OBJECTIVE: To assess the impact of a child feeding training program for primary care health professionals about breastfeeding and complementary feeding practices. METHODS: Cluster-randomized field trial conducted in the city of Porto Alegre, (RS, Brazil. Twenty primary health care centers (HCC were randomized into intervention (n = 9 and control (n = 11 groups. The health professionals (n = 200 at the intervention group centers received training about healthy feeding practices. Pregnant women were enrolled at the study. Up to six months of child's age, home visits were made to obtain variables related to breastfeeding and introduction of foods. RESULTS: 619 children were evaluated: 318 from the intervention group and 301 from the control group. Exclusive breastfeeding prevalence in the first (72.3 versus 59.4%; RR = 1.21; 95%CI 1.08 - 1.38, second (62.6 versus 48.2%; RR = 1.29; 95%CI 1.10 - 1.53, and third months of life (44.0% versus 34.6%; RR = 1.27; 95%CI 1.04 - 1.56 was higher in the intervention group compared to the control group. The prevalence of children who consumed meat four or five times per week was higher in the intervention group than in the control group (36.8 versus 22.6%; RR = 1.62; 95%CI 1.32 - 2.03. The prevalence of children who had consumed soft drinks (34.9 versus 52.5%; RR = 0.66; 95%CI 0.54 - 0.80, chocolate (24.5 versus 36.7% RR = 0.66 95%CI 0.53 - 0.83, petit suisse (68.9 versus 79.7; 95%CI 0.75 - 0.98 and coffee (10.4 versus 20.1%; RR = 0.51; 95%CI 0.31 - 0.85 in their six first months of life was lower in the intervention group. CONCLUSION: The training of health professionals had a positive impact on infant feeding practices, contributing to the promotion of child health.

  13. School meals defined from the perspective of students catered for under the National School Feeding Program, Brazil.

    Science.gov (United States)

    Paiva, Janaína Braga de; Freitas, Maria do Carmo Soares de; Santos, Ligia Amparo da Silva

    2016-08-01

    Based on socio-anthropological studies into food and in connection with guidance from the Public Policy on Food and Nutrition Security in Brazil, this paper sought to objectively analyze students' views of the school meals given to them as part of the National School Feeding Program (PNAE). The data was produced through ethnographic exercises that were developed where the above Program (hereafter Program) had been implemented in a semi-arid municipality in the state of Bahia. The exercises also involved the production of written material and the use of focus groups with teenagers in primary school education. Of particular note in this study was the time and space the students had for their break/recreation period which brought to light the relationship between the body and food. Based on the responses given we were able to identify different understandings and meanings associated with the food served in these institutions. The study helped to shed some light on the relational aspects between habitual eating at "home-on the road-and-in school" with the right to have school meals. We were also able to obtain a broader understanding of the eating habits of teenagers that are catered for as part of the PNAE.

  14. School feeding program has resulted in improved dietary diversity, nutritional status and class attendance of school children.

    Science.gov (United States)

    Zenebe, Mastewal; Gebremedhin, Samson; Henry, Carol J; Regassa, Nigatu

    2018-01-23

    School Feeding Program (SFP) is a targeted safety net program designed to provide educational and health benefits to vulnerable children. However, limited evidence exists regarding the effect of the intervention on the nutritional status and school attendance of children. The study is aimed at examining the effects of SFP on dietary diversity, nutritional status and class attendance of school children in Boricha district, Southern Ethiopia. The study was conducted based on a representative data collected from 290 students drawn from the district. A school-based comparative cross-sectional study was conducted on school children aged 10-14 years. Data were collected using structured pretested questionnaire. The effects of SFP on dietary diversity score (DDS), class attendance rate, body-mass-index for age (BAZ) and height-for-age (HAZ) Z-scores were assessed using multivariable linear regression model. The finding showed significantly higher mean (±SD) of DDS in SFP beneficiaries (5.8 ± 1.1) than the non-beneficiaries (3.5 ± 0.7) (P nutritional status, and class attendance of school children, we strongly recommend scaling up the program to other food insecure areas.

  15. Qualidade microbiológica e temperatura de dietas enterais antes e após implantação do sistema de análise de perigos e pontos críticos de controle Microbiological quality and temperatures of enteral feedings before and after implementation of hazard analysis and critical control point

    Directory of Open Access Journals (Sweden)

    Miriam Isabel Souza dos Santos Simon

    2007-04-01

    Full Text Available OBJETIVOS: Avaliar a qualidade microbiológica e a temperatura de dietas enterais antes e após a implementação do sistema Análise de Perigos e Pontos Críticos de Controle na Central de Produção de Alimentação Enteral do Hospital de Clínicas de Porto Alegre. MÉTODOS: Durante o período de setembro de 2001 a janeiro de 2002, foram coletadas 320 amostras de 4 tipos de dietas enterais produzidas na Central de Produção de Alimentação Enteral (dietas padrão I, II, III e dieta especial, as quais foram submetidas a análises microbiológicas e de temperatura. As amostras foram coletadas semanalmente em dois pontos do processo: logo após o preparo e após 16 horas de armazenamento refrigerado. Para comparação dos dados pré e pós análise dos perigos em pontos criticos e de controle, utilizou-se o teste "t" de Wilcoxon para amostras pareadas (teste não-paramétrico equivalente ao teste "t" de Student para amostras pareadas com nível de significância de 0,05. RESULTADOS: Antes da análise de perigos e pontos críticos de controle, 92% das temperaturas de armazenamento estavam acima dos valores de refererência vigentes. Após a implantação da análise de perigos e pontos críticos de controle, houve reduções significantes (pOBJECTIVE: This study evaluated microbiological quality and temperature of enteral formulas before and after the implementation of the Hazard Analysis Critical Control Points system at the Central of Enteral Feedings of Hospital de Clínicas de Porto Alegre. METHODS: During the period of September 2001 and January 2002, 320 samples of four kinds of enteral feeding identified as diets I, II, III, and Special diet were collected and submitted to temperature and microbiological analysis. Samples were collected weekly in two steps of the flow chart of production: immediately after preparation and after 16 hours of storage at refrigeration. For statistical analysis, the Wilcoxon's test was used. RESULTS: Before

  16. Comparative assessment of the food purchase program and the national school feeding program's impact in Ubá, Minas Gerais, Brazil

    Directory of Open Access Journals (Sweden)

    Leandro Gomes de Oliveira

    Full Text Available ABSTRACT: The Food Purchase Program (PAA and the National School Feeding Program (PNAE are the main trading programs of Brazil that promote a connection between the family farm and institutional markets. The case study portrayed in this article aimed to evaluate and compare the socioeconomic impacts generated by the PAA and PNAE among Ubá's family farmers in Minas Gerais. To do this, two tipes of questionnaires were applied to managers and farmers who participate in the programs and obtained data were analyzed by descriptive statistic methods and non-parametric tests (Mann-Whitney. Results showed that the two policies present positive socioeconomic benefits to family farmers, although the PNAE's producers income be higher and the food prices traded in PAA are superior. On the other side, having participated in the PAA and PNAE does not provide extra income arising from entry into new markets, which in theory could be the result of improving the quality of production,and does not promote the reduction in the use of fertilizers and pesticides.

  17. Evaluation of the impact of a nutritional program for undernourished children in Brazil

    NARCIS (Netherlands)

    Santos, Iná S; Gigante, Denise P; Coitinho, Denise C; Haisma, Hinke; Valle, Neiva C J; Valente, Gicele

    2005-01-01

    To assess the effectiveness on child growth and body composition of a supplementary feeding program (Milk Supplement Program), a prospective, controlled study was conducted in Northeast Brazil. When entering the Program, children from 10 municipalities with the highest coverage rates in the Program

  18. Outbreak of mass sociogenic illness in a school feeding program in northwest Bangladesh, 2010.

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    Farhana Haque

    Full Text Available BACKGROUND: In 2010, an acute illness outbreak was reported in school students eating high-energy biscuits supplied by the school feeding programme in northwest Bangladesh. We investigated this outbreak to describe the illness in terms of person, place and time, develop the timeline of events, and determine the cause and community perceptions regarding the outbreak. METHODS: We defined case-patients as students from affected schools reporting any two symptoms including abdominal pain, heartburn, bitter taste, and headache after eating biscuits on the day of illness. We conducted in-depth interviews and group discussions with students, teachers, parents and community members to explore symptoms, exposures, and community perceptions. We conducted a questionnaire survey among case-patients to determine the symptoms and ascertain food items eaten 12 hours before illness onset, and microbiological and environmental investigations. RESULTS: Among 142 students seeking hospital care, 44 students from four schools qualified as case-patients. Of these, we surveyed 30 who had a mean age of 9 years; 70% (21/30 were females. Predominant symptoms included abdominal pain (93%, heartburn (90%, and bitter taste (57%. All students recovered within a few hours. No pathogenic Vibrio cholerae, Shigella or Salmonella spp. were isolated from collected stool samples. We found no rancid biscuits in schools and storage sites. The female index case perceived the unusually darker packet label as a "devil's deed" that made the biscuits poisonous. Many students, parents and community members reported concerns about rumors of students dying from biscuit poisoning. CONCLUSIONS: Rapid onset, followed by rapid recovery of symptoms; female preponderance; inconsistent physical, microbiological and environmental findings suggested mass sociogenic illness rather than a foodborne or toxic cause. Rumours of student deaths heightening community anxiety apparently propagated this

  19. Low Emission Feed

    NARCIS (Netherlands)

    Klop, G.

    2016-01-01

    Research into manipulating methane (CH4) production as a result of enteric fermentation in ruminants currently receives global interest. Using feed additives may be a feasible strategy to mitigate CH4 as they are supplied in such amounts that the basal diet composition will not be largely affected.

  20. Low Emission Feed

    NARCIS (Netherlands)

    Klop, G.

    2016-01-01

    Research into manipulating methane (CH4) production as a result of enteric fermentation in ruminants currently receives global interest. Using feed additives may be a feasible strategy to mitigate CH4 as they are supplied in such amounts that the basal diet composition will not be largely

  1. Feeding Your Baby

    Medline Plus

    Full Text Available ... your baby Feeding your baby E-mail to a friend Please fill in all fields. Please enter a valid e-mail address. Your information: Your recipient's ... Sign up to save this page. Saving Just a moment, please. You've saved this page It's ...

  2. Enteral nutrition in person with Dementia: Indication, effects and benefits

    Directory of Open Access Journals (Sweden)

    Daniela Alves

    2016-04-01

    Full Text Available Objective: This systematic literature review aims to clarify indications for the use of enteral feeding in patients with dementia. Difficulties in feeding patients with dementia may arise at any stage of the disease and may include malnutrition, weight loss, decreased quality of life, among others. Enteral tube feeding by tube may be a way of mitigating the effects, but its benefits are under discussion. Methods: Eight qualitative studies were included: 5 primary sources, 3 systematic literature reviews, published in the 2008-2013 period. Results: Enteral tube feeding in patients with dementia may affect survival/mortality rate (no evidence of benefit, nutritional status (no improvement, functional status and cognitive development (no improvement, aspiration (does not reduce the risk of aspiration, pressure ulcers (no evidence of benefit in ulcers incidence and progression, and quality of life (without hard data in most studies. Conclusion: Evidence on benefits of enteral tube feeding in patients with dementia was not conclusive and may even have the opposite effect. We lack data on the adverse effects of these interventions. Keywords: Palliative care; Dementia; Enteral feeding; Therapeutic use.

  3. Compensatory Feeding Following a Predator Removal Program : Detection and Mechanisms, 1982-1996 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, James H.

    2002-02-28

    Predator removal is one of the oldest management tools in existence, with evidence that ancient Greeks used a bounty reward for wolves over 3,000 years ago (Anonymous 1964). Efforts to control predators on fish have been documented in scientific journals for at least 60 years (Eschmeyer 1937; Lagler 1939; Foerster and Ricker 1941; Smith and Swingle 1941; Jeppson and Platts 1959), and has likely been attempted for much longer. Complete eradication of a target species from a body of water has rarely been the objective of predator removal programs, which instead have attempted to eliminate predators from specific areas, to reduce the density or standing stock of predators, or to kill the largest individuals in the population (Meronek et al. 1996). In evaluating management programs that remove only part of a predator population, the compensatory response(s) of the remaining predators must be considered. Some potential compensatory responses by remaining individuals include increased reproductive output, increased growth rate, or increased consumption of certain prey species (Jude et al. 1987). If compensation by predators that remain in the system following a removal effort occurs, it may reduce the effectiveness of the predator control program. Northern pike-minnow Ptychocheilus oregonensis (formerly called northern squawfish) consume juvenile salmon in rivers, lakes, and reservoirs in British Columbia, Washington, Idaho, Oregon, and California. Northern pikeminnow have been estimated to consume about 11% of all juvenile salmon that migrate through John Day Reservoir on the Columbia River (Rieman et al. 1991). Modeling studies suggested that removal of 20% of the northern pikeminnow population in John Day Reservoir would result in a 50% decrease in predation-related mortality of juvenile salmon migrating through this reach (Beamesderfer et al. 1991). Since the early 1940's, other programs have been implemented to remove northern pikeminnow, with hopes of

  4. Comparative efficacy of a phytogenic feed additive and an antibiotic growth promoter on production performance, caecal microbial population and humoral immune response of broiler chickens inoculated with enteric pathogens

    Directory of Open Access Journals (Sweden)

    Toshi Wati

    2015-09-01

    Full Text Available The aim of this work was to compare the efficacy of a commercially available phytogenic feed additive (PFA and an antibiotic growth promoter, which was bacitracin methylene disalicylate (BMD, on performance, nutrient retention, caecal colonization of bacteria and humoral immune responses against Newcastle disease in broiler chickens challenged orally with Salmonella enteritidis and Escherichia coli. One-day-old male Cobb 400 broiler chicks (n = 120 were fed with 1 a negative control (NC diet, which is the basal diet without any added growth promoter, 2 a positive control (PC diet, the basal diet supplemented with BMD, 500 mg/kg and 3 a diet supplemented with PFA (150 mg/kg for 39 days and the birds were inoculated with S. enteritidis and E. coli on d 28. Supplementation of PFA improved body weight, feed conversion ratio, retention of N and crude fiber, increased fecal moisture content and decreased digesta transit time as compared with the NC and PC groups (P < 0.01. Both the PC and the PFA was found to be equally effective in controlling the surge in numbers of Salmonella and E. coli following oral inoculation of these bacteria as compared with the NC group (P < 0.05 at 24 h past inoculation. Caecal content analysis on d 39 indicated lower numbers of Salmonella, E. coli and Clostridium in the PC and PFA groups as compared with the NC group (P < 0.05. The number of Lactobacillus in the PFA group was higher than those in the NC and PC groups (P < 0.05. Humoral immune response, measured as hemagglutination inhibition titer against Newcastle disease, was better in the PC and PFA groups compared with the NC group (P < 0.05 at d 21 but the difference did not last till d 39. The heterophil to lymphocyte ratio was narrower (P < 0.001 and alkaline phosphatase activity was higher (P < 0.01 in the PFA group as compared with the NC and PC groups on d 39. It was concluded that the PFA, which is animal, environment and consumer friendly, may be used as an

  5. Inpatient tube weaning in children with long-term feeding tube dependency: A retrospective analysis.

    Science.gov (United States)

    Trabi, Thomas; Dunitz-Scheer, Marguerite; Kratky, Elisabeth; Beckenbach, Hannes; Scheer, Peter J

    2010-11-01

    This study investigates the outcome of an intervention program to establish oral feeding after prolonged tube feeding in children. The intervention is based on supervised reduction of enteral formula within a few days supported by a 3-week program of speech therapy, occupational therapy, psychoanalytically based eating therapy, physical therapy, psychodynamic coaching, and nutritional counseling of the infant and his or her parents. Two hundred twenty-one cases were included in this study. All patients had been severely ill or were handicapped and had been exclusively fed by tube for most of their lives. The major outcome variable was complete discontinuation of tube feeding with sufficient oral feeding after treatment, defined as the child's ability to sustain stable body weight by self-motivated oral feeding. Two hundred three patients (92%) were completely fed orally after treatment. Tube feeding was discontinued completely within 8 days in mean, and mean in-patient treatment time was 21.6 days. The current method can be used by a trained and experienced team to wean tube-dependent children from prolonged tube feeding. Tube weaning should be addressed from the beginning of tube feeding in all children who are expected to restore oral feeding after the phase of nutritional stabilization. Since successful programs are rare, we were motivated to present our results of this elaborate program in this article. Copyright © 2010 Michigan Association for Infant Mental Health.

  6. [Bases for formulating a program to promote breast-feeding: methodological aspects].

    Science.gov (United States)

    Avila-rosas, H; Toussaint, G; Dehesa-sierra, S; Cabrera-olivo, P; Flores-viladroza, L; Brito-duran, E

    1988-01-01

    Based on the relevance of breastfeeding for maternal-infant health, it is necessary that the prospective and longitudinal studies carried out in Mexico be analyzed as a whole in order to create an analytic model and to develop an institutional intervention program concerning the mother's risk of not starting or of abandoning lactation. To create this program all the factors which can be modified must be taken into account in order to make sure the mother has the elements to make a decision. The National Institute of Perinatology has developed a research program about lactation that consists of 3 studies that have been carried out since 1983. The general aim of these studies is to understand the breastfeeding phenomenon in an integral way considering the role of the institution as an educational instrument and a means of providing health support. These studies were based on different perspectives, approaches and times but had similar objectives. For this reason it is desirable to analyze them as a whole in order to obtain new considerations and temporal projections. In order to integrate the 3 studies a database will be created and then an analytical model (from a multivariate analysis) will be generated from the 1st study (by temporal order) which will be tested in the 2nd study making the pertinent modifications and finally it will be applied in the 3rd study. At the same time it will be necessary to group the variables into 2 classification systems: The first according to the temporal proximity with regard to lactation and the second according to the organization level to which they belong.

  7. Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results From the MAL-ED Birth Cohort.

    Science.gov (United States)

    Mushaphi, Lindelani Fhumudzani; Mahopo, Tjale Cloupas; Nesamvuni, Cebisa Noxolo; Baloyi, Brenda; Mashau, Ellen; Richardson, Jeniata; Dillingham, Rebecca; Guerrant, Richard; Ambikapathi, Ramya; Bessong, Pascal

    2017-09-01

    There is strong evidence that exclusive breastfeeding (EBF) in the first 6 months of life reduces the risk of diseases in infancy and in later life. To understand the maternal reasoning that influences optimum infant feeding practices of caregivers in semirural communities of Limpopo province. Nested qualitative study among mothers in an ongoing birth cohort study was conducted; structured and semi-structured interviews were used to collect data. Data from 234 infants after 6 months of follow-up was included for quantitative analysis. Four focus discussion groups comprising 7 to 10 caregivers were used to obtain perception of mothers on breastfeeding. A semi-structured interview guide was used to stimulate discussions. Thematic content analyses were conducted to identify the main themes that influence breastfeeding practices of caregivers. Over 90% of the caregivers initiated breastfeeding after delivery. However, less than 1% of mothers practiced EBF by 3 months, and none of the children were exclusively breastfed for up to 6 months. All caregivers introduced non-breast milk liquids and solids by the second month of child's life. Common reasons for introducing non-breast milk foods included insufficiency of breast milk production, going back to work or school, and influence by elderly women (mothers/mothers-in-law) and church members. Exclusive breastfeeding was not practiced in this community due to cultural and religious beliefs and misinformation. The involvement of elderly women and church members in infant feeding education and promotion programs and the dissemination of breastfeeding information through mobile phones to younger mothers are recommended.

  8. A Retrospective Chart Review of Dietary Diversity and Feeding Behavior of Children with Autism Spectrum Disorder before and after Admission to a Day-Treatment Program

    Science.gov (United States)

    Sharp, William G.; Jaquess, David L.; Morton, Jane F.; Miles, Aida G.

    2011-01-01

    The nutritional status and mealtime performance among a group of children with autism spectrum disorders (ASD) were examined before and after admission to an intensive feeding day-treatment program. Treatment involved escape extinction, reinforcement, and stimulus fading procedures. Outcomes focused on dietary diversity and mealtime performance,…

  9. Evaluation of two feeding programs on productive traits and foot injuries in commercial turkeys

    Directory of Open Access Journals (Sweden)

    Ronald Santos-Ricalde

    2017-01-01

    Full Text Available Introducción : Varios factores afectan la ganacia de peso y el rendimiento de canal en las aves. Entre estos, los programas de alimentación, el se xo y las enfermedades son los má s relevamtes. El objetivo de este trabajo fue evaluar el efecto de dos programas de alimentación, uno alto en proteína (AP y otro bajo en proteína (BP, en pavos de ambos sexos, sobre el peso vivo, rendimiento en canal y lesiones en patas. Méto do : El program a de alimentacion alto en proteí na (AP consistio en diet as con mayor contenido de proteí na que las utilizadas en el programa de alime n ta ció n bajo en proteína (BP, sin embargo, el nivel de energía metabolizable en las dietas fue simil ar en a mbos programas. Se evaluó la gancia diaria de peso, rendimiento de canal y lesiones en patas. Se utilizó un diseño completamente al azar con arreglo factorial con 128 repeticiones por tratamiento. El analisis estadístico incluyó los efe ctos del programa de alimentación, sexo y la interacció n. Resultados : Los pavos del programa AP fueron más pesados (P1.5 cm de diá metro fueron más frecuentes (P<0.06 en los pavos alimentados con el programa AP (28.3% vs . BP (18.1% y en los machos (31.9% vs . hembras (14.9%; P<0.05. Adicional mente, conforme los pavos incrementaron de edad las lesiones grado 2 en patas fueron más frecuentes (34.9, 37.8 y 60.2% a las 15, 19 y 23 semanas de edad, respectivamente. Conclusión : Los resultados indican que los pavos criados con un programa AP fueron más pesados, mientras que los pavos machos fueron más pesados y rindieron más en canal que las hembras. La frecuencia y severidad de las lesiones en las patas de las aves fueron mayores en los pavos machos y de mayor edad.

  10. Evaluation of feeding various sources of distillers dried grains with solubles in non-feed-withdrawal molt programs for laying hens.

    Science.gov (United States)

    Bland, Kelly; Utterback, Pam; Koelkebeck, Ken; Parsons, Carl

    2014-06-01

    An experiment was conducted using 588 Hy-Line W-36 hens (68 wk of age) to evaluate if laying hens can be successfully molted by ad libitum feeding various levels of 3 sources of distillers dried grains with solubles (DDGS). Treatment 1 consisted of a 47% corn (C):47% soy hulls (SH) molt diet (C:SH) fed for 28 d (positive control). Treatments 2, 3, and 4 were molt diets containing 94% DDGS from the 3 sources fed for 28 d. Treatments 5, 6, and 7 were 32% C: 42% SH: 20% DDGS, from each of the 3 DDGS sources, also fed for 28 d. At the end of the 28-d molt period, all hens were fed a 16% CP corn-soybean meal layer diet. Body weight loss during the molt period was significantly greater (P hens fed the C:SH diet (26%) than hens fed the diets containing DDGS, and the reduction in BW loss varied among DDGS sources. Feed intake was lower (P Hens fed the C:SH diet had egg production near 0% during the last 3 wk of the molt period. Hens on the other treatments did not have mean egg production below 17% during the molt period (wk 1 to 4), and the reduction in egg production varied among DDGS sources. Postmolt hen-day egg production (5-41 wk) did not significantly differ among treatments; however, egg mass and egg specific gravity were generally reduced (P hens fed the 94% DDGS molt diets compared with hens fed the C:SH diet. This study showed that molt and postmolt performance responses varied among DDGS sources; however, none of the molt diets containing 20 to 94% DDGS yielded molt period reductions in BW or egg production similar to a 47% C: 47% SH diet. Poultry Science Association Inc.

  11. Evaluation of limit feeding varying levels of distillers dried grains with solubles in non-feed-withdrawal molt programs for laying hens.

    Science.gov (United States)

    Mejia, L; Meyer, E T; Studer, D L; Utterback, P L; Utterback, C W; Parsons, C M; Koelkebeck, K W

    2011-02-01

    An experiment was conducted with 672 Hy-Line W-36 Single Comb White Leghorn hens (69 wk of age) to evaluate the effects of feeding varying levels of corn distillers dried grains with solubles (DDGS) with corn, wheat middlings, and soybean hulls on long-term laying hen postmolt performance. The control molt treatment consisted of a 47% corn:47% soybean hulls (C:SH) diet fed ad libitum for 28 d. Hens fed the other 7 treatments were limit fed 65 g/hen per day for 16 d, and then fed 55 g/hen per day for 12 d. Hens on treatments 2 and 3 were fed 49% C:35% wheat middlings (WM) or SH:10% DDGS diets (C:WM:10DDGS, C:SH:10DDGS). Hens on treatments 4 and 5 were fed 49% C:25% WM or SH:20% DDGS diets (C:WM:20DDGS, C:SH:20DDGS). Those on treatments 6 and 7 were fed 47% C:47% DDGS (C:DDGS) or 47% WM:47% DDGS (WM:DDGS) diets. Those on treatment 8 were fed a 94% DDGS diet. At 28 d, all hens were fed a corn-soybean meal layer diet (16% CP) and production performance was measured for 36 wk. None of the hens fed the molt diets went completely out of production, and only the C:SH and C:SH:10DDGS molt diets decreased hen-day egg production to below 5% by wk 4 of the molt period. Postmolt egg production was lowest (P 0.05) in egg weights were detected among treatments throughout the postmolt period. In addition, no consistent differences were observed among treatments for egg mass throughout the postmolt period. Overall results of this study indicated that limit feeding diets containing DDGS at levels of 65 or 55 g/hen per day during the molt period did not cause hens to totally cease egg production.

  12. Clinical Trial to Comparison the Effect of Family- centered Educational-supportive Program on Mothers’ Empowerment in Breast-feeding

    Directory of Open Access Journals (Sweden)

    Zeinab Heidari

    2016-03-01

    Results: Thirty-five mothers were in the intervention group and 35 were in the control group. The mean of the total score of breast-feeding empowerment and its seven areas in the intervention group was significantly higher than that of the control group. Moreover, exclusive breast-feeding was also significantly higher in the intervention group (P

  13. Limiting bacterial contamination of enteral nutrient solutions: 6-year history with reduction of contamination at two institutions.

    Science.gov (United States)

    Fagerman, K E

    1992-02-01

    Running enteral nutrient solution (ENS) bacterial contamination logs that were collected over a 6-year time frame are presented. At hospital A, reconstituted ENS were prepared by the pharmacy department in bulk and were frozen in the final container. These solutions were cultured and counted after 12 hours of storage at room temperature to stimulate this institution's hang time. Major reductions in ENS bacterial counts occurred after improvements in sanitation, a reduction in solution hang time, the conversion to the use of sterile water for dilution and reconstitution of ENS, and most dramatically, after the incorporation of a preservative (potassium sorbate) to reconstituted ENS. At hospital B, ENS usage consisted of canned feedings that were prepared by nursing personnel and were transferred to the feeding container at the bedside. Reductions in final counts of contamination of ENS occurred after procedural changes, which included container changes every 24 hours, use of sterile water for dilution, cleansing of can lids with alcohol swabs before use, rinsing and air drying of intermittent feeding containers between feedings, and limiting feeding container fills to 4-hour hang time quantities. At both institutions, the value of an ongoing three-class enteral quality control program with a defined acceptance/rejection criteria was demonstrated in that ENS contamination was reduced to acceptable levels comparable with federal standards for milk and dairy products.

  14. [Microbiologic evaluation of enteral diets handled in a hospital].

    Science.gov (United States)

    Lima, Ana Raquel da Costa; Barros, Luciana Machado; Rosa, Monique Silveira; Cardonha, Angela Maria Soares; Dantas, Maria Amélia Marques

    2005-01-01

    To evaluate the microbiological quality of open enteral feeding system manipulated in a specialized hospital in oncology in the city of Natal-RN. 20 samples of industrialized enteral feeding in open system had been analyzed. The searched microrganisms had been: Bacillus cereus, total coliforms, Escherichia coli, Salmonella sp, Clostridium sulfite reducer, mesophilic aerobic bacteria and coagulase positive Staphylococci. The methodology used for accomplishment of the microbiological analyses was the praised one for the Food and Drug Administration--FDA. It was evidenced total coliforms, Escherichia coli and mesophilic aerobic bacteria contamination in 25%, 10% and 20% of the analyzed samples, respectively. It was not identified the presence of Bacillus cereus, Salmonella sp, Clostridium sulfite reducer, and coagulase positive Staphylococci in none of the analyzed samples. The gotten results show that the enteral feedings are in unsatisfactory hygienic-sanitary conditions, evidencing the necessity of a bigger control in the manipulation of the same ones.

  15. Chilean complementary feeding program reduces anemia and improves iron status in children aged 11 to 18 months.

    Science.gov (United States)

    Brito, Alex; Olivares, Manuel; Pizarro, Tito; Rodríguez, Lorena; Hertrampf, Eva

    2013-12-01

    Iron deficiency is the most prevalent nutritional deficiency in the world, primarily affecting infants, young children, and women of childbearing age. To evaluate the impact of the National Complementary Feeding Program (NCFP) on anemia and iron status in Chilean children aged 11 to 18 months. Two studies were performed. The first study was performed at one public outpatient health center in Santiago, using data collected in 1999 (n = 128) and 2000 (n = 125), before and after the national introduction of iron-fortified milk. Subsequently, a study of a representative sample (n = 320) from the two most populated areas of the country was performed in 2009. One year after fortification, the prevalence of anemia was 9%; significantly lower (p < .001) than the 27% prevalence observed 1 year before. Ten years after fortification, 14% of children were anemic and 77% of children with anemia (12% of all children) suffered from iron-deficiency anemia. In 2009, 11% of children consuming iron-fortified milk delivered by the NCFP (73%) were anemic, significantly lower (p = .028) than the 21% prevalence of anemia observed in children without consumption. Consumption of iron-fortified milk was positively associated with hemoglobin concentration (r = 0.28, p = .022) and was associated with a lower prevalence of anemia after adjusting for confounding factors (odds ratio, 0.50; 95% CI, 0.26 to 0.96). In Chile, the NCFP has had an impact on the reduction of anemia and improved the iron status of children aged 11 to 18 months. Increasing the consumption of this iron-fortified milk could enhance the impact of the NCFP.

  16. Continuous parenteral and enteral nutrition induces metabolic dysfunction in neonatal pigs

    DEFF Research Database (Denmark)

    Stoll, Barbara; Puiman, Patrycja Jolanta; Cui, Liwei

    2012-01-01

    We previously showed that parenteral nutrition (PN) compared with formula feeding results in hepatic insulin resistance and steatosis in neonatal pigs. The current aim was to test whether the route of feeding (intravenous [IV] vs enteral) rather than other feeding modalities (diet, pattern) had...

  17. Hypophosphatemia associated with enteral alimentation in cats.

    Science.gov (United States)

    Justin, R B; Hohenhaus, A E

    1995-01-01

    Hypophosphatemia is uncommon in cats, but it has been reported in association with diabetes mellitus and hepatic lipidosis, where it can cause hemolysis, rhabdomyopathy, depression, seizures, and coma. The purpose of this article is to describe 9 cats that developed low serum phosphorus concentrations (alimentation. Serum biochemical analyses from more than 6,000 cats were reviewed. The medical records of all cats with hypophosphatemia were examined for history of enteral alimentation; diabetic cats were excluded from the study. Nine cats, ranging in age from 3 to 17 years, were identified. All cats had normal serum phosphorus concentrations before tube feeding began. Onset of hypophosphatemia occurred 12 to 72 hours after initiation of enteral alimentation, and the nadir for phosphorus concentrations ranged from 0.4 to 2.4 mg/dL. Hemolysis occurred in 6 of the 9 cats. Hypophosphatemia secondary to enteral alimentation is an uncommon clinical finding in cats. Cats with high alanine aminotransferase activity, hyperbilirubinemia, and weight loss should be closely monitored for hypophosphatemia during the first 72 hours of enteral alimentation.

  18. Clinical trial on the effects of a free-access acidified milk replacer feeding program on the health and growth of dairy replacement heifers and veal calves.

    Science.gov (United States)

    Todd, C G; Leslie, K E; Millman, S T; Bielmann, V; Anderson, N G; Sargeant, J M; DeVries, T J

    2017-01-01

    The objectives of this study were to evaluate the effects of free-access acidified milk replacer feeding on the pre- and postweaning health of dairy and veal calves. Individually housed calves were systematically assigned at birth to 1 of 2 feeding programs: free-access feeding (ad libitum) of acidified milk replacer (ACD, n=249) or traditional restricted feeding (3L fed twice daily) of milk replacer (RES, n=249). Calves were fed milk replacer containing 24% crude protein and 18% fat. Acidified milk replacer was prepared to a target pH between 4.0 and 4.5 using formic acid. Calves were weaned off milk replacer at approximately 6wk of age. Weaning occurred over 5d, and during this weaning period, ACD calves had access to milk replacer for 12h/d and RES calves were offered only one feeding of milk replacer (3 L) daily. Calves were monitored daily for signs of disease. Fecal consistency scores were assigned each week from birth until weaning. A subset of calves was systematically selected for fecal sampling at 3 time points between 7 and 27d of age. Fecal samples were analyzed for enterotoxigenic Escherichia coli F5, Cryptosporidium parvum, rotavirus, and coronavirus. Hip width, hip height, body length, heart girth, and body weight were measured at birth and weaning. Postweaning body weight measurements were collected from the heifers at approximately 8mo of age. Postweaning body weight and carcass grading information was collected from the veal calves at slaughter once a live weight between 300 and 350kg had been achieved. The odds of ACD calves being treated for a preweaning disease event tended to be lower than that of the RES calves (1.2 vs. 5.2%, respectively). Preweaning mortality, postweaning disease treatment, and postweaning mortality did not differ between feeding treatments. The ACD feeding treatment supported greater preweaning average daily gain (0.59 vs. 0.43kg/d) and structural growth than RES feeding. Postweaning average daily gain and carcass

  19. Enteric methane emissions from German pigs

    DEFF Research Database (Denmark)

    Dämmgen, Ulrich; Schulz, Joachim; Klausing, Heinrich Kleine

    2012-01-01

    Methane emissions from enteric fermentation of pigs are object of emission reporting. Hitherto they were treated as part of the energy balance of pigs, in accordance with IPCC guidance documents. They were calculated from the gross energy intake rate and a constant methane conversion ratio....... Meanwhile numerous experimental data on methane emissions from enteric fermentation is available in Germany and abroad; the results are compiled in this work. These results also allow for a description of transformation processes in the hind gut and a subsequent establishment of models that relate emissions...... to feed and performance data. The model by Kirchgeßner et al. (1995) is based on German experimental data and reflects typical national diet compositions. It is used to quantify typical emissions and methane conversion ratios. The results agree with other experimental findings at home and abroad...

  20. Self-insertion of a nasogastric tube for home enteral nutrition: a pilot study.

    Science.gov (United States)

    Quilliot, Didier; Zallot, Camille; Malgras, Aurélie; Germain, Adeline; Bresler, Laurent; Ayav, Ahmet; Bigard, Marc-André; Peyrin-Biroulet, Laurent; Ziegler, Olivier

    2014-09-01

    Enteral tube feeding can be a source of discomfort and reluctance from patients. We evaluated for the first time the tolerability of self-insertion of a nasogastric (NG) tube for home enteral nutrition (EN). All patients requiring enteral tube feeding for chronic diseases were enrolled in a therapeutic patient education (TPE) program at Nancy University Hospital. In our department, between November 2008 and August 2012, 66 patients received EN with an NG tube. Twenty-nine of 66 had self-insertion of the NG tube (median age, 44 years), 17 had an anatomical contraindication, and 20 were excluded because of cognitive disability or language barrier or refusal. Twenty-eight of 29 patients completed the TPE program. One patient died of pancreatic cancer in palliative care during the study. Median follow-up was 20 months (interquartile range [IQR], 4-31). Median gain weight was 3.1 kg (IQR, 1.8-6.0) (P = .0002). Median duration of self-insertion of the NG tube was 3 months (IQR, 2-5), and it was well tolerated by all 29 patients. Two patients described minor adverse events: abdominal pain and nausea for 1 patient and epistaxis leading to temporary discontinuation of EN for another patient. A group of 10 consecutive patients previously had a long-term NG tube for EN. If they had the choice between a self-inserted NG tube and a long-term NG tube, all 10 patients reported they would prefer to start again with the self-inserted NG tube. This pilot study suggests that self-insertion of an NG tube may be efficacious and well tolerated in patients receiving EN for chronic conditions. © 2013 American Society for Parenteral and Enteral Nutrition.

