Nutrition education intervention for college female athletes.

Science.gov (United States)

Abood, Doris A; Black, David R; Birnbaum, Rachel D

2004-01-01

To evaluate the efficacy of a nutrition education intervention for college female athletes to improve nutrition knowledge, build self-efficacy with respect to making healthful dietary choices, and improve dietary intake. A pretest-posttest control group design was implemented. A women's soccer team (n =15) and a women's swim team (n = 15) were randomly assigned to experimental and control groups, respectively. The intervention focused on nutrition knowledge, self-efficacy in making healthful dietary choices, and dietary practices to demonstrate treatment effect. Dependent variables were nutrition knowledge, self-efficacy, and dietary practices. Independent variables were group assignment. The Mann-Whitney U test was used to analyze the results between groups, and the Fisher exact probability test was used to detect differences between groups in the number of positive dietary changes. Treatment participants significantly improved nutrition knowledge, self-efficacy (P nutrition education intervention research among athletes and demonstrates the ability to increase not only nutrition knowledge, which is typically reported, but also self-efficacy and improvement in overall positive dietary changes during an 8-week intervention.

Position of the Academy of Nutrition and Dietetics: oral health and nutrition.

Science.gov (United States)

Touger-Decker, Riva; Mobley, Connie

2013-05-01

It is the position of the Academy of Nutrition and Dietetics that nutrition is an integral component of oral health. The Academy supports integration of oral health with nutrition services, education, and research. Collaboration between dietetics practitioners and oral health care professionals is recommended for oral health promotion and disease prevention and intervention. Scientific and epidemiological data suggest a lifelong synergy between diet, nutrition, and integrity of the oral cavity in health and disease. Oral health and nutrition have a multifaceted relationship. Oral infectious diseases, as well as acute, chronic, and systemic diseases with oral manifestations, impact an individual's functional ability to eat and their nutrition status. Likewise, nutrition and diet can affect the development and integrity of the oral cavity and progression of oral diseases. As knowledge of the link between oral and nutrition health increases, dietetics practitioners and oral health care professionals must learn to provide screening, education, and referrals as part of comprehensive client/patient care. The provision of medical nutrition therapy, including oral and overall health, is incorporated into the Standards of Practice for registered dietitians and dietetic technicians, registered. Inclusion of didactic and clinical practice concepts that illustrate the role of nutrition in oral health is essential in education programs for both professional groups. Collaborative endeavors between dietetics, dentistry, medicine, and allied health professionals in research, education, and delineation of practice roles are needed to ensure comprehensive health care. The multifaceted interactions between diet, nutrition, and oral health in practice, education, and research in both dietetics and dentistry merit continued, detailed delineation. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

The effect of a multifaceted educational intervention on medication preparation and administration errors in neonatal intensive care

NARCIS (Netherlands)

Chedoe, Indra; Molendijk, Harry; Hospes, Wobbe; Van den Heuvel, Edwin B.; Taxis, Katja

Objective To examine the effect of a multifaceted educational intervention on the incidence of medication preparation and administration errors in a neonatal intensive care unit (NICU). Design Prospective study with a preintervention and postintervention measurement using direct observation. Setting

Niños Sanos, Familia Sana: Mexican immigrant study protocol for a multifaceted CBPR intervention to combat childhood obesity in two rural California towns.

Science.gov (United States)

de la Torre, Adela; Sadeghi, Banafsheh; Green, Richard D; Kaiser, Lucia L; Flores, Yvette G; Jackson, Carlos F; Shaikh, Ulfat; Whent, Linda; Schaefer, Sara E

2013-10-31

Overweight and obese children are likely to develop serious health problems. Among children in the U.S., Latino children are affected disproportionally by the obesity epidemic. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a five-year, multi-faceted intervention study to decrease the rate of BMI growth in Mexican origin children in California's Central Valley. This paper describes the methodology applied to develop and launch the study. Investigators use a community-based participatory research approach to develop a quasi-experimental intervention consisting of four main components including nutrition, physical activity, economic and art-community engagement. Each component's definition, method of delivery, data collection and evaluation are described. Strategies to maintain engagement of the comparison community are reported as well. We present a study methodology for an obesity prevention intervention in communities with unique environmental conditions due to rural and isolated location, limited infrastructure capacity and limited resources. This combined with numerous cultural considerations and an unstable population with limited exposure to researcher expectations necessitates reassessment and adaptation of recruitment strategies, intervention delivery and data collection methods. Trial registration # NCT01900613. NCT01900613.

Determining appropriate nutritional interventions for South African children living in informal urban settlements.

Science.gov (United States)

Coutsoudis, A; Jinabhai, C C; Coovadia, H M; Mametja, L D

1994-09-01

Rapid urbanisation in South Africa has led to the creation of informal shack settlements where the health status of children is in jeopardy; it needs to be monitored so that appropriate intervention strategies can be formulated. Accordingly, the nutritional status of 190 children (3-6 years of age) living in Besters, a typical urban shack settlement north of Durban, was assessed anthropometrically. In addition the following biochemical values were determined: vitamins A and E, calcium, magnesium, phosphorus, albumin, haemoglobin, serum iron and ferritin and percentage of transferrin saturation. Malnutrition was evident in 13% of the children who were underweight (below the National Center for Health Statistics (NCHS) third weight-for-age percentile) and 27% who were stunted (below the NCHS third height-for-age percentile). Concentrations of albumin, calcium, magnesium, phosphorus and vitamin E were close to normal, with no more than 10% of the sample having values outside the normal range. However, 44% of the children had low serum retinol levels (poor vitamin A and iron status. A broad multifaceted comprehensive health intervention programme is therefore required.

The evaluation of a multifaceted intervention to promote "speaking up" and strengthen interprofessional teamwork climate perceptions.

Science.gov (United States)

Ginsburg, Liane; Bain, Lorna

2017-03-01

Communication failure is a leading cause of error and is often due to inhibition of individuals to speak up in interprofessional healthcare environments. The present study sought to evaluate the impact of a multifaceted intervention designed to promote speaking up on teamwork climate in one clinical department of a large community hospital based in Canada. The multifaceted intervention included a role-playing simulation workshop, teamwork climate data feedback and facilitated discussion with the interprofessional team (discussion briefings), and other department-led initiatives to promote trust, teamwork, and speaking up among interprofessional team members. A quasi-experiment (pretest-posttest control group design, using two posttests several months apart) was used to evaluate the impact of the complete intervention on individual teamwork climate perceptions. The intervention was implemented with an intact interprofessional team (the Emergency Department-ED) in 2014. The intensive care unit (ICU) was used as the control unit. Survey response rates were the highest at time 1 (83/102 = 81% for the ED and 29/31 = 94% for the ICU) and the lowest at time 3 (38/105 = 36% for the ED and 14/30 = 47% for the ICU). The results obtained from paired and unpaired analyses suggest that this type of multifaceted approach can improve staff perceptions of teamwork climate. The teamwork climate score in the ED was significantly higher at follow-up (Mt2 = 3.42, SD = 0.66) compared to baseline (Mt1 = 3.13, SD = 0.72), (F(1, 34) = 12.2, p = .001, eta 2 p = .263), while baseline and follow-up scores were not significantly different between baseline and follow-up for the ICU group (Mt1 = 4.12, SD = 0.60; Mt2 = 4.15, SD = 0.56; F(1, 34) = 0.06, p = .806, eta 2 p = .002). Sustaining high levels of participation in interprofessional initiatives and engaging physicians remain challenging when interventions are used in context. Improving team

Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial.

Science.gov (United States)

Spink, Martin J; Menz, Hylton B; Fotoohabadi, Mohammad R; Wee, Elin; Landorf, Karl B; Hill, Keith D; Lord, Stephen R

2011-06-16

To determine the effectiveness of a multifaceted podiatry intervention in preventing falls in community dwelling older people with disabling foot pain. Parallel group randomised controlled trial. University health sciences clinic in Melbourne, Australia. 305 community dwelling men and women (mean age 74 (SD 6) years) with disabling foot pain and an increased risk of falling. 153 were allocated to a multifaceted podiatry intervention and 152 to routine podiatry care, with 12 months' follow-up. Multifaceted podiatry intervention consisting of foot orthoses, advice on footwear, subsidy for footwear ($A100 voucher; £65; €74), a home based programme of foot and ankle exercises, a falls prevention education booklet, and routine podiatry care for 12 months. The control group received routine podiatry care for 12 months. Proportion of fallers and multiple fallers, falling rate, and injuries resulting from falls during follow-up. Overall, 264 falls occurred during the study. 296 participants returned all 12 calendars: 147 (96%) in the intervention group and 149 (98%) in the control group. Adherence was good, with 52% of the participants completing 75% or more of the requested three exercise sessions weekly, and 55% of those issued orthoses reporting wearing them most of the time. Participants in the intervention group (n=153) experienced 36% fewer falls than participants in the control group (incidence rate ratio 0.64, 95% confidence interval 0.45 to 0.91, P=0.01). The proportion of fallers and multiple fallers did not differ significantly between the groups (relative risk 0.85, 0.66 to 1.08, P=0.19 and 0.63, 0.38 to 1.04, P=0.07). One fracture occurred in the intervention group and seven in the control group (0.14, 0.02 to 1.15, P=0.07). Significant improvements in the intervention group compared with the control group were found for the domains of strength (ankle eversion), range of motion (ankle dorsiflexion and inversion/eversion), and balance (postural sway on the

Impact of a multifaceted educational intervention including serious games to improve the management of invasive candidiasis in critically ill patients.

Science.gov (United States)

Ferrer, R; Zaragoza, R; Llinares, P; Maseda, E; Rodríguez, A; Quindós, G

Infections caused by Candida species are common in critically ill patients and contribute to significant morbidity and mortality. The EPICO Project (Epico 1 and Epico 2.0 studies) recently used a Delphi approach to elaborate guidelines for the diagnosis and treatment of this condition in critically ill adult patients. We aimed to evaluate the impact of a multifaceted educational intervention based on the Epico 1 and Epico 2.0 recommendations. Specialists anonymously responded to two online surveys before and after a multifaceted educational intervention consisting of 60-min educational sessions, the distribution of slide kits and pocket guides with the recommendations, and an interactive virtual case presented at a teleconference and available for online consultation. A total of 74 Spanish hospitals. Specialists of the Intensive Care Units in the participating hospitals. Specialist knowledge and reported practices evaluated using a survey. The McNemar test was used to compare the responses in the pre- and post-intervention surveys. A total of 255 and 248 specialists completed both surveys, in both periods, respectively. The pre-intervention surveys showed many specialists to be unaware of the best approach for managing invasive candidiasis. After both educational interventions, specialist knowledge and reported practices were found to be more in line with nearly all the recommendations of the Epico 1 and Epico 2.0 guidelines, except as regards de-escalation from echinocandins to fluconazole in Candida glabrata infections (p=0.055), and the duration of antifungal treatment in both candidemia and peritoneal candidiasis. This multifaceted educational intervention based on the Epico Project recommendations improved specialist knowledge of the management of invasive candidiasis in critically ill patients. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Perinatal nutrition interventions and post-partum depressive symptoms.

Science.gov (United States)

Gould, Jacqueline F; Best, Karen; Makrides, Maria

2017-12-15

Postpartum depression (PPD) is the most prevalent mood disorder associated with childbirth. No single cause of PPD has been identified, however the increased risk of nutritional deficiencies incurred through the high nutritional requirements of pregnancy may play a role in the pathology of depressive symptoms. Three nutritional interventions have drawn particular interest as possible non-invasive and cost-effective prevention and/or treatment strategies for PPD; omega-3 (n-3) long chain polyunsaturated fatty acids (LCPUFA), vitamin D and overall diet. We searched for meta-analyses of randomised controlled trials (RCT's) of nutritional interventions during the perinatal period with PPD as an outcome, and checked for any trials published subsequently to the meta-analyses. Fish oil: Eleven RCT's of prenatal fish oil supplementation RCT's show null and positive effects on PPD symptoms. Vitamin D: no relevant RCT's were identified, however seven observational studies of maternal vitamin D levels with PPD outcomes showed inconsistent associations. Diet: Two Australian RCT's with dietary advice interventions in pregnancy had a positive and null result on PPD. With the exception of fish oil, few RCT's with nutritional interventions during pregnancy assess PPD. Further research is needed to determine whether nutritional intervention strategies during pregnancy can protect against symptoms of PPD. Given the prevalence of PPD and ease of administering PPD measures, we recommend future prenatal nutritional RCT's include PPD as an outcome. Copyright © 2016 Elsevier B.V. All rights reserved.

DAIRY PRODUCTION: A NUTRITION INTERVENTION IN A ...

African Journals Online (AJOL)

DAIRY PRODUCTION: A NUTRITION INTERVENTION IN A SUGARCANE GROWING AREA IN WESTERN KENYA. ... African Journal of Food, Agriculture, Nutrition and Development ... The influence of dairy production and a select number of household characteristics on the children's nutritional status was evaluated.

Nutritional intervention for amyotrophic lateral sclerosis.

Science.gov (United States)

Morassutti, I; Giometto, M; Baruffi, C; Marcon, M L; Michieletto, S; Giometto, B; Spinella, N; Paccagnella, A

2012-09-01

The aim of the study was to assess the consequences of early and systematic nutritional intervention on the clinical conditions of amyotrophic lateral sclerosis (ALS) patients and on the opportunity to maintain a good nutritional status for as long as possible. Thirty-three subjects with ALS. Protocol Group: 12 subjects (9 M and 3 F) monitored according to a precise nutritional intervention protocol. 21 subjects (10 M and 11 F) monitored before applying the protocol. Data recorded at the time of initial assessment were compared and expressed as the mean ± standard deviation for the Protocol Group vs. the BMI (kg/m2) 23.6 ± 4.1 vs. 21.6 ± 3.5; weight loss as a percentage of usual weight 6.6 ± 7.9 vs. 16.3 ± 8.8 (P=0.003). At six months: weight loss as a percentage of usual weight 4.9 ± 6.2 vs. 16.9 ± 10.2 (P=0.002). At 12 months: weight loss as a percentage of usual weight 7.3 ± 7.1 vs. 17.5 ± 11.1 (P=0.03). At the first follow-up visit, fewer patients in the Protocol Group were receiving enteral nutrition (25%) than patients in the CONTROL GROUP (60%). At six-month follow-up visit: 30% vs. 68%. Standard enteral nutrition formulas were used. One year after initial assessment, the mortality rate was 17% for the Protocol Group, whereas it was 24% at six months and 33% after one year for the CONTROL GROUP. If patients are treated before any significant weight loss occurs, early and specific nutritional intervention allows good nutritional status to be maintained for a longer period; if artificial nutrition is required, standard diets are able to ensure adequate clinical results.

How to help depressed older people living in residential care: a multifaceted shared-care intervention for late-life depression.

Science.gov (United States)

Llewellyn-Jones, R H; Baikie, K A; Castell, S; Andrews, C L; Baikie, A; Pond, C D; Willcock, S M; Snowdon, J; Tennant, C C

2001-12-01

To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents whowere eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. INTERVENTION DESCRIPTION: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) training for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed residents are substantial.

Impact of a nutrition intervention program on the growth and nutritional status of Nicaraguan adolescent girls.

Science.gov (United States)

Pawloski, Lisa Renee; Moore, Jean Burley

2007-06-01

This research examines the impact of a nutrition education intervention program on the nutritional status and knowledge of Nicaraguan adolescent girls. Anthropometric measurements, hemoglobin values, and data concerning nutritional knowledge were collected from adolescent girls living in Managua, Nicaragua. Using a pre-test/post-test design, data are compared prior to and after the nutrition intervention program. When using Mexican American reference data, statistically significant differences in height-for-age z-scores and weight-for-age z-scores were found when comparing the entire sample of baseline data with data collected after three years of the nutrition intervention program (p nutritional knowledge (p hemoglobin data revealed a significant decrease which may be due to specific environmental factors and pubertal changes. This research has implications concerning the development of successful adolescent focused nutrition intervention programs in Nicaragua, and examines the possibility that catch-up growth occurs during adolescence.

Promoting equity through integrated early child development and nutrition interventions.

Science.gov (United States)

Black, Maureen M; Dewey, Kathryn G

2014-01-01

Sustainable development, a foundation of the post-2015 global agenda, depends on healthy and productive citizens. The origins of adult health begin early in life, stemming from genetic-environmental interactions that include adequate nutrition and opportunities for responsive learning. Inequities associated with inadequate nutrition and early learning opportunities can undermine children's health and development, thereby compromising their productivity and societal contributions. Transactional theory serves as a useful framework for examining the associations that link early child development and nutrition because it emphasizes the interplay that occurs between children and the environment, mediated through caregiver interactions. Although single interventions targeting early child development or nutrition can be effective, there is limited evidence on the development, implementation, evaluation, and scaling up of integrated interventions. This manuscript introduces a special edition of papers on six topics central to integrated child development/nutrition interventions: (1) review of integrated interventions; (2) methods and topics in designing integrated interventions; (3) economic considerations related to integrated interventions; (4) capacity-building considerations; (5) examples of integrated interventions; and (6) policy implications of integrated interventions. Ensuring the health and development of infants and young children through integrated child development/nutrition interventions promotes equity, a critical component of sustainable development. © 2014 New York Academy of Sciences.

Effect of Digital Nutrition Education Intervention on the Nutritional Knowledge Levels of Information Technology Professionals.

Science.gov (United States)

Sharma, Priya; Rani, M Usha

2016-01-01

The purpose of the study was to determine the changes in knowledge of information technology (IT) professionals after receiving a nutrition education intervention for a month. The sample comprised of 40 IT professionals (29 males and 11 females). The sample was drawn from four IT companies of Hyderabad city using random sampling techniques. The data on the general information of the subjects was collected. The data regarding the commonly accessed sources of nutrition and health information by the subjects was also obtained from the study. The intervention study group received nutrition education by distribution of the developed CD-ROMs to them followed by interactive sessions. To assess the impact of nutrition education intervention, the knowledge assessment questionnaire (KAQ) was developed and administered before and after the education programme. A significant improvement in the mean nutritional knowledge scores was observed among the total study subjects from 22.30 to 40.55 after the intervention (p educated groups on nutrition, physical activity and overall health education to improve their health, lifestyle and eating habits.

Developing, implementing, and evaluating a multifaceted quality improvement intervention to promote sleep in an ICU.

Science.gov (United States)

Kamdar, Biren B; Yang, Jessica; King, Lauren M; Neufeld, Karin J; Bienvenu, O Joseph; Rowden, Annette M; Brower, Roy G; Collop, Nancy A; Needham, Dale M

2014-01-01

Critically ill patients commonly experience poor sleep quality in the intensive care unit (ICU) because of various modifiable factors. To address this issue, an ICU-wide, multifaceted quality improvement (QI) project was undertaken to promote sleep in the Johns Hopkins Hospital Medical ICU (MICU). To supplement previously published results of this QI intervention, the present article describes the specific QI framework used to develop and implement this intervention, which consists of 4 steps: (a) summarizing the evidence to create a list of sleep-promoting interventions, (b) identifying and addressing local barriers to implementation, (c) selecting performance measures to assess intervention adherence and patient outcomes, and (d) ensuring that all patients receive the interventions through staff engagement and education and regular project evaluation. Measures of performance included daily completion rates of daytime and nighttime sleep improvement checklists and completion rates of individual interventions. Although long-term adherence and sustainability pose ongoing challenges, this model provides a foundation for future ICU sleep promotion initiatives. © 2013 by the American College of Medical Quality.

Cost-effectiveness of nutritional intervention on healing of pressure ulcers.

Science.gov (United States)

Hisashige, Akinori; Ohura, Takehiko

2012-12-01

Pressure ulcers not only affect quality of life among the elderly, but also bring a large economic burden. There is limited evidence available for the effectiveness of nutritional interventions for treatment of pressure ulcers. In Japan, recently, a 60-patient randomized controlled trial of nutritional intervention on pressure ulcers demonstrated improvement in healing of pressure ulcers, compared with conventional management. To evaluate value for money of nutritional intervention on healing of pressure ulcers, cost-effective analysis was carried out using these trial results. The analysis was carried out from a societal perspective. As effectiveness measures, pressure ulcer days (PUDs) and quality-adjusted life years (QALYs) were estimated. Prevalence of pressure ulcers was estimated by the Kaplan-Meier method. Utility score for pressure ulcers is derived from a cross-sectional survey among health professionals related to pressure ulcers. Costs (e.g., nutritional interventions and management of pressure ulcers) were estimated from trial data during observation and follow-up. Stochastic and qualitative sensitivity analyses were performed to examine the robustness of results. For observation (12 weeks) and follow-up (12-week observation plus 4-week follow-up), nutritional intervention reduced PUDs by 9.6 and 16.2 per person, and gained 0.226 × 10(-2) QALYs and 0.382 × 10(-2) QALYs per person, respectively. In addition, costs were reduced by $542 and $881 per person, respectively. This means nutritional intervention is dominant (cost savings and greater effectiveness). The sensitivity analyses showed the robustness of these results. Economic evaluation of nutritional intervention on healing pressure ulcers from a small randomized controlled trial showed that this intervention is cost saving with health improvement. Further studies are required to determine whether this is a cost-effective intervention for widespread use. Copyright © 2012 Elsevier Ltd and

Impact of a Nutrition Intervention Program on the Growth and Nutritional Status of Nicaraguan Adolescent Girls

OpenAIRE

Pawloski, Lisa Renee; Burley Moore, Jean

2007-01-01

This research examines the impact of a nutrition education intervention program on the nutritional status and knowledge of Nicaraguan adolescent girls. Anthropometric measurements, hemoglobin values, and data concerning nutritional knowledge were collected from adolescent girls living in Managua, Nicaragua. Using a pre-test/post-test design, data are compared prior to and after the nutrition intervention program. When using Mexican American reference data, statistically significan...

Shopper marketing nutrition interventions.

Science.gov (United States)

Payne, Collin R; Niculescu, Mihai; Just, David R; Kelly, Michael P

2014-09-01

Grocery stores represent a context in which a majority of people's food purchases occur. Considering the nutrition quality of the population's food intake has dramatically decreased, understanding how to improve food choice in the grocery store is paramount to healthier living. In this work, we detail the type of financial resources from which shoppers could draw (i.e., personal income and benefits from government food assistance programs to low income populations) and explain how these financial resources are allocated in the grocery store (i.e., planned, unplanned, error). Subsequently, we identify a conceptual framework for shopper marketing nutrition interventions that targets unplanned fruit and vegetable purchases (i.e., slack, or willingness to spend minus list items). Targeting slack for fresh fruit and vegetable purchases allows retailers to benefit economically (i.e., fruit and vegetables are higher margin) and allows shoppers to improve their nutrition without increasing their budgets (i.e., budget neutrality). We also provide preliminary evidence of what in-store marketing of fresh fruits and vegetables could entail by modifying grocery carts and grocery floors to provide information of what is common, normal, or appropriate fruit and vegetable purchases. In each example, fresh fruit and vegetable purchases increased and evidence suggested shopper budget neutrality. To provide context for these results, we detail measurement tools that can be used to measure shopper behaviors, purchases, and consumption patterns. Finally, we address theoretical, practical, and policy implications of shopper marketing nutrition interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

Effectiveness of Nutrition Education vs. Non-Nutrition Education Intervention in Improving Awareness Pertaining Iron Deficiency among Anemic Adolescents.

Science.gov (United States)

Yusoff, Hafzan; Wan Daud, Wan Nudri; Ahmad, Zulkifli

2013-01-01

This study was carried out to compare the effect between nutrition education intervention and non-nutrition education intervention on awareness regarding iron deficiency among schooling adolescents in Tanah Merah, one of rural district in Kelantan, Malaysia. This study which was started in year 2010 involved 280 respondents (223 girls, 57 boys, age: 16 yr) from schools in Tanah Merah. The selection criteria were based on hemoglobin level (Hb = 7 - 11.9 g/dL for girls; Hb = 7 - 12.9 g/dL for boys). They were divided into 2 groups. The first group received nutrition education package (Nutrition education, NE), whereas another group was entitled to receive non-nutrition education intervention (Non-Nutrition Education, NNE) (supplement only). Both interventions were implemented for 3 months. The changes in awareness among respondents of both groups were evaluated using multi-choices questionnaire. Nutrition education receiver group (NE) demonstrated improvement in awareness at post-intervention. No substantial improvement was demonstrated by the counterpart group (NNE). Multimedia nutrition education program conducted at school setting was in fact practical and effective in improving awareness on iron deficiency among anemic adolescents.

Integrated nutritional intervention among mothers of under-five ...

African Journals Online (AJOL)

Integrated nutritional intervention among mothers of under-five children in rural communities of a developing country: its effects on maternal practice of complementary feeding and child's nutritional status.

Sleep in elite athletes and nutritional interventions to enhance sleep.

Science.gov (United States)

Halson, Shona L

2014-05-01

Sleep has numerous important physiological and cognitive functions that may be particularly important to elite athletes. Recent evidence, as well as anecdotal information, suggests that athletes may experience a reduced quality and/or quantity of sleep. Sleep deprivation can have significant effects on athletic performance, especially submaximal, prolonged exercise. Compromised sleep may also influence learning, memory, cognition, pain perception, immunity and inflammation. Furthermore, changes in glucose metabolism and neuroendocrine function as a result of chronic, partial sleep deprivation may result in alterations in carbohydrate metabolism, appetite, food intake and protein synthesis. These factors can ultimately have a negative influence on an athlete's nutritional, metabolic and endocrine status and hence potentially reduce athletic performance. Research has identified a number of neurotransmitters associated with the sleep-wake cycle. These include serotonin, gamma-aminobutyric acid, orexin, melanin-concentrating hormone, cholinergic, galanin, noradrenaline, and histamine. Therefore, nutritional interventions that may act on these neurotransmitters in the brain may also influence sleep. Carbohydrate, tryptophan, valerian, melatonin and other nutritional interventions have been investigated as possible sleep inducers and represent promising potential interventions. In this review, the factors influencing sleep quality and quantity in athletic populations are examined and the potential impact of nutritional interventions is considered. While there is some research investigating the effects of nutritional interventions on sleep, future research may highlight the importance of nutritional and dietary interventions to enhance sleep.

Evaluation of Nutrition Interventions in Children in Conflict Zones: A Narrative Review.

Science.gov (United States)

Carroll, Grace J; Lama, Sonam D; Martinez-Brockman, Josefa L; Pérez-Escamilla, Rafael

2017-09-01

Food and nutrition insecurity becomes increasingly worse in areas affected by armed conflict. Children affected by conflict, or in war-torn settings, face a disproportionate burden of malnutrition and poor health outcomes. As noted by humanitarian response reviews, there is a need for a stronger evidence-based response to humanitarian crises. To achieve this, we systematically searched and evaluated existing nutrition interventions carried out in conflict settings that assessed their impact on children's nutrition status. To evaluate the impact of nutrition interventions on children's nutrition and growth status, we identified published literature through EMBASE, PubMed, and Global Health by using a combination of relevant text words and Medical Subject Heading terms. Studies for this review must have included children (aged ≤18 y), been conducted in conflict or postconflict settings, and assessed a nutrition intervention that measured ≥1 outcome for nutrition status (i.e., stunting, wasting, or underweight). Eleven studies met the inclusion and exclusion criteria for this review. Five different nutrition interventions were identified and showed modest results in decreasing the prevalence of stunting, wasting, underweight, reduction in severe or moderate acute malnutrition or both, mortality, anemia, and diarrhea. Overall, nutrition interventions in conflict settings were associated with improved children's nutrition or growth status. Emergency nutrition programs should continue to follow recent recommendations to expand coverage and access (beyond refugee camps to rural areas) and ensure that aid and nutrition interventions are distributed equitably in all conflict-affected populations. © 2017 American Society for Nutrition.

Multifaceted shared care intervention for late life depression in residential care: randomised controlled trial.

Science.gov (United States)

Llewellyn-Jones, R H; Baikie, K A; Smithers, H; Cohen, J; Snowdon, J; Tennant, C C

1999-09-11

To evaluate the effectiveness of a population based, multifaceted shared care intervention for late life depression in residential care. Randomised controlled trial, with control and intervention groups studied one after the other and blind follow up after 9.5 months. Population of residential facility in Sydney living in self care units and hostels. 220 depressed residents aged >/=65 without severe cognitive impairment. The shared care intervention included: (a) multidisciplinary consultation and collaboration, (b) training of general practitioners and carers in detection and management of depression, and (c) depression related health education and activity programmes for residents. The control group received routine care. Geriatric depression scale. Intention to treat analysis was used. There was significantly more movement to "less depressed" levels of depression at follow up in the intervention than control group (Mantel-Haenszel stratification test, P=0.0125). Multiple linear regression analysis found a significant intervention effect after controlling for possible confounders, with the intervention group showing an average improvement of 1.87 points on the geriatric depression scale compared with the control group (95% confidence interval 0.76 to 2.97, P=0.0011). The outcome of depression among elderly people in residential care can be improved by multidisciplinary collaboration, by enhancing the clinical skills of general practitioners and care staff, and by providing depression related health education and activity programmes for residents.

An evaluation of a public health nutrition workforce development intervention for the nutrition and dietetics workforce.

Science.gov (United States)

Palermo, C; Hughes, R; McCall, L

2010-06-01

Workforce development is a key element for building the capacity to effectively address priority population nutrition issues. On-the-job learning and mentoring have been proposed as strategies for practice improvement in public health nutrition; however, there is limited evidence for their effectiveness. An evaluation of a mentoring circle workforce development intervention was undertaken. Thirty-two novice public health nutritionists participated in one of three mentoring circles for 2 h, every 6 weeks, over a 7-month period. Pre- and post-intervention qualitative (questionnaire, interview, mentor diary) and quantitative (competence, time working in public health nutrition) data were collected. The novice public health nutritionists explained the intervention facilitated sharing of ideas and strategies and promoted reflective practice. They articulated the important attributes of the mentor in the intervention as having experience in and a passion for public health, facilitating a trusting relationship and providing effective feedback. Participants reported a gain in competency and had an overall mean increase in self-reported competence of 15% (range 3-48% change; P work time allocated to preventive work post-intervention. Mentoring supported service re-orientation and competency development in public health nutrition. The nature of the group learning environment and the role and qualities of the mentor were important elements contributing to the interventions effects. Mentoring circles offer a potentially effective strategy for workforce development in nutrition and dietetics.

Efficacy of a multifaceted podiatry intervention to improve balance and prevent falls in older people: study protocol for a randomised trial.

Science.gov (United States)

Spink, Martin J; Menz, Hylton B; Lord, Stephen R

2008-11-25

Falls in older people are a major public health problem, with at least one in three people aged over 65 years falling each year. There is increasing evidence that foot problems and inappropriate footwear increase the risk of falls, however no studies have been undertaken to determine whether modifying these risk factors decreases the risk of falling. This article describes the design of a randomised trial to evaluate the efficacy of a multifaceted podiatry intervention to reduce foot pain, improve balance, and reduce falls in older people. Three hundred community-dwelling men and women aged 65 years and over with current foot pain and an increased risk of falling will be randomly allocated to a control or intervention group. The "usual cae" control group will receive routine podiatry (i.e. nail care and callus debridement). The intervention group will receive usual care plus a multifaceted podiatry intervention consisting of: (i) prefabricated insoles customised to accommodate plantar lesions; (ii) footwear advice and assistance with the purchase of new footwear if current footwear is inappropriate; (iii) a home-based exercise program to strengthen foot and ankle muscles; and (iv) a falls prevention education booklet. Primary outcome measures will be the number of fallers, number of multiple fallers and the falls rate recorded by a falls diary over a 12 month period. Secondary outcome measures assessed six months after baseline will include the Medical Outcomes Study Short Form 12 (SF-12), the Manchester Foot Pain and Disability Index, the Falls Efficacy Scale International, and a series of balance and functional tests. Data will be analysed using the intention to treat principle. This study is the first randomised trial to evaluate the efficacy of podiatry in improving balance and preventing falls. The trial has been pragmatically designed to ensure that the findings can be generalised to clinical practice. If found to be effective, the multifaceted podiatry

Efficacy of a multifaceted podiatry intervention to improve balance and prevent falls in older people: study protocol for a randomised trial

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Menz Hylton B

2008-11-01

Full Text Available Abstract Background Falls in older people are a major public health problem, with at least one in three people aged over 65 years falling each year. There is increasing evidence that foot problems and inappropriate footwear increase the risk of falls, however no studies have been undertaken to determine whether modifying these risk factors decreases the risk of falling. This article describes the design of a randomised trial to evaluate the efficacy of a multifaceted podiatry intervention to reduce foot pain, improve balance, and reduce falls in older people. Methods Three hundred community-dwelling men and women aged 65 years and over with current foot pain and an increased risk of falling will be randomly allocated to a control or intervention group. The "usual cae" control group will receive routine podiatry (i.e. nail care and callus debridement. The intervention group will receive usual care plus a multifaceted podiatry intervention consisting of: (i prefabricated insoles customised to accommodate plantar lesions; (ii footwear advice and assistance with the purchase of new footwear if current footwear is inappropriate; (iii a home-based exercise program to strengthen foot and ankle muscles; and (iv a falls prevention education booklet. Primary outcome measures will be the number of fallers, number of multiple fallers and the falls rate recorded by a falls diary over a 12 month period. Secondary outcome measures assessed six months after baseline will include the Medical Outcomes Study Short Form 12 (SF-12, the Manchester Foot Pain and Disability Index, the Falls Efficacy Scale International, and a series of balance and functional tests. Data will be analysed using the intention to treat principle. Discussion This study is the first randomised trial to evaluate the efficacy of podiatry in improving balance and preventing falls. The trial has been pragmatically designed to ensure that the findings can be generalised to clinical practice. If

Health Alliance for prudent antibiotic prescribing in patients with respiratory tract infections (HAPPY AUDIT -impact of a non-randomised multifaceted intervention programme

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Reutskiy Anatoliy

2011-06-01

Full Text Available Abstract Background Excessive use of antibiotics is worldwide the most important reason for development of antimicrobial resistance. As antibiotic resistance may spread across borders, high prevalence countries may serve as a source of bacterial resistance for countries with a low prevalence. Therefore, bacterial resistance is an important issue with a potential serious impact on all countries. Initiatives have been taken to improve the quality of antibiotic prescribing in primary care, but only few studies have been designed to determine the effectiveness of multifaceted strategies across countries with different practice setting. The aim of this study was to evaluate the impact of a multifaceted intervention targeting general practitioners (GPs and patients in six countries with different health organization and different prevalence of antibiotic resistance. Methods GPs from two Nordic countries, two Baltic Countries and two Hispano-American countries registered patients with respiratory tract infections (RTIs in 2008 and 2009. After first registration they received individual prescriber feedback and they were offered an intervention programme that included training courses, clinical guidelines, posters for waiting rooms, patient brochures and access to point of care tests (Strep A and C-Reactive Protein. Antibiotic prescribing rates were compared before and after the intervention. Results A total of 440 GPs registered 47011 consultations; 24436 before the intervention (2008 and 22575 after the intervention (2009. After the intervention, the GPs significantly reduced the percentage of consultations resulting in an antibiotic prescription. In patients with lower RTI the GPs in Lithuania reduced the prescribing rate by 42%, in Russia by 25%, in Spain by 25%, and in Argentina by 9%. In patients with upper RTIs, the corresponding reductions in the antibiotic prescribing rates were in Lithania 20%, in Russia 15%, in Spain 9%, and in Argentina 5

Evaluation of Adherence to Nutritional Intervention Through Trajectory Analysis.

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Sevilla-Villanueva, B; Gibert, K; Sanchez-Marre, M; Fito, M; Covas, M I

2017-05-01

Classical pre-post intervention studies are often analyzed using traditional statistics. Nevertheless, the nutritional interventions have small effects on the metabolism and traditional statistics are not enough to detect these subtle nutrient effects. Generally, this kind of studies assumes that the participants are adhered to the assigned dietary intervention and directly analyzes its effects over the target parameters. Thus, the evaluation of adherence is generally omitted. Although, sometimes, participants do not effectively adhere to the assigned dietary guidelines. For this reason, the trajectory map is proposed as a visual tool where dietary patterns of individuals can be followed during the intervention and can also be related with nutritional prescriptions. The trajectory analysis is also proposed allowing both analysis: 1) adherence to the intervention and 2) intervention effects. The analysis is made by projecting the differences of the target parameters over the resulting trajectories between states of different time-stamps which might be considered either individually or by groups. The proposal has been applied over a real nutritional study showing that some individuals adhere better than others and some individuals of the control group modify their habits during the intervention. In addition, the intervention effects are different depending on the type of individuals, even some subgroups have opposite response to the same intervention.

Pushing the Limits: Cognitive, Affective, & Neural Plasticity Revealed by an Intensive Multifaceted Intervention

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Michael David Mrazek

2016-03-01

Full Text Available Scientific understanding of how much the adult brain can be shaped by experience requires examination of how multiple influences combine to elicit cognitive, affective, and neural plasticity. Using an intensive multifaceted intervention, we discovered that substantial and enduring improvements can occur in parallel across multiple cognitive and neuroimaging measures in healthy young adults. The intervention elicited substantial improvements in physical health, working memory, standardized test performance, mood, self-esteem, self-efficacy, mindfulness, and life satisfaction. Improvements in mindfulness were associated with increased degree centrality of the insula, greater functional connectivity between insula and somatosensory cortex, and reduced functional connectivity between posterior cingulate cortex and somatosensory cortex. Improvements in working memory and reading comprehension were associated with increased degree centrality of a region within the middle temporal gyrus that was extensively and predominately integrated with the executive control network. The scope and magnitude of the observed improvements represent the most extensive demonstration to date of the considerable human capacity for change. These findings point to higher limits for rapid and concurrent cognitive, affective, and neural plasticity than is widely assumed.

Multifaceted intervention to curb in-hospital over-prescription of proton pump inhibitors: A longitudinal multicenter quasi-experimental before-and-after study.

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Del Giorno, Rosaria; Ceschi, Alessandro; Pironi, Michela; Zasa, Anna; Greco, Angela; Gabutti, Luca

2018-04-01

Proton pump inhibitors (PPIs) are indicated for a restricted number of clinical conditions, and their misuse can lead to several adverse effects. Despite that, the proportion of overuse is alarmingly high. To test the efficacy of a multifaceted strategy in order to achieve a significant reduction of new PPI prescriptions at discharge in hospitalized patients. Multicenter longitudinal quasi-experimental before-and-after study conducted from July 1st, 2014 to June 30th, 2017. 44,973 admissions in a network of 5 public teaching hospitals of the Italian-speaking region of Switzerland. Multifaceted strategy consisting in a continuous transparent monitoring-benchmarking and in capillary educational interventions applied in the internal medicine departments. To confirm the causality of the results we monitored the trend of new PPI prescriptions in the, not exposed to the intervention, surgery departments of the same hospital network. New PPI prescriptions at hospital discharge. Over the 36month study period 44,973 patient files were analyzed. At admission, comparing internal medicine vs. surgery departments, 44.9% vs. 23.3% of patients were already being treated with a PPI. The annual rate of new PPI prescriptions, for internal medicine showed a decreasing trend: 19, 19, 18, 16% in years 2014, 2015, 2016, 2017, respectively (pintroduction of a multifaceted intervention significantly reduced the time trend of PPI prescriptions at hospital discharge in internal medicine departments. Further studies are needed to confirm whether the strategy proposed could contribute to optimize the in-hospital drug prescription behavior in other healthcare settings as well. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Effects of Nutrition Health Intervention on Pupils' Nutrition Knowledge and Eating Habits

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Raiha, Teija; Tossavainen, Kerttu; Turunen, Hannele; Enkenberg, Jorma; Kiviniemi, Vesa

2012-01-01

The purpose of this investigation was to evaluate the effects of nutrition health intervention on pupils' nutrition knowledge and eating habits from grade seven to grade nine. The study was part of the ENHPS (since 2008, Schools for Health in Europe (SHE)) program in Finland, and more specifically its sub-project titled "From Puijo to the…

Implementing a multifaceted intervention to decrease central line-associated bloodstream infections in SEHA (Abu Dhabi Health Services Company) intensive care units: the Abu Dhabi experience.

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Latif, Asad; Kelly, Bernadette; Edrees, Hanan; Kent, Paula S; Weaver, Sallie J; Jovanovic, Branislava; Attallah, Hadeel; de Grouchy, Kristin K; Al-Obaidli, Ali; Goeschel, Christine A; Berenholtz, Sean M

2015-07-01

OBJECTIVE To determine whether implementation of a multifaceted intervention would significantly reduce the incidence of central line-associated bloodstream infections. DESIGN Prospective cohort collaborative. SETTING AND PARTICIPANTS Intensive care units of the Abu Dhabi Health Services Company hospitals in the Emirate of Abu Dhabi. INTERVENTIONS A bundled intervention consisting of 3 components was implemented as part of the program. It consisted of a multifaceted approach that targeted clinician use of evidence-based infection prevention recommendations, tools that supported the identification of local barriers to these practices, and implementation ideas to help ensure patients received the practices. Comprehensive unit-based safety teams were created to improve safety culture and teamwork. Finally, the measurement and feedback of monthly infection rate data to safety teams, senior leaders, and staff in participating intensive care units was encouraged. The main outcome measure was the quarterly rate of central line-associated bloodstream infections. RESULTS Eighteen intensive care units from 7 hospitals in Abu Dhabi implemented the program and achieved an overall 38% reduction in their central line-associated bloodstream infection rate, adjusted at the hospital and unit level. The number of units with a quarterly central line-associated bloodstream infection rate of less than 1 infection per 1,000 catheter-days increased by almost 40% between the baseline and postintervention periods. CONCLUSION A significant reduction in the global morbidity and mortality associated with central line-associated bloodstream infections is possible across intensive care units in disparate settings using a multifaceted intervention.

Using social marketing principles to guide the development of a nutrition education initiative for preschool-aged children.

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Young, Laura; Anderson, Jennifer; Beckstrom, Leslie; Bellows, Laura; Johnson, Susan L

2004-01-01

Within the field of nutrition education, social marketing has become a promising framework to systematically approach problems related to nutrition behavior. In 1997, the Colorado Nutrition Network began developing a social marketing campaign to promote healthful food choices among low-income Coloradans. A multifaceted formative evaluation plan that included focus groups, campaign concept pretesting, and a food frequency questionnaire was used to segment and scrutinize the target audience. The resulting pilot program was a blend of educational and marketing strategies targeting preschoolers that was implemented in Head Start classrooms. The 12-week intervention contained a narrow, behavior-based "try new foods" message, multiple nutrition education activities, and repeated opportunities to taste 13 novel foods. Key strategies used and findings from the formative evaluation process are presented herein in an effort to provide insight for nutrition educators interested in developing similar interventions.

Research on Intervention Measures of Sports Nutrition for Athletes' Fatigue Recovery

OpenAIRE

Zichao Chen

2015-01-01

This study analyzes the necessity of sports nutrition intervention for the recovery of the athletes' fatigue, discussing the intervention measures of sports nutrition for athletes' fatigue recovery with the help of the interpretation of sports fatigue. The nutrition supplement for sports fatigue which is an effective method to alleviate the symptoms, promote the recovery and guarantee the training.

Systematic review of control groups in nutrition education intervention research.

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Byrd-Bredbenner, Carol; Wu, FanFan; Spaccarotella, Kim; Quick, Virginia; Martin-Biggers, Jennifer; Zhang, Yingting

2017-07-11

Well-designed research trials are critical for determining the efficacy and effectiveness of nutrition education interventions. To determine whether behavioral and/or cognition changes can be attributed to an intervention, the experimental design must include a control or comparison condition against which outcomes from the experimental group can be compared. Despite the impact different types of control groups can have on study outcomes, the treatment provided to participants in the control condition has received limited attention in the literature. A systematic review of control groups in nutrition education interventions was conducted to better understand how control conditions are described in peer-reviewed journal articles compared with experimental conditions. To be included in the systematic review, articles had to be indexed in CINAHL, PubMed, PsycINFO, WoS, and/or ERIC and report primary research findings of controlled nutrition education intervention trials conducted in the United States with free-living consumer populations and published in English between January 2005 and December 2015. Key elements extracted during data collection included treatment provided to the experimental and control groups (e.g., overall intervention content, tailoring methods, delivery mode, format, duration, setting, and session descriptions, and procedures for standardizing, fidelity of implementation, and blinding); rationale for control group type selected; sample size and attrition; and theoretical foundation. The search yielded 43 publications; about one-third of these had an inactive control condition, which is considered a weak study design. Nearly two-thirds of reviewed studies had an active control condition considered a stronger research design; however, many failed to report one or more key elements of the intervention, especially for the control condition. None of the experimental and control group treatments were sufficiently detailed to permit replication of the

Nutritional Interventions for Cancer-induced Cachexia

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Gullett, Norleena P.; Mazurak, Vera; Hebbar, Gautam; Ziegler, Thomas R.

2011-01-01

Cancer-induced cachexia remains a significant cause of morbidity and mortality in cancer treatment. Cancer research and development continues at an aggressive pace and yet a degree of cancer-induced cachexia is experienced by up to 80% of advanced stage cancer patients. Unfortunately, there are no established treatment regimens for this condition. Weight loss and fatigue consistently appear in patient oncologic histories and progress notes. However, few oncologists fully understand the pathologic mechanisms causing cachexia resulting in well-meaning advice to increase caloric intake with minimal results. Our goal is to describe the pathologic basis of cancer-induced cachexia and to detail accompanying metabolic derangements. Understanding the causes of cachexia sheds light on the subsequent need for multi-modality therapy including clinical intervention with specialized nutrition support, drug therapy, lifestyle and diet changes. In addition to nutrition support modalities, practicing oncologists may prescribe medical therapies designed to increase body weight and lean body mass, including megestrol acetate, tetrahydrocannibinol, oxandrolone, and non-steroidal anti-inflammatory drugs. A variety of experimental therapies are also being investigated for cancer-induced cachexia including tumor necrosis factor-alpha inhibitors and ghrelin infusions. We review the available data to support nutrition-oriented interventions in cancer-induced cachexia, including omega-3 fatty acids, amino-acid loading/protein supplementation, parenteral and enteral nutrition support, and food-derived compounds such as curcumin, reservatrol, and pomegranate. PMID:21420558

Nutritional interventions to reduce cardiovascular risk factors: an Iranian perspective

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Sharifi N

2015-04-01

Full Text Available Nasrin Sharifi,1 Reza Amani2 1Department of Nutrition, 2Health Research Institute, Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Abstract: Cardiovascular disease (CVD is the leading cause of death not only in industrialized and developed countries but also in developing societies. Changes in lifestyle of the population living in developing countries, which is due to the socioeconomic and cultural transition, are important reasons for increase in the rate of CVD. This observation has led to extensive body of researches on CVD prevention. In Iran, as a developing country in the Middle East, the increasing incidence of CVD has prompted the health policy-makers to emphasize on nutritional interventions as a part of the main strategies to alleviate the condition. Hence, in this article, we aimed to review the nutritional interventions on preventing CVDs from the perspectives of Iranian lifestyles and dietary patterns using data search sources such as Medline, Google scholar, and Iran doc. Keywords: nutrition, intervention, cardiovascular disease, Iran

Integrated nutritional intervention in the elderly after hip fracture. A process evaluation.

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Breedveld-Peters, José J L; Reijven, Petronella L M; Wyers, Caroline E; van Helden, Svenhjalmar; Arts, J J Chris; Meesters, Berry; Prins, Martin H; van der Weijden, Trudy; Dagnelie, Pieter C

2012-04-01

Within a multicentre randomized controlled trial aimed at improving the nutritional status and increase the speed of recovery of elderly hip fracture patients, we performed a process evaluation to investigate the feasibility of the intervention within the present Dutch health care system. Patients in the intervention group received nutritional counseling during 10 contacts. Oral nutritional supplements were advised as needed until three months after hip fracture surgery. The intervention was evaluated with respect to dieticians' adherence to the study protocol, content of nutritional counseling, and patients' adherence to recommendations given. We included 66 patients (mean age of 76, range 55-92 years); 74% women. Eighty-three percent of patients received all 10 contacts as planned, but in 62% of the patients one or more telephone calls had to be replaced by face to face contacts. Nutritional counseling was complete in 91% of contacts. Oral nutritional supplementation was needed for a median period of 76 days; 75% of the patients took the oral nutritional supplements as recommended. Nutritional counseling in elderly hip fracture patients through face to face contacts and telephone calls is feasible. However, individual tailoring of the intervention is recommended. The majority of hip fracture patients needed >2 months oral nutritional supplements to meet their nutritional requirements. The trial was registered at clincialtrails.gov as NCT00523575. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Nutrition interventions in patients with Crohn´s disease

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Eva Beňová

2016-10-01

Full Text Available Crohn's disease is a chronic non-specific inflammatory bowel disease of any part of the digestive tract. The seriousness of the disease requires a multi-disciplinary approach when providing patients with secondary and tertiary care. Patients also have specific problems from the nursing perspective that require intervention of nurses, e.g. in the area of nutrition. The role of a nurse in a specific community lies in supporting public health in the field of prevention, health education, group educational activities and care of the acutely or chronically ill. The regulation tool of nursing practice when providing community care is the documented form of nursing data expressed by means of expert terminology. The Omaha System is a standardised terminology for multi-disciplinary teams providing community care. The objective of the research is to draw attention to the possibility of using standardised terminology of the Omaha System when supporting public health in patients with Crohn's disease with nutrition problems. The research was divided into 3 stages: in the first stage we assessed the nutrition problem in 100 patients dispensarised in gastroenterology counselling centres using a form from the Omaha System. Out of these, identified 42 patients suffered from Crohn's disease and had problems with nutrition; in the second stage we chose interventions for nutrition from the Intervention Scheme of the Omaha System: their efficiency in patients was assessed by a nurse/nutritionist in the third stage of the research when the patients came to the gastroenterology counselling centre using Problem Rating Scale for Outcomes. When comparing the initial and final nutrition assessment with socio-demographic indicators we found a statistically significant difference (p = 0.000 between the status assessment where women scored a more remarkable advance than men when comparing the initial and the final assessment. With respect to age groups, education and jobs

Early Nutrition and Physical Activity Interventions in Childhood Cancer Survivors.

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Zhang, Fang Fang; Kelly, Michael J; Must, Aviva

2017-06-01

Childhood cancer survivors experience excessive weight gain early in treatment. Lifestyle interventions need to be initiated early in cancer care to prevent the early onset of obesity and cardiovascular disease (CVD). We reviewed the existing literature on early lifestyle interventions in childhood cancer survivors and consider implications for clinical care. Few lifestyle interventions focus on improving nutrition in childhood cancer survivors. A consistent effect on reducing obesity and CVD risk factors is not evident from the limited number of studies with heterogeneous intervention characteristics, although interventions with a longer duration and follow-up show more promising trends. Future lifestyle interventions should be of a longer duration and include a nutrition component. Interventions with a longer duration and follow-up are needed to assess the timing and sustainability of the intervention effect. Lifestyle interventions introduced early in cancer care are both safe and feasible.

A Nutrition Education Intervention Trial for Adolescent Girls in Isfahan: Study Design and Protocol

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Morvarid Ghasab Shirazi

2016-11-01

Full Text Available BackgroundNutrition behaviors of adolescent girls is of serious health concerns. Although nutrition education interventions in Iran have met with some success, most of them could not promote nutrition behavioral changes. The aim of our study is to determine a school-based nutrition education intervention to improve adolescents’ nutrition behaviors and behavioral mediators based on the social cognitive theory (SCT.Materials and MethodsThis study is a single-blind randomized controlled trial. Eligible participants will be all student girls in grade 6 and 7, their parents and teachers in Isfahan governmental schools. This multi com­ponent school-based intervention include adolescents’ nutrition education package, parents’ nutrition massages, participatory homework, parents and teachers nutrition education package, supportive group, and collaboration with decision makers. Changing in nutrition behaviors including breakfast, fruit and vegetable, snack and fast food consumption will be examined, as primary outcome. Secondary outcome will be behavioral mediators such as knowledge, self-efficacy, intention, situation, self-regulation, social support, outcome expectations and expectancies, in adolescent girls. The outcomes will be assessed at baseline, and after 3 and 6-month follow-up.DiscussionThis study evaluates a school-based, guided SCT intervention, designed to improve healthy dietary behaviors, nutrition knowledge of adolescent girls. Few behavioral interventions have targeted this high-risk population in Iran. The intervention seems to be promising and has the potential to bridge the gap of the limited program outcomes of nutrition education in Iranian adolescents.

Beneficial Effect of Educational and Nutritional Intervention on the Nutritional Status and Compliance of Gastric Cancer Patients Undergoing Chemotherapy: A Randomized Trial.

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Xie, Feng-Lan; Wang, Yong-Qian; Peng, Li-Fen; Lin, Fang-Yu; He, Yu-Long; Jiang, Zhuo-Qin

2017-07-01

Surgery combined with chemotherapy is the standard treatment for gastric cancer (GC); however, chemotherapy-relative adverse effects are common and result in malnutrition and a poor prognosis. In addition, compliance to postoperative chemotherapy remains a problem. This study aimed to prospectively investigate the effect of educational and nutritional interventions on the nutritional status and compliance of GC patients undergoing postoperative chemotherapy. A total of 144 GC patients were randomized into an intervention group that received intensive individualized nutritional and educational interventions during the entire course of chemotherapy and control group that received basic nutrition care and health education during hospitalization. The nutritional status and compliance between the two groups were compared. The interventions significantly improved calorie and iron intake within 24 h after the first chemotherapy session, and improved patients' weight, hemoglobin, total serum protein, and albumin levels during the entire course of chemotherapy. The compliance rate with chemotherapy was significantly higher in the intervention group than in the control group (73.61% vs. 55.56%, P = 0.024). A combination of nutritional and educational interventions provided beneficial effect on the nutrition status and compliance of gastric patients undergoing postoperative chemotherapy, which is worthy of clinical application.

Assessing Interventions: IAEA Technical Cooperation Enhances Nutrition Programmes

International Nuclear Information System (INIS)

Aning, Kwaku

2014-01-01

Malnutrition — in all its forms — is a significant development challenge, affecting childhood health, workplace productivity, and national health programmes in countries around the world. While the effects of undernutrition are well recognized, there is less recognition of the fact that the long term impact of obesity or inappropriate nutrition can also be very damaging to health and to national economies. Increasingly, countries around the world are taking action to implement nutritional or physical activity interventions designed to improve the future health of children, as well as the health of their populations in general. Such interventions may include the promotion of exclusive breastfeeding, school breakfast or lunch programmes, nutrition awareness campaigns, food fortification, and investment in sports activities and facilities. The IAEA, through its Technical Cooperation (TC) programme, is working with its Member States to help them to assess the efficiency and effectiveness of such intervention programmes, in order to ensure that government efforts are having the desired effect, and that resources are being well applied. For such assessments, reliable data are essential, and it is here that nuclear science and technology come into play

Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?

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Ruel, Marie T; Alderman, Harold

2013-08-10

Acceleration of progress in nutrition will require effective, large-scale nutrition-sensitive programmes that address key underlying determinants of nutrition and enhance the coverage and effectiveness of nutrition-specific interventions. We reviewed evidence of nutritional effects of programmes in four sectors--agriculture, social safety nets, early child development, and schooling. The need for investments to boost agricultural production, keep prices low, and increase incomes is undisputable; targeted agricultural programmes can complement these investments by supporting livelihoods, enhancing access to diverse diets in poor populations, and fostering women's empowerment. However, evidence of the nutritional effect of agricultural programmes is inconclusive--except for vitamin A from biofortification of orange sweet potatoes--largely because of poor quality evaluations. Social safety nets currently provide cash or food transfers to a billion poor people and victims of shocks (eg, natural disasters). Individual studies show some effects on younger children exposed for longer durations, but weaknesses in nutrition goals and actions, and poor service quality probably explain the scarcity of overall nutritional benefits. Combined early child development and nutrition interventions show promising additive or synergistic effects on child development--and in some cases nutrition--and could lead to substantial gains in cost, efficiency, and effectiveness, but these programmes have yet to be tested at scale. Parental schooling is strongly associated with child nutrition, and the effectiveness of emerging school nutrition education programmes needs to be tested. Many of the programmes reviewed were not originally designed to improve nutrition yet have great potential to do so. Ways to enhance programme nutrition-sensitivity include: improve targeting; use conditions to stimulate participation; strengthen nutrition goals and actions; and optimise women's nutrition, time

Designing a multifaceted quality improvement intervention in primary care in a country where general practice is seeking recognition: the case of Cyprus

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Stoffers Henri E

2008-08-01

Full Text Available Abstract Background Quality Improvement Interventions require significant financial investments, and therefore demand careful consideration in their design in order to maximize potential benefits. In this correspondence we present the methodological approach of a multifaceted quality improvement intervention aiming to improve quality of care in primary care, properly tailored for a country such as Cyprus where general practice is currently seeking recognition. Methods Our methodological approach was focused on the design of an open label, community-based intervention controlled trial using all patients from two urban and two rural public primary care centers diagnosed with hypertension and type II diabetes mellitus. The design of our intervention was grounded on a strong theoretical framework that included the Unified Theory of Acceptance and Use of Technology, and the Chronic Care Model, which synthesize evidence-based system changes in accordance with the Theory of Planned Behavior and the Theory of Reasoned Action. The primary outcome measure was improvement in the quality of care for two chronic diseases evaluated through specific clinical indicators, as well as the patient satisfaction assessed by the EUROPEP questionnaire and additional personal interviews. Results We designed a multifaceted quality improvement intervention model, supported by a varying degree of scientific evidence, tailored to local needs and specific country characteristics. Overall, the main components of the intervention were the development and adoption of an electronic medical record and the introduction of clinical guidelines for the management of the targeted chronic diseases facilitated by the necessary model of organizational changes. Conclusion Health planners and policy makers need to be aware of the potential use of certain theoretical models and applied methodology as well as inexpensive tools that may be suitably tailored to the local needs, in order to

Designing a multifaceted quality improvement intervention in primary care in a country where general practice is seeking recognition: the case of Cyprus.

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Samoutis, George A; Soteriades, Elpidoforos S; Stoffers, Henri E; Zachariadou, Theodora; Philalithis, Anastasios; Lionis, Christos

2008-08-27

Quality Improvement Interventions require significant financial investments, and therefore demand careful consideration in their design in order to maximize potential benefits. In this correspondence we present the methodological approach of a multifaceted quality improvement intervention aiming to improve quality of care in primary care, properly tailored for a country such as Cyprus where general practice is currently seeking recognition. Our methodological approach was focused on the design of an open label, community-based intervention controlled trial using all patients from two urban and two rural public primary care centers diagnosed with hypertension and type II diabetes mellitus. The design of our intervention was grounded on a strong theoretical framework that included the Unified Theory of Acceptance and Use of Technology, and the Chronic Care Model, which synthesize evidence-based system changes in accordance with the Theory of Planned Behavior and the Theory of Reasoned Action. The primary outcome measure was improvement in the quality of care for two chronic diseases evaluated through specific clinical indicators, as well as the patient satisfaction assessed by the EUROPEP questionnaire and additional personal interviews. We designed a multifaceted quality improvement intervention model, supported by a varying degree of scientific evidence, tailored to local needs and specific country characteristics. Overall, the main components of the intervention were the development and adoption of an electronic medical record and the introduction of clinical guidelines for the management of the targeted chronic diseases facilitated by the necessary model of organizational changes. Health planners and policy makers need to be aware of the potential use of certain theoretical models and applied methodology as well as inexpensive tools that may be suitably tailored to the local needs, in order to effectively design quality improvement interventions in primary care

The nutrition intervention improved adult human capital and economic productivity.

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Martorell, Reynaldo; Melgar, Paul; Maluccio, John A; Stein, Aryeh D; Rivera, Juan A

2010-02-01

This article reviews key findings about the long-term impact of a nutrition intervention carried out by the Institute of Nutrition of Central America and Panama from 1969 to 1977. Results from follow-up studies in 1988-89 and 2002-04 show substantial impact on adult human capital and economic productivity. The 1988-89 study showed that adult body size and work capacity increased for those provided improved nutrition through age 3 y, whereas the 2002-04 follow-up showed that schooling was increased for women and reading comprehension and intelligence increased in both men and women. Participants were 26-42 y of age at the time of the 2002-04 follow-up, facilitating the assessment of economic productivity. Wages of men increased by 46% in those provided with improved nutrition through age 2 y. Findings for cardiovascular disease risk factors were heterogeneous; however, they suggest that improved nutrition in early life is unlikely to increase cardiovascular disease risk later in life and may indeed lower risk. In conclusion, the substantial improvement in adult human capital and economic productivity resulting from the nutrition intervention provides a powerful argument for promoting improvements in nutrition in pregnant women and young children.

Nutritional status of patients with ataxia-telangiectasia: A case for early and ongoing nutrition support and intervention.

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Ross, Lynda J; Capra, Sandra; Baguley, Brenton; Sinclair, Kate; Munro, Kate; Lewindon, Peter; Lavin, Martin

2015-08-01

Ataxia-telangiectasia (A-T) is a rare genomic syndrome resulting in severe disability. Chronic childhood disorders can profoundly influence growth and development. Nutrition-related issues in A-T are not well described, and there are no nutritional guidelines. This study investigated the nutrition-related characteristics and behaviours of Australian A-T patients attending a national clinic. A cross-sectional analysis of 13 A-T patients (nine females; aged: 4-23 years): nutritional status was assessed by anthropometric and body cell mass (BCM) calculations. Parents reported their child's diet history and physical and behavioural factors that affect nutrition including fatigue and need for assistance. Ten (77%) had short stature (height for age z scores nutritional barriers as chronic tiredness and the need for care giver assistance with meals. This study confirms profound malnutrition in Australian A-T patients. Poor intakes and diet quality suggest the need for early nutrition intervention. Ongoing support for families and early discussions on tube feeding are required to address changing needs in childhood and likely nutritional decline into adulthood. A prospective study is required to assess feasibility and effectiveness of nutrition interventions in young people with A-T. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Nutrition support and dietary interventions for patients with lung cancer: current insights

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Kiss N

2016-01-01

Full Text Available Nicole Kiss1,2 1Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia; 2Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia Abstract: Malnutrition and weight loss are prevalent in patients with lung cancer. The impact of malnutrition on patients with cancer, and specifically in patients with lung cancer, has been demonstrated in a large number of studies. Malnutrition has been shown to negatively affect treatment completion, survival, quality of life, physical function, and health care costs. Emerging evidence is providing some insight into which lung cancer patients are at higher nutritional risk. In lung cancer patients treated with radiotherapy, stage III or more disease, treatment with concurrent chemotherapy and the extent of radiotherapy delivered to the esophagus appear to confer a higher risk of weight loss during and post-treatment. Studies investigating nutrition interventions for lung cancer patients have examined intensive dietary counseling, supplementation with fish oils, and interdisciplinary models of nutrition and exercise interventions and show promise for improved outcomes from these interventions. However, further research utilizing these interventions in large clinical trials is required to definitively establish effective interventions in this patient group. Keywords: lung cancer, nutrition, malnutrition

RE-AIM Analysis of a School-Based Nutrition Education Intervention in Kindergarteners

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Larsen, Andrew L.; Liao, Yue; Alberts, Janel; Huh, Jimi; Robertson, Trina; Dunton, Genevieve F.

2017-01-01

Background: Few nutrition interventions in kindergarten classes have been evaluated, and none has been tested for program effectiveness, implementation, and dissemination. Building a Healthy Me (BHM) is a nutrition intervention for kindergarteners that is classroom-based and includes a family component. This study evaluated the public health…

Estimating the cost of delivering direct nutrition interventions at scale: national and subnational level insights from India.

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Menon, Purnima; McDonald, Christine M; Chakrabarti, Suman

2016-05-01

India's national nutrition and health programmes are largely designed to provide evidence-based nutrition-specific interventions, but intervention coverage is low due to a combination of implementation challenges, capacity and financing gaps. Global cost estimates for nutrition are available but national and subnational costs are not. We estimated national and subnational costs of delivering recommended nutrition-specific interventions using the Scaling Up Nutrition (SUN) costing approach. We compared costs of delivering the SUN interventions at 100% scale with those of nationally recommended interventions. Target populations (TP) for interventions were estimated using national population and nutrition data. Unit costs (UC) were derived from programmatic data. The cost of delivering an intervention at 100% coverage was calculated as (UC*projected TP). Cost estimates varied; estimates for SUN interventions were lower than estimates for nationally recommended interventions because of differences in choice of intervention, target group or unit cost. US$5.9bn/year are required to deliver a set of nationally recommended nutrition interventions at scale in India, while US$4.2bn are required for the SUN interventions. Cash transfers (49%) and food supplements (40%) contribute most to costs of nationally recommended interventions, while food supplements to prevent and treat malnutrition contribute most to the SUN costs. We conclude that although such costing is useful to generate broad estimates, there is an urgent need for further costing studies on the true unit costs of the delivery of nutrition-specific interventions in different local contexts to be able to project accurate national and subnational budgets for nutrition in India. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients - results of a pragmatic intervention.

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Bell, Jack J; Bauer, Judith D; Capra, Sandra; Pulle, Ranjeev Chrys

2014-12-01

Malnutrition is highly prevalent and resistant to intervention following hip fracture. This study investigated the impact of individualised versus multidisciplinary nutritional care on nutrition intake and outcomes in patients admitted to a metropolitan hospital acute hip fracture unit. A prospective, controlled before and after comparative interventional study aligning to the CONSORT guidelines for pragmatic clinical trials. Randomly selected patients receiving individualised nutritional care (baseline) were compared with post-interventional patients receiving a new model of nutritional care promoting nutrition as a medicine, multidisciplinary nutritional care, foodservice enhancements, and improved nutrition knowledge and awareness. Malnutrition was diagnosed using the Academy of Nutrition and Dietetics criteria. Fifty-eight weighed food records were available for each group across a total of 82 patients (n = 44, n = 38). Group demographics were not significantly different with predominantly community dwelling (72%), elderly (82.2 years), female (70%), malnourished (51.0%) patients prone to co-morbidities (median 5) receiving early surgical intervention (median D1). Multidisciplinary nutritional care reduced intake barriers and increased total 24-h energy (6224 vs. 2957 kJ; p hip fracture inpatients. Similar pragmatic study designs should be considered in other elderly inpatient populations perceived resistant to nutritional intervention. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Nutrition education intervention for dependent patients: protocol of a randomized controlled trial.

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Arija, Victoria; Martín, Núria; Canela, Teresa; Anguera, Carme; Castelao, Ana I; García-Barco, Montserrat; García-Campo, Antoni; González-Bravo, Ana I; Lucena, Carme; Martínez, Teresa; Fernández-Barrés, Silvia; Pedret, Roser; Badia, Waleska; Basora, Josep

2012-05-24

Malnutrition in dependent patients has a high prevalence and can influence the prognosis associated with diverse pathologic processes, decrease quality of life, and increase morbidity-mortality and hospital admissions.The aim of the study is to assess the effect of an educational intervention for caregivers on the nutritional status of dependent patients at risk of malnutrition. Intervention study with control group, randomly allocated, of 200 patients of the Home Care Program carried out in 8 Primary Care Centers (Spain). These patients are dependent and at risk of malnutrition, older than 65, and have caregivers. The socioeconomic and educational characteristics of the patient and the caregiver are recorded. On a schedule of 0-6-12 months, patients are evaluated as follows: Mini Nutritional Assessment (MNA), food intake, dentures, degree of dependency (Barthel test), cognitive state (Pfeiffer test), mood status (Yesavage test), and anthropometric and serum parameters of nutritional status: albumin, prealbumin, transferrin, haemoglobin, lymphocyte count, iron, and ferritin.Prior to the intervention, the educational procedure and the design of educational material are standardized among nurses. The nurses conduct an initial session for caregivers and then monitor the education impact at home every month (4 visits) up to 6 months. The North American Nursing Diagnosis Association (NANDA) methodology will be used. The investigators will study the effect of the intervention with caregivers on the patient's nutritional status using the MNA test, diet, anthropometry, and biochemical parameters.Bivariate normal test statistics and multivariate models will be created to adjust the effect of the intervention.The SPSS/PC program will be used for statistical analysis. The nutritional status of dependent patients has been little studied. This study allows us to know nutritional risk from different points of view: diet, anthropometry and biochemistry in dependent patients at

Nutrition education intervention for dependent patients: protocol of a randomized controlled trial

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Arija Victoria

2012-05-01

Full Text Available Abstract Background Malnutrition in dependent patients has a high prevalence and can influence the prognosis associated with diverse pathologic processes, decrease quality of life, and increase morbidity-mortality and hospital admissions. The aim of the study is to assess the effect of an educational intervention for caregivers on the nutritional status of dependent patients at risk of malnutrition. Methods/Design Intervention study with control group, randomly allocated, of 200 patients of the Home Care Program carried out in 8 Primary Care Centers (Spain. These patients are dependent and at risk of malnutrition, older than 65, and have caregivers. The socioeconomic and educational characteristics of the patient and the caregiver are recorded. On a schedule of 0–6–12 months, patients are evaluated as follows: Mini Nutritional Assessment (MNA, food intake, dentures, degree of dependency (Barthel test, cognitive state (Pfeiffer test, mood status (Yesavage test, and anthropometric and serum parameters of nutritional status: albumin, prealbumin, transferrin, haemoglobin, lymphocyte count, iron, and ferritin. Prior to the intervention, the educational procedure and the design of educational material are standardized among nurses. The nurses conduct an initial session for caregivers and then monitor the education impact at home every month (4 visits up to 6 months. The North American Nursing Diagnosis Association (NANDA methodology will be used. The investigators will study the effect of the intervention with caregivers on the patient’s nutritional status using the MNA test, diet, anthropometry, and biochemical parameters. Bivariate normal test statistics and multivariate models will be created to adjust the effect of the intervention. The SPSS/PC program will be used for statistical analysis. Discussion The nutritional status of dependent patients has been little studied. This study allows us to know nutritional risk from different points of

[Results of nutritional intervention in children and adolescents with cystic fibrosis].

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Gaspar, Maria Cristina A; Chiba, Sônia M; Gomes, Clóvis E T; Juliano, Yara; Novo, Neil F; Ancona-Lopez, Fabio

2002-01-01

Few studies have verified longitudinally the evolution of the nutritional status of patients with cystic fibrosis. The objective of this study is to follow the evolution of the nutritional status, body composition and energy consumption, macronutrients and micronutrients ingested by children and adolescents by means of nutritional interventions at the Clinic of Cystic Fibrosis/Pediatric Pneumology of the Department of Pediatrics of Universidade Federal de São Paulo. 18 patients were involved in this study, thirteen males and five females with ages ranging from 0.3 to 18.4 years. We performed three evaluations: evaluation 1 (M1--prenutritional intervention), M2 after 6 months, and M3 after 12 months. In these three instances we verified: the z score for weight/age, weight/height and height/age and the calculation of a 3-day diet record. We verified the body composition (anthropometry) in M1 and M3. The nutritional interventions were hypercaloric, hyperproteic, with adequate amount of ingested macronutrients and micronutrients. We observed an increase in the z score for height/age (M1=-1.07; M2=-0.69; M3=-0.50) and fat-free mass after the nutritional interventions, without improvement in the z score for weight/height and fat mass. We verified an increase in the energy intake during M2 (139%) and M3 (132%) compared to M1 (106%). Remarkable increase in the intake of protein, calcium, iron and vitamin C by the patients was found. The occurrence of anemia was found in 44% (8/18) of the patients. The improvement of the z score in height/age and fat-free mass was probably due to the increase in energy consumption after the nutritional intervention. A significant improvement in the z score for weight/height and fat mass was not found, probably due to a gain in height and fat-free mass.

Development of the Oxford Hills Healthy Moms Project using a social marketing process: a community-based physical activity and nutrition intervention for low-socioeconomic-status mothers in a rural area in Maine.

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Dharod, Jigna M; Drewette-Card, Rebecca; Crawford, David

2011-03-01

A physical activity and nutrition community intervention called the Oxford Hills Healthy Moms (OHHM) Project was developed using a multifaceted social marketing process, including review of state surveillance results, key informant interviews, and a survey and focus group discussions with low-socioeconomic-status (low-SES) mothers. This formative work was used to make key decisions on the selection of the intervention region, segmentation of the audience, and design of intervention strategies addressing multiple levels of the socioecological model. The OHHM Project aims to increase fruit and vegetable consumption and physical activity levels among low-SES mothers in the Oxford Hills region of Maine. The OHHM Project includes five components: (a) physical activity buddy program, (b) cooking club with education, (c) fruit and vegetable discount buying club with education, (d) increased access to produce vendors, and (e) increased access to places for physical activity.

Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions.

OpenAIRE

Brug, Hans; Oenema, Anke; Ferreira, Isabel

2005-01-01

Abstract Background The present paper intends to contribute to the debate on the usefulness and barriers in applying theories in diet and physical activity behavior-change interventions. Discussion Since behavior theory is a reflection of the compiled evidence of behavior research, theory is the only foothold we have for the development of behavioral nutrition and physical activity interventions. Application of theory should improve the effectiveness of interventions. However, some of the the...

Nutritional interventions for survivors of childhood cancer.

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Cohen, Jennifer E; Wakefield, Claire E; Cohn, Richard J

2016-08-22

Childhood cancer survivors are at a higher risk of developing health conditions such as osteoporosis, and cardiovascular disease than their peers. Health-promoting behaviour, such as consuming a healthy diet, could lessen the impact of these chronic issues, yet the prevalence rate of health-protecting behaviour amongst survivors of childhood cancer is similar to that of the general population. Targeted nutritional interventions may prevent or reduce the incidence of these chronic diseases. The primary aim of this review was to assess the efficacy of a range of nutritional interventions designed to improve the nutritional intake of childhood cancer survivors, as compared to a control group of childhood cancer survivors who did not receive the intervention. Secondary objectives were to assess metabolic and cardiovascular risk factors, measures of weight and body fat distribution, behavioural change, changes in knowledge regarding disease risk and nutritional intake, participants' views of the intervention, measures of health status and quality of life, measures of harm associated with the process or outcomes of the intervention, and cost-effectiveness of the intervention We searched the electronic databases of the Cochrane Central Register of Controlled Trials (CENTRAL; 2013, Issue 3), MEDLINE/PubMed (from 1945 to April 2013), and Embase/Ovid (from 1980 to April 2013). We ran the search again in August 2015; we have not yet fully assessed these results, but we have identified one ongoing trial. We conducted additional searching of ongoing trial registers - the International Standard Randomised Controlled Trial Number register and the National Institutes of Health register (both screened in the first half of 2013) - reference lists of relevant articles and reviews, and conference proceedings of the International Society for Paediatric Oncology and the International Conference on Long-Term Complications of Treatment of Children and Adolescents for Cancer (both 2008 to

Improving women's nutrition imperative for rapid reduction of childhood stunting in South Asia: coupling of nutrition specific interventions with nutrition sensitive measures essential.

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Vir, Sheila C

2016-05-01

The implications of direct nutrition interventions on women's nutrition, birth outcome and stunting rates in children in South Asia are indisputable and well documented. In the last decade, a number of studies present evidence of the role of non-nutritional factors impacting on women's nutrition, birth outcome, caring practices and nutritional status of children. The implications of various dimensions of women's empowerment and gender inequality on child stunting is being increasingly recognised. Evidence reveals the crucial role of early age of marriage and conception, poor secondary education, domestic violence, inadequate decision-making power, poor control over resources, strenuous agriculture activities, and increasing employment of women and of interventions such as cash transfer scheme and microfinance programme on undernutrition in children. Analysis of the nutrition situation of women and children in South Asia and programme findings emphasise the significance of reaching women during adolescence, pre-conception and pregnancy stage. Ensuring women enter pregnancy with adequate height and weight and free from being anemic is crucial. Combining nutrition-specific interventions with measures for empowerment of women is essential. Improvement in dietary intake and health services of women, prevention of early age marriage and conception, completion of secondary education, enhancement in purchasing power of women, reduction of work drudgery and elimination of domestic violence deserve special attention. A range of programme platforms dealing with health, education and empowerment of women could be strategically used for effectively reaching women prior to and during pregnancy to accelerate reduction in stunting rates in children in South Asia. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

A Preliminary Randomized Controlled Trial of Multifaceted Educational Intervention for Mild Cognitive Impairment Among Elderly Malays in Kuala Lumpur

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Sa’ida Munira Johari

2014-06-01

Conclusion: A 12-month educational intervention on nutritional, lifestyle, and cognitive exercise significantly improved nutritional status, knowledge, and attitude score. The study lacked power to demonstrate a statistically significant positive effect on cognitive functioning; thus, the preliminary findings should be confirmed in a larger trial.

Evaluation of a Theory-Based Intervention Aimed at Improving Coaches' Recommendations on Sports Nutrition to Their Athletes.

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Jacob, Raphaëlle; Lamarche, Benoît; Provencher, Véronique; Laramée, Catherine; Valois, Pierre; Goulet, Claude; Drapeau, Vicky

2016-08-01

Coaches are a major source of nutrition information and influence for young athletes. Yet, most coaches do not have training in nutrition to properly guide their athletes. The aim of this study was to evaluate the effectiveness of an intervention aimed at improving the accuracy of coaches' recommendations on sports nutrition. This was a quasi-experimental study with a comparison group and an intervention group. Measurements were made at baseline, post-intervention, and after a 2-month follow-up period. Coaches' recommendations on sports nutrition during the follow-up period were recorded in a diary. High school coaches from various sports (n=41) were randomly assigned to a comparison group or an intervention group. Both groups attended two 90-minute sessions of a theory-based intervention targeting determinants of coaches' intention to provide recommendations on sports nutrition. The intervention group further received an algorithm that summarizes sports nutrition guidelines to help promote decision making on sports nutrition recommendations. Nutrition knowledge and accuracy of coaches' recommendations on sports nutrition. χ(2) analyses and t-tests were used to compare baseline characteristics; mixed and general linear model analyses were used to assess the change in response to the intervention and differences in behaviors, respectively. Coaches in the intervention vs comparison group provided more nutrition recommendations during the 2-month post-intervention period (mean number of recommendations per coach 25.7±22.0 vs 9.4±6.5, respectively; P=0.004) and recommendations had a greater accuracy (mean number of accurate recommendations per coach 22.4±19.9 [87.1%] vs 4.3±3.2 [46.1%], respectively; Psports nutrition knowledge level over time and helped them to provide more accurate recommendations on sports nutrition. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Nutritional decline in cystic fibrosis related diabetes: the effect of intensive nutritional intervention.

LENUS (Irish Health Repository)

White, H

2012-02-01

BACKGROUND: Reports indicate that nutritional and respiratory decline occur up to four years prior to diagnosis of cystic fibrosis related diabetes (CFRD). Our aim was to establish whether intensive nutritional intervention prevents pre-diabetic nutritional decline in an adult population with CFRD. METHODS: 48 adult patients with CFRD were matched to 48 controls with CF, for age, gender and lung pathogen status. Nutritional and other clinical indices were recorded at annual intervals from six years before until two years after diagnosis. Data were also analysed to examine the impact of early and late acquisition of CFRD. RESULTS: No important differences in weight, height, body mass index (BMI), lung function or intravenous treatment were found between groups in the six years prior to diagnosis, nor any significant deviation over time. In those who developed diabetes, use of overnight enteral tube feeding (ETF) was four times as likely at the time of diagnosis, compared to controls [ETF 43.8% (CFRD) v 18.8% (CF Controls), OR 4.0, CI 1.3 to 16.4, p=0.01]. Age at onset of CFRD played a significant role in determining the pre-diabetic clinical course. Younger diabetics with continued growth at study onset (n=17) had a lower BMI from 2 years prior to diagnosis compared to controls [BMI 18.9 kg\\/m(2) (CFRD) v 20.8 kg\\/m(2) (CF Controls), diff=1.9, CI -0.1 to 3.7 p=0.04]. The BMI of older diabetics (completed growth at study onset) was equal to that of controls throughout. CONCLUSION: Pre-diabetic nutritional decline is not inevitable in adults with CFRD, but is influenced by age of onset. In the group overall, those with CFRD are more likely to require ETF from 2 years prior to diagnosis. Despite intensive nutritional intervention, patients who continue to grow throughout the pre-diabetic years, show a level of nutritional decline absent in older adults.

Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multifaceted intervention in a hospital setting.

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Sving, Eva; Fredriksson, Lennart; Gunningberg, Lena; Mamhidir, Anna-Greta

2017-10-01

To describe registered nurses', assistant nurses' and first-line managers' experiences and perceptions of a multifaceted hospital setting intervention focused on implementing evidence-based pressure ulcer prevention. Pressure ulcer prevention is deficient. Different models exist to support implementation of evidence-based care. Little is known about implementation processes. A descriptive qualitative approach. Five focus-group nurse interviews and five individual first-line manager interviews were conducted at five Swedish hospital units. Qualitative content analysis was used. The findings support that the intervention and the implementation process changed the understanding and way of working with pressure ulcer prevention: from treating to preventing. This became possible as 'Changed understanding enables changed actions - through one's own performance and reflection on pressure ulcer prevention'. Having a common outlook on pressure ulcer prevention, easy access to pressure-reducing equipment, and external and internal facilitator support were described as important factors for changed practices. Bedside support, feedback and discussions on current results increased the awareness of needed improvements. The multifaceted intervention approach and the participants' positive attitudes seemed to be crucial for changing understanding and working more preventatively. The strategies used and the skills of the facilitators need to be tailored to the problems surrounding the context. Feedback discussions among the staff regarding the results of the care provided also appear to be vital. It is crucial that dedicated facilitators are involved to promote the implementation process. A preventative mindset should be strived for. Creating an implementation plan with an outcome and a process evaluation should be emphasised. It is important to give the staff regular feedback on the quality of care and on those occasions allocate time for discussion and reflection. © 2016 John

Workshop Report: concepts and methods in the economics of nutrition--gateways to better economic evaluation of nutrition interventions.

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Lenoir-Wijnkoop, I; Nuijten, M J C; Gutiérrez-Ibarluzea, I; Hutton, J; Poley, M J; Segal, L; Bresson, J L; van Ganse, E; Jones, P; Moreno, L; Salminen, S; Dubois, D

2012-11-14

Improving health through better nutrition of the population may contribute to enhanced efficiency and sustainability of healthcare systems. A recent expert meeting investigated in detail a number of methodological aspects related to the discipline of nutrition economics. The role of nutrition in health maintenance and in the prevention of non-communicable diseases is now generally recognised. However, the main scope of those seeking to contain healthcare expenditures tends to focus on the management of existing chronic diseases. Identifying additional relevant dimensions to measure and the context of use will become increasingly important in selecting and developing outcome measurements for nutrition interventions. The translation of nutrition-related research data into public health guidance raises the challenging issue of carrying out more pragmatic trials in many areas where these would generate the most useful evidence for health policy decision-making. Nutrition exemplifies all the types of interventions and policy which need evaluating across the health field. There is a need to start actively engaging key stakeholders in order to collect data and to widen health technology assessment approaches for achieving a policy shift from evidence-based medicine to evidence-based decision-making in the field of nutrition.

Effectiveness of nutritional intervention in overweight women in Primary Health Care

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Nathália Luíza Ferreira

2014-12-01

Full Text Available Objective: To assess the effectiveness of nutritional intervention in overweight women undergoing Primary Health Care.Methods: An intervention study was conducted with overweight adult and elderly women aged 20 years or older (body mass index ≥25.0 kg/m² and ≥27.0 kg/m², respectively who were subjected to 12 months of individual nutritional monitoring. The effectiveness of the intervention was assessed by dietary, health, and anthropometric indicators.Results: Most of the 71 individuals were adults with a low income and poor level of education. After the intervention, there was an increase in number of meals and in the frequency of breakfasting. Moreover, there were more fruits and vegetables consumed, in addition to a decrease in household availability of salt, sugar, oil, and fried foods consumption. An improvement in health and weight self-perception was observed, as well as a decrease in body mass and abdominal adiposity, in particular among those participating in several consultations (n >9.Conclusion: The proposed nutritional intervention was effective and viable for improving the care of overweight individuals and those suffering from destabilized comorbidities, and may be extended to other contexts.

Effect of educational intervention program for parents on adolescents'nutritional behaviors in Isfahan in 2016.

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Mokhtari, Fatemeh; Kazemi, Ashraf; Ehsanpour, Soheila

2017-01-01

Family participation is an important element on nutritional education especially for students. Parents have a key role in instilling and understanding healthy eating habits, but yet the use of family participation strategies in the nutrition education was low. The aim of this study is determining the effect of parental educational intervention program for parents on adolescents' nutritional behaviors in Isfahan, Iran in 2016. This study was a kind of field trial that conducted on 63 girl teenagers from junior high schools of Isfahan in 2016 that were randomly divided into two groups of intervention and control. The data collection tool which was a researcher made questionnaire was completed in both groups before and 1 month after the intervention. The intervention included three training sessions for parents and giving educational compact disc and forwarding SMS. To analysis of data independent t -test and paired t -test were used. Paired t -test showed that in intervention group the average score of fruit ( P = 0.03) and in control group the average score of vegetables ( P < 0.05) were significant statistical difference, but in other aspects of nutritional behaviors was not a significant difference. Independent t -test showed that after intervention, mean scores nutritional behavior of adolescent girls in both groups had no significant differences. No significant difference was in the nutritional behaviors before and after the intervention. Hence, just educating the parents is not enough for achieving appropriate nutritional behaviors in the adolescents.

Effectiveness of Nutrition Education vs. Non-Nutrition Education Intervention in Improving Awareness Pertaining Iron Deficiency among Anemic Adolescents

OpenAIRE

Hafzan Yusoff; Wan Nudri Wan Daud; Zulkifli Ahmad

2013-01-01

Background This study was carried out to compare the effect between nutrition education intervention and non-nutrition education intervention on awareness regarding iron deficiency among schooling adolescents in Tanah Merah, one of rural district in Kelantan, Malaysia. Methods: This study which was started in year 2010 involved 280 respondents (223 girls, 57 boys, age: 16 yr) from schools in Tanah Merah. The selection criteria were based on hemoglobin level (Hb = 7 ? 11.9 g/dL for girls; Hb =...

Can worksite nutritional interventions improve productivity and firm profitability?