  1. Enteral nutrition - child - managing problems

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000164.htm Enteral nutrition - child - managing problems To use the sharing features ... trouble breathing, call 911. References Mcclave SA. Enteral nutrition. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

  2. Evaluation of an intensive desensitisation, oral tolerance therapy and hunger provocation program for children who have had prolonged periods of tube feeds.

    Science.gov (United States)

    Harding, Celia; Faiman, Abi; Wright, Julie

    2010-12-01

    Some children with feeding difficulties may require nasogastric tube feeding or insertion of a percutaneous endoscopic gastrostomy (PEG) from a young age. A small cohort of these children can develop severe oral aversions that can delay the re-introduction of oral feeding. Multidisciplinary approaches that provide an intensive approach are deemed the most effective method of intervention to reduce nasogastric and PEG dependency. Two children and their parents received an intensive approach to reduce PEG feeds (Child A and Child B), while one child and her parents elected to receive a traditional feeding clinic approach (Child C). The mean age of the participants was 4 years 4 months. Child A initially took 2090 kJ (44% daily nutritional requirement) via her PEG before the intensive program, and Child B took 100% daily nutritional requirement via his PEG. Three months post the intervention, Child A took 100% of her nutritional requirements orally and Child B had reduced PEG requirement significantly to 38% of daily nutritional requirement. Child C showed no changes in PEG versus oral intake. Children who received the intervention were able to remain focused on mealtimes for longer, with fewer instances of leaving the table. Parents altered their language styles post coaching on the intensive intervention using fewer reprimands. No changes with these behaviours were noted with Child C. Although this was a small pilot study, there are some strategies used within an intensive multidisciplinary context that can enable children to reduce their reliance on PEG feeds significantly. © 2010 The Authors. International Journal of Evidence-Based Healthcare © 2010 The Joanna Briggs Institute.

  3. Transgastrostomy jejunal intubation for enteric alimentation.

    Science.gov (United States)

    McLean, G K; Rombeau, J L; Caldwell, M D; Ring, E J; Freiman, D B

    1982-12-01

    Malnourished patients who cannot maintain an adequate oral intake but have normal intestinal absorption and motility are candidates for enteric alimentation. When impaired gastric peristalsis or an increased risk for aspiration makes gastrostomy feeding unsafe, direct jejunal infusion is the preferred route of alimentation. Angiographic techniques were used to convert previously placed, simple gastrostomies to combined gastrostomy-jejunostomies in 14 patients. In 17 additional patients, a combined gastrostomy-jejunal tube was placed under local anesthesia; angiographic techniques assisted in the placement of 11 of these tubes.

  4. Enteric methane emissions from German dairy cows

    DEFF Research Database (Denmark)

    Dammgen, U; Rosemann, C; Haenel, H D

    2012-01-01

    Up to now, the German agricultural emission inventory used a model for the assessment of methane emissions from enteric fermentation that combined an estimate of the energy and feed requirements as a function of performance parameters and diet composition, with the constant methane conversion rate......, as stated by IPCC. A methane emission model was selected here that is based on German feed data. It was combined with the hitherto applied model describing energy requirements. The emission rates thus calculated deviate from those previously obtained. In the new model, the methane conversion rate is back......-calculated from emission rates and gross energy intake rates. For German conditions of animal performance and diet composition, the national means of methane conversion rates range between 71 kJ MJ(-1) and 61 kJ MJ(-1) for low and high performances (4700 kg animal(-1) a(-1) in 1990 to 7200 kg animal(-1) a(-1...

  5. Entering The Newsroom

    DEFF Research Database (Denmark)

    Peters, Chris

    2017-01-01

    discourses surrounding this fictional program reveals much about the actual news industry itself, its societal value, public reputation and media literacy in general. By utilising an approach to storytelling that sets a fictional program in the world of recent non-fictional events, the semi...

  6. Residual feed intake and breeding approaches for enteric methane mitigation

    NARCIS (Netherlands)

    Berry, D.P.; Lassen, J.; Haas, de Y.

    2015-01-01

    The expanding world human population will require greater food production within the constraints of increasing societal pressure to minimize the resulting impact on the environment. Breeding goals in the past have achieved substantial gains in environmental load per unit product produced, despite no

  7. issues related to methane emission from enteric fermentation ...

    African Journals Online (AJOL)

    JACQUES

    2016-03-23

    Mar 23, 2016 ... Enteric methane production lowers the efficiency of feed utilization in ruminants and contributes to greenhouse gas emissions which are responsible for global climate change. This study examined the effects of nine essential oils (EO) from Citrus aurantifolia, Cymbopogon citratus, Eucalyptus citriodora,.

  8. Influence of enteric bacteria and parasite infection and nutritional ...

    African Journals Online (AJOL)

    Influence of enteric bacteria and parasite infection and nutritional status on diarrhoea occurrence in six to 60 month old children admitted at Morogoro ... Other factors found to significantly (p<0.05) influence diarrhoea occurrence included age when breastfeeding stopped, food(s) given, feeding utensils and the child´s toilet.

  9. Waste feed delivery test and evaluation plan

    International Nuclear Information System (INIS)

    O'TOOLE, S.M.

    1999-01-01

    This plan documents the Waste Feed Delivery Program test and evaluation planning and implementation approach. The purpose of this document is to define and communicate the Waste Feed Delivery Program Test and Evaluation scope, objectives, planning and implementation approach

  10. Waste feed delivery test and evaluation plan

    Energy Technology Data Exchange (ETDEWEB)

    O' TOOLE, S.M.

    1999-09-30

    This plan documents the Waste Feed Delivery Program test and evaluation planning and implementation approach. The purpose of this document is to define and communicate the Waste Feed Delivery Program Test and Evaluation scope, objectives, planning and implementation approach.

  11. The Use of Enteral Nutrition in the Management of Stroke

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2016-12-01

    Full Text Available This article discusses the use of enteral nutrition in the management of stroke. Stroke is a major source of disability, including dysphagia. The clinical manifestation of swallowing difficulties in stroke patients may lead to malnutrition which has implications for health status and clinical outcomes including morbidity, mortality and cost to the health service. The prevalence of malnutrition following an acute stroke could range from 8% to 34%. Therefore, the need to develop and implement the use of enteral nutrition support in stroke patients becomes pertinent. A range of enteral feeding tubes and feeding methods may be used to support stroke patients who are unable to meet their nutritional requirements through oral intake alone, although each of these approaches has its merits and limitations. Based on this review, there is evidence that enteral nutrition support is a useful method of providing nutrition for patients with dysphagia following a stroke in order to enhance their nutritional status and promote their health. However, there are challenges in the use of enteral tube feeding in these patients.

  12. Early life nutritional programming of long-term weight gain and feed intake in the porcine model

    NARCIS (Netherlands)

    Clouard, C.M.; Gerrits, W.J.J.; Kemp, B.; Val-Laillet, David; Bolhuis, J.E.

    2016-01-01

    We studied the effect of a prenatal and/or postnatal Western-like diet high in fat, refined sugar, and cholesterol on long-term feed intake and growth of piglets. Thirty-two sows and their offspring were allocated to 1 of 4 dietary treatments in a 2×2 factorial design, with 8-week prenatal and

  13. Identifying cost-minimizing strategies for guaranteeing target dairy income over feed cost via use of the Livestock Gross Margin dairy insurance program.

    Science.gov (United States)

    Valvekar, M; Cabrera, V E; Gould, B W

    2010-07-01

    Milk and feed price volatility are the major source of dairy farm risk. Since August 2008 a new federally reinsured insurance program has been available to many US dairy farmers to help minimize the negative effects of adverse price movements. This insurance program is referred to as Livestock Gross Margin Insurance for Dairy Cattle. Given the flexibility in contract design, the dairy farmer has to make 3 critical decisions when purchasing this insurance: 1) the percentage of monthly milk production to be covered, 3) declared feed equivalents used to produce this milk, and 3) the level of gross margin not covered by insurance (i.e., deductible). The objective of this analysis was to provide an optimal strategy of how a dairy farmer could incorporate this insurance program to help manage the variability in net farm income. In this analysis we assumed that a risk-neutral dairy farmer wants to design an insurance contract such that a target guaranteed income over feed cost is obtained at least cost. We undertook this analysis for a representative Wisconsin dairy farm (herd size: 120 cows) producing 8,873 kg (19,545 lb) of milk/cow per year. Wisconsin statistical data indicates that dairy farms of similar size must require an income over feed cost of at least $110/Mg ($5/cwt) of milk to be profitable during the coverage period. Therefore, using data for the July 2009 insurance contract to insure $110/Mg of milk, the least cost contract was found to have a premium of $1.22/Mg ($0.055/cwt) of milk produced insuring approximately 52% of the production with variable monthly production covered during the period of September 2009 to June 2010. This premium represented 1.10% of the desired IOFC. We compared the above optimal strategy with an alternative nonoptimal strategy, defined as a contract insuring the same proportion of milk as the optimal (52%) but with a constant amount insured across all contract months. The premium was found to be almost twice the level obtained

  14. ENTERIC NERVOUS SYSTEM: A REVIEW

    OpenAIRE

    Kurt, Cansu; Göy, Defne Flora; Özden, Gülşah; Barutçu, Öykü; Bozer, Cüneyt

    2015-01-01

    Enteric nervous system directs and regulates the breakdown, absorption and elimination of food in our digestive system. However, alongside its digestive functions, enteric nervous system has also gained importance because of the discovery of its bidirectional link with intestinal flora, which has recently started to be considered as a separate organ in addiction to its digestive functions. Enteric nervous system contains approximately 100 million nerve cells, operates both independently and i...

  15. Selection of Feed Intake or Feed Efficiency

    DEFF Research Database (Denmark)

    Veerkamp, Roel F; Pryce, Jennie E; Spurlock, Diane

    2013-01-01

    The widespread use of genomic information in dairy cattle breeding programs has opend up the possibility to select for novel traits, especially for traits that are traditionally difficult to record in a progeny testing scheme. Feed intake and efficiency is such a difficult to measure trait...

  16. Postoperative Feeding Difficulties after Repair of Congenital ...

    African Journals Online (AJOL)

    Of these, 24 (37.5%) developed feeding difficulties in the immediate post operative period. The causes of the feeding difficulties were Gastro-oesophageal reflux (GOR) 9, Recurrent diaphragmatic hernia 8, Adhesive intestinal obstruction 4, Poor intestinal motility 2, Campylobacter enteritis, 1, Hypertrophic pyloric stenosis, 1.

  17. SCIENTIFIC BASIS OF ADDITIONAL FOOD INTRODUCTION, STATED IN THE NATIONAL PROGRAM OF THE INFANTS FEEDING OPTIMIZATION IN THE RUSSIAN FEDERATION. PART II

    Directory of Open Access Journals (Sweden)

    V. A. Skvortsova

    2012-01-01

    Full Text Available The article contains the results of the study of clinical and biochemical blood markers of iron metabolism in infants. This study represents a part of the research, aimed to scientific confirmation of the statements associated with additional food introduction and stated in the «National program of the infants feeding optimization in the Russian Federation». In controlled conditions the children were divided into 2 main groups: feeding with breast milk and with artificial milk formulas. Each group was divided into sub-groups according to the age of the additional food introduction: 4, 5 or 6 months. The received data suggest that the iron content was appropriate in both groups at the age of 4 months before the additional food introduction; there was a gradual decrease of several values after that, especially marked in children feeding with breast milk and later introduction of additional food. The comparative analysis showed that at the age of 9 months the lowest values were in breast-fed children with additional food introduction at the age of 6 months. This can be associated not only with late additional food introduction, but also with difficulties occurring when beginning it at this age and leading to insufficient supply with certain nutrients, including iron. The detailed analysis of diets for children of different sub-groups will be discussed in the next article.

  18. The potential effectiveness of the nutrition improvement program on infant and young child feeding and nutritional status in the Northwest and Southwest regions of Cameroon, Central Africa.

    Science.gov (United States)

    Reinsma, Kate; Nkuoh, Godlove; Nshom, Emmanuel

    2016-11-15

    Despite the recent international focus on maternal and child nutrition, little attention is paid to nutrition capacity development. Although infant feeding counselling by health workers increases caregivers' knowledge, and improves breastfeeding, complementary feeding, and children's linear growth, most of the counselling in sub-Saharan Africa is primarily conducted by nurses or volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. The Cameroon Baptist Convention Health Services Nutrition Improvement Program (NIP) has integrated a cadre of nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices (IYCF). The study objective was to evaluate the effects of NIP's infant feeding counselors on exclusive breastfeeding (EBF), complementary feeding (CF), and children's linear growth. A cross-sectional evaluation design was used. Using systematic random sampling, caregivers were recruited from NIP sites (n = 359) and non-NIP sites (n = 415) from Infant Welfare Clinics (IWCs) in the Northwest (NWR) and Southwest Regions (SWR) of Cameroon between October 2014 and April 2015. Differences in EBF and CF practices and children's linear growth between NIP and non-NIP sites were determined using chi-square and multiple logistic regression. After adjusting for differences in religion, occupation, and number of months planning to breastfeed, children were almost seven times (Odds Ratio [OR]: 6.9; 95% Confidence Interval [CI]: 2.30, 21.09; β = 1.94) more likely to be exclusively breastfed at NIP sites compared to non-NIP sites. After adjusting for differences in occupation, religion, number of months planning to breastfeed, rural environment, economic status, attending other Infant Welfare Clinics, and non-biological caregiver, children were five times more likely to be stunted at

  19. The potential effectiveness of the nutrition improvement program on infant and young child feeding and nutritional status in the Northwest and Southwest regions of Cameroon, Central Africa

    Directory of Open Access Journals (Sweden)

    Kate Reinsma

    2016-11-01

    Full Text Available Abstract Background Despite the recent international focus on maternal and child nutrition, little attention is paid to nutrition capacity development. Although infant feeding counselling by health workers increases caregivers’ knowledge, and improves breastfeeding, complementary feeding, and children’s linear growth, most of the counselling in sub-Saharan Africa is primarily conducted by nurses or volunteers, and little is done to develop capacity for nutrition at the professional, organizational, or systemic levels. The Cameroon Baptist Convention Health Services Nutrition Improvement Program (NIP has integrated a cadre of nutrition counselors into prevention of mother-to-child transmission of HIV programs, infant welfare clinics, and antenatal clinics to improve infant and young child feeding practices (IYCF. The study objective was to evaluate the effects of NIP’s infant feeding counselors on exclusive breastfeeding (EBF, complementary feeding (CF, and children’s linear growth. Methods A cross-sectional evaluation design was used. Using systematic random sampling, caregivers were recruited from NIP sites (n = 359 and non-NIP sites (n = 415 from Infant Welfare Clinics (IWCs in the Northwest (NWR and Southwest Regions (SWR of Cameroon between October 2014 and April 2015. Differences in EBF and CF practices and children’s linear growth between NIP and non-NIP sites were determined using chi-square and multiple logistic regression. Results After adjusting for differences in religion, occupation, and number of months planning to breastfeed, children were almost seven times (Odds Ratio [OR]: 6.9; 95% Confidence Interval [CI]: 2.30, 21.09; β = 1.94 more likely to be exclusively breastfed at NIP sites compared to non-NIP sites. After adjusting for differences in occupation, religion, number of months planning to breastfeed, rural environment, economic status, attending other Infant Welfare Clinics, and non-biological caregiver

  20. The partnership between the Brazilian School Feeding Program and family farming: a way for reducing ultra-processed foods in school meals.

    Science.gov (United States)

    Teo, Carla Rosane Paz Arruda

    2018-01-01

    To evaluate the profile of food acquisition in the National School Feeding Program according to the extent and purpose of food processing in three municipalities of southern Brazil during the implementation period of Law 11.947/2009. Descriptive cross-sectional study. Data for 2008-2010 involved quantities, prices and types of suppliers for food items purchased. In total, 1529 purchases were analysed. The items were classified into the following groups: G1 (unprocessed/minimally processed), G2 (culinary ingredients), G3 (processed), G4 (ultra-processed). Quantities of purchased foods were converted into energy and average prices ($US/4184 kJ (1000 kcal)) were calculated. The proportion of each food group in total purchases was expressed as both a percentage of total energy and a percentage of total expenditure. Data analysis was carried out in Stata version 12.1. Three municipalities in southern Brazil. Relative contribution to total energy purchased was high for G1 (49·8 %; G2, 23·8 %; G3, 4·5 %; G4, 21·8 %). Among acquisitions from family farming, G1 represented 51·3 % of the total energy purchased; G2, 9·9 %; G3, 19·7 %; G4, 19·0 %. Total cost was as follows: G1, 61·6 %; G2, 3·9 %; G3, 18·5 %; G4, 16·0 %. Prices for food products from family farms were consistently higher. Average price from family farms was 1·3; from conventional suppliers, 0·9. The implementation of Law 11.947/2009 produced a positive effect on the regional profile of food purchases for the School Feeding Program. However, there is still considerable potential to promote health by strengthening relationships between family farming and school feeding.

  1. Polypharmacy and enteral nutrition in patients with complex chronic diseases

    Science.gov (United States)

    Romero Jiménez, Rosa Mª; Ortega Navarro, Cristina; Cuerda Compés, Cristina

    2017-05-08

    Oral medications are often administered through enteral feeding tubes in patients with complex chronic diseases. It is important to consider possible interactions between drugs and enteral nutrition that might lead to unsuccessful treatment or tube occlusion. These patients become subjects for higher risk of problems and errors such as drug incompatibility with enteral nutrition and inappropriate dosage form selection. It is possible to minimize the risk of tube occlusion and incompatibilities problems by recognizing potential medication errors, selecting the most appropriate drug and dosage form and using appropriate administration techniques. In this context, high-alert medications for patients with chronic diseases deserve special attention. Furthermore, risk exposure should be considered among healthcare professionals and patient caregivers handling hazardous drugs. Therefore, main incompatibility problems between drugs and enteral nutrition have been reviewed, including general recommendations for administration of oral medications through enteral feeding tubes and safe handling of hazardous drugs. Specific recommendations for administration of high-alert medications for patients with chronic diseases are also included.

  2. Enteric Diseases of Poultry with Special Attention to Clostridium perfringens

    Directory of Open Access Journals (Sweden)

    Hafez Mohamed Hafez

    2011-06-01

    Full Text Available The enteric heath of growing poultry is imperative to success of the production. The basic role of poultry production is turning feed stuffs into meat. Any changes in this turning process, due to mechanical, chemical or biological disturbance of digestive system (enteric disorders is mostly accompanied with high economic losses due to poor performance, increased mortality rates and increased medication costs. The severity of clinical signs and course of the disorders are influenced several factors such as management, nutrition and the involved agent(s. Several pathogens (viruses, bacteria and parasites are incriminated as possible cause of enteric disorders either alone (mono-causal, in synergy with other micro-organisms (multi-causal, or with non-infectious causes such as feed and /or management related factors. In addition, excessive levels of mycotoxins and biogenic amines in feed lead to enteric disorders. Also factors such as high stocking density, poor litter conditions, poor hygiene and high ammonia level and other stressful situation may reduce the resistance of the birds and increases their susceptibility to infections. Under field conditions, however, under filed conditions it is difficult to determine whether the true cause of enteric disorders, is of infectious or non-infectious origin. In recent years and since the ban of use of antimicrobial growth promoters in several countries the incidence of intestinal disorders especially those caused by clostridial infection was drastically increased. The present review described in general the several factors involved in enteric disorders and summarized the available literatures about Clostridium perfringens infection in poultry.

  3. Should early enteral nutrition be used in the trauma intensive care ...

    African Journals Online (AJOL)

    optimal timing of the initiation of parenteral nutrition, all agree that the enteral route should be used as the first option, provided that the gut is functional.2,4-8 The concept of early enteral feeding (EEF) refers to the initiation of enteral nutrition within the first 24-48 hours post injury.4-9 Advantages of this approach include a ...

  4. Effect of programmed diurnal temperature cycles on plasma thyroxine level, body temperature, and feed intake of holstein dairy cows

    Science.gov (United States)

    Scott, I. M.; Johnson, H. D.; Hahn, G. L.

    1983-03-01

    Holstein cows exposed to simulated summer diurnal ambient temperature cycles of Phoenix, Arizona and Atlanta, Georgia and diurnal modifications of these climates displayed daily cycles fluctuations in plasma thyroxine (T4) and rectal temperatures (Tre). There were daily diurnal changes in T4 and Tre under all simulated climate conditions. Maximal values generally occurred in the evening hours and minimum values in the morning. Although the diurnal rhythm was influenced by the various simulated climates (diurnal modifications) a diurnal rhythm was very evident even under constant conditions at thermoneutral (Tnc) and at cyclic thermoneutral conditions (TN). The major significance of the study is that the initiation of night cooling of the animals at a time when their Tre was highest was most beneficial to maintenance of a TN plasma T4 level. There was a highly significant negative relationship of average T4 and average Tre. There was also a significant negative relationship of feed consumption and average temperature-humidity index (THI). These data suggest that night cooling may be a most effective method to alleviate thermoregulatory limitations of a hot climate on optimal animal performance. Decreasing the night time air temperature (Ta) or THI or increasing the diurnal range allows the cows to more easily dissipate excess body heat accumulated during the day and minimize the thermal inhibition on feed intake, and alterations in plasma T4 and Tre.

  5. Always Feed the Clowns and Other Tips for Building Better Partnerships between School Librarians and Providers of Educational Programs

    Science.gov (United States)

    Edwards, Jason

    2015-01-01

    Jason Edwards travels to schools and libraries across the nation performing educational enrichment programs, such as his Monster Hunt Library Skills-Building Adventure Program, for librarians and students. In this article, he shares tips that he has gleaned that may help librarian/programmer partnerships function more smoothly. Three of the…

  6. Enteric Methane Emission from Pigs

    DEFF Research Database (Denmark)

    Jørgensen, Henry; Theil, Peter Kappel; Knudsen, Knud Erik Bach

    2011-01-01

    per kg meat produced is increased (Fernández et al. 1983; Lekule et al. 1990). The present chapter will summarise our current knowledge concerning dietary and enteric fermentation that may influence the methane (CH4) emission in pigs. Enteric fermentation is the digestive process by which.......3 % of the worlds pig population. The main number of pigs is in Asia (59.6 %) where the main pig population stay in China (47.8 % of the worlds pig population). The objective of the chapter is therefore: To obtain a general overview of the pigs’ contribution to methane emission. Where is the pigs’ enteric gas...... produced and how is it measured. The variation in methane emission and factors affecting the emission. Possibility for reducing the enteric methane emission and the consequences....

  7. Recent Advances in Enteral Nutrition

    OpenAIRE

    Ojo, Omorogieva; Brooke, Joanne

    2016-01-01

    There have been significant advances in the provision of enteral nutrition support in the acute and community healthcare settings. Enteral nutrition is beneficial to individuals who have functional guts but may not be able to meet their nutritional requirements via a normal diet. Most of these people have neurological conditions such as stroke, multiple sclerosis and dementia which could impact on swallowing reflexes, leading to dysphagia [1]. Others may have cancer, intellectual disability o...

  8. Outpatient Therapeutic Feeding Program Outcomes and Determinants in Treatment of Severe Acute Malnutrition in Tigray, Northern Ethiopia: A Retrospective Cohort Study

    Science.gov (United States)

    Yebyo, Henock Gebremedhin; Kendall, Carl; Nigusse, Daniel; Lemma, Wuleta

    2013-01-01

    Background Outpatient Therapeutic feeding Program (OTP) brings the services for management of Severe Acute Malnutrition (SAM) closer to the community by making services available at decentralized treatment points within the primary health care settings, through the use of ready-to-use therapeutic foods, community outreach and mobilization. Little is known about the program outcomes. This study revealed the levels of program outcome indictors and determinant factors to recovery rate. Methods A retrospective cohort study was conducted on 628 children who had been managed for SAM under OTP from April/2008 to January/2012. The children were selected using systematic random sampling from 12 health posts and 4 health centers. The study relied on information of demographic characteristics, anthropometries, Plumpy'Nut, medical problems and routine medications intakes. The results were estimated using Kaplan-Meier survival curves, log-rank test and Cox-regression. Results The recovery, defaulter, mortality and weight gain rates were 61.78%, 13.85%, 3.02% and 5.23 gm/kg/day, respectively. Routine medications were administered partially and children with medical problems were managed inappropriately under the program. As a child consumed one more sachet of Plumpy'Nut, the recovery rate from SAM increased by 4% (HR = 1.04, 95%-CI = 1.03, 1.05, Pworming had 95% (HR = 1.95, 95%-CI = 1.17, 3.23) and 74% (HR = 1.74, 95%-CI = 1.07, 2.83) more probability to recover from SAM as compared to those who didn't take them. Conclusions The OTP was partially successful. Management of children with comorbidities under the program and partial administration of routine drugs were major threats for the program effectiveness. The stakeholders should focus on creating the capacity of the OTP providers on proper management of SAM to achieve fully effective program. PMID:23755286

  9. The Influence of Method, Timing of Onset and Duration of Enteral ...

    African Journals Online (AJOL)

    Duration of Enteral Feeding on the Duration of. Hospitalization of Newborn Infants in a Nigerian. Special Care Baby Unit. Ogunlesi TA, Ogunfowora OB. Department of Paediatrics, Olabisi Onabanjo University, Sagamu, Nigeria. Abstract. Background: Feeding practices among high‑risk newborn babies have not been ...

  10. Feeding behavior of growing-finishing pigs reared under precision feeding strategies.

    Science.gov (United States)

    Andretta, I; Pomar, C; Kipper, M; Hauschild, L; Rivest, J

    2016-07-01

    The feeding behavior of growing-finishing pigs reared under precision feeding strategies was studied in 35 barrows and 35 females (average initial BW of 30.4 ± 2.2 kg) over 84 d. Five different feeding programs were evaluated, namely a conventional 3-phase program in which pigs were fed with a constant blend of diet A (high nutrient density) and diet B (low nutrient density) and 4 daily phase-feeding programs in which pigs were fed daily with a blend meeting 110, 100, 90, or 80% of the individual Lys requirements. Electronic feeder systems automatically recorded the visits to the feeder, the time of the meals, and the amount of feed consumed per meal. The trial lasted 84 d and the database contained 59,701 feeder visits. The recorded database was used to calculate the number of meals per day, feeding time per meal (min), intervals between meals (min), feed intake per meal (g), and feed consumption rate (feed intake divided by feeding time per meal, expressed in g/min) of each animal. The feeding pattern was predominantly diurnal (73% of the feeder visits). Number of meals, duration of meals, time between meals, feed consumed per meal, and feed consumption rate were not affected by the feeding programs. The females ingested 19% less feed per meal and had a 6% lower feed consumption rate in comparison with the barrows ( feeding behavior was not correlated with diet composition. However, feed efficiency was negatively correlated with amount of feed consumed per meal ( = -0.38, feed consumption rate ( = -0.44, Feed consumption rate was also negatively correlated with protein efficiency ( = -0.44, feed consumption rate and number of meals per day are the variables related most closely to pig production performance results. Current results indicate that using precision feeding as an approach to reduce Lys intake does not interfere with the feeding behavior of growing-finishing pigs.

  11. [Early enteral nutrition in gastrointestinal surgery].

    Science.gov (United States)

    Ghesquière, F; Olivero de Rubiana, J P; Mourot, N; Garen, C; Wulverick, M; Viars, P

    1980-01-01

    In a series of twenty similar patients, having a healthy small intestine and having undergone elective surgery, two protocols of alimentation were studied. Beginning from the 8th post-operative hour, enteral alimentation is carried out by means of access to the jejunum and continued for ten days. The volume of liquid in the alimentary canal is progressively increased allowing the intravenous route to be stopped on average after 3,9 days. The high amount of the nitrogen and calory supply limits the post-operative nitrogen catabolism and rapidly restores a positive nitrogen balance. In other respects the weight loss is less than 2%, the biological constants are stable and no serious complications are linked with this technique. The early use of GI tract deals with the alimentational and electrolyte needs of the post-operative patient and diminishes the risks of iatrogenic complications of long term intravenous infusions. Relying on experimental data proving the absence of cessation of peristalsis of the small intestine in the immediate post-operative period and also the continuation of its capacity for absorption, this work demonstrates the possibility of early enteral alimentation. A better knowledge of the indications and contra-indications of this technique of feeding, of its methods of administration, and of the capabilities of absorption of the alimentary canal, must extend its indications to the high risk operative patients.

  12. SNP Polymorphism Survey of the Parental Lines of ISRA Sorghum Breeding Program as Part of the Feed the Future

    Data.gov (United States)

    US Agency for International Development — Polymorphism of SNP Markers (single nucleotide polymorphisms) was assessed on 24 parental lines of the ISRA sorghum breeding program . About 1300 SNP have been used...

  13. Iron intakes of Australian infants and toddlers: findings from the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program.

    Science.gov (United States)

    Atkins, Linda A; McNaughton, Sarah A; Campbell, Karen J; Szymlek-Gay, Ewa A

    2016-01-28

    Fe deficiency remains the most common nutritional deficiency worldwide and young children are at particular risk. Preventative food-based strategies require knowledge of current intakes, sources of Fe, and factors associated with low Fe intakes; yet few data are available for Australian children under 2 years. This study's objectives were to determine intakes and food sources of Fe for Australian infants and toddlers and identify non-dietary factors associated with Fe intake. Dietary, anthropometric and socio-demographic data from the Melbourne Infant Feeding, Activity and Nutrition Trial Program were analysed for 485 infants (mean age: 9·1 (sd 1·2) months) and 423 toddlers (mean age: 19·6 (sd 2·6) months) and their mothers. Dietary intakes were assessed via 24-h recalls over 3 non-consecutive days. Prevalence of inadequate Fe intake was estimated using the full probability approach. Associations between potential non-dietary predictors (sex, breast-feeding status, age when introduced to solid foods, maternal age, maternal education, maternal employment status and mother's country of birth) and Fe intakes were assessed using linear regression. Mean Fe intakes were 9·1 (sd 4·3) mg/d for infants and 6·6 (sd 2·4) mg/d for toddlers. Our results showed that 32·6 % of infants and 18·6 % of toddlers had inadequate Fe intake. Main food sources of Fe were Fe-fortified infant formula and cereals for infants and toddlers, respectively. Female sex and current breast-feeding were negatively associated with infant Fe intakes. Introduction to solid foods at or later than 6 months was negatively associated with Fe intake in toddlers. These data may facilitate food-based interventions to improve Australian children's Fe intake levels.

  14. Chronic maternal inflammation or high-fat-feeding programs offspring obesity in a sex-dependent manner

    DEFF Research Database (Denmark)

    Dudele, A; Hougaard, K S; Kjølby, M

    2017-01-01

    , characteristic of the obese state, provides a causal role for this disastrous fetal programming in mice. Methods: We exposed pregnant and lactating C57BL/6JBom female mice to either high-fat diet (HFD), or continuous infusion of lipopolysaccharide (LPS), a potent trigger of innate immunity, and studied offspring...... inflammatory response to HFD at adulthood. Conclusions: This supports our hypothesis and highlights the programming potential of inflammation in obese pregnancies....

  15. Reduction in diarrhea incidence by soluble fiber in patients receiving total or supplemental enteral nutrition.

    Science.gov (United States)

    Homann, H H; Kemen, M; Fuessenich, C; Senkal, M; Zumtobel, V

    1994-01-01

    Gastrointestinal side effects, particularly diarrhea, are still the main reasons for discontinuation of enteral nutrition. Although the causes of diarrhea are diverse, the enteral nutrition solution is frequently suspected of playing a leading role in causing diarrhea. Our randomized, prospective, double-blind trial with 100 patients assessed the effects of feeding a standard diet (Nutrodrip Standard) vs the same diet supplemented with 20 g of soluble fiber, containing partially hydrolyzed guar gum (Sunfiber), per 1000 mL. Thirty patients received total enteral nutrition postoperatively, and 70 patients received enteral supplementation. The patients receiving total enteral nutrition with soluble fiber had decreased diarrhea but increased flatulence. In none of these patients did enteral feeding have to be discontinued because of gastrointestinal side effects, whereas in four patients who were on a standard diet, enteral feeding had to be interrupted because of diarrhea (p < .05). Similar observations were made in patients receiving enteral supplementation. In both groups, the incidence of diarrhea decreased significantly with the soluble fiber diet compared with the standard diet (6 vs 15, p < .05). Enteral feeding with a formula supplemented with partially hydrolyzed guar gum reduces the incidence of diarrhea in patients receiving total enteral nutrition as well as in those receiving enteral supplementation, regardless of the cause of diarrhea. The increased hydrogen production and the significantly higher rate of flatulence are likely to result from fermentation of the soluble fiber in the colon, with concomitant production of short-chain fatty acids, which leads to increased absorption of short-chain fatty acids, sodium, and water by the colonocytes. This effect, together with the observed cholecystokinin-mediated decrease in colonic transit time with partially hydrolyzed guar gum, may explain the reduction in the incidence of diarrhea in this study.

  16. Molecular Transducers from Roots Are Triggered in Arabidopsis Leaves by Root-Knot Nematodes for Successful Feeding Site Formation: A Conserved Post-Embryogenic De novo Organogenesis Program?

    Directory of Open Access Journals (Sweden)

    Rocío Olmo

    2017-05-01

    Full Text Available Root-knot nematodes (RKNs; Meloidogyne spp. induce feeding cells (giant cells; GCs inside a pseudo-organ (gall from still unknown root cells. Understanding GCs ontogeny is essential to the basic knowledge of RKN–plant interaction and to discover novel and effective control strategies. Hence, we report for the first time in a model plant, Arabidopsis, molecular, and cellular features concerning ectopic de novo organogenesis of RKNs GCs in leaves. RKNs induce GCs in leaves with irregular shape, a reticulated cytosol, and fragmented vacuoles as GCs from roots. Leaf cells around the nematode enter G2-M shown by ProCycB1;1:CycB1;1(NT-GUS expression, consistent to multinucleated GCs. In addition, GCs nuclei present irregular and varied sizes. All these characteristics mentioned, being equivalent to GCs in root-galls. RKNs complete their life cycle forming a gall/callus-like structure in the leaf vascular tissues resembling auxin-induced callus with an auxin-response maxima, indicated by high expression of DR5::GUS that is dependent on leaf auxin-transport. Notably, induction of leaves calli/GCs requires molecular components from roots crucial for lateral roots (LRs, auxin-induced callus and root-gall formation, i.e., LBD16. Hence, LBD16 is a xylem pole pericycle specific and local marker in LR primordia unexpectedly induced locally in the vascular tissue of leaves after RKN infection. LBD16 is also fundamental for feeding site formation as RKNs could not stablish in 35S::LBD16-SRDX leaves, and likely it is also a conserved molecular hub between biotic and developmental signals in Arabidopsis either in roots or leaves. Moreover, RKNs induce the ectopic development of roots from leaf and root-galls, also formed in mutants compromised in LR formation, arf7/arf19, slr, and alf4. Therefore, nematodes must target molecular signatures to induce post-embryogenic de novo organogenesis through the LBD16 callus formation pathway partially different from those

  17. Nutritional status, feeding practices and state of other related indicators at onset of a multi-model community nutrition intervention program in Mpigi District, Uganda.

    Science.gov (United States)

    Tumwesigye, Nazarius Mbona; Tushemerirwe, Florence Basiimwa; Kajjura, Richard; Nabunya, Victoria; Naitala, Ronald Andrew; Namanda, Cissie

    2016-12-01

    In Uganda, malnutrition level has persistently remained high among the under-fives and this has led NGOs like World Vision, Uganda into finding innovative ways for intervention. This paper presents an assessment of nutrition status and values of related indicators at onset of a community intervention program in four sub-counties of Mpigi district in Central Uganda. This was a cross-sectional study to provide baseline information for a nutrition intervention. The study units were index children aged 6-59 months from 818 households. Face to face interviews were conducted using semi-structured questionnaires. Values of key indicators were computed and compared between designated control and intervention areas. Stunting level was 32% while wasting was 3% and underweight at 10%. Most of the index children (78%) started breastfeeding within the first hour of birth. Nearly a third of the households visited had a kitchen garden and this did not differ by intervention status. Like at regional level, nutrition status and feeding practices in the study area were poor. The values of these indicators did not significantly change by designated intervention status. Much effort was needed to realize a difference in nutrition and feeding practices in designated intervention areas.