DEFF Research Database (Denmark)

Jensen, Jørgen Dejgård

2011-01-01

’ nutritional knowledge, food intake and health and on the firm’s profitability, mainly in terms of reduced absenteeism and presenteeism. Conclusions: Well-targeted and efficiently implemented diet-related worksite health promotion interventions may improve labour productivity by 1%–2%. On larger worksites......Aims: This paper investigates whether and how worksite nutrition policies can improve employee productivity. Methods: The questions are pursued through a literature review, including a systematic search of literature – combined with literature identified from backward references – on randomized......, such productivity gains are likely to more than offset the costs of implementing such interventions. These conclusions are subject to some uncertainty due to the relatively limited amount of literature in the field....

Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions

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Franz MJ

2018-06-01

Full Text Available Marion J Franz,1 Janice MacLeod2 1Nutrition Concepts by Franz, Minneapolis, MN, 2Clinical Innovation, WellDoc, Columbia, MD, USA Abstract: A systematic review was conducted by the Academy of Nutrition and Dietetics to determine the evidence for the effectiveness of individualized nutrition therapy provided by a dietitian nutritionist and evidence-based (EB nutrition-therapy interventions in adults with diabetes. This article briefly reviews the systematic process used and summarizes the effectiveness evidence and intervention recommendations. In persons with type 2 diabetes (T2D, 18 studies met study criteria for the effectiveness question. A 0.3%–2.0% decrease from baseline in glycated hemoglobin was reported at 3 months in 13 study arms, a 0.3%–1.8% decrease at 6 months in 12 study arms, a 0.3%–1.6% decrease at 12 months with ongoing support in six study arms, and a 0.6%–1.8% decrease at >12 months in four study arms. An initial series of encounters with follow-up visits and implementation of a variety of nutrition-therapy interventions, all of which reduced energy intake, were reported. Nutrition therapy also significantly decreased doses or number of glucose-lowering medications used and resulted in improvements in quality of life. Mixed effects on cardiovascular risk factors and body weight were reported. Fourteen questions were identified related to nutrition-therapy interventions. A total of 38 studies met study criteria for the nutrition-intervention questions, from which 30 conclusion statements and 19 nutrition-practice guideline recommendations for T2D were written. Three additional NPG recommendations for T2D were written based on evidence reviewed by the American Diabetes Association. The 22 nutrition-intervention recommendations for T2D are summarized. How to implement nutrition-practice guideline recommendations effectively by health care providers and individuals with T2D remains challenging. Of importance, it is

A pilot study to examine the effects of a nutrition intervention on nutrition knowledge, behaviors, and efficacy expectations in middle school children.

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Fahlman, Mariane M; Dake, Joseph A; McCaughtry, Nate; Martin, Jeffrey

2008-04-01

This was a pilot study to determine the impact of the Michigan Model (MM) Nutrition Curriculum on nutrition knowledge, efficacy expectations, and eating behaviors in middle school students. The study was conducted in a large metropolitan setting and approved by the Institutional Review Board. The participants for this study were divided into an intervention group (n = 407) and a control group (n = 169). An MM instructor trained health teachers in the use of the curriculum, and the teacher subsequently taught the curriculum to students in the intervention group. A valid and reliable questionnaire was used to determine pre-post differences. It consisted of 3 subscales assessing eating habits, nutrition knowledge, and efficacy expectations toward healthy eating. Subscale scores were analyzed using a 2 groups (intervention vs control) x 2 times (pre vs post) analysis of variance. The intervention group increased their nutrition knowledge at post. There was also a significant main effect for groups in the subscales "Eating Behaviors" and "Efficacy Expectations Regarding Healthy Eating." Subsequent post hoc analysis revealed that the intervention group was significantly more likely to eat fruits and vegetables and less likely to eat junk food than the control group. Students in the intervention group also felt more confident that they could eat healthy. The results of this pilot study suggest that the MM Nutrition Curriculum delivered by trained professionals resulted in significant positive changes in both nutrition knowledge and behaviors in middle school children. Further research needs to be conducted to determine the long-term impact.

Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions.

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Lartey, Anna

2008-02-01

Women of child-bearing age (especially pregnant and lactating women), infants and young children are in the most nutritionally-vulnerable stages of the life cycle. Maternal malnutrition is a major predisposing factor for morbidity and mortality among African women. The causes include inadequate food intake, poor nutritional quality of diets, frequent infections and short inter-pregnancy intervals. Evidence for maternal malnutrition is provided by the fact that between 5 and 20% of African women have a low BMI as a result of chronic hunger. Across the continent the prevalence of anaemia ranges from 21 to 80%, with similarly high values for both vitamin A and Zn deficiency levels. Another challenge is the high rates of HIV infection, which compromise maternal nutritional status. The consequences of poor maternal nutritional status are reflected in low pregnancy weight gain and high infant and maternal morbidity and mortality. Suboptimal infant feeding practices, poor quality of complementary foods, frequent infections and micronutrient deficiencies have largely contributed to the high mortality among infants and young children in the region. Feeding children whose mothers are infected with HIV continues to remain an issue requiring urgent attention. There are successful interventions to improve the nutrition of mothers, infants and young children, which will be addressed. Interventions to improve the nutrition of infants and young children, particularly in relation to the improvement of micronutrient intakes of young children, will be discussed. The recent release by WHO of new international growth standards for assessing the growth and nutritional status of children provides the tool for early detection of growth faltering and for appropriate intervention.

Theory, evidence and Intervention Mapping to improve behavior nutrition and physical activity interventions

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Ferreira Isabel

2005-04-01

Full Text Available Abstract Background The present paper intends to contribute to the debate on the usefulness and barriers in applying theories in diet and physical activity behavior-change interventions. Discussion Since behavior theory is a reflection of the compiled evidence of behavior research, theory is the only foothold we have for the development of behavioral nutrition and physical activity interventions. Application of theory should improve the effectiveness of interventions. However, some of the theories we use lack a strong empirical foundation, and the available theories are not always used in the most effective way. Furthermore, many of the commonly-used theories provide at best information on what needs to be changed to promote healthy behavior, but not on how changes can be induced. Finally, many theories explain behavioral intentions or motivation rather well, but are less well-suited to explaining or predicting actual behavior or behavior change. For more effective interventions, behavior change theory needs to be further developed in stronger research designs and such change-theory should especially focus on how to promote action rather than mere motivation. Since voluntary behavior change requires motivation, ability as well as the opportunity to change, further development of behavior change theory should incorporate environmental change strategies. Conclusion Intervention Mapping may help to further improve the application of theories in nutrition and physical activity behavior change.

Using ethnography in implementation research to improve nutrition interventions in populations.

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Tumilowicz, Alison; Neufeld, Lynnette M; Pelto, Gretel H

2015-12-01

'Implementation research in nutrition' is an emerging area of study aimed at building evidence-based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view--the insider's perspective--and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the 'emic' (insider's) perspective. Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography. Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the 'black box' in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. © 2015 John Wiley & Sons Ltd.

Improving diets and nutrition through an integrated poultry value chain and nutrition intervention (SELEVER) in Burkina Faso: study protocol for a randomized trial.

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Gelli, Aulo; Becquey, Elodie; Ganaba, Rasmane; Headey, Derek; Hidrobo, Melissa; Huybregts, Lieven; Verhoef, Hans; Kenfack, Romain; Zongouri, Sita; Guedenet, Hannah

2017-09-06

The SELEVER study is designed to evaluate the impact of an integrated agriculture-nutrition package of interventions (including poultry value chain development, women's empowerment activities, and a behavior change communications strategy to promote improved diets and feeding, care, and hygiene practices) on the diets, health, and nutritional status of women and children in Burkina Faso. This paper presents the rationale and study design. The impact evaluation involves a cluster randomized controlled trial design that will be implemented in 120 rural communities/villages within 60 communes supported by SELEVER in the Boucle de Mouhoun, Centre-Ouest, and Haut-Bassins regions of Burkina Faso. Communities will be randomly assigned to one of three treatment arms, including: (1) SELEVER intervention group; (2) SELEVER with an intensive WASH component; and (3) control group without intervention. Primary outcomes include the mean probability of adequacy of diets for women and children (aged 2-4 years at baseline), infant and young child feeding practices of caregivers of children aged 0-2 years, and household poultry production and sales. Intermediate outcomes along the agriculture and nutrition pathways will also be measured, including child nutrition status and development. The evaluation will follow a mixed-methods approach, including a panel of child-, household-, community-, and market-level surveys, and data collection points during post-harvest and lean seasons, as well as one year after implementation completion to examine sustainability. To our knowledge, this study is the first to rigorously examine from a food systems perspective, the simultaneous impact of scaling-up nutrition-specific and nutrition-sensitive interventions through a livestock value-chain and community-intervention platform, across nutrition, health, and agriculture domains. The findings of this evaluation will provide evidence to support the design of market-based nutrition

Effectiveness of a multifaceted implementation strategy on physicians? referral behavior to an evidence-based psychosocial intervention in dementia: a cluster randomized controlled trial

OpenAIRE

D?pp, Carola ME; Graff, Maud JL; Teerenstra, Steven; Nijhuis-van der Sanden, Maria WG; Olde Rikkert, Marcel GM; Vernooij-Dassen, Myrra JFJ

2013-01-01

BACKGROUND: To evaluate the effectiveness of a multifaceted implementation strategy on physicians' referral rate to and knowledge on the community occupational therapy in dementia program (COTiD program). METHODS: A cluster randomized controlled trial with 28 experimental and 17 control clusters was conducted. Cluster included a minimum of one physician, one manager, and two occupational therapists. In the control group physicians and managers received no interventions and occupational therap...

Behavioral Nutrition Interventions Using e- and m-Health Communication Technologies: A Narrative Review.

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Olson, Christine M

2016-07-17

e- and m-Health communication technologies are now common approaches to improving population health. The efficacy of behavioral nutrition interventions using e-health technologies to decrease fat intake and increase fruit and vegetable intake was demonstrated in studies conducted from 2005 to 2009, with approximately 75% of trials showing positive effects. By 2010, an increasing number of behavioral nutrition interventions were focusing on body weight. The early emphasis on interventions that were highly computer tailored shifted to personalized electronic interventions that included weight and behavioral self-monitoring as key features. More diverse target audiences began to participate, and mobile components were added to interventions. Little progress has been made on using objective measures rather than self-reported measures of dietary behavior. A challenge for nutritionists is to link with the private sector in the design, use, and evaluation of the many electronic devices that are now available in the marketplace for nutrition monitoring and behavioral change.

Nutrition interventions at point-of-sale to encourage healthier food purchasing: a systematic review.

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Liberato, Selma C; Bailie, Ross; Brimblecombe, Julie

2014-09-05

Point-of-sale is a potentially important opportunity to promote healthy eating through nutrition education and environment modification. The aim of this review was to describe and review the evidence of effectiveness of various types of interventions that have been used at point-of-sale to encourage purchase and/or eating of healthier food and to improve health outcomes, and the extent to which effectiveness was related to intensity, duration and intervention setting. Records from searches in databases were screened and assessed against inclusion criteria. Included studies had risk of bias assessed. Intervention effectiveness was assessed for two outcomes: i) purchase and/or intake of healthier food options and/or nutrient intake; and ii) mediating factors that might effect the primary outcome. The search identified 5635 references. Thirty-two papers met the inclusion criteria. Twelve studies had low risk of bias and were classified as strong, nine were moderate and 11 were weak. Six intervention types and a range of different outcome measures were described in these papers: i) nutrition education and promotion alone through supermarkets/stores; ii) nutrition education plus enhanced availability of healthy food; iii) monetary incentive alone; iv) nutrition education plus monetary incentives; v) nutrition intervention through vending machines; and vi) nutrition intervention through shopping online. The evidence of this review indicates that monetary incentives offered to customers for a short-term look promising in increasing purchase of healthier food options when the intervention is applied by itself in stores or supermarkets. There was a lack of good quality studies addressing all other types of relevant point-of-sale interventions examining change in purchase and/or intake of healthier food options. There were few studies that examined mediating factors that might mediate the effect on the primary outcomes of relevant interventions. A range of intervention types

Nutrition interventions for children aged less than 5 years following natural disasters: a systematic review.

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Pradhan, Pranil Man Singh; Dhital, Rolina; Subhani, Huma

2016-09-20

The objective of this paper was to review various nutritional interventions targeted at under-five children in countries that had suffered from natural disasters and to analyse their effect on nutrition-related outcomes. Systematic review. Countries that had suffered from natural disasters. Children aged natural disaster. Primary nutrition-related outcomes were stunting, wasting and underweight. The secondary nutrition-related outcome was anaemia. Of the 1218 studies that the reviewers agreed on, five matched the inclusion criteria and were included in this narrative synthesis. Four studies were longitudinal and one was cross-sectional in design. Food supplementation was an integral part of nutritional interventions in all the included studies. The most consistent nutritional outcome in all five included studies was reduced prevalence of wasting, followed by reduced prevalence of underweight in four, stunting in three and anaemia in one of the five included studies. The largest reduction in the prevalence of wasting and underweight was reported by the study in Sri Lanka. Overall, the quality of evidence ranged from moderate to weak. Integrated nutrition interventions using locally available health resources yielded the best results. However, sound evidence on the most effective interventions is still lacking. Intervention studies with comparison groups are necessary to obtain more robust evidence on the effectiveness of nutrition interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Nutritional intervention and quality of life in adult oncology patients.

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Marín Caro, Mónica María; Laviano, Alessandro; Pichard, Claude

2007-06-01

The evaluation of quality of life (QoL) assesses patients' well-being by taking into account physical, psychological and social conditions. Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of QoL. These metabolic changes lead to decreased food intake and promote wasting. Cancer-related malnutrition can evolve to cancer cachexia due to complex interactions between pro-inflammatory cytokines and host metabolism. Beside and beyond the physical and the metabolic effects of cancer, patients often suffer as well from psychological distress, including depression. Depending on the type of cancer treatment (either curative or palliative) and on patients' clinical conditions and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counselling, oral supplementation, enteral or total parenteral nutrition). Such an approach, which should be started as early as possible, can reduce or even reverse their poor nutritional status, improve their performance status and consequently their QoL. Nutritional intervention accompanying curative treatment has an additional and specific role, which is to increase the tolerance and response to the oncology treatment, decrease the rate of complications and possibly reduce morbidity by optimizing the balance between energy expenditure and food intake. In palliative care, nutritional support aims at improving patient's QoL by controlling symptoms such as nausea, vomiting and pain related to food intake and postponing loss of autonomy. The literature review supports that nutritional care should be integrated into the global oncology care because of its significant contribution to QoL. Furthermore, the assessment of QoL should be part of the evaluation of any nutritional support to optimize its adequacy to the patient's needs and expectations.

Factors Associated with Effective Nutrition Interventions for Pregnant Indigenous Women: A Systematic Review.

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Ashman, Amy M; Brown, Leanne J; Collins, Clare E; Rollo, Megan E; Rae, Kym M

2017-08-01

Indigenous people continue to experience health disparities relative to non-Indigenous populations. Interventions to improve nutrition during pregnancy in these groups may improve health outcomes for mothers and their infants. The effectiveness of existing nutrition intervention programs has not been reviewed previously. The objective was to identify interventions targeting improving nutrition-related outcomes for pregnant Indigenous women residing in Organisation for Economic Co-operation and Development countries, and to identify positive factors contributing to successful programs. Thirteen electronic databases were searched up until October 2015. Key words identified studies intervening to improve nutrition-related outcomes for pregnant Indigenous women. Two reviewers assessed articles for inclusion and study quality and extracted data. Only studies published in English were included. Data were summarized narratively. Abstracts and titles were screened (n=2,566) and 315 full texts were reviewed for eligibility. This review included 27 articles from 20 intervention programs from Australia, Canada, and the United States. The most prevalent measurable outcomes were birth weight (n=9) and breastfeeding initiation/duration (n=11). Programs with statistically significant results for these outcomes employed the following nutrition activities: individual counseling/education (n=8); delivery by senior Indigenous woman (n=2), peer counselor (n=3), or other Indigenous health worker (n=4); community-wide interventions (n=2); media campaigns (n=2); delivery by non-Indigenous health professional (n=3); and home visits (n=3). Heterogeneity of included studies made it challenging to make firm recommendations regarding program success. Authors of included studies recommended community consultation be included when designing studies and working with communities at all stages of the research process. Individualized counseling/education can contribute to successful program

A multifaceted intervention to improve mental health literacy in students of a multicampus university: a cluster randomised trial.

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Reavley, Nicola J; McCann, Terence V; Cvetkovski, Stefan; Jorm, Anthony F

2014-10-01

The aim of the current study was to assess whether a multifaceted intervention could improve mental health literacy, facilitate help seeking and reduce psychological distress and alcohol misuse in students of a multicampus university in Melbourne, Australia. In this cluster randomized trial, nine university campuses were paired (some pairs included more than one campus), with one of each pair randomly assigned to either the intervention or control condition. The interventions were designed to be whole-of-campus and to run over 2 academic years with their effectiveness assessed through recruitment of a monitoring sample of students from each campus. Interventions included emails, posters, campus events, factsheets/booklets and mental health first aid training courses. Participants had a 20-min telephone interview at baseline and at the end of academic years 1 and 2. This assessed mental health literacy, help seeking, psychological distress and alcohol use. The primary outcomes were depression and anxiety levels and alcohol use and pertained to the individual level. There were no effects on psychological distress and alcohol use. Recall of intervention elements was greater in the intervention group at the end of year 2. Students in the intervention group were more likely to say they would go to a drug and alcohol centre for alcohol problems at the end of 6 months. Although education and awareness may play a role in improving mental health literacy, it is likely that, to achieve changes in psychological distress, interventions would need to be more personalized and intensive.

Development of a Nutrition Education Intervention for Food Bank Clients.

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Dave, Jayna M; Thompson, Deborah I; Svendsen-Sanchez, Ann; McNeill, Lorna Haughton; Jibaja-Weiss, Maria

2017-03-01

The focus of this article is the development of a nutrition education intervention for food bank clients. Formative research using mixed-methods (qualitative and quantitative) and community-based participatory research principles was conducted to assess the nutrition education needs of clients obtaining service from the Houston Food Bank (HFB). Participants were HFB and pantry staff and clients. Interview data were coded and analyzed using grounded theory approach. Themes were then identified. Quantitative data were analyzed for frequencies and descriptives. Data were used to tailor the curriculum to the target population. Six HFB staff, 49 pantry staff from 17 pantries, and 54 clients from 10 pantries participated in interviews and focus groups and completed questionnaires. The participants provided opinion on the current nutrition education provided via the food bank and made suggestions on strategies for development of an intervention. Their feedback was used to develop the six-session intervention curriculum to be delivered over 6 months. This research provides evidence that it is critical for members of the target audience be included in formative research to develop behavior change programs that are relevant and appealing and target their needs and interests.

A review of the nature and effectiveness of nutrition interventions in adult males--a guide for intervention strategies.

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Taylor, Pennie J; Kolt, Gregory S; Vandelanotte, Corneel; Caperchione, Cristina M; Mummery, W Kerry; George, Emma S; Karunanithi, Mohanraj; Noakes, Manny J

2013-01-29

Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1) published from January 1990 to August 2011 and 2) male only studies (≥18 years) or 3) where males contributed to >90% of the active cohort. A study must have described, (i) a significant change (pstudies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg) and/or BMI (kg/m2) changes (p≤0.05). Four studies had effective interventions (pself-monitoring and tailored feedback. Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to guide researchers in making informed decisions on how to best utilise resources in interventions to engage adult males while highlighting the need for improved reporting of intervention protocols.

The efficacy of acute nutritional interventions on soccer skill performance.

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Russell, Mark; Kingsley, Michael

2014-07-01

The use of nutritional ergogenic aids in team sports such as soccer is now commonplace. Aligned with the primary aim of soccer, which is to score more goals than the opposition within the allotted time, the quality of performance of technical actions (i.e., skills) executed during soccer-specific exercise is likely to determine success. However, when seeking to maintain soccer skill performance, information about the efficacy of nutritional interventions is lacking and factors which might modulate the efficacy of such strategies are unclear. This review aimed (i) to systematically evaluate the current research that examines the efficacy of nutritional interventions on soccer skills, and (ii) to provide a qualitative commentary on factors that have the potential to modulate the efficacy of such strategies. Relevant databases (PubMed and SPORTDiscus) were searched up to and including 1 July, 2013 for studies that investigated the efficacy of acute nutritional interventions on soccer skill performances. Overall, 279 records were retrieved. Articles were sequentially excluded from the review based on specific criteria, being: (A) articles that did not report outcomes directly relating to skilled performances in soccer, (B) articles that examined the influence of interventions that were not nutritional in origin and/or were nutritional in origin but provided >3 hours before skill testing commenced, (C) articles that were review papers, and (D) post-acceptance withdrawal of articles methods from database. Articles were independently assessed for the quality of the methods employed based upon the Physiotherapy Evidence Database (PEDro) scale. Records achieving a minimum PEDro score of 5 out of 10 were included in this review. Qualitative appraisal of 13 articles was performed after the application of exclusion criteria and quality assurance processes. The majority (n = 8) of articles examined the influence of carbohydrates on technical performance whereas fewer studies

Early Child Development and Nutrition: A Review of the Benefits and Challenges of Implementing Integrated Interventions.

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Hurley, Kristen M; Yousafzai, Aisha K; Lopez-Boo, Florencia

2016-03-01

Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged early child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions. © 2016 American Society for Nutrition.

School Children's Intestinal Parasite and Nutritional Status One Year after Complementary School Garden, Nutrition, Water, Sanitation, and Hygiene Interventions in Burkina Faso.

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Erismann, Séverine; Diagbouga, Serge; Schindler, Christian; Odermatt, Peter; Knoblauch, Astrid M; Gerold, Jana; Leuenberger, Andrea; Shrestha, Akina; Tarnagda, Grissoum; Utzinger, Jürg; Cissé, Guéladio

2017-09-01

The potential health benefits of combined agricultural, nutrition, water, sanitation, and hygiene (WASH) interventions are poorly understood. We aimed to determine whether complementary school garden, nutrition, and WASH interventions reduce intestinal parasites and improve school children's nutritional status in two regions of Burkina Faso. A cluster-randomized controlled trial was conducted in the Plateau Central and Center-Ouest regions of Burkina Faso. A total of 360 randomly selected children, aged 8-15 years, had complete baseline and end-line survey data. Mixed regression models were used to assess the impact of the interventions, controlling for baseline characteristics. The prevalence of intestinal parasitic infections decreased both in intervention and control schools, but the decrease was significantly higher in the intervention schools related to the control schools (odds ratio [OR] of the intervention effect = 0.2, 95% confidence interval [CI] = 0.1-0.5). Indices of undernutrition did not decrease at end-line in intervention schools. Safe handwashing practices before eating and the use of latrines at schools were significantly higher in the intervention schools than in the control schools at end-line (OR = 6.9, 95% CI = 1.4-34.4, and OR = 14.9, 95% CI = 1.4-153.9, respectively). Parameters of water quality remained unchanged. A combination of agricultural, nutritional, and WASH-related interventions embedded in the social-ecological systems and delivered through the school platform improved several child health outcomes, including intestinal parasitic infections and some WASH-related behaviors. Sustained interventions with stronger household and community-based components are, however, needed to improve school children's health in the long-term.

A successful strategy for increasing the influenza vaccination rate of healthcare workers without a mandatory policy outside of the United States: a multifaceted intervention in a Japanese tertiary care center.

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Honda, Hitoshi; Sato, Yumiko; Yamazaki, Akinori; Padival, Simi; Kumagai, Akira; Babcock, Hilary

2013-11-01

Although mandatory vaccination programs have been effective in improving the vaccination rate among healthcare workers, implementing this type of program can be challenging because of varied reasons for vaccine refusal. The purpose of our study is to measure improvement in the influenza vaccination rate from a multifaceted intervention at a Japanese tertiary care center where implementing a mandatory vaccination program is difficult. Before-and-after trial. Healthcare workers at a 550-bed, tertiary care, academic medical center in Sapporo, Japan. We performed a multifaceted intervention including (1) use of a declination form, (2) free vaccination, (3) hospital-wide announcements during the vaccination period, (4) prospective audit and real-time telephone interview for healthcare workers who did not receive the vaccine, (5) medical interview with the hospital executive for noncompliant (no vaccine, no declination form) healthcare workers during the vaccination period, and (6) mandatory submission of a vaccination document if vaccinated outside of the study institution. With the new multifaceted intervention, the vaccination rate in the 2012-2013 season increased substantially, up to 97%. This rate is similar to that reported in studies with a mandatory vaccination program. Improved vaccination acceptance, particularly among physicians, likely contributed to the overall increase in the vaccination rate reported in the study. Implementation of comprehensive strategies with strong leadership can lead to substantial improvements in vaccine uptake among healthcare workers even without a mandatory vaccination policy. The concept is especially important for institutions where implementing mandatory vaccination programs is challenging.

Highlighting the evidence gap: how cost-effective are interventions to improve early childhood nutrition and development?

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Batura, Neha; Hill, Zelee; Haghparast-Bidgoli, Hassan; Lingam, Raghu; Colbourn, Timothy; Kim, Sungwook; Sikander, Siham; Pulkki-Brannstrom, Anni-Maria; Rahman, Atif; Kirkwood, Betty; Skordis-Worrall, Jolene

2015-07-01

There is growing evidence of the effectiveness of early childhood interventions to improve the growth and development of children. Although, historically, nutrition and stimulation interventions may have been delivered separately, they are increasingly being tested as a package of early childhood interventions that synergistically improve outcomes over the life course. However, implementation at scale is seldom possible without first considering the relative cost and cost-effectiveness of these interventions. An evidence gap in this area may deter large-scale implementation, particularly in low- and middle-income countries. We conduct a literature review to establish what is known about the cost-effectiveness of early childhood nutrition and development interventions. A set of predefined search terms and exclusion criteria standardized the search across five databases. The search identified 15 relevant articles. Of these, nine were from studies set in high-income countries and six in low- and middle-income countries. The articles either calculated the cost-effectiveness of nutrition-specific interventions (n = 8) aimed at improving child growth, or parenting interventions (stimulation) to improve early childhood development (n = 7). No articles estimated the cost-effectiveness of combined interventions. Comparing results within nutrition or stimulation interventions, or between nutrition and stimulation interventions was largely prevented by the variety of outcome measures used in these analyses. This article highlights the need for further evidence relevant to low- and middle-income countries. To facilitate comparison of cost-effectiveness between studies, and between contexts where appropriate, a move towards a common outcome measure such as the cost per disability-adjusted life years averted is advocated. Finally, given the increasing number of combined nutrition and stimulation interventions being tested, there is a significant need for evidence of cost

Nutrition and youth soccer for childhood overweight: a pilot novel chiropractic health education intervention.

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Leach, Robert A; Yates, Joyce M

2008-01-01

The purpose of this pilot novel chiropractic health education intervention was to gather preliminary evidence regarding possible benefits from recreational youth soccer and nutrition education in overweight women. A secondary purpose was to determine whether some nutrition knowledge is an independent predictor of changes in body mass index (BMI). A quiz developed and validated on separate age and sex appropriate blinded cohorts was used on study participants-22 volunteers of 57 eligible fourth-grade, overweight female Mississippi public school students. At the beginning of a 5-month study period, a 15-minute baseline nutrition intervention, grounded in Social Cognitive Theory and based on the United States Department of Agriculture's "My Tips for Families" information, was applied in a chiropractic clinic. Subjects were then randomized to 2 months of recreational soccer (n = 14) or waiting list control (n = 8). No preintervention differences were found in height, weight, BMI, or age. Higher follow-up BMI scores were found in both groups, and no significant differences between groups were found, possibly because of the small sample sizes and the short 8-week soccer intervention period. Gains in nutrition knowledge were sustained (P nutrition knowledge and follow-up BMI (r = -.185; P nutrition education alone may be an ineffective intervention for overweight children. The study provides an example of how youth soccer may benefit overweight children.

A Worksite Nutrition Intervention is Effective at Improving Employee Well-Being: A Pilot Study.

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Sutliffe, Jay T; Carnot, Mary Jo; Fuhrman, Joel H; Sutliffe, Chloe A; Scheid, Julia C

2018-01-01

Worksite dietary interventions show substantial potential for improving employee health and well-being. The aim of this pilot study was to determine the effect of a worksite nutrition intervention on improving well-being. Thirty-five university employees participated in a 6-week nutrition intervention. The dietary protocol emphasized the daily consumption of greens, beans/legumes, a variety of other vegetables, fruits, nuts, seeds, and whole grains, referred to as a micronutrient-dense, plant-rich diet. Participants were encouraged to minimize the consumption of refined foods and animal products. Significant improvements in sleep quality, quality of life, and depressive symptoms were found. Findings reveal that a worksite nutrition intervention is effective at improving sleep quality, quality of life, and depressive symptoms with a projected improvement in work productivity and attendance.

Nutritional interventions for preventing and treating pressure ulcers.

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Langer, Gero; Fink, Astrid

2014-06-12

ulcer development (pooled RR 0.86; 95% CI 0.73 to 1.00; P value 0.05; I(2) = 13%, random effects). This outcome is at unclear or high risk of bias.Fourteen trials evaluated the effects of nutritional supplements on the healing of existing pressure ulcers: seven trials examined mixed nutritional supplements, three the effects of proteins, two trials examined zinc, and two studies examined ascorbic acid. The included trials were heterogeneous with regard to participants, interventions, comparisons and outcomes and meta-analysis was not appropriate. There was no clear evidence of an improvement in pressure ulcer healing from the nutritional supplements evaluated in any of these individual studies. There is currently no clear evidence of a benefit associated with nutritional interventions for either the prevention or treatment of pressure ulcers. Further trials of high methodological quality are necessary.

A multifaceted community-based asthma intervention in Chicago: effects of trigger reduction and self-management education on asthma morbidity.

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Turyk, Mary; Banda, Elizabeth; Chisum, Gay; Weems, Dolores; Liu, Yangyang; Damitz, Maureen; Williams, Rhonda; Persky, Victoria

2013-09-01

Home-based, multifaceted interventions have been effective in reducing asthma morbidity in children. However, identification of independent components that contribute to outcomes and delineating effectiveness by level of asthma symptoms would help to refine the intervention and target appropriate populations. A community health educator led asthma intervention implemented in a low-income African-American neighborhood included asthma management education, individually tailored low-cost asthma home trigger remediation, and referrals to social and medical agencies, when appropriate. Changes in asthma morbidity measures were assessed in relation to implementation of individual intervention components using multivariable logistic regression. Among the 218 children who completed the year-long program, there were significant reductions in measures of asthma morbidity, including symptoms, urgent care visits, emergency department (ED) visits, hospitalizations, missed school days, and missed work days for caretakers. We also found significant decreases in the prevalence of many home asthma triggers and improvements in asthma management practices. Improvement in caretaker's ability to manage the child's asthma was associated with reduction in ED visits for asthma and uncontrolled asthma. Specific home interventions, such as repair of water leaks and reduced exposure to plants, dust, clutter and stuffed toys, may be related to reduction in asthma morbidity. This program was effective in reducing asthma morbidity in low-income African-American children and identified specific interventions as possible areas to target in future projects. Furthermore, the intervention was useful in children with persistent asthma symptoms as well as those with less frequent asthma exacerbations.

Effectiveness of pharmacovigilance: multifaceted educational intervention related to the knowledge, skills and attitudes of multidisciplinary hospital staff

Directory of Open Access Journals (Sweden)

Fabiana Rossi Varallo

Full Text Available OBJECTIVES: Most educational interventions in pharmacovigilance are designed to encourage physicians to report adverse drug reactions. However, multidisciplinary teams may play an important role in reporting drug-related problems. This study assessed the impact of a multifaceted educational intervention in pharmacovigilance on the knowledge, skills and attitudes of hospital professionals. METHOD: This prospective, open-label, non-randomized study was performed in a medium-complexity hospital in São Paulo, Brazil. The intervention involved four activities: 1 an interactive lecture, 2 a practical class, 3 a pre-post questionnaire administered to professionals on a multidisciplinary team, and 4 educational material. The intervention’s impact on the professionals’ knowledge and skills was assessed using the World Health Organization’s definitions. The intervention’s effect on the professionals’ attitudes was analysed by the prevalence of adverse drug event reports (adverse drug reactions, medication errors, therapeutic failure and drug quality deviations and the relevance (seriousness and expectancy of the events. RESULTS: One hundred seventy-three professionals were enrolled. A 70-fold increase in the number of adverse drug event reports was observed during the 12 months post-intervention. The intervention improved the professionals’ form-completion skills (p<0.0001 and their knowledge of pharmacovigilance (p<0.0001. The intervention also contributed to detecting serious drug-induced events. The nursing staff reported medication errors, and pharmacists and physiotherapists recognized serious adverse drug reactions. Physicians communicated suspicions of therapeutic failure. CONCLUSIONS: A multidisciplinary approach to drug-safety assessments contributes to identifying new, relevant drug-related problems and improving the rate of adverse drug event reporting. This strategy may therefore be applied to improve risk communication in

Observation of dietary intervention on nutritional risk in patients with liver cirrhosis

Directory of Open Access Journals (Sweden)

ZHANG Min

2014-08-01

Full Text Available ObjectiveTo detect nutritional problems in liver cirrhosis patients early through nutritional risk screening, and to provide them with individual dietary intervention for improving their malnutrition and avoiding or reducing diet-related complications. MethodsThe nutritional risk of liver cirrhosis patients was assessed according to the NRS 2002 standard. A total of 134 patients admitted to our hospital from October 2011 to October 2013 were randomly assigned to intervention group (66 cases and control group (68 cases. Their anthropometric parameters, NRS 2002 scores, blood test results, length of hospital stay, and times of hospitalization within six months were recorded and analyzed. A Student′s t-test was used to analyze continuous data in normal distribution, and the rank sum test for continuous data in non-normal distribution; the chi-square test was used to analyze categorical data. ResultsPatients in control group showed significant changes in body mass index (BMI, lean muscle mass, bone mass, serum total protein, and albumin one week after admission (P＜0.05 for all. Patients in intervention group showed significant changes in body mass, BMI, body moisture rate, bone mass, hemoglobin, prealbumin, serum albumin, and NRS 2002 score one week after admission (P＜0.05 for all. There were significant differences between the two groups in hemoglobin, prealbumin, and NRS 2002 score one week after admission and times of hospitalization within six months (P＜0.05 for all. ConclusionsIndividual dietary intervention has both short-term effect and long-term effect. Liver cirrhosis patients with nutritional risk need individual dietary intervention.

Nutritional interventions and the IL-6 response to exercise.

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Hennigar, Stephen R; McClung, James P; Pasiakos, Stefan M

2017-09-01

IL-6 is a pleiotropic cytokine with a wide range of biologic effects. In response to prolonged exercise, IL-6 is synthesized by contracting skeletal muscle and released into circulation. Circulating IL-6 is thought to maintain energy status during exercise by acting as an energy sensor for contracting muscle and stimulating glucose production. If tissue damage occurs, immune cells infiltrate and secrete cytokines, including IL-6, to repair skeletal muscle damage. With adequate rest and nutrition, the IL-6 response to exercise is attenuated as skeletal muscle adapts to training. However, sustained elevations in IL-6 due to repeated bouts of unaccustomed activities or prolonged exercise with limited rest may result in untoward physiologic effects, such as accelerated muscle proteolysis and diminished nutrient absorption, and may impair normal adaptive responses to training. Recent intervention studies have explored the role of mixed meals or carbohydrate, protein, ω-3 fatty acid, or antioxidant supplementation in mitigating exercise-induced increases in IL-6. Emerging evidence suggests that sufficient energy intake before exercise is an important factor in attenuating exercise-induced IL-6 by maintaining muscle glycogen. We detail various nutritional interventions that may affect the IL-6 response to exercise in healthy human adults and provide recommendations for future research exploring the role of IL-6 in the adaptive response to exercise.-Hennigar, S. R., McClung, J. P., Pasiakos, S. M. Nutritional interventions and the IL-6 response to exercise. © FASEB.

Poor cognitive ageing: Vulnerabilities, mechanisms and the impact of nutritional interventions.

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Miquel, Sophie; Champ, Claire; Day, Jon; Aarts, Esther; Bahr, Ben A; Bakker, Martijntje; Bánáti, Diána; Calabrese, Vittorio; Cederholm, Tommy; Cryan, John; Dye, Louise; Farrimond, Jonathan A; Korosi, Aniko; Layé, Sophie; Maudsley, Stuart; Milenkovic, Dragan; Mohajeri, M Hasan; Sijben, John; Solomon, Alina; Spencer, Jeremy P E; Thuret, Sandrine; Vanden Berghe, Wim; Vauzour, David; Vellas, Bruno; Wesnes, Keith; Willatts, Peter; Wittenberg, Raphael; Geurts, Lucie

2018-03-01

Ageing is a highly complex process marked by a temporal cascade of events, which promote alterations in the normal functioning of an individual organism. The triggers of normal brain ageing are not well understood, even less so the factors which initiate and steer the neuronal degeneration, which underpin disorders such as dementia. A wealth of data on how nutrients and diets may support cognitive function and preserve brain health are available, yet the molecular mechanisms underlying their biological action in both normal ageing, age-related cognitive decline, and in the development of neurodegenerative disorders have not been clearly elucidated. This review aims to summarise the current state of knowledge of vulnerabilities that predispose towards dysfunctional brain ageing, highlight potential protective mechanisms, and discuss dietary interventions that may be used as therapies. A special focus of this paper is on the impact of nutrition on neuroprotection and the underlying molecular mechanisms, and this focus reflects the discussions held during the 2nd workshop 'Nutrition for the Ageing Brain: Functional Aspects and Mechanisms' in Copenhagen in June 2016. The present review is the most recent in a series produced by the Nutrition and Mental Performance Task Force under the auspice of the International Life Sciences Institute Europe (ILSI Europe). Coupling studies of cognitive ageing with studies investigating the effect of nutrition and dietary interventions as strategies targeting specific mechanisms, such as neurogenesis, protein clearance, inflammation, and non-coding and microRNAs is of high value. Future research on the impact of nutrition on cognitive ageing will need to adopt a longitudinal approach and multimodal nutritional interventions will likely need to be imposed in early-life to observe significant impact in older age. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Improving the quality of nurse clinical documentation for chronic patients at primary care clinics: A multifaceted intervention.

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Mahomed, Ozayr H; Naidoo, Salsohni; Asmall, Shaidah; Taylor, Myra

2015-09-25

Deficiencies in record keeping practices have been reported at primary care level in the public health sector in South Africa. These deficiencies have the potential to negatively impact patient health outcomes as the break in information may hinder continuity of care. This disruption in information management has particular relevance for patients with chronic diseases. The aim of this study was to establish if the implementation of a structured clinical record (SCR) as an adjunct tool to the algorithmic guidelines for chronic disease management improved the quality of clinical records at primary care level. A quasi-experimental study (before and after study with a comparison group) was conducted across 30 primary health care clinics (PHCs) located in three districts in South Africa. Twenty PHCs that received the intervention were selected as intervention clinics and 10 facilities were selected as comparison facilities. The lot quality assurance sampling (LQAS) method was used to determine the number of records required to be reviewed per diagnostic condition per facility. There was a a statistically significant increase in the percentage of clinical records achieving compliance to the minimum criteria from the baseline to six months post-intervention for both HIV patients on antiretroviral treatment and patients with non-communicable diseases (hypertension and diabetes). A multifaceted intervention using a SCR to supplement the educational outreach component (PC 101 training) has demonstrated the potential for improving the quality of clinical records for patients with chronic diseases at primary care clinics in South Africa.

Nourishing networks: A social-ecological analysis of a network intervention for improving household nutrition in Western Kenya.

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DeLorme, Autumn L; Gavenus, Erika R; Salmen, Charles R; Benard, Gor Ouma; Mattah, Brian; Bukusi, Elizabeth; Fiorella, Kathryn J

2018-01-01

A growing body of research emphasizes the need to engage social networks in maternal and child nutrition interventions. However, an understanding of how interventions functionally engage not only mothers but fathers, grandparents, friends, and other social network members remains limited. This study uses an adaptation of a social-ecological model to analyze the multiple levels at which the Kanyakla Nutrition Program operates to change behavior. This study analyzes focus group data (four groups; n = 35, 7 men and 28 women) following the implementation of the Kanyakla Nutrition Program, a novel nutrition intervention engaging social networks to increase nutrition knowledge, shift perceptions, and promote positive practices for infant and young child feeding and community nutrition in general. Participant perspectives indicate that the Kanyakla Nutrition Program contributed to nutrition knowledge and confidence, changed perceptions, and supported infant and child feeding practices at the individual, interpersonal, and institutional levels. However, many respondents report challenges in transcending barriers at the broader community and systems levels of influence, where environmental and economic constraints continue to affect food access. Analysis of the Kanyakla Nutrition Program suggests that for interventions addressing household level determinants of nutrition, simultaneously engaging the household's network of interpersonal and community relationships can play a role in building momentum and consensus to address persistent structural barriers to improved nutrition. Copyright © 2017 Elsevier Ltd. All rights reserved.

A novel school-based intervention to improve nutrition knowledge in children: cluster randomised controlled trial

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Ong Ken K

2010-03-01

Full Text Available Abstract Background Improving nutrition knowledge among children may help them to make healthier food choices. The aim of this study was to assess the effectiveness and acceptability of a novel educational intervention to increase nutrition knowledge among primary school children. Methods We developed a card game 'Top Grub' and a 'healthy eating' curriculum for use in primary schools. Thirty-eight state primary schools comprising 2519 children in years 5 and 6 (aged 9-11 years were recruited in a pragmatic cluster randomised controlled trial. The main outcome measures were change in nutrition knowledge scores, attitudes to healthy eating and acceptability of the intervention by children and teachers. Results Twelve intervention and 13 control schools (comprising 1133 children completed the trial. The main reason for non-completion was time pressure of the school curriculum. Mean total nutrition knowledge score increased by 1.1 in intervention (baseline to follow-up: 28.3 to 29.2 and 0.3 in control schools (27.3 to 27.6. Total nutrition knowledge score at follow-up, adjusted for baseline score, deprivation, and school size, was higher in intervention than in control schools (mean difference = 1.1; 95% CI: 0.05 to 2.16; p = 0.042. At follow-up, more children in the intervention schools said they 'are currently eating a healthy diet' (39.6% or 'would try to eat a healthy diet' (35.7% than in control schools (34.4% and 31.7% respectively; chi-square test p Conclusions The 'Top Grub' card game facilitated the enjoyable delivery of nutrition education in a sample of UK primary school age children. Further studies should determine whether improvements in nutrition knowledge are sustained and lead to changes in dietary behaviour.

Nutrition-based interventions to address metabolic syndrome in the Navajo: a systematic review.

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Nava, Lorenzo T; Zambrano, Jenelle M; Arviso, Karen P; Brochetti, Denise; Becker, Kathleen L

2015-11-01

The objective of this systematic review is to identify nutrition-based interventions that may be effective for the prevention and treatment of metabolic syndrome in the Navajo. Metabolic syndrome, a major risk factor for cardiovascular disease, affects almost half of the Navajo population. The diet of the Navajo, heavy in fat and refined carbohydrates, has been identified as an important contributing factor to the high rates of metabolic syndrome in this population. A search was conducted on PubMed, EMBASE and CINAHL to identify studies published before October, 2013, involving nutrition-based interventions in adult populations similar to the Navajo targeting at least one measure of metabolic syndrome. Data on efficacy and participation were gathered and synthesised qualitatively. Out of 19 studies included in this systematic review, 11 interventions were identified to be effective at improving at least one measure of metabolic syndrome. Level of exposure to the intervention, frequency of intervention activities, family and social support, cultural adaptation and case management were identified as factors that may improve the efficacy of an intervention. Multiple nutrition-based interventions have been found to be effective in populations similar to the Navajo. Development of a strategy to address metabolic syndrome in the Navajo may involve aspects from multiple interventions to increase efficacy and maximise participation. © 2015 John Wiley & Sons Ltd.

A Worksite Nutrition Intervention is Effective at Improving Employee Well-Being: A Pilot Study

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Jay T. Sutliffe

2018-01-01

Full Text Available Background. Worksite dietary interventions show substantial potential for improving employee health and well-being. The aim of this pilot study was to determine the effect of a worksite nutrition intervention on improving well-being. Methods. Thirty-five university employees participated in a 6-week nutrition intervention. The dietary protocol emphasized the daily consumption of greens, beans/legumes, a variety of other vegetables, fruits, nuts, seeds, and whole grains, referred to as a micronutrient-dense, plant-rich diet. Participants were encouraged to minimize the consumption of refined foods and animal products. Results. Significant improvements in sleep quality, quality of life, and depressive symptoms were found. Conclusions. Findings reveal that a worksite nutrition intervention is effective at improving sleep quality, quality of life, and depressive symptoms with a projected improvement in work productivity and attendance.

Nutritional care of Danish medical inpatients: Effect on dietary intake and the occupational groups' perspectives of intervention

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Jensen Lillian

2004-09-01

Full Text Available Abstract Background Many patients do not eat and drink sufficiently during hospitalisation. The clinical consequences of this under nutrition include lassitude, an increased risk of complications and prolonged convalescence. The aim of the study was 1 to introduce intervention targeting nutritional care for medical inpatients, 2 to investigate the effect of this intervention, and 3 to investigate the occupational groups' attitudes towards nutritional intervention and nutritional care in general. Methods The design was to determinate the extent to which the protein and energy requirements of medical inpatients were met before and after intervention. Dietary protein and energy intakes were assessed by 72-hour weighed food records. A total number of 108 medical patients at four bed sections and occupational groups in the two intervention bed sections, Aarhus University Hospital, Denmark participated. The intervention included introduction and implementation of nursing procedures targeting nutritional care during a five-month investigation period using standard food produced at the hospital. The effect of intervention for independent groups of patients were tested by one-way analysis of variance. After the intervention occupational groups were interviewed in focus groups. Results Before the intervention hospital food on average met 72% of the patients' protein requirement and 85% of their energy requirement. After intervention hospital food satisfied 85% of the protein and 103% of the energy requirements of 14 patients in one intervention section and 56% of the protein and 76% of the energy requirement of 17 patients in the other intervention section. Hospital food satisfied 61% of the protein and 75% of the energy requirement in a total of 29 controls. From the occupational groups' point of view lack of time, lack of access to food, and lack of knowledge of nutritional care for patients were identified as barriers to better integration of

Intervention strategies to improve nutrition and health behaviours before conception.

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Barker, Mary; Dombrowski, Stephan U; Colbourn, Tim; Fall, Caroline H D; Kriznik, Natasha M; Lawrence, Wendy T; Norris, Shane A; Ngaiza, Gloria; Patel, Dilisha; Skordis-Worrall, Jolene; Sniehotta, Falko F; Steegers-Theunissen, Régine; Vogel, Christina; Woods-Townsend, Kathryn; Stephenson, Judith

2018-05-05

The nutritional status of both women and men before conception has profound implications for the growth, development, and long-term health of their offspring. Evidence of the effectiveness of preconception interventions for improving outcomes for mothers and babies is scarce. However, given the large potential health return, and relatively low costs and risk of harm, research into potential interventions is warranted. We identified three promising strategies for intervention that are likely to be scalable and have positive effects on a range of health outcomes: supplementation and fortification; cash transfers and incentives; and behaviour change interventions. On the basis of these strategies, we suggest a model specifying pathways to effect. Pathways are incorporated into a life-course framework using individual motivation and receptiveness at different preconception action phases, to guide design and targeting of preconception interventions. Interventions for individuals not planning immediate pregnancy take advantage of settings and implementation platforms outside the maternal and child health arena, since this group is unlikely to be engaged with maternal health services. Interventions to improve women's nutritional status and health behaviours at all preconception action phases should consider social and environmental determinants, to avoid exacerbating health and gender inequalities, and be underpinned by a social movement that touches the whole population. We propose a dual strategy that targets specific groups actively planning a pregnancy, while improving the health of the population more broadly. Modern marketing techniques could be used to promote a social movement based on an emotional and symbolic connection between improved preconception maternal health and nutrition, and offspring health. We suggest that speedy and scalable benefits to public health might be achieved through strategic engagement with the private sector. Political theory supports

Narrative Review of Pedagogical Interventions on Nutrition Knowledge and Weight Prejudice

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Werkhoven, Thea; Cotton, Wayne; Dudley, Dean

2016-01-01

Objectives: To synthesize and review pedagogically informed interventions that increase nutrition knowledge and decrease weight prejudice among practicing and pre-service health and education professionals. These factors have been addressed as separate entities in intervention-based research and this represents a gap in current literature. The…

Clinical outcome of nutrition-oriented intervention for primary intestinal lymphangiectasia.

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Tang, Qing-Ya; Wen, Jie; Wu, Jiang; Wang, Ying; Cai, Wei

2011-02-01

primary intestinal lymphangiectasia (PIL) is a rare digestive disease and few studies have focused on the therapeutic effect in PIL patients. This study was undertaken to evaluate nutrition-oriented intervention in children with PIL. four children with PIL were studied. Their medical records were reviewed. Anthropometric measurements and blood tests were performed during a 8-18 month follow-up. during hospitalization, the 4 patients were subjected to diet intervention. Parenteral nutrition (PN) support was also given to 3 of them. Clinical symptoms and laboratory parameters of the patients were significantly improved at discharge. After discharge, the patients continued diet control, 2 of whom received intermittent PN support. The mean follow-up duration of the 4 patients was 13 months (range, 8-18 months) and they all kept in a stable condition without symptoms relapse. Weight, height and body mass index for age were normal during the follow-up, while total protein, albumin and immunoglobulin concentrations were still slightly below normal level. nutrition therapy is effective as a valid and safe therapeutic management for PIL patients. No growth retardation was observed in the 4 children after the therapy, but they are still at risk of nutrient malabsorption. Therefore, they need long-term, regular monitoring and intensive nutritional care.

The application of near infrared spectroscopy in nutritional intervention studies

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Philippa A Jackson

2013-08-01

Full Text Available Functional near infrared spectroscopy (NIRS is a non-invasive optical imaging technique used to monitor cerebral blood flow (CBF and by proxy neuronal activation. The use of NIRS in nutritional intervention studies is a relatively novel application of this technique, with only a small, but growing, number of trials published to date. These trials—in which the effects on CBF following administration of dietary components such as caffeine, polyphenols and omega-3 polyunsaturated fatty acids are assessed—have successfully demonstrated NIRS as a sensitive measure of change in haemodynamic response during cognitive tasks in both acute and chronic treatment intervention paradigms. The existent research in this area has been limited by the constraints of the technique itself however advancements in the measurement technology, paired with studies endeavouring increased sophistication in number and locations of channels over the head should render the use of NIRS in nutritional interventions particularly valuable in advancing our understanding of the effects of nutrients and dietary components on the brain.

Preoperative nutritional interventions in morbid obesity: impact on body weight, energy intake, and eating quality.

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Melendez-Araújo, Mariana Silva; de Matos Arruda, Sérgio Lincoln; de Oliveira Kelly, Emily; de Carvalho, Kênia Mara Baiocchi

2012-12-01

Although the benefits of preoperative weight loss and adequacy of dietary patterns in bariatric surgery is well-recognized, the nutritional strategies in the preoperative period have been scarcely investigated. We aimed to evaluate the impact of intensive and standard nutritional interventions on body weight, energy intake, and eating quality. This is a retrospective study in which 32 patients undergoing intensive nutritional intervention, with low-calorie diet (10 kcal/kg) and biweekly visits, were pair-matched by age, sex, and body mass index with 32 patients under a standard nutritional intervention, based on a general dietary counseling. Twenty-four-hour food recall was used to assess energy intake and to derive healthy eating index (HEI). The follow-up preoperative period varied from 8 to 16 weeks. Weight loss was observed in 72% of the patients from the intensive intervention group and 75% of the patients from the standard intervention group. According to the mixed model analysis, time effect on weight loss in both groups was significant (P = 0.0002); however, no difference was found between the intervention groups (P = 0.71). The time effect was significant in both groups for energy intake reduction as well (P eating quality was expressed by the nutrient score of the HEI that increased significantly overtime (P = 0.02), also without distinction between the groups (P = 0.61). Both intensive and standard nutritional interventions promoted weight loss, energy intake reduction, and improvement of eating quality in morbidly obese patients during preoperative period.

Nutritional support and dietary interventions following esophagectomy: challenges and solutions

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Paul M

2017-03-01

Full Text Available Melanie Paul, Melanie Baker, Robert N Williams, David J Bowrey Department of Surgery, Leicester Royal Infirmary, Leicester, UK Background and aims: Provision of adequate nutrition after esophagectomy remains a major challenge. The aims of this review were to describe the challenges facing this patient population and to determine the evidence base underpinning current nutritional and dietetic interventions after esophagectomy. Methods: Medline, Embase and CINAHL databases were searched for English language publications of the period 1990–2016 reporting on the outcome of nutritional or dietetic interventions after esophagectomy or patient-related symptoms. Results: Four studies demonstrated that early reintroduction of oral fluids was safe and was associated with a shorter hospital stay and ileus duration. One of three studies comparing in-hospital enteral nutrition against usual care showed that enteral feeding was well tolerated and was associated with a shorter hospital stay. Eight studies comparing enteral with parenteral nutrition showed similar surgical complication rates. Enteral feeding was associated with a shorter duration of ileus and lower health care costs. In hospital, all types of enteral access (nasoenteral, jejunostomy were equivalent in their safety profiles. Cohort studies indicate that technical (tube dysfunction and feed (diarrhea, distention problems were common with jejunostomies but are easily managed. The mortality risk associated with jejunostomy in hospital is 0.2% (reported range 0%–1%, principally due to small bowel ischemia. There have been no reports of serious jejunostomy complications in patients receiving home feeding. One study demonstrated the advantages of home feeding in weight, muscle and fat preservation. Studies reporting 12 months or more after esophagectomy indicate a high frequency of persistent symptoms, dumping syndrome 15%–75% (median 46%, dysphagia 11%–38% (median 27%, early satiety 40%–90

A Content Analysis of Kindergarten-12th Grade School-Based Nutrition Interventions: Taking Advantage of Past Learning

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Roseman, Mary G.; Riddell, Martha C.; Haynes, Jessica N.

2011-01-01

Objective: To review the literature, identifying proposed recommendations for school-based nutrition interventions, and evaluate kindergarten through 12th grade school-based nutrition interventions conducted from 2000-2008. Design: Proposed recommendations from school-based intervention reviews were developed and used in conducting a content…

Nutritional Intervention as part of Functional Rehabilitation in Older People with reduced functional ability

DEFF Research Database (Denmark)

Beck, Anne Marie; Dent, Elsa; Baldwin, Christine

2016-01-01

body weight, hand-grip strength or muscle strength. There was no difference between groups in the critical outcomes; balance, cognition, activities of daily living and mortality at long-term follow-up. Nutritional intervention given with functional rehabilitation was associated with an increased...... studies considered to be clinical homogenous were combined in a meta-analysis Results Of the 788 studies screened, five were identified for inclusion. Nutritional intervention given with functional rehabilitation improved energy and protein intake, although it failed to provide any improvement in final....... Conclusions This meta-analysis highlights concerns regarding the quality of the randomisation of participants at baseline. Future high-quality research is essential to establish whether older people with loss of functional abilities can benefit from nutritional intervention....

Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: a systematic review.

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Langius, Jacqueline A E; Zandbergen, Myrna C; Eerenstein, Simone E J; van Tulder, Maurits W; Leemans, C René; Kramer, Mark H H; Weijs, Peter J M

2013-10-01

We performed a systematic review to examine the effect of nutritional interventions on nutritional status, quality of life (QoL) and mortality in patients with head and neck squamous cell cancer (HNSCC) receiving radiotherapy or chemoradiotherapy. We searched Pubmed, EMBASE, CENTRAL and Cinahl from inception through January 3rd, 2012 to identify randomized controlled trials (RCTs) from a broad range of nutritional interventions in patients with HNSCC during (chemo)radiotherapy. Two reviewers independently assessed study eligibility and risk of bias, and extracted data. Of 1141 titles identified, 12 study reports were finally included, describing 10 different studies with 11 interventions. Four out of 10 studies examined the effects of individualized dietary counseling, and showed significant benefits on nutritional status and QOL compared to no counseling or general nutritional advice by a nurse (p gastronomy (PEG) feeding on nutritional status shortly after RT compared with nasogastric feeding (p = 0.001). Two studies showed that prophylactic PEG feeding was not superior over tube feeding if required. This review shows beneficial effects of individualized dietary counseling on nutritional status and QoL, compared to no counseling or standard nutritional advice. Effects of ONS and tube feeding were inconsistent. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

A review of the nature and effectiveness of nutrition interventions in adult males – a guide for intervention strategies

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Taylor Pennie J

2013-01-01

Full Text Available Abstract Background Energy excess, low fruit and vegetable intake and other suboptimal dietary habits contribute to an increased poor health and the burden of disease in males. However the best way to engage males into nutrition programs remains unclear. This review provides a critical evaluation of the nature and effectiveness of nutrition interventions that target the adult male population. Methods A search for full-text publications was conducted using The Cochrane Library; Web of Science; SCOPUS; MEDLINE and CINAHL. Studies were included if 1 published from January 1990 to August 2011 and 2 male only studies (≥18 years or 3 where males contributed to >90% of the active cohort. A study must have described, (i a significant change (p Results Nine studies were included. Sample sizes ranged from 53 to 5042 male participants, with study durations ranging from 12 weeks to 24 months. Overlap was seen with eight of the nine studies including a weight management component whilst six studies focused on achieving changes in dietary intake patterns relating to modifications of fruit, vegetable, dairy and total fat intakes and three studies primarily focused on achieving weight loss through caloric restriction. Intervention effectiveness was identified for seven of the nine studies. Five studies reported significant positive changes in weight (kg and/or BMI (kg/m2 changes (p≤0.05. Four studies had effective interventions (p Intervention features, which appeared to be associated with better outcomes, include the delivery of quantitative information on diet and the use of self-monitoring and tailored feedback. Conclusion Uncertainty remains as to the features of successful nutrition interventions for males due to limited details provided for nutrition intervention protocols, variability in mode of delivery and comparisons between delivery modes as well as content of information provided to participants between studies. This review offers knowledge to

A review of school nutrition interventions globally as an evidence ...

African Journals Online (AJOL)

Keywords: school intervention; nutrition; physical activity; health promotion. A review of school ... The disease profile of the world is changing rapidly, especially in low- ...... Department of Health, Medical Research Council, Macro International.

Early Child Development and Nutrition: A Review of the Benefits and Challenges of Implementing Integrated Interventions1234

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Hurley, Kristen M; Yousafzai, Aisha K; Lopez-Boo, Florencia

2016-01-01

Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions. PMID:26980819

Outcomes of nutritional interventions to treat dysphagia in esophageal cancer: a population-based study.

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Modi, R M; Mikhail, S; Ciombor, K; Perry, K A; Hinton, A; Stanich, P P; Zhang, C; Conwell, D L; Krishna, S G

2017-11-01

Esophageal cancer (EC) is increasing in prevalence due to rising incidence and improved treatment strategies. Dysphagia is a significant morbidity in patients with EC requiring nutritional intervention. We sought to evaluate outcomes of nutritional interventions for EC patients hospitalized with dysphagia at a population level. The National Inpatient Sample (2002-2012) was utilized to include all adult inpatients (≥18 years of age) with EC and presence of dysphagia and stricture that underwent nutritional interventions including feeding tube (FT) placement, esophageal stenting, or parenteral nutrition (PN). Temporal trends were examined with multivariate analysis performed for mortality, length of stay (LOS), and cost of hospitalization. A total of 509,593 EC patients had 12,205 hospitalizations related to dysphagia. The hospitalization rates doubled over the study period (1.52% vs. 3.28%, p esophageal stenting (13%), and PN (11%). PN was more frequently associated with a diagnosis of sepsis (6.1%, p = 0.023) compared to FT (2.5%) or esophageal stenting (1.8%). Multivariate analysis demonstrated FT and esophageal stenting had comparable mortality (OR 1.06, 95% CI: 0.49, 2.32); however, PN was associated with higher mortality (OR 2.37, 95% CI: 1.22, 4.63), cost of hospitalization ($5,510, 95% CI: 2,262, 8,759), and LOS (2.13 days, 95% CI: 0.72, 3.54). This study shows that hospitalizations for EC with dysphagia and related nutritional interventions are increasing. As a single modality, parenteral nutrition should be avoided. Among our esophageal stent and FT population, further studies are necessary to determine adequate interventions based on disease stage. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Using ethnography in implementation research to improve nutrition interventions in populations

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Neufeld, Lynnette M.; Pelto, Gretel H.

2015-01-01

Abstract ‘Implementation research in nutrition’ is an emerging area of study aimed at building evidence‐based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view – the insider's perspective – and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the ‘emic’ (insider's) perspective.Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography.Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the ‘black box’ in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. PMID:26778802

The effectiveness of nutrition interventions on dietary outcomes by relative social disadvantage: a systematic review.

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Oldroyd, J; Burns, C; Lucas, P; Haikerwal, A; Waters, E

2008-07-01

To determine whether nutrition interventions widen dietary inequalities across socioeconomic status groups. Systematic review of interventions that aim to promote healthy eating. CINAHL and MEDLINE were searched between 1990 and 2007. Studies were included if they were randomised controlled trials or concurrent controlled trials of interventions to promote healthy eating delivered at a group level to low socioeconomic status groups or studies where it was possible to disaggregate data by socioeconomic status. Six studies met the inclusion criteria. Four were set in educational setting (three elementary schools, one vocational training). The first found greater increases in fruit and vegetable consumption in children from high-income families after 1 year (mean difference 2.4 portions per day, pdisadvantaged areas (pprimary care settings. The first found that, as a result of the intervention, the difference in consumption of added fat between the intervention and the control group was -8.9 g/day for blacks and -12.0 g/day for whites (p<0.05). In the second study, there was greater attrition among the ethnic minority participants than among the white participants (p<0.04). Nutrition interventions have differential effects by socioeconomic status, although in this review we found only limited evidence that nutrition interventions widen dietary inequalities. Due to small numbers of included studies, the possibility that nutrition interventions widen inequalities cannot be excluded. This needs to be considered when formulating public health policy.

The REFORM study protocol: a cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people.

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Cockayne, Sarah; Adamson, Joy; Corbacho Martin, Belen; Fairhurst, Caroline; Hewitt, Catherine; Hicks, Kate; Hull, Robin; Keenan, Anne Maree; Lamb, Sarah E; Loughrey, Lorraine; McIntosh, Caroline; Menz, Hylton B; Redmond, Anthony C; Rodgers, Sara; Vernon, Wesley; Watson, Judith; Torgerson, David

2014-12-17

Falls and fall-related injuries are a serious cause of morbidity and cost to society. Foot problems and inappropriate footwear may increase the risk of falls; therefore podiatric interventions may play a role in reducing falls. Two Cochrane systematic reviews identified only one study of a podiatry intervention aimed to reduce falls, which was undertaken in Australia. The REFORM trial aims to evaluate the clinical and cost-effectiveness of a multifaceted podiatry intervention in reducing falls in people aged 65 years and over in a UK and Irish setting. This multicentre, cohort randomised controlled trial will recruit 2600 participants from routine podiatry clinics in the UK and Ireland to the REFORM cohort. In order to detect a 10% point reduction in falls from 50% to 40%, with 80% power 890 participants will be randomised to receive routine podiatry care and a falls prevention leaflet or routine podiatry care, a falls prevention leaflet and a multifaceted podiatry intervention. The primary outcome is rate of falls (falls/person/time) over 12 months assessed by patient self-report falls diary. Secondary self-report outcome measures include: the proportion of single and multiple fallers and time to first fall over a 12-month period; Short Falls Efficacy Scale-International; fear of falling in the past 4 weeks; Frenchay Activities Index; fracture rate; Geriatric Depression Scale; EuroQoL-five dimensional scale 3-L; health service utilisation at 6 and 12 months. A qualitative study will examine the acceptability of the package of care to participants and podiatrists. The trial has received a favourable opinion from the East of England-Cambridge East Research Ethics Committee and Galway Research Ethics Committee. The trial results will be published in peer-reviewed journals and at conference presentations. Current Controlled Trials ISRCTN68240461 assigned 01/07/2011. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

Improving the quality of nurse clinical documentation for chronic patients at primary care clinics: A multifaceted intervention

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Ozayr H. Mahomed

2015-09-01

Full Text Available Background: Deficiencies in record keeping practices have been reported at primary care level in the public health sector in South Africa. These deficiencies have the potential to negatively impact patient health outcomes as the break in information may hinder continuity of care. This disruption in information management has particular relevance for patients with chronic diseases. Objectives: The aim of this study was to establish if the implementation of a structured clinical record (SCR as an adjunct tool to the algorithmic guidelines for chronic disease management improved the quality of clinical records at primary care level. Method: A quasi-experimental study (before and after study with a comparison group was conducted across 30 primary health care clinics (PHCs located in three districts in South Africa. Twenty PHCs that received the intervention were selected as intervention clinics and 10 facilities were selected as comparison facilities. The lot quality assurance sampling (LQAS method was used to determine the number of records required to be reviewed per diagnostic condition per facility. Results: There was a a statistically significant increase in the percentage of clinical records achieving compliance to the minimum criteria from the baseline to six months post-intervention for both HIV patients on antiretroviral treatment and patients with non-communicable diseases (hypertension and diabetes. Conclusions: A multifaceted intervention using a SCR to supplement the educational outreach component (PC 101 training has demonstrated the potential for improving the quality of clinical records for patients with chronic diseases at primary care clinics in South Africa.

Novel, Family-Centered Intervention to Improve Nutrition in Patients Recovering From Critical Illness: A Feasibility Study.

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Marshall, Andrea P; Lemieux, Margot; Dhaliwal, Rupinder; Seyler, Hilda; MacEachern, Kristen N; Heyland, Daren K

2017-06-01

Critically ill patients are at increased risk of developing malnutrition-related complications because of physiological changes, suboptimal delivery, and reduced intake. Strategies to improve nutrition during critical illness recovery are required to prevent iatrogenic underfeeding and risk of malnutrition. The purpose of this study was to assess the feasibility and acceptability of a novel family-centered intervention to improve nutrition in critically ill patients. A 3-phase, prospective cohort feasibility study was conducted in 4 intensive care units (ICUs) across 2 countries. Intervention feasibility was determined by patient eligibility, recruitment, and retention rates. The acceptability of the intervention was assessed by participant perspectives collected through surveys. Participants included family members of the critically ill patients and ICU and ward healthcare professionals (HCPs). A total of 75 patients and family members, as well as 56 HCPs, were enrolled. The consent rate was 66.4%, and 63 of 75 (84%) of family participants completed the study. Most family members (53/55; 98.1%) would recommend the nutrition education program to others and reported improved ability to ask questions about nutrition (16/20; 80.0%). Family members viewed nutrition care more positively in the ICU. HCPs agreed that families should partner with HCPs to achieve optimal nutrition in the ICU and the wards. Health literacy was identified as a potential barrier to family participation. The intervention was feasible and acceptable to families of critically ill patients and HCPs. Further research to evaluate intervention impact on nutrition intake and patient-centered outcomes is required.

Malnutrition, cachexia and nutritional intervention: when much becomes too much

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Serena Rianda

2013-06-01

Full Text Available Disease-associated malnutrition, also defined as cachexia, is a complex syndrome characterised by the progressive deterioration of nutritional status resulting from the combined effects of reduced appetite and food intake, and profound changes in host metabolism. Cachexia has been repeatedly demonstrated to represent a negative prognostic factor for patients suffering from acute and chronic diseases, including cancer. In oncology patients, early diagnosis of cachexia and timely nutritional intervention have been demonstrated not only to prevent further deterioration of nutritional status, but also to increase quality of life and survival when integrated in a multiprofessional and multidisciplinary approach. However, nutritional therapy is associated to the possible development of complications, which may be fatal. Therefore, nutritional therapy in severely malnourished patients should be cautiously prescribed by experts in the field, who should develop a monitoring program to early detect complications and to maximise the clinical efficacy.Here we describe a cancer patient affected by refeeding syndrome, who was fortunately early diagnosed and properly treated.

Can agricultural interventions improve child nutrition? Evidence from Tanzania

DEFF Research Database (Denmark)

Larsen, Anna Folke; Lilleør, Helene Bie

2016-01-01

the impact on early childhood nutrition, measured as height-for-age, of an agricultural intervention that improved food security among smallholder farmers by providing them with a “basket” of new technology options. We find that height-for-age measures among children from participating households increased...

Impact of nutritional interventions on food consumption pattern changes of workers and staff

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Maryam Boshtam

2011-10-01

Full Text Available Background: Worksite Intervention Project from Isfahan Healthy Heart Program aiming at modifying life style of workers and staff in Isfahan and Najafabad (intervention areas, and Arak (reference area carried out for 5 years. Nutritional interventions are one of the interventions of this project. This research aiming at studying the effect of these interventions on food consumption pattern changes carried out in workers and staff of Isfahan and Najafabad. Materials and Method: Food consumption pattern by food frequency questionnaire and demographic information of this group were collected before, after and annually during the intervention. Data were analyzed by Genera Linear Models (GLM, descriptive and trend analysis. Results: Beverage and hydrogenated oil consumption decreased and fruits and vegetables increased in workers and staff of intervention area more than reference area (p0.27. Compare to reference society fast food consumption in office staff of intervention society was increased (p<0.001.Conclusion: We conclude that nutritional interventions have favorite effects on practice of workers and staff of this Iranian population and interventions used in this study can use as applicable interventions for similar societies

Effect of a Nutritional Intervention in Athlete’s Body Composition, Eating Behaviour and Nutritional Knowledge: A Comparison between Adults and Adolescents

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Marcus Nascimento

2016-09-01

Full Text Available The objective of the present study is to evaluate and compare the effect of a nutritional intervention between adolescent and adult. In a before and after quasi-experimental clinical study, 32 athletes (21 adults, age range 20–32 years; 11 adolescents, age range: 12–19 years participated in a nutritional counselling consisting of four consultations separated by an interval of 45 to 60 days. The athlete’s eating behaviour, body composition and nutrition knowledge were evaluated at the beginning and at the end of the protocol. Both groups increased lean body mass and nutritional knowledge. Adolescents increased their mid-arm muscle circumference and improved meal frequency, and daily water intake. Athletes of both groups improved their ingestion of vegetables and fruits and decreased the ingestion of sweets and oils. Adolescents showed a higher prevalence of individuals that remained within or approached to the recommendations of sweets. This is the first study to evaluate and compare the effect of a nutritional intervention between adolescent and adult athletes body composition, eating behaviour and nutritional knowledge. The nutritional counselling has been effective in promoting beneficial changes on the athlete’s eating behaviour, nutritional knowledge and body composition, however, some healthy changes were only experienced by adolescents, especially in the frequency of meals and the intake of sweets.

Public health interventions, barriers, and opportunities for improving maternal nutrition in India.

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Ramakrishnan, Usha; Lowe, Alyssa; Vir, Sheila; Kumar, Shuba; Mohanraj, Rani; Chaturvedi, Anuraag; Noznesky, Elizabeth A; Martorell, Reynaldo; Mason, John B

2012-06-01

Inadequate nutrient intake, early and multiple pregnancies, poverty, caste discrimination, and gender inequality contribute to poor maternal nutrition in India. While malnutrition is seen throughout the life cycle, it is most acute during childhood, adolescence, pregnancy, and lactation. Although nutrition policies are on the books and interventions are in place, child malnutrition and maternal undernutrition persist as severe public health problems. To evaluate the implementation of maternal nutrition programs in India. The research was conducted in two phases. Phase 1 consisted of a desk review of national and state policies pertinent to maternal nutrition and national-level key informant interviews with respondents who have a working knowledge of relevant organizations and interventions. Phase 2 utilized in-depth interviews and focus group discussions at the state, district, and community levels in eight districts of two states: Tamil Nadu and Uttar Pradesh. All data were analyzed thematically. India has a rich portfolio of programs and policies that address maternal health and nutrition; however, systematic weaknesses, logistical gaps, resource scarcity, and poor utilization continue to hamper progress. Elevating the priority given to maternal nutrition in government health programs and implementing strategies to improve women's status will help to address many of the challenges facing India's nutrition programs. Programs can be strengthened by promoting integration of services, ensuring effective procurement mechanisms for micronutrient and food supplements, establishing regional training facilities for improved program implementation, and strengthening program monitoring and evaluation.

Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries12

OpenAIRE

Kim, Sunny S.; Rogers, Beatrice L.; Coates, Jennifer; Gilligan, Daniel O.; Sarriot, Eric

2013-01-01

After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, “Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries,” provided not only frameworks for conceptualizing sustain...

A cluster randomised controlled trial of a nutrition education intervention in the community.

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Madigan, S M; Fleming, P; Wright, M E; Stevenson, M; Macauley, D

2014-04-01

Patients with enteral feeding tubes are increasingly managed in their home environment and these patients require support from a range of healthcare professionals. A cluster randomised trial of an educational intervention was undertaken among General Practitioners and nurses both in the community and in nursing home caring for patients recently discharged to primary care. This was a short, duration (nutrition education programme delivered in the work place soon after the patient was discharged from hospital. The primary outcome was an improvement in knowledge immediately after the intervention and the secondary outcome was knowledge at 6 months. Those in the intervention group had improved knowledge, which was significantly greater than those in the control group (P work-based targeted nutrition education programme is effective for improving knowledge among general practitioners and nurses both in the community and in nursing homes. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

Metabolism and catabolism in hip fracture patients: nutritional and anabolic intervention--a review.

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Hedström, Margareta; Ljungqvist, Olle; Cederholm, Tommy

2006-10-01

Patients suffering from hip fracture are known to be at risk of catabolism and protein-energy malnutrition. In this review we discuss the pathogenesis of hip fracture-related catabolism per- and postoperatively. We also describe the consequences of malnutrition after a hip fracture and summarize studies that have evaluated the effect of nutritional or anabolic treatment of these patients. There has been relatively little published on the effects of nutritional and anabolic pharmacological interventions for improvement of nutritional status and on the role of nutritional status in clinical outcomes. Even so, there have been 19 randomized studies in this field. 12 studies evaluated nutritional supplementation or protein supplementation. 6 found improved clinical outcome with fewer complications, faster recovery and shorter length of hospital stay, whereas the others reported no difference in clinical outcome. For pharmacological interventions, the outcomes have been even less clear. Supplementation studies in general appear to be underpowered or suffer logistic problems. Studies of higher scientific quality are needed, and enteral feeding, anabolic treatment and multimodal approaches need to be evaluated in greater depth.

'It Opened My Eyes'-examining the impact of a multifaceted chlamydia testing intervention on general practitioners using Normalization Process Theory.

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Yeung, Anna; Hocking, Jane; Guy, Rebecca; Fairley, Christopher K; Smith, Kirsty; Vaisey, Alaina; Donovan, Basil; Imrie, John; Gunn, Jane; Temple-Smith, Meredith

2018-03-28

Chlamydia is the most common notifiable sexually transmissible infection in Australia. Left untreated, it can develop into pelvic inflammatory disease and infertility. The majority of notifications come from general practice and it is ideally situated to test young Australians. The Australian Chlamydia Control Effectiveness Pilot (ACCEPt) was a multifaceted intervention that aimed to reduce chlamydia prevalence by increasing testing in 16- to 29-year-olds attending general practice. GPs were interviewed to describe the effectiveness of the ACCEPt intervention in integrating chlamydia testing into routine practice using Normalization Process Theory (NPT). GPs were purposively selected based on age, gender, geographic location and size of practice at baseline and midpoint. Interview data were analysed regarding the intervention components and results were interpreted using NPT. A total of 44 GPs at baseline and 24 at midpoint were interviewed. Most GPs reported offering a test based on age at midpoint versus offering a test based on symptoms or patient request at baseline. Quarterly feedback was the most significant ACCEPt component for facilitating a chlamydia test. The ACCEPt intervention has been able to moderately normalize chlamydia testing among GPs, although the components had varying levels of effectiveness. NPT can demonstrate the effective implementation of an intervention in general practice and has been valuable in understanding which components are essential and which components can be improved upon.

The nutrition-microcredit synergy: A case for multiple interventions ...

African Journals Online (AJOL)

An intervention to enhance children's diet and nutritional status was developed based on the assumption that improving knowledge, attitudes, and beliefs of caregivers would lead to increased use of ASF for young children only if ASF availability (presence in the communities) and accessibility (families' ability to obtain ASF ...

Evaluation of a kindergarten-based nutrition education intervention for pre-school children in China.

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Hu, Chuanlai; Ye, Dongqing; Li, Yingchun; Huang, Yongling; Li, Li; Gao, Yongqing; Wang, Sufang

2010-02-01

To evaluate the impact of nutrition education in kindergartens and to promote healthy dietary habits in children. Prospective cohort study. Four kindergartens with 1252 children were randomized to the intervention group and three with 850 children to the control group. The personal nutritional knowledge, attitudes and dietary behaviours of the parents were also investigated. Each month, children and parents in the intervention group participated in nutrition education activities. The main outcome measures were anthropometrics and diet-related behaviours of the children and the nutritional knowledge and attitudes of the parents at baseline, 6 months (mid-term) and 1 year (post-test). Baseline demographic and socio-economic characteristics were also collected. Seven kindergartens from Hefei, the capital city of Anhui Province, eastern China. Two thousand one hundred and two 4- to 6-year-old pre-schoolers from seven kindergartens participated. The prevalence of children's unhealthy diet-related behaviours decreased significantly and good lifestyle behaviours increased in the group receiving nutrition education compared with controls. Parental eating habits and attitudes to planning their children's diets also changed appreciably in the intervention group compared with the control group (P education improves pre-schoolers' lifestyle behaviours and brings about beneficial changes in parents' attitudes to planning their children's diets and their own personal eating habits.

Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

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Walzer, Stefan; Droeschel, Daniel; Nuijten, Mark; Chevrou-Séverac, Hélène

2014-01-01

Health care decision-makers have begun to realize that medical nutrition plays an important role in the delivery of care, and it needs to be seen as a sole category within the overall health care reimbursement system to establish the value for money. Indeed, improving health through improving patients' nutrition may contribute to the cost-effectiveness and financial sustainability of health care systems. Medical nutrition is regulated by a specific bill either in Europe or in the United States, which offers specific legislations and guidelines (as provided to patients with special nutritional needs) and indications for nutritional support. Given that the efficacy of medical nutrition has been proven, one can wonder whether the heterogeneous nature of its coverage/reimbursement across countries might be due to the lack of health-related economic evidence or value-for-money of nutritional interventions. This paper aims to address this knowledge gap by performing a systematic literature review on health economics evidence regarding medical nutrition, and by summarizing the results of these publications related to the value for money of medical nutrition interventions. A systematic literature search was initiated and executed based on a predefined search protocol following the population, intervention, comparison, and outcomes (PICO) criteria. Following the systematic literature search of recently published literature on health economics evidence regarding medical nutrition, this study aims to summarize the results of those publications that are related to the value for money of medical nutrition interventions. The evaluations were conducted by analyzing different medical nutrition according to their indications, the economic methodology or perspective adopted, the cost source and utility measures, selected efficiency measures, as well as the incremental cost-effectiveness ratio. A total of 225 abstracts were identified for the detailed review, and the data were

Exercise and nutritional interventions for improving aging muscle health.

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Forbes, Scott C; Little, Jonathan P; Candow, Darren G

2012-08-01

Skeletal muscle mass declines with age (i.e., sarcopenia) resulting in muscle weakness and functional limitations. Sarcopenia has been associated with physiological changes in muscle morphology, protein and hormonal kinetics, insulin resistance, inflammation, and oxidative stress. The purpose of this review is to highlight how exercise and nutritional intervention strategies may benefit aging muscle. It is well known that resistance exercise training increases muscle strength and size and evidence also suggests that resistance training can increase mitochondrial content and decrease oxidative stress in older adults. Recent findings suggest that fast-velocity resistance exercise may be an effective intervention for older adults to enhance muscle power and functional capacity. Aerobic exercise training may also benefit aging skeletal muscle by enhancing mitochondrial bioenergetics, improving insulin sensitivity, and/or decreasing oxidative stress. In addition to exercise, creatine monohydrate, milk-based proteins, and essential fatty acids all have biological effects which could enhance some of the physiological adaptations from exercise training in older adults. Additional research is needed to determine whether skeletal muscle adaptations to increased activity in older adults are further enhanced with effective nutritional interventions and whether this is due to enhanced muscle protein synthesis, improved mitochondrial function, and/or a reduced inflammatory response.

A practical scale for Multi-Faceted Organizational Health Climate Assessment.

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Zweber, Zandra M; Henning, Robert A; Magley, Vicki J

2016-04-01

The current study sought to develop a practical scale to measure 3 facets of workplace health climate from the employee perspective as an important component of a healthy organization. The goal was to create a short, usable yet comprehensive scale that organizations and occupational health professionals could use to determine if workplace health interventions were needed. The proposed Multi-faceted Organizational Health Climate Assessment (MOHCA) scale assesses facets that correspond to 3 organizational levels: (a) workgroup, (b) supervisor, and (c) organization. Ten items were developed and tested on 2 distinct samples, 1 cross-organization and 1 within-organization. Exploratory and confirmatory factor analyses yielded a 9-item, hierarchical 3-factor structure. Tests confirmed MOHCA has convergent validity with related constructs, such as perceived organizational support and supervisor support, as well as discriminant validity with safety climate. Lastly, criterion-related validity was found between MOHCA and health-related outcomes. The multi-faceted nature of MOHCA provides a scale that has face validity and can be easily translated into practice, offering a means for diagnosing the shortcomings of an organization or workgroup's health climate to better plan health and well-being interventions. (c) 2016 APA, all rights reserved).

Nutritional Interventions in Head and Neck Cancer Patients Undergoing Chemoradiotherapy: A Narrative Review

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Maurizio Bossola

2015-01-01

Full Text Available The present review aimed to define the role of nutritional interventions in the prevention and treatment of malnutrition in HNC patients undergoing CRT as well as their impact on CRT-related toxicity and survival. Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. In addition, chemo-radiotherapy (CRT causes or exacerbates symptoms, such as alteration or loss of taste, mucositis, xerostomia, fatigue, nausea and vomiting, with consequent worsening of malnutrition. Nutritional counseling (NC and oral nutritional supplements (ONS should be used to increase dietary intake and to prevent therapy-associated weight loss and interruption of radiation therapy. If obstructing cancer and/or mucositis interfere with swallowing, enteral nutrition should be delivered by tube. However, it seems that there is not sufficient evidence to determine the optimal method of enteral feeding. Prophylactic feeding through nasogastric tube or percutaneous gastrostomy to prevent weight loss, reduce dehydration and hospitalizations, and avoid treatment breaks has become relatively common. Compared to reactive feeding (patients are supported with oral nutritional supplements and when it is impossible to maintain nutritional requirements enteral feeding via a NGT or PEG is started, prophylactic feeding does not offer advantages in terms of nutritional outcomes, interruptions of radiotherapy and survival. Overall, it seems that further adequate prospective, randomized studies are needed to define the better nutritional intervention in head and neck cancer patients undergoing chemoradiotherapy.

The Shaping Healthy Choices Program: design and implementation methodologies for a multicomponent, school-based nutrition education intervention.

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Scherr, Rachel E; Linnell, Jessica D; Smith, Martin H; Briggs, Marilyn; Bergman, Jacqueline; Brian, Kelley M; Dharmar, Madan; Feenstra, Gail; Hillhouse, Carol; Keen, Carl L; Nguyen, Lori M; Nicholson, Yvonne; Ontai, Lenna; Schaefer, Sara E; Spezzano, Theresa; Steinberg, Francene M; Sutter, Carolyn; Wright, Janel E; Young, Heather M; Zidenberg-Cherr, Sheri

2014-01-01

To provide a framework for implementation of multicomponent, school-based nutrition interventions. This article describes the research methods for the Shaping Healthy Choices Program, a model to improve nutrition and health-related knowledge and behaviors among school-aged children. Longitudinal, pretest/posttest, randomized, controlled intervention. Four elementary schools in California. Fourth-grade students at intervention (n = 252) and control (n = 238) schools and their parents and teachers. Power analyses demonstrate that a minimum of 159 students per group will be needed to achieve sufficient power. The sample size was determined using the variables of nutrition knowledge, vegetable preference score, and body mass index percentile. A multicomponent school-based nutrition education intervention over 1 academic year, followed by activities to support sustainability of the program. Dietary and nutrition knowledge and behavior, critical thinking skills, healthy food preferences and consumption, and physical activity will be measured using a nutrition knowledge questionnaire, a food frequency questionnaire, a vegetable preferences assessment tool, the Test of Basic Science Process Skills, digital photography of plate waste, PolarActive accelerometers, anthropometrics, a parent questionnaire, and the School and Community Actions for Nutrition survey. Evaluation will include quantitative and qualitative measures. Quantitative data will use paired t, chi-square, and Mann-Whitney U tests and regression modeling using P = .05 to determine statistical significance. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The interventions of nutritional education on malnutrition infants mothers in Wonokromo Surabaya

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Wiwik Afridah

2015-11-01

Full Text Available 800x600 Mother’s knowledge has great affect to the nutritional status of the infants, because mother has a big role in providing the food in the family. That Knowledge was heavily influenced by social circumstances of the family's such as lack of family income that may affect the mother's in providing the food in the family. The research objective is to examine the effect of nutrition education intervention on body weight of malnutrition infants in RW 07 Wonokromo, Surabaya.This study uses a pre-experimental study design with pre-post test type approach. The subjects were children aged six months to five years who are malnutrition and poor nutrition, with indexes BW/U is less than Z score, located in Wonokromo Village, Surabaya. Sampling techniques in a study conducted by simple random sampling. Analysis of differences nutritional status of children before and after giving of nutrition education were tested by paired t test (paired t test and differences of mother’s knowledge before and after giving of nutrition education were tested by Wilcoxon signed rank test.Results of statistically tests by using a paired t-test obtained P Value (0.108 > α (0.05 means there is no different on giving of nutrition education intervention on weight infants in the RW. 07 Wonokromo Village, Surabaya. Results of statistically tests by using the Wilcoxon signed rank test obtained P Value (0.157 > α (0.05 means there is no different on giving of nutrition education intervention on parent’s knowledge level of a toddler in the RW. 07 Wonokromo Village Surabaya.Required planning and strategies to change behavior and awareness of nutrition and health. Using 4P concept for viewpoint of trainers/educators and 4C for viewpoint of participants or trained, and performed by ABC approach (Advocacy, Situation control and the Movement Atmosphere/mobilization. Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 st1\\:*{behavior:url(#ieooui } /* Style

Supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults.