  18. Variation in outcomes of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT) Program according to maternal education and age.

    Science.gov (United States)

    Cameron, Adrian J; Ball, Kylie; Hesketh, Kylie D; McNaughton, Sarah A; Salmon, Jo; Crawford, David A; Lioret, Sandrine; Campbell, Karen J

    2014-01-01

    To assess the effectiveness of the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program according to maternal education and age. A cluster-randomised controlled trial involving 542 mother/infant pairs from 62 existing first-time parent groups was conducted in 2008 in Melbourne, Australia. The intervention involved 6 × 2-hour dietitian-delivered sessions, DVD and written resources from infant age 4-15 months. Outcomes included infant diet (3 × 24 h diet recalls), physical activity (accelerometry), television viewing and body mass index. We tested for moderation by maternal education (with/without a University degree) and age (Child obesity prevention interventions may be differentially effective according to maternal education and age. Evidence of differential effects is important for informing more sensitively targeted/tailored approaches. © 2013.

  19. Enteritis

    Science.gov (United States)

    ... disease The inflammation can also involve the stomach ( gastritis ) and large intestine ( colitis ). Risk factors include: Recent ... a few days in otherwise healthy people. Possible Complications Complications may include: Dehydration Long-term diarrhea Note: ...

  20. Effects of daily milk supplementation on improving the physical and mental function as well as school performance among children: results from a school feeding program.

    Science.gov (United States)

    Rahmani, Khadijeh; Djazayery, Abolghasem; Habibi, Mohsen Ibrahim; Heidari, Homa; Dorosti-Motlagh, Ahmad Reza; Pourshahriari, Mahsima; Azadbakht, Leila

    2011-04-01

    School feeding programs are important interventions for improving the nutritional status of students. Therefore, this study was conducted to evaluate the effects of milk supplementation on physical, mental and school performance of students. This case-control population-based intervention was conducted on 469 students from 4 schools in a medium socio-economic status region in Tehran. The schools were chosen by Iranian ministry of education and training and they were allocated in case and control groups randomly. All the students in the first to third classes in the intervention schools were daily consumed sterilized and homogenized milk for three months (250 ml each). Anthropometric measurements were done according to the standard methods. For evaluating the mental function, the Raven's Coloured Progressive Matrices (CPM) and Wechsler Intelligence Scale for children (verbal, non-verbal, total Intelligent Quotient) were conducted on students. School performance was assessed by grade-point averages of each student. The weight of children was significantly different between control and intervention group at the end of the study among girls (23.0 ± 3.8 vs. 23.8 ± 4.3 kg; p < 0.05). Psychological tests' scores were significantly different between the control and the intervention groups (p < 0.05) at the end of the trial among boys. The grade-point average was significantly different at the end of the trial between the intervention and the control group among girls (p < 0.05). School feeding programs focus on milk supplementation had beneficial effects on the physical function and school performances specifically among girls in Iran.

  1. Effects of daily milk supplementation on improving the physical and mental function as well as school performance among children: Results from a school feeding program

    Directory of Open Access Journals (Sweden)

    Khadijeh Rahmani

    2011-01-01

    Full Text Available Background: School feeding programs are important interventions for improving the nutritional status of students. Therefore, this study was conducted to evaluate the effects of milk supplementation on physical, mental and school performance of students. Methods: This case-control population-based intervention was conducted on 469 students from 4 schools in a medium socio-economic status region in Tehran. The schools were chosen by Iranian ministry of education and training and they were allocated in case and control groups randomly. All the students in the first to third classes in the intervention schools were daily consumed sterilized and homogenized milk for three months (250 ml each. Anthropometric measurements were done according to the standard methods. For evaluating the mental function, the Raven′s Coloured Progressive Matrices (CPM and Wechsler Intelligence Scale for children (verbal, non-verbal, total Intelligent Quotient were conducted on students. School performance was assessed by grade-point averages of each student. Results: The weight of children was significantly different between control and intervention group at the end of the study among girls (23.0 ± 3.8 vs. 23.8 ± 4.3 kg; p < 0.05. Psychological tests′ scores were significantly different between the control and the intervention groups (p < 0.05 at the end of the trial among boys. The grade-point average was significantly different at the end of the trial between the intervention and the control group among girls (p < 0.05. Conclusions: School feeding programs focus on milk supplementation had beneficial effects on the physical function and school performances specifically among girls in Iran.

  2. Effects of daily milk supplementation on improving the physical and mental function as well as school performance among children: results from a school feeding program

    Science.gov (United States)

    Rahmani, Khadijeh; Djazayery, Abolghasem; Habibi, Mohsen Ibrahim; Heidari, Homa; Dorosti-Motlagh, Ahmad Reza; Pourshahriari, Mahsima; Azadbakht, Leila

    2011-01-01

    BACKGROUND: School feeding programs are important interventions for improving the nutritional status of students. Therefore, this study was conducted to evaluate the effects of milk supplementation on physical, mental and school performance of students. METHODS: This case-control population-based intervention was conducted on 469 students from 4 schools in a medium socio-economic status region in Tehran. The schools were chosen by Iranian ministry of education and training and they were allocated in case and control groups randomly. All the students in the first to third classes in the intervention schools were daily consumed sterilized and homogenized milk for three months (250 ml each). Anthropometric measurements were done according to the standard methods. For evaluating the mental function, the Raven's Coloured Progressive Matrices (CPM) and Wechsler Intelligence Scale for children (verbal, non-verbal, total Intelligent Quotient) were conducted on students. School performance was assessed by grade-point averages of each student. RESULTS: The weight of children was significantly different between control and intervention group at the end of the study among girls (23.0 ± 3.8 vs. 23.8 ± 4.3 kg; p < 0.05). Psychological tests’ scores were significantly different between the control and the intervention groups (p < 0.05) at the end of the trial among boys. The grade-point average was significantly different at the end of the trial between the intervention and the control group among girls (p < 0.05). CONCLUSIONS: School feeding programs focus on milk supplementation had beneficial effects on the physical function and school performances specifically among girls in Iran. PMID:22091261

  3. Enteral nutrition practices in the intensive care unit: Understanding of nursing practices and perspectives

    Directory of Open Access Journals (Sweden)

    Babita Gupta

    2012-01-01

    Full Text Available Background: Adequate nutritional support is important for the comprehensive management of patients in intensive care units (ICUs. Aim: The study was aimed to survey prevalent enteral nutrition practices in the trauma intensive care unit, nurses′ perception, and their knowledge of enteral feeding. Study Design: The study was conducted in the ICU of a level 1 trauma center, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India. The study design used an audit. Materials and Methods: Sixty questionnaires were distributed and the results analyzed. A database was prepared and the audit was done. Results: Forty-two (70% questionnaires were filled and returned. A majority (38 of staff nurses expressed awareness of nutrition guidelines. A large number (32 of staff nurses knew about nutrition protocols of the ICU. Almost all (40 opined enteral nutrition to be the preferred route of nutrition unless contraindicated. All staff nurses were of opinion that enteral nutrition is to be started at the earliest (within 24-48 h of the ICU stay. Everyone opined that the absence of bowel sounds is an absolute contraindication to initiate enteral feeding. Passage of flatus was considered mandatory before starting enteral nutrition by 86% of the respondents. Everyone knew that the method of Ryle′s tube feeding in their ICU is intermittent boluses. Only 4 staff nurses were unaware of any method to confirm Ryle′s tube position. The backrest elevation rate was 100%. Gastric residual volumes were always checked, but the amount of the gastric residual volume for the next feed to be withheld varied. The majority said that the unused Ryle′s tube feed is to be discarded after 6 h. The most preferred (48% method to upgrade their knowledge of enteral nutrition was from the ICU protocol manual. Conclusion: Information generated from this study can be helpful in identifying nutrition practices that are lacking and may be used to review and revise enteral feeding

  4. Genomic diversification of giant enteric symbionts reflects host dietary lifestyles

    KAUST Repository

    Ngugi, David

    2017-08-24

    Herbivorous surgeonfishes are an ecologically successful group of reef fish that rely on marine algae as their principal food source. Here, we elucidated the significance of giant enteric symbionts colonizing these fishes regarding their roles in the digestive processes of hosts feeding predominantly on polysiphonous red algae and brown Turbinaria algae, which contain different polysaccharide constituents. Using metagenomics, single-cell genomics, and metatranscriptomic analyses, we provide evidence of metabolic diversification of enteric microbiota involved in the degradation of algal biomass in these fishes. The enteric microbiota is also phylogenetically and functionally simple relative to the complex lignocellulose-degrading microbiota of terrestrial herbivores. Over 90% of the enzymes for deconstructing algal polysaccharides emanate from members of a single bacterial lineage,

  5. Compatibility of enteral products with commonly employed drug additives.

    Science.gov (United States)

    Cutie, A J; Altman, E; Lenkel, L

    1983-01-01

    Although drugs are routinely administered through gavage feedings set along with enteral products, there is little scientific data available to the physician, pharmacist, nurse, and dietician concerning the physical and chemical compatibility of drugs with enteral formulations. This study assesses the compatibility of Ensure (Ross Laboratories, Columbus, OH), Ensure Plus (Ross Laboratories, Columbus, OH), Osmolite (Ross Laboratories, Columbus, OH) with antibiotics, gastrointestinal agents, antipsychotic agents, urinary antiseptics cough and cold medications, and other commonly used additives. All enteral formulations were examined immediately after mixing for phase changes, creaming, and particle growth using a contrast light and a rotation viscometer. Results are presented in a tabular format. Guidelines and recommendations concerning how the addition of troublesome drug additives can be added are also presented.

  6. [Enteral resorption and tumor cachexia].

    Science.gov (United States)

    Weiner, R; Matkowitz, R; Hartig, W; Conradi, G; Laue, R

    1979-01-15

    The rapid loss of the body weight of oncological patients in the advanced stage of the carcinomatous disease is caused by numerous pathophysiological mechanisms. With the help of the modified D-xylose absorption test was investigated which value have disturbances of the enteral absorption in the complex of causes for the development of a tumour cachexia. For the patients in the stage of generalisation of the carcinomatous disease clear disturbances in the enteral food intake could be proved in contrast to patients with carcinoma without general tumour symptomatology and healthy persons. The influence of chemo- and radio-therapy on the enteral absorption of patients with carcinoma was discussed. The forced alimentation of oncological patients with unspezific tumour symptoms must be regarded as a firm constituent in the treatment of patients with carcinoma.

  7. Diet-Dependent Effects of Minimal Enteral Nutrition on Intestinal Function and Necrotizing Enterocolitis in Preterm Pigs

    DEFF Research Database (Denmark)

    Cilieborg, Malene Skovsted; Boye, Mette; Thymann, Thomas

    2011-01-01

    Background: A rapid advance in enteral feeding is associated with necrotizing enterocolitis (NEC) in preterm infants. Therefore, minimal enteral nutrition (MEN) combined with parenteral nutrition (PN) is common clinical practice, but the effects on NEC and intestinal function remain poorly...... characterized. It was hypothesized that a commonly used MEN feeding volume (16-24 mL/kg/d) prevents NEC and improves intestinal structure, function, and microbiology in preterm pigs. Methods: After preterm birth pigs were stratified into 4 nutrition intervention groups that received the following treatments: (1......) PN followed by full enteral formula feeding (OF group, n = 12); (2) PN supplemented with formula MEN and followed by full formula feeding (FF, n = 12); (3) PN plus colostrum MEN followed by formula feeding (CF, n = 12); (4) PN plus colostrum MEN followed by colostrum feeding (CC, n = 10). Results...

  8. Carbamazepine-induced eosinophilic enteritis.

    Science.gov (United States)

    Shakeer, V K; Devi, Sobhana R; Chettupuzha, Antony Paul; Mustafa, C P; Sandesh, K; Kumar, Sunil K; Thomas, Varghese; Ashraf, A Syed

    2002-01-01

    We describe a 15-year-old boy who was on carbamazepine for the past 8 years for seizure disorder, who developed recurrent episodes of small bowel obstruction. Full-thickness small bowel biopsy obtained at laparotomy was consistent with eosinophilic enteritis. He improved clinically after tapering the drug.

  9. enter endoscopic third ventriculostomy (ETV)

    African Journals Online (AJOL)

    Ventriculoperitoneal 78. Point of View: Exit ventriculoperitoneal shunt; enter endoscopic third ventriculostomy (ETV): contemporary views on hydrocephalus and their implications on management. Abstract. Hydrocephalus has been known to affect humans since the birth of human medicine as it is described by Hippocrates.

  10. Nutrición enteral

    OpenAIRE

    Barrachina Bellés, Lidón; García Hernández, Misericordia; Oto Cavero, Isabel

    1984-01-01

    Este trabajo nos introduce en la administración de la nutrición enteral, haciendo una revisión de los aspectos a tener en cuenta tanto en sus indicaciones, vias, tipos, métodos, cuidados y complicaciones más importantes.

  11. Intrathoracic enteric foregut duplication cyst.

    Directory of Open Access Journals (Sweden)

    Birmole B

    1994-10-01

    Full Text Available A one month old male child presented with respiratory distress since day 10 of life. There was intercostal retraction and decreased air entry on the right side. Investigations revealed a well defined cystic mass in the posterior mediastinum with vertebral anomalies, the cyst was excised by posterolateral thoracotomy. Histopathology revealed it to be an enteric foregut duplication cyst.

  12. Outpatient therapeutic feeding program outcomes and determinants in treatment of severe acute malnutrition in tigray, northern ethiopia: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Henock Gebremedhin Yebyo

    Full Text Available BACKGROUND: Outpatient Therapeutic feeding Program (OTP brings the services for management of Severe Acute Malnutrition (SAM closer to the community by making services available at decentralized treatment points within the primary health care settings, through the use of ready-to-use therapeutic foods, community outreach and mobilization. Little is known about the program outcomes. This study revealed the levels of program outcome indictors and determinant factors to recovery rate. METHODS: A retrospective cohort study was conducted on 628 children who had been managed for SAM under OTP from April/2008 to January/2012. The children were selected using systematic random sampling from 12 health posts and 4 health centers. The study relied on information of demographic characteristics, anthropometries, Plumpy'Nut, medical problems and routine medications intakes. The results were estimated using Kaplan-Meier survival curves, log-rank test and Cox-regression. RESULTS: The recovery, defaulter, mortality and weight gain rates were 61.78%, 13.85%, 3.02% and 5.23 gm/kg/day, respectively. Routine medications were administered partially and children with medical problems were managed inappropriately under the program. As a child consumed one more sachet of Plumpy'Nut, the recovery rate from SAM increased by 4% (HR = 1.04, 95%-CI = 1.03, 1.05, P<0.001. The adjusted hazard ratios to recovery of children with diarrhea, appetite loss with Plumpy'Nut and failure to gain weight were 2.20 (HR = 2.20, 95%-CI = 1.31, 3.41, P = 0.001, 4.49 (HR = 1.74, 95%-CI = 1.07, 2.83, P = 0.046 and 3.88 (HR = 1.95, 95%-CI = 1.17, 3.23, P<0.001, respectively. Children who took amoxicillin and de-worming had 95% (HR = 1.95, 95%-CI = 1.17, 3.23 and 74% (HR = 1.74, 95%-CI = 1.07, 2.83 more probability to recover from SAM as compared to those who didn't take them. CONCLUSIONS: The OTP was partially successful. Management of

  13. Het effect van voersamenstelling op bacteriële darmaandoeningen bij varkens = The effect of feed composition on bacterial intestinal diseases in pigs

    NARCIS (Netherlands)

    Meulen, van der J.; Peet-Schwering, van der C.M.C.

    2007-01-01

    Feed composition, and especially carbohydrate composition, may affect the development of enteric bacterial diseases. Also the kind of feed ingredients (soybean or not) and feed treatment (milling size, pelletizing, fermentation) may be important. A more coarse grinding, no pelletizing and

  14. Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation123

    Science.gov (United States)

    Rawat, Rahul; Nguyen, Phuong Hong; Tran, Lan Mai; Hajeebhoy, Nemat; Nguyen, Huan Van; Baker, Jean; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima

    2017-01-01

    Background: Rigorous evaluations of health system–based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys (n = ∼500 children aged 6–23.9 mo and ∼1000 children aged 24–59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623. PMID:28179488

  15. [Situation of the municipalities of São Paulo state in relation to the purchase of products directly from family farms for the National School Feeding Program (PNAE)].

    Science.gov (United States)

    Villar, Betzabeth Slater; Schwartzman, Flavia; Januario, Bruna Lourenço; Ramos, Jamile Fernandes

    2013-03-01

    In 2009, Law 11,947 was passed, which provides for the care of school meals and consolidates the linkage of family farming with the National School Feeding Program (PNAE), by stipulating that at least 30% of the total financial resources granted by the Federal Government to the states and municipalities should be used for the acquisition of food directly from family farmers and rural entrepreneurs family or their organizations. To characterize the situation of the municipalities of São Paulo state in relation to the acquisition of products directly from family farmers after approval of Law 11,947. The diagnosis was carried out in the months of June to August 2011 by institutions linked to the Intersectoral School Feeding State Commission (CEIA). For the survey, a questionnaire was used and telephone interviews were conducted with representatives of the 645 municipal districts. It was possible to obtain the following information for a total of 613 municipalities: 47% (288) had already made local purchases at least once in all its stages. Of the 325 municipalities that do not conducted the process at all stages, 57% had not published a public call; 37% published but had not signed the purchase contract; 2% published a call, signed the contract but had not received the products; and 4% published at least one call, received the products but had not yet paid the farmers. The results show that approximately 50% of the municipalities evaluated are in a positive situation in relation to the local procurement for PNAE. However, the number of municipalities that did not publish the public call or not signed the contract is still important and deserves attention of the sectors involved.

  16. Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation.

    Science.gov (United States)

    Rawat, Rahul; Nguyen, Phuong Hong; Tran, Lan Mai; Hajeebhoy, Nemat; Nguyen, Huan Van; Baker, Jean; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima

    2017-04-01

    Background: Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys ( n = ∼500 children aged 6-23.9 mo and ∼1000 children aged 24-59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623.

  17. CONSEQUENCES OF IMPROPER INFANT FEEDING

    Directory of Open Access Journals (Sweden)

    I.N. Zakharova

    2007-01-01

    Full Text Available The article deals with the concept of food programming according to which the type of nourishment of an infant programs peculiarities of his metabolism all along his entire future life, and as a consequence, predisposition to certain diseases and characteristics of their run. The work gives an estimate of the hazards and consequences of improper infant feeding and explains the advantages of the breast feeding. The authors present modern information on preparation of baby milk formulas.Key words: infants, health, feeding, adapted milk formulas, nucleotides, long chain polyunsaturated fatty acids, oligosaccharides.

  18. Program impact pathway analysis of a social franchise model shows potential to improve infant and young child feeding practices in Vietnam.

    Science.gov (United States)

    Nguyen, Phuong H; Menon, Purnima; Keithly, Sarah C; Kim, Sunny S; Hajeebhoy, Nemat; Tran, Lan M; Ruel, Marie T; Rawat, Rahul

    2014-10-01

    By mapping the mechanisms through which interventions are expected to achieve impact, program impact pathway (PIP) analysis lays out the theoretical causal links between program activities, outcomes, and impacts. This study examines the pathways through which the Alive & Thrive (A&T) social franchise model is intended to improve infant and young child feeding (IYCF) practices in Vietnam. Mixed methods were used, including qualitative interviews with franchise management board members (n = 12), surveys with health providers (n = 120), counseling observations (n = 160), and household surveys (n = 2045). Six PIP components were assessed: 1) franchise management, 2) training and IYCF knowledge of health providers, 3) service delivery, 4) program exposure and utilization, 5) maternal behavioral determinants (knowledge, beliefs, and intentions) toward optimal IYCF practices, and 6) IYCF practices. Data were collected from A&T-intensive areas (A&T-I; mass media + social franchise) and A&T-nonintensive areas (A&T-NI; mass media only) by using a cluster-randomized controlled trial design. Data from 2013 were compared with baseline where similar measures were available. Results indicate that mechanisms are in place for effective management of the franchise system, despite challenges to routine monitoring. A&T training was associated with increased capacity of providers, resulting in higher-quality IYCF counseling (greater technical knowledge and communication skills during counseling) in A&T-I areas. Franchise utilization increased from 10% in 2012 to 45% in 2013 but fell below the expected frequency of 9-15 contacts per mother-child dyad. Improvements in breastfeeding knowledge, beliefs, intentions, and practices were greater among mothers in A&T-I areas than among those in A&T-NI areas. In conclusion, there are many positive changes along the impact pathway of the franchise services, but challenges in utilization and demand creation should be addressed to achieve the full

  19. Transition from parenteral to enteral nutrition induces immediate diet-dependent gut histological and immunological responses in preterm neonates

    DEFF Research Database (Denmark)

    Siggers, Jayda; Sangild, Per T.; Jensen, Tim Kåre

    2011-01-01

    -six preterm pigs were fed total parenteral nutrition (TPN) for 48 h followed by enteral feeding for 0, 8, 17, or 34 h with either colostrum (Colos, n = 20) or formula (Form, n = 31). Macroscopic NEC lesions were detected in Form pigs throughout the enteral feeding period (20/31, 65%), whereas most Colos pigs...... bacterial groups (Clostridium, Enterococcus, Streptococcus species) increased with time. We conclude that a switch from parenteral to enteral nutrition rapidly induces diet-dependent histopathological, functional, and proinflammatory insults to the immature intestine. Great care is required when introducing......Necrotizing enterocolitis (NEC) in preterm infants develops very rapidly from a mild intolerance to enteral feeding into intestinal mucosal hemorrhage, inflammation, and necrosis. We hypothesized that immediate feeding-induced gut responses precede later clinical NEC symptoms in preterm pigs. Fifty...

  20. CERN openlab enters fifth phase

    CERN Multimedia

    Andrew Purcell

    2015-01-01

    CERN openlab is a unique public-private partnership between CERN and leading ICT companies. At the start of this year, openlab officially entered its fifth phase, which will run until the end of 2017. For the first time in its history, it has extended beyond the CERN community to include other major European and international research laboratories.   Founded in 2001 to develop the innovative ICT systems needed to cope with the unprecedented computing challenges of the LHC, CERN openlab unites science and industry at the cutting edge of research and innovation. In a white paper published last year, CERN openlab set out the main ICT challenges it will tackle during its fifth phase, namely data acquisition, computing platforms, data storage architectures, computer management and provisioning, networks and connectivity, and data analytics. As it enters its fifth phase, CERN openlab is expanding to include other research laboratories. "Today, research centres in other disciplines are also st...

  1. Feeding behavior.

    Science.gov (United States)

    Ralston, S L

    1986-12-01

    Problems related to feeding behavior in horses fall into three main categories: underconsumption, overconsumption, and abnormal consumption. Anorexia may be caused by a variety of diseases and overcome by removing the underlying causes (pain, fever), and physical or chemical stimulation of appetite. "Hypophagia" may be caused by poor dentition, disease, or stress. Again, removal of the cause or stimulation by physical or chemical means may improve intakes. Acute and chronic overconsumption of feeds are reflections of the normal controls (or lack thereof) of feeding in the horse. The only reliable prevention is to limit access to feeds. Abnormal eating behaviors such as pica or coprophagy are usually caused by a dietary imbalance or boredom. Coprophagey, however, is a normal behavior in young foals. Drinking disorders are rare, the only common one being the avoidance of "strange" water. Masking water at home with specific flavors such as peppermint or vinegar may encourage the horse to drink water from other sources to which the "home" flavor has been added.

  2. fish feed

    African Journals Online (AJOL)

    En-Joy

    with fishing nets. Fish were identified and authenticated at the Fishery section,. Department of Biological Sciences,. Ahmadu Bello University, Zaria, Nigeria ..... salmon.Aquaculture, 89: 301-314. GABRIEL, U. U., AKINROTIMI, O. A.,. BEKIBELE, D. O., ONUNKWO, D. N. and ANYANWU, P. E. (2007). Locally produced fish feed ...

  3. Enteric paramphistomiasis in Yankasa sheep.

    Science.gov (United States)

    Bida, S A; Schillhorn van Veen, T

    1977-02-01

    An outbreak of acute enteric paramphistomiasis was observed among Yankasa (indigenous) sheep that were herded with cattle on the University farm at Samaru in February 1973. Mortality was approximately thirty to forty per cent. The most important clinical signs were anorexia, unthriftiness and profuse foetid diarrhoea soiling the perianal region and hind legs. Diagnosis was based on the post-mortem findings, clinical signs and presence of conical flukes identified as Paramphistomum microbothrium.

  4. Surgical treatment of radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Cross, M.J.; Frazee, R.C. (Department of General Surgery, Scott and White Memorial Hospital, Temple TX (United States))

    1992-02-01

    Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting.

  5. Surgical treatment of radiation enteritis

    International Nuclear Information System (INIS)

    Cross, M.J.; Frazee, R.C.

    1992-01-01

    Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting

  6. Communication Skill Attributes Needed for Vocational Education enter The Workplace

    Science.gov (United States)

    Wahyuni, L. M.; Masih, I. K.; Rejeki, I. N. Mei

    2018-01-01

    Communication skills are generic skills which need to be developed for success in the vocational education entering the workforce. This study aimed to discover the attributes of communication skill considered important in entering the workforce as perceived by vocational education students. The research was conducted by survey method using questionnaire as data collecting tool. The research population is final year student of D3 Vocational education Program and D4 Managerial Vocational education in academic year 2016/2017 who have completed field work practice in industry. The sampling technique was proportional random sampling. Data were analyzed with descriptive statistics and independent sampel t-test. Have ten communication skills attributes with the highest important level required to enter the workplace as perceived by the vocational education diploma. These results indicate that there was the same need related communication skills to enter the workforce

  7. Indications for tube feedings in elderly patients.

    Science.gov (United States)

    Ciocon, J O

    1990-01-01

    Tube feedings are utilized in elderly patients with acute and chronic problems. Inadequate oral intake with malnutrition, comatose state, neurologic disorders with severe dysphagia, extensive burns, massive gastrointestinal resection, and oropharyngeal and upper gastrointestinal malignancies are the commonly encountered conditions requiring tube alimentation. Dysphagia with frequent aspiration is the most common indication for use of tube feedings in the elderly. Nasogastric tube is preferred for short-term feeding, while gastrostomy or jejunostomy is indicated for long-term or permanent nutritional support. Nutritional assessment should be done initially and on a regular basis. Specific formulas are available to calculate height, weight, and caloric needs of bedbound elderly patients. Various enteral feeding formulas are available for a specific clinical condition and are preferably administered by continuous drip using a pump. Parenteral nutrition is also indicated for certain situations in which enteral feeding cannot meet the patient's nutritional requirement, and in particular situations where enteral feeding is contraindicated and not feasible. Optimal patient care is dependent on adequate nutritional support.

  8. Genomic diversification of giant enteric symbionts reflects host dietary lifestyles.

    Science.gov (United States)

    Ngugi, David Kamanda; Miyake, Sou; Cahill, Matt; Vinu, Manikandan; Hackmann, Timothy J; Blom, Jochen; Tietbohl, Matthew D; Berumen, Michael L; Stingl, Ulrich

    2017-09-05

    Herbivorous surgeonfishes are an ecologically successful group of reef fish that rely on marine algae as their principal food source. Here, we elucidated the significance of giant enteric symbionts colonizing these fishes regarding their roles in the digestive processes of hosts feeding predominantly on polysiphonous red algae and brown Turbinaria algae, which contain different polysaccharide constituents. Using metagenomics, single-cell genomics, and metatranscriptomic analyses, we provide evidence of metabolic diversification of enteric microbiota involved in the degradation of algal biomass in these fishes. The enteric microbiota is also phylogenetically and functionally simple relative to the complex lignocellulose-degrading microbiota of terrestrial herbivores. Over 90% of the enzymes for deconstructing algal polysaccharides emanate from members of a single bacterial lineage, " Candidatus Epulopiscium" and related giant bacteria. These symbionts lack cellulases but encode a distinctive and lineage-specific array of mostly intracellular carbohydrases concurrent with the unique and tractable dietary resources of their hosts. Importantly, enzymes initiating the breakdown of the abundant and complex algal polysaccharides also originate from these symbionts. These are also highly transcribed and peak according to the diel lifestyle of their host, further supporting their importance and host-symbiont cospeciation. Because of their distinctive genomic blueprint, we propose the classification of these giant bacteria into three candidate genera. Collectively, our findings show that the acquisition of metabolically distinct " Epulopiscium " symbionts in hosts feeding on compositionally varied algal diets is a key niche-partitioning driver in the nutritional ecology of herbivorous surgeonfishes.

  9. ESPEN Guidelines on Enteral Nutrition: Geriatrics.

    Science.gov (United States)

    Volkert, D; Berner, Y N; Berry, E; Cederholm, T; Coti Bertrand, P; Milne, A; Palmblad, J; Schneider, St; Sobotka, L; Stanga, Z; Lenzen-Grossimlinghaus, R; Krys, U; Pirlich, M; Herbst, B; Schütz, T; Schröer, W; Weinrebe, W; Ockenga, J; Lochs, H

    2006-04-01

    Nutritional intake is often compromised in elderly, multimorbid patients. Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility to increase or to insure nutrient intake in case of insufficient oral food intake. The present guideline is intended to give evidence-based recommendations for the use of ONS and TF in geriatric patients. It was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. The guideline was discussed and accepted in a consensus conference. EN by means of ONS is recommended for geriatric patients at nutritional risk, in case of multimorbidity and frailty, and following orthopaedic-surgical procedures. In elderly people at risk of undernutrition ONS improve nutritional status and reduce mortality. After orthopaedic-surgery ONS reduce unfavourable outcome. TF is clearly indicated in patients with neurologic dysphagia. In contrast, TF is not indicated in final disease states, including final dementia, and in order to facilitate patient care. Altogether, it is strongly recommended not to wait until severe undernutrition has developed, but to start EN therapy early, as soon as a nutritional risk becomes apparent.

  10. Genetic parameters for predicted methane production and potential for reducing enteric emissions through genomic selection.

    Science.gov (United States)

    Haas, Y de; Windig, J J; Calus, M P L; Dijkstra, J; Haan, M de; Bannink, A; Veerkamp, R F

    2011-12-01

    Mitigation of enteric methane (CH₄) emission in ruminants has become an important area of research because accumulation of CH₄ is linked to global warming. Nutritional and microbial opportunities to reduce CH₄ emissions have been extensively researched, but little is known about using natural variation to breed animals with lower CH₄ yield. Measuring CH₄ emission rates directly from animals is difficult and hinders direct selection on reduced CH₄ emission. However, improvements can be made through selection on associated traits (e.g., residual feed intake, RFI) or through selection on CH₄ predicted from feed intake and diet composition. The objective was to establish phenotypic and genetic variation in predicted CH₄ output, and to determine the potential of genetics to reduce methane emissions in dairy cattle. Experimental data were used and records on daily feed intake, weekly body weights, and weekly milk production were available from 548 heifers. Residual feed intake (MJ/d) is the difference between net energy intake and calculated net energy requirements for maintenance as a function of body weight and for fat- and protein-corrected milk production. Predicted methane emission (PME; g/d) is 6% of gross energy intake (Intergovernmental Panel on Climate Change methodology) corrected for energy content of methane (55.65 kJ/g). The estimated heritabilities for PME and RFI were 0.35 and 0.40, respectively. The positive genetic correlation between RFI and PME indicated that cows with lower RFI have lower PME (estimates ranging from 0.18 to 0.84). Hence, it is possible to decrease the methane production of a cow by selecting more-efficient cows, and the genetic variation suggests that reductions in the order of 11 to 26% in 10 yr are theoretically possible, and could be even higher in a genomic selection program. However, several uncertainties are discussed; for example, the lack of true methane measurements (and the key assumption that methane

  11. A Map Enters the Conversation

    DEFF Research Database (Denmark)

    Munk, Anders Kristian

    'modes of mattering'. In this paper I explore what difference digital cartography can make to STS practice. I draw on three examples from my own work where digitally mediated maps have entered the conversation and made critical, often surprising, differences to the research process. In my first example...... the map is brought along as an ethnographic device on a piece of fieldwork, in my second example it serves as the central collaborative object in a participatory design project, and in my third example the map becomes the object of contestation as it finds itself centre stage in the controversy...

  12. Preoperative Feeding Neonates With Cardiac Disease.

    Science.gov (United States)

    Scahill, Carly J; Graham, Eric M; Atz, Andrew M; Bradley, Scott M; Kavarana, Minoo N; Zyblewski, Sinai C

    2017-01-01

    The potential for necrotizing enterocolitis (NEC) in neonates requiring cardiac surgery has contributed largely to wide feeding practice variations and a hesitation to initiate enteral feeding during the preoperative period, specifically those patients with hypoplastic left heart syndrome. A retrospective chart review of neonates undergoing cardiac surgery at a single institution between July 2011 and July 2013 was performed. The primary objective of this study was to determine if preoperative feeding was associated with NEC in neonates requiring cardiac surgery. Univariable and multivariable analyses were performed to evaluate the relationship between preoperative feeding and NEC. Secondary outcomes including growth failure, total ventilator days, total length of stay, and tube-assisted feeds at discharge were analyzed. One hundred thirty consecutive neonates who required cardiac surgery were included in the analysis. Preoperative feeding occurred in 61% (n = 79). The overall prevalence of NEC was 9% (12/130), including three neonates with surgical NEC. There was no difference in the prevalence of NEC between the preoperative feeding and nil per os (NPO) groups. Preoperative NPO status was associated with longer ventilator-dependent days ( P = .01) but was not associated with worsened growth failure, longer length of stay, or increased prevalence of tube-assisted feeds at discharge. In this study cohort, preoperative feeding was associated with a low prevalence of NEC. Larger prospective studies evaluating the safety and benefits of preoperative feeding in cardiac neonates are warranted.

  13. Original Article The effect of grower feed diet supplemented with ...

    African Journals Online (AJOL)

    We report a preliminary study on the effect of grower feed diet supplemented with mashed Ganoderma lucidum against some enteric zoonotic parasites of wild rock pigeons (Columba livia) in Benin City, Nigeria. The pigeons were fed ad libitum with supplemented and non-supplemented grower feed diet in sawdust-floored ...

  14. Systematic review of five feeding routes after pancreatoduodenectomy

    NARCIS (Netherlands)

    Gerritsen, A.; Besselink, M. G. H.; Gouma, D. J.; Steenhagen, E.; Borel Rinkes, I. H. M.; Molenaar, I. Q.