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Baldwin, Christine; Kimber, Katherine L; Gibbs, Michelle; Weekes, Christine Elizabeth

2016-12-20

Supportive interventions such as serving meals in a dining room environment or the use of assistants to feed patients are frequently recommended for the management of nutritionally vulnerable groups. Such interventions are included in many policy and guideline documents and have implications for staff time but may incur additional costs, yet there appears to be a lack of evidence for their efficacy. To assess the effects of supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults. We identified publications from comprehensive searches of the Cochrane Library, MEDLINE, Embase, AMED, British Nursing Index, CINAHL, SCOPUS, ISI Web of Science databases, scrutiny of the reference lists of included trials and related systematic reviews and handsearching the abstracts of relevant meetings. The date of the last search for all databases was 31 March 2013. Additional searches of CENTRAL, MEDLINE, ClinicalTrials.gov and WHO ICTRP were undertaken to September 2016. The date of the last search for these databases was 14 September 2016. Randomised controlled trials of supportive interventions given with the aim of enhancing dietary intake in nutritionally vulnerable adults compared with usual care. Three review authors and for the final search, the editor, selected trials from titles and abstracts and independently assessed eligibility of selected trials. Two review authors independently extracted data and assessed risk of bias, as well as evaluating overall quality of the evidence utilising the GRADE instrument, and then agreed as they entered data into the review. The likelihood of clinical heterogeneity amongst trials was judged to be high as trials were in populations with widely different clinical backgrounds, conducted in different healthcare settings and despite some grouping of similar interventions, involved interventions that varied considerably. We were only able, therefore, to conduct meta-analyses for the outcome measures

Study sponsorship and the nutrition research agenda: analysis of randomized controlled trials included in systematic reviews of nutrition interventions to address obesity.

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Fabbri, Alice; Chartres, Nicholas; Scrinis, Gyorgy; Bero, Lisa A

2017-05-01

To categorize the research topics covered by a sample of randomized controlled trials (RCT) included in systematic reviews of nutrition interventions to address obesity; to describe their funding sources; and to explore the association between funding sources and nutrition research topics. Cross-sectional study. RCT included in Cochrane Reviews of nutrition interventions to address obesity and/or overweight. Two hundred and thirteen RCT from seventeen Cochrane Reviews were included. Funding source and authors' conflicts of interest were disclosed in 82·6 and 29·6 % of the studies, respectively. RCT were more likely to test an intervention to manipulate nutrients in the context of reduced energy intake (44·2 % of studies) than food-level (11·3 %) and dietary pattern-level (0·9 %) interventions. Most of the food industry-sponsored studies focused on interventions involving manipulations of specific nutrients (66·7 %). Only 33·1 % of the industry-funded studies addressed dietary behaviours compared with 66·9 % of the non-industry-funded ones (P=0·002). The level of food processing was poorly considered across all funding sources. The predominance of RCT examining nutrient-specific questions could limit the public health relevance of rigorous evidence available for systematic reviews and dietary guidelines.

[Effects of Lifestyle Intervention on Fatigue, Nutritional Status and Quality of Life in Patients with Gynecologic Cancer].

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An, Hyunjin; Nho, Ju Hee; Yoo, Sunyoung; Kim, Hyunmin; Nho, Minji; Yoo, Hojeong

2015-12-01

The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer. A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks. Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer. Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.

Integrating nutrition and child development interventions: scientific basis, evidence of impact, and implementation considerations.

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Black, Maureen M; Pérez-Escamilla, Rafael; Rao, Sylvia Fernandez

2015-11-01

The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children's linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5.

Nutrition and physical activity educational intervention on CHD risk factors: a systematic review study.

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Rahmati Najarkolaei, Fatemeh; Ghaffarpasand, Eiman; Gholami Fesharaki, Mohammad; Jonaidi Jafari, Nematollah

2015-01-01

Fast growing epidemic of chronic diseases causes many health challenges over the world. Regarding reported pros and cons, the aim of the current study is to review the effect of nutrition and physical educational intervention in decreasing cardiovascular risk factors. In this review study, searching has done through the English and Persian databases. Articles with other languages, lack of important information, and score 3 or less in the JADAD standard checklist were exluded from the study. In the primary search, 194 articles have been found.Through four stages of secondary search and further evaluation, 43 articles were selected. These articles were published between 1989 to 2013. According to these findings, the majority of articles showed a positive effect of nutrition and physical activity educational interventions on cardiovascular risk factors- blood cholesterol, systolic and diastolic blood pressure, as well as smoking cigarette in high risk patients. These results, suggest the necessity of continiuting nutrition and physical educational intervention for individuals with cardiovascular risk factors.

Nutrition impact symptoms in advanced cancer patients: frequency and specific interventions, a case-control study.

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Omlin, Aurelius; Blum, David; Wierecky, Jan; Haile, Sarah R; Ottery, Faith D; Strasser, Florian

2013-03-01

Involuntary weight loss (IWL) is frequent in advanced cancer patients causing compromised anticancer treatment outcomes and function. Cancer cachexia is influenced by nutrition impact symptoms (NIS). The aim of this study was to explore the frequency of NIS in advanced patients and to assess specific interventions guided by a 12-item NIS checklist. Consecutive patients from an outpatient nutrition-fatigue clinic completed the NIS checklist. The NIS checklist was developed based on literature review and multiprofessional clinical expert consensus. Chart review was performed to detect defined NIS typical interventions. Oncology outpatients not seen in the nutrition-fatigue clinic were matched for age, sex, and tumor to serve as controls. In 52 nutrition-fatigue clinic patients, a mixed cancer population [IWL in 2 months 5.96 % (mean)], the five most frequent NIS were taste and smell alterations 27 %, constipation 19 %, abdominal pain 14 %, dysphagia 12 %, and epigastric pain 10 %. A statistically significant difference for NIS typical interventions in patients with taste and smell alterations (p = 0.04), constipation (p = 0.01), pain (p = 0.0001), and fatigue (p = 0.0004) were found compared to the control population [mixed cancer, 3.53 % IWL in 2 months (mean)]. NIS are common in advanced cancer patients. The NIS checklist can guide therapeutic nutrition-targeted interventions. The awareness for NIS will likely evoke more research in assessment, impact, and treatment.

Can worksite nutritional interventions improve productivity and firm profitability? A literature review.

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Jensen, Jørgen Dejgård

2011-07-01

This paper investigates whether and how worksite nutrition policies can improve employee productivity. The questions are pursued through a literature review, including a systematic search of literature--combined with literature identified from backward references--on randomized controlled or quasi-experimental worksite intervention trials and observational cross-sectional studies. Studies were selected on the basis of topic relevance, according to publication title and subsequently according to abstract content. A quality appraisal of the studies was based on study design and clarity in definition of interventions, as well as environmental and outcome variables. The search identified 2,358 publications, 30 of which were found suitable for the review. Several of the reviewed studies suggest that diet-related worksite interventions have positive impacts on employees' nutritional knowledge, food intake and health and on the firm's profitability, mainly in terms of reduced absenteeism and presenteeism. Well-targeted and efficiently implemented diet-related worksite health promotion interventions may improve labour productivity by 1%-2%. On larger worksites, such productivity gains are likely to more than offset the costs of implementing such interventions. These conclusions are subject to some uncertainty due to the relatively limited amount of literature in the field.

Promoting Early Child Development With Interventions in Health and Nutrition: A Systematic Review.

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Vaivada, Tyler; Gaffey, Michelle F; Bhutta, Zulfiqar A

2017-08-01

Although effective health and nutrition interventions for reducing child mortality and morbidity exist, direct evidence of effects on cognitive, motor, and psychosocial development is lacking. To review existing evidence for health and nutrition interventions affecting direct measures of (and pathways to) early child development. Reviews and recent overviews of interventions across the continuum of care and component studies. We selected systematic reviews detailing the effectiveness of health or nutrition interventions that have plausible links to child development and/or contain direct measures of cognitive, motor, and psychosocial development. A team of reviewers independently extracted data and assessed their quality. Sixty systematic reviews contained the outcomes of interest. Various interventions reduced morbidity and improved child growth, but few had direct measures of child development. Of particular benefit were food and micronutrient supplementation for mothers to reduce the risk of small for gestational age and iodine deficiency, strategies to reduce iron deficiency anemia in infancy, and early neonatal care (appropriate resuscitation, delayed cord clamping, and Kangaroo Mother Care). Neuroprotective interventions for imminent preterm birth showed the largest effect sizes (antenatal corticosteroids for developmental delay: risk ratio 0.49, 95% confidence interval 0.24 to 1.00; magnesium sulfate for gross motor dysfunction: risk ratio 0.61, 95% confidence interval 0.44 to 0.85). Given the focus on high-quality studies captured in leading systematic reviews, only effects reported within studies included in systematic reviews were captured. These findings should guide the prioritization and scale-up of interventions within critical periods of early infancy and childhood, and encourage research into their implementation at scale. Copyright © 2017 by the American Academy of Pediatrics.

Evidence Synthesis and Translation for Nutrition Interventions to Combat Micronutrient Deficiencies with Particular Focus on Food Fortification

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Mark Lawrence

2016-09-01

Full Text Available Over two billion people suffer from micronutrient deficiencies. Food fortification is a prominent nutrition intervention to combat such deficiencies; however, its effectiveness, risks, and ethical implications vary depending on the contexts associated with the deficiency it is addressing and the circumstances with its implementation. The aim of this research was to analyse the profile of nutrition interventions for combating micronutrient deficiency with particular focus on food fortification reported in existing systematic reviews (SRs, guidelines and policy statements, and implementation actions for nutrition. A review of secondary data available from online databases of SRs, guidelines and policy statements, and implementation actions, categorised as either “nutrition-specific interventions” (NSpI or “nutrition-sensitive interventions” (NSeI, was conducted. Currently, there is evidence available for a diversity of food fortification topics, and there has been much translation into action. Indeed, food fortification and micronutrient supplementation interventions and NSpI more broadly dominate the profile of interventions for which there were SRs, guidelines, and policy statements available. The findings demonstrate that, although there is a rational linear relationship between evidence synthesis and translation in formulating policy and actions to combat micronutrient deficiencies, the various nutrition interventions available to help combat micronutrient deficiencies are not equally represented in the evidence synthesis and translation processes. Effective and safe policies and actions to combat micronutrient deficiencies require decisions to be informed from a body of evidence that consists of evidence from a variety of interventions. Into the future, investment in making available a higher number of SRs, guidelines and policy statements, and actions of NSeI is indicated.

Clinical effectiveness and cost-effectiveness of a multifaceted podiatry intervention for falls prevention in older people: a multicentre cohort randomised controlled trial (the REducing Falls with ORthoses and a Multifaceted podiatry intervention trial).

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Cockayne, Sarah; Rodgers, Sara; Green, Lorraine; Fairhurst, Caroline; Adamson, Joy; Scantlebury, Arabella; Corbacho, Belen; Hewitt, Catherine E; Hicks, Kate; Hull, Robin; Keenan, Anne-Maree; Lamb, Sarah E; McIntosh, Caroline; Menz, Hylton B; Redmond, Anthony; Richardson, Zoe; Vernon, Wesley; Watson, Judith; Torgerson, David J

2017-04-01

Falls are a serious cause of morbidity and cost to individuals and society. Evidence suggests that foot problems and inappropriate footwear may increase the risk of falling. Podiatric interventions could help reduce falls; however, there is limited evidence regarding their clinical effectiveness and cost-effectiveness. To determine the clinical effectiveness and cost-effectiveness of a multifaceted podiatry intervention for preventing falls in community-dwelling older people at risk of falling, relative to usual care. A pragmatic, multicentred, cohort randomised controlled trial with an economic evaluation and qualitative study. Nine NHS trusts in the UK and one site in Ireland. In total, 1010 participants aged ≥ 65 years were randomised (intervention, n  = 493; usual care, n  = 517) via a secure, remote service. Blinding was not possible. All participants received a falls prevention leaflet and routine care from their podiatrist and general practitioner. The intervention also consisted of footwear advice, footwear provision if required, foot orthoses and foot- and ankle-strengthening exercises. The primary outcome was the incidence rate of falls per participant in the 12 months following randomisation. The secondary outcomes included the proportion of fallers and multiple fallers, time to first fall, fear of falling, fracture rate, health-related quality of life (HRQoL) and cost-effectiveness. The primary analysis consisted of 484 (98.2%) intervention and 507 (98.1%) usual-care participants. There was a non-statistically significant reduction in the incidence rate of falls in the intervention group [adjusted incidence rate ratio 0.88, 95% confidence interval (CI) 0.73 to 1.05; p  = 0.16]. The proportion of participants experiencing a fall was lower (50% vs. 55%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00; p  = 0.05). No differences were observed in key secondary outcomes. No serious, unexpected and related adverse events were reported. The

A Community-Based Positive Deviance/Hearth Infant and Young Child Nutrition Intervention in Ecuador Improved Diet and Reduced Underweight.

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Roche, Marion L; Marquis, Grace S; Gyorkos, Theresa W; Blouin, Brittany; Sarsoza, Julieta; Kuhnlein, Harriet V

2017-03-01

Underweight and stunting are serious problems in Ecuador that require interventions in the first 2 years of life. The researchers assessed the effectiveness of a Positive Deviance (PD)/Hearth community-based intervention using local foods to improve infant and young children's nutrition. A quasi-experimental nonrandomized study was conducted between March and October, 2009. The intervention and study were implemented in the Ecuadorian highlands provinces of Chimborazo and Tungurahua. Eighty mother-child pairs in 6 intervention communities and 184 mother-child pairs in 9 comparison communities. Mothers met in participatory peer-led PD/Hearth cooking and nutrition education sessions for 12 days. Dietary intake and nutritional status were collected at baseline and 6-month follow-up. Multiple linear and logistic regression were used for growth outcomes, and ANCOVA for mean dietary intakes. Mothers in the intervention were 1.3-5.7 times more likely to feed their children the promoted foods (P Hearth interventions support mothers to improve infant and young children's nutrition practices and reduce underweight. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Development and evaluation of an educational intervention program for pre-professional adolescent ballet dancers: nutrition for optimal performance.

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Doyle-Lucas, Ashley F; Davy, Brenda M

2011-06-01

The purpose of this investigation was to develop, implement, and evaluate a theoretically based nutritional education intervention through a DVD lecture series (three 30-minute classes) in summer intensive programs for pre-professional, adolescent ballet dancers. Objectives of this intervention program were to increase knowledge of basic sports nutrition principles and the Female Athlete Triad and promote self-efficacy for adopting healthier dietary habits. Dancers ranging from 13 to 18 years old who were attending summer intensive programs affiliated with professional ballet companies were recruited. Group One (n = 231) participated in the nutrition education program, while Group Two the control participants (n = 90) did not. Assessments of the participants' dietary status consisted of a demographic questionnaire, a Sports Nutrition Knowledge and Behavior Questionnaire, and a Food Frequency Questionnaire. The intervention group was assessed at baseline, immediately post-program, and at six weeks post-program. The control group was assessed at baseline and at six weeks post-baseline. The intervention program was effective at increasing nutrition knowledge, perceived susceptibility to the Female Athlete Triad, and self-efficacy constructs. Improvements in dietary intake were also observed among intervention group participants. To improve overall health and performance nutrition education should be incorporated into the training regimens of adolescent dancers. This potentially replicable DVD-based program may be an effective, low-cost mechanism for doing that.

Customized nutrition intervention and personalized counseling helps achieve nutrition targets in perioperative liver transplant patients.

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Daphnee, D K; John, Sheila; Rajalakshmi, P; Vaidya, Anil; Khakhar, Anand; Bhuvaneshwari, S; Ramamurthy, Anand

2018-02-01

Nutritional therapy is an integral part of care in all phases of liver transplantation (LTx). However, there are several factors that make it a challenge to manage malnutrition in these patients including, but not limited to, loss of appetite, dietary restrictions and dietary habits. Dietary habits are guided by personal choice, social, cultural and regional background with diversity ranging from veganism to vegetarianism with the latter predominant in Indian population. Therefore, it is difficult to improve nutritional intake of patients with standard dietary recommendations. We evaluated the effects of implementing personalized dietary counseling and a customized nutrition plan on its ability to enhance oral intake and, thereby improve nutritional status of patients with end stage liver disease (ESLD) being evaluated for LTx. We compared the outcomes with a matched group of patients who were prescribed standard dietary recommendations from a historic database. Primary outcome was measured by number of patients achieving ≥75% of recommended energy and protein requirements during hospitalization for LTx. Secondary outcomes included mean energy and protein intake, hours of ventilation, length of stay in Intensive Care Unit (ICU) and hospital, mortality and readmission rate in the acute phase (3months) after LTx. This was a prospective observational study, performed at a single LTx centre. All patients >18years who enrolled for LTx and consented for the study were included. The study was conducted after obtaining institutional ethics committee approval. A protocol based nutrition planning was implemented from April'14. According to this protocol, all patients being evaluated for LTx underwent a detailed nutritional assessment by a qualified Clinical Dietitian (CD) and regularly followed up with until LTx. Nutritional intervention, including a customized nutrition care plan and personalized dietary counseling, was provided based on the severity of malnutrition. To

A systematic literature review of nutrition interventions in vending machines that encourage consumers to make healthier choices.

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Grech, A; Allman-Farinelli, M

2015-12-01

Internationally, vending machines are scrutinized for selling energy-dense nutrient-poor foods and beverages, and the contribution to overconsumption and subsequent risk of obesity. The aim of this review is to determine the efficacy of nutrition interventions in vending machine in eliciting behaviour change to improve diet quality or weight status of consumers. Electronic databases Cochrane, EMBASE, CINAHL, Science Direct and PubMed were searched from inception. (i) populations that have access to vending machines; (ii) nutrition interventions; (iii) measured outcomes of behaviour change (e.g. sales data, dietary intake or weight change); and (iv) experimental trials where controls were not exposed to the intervention. Risk of bias was assessed independently by two researchers, and higher quality research formed the basis of this qualitative review. Twelve articles from 136 searched were included for synthesis. Intervention settings included schools, universities and workplaces. Reducing price or increasing the availability increased sales of healthier choices. The results of point-of-purchase nutrition information interventions were heterogeneous and when measured changes to purchases were small. This review offers evidence that pricing and availability strategies are effective at improving the nutritional quality foods and beverages purchased from vending machines. Evidence on how these interventions alter consumer's overall diet or body mass index is needed. © 2015 World Obesity.

Enhancing the quality of oral nutrition support for hospitalized patients: a mixed methods knowledge translation study (The EQONS study).

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Gerrish, Kate; Laker, Sara; Taylor, Carolyn; Kennedy, Fiona; McDonnell, Ann

2016-12-01

The aim of this study was to report a multifaceted knowledge translation intervention to facilitate use of the Malnutrition Universal Screening Tool and innovation in nutritional care for patients at risk of malnutrition. Malnutrition among hospitalized patients is a widespread problem leading to adverse health outcomes. Despite evidence of the benefits of malnutrition screening and recommendations for achieving good nutrition, shortfalls in practice continue. A mixed method integrated knowledge translation study. The knowledge translation intervention comprised nutrition champions supported by knowledge translation facilitators and an action planning process. Data collection was undertaken over 18 months between 2011-2012 in a hospital in England. Data comprised observation of mealtimes, audit of patient records, survey of nurses and semi-structured interviews with nutrition champions, knowledge translation facilitators, senior ward nurses and nurse managers. Statistically significant relationships (Chi Square) were observed between self-reported confidence of nurses (a) to assess patients using the Malnutrition Universal Screening Tool, (b) to teach colleagues how to use the Malnutrition Universal Screening Tool and (c) to ensure that patients were assessed within 24 hours of admission. Ward-based nutrition champions facilitated successful innovation in nutrition support. Contextual factors operating at micro (ward), meso (organization) and macro (healthcare system) levels acted as barriers and enablers for change. Nutrition champions were successful in increasing the timely assessment of patients at risk of malnutrition and promoting innovation in nutritional care. Support from knowledge translation facilitators helped nutrition champions develop their role and work collaboratively with senior ward nurses to implement action plans for improving nutrition. © 2016 John Wiley & Sons Ltd.

Nutrition for homeless populations: shelters and soup kitchens as opportunities for intervention.

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Koh, Katherine A; Bharel, Monica; Henderson, David C

2016-05-01

Nutrition is a daily challenge for the homeless population in America. Homeless individuals suffer from a high prevalence of diseases related to poor diet, yet there has been little public health effort to improve nutrition in this population. Shelters and soup kitchens may have an untapped potential to impact food access, choice and quality. We offer ideas for intervention and lessons learned from ten shelters and soup kitchens around Greater Boston, MA, USA. By advancing food quality, education and policies in shelters and soup kitchens, the homeless population can be given an opportunity to restore its nutrition and health.

Impact of nutrition environmental interventions on point-of-purchase behavior in adults: a review.

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Seymour, Jennifer D; Yaroch, Amy Lazarus; Serdula, Mary; Blanck, Heidi Michels; Khan, Laura Kettel

2004-09-01

Nutrition interventions targeted to individuals are unlikely to significantly shift US dietary patterns as a whole. Environmental and policy interventions are more promising for shifting these patterns. We review interventions that influenced the environment through food availability, access, pricing, or information at the point-of-purchase in worksites, universities, grocery stores, and restaurants. Thirty-eight nutrition environmental intervention studies in adult populations, published between 1970 and June 2003, were reviewed and evaluated on quality of intervention design, methods, and description (e.g., sample size, randomization). No policy interventions that met inclusion criteria were found. Many interventions were not thoroughly evaluated or lacked important evaluation information. Direct comparison of studies across settings was not possible, but available data suggest that worksite and university interventions have the most potential for success. Interventions in grocery stores appear to be the least effective. The dual concerns of health and taste of foods promoted were rarely considered. Sustainability of environmental change was never addressed. Interventions in "limited access" sites (i.e., where few other choices were available) had the greatest effect on food choices. Research is needed using consistent methods, better assessment tools, and longer durations; targeting diverse populations; and examining sustainability. Future interventions should influence access and availability, policies, and macroenvironments.

Economic evaluation of an extended nutritional intervention in older Australian hospitalized patients: a randomized controlled trial.

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Sharma, Yogesh; Thompson, Campbell; Miller, Michelle; Shahi, Rashmi; Hakendorf, Paul; Horwood, Chris; Kaambwa, Billingsley

2018-02-05

Prevalence of malnutrition in older hospitalized patients is 30%. Malnutrition is associated with poor clinical outcomes in terms of high morbidity and mortality and is costly for hospitals. Extended nutrition interventions improve clinical outcomes but limited studies have investigated whether these interventions are cost-effective. In this randomized controlled trial, 148 malnourished general medical patients ≥60 years were recruited and randomized to receive either an extended nutritional intervention or usual care. Nutrition intervention was individualized and started with 24 h of admission and was continued for 3 months post-discharge with a monthly telephone call whereas control patients received usual care. Nutrition status was confirmed by Patient generated subjective global assessment (PG-SGA) and health-related quality of life (HRQoL) was measured using EuroQoL 5D (EQ-5D-5 L) questionnaire at admission and at 3-months follow-up. A cost-effectiveness analysis was conducted for the primary outcome (incremental costs per unit improvement in PG-SGA) while a cost-utility analysis (CUA) was undertaken for the secondary outcome (incremental costs per quality adjusted life year (QALY) gained). Nutrition status and HRQoL improved in intervention patients. Mean per included patient Australian Medicare costs were lower in intervention group compared to control arm (by $907) but these differences were not statistically significant (95% CI: -$2956 to $4854). The main drivers of higher costs in the control group were higher inpatient ($13,882 versus $13,134) and drug ($838 versus $601) costs. After adjusting outcomes for baseline differences and repeated measures, the intervention was more effective than the control with patients in this arm reporting QALYs gained that were higher by 0.0050 QALYs gained per patient (95% CI: -0.0079 to 0.0199). The probability of the intervention being cost-effective at willingness to pay values as low as $1000 per unit

Physical activity and nutrition behavioural outcomes of a home-based intervention program for seniors: a randomized controlled trial

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Burke Linda

2013-01-01

Full Text Available Abstract Background This intervention aimed to ascertain whether a low-cost, accessible, physical activity and nutrition program could improve physical activity and nutrition behaviours of insufficiently active 60–70 year olds residing in Perth, Australia. Methods A 6-month home-based randomised controlled trial was conducted on 478 older adults (intervention, n = 248; control, n = 230 of low to medium socioeconomic status. Both intervention and control groups completed postal questionnaires at baseline and post-program, but only the intervention participants received project materials. A modified fat and fibre questionnaire measured nutritional behaviours, whereas physical activity was measured using the International Physical Activity Questionnaire. Generalised estimating equation models were used to assess the repeated outcomes over both time points. Results The final sample consisted of 176 intervention participants and 199 controls (response rate 78.5% with complete data. After controlling for demographic and other confounding factors, the intervention group demonstrated increased participation in strength exercise (p Conclusions A minimal contact, low-cost and home-based physical activity program can positively influence seniors’ physical activity and nutrition behaviours. Trial registration anzctr.org.au Identifier: ACTRN12609000735257

Food and nutrition programs for Aboriginal and Torres Strait Islander Australians: an overview of systematic reviews.

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Browne, Jennifer; Adams, Karen; Atkinson, Petah; Gleeson, Deborah; Hayes, Rick

2017-09-19

Objective To provide an overview of previous reviews of programs that aimed to improve nutritional status or diet-related health outcomes for Aboriginal and Torres Strait Islander peoples, in order to determine what programs are effective and why. Methods A systematic search of databases and relevant websites was undertaken to identify reviews of nutrition interventions for Aboriginal and Torres Strait Islander Australians. Pairs of reviewers undertook study selection and data extraction and performed quality assessment using a validated tool. Results Twelve papers reporting 11 reviews were identified. Two reviews were rated high quality, three were rated medium and six were rated low quality. The reviews demonstrated that a positive effect on nutrition and chronic disease indicators can be a result of: 1) incorporating nutrition and breastfeeding advice into maternal and child health care services; and 2) multifaceted community nutrition programs. The evidence suggests that the most important factor determining the success of Aboriginal and Torres Strait Islander food and nutrition programs is community involvement in (and, ideally, control of) program development and implementation. Conclusions Community-directed food and nutrition programs, especially those with multiple components that address the underlying causes of nutrition issues, can be effective in improving nutrition-related outcomes. What is known about the topic? More effective action is urgently required in order to reduce the unacceptable health inequalities between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Food insecurity and nutrition-related chronic conditions are responsible for a large proportion of the ill health experienced by Australia's First Peoples. What does this paper add? This narrative overview of 11 reviews published between 2005 and 2015 provides a synthesis of the current evidence for improving Aboriginal and Torres Strait Islander nutrition

Improving nutrition and physical activity in the workplace: a meta-analysis of intervention studies.

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Hutchinson, Amanda D; Wilson, Carlene

2012-06-01

A comprehensive search of the literature for studies examining physical activity or nutrition interventions in the workplace, published between 1999 and March 2009, was conducted. This search identified 29 relevant studies. Interventions were grouped according to the theoretical framework on which the interventions were based (e.g. education, cognitive-behavioural, motivation enhancement, social influence, exercise). Weighted Cohen's d effect sizes, percentage overlap statistics, confidence intervals and fail safe Ns were calculated. Most theoretical approaches were associated with small effects. However, large effects were found for some measures of interventions using motivation enhancement. Effect sizes were larger for studies focusing on one health behaviour and for randomized controlled trials. The workplace is a suitable environment for making modest changes in the physical activity, nutrition and health of employees. Further research is necessary to determine whether these changes can be maintained in the long term.

Nutritional interventions for adolescents using information and communication technologies (ICTs: A systematic review.

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Giselle Rhaisa do Amaral E Melo

Full Text Available A cost-effective and interactive way of promoting healthy nutrition behaviors among adolescents is using information and communication technologies (ICTs. We systematically reviewed studies to identify technologies and their main characteristics used for nutritional interventions for adolescents, as well as to evaluate their quality and effectiveness. Our full protocol is available on the PROSPERO website (#CRD42016035882. A search was conducted across five databases for articles describing nutritional interventions that used ICTs designed mainly for healthy adolescents. Randomized controlled trials, quasi-experimental and observational studies, and full and original papers, all of them published from 2005 to 2015, were included. Study quality was assessed by the Effective Public Health Practice Project Quality Assessment Tool. Our search yielded 559 titles and abstracts. Eleven studies met the inclusion criteria. Participants were recruited mostly from schools. Study follow-up ranged from two weeks to two years. Four interventions were based on the Social Cognitive Theory. Interventional strategies included computer games, programs, text messages, and interactive CD-ROMs. Nine studies used computer-mediated ICTs. Five studies focused on multiple behaviors simultaneously. Participants were exposed to interventions only once, daily, weekly, or according to a pre-determined number of lessons. Five studies had significant outcomes. Our quality assessment revealed three studies to be weak due to non-representativeness of their samples and usage of non-validated questionnaires. Besides the heterogeneity and poor quality of the analyzed studies, it can be suggested that long-term interventions for adolescents that make use of frequent exposure to technological resources, and that have a theoretical component aimed at a single health behavior change, tend to be more successful.

The nutrition-based comprehensive intervention study on childhood obesity in China (NISCOC: a randomised cluster controlled trial

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Xu Guifa

2010-05-01

Full Text Available Abstract Background Childhood obesity and its related metabolic and psychological abnormalities are becoming serious health problems in China. Effective, feasible and practical interventions should be developed in order to prevent the childhood obesity and its related early onset of clinical cardiovascular diseases. The objective of this paper is to describe the design of a multi-centred random controlled school-based clinical intervention for childhood obesity in China. The secondary objective is to compare the cost-effectiveness of the comprehensive intervention strategy with two other interventions, one only focuses on nutrition education, the other only focuses on physical activity. Methods/Design The study is designed as a multi-centred randomised controlled trial, which included 6 centres located in Beijing, Shanghai, Chongqing, Shandong province, Heilongjiang province and Guangdong province. Both nutrition education (special developed carton style nutrition education handbook and physical activity intervention (Happy 10 program will be applied in all intervention schools of 5 cities except Beijing. In Beijing, nutrition education intervention will be applied in 3 schools and physical activity intervention among another 3 schools. A total of 9750 primary students (grade 1 to grade 5, aged 7-13 years will participate in baseline and intervention measurements, including weight, height, waist circumference, body composition (bioelectrical impendence device, physical fitness, 3 days dietary record, physical activity questionnaire, blood pressure, plasma glucose and plasma lipid profiles. Data concerning investments will be collected in our study, including costs in staff training, intervention materials, teachers and school input and supervising related expenditure. Discussion Present study is the first and biggest multi-center comprehensive childhood obesity intervention study in China. Should the study produce comprehensive results, the

Empowering Esrd Patients For Assisted Self Nutritional Care: A Simple But Effective Intervention For Improving Nutritional Status Of Hemodialysis Patients

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Pratim Sengupta

2012-06-01

Full Text Available Protein energy wasting (PEW is a prevalent problem among hemodialysis patients. Lack of adherence to dietary principle based conventional diet charts often fail to satisfy the nutritional requirements of the patients. We studied the effect of simple nutritional training and empowerment of the patients to formulate their own dietary menu in nutritional parameters of hemodialysis patients in 68 stable non diabetic End stage renal disease (ESRD patients who are on maintenance hemodialysis. The factors which otherwise can affect the nutritional status like sepsis, malignancy,tuberculosis were excluded. At the beginning patient's baseline nutritional status was assessed by anthropometric measurements, Subjective Global Assessment and serum albumin level. Body composition was assessed by linear regression equation (Durin-Womersley and Siri equation. The patients were divided in two comparable groups (Group-A&B. In group A patients were prescribed individualized dietary prescription; based on their nutritional allowance as per KDOQI guideline. In Group-B the patients were initially made familiar with the dietary principals of the commonly consumed food. Then they were trained by renal nutritionist by study material, visual aid, and proportional food models and one to one discussion to formulate a dietary menu, by these they were empowered to formulate their own dietary menu. They were constantly assisted when faced any problem. In both the group the nutritional parameters were reassessed after three months of intervention. The results were analyzed statistically. There was statistically significant mean increment in the fat free mass index in GroupB[0.8%(Gr.-AVs1.0%(Gr.-B,(p<0.05], the mean increment in the serum albumin in the GroupB was also significantly higher than GroupA[(0.6gm/dl(Gr.A Vs 0.9 gm/dl(Gr.B, p<0.0].Compared to Group-A there was statistically favorable anthropometric changes in Group-B. In conclusion patient empowerment and self

An integrated microcredit, entrepreneurial training, and nutrition education intervention is associated with better growth among preschool-aged children in rural Ghana.

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Marquis, Grace S; Colecraft, Esi K; Sakyi-Dawson, Owuraku; Lartey, Anna; Ahunu, Ben K; Birks, Katherine A; Butler, Lorna M; Reddy, Manju B; Jensen, Helen H; Huff-Lonergan, Elizabeth

2015-02-01

Poor diet quality is a determinant of the high prevalence rates of malnutrition in Ghana. There is little evidence on the effectiveness of a multisector intervention to improve children's diets and nutritional status. The project tested whether participation in an entrepreneurial and nutrition education intervention with microcredit was associated with the nutritional status of children 2-5 y of age. A quasi-experimental 16-mo intervention was conducted with microcredit loans and weekly sessions of nutrition and entrepreneurship education for 179 women with children 2-5 y of age [intervention group (IG)]. Nonparticipating women and their children from the same villages (nonparticipant, n = 142) and from similar neighboring villages (comparison, n = 287) were enrolled. Repeated measures linear regression models were used first to examine children's weight-for-age (WAZ), height-for-age (HAZ), and body mass index-for-age (BAZ) z scores at baseline and at 4 follow-up time points ∼4 mo apart. Time, intervention status, time-by-intervention interaction terms, region of residence, household wealth rank, household head occupation, number of children microcredit and education may improve nutritional outcomes of children living in poor, rural communities. © 2015 American Society for Nutrition.

A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home.

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Sandora, Thomas J; Taveras, Elsie M; Shih, Mei-Chiung; Resnick, Elissa A; Lee, Grace M; Ross-Degnan, Dennis; Goldmann, Donald A

2005-09-01

Good hand hygiene may reduce the spread of infections in families with children who are in out-of-home child care. Alcohol-based hand sanitizers rapidly kill viruses that are commonly associated with respiratory and gastrointestinal (GI) infections. The objective of this study was to determine whether a multifactorial campaign centered on increasing alcohol-based hand sanitizer use and hand-hygiene education reduces illness transmission in the home. A cluster randomized, controlled trial was conducted of homes of 292 families with children who were enrolled in out-of-home child care in 26 child care centers. Eligible families had > or =1 child who was 6 months to 5 years of age and in child care for > or =10 hours/week. Intervention families received a supply of hand sanitizer and biweekly hand-hygiene educational materials for 5 months; control families received only materials promoting good nutrition. Primary caregivers were phoned biweekly and reported respiratory and GI illnesses in family members. Respiratory and GI-illness-transmission rates (measured as secondary illnesses per susceptible person-month) were compared between groups, adjusting for demographic variables, hand-hygiene practices, and previous experience using hand sanitizers. Baseline demographics were similar in the 2 groups. A total of 1802 respiratory illnesses occurred during the study; 443 (25%) were secondary illnesses. A total of 252 GI illnesses occurred during the study; 28 (11%) were secondary illnesses. The secondary GI-illness rate was significantly lower in intervention families compared with control families (incidence rate ratio [IRR]: 0.41; 95% confidence interval [CI]: 0.19-0.90). The overall rate of secondary respiratory illness was not significantly different between groups (IRR: 0.97; 95% CI: 0.72-1.30). However, families with higher sanitizer usage had a marginally lower secondary respiratory illness rate than those with less usage (IRR: 0.81; 95% CI: 0.65-1.09). A

Delivering an action agenda for nutrition interventions addressing adolescent girls and young women: priorities for implementation and research.

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Bhutta, Zulfiqar A; Lassi, Zohra S; Bergeron, Gilles; Koletzko, Berthold; Salam, Rehana; Diaz, Angela; McLean, Mireille; Black, Robert E; De-Regil, Luz Maria; Christian, Parul; Prentice, Andrew M; Klein, Jonathan D; Keenan, William; Hanson, Mark

2017-04-01

Adolescent nutritional behaviors are assuming considerable importance in nutrition interventions given their important relationships with medium- and long-term outcomes. This is the period when young people undergo major anatomical and physiological maturational changes in preparation for adulthood. Nutritional requirements during puberty are higher during adolescence than during the prepubertal stage and during adulthood. A significant proportion of adolescents also become parents, and hence the importance of their health and nutritional status before as well as during pregnancy has its impact on their own health, fetal well-being, and newborn health. In this paper, we describe the evidence-based nutrition recommendations and the current global guidance for nutrition actions for adolescents. Despite the limitations of available information, we believe that a range of interventions are feasible to address outcomes in this age group, although some would need to start earlier in childhood. We propose packages of preventive care and management comprising nutrition-specific and nutrition-sensitive interventions to address adolescent undernutrition, overnutrition, and micronutrient deficiencies. We discuss potential delivery platforms and strategies relevant to low- and middle-income countries. Beyond the evidence synthesis, there is a clear need to translate evidence into policy and for implementation of key recommendations and addressing knowledge gaps through prioritized research. © 2017 New York Academy of Sciences.

The Interplay between Maternal Nutrition and Stress during Pregnancy: Issues and Considerations.

Science.gov (United States)

Lindsay, Karen L; Buss, Claudia; Wadhwa, Pathik D; Entringer, Sonja

2017-01-01

Several studies about humans and animals have separately examined the effects of prenatal nutrition and stress on fetal development, pregnancy, and birth outcomes, and subsequent child health and disease risk. Although substantial evidence from non-pregnant literature supports the presence of bidirectional interactions between nutrition and stress at various psychological, behavioral, and physiological levels, such interaction effects have not yet been systematically examined in the context of pregnancy. This paper discusses the multifaceted and multilevel relationship between nutrition and stress. It then reviews the currently available observational and experimental evidence in animals and humans regarding the interplay between maternal psychosocial stress, dietary intake, and nutritional state during pregnancy, and implications for maternal and child health-related outcomes. Key Messages: During pregnancy, maternal psychosocial stress, dietary behavior, and nutritional state likely regulate and counter-regulate one another. Emerging evidence suggests that omega-3 fatty acids may attenuate maternal psychosocial stress, and that high maternal pre-pregnancy body mass index exacerbates unhealthy dietary behaviors under high-stress conditions. Longitudinal studies are warranted in order to understand the interplay between prenatal psychosocial stress, diet, and stress- and nutrition-related biomarkers to obtain further insight and inform the development and design of future, more effective intervention trials for improved maternal and child health outcomes. © 2017 S. Karger AG, Basel.

Systematic Literature Review of Randomized Control Trials Assessing the Effectiveness of Nutrition Interventions in Community-Dwelling Older Adults

Science.gov (United States)

Bandayrel, Kristofer; Wong, Sharon

2011-01-01

Objective: Nutrition interventions may play an important role in maintaining the health and quality of life in community-dwelling older adults. To the authors' knowledge, no systematic literature review has been conducted on the effectiveness of nutrition interventions in the community-dwelling older adult population. Design: Systematic literature…

A study of Community Based Nutritional Intervention and prevention of malnutrition

Directory of Open Access Journals (Sweden)

Neelam Anupama Toppo

2015-01-01

Full Text Available Background: PEM is one of the major health and nutritional problem in India. It is not only an important cause of childhood mortality and morbidity but also leads to permanent impairment of both physical and mental growth of those who survive. Malnutrition is implicated in >50% of deaths of <5 children (5 million/yr. Improving nutrition for children is crucial in meeting two of the Millennium Development Goals. According to national family health survey-3 there is considerable variation across states with Madhya Pradesh recording the highest rate for underweight children (60.3% and Kerala among the lowest (28.8%. The great majority of cases of PEM nearly 80% are intermediate that is mild and moderate cases which frequently go unrecognized. These are the fact that made us to pick this issue in order to benefit the children of locality to some extent. Objectives: To identify under 5 year children with malnutrition, To demonstrate the method of preparing high protein mix diet and to educate mothers about adequate recommended diet as per age of children, To find out whether high protein mix improves nutritional status of identified malnourished children. Methodology: It was cross sectional and interventional study carried out in two villages of Jabalpur districts during the period of three months among 100 under five children. We had screened them and calculated weight for age (% and categorized them according to Gomez Classification that is normal, mild, moderate and severe malnutrition. Intervention was done on malnourished children then 4 follow ups at the interval of 15 days. Intervention strategies: Nutrition education and provision of High Protein Mix Diet. Result: 12% children were identified as malnourished where 7% were having mild grade malnutrition and 5% with moderate grade of malnutrition. Among male there were 14.04% children were malnourished while among female 9.3% were malnourished. After intervention 50% children were showing

A study of Community Based Nutritional Intervention and prevention of malnutrition

Directory of Open Access Journals (Sweden)

Neelam Anupama Toppo

2015-12-01

Full Text Available Background: PEM is one of the major health and nutritional problem in India. It is not only an important cause of childhood mortality and morbidity but also leads to permanent impairment of both physical and mental growth of those who survive. Malnutrition is implicated in >50% of deaths of <5 children (5 million/yr. Improving nutrition for children is crucial in meeting two of the Millennium Development Goals. According to national family health survey-3 there is considerable variation across states with Madhya Pradesh recording the highest rate for underweight children (60.3% and Kerala among the lowest (28.8%. The great majority of cases of PEM nearly 80% are intermediate that is mild and moderate cases which frequently go unrecognized. These are the fact that made us to pick this issue in order to benefit the children of locality to some extent. Objectives: To identify under 5 year children with malnutrition, To demonstrate the method of preparing high protein mix diet and to educate mothers about adequate recommended diet as per age of children, To find out whether high protein mix improves nutritional status of identified malnourished children. Methodology: It was cross sectional and interventional study carried out in two villages of Jabalpur districts during the period of three months among 100 under five children. We had screened them and calculated weight for age (% and categorized them according to Gomez Classification that is normal, mild, moderate and severe malnutrition. Intervention was done on malnourished children then 4 follow ups at the interval of 15 days. Intervention strategies: Nutrition education and provision of High Protein Mix Diet. Result: 12% children were identified as malnourished where 7% were having mild grade malnutrition and 5% with moderate grade of malnutrition. Among male there were 14.04% children were malnourished while among female 9.3% were malnourished. After intervention 50% children were showing

Brief Education Intervention Increases Nutrition Knowledge and Confidence of Coaches of Junior Australian Football Teams.

Science.gov (United States)

Belski, Regina; Donaldson, Alex; Staley, Kiera; Skiadopoulos, Anne; Randle, Erica; O'Halloran, Paul; Kappelides, Pam; Teakel, Steve; Stanley, Sonya; Nicholson, Matthew

2018-05-03

This study evaluated the impact of a brief (20-min) nutrition education intervention embedded in an existing mandatory coach education course for coaches of junior (8-12 years old) Australian football teams. A total of 284 coaches (68% of 415 coaching course participants) completed a presession questionnaire, and 110 coaches (27% of coaching course participants) completed an identical postsession questionnaire. The responses to the pre- and postsession surveys were matched for 78 coaches. Coaches' ratings of their own understanding of the nutritional needs of young athletes (6.81, 8.95; p 95%) provided a correct response to six of the 15 nutrition and hydration knowledge questions included in the presession questionnaire. Even with this high level of presession knowledge, there was a significant improvement in the coaches' nutrition and hydration knowledge after the education session across five of the 15 items, compared with before the education session. The results of this study suggest that a simple, short nutrition education intervention, embedded in an existing coach education course, can positively influence the nutrition knowledge and self-efficacy of community-level, volunteer coaches of junior sports participants.

Improving the implementation of perioperative safety guidelines using a multifaceted intervention approach: protocol of the IMPROVE study, a stepped wedge cluster randomized trial.

Science.gov (United States)

Emond, Yvette E J J M; Calsbeek, Hiske; Teerenstra, Steven; Bloo, Gerrit J A; Westert, Gert P; Damen, Johan; Wolff, André P; Wollersheim, Hub C

2015-01-08

This study is initiated to evaluate the effects, costs, and feasibility at the hospital and patient level of an evidence-based strategy to improve the use of Dutch perioperative safety guidelines. Based on current knowledge, expert opinions and expertise of the project team, a multifaceted implementation strategy has been developed. This is a stepped wedge cluster randomized trial including nine representative hospitals across The Netherlands. Hospitals are stratified into three groups according to hospital type and geographical location and randomized in terms of the period for receipt of the intervention. All adult surgical patients meeting the inclusion criteria are assessed for patient outcomes. The implementation strategy includes education, audit and feedback, organizational interventions (e.g., local embedding of the guidelines), team-directed interventions (e.g., multi-professional team training), reminders, as well as patient-mediated interventions (e.g., patient safety cards). To tailor the implementation activities, we developed a questionnaire to identify barriers for effective guideline adherence, based on (a) a theoretical framework for classifying barriers and facilitators, (b) an instrument for measuring determinants of innovations, and (c) 19 semi-structured interviews with perioperative key professionals. Primary outcome is guideline adherence measured at the hospital (i.e., cluster) and patient levels by a set of perioperative Patient Safety Indicators (PSIs), which was developed parallel to the perioperative guidelines. Secondary outcomes at the patient level are in-hospital complications, postoperative wound infections and mortality, length of hospital stay, and unscheduled transfer to the intensive care unit, non-elective readmission to the hospital and unplanned reoperation, all within 30 days after the initial surgery. Also, patient safety culture and team climate will be studied as potential determinants. Finally, a process evaluation is

Integrating Nutrition and Child Development Interventions: Scientific Basis, Evidence of Impact, and Implementation Considerations123

Science.gov (United States)

Black, Maureen M; Pérez-Escamilla, Rafael; Fernandez Rao, Sylvia

2015-01-01

The Millennium Development Goals (MDGs) have contributed to unprecedented reductions in poverty and improvement in the lives of millions of men, women, and children in low- and middle-income countries. Yet, hundreds of millions of children under 5 y of age are not reaching their developmental potential. This article reviews the scientific basis for early childhood nutrition and child development interventions, the impact of integrated interventions on children’s linear growth and cognitive development, and implementation strategies for integrated nutrition and child development programs. Advances in brain science have documented that the origins of adult health and well-being are grounded in early childhood, from conception through age 24 mo (first 1000 d) and extending to age 5 y (second 1000 d). Young children with adequate nutrition, nurturant caregiving, and opportunities for early learning have the best chances of thriving. Evidence from adoption, experimental, and quasi-experimental studies has shown that stunting prevention is sensitive during the first 1000 d, and sensitivity to child development interventions extends through the second 1000 d. Cognitive development responds to interventions post–1000 d with effect sizes that are inversely associated with initial age and length of program exposure. Integrated interventions need governance structures that support integrated policies and programming, with attention to training, supervision, and monitoring. The MDGs have been replaced by the Sustainable Development Goals (SDGs), with targets for the next 15 y. Achievement of the SDGs depends on children receiving adequate nutrition, nurturant caregiving, and learning opportunities from conception through age 5. PMID:26875208

Evaluation of a Continuing Educational Intervention for Primary Health Care Professionals about Nutritional Care of Patients at Home.

Science.gov (United States)

Berggren, E; Orrevall, Y; Olin, A Ödlund; Strang, P; Szulkin, R; Törnkvist, L

2016-04-01

Evaluate the effectiveness of a continuing educational intervention on primary health care professionals' familiarity with information important to nutritional care in a palliative phase, their collaboration with other caregivers, and their level of knowledge about important aspects of nutritional care. Observational cohort study. 10 primary health care centers in Stockholm County, Sweden. 140 district nurses/registered nurses and general practitioners/physicians working with home care. 87 professionals participated in the intervention group (IG) and 53 in the control group (CG). The intervention consisted of a web-based program offering factual knowledge; a practical exercise linking existing and new knowledge, abilities, and skills; and a case seminar facilitating reflection. The intervention's effects were measured by a computer-based study-specific questionnaire before and after the intervention, which took approximately 1 month. The CG completed the questionnaire twice (1 month between response occasions). The intervention effects, odds ratios, were estimated by an ordinal logistic regression. In the intra-group analyses, statistically significant changes occurred in the IG's responses to 28 of 32 items and the CG's responses to 4 of 32 items. In the inter-group analyses, statistically significant effects occurred in 20 of 32 statements: all 14 statements that assessed familiarity with important concepts and all 4 statements about collaboration with other caregivers but only 2 of the 14 statements concerning level of knowledge. The intervention effect varied between 2.5 and 12.0. The intervention was effective in increasing familiarity with information important to nutritional care in a palliative phase and collaboration with other caregivers, both of which may create prerequisites for better nutritional care. However, the intervention needs to be revised to better increase the professionals' level of knowledge about important aspects of nutritional care.

Assessing the impact of the primary school-based nutrition intervention Petits cuistots--parents en réseaux.

Science.gov (United States)

Bisset, Sherri L; Potvin, Louise; Daniel, Mark; Paquette, Manon

2008-01-01

This study sought to provide an intermediate impact assessment of the nutrition intervention Petits cuistots--parents en réseaux (Little Cooks--Parental Networks) on: 1) knowledge, attitude, capacity and experience with regard to nutrition, diet and cookery, and 2) parental and/or family participation in school. A total of 388 students from grades 5 (participants) and 6 (non-participants). The evaluation of the nutrition intervention took place in each of the seven participating elementary schools, all of which are located in Montreal's most disadvantaged neighbourhoods. The program component "Little Cooks" is a nutrition workshop run by community dieticians. Each of the eight annual workshops features a food item and nutrition theme with a recipe for a collective food preparation and tasting experience. Classroom teachers participate to provide classroom management and program support. The "Parental Networks" component of the program invites parents to assist with the nutrition workshop, and offers additional parent and family activities which link to nutrition workshop themes (e.g., dinners or visits to local food producers). The program had some impact on knowledge of the nutrient content of food, food produce and cooking; attitude and experience with tasting of new or less common foods; and perceived cooking capacity. Families with students participating in the program participated more in school activities than did families of students not in the program. Our assessment indicates a potential program impact upon several intermediate impact measures, and in so doing highlights a promising nutrition capacity-promoting intervention.

Patients with eating disorders showed no signs of coeliac disease before and after nutritional intervention.

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Kaltsa, Maria; Garoufi, Anastasia; Tsitsika, Artemis; Tsirogianni, Alexandra; Papasteriades, Chryssa; Kossiva, Lydia

2015-07-01

This study assessed the presence of specific antibodies for coeliac disease in outpatients suffering from eating disorders before and after nutritional intervention. We also evaluated whether those patients should undergo regular screening for coeliac disease. The sample consisted of 154 patients with a mean age of 16.7 years - ranging from one to 19 years of age - suffering from eating disorders. Serology screening for coeliac disease and total immunoglobulin A (IgA) levels was evaluated in the 154 children before the nutritional intervention and in 104 patients after the intervention. The patients consumed an adequate amount of gluten in both phases. Postintervention evaluation revealed that 92 patients (88.5%) achieved a normal body weight, while the remaining 12 (11.5%) became obese. Postprandial abdominal discomfort and pain were resolved. The serology tests were negative in all patients, before and after intervention. None displayed IgA deficiency. To the best of our knowledge, this was the first prospective study where patients underwent a screening serology for coeliac disease before and after nutritional intervention. No indication of the coexistence of eating disorders and coeliac disease was documented, and the patients in our study were unlikely to require regular screening for coeliac disease. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

EVALUATING THE EFFECT OF AN EDUCATIONAL INTERVENTION ON PARENTS' NUTRITIONAL SOCIAL SUPPORT

OpenAIRE

Fatemeh Mokhtari1 , Soheila Ehsanpour2 and Ashraf Kazemi 3*

2017-01-01

Background: Social support is one of the important effective factors on health-related behaviors in different groups. The present study has evaluated the effect of an educational intervention on parents’ nutritional social support for having a healthy diet by teenagers. Methods: This field trial was conducted in two groups on the parents of 63 female early adolescent.The level of parents’ nutritional social support for having a healthy diet were measured using a questionnaire. One month after...

Early Parenteral Nutrition in Patients with Biliopancreatic Mass Lesions, a Prospective, Randomized Intervention Trial.

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Janine Krüger

Full Text Available Patients with biliopancreatic tumors frequently suffer from weight loss and cachexia. The in-hospital work-up to differentiate between benign and malignant biliopancreatic lesions requires repeated pre-interventional fasting periods that can aggravate this problem. We conducted a randomized intervention study to test whether routine in-hospital peripheral intravenous nutrition on fasting days (1000 ml/24 h, 700 kcal has a beneficial effect on body weight and body composition.168 patients were screened and 100 enrolled in the trial, all undergoing in-hospital work-up for biliopancreatic mass lesions and randomized to either intravenous nutrition or control. Primary endpoint was weight loss at time of hospital discharge; secondary endpoints were parameters determined by bioelectric impedance analysis and quality of life recorded by the EORTC questionnaire.Within three months prior to hospital admission patients had a median self-reported loss of 4.0 kg (25*th: -10.0 kg and 75*th* percentile: 0.0kg of body weight. On a multivariate analysis nutritional intervention increased body weight by 1.7 kg (95% CI: 0.204; 3.210, p = 0.027, particularly in patients with malignant lesions (2.7 kg (95% CI: 0.71; 4.76, p < 0.01.In a hospital setting, patients with suspected biliopancreatic mass lesions stabilized their body weight when receiving parenteral nutrition in fasting periods even when no total parenteral nutrition was required. Analysis showed that this effect was greatest in patients with malignant tumors. Further studies will be necessary to see whether patient outcome is affected as well.ClinicalTrials.gov NCT02670265.

Nutritional knowledge following interventional educational sessions in children on regular hemodialysis

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Doaa Mohammed Youssef

2015-01-01

Full Text Available To evaluate the impact of nutritional knowledge following interventional educational sessions in chronic dialysis patients, we studied 40 children on chronic regular hemodialysis (HD at the beginning and after six months of nutrition educational sessions using a predesigned questionnaire. We also measured the anthropometric parameters of nutrition to evaluate the impact of this education on the health of patients. We found a highly statistically significant increase in patients′ scores and in adequate knowledge using the questionnaire after the educational sessions. Our results showed a statistically significant decrease in body mass index and weight after educational sessions for six months. Moreover, there were no significant decreases in serum phosphorus, ferritin, iron and creatinine, in contrast with no significant increase in hemoglobin, serum calcium, blood urea nitrogen and serum albumin. We conclude that nutritional education is significantly effective with regard to the level of knowledge, but not with regard to the attitude and practice in children on chronic HD.

Nutritional knowledge following interventional educational sessions in children on regular hemodialysis.

Science.gov (United States)

Youssef, Doaa Mohammed; Abo Al Fotoh, Mohammad Nagib; Elibehidy, Rabab Mohamed; Ramadan, Shreen Magdy Ahmad; Mohammad, Ehab Mohammady

2015-03-01

To evaluate the impact of nutritional knowledge following interventional educational sessions in chronic dialysis patients, we studied 40 children on chronic regular hemodialysis (HD) at the beginning and after six months of nutrition educational sessions using a predesigned questionnaire. We also measured the anthropometric parameters of nutrition to evaluate the impact of this education on the health of patients. We found a highly statistically significant increase in patients' scores and in adequate knowledge using the questionnaire after the educational sessions. Our results showed a statistically significant decrease in body mass index and weight after educational sessions for six months. Moreover, there were no significant decreases in serum phosphorus, ferritin, iron and creatinine, in contrast with no significant increase in hemoglobin, serum calcium, blood urea nitrogen and serum albumin. We conclude that nutritional education is significantly effective with regard to the level of knowledge, but not with regard to the attitude and practice in children on chronic HD.

Determining appropriate nutritional interventions for South African ...

African Journals Online (AJOL)

Significant positive correlations were found between serum retinol and all biochemical indicators of iron status except serum ferritin. This study highlights the fact that nutrient deficiencies are interrelated, particularly protein energy malnutrition and poor vitamin A and iron status. A broad multifaceted comprehensive health ...

Capturing health and eating status through a nutritional perception screening questionnaire (NPSQ9) in a randomised internet-based personalised nutrition intervention: the Food4Me study.

Science.gov (United States)

San-Cristobal, Rodrigo; Navas-Carretero, Santiago; Celis-Morales, Carlos; Livingstone, Katherine M; Stewart-Knox, Barbara; Rankin, Audrey; Macready, Anna L; Fallaize, Rosalind; O'Donovan, Clare B; Forster, Hannah; Woolhead, Clara; Walsh, Marianne C; Lambrinou, Christina P; Moschonis, George; Manios, Yannis; Jarosz, Miroslaw; Daniel, Hannelore; Gibney, Eileen R; Brennan, Lorraine; Gundersen, Thomas E; Drevon, Christian A; Gibney, Mike; Marsaux, Cyril F M; Saris, Wim H M; Lovegrove, Julie A; Frewer, Lynn J; Mathers, John C; Martinez, J Alfredo

2017-12-11

National guidelines emphasize healthy eating to promote wellbeing and prevention of non-communicable diseases. The perceived healthiness of food is determined by many factors affecting food intake. A positive perception of healthy eating has been shown to be associated with greater diet quality. Internet-based methodologies allow contact with large populations. Our present study aims to design and evaluate a short nutritional perception questionnaire, to be used as a screening tool for assessing nutritional status, and to predict an optimal level of personalisation in nutritional advice delivered via the Internet. Data from all participants who were screened and then enrolled into the Food4Me proof-of-principle study (n = 2369) were used to determine the optimal items for inclusion in a novel screening tool, the Nutritional Perception Screening Questionnaire-9 (NPSQ9). Exploratory and confirmatory factor analyses were performed on anthropometric and biochemical data and on dietary indices acquired from participants who had completed the Food4Me dietary intervention (n = 1153). Baseline and intervention data were analysed using linear regression and linear mixed regression, respectively. A final model with 9 NPSQ items was validated against the dietary intervention data. NPSQ9 scores were inversely associated with BMI (β = -0.181, p nutritional status and to tailor nutritional advice. NCT01530139 .

Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial).

Science.gov (United States)

Cockayne, Sarah; Adamson, Joy; Clarke, Arabella; Corbacho, Belen; Fairhurst, Caroline; Green, Lorraine; Hewitt, Catherine E; Hicks, Kate; Kenan, Anne-Maree; Lamb, Sarah E; McIntosh, Caroline; Menz, Hylton B; Redmond, Anthony C; Richardson, Zoe; Rodgers, Sara; Vernon, Wesley; Watson, Judith; Torgerson, David J

2017-01-01

Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention. Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness. In the primary analysis were 484 (98.2%) intervention and 507 (98.1%) control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16). The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05) as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01). There was an increase (p = 0.02) in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314) and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained. There was a small reduction in falls. The intervention may be cost-effective. ISRCTN ISRCTN68240461.

Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial.

Directory of Open Access Journals (Sweden)

Sarah Cockayne

Full Text Available Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention.Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness.In the primary analysis were 484 (98.2% intervention and 507 (98.1% control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16. The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05 as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01. There was an increase (p = 0.02 in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY difference 0.0129, 95% CI -0.0050 to 0.0314 and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained.There was a small reduction in falls. The intervention may be cost-effective.ISRCTN ISRCTN68240461.

Twin pregnancy: the impact of the Higgins Nutrition Intervention Program on maternal and neonatal outcomes.

LENUS (Irish Health Repository)

Dubois, S

1991-06-01

Perinatal outcomes were compared between 354 twins treated with the Higgins Nutrition Intervention Program and 686 untreated twins. After differing distributions of key confounding variables were adjusted for, the twins in the intervention group weighed an average of 80 g more (P less than 0.06) than the nonintervention twins; their low-birth-weight rate was 25% lower (P less than 0.05) and their very-low-birth-weight rate was almost 50% lower (P less than 0.05). Although the rate of preterm delivery was 30% lower in the intervention group (P less than 0.05), the rates of intrauterine growth retardation were similar in the two groups. Fetal mortality was slightly higher (14 vs 12 per 1000, NS), but early neonatal mortality was fivefold lower (3 vs 19 per 1000, P less than 0.06) in the intervention group. Maternal morbidity was significantly lower (P less than 0.05) in the intervention group. There was a trend towards lower infant morbidity in the intervention group. These results suggest that nutritional intervention can significantly improve twin-pregnancy outcome.

Evaluating the effectiveness of a tailored multifaceted performance feedback intervention to improve the quality of care: protocol for a cluster randomized trial in intensive care

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Westert Gert P

2011-10-01

Full Text Available Abstract Background Feedback is potentially effective in improving the quality of care. However, merely sending reports is no guarantee that performance data are used as input for systematic quality improvement (QI. Therefore, we developed a multifaceted intervention tailored to prospectively analyzed barriers to using indicators: the Information Feedback on Quality Indicators (InFoQI program. This program aims to promote the use of performance indicator data as input for local systematic QI. We will conduct a study to assess the impact of the InFoQI program on patient outcome and organizational process measures of care, and to gain insight into barriers and success factors that affected the program's impact. The study will be executed in the context of intensive care. This paper presents the study's protocol. Methods/design We will conduct a cluster randomized controlled trial with intensive care units (ICUs in the Netherlands. We will include ICUs that submit indicator data to the Dutch National Intensive Care Evaluation (NICE quality registry and that agree to allocate at least one intensivist and one ICU nurse for implementation of the intervention. Eligible ICUs (clusters will be randomized to receive basic NICE registry feedback (control arm or to participate in the InFoQI program (intervention arm. The InFoQI program consists of comprehensive feedback, establishing a local, multidisciplinary QI team, and educational outreach visits. The primary outcome measures will be length of ICU stay and the proportion of shifts with a bed occupancy rate above 80%. We will also conduct a process evaluation involving ICUs in the intervention arm to investigate their actual exposure to and experiences with the InFoQI program. Discussion The results of this study will inform those involved in providing ICU care on the feasibility of a tailored multifaceted performance feedback intervention and its ability to accelerate systematic and local quality

Knowledge about nutrition, eating habits and weight reduction intervention among methadone maintenance treatment patients.

Science.gov (United States)

Sason, Anat; Adelson, Miriam; Herzman-Harari, Sarit; Peles, Einat

2018-03-01

Methadone maintenance treatment (MMT) patients are often under-nourished and overweight. The impact of a nutrition intervention program to improve knowledge about healthy food habits and losing weight was studied. Patients were screened for knowledge about nutrition and body mass index (BMI). Those with a low knowledge score or a BMI ≥26 (n=89) were randomly divided into either intervention (two lectures on healthy nutrition followed by weight monitoring over 6weeks), or controls (weighed at baseline, post-lectures and at study closure). The Yale Food Addiction Scale (YFAS), eating behavior rating, and nutrition knowledge questionnaires were used. Knowledge and food habit scores improved in the intervention group (28.4±4.3, 37.2±3.1, 32.5±3.9 pre-, post- and 6-weeks post-lectures, respectively), with no change in the controls (28.6±3.4, 28.2±4.9, 28.1±5.3, repeated measured p(time)=0.001, p(group)=0.001, p(interaction)=0.001); food habit (intervention: 35.0±7.0, 38.4±5.2, 37.5±5.3, controls: 34.0±6.9, 34.7±6.9, 34.6±7.4, p(time)=0.001, p(group)=0.04, p(interaction)=0.06). BMI scores however did not change and were similar in both groups (p=0.9). Of all patients, 10.1% met the criteria of food addiction according to the YFAS, 40.4% lost weight and 28% gained weight, with no group differences. There were more symptoms of food addiction among the patients who gained weight vs. those who lost weight (3.7±2.0 vs. 2.6±1.8, respectively, p=0.04). We concluded that although weight loss was not observed, intervention is recommended for improving knowledge about nutrition and for fostering healthy eating habits with the aim of reducing diet-related morbidity among all MMT patients. Longitudinal program combined with physical activity is needed to study if may lead to weight loss. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo) radiotherapy: a systematic review

NARCIS (Netherlands)

Langius, J.A.E.; Zandbergen, M.C.; Eerenstein, S.E.J.; van Tulder, M.W.; Leemans, C.R.; Kramer, M.H.H.; Weijs, P.J.M.

2013-01-01

Background and aims: We performed a systematic review to examine the effect of nutritional interventions on nutritional status, quality of life (QoL) and mortality in patients with head and neck squamous cell cancer (HNSCC) receiving radiotherapy or chemoradiotherapy. Methods: We searched Pubmed,

Protein calorie malnutrition, nutritional intervention and personalized cancer care.

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Gangadharan, Anju; Choi, Sung Eun; Hassan, Ahmed; Ayoub, Nehad M; Durante, Gina; Balwani, Sakshi; Kim, Young Hee; Pecora, Andrew; Goy, Andre; Suh, K Stephen

2017-04-04

Cancer patients often experience weight loss caused by protein calorie malnutrition (PCM) during the course of the disease or treatment. PCM is expressed as severe if the patient has two or more of the following characteristics: obvious significant muscle wasting, loss of subcutaneous fat; nutritional intake of 2% in 1 week, 5% in 1 month, or 7.5% in 3 months. Cancer anorexia-cachexia syndrome (CACS) is a multifactorial condition of advanced PCM associated with underlying illness (in this case cancer) and is characterized by loss of muscle with or without loss of fat mass. Cachexia is defined as weight loss of more than 5% of body weight in 12 months or less in the presence of chronic disease. Hence with a chronic illness on board even a small amount of weight loss can open the door to cachexia. These nutritional challenges can lead to severe morbidity and mortality in cancer patients. In the clinic, the application of personalized medicine and the ability to withstand the toxic effects of anti-cancer therapies can be optimized when the patient is in nutritional homeostasis and is free of anorexia and cachexia. Routine assessment of nutritional status and appropriate intervention are essential components of the effort to alleviate effects of malnutrition on quality of life and survival of patients.

Long-term consequences of nutrition and growth in early childhood and possible preventive interventions.

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Adair, Linda S

2014-01-01

Maternal nutritional deficiencies and excesses during pregnancy, and faster infant weight gain in the first 2 years of life are associated with increased risk of noncommunicable diseases (NCDs) in adulthood. The first 1,000 days of life (from conception until the child reaches age 2 years) represent a vulnerable period for programming of NCD risk, and are an important target for prevention of adult disease. This paper takes a developmental perspective to identify periconception, pregnancy, and infancy nutritional stressors, and to discuss mechanisms through which they influence later disease risk with the goal of informing age-specific interventions. Low- and middle-income countries need to address the dual burden of under- and overnutrition by implementing interventions to promote growth and enhance survival and intellectual development without increasing chronic disease risk. In the absence of good evidence from long-term follow-up of early life interventions, current recommendations for early life prevention of adult disease presume that interventions designed to optimize pregnancy outcomes and promote healthy infant growth and development will also reduce chronic disease risk. These include an emphasis on optimizing maternal nutrition prior to pregnancy, micronutrient adequacy in the preconception period and during pregnancy, promotion of breastfeeding and high-quality complementary foods, and prevention of obesity in childhood and adolescence. © 2014 Nestec Ltd., Vevey/S. Karger AG, Basel.

Undernutrition, poor feeding practices, and low coverage of key nutrition interventions.

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Lutter, Chessa K; Daelmans, Bernadette M E G; de Onis, Mercedes; Kothari, Monica T; Ruel, Marie T; Arimond, Mary; Deitchler, Megan; Dewey, Kathryn G; Blössner, Monika; Borghi, Elaine

2011-12-01

To estimate the global burden of malnutrition and highlight data on child feeding practices and coverage of key nutrition interventions. Linear mixed-effects modeling was used to estimate prevalence rates and numbers of underweight and stunted children according to United Nations region from 1990 to 2010 by using surveys from 147 countries. Indicators of infant and young child feeding practices and intervention coverage were calculated from Demographic and Health Survey data from 46 developing countries between 2002 and 2008. In 2010, globally, an estimated 27% (171 million) of children younger than 5 years were stunted and 16% (104 million) were underweight. Africa and Asia have more severe burdens of undernutrition, but the problem persists in some Latin American countries. Few children in the developing world benefit from optimal breastfeeding and complementary feeding practices. Fewer than half of infants were put to the breast within 1 hour of birth, and 36% of infants younger than 6 months were exclusively breastfed. Fewer than one-third of 6- to 23-month-old children met the minimum criteria for dietary diversity, and only ∼50% received the minimum number of meals. Although effective health-sector-based interventions for tackling childhood undernutrition are known, intervention-coverage data are available for only a small proportion of them and reveal mostly low coverage. Undernutrition continues to be high and progress toward reaching Millennium Development Goal 1 has been slow. Previously unrecognized extremely poor breastfeeding and complementary feeding practices and lack of comprehensive data on intervention coverage require urgent action to improve child nutrition.

A nutritional intervention to reduce the calorie content of meals served at psychiatric rehabilitation programs.

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Casagrande, Sarah Stark; Dalcin, Arlene; McCarron, Phyllis; Appel, Lawrence J; Gayles, Debra; Hayes, Jennifer; Daumit, Gail

2011-12-01

To assess the effectiveness of an intervention to reduce the calorie content of meals served at two psychiatric rehabilitation programs. Intervention staff assisted kitchen staff with ways to reduce calories and improve the nutritional quality of meals. Breakfast and lunch menus were collected before and after a 6-month intervention period. ESHA software was used to determine total energy and nutrient profiles of meals. Total energy of served meals significantly decreased by 28% at breakfast and 29% at lunch for site 1 (P breakfast for site 2 (P = 0.018). Total sugars significantly decreased at breakfast for both sites (P ≤ 0.001). In general, sodium levels were high before and after the intervention period. The nutrition intervention was effective in decreasing the total energy and altering the composition of macro-nutrients of meals. These results highlight an unappreciated opportunity to improve diet quality in patients attending psychiatric rehabilitation programs.

Does nutritional intervention maintain its prognostic benefit in the long term for malnourished patients hospitalised for heart failure?

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Bonilla-Palomas, J L; Gámez-López, A L; Castillo-Domínguez, J C; Moreno-Conde, M; López-Ibáñez, M C; Anguita-Sánchez, M

2018-03-01

To assess the long-term effect of nutritional intervention on malnourished, hospitalised patients with heart failure (HF). A total of 120 malnourished patients hospitalized for HF were randomised to undergo (or not) an individual nutritional intervention for 6 months. The primary event was the combination of all-cause death and readmission for HF. We performed an intent-to-treat analysis and assessed the effect of the intervention at 24 months. The combined event occurred in 47.5% of the intervention group and in 73.8% of the control group (hazard ratio: 0.45; 95% confidence interval: 0.28-0.72; P=.001). Thirty-nine percent of the intervention group and 59% of the control group died (hazard ratio: 0.53; 95% confidence interval: 0.31-0.89; P=.017). A nutritional intervention for malnourished patients hospitalised for HF maintains its prognostic benefit in the long-term follow-up. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

[ENTERAL NUTRITION ON THE NUTRITIONAL STATUS OF CANCER].

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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.

Limitations of studies on school-based nutrition education interventions for obesity in China: a systematic review and meta-analysis.

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Kong, Kaimeng; Liu, Jie; Tao, Yexuan

2016-01-01

School-based nutrition education has been widely implemented in recent years to fight the increasing prevalence of childhood obesity in China. A comprehensive literature search was performed using six databases to identify studies of school-based nutrition education interventions in China. The methodological quality and the risk of bias of selected literature were evaluated. Stratified analysis was performed to identify whether different methodologies influenced the estimated effect of the intervention. Seventeen articles were included in the analysis. Several of the included studies had inadequate intervention duration, inappropriate randomization methods, selection bias, unbalanced baseline characteristics between control and intervention groups, and absent sample size calculation. Overall, the studies showed no significant impact of nutrition education on obesity (OR=0.76; 95% CI=0.55-1.05; p=0.09). This can be compared with an OR of 0.68 for interventions aimed at preventing malnutrition and an OR of 0.49 for interventions aimed at preventing iron-deficiency anemia. When studies with unbalanced baseline characteristics between groups and selection bias in the study subjects were excluded, the impact of nutrition education on obesity was significant (OR=0.73; 95% CI=0.55-0.98; p=0.003). An analysis stratified according to the duration of intervention revealed that the intervention was effective only when it lasted for more than 2 years (OR=0.49, 95% CI=0.42-0.58; pnutrition education programs in China have some important limitations that might affect the estimated effectiveness of the intervention.

Office-based physical activity and nutrition intervention: barriers, enablers, and preferred strategies for workplace obesity prevention, Perth, Western Australia, 2012.

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Blackford, Krysten; Jancey, Jonine; Howat, Peter; Ledger, Melissa; Lee, Andy H

2013-09-12

Workplace health promotion programs to prevent overweight and obesity in office-based employees should be evidence-based and comprehensive and should consider behavioral, social, organizational, and environmental factors. The objective of this study was to identify barriers to and enablers of physical activity and nutrition as well as intervention strategies for health promotion in office-based workplaces in the Perth, Western Australia, metropolitan area in 2012. We conducted an online survey of 111 employees from 55 organizations. The online survey investigated demographics, individual and workplace characteristics, barriers and enablers, intervention-strategy preferences, and physical activity and nutrition behaviors. We used χ(2) and Mann-Whitney U statistics to test for differences between age and sex groups for barriers and enablers, intervention-strategy preferences, and physical activity and nutrition behaviors. Stepwise multiple regression analysis determined factors that affect physical activity and nutrition behaviors. We identified several factors that affected physical activity and nutrition behaviors, including the most common barriers ("too tired" and "access to unhealthy food") and enablers ("enjoy physical activity" and "nutrition knowledge"). Intervention-strategy preferences demonstrated employee support for health promotion in the workplace. The findings provide useful insights into employees' preferences for interventions; they can be used to develop comprehensive programs for evidence-based workplace health promotion that consider environmental and policy influences as well as the individual.

Realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

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Mogre, Victor; Scherpbier, Albert J J A; Stevens, Fred; Aryee, Paul; Cherry, Mary Gemma; Dornan, Tim

2016-01-01

Objective To determine what, how, for whom, why, and in what circumstances educational interventions improve the delivery of nutrition care by doctors and other healthcare professionals work. Design Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched MEDLINE, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations. Results Over half of the 46 studies from which we extracted data originated from the USA. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included feeling competent, feeling confident and comfortable, having greater self-efficacy, being less inhibited by barriers in healthcare systems and feeling that nutrition care was accepted and recognised. Conclusions These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve

Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review.

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Campagnolo, N; Johnston, S; Collatz, A; Staines, D; Marshall-Gradisnik, S

2017-06-01

Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is characterised by unexplained fatigue for at least 6 months accompanied by a diverse but consistent set of symptoms. Diet modification and nutritional supplements could be used to improve patient outcomes, such fatigue and quality of life. We reviewed and discussed the evidence for nutritional interventions that may assist in alleviating symptoms of CFS/ME. Medline, Cinahl and Scopus were systematically searched from 1994 to May 2016. All studies on nutrition intervention were included where CFS/ME patients modified their diet or supplemented their habitual diet on patient-centred outcomes (fatigue, quality of life, physical activity and/or psychological wellbeing). Seventeen studies were included that meet the inclusion criteria. Of these, 14 different interventions were investigated on study outcomes. Many studies did not show therapeutic benefit on CFS/ME. Improvements in fatigue were observed for nicotinamide adenine dinucleotide hydride (NADH), probiotics, high cocoa polyphenol rich chocolate, and a combination of NADH and coenzyme Q10. This review identified insufficient evidence for the use of nutritional supplements and elimination or modified diets to relieve CFS/ME symptoms. Studies were limited by the number of studies investigating the interventions, small sample sizes, study duration, variety of instruments used, and studies not reporting dietary intake method. Further research is warranted in homogeneous CFS/ME populations. © 2017 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.

A randomized nutrition counseling intervention in pediatric leukemia patients receiving steroids results in reduced caloric intake.

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Li, Rhea; Donnella, Hayley; Knouse, Phillip; Raber, Margaret; Crawford, Karla; Swartz, Maria C; Wu, Jimin; Liu, Diane; Chandra, Joya

2017-02-01

Quality of life in survivors of pediatric acute lymphocytic leukemia (ALL) can be compromised by chronic diseases including increased risk of second cancers, cardiovascular disease, and diabetes. Overweight or obesity further increases these risks. Steroids are a component of chemotherapy for ALL, and weight gain is a common side effect. To impact behaviors associated with weight gain, we conducted a randomized nutrition counseling intervention in ALL patients on treatment. ALL patients on a steroid-based treatment regimen at the MD Anderson Children's Cancer Hospital were recruited and randomized into control or intervention groups. The control group received standard care and nutrition education materials. The intervention group received monthly one-on-one nutrition counseling sessions, consisting of a baseline and 12 follow-up visits. Anthropometrics, dietary intake (3-day 24-hr dietary recalls) and oxidative stress measures were collected at baseline, 6 months, and postintervention. Dietary recall data were analyzed using the Nutrition Data System for Research. Twenty-two patients (median age 11.5 years), all in the maintenance phase of treatment, were recruited. The intervention group (n = 12) reported significantly lower calorie intake from baseline to 12-month follow-up and significant changes in glutamic acid and selenium intake (P < 0.05). Waist circumference was significantly associated with calorie, vitamin E, glutamic acid, and selenium intake. A year-long dietary intervention was effective at reducing caloric intake in pediatric ALL patients receiving steroid-based chemotherapy, indicating that this is a modality that can be built upon for obesity prevention and management. © 2016 Wiley Periodicals, Inc.

Nutrition education intervention for dependent patients: protocol of a randomized controlled trial

OpenAIRE

Arija Victoria; Martín Núria; Canela Teresa; Anguera Carme; Castelao Ana I; García-Barco Montserrat; García-Campo Antoni; González-Bravo Ana I; Lucena Carme; Martínez Teresa; Fernández-Barrés Silvia; Pedret Roser; Badia Waleska; Basora Josep

2012-01-01

Abstract Background Malnutrition in dependent patients has a high prevalence and can influence the prognosis associated with diverse pathologic processes, decrease quality of life, and increase morbidity-mortality and hospital admissions. The aim of the study is to assess the effect of an educational intervention for caregivers on the nutritional status of dependent patients at risk of malnutrition. Methods/Design Intervention study with control group, randomly allocated, of 200 patients of t...

Rural nutrition interventions with indigenous plant foods - a case study of vitamin A deficiency in Malawi

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Babu S.C.

2000-01-01

Full Text Available Identification, propagation, and introduction of a nutritionally rich, indigenous plant species in the existing cropping system are presented in this paper as a method of rural nutrition intervention. A case study of Moringa (Moringa oleifera Lam., Moringaceae, which is a common tree in Malawi and one of the richest sources of vitamin A and vitamin C compared to the commonly consumed vegetables is presented to address the problem of vitamin A deficiency. After a brief review of the prevalence of vitamin A deficiency and the efforts to reduce its incidence in Malawi, Moringa is suggested as a potential solution to the problem. A framework for designing nutrition intervention with Moringa is described for actual implementation. It is argued that attempts to identify, document, and encourage the utilization of nutrient-rich indigenous plants could be cost-effective, and a sustainable method of improving the nutritional status of local populations.

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review

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Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo

2017-01-01

Background The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. Aim The goal of this scoping review is to delineate and “map” the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. Methods A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O’Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. Results The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. Discussion The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

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Hurlimann, Thierry; Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo; Godard, Béatrice

2017-01-01

The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

Directory of Open Access Journals (Sweden)

Thierry Hurlimann

Full Text Available The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc. contexts.The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise.A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications.The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented.The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these

The molecular basis of nutritional intervention in multiple sclerosis: a narrative review.

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Riccio, P

2011-08-01

It is commonly accepted that nutrition is one of the possible environmental factors involved in the pathogenesis of multiple sclerosis (MS), but its role as complementary MS treatment is unclear and largely disregarded. At present, MS therapy is not associated to a particular diet, probably due to lack of information on the effects of nutrition on the disease. To overcome the distrust of the usefulness of dietary control in MS and to encourage nutritional interventions in the course of the disease, it is necessary to assess the nature and the role of bioactive dietary molecules and their targets, and establish how a dietary control can influence cell metabolism and improve the wellness of MS patients. The aim of this review is to provide a rationale for a nutritional intervention in MS by evaluating at the molecular level the effects of dietary molecules on the inflammatory and autoimmune processes involved in the disease. Present data reveal that healthy dietary molecules have a pleiotropic role and are able to change cell metabolism from anabolism to catabolism and down-regulate inflammation by interacting with enzymes, nuclear receptors and transcriptional factors. The control of gut dysbiosis and the combination of hypo-caloric, low-fat diets with specific vitamins, oligoelements and dietary integrators, including fish oil and polyphenols, may slow-down the progression of the disease and ameliorate the wellness of MS patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

Nutritional Intervention in Young Women with Eating Disorders: A Brief Report

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McAleavey, Kristen

2010-01-01

Eating disorders in young women are often associated with a number of comorbid conditions, including mood disorders and cognitive problems. Although group therapy is often used as part of overall treatment for eating disorders in many types of settings, specific nutritional interventions used in such settings have rarely been evaluated. In this…

Case Study: Using Contemporary Behaviour Change Science to Design and Implement an Effective Nutritional Intervention within Professional Rugby League.

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Costello, Nessan; McKenna, Jim; Sutton, Louise; Deighton, Kevin; Jones, Ben

2018-01-18

Designing and implementing successful dietary intervention is integral to the role of sport nutrition professionals as they attempt to positively change the dietary behaviour of athletes. High-performance sport is a time-pressured environment where immediate results can often supersede pursuit of the most effective evidence-based practice. However, efficacious dietary intervention necessitates comprehensive, systematic and theoretical behavioural design and implementation if the habitual dietary behaviours of athletes are to be positively changed. Therefore, this case study demonstrates how the Behaviour Change Wheel was used to design and implement an effective nutritional intervention within professional rugby league. The eight-step intervention targeted athlete consumption of a high quality dietary intake of 25.1 MJ each day, to achieve an overall body mass increase of 5 kg across a twelve-week intervention period. The Capability, Opportunity, Motivation-Behaviour model and APEASE criteria were used to identify population-specific intervention functions, policy categories, behaviour change techniques and modes of intervention delivery. The resulting intervention was successful, increasing the average daily energy intake of the athlete to 24.5 MJ, which corresponded in a 6.2 kg body mass gain. Despite consuming 0.6 MJ less per day than targeted, secondary outcome measures of diet quality, strength, body composition and immune function all substantially improved, supporting a sufficient energy intake and the overall efficacy of a behavioural approach. Ultimately, the Behaviour Change Wheel provides sport nutrition professionals with an effective and practical step-wise method via which to design and implement effective nutritional interventions for use within high-performance sport.

Effects of a multifaceted implementation intervention to increase utilization of pharmacological treatments for alcohol use disorders in the US Veterans Health Administration.

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Harris, Alex H S; Brown, Randall; Dawes, Michael; Dieperink, Eric; Myrick, Donald Hugh; Gerould, Heather; Wagner, Todd H; Wisdom, Jennifer P; Hagedorn, Hildi J

2017-11-01

Over 16 million Americans meet diagnostic criteria for alcohol use disorder (AUD), but only 7.8% of them receive formal treatment each year. Safe and effective pharmacological treatments for AUD exist; however, they are rarely prescribed. Therefore, we developed and pilot tested a multifaceted implementation intervention to improve consideration and receipt of effective pharmacologic treatments for AUD, focusing on primary care settings where patients have the most frequent contact with healthcare systems. The intervention included training of local providers to serve as champions and a website for primary care providers that included educational materials, a case-finding dashboard, and contact information for local and national clinical experts. We also mailed patients educational material about treatment options. The intervention was implemented at three large facilities of the Veterans Health Administration (VHA). An interrupted time series design, analyzed with segmented logistic regression, was used to evaluate the intervention's effects. The odds of a patient with AUD receiving one of the AUD medications was increasing throughout the pre-implementation period, and the rate of change (slope) increased significantly in the implementation period. Translating these numbers into percentages, at baseline 2.9% of patients filled a prescription for an AUD medication within 30days of a primary care visit. This increased to 3.8% by the end of the pre-implementation period (increasing 0.037% per month), and increased to 5.2% by the end of the implementation period (increasing 0.142% per month). However, the intervention effect was not significant when control sites were added, suggesting that improvement may have been driven by secular trends rather than solely by this intervention. Although the intervention was feasible, it was not effective. Continued analysis of process and implementation data including qualitative interviews with key stakeholders, may elucidate the

A Narrative Review of Social Media and Game-Based Nutrition Interventions Targeted at Young Adults.

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Nour, Monica; Yeung, Sin Hang; Partridge, Stephanie; Allman-Farinelli, Margaret

2017-05-01

The increased popularity of social media and mobile gaming among young adults provides an opportunity for innovative nutrition programs. This review evaluated the efficacy of these strategies in interventions targeted at 18- to 35-year-olds. The protocol was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Ten scientific databases, information technology conference proceedings, and gray literature were searched. Two reviewers conducted screening, data extraction, and quality assessments. Interventions were included if they used social media or electronic games. Comparisons were made pre- to post-intervention, or between intervention and control arms. Outcomes of interest included change in nutrition knowledge, attitudes, behavior, or weight and/or body composition. Eleven social media-based (randomized controlled trials [RCT] n=7) and six game-based [RCT n=1]) interventions were included. Overall quality of studies was low. Social media-based strategies included forum/blogs (n=5), Facebook (n=5), Twitter (n=1), YouTube (n=1), and chat rooms (n=1). Eight (RCT n=6) of 11 social media-based studies demonstrated improvements in outcomes. Findings suggested that social media may be more effective when combined with other strategies. Virtual reality games (n=3), web-based games (n=2), and a mobile application (n=1) were used in the gaming interventions. While a significant increase in knowledge was reported by three gaming studies (RCT=1), two used nonvalidated tools and longer-term measures of weight and behavioral outcomes were limited. The use of social media and gaming for nutrition promotion is in its infancy. Preliminary evidence suggests that these strategies have some utility for intervening with young adults. Further research using high-quality study designs is required, with measurement of outcomes over longer time periods. The systematic review protocol is registered with PROSPERO (registration number: CRD42015025427

A multifaceted intervention to improve the quality of care of children in district hospitals in Kenya: a cost-effectiveness analysis.