    2013-01-01

    Current European guidelines recommend routine enteral feeding after pancreato-duodenectomy (PD), whereas American guidelines do not. The aim of this study was to determine the optimal feeding route after PD. A systematic search was performed in PubMed, Embase and the Cochrane Library. Included were

  15. Health, Social Participation and Entering Paid Employment among Unemployed Persons

    NARCIS (Netherlands)

    B.E. Carlier (Bouwine)

    2017-01-01

    markdownabstractUnemployed persons have poorer health compared to employed persons. Also, persons with a poor health are less likely to enter the workforce than healthy persons. So, more insight is needed in determinants of re-employment and effective re-employment programs for unemployed persons

  16. Enteral Formula Containing Egg Yolk Lecithin Improves Diarrhea.

    Science.gov (United States)

    Akashi, Tetsuro; Muto, Ayano; Takahashi, Yayoi; Nishiyama, Hiroshi

    2017-09-01

    Diarrhea often occurs during enteral nutrition. Recently, several reports showed that diarrhea improves by adding egg yolk lecithin, an emulsifier, in an enteral formula. Therefore, we evaluated if this combination could improve diarrhea outcomes. We retrospectively investigated the inhibitory effects on watery stools by replacing a polymeric fomula with that containing egg yolk lecithin. Then, we investigated the emulsion stability in vitro. Next, we examined the lipid absorption using different emulsifiers among bile duct-ligated rats and assessed whether egg yolk lecithin, medium-chain triglyceride, and dietary fiber can improve diarrhea outcomes in a rat model of short bowel syndrome. Stool consistency or frequency improved on the day after using the aforementioned combination in 13/14 patients. Average particle size of the egg yolk lecithin emulsifier did not change by adding artificial gastric juice, whereas that of soy lecithin and synthetic emulsifiers increased. Serum triglyceride concentrations were significantly higher in the egg yolk lecithin group compared with the soybean lecithin and synthetic emulsifier groups in bile duct-ligated rats. In rats with short bowels, the fecal consistency was a significant looser the dietary fiber (+) group than the egg yolk lecithin (+) groups from day 6 of test meal feedings. The fecal consistency was also a significant looser the egg yolk lecithin (-) group than the egg yolk lecithin (+) groups from day 4 of test meal feeding. The fecal consistency was no significant difference between the medium-chain triglycerides (-) and egg yolk lecithin (+) groups. Enteral formula emulsified with egg yolk lecithin promotes lipid absorption by preventing the destruction of emulsified substances by gastric acid. This enteral formula improved diarrhea and should reduce the burden on patients and healthcare workers.

  17. Nutritional analysis of blenderized enteral diets in the Philippines.

    Science.gov (United States)

    Sullivan, Mary M; Sorreda-Esguerra, Pearl; Platon, Maria Bernadette; Castro, Cynthia G; Chou, Nancy R; Shott, Susan; Comer, Gail M; Alarcon, Pedro

    2004-01-01

    The objective of this study was to analyze the nutritional quality and viscosity of blenderized enteral tube feedings (BTFs) from four hospitals in the Philippines. Samples of two different BTFs (one standard and one modified) were collected from each hospital on three separate occasions and analyzed for macronutrients, micronutrients, and viscosity. There was considerable variation among the BTFs for the concentrations of most nutrients measured. For standard BTF samples, the caloric density ranged from 66-123 kcal/100g and the percentages of total weight for protein, carbohydrate, and fat ranged from 1.5-4.0%, 8.6-21.4%, and 0.27-3.40%, respectively. Levels of specific vitamins were undetectable in 10 standard and 15 modified BTF samples. In samples where vitamin levels were detectable, results were: vitamin A, 625-8850 IU/kg; riboflavin, 0.40-5.00 mg/kg; and pyridoxine, 0.14-3.00 mg/kg. Mineral concentrations also varied greatly (eg calcium, 64-524 mg/kg; sodium, 148-886 mg/kg; iron, 3.0-13.7 mg/kg; and zinc, 1.8- 11.5 mg/kg). Correlation coefficients were statistically significant only for carbohydrate (r = 0.48, P = 0.017). Measured values tended to be lower than expected values for all nutrients, although the difference was statistically significant only for calories (P = 0.023). The viscosity of BTF samples ranged from 2.3-45,060 centipoise, excluding three samples that were too viscous for analysis. This study demonstrates that hospital prepared blenderized enteral tube feedings render unpredictable levels of micronutrients and macronutrients and appear likely to deliver less than the desired amounts of nutrients. Additionally, the viscosity of these feedings may be unsuitable for infusion through feeding tubes.

  18. Fasting, circadian rhythms, and time restricted feeding in healthy lifespan

    OpenAIRE

    Longo, Valter D.; Panda, Satchidananda

    2016-01-01

    Feeding in most animals is confined to a defined period, leaving short periods of fasting that coincide with sleep. Fasting enables organisms to enter alternative metabolic phases, which rely less on glucose and more on ketone body-like carbon sources. Both intermittent and periodic fasting result in benefits ranging from prevention to the enhanced treatment of diseases. Similarly, time-restricted feeding (TRF), in which feeding time is restricted to certain hours of the day, allows the daily...

  19. Strategies to improve feeding tolerance in preterm infants.

    Science.gov (United States)

    Fanaro, Silvia

    2012-10-01

    Postnatal growth restriction and failure to thrive is a major issue in preterm, especially extremely low-birth-weight infants. Optimization of enteral nutrition, without increasing the risk of necrotizing enterocolitis (NEC), has thus become a priority for the neonatologist, who often has to face the challenge of interpreting the clinical and prognostic significance of common and aspecific signs of feeding intolerance (FI). The neonatologist often prescribes enteral nutrition as if walking on a tightrope between the purposed attainment of full enteral feeding and the fear of NEC. Despite advances in neonatal intensive care, NEC still remains one of the leading causes of mortality (15-30%) and morbidity in very-low-birth-weight infants. However, the relationship between FI and NEC remains unknown. Feeding intolerance often leads to discontinuation of enteral feeds, delayed attainment of full enteral feeding and prolongation of hospitalization. Strategies aimed at preventing and/or treating episodes of feeding intolerance are diverse and not always supported by scientific evidence.

  20. Everything the nurse practitioner should know about pediatric feeding tubes.

    Science.gov (United States)

    Hannah, Erin; John, Rita Marie

    2013-11-01

    To provide an overview of the current feeding tubes in use in the pediatric population including feeding tube complications, and specific guidance for patients at the initiation, throughout the use of, and at the discontinuation of tube feeding. A review of the literature was performed using multiple databases including PubMed, CINAHL, Ovid Medline, and Cochrane Library. Key words used included pediatric gastrostomy (G) tubes, nasogastric (NG) tubes, gastrojejunostomy (GJ) tubes, enteral access, and nurse practitioner (NP). Any child who cannot obtain nutrition orally is a candidate for enteral feeding tube access. Tube feeding is the recommended care guideline for children that are undernourished or unable to safely take-in oral nutrition. Tube feeding has been known to improve health-related quality of life. There are a number of different forms of feeding tubes that can be used in children, including NG, orogastric, G, and GJ tubes. Children are being sent home regularly with enteral feeding tube access and NPs will encounter these patients in everyday practice. It is important that NPs know the risks and benefits of tube feeding as well as the types of tubes currently in use and their indications, advantages, disadvantages, and complications. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  1. Feed intake of sheep when allowed ad libitum access to feed in methane respiration chambers.

    Science.gov (United States)

    Bickell, S L; Revell, D K; Toovey, A F; Vercoe, P E

    2014-05-01

    The patterns of feed intake when animals are allowed ad libitum access to feed in a respiration chamber is not known, nor are the potential effects of the artificial environment of chambers on voluntary feed intake. The objectives of the study were to describe the pattern of hourly feed intake of sheep when fed for ad libitum intake in respiration chambers and determine the repeatability of this pattern and the correlation between feed intake and methane production calculated at hourly intervals. Daily and hourly measurements of methane production and feed intake of 47 Merino wethers were measured in respiration chambers twice, 4 wk apart. We found that hourly feed intake of sheep with ad libitum access to feed in respiration chambers showed a repeatable pattern over the 2 measurement periods (r = 0.89, P sheep ate continuously throughout the 23 h period, but most of the eating occurred during the first 8 h in the respiration chambers. There was a significant linear correlation (r = 0.22) between hourly feed intake and hourly methane production (P sheep had 15 to 25% lower feed intake in the respiration chambers compared with their feed intake during the previous week in the animal house pens. In addition, daily feed intake in the respiration chamber was not correlated with feed intake in any of the 7 d before entering the chamber (P > 0.05). Future methane research may consider using feed intake and changes in intake levels as a quantitative indicator of habituation to the methane measurement procedure and environment, which, given the tight association between feed intake and methane production, will be crucial in providing accurate values for methane production.

  2. Estimation of costs for control of Salmonella in high-risk feed materials and compound feed

    Directory of Open Access Journals (Sweden)

    Martin Wierup

    2014-06-01

    Full Text Available Introduction: Feed is a potential and major source for introducing Salmonella into the animal-derived food chain. This is given special attention in the European Union (EU efforts to minimize human food-borne Salmonella infections from animal-derived food. The objective of this study was to estimate the total extra cost for preventing Salmonella contamination of feed above those measures required to produce commercial feed according to EU regulation (EC No 183/2005. The study was carried out in Sweden, a country where Salmonella infections in food-producing animals from feed have largely been eliminated. Methods: On the initiative and leadership of the competent authority, the different steps of feed production associated with control of Salmonella contamination were identified. Representatives for the major feed producers operating in the Swedish market then independently estimated the annual mean costs during the years 2009 and 2010. The feed producers had no known incentives to underestimate the costs. Results and discussion: The total cost for achieving a Salmonella-safe compound feed, when such a control is established, was estimated at 1.8–2.3 € per tonne of feed. Of that cost, 25% relates to the prevention of Salmonella contaminated high-risk vegetable feed materials (mainly soybean meal and rapeseed meal from entering feed mills, and 75% for measures within the feed mills. Based on the feed formulations applied, those costs in relation to the farmers’ 2012 price for compound feed were almost equal for broilers and dairy cows (0.7%. Due to less use of protein concentrate to fatten pigs, the costs were lower (0.6%. These limited costs suggest that previous recommendations to enforce a Salmonella-negative policy for animal feed are realistic and economically feasible to prevent a dissemination of the pathogen to animal herds, their environment, and potentially to human food products.

  3. Het effect van voersamenstelling op bacteriële darmaandoeningen bij varkens = The effect of feed composition on bacterial intestinal diseases in pigs

    OpenAIRE

    Meulen, van der, J.; Peet-Schwering, van der, C.M.C.

    2007-01-01

    Feed composition, and especially carbohydrate composition, may affect the development of enteric bacterial diseases. Also the kind of feed ingredients (soybean or not) and feed treatment (milling size, pelletizing, fermentation) may be important. A more coarse grinding, no pelletizing and fermentation may be preferable in the reduction of the development of enteric bacterial diseases.

  4. Efeito antagônico do ferro e do zinco em uma formulação de alimentação enteral utilizando planejamento de misturas da metodologia de superfície de resposta The antagonic effect of iron and zinc in formulations of feeding diets studied by response surface methodology for mixtures

    Directory of Open Access Journals (Sweden)

    Luciana Bueno

    2008-01-01

    Full Text Available Nutritional therapy with enteral diets became substantially specialized over the last years. This work's aim was to study the effect of the components of a formulation: fiber, calcium and medium-chain triglycerides for dialysability of minerals. Analysis of multiple variables was carried out using response surface methodology. The level curve showed an antagonic effect of interaction between iron and zinc. TCM was the variable responsible for characterizing competition between the two minerals in the formulation. More studies on foods are needed for knowing the effecs of minerals in formulations.

  5. The NOURISH randomised control trial: Positive feeding practices and food preferences in early childhood - a primary prevention program for childhood obesity

    Directory of Open Access Journals (Sweden)

    Farrell Ann

    2009-10-01

    Full Text Available Abstract Background Primary prevention of childhood overweight is an international priority. In Australia 20-25% of 2-8 year olds are already overweight. These children are at substantially increased the risk of becoming overweight adults, with attendant increased risk of morbidity and mortality. Early feeding practices determine infant exposure to food (type, amount, frequency and include responses (eg coercion to infant feeding behaviour (eg. food refusal. There is correlational evidence linking parenting style and early feeding practices to child eating behaviour and weight status. A focus on early feeding is consistent with the national focus on early childhood as the foundation for life-long health and well being. The NOURISH trial aims to implement and evaluate a community-based intervention to promote early feeding practices that will foster healthy food preferences and intake and preserve the innate capacity to self-regulate food intake in young children. Methods/Design This randomised controlled trial (RCT aims to recruit 820 first-time mothers and their healthy term infants. A consecutive sample of eligible mothers will be approached postnatally at major maternity hospitals in Brisbane and Adelaide. Initial consent will be for re-contact for full enrolment when the infants are 4-7 months old. Individual mother- infant dyads will be randomised to usual care or the intervention. The intervention will provide anticipatory guidance via two modules of six fortnightly parent education and peer support group sessions, each followed by six months of regular maintenance contact. The modules will commence when the infants are aged 4-7 and 13-16 months to coincide with establishment of solid feeding, and autonomy and independence, respectively. Outcome measures will be assessed at baseline, with follow up at nine and 18 months. These will include infant intake (type and amount of foods, food preferences, feeding behaviour and growth and self

  6. CERN openlab enters new phase

    CERN Multimedia

    Katarina Anthony

    2012-01-01

    The newest phase of CERN’s openlab framework was inaugurated this week during a meeting of the openlab partners. This phase will last three years and will bring together existing openlab partners and a new contributor: Huawei.   Group picture taken at the first CERN openlab IV annual Board of Sponsors meeting, in the presence of the CERN Director-General, the partners and the openlab team members. © Fons Rademakers (CERN Photo Club). Eleven years ago, the creation of the CERN openlab created a long-term link between industrial partners and the Organization. Its framework has allowed industry to carry out large-scale IT research and development in an open atmosphere – an “Open Lab”, if you will. For CERN, openlab has contributed to giving the computing centre and, more broadly, the LHC community, the opportunity to ensure that the next generation of services and products is suitable to their needs. Now entering its fourth phase, openlab will ...

  7. Extending the enteric nervous system.

    Science.gov (United States)

    Sbarbati, Andrea; Osculati, Francesco

    2007-08-01

    The work reviews the evidence suggesting that lingual components of the autonomic system may be considered the most rostral portion of the enteric nervous system (ENS) defining the concept of lingual ENS (LENS). The LENS is not dissimilar from the more distally located portions of the ENS, however, it is characterized by a massive sensory input generated by collaterals of gustatory and trigeminal fibers. The different neuronal subpopulations that compose the LENS operate reflexes involved in regulation of secretion and vasomotility. Systemic reflexes on the digestive and respiratory apparatus are operated by means of neural connections through the pharynx or larynx. The LENS can modulate the activity of distally located organs by means of the annexed glands.The LENS seems therefore to be a "chemical eye" located at the beginning of the digestive apparatus which analyses the foods before their ingestion and diffuses this information distally. The definition of the LENS supports the concept of an elevated degree of autonomy in the ENS and puts in a new light the role of the gustatory system in modulation of the digestive functions. For its characteristics, the LENS appears to be an ideal model to study the elementary connectivity of the ENS.

  8. Entering China: an unconventional approach.

    Science.gov (United States)

    Vanhonacker, W

    1997-01-01

    Conventional wisdom has it that the best way to do business in China is through an equity joint venture (EJV) with a well-connected Chinese partner. But pioneering companies are starting a trend toward a new way to enter that market: as a wholly foreign-owned enterprise, or WFOE. Increasingly, says the author, joint ventures do not offer foreign companies what they need to succeed in China. For example, many companies want to do business nationally, but the prospects for finding a Chinese partner with national scope are poor. Moreover, there are often conflicting perceptions between partners about how to operate an EJV: Chinese companies, for example, typically have a more immediate interest in profits than foreign investors do. By contrast, the author asserts, WFOEs are faster to set up and easier to manage; and they allow managers to expand operations more rapidly. That makes them the perfect solution, right? The answer is a qualified yes. First, foreign companies will still need sources of guanxi, or social and political connections. Second, managers must take steps to avoid trampling on China's cultural or economic sovereignty. Third and perhaps most important, foreign companies must be prepared to bring something of value to China-usually in the form of jobs or new technology that can help the country develop. Companies willing to make the effort, says the author, can reap the rewards of China's burgeoning marketplace.

  9. [Role of donor human milk feeding in preventing nosocomial infection in very low birth weight infants].

    Science.gov (United States)

    Bi, Hong-Juan; Xu, Jing; Wei, Qiu-Fen

    2018-02-01

    To investigate the role of donor human milk in the prevention of nosocomial infection in very low birth weight infants. MeETHODS: A total of 105 hospitalized preterm infants with a very low birth weight were enrolled. They were classified into mother's own milk feeding group, donor human milk feeding group, and preterm formula feeding group, with 35 infants in each group. The three groups were compared in terms of incidence rates of nosocomial infection, necrotizing enterocolitis, and feeding intolerance, time to full enteral feeding, and early growth indices. Compared with the preterm formula feeding group, the donor human milk feeding group and the mother's own milk feeding group had significantly lower incidence rates of nosocomial infection and necrotizing enterocolitis and shorter time to full enteral feeding (Pgroups. Donor human milk can be used in case of a lack of mother's own milk and may help to reduce nosocomial infection.

  10. A prediction equation for enteric methane emission from dairy cows for use in NorFor

    DEFF Research Database (Denmark)

    Nielsen, N I; Volden, H; Åkerlind, M

    2013-01-01

    A data-set with 47 treatment means (N = 211) was compiled from research institutions in Denmark, Norway, and Sweden in order to develop a prediction equation for enteric methane (CH4) emissions from dairy cows. The aim was to implement the equation in the Nordic feed evaluation system Nor...

  11. Gene ontology of differentially expressed genes in the Necrotic enteritis induced chicken lines

    Science.gov (United States)

    Necrotic enteritis caused by Clostridium perfringens has become prevalent in the broiler industry due to the withdrawal of antibiotics in poultry feed. The expression level of intestinal mRNA from two chicken lines (line 6.3: MD-resistant and 7.2: MD-susceptible) was significantly different followi...

  12. An integrated nutrition and health program package on IYCN improves breastfeeding but not complementary feeding and nutritional status in rural northern India: A quasi-experimental randomized longitudinal study.

    Science.gov (United States)

    Singh, Veena; Ahmed, Saifuddin; Dreyfuss, Michele L; Kiran, Usha; Chaudhery, Deepika N; Srivastava, Vinod K; Ahuja, Ramesh C; Baqui, Abdullah H; Darmstadt, Gary L; Santosham, Mathuram; West, Keith P

    2017-01-01

    Undernutrition below two years of age remains a major public health problem in India. We conducted an evaluation of an integrated nutrition and health program that aimed to improve nutritional status of young children by improving breast and complementary feeding practices over that offered by the Government of India's standard nutrition and health care program. In Uttar Pradesh state, through multi-stage cluster random sampling, 81 villages in an intervention district and 84 villages in a comparison district were selected. A cohort of 957 third trimester pregnant women identified during house-to-house surveys was enrolled and, following childbirth, mother-child dyads were followed every three months from birth to 18 months of age. The primary outcomes were improvements in weight-for-age and length-for-age z scores, with improved breastfeeding and complementary feeding practices as intermediate outcomes. Optimal breastfeeding practices were higher among women in intervention than comparison areas, including initiating breastfeeding within one hour of delivery (17.4% vs. 2.7%, punderweight status was lower at 12 months (58.5% vs. 69.3%, p = 0.047) among intervention children. The prevalence of stunting was similar between study arms at all ages. Coefficients to show the differences between the intervention and comparison districts (0.13 cm/mo) suggested significant faster linear growth among intervention district infants at earlier ages (0-5 months). Mothers participating in the intervention district were more likely to follow optimal breast, although not complementary feeding practices. The program modestly improved linear growth in earlier age and weight gain in late infancy. Comprehensive nutrition and health interventions are complex; the implementation strategies need careful examination to improve feeding practices and thus impact growth. The trial was registered with ClinicalTrials.gov, NCT00198835.

  13. Development and Evaluation of a Home Enteral Nutrition Team

    Directory of Open Access Journals (Sweden)

    Sarah Dinenage

    2015-03-01

    Full Text Available The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1 prevention of hospital admission and related transport for ETF related issues; (2 effective management and reduction of waste of feed and thickener; (3 balloon gastrostomy tube replacement by the HEN Team in the patient’s home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

  14. Development and evaluation of a home enteral nutrition team.

    Science.gov (United States)

    Dinenage, Sarah; Gower, Morwenna; Van Wyk, Joanna; Blamey, Anne; Ashbolt, Karen; Sutcliffe, Michelle; Green, Sue M

    2015-03-05

    The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1) prevention of hospital admission and related transport for ETF related issues; (2) effective management and reduction of waste of feed and thickener; (3) balloon gastrostomy tube replacement by the HEN Team in the patient's home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

  15. Early versus On-Demand Nasoenteric Tube Feeding in Acute Pancreatitis

    NARCIS (Netherlands)

    Bakker, Olaf J.; van Brunschot, Sandra; van Santvoort, Hjalmar C.; Besselink, Marc G.; Bollen, Thomas L.; Boermeester, Marja A.; Dejong, Cornelis H.; van Goor, Harry; Bosscha, Koop; Ahmed Ali, Usama; Bouwense, Stefan; van Grevenstein, Wilhelmina M.; Heisterkamp, Joos; Houdijk, Alexander P.; Jansen, Jeroen M.; Karsten, Thom M.; Manusama, Eric R.; Nieuwenhuijs, Vincent B.; Schaapherder, Alexander F.; van der Schelling, George P.; Schwartz, Matthijs P.; Spanier, B. W. Marcel; Tan, Adriaan; Vecht, Juda; Weusten, Bas L.; Witteman, Ben J.; Akkermans, Louis M.; Bruno, Marco J.; Dijkgraaf, Marcel G.; van Ramshorst, Bert; Gooszen, Hein G.

    2014-01-01

    BACKGROUND Early enteral feeding through a nasoenteric feeding tube is often used in patients with severe acute pancreatitis to prevent gut-derived infections, but evidence to support this strategy is limited. We conducted a multicenter, randomized trial comparing early nasoenteric tube feeding with

  16. The effects of a step-up ractopamine feeding program on growth performance and low-sodium ham characteristics of purebred Berkshire pigs.

    Science.gov (United States)

    Bohrer, B M; Kyle, J M; Little, K L; Zerby, H N; Boler, D D

    2013-11-01

    Objectives were to test the effect of a low-sodium curing solution on processing characteristics of hams from purebred Berkshire pigs that were fed a step-up ractopamine HCl (RAC) feeding program or a negative control diet. Sixty pairs (n=120) of hams were selected from two blocks of purebred Berkshire pigs (n=200) that were fed either a control diet or 7.4 mg of ractopamine/kg of diet for 14 d followed by 10.0 mg of ractopamine/kg of diet for the last 14 d before slaughter. Three-piece, section-formed hams were cured with a standard (1.98% NaCl; REG) curing solution or a low-sodium with KCl replacement (0.67% NaCl and 1.29% KCl; LOW) curing solution. Pigs fed RAC had 3.18% greater BW, 11.90% greater ADG, and 10.34% greater G:F compared with control pigs. No differences (P≥0.07) were detected for the effect of diet, curing solution, or the interaction between diet and curing solution for ham weights, pump uptake, or cook yield [(cooked weight/green weight) 100]. Break strength (an indication of protein interaction and bind strength; 5.97 vs. 6.99 kg) and protein fat-free values (24.58 vs. 25.98%) were less (P≤0.05) in hams cured with LOW curing solution compared with hams cured with REG curing solution. Lightness (L*) and yellowness (b*) values were greater (P≤0.03), while redness (a*) values were less (P<0.01) in hams cured with LOW curing solution compared with hams cured with REG curing solution. A trained sensory panel detected less (P=0.03) flavor intensity in hams cured with LOW curing solution compared with hams cured with REG curing solution. Yet, no differences (P≥0.55) were detected between hams cured with LOW or REG curing solution for saltiness. Overall acceptability of hams cured with LOW curing solution tended to be less (P=0.09) compared with hams cured with REG curing solution; however, the magnitude of this difference was 0.34 on a 1 to 9 scale. Hams cured with LOW curing solution made hams paler and contain less intense flavor compared

  17. Displays: Entering a New Dimension

    Science.gov (United States)

    Starkman, Neal

    2007-01-01

    As display technologies prepare to welcome 3-D, the 21st-century classroom will soon bear little resemblance to anything students and teachers have ever seen. In this article, the author presents the latest innovations in the world of digital display technology. These include: (1) Touchlight, an interactive touch screen program that takes a normal…

  18. Clostridial necrotic enteritis in chicken associated with growth rate depression

    Directory of Open Access Journals (Sweden)

    Adin Priadi

    2008-03-01

    Full Text Available Clostridium perfringens (C. perfringens is a normal inhabitant of the intestinal tract of chickens as well as a potential pathogen causing necrotic enteritis. C. perfringens only causes necrotic enteritis when it transforms from non-toxin producing type to toxin producing type. The alpha toxin, (phospholipase C is believed to be a key to the occurrence of Clostridial necrotic enteritis (CNE. The best known predisposing factor is mucosal damage, caused by coccidiosis that damages the intestinal lining, making the gut susceptible to infections including C. perfringens. The purpose of this study was to observe the chicken performance in experimental CNE and field cases of CNE. Diagnosis of CNE were made by latex agglutination test, isolation and identification of the agent. Pathological and histopathological changes were also observed. Experimentally, NE could be reproduced when Eimeria sp and C. perfringens spores are inoculated in chicken. Signs of an NE are wet litter and diarrhea, and an increase in mortality is not often obvious. The depression of growth rate and feed efficiency of chicken become noticeable by week 5 because of damage to the intestine and the subsequent reduction in digestion and absorption of food. Subclinical form of CNE was also frequently found in the field, leading to significant decreases in performance. Chicken gut samples examinations revealed that subclinical form of CNE causes damage to the intestinal mucosa caused by C. perfringens leads to decreased digestion and absorption, increased feed conversion ratio and reduced weight gain. Dual infection with C. perfringens and Eimeria sp. was frequently found in field. The results of these studies provide evidence for C. perfringens as a causative bacteria for growth depression.

  19. Avaliação de diferentes programas de restrição alimentar na recria de matrizes avícolas tipo corte Evaluation of different feeding programs for broiler breeder females during the rearing period

    Directory of Open Access Journals (Sweden)

    Neventon Santi Vieira

    1995-01-01

    Santa Maria, to study the of feeding programs on the body weight gain, uniformity of weight and viability of broiler breeders. A completely randomized designe with 3 treatments and 4 replicates of 67 birds was used. In the fírst 2 weeks of age they were all feed ad libitum, and in the 2 subsequent weeks feed was controled daily. From 5 to 20 weeks they were submitted to the following feeding treatments: T1: 5-14 weeks = "Skip-a-Day", 15-17 = "Skip on day out of two and 18-20 = controled daily; T2: 5-8 weeks = "Skip-a-Day", 9-16 = 48-57-63 hours of feeding intervals and 17-20 = ''Skip one day out of two"; T3 = 5-20 " 48-57-63 hours intervals between feeding. The results show that the feeding program of 48-57-63 hours interval between feeding during the rearing period can be used with no negative effects on the parameters studied, and with the advantage ofno need of feeding during the weekend, saving handwork costs.

  20. [ENTERAL NUTRITION ON THE NUTRITIONAL STATUS OF CANCER].

    Science.gov (United States)

    Escortell Sánchez, Raquel; Reig García-Galbis, Manuel

    2015-10-01

    to identify what effect causes enteral nutrition on nutritional status of cancer. a search was performed using the keywords "Cancer" AND "Enteral Nutrition" AND "Supplementation" in four document databases: Pubmed, EBSCO, ProQuest, and Web of Science. age of the sample, major than 18 years; submitted to surgery for cancer; that the intervention program was including diet and employment or not of nutritional Supplementation; clinical trials published between January 2004 and December 2014, in scientific journals indexed. we analyzed 660 articles, of which only 2% has been included. 58% of intervention programs are applied outside Spain; 84% of the interventions was carried out in a hospitable ambient; 58% of the sample is formed by adults older than 54 years; 33% of the interventions were multidisciplinary and its duration ranges between 1 and 4 years. we found just a few national interventions in cancer participants and there two types of interventions: by exclusive polymeric enteral formula or mixed with immunonutrition. enteral nutrition shows against the parenteral and its introduction at an early stage, it helps to improve nutritional status of the patient; polymeric formulas next immunonutrition, it helps to reduce the time of hospitalization; the analytical parameters are shown as a measurement pattern when assessing the improvement in nutritional status in cancer. It is recommended to increase the research in this field, especially in children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  1. Sequential intrahepatic metabolic effects of enteric galactose alimentation in newborn rats.

    Science.gov (United States)

    Kliegman, R M; Morton, S

    1988-09-01

    We determined metabolic responses after enteric galactose alimentation in 5- to 7-day-old newborn rats fasted for 24 h. The glycemic response was attenuated after enteric galactose feeding compared with the response after enteric glucose-fed rat pups. 14C radioactivity in blood from galactose-fed pups was reduced as counts in blood galactose were lower than counts in blood glucose in glucose-fed pups. Nonetheless within 15 min, [14C] from galactose appeared in blood glucose suggesting rapid conversion of galactose to glucose. The plasma insulin response was also attenuated after galactose feeding compared with the insulin response after enteric glucose. Hepatic glycogen content increased rapidly after enteric galactose feeding and was higher than after glucose feeding at 60, 120, and 180 min. Significant glycogen synthesis after oral glucose was delayed and occurred at 240 min. Carbon radioactivity in glycogen was higher in galactose fed pups between 15 and 360 min of the study. Serial determination of hepatic metabolites revealed an increase of galactose-1-phosphate levels after oral galactose at 240 and 300 min and a transient decline of ATP at 15 min. Other hepatic metabolites did not demonstrate significant differences between the two groups. These data suggest that hepatic glycogen synthesis is more rapid and occurs sooner after galactose than after glucose alimentation in previously fasted newborn rats. Galactose may enter a more direct pathway for neonatal hepatic glycogen synthesis. The relatively delayed entry of glucose label into hepatic glycogen and the delay of net glycogen synthesis after oral glucose suggest that glucose entry is not direct and may require further metabolism before incorporation into glycogen.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Bronchopulmonary complications associated to enteral nutrition devices in patients admitted to internal medicine departments.

    Science.gov (United States)

    Marco, J; Barba, R; Lázaro, M; Matía, P; Plaza, S; Canora, J; Zapatero, A

    2013-01-01

    Enteral nutrition using feeding devices such as nasogastric (NG) tube or percutaneous endoscopic gastrostomy (PEG) is an effective feeding method subject that may give rise to complications. We have studied the relationship between enteral nutrition feeding devices in patients admitted to the Internal Medicine Departments and the development of pulmonary complications (bronchial aspiration and aspiration pneumonia). All of the patients discharge between 2005 and 2009 from the Internal Medicine (IM) Departments of the public hospitals of the National Health System in Spain were analyzed. The data of patients with bronchial aspiration or aspiration pneumonia who also were carriers of NG tubes or PEG, were obtained from the Minimum Basic Data Set (MBDS). From a total of 2,767,259 discharges, 26,066 (0.92%) patients with nasogastric tube (NG tube) or percutaneous gastrostomy (PEG) were identified. A total of 21.5% of patients with NG tube and 25.9% of patients with PEG had coding for a bronchopulmonary aspiration on their discharge report versus 1.2% of patients without an enteral feeding tube. In the multivariate analysis, the likelihood of suffering bronchoaspiration was 9 times greater in patients with SNG (OR: 9.1; 95% CI: 8.7-9.4) and 15 greater in subjects with PEG (OR: 15.2; 95% CI: 14.5-15.9) than in subjects without SNG or PEG. Mean stay (9.2 and 12.7 more days), diagnostic complexity and costs were much higher in patients with SNG or PEG compared to patients in hospital who did not require these devices. An association was found between SNG and PEG for enteral feeding and pulmonary complications. Mean stay, diagnostic complexity and cost per admission of these patients was higher in patients who did not require enteral nutrition. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  3. Programming Merino lambs by early feed restriction reduces growth rates and increases fat accretion during the fattening period with no effect on meat quality traits.

    Science.gov (United States)

    Santos, Alba; Giráldez, F Javier; Mateo, Javier; Frutos, Javier; Andrés, Sonia

    2018-01-01

    The objective of the study was to determine the effect of early feed restriction on carcass and meat quality traits in Merino lambs. Twenty-four male Merino lambs (4.81±0.256kg) were assigned to two groups (12 animals in each group). The first group (ad libitum, ADL) was kept permanently with the dams. The second group (restricted, RES) was milk-restricted. After weaning (15kg), daily feed intake of all lambs was identical, but a lower gain: feed ratio was recorded in the RES group (0.320 vs. 0.261; P<0.001). After animals were slaughtered (27kg), lower ultimate pH and reduced yellow colouration of subcutaneous fat was recorded in meat from the RES lambs when compared to ADL group, whereas a trend towards a significant increment of intramuscular fat content and no effect on meat quality traits was observed in the RES lambs. Early feed restriction may be useful to increase intramuscular fat accretion in Merino lambs during the fattening period. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Prospective, randomized trial on the effect of cyclic versus continuous enteral nutrition on postoperative gastric function after pylorus-preserving pancreatoduodenectomy

    NARCIS (Netherlands)

    van Berge Henegouwen, M. I.; Akkermans, L. M.; van Gulik, T. M.; Masclee, A. A.; Moojen, T. M.; Obertop, H.; Gouma, D. J.

    1997-01-01

    OBJECTIVE: The effect of a cyclic versus a continuous enteral feeding protocol on postoperative delayed gastric emptying, start of normal diet, and hospital stay was assessed in patients undergoing pylorus-preserving pancreatoduodenectomy (PPPD). SUMMARY BACKGROUND DATA: Delayed gastric emptying

  5. Enter as an outsider: Teaching organizational humility.

    Science.gov (United States)

    Clabby, John F

    2017-05-01

    The concept of cultural humility acknowledges the enormous task of becoming culturally competent by encouraging curiosity about the context within which others live. For physicians, this includes curiosity about the organizations in which they work as Outsiders in settings such as a new hospital or patients' homes. However, efforts to train healthcare professionals in cultural competence are often de-emphasized due to the pressure learners feel to acquire Medical Knowledge and clinical skills. Little time is devoted to address the significance of cultural humility for fully appreciating the experiences of others. Efforts to educate physicians-in-training about the cultural aspects of care require innovative approaches that help them recognize bias without provoking defensiveness. Enter as an Outsider is a highly focused activity which fosters a culturally humble approach to an often neglected problem, organizational bias. This article describes how cultural humility is explained to learners and small group activities are used to explore the thoughts and feelings of an organization's Insiders and Outsiders. This program relies on instructor self-disclosure to facilitate learning and on a video vignette from popular-culture media to illustrate being an Outsider in a healthcare setting. Participants in this training have improved their ability to recognize when they are Outsiders where they provide care. They have developed a better understanding that cultural humility in organizations is a gateway to providing quality care. They have begun the process of committing to respectfully learn from the organization's Insiders.

  6. effects of enteral glutamine supplementation on reduction

    African Journals Online (AJOL)

    However, there is limited published data focused on effect of enteral glutamine on infection rate in patients with severe burns. Results from recently published RCT on effects of enteral glutamine, show a trend of an overall reduction in incidence of bacteraemia, lower antibiotic usage and lower mortality rates in patients with ...

  7. Noncommunicating Isolated Enteric Duplication Cyst in the ...

    African Journals Online (AJOL)

    Noncommunicating isolated enteric duplications in the abdomen are an extremely rare variant of enteric duplications with their own blood supply. We report a case of a noncommunicating isolated ileal duplication in a 10-month-old boy. He was admitted because of severe abdominal distension and developed irritability ...

  8. Enteral Nutrition and Acute Pancreatitis: A Review

    NARCIS (Netherlands)

    Spanier, B. W. M.; Bruno, M. J.; Mathus-Vliegen, E. M. H.

    2011-01-01

    Introduction. In patients with acute pancreatitis (AP), nutritional support is required if normal food cannot be tolerated within several days. Enteral nutrition is preferred over parenteral nutrition. We reviewed the literature about enteral nutrition in AP. Methods. A MEDLINE search of the English

  9. Understanding and controlling the enteric nervous system

    NARCIS (Netherlands)

    Boeckxstaens, G. E.

    2002-01-01

    The enteric nervous system or the `Little Brain' of the gut controls gastrointestinal motility and secretion, and is involved in visceral sensation. In this chapter, new developments in understanding the function of the enteric nervous system are described. In particular, the interaction of this

  10. Modulation of intestinal inflammation by minimal enteral nutrition with amniotic fluid in preterm pigs

    DEFF Research Database (Denmark)

    Østergaard, Mette V; Bering, Stine Brandt; Jensen, Michael L

    2014-01-01

    Background: Necrotizing enterocolitis (NEC) is a severe inflammatory disorder, associated with the difficult transition from parenteral to enteral feeding after preterm birth. We hypothesized that minimal enteral nutrition (MEN) with amniotic fluid (AF), prior to enteral formula feeding, would...... improve resistance to NEC in preterm pigs. Methods: Experiment 1: IEC-6 cells were incubated with porcine (pAF) and human AF (hAF) to test AF-stimulated enterocyte proliferation and migration in vitro. Experiment 2: Cesarean-delivered, preterm pigs were fed parenteral nutrition and MEN with pAF, h......AF, or control fluid (MEN-pAF, MEN-hAF, or MEN-CTRL; all n = 9) for 2 days before tissue collection. Experiment 3: Preterm pigs were fed MEN diets as in experiment 2, but followed by 2 days of enteral formula feeding, which predisposes to NEC (NEC-pAF, NEC-hAF, or NEC-CTRL; n = 10–12). Results: Both pAF and h...

  11. Intestinal endocrine cells in radiation enteritis

    International Nuclear Information System (INIS)

    Pietroletti, R.; Blaauwgeers, J.L.; Taat, C.W.; Simi, M.; Brummelkamp, W.H.; Becker, A.E.

    1989-01-01

    In this study, the intestinal endocrine cells were investigated in 13 surgical specimens affected by radiation enteritis. Endocrine cells were studied by means of Grimelius' silver staining and immunostaining for chromogranin, a general marker of endocrine cells. Positively stained cells were quantified by counting their number per unit length of muscularis mucosa. Results in radiation enteritis were compared with matched control specimens by using Student's t test. Chromogranin immunostaining showed a statistically significant increase of endocrine cells in radiation enteritis specimens compared with controls both in small and large intestine (ileum, 67.5 +/- 23.5 cells per unit length of muscularis mucosa in radiation enteritis versus 17.0 +/- 6.1 in controls; colon, 40.9 +/- 13.7 cells per unit length of muscularis mucosa in radiation enteritis versus 9.5 +/- 4.1 in controls--p less than 0.005 in both instances). Increase of endocrine cells was demonstrated also by Grimelius' staining; however, without reaching statistical significance. It is not clear whether or not the increase of endocrine cells in radiation enteritis reported in this study is caused by a hyperplastic response or by a sparing phenomenon. We should consider that increased endocrine cells, when abnormally secreting their products, may be involved in some of the clinical features of radiation enteropathy. In addition, as intestinal endocrine cells produce trophic substances to the intestine, their increase could be responsible for the raised risk of developing carcinoma of the intestine in long standing radiation enteritis

  12. Glutamine-enriched enteral nutrition in very low birth weight infants. Design of a double-blind randomised controlled trial [ISRCTN73254583

    NARCIS (Netherlands)

    van den Berg, Anemone; van Elburg, Ruurd M.; Twisk, Jos W. R.; Fetter, Willem P. F.

    2004-01-01

    Enteral feeding of very low birth weight (VLBW) infants is a challenge, since metabolic demands are high and administration of enteral nutrition is limited by immaturity of the gastrointestinal tract. The amino acid glutamine plays an important role in maintaining functional integrity of the gut. In

  13. Parenteral lipids and partial enteral nutrition affect hepatic lipid composition but have limited short term effects on formula-induced necrotizing enterocolitis in preterm piglets

    DEFF Research Database (Denmark)

    Vegge, Andreas; Thymann, Thomas; Lauritzen, Lotte

    2015-01-01

    Rapid transition from total parenteral nutrition (TPN) to enteral feeding is a risk factor for necrotizing enterocolitis (NEC) in preterm infants. We hypothesized that partial enteral nutrition with colostrum, increased proportion of n-3 polyunsaturated fatty acids (PUFA), or exclusion of lipid...

  14. [Effect of enteral naloxone on the incidence of gastritis and esophagitis in mechanically ventilated patients].

    Science.gov (United States)

    Meissner, W; Hartmann, M; Kähler, G; Brauer, M

    2004-09-01

    Gastrtis and esophagitis are frequent and severe complications in intensive care patients, mainly caused by increased duodenogastral reflux. Opioids, commonly used in intensive care, are known to impair gastrointestinal (GI) motility which increases retrograd flow of gastric content. In a previous study, we showed that enteral administered naloxone reduces gastric reflux by selectively blocking GI opioid receptors. Therefore, in a subpopulation of these patients we studied the effect of enteral naloxone on the incidence of mucosal injury in opioid-treated, mechanically ventilated patients. After IRB approval, mechanically ventilated, fentanyl-treated patients without gastrointestinal surgery or diseases were assigned to receive 8 mg naloxone or placebo four times daily via a gastric tube. Additional inclusion criteria were opioid treatment for at least three days and endoscopy of the upper GI tract. Frequency of gastritis and esophagitis was quantified according to the Savary-Miller Score, and further parameter of GI motility (frequency of propulsive medication, amount of enteral feeding) were measured. In four of seventeen patients of the naloxone group (24 %) and 14 of 22 patients of the placebo group (64 %; p = 0.02), esophageal or gastral mucosal injuries were detected. In the naloxone group, gastral reflux as well as need for propulsive medication were significantly lower. Volume of enteral feeding showed an increasing trend in the second half of the study. Reduction of esophagogastral mucosal injury and reduced need for procinetic medication suggests an improvement of GI motility by enteral naloxone in fentanyl-treated, mechanically ventilated patients.

  15. Soya Saponins Induce Enteritis in Atlantic Salmon (Salmo salar L.).

    Science.gov (United States)

    Krogdahl, Åshild; Gajardo, Karina; Kortner, Trond M; Penn, Michael; Gu, Min; Berge, Gerd Marit; Bakke, Anne Marie

    2015-04-22

    Soybean meal-induced enteritis (SBMIE) is a well-described condition in the distal intestine of salmonids, and saponins have been implicated as the causal agent. However, the question remains whether saponins alone cause SBMIE. Moreover, the dose-response relationship has not been described. In a 10 week feeding trial with Atlantic salmon, a highly purified (95%) soya saponin preparation was supplemented (0, 2, 4, 6, or 10 g/kg) to two basal diets, one containing fishmeal as the major protein source (FM) and the other 25% lupin meal (LP). Saponins caused dose-dependent increases in the severity of inflammation independent of the basal diet, with concomitant alterations in digestive functions and immunological marker expression. Thus, saponins induced inflammation whether the diet contained other legume components or not. However, responses were often the same or stronger in fish fed the corresponding saponin-supplemented LP diets despite lower saponin exposure, suggesting potentiation by other legume component(s).

  16. Esophagitis and enteritis caused by herpesvirus in pigeons.

    Directory of Open Access Journals (Sweden)

    Egobol, L.

    2002-01-01

    Full Text Available The pigeon squabs, aged 5-26 day-old, showed clinical signs of dullness, anorexia, indigestion, reten-tion of feed in crop, progressive emaciation then died. The morbidity rate and mortality rate were 7.14% (50/700. The adult pigeons did not show any signs of disease. From pathological finding, pharyngitis, esophagitis were found with diphtheritic membrane covering necrotic ulcers on the mucosa of pharynx, esophagus and crop. From histopathological findings, esophagitis with epithelial hyperplasia and sloughed, lamina propria mucosa edema with lymphoid cells infiltration were found in duodenum and jejunum. The intranuclear inclusion body, Cowdry type A, was found in epithelial mucosa of esophagus, enterocyte of jejunum and lymphoid cells in spleen. FA test to duck virus enteritis and inoculation to ducklings showed negative results. Electron microscopic study revealed electron dense core sized 146-167 nm., which was identified as herpesvirus.

  17. [Feeding tube placement: auscultatory method and x-ray agreement].

    Science.gov (United States)

    Beghetto, Mariur Gomes; Anziliero, Franciele; Leães, Dória Migotto; de Mello, Elza Daniel

    2015-12-01

    to evaluate the correlation between the auscultation test and X-ray when detecting the position of an enteral feeding tube. cross-sectional study in an intensive care unit in southern Brazil, in 2011. Clinical nurse and nurse researcher performed auscultation test recording the impressions regarding the placement of an enteral feeding tube in 80 patients. A doctor evaluated the X-ray. Kappa coefficient and PABAK reviewed the agreements. The X-ray showed that 70% of the enteral tubes were in the stomach, 27.4% in the duodenum, 1.3% in the esophagus, and 1.3% in the right lung. There was a weak correlation between clinical nurses and nurse researchers (PABAK=0.054; P=0.103), clinical nurses and X-rays (PABAK=0.188; P=0.111) and nurse researchers and X-rays (PABAK=0.128; P=0.107) . The auscultation test did not detect two risk conditions, enteral feeding tube in the esophagus and the bronchus. the auscultation test showed little agreement with the X-ray on the enteral feeding tube location.

  18. Infection strategies of enteric pathogenic Escherichia coli.

    Science.gov (United States)

    Clements, Abigail; Young, Joanna C; Constantinou, Nicholas; Frankel, Gad

    2012-01-01

    Enteric Escherichia coli (E. coli) are both natural flora of humans and important pathogens causing significant morbidity and mortality worldwide. Traditionally enteric E. coli have been divided into 6 pathotypes, with further pathotypes often proposed. In this review we suggest expansion of the enteric E. coli into 8 pathotypes to include the emerging pathotypes of adherent invasive E. coli (AIEC) and Shiga-toxin producing enteroaggregative E. coli (STEAEC). The molecular mechanisms that allow enteric E. coli to colonize and cause disease in the human host are examined and for two of the pathotypes that express a type 3 secretion system (T3SS) we discuss the complex interplay between translocated effectors and manipulation of host cell signaling pathways that occurs during infection.

  19. Do enteric neurons make hypocretin? ☆

    Science.gov (United States)

    Baumann, Christian R.; Clark, Erika L.; Pedersen, Nigel P.; Hecht, Jonathan L.; Scammell, Thomas E.

    2008-01-01

    Hypocretins (orexins) are wake-promoting neuropeptides produced by hypothalamic neurons. These hypocretin-producing cells are lost in people with narcolepsy, possibly due to an autoimmune attack. Prior studies described hypocretin neurons in the enteric nervous system, and these cells could be an additional target of an autoimmune process. We sought to determine whether enteric hypocretin neurons are lost in narcoleptic subjects. Even though we tried several methods (including whole mounts, sectioned tissue, pre-treatment of mice with colchicine, and the use of various primary antisera), we could not identify hypocretin-producing cells in enteric nervous tissue collected from mice or normal human subjects. These results raise doubts about whether enteric neurons produce hypocretin. PMID:18191238

  20. OCCURRENCE OF ENTERIC VIRUSES IN WATERS

    Science.gov (United States)

    A number of different types of human enteric viruses cause waterborne outbreaks when individuals are exposed to contaminated drinking and recreational waters. Vaccination against poliovirus has virtually eliminated poliomyelitis from the planet, but other members of the enterovi...

  1. [Indications and practice of enteral nutrition].

    Science.gov (United States)

    Hallay, Judit; Nagy, Dániel; Fülesdi, Béla

    2014-12-21

    Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient's condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy.

  2. Do enteric neurons make hypocretin? ☆

    OpenAIRE

    Baumann, Christian R.; Clark, Erika L.; Pedersen, Nigel P.; Hecht, Jonathan L.; Scammell, Thomas E.

    2007-01-01

    Hypocretins (orexins) are wake-promoting neuropeptides produced by hypothalamic neurons. These hypocretin-producing cells are lost in people with narcolepsy, possibly due to an autoimmune attack. Prior studies described hypocretin neurons in the enteric nervous system, and these cells could be an additional target of an autoimmune process. We sought to determine whether enteric hypocretin neurons are lost in narcoleptic subjects. Even though we tried several methods (including whole mounts, s...

  3. Laboratory Screening for Children Entering Foster Care.

    Science.gov (United States)

    Greiner, Mary V; Beal, Sarah J; Nause, Katie; Staat, Mary Allen; Dexheimer, Judith W; Scribano, Philip V

    2017-12-01

    To determine the prevalence of medical illness detected by laboratory screening in children entering foster care in a single, urban county. All children entering foster care in a single county in Ohio were seen at a consultation foster care clinic and had laboratory screening, including testing for infectious diseases such as HIV, hepatitis B, hepatitis C, syphilis, and tuberculosis as well as for hemoglobin and lead levels. Over a 3-year period (2012-2015), laboratory screening was performed on 1977 subjects entering foster care in a consultative foster care clinic. The prevalence of hepatitis B, hepatitis C, syphilis, and tuberculosis were all found to be <1%. There were no cases of HIV. Seven percent of teenagers entering foster care tested positive for Chlamydia . A secondary finding was that 54% of subjects were hepatitis B surface antibody-negative, indicating an absence of detected immunity to the hepatitis B virus. Routine laboratory screening for children entering foster care resulted in a low yield. Targeted, rather than routine, laboratory screening may be a more clinically meaningful approach for children entering foster care. Copyright © 2017 by the American Academy of Pediatrics.

  4. Resistance of Enteric Viruses on Fomites.

    Science.gov (United States)

    Alidjinou, Enagnon Kazali; Sane, Famara; Firquet, Swan; Lobert, Pierre-Emmanuel; Hober, Didier

    2017-06-15

    Human enteric viruses are associated with several clinical features, especially gastroenteritis. Large amounts of these viruses can be released in the environment and spread to people. Enteric viruses are nonenveloped viruses and have displayed good survival in the environment. They can be significantly resistant in food and water but also on fomites, and this is thought to play a role in transmission, leading to sporadic cases or outbreaks. The survival of enteric viruses on fomites relies on many factors including the virus itself, fomite properties, and extrinsic environmental factors such as temperature or relative humidity. Several reports in the literature have found an association with gastroenteritis cases or outbreaks and fomites naturally contaminated by enteric viruses. However, the study of virus survival following natural contamination is challenging, and most published studies are laboratory based, using experimental contamination. In addition, recent and detailed data on the resistance of each of the main enteric viruses on fomites are scarce. Many approaches, both physical and chemical, can be used to inactivate enteric viruses, the efficacy of which depends on the virus and the disinfection conditions. © 2017 S. Karger AG, Basel.

  5. Correlates of protection for enteric vaccines.

    Science.gov (United States)

    Holmgren, Jan; Parashar, Umesh D; Plotkin, Stanley; Louis, Jacques; Ng, Su-Peing; Desauziers, Eric; Picot, Valentina; Saadatian-Elahi, Mitra

    2017-06-08

    An immunological Correlate of Protection (CoP) is an immune response that is statistically interrelated with protection. Identification of CoPs for enteric vaccines would help design studies to improve vaccine performance of licensed vaccines in low income settings, and would facilitate the testing of future vaccines in development that might be more affordable. CoPs are lacking today for most existing and investigational enteric vaccines. In order to share the latest information on CoPs for enteric vaccines and to discuss novel approaches to correlate mucosal immune responses in humans with protection, the Foundation Mérieux organized an international conference of experts where potential CoPs for vaccines were examined using case-studies for both bacterial and viral enteric pathogens. Experts on the panel concluded that to date, all established enteric vaccine CoPs, such as those for hepatitis A, Vi typhoid and poliovirus vaccines, are based on serological immune responses even though these may poorly reflect the relevant gut immune responses or predict protective efficacy. Known CoPs for cholera, norovirus and rotavirus could be considered as acceptable for comparisons of similarly composed vaccines while more work is still needed to establish CoPs for the remaining enteric pathogens and their candidate vaccines. Novel approaches to correlate human mucosal immune responses with protection include the investigation of gut-originating antibody-secreting cells (ASCs), B memory cells and follicular helper T cells from samples of peripheral blood during their recirculation. Copyright © 2017.

  6. Intermittent and continuous enteral nutrition in critically ill dogs: a prospective randomized trial.

    Science.gov (United States)

    Holahan, M; Abood, S; Hauptman, J; Koenigsknecht, C; Brown, A

    2010-01-01

    Malnutrition is a common problem in critically ill dogs and is associated with increased morbidity and mortality in human medicine. Enteral nutrition (EN) delivery methods have been evaluated in humans to determine which is most effective in achieving caloric goals. To compare continuous infusion and intermittent bolus feeding of EN in dogs admitted to a critical care unit. Fifty-four dogs admitted to the critical care unit and requiring nutritional support with a nasoenteric feeding tube. Prospective randomized clinical trial. Dogs were randomized to receive either continuous infusion (Group C) or intermittent bolus feeding (Group I) of liquid EN. The percentage of prescribed nutrition delivered (PPND) was calculated every 24 hours. Frequencies of gastrointestinal (GI), mechanical, and technical complications were recorded and gastric residual volumes (GRVs) were measured. PPND was significantly lower in Group C (98.4%) than Group I (100%). There was no significant difference in GI or mechanical complications, although Group C had a significantly higher rate of technical complications. GRVs did not differ significantly between Group C (3.1 mL/kg) and Group I (6.3 mL/kg) and were not correlated with the incidence of vomiting or regurgitation. There was a statistically significant difference in the PPND between continuously and intermittently fed dogs, but this difference is unlikely to be clinically relevant. Critically ill dogs can be successfully supported with either continuous infusion or intermittent bolus feeding of EN with few complications. Increased GRVs may not warrant termination of enteral feeding.

  7. Enteric neuroplasticity in seawater-adapted European eel (Anguilla anguilla)

    Science.gov (United States)

    Sorteni, C; Clavenzani, P; De Giorgio, R; Portnoy, O; Sirri, R; Mordenti, O; Di Biase, A; Parmeggiani, A; Menconi, V; Chiocchetti, R

    2014-01-01

    European eels live most of their lives in freshwater until spawning migration to the Sargasso Sea. During seawater adaptation, eels modify their physiology, and their digestive system adapts to the new environment, drinking salt water to compensate for the continuous water loss. In that period, eels stop feeding until spawning. Thus, the eel represents a unique model to understand the adaptive changes of the enteric nervous system (ENS) to modified salinity and starvation. To this purpose, we assessed and compared the enteric neuronal density in the cranial portion of the intestine of freshwater eels (control), lagoon eels captured in brackish water before their migration to the Sargasso Sea (T0), and starved seawater eels hormonally induced to sexual maturity (T18; 18 weeks of starvation and treatment with standardized carp pituitary extract). Furthermore, we analyzed the modification of intestinal neuronal density of hormonally untreated eels during prolonged starvation (10 weeks) in seawater and freshwater. The density of myenteric (MP) and submucosal plexus (SMP) HuC/D-immunoreactive (Hu-IR) neurons was assessed in wholemount preparations and cryosections. The number of MP and SMP HuC/D-IR neurons progressively increased from the freshwater to the salty water habitat (control > T0 > T18; P neuroplasticity as indicated by the increasing number of HuC/D-IR MP and SMP neurons, a mechanism likely contributing to maintaining the body homeostasis of this fish in extreme conditions. PMID:24433383

  8. Radicidation and radappertization of animal feeds in Israel, 1968-1977

    International Nuclear Information System (INIS)

    Lapidot, M.

    1979-01-01

    Contamination of animal feed and animal products with salmonellae and other enteric microorganisms has considerably increased in recent years. This has resulted in commensurate increases in the incidence of salmonellosis and other enteric diseases in both animals and humans. The development of radappertization for laboratory animal feeds and of radicidation for farm animal feeds over the last ten years in Israel is reviewed. The products considered were radappertized feeds for SPF rodent colonies and for commercial SPF poultry flocks, and radicidized feed for breeder and broiler flocks. In the latter case microbiological, biological, technological and economic aspects are considered. The petition and clearance for radicidized poultry feed are briefly discussed. The potential use of radicidation in the preparation of animal feeds from organic wastes, i.e. putrescibles in household garbage and sewage sludge, is outlined, and the factors involved are evaluated. (author)

  9. If You Feed Them, Will They Come? The Use of Social Marketing to Increase Interest in Attending a College Alcohol Program

    Science.gov (United States)

    Palmer, Rebekka S.; Kilmer, Jason R.; Larimer, Mary E.

    2006-01-01

    The authors used social marketing to design and test advertisement components aimed at increasing students' interest in attending an alcohol program focused on reaching students who drink heavily, although the authors offered no such program. Participants were undergraduate students in introductory psychology courses (N = 551). Questionnaires…

  10. Replaceable Jejunal Feeding Tubes in Severely Ill Children

    Directory of Open Access Journals (Sweden)

    Tabea Pang

    2017-01-01

    Full Text Available Long-term enteral nutrition in chronically ill, malnourished children represents a clinical challenge if adequate feeding via nasogastric or gastrostomy tubes fails. We evaluated the usefulness and complications of a new type of surgical jejunostomy that allows for easier positioning and replacement of the jejunal feeding tube in children. We surgically inserted replaceable jejunal feeding tubes (RJFT connected to a guide thread which exited through a separate tiny opening of the abdominal wall. In a retrospective case series, we assessed the effectiveness and complications of this technique in severely ill children suffering from malnutrition and complex disorders. Three surgical complications occurred, and these were addressed by reoperation. Four children died from their severe chronic disorders within the study period. The RJFT permitted continuous enteral feeding and facilitated easy replacement of the tube. After the postoperative period, jejunal feeding by RJFT resulted in adequate weight gain. This feeding access represents an option for children in whom sufficient enteral nutrition by nasogastric tubes or gastrostomy proved impossible. Further studies are required to investigate the safety and effectiveness of this surgical technique in a larger case series.

  11. Heritability for enteric methane emission from Danish Holstein cows using a non-invasive FTIR method

    DEFF Research Database (Denmark)

    Lassen, Jan; Løvendahl, Peter

    2013-01-01

    Enteric methane emission from ruminants contributes substantially to the greenhouse effect. Few studies have focused on the genetic variation in enteric methane emission from dairy cattle. One reason for that is the limited number of methods appropriate for large scale phenotyping to measure...... around 0.40 for the ratio between methane and carbon dioxide concentrations. Using the ratio between methane and carbon dioxide as a phenotype makes it possible to quantify the amount of methane produced per cow, because the amount of carbon dioxide can be estimated from variables such as weight, milk...... production and feed intake (Madsen et al ., 2010). In a study of 548 heifers a heritability estimate of 0.35 was obtained for predicted methane emission based on registrations on feed intake rather than on direct measurements (de Haas et al., 2011). Estimates of this magnitude justify the use of genetic...

  12. Enteral vs. parenteral nutrition for the critically ill patient: a combined support should be preferred.

    Science.gov (United States)

    Heidegger, Claudia-Paula; Darmon, Patrice; Pichard, Claude

    2008-08-01

    Current recommendations suggest starting enteral feeding as soon as possible whenever the gastrointestinal tract is functioning. The disadvantage of enteral support is that insufficient energy and protein coverage can occur. This review focuses on some recent findings regarding the nutritional support of critically ill patients and evaluates the data presented. An increasing nutritional deficit during a long ICU stay is associated with increased morbidity (infection rate, wound healing, mechanical ventilation, length of stay, duration of recovery), and costs. Evidence shows that enteral nutrition can result in underfeeding and that nutritional goals are frequently reached only after 1 week. Contrary to former beliefs, recent meta-analyses of ICU studies showed that parenteral nutrition is not related to a surplus mortality and may even be associated with improved survival. Early enteral nutrition is recommended for critically ill patients. Supplemental parenteral nutrition combined with enteral nutrition can be considered to cover the energy and protein targets when enteral nutrition alone fails to achieve the caloric goal. Whether such a combined nutritional support provides additional benefit on the overall outcome has to be proven in further studies on clinical outcome, including physical and cognitive functioning, quality of life, cost-effectiveness, and cost-utility.

  13. Feeding Your Baby

    Medline Plus

    Full Text Available ... for your baby Feeding your baby Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ... for your baby Feeding your baby Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ...

  14. Feeding Your Baby

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    Full Text Available ... your baby Feeding your baby Common illnesses Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ... your baby Feeding your baby Common illnesses Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ...

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    Full Text Available ... baby Feeding your baby Common illnesses Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ... baby Feeding your baby Common illnesses Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature birth ...

  16. Feeding Your Baby

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    Full Text Available ... pump Baby Feeding your baby Other Baby topics ') document.write(' Caring for your baby ') document.write('') } ') document.write(' Feeding your baby ') document.write('') } ') ...

  17. Feeding Your Baby

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    Full Text Available ... Frequently asked questions Email sign up Join our online community March for Babies Nacersano Share Your Story ... Frequently asked questions Email sign up Join our online community Home > Baby > Feeding your baby Feeding your ...

  18. Pemberian makanan enteral berformulasi bahan pangan lokal terhadap kadar zat besi dan hemoglobin pada tikus putih (Rattus norvegicus

    Directory of Open Access Journals (Sweden)

    Dini Ariani

    2013-07-01

    Full Text Available Background: Enteral nutrition is nutrition used to fulfill the needs of nutrition entirely and as the supplement for malnutrition patient. In a certain condition of a patient, this nutrition is usually given in the form of liquid. Local material foods such as tempeh, rice, mung bean, and ganyong have adequate nutrition, therefore they are suitable for being used as main raw materials in the making of enteral nutrition. Objective: To know the influence of feeding enteral nutrition formulated with local food material toward malnutrition white rats (Rattus norvegicus of which the parameters are iron (Fe, hemoglobin (Hb level and weight. Method: This research used Completely Random Design (CRD. Twenty-seven of malnutrition male white rats were divided into 3 groups of treatment with 9 repetitions for each group of the treatment. Group A was given enteral nutrition diet of formula A (tempeh, rice, and mung bean as the main raw material, group B was given enteral nutrition diet of formula B (tempeh, rice, mung bean, and ganyong as the main raw material, and group C (as the positive control was given commercial enteral nutrition. The daily giving of enteral nutrition is 20 g/day during 30 days. The analysis of Fe and Hb level and the measurement of weight firstly were done before the treatment is given. The next measurement was conducted in 15th day and 31st day. Statistical analysis used ANOVA test dan DMRT of significance 5%. Results: The result showed that the treatment of the enteral nutrition feeding of formula B was more optimal than formula A in terms of the way to increase the level of Hb and Fe. Those two components will give positive effect toward the increasing of the weight of malnutrition white rats (Rattus norvegicus. Conclusion: The enteral nutrition of formula B is more proper to be developed as the main material of making enteral food in order to treat the malnutrition.

  19. Very early feeding in stable small for gestational age preterm infants: a randomized clinical trial.

    Science.gov (United States)

    Arnon, Shmuel; Sulam, Daniella; Konikoff, Fred; Regev, Rivka H; Litmanovitz, Ita; Naftali, Timna

    2013-01-01

    To examine the effect of initiating very early feeding on time-to-reach full feeding in stable, small for gestational age (SGA) preterm infants. Preterm infants with gestational age below 37 weeks and birth weight below the 10(th) percentile were randomly allocated to a very early (within 24 hours of birth) feeding regimen or delayed (after 24 hours of birth) feeding. All infants had in utero evidence of absent or reverse diastolic flow. Infants unable to start early feeding were excluded. Time-to-reach full feeding, feeding progression, and related morbidity were compared. Electrogastrography (EGG) was used to measure pre- and postprandial gastric motility on the second and seventh day after feeding initiation. Sixty infants were included in the study, 30 in each group. Infants included in the very early feeding regimen achieved full enteral feeding sooner than controls (98±80-157 vs. 172±123-261 hours of age, respectively; p= 0.004) and were discharged home earlier (p=0.04). No necrotizing enterocolitis (NEC) was documented in both study groups. Gastric motility was improved at day seven after feeding initiation in both study groups, with no difference between groups. Stable SGA preterm infants on a very early feeding regimen achieved full enteral feeding and were discharged home significantly earlier than those on a delayed regimen, with no excess morbidity. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  20. If you feed them, will they come? The use of social marketing to increase interest in attending a college alcohol program.

    Science.gov (United States)

    Palmer, Rebekka S; Kilmer, Jason R; Larimer, Mary E

    2006-01-01

    The authors used social marketing to design and test advertisement components aimed at increasing students' interest in attending an alcohol program focused on reaching students who drink heavily, although the authors offered no such program. Participants were undergraduate students in introductory psychology courses (N = 551). Questionnaires included measures assessing demographic information, alcohol use and negative consequences, and interest in attending an alcohol program in response to exposure to 1 of 12 systematically varied advertisements. The authors found that approximately 20% of participants across all ad types indicated some level of interest in attending the alcohol program. Students who use alcohol reported more interest in attending when an informational message was used. Of the participants offered food, 41.9% indicated the food offered in the advertisement impacted their interest in attending. Results suggest market segmentation plays a role in developing effective advertisements to recruit different groups of students based on their reported drinking behavior.

  1. Minimal Enteral Nutrition to Improve Adaptation After Intestinal Resection in Piglets and Infants

    DEFF Research Database (Denmark)

    Aunsholt, Lise; Qvist, Niels; Sangild, Per Torp

    2018-01-01

    BACKGROUND: Minimal enteral nutrition (MEN) may induce a diet-dependent stimulation of gut adaptation following intestinal resection. Bovine colostrum is rich in growth factors, and we hypothesized that MEN with colostrum would stimulate intestinal adaptation, compared with formula, and would......, enteral colostrum supplementation was well tolerated, and no infants developed clinical signs of cow's milk allergy. CONCLUSION: Minimal enteral nutrition feeding with bovine colostrum and formula induced similar intestinal adaptation after resection in piglets. Colostrum was well tolerated by newly...... be well tolerated in patients with short bowel syndrome. METHODS: In experiment 1, 3-day-old piglets with 50% distal small intestinal resection were fed parenteral nutrition (PN, n = 10) or PN plus MEN given as either colostrum (PN-COL, n = 5) or formula (PN-FORM, n = 9) for 7 days. Intestinal nutrient...

  2. New Technologies for Detection of Enteric Parasites.

    Science.gov (United States)

    Ryan, Una; Paparini, Andrea; Oskam, Charlotte

    2017-07-01

    Enteric parasites are major contributors to the global diarrhoeal disease load, infecting >67.2 million people. Their prevalence and clinical impact, however, are underestimated due to lack of adequate detection, which is largely still based on microscopy, particularly in developing countries. New commercially available enteric panel assays, which detect parasites (as well as bacteria and/or viruses) using multiplex PCR, offer enhanced sensitivity and specificity as well as the ability to detect mixed infections, and will play an important role in epidemiological surveillance and outbreak investigations. A major limitation of these technologies, however, particularly for developing countries, is the costs involved. Emerging technologies for low-resource, point-of-care (POC) settings have the potential to dramatically improve the cost and accuracy of enteric parasite detection in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. The spectrum of radiation enteritis: surgical considerations

    International Nuclear Information System (INIS)

    Haddad, G.K.; Grodsinsky, C.; Allen, H.

    1983-01-01

    Radiation therapy, often used to treat gynecologic and urologic pelvic malignancies, has varying, adverse effects on the bowel. Radiation enteritis may occur from one month to 20 years after irradiation, and disabling symptoms may require surgery in 10 to 20 per cent of patients. From our experience with 20 patients who required surgery for radiation enteritis and who were followed for up to 20 years, we were able to identify three clinical groups. Patients in the first group need only medical treatment for their symptoms, and observation, whereas patients in the second group may present with acute, debilitating, life-threatening symptoms that may require emergency surgery. Patients in the third group have a long-standing history of intermittent bowel obstruction and/or enteric fistulas that are best treated with adequate nutritional support followed by timely surgical intervention

  4. Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: A retrospective review

    International Nuclear Information System (INIS)

    Mangar, Stephen; Slevin, Nicholas; Mais, Kathleen; Sykes, Andrew

    2006-01-01

    Background and purpose: To identify objective pre-treatment clinical parameters that could be used to predict for patients at high risk of requiring enteral tube feeding prior to head and neck radiotherapy. Patients and methods: A retrospective study was conducted on 160 consecutive patients attending for radiotherapy assessment. Regression analysis was used to determine various pre-treatment nutritional and tumour specific parameters associated with the use of enteral nutrition either before (prophylactic) or during (reactive) radiotherapy (RT). The significant parameters identified were then selected into categorical variables and compared between those who needed reactive enteral nutrition and the remainder of the group who did not. These results were used to generate predictive factors that could be used to identify those at high risk of malnutrition during RT for whom early or prophylactic enteral nutrition should be considered. Results: Fifty patients required enteral feeding of which 60% required this prior to radiotherapy. Multivariate analysis identified the following factors to be significant-body mass index, performance status (PS), advanced stage, pre-treatment weight loss, low serum albumin and protein, age, and smoking. The most significant categorical predictive parameters for reactive enteral feeding were stage 3-4 disease, PS 2-3, and smoking >20/day. The combination of these factors predicted a 75% chance of needing enteral nutrition. Conclusion: Nutritional assessment is important prior to radiotherapy and is multifactorial. Using a combination of relatively simple and objective parameters (performance status, smoking and disease stage) it is possible to identify those at high risk of needing enteral nutrition prior to starting RT

  5. The incidence of infants with rotavirus enteritis combined with lactose intolerance.

    Science.gov (United States)

    Hu, Yulian; Gui, Linyan; Chang, Jing; Liu, Jingyan; Xu, Shuling; Deng, Caiyan; Yu, Fengqin; Ma, Zhanmin; Wang, Guangzhou; Zhang, Changjun

    2016-01-01

    This study was to research the incidence of infants with rotavirus enteritis combined with lactose intolerance and the clinical effect of low lactose milk powder for infantile rotavirus enteritis with lactose intolerance. The control groups were 126 cases of infants with diarrhea randomly collected from our hospital at the same period, which their rotavirus detection was negative. The observation group was 185 cases of infants with rotavirus, which was tested to be positive. Through the urine galactose determination, 62 cases of the control group were positive and 124 cases of the observation group were positive. Then 124 cases of infants with rotavirus combined with lactose intolerance were randomly divided into two groups. 60 cases in the control group were given rehydration, correction of acidosis, oral smecta, Intestinal probiotics and other conventional treatment, then continued to the original feeding method. While, 64 cases in the treatment group, on the basis of routine treatment, applied the low lactose milk feeding. To observe the total effective rate for the two groups. The incidence of lactose intolerance in children with rotavirus enteritis (67.03%) was significantly higher than that of children with diarrhea (49.2%), which was tested to be negative. And the difference was statistically significant (pintolerance. The low lactose milk powder could improve the therapeutic effectively and could reduce the duration of disease, and restored to normal diet for 2 weeks feeding time.

  6. The challenge of nutritional profiling of a protein-free feed module for children on low protein tube feeds with organic acidaemias.

    Science.gov (United States)

    Daly, A; Evans, S; Ashmore, C; Chahal, S; Santra, S; MacDonald, A

    2017-06-01

    Enteral tube feeding for children with organic acidaemias (OA) is recommended. Protein restriction, providing minimum safe levels of protein intake, is advocated. Standard paediatric tube feeding formulae provide more than the minimum safe protein requirements and are unsuitable in OA without modification. Modified paediatric enteral feeds consist of several modular ingredients. The aim of this prospective longitudinal interventional study was to assess the efficacy of a premeasured novel protein-free module developed for children aged over 12 months compared to conventional practice. In total, 15 children with OA (11.6-31 kg) needing enteral feeding were recruited. The protein-free module, from either a protein-free infant feed or modular ingredients, was replaced by the study feed. To ensure metabolic stability, energy and protein intake were unchanged. Dietary intake, anthropometry and nutritional biochemistry were recorded at baseline and week 26. Dietary intakes of magnesium (P = 0.02), sodium (P = 0.005), vitamin D (P = 0.04), docosahexaenoic acid (P = 0.01) and arachidonic acid (P = 0.001) significantly improved; plasma selenium (P = 0.002) and whole blood glutathione peroxidase (P = 0.02) significantly increased. Feed preparation accuracy as measured by composition analysis showed consistent errors both in pre- and study feeds. A protein-free module improved nutritional intake and biochemistry, although feed preparation errors remained a common finding. © 2017 The British Dietetic Association Ltd.