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Barasa, Edwine W; Ayieko, Philip; Cleary, Susan; English, Mike

2012-01-01

To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+) strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale. Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals) with a partial intervention (n = 4 hospitals). Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$). Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average) quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26-67.06) in intervention hospitals compared to US$31.1 (95% CI 30.67-47.18) in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19-2.31) per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A "what-if" analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY) averted by scaling up would vary between US$39.8 and US$398.3. Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital mortality suggest the intervention could be cost

A multifaceted intervention to improve the quality of care of children in district hospitals in Kenya: a cost-effectiveness analysis.

Directory of Open Access Journals (Sweden)

Edwine W Barasa

Full Text Available To improve care for children in district hospitals in Kenya, a multifaceted approach employing guidelines, training, supervision, feedback, and facilitation was developed, for brevity called the Emergency Triage and Treatment Plus (ETAT+ strategy. We assessed the cost effectiveness of the ETAT+ strategy, in Kenyan hospitals. Further, we estimate the costs of scaling up the intervention to Kenya nationally and potential cost effectiveness at scale.Our cost-effectiveness analysis from the provider's perspective used data from a previously reported cluster randomized trial comparing the full ETAT+ strategy (n = 4 hospitals with a partial intervention (n = 4 hospitals. Effectiveness was measured using 14 process measures that capture improvements in quality of care; their average was used as a summary measure of quality. Economic costs of the development and implementation of the intervention were determined (2009 US$. Incremental cost-effectiveness ratios were defined as the incremental cost per percentage improvement in (average quality of care. Probabilistic sensitivity analysis was used to assess uncertainty. The cost per child admission was US$50.74 (95% CI 49.26-67.06 in intervention hospitals compared to US$31.1 (95% CI 30.67-47.18 in control hospitals. Each percentage improvement in average quality of care cost an additional US$0.79 (95% CI 0.19-2.31 per admitted child. The estimated annual cost of nationally scaling up the full intervention was US$3.6 million, approximately 0.6% of the annual child health budget in Kenya. A "what-if" analysis assuming conservative reductions in mortality suggests the incremental cost per disability adjusted life year (DALY averted by scaling up would vary between US$39.8 and US$398.3.Improving quality of care at scale nationally with the full ETAT+ strategy may be affordable for low income countries such as Kenya. Resultant plausible reductions in hospital mortality suggest the intervention could be

Effectiveness of recruitment to a smartphone-delivered nutrition intervention in New Zealand: analysis of a randomised controlled trial

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Volkova, Ekaterina; Michie, Jo; Corrigan, Callie; Sundborn, Gerhard; Eyles, Helen; Jiang, Yannan; Mhurchu, Cliona Ni

2017-01-01

Objectives Delivery of interventions via smartphone is a relatively new initiative in public health, and limited evidence exists regarding optimal strategies for recruitment. We describe the effectiveness of approaches used to recruit participants to a smartphone-enabled nutrition intervention trial. Methods Internet and social media advertising, mainstream media advertising and research team networks were used to recruit New Zealand adults to a fully automated smartphone-delivered nutrition ...

Nutritional interventions for optimizing healthy body composition in older adults in the community: an umbrella review of systematic reviews.

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Schultz, Timothy J; Roupas, Peter; Wiechula, Richard; Krause, Debra; Gravier, Susan; Tuckett, Anthony; Hines, Sonia; Kitson, Alison

2016-08-01

Optimizing body composition for healthy aging in the community is a significant challenge. There are a number of potential interventions available for older people to support both weight gain (for those who are underweight) and weight loss (for overweight or obese people). While the benefits of weight gain for underweight people are generally clearly defined, the value of weight loss in overweight or obese people is less clear, particularly for older people. This umbrella review aimed to measure the effectiveness of nutritional interventions for optimizing healthy body composition in older adults living in the community and to explore theirqualitative perceptions. The participants were older adults, 60 years of age or older, living in the community. The review examinedsix types of nutritional interventions: (i) dietary programs, (ii) nutritional supplements, (iii) meal replacements, (iv) food groups, (v) food delivery support and eating behavior, and (vi) nutritional counselling or education. This umbrella review considered any quantitative systematic reviews and meta-analyses of effectiveness, or qualitative systematic reviews, or a combination (i.e. comprehensive reviews). The quantitative outcome measures of body composition were: (i) nutritional status (e.g. proportion of overweight or underweight patients); (ii) fat mass (kg), (iii) lean mass or muscle mass (kg), (iv) weight (kg) or BMI (kg/m), (v) bone mass (kg) or bone measures such as bone mineral density, and (vi) hydration status. The phenomena of interestwere the qualitative perceptions and experiences of participants. We developed an iterative search strategy for nine bibliometric databases and gray literature. Critical appraisal of 13 studies was conducted independently in pairs using standard Joanna Briggs Institute tools. Six medium quality and seven high quality studies were identified. Data was extracted independently in pairs from all 13 included studies using the standard Joanna Briggs Institute

Evaluation of a Nutritional Support Intervention in Malnourished HIV-Infected Children in Bamako, Mali.

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Jesson, Julie; Coulibaly, Aba; Sylla, Mariam; NʼDiaye, Clémentine; Dicko, Fatoumata; Masson, David; Leroy, Valériane

2017-10-01

We assessed a nutritional support intervention in malnourished HIV-infected children in a HIV-care program of the University Hospital Gabriel Touré, Bamako, Mali. All HIV-infected children younger than 15 years were diagnosed for malnutrition between 07 and 12, 2014. Malnutrition was defined according to the WHO growth standards with Z-scores. Two types were studied: acute malnutrition (AM) and chronic malnutrition (CM). All participants were enrolled in a 6-month prospective interventional cohort, receiving Ready-To-Use Therapeutic Food, according to type of malnutrition. The nutritional intervention was offered until child growth reached -1.5 SD threshold. Six-month probability to catch up growth (>-2 SD) was assessed for AM using Kaplan-Meier curves and Cox model. Among the 348 children screened, 198 (57%) were malnourished of whom 158 (80%) children were included: 97 (61%) for AM (35 with associated CM) and 61 (39%) with CM. Fifty-nine percent were boys, 97% were on antiretroviral therapy, median age was 9.5 years (Interquartile Range: 6.7-12.3). Among children with AM, 74% catch-up their growth at 6-month; probability to catch-up growth was greater for those without associated CM (adjusted Hazard Ratio = 1.97, CI 95%: 1.13 to 3.44). Anemia decreased significantly from 40% to 12% at the end of intervention (P nutritional screening and care in the pediatric HIV-care package is needed to optimize growth and prevent metabolic disorders.

Web-Based Intervention for Nutritional Management in Cystic Fibrosis: Development, Usability, and Pilot Trial.

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Stark, Lori J; Opipari-Arrigan, Lisa; Filigno, Stephanie S; Simon, Stacey L; Leonard, Amanda; Mogayzel, Peter J; Rausch, Joseph; Zion, Cynthia; Powers, Scott W

2016-06-01

Usability and pilot testing of a web intervention (BeInCharge.org [BIC]) of behavior plus nutrition intervention for children with cystic fibrosis (CF) ages 4-9 years. Think Aloud methodology was used with five mothers to assess usability and refine the intervention. A pilot trial was then conducted with 10 mothers of children with CF ages 4-9 years randomized to the web-based BIC or a Standard Care Control (STC). Change in weight gain for each group was compared in a pre-to-post design. Mothers rated the usability and clarity of BIC highly. The pilot trial showed children of mothers who received BIC had a significant change in weight pre-to-post-treatment (0.67 kg, p = .04). Change for the STC was not significant (0.41 kg, p = .10). A web-based behavior plus nutrition intervention appears promising in increasing weight gain in children with CF. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

the Importance of an early exercise and nutrition intervention among RENAL TRANSPLANT RECIPIENTS

Directory of Open Access Journals (Sweden)

Andrea Mahrova

2012-06-01

In conclusion, the combination of an exercise and nutrition intervention was the most effective and could give each patient an opportunity to achieve an optimal physical and psychological level almost equal to their original condition.

Process evaluation determines the pathway of success for a health center-delivered, nutrition education intervention for infants in Trujillo, Peru.

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Robert, Rebecca C; Gittelsohn, Joel; Creed-Kanashiro, Hilary M; Penny, Mary E; Caulfield, Laura E; Narro, M Rocio; Black, Robert E

2006-03-01

Process evaluation was used to explain the success of a randomized, controlled trial of an educational intervention to improve the feeding behaviors of caregivers and the nutritional status of infants in Trujillo, Peru. Health personnel delivered a multicomponent intervention within the environment of usual care at government health centers. We created a model of the expected intervention pathway to successful outcomes. Process data were then collected on health center implementation of the intervention and caregiver reception to it. Using multivariate models, we found that variables of health center implementation, caregiver exposure, and caregiver message recall were all significant determinants in the pathway leading to improved feeding behaviors. These outcomes were consistent with our original intervention model. Further support for our model arose from the differences in caregiver reception between intervention and control centers. Process data allowed us to characterize the pathway through which an effective nutrition intervention operated. This study underscores the importance of including process evaluation, which will lead to the development and implementation of more effective nutrition interventions.

Psychosocial changes in the Mississippi communities for healthy living (MCHL) nutrition intervention

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The objective of the study was to evaluate the psychosocial changes reported by participants in a nutrition education intervention in the Lower Mississippi Delta. The psychosocial constructs such as decisional balance (DB), self-efficacy (SE), and social support (SS) are correlated with fruit and ve...

Palm oil and pyrantel as child nutrition mass interventions in Papua New Guinea.

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Pust, R E; Binns, C W; Weinhold, D W; Martin, J R

1985-03-01

Two mass interventions in the local low energy-density diet were evaluated for safety, acceptability and nutritional efficacy in a four-group matched study of 896 Papua New Guinea children aged 12-54 months. A single dose of 125 mg of pyrantel pamoate and an 800 mg supply of red palm oil were given monthly at the regular child health clinics. Both were safe and highly accepted. Children given palm oil gained more weight than controls (P less than .05) in the first three study months, confirming a pilot study. However, weight gain after one year was 94% of standard, with no differences in anthropometry, morbidity or mortality between groups. The lack of demonstrable differences at one year is attributed to secular improvement in control group nutrition and to diffusion of palm oil supplies within the family. While pyrantel was an effective antihelminthic, further study is needed to define the nutritional role of mass worm treatment. Palm oil was economical and culturally popular; thus it should be an ideal import substitution. It is clinically useful where diets are of low energy-density. However, any simultaneous demonstration of its nutritional safety, acceptability as a sustained mass intervention must be carried out in an area where major child growth deficits remain and expropriation of the oil by other household members can be controlled.

[Impact of a nutrition education intervention in teachers, preschool and basic school-age children in Valparaiso region in Chile].

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Vio, Fernando; Salinas, Judith; Montenegro, Edith; González, Carmen Gloria; Lera, Lydia

2014-06-01

To assess the impact of a nutrition education program for teachers in the nutritional status, food knowledge and food consumption of their pre basic and basic students, and in the controls. A nutrition education intervention was conducted in pre basic and basic teachers in a school year, with a pre-post evaluation of their students, compared with a control group. Subjects were 817 students (389 men and 428 women) from pre kindergarten to the second grade. The 465 students of the intervened group were distributed in two schools (Liceo 1 = 283; Liceo 2 = 182) and 352 in the control school. The nutrition intervention consisted in 9 interactive workshops for teachers with the utilization of Information and Communication Technologies (ICT). The pre post evaluation consisted in a nutritional status assessment, and a food and nutrition survey with questions related with food knowledge and food consumption, at the beginning and at the end of the school year. There were no significant differences in nutritional status between the beginning and the end of the intervention. In one of the experimental schools (Liceo 2) there was a significant decrease in obesity, in women and in the age-group 7-9 years. In the experimental group there was a significant improvement in food knowledge and a decrease in non-healthy food consumption. In the control group, consumption of non-healthy food was stable, with a decrease in fruits and vegetables consumption. As it was demonstrated in similar studies, a short interactive nutrition education intervention with utilization of ICT in pre basic and basic teachers can produce positive changes in nutritional status of their students, improving food knowledge and healthy food consumption and decreasing non-healthy food consumption, compared with the control group. However, a strategy to incorporate parents in school nutrition education programs is still a pending issue. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights

Building evidence for sustainability of food and nutrition intervention programs in developing countries.

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Kim, Sunny S; Rogers, Beatrice L; Coates, Jennifer; Gilligan, Daniel O; Sarriot, Eric

2013-09-01

After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, "Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries," provided not only frameworks for conceptualizing sustainability but concrete evidence about the approaches and methods used as well as lessons on how they do or do not work in particular contexts. We presented the following findings: 1) sustainability of activities and impacts of Title II food aid programs in Bolivia and Kenya, 2) sustainability of impact in terms of adoption and consumption of a biofortified orange sweet potato in Uganda, and 3) lessons from incorporating pro-sustainability investment strategies in child survival programs in Guinea. Our symposium introduced a new important body of research on program sustainability to provide insights and stimulate innovative thinking in the design and planning of further applied research and future prosustainability intervention programs.

The spinal stenosis pedometer and nutrition lifestyle intervention (SSPANLI) randomized controlled trial protocol.

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Tomkins-Lane, Christy C; Lafave, Lynne M Z; Parnell, Jill A; Krishnamurthy, Ashok; Rempel, Jocelyn; Macedo, Luciana G; Moriartey, Stephanie; Stuber, Kent J; Wilson, Philip M; Hu, Richard; Andreas, Yvette M

2013-11-14

Because of symptoms, people with lumbar spinal stenosis (LSS) are often inactive, and this sedentary behaviour implies risk for diseases including obesity. Research has identified body mass index as the most powerful predictor of function in LSS. This suggests that function may be improved by targeting weight as a modifiable factor. An e-health lifestyle intervention was developed aimed at reducing fat mass and increasing physical activity in people with LSS. The main components of this intervention include pedometer-based physical activity promotion and nutrition education. The Spinal Stenosis Pedometer and Nutrition Lifestyle INTERVENTION (SSPANLI) was developed and piloted with 10 individuals. The protocol for a randomized controlled trail comparing the SSPANLI intervention to usual non-surgical care follows. One hundred six (106) overweight or obese individuals with LSS will be recruited. Baseline and follow-up testing includes dual energy x-ray absorptiometry, blood draw, 3-day food record, 7-day accelerometry, questionnaire, maximal oxygen consumption, neurological exam, balance testing and a Self-Paced Walking Test. During Week 1, the intervention group will receive a pedometer, and a personalized consultation with both a Dietitian and an exercise specialist. For 12 weeks participants will log on to the e-health website to access personal step goals, walking maps, nutrition videos, and motivational quotes. Participants will also have access to in-person Coffee Talk meetings every 3 weeks, and meet with the Dietitian and exercise specialist at week 6. The control group will proceed with usual care for the 12-week period. Follow-up testing will occur at Weeks 13 and 24. This lifestyle intervention has the potential to provide a unique, non-surgical management option for people with LSS. Through decreased fat mass and increased function, we may reduce risk for obesity, chronic diseases of inactivity, and pain. The use of e-health interventions provides an

The establishment of enteral nutrition with minimally-invasive interventional procedure under endoscopic or imaging guidance

International Nuclear Information System (INIS)

Li Feng; Cheng Yingsheng

2010-01-01

For patients unable to get the necessary nutrition orally, a variety of techniques,including surgical way, to make gastrostomy with tube placement have been employed. For recent years, gastrostomy and tube placement with the help of endoscopic guidance or percutaneous interventional management has been developed, which is superior to surgical procedure in minimizing injuries, decreasing cost and reducing complications. In certain clinical situations, both endoscopic method and interventional method can be employed. This paper aims to make a comprehensive review of the indications, techniques and skills, advantages and disadvantages of both the endoscopy-guided and the imaging-guided percutaneous gastrojejunostomy for the establishment of enteral nutrition. (authors)

Effects of nutrition education on levels of nutritional awareness of pregnant women in Western iran.

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Fallah, Farnoush; Pourabbas, Ahmad; Delpisheh, Ali; Veisani, Yousef; Shadnoush, Mahdi

2013-01-01

Maternal nutritional health, before and during pregnancy, influences the health status of herself and her developing fetus. Pregnancy is an important condition for improving nutritional knowledge. The present study aimed at determining effects of nutrition education on levels of nutritional awareness of a representative group of pregnant women in Western Iran. A quasi-experimental intervention was undertaken on a random sample of pregnant women (n = 100) attending urban health centers in Ilam city (western Iran) during the year 2011 for prenatal care. A nutritional education program containing two to four lessons was undertaken for small groups of between six to ten women. Nutritional knowledge was assessed before intervention (pretest) and followed by two posttests within three weeks interval. The awareness level of pregnant women about healthy nutrition was significantly increased from 3% before intervention to 31% after the nutritional education intervention (P nutritional education intervention will have a positive effect on nutritional awareness of pregnant women.

Explaining the effects of a point-of-purchase nutrition-information intervention in university canteens: a structural equation modelling analysis.

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Hoefkens, Christine; Pieniak, Zuzanna; Van Camp, John; Verbeke, Wim

2012-09-11

The importance of canteen meals in the diet of many university students makes the provision of simple point-of-purchase (POP) nutrition information in university canteens a potentially effective way to promote healthier diets in an important group of young adults. However, modifications to environments such as the posting of POP nutrition information in canteens may not cause an immediate change in meal choices and nutrient intakes. The present study aimed at understanding the process by which the POP nutrition information achieved its effects on the meal choice and energy intake, and whether the information was more effective in changing the meal choice of subgroups of university canteen customers. The POP nutrition-information intervention used a one-group pretest-posttest design. A sample of 224 customers of two university canteens completed the baseline and 6-months follow-up surveys. A multi-group structural equation modelling analysis was used to test mediation effects of individual difference variables (liking, understanding and use of the information, subjective knowledge and attitude) on the energy intake from canteen meals, moderated by the objective nutrition knowledge and motivation to change diet. Significant relations were identified between liking of the information and its use on one hand and a positive effect in attitude towards healthy canteen meals on the other hand. Motivation to change diet and sufficient objective nutrition knowledge were required to maintain a recommended energy intake from canteen meals or to lead to a decrease in energy intake. Participants with greater objective nutrition knowledge had a greater understanding of the POP nutrition information which also resulted in a more effective use of the information. The results suggest that nutrition-information interventions may be more effective when using nutrition information that is generally liked by the target population in combination with an educational intervention to

[Intervention programs in hospital nutrition: actions, design, components and implementation].

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Santana Porben, S; Barreto Penié, J

2005-01-01

Metabolic, Nutrient and Feeding Intervention Programs must become the methodological tool for dealing with the health problem posed by disease-associated-malnutrition on one side, and the "Bad Practices" affecting the nutritional status of the patient, on the other one. Programs like these ones should prescribe clear policies and actions in the three domains of contemporary medical practice: assistance, research and education. The fullfillment of these Program's objectives, and the relization of the implicit benefits, will only be possible if a methodological platform that armonically integrates elements of Continuous Education, Cost Analysis, Recording and Documentation, and Quality Control and Assurance, is created. The experience acumulated after the inception and conduction of the Intervention Program at the Clinical-Surgical "Hermanos Ameijeiras" Hospital (Havana City, Cuba) has served to demostrate that it is feasible not only to create a theoretical and practical body to satisfy the aforementioned goals, but, also, to export it to another institutions of the country, in view of the fact that minimal investments for adquiring the resources needed to deploy such Program, as well as for training and capacitation of medic and paramedic personel in the corresponding Recording & Documentation and Feeding & Nutrition Good Practices might result in short-term economical and medical care benefits.

"If it's issues to do with nutrition…I can decide…": gendered decision-making in joining community-based child nutrition interventions within rural coastal Kenya.

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Muraya, Kelly W; Jones, Caroline; Berkley, James A; Molyneux, Sassy

2017-12-01

Gender roles and relations play an important role in child health and nutritional status. While there is increasing recognition of the need to incorporate gender analysis in health planning and programme development, there has been relatively little attention paid to the gendered nature of child nutrition interventions. This qualitative study undertaken in rural Coastal Kenya aimed to explore the interaction between household gender relations and a community-based child nutrition programme, with a focus on household decision-making dynamics related to joining the intervention. Fifteen households whose children were enrolled in the programme were followed up over a period of 12 months. Over a total of 60 household visits, group and individual in-depth interviews were conducted with a range of respondents, supplemented by non-participant observations. Data were analysed using a framework analysis approach. Engagement with the intervention was highly gendered with women being the primary decision-makers and engagers. Women were responsible for managing child feeding and minor child illnesses in households. As such, involvement in community-based nutrition interventions and particularly one that targeted a condition perceived as non-serious, fell within women's domain. Despite this, the nutrition programme of interest could be categorized as gender-blind. Gender was not explicitly considered in the design and implementation of the intervention, and the gender roles and norms in the community with regards to child nutrition were not critically examined or challenged. In fact, the intervention might have inadvertently reinforced existing gender divisions and practices in relation to child nutrition, by (unintentionally) excluding men from the nutrition discussions and activities, and thereby supporting the notion of child feeding and nutrition as "women's business". To improve outcomes, community-based nutrition interventions need to understand and take into account

Initial Nutritional Assessment of Infants With Cleft Lip and/or Palate: Interventions and Return to Birth Weight.

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Kaye, Alison; Thaete, Kristi; Snell, Audrey; Chesser, Connie; Goldak, Claudia; Huff, Helen

2017-03-01

  To assess and quantify cleft team practices with regard to nutritional support in the neonatal period Design :  Retrospective review.   Tertiary pediatric hospital.   One hundred consecutive newborn patients with a diagnosis of cleft lip and/or cleft palate between 2009 and 2012.   Birth weight, cleft type, initial cleft team weight measurements, initial feeding practices, recommended nutritional interventions, and follow-up nutritional assessments.   All patients in the study were evaluated by a registered dietitian and an occupational feeding therapist. Average birth weight and average age at the first cleft team visit were similar for each cleft type: cleft lip (CL), cleft lip and palate (CLP), and cleft palate (CP). The calculated age (in days) for return to birth weight was significantly different between cleft types: CL = 13.58 days, CLP = 15.88 days, and CP = 21.93 days. Exclusive use of breast milk was 50% for patients with CL, 30.3% for patients with CLP, and 21.4% for patients with CP. Detailed nutritional interventions were made for 31 patients at the first visit: two with CL, 14 with CLP, and 15 with CP.   Distinct differences were seen in neonatal weight gain between cleft types. There was significantly greater total weight gain for patients with CL at their first visit and significantly slower return to birth weight for patients with isolated CP. Patients with CL required far fewer interventions at the initial assessment and were more likely to be provided breast milk exclusively or in combination with formula. Infants with CP were far less likely to receive any breast milk. Patients with CLP and CP required frequent nutritional interventions.

Self-Efficacy and Nutrition Education: A Study of the Effect of an Intervention with Faith Community Nurses.

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Gotwals, Beth

2018-02-01

The faith community provides an important access point for practice focused on population health at a time when health issues such as obesity and overweight are affecting large number of Americans. The purpose of this study was to examine faith community nurses' self-efficacy perceptions following a nutrition educational intervention. A convenience sample of 92 faith community nurses were randomly assigned to experimental and control groups. The t-distribution analysis revealed significant differences between the nutrition knowledge self-efficacy (p = .016) and nutrition counseling self-efficacy (p = .010) post-test scores for the experimental and control groups. This type of educational intervention provides a model to be used with faith community nurses as they integrate faith and health in this setting.

Is a Nutrition Education Intervention Associated with a Higher Intake of Fruit and Vegetables and Improved Nutritional Knowledge among Housewives in Mauritius?

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Cannoosamy, Komeela; Pem, Dhandevi; Bhagwant, Suress; Jeewon, Rajesh

2016-11-29

The purpose of the study was to assess the determinants of nutrition behaviors and body mass index and determine the impact of a nutrition education intervention (NEI) among Mauritian housewives. A pretest-posttest design was used assessing Nutrition Knowledge (NK), Nutrition Attitudes, Fruit and Vegetable Intake (FVI), body mass index (BMI). Two hundred Mauritian housewives were recruited. The NEI was in the form of a lecture and lasted for twenty minutes. Statistical tests performed revealed that the mean NK score at baseline was 65.8 ± 6.92 and a significant increase of +17.1 at post-test and +16.1 at follow-up was observed. Determinants of NK were age, presence of elderly people, and BMI. Mean nutrition attitude score at baseline was 2.37 ± 0.22 with significant increase of +0.2 (post-test) and +0.17 at follow-up. Age, level of education, presence of elders, and NK were linked to a positive attitude. FVI was predicted by age, income, presence of elders, NK, and nutrition attitudes. Baseline FVI was 4.77 ± 1.11 which increased significantly ( p nutrition behaviors.

Evaluation of effectiveness of class-based nutrition intervention on changes in soft drink and milk consumption among young adults.

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Ha, Eun-Jeong; Caine-Bish, Natalie; Holloman, Christopher; Lowry-Gordon, Karen

2009-10-26

During last few decades, soft drink consumption has steadily increased while milk intake has decreased. Excess consumption of soft drinks and low milk intake may pose risks of several diseases such as dental caries, obesity, and osteoporosis. Although beverage consumption habits form during young adulthood, which has a strong impact on beverage choices in later life, nutrition education programs on beverages are scarce in this population. The purpose of this investigation was 1) to assess soft drink and milk consumption and 2) to evaluate the effectiveness of 15-week class-based nutrition intervention in changing beverage choices among college students. A total of 80 college students aged 18 to 24 years who were enrolled in basic nutrition class participated in the study. Three-day dietary records were collected, verified, and analyzed before and after the intervention. Class lectures focused on healthful dietary choices related to prevention of chronic diseases and were combined with interactive hands on activities and dietary feedback. Class-based nutrition intervention combining traditional lecture and interactive activities was successful in decreasing soft drink consumption. Total milk consumption, specifically fat free milk, increased in females and male students changed milk choice favoring skim milk over low fat milk. (1% and 2%). Class-based nutrition education focusing on prevention of chronic diseases can be an effective strategy in improving both male and female college students' beverage choices. Using this type of intervention in a general nutrition course may be an effective approach to motivate changes in eating behaviors in a college setting.

Evaluation of effectiveness of class-based nutrition intervention on changes in soft drink and milk consumption among young adults

Directory of Open Access Journals (Sweden)

Holloman Christopher

2009-10-01

Full Text Available Abstract Background During last few decades, soft drink consumption has steadily increased while milk intake has decreased. Excess consumption of soft drinks and low milk intake may pose risks of several diseases such as dental caries, obesity, and osteoporosis. Although beverage consumption habits form during young adulthood, which has a strong impact on beverage choices in later life, nutrition education programs on beverages are scarce in this population. The purpose of this investigation was 1 to assess soft drink and milk consumption and 2 to evaluate the effectiveness of 15-week class-based nutrition intervention in changing beverage choices among college students. Methods A total of 80 college students aged 18 to 24 years who were enrolled in basic nutrition class participated in the study. Three-day dietary records were collected, verified, and analyzed before and after the intervention. Class lectures focused on healthful dietary choices related to prevention of chronic diseases and were combined with interactive hands on activities and dietary feedback. Results Class-based nutrition intervention combining traditional lecture and interactive activities was successful in decreasing soft drink consumption. Total milk consumption, specifically fat free milk, increased in females and male students changed milk choice favoring skim milk over low fat milk. (1% and 2%. Conclusion Class-based nutrition education focusing on prevention of chronic diseases can be an effective strategy in improving both male and female college students' beverage choices. Using this type of intervention in a general nutrition course may be an effective approach to motivate changes in eating behaviors in a college setting.

Understanding Parkinson Disease: A Complex and Multifaceted Illness.

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Gopalakrishna, Apoorva; Alexander, Sheila A

2015-12-01

Parkinson disease is an incredibly complex and multifaceted illness affecting millions of people in the United States. Parkinson disease is characterized by progressive dopaminergic neuronal dysfunction and loss, leading to debilitating motor, cognitive, and behavioral symptoms. Parkinson disease is an enigmatic illness that is still extensively researched today to search for a better understanding of the disease, develop therapeutic interventions to halt or slow progression of the disease, and optimize patient outcomes. This article aims to examine in detail the normal function of the basal ganglia and dopaminergic neurons in the central nervous system, the etiology and pathophysiology of Parkinson disease, related signs and symptoms, current treatment, and finally, the profound impact of understanding the disease on nursing care.

A nutrition intervention with a main focus on vegetables and bread consumption among young men in the Norwegian National Guard.

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Uglem, Solveig; Stea, Tonje Holte; Kjøllesdal, Marte Karoline Råberg; Frølich, Wenche; Wandel, Margareta

2013-01-01

Young men are difficult to reach with conventional nutrition information and they have a low intake of vegetables and whole grain cereals. Few intervention studies have focused on improving young men's consumption of vegetables and whole grains. A 5-month intervention focusing on a combination of increased availability of healthy foods and nutritional information was developed to stimulate the intake of vegetables and semi-whole grain bread among a group of young men in the Norwegian military. A total of 376 recruits in the intervention group and 105 recruits in the control group participated in the entire study. The average daily increase in consumption of vegetables was 82 g (pbread 47 g (pbread, when controlling for baseline values, and seasonal variation for vegetables. The recruits in the intervention group received higher scores on the questions concerning nutritional knowledge after the intervention, compared to baseline (pbread, without a reduction in food satisfaction, among young men in the military.

Targeted Nutritional and Behavioral Feeding Intervention for a Child with Autism Spectrum Disorder

Directory of Open Access Journals (Sweden)

Kelly Barnhill

2016-01-01

Full Text Available A variety of feeding issues and concerns, including food aversion, food selectivity, and complete food refusal, are not uncommon among children with autism spectrum disorder (ASD. Other underlying issues are often comorbid with the concerns for feeding and ASD. These may include food allergies, gastrointestinal issues, oral motor issues, and swallowing disorders. The refusal to consume particular foods coupled with the inability to tolerate, digest, and absorb these foods can compromise an individual’s overall nutrition status. Therefore, a child’s behavior toward food and feeding activities has great impact on dietary intake, nutritional status, and growth. This case report is the first to document combined medical, behavioral, and nutritional intervention for a toddler with ASD and comorbid feeding disorder.

Effects of Nutritional Interventions during Pregnancy on Infant and Child Cognitive Outcomes: A Systematic Review and Meta-Analysis

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Rachael M. Taylor

2017-11-01

Full Text Available Background: Epidemiological studies have demonstrated that folate, iodine and iron intake during pregnancy impacts on foetal brain development and cognitive function. However, in human studies, the relationship with other dietary nutrients is less clear. Objective: This systematic review aims to critically appraise the current literature and meta-analyses results from nutritional interventions during pregnancy that aimed to optimise infant and child cognitive outcomes. Design: Ten electronic databases were searched for articles published up to August 2017. The search was limited to articles published in English. Randomised controlled trials (RCTs testing the impact of any nutritional intervention (dietary counselling, education, nutrient supplementation, fortified foods and/or foods during pregnancy on cognitive outcomes of children (<10 years old. Two independent reviewers assessed study eligibility and quality using the American Dietetic Association quality criteria checklist for primary research. Standardised mean differences were used for nine cognitive domains to measure effects for meta-analyses. Results: A total of 34 RCTs were included (21 studies included children aged less than 35 months, 10 studies included children aged 36–60 months and 3 studies included children aged 61–119 months. The types of nutritional interventions included nutrient supplements, whole foods, fortified foods and nutrition education. The following nine cognition outcomes: attention, behaviour, crystallised intelligence, fluid intelligence, global cognition, memory, motor skills, visual processing, and problem solving were not significantly impacted by nutritional interventions, although 65% of studies conducted post-hoc data analyses and were likely to be underpowered. Although, long chain polyunsaturated fatty acids (LCPUFA supplementation was associated with a marginal increase in crystallised intelligence (Effect size (ES: 0.25; 95% confidence interval

Effects of a nutritional intervention program based on the self-determination theory and promoting the Mediterranean diet

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Vicky Leblanc

2015-12-01

Full Text Available Our objective was to determine gender differences in the impact of a nutritional intervention based on the self-determination theory and promoting the Mediterranean diet on changes in eating-related self-determined motivation and adherence to the Mediterranean diet. Changes in eating-related self-determined motivation were larger in men than in women in response to the intervention and at follow-up, but the magnitude of change decreased with time in both genders. Changes in eating-related self-determined motivation were positively associated with changes in the Mediterranean diet adherence in response to the intervention and at follow-up in men only, suggesting that the nutritional program seems to fit better men than women.

Effects of a nutritional intervention program based on the self-determination theory and promoting the Mediterranean diet.

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Leblanc, Vicky; Bégin, Catherine; Hudon, Anne-Marie; Royer, Marie-Michelle; Corneau, Louise; Dodin, Sylvie; Lemieux, Simone

2016-01-01

Our objective was to determine gender differences in the impact of a nutritional intervention based on the self-determination theory and promoting the Mediterranean diet on changes in eating-related self-determined motivation and adherence to the Mediterranean diet. Changes in eating-related self-determined motivation were larger in men than in women in response to the intervention and at follow-up, but the magnitude of change decreased with time in both genders. Changes in eating-related self-determined motivation were positively associated with changes in the Mediterranean diet adherence in response to the intervention and at follow-up in men only, suggesting that the nutritional program seems to fit better men than women.

Systematic review and meta-analysis of the evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo(radio)therapy: current evidence and guidance for design of future trials

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de van der Schueren, M A E; Blanchard, H; Jourdan, M; Arends, J; Baracos, V E

2018-01-01

Abstract Background Driven by reduced nutritional intakes and metabolic alterations, malnutrition in cancer patients adversely affects quality of life, treatment tolerance and survival. We examined evidence for oral nutritional interventions during chemo(radio)therapy. Design We carried out a systematic review of randomized controlled trials (RCT) with either dietary counseling (DC), high-energy oral nutritional supplements (ONS) aiming at improving intakes or ONS enriched with protein and n-3 polyunsaturated fatty acids (PUFA) additionally aiming for modulation of cancer-related metabolic alterations. Meta-analyses were carried out on body weight (BW) response to nutritional interventions, with subgroup analyses for DC and/or high-energy ONS or high-protein n-3 PUFA-enriched ONS. Results Eleven studies were identified. Meta-analysis showed overall benefit of interventions on BW during chemo(radio)therapy (+1.31 kg, 95% CI 0.24–2.38, P = 0.02, heterogeneity Q = 21.1, P = 0.007). Subgroup analysis showed no effect of DC and/or high-energy ONS (+0.80 kg, 95% CI −1.14 to 2.74, P = 0.32; Q = 10.5, P = 0.03), possibly due to limited compliance and intakes falling short of intake goals. A significant effect was observed for high-protein n-3 PUFA-enriched intervention compared with isocaloric controls (+1.89 kg, 95% CI 0.51–3.27, P = 0.02; Q = 3.1 P = 0.37). High-protein, n-3 PUFA-enriched ONS studies showed attenuation of lean body mass loss (N = 2 studies) and improvement of some quality of life domains (N = 3 studies). Overall, studies were limited in number, heterogeneous, and inadequately powered to show effects on treatment toxicity or survival. Conclusion This systematic review suggests an overall positive effect of nutritional interventions during chemo(radio)therapy on BW. Subgroup analyses showed effects were driven by high-protein n-3 PUFA-enriched ONS, suggesting the benefit of targeting metabolic

A theory-based evaluation of a dissemination intervention to improve childcare cooks' intentions to implement nutritional guidelines on their menus.

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Yoong, Sze Lin; Jones, Jannah; Marshall, Josephine; Wiggers, John; Seward, Kirsty; Finch, Meghan; Fielding, Alison; Wolfenden, Luke

2016-07-25

Childcare services represent a key setting to implement nutritional interventions to support the development of healthy eating behaviours in young children. Childcare-specific nutritional guidelines outlining recommendations for provision of food in care have been developed. Despite this, research suggests that few childcare services currently implement these guidelines. This study aimed to examine the impact of providing printed educational materials on childcare service cooks' intentions to use nutritional guidelines and provide fruit and vegetables on their menu. A randomised controlled trial was conducted with 77 childcare services (38 control and 39 intervention). Intervention service cooks were mailed a two-page educational material together with a menu planning checklist. Intervention development and evaluation was guided by the theory of planned behaviour. Outcome data assessing intentions to use nutritional guidelines and serves of fruit and vegetables provided on menus (primary outcomes) as well as secondary outcomes (attitudes, behavioural regulation and social norms) were collected via a telephone interview with cooks. Relative to the comparison group, cooks in the intervention arm had significantly higher intentions to use the guidelines (p value 0.0005), accompanied by significant changes in perceived behavioural control (p value 0.0008) and attitudes (p value 0.0071). No significant difference in serves of fruit (p value 0.7278) and vegetables (p value 0.0573) was observed. The use of educational materials can improve childcare service cooks' intentions to use nutritional guidelines; however, as a standalone strategy, it may not improve provision of food on menus.

“The 3/3 Strategy”: A Successful Multifaceted Hospital Wide Hand Hygiene Intervention Based on WHO and Continuous Quality Improvement Methodology

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Mestre, Gabriel; Berbel, Cristina; Tortajada, Purificación; Alarcia, Margarita; Coca, Roser; Gallemi, Gema; Garcia, Irene; Fernández, Mari Mar; Aguilar, Mari Carmen; Martínez, José Antonio; Rodríguez-Baño, Jesús

2012-01-01

Background Only multifaceted hospital wide interventions have been successful in achieving sustained improvements in hand hygiene (HH) compliance. Methodology/Principal Findings Pre-post intervention study of HH performance at baseline (October 2007– December 2009) and during intervention, which included two phases. Phase 1 (2010) included multimodal WHO approach. Phase 2 (2011) added Continuous Quality Improvement (CQI) tools and was based on: a) Increase of alcohol hand rub (AHR) solution placement (from 0.57 dispensers/bed to 1.56); b) Increase in frequency of audits (three days every three weeks: “3/3 strategy”); c) Implementation of a standardized register form of HH corrective actions; d) Statistical Process Control (SPC) as time series analysis methodology through appropriate control charts. During the intervention period we performed 819 scheduled direct observation audits which provided data from 11,714 HH opportunities. The most remarkable findings were: a) significant improvements in HH compliance with respect to baseline (25% mean increase); b) sustained high level (82%) of HH compliance during intervention; c) significant increase in AHRs consumption over time; c) significant decrease in the rate of healthcare-acquired MRSA; d) small but significant improvements in HH compliance when comparing phase 2 to phase 1 [79.5% (95% CI: 78.2–80.7) vs 84.6% (95% CI:83.8–85.4), phygiene day”; and “negative”:73.7% as lowest HH compliance coinciding with a statutory lay-off proceeding). Conclusions/Significance CQI tools may be a key addition to WHO strategy to maintain a good HH performance over time. In addition, SPC has shown to be a powerful methodology to detect special causes in HH performance (positive and negative) and to help establishing adequate feedback to healthcare workers. PMID:23110061

Impact and outcomes of nutritional support team intervention in patients with gastrointestinal disease in the intensive care unit.

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Park, Yong Eun; Park, Soo Jung; Park, Yehyun; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho

2017-12-01

Nutritional support has become an important intervention for critically ill patients. Many studies have reported on the effects of nutritional support for the patients within the intensive care unit (ICU); however, no studies have specifically assessed patients with gastrointestinal diseases who may have difficulty absorbing enteral nutrition (EN) in the ICU.Sixty-two patients with gastrointestinal disease were admitted to the ICU between August 2014 and August 2016 at a single tertiary university hospital. We analyzed 2 different patient groups in a retrospective cohort study: those who received nutritional support team (NST) intervention and those who did not.Forty-four (71.0%) patients received nutritional support in ICU and 18 (29.0%) did not. Variables including male sex, high albumin or prealbumin level at the time of ICU admission, and short transition period into EN showed statistically significant association with lower mortality on the univariate analysis (all P < .05). Multivariate analysis revealed that longer length of hospital stay (P = .013; hazard ratio [HR], 0.972; 95% confidence interval [CI], 0.951-0.994), shorter transition into EN (P = .014; HR, 1.040; 95% CI, 1.008-1.072), higher prealbumin level (P = .049; HR, 0.988; 95% CI, 0.976-1.000), and NST intervention (P = .022; HR, 0.356; 95% CI, 0.147-0.862) were independent prognostic factors for lower mortality.In conclusion, NST intervention related to early initiated EN, and high prealbumin levels are beneficial to decrease mortality in the acutely ill patients with GI disease.

Older patients’ use of technology for a post-discharge nutritional intervention

DEFF Research Database (Denmark)

Lindhardt, T.; Nielsen, M. H.

2017-01-01

Background Malnutrition is frequent in older people and a precursor for morbidity and hospitalisation; furthermore low intake and weight loss during and after hospitalisation is well-described. Such patients are often excluded from technology projects on account of lack of skills. This is a barri......'s preferences and views on barriers to successful intervention and use of technology in health care. This will guide the design of a future sufficiently powered study. Effect evaluation provided guidance for future sample size calculation.......-experimental controlled feasibility trial and embedded qualitative interviews. Participants: Older medical patients (mean age 79.4 years; women 66.7%) at nutritional risk and discharged to own home were included consecutively to first the control group (n = 18) and later the intervention group (n = 18). Nine intervention...

The effect of complex workplace dietary interventions on employees' dietary intakes, nutrition knowledge and health status: a cluster controlled trial.

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Geaney, Fiona; Kelly, Clare; Di Marrazzo, Jessica Scotto; Harrington, Janas M; Fitzgerald, Anthony P; Greiner, Birgit A; Perry, Ivan J

2016-08-01

Evidence on effective workplace dietary interventions is limited. The comparative effectiveness of a workplace environmental dietary modification and an educational intervention both alone and in combination was assessed versus a control workplace on employees' dietary intakes, nutrition knowledge and health status. In the Food Choice at Work cluster controlled trial, four large, purposively selected manufacturing workplaces in Ireland were allocated to control (N=111), nutrition education (Education) (N=226), environmental dietary modification (Environment) (N=113) and nutrition education and environmental dietary modification (Combined) (N=400) in 2013. Nutrition education included group presentations, individual consultations and detailed nutrition information. Environmental dietary modification included menu modification, fruit price discounts, strategic positioning of healthier alternatives and portion size control. Data on dietary intakes, nutrition knowledge and health status were obtained at baseline and follow-up at 7-9months. Multivariate analysis of covariance compared changes across the four groups with adjustment for age, gender, educational status and other baseline characteristics. Follow-up data at 7-9months were obtained for 541 employees (64% of 850 recruited) aged 18-64years: control: 70 (63%), Education: 113 (50%), 74 (65%) and Combined: 284 (71%). There were significant positive changes in intakes of saturated fat (p=0.013), salt (p=0.010) and nutrition knowledge (p=0.034) between baseline and follow-up in the combined intervention versus the control. Small but significant changes in BMI (-1.2kg/m(2) (95% CI -2.385, -0.018, p=0.047) were observed in the combined intervention. Effects in the education and environment alone workplaces were smaller and generally non-significant. Combining nutrition education and environmental dietary modification may be an effective approach for promoting a healthy diet and weight loss at work. Copyright © 2016

Effectiveness of Multifaceted Care Approach on Adverse Clinical Outcomes in Nondiabetic CKD: A Systematic Review and Meta-analysis

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Aminu K. Bello

2017-07-01

Discussion: Multifaceted interventions targeting multiple risk factors tended to reduce the risk of all-cause mortality and reduced the risk to progress to end-stage kidney failure in patients with CKD. There is a need for high-quality studies that can rigorously evaluate a set of interventions targeting multiple domains of CKD management in the population with nondiabetic CKD due to paucity of data in the current published literature.