  7. Tread-water feeding of Bryde's whales.

    Science.gov (United States)

    Iwata, Takashi; Akamatsu, Tomonari; Thongsukdee, Surasak; Cherdsukjai, Phaothep; Adulyanukosol, Kanjana; Sato, Katsufumi

    2017-11-06

    Many previous studies have shown that rorqual whales (Balaenopteridae), including the blue whale (Balaenoptera musculus), fin whale (B. physalus), sei whale (B. borealis), Bryde's whale (B. edeni), minke whale (B. acutorostrata), and humpback whale (Megaptera novaeangliae), employ a strategy called lunge feeding to capture a large amount of krill and/or fish for nourishment [1]. Lunge feeding entails a high energetic cost due to the drag created by an open mouth at high speeds [1,2]. In the upper Gulf of Thailand, Bryde's whales, which feed on small fish species [3], predominantly anchovies, demonstrated a range of feeding behaviors such as oblique, vertical, and lateral lunging. Moreover, they displayed a novel head-lifting feeding behavior characterized by holding the vertical posture for several seconds with an open mouth at the water surface. This study describes the head-lifting feeding by Bryde's whales, which is distinct from the typical lunge feeding of rorqual whales. Whales showing this behavior were observed on 58 occasions, involving 31 whales and including eight adult-calf pairs. Whales caught their prey using a series of coordinated movements: (i) lifting the head above the water with a closed mouth, (ii) opening the mouth until the lower jaw contacted the sea surface, which created a current of water flowing into the mouth, (iii) holding their position for several seconds, (iv) waiting for the prey to enter the mouth, and (v) closing the mouth and engulfing the prey underwater (Figure 1A-F, Movie S1 in Supplemental Information published with this article online). When a whale kept its upper jaw above the sea surface, many anchovies in the targeted shoal appeared to lose orientation and flowed passively into the mouth of the whale by the current created by the lower mandible breaking the surface of the water. We measured the duration of feeding events when the whales had a wide-open mouth mostly above the sea surface. The mean and maximum feeding

  8. Home enteral nutrition in children: an 11-year experience with 416 patients.

    Science.gov (United States)

    Daveluy, Walter; Guimber, Dominique; Mention, Karine; Lescut, Dominique; Michaud, Laurent; Turck, Dominique; Gottrand, Frédéric

    2005-02-01

    We report our experience of paediatric home enteral nutrition, as there is little detailed evidence published. All patients younger than 18 years commencing treatment between January 1990 and December 2000 were included in this retrospective study. The study covered 416 children and adolescents, corresponding to a total of 243,844 days of home enteral nutrition (HEN). The mean (+/-SD) age of patients commencing treatment was 5.4+/-5.3 years (range 0.1-17.8). Indications were digestive disorders in 35% of patients, neurological and muscular disorders in 35%, malignancy in 11%, failure to thrive in 8%, and miscellaneous ailments in 9%. Enteral feeding comprised commercially available paediatric industrial diets in 36%, adult-type diet in 35% and infant formulas in 29%. Children received enteral feeding by nasogastric tube (53%), or gastrostomy (41%). A mechanical pump was used in 98% of the patients. The mean duration of treatment was 595+/-719 days. HEN can be used while treating a large group of chronic diseases of children. It can be started very early in life and is often prolonged over several years.

  9. [Artificial nutrition in children (I): enteral access].

    Science.gov (United States)

    Estevão-Costa, José

    2014-01-01

    Appropriate nutritional support is crucial in the therapeutic approach of multiple conditions, which justifies the frequent and increasing use of specific access routes for enteral and parenteral nutrition. This article reviews the relevant literature concerning indications, procedures, effectiveness and complications of enteral access routes in children. The decision between gastric and postpyloric access, and between nasogastric tube and gastrostomy is thoroughly discussed. Percutaneous endoscopic gastrostomy is the most commonly used technique when a long-term gastric access is required, given its efficacy and safety although the associated morbidity is not negligible;laparoscopic gastrostomy emerges as a potentially advantageous alternative.

  10. Enteric alpha defensins in norm and pathology

    Directory of Open Access Journals (Sweden)

    Lisitsyn Nikolai A

    2012-01-01

    Full Text Available Abstract Microbes living in the mammalian gut exist in constant contact with immunity system that prevents infection and maintains homeostasis. Enteric alpha defensins play an important role in regulation of bacterial colonization of the gut, as well as in activation of pro- and anti-inflammatory responses of the adaptive immune system cells in lamina propria. This review summarizes currently available data on functions of mammalian enteric alpha defensins in the immune defense and changes in their secretion in intestinal inflammatory diseases and cancer.

  11. Enteric glial cells have specific immunosuppressive properties.

    Science.gov (United States)

    Kermarrec, Laetitia; Durand, Tony; Neunlist, Michel; Naveilhan, Philippe; Neveu, Isabelle

    2016-06-15

    Enteric glial cells (EGC) have trophic and neuroregulatory functions in the enteric nervous system, but whether they exert a direct effect on immune cells is unknown. Here, we used co-cultures to show that human EGC can inhibit the proliferation of activated T lymphocytes. Interestingly, EGC from Crohn's patients were effective at one EGC for two T cells whereas EGC from control patients required a ratio of 1:1. These data suggest that EGC contribute to local immune homeostasis in the gastrointestinal wall. They also raise the possibility that EGC have particular immunosuppressive properties in inflammatory bowel diseases such as Crohn's disease. Copyright © 2016. Published by Elsevier B.V.

  12. Continuous enteral administration can overcome the limited capacity to absorb glucose in rats with methotrexate-induced gastrointestinal mucositis

    NARCIS (Netherlands)

    Fijlstra, Margot; Rings, Edmond H. H. M.; van Dijk, Theo H.; Plosch, Torsten; Verkade, Henkjan J.; Tissing, Wim J. E.

    Patients with chemotherapy-induced gastrointestinal mucositis often suffer from weight loss. It is not well known how to enterally feed mucositis patients, potentially experiencing malabsorption. Recently, we showed in a rat model of methotrexate (MTX)-induced mucositis that intestinal absorption of

  13. Effect Of Oligomeric Enteral Nutrition On Symptoms Of Acute Radiation Enteritis

    International Nuclear Information System (INIS)

    Dubinsky, P.

    2008-01-01

    Radiotherapy of abdominal and pelvic tumours is frequently associated with acute radiation enteritis. Predominant symptoms include diarrhea, watery stools, abdominal pain, nausea and vomiting. There are very few effective interventions available for this condition. Enteral oligomeric nutrition has been used in bowel diseases with functional failure similar to radiation enteritis. The aim of presented work was to observe occurrence of symptoms of radiation enteritis in patients undergoing abdominal or pelvic radiotherapy. Apart from diet and pharmacological therapy, oral oligomeric enteral nutrition (Peptisorb Powder Nutricia) at the dose of 1000 - 2000 ml per day was administered for minimum of 4 days. Planned period of administration was 14 days and longer. Symptoms of radiation enteritis were evaluated at the beginning and in the end of administration. Prevalence of all evaluated symptoms of radiation enteritis was decreased and difference was statistically significant for diarrhea, watery stools, abdominal pain, nausea and vomiting. The use of evaluated oligomeric nutritional support might, in conjunction with pharmacotherapy and diet, alleviate symptoms of acute radiation enteritis and maintain nutritional status of patients. (author)

  14. Feed safety in the feed supply chain

    Directory of Open Access Journals (Sweden)

    Pinotti, L.

    2011-01-01

    Full Text Available A number of issues have weakened the public's confidence in the quality and wholesomeness of foods of animal origin. As a result farmers, nutritionists, industry and governments have been forced to pay serious attention to animal feedstuff production processes, thereby acknowledging that animal feed safety is an essential prerequisite for human food safety. Concerns about these issues have produced a number of important effects including the ban on the use of processed animal proteins, the ban on the addition of most antimicrobials to farm animals diets for growth‐promotion purposes, and the implementation of feed contaminant regulations in the EU. In this context it is essential to integrate knowledge on feed safety and feed supply. Consequently, purchase of new and more economic sources of energy and protein in animal diets, which is expected to conform to adequate quality, traceability, environmental sustainability and safety standards, is an emerging issue in livestock production system.

  15. Breast-Feeding Twins: Making Feedings Manageable

    Science.gov (United States)

    ... baby separately. Likewise, some babies might show a preference for individual feedings. Try different approaches or a ... Brodsky D, et al. Breastfeeding and the premature infant. In: Primary Care of the Premature Infant. Philadelphia, ...

  16. Achieving optimal feeds for preterm babies, recommendations and ...

    African Journals Online (AJOL)

    Preterm deaths are responsible for the highest number of neonatal mortality in Nigeria. Preterm nutrition contributes significantly to overall outcome particularly as it relates to neurodevelopment. Recently, new guidelines for enteral feedings in premature infants were issued by the American Academy of Paediatrics and ...

  17. Breast feeding in Kelantan.

    Science.gov (United States)

    Balakrishnan, S; Hussein, H B

    1977-04-01

    The incidence of breastfeeding is investigated in relation to duration of breastfeeding without supplementation and the age when solids were first introduced in the infant's diet. The study also evaluates the awareness of the mothers of the benefits of breast milk. 461 mothers were interviewed in May 1976 by 3 doctors including the author. 95% (438) were found to breastfeed their babies at least once or twice a day. However, only 18% (86) of the mothers were fully breastfeeding up to 3 months and 9% (45) were breastfeeding without added solids up to 6 months. A disappointing finding was the introduction of solid foods by 78% (351) of the mothers before the end of the 3rd month; of these, 117 or 25% have introduced the solids as early as the 1st 6 months. Only 5% (23) were artificially feeding their infants. 86% (399) agreed that breast milk was the best milk for their children but only 277 (59%) agreed that infection occurs less frequently in breastfed than bottlefed children. 65% (302) were aware that solids should be introduced after 6 months to the infant's diet. Only 48% (222) were aware that a well-balanced diet is essential for an adequate supply of breast milk. Although 50% (232) reported that they were advised by nurses or bidans to breastfeed their children, only 37% (172) were given instructions on the technique of breastfeeding. Breastfeeding programs launched by the Ministry of Health should promote breastfeeding for at least 4-6 months duration and discourage early complement feeding and introduction of solids to infants less than 6 months of age.

  18. Factors Influencing Senior Athletic Training Students' Preparedness to Enter the Workforce

    Science.gov (United States)

    Mazerolle, Stephanie M.; Benes, Sarah S.

    2014-01-01

    Context: Athletic training education programs must provide the student with opportunities to learn the roles and responsibilities of the athletic trainer. Objective: Investigate factors that help prepare the athletic training student (ATS) to successfully enter the workplace upon graduation from her undergraduate program. Design: Exploratory…

  19. Modelling the Effect of Diet Composition on Enteric Methane Emissions across Sheep, Beef Cattle and Dairy Cows

    Science.gov (United States)

    Bell, Matt; Eckard, Richard; Moate, Peter J.; Yan, Tianhai

    2016-01-01

    Simple Summary Enteric methane emissions produced by ruminant livestock has gained global interest due to methane being a potent greenhouse gas and ruminants being a significant source of emissions. In the absence of measurements, prediction models can facilitate the estimation of enteric methane emissions from ruminant livestock and aid investigation of mitigation options. This study developed a practical method using feed analysis information for predicting enteric methane emissions from sheep, beef cattle and dairy cows fed diets encompassing a wide range of nutrient concentrations. Abstract Enteric methane (CH4) is a by-product from fermentation of feed consumed by ruminants, which represents a nutritional loss and is also considered a contributor to climate change. The aim of this research was to use individual animal data from 17 published experiments that included sheep (n = 288), beef cattle (n = 71) and dairy cows (n = 284) to develop an empirical model to describe enteric CH4 emissions from both cattle and sheep, and then evaluate the model alongside equations from the literature. Data were obtained from studies in the United Kingdom (UK) and Australia, which measured enteric CH4 emissions from individual animals in calorimeters. Animals were either fed solely forage or a mixed ration of forage with a compound feed. The feed intake of sheep was restricted to a maintenance amount of 875 g of DM per day (maintenance level), whereas beef cattle and dairy cows were fed to meet their metabolizable energy (ME) requirement (i.e., production level). A linear mixed model approach was used to develop a multiple linear regression model to predict an individual animal’s CH4 yield (g CH4/kg dry matter intake) from the composition of its diet. The diet components that had significant effects on CH4 yield were digestible organic matter (DOMD), ether extract (EE) (both g/kg DM) and feeding level above maintenance intake: CH4 (g/kg DM intake) = 0.046 (±0.001) × DOMD

  20. Randomized controlled trial: impact of glycerin suppositories on time to full feeds in preterm infants.

    Science.gov (United States)

    Khadr, Sophie N; Ibhanesebhor, Samuel E; Rennix, Connie; Fisher, Hazel E; Manjunatha, Chikkanayakanahalli M; Young, David; Abara, Rosemary C

    2011-01-01

    Feed intolerance delays achievement of enteral feeding in preterm infants. Parenteral nutrition is associated with cholestasis and increased risk of sepsis. Glycerin suppositories have been used to promote gastrointestinal motility and feed tolerance. To investigate whether daily glycerin suppositories (a) reduce the time to full enteral feeding in infants born at suppositories; 28-31(+6) weeks subgroup); controls - no intervention. The same feeding protocol and departmental guidelines for other aspects of neonatal intensive care were used in all subjects. Analysis was by intention to treat. 54 babies were recruited (31 males), 29 randomized to receive suppositories; 48 achieved full enteral feeds. The median (range) time to full feeds was 1.6 days shorter in intervention group babies than controls, but not statistically significant: 7.4 (4.6-30.9) days versus 9.0 (4.4-13.3) days (p = 0.780; 95% confidence interval: -1.917, 2.166). No significant differences were observed in secondary outcomes. Intervention group babies passed their first stool earlier than controls (median: day 2 vs. day 4; p = 0.016). Regular glycerin suppositories did not reduce the time to full enteral feeds in infants born at <32 weeks' gestation in our setting. Copyright © 2011 S. Karger AG, Basel.

  1. Entering a Crack: An Encounter with Gossip

    Science.gov (United States)

    Henderson, Linda

    2014-01-01

    In this paper, I enter a crack to think otherwise about the concept "gossip". Drawing on previous scholarship engaging with Deleuzian concepts to inform research methodologies, this paper builds on this body of work. Following Deleuze and Guattari, the paper undertakes a mapping of gossip, subsequent to an encounter with a crack.…

  2. Kokainudløst iskaemisk enteritis

    DEFF Research Database (Denmark)

    Hobolth, Lise; Bendtsen, Flemming

    2009-01-01

    and a pill cam capsule endoscopy were normal. In all cases the condition normalized spontaneously. A thorough interview revealed a recreational use of cocaine, and diary recordings confirmed the association between her abdominal pain and cocaine use. Ischaemic enteritis has previously been described...... in cocaine users. Udgivelsesdato: 2009-Sep...

  3. [Enteral alimentation at home: why PEG now?].

    Science.gov (United States)

    Suzuki, Y; Hanyu, N; Kashiwagi, H; Kubo, T; Aoki, T

    1996-12-01

    The history of percutaneous endoscopic gastrostomy (PEG) is relatively short. In 1980, a report entitled "Gastrostomy without laparotomy: A percutaneous endoscopic technique" by Ponsky and Gaudere was first published in the Journal of Pediatric Surgery. Thereafter, PEG soon saw widespread use in Western countries because of its clinical efficacy and economy. It has been performed in about 170,000 cases annually in the US. In contrast, its spread in Japan has been extremely slow: only about 10,000 cases have undergone this procedure annually, and this number accounted for less than 5% of patients receiving enteral alimentation. The reason why PEG has not spread may be the medical insurance system in Japan and the local distaste for operation scarring. However, in consideration of the unprecedented ageing of society that is surely coming in the near future, the role of PEG in Japan must be reexamined. In this report, we presented the methodology of enteral alimentation at home by means of PEG, giving special consideration to: (1) "What points are improved by using enteral alimentation at home by means of PEG in various diseases; (2) dysphagia due to cerebral angiopathy; (3) terminal cancer; (4) otolaryngological diseases; and (5) Crohn disease. We also discussed "Why PEG is important now?" in performing enteral alimentation at home.

  4. Campylobacter enteritis among children in Dembia District ...

    African Journals Online (AJOL)

    Objective: To estimate the magnitude of Campylobacter enteritis in children below fifteen years of age. Design: A cross-sectional survey. Setting: Seven villages found in the outskirts of Kolla Diba town were covered. The town is located 35 kilometres away from Gondar teaching hospital. Participants: Stool specimens were ...

  5. CAMPYLOBACTER ENTERITIS AMONG CHILDREN IN DEMBIA ...

    African Journals Online (AJOL)

    hi-tech

    2000-12-12

    Dec 12, 2000 ... Objective: To estimate the magnitude of Campylobacter enteritis in children below fifteen years of age. Design: A cross-sectional survey. Setting: Seven villages found in the outskirts of Kolla Diba town were covered. The town is located 35 kilometres away from Gondar teaching hospital. Participants: Stool ...

  6. Astronaut John Glenn Enters Friendship 7

    Science.gov (United States)

    1962-01-01

    Astronaut John Glenn enters the Mercury spacecraft, Friendship 7, prior to the launch of MA-6 on February 20, 1961 and became the first American who orbited the Earth. The MA-6 mission was the first manned orbital flight boosted by the Mercury-Atlas vehicle, a modified Atlas ICBM (Intercontinental Ballistic Missile), lasted for five hours, and orbited the Earth three times.

  7. Aspects of enteral nutrition in cancer chemotherapy

    NARCIS (Netherlands)

    Smit, Jitske Martha

    1985-01-01

    This thesis deals with several aspects of the influences of intensive cancer chemotherapy on the nutritional status, the metabolism, and the gastrointestinal tract of the host and describes whether these results can be influenced by enteral hyperalimentation, We studied these aspects in patients

  8. Ghanaian Women Enter into Popular Entertainment | Collins ...

    African Journals Online (AJOL)

    This article discuses the problems faced by West African and particularly Ghanaian female popular performers and the various factors that have, since the 1960's led to increasing numbers of women entering the professional theatre and the commercial entertainment industry. The study examines the upsurge of female ...

  9. Experimental Yersinia pseudotuberculosis enteritis in laboratory ...

    African Journals Online (AJOL)

    and guinea pigs. Animals orally fed with clean water showed no symptoms of yersiniosis. Rabbits infected with Y. pseudotuberculosis showed signs of illness while guinea pigs did not show any clinical sign. Visceral organs of infected rabbits showed enteritis with necrotic lesions but no pathological changes were observed ...

  10. Isolated Enteric Cyst in the Neck

    Directory of Open Access Journals (Sweden)

    Amit Mahore

    2014-01-01

    Full Text Available We report an extremely rare case of isolated enteric cyst in the neck region which was diagnosed on the histopathological examination. It was suspected to be duplication cyst on radiology. We have also evaluated the differential diagnosis and management issues.

  11. [Enteral nutrition in the multiple trauma patient].

    Science.gov (United States)

    Sánchez-Izquierdo Riera, J A; Montejo González, J C

    1992-01-01

    The hypermetabolism that develops in patients with severe polytraumatism has led to the need for an aggressive metabolic-nutritional support from the start. Parenteral Nutrition is the preferred technique in many instances, due to the doubts on the effectiveness of enteral nutrition in the control of the metabolic response and to problems of gastrointestinal tolerance derived from its administration. However, the role of enteral nutrition as an important factor which limits the development of bacterial translocation and the chain of events leading to multiorganic failure appears to be more and more well-established and is an important argument for justifying the early administration of enteral nutrition in these patients. In accordance with the accumulated experience of several authors over the past few years, enteral nutrition may be administered early in polytraumatized patients. This is not only accompanied by the evidence of acceptable gastrointestinal tolerance to the diet, but also by additional advantages compared to parenteral nutrition, such as the maintenance of trophism and immunocompetence of the digestive mucosa, the reduction of septic complications and also greater nutritional effectiveness which can be evaluated by the behaviour of the seric proteins used as nutritional evolution markers. The interest of the different diet formulae which exist at present, for example diets enriched with branched-chain amino acids, diets with added fibre, peptidic diets, specific pulmonary diets or "euglycaemic diets" is evaluated in this review. All these diets may mean an increase in the effectiveness and/or tolerance of enteral nutrition in polytraumatized patients, and also contribute to the handling of specific problems such as "stress" hyperglycaemia or the withdrawal of mechanical ventilation support. The use of specific nutrients for the digestive mucosa, such as glutamine or short chain fatty acids seems to be an important factor in the reduction of

  12. Beneficial Uses Program progress report, period ending December 31, 1976. [Gamma inactivation of microorganisms in sewage sludge

    Energy Technology Data Exchange (ETDEWEB)

    1977-03-01

    Progress is reported on a comprehensive program to develop the necessary technologies for cost/beneficial uses of existing and future surplus radioactive materials. The major portion of the work was concentrated on the testing of the effectiveness of ..gamma.. sources for the processing of sewage sludge to inactivate enteric viruses and bacteria and the subsequent testing of the biological effects of the treated sludge when used as fertilizer or additives to animal feeds.

  13. Frequency of changing enteral alimentation bags and tubing, and adverse clinical outcomes in patients in a long term care facility.

    Science.gov (United States)

    Graham, S; McIntyre, M; Chicoine, J; Gerard, B; Laughren, R; Cowley, G; Morrison, J; Aoki, F Y; Nicolle, L E

    1993-01-01

    Enteral alimentation, given via nasogastric or gastrostomy tubes, is a well established practice to provide nutrition for patients with significant neurological injury. The frequency with which enteral feeding bags and tubes require change and potential adverse effects associated with bacterial contamination of tube feeds remain controversial. The authors studied different times between enteral feeding bag and tube changes, and the effect on adverse clinical outcomes in residents of a long term care facility. In the first study, residents were randomized to 24 h (n = 2), 48 h (n = 3) or 72 h (n = 6) tube feeding and bag changes with clinical status monitored in a standardized fashion for six months. In the second study, patients were randomized to 24 h (n = 6) or 72 h (n = 6) changes. Patient-days of follow-up were 382, 574 and 1000 for the three arms of the first study period and 556 and 496 for the two arms of the second study. No differences in potential clinical adverse events--including fever, gastrointestinal symptoms or pneumonia--were observed with different durations of tubing change. This study suggests it is appropriate to change alimentation tube and feeding bags every 72 h (rather than every 24 h). The less frequent changes will decrease supply costs and free nursing time for other activities.

  14. Quantitative taste evaluation of total enteral nutrients.

    Science.gov (United States)

    Mukai, Junji; Miyanaga, Yohko; Ishizaka, Toshihiko; Asaka, Kiyokazu; Nakai, Yuka; Tsuji, Eriko; Uchida, Takahiro

    2004-12-01

    The purpose of this study was to evaluate quantitatively the taste of the various total enteral nutrients marketed in Japan using human gustatory sensation tests and an artificial taste sensor. In the human gustatory sensation test, four basic taste intensities (sweetness, saltiness, sourness, and bitterness), as well as 15 kinds of palatability scales, were evaluated according to the semantic differential (SD) method. Among 15 palatability items, the item; difficult to drink/easy to drink, was adopted as an overall palatability since it shows the highest factor loading by factor analysis. The overall palatability was found to be highly positively correlated with sweetness and sourness, but negatively correlated with bitterness and saltiness. Addition of a flavour to the amino acid-based enteral nutrient AminolebanEN significantly improved its palatability. This effect is presumably due to sour components of the flavour, such as citric acid, which reduce the bitterness intensity of branched-chain amino acids in the product. The sweetness and sourness intensities predicted by the taste sensor showed a high correlation with the results obtained in the human gustatory sensation tests. The taste sensor was able to predict the overall palatability of the total enteral nutrients with high accuracy. The products could be classified into three groups (peptide-based, amino-acid-based, and protein-based) by principal component analysis using sensor output of 8 channels. The products could be also classified into four groups; peptide-based, amino-acid-based, and protein-based and flavor addition group by principal component analysis using sensor output of channels 1, 3, 4 and 7, which are specific to basic tastes. The taste sensor could therefore be useful in predicting the taste or palatability of total enteral nutrients, and could contribute to attempts to improve compliance for such products and for enteral nutrients.

  15. Cost-effectiveness of feeding strategies to reduce greenhouse gas emissions from dairy farming.

    Science.gov (United States)

    Van Middelaar, C E; Dijkstra, J; Berentsen, P B M; De Boer, I J M

    2014-01-01

    The objective of this paper was to evaluate the cost-effectiveness of 3 feeding strategies to reduce enteric CH4 production in dairy cows by calculating the effect on labor income at the farm level and on greenhouse gas (GHG) emissions at the chain level (i.e., from production of farm inputs to the farm gate). Strategies included were (1) dietary supplementation of an extruded linseed product (56% linseed; 1kg/cow per day in summer and 2kg/cow per day in winter), (2) dietary supplementation of a nitrate source (75% nitrate; 1% of dry matter intake), and (3) reducing the maturity stage of grass and grass silage (grazing at 1,400 instead of 1,700kg of dry matter/ha and harvesting at 3,000 instead of 3,500kg of dry matter/ha). A dairy farm linear programing model was used to define an average Dutch dairy farm on sandy soil without a predefined feeding strategy (reference situation). Subsequently, 1 of the 3 feeding strategies was implemented and the model was optimized again to determine the new economically optimal farm situation. Enteric CH4 production in the reference situation and after implementing the strategies was calculated based on a mechanistic model for enteric CH4 and empirical formulas explaining the effect of fat and nitrate supplementation on enteric CH4 production. Other GHG emissions along the chain were calculated using life cycle assessment. Total GHG emissions in the reference situation added up to 840kg of CO2 equivalents (CO2e) per t of fat- and protein-corrected milk (FPCM) and yearly labor income of €42,605. Supplementation of the extruded linseed product reduced emissions by 9kg of CO2e/t of FPCM and labor income by €16,041; supplementation of the dietary nitrate source reduced emissions by 32kg of CO2e/t of FPCM and labor income by €5,463; reducing the maturity stage of grass and grass silage reduced emissions by 11kg of CO2e/t of FPCM and labor income by €463. Of the 3 strategies, reducing grass maturity was the most cost

  16. 43 CFR 404.56 - If a financial assistance agreement is entered into for a rural water supply project that...

    Science.gov (United States)

    2010-10-01

    ... entered into for a rural water supply project that benefits more than one Indian tribe, is the approval of... Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Miscellaneous § 404.56 If a financial assistance agreement is entered into for a rural water supply project that...

  17. Practice of Exclusive Breast Feeding Program in 2013 at Puskesmas of Probolinggo City (A Case Study in Kedopok and Sukabumi of Health Center Services

    Directory of Open Access Journals (Sweden)

    Astridya Paramita

    2016-01-01

    Full Text Available Background: Scientifi c research proves that babies tend to grow more healthy and intelligent with a given exclusive breastfeeding in the fi rst 6 months of life. The coverage of exclusive breastfeeding infants 0–5 months was fl uctuating. This study aimed to review the implementation of exclusive breastfeeding promotion program in Primary Health Care (PHC of Probolinggo City. Methods: Qualitative methods with purposive techniques informant selection was applied in this case study. The study was conducted at the Sukabumi and Kedopok PHC of Probolinggo City in 2013. Results: The results showed the weak management functions of programme in PHC and the less attention of Probolinggo Government related to the limited number of health worker n cost of health promotion activities . The success of exclusive breastfeeding Health Promotion Program is not only determined by the input component , but also creativity and active efforts of health promotion strategies as practiced in Sukabumi PHC. Recommendations: Optimization of monitoring and evaluation program exclusive breastfeeding in PHC from the Municipality/District Government, and his staff; strengthening the input component; and the implementation of advocacy, ”bina suasana”, empowerment and partnerships activities.

  18. Esophagojejunostomy Feeding Tube Placement in 5 Dogs with Pancreatitis and Anorexia

    OpenAIRE

    Forrest Cummings; Catherine A. Daley

    2014-01-01

    Enteral feeding tube placement has been described in veterinary medicine for several years. Indications include oral, esophageal, gastrointestinal, pancreatic, hepatic, and neurologic diseases. In this paper, endoscopically assisted placement of an esophagojejunostomy (EJ) feeding tube in dogs with pancreatitis and prolonged anorexia is described. To the author's knowledge there are no published reports of this procedure. Esophagojejunostomy feeding tubes provide an alternative to other forms...

  19. Partnership with nursing mothers: an interim strategy for combating childhood enteric diseases in Nigeria.

    Science.gov (United States)

    Elegbe, I A; Juba, A

    1988-01-01

    Five hundred and fifteen homes of nursing mothers in Ile-Ife, Nigeria, who had earlier brought their children for treatment of diarrhoeal diseases at the IUTHC infant child welfare clinics were visited between January 1982 and June 1984. The mothers' perceptions as to causes, prevention and control of childhood enteritis were elicited: 49.7% of the mothers attributed the cause of the disease to evil spirits; and 9.5% believed enteritis in children to be due to contamination of children's feeds. Modern medicine was perceived to be the ideal method for treating this disease by only 7.4% of the mothers, while 88.8% opted for any of the traditional methods. In order to reduce the devasting effects of enteric diseases among children born to mothers in tropical countries of Africa and Asia, it is imperative that all health workers understand the cultural and social perceptions of their clients towards the disease in question. Illiteracy, and unsanitary and unhygienic environmental conditions were found to be the main factors precipitating enteritis. Implications and strategies for minimizing diarrhoea and other childhood enteric diseases are discussed in the text.

  20. Modelling the Effect of Diet Composition on Enteric Methane Emissions across Sheep, Beef Cattle and Dairy Cows.

    Science.gov (United States)

    Bell, Matt; Eckard, Richard; Moate, Peter J; Yan, Tianhai

    2016-09-08

    Enteric methane (CH ₄ ) is a by-product from fermentation of feed consumed by ruminants, which represents a nutritional loss and is also considered a contributor to climate change. The aim of this research was to use individual animal data from 17 published experiments that included sheep ( n = 288), beef cattle ( n = 71) and dairy cows ( n = 284) to develop an empirical model to describe enteric CH ₄ emissions from both cattle and sheep, and then evaluate the model alongside equations from the literature. Data were obtained from studies in the United Kingdom (UK) and Australia, which measured enteric CH ₄ emissions from individual animals in calorimeters. Animals were either fed solely forage or a mixed ration of forage with a compound feed. The feed intake of sheep was restricted to a maintenance amount of 875 g of DM per day (maintenance level), whereas beef cattle and dairy cows were fed to meet their metabolizable energy (ME) requirement (i.e., production level). A linear mixed model approach was used to develop a multiple linear regression model to predict an individual animal's CH ₄ yield (g CH ₄ /kg dry matter intake) from the composition of its diet. The diet components that had significant effects on CH ₄ yield were digestible organic matter (DOMD), ether extract (EE) (both g/kg DM) and feeding level above maintenance intake: CH ₄ (g/kg DM intake) = 0.046 (±0.001) × DOMD - 0.113 (±0.023) × EE - 2.47 (±0.29) × (feeding level - 1), with concordance correlation coefficient ( CCC ) = 0.655 and RMSPE = 14.0%. The predictive ability of the model developed was as reliable as other models assessed from the literature. These components can be used to predict effects of diet composition on enteric CH ₄ yield from sheep, beef and dairy cattle from feed analysis information.

  1. Modelling the Effect of Diet Composition on Enteric Methane Emissions across Sheep, Beef Cattle and Dairy Cows

    Directory of Open Access Journals (Sweden)

    Matt Bell

    2016-09-01

    Full Text Available Enteric methane (CH 4 is a by-product from fermentation of feed consumed by ruminants, which represents a nutritional loss and is also considered a contributor to climate change. The aim of this research was to use individual animal data from 17 published experiments that included sheep ( n = 288, beef cattle ( n = 71 and dairy cows ( n = 284 to develop an empirical model to describe enteric CH 4 emissions from both cattle and sheep, and then evaluate the model alongside equations from the literature. Data were obtained from studies in the United Kingdom (UK and Australia, which measured enteric CH 4 emissions from individual animals in calorimeters. Animals were either fed solely forage or a mixed ration of forage with a compound feed. The feed intake of sheep was restricted to a maintenance amount of 875 g of DM per day (maintenance level, whereas beef cattle and dairy cows were fed to meet their metabolizable energy (ME requirement (i.e., production level. A linear mixed model approach was used to develop a multiple linear regression model to predict an individual animal’s CH 4 yield (g CH 4 /kg dry matter intake from the composition of its diet. The diet components that had significant effects on CH 4 yield were digestible organic matter (DOMD, ether extract (EE (both g/kg DM and feeding level above maintenance intake: CH 4 (g/kg DM intake = 0.046 (±0.001 × DOMD − 0.113 (±0.023 × EE − 2.47 (±0.29 × (feeding level − 1, with concordance correlation coefficient ( CCC = 0.655 and RMSPE = 14.0%. The predictive ability of the model developed was as reliable as other models assessed from the literature. These components can be used to predict effects of diet composition on enteric CH 4 yield from sheep, beef and dairy cattle from feed analysis information.

  2. Ad libitum or demand/semi-demand feeding versus scheduled interval feeding for preterm infants.

    Science.gov (United States)

    McCormick, Felicia M; Tosh, Karen; McGuire, William

    2010-02-17

    Scheduled interval feeding of prescribed enteral volumes is current standard practice for preterm infants. However, feeding preterm infants in response to their hunger and satiation cues (ad libitum or demand/semi demand) rather than at scheduled intervals might help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge. To assess the effect of a policy of feeding preterm infants on an ad libitum or demand/semi-demand basis versus feeding prescribed volumes at scheduled intervals on growth rates and the time to hospital discharge. We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2009), MEDLINE (1966 to Oct 2009), EMBASE (1980 to Oct 2009), CINAHL (1982 to Oct 2009), conference proceedings, and previous reviews. Randomised or quasi-randomised controlled trials (including cluster randomised trials) that compared a policy of feeding preterm infants on an ad libitum or demand/semi-demand basis versus feeding at scheduled intervals. We used the standard methods of the Cochrane Neonatal Review Group with separate evaluation of trial quality and data extraction by two review authors. We found eight randomised controlled trials that compared ad libitum or demand/semi-demand regimens with scheduled interval regimes in preterm infants in the transition phase from intragastric tube to oral feeding. The trials were generally small and of variable methodological quality. The duration of the intervention and the duration of data collection and follow-up in most of the trials was not likely to have allowed detection of measurable effects on growth. Three trials reported that feeding preterm infants using an ad libitum or demand/semi-demand feeding regimen allowed earlier discharge from hospital (by about two to four days) but other trials did not confirm this

  3. Nutritional analysis and microbiological evaluation of commercially available enteral diets for cats.

    Science.gov (United States)

    Prantil, Lori R; Markovich, Jessica E; Heinze, Cailin R; Linder, Deborah E; Tams, Todd R; Freeman, Lisa M

    2016-01-01

    To determine the prevalence of nutrients less than or greater than accepted standards in commercially available enteral diets for cats, and to identify contamination incidence in enteral diets for cats. Prospective cross-sectional study. University teaching hospital. Seven commercial enteral diets for cats. Labels were evaluated to determine if diets were intended to be nutritionally complete and balanced. One diet under storage techniques partially representative of clinical conditions was sampled on days 0, 1, 3, 5, and 7 of storage for aerobic bacterial culture. All 7 diets were analyzed for key nutrients and results were compared to Association of American Feed Control Officials (AAFCO) Nutrient Profiles for Adult Cats for maintenance and National Research Council recommended allowance (NRC-RA). From label information, 4 diets were classified as complete and balanced and 3 diets were classified as not complete and balanced. All 7 diets had at least 1 nutrient less than the AAFCO minimums and the NRC-RA. The total number of nutrients less than AAFCO minimums ranged from 3 to 9 (median = 4), with iron, potassium, and manganese being the most common. Concentrations of some nutrients were undetectable. None of the samples tested had a positive aerobic culture at baseline (day 0) or on subsequent samples from days 1, 3, 5, and 7 under any storage condition. None of the diets analyzed met all of the minimum nutrient concentrations. While short-term feeding may not be of concern for an individual patient, clinicians should be aware of potential nutritional limitations when feeding enteral diets to ill or injured cats. © Veterinary Emergency and Critical Care Society 2015.

  4. NUCLEOTIDES IN INFANT FEEDING

    Directory of Open Access Journals (Sweden)

    L.G. Mamonova

    2007-01-01

    Full Text Available The article reviews the application of nucleotides-metabolites, playing a key role in many biological processes, for the infant feeding. The researcher provides the date on the nucleotides in the women's milk according to the lactation stages. She also analyzes the foreign experience in feeding newborns with nucleotides-containing milk formulas. The article gives a comparison of nucleotides in the adapted formulas represented in the domestic market of the given products.Key words: children, feeding, nucleotides.

  5. Patient needs and research priorities in the enteral nutrition market - a quantitative prioritization analysis.

    Science.gov (United States)

    Weenen, T C; Jentink, A; Pronker, E S; Commandeur, H R; Claassen, E; Boirie, Y; Singer, P

    2014-10-01

    A quantitative systematic identification and prioritization of unmet needs and research opportunities in relation to enteral nutrition was conducted by means of a tailor-made health research prioritization process. The research objectives were reached by conducting qualitative interviews followed by quantitative questionnaires targeting enteral nutrition key opinion leaders (KOLs). (1) Define disease areas that deserve more research attention; (2) Rank importance of product characteristics of tube feeding (TF) and oral nutritional supplements (ONS); (3) Assess involvement of KOLs in enteral nutrition R&D process. KOLs ranked three product characteristics and three disease areas that deserve additional research attention. From these, overall priority scores were calculated by multiplying ranks for both product characteristics and disease areas. 17 qualitative interviews were conducted and 77 questionnaires (response rate 35%) were completed and returned. (1) Disease areas in ONS and TF with highest priorities are: ONS: general malnutrition & geriatrics, TF: intensive care. (2) TF product characteristics with highest priorities are: composition and clinical evidence from a KOL perspective; tolerance and ease of use from a patient perspective. ONS product characteristics with highest priorities are: composition, clinical evidence and taste from a KOL perspective; taste from a patient perspective. We find a high discrepancy between product characteristic prioritization from a KOL and patient perspective. (3) Although 62% of all KOLs give advice to enteral nutrition companies on patient needs, they under-influence the setting of research priorities by enteral nutrition companies. This study provides a systematic approach to achieve research prioritization in enteral nutrition. In addition to providing new directions for enteral nutrition research and development, this study highlights the relevance of involving KOLs in the identification of research priorities as they

  6. Impact of coccidiosis control program and feeding plan on white striping prevalence and severity degree on broiler breast fillets evaluated at three growing ages.

    Science.gov (United States)

    Dalle Zotte, A; Tasoniero, G; Russo, E; Longoni, C; Cecchinato, M

    2015-09-01

    This study investigated the impact of 2 coccidiosis control systems (vaccine vs anticoccidial) and 2 feeding plans (standard energy vs low energy content, the latter supplemented with threonine and enzymes in the second half of the production cycle) on white striping (WS) prevalence and severity in chicken broiler breasts at commercial slaughter age (51 d). The age of lesion onset was also investigated with the sacrifice of 80 chicks at 12, and 80 chicks at 25 d of age. Seven hundred and twenty ROSS 708 strain male chicks were divided into 4 groups: a non-vaccinated group fed with standard diet (CONTROL); two groups vaccinated against coccidiosis but fed either a standard diet (VACC) or a low-energy diet supplemented with threonine and enzymes (VACC-LE plus); and a fourth group fed a standard diet containing anticoccidial additive except during the finishing period (COX). After live performance, yields, and fillet pH were measured, the breasts were weighed and scored as level 0 (no WS), level 1 (moderate WS), and level 2 (severe WS) at each of the 3 ages; data were covariate for slaughter weight. The results suggest an ameliorative effect of coccidiosis control systems when compared to the control group in terms of live weight, breast yield, and whole breast weight, with heavier fillets characterized by higher pH values. WS appeared at 25 d of age with an average prevalence of 11.5% and with lesions of moderate severity. There were no statistically significant differences due to the experimental treatment at this age. At commercial slaughter age, total average prevalence was 96%, with COX birds showing higher level 2 prevalence (77.6%). This could be related to the higher slaughter weight reached by the COX group (P<0.001) and the treatment effect (P<0.01) that probably adds to the effect of live weight. Diet had no effect on overall live performance of VACC-LE plus chickens, which were similar to those of the VACC group. © 2015 Poultry Science Association Inc.

  7. Infectious waste feed system

    Science.gov (United States)

    Coulthard, E. James

    1994-01-01

    An infectious waste feed system for comminuting infectious waste and feeding the comminuted waste to a combustor automatically without the need for human intervention. The system includes a receptacle for accepting waste materials. Preferably, the receptacle includes a first and second compartment and a means for sealing the first and second compartments from the atmosphere. A shredder is disposed to comminute waste materials accepted in the receptacle to a predetermined size. A trough is disposed to receive the comminuted waste materials from the shredder. A feeding means is disposed within the trough and is movable in a first and second direction for feeding the comminuted waste materials to a combustor.

  8. Enteral nutrition during bone marrow transplantation in patients with pediatric cancer: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Adriana Garófolo

    Full Text Available CONTEXT AND OBJECTIVE: Cancer patients undergoing bone marrow transplantation (BMT often require nutritional therapy due to treatment toxicities. The aim here was to evaluate the use of tube feeding and its applicability, indications, contraindications and complications in these patients. DESIGN AND SETTING: Prospective observational study conducted at a public university in São Paulo between January 2002 and August 2007. METHODS: The patients were followed up daily in the BMT unit by a research dietitian. Tube feeding was indicated when oral supplementation proved to be insufficient, when the patient had severe malnutrition or there was an impediment to use of oral feeding. It was contraindicated in the presence of gastrointestinal toxicity of grade 3 and 4 or other conditions that implied a risk or hindered its use or placement. Complications of tube feeding were divided into minor and major, according to whether they had life-threatening implications. RESULTS: Forty-two (47.2% patients had indications for tube feeding: the main reasons were transplantation inadequate food and supplement intake, insufficient intake with malnutrition or weight loss, severe malnutrition or need for oral fasting. Thirty-one (73.8% received tube feeding: 11 autologous and 20 allogenic patients (P = 0.04. The main contraindications were severe gastrointestinal toxicities and sinusitis. Minor complications from tube feeding were more prevalent in patients with allogenic BMT, but no major complications were observed. CONCLUSION: Enteral nutrition is a feasible procedure in patients undergoing BMT and should be encouraged. The main difficulty in BMT patients, in relation to tube feeding, is gastrointestinal toxicities.

  9. Clinical and nutritional implications of radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Beer, W.H.; Fan, A.; Halsted, C.H.

    1985-01-01

    The clinical and nutritional significance of radiation enteritis was assessed in eight patients with chronic diarrhea which followed curative doses of radiotherapy for pelvic malignancies. Steatorrhea, found in seven malnourished patients, was ascribed to ileal disease or previous surgery, or to bacterial contamination of the small intestine. Lactose intolerance, assessed by breath hydrogen excretion after oral lactose and by jejunal lactase levels, was found in six patients. In a subgroup of five patients, the administration of two different defined formula liquid diets by nasoduodenal infusion decreased fecal fluid and energy losses by about one-half. Compared to Vivonex-HN, the infusion of Criticare-HN was associated with greater likelihood of intestinal gas production but a three-fold greater utilization of protein. Intestinal malabsorption and malnutrition in radiation enteritis has diverse etiologies. Whereas nutritional support by liquid diet limits fecal fluid and energy losses, these diets differ significantly in clinical tolerance and biologic value.

  10. Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Carolina Justus Buhrer Ferreira Neto

    2016-01-01

    Full Text Available Abstract Objective: to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. Method: quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r program, and frequencies were calculated. Results: 786 errors were observed, 63.9% (502 in Phase 2, and 36.1% (284 in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. Conclusion: guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes.

  11. HIV, opiates, and enteric neuron dysfunction.

    Science.gov (United States)

    Galligan, J J

    2015-04-01

    Human immune deficient virus (HIV) is an immunosuppressive virus that targets CD4(+) T-lymphocytes. HIV infections cause increased susceptibility to opportunistic infections and cancer. HIV infection can also alter central nervous system (CNS) function causing cognitive impairment. HIV does not infect neurons but it does infect astrocytes and microglia in the CNS. HIV can also infect enteric glia initiating an intestinal inflammatory response which causes enteric neural injury and gut dysfunction. Part of the inflammatory response is HIV induced production of proteins including, Transactivator of transcription (Tat) which contribute to neuronal injury after release from HIV infected glial cells. A risk factor for HIV infection is intravenous drug use with contaminated needles and chronic opiate use can exacerbate neural injury in the nervous system. While most research focuses on the actions of Tat and other HIV related proteins and opiates on the brain, recent data indicate that Tat can cause intestinal inflammation and disruption of enteric neuron function, including alteration of Na(+) channel activity and action potential generation. A paper published in this issue of Neurogastroenterology and Motility extends these findings by identifying an interaction between Tat and morphine on enteric neuron Na(+) channels and on intestinal motility in vivo using a Tat expressing transgenic mouse model. These new data show that Tat protein can enhance the inhibitory actions of morphine on action potential generation and propulsive motility. These findings are important to our understanding of how HIV causes diarrhea in infected patients and for the use of opioid drugs to treat HIV-induced diarrhea. © 2015 John Wiley & Sons Ltd.

  12. Low emission feed : opportunities to mitigate enteric methane production of dairy cows

    NARCIS (Netherlands)

    Hatew, B.

    2015-01-01

    As global demand for high-quality food originating from animal production is expected to rise due to an increasing human population and consumer income level, the expected role of ruminants in meeting this demand brings multiple challenges. Ruminant production needs to adapt to environmental changes

  13. Low emission feed : opportunities to mitigate enteric methane production of dairy cows

    NARCIS (Netherlands)

    Hatew, B.

    2015-01-01

    As global demand for high-quality food originating from animal production is expected to rise due to an increasing human population and consumer income level, the expected role of ruminants in meeting this demand brings multiple challenges. Ruminant production needs to adapt to environmental

  14. Experience with Early Enteral Feeding in a Patient with Venoarterial Extracorporeal Membrane Oxygenation

    Directory of Open Access Journals (Sweden)

    V. V. Lomivorotov

    2010-01-01

    Full Text Available The study deals with the pathogenesis and early diagnosis of renal dysfunction in low and extremely low birth weight (ELBW premature neonates. Objective: to study the specific features of the mechanisms responsible for the development of acute renal failure (ARF in low and ELBW neonates and to use an analysis of oxygen status parameters as a method for early diagnosis of neonatal ARF. Subjects and methods. The study included 172 neonatal infants with a birth body weight of 800 to 1500 g. The values of blood gas composition and base-acid balance, and oxygen status were daily studied in all the children, by analyzing all the indices reflecting tissue hypoxia. Results. Analysis of oxygen status parameters in relation to a baby’s body weight revealed no considerable differences. The development of renal dysfunction and ARF in low and ELBW neonates was demonstrated to be most frequently caused by the progression of respiratory failure and tissue hypoxia, which suggests secondary renal lesion in the pattern of multiple organ dysfunction. It was ascertained that edema had a direct correlation with a physiological shunt fraction and oxygenation index and a moderate inverse correlation with blood oxygen tension and respiration index. In addition, an inverse correlation was found between the serum concentration of lactate and the daily volume of diuresis. The rate of hourly diuresis had a direct correlation with respiratory index and an inverse correlation with oxygenation index. Conclusion. Dysfunction of the kidneys and acute renal failure in neonatal infants in the pattern of multiple organ syndrome are secondary and closely related to the progres– sion of respiratory failure, as suggested by the oxygen status parameters that may be used for the prediction and early diagnosis or Key words: acute renal failure, renal dysfunction, neonaQtal infants, low and extremely low birth weight, hypoxia, oxygen status, multiple organ dysfunction. neonates. Key words: acute renal failure, renal dysfunction, neonatal infants, low and extremely low birth weight, hypoxia, oxygen status, multiple organ dysfunction.

  15. Introduction of enteral food increases plasma GLP-2 and decreases GLP-2 receptor mRNA abundance during pig development

    DEFF Research Database (Denmark)

    Petersen, Yvette M; Hartmann, Bolette; Holst, Jens Juul

    2003-01-01

    in these pigs. We conclude that the introduction of enteral feeding transiently increases plasma GLP-2 concentrations and decreases small intestinal GLP-2R mRNA levels during pig development. GLP-2 may play a role in the growth of the small intestine around birth and weaning via a response to enteral nutrition....... transcription polymerase chain reaction) during pre- and postnatal development and the relationship between these variables and small intestinal growth in enterally and parenterally fed fetal and newborn pigs (premature and term-delivered, 92 and 100% gestation, respectively). Plasma GLP-2 concentrations...... increased before birth, peaked in suckling 1-d-old pigs (87 +/- 14 pmol/L, P enteral infusion...

  16. Enteral Nutrition in Dementia: A Systematic Review

    Science.gov (United States)

    Brooke, Joanne; Ojo, Omorogieva

    2015-01-01

    The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life. PMID:25854831

  17. Enteral Nutrition in Dementia: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Joanne Brooke

    2015-04-01

    Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.

  18. Local food-based complementary feeding recommendations developed by the linear programming approach to improve the intake of problem nutrients among 12-23-month-old Myanmar children.

    Science.gov (United States)

    Hlaing, Lwin Mar; Fahmida, Umi; Htet, Min Kyaw; Utomo, Budi; Firmansyah, Agus; Ferguson, Elaine L

    2016-07-01

    Poor feeding practices result in inadequate nutrient intakes in young children in developing countries. To improve practices, local food-based complementary feeding recommendations (CFR) are needed. This cross-sectional survey aimed to describe current food consumption patterns of 12-23-month-old Myanmar children (n 106) from Ayeyarwady region in order to identify nutrient requirements that are difficult to achieve using local foods and to formulate affordable and realistic CFR to improve dietary adequacy. Weekly food consumption patterns were assessed using a 12-h weighed dietary record, single 24-h recall and a 5-d food record. Food costs were estimated by market surveys. CFR were formulated by linear programming analysis using WHO Optifood software and evaluated among mothers (n 20) using trial of improved practices (TIP). Findings showed that Ca, Zn, niacin, folate and Fe were 'problem nutrients': nutrients that did not achieve 100 % recommended nutrient intake even when the diet was optimised. Chicken liver, anchovy and roselle leaves were locally available nutrient-dense foods that would fill these nutrient gaps. The final set of six CFR would ensure dietary adequacy for five of twelve nutrients at a minimal cost of 271 kyats/d (based on the exchange rate of 900 kyats/USD at the time of data collection: 3rd quarter of 2012), but inadequacies remained for niacin, folate, thiamin, Fe, Zn, Ca and vitamin B6. TIP showed that mothers believed liver and vegetables would cause worms and diarrhoea, but these beliefs could be overcome to successfully promote liver consumption. Therefore, an acceptable set of CFR were developed to improve the dietary practices of 12-23-month-old Myanmar children using locally available foods. Alternative interventions such as fortification, however, are still needed to ensure dietary adequacy of all nutrients.

  19. Comparison of lipid and calorie loss from donor human milk among 3 methods of simulated gavage feeding: one-hour, 2-hour, and intermittent gravity feedings.

    Science.gov (United States)

    Brooks, Christine; Vickers, Amy Manning; Aryal, Subhash

    2013-04-01

    The objective of this study was to compare the differences in lipid loss from 24 samples of banked donor human milk (DHM) among 3 feeding methods: DHM given by syringe pump over 1 hour, 2 hours, and by bolus/gravity gavage. Comparative, descriptive. There were no human subjects. Twenty-four samples of 8 oz of DHM were divided into four 60-mL aliquots. Timed feedings were given by Medfusion 2001 syringe pumps with syringes connected to narrow-lumened extension sets designed for enteral feedings and connected to standard silastic enteral feeding tubes. Gravity feedings were given using the identical syringes connected to the same silastic feeding tubes. All aliquots were analyzed with the York Dairy Analyzer. Univariate repeated-measures analyses of variance were used for the omnibus testing for overall differences between the feeding methods. Lipid content expressed as grams per deciliter at the end of each feeding method was compared with the prefed control samples using the Dunnett's test. The Tukey correction was used for other pairwise multiple comparisons. The univariate repeated-measures analysis of variance conducted to test for overall differences between feeding methods showed a significant difference between the methods (F = 58.57, df = 3, 69, P gravity feeding methods (P = .3296). Pairwise comparison using the Tukey correction revealed a significant difference between both gravity and 1-hour feeding methods (P gravity and 2-hour feeding method (P gravity feedings, the timed feedings resulted in a statistically significant loss of fat as compared with their controls. These findings should raise questions about how those infants in the neonatal intensive care unit are routinely gavage fed.

  20. Feeding Your Baby

    Medline Plus

    Full Text Available ... opportunities Our corporate partners In Your Area Tools & Resources Careers Events in your area Frequently asked questions Email sign up Join our online community Home > Baby > Feeding your baby Feeding your baby E-mail to a friend Please fill in all ...

  1. Feeding Your Baby

    Medline Plus

    Full Text Available ... In This Topic Breastfeeding help Breastfeeding is best Food allergies and baby Formula feeding How to breastfeed Keeping a breastfeeding log Keeping breast milk safe and healthy Problems and discomforts when breastfeeding Starting your baby on solid foods Using a breast pump Baby Feeding your baby ...

  2. Invited review: Enteric methane in dairy cattle production: quantifying the opportunities and impact of reducing emissions.

    Science.gov (United States)

    Knapp, J R; Laur, G L; Vadas, P A; Weiss, W P; Tricarico, J M

    2014-01-01

    Many opportunities exist to reduce enteric methane (CH4) and other greenhouse gas (GHG) emissions per unit of product from ruminant livestock. Research over the past century in genetics, animal health, microbiology, nutrition, and physiology has led to improvements in dairy production where intensively managed farms have GHG emissions as low as 1 kg of CO2 equivalents (CO2e)/kg of energy-corrected milk (ECM), compared with >7 kg of CO2 e/kg of ECM in extensive systems. The objectives of this review are to evaluate options that have been demonstrated to mitigate enteric CH4 emissions per unit of ECM (CH4/ECM) from dairy cattle on a quantitative basis and in a sustained manner and to integrate approaches in genetics, feeding and nutrition, physiology, and health to emphasize why herd productivity, not individual animal productivity, is important to environmental sustainability. A nutrition model based on carbohydrate digestion was used to evaluate the effect of feeding and nutrition strategies on CH4/ECM, and a meta-analysis was conducted to quantify the effects of lipid supplementation on CH4/ECM. A second model combining herd structure dynamics and production level was used to estimate the effect of genetic and management strategies that increase milk yield and reduce culling on CH4/ECM. Some of these approaches discussed require further research, but many could be implemented now. Past efforts in CH4 mitigation have largely focused on identifying and evaluating CH4 mitigation approaches based on nutrition, feeding, and modifications of rumen function. Nutrition and feeding approaches may be able to reduce CH4/ECM by 2.5 to 15%, whereas rumen modifiers have had very little success in terms of sustained CH4 reductions without compromising milk production. More significant reductions of 15 to 30% CH4/ECM can be achieved by combinations of genetic and management approaches, including improvements in heat abatement, disease and fertility management, performance

  3. Enteral nutrition for preterm infants: by bolus or continuous? An update

    Directory of Open Access Journals (Sweden)

    Valentina Bozzetti

    2017-06-01

    Full Text Available Optimization of nutritional management of preterm infants is crucial for achievement of their long-term health. Enteral nutrition is preferred to total parenteral nutrition (TPN because the former avoids complications related to vascular catheterization, sepsis, adverse effects of TPN, and fasting. Due to the lack of ability of preterm infants to coordinate suckling, swallowing, and breathing, tube feeding is necessary for most infants less than 1500 g to ensure sufficient feeding tolerance, to support optimal growth and to reduce the risk of aspiration. Therefore, feeding by orogastric or nasogastric tube using either continuous or intermittent bolus delivery of formula or human milk is common practice for these infants. Theoretical risks and benefits of both continuous nasogastric milk feeding and intermittent bolus milk feeding have been proposed. According to the literature, continuous nutrition could be preferred in smaller infants (as those with a birthweight below 1250 g or hemodynamically impaired infants; in stable growing infants nutrition can be administered intermittently as in healthy term infants.

  4. Continuous elemental enteral alimentation in the treatment of children and adolescents with Crohn's disease.

    Science.gov (United States)

    Morin, C L; Roulet, M; Roy, C C; Weber, A; Lapointe, N

    1982-01-01

    Ten pediatric patients, aged 8.5-19 years, with active symptomatic Crohn's disease, received a three-week period of continuous elemental enteral alimentation with no other form of treatment. All patients in this study were selected according to the following criteria, which were applied consecutively: (1) newly diagnosed patients with no previous treatment for Crohn's disease, (2) disease activity index over 200, and (3) no complication requiring surgery. All patients experienced a clinical remission and improved their immunologic and nutritional status during the elemental enteral alimentation. The mean disease activity index for the whole group was 307.0 +/- 23.6 (range: 203 to 413) before and 69.2 +/- 11.4 (range: 15 to 114) after the feeding period. Significant increases in body weight, triceps skinfold, mid-arm circumference, serum transferrin and mean percentage of T lymphocytes were also observed. Following cessation of enteral alimentation, a small declining dose of prednisone was used during a one-year follow-up period. Eight of the ten patients were still in clinical remission three months after the feeding period and their nutritional status had continued to improve during that period of time.

  5. Extended roles and the dietitian: community adult enteral tube care.

    Science.gov (United States)

    Stanley, W; Borthwick, A M

    2013-06-01

    Role flexibility is considered central to a health policy agenda stressing workforce redesign measures and professional role boundary change. Extensions in health professionals' role boundaries may involve the incorporation of new or 'vacant' roles, as well as the competitive acquisition of others. In the present study, the experiences of dietitians with extended roles in home enteral tube feeding (HETF) were explored and considered within the context of workforce role transition. Six semi-structured interviews conducted with dietitians specialising in HETF were undertaken and the emergent role development for dietitians in HETF was explored. Dietetic HETF roles emerged as a form of diversification, occupying a task 'vacancy', commonly on an opportunistic basis. Role overlap in these community based tasks was negotiated with community nurses, privately funded industry nurses and other medical staff. Notably, role conflict was encountered only with nutrition nurse specialists. To date, a lack of role exclusivity in a small and confined speciality field with multiple potential competitors has resulted in surprisingly little role conflict. Financial constraints within the National Health Service are considered likely to favour a privately funded service model of delivery, and this may have implications for dietitians specialising in this field. Dietitians also perceived an increase in professional status as a result of extended roles. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

  6. The development and application of an engagement index on the participants use of an infant feeding app: the Growing healthy program

    Directory of Open Access Journals (Sweden)

    Sarah Taki

    2015-10-01

    Methods/Results: The Engagement Index (EI tool developed by Web analytics Demystified (Peterson & Carrabis, 2008 was adapted and used to measure how participants engaged with the Growing healthy app. The EI tool comprises five sub-indices designed to capture a range of participant behaviours: Click-Depth Index (Ci describes the number of pages accessed each time participants visit the app (Ci= Sessions having at least ‘n’ page views / All Sessions; Recency Index (Ri measures the days elapsed since the participant last accessed the app (Ri= 1/Number of days elapsed since the most recent session; Loyalty Index (Li measures the frequency of app access over the program (Li= 1 - (1 / Number of visitor sessions during the timeframe; Interaction Index (Ii measures the number of push notifications opened from those sent (Ii= Sessions where visitor completes an action / All Sessions; and Feedback Index (Fi is a subjective indicator of the participant’s satisfaction with the app (Fi= number of positive responses/number of survey questions completed. Participants’ subjective satisfaction with the app was assessed from a quantitative survey (questions included: ease of navigation, readability, quality and usefulness of the content on the app this score comprised the Fi. The total participant EI score was then calculated as the average across the five sub-indices, thus providing a scale ranging from disengaged through to highly engaged. Modelling will be done to establish the strength of the relationship between the EI and intervention outcomes, whilst controlling for co-variates such as parental age. Secondary analysis will be undertaken to consider the strength of associations between each sub-index and study outcomes. Conclusion MHealth interventions delivered by apps provide the opportunity to investigate participants’ engagement with the intervention and its constituent parts. The use of an Engagement Index may help researchers to understand how participants

  7. The Comparison of Continuous and Intermittent Enteral Nutrition In Cerebrovascular Patients

    Directory of Open Access Journals (Sweden)

    Levent Güngör

    2011-06-01

    Full Text Available OBJECTIVE: Dysphagia and malnutrition are not so rare in stroke patients, and have an unfavorable influence on recovery. Nutritional support may reduce infections, duration of hospital stay and mortality. However, there is no clear evidence about the modality of nasogastric nutrition. In this study, intermittent and continuous enteral nutrition is compared by means of pulmonary infections and gastrointestinal tolerance, among acute cerebrovascular patients. METHODS: Sixty two acute cerebrovascular patients with dysphagia were included the study. The same volume of nutrition product was infused 4 times daily to 31 patients, and continuously for 24 hours to the remaining 31. After 10 days of follow-up, the rates of pulmonary infections, diarrhea, increased gastric residual volumes, vomiting and tube occlusion were compared between two groups. RESULTS: Twenty patients developed pneumonia (32% and 8 diarrhea (13%. Mortality due to complications associated with tube feeding was 6%. Aspiration and related pneumonia was present in 11 patients in the intermittent nutrition group (35%, and in 9 patients in the continuous nutrition group (29%. The rate of pulmonary infection was not statistically different between two groups (p>0.05. Diarrhea was observed in 7 intermittently fed patients (23%, while was present only in 1 patient (3% in the continuously fed group. Diarrhea was more common in the intermittent nutrition group, just at the statistical border (p=0.05. None of the patients developed tube occlusion, vomiting and gastric retention. The rate of mortality and the interruption of feeding was not significantly different between two groups (p>0.05. CONCLUSION: Diarrhea and pulmonary infections are more prevalent with intermittent tube feeding with respect to continuous enteral nutrition, though the difference is not so conspicuous. The reason may be contamination of the equipments and the feeding solution because of frequent manipulation and

  8. Development and research program for a soil-based bioregenerative agriculture system to feed a four person crew at a Mars base

    Science.gov (United States)

    Silverstone, S.; Nelson, M.; Alling, A.; Allen, J.

    For humans to survive during long-term missions on the Martian surface, bioregenerative life support systems including food production will decrease requirements for launch of Earth supplies, and increase mission safety. It is proposed that the development of ``modular biospheres''- closed system units that can be air-locked together and which contain soil-based bioregenerative agriculture, horticulture, with a wetland wastewater treatment system is an approach for Mars habitation scenarios. Based on previous work done in long-term life support at Biosphere 2 and other closed ecological systems, this consortium proposes a research and development program called Mars On Earth™ which will simulate a life support system designed for a four person crew. The structure will consist of /6 × 110 square meter modular agricultural units designed to produce a nutritionally adequate diet for 4 people, recycling all air, water and waste, while utilizing a soil created by the organic enrichment and modification of Mars simulant soils. Further research needs are discussed, such as determining optimal light levels for growth of the necessary range of crops, energy trade-offs for agriculture (e.g. light intensity vs. required area), capabilities of Martian soils and their need for enrichment and elimination of oxides, strategies for use of human waste products, and maintaining atmospheric balance between people, plants and soils.

  9. Gastrostomy feeding tube - pump - child

    Science.gov (United States)

    ... tube feeding; PEG tube care; Feeding - gastrostomy tube - pump; G-tube - pump; Gastrostomy button - pump; Bard Button - pump; MIC-KEY - pump ... Gather supplies: Feeding pump (electronic or battery powered) Feeding ... pump (includes a feeding bag, drip chamber, roller clamp, ...

  10. Prediction of enteric methane emissions from cattle.

    Science.gov (United States)

    Moraes, Luis E; Strathe, Anders B; Fadel, James G; Casper, David P; Kebreab, Ermias

    2014-07-01

    Agriculture has a key role in food production worldwide and it is a major component of the gross domestic product of several countries. Livestock production is essential for the generation of high quality protein foods and the delivery of foods in regions where animal products are the main food source. Environmental impacts of livestock production have been examined for decades, but recently emission of methane from enteric fermentation has been targeted as a substantial greenhouse gas source. The quantification of methane emissions from livestock on a global scale relies on prediction models because measurements require specialized equipment and may be expensive. The predictive ability of current methane emission models remains poor. Moreover, the availability of information on livestock production systems has increased substantially over the years enabling the development of more detailed methane prediction models. In this study, we have developed and evaluated prediction models based on a large database of enteric methane emissions from North American dairy and beef cattle. Most probable models of various complexity levels were identified using a Bayesian model selection procedure and were fitted under a hierarchical setting. Energy intake, dietary fiber and lipid proportions, animal body weight and milk fat proportion were identified as key explanatory variables for predicting emissions. Models here developed substantially outperformed models currently used in national greenhouse gas inventories. Additionally, estimates of repeatability of methane emissions were lower than the ones from the literature and multicollinearity diagnostics suggested that prediction models are stable. In this context, we propose various enteric methane prediction models which require different levels of information availability and can be readily implemented in national greenhouse gas inventories of different complexity levels. The utilization of such models may reduce errors

  11. Mycophenolic acid agents: is enteric coating the answer?

    Directory of Open Access Journals (Sweden)

    Manitpisitkul W

    2011-03-01

    Full Text Available Wana Manitpisitkul1, Sabrina Lee2, Matthew Cooper31Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, USA; 2Solid Organ Transplant Program, University of Utah Health Care, Salt Lake City, UT, USA; 3Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Addition of mycophenolate mofetil (MMF to calcineurin-based immunosuppressive therapy has led to a significant improvement in graft survival and reduction of acute rejection in renal transplant recipients. However, in clinical practice, MMF dose reduction, interruption, or discontinuation due to hematological and gastrointestinal (GI side-effects occurred in up to 50% of the patients. Large retrospective analyses have demonstrated that patients requiring MMF dose manipulation due to adverse events experienced a higher rate of rejection and graft loss. Enteric-coated mycophenolate sodium (EC-MPS was developed with the goal of improving upper GI side-effects. Here, we review the efficacy and safety of EC-MPS in de novo kidney transplant recipient, and in stable renal transplant patients who were converted from MMF. The changes in GI-related adverse events using patient-reported outcome instruments are also reviewed.Keywords: enteric-coated mycophenolate sodium, mycophenolate mofetil, kidney transplant, efficacy, gastrointestinal tolerability

  12. Programming

    International Nuclear Information System (INIS)

    Jackson, M.A.

    1982-01-01

    The programmer's task is often taken to be the construction of algorithms, expressed in hierarchical structures of procedures: this view underlies the majority of traditional programming languages, such as Fortran. A different view is appropriate to a wide class of problem, perhaps including some problems in High Energy Physics. The programmer's task is regarded as having three main stages: first, an explicit model is constructed of the reality with which the program is concerned; second, this model is elaborated to produce the required program outputs; third, the resulting program is transformed to run efficiently in the execution environment. The first two stages deal in network structures of sequential processes; only the third is concerned with procedure hierarchies. (orig.)

  13. Programming

    CERN Document Server

    Jackson, M A

    1982-01-01

    The programmer's task is often taken to be the construction of algorithms, expressed in hierarchical structures of procedures: this view underlies the majority of traditional programming languages, such as Fortran. A different view is appropriate to a wide class of problem, perhaps including some problems in High Energy Physics. The programmer's task is regarded as having three main stages: first, an explicit model is constructed of the reality with which the program is concerned; second, this model is elaborated to produce the required program outputs; third, the resulting program is transformed to run efficiently in the execution environment. The first two stages deal in network structures of sequential processes; only the third is concerned with procedure hierarchies.

  14. The Relationship between Glucagon-Like Peptide 2 and Feeding Intolerance in Preterm Infants

    DEFF Research Database (Denmark)

    Ozer, Esra Arun; Holst, Jens Juul; Duman, Nuray

    2008-01-01

    Glucagon-like peptide 2 (GLP-2) is a hormone produced primarily in the distal intestine, stimulated by enteral nutrients, and playing diverse roles in the intestinal adaptation and growth. We aimed to investigate whether GLP-2 may play a role in the development of feeding intolerance which...... is a common problem in preterm newborns resulting from the intestinal immaturity. The study included 20 term and 28 preterm neonates. Of preterm babies, 13 showed feeding intolerance fulfilling at least one of the following criteria: abdominal distension, increased gastric residual volume and presence of bile...... of term newborns. However, preterm neonates with feeding intolerance showed significantly lower levels of GLP-2 and increased duration to achieve full enteral feeding and hospitalization. It is suggested that GLP-2 plays a significant role in the regulation of feeding in newborns and that preterm babies...

  15. Organic Poultry Feeding

    Directory of Open Access Journals (Sweden)

    Arda Yıldırım

    2014-02-01

    Full Text Available Many people have led to the consumption of organic animal products in the event that the increase in sensitivity to a healthy diet in developed countries, and maintaining the safety of food of animal origin. Feeding and breeding in conventional production are emerged some of the negative effects and also it is more in organic production with new restrictions. Organic production is based on animal welfare. On the basis of behaviors such as feather-pecking and cannibalism known to be low in protein level of rations and unbalanced in terms of amino acids or minerals. As of 2015, organic poultry feed provided the appropriate conditions that will be 95% organic certified in Turkey and therefore, to create a balanced ration and feed hygiene in protecting brings serious challenges. Fodder supply of organic poultry feed raw materials that make up the quality, quantity and issue forms a significant effect on the health of the poultry additives permitted. The quality of the feed raw materials that constituent diets, quantity, feed supplying form and permitted feed additives significantly affects the health of poultry. Different physiological stages of the animal's nutritional requirements in order to ensure production of quality poultry products must be met from organically produced and very well-known with the contents of feedstuff digestibility. In this study, the problems encountered in feeding can be eliminated while performing economic production with considering animal welfare, following that balanced and adequate organic ration formulations and issues such as improving the production of feed raw materials are discussed.

  16. Dioxins contamination in the feed additive (feed grade cupric sulfate) tied to chlorine industry

    Science.gov (United States)

    Wang, Pu; Zhang, Qinghua; Lan, Yonghui; Xu, Shiai; Gao, Renfu; Li, Gang; Zhang, Haidong; Shang, Hongtao; Ren, Daiwei; Zhu, Chaofei; Li, Yingming; Li, Xiaomin; Jiang, Guibin

    2014-08-01

    The sources of polychlorinated dibenzo-p-dioxins/dibenzofurans (PCDD/Fs) found in animal feed additive (feed grade cupric sulfate, CuSO4) were investigated and traced back to the formation of chlorinated organic compounds in the chlor-alkali industry. PCDD/Fs could be transported through the supply chain: hydrochloric acid (HCl) by-produced during formation of chlorinated organic compounds in chlor-alkali industry --> spent acid etching solution (acid-SES) generated in printed circuit board production --> industrial cupric salt --> CuSO4 in animal feed, and finally enter the food chain. The concentration ranges in HCl and acid-SES were similar, of which the level in acid-SES was also consistent with that in various cupric salt products including CuSO4 based on Cu element content. PCDD/Fs also showed very similar congener profiles in all the sample types. This indicates a probable direct transport pathway of PCDD/Fs into the food chain, which may eventually be exposed to humans through consumption. To date this is the first study in China that systematically reports on the PCDD/Fs transport from industrial pollution sources to industrial processes and finally enters the human food chain.

  17. Enteric neurons show a primary cilium.

    Science.gov (United States)

    Luesma, Ma José; Cantarero, Irene; Castiella, Tomás; Soriano, Mario; Garcia-Verdugo, José Manuel; Junquera, Concepción

    2013-01-01

    The primary cilium is a non-motile cilium whose structure is 9+0. It is involved in co-ordinating cellular signal transduction pathways, developmental processes and tissue homeostasis. Defects in the structure or function of the primary cilium underlie numerous human diseases, collectively termed ciliopathies. The presence of single cilia in the central nervous system (CNS) is well documented, including some choroid plexus cells, neural stem cells, neurons and astrocytes, but the presence of primary cilia in differentiated neurons of the enteric nervous system (ENS) has not yet been described in mammals to the best of our knowledge. The enteric nervous system closely resembles the central nervous system. In fact, the ultrastructure of the ENS is more similar to the CNS ultrastructure than to the rest of the peripheral nervous system. This research work describes for the first time the ultrastructural characteristics of the single cilium in neurons of rat duodenum myenteric plexus, and reviews the cilium function in the CNS to propose the possible role of cilia in the ENS cells. © 2012 The Authors. Published by Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

  18. Filamentous Influenza Virus Enters Cells via Macropinocytosis

    Science.gov (United States)

    Rossman, Jeremy S.; Leser, George P.