Cost-effectiveness of a Nutrition Education Curriculum Intervention in Elementary Schools.

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Graziose, Matthew M; Koch, Pamela A; Wang, Y Claire; Lee Gray, Heewon; Contento, Isobel R

2017-09-01

To estimate the long-term cost-effectiveness of an obesity prevention nutrition education curriculum (Food, Health, & Choices) as delivered to all New York City fifth-grade public school students over 1 year. This study is a standard cost-effectiveness analysis from a societal perspective, with a 3% discount rate and a no-intervention comparator, as recommended by the US Panel on Cost-effectiveness in Health and Medicine. Costs of implementation, administration, and future obesity-related medical costs were included. Effectiveness was based on a cluster-randomized, controlled trial in 20 public schools during the 2012-2013 school year and linked to published estimates of childhood-to-adulthood body mass index trajectories using a decision analytic model. The Food, Health, & Choices intervention was estimated to cost $8,537,900 and result in 289 fewer males and 350 fewer females becoming obese (0.8% of New York City fifth-grade public school students), saving 1,599 quality-adjusted life-years (QALYs) and $8,098,600 in direct medical costs. Food, Health, & Choices is predicted to be cost-effective at $275/QALY (95% confidence interval, -$2,576/QALY to $2,084/QALY) with estimates up to $6,029/QALY in sensitivity analyses. This cost-effectiveness model suggests that a nutrition education curriculum in public schools is effective and cost-effective in reducing childhood obesity, consistent with the authors' hypothesis and previous literature. Future research should assess the feasibility and sustainability of scale-up. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Nutritional support and dietary interventions for women with polycystic ovary syndrome

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Papavasiliou K

2017-09-01

Full Text Available Kleopatra Papavasiliou, Emilia Papakonstantinou Unit of Human Nutrition, Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece Abstract: Polycystic ovary syndrome (PCOS is a common endocrine disorder in reproductive-aged women, which leads to reproductive, metabolic and hormonal abnormalities. Hyperinsulinemia, insulin resistance, androgen excess, ovulatory dysfunction, polycystic ovaries, gonadotropin abnormalities, obesity, adipose tissue dysfunction, difficulty to conceive and high-risk pregnancy are the most common PCOS-associated complications. The aim of this review was to describe and evaluate the effects of dietary interventions on PCOS-associated outcomes and to provide some evidence-based dietary advice for use in clinical practice. There is no optimal diet or macronutrient composition for PCOS. However, lifestyle modification, including a small-to-moderate weight loss of 5–10% (combined diet with regular physical activity with any dietary pattern of choice, depending on the individuals’ preferences, culture, habits and metabolic needs (ie, Mediterranean diet, Dietary Approaches to Stop Hypertension [DASH] diet or moderately low-carbohydrate diets [30–45% of energy], as well as alternative dietary interventions, including small, frequent meal (five to six meals daily consumption at regular times, with the majority of carbohydrates consumed at lunch time or equally distributed throughout the day, seems to offer the evidence-based first-line strategy for the management of PCOS symptoms and insulin resistance. No conclusions can be drawn at this time for high protein diets, polyunsaturated fatty acids or micronutrient supplementation. Keywords: nutrition, meal frequency, dietary strategies, insulin resistance 

A critical appraisal of nutritional intervention studies in malnourished, community dwelling older persons

NARCIS (Netherlands)

van Schueren, M.A.E.; Wijnhoven, H A H; Kruizenga, H M; Visser, M

2016-01-01

BACKGROUND & AIMS: With the rapidly increasing number of malnourished older persons in the community, this review aims to summarize the effects of nutritional intervention studies for this target group. METHODS: Based on 2 previous reviews (2009, 2011) an update of the literature was performed.

Public health and nutrition after the Spanish Civil War. An intervention by the Rockefeller Foundation.

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Del Cura, Isabel; Huertas, Rafael

2009-10-01

We describe a nutritional intervention by the Rockefeller Foundation's International Health Division in Spain after the Spanish Civil War, delineating the relationships between the technicians sent by the Rockefeller Foundation and the Spanish health authorities. We analyze reports of the nutritional situation in Spain in the early 1940s and the design and outcomes of a nutrition survey conducted in a district of Madrid by American and Spanish nutritionists. This nutritional survey, which was based on food intake interviews and was complemented with anthropometric measurements, clinical examinations, and blood tests, found several symptoms and signs of malnutrition. The Rockefeller Foundation's nutritional research was an important historical precedent for later studies made in emergency situations or armed conflicts. Similar surveys have been carried out in the last several decades by distinguished academic departments of public health and epidemiology and by humanitarian aid agencies.

Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report.

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Farrell, Elizabeth; Naber, Erin; Geigle, Paula

2010-01-01

This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.

Evaluation of the effectiveness of a nutrition education intervention performed by primary school teachers

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Erminia Agozzino

2007-12-01

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Background: Long-term interventions based on the active involvement of students, carried out by properly prepared staff using didactic support material (brochures, games etc. including the participation/involvement of mothers or associates in community interventions; seem to be the most effective ones. This study evaluates the effectiveness of nutrition education interventions carried out by teachers with active didactic methodologies.

Methods: The research was carried out by administering a frequency of food intake questionnaire, before and after the intervention. To compare the answers given before and after the educational intervention the Wilcoxon-test was applied to dependent data discriminating the group with “sufficient implementation” of the project versus “insufficient implementation”.

Results: Our data demonstrates that a substantial percentage of children do not report an adequate nutritional intake, making education interventions not only opportune but necessary. In both groups there was an increase in the number of subjects having breakfast, particularly in terms of bread and biscuits intake. In the group with “sufficient implementation” there was an increase in the intake of all kinds of food with respect to the previous day’s intake and a decrease in the intake of meat, fish and legumes consumed during the previous week; in the group with “insufficient implementation” only fish intake increased significantly while vegetable intake decreased in a non-significant way. So this educational intervention appears to have been particularly effective in modifying breakfast habits and reducing snack.

Explaining the effects of a point-of-purchase nutrition-information intervention in university canteens: a structural equation modelling analysis

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Hoefkens Christine

2012-09-01

Full Text Available Abstract Background The importance of canteen meals in the diet of many university students makes the provision of simple point-of-purchase (POP nutrition information in university canteens a potentially effective way to promote healthier diets in an important group of young adults. However, modifications to environments such as the posting of POP nutrition information in canteens may not cause an immediate change in meal choices and nutrient intakes. The present study aimed at understanding the process by which the POP nutrition information achieved its effects on the meal choice and energy intake, and whether the information was more effective in changing the meal choice of subgroups of university canteen customers. Methods The POP nutrition-information intervention used a one-group pretest-posttest design. A sample of 224 customers of two university canteens completed the baseline and 6-months follow-up surveys. A multi-group structural equation modelling analysis was used to test mediation effects of individual difference variables (liking, understanding and use of the information, subjective knowledge and attitude on the energy intake from canteen meals, moderated by the objective nutrition knowledge and motivation to change diet. Results Significant relations were identified between liking of the information and its use on one hand and a positive effect in attitude towards healthy canteen meals on the other hand. Motivation to change diet and sufficient objective nutrition knowledge were required to maintain a recommended energy intake from canteen meals or to lead to a decrease in energy intake. Participants with greater objective nutrition knowledge had a greater understanding of the POP nutrition information which also resulted in a more effective use of the information. Conclusions The results suggest that nutrition-information interventions may be more effective when using nutrition information that is generally liked by the target

Evaluation of fast food behavior in pre-school children and parents following a one-year intervention with nutrition education.

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Gao, Yongqing; Huang, Yuee; Zhang, Yongjun; Liu, Fengqiong; Feng, Cindy Xin; Liu, Tingting; Li, Changwei; Ling, Dong Dong; Mu, Yongping; Tarver, Siobhan L; Wang, Mao; Sun, Wenjie

2014-06-30

A community-based intervention study was conducted to assess a nutrition education intervention on western style fast food consumption among Chinese children and parents. Eight kindergartens from three district areas of Hefei City (a total of 1252 children aged 4-6 years and their parents) were randomly selected. Descriptive and analytical statistical methods were used to evaluate the baseline, midterm, and final western style fast food knowledge, attitude, and practice in both parents and children were used to identify and compare the knowledge, attitude, and practice in the parents and children. Parents and children were divided into "intervention" and "control" groups based on nutrition education status. Consumption of western style fast food at breakfast in Chinese children and parents is not high. The main reasons for this in children is that consumption of western style fast food is not viewed as "food", but rather as a "gift" or "interesting". The time of children's consumption of western style fast food is mostly likely to be in the weekends. The nutrition education modified the parents' western style fast food behavior (p nutrition concept should be built up among Chinese, especially in children. Insights from the families provide leads for future research and ideas for the nutrition education.

Evaluation of the effect of an intervention on the nutritional status of hospitalized patients.

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Miguel Montoya, Isabel; Ortí Lucas, Rafael; Ferrer Ferrándiz, Esperanza; Martín Baena, David; Montejano Lozoya, Raimunda

2017-04-07

To compare the nutritional status of a population of hospitalized patients, divided into 2 different groups, both at admission and hospital discharge, and to assess the influence of nutritional alteration during the hospital stay. Quasi-experimental study comprising 2 groups of patients (N=581); an intervention group (n=303), in which nurses received specific training on managing care methodology, and a control group (n=278), in which nurses continued their usual dynamics. Each group was made up of 2 care units with patients from both surgical and medical specialties. patients admitted to the selected units with a minimum stay of 5 days. The sample selection was performed prospectively and consecutively after implementing the training. Of the 581 patients studied, 49.4% were women and 50.6% were men. Mean patient age was 68.29 (SD 16.23) years. In the intervention group, the odds ratio (OR) associated with good nutritional status was multiplied by 1.7 (OR=1.67) compared to the control group in the first evaluation and by 1.4 times (OR=1.43) at hospital discharge. The average stay in days was higher in the control group (13.71, SD 10.19) than in the intervention group (10.89, SD 7.49) (Pnutritional alteration and a shorter hospital stay than those admitted to the control units. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Effect of personalized dietary intervention on nutritional, metabolic and vascular indices in patients with chronic kidney disease.

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Lai, S; Molfino, A; Coppola, B; De Leo, S; Tommasi, V; Galani, A; Migliaccio, S; Greco, E A; Gnerre Musto, T; Muscaritoli, M

2015-09-01

Patients with chronic kidney disease (CKD) present a markedly increased cardiovascular (CV) morbidity and mortality since the early stages of the disease and a high prevalence of malnutrition, inflammation, and accelerated atherosclerosis. Personalized nutritional intervention, with of a low-protein diet (LPD), since the early stages of CKD should be able to achieve significant metabolic improvements. In our study we have verified the effects of a personalized dietary intervention in patients in the CKD stages 3/4 KDOQI on nutritional, metabolic and vascular indices. We have evaluated renal function, lipid profile, mineral metabolism, inflammatory indices, and acid-base balance of 16 patients with CKD (stages 3/4 KDOQI). Assessment of nutritional status, body composition, bone mineral density and muscle mass, using body mass index (BMI), handgrip strength, bioelectrical impedance analysis (BIA), and dual energy X-ray absorptiometry (DEXA) was performed. Vascular indices and endothelial dysfunction such as carotid intima-media thickness (cIMT) and the brachial artery flow-mediated dilation (baFMD) were also analyzed. After dietary interventions, we observed a significant increase in plasma bicarbonate (p = 0.004) and vitamin D levels (p = 0.03) and a concomitant significant reduction of phosphorus concentration (p = 0.001) and C-reactive protein (CRP) (p = 0.01). Nutritional intervention potentially plays a major role in reducing the progression of CKD and systemic complications of predialysis patients. A low-protein diet (LPD) ensuring vegetable protein intake and a reduced amount of specific micronutrients should be recommended to stage 3/4 CKD patients in order to ameliorate metabolic profile, renal outcome, and reduce cardiovascular risk factors.

Nutrition impact symptoms in advanced cancer patients: frequency and specific interventions, a case?control study

OpenAIRE

Omlin, Aurelius; Blum, David; Wierecky, Jan; Haile, Sarah R.; Ottery, Faith D.; Strasser, Florian

2013-01-01

Background Involuntary weight loss (IWL) is frequent in advanced cancer patients causing compromised anticancer treatment outcomes and function. Cancer cachexia is influenced by nutrition impact symptoms (NIS). The aim of this study was to explore the frequency of NIS in advanced patients and to assess specific interventions guided by a 12-item NIS checklist. Methods Consecutive patients from an outpatient nutrition-fatigue clinic completed the NIS checklist. The NIS checklist was developed b...

The Effects of a Sports Nutrition Education Intervention on Nutritional Status, Sport Nutrition Knowledge, Body Composition, and Performance during Off Season Training in NCAA Division I Baseball Players

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Fabrício Eduardo Rossi, Andrew Landreth, Stacey Beam, Taylor Jones, Layne Norton, Jason Michael Cholewa

2017-03-01

Full Text Available This study investigated the effects of a sport nutrition education intervention (SNEI on dietary intake, knowledge, body composition, and performance in NCAA Division I baseball players. Resistance trained NCAA Division I baseball players (82.4 ± 8.2 kg; 1.83 ± 0.06 m; 13.7 ± 5 % body fat participated in the study during 12 weeks of off-season training. Fifteen players volunteered for SNEI while 15 players matched for position served as controls (C for body composition and performance. The nutrition intervention group (NI received a 90 min SNEI encompassing energy intake (Kcal, carbohydrate (CHO, protein (PRO, fat, food sources, and hydration. Sport nutrition knowledge questionnaires were administered to NI pre and post. Nutritional status was determined by three-day dietary logs administered to NI pre and post. Body composition and performance (5-10-5 shuttle test, vertical jump, broad jump, 1 RM squat were measured pre and post for C and NI. Knowledge increased in NI. Pro and fat, but not CHO intake increased in NI. FM decreased pre to post in NI (11.5 ± 4.8 vs. 10.5 ± 5.4 kg but not C (11.3 ± 4.7 vs. 11.9 ± 4.5 kg. FFM increased pre to post with no differences between groups. The 5-10-5 shuttle times decreased significantly more in NI (4.58 ± 0.15 vs. 4.43 ± 0.13 sec compared to C (4.56 ± 0.18 vs. 4.50 ± 0.16 sec. Jump and squat performance increased pre to post with no differences between groups. Our findings indicate that an off season SNEI is effective at improving sport nutrition knowledge and some, but not all, nutrient intakes and performance measures in Division I baseball players.

The Effects of a Sports Nutrition Education Intervention on Nutritional Status, Sport Nutrition Knowledge, Body Composition, and Performance during Off Season Training in NCAA Division I Baseball Players.

Science.gov (United States)

Rossi, Fabrício Eduardo; Landreth, Andrew; Beam, Stacey; Jones, Taylor; Norton, Layne; Cholewa, Jason Michael

2017-03-01

This study investigated the effects of a sport nutrition education intervention (SNEI) on dietary intake, knowledge, body composition, and performance in NCAA Division I baseball players. Resistance trained NCAA Division I baseball players (82.4 ± 8.2 kg; 1.83 ± 0.06 m; 13.7 ± 5 % body fat) participated in the study during 12 weeks of off-season training. Fifteen players volunteered for SNEI while 15 players matched for position served as controls (C) for body composition and performance. The nutrition intervention group (NI) received a 90 min SNEI encompassing energy intake (Kcal), carbohydrate (CHO), protein (PRO), fat, food sources, and hydration. Sport nutrition knowledge questionnaires were administered to NI pre and post. Nutritional status was determined by three-day dietary logs administered to NI pre and post. Body composition and performance (5-10-5 shuttle test, vertical jump, broad jump, 1 RM squat) were measured pre and post for C and NI. Knowledge increased in NI. Pro and fat, but not CHO intake increased in NI. FM decreased pre to post in NI (11.5 ± 4.8 vs. 10.5 ± 5.4 kg) but not C (11.3 ± 4.7 vs. 11.9 ± 4.5 kg). FFM increased pre to post with no differences between groups. The 5-10-5 shuttle times decreased significantly more in NI (4.58 ± 0.15 vs. 4.43 ± 0.13 sec) compared to C (4.56 ± 0.18 vs. 4.50 ± 0.16 sec). Jump and squat performance increased pre to post with no differences between groups. Our findings indicate that an off season SNEI is effective at improving sport nutrition knowledge and some, but not all, nutrient intakes and performance measures in Division I baseball players.

A nutrition intervention with a main focus on vegetables and bread consumption among young men in the Norwegian National Guard

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Uglem, Solveig; Stea, Tonje Holte; Kjøllesdal, Marte Karoline Råberg; Frølich, Wenche; Wandel, Margareta

2013-01-01

Background Young men are difficult to reach with conventional nutrition information and they have a low intake of vegetables and whole grain cereals. Few intervention studies have focused on improving young men's consumption of vegetables and whole grains. Objective A 5-month intervention focusing on a combination of increased availability of healthy foods and nutritional information was developed to stimulate the intake of vegetables and semi-whole grain bread among a group of young men in the Norwegian military. Subjects A total of 376 recruits in the intervention group and 105 recruits in the control group participated in the entire study. Results The average daily increase in consumption of vegetables was 82 g (pfood satisfaction after the intervention. Conclusion The combination of increased availability of healthy food items and nutrition information was an effective way to increase the intake of vegetables and semi-whole grain bread, without a reduction in food satisfaction, among young men in the military. PMID:24155686

Social marketing-based communications to integrate and support the HEALTHY study intervention

Science.gov (United States)

DeBar, LL; Schneider, M; Ford, EG; Hernandez, AE; Showell, B; Drews, KL; Moe, EL; Gillis, B; Jessup, AN; Stadler, DD; White, M

2009-01-01

The HEALTHY study was a randomized, controlled, multicenter, middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Participants were a racially, ethnically and geographically diverse cohort from across the United States. Here, we describe the conceptual underpinnings and design of the social marketing-based communications component of the HEALTHY study intervention that combined changes in the school nutrition and physical education (PE) environment with behavior change initiatives. The communications intervention component coordinated multiple elements to deliver campaigns that served to integrate and support all aspects of the HEALTHY intervention. The campaigns unfolded across five semesters of middle school, each targeting a specific theme related to the HEALTHY objectives. Communications campaigns comprised (1) core elements such as branding, posters, banners and visual and verbal messaging, (2) student events supporting the nutrition, PE and behavior intervention components through the application of social marketing and communications strategies, including the incorporation of student-generated media and (3) distribution of premiums and theme enhancers to extend the visibility of the study beyond the intervention environment. Formative research conducted with students, parents and school administrators was used to refine the communications strategy. Student peer communicators selected from the student body were involved to influence the normative student environment. Marketing and creative design experts developed a brand, logo, activities and materials. In the latter half of the study, student-generated messages and media were used to reflect local interests and culture and enhance peer influence. The HEALTHY intervention delivery and impact were strengthened by the

Social marketing-based communications to integrate and support the HEALTHY study intervention.

Science.gov (United States)

DeBar, L L; Schneider, M; Ford, E G; Hernandez, A E; Showell, B; Drews, K L; Moe, E L; Gillis, B; Jessup, A N; Stadler, D D; White, M

2009-08-01

The HEALTHY study was a randomized, controlled, multicenter, middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Participants were a racially, ethnically and geographically diverse cohort from across the United States. Here, we describe the conceptual underpinnings and design of the social marketing-based communications component of the HEALTHY study intervention that combined changes in the school nutrition and physical education (PE) environment with behavior change initiatives. The communications intervention component coordinated multiple elements to deliver campaigns that served to integrate and support all aspects of the HEALTHY intervention. The campaigns unfolded across five semesters of middle school, each targeting a specific theme related to the HEALTHY objectives. Communications campaigns comprised (1) core elements such as branding, posters, banners and visual and verbal messaging, (2) student events supporting the nutrition, PE and behavior intervention components through the application of social marketing and communications strategies, including the incorporation of student-generated media and (3) distribution of premiums and theme enhancers to extend the visibility of the study beyond the intervention environment. Formative research conducted with students, parents and school administrators was used to refine the communications strategy. Student peer communicators selected from the student body were involved to influence the normative student environment. Marketing and creative design experts developed a brand, logo, activities and materials. In the latter half of the study, student-generated messages and media were used to reflect local interests and culture and enhance peer influence. The HEALTHY intervention delivery and impact were strengthened by the

Effects of aerobic exercise and medical nutrition intervention on endothelial injury and placental blood perfusion in patients with preeclampsia

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Zhen-Ju Zhang1

2017-06-01

Full Text Available Objective: To study the effects of aerobic exercise and medical nutrition intervention on endothelial injury and placental blood perfusion in patients with preeclampsia. Methods: 72 cases of patients diagnosed with preeclampsia in Department of Obstetrics and Gynecology of Zigong Third People’s Hospital between January 2013 and August 2016 were selected randomly divided into two groups, the observation group received aerobic exercise, medical nutrition combined with routine intervention, and the control group received routine intervention. Before and after intervention, serum endothelial injury markers were detected. After delivery, the expression of apoptosis molecules and the contents of stress molecules caused by hypoxia in placenta were detected. Results: After intervention, serum AnnexinV, vWF, ET-1 and oxLDL contents of both groups were lower than those before intervention while NO, PLGF and ABCA1 contents were higher than those before intervention and serum AnnexinV, vWF, ET-1 and oxLDL contents of observation group were lower than those of control group while NO, PLGF and ABCA1 contents were higher than those of control group; after delivery, Bax, Fas, FasL and Caspase-3 mRNA expression as well as MDA, AOPP, CHOP and GRP78 protein contents in placenta of observation group were lower than those of control group. Conclusion: Aerobic exercise and medical nutrition intervention can reduce the endothelial injury and improve the placental hypoxia of preeclampsia.

Nutritional intervention in cognitively impaired geriatric trauma patients: a feasibility study

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Eschbach D

2016-09-01

Full Text Available D Eschbach,1 T Kirchbichler,1 T Wiesmann,2 L Oberkircher,1 C Bliemel,1 S Ruchholtz,1 B Buecking1 1Center for Orthopedics and Trauma Surgery, 2Department of Anaesthesiology and Critical Care, University of Marburg, Marburg, Germany Background: Most studies focusing on improving the nutritional status of geriatric trauma patients exclude patients with cognitive impairment. These patients are especially at risk of malnutrition at admission and of worsening during the perioperative fasting period. This study was planned as a feasibility study to identify the difficulties involved in including this high-risk collective of cognitively impaired geriatric trauma patients. Patients and methods: This prospective intervention study included cognitively impaired geriatric patients (Mini–Mental State Examination <25, age >65 years with hip-related fractures. We assessed Mini Nutritional Assessment (MNA, Nutritional Risk Screening (NRS 2002, body mass index, calf circumference, American Society of Anesthesiologists’ classification, and Braden Scale. All patients received parenteral nutritional supplementation of 800 kcal/d for the 96-hour perioperative period. Serum albumin and pseudocholinesterase were monitored. Information related to the study design and any complications in the clinical course were documented. Results: A total of 96 patients were screened, among whom eleven women (median age: 87 years; age range: 74–91 years and nine men (median age: 82 years; age range: 73–89 years were included. The Mini–Mental State Examination score was 9.5 (0–24. All patients were manifestly undernourished or at risk according to MNA and NRS 2002. The body mass index was 23 kg/m2 (13–30 kg/m2, the calf circumference was 29.5 cm (18–34 cm, and the mean American Society of Anesthesiologists’ classification status was 3 (2–4. Braden Scale showed 18 patients at high risk of developing pressure ulcers. In all, 12 patients had nonsurgical

Complementary school garden, nutrition, water, sanitation and hygiene interventions to improve children’s nutrition and health status in Burkina Faso and Nepal: a study protocol

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Séverine Erismann

2016-03-01

Full Text Available Abstract Background Malnutrition and intestinal parasitic infections are common among children in Burkina Faso and Nepal. However, specific health-related data in school-aged children in these two countries are scarce. In the frame of a larger multi-stakeholder project entitled “Vegetables go to School: Improving Nutrition through Agricultural Diversification” (VgtS, a study has been designed with the objectives to: (i describe schoolchildren’s health status in Burkina Faso and Nepal; and to (ii provide an evidence-base for programme decisions on the relevance of complementary school garden, nutrition, water, sanitation and hygiene (WASH interventions. Methods/Design The studies will be conducted in the Centre Ouest and the Plateau Central regions of Burkina Faso and the Dolakha and Ramechhap districts of Nepal. Data will be collected and combined at the level of schools, children and their households. A range of indicators will be used to examine nutritional status, intestinal parasitic infections and WASH conditions in 24 schools among 1144 children aged 8–14 years at baseline and a 1-year follow-up. The studies are designed as cluster randomised trials and the schools will be assigned to two core study arms: (i the ‘complementary school garden, nutrition and WASH intervention’ arm; and the (ii ‘control’ arm with no interventions. Children will be subjected to parasitological examinations using stool and urine samples and to quality-controlled anthropometric and haemoglobin measurements. Drinking water will be assessed for contamination with coliform bacteria and faecal streptococci. A questionnaire survey on nutritional and health knowledge, attitudes and practices (KAP will be administered to children and their caregivers, also assessing socioeconomic, food-security and WASH conditions at household level. Focus group and key-informant interviews on children’s nutrition and hygiene perceptions and behaviours will be

Applications of isotopes in the development of nutrition policies and evaluation of interventions. Report of a contractual service agreement

International Nuclear Information System (INIS)

Vio, F.; Uauy, R.

2000-01-01

In the last 10-20 years, the development of science and technology applied to nutrition has been impressive. Nutrition can no longer be underestimated as a scientific discipline; nutrition embraces now modern physiology and biochemistry (including molecular biology), anthropology and the social sciences and requires real expertise from many sources, including the nuclear sector. Isotopic-based nuclear techniques provide reliable biological indicators that give, at the decision-maker level, important information to target and track progress in food and nutrition programs. They serve as tools for evaluating nutritional status of populations and individuals for micronutrients and vitamins, nutrient intake and bioavailability, body composition and energy balance. The information provided verifies the nature of the nutrition problem, helps implement or redirect on-going programs, guides in the processing of local foods and provides indicators of important long-term health improvements or broader social and economic advances. As a result of the investment in human resources undertaken by IAEA in recent years, under its mandate to promote the peaceful uses of nuclear technology, nutritionists in developing countries are now more aware of the significance and benefits of isotopic techniques. This includes stable isotopic methods that are biologically safe and have no adverse environmental impacts. Equipment is being increasingly made available by national investments in the science base. Sometimes IAEA has given specific and direct support but in many instances support previously provided for other nuclear sectors could be harnessed to address nutritional problems. In summary, the objectives now are to meet the nutrition challenges facing countries by the use of isotopes in nutritional evaluations, bearing in mind that isotopic and nuclear techniques are tools, not solutions by themselves. IAEA does not manage or fund nutrition investigations or interventions at the public

Applications of isotopes in the development of nutrition policies and evaluation of interventions. Report of a contractual service agreement

Energy Technology Data Exchange (ETDEWEB)

Vio, F; Uauy, R [Instituto de Nutricion y Tecnologia de los Alimentos, Universidad de Chile, Santiago (Chile)

2000-07-01

In the last 10-20 years, the development of science and technology applied to nutrition has been impressive. Nutrition can no longer be underestimated as a scientific discipline; nutrition embraces now modern physiology and biochemistry (including molecular biology), anthropology and the social sciences and requires real expertise from many sources, including the nuclear sector. Isotopic-based nuclear techniques provide reliable biological indicators that give, at the decision-maker level, important information to target and track progress in food and nutrition programs. They serve as tools for evaluating nutritional status of populations and individuals for micronutrients and vitamins, nutrient intake and bioavailability, body composition and energy balance. The information provided verifies the nature of the nutrition problem, helps implement or redirect on-going programs, guides in the processing of local foods and provides indicators of important long-term health improvements or broader social and economic advances. As a result of the investment in human resources undertaken by IAEA in recent years, under its mandate to promote the peaceful uses of nuclear technology, nutritionists in developing countries are now more aware of the significance and benefits of isotopic techniques. This includes stable isotopic methods that are biologically safe and have no adverse environmental impacts. Equipment is being increasingly made available by national investments in the science base. Sometimes IAEA has given specific and direct support but in many instances support previously provided for other nuclear sectors could be harnessed to address nutritional problems. In summary, the objectives now are to meet the nutrition challenges facing countries by the use of isotopes in nutritional evaluations, bearing in mind that isotopic and nuclear techniques are tools, not solutions by themselves. IAEA does not manage or fund nutrition investigations or interventions at the public

Effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of older adults living alone.

Science.gov (United States)

Ahn, Jeong-Ah; Park, JeeWon; Kim, Chun-Ja

2017-09-07

The effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of 71 older adults living alone were examined. Although a regular dietary meal plan is recommended for improving nutritional status of older adults living alone, little research is done in this field in Korea. A pre- and post-test controlled quasi-experimental design was used at public health centres. The intervention group participated in an intensive nutritional education and support programme once a week for 8 weeks with dietary menus provided by home visiting nurses/dieticians; control group received usual care. Dietary habits and nutritional knowledge were assessed using structured questionnaires; nutritional intake status was analysed using Computer Aided Nutritional Analysis Program 5.0. The mean age of participants was 77.6 years, and 81.7% of the participants were women. At 8 weeks, there were significant interactions of group by time for dietary habits, nutritional knowledge and selected nutritional status of protein, iron and vitamins of B 2 and C. Changes over time in the mean score of dietary habits and nutritional knowledge were significantly improved in the intervention group compared to the control group. The percentages of normal nutrition intake of protein, iron and vitamins A and C in the intervention group were significantly higher than the control group at 8 weeks. Nutritional education and support programme positively impacted dietary habits, nutritional knowledge and selected nutritional status in older adults living alone, and we highlight the need for community-based nutritional education and counselling programmes. Older adults living alone in a community have relatively poor nutritional status and thus require tailored nutritional intervention according to objective nutritional analysis. It is necessary to link visiting nurses with dieticians in the community to manage effective nutritional

Nutritional interventions to reduce symptoms in children and adults with attention deficit hyperactivity disorder

DEFF Research Database (Denmark)

Pedersen, Preben; Bjerrum, Merete; Larsen, Palle

2017-01-01

REVIEW QUESTION/OBJECTIVE:: The objective of this scoping review is to examine and map reported nutritional interventions and their outcomes in relieving symptoms of attention deficit hyperactivity disorder (ADHD) in the daily lives of children and adults. A further objective is to determine...

Effect of a School-Based Intervention on Nutritional Knowledge and Habits of Low-Socioeconomic School Children in Israel: A Cluster-Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Vered Kaufman-Shriqui

2016-04-01

Full Text Available Early social and economic deprivation, associated with poor nutrition and physical inactivity, may lead to adverse health trajectories. A cluster-randomized controlled-trial examining the effect of a school-based comprehensive intervention on nutrition knowledge, eating habits, and behaviors among low socioeconomic status (LSES school-aged children was performed. LSES school-aged children (4–7 years and their mothers were recruited from 11 schools, located in one town. The intervention was implemented on three levels: children, mothers, and teachers. The intervention (IArm included nutrition classes for children, mothers, and teachers and physical activity (PA classes for children; the control (CArm received PA only. Interventions were conducted by professional personnel, who were trained during in a two-day session to deliver the specific program in schools. Family data were obtained by parental interviews. Food knowledge observations, packed lunch records, and anthropometric measurements were obtained in school at baseline, six months, and at the end of the school year. Of 258 children enrolled, 220 (87.6% completed the six-month program. Only children in the IArm improved their nutrition knowledge and eating-habits and increased food variety and fruit and vegetable consumption, quality score of packed lunches (p < 0.001 for all, habitual water drinking increased (p = 0.02, and decreased sweet-drink consumption (p = 0.05. A school-based comprehensive nutrition intervention targeting LSES population improved eating habits, nutritional knowledge, and healthier packed lunches.

Impact of an early education multimedia intervention in managing nutrition-related chemotherapy side effects: a pilot study.

Science.gov (United States)

Thompson, Julie; Silliman, Kathryn; Clifford, Dawn E

2013-12-01

The purpose of the educational intervention was to measure changes in knowledge, perceived benefit of nutrition, and perceived self efficacy in handling side effects of chemotherapy before and after viewing a 15 minute DVD among patients with cancer. A convenience sample of 14 (4 male, 10 female, 61 ± 9 years) patients with cancer, early to chemotherapy, participated in the study. Participants completed a survey with demographic, knowledge items, and perceived health belief and self efficacy statements; viewed the DVD; and were then sent home with a one page handout. Two weeks after the nutrition education intervention, a second survey was completed including an item about tips used. Change was measured using paired t-test and wilcoxon signed rank tests. The mean score on the four knowledge items significantly increased (p informative and most (n = 11, 79%) responded that it was useful. The majority reported (n = 10, 71%) a tip they used from the DVD. This short multimedia nutrition education intervention was found primarily to increase knowledge and could form a useful component of counseling services for patients undergoing chemotherapy.

Nutrition intervention program and childhood malnutrition: a comparative study of two rural riverine communities in bayelsa state, Nigeria.

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Sawyer, W; Ordinioha, B; Abuwa, Pnc

2013-07-01

The prevalence of malnutrition is high in the Niger delta region of Nigeria, in spite of the region's oil wealth and nutrition intervention programs have been found to be effective in similar circumstance. This study is to assess the nutrition intervention program, implemented by UNICEF in some rural communities of Bayelsa State, one of the six States in the Niger delta region of Nigeria. The study was carried out in 2009 in Toruorua and Gbaranbiri, two rural riverine communities, in Baylesa State. Toruorua benefited from the nutrition intervention program of UNICEF between 1999 and 2008, while Gbaranbiri did not benefit. A comparative, cross-sectional study design was used, with the data collected using anthropometry and semi-structured questionnaire, administered on 105 respondents, chosen with the cluster sampling technique, popularized by UNICEF, from each of the study communities. Data were analyzed using EPI-INFO version 2002, Microsoft Excel software, and manually. Differences between the study communities were tested using the student's t-test for means, and Chi-square test for proportions. Significant values were set at P childhood malnutrition.

Multimodal interventions including nutrition in the prevention and management of disease-related malnutrition in adults: a systematic review of randomised control trials.

Science.gov (United States)

Thorne, Frances; Baldwin, Christine

2014-06-01

There has been a move to improve nutritional status in malnourished patients through the use of multimodal interventions (MI). There are currently no systematic reviews that have examined their effectiveness. This analysis aimed to examine the effects on nutritional, clinical, functional and patient-centred outcomes. A systematic review and meta-analysis using Cochrane methodology. 15 studies were included in the analysis, 13 comparing MI with usual care and 2 comparing MI with a nutrition intervention alone. Quality of studies varied and studies reported few relevant outcomes. Only 3 outcomes were compatible with meta-analysis; weight, mortality and length of stay (LOS). No statistically significant differences between groups were found. Narrative review was inconclusive. There was no evidence of benefit in the intervention groups in relation to body composition, functional status or quality of life (QoL). Intervention groups appeared to show a trend towards increased energy and protein intake however data was provided by only 2 studies (301 participants). No conclusive evidence of benefit for MI on any of the reviewed outcomes was found. Well designed, high quality trials addressing the impact of MI on relevant nutritional, functional and clinical outcomes are required. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries12

Science.gov (United States)

Kim, Sunny S.; Rogers, Beatrice L.; Coates, Jennifer; Gilligan, Daniel O.; Sarriot, Eric

2013-01-01

After making large investments to put in place effective health and nutrition interventions, researchers, program implementers, policy makers, and donors all expect lasting effects. However, it is uncertain whether this is the case, and there is less certainty on how to approach the study of program sustainability. This symposium, “Building Evidence for Sustainability of Food and Nutrition Intervention Programs in Developing Countries,” provided not only frameworks for conceptualizing sustainability but concrete evidence about the approaches and methods used as well as lessons on how they do or do not work in particular contexts. We presented the following findings: 1) sustainability of activities and impacts of Title II food aid programs in Bolivia and Kenya, 2) sustainability of impact in terms of adoption and consumption of a biofortified orange sweet potato in Uganda, and 3) lessons from incorporating pro-sustainability investment strategies in child survival programs in Guinea. Our symposium introduced a new important body of research on program sustainability to provide insights and stimulate innovative thinking in the design and planning of further applied research and future prosustainability intervention programs. PMID:24038245

Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trial.

Science.gov (United States)

Kadiyala, Suneetha; Prost, Audrey; Harris-Fry, Helen; O'Hearn, Meghan; Pradhan, Ronali; Pradhan, Shibananth; Mishra, Naba Kishore; Rath, Suchitra; Nair, Nirmala; Rath, Shibanand; Tripathy, Prasantha; Krishnan, Sneha; Koniz-Booher, Peggy; Danton, Heather; Elbourne, Diana; Sturgess, Joanna; Beaumont, Emma; Haghparast-Bidgoli, Hassan; Skordis-Worrall, Jolene; Mohanty, Satyanarayan; Upadhay, Avinash; Allen, Elizabeth

2018-03-09

Maternal and child undernutrition have adverse consequences for pregnancy outcomes and child morbidity and mortality, and they are associated with low educational attainment, economic productivity as an adult, and human wellbeing. 'Nutrition-sensitive' agriculture programs could tackle the underlying causes of undernutrition. This study is a four-arm cluster randomised controlled trial in Odisha, India. Interventions are as follows: (1) an agricultural extension platform of women's groups viewing and discussing videos on nutrition-sensitive agriculture (NSA) practices, and follow-up visits to women at home to encourage the adoption of new practices shown in the videos; (2) women's groups viewing and discussing videos on NSA and nutrition-specific practices, with follow-up visits; and (3) women's groups viewing and discussing videos on NSA and nutrition-specific practices combined with a cycle of Participatory Learning and Action meetings, with follow-up visits. All arms, including the control, receive basic nutrition training from government community frontline workers. Primary outcomes, assessed at baseline and 32 months after the start of the interventions, are (1) percentage of children aged 6-23 months consuming ≥ 4 out of 7 food groups per day and (2) mean body mass index (BMI) (kg/m 2 ) of non-pregnant, non-postpartum (gave birth > 42 days ago) mothers or female primary caregivers of children aged 0-23 months. Secondary outcomes are percentage of mothers consuming ≥ 5 out of 10 food groups per day and percentage of children's weight-for-height z-score  70%) proportion of Scheduled Tribe or Scheduled Caste (disadvantaged) households. A process evaluation will assess the quality of implementation and mechanisms behind the intervention effects. A cost-consequence analysis will compare incremental costs and outcomes of the interventions. This trial will contribute evidence on the impacts of NSA extension through participatory, low-cost, video

Individualized nutrition intervention is of major benefit to colorectal cancer patients: long-term follow-up of a randomized controlled trial of nutritional therapy.

Science.gov (United States)

Ravasco, Paula; Monteiro-Grillo, Isabel; Camilo, Maria

2012-12-01

In our published randomized trial in colorectal cancer, group 1 (n = 37) received individualized nutritional counseling and education about regular foods, group 2 (n = 37) received dietary supplements and consumed their usual diet of regular foods, and group 3 (n = 37) consumed their usual diet of regular foods. Neither group 2 nor group 3 received individualized counseling. Early nutritional counseling during radiotherapy was highly effective at reducing acute radiotherapy toxicity and improving nutritional intake/status and quality of life (QoL). Efficacy persisted for 3 mo after the intervention. The objective was to perform long-term follow-up in survivors of that clinical trial to specifically evaluate survival, late toxicity, QoL, and nutritional variables. Medical data were collected from patients' records, and prescheduled interviews were conducted by dietitians for individualized evaluations. Analyses and comparisons between groups (adjusted for stage) were performed after a median follow-up of 6.5 (range: 4.9-8.1) y. Patients complied with the Radiotherapy Department's follow-up protocol. Nutritional deterioration was higher (P nutritional status was maintained in 91% of group 1 patients but not in any of the group 3 patients (P group 2 > group 1 (P group 1 (P nutritional status and intake (P nutritional status, and QoL predicted shorter survival and late toxicity (HR: 8.25; 95% CI: 2.74, 1.47; P nutrition at improving long-term prognosis in colorectal cancer. Overall, the data indicate that early individualized nutritional counseling and education during radiotherapy is valuable for patients.

Randomized nutrition education intervention to improve carbohydrate counting in adolescents with type 1 diabetes study: is more intensive education needed?

Science.gov (United States)

Spiegel, Gail; Bortsov, Andrey; Bishop, Franziska K; Owen, Darcy; Klingensmith, Georgeanna J; Mayer-Davis, Elizabeth J; Maahs, David M

2012-11-01

Youth with type 1 diabetes do not count carbohydrates accurately, yet it is an important strategy in blood glucose control. The study objective was to determine whether a nutrition education intervention would improve carbohydrate counting accuracy and glycemic control. We conducted a randomized, controlled nutrition intervention trial that was recruited from February 2009 to February 2010. Youth (12 to 18 years of age, n = 101) with type 1 diabetes were screened to identify those with poor carbohydrate counting accuracy, using a previously developed carbohydrate counting accuracy test covering commonly consumed foods and beverage items presented in six mixed meals and two snacks. All participants (n = 66, age = 15 ± 3 years, 41 male, diabetes duration = 6 ± 4 years, hemoglobin A1c [HbA1c] = 8.3% ± 1.1%) were randomized to the control or intervention group at the baseline visit. The intervention group attended a 90-minute class with a registered dietitian/certified diabetes educator and twice kept 3-day food records, which were used to review carbohydrate counting progress. Carbohydrate counting accuracy (measured as described) and HbA1c were evaluated at baseline and 3 months to determine the effectiveness of the intervention. t Tests, Spearman correlations, and repeated measures models were used. At baseline, carbohydrate content was over- and underestimated in 16 and 5 of 29 food items, respectively. When foods were presented as mixed meals, participants either significantly over- or underestimated 10 of the 9 meals and 4 snacks. After 3 months of follow-up, HbA1c decreased in both the intervention and control groups by -0.19% ± 0.12% (P = 0.12) and -0.08% ± 0.11% (P = 0.51), respectively; however, the overall intervention effect was not statistically significant for change in HbA1c or carbohydrate counting accuracy. More intensive intervention might be required to improve adolescents' carbohydrate counting accuracy and nutrition management of type 1

Nutrition support in hospitalised adults at nutritional risk.

Science.gov (United States)

Feinberg, Joshua; Nielsen, Emil Eik; Korang, Steven Kwasi; Halberg Engell, Kirstine; Nielsen, Marie Skøtt; Zhang, Kang; Didriksen, Maria; Lund, Lisbeth; Lindahl, Niklas; Hallum, Sara; Liang, Ning; Xiong, Wenjing; Yang, Xuemei