    2012-01-01

    Influenza virus is pleiomorphic, producing both spherical (100-nm-diameter) and filamentous (100-nm by 20-μm) virions. While the spherical virions are known to enter host cells through exploitation of clathrin-mediated endocytosis, the entry pathway for filamentous virions has not been determined, though the existence of an alternative, non-clathrin-, non-caveolin-mediated entry pathway for influenza virus has been known for many years. In this study, we confirm recent results showing that influenza virus utilizes macropinocytosis as an alternate entry pathway. Furthermore, we find that filamentous influenza viruses use macropinocytosis as the primary entry mechanism. Virions enter cells as intact filaments within macropinosomes and are trafficked to the acidic late-endosomal compartment. Low pH triggers a conformational change in the M2 ion channel protein, altering membrane curvature and leading to a fragmentation of the filamentous virions. This fragmentation may enable more-efficient fusion between the viral and endosomal membranes. PMID:22875971

  19. [Our experience with ambulatory enteral nutrition].

    Science.gov (United States)

    Orduña, R M; Giménez Martínez, R; Valdivia Garvayo, M; Ruiz Santa-Olalla, A T; Roca Fernández-Castanys, E; Pérez de la Cruz, A

    1995-01-01

    Enteral nutrition in the home of the patient, has gained interest in recent years. In our health care area, we do not have a Unit of at Home Hospitalization, which has not prevented the implementation of this therapeutic modality in certain types of patients. 89 cases who have undergone enteral Nutrition in their home after the last hospital admission, were reviewed. According to the basic pathology, 41.6% (37 patients) correspond to neurological patients; 51.7% correspond to neoplasmic patients, and 6.7% are classified as miscellaneous. The average age is 64 years (18 months-92 years); the mean caloric ingestion is 1,520 Kcal/day (500-2,500), and the duration is a mean of 315 days (7-1,560). The complications observed through ambulatory visits of the patient and/or the family, accounted for a total of 36, of which 30 (83%) were digestive, and were corrected with the usual methods. In 8 cases (22%), it involved mechanical complications, and only 2 cases involved metabolic complications. Only 1 serious complication (massive bronchoaspiration) could have been avoided. The results indicate a good degree of acceptance, with similar results to those described by other authors, and with a low incidence of severe complications.

  20. FRACTIONAL CRYSTALLIZATION FEED ENVELOPE

    International Nuclear Information System (INIS)

    HERTING DL

    2008-01-01

    Laboratory work was completed on a set of evaporation tests designed to establish a feed envelope for the fractional crystallization process. The feed envelope defines chemical concentration limits within which the process can be operated successfully. All 38 runs in the half-factorial design matrix were completed successfully, based on the qualitative definition of success. There is no feed composition likely to be derived from saltcake dissolution that would cause the fractional crystallization process to not meet acceptable performance requirements. However, some compositions clearly would provide more successful operation than other compositions

  1. 7 CFR 1145.2 - Program.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Program. 1145.2 Section 1145.2 Agriculture Regulations... Orders; Milk), DEPARTMENT OF AGRICULTURE DAIRY FORWARD PRICING PROGRAM Program Rules § 1145.2 Program. (a... be entered into under the program after September 30, 2012, and no forward contract entered into...

  2. Permissive or Trophic Enteral Nutrition and Full Enteral Nutrition Had Similar Effects on Clinical Outcomes in Intensive Care: A Systematic Review of Randomized Clinical Trials.

    Science.gov (United States)

    Silva, Camila F A; de Vasconcelos, Simone G; da Silva, Thales A; Silva, Flávia M

    2018-01-26

    The aim of this study was to systematically review the effect of permissive underfeeding/trophic feeding on the clinical outcomes of critically ill patients. A systematic review of randomized clinical trials to evaluate the mortality, length of stay, and mechanical ventilation duration in patients randomized to either hypocaloric or full-energy enteral nutrition was performed. Data sources included PubMed and Scopus and the reference lists of the articles retrieved. Two independent reviewers participated in all phases of this systematic review as proposed by the Cochrane Handbook, and the review was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 7 randomized clinical trials that included a total of 1,717 patients were reviewed. Intensive care unit length of stay and mechanical ventilation duration were not statistically different between the intervention and control groups in all randomized clinical trials, and mortality rate was also not different between the groups. In conclusion, hypocaloric enteral nutrition had no significantly different effects on morbidity and mortality in critically ill patients when compared with full-energy nutrition. It is still necessary to determine the safety of this intervention in this group of patients, the optimal amount of energy provided, and the duration of this therapy. © 2018 American Society for Parenteral and Enteral Nutrition.

  3. Alternatives to antibiotics to prevent necrotic enteritis in broiler chickens: a microbiologist’s perspective.

    Directory of Open Access Journals (Sweden)

    Delphine Louise Caly

    2015-12-01

    Full Text Available Since the 2006 European ban on the use of antibiotics as growth promoters in animal feed, numerous studies have been published describing alternative strategies to prevent diseases in animals. A particular focus has been on prevention of necrotic enteritis in poultry caused by Clostridium perfringens by the use of microbes or microbe-derived products. Microbes produce a plethora of molecules with antimicrobial properties and they can also have beneficial effects through interactions with their host. Here we review recent developments in novel preventive treatments against C. perfringens-induced necrotic enteritis in broiler chickens that employ yeasts, bacteria and bacteriophages or secondary metabolites and other microbial products in disease control.

  4. Analysis of Tank 38H (HTF-38-15-119, 127) Surface, Subsurface and Tank 43H (HTF-43-15-116, 117 and 118) Surface, Feed Pump Suction and Jet Suction Subsurface Supernatant Samples in Support of Enrichment, Corrosion Control and Salt Batch Planning Programs

    Energy Technology Data Exchange (ETDEWEB)

    Oji, L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2015-12-17

    Compositional feed limits have been established to ensure that a nuclear criticality event for the 2H and 3H Evaporators is not possible. The Enrichment Control Program (ECP) requires feed sampling to determine the equivalent enriched uranium content prior to transfer of waste other than recycle transfers (requires sampling to determine the equivalent enriched uranium at two locations in Tanks 38H and 43H every 26 weeks) The Corrosion Control Program (CCP) establishes concentration and temperature limits for key constituents and periodic sampling and analysis to confirm that waste supernate is within these limits. This report provides the results of analyses on Tanks 38H and 43H surface and subsurface supernatant liquid samples in support of the ECP, the CCP, and the Salt Batch 10 Planning Program.

  5. Mining free-text medical records for companion animal enteric syndrome surveillance.

    Science.gov (United States)

    Anholt, R M; Berezowski, J; Jamal, I; Ribble, C; Stephen, C

    2014-03-01

    Large amounts of animal health care data are present in veterinary electronic medical records (EMR) and they present an opportunity for companion animal disease surveillance. Veterinary patient records are largely in free-text without clinical coding or fixed vocabulary. Text-mining, a computer and information technology application, is needed to identify cases of interest and to add structure to the otherwise unstructured data. In this study EMR's were extracted from veterinary management programs of 12 participating veterinary practices and stored in a data warehouse. Using commercially available text-mining software (WordStat™), we developed a categorization dictionary that could be used to automatically classify and extract enteric syndrome cases from the warehoused electronic medical records. The diagnostic accuracy of the text-miner for retrieving cases of enteric syndrome was measured against human reviewers who independently categorized a random sample of 2500 cases as enteric syndrome positive or negative. Compared to the reviewers, the text-miner retrieved cases with enteric signs with a sensitivity of 87.6% (95%CI, 80.4-92.9%) and a specificity of 99.3% (95%CI, 98.9-99.6%). Automatic and accurate detection of enteric syndrome cases provides an opportunity for community surveillance of enteric pathogens in companion animals. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Feeding Your Baby

    Medline Plus

    Full Text Available ... may need time and practice to get comfortable breastfeeding, but you’ll get the hang of it! ... Learn what you can do if you have breastfeeding problems or discomforts . If you’re feeding your ...

  7. Feeding Your Baby

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    Full Text Available ... discomforts when breastfeeding Starting your baby on solid foods Using a breast pump Baby Feeding your ... health & safety ') document.write('') } Ask our experts! Have a question? ...

  8. Feeding Your Baby

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    Full Text Available ... baby during the first year of life. Learn how to breastfeed and why breast milk is so ... you’re feeding your baby formula , find out how to choose the best one for your baby ...

  9. Feeding Your Baby

    Medline Plus

    Full Text Available ... started. Learn what you can do if you have breastfeeding problems or discomforts . If you’re feeding ... Family health & safety ') document.write('') } Ask our experts! Have a question? We've got answers. Reach out ...

  10. Feeding Your Baby

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    Full Text Available ... this page It's been added to your dashboard . Time to eat! Feeding your baby helps her grow healthy and strong. It’s also a great time for you and your partner to bond with ...

  11. Feeding Your Baby

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    Full Text Available ... bond with her. Breast milk is the best food for your baby during the first year of ... feeding safe. And then get ready for solid foods ! In This Topic Breastfeeding help Breastfeeding is best ...

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    Full Text Available ... for your baby Feeding your baby Common illnesses Family health & safety Complications & Loss Pregnancy complications Preterm labor & ... health research Prematurity research centers For providers NICU Family Support® Prematurity Campaign Collaborative Info for your patients ...

  13. Feeding Your Baby

    Medline Plus

    Full Text Available ... what you can do if you have breastfeeding problems or discomforts . If you’re feeding your baby ... breastfeeding log Keeping breast milk safe and healthy Problems and discomforts when breastfeeding Starting your baby on ...

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    Full Text Available ... Global Map Premature Birth Report Cards Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & ... your baby Feeding your baby Common illnesses Family health & safety Complications & Loss Pregnancy complications Preterm labor & premature ...

  15. A survey of the enteral nutrition practices in patients with neurological disorders in the tertiary hospitals of China.

    Science.gov (United States)

    Su, Ying-Ying; Gao, Dai-Quan; Zeng, Xiao-Yan; Sha, Rui-Juan; Niu, Xiao-Yuan; Wang, Chang-Qing; Zhou, Dong; Jiang, Wen; Cui, Fang; Yang, Yi; Pan, Su-Yue; Zhang, Xu; Li, Lian-Di; Gao, Liang; Peng, Bin; Zhong, Chun-Long; Liu, Zhen-Chuan; Li, Li-Hong; Tan, Hong; Lv, Pei-Yuan

    2016-01-01

    With the development of enteral nutrition in patients with neurological disorders in China, related guidelines were published in 2011. The Chinese Society for Parenteral and Enteral Nutrition conducted a survey to evaluate the status quo of enteral nutrition practices in these patients. This multicenter prospective investigation was conducted from April 2012 to April 2013 and involved 18 tertiary hospitals in China. The survey using standardized questionnaires sought information about the basic protocols for enteral nutrition (devices and staffing) and specific information about patients with neurological conditions who received nutrition by way of enteral feeding. In the 18 hospitals from 13 provinces, 83.3% patients were configured with an enteral nutrition infusion pump, 77.8% had a percutaneous endoscopic gastrostomy (PEG) device, and 88.9% had a clinical nutrition support group. Four hundred four patients participated in this survey (259 men, 145 women; mean age 61.3±14.7 years), 85.7% had suffered a stroke, 83.9% had impaired consciousness, and 98.0% had dysphagia. Of the 10 guidelines for enteral nutrition practices, setting the energy target, choosing the enteral nutrition tube, and monitoring the patient received unsatisfactory ratings were in poor compliance (56.2%, 30.0% and 38.9%, respectively); the remaining seven guidelines were in good compliance (each >75%). The survey suggested that configuration of the enteral nutritional devices and staffing was adequate in China's tertiary hospitals. However, some associated practices had not yet reached the desired levels of competency, indicating a need for this to be understood and for improved training.

  16. [Safety and efficacy of enteral nutritional suspension (TPF-FOS) JEVITY in acute stroke].

    Science.gov (United States)

    Peng, Bin; Su, Ying-ying; Cui, Li-ying; Wang, Shao-shi; Guan, Yang-tai; Zhou, Dong; Zhao, He-qing

    2011-10-11

    To evaluate the safety and efficacy of enteral nutritional suspension (TPF-FOS) JEVITY in acute stroke patients. A multicenter, prospective, post-marketing observational study was conducted. A total of 103 acute stroke patients with dysphagia received a 10-day regimen of enteral nutritional suspension (TPF-FOS) JEVITY via nasal gastric tube feeding. The parameters of serum prealbumin, serum albumin and percentage of abnormal blood glucose were evaluated and compared. The incidence of adverse events was recorded. The data were analyzed by paired t-test. At the end of the study in comparison with the baselines, the serum prealbumin increased significantly (213 mg/L ± 56 mg/L vs 219 mg/L ± 66 mg/L) and serum albumin decreased markedly (38 g/L ± 5 g/L vs 36 g/L ± 5 g/L) but stayed stable during tube feeding. No significant changes were found in percentage of abnormal blood glucose (40.78% vs 38.76%), body mass index (23.1 kg/m(2) ± 3.0 kg/m(2) vs 22.8 kg/m(2) ± 2.9 kg/m(2)) and C-reactive protein (13 mg vs 14 mg). Only 18 adverse events were related with the study product. And most of them were gastrointestinal reactions. Enteral nutritional suspension (TPF-FOS) JEVITY may increase the level of serum prealbumin in acute stroke patients and improve the patient nutritional status. With a low incidence of adverse events, it is a preferred option for enteral nutrition formulas in stroke.

  17. School Feeding Programmes: Myth and Potential.

    Science.gov (United States)

    Levinger, Beryl

    1984-01-01

    A review of research showed that school feeding programs (SFP) in elementary schools of developing nations do have a positive impact on student enrollment and school attendance. However, research studies examining the impact of SFP's on academic performance were inconclusive. Research findings are used to make recommendations for SFP design. (RM)

  18. Nasogastric Tube Feeding-Induced Esophageal Bezoar: Case Description.

    Science.gov (United States)

    Degheili, Jad A; Sebaaly, Mikhael G; Hallal, Ali H

    2017-01-01

    Background . Bezoars are well established entities causing gastrointestinal obstructions. Depending on the prominent constituent of these bezoars, the latter are divided into four subtypes: pharmacobezoars, lactobezoars, trichobezoars, and phytobezoars. Less frequently reported types of bezoars are reported including those formed secondary to nasogastric tube feeding with casein-based formulas. Case Presentation. A 69-year-old male presented following cardiac arrest postmyocardial infarction. Patient sustained anoxic brain injury after resuscitation, rendering him ventilator dependant along with nasogastric tube feeding, initially. Dislodging of the nasogastric tube at one time rendered it difficult to reinsert it, with investigation showing the presence of calcified material within the distal oesophagus, mainly composed of casein-based products secondary to enteral feeding. Conclusion. Bezoars are well known to cause gastrointestinal obstructions due to their indigestible characteristics within the alimentary tract. More rare causes of bezoars include those formed from casein-based feeding formulas administered to patients with sustained enteral feeding. Esophageal obstruction, secondary to casein-based bezoars, occurs due to multiple risk factors, especially in those necessitating intensive care. Approach in such scenarios requires a multiteam approach.

  19. Esophagojejunostomy Feeding Tube Placement in 5 Dogs with Pancreatitis and Anorexia

    Directory of Open Access Journals (Sweden)

    Forrest Cummings

    2014-01-01

    Full Text Available Enteral feeding tube placement has been described in veterinary medicine for several years. Indications include oral, esophageal, gastrointestinal, pancreatic, hepatic, and neurologic diseases. In this paper, endoscopically assisted placement of an esophagojejunostomy (EJ feeding tube in dogs with pancreatitis and prolonged anorexia is described. To the author’s knowledge there are no published reports of this procedure. Esophagojejunostomy feeding tubes provide an alternative to other forms of postgastric feeding tube placement (e.g., nasojejunal, gastrojejunostomy, and jejunostomy tubes without the associated complications of patient discomfort, sneezing, epistaxis, and peritonitis. Tube occlusion, transient vomiting and loose stool were the most commonly reported complications.

  20. Emerging roles for enteric glia in gastrointestinal disorders

    OpenAIRE

    Sharkey, Keith A.

    2015-01-01

    Enteric glia are important components of the enteric nervous system (ENS) and also form an extensive network in the mucosa of the gastrointestinal (GI) tract. Initially regarded as passive support cells, it is now clear that they are actively involved as cellular integrators in the control of motility and epithelial barrier function. Enteric glia form a cellular and molecular bridge between enteric nerves, enteroendocrine cells, immune cells, and epithelial cells, depending on their location....

  1. Method of measuring the mass flow rate of a substance entering a cocurrent fluid stream

    International Nuclear Information System (INIS)

    Cochran, H.D. Jr.

    1978-01-01

    An improved method of monitoring the mass flow rate of a substance entering a coherent fluid stream is described. The method very basically consists of heating equal sections of the fluid stream above and below the point of entry of the substance to be monitored, and measuring and comparing the resulting change in temperature of the sections. Advantage is taken of the difference in thermal characteristics of the fluid and the substance to be measured to correlate temperature differences in the sections above and below the substance feed point for providing an indication of the mass flow rate of the substance

  2. 9 CFR 113.204 - Mink Enteritis Vaccine, Killed Virus.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Mink Enteritis Vaccine, Killed Virus..., DEPARTMENT OF AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.204 Mink Enteritis Vaccine, Killed Virus. Mink Enteritis Vaccine...

  3. Noncommunicating isolated enteric duplication cyst in the abdomen ...

    African Journals Online (AJOL)

    Noncommunicating isolated enteric duplication cyst in the abdomen in children: report of one case and review of the literature. Hyun-Young Kim, Soo-Hong Kim, Kwi-Won Park and Sung-Eun Jung. Noncommunicating isolated enteric duplications in the abdomen are an extremely rare variant of enteric duplications with their ...

  4. Early enteral nutrition compared to outcome in critically ill trauma ...

    African Journals Online (AJOL)

    Objectives: The benefit of an early enteral nutrition start in critical ill patients is widely accepted. However, limited published data focus on trauma patients. This study aimed to investigate the effect of early enteral nutrition initiation on length of stay and mortality in an intensive care unit (ICU), as well as explore if enteral ...

  5. Discontinuation of tube feeding in young children by hunger provocation

    NARCIS (Netherlands)

    Kindermann, Angelika; Kneepkens, Corneille Marie Francois; Stok, Anita; van Dijk, Elisabeth Maria; Engels, Michelle; Douwes, Adriaan Cornelis

    2008-01-01

    OBJECTIVES: Pathological food refusal (PFR) is not rare in young children with chronic conditions requiring prolonged tube feeding. We investigated whether these children could be weaned from tube feeding with a multidisciplinary hunger provocation program. PATIENTS AND METHODS: The study included

  6. Russian Gas Market: Entering New Era

    International Nuclear Information System (INIS)

    Mitrova, Tatiana; Molnar, Gergely

    2015-04-01

    After a period of extensive growth in the 2000's, the Russian gas industry is now facing numerous challenges. Mounting competition by independent producers and the development of new production by Gazprom, combined with stagnating domestic demand and weakening export markets, have created a situation of overproduction, made worse by western sanctions and low oil and gas prices. Expansion to the East thanks to the recent China deal is not expected to provide much relief before 2024. The coming decade will be critical for the industry and its outcome will largely depend on the government's pricing and institutional policies but the role of the state should remain essential. This document presents the key findings of the New CEDIGAZ report 'Russian Gas Market: Entering New Era'. The report analyses the ongoing changes in the Russian industry and the challenges to be met

  7. Optimal Time to Enter a Retirement Village

    Directory of Open Access Journals (Sweden)

    Jinhui Zhang

    2017-03-01

    Full Text Available We consider the financial planning problem of a retiree wishing to enter a retirement village at a future uncertain date. The date of entry is determined by the retiree’s utility and bequest maximisation problem within the context of uncertain future health states. In addition, the retiree must choose optimal consumption, investment, bequest and purchase of insurance products prior to their full annuitisation on entry to the retirement village. A hyperbolic absolute risk-aversion (HARA utility function is used to allow necessary consumption for basic living and medical costs. The retirement village will typically require an initial deposit upon entry. This threshold wealth requirement leads to exercising the replication of an American put option at the uncertain stopping time. From our numerical results, active insurance and annuity markets are shown to be a critical aspect in retirement planning.

  8. Gastric emptying of enteric-coated tablets

    International Nuclear Information System (INIS)

    Park, H.M.; Chernish, S.M.; Rosenek, B.D.; Brunelle, R.L.; Hargrove, B.; Wellman, H.N.

    1984-01-01

    To evaluate the gastric emptying time of pharmaceutical dosage forms in a clinical setting, a relatively simple dual-radionuclide technique was developed. Placebo tablets of six different combinations of shape and size were labeled with indium-111 DTPA and enteric coated. Six volunteers participated in a single-blind and crossover study. Tablets were given in the morning of a fasting stomach with 6 oz of water containing /sup 99m/Tc pertechnetate and continuously observed with a gamma camera. A scintigraph was obtained each minute. The results suggested that the size, shape, or volume of the tablet used in this study had no significant effect in the rate of gastric emptying. The tablets emptied erratically and unpredictably, depending upon their time of arrival in the stomach in relation to the occurrence of interdigestive myoelectric contractions. The method described is a relatively simple and accurate technique to allow one to follow the gastric emptying of tablets

  9. Reactive Arthritis Caused by Yersinia enterocolitica Enteritis.

    Science.gov (United States)

    Honda, Kazuya; Iwanaga, Nozomi; Izumi, Yasumori; Tsuji, Yoshika; Kawahara, Chieko; Michitsuji, Toru; Higashi, Shuntaro; Kawakami, Atsushi; Migita, Kiyoshi

    2017-01-01

    We report a case of reactive arthritis (ReA) triggered by Yersinia enterocolitica enteritis. A 24-year-old Japanese man developed polyarthritis in the lower limbs. Two weeks prior to these symptoms, he noted diarrhea, right lower abdominal pain and a fever. Y. enterocolitica was not isolated from a stool culture; however, he was diagnosed with ReA based on the colonoscopic findings of a high anti-Y. enterocolitica antibody titer and HLA-B27 antigen positivity. Following treatment with methotrexate and steroids, his arthritis improved. This is the first reported Japanese case of ReA in the English literature after a gastrointestinal infection caused by Y. enterocolitica.

  10. Age, lighting treatment, feed allocation and feed form influence ...

    African Journals Online (AJOL)

    2016-02-09

    Feb 9, 2016 ... During a broiler breeder trial with 3200 Cobb 500 hens, the effects of lighting treatment after 20 weeks' feed allocation and of feed form .... these trials (Lewis et al., 2007) the researchers monitored the effects of feed allocation and feed form on the time taken to ..... This phenomenon has been reported many ...

  11. Mechanosensitivity in the enteric nervous system

    Directory of Open Access Journals (Sweden)

    Gemma eMazzuoli-Weber

    2015-10-01

    Full Text Available The enteric nervous system (ENS autonomously controls gut muscle activity. Mechanosensitive enteric neurons (MEN initiate reflex activity by responding to mechanical deformation of the gastrointestinal wall. MEN throughout the gut primarily respond to compression or stretch rather than to shear force. Some MEN are multimodal as they respond to compression and stretch. Depending on the region up to 60% of the entire ENS population responds to mechanical stress. MEN fire action potentials after mechanical stimulation of processes or soma although they are more sensitive to process deformation. There are at least two populations of MEN based on their sensitivity to different modalities of mechanical stress and on their firing pattern. 1 Rapidly, slowly and ultra-slowly adapting neurons which encode compressive forces. 2 Ultra-slowly adapting stretch-sensitive neurons encoding tensile forces. Rapid adaptation of firing is typically observed after compressive force while slow adaptation or ongoing spike discharge occurs often during tensile stress (stretch. All MEN have some common properties: they receive synaptic input, are low fidelity mechanoreceptors and are multifunctional in that some serve interneuronal others even motor functions. Consequently, MEN possess processes with mechanosensitive as well as efferent functions. This raises the intriguing hypothesis that MEN sense and control muscle activity at the same time as servo-feedback loop. The mechanosensitive channel(s or receptor(s expressed by the different MEN populations are unknown. Future concepts have to incorporate compressive and tensile-sensitive MEN into neural circuits that controls muscle activity. They may interact to control various forms of a particular motor pattern or regulate different motor patterns independently from each other.

  12. Effect of physician education and patient counseling on inpatient nonsurgical percutaneous feeding tube placement rate, indications, and outcome.

    Science.gov (United States)

    Swaminath, Arun; Longstreth, George F; Runnman, Eva M; Yang, Su-Jau

    2010-02-01

    The decision to place a percutaneous feeding tube (PFT) in patients who are at the end of life is multidimensional and often complicated. We assessed the effect of physician education and counseling for patients and their surrogates on inpatient nonsurgical (endoscopic and radiologic) PFT placement rates, indications, complications, and mortality. In a pre-paid group practice, a geriatrician initiated a program of physician education and patient/surrogate counseling on the ethical and nutritional aspects of long-term enteral feeding. We compared rates of nonsurgical PFT placement (excluding those for cancer therapy or gastric decompression), indications, complications, and short- and long-term mortality in adult inpatients before (2004) and after (2005) the program. In 2004 and 2005, 115 and 60 inpatients underwent PFT placement, respectively. The annual number of hospital admissions was similar, but the rate of PFT placement declined (0.80% vs. 0.44%, P 0.05. Severe infectious complications occurred in 4 (3%) versus 0 (0%) patients, P > 0.05. Mortality (2004 versus 2005) at 30 days (23 [20%] versus 11 [18%]), 1 year (62 [54%] versus 29 [48%]) and 2 years (72 [63%] versus 31 [52%]) was similar, P > 0.05. A pilot program of educating referring physicians and counseling patients and their surrogates reduced the rate of inpatient PFT placement by nearly 50%. Indications, severe complications and short- and long-term mortality remained unchanged.

  13. Probiotic Enhanced Intestinal Immunity in Broilers against Subclinical Necrotic Enteritis

    Directory of Open Access Journals (Sweden)

    Hesong Wang

    2017-11-01

    Full Text Available Along with banning of antibiotics, necrotic enteritis (NE, especially subclinical NE (SNE whereby no clinical signs are present in chicks, has become one of the most threatening problems in poultry industry. Therefore, increasing attention has been focused on research and application of effective probiotic strains, as an alternative to antibiotics, to prevent SNE in broilers. In the present study, we evaluated the effects of Lactobacillus johnsonii BS15 on the prevention of SNE in broilers. Specifically, assessment determined the growth performance and indexes related to intestinal mucosal immunity in the ileum and cecal tonsil of broilers. A total of 300 1-day-old Cobb 500 chicks were randomly distributed into the following 5 groups: control group (fed with basal diet + de Man, Rogosa, and Sharpe liquid medium [normal diet], SNE group (normal diet, BS15 group (basal diet + 1 × 106 colony-forming units BS15/g as fed [BS15 diet], treatment group (normal diet [days 1–28] + BS15 diet [days 29–42], and prevention group (BS15 diet [days 1–28] + normal diet [days 29–42] throughout a 42-day experimental period. SNE infection was treated for all chicks in the SNE, BS15, treatment, and prevention groups. The present results demonstrated that BS15 supplementation of feeds in BS15 and prevention groups exerted a positive effect on preventing negative influences on growth performance; these negative influences included low body weight gain and increased feed conversion ratio caused by SNE. Although no changes were detected in all determined indexes in cecal tonsils, BS15-treated broilers were free from SNE-caused damage in villi in the ileum. BS15 inhibited SNE-caused decrease in immunoglobulins in the ileum. In the lamina propria of ileum, T cell subsets of lymphocytes influenced by SNE were also controlled by BS15. BS15 affected antioxidant abilities of the ileum and controlled SNE-induced mitochondrion-mediated apoptosis by

  14. Nutrient Intake and Contribution of Home Enteral Nutrition to Meeting Nutritional Requirements after Oesophagectomy and Total Gastrectomy

    Science.gov (United States)

    Baker, Melanie L; Halliday, Vanessa; Robinson, Pauline; Smith, Karen; Bowrey, David J

    2017-01-01

    Background/Objectives This study evaluated nutrition after oesophago-gastric resection and the influence of home jejunostomy feeding in the six months after surgery. Subjects/Methods Data on nutritional intake and physiologic measures were collected as part of a randomised trial with measurements taken before and up to six months after surgery. Results 41 participants (32 oesophagectomy, 9 total gastrectomy) received home jejunostomy feeding (n=18) or usual care without feeding (n=23). At hospital discharge, oral intakes were adequate for energy and protein in 9% and 6% respectively. By three and six months, these values had increased to 61% & 55%, 94% & 77% respectively. Six participants (26%) who received usual care required rescue feeding. Six weeks after hospital discharge, energy intakes were met in those who received jejunal feeding due to the contribution of enteral nutrition. Jejunal feeding did not affect oral intake, being similar in both groups (fed: 77% estimated need, usual care: 79%). At three months, inadequate micronutrient intakes were seen in over one third. Compared to baseline values, six weeks after surgery, weight loss exceeding 5% was seen in 5/18 (28%) who received feeding, 14/17 (82%) who received usual care and 5/6 (83%) of those who required rescue feeding, p=0.002. Weight loss averaged 4.1% (fed), 10.4% (usual care) and 9.2% (rescue fed), p=0.004. These trends persisted out to six months. Conclusions Supplementary jejunostomy feeding made an important contribution to meeting nutrition after oesophago-gastric resection. Importantly, oral nutritional intake was not compromised dispelling the assertion that jejunal feeding deincentivises patients from eating. PMID:28656968

  15. Evaluation of jejunostomy tube feeding after abdominal surgery in dogs.

    Science.gov (United States)

    Tsuruta, Kaoru; Mann, F A; Backus, Robert C

    2016-07-01

    To describe the use of postoperative intrajejunal feeding and to evaluate the association of preoperative plasma albumin concentrations with intrajejunal feeding-related complications and clinical outcome. Prospective, observational study. University veterinary teaching hospital. Sixty-four dogs. Jejunostomy tube placement during abdominal surgery. Most dogs (81%) survived. The median intrajejunal feeding period was 2.1 days (range: 1-16 days; n = 64). Only 3 (5%) dogs received their estimated resting energy requirement by intrajejunal feeding. Of dogs that were fed intrajejunally (58 out of 64), most (55 out of 58) received intrajejunal feeding within 24 hours after surgery. Energy provision via the jejunal feeding tube did not differ between dogs with and without complications (P = 0.592), or between nonsurvivors and survivors (P = 0.298). Thirty-five dogs ate voluntarily concurrently with intrajejunal feeding. Of dogs that ate voluntarily concurrently with intrajejunal feeding for ≤50% of the postoperative period, most (74%) survived to discharge. Complications were seen in 22% of dogs, and none were life-threatening; gastrointestinal signs were most common. There was no difference in preoperative plasma albumin concentration between dogs with and without complications (P = 0.432) and between nonsurvivors and survivors (P = 0.727). Fecal score was not significantly different between the 2 liquid diets studied (FormulaV Enteral Care HLP and CliniCare Canine/Feline; P = 0.927). A jejunostomy tube placed during abdominal surgery was likely to be used at the study institution. Few complications were seen and none were life-threatening. Intrajejunal feeding was initiated early after surgery and did not interfere with the initiation of voluntary oral intake. Fecal scores were high and were useful for an objective assessment of fecal consistency in dogs with intrajejunal feeding. © Veterinary Emergency and Critical Care Society 2016.

  16. Impact of feeding method on diaphragm electrical activity and central apnea in preterm infants (FEAdi study).

    Science.gov (United States)

    Ng, Eugene; Schurr, Patti; Reilly, Maureen; Dunn, Michael; Beck, Jennifer

    2016-10-01

    In preterm infants, it is unknown whether feeding affects neural breathing pattern. By measuring the diaphragm electrical activity (Edi) waveform, we evaluated the effect of enteral feeding and compared the effects of feeding methods on neural breathing pattern and central apnea in very low birth weight preterm infants. In a prospective, randomized, crossover study, ten non-ventilated preterm infants with birth weightsapnea. Primary outcome was change in Edi min with feed. Secondary outcomes include change in Edi peak, frequency and duration of central apnea with feeding. Although intrasubject coefficient of variation was not significantly different, individual responses to feeding and feeding method were variable. No significant difference in Edi timing, Edi min, Edi peak, or apnea was observed for the different epochs. In this study cohort, neural breathing pattern does not appear to be consistently affected by enteral feeding or the feeding method. Compared with BF, SF does not appear to reduce the number or duration of apneas. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Antibiotic-Resistant Enteric Bacteria in Environmental Waters

    Directory of Open Access Journals (Sweden)

    Lisa M. Casanova

    2016-11-01

    Full Text Available Sources of antibiotic resistant organisms, including concentrated animal feeding operations (CAFOs, may lead to environmental surface and groundwater contamination with resistant enteric bacteria of public health concern. The objective of this research is to determine whether Salmonella, Escherichia coli, Yersinia enterocolitica, and enterococci resistant to clinically relevant antibiotics are present in surface and groundwater sources in two eastern North Carolina counties, Craven and Wayne. 100 surface and groundwater sites were sampled for Salmonella, E. coli, and enterococci, and the bacteria isolated from these samples were tested for susceptibility to clinically relevant antibiotics. Salmonella were detected at low levels in some surface but not groundwater. E. coli were in surface waters but not ground in both counties. Enterococci were present in surface water and a small number of groundwater sites. Yersinia was not found. Bacterial densities were similar in both counties. For Salmonella in surface water, the most frequent type of resistance was to sulfamethoxazole. There was no ciprofloxacin resistance. There were a few surface water E. coli isolates resistant to chloramphenicol, gentamicin, and ampicillin. Enterococci in surface water had very low levels of resistance to vancomycin, chloramphenicol, ampicillin, and streptomycin. E. coli and enterococci are present more frequently and at higher levels in surface water than Salmonella, but groundwater contamination with any of these organisms was rare, and low levels of resistance can be found sporadically. Resistant bacteria are relatively uncommon in these eastern N.C. surface and groundwaters, but they could pose a risk of human exposure via ingestion or primary contact recreation.

  18. Enteric glial cells: new players in Parkinson's disease?

    Science.gov (United States)

    Clairembault, Thomas; Leclair-Visonneau, Laurène; Neunlist, Michel; Derkinderen, Pascal

    2015-04-01

    Lewy pathology has been described in neurons of the enteric nervous system in nearly all Parkinson's disease (PD) patients at autopsy. The enteric nervous system not only contains a variety of functionally distinct enteric neurons but also harbors a prominent component of glial cells, the so-called enteric glial cells, which, like astrocytes of the central nervous system, contribute to support, protect, and maintain the neural network. A growing body of evidence supports a role for enteric glial cells in the pathophysiology of gastrointestinal disorders such as inflammatory bowel disease and chronic constipation. We have recently shown that enteric glial cell dysfunction occurs in PD. In the present review, we discuss the possible implications of enteric glia in PD-related gut dysfunction as well as in disease initiation and development. © 2014 International Parkinson and Movement Disorder Society.

  19. Condensate feeding system

    International Nuclear Information System (INIS)

    Iwami, Hiroshi.

    1981-01-01

    Purpose: To control the dissolved oxygen concentration in water of a condensate feeding system to a desired level. Constitution: Coolant is fed to a nuclear reactor through a route from the steam exit of the reactor and by way of turbine, turbine condensator, condensate pump, condensate desalinator, feedwater heater and feed pump. Steam extraction lines are branched from the turbines, and pipeways are further branched from the steam extraction lines for feeding steam by way of extraction steam injection valves to steam-water mixers disposed on the upstream of the feedwater heater. On the downstream of the feedwater heater, is provided a dissolved oxygen concentration meter, the indication value of which controls the opening degree of the steam injection valves which, in turn, controls the opening degree of the steam feed valves for the feedwater heater to adjust the amount for the injection steams. Accordingly, the dissolved oxygen concentration in the water of the condensate feeding system can be controlled by the inclusion of steams with high dissolved oxygen concentration into the feedwater system from the turbine steam extraction lines by way of the mixers. (Furukawa, Y.)

  20. Input: Enter the Word-Processing Computer.

    Science.gov (United States)

    Hennings, Dorothy Grant

    1981-01-01

    Describes ways that word-processing computers can be used to teach writing and editing skills and related attitudes. Explores the advantages and disadvantages of using computers in writing programs, as well as some misconceptions about computers. (HTH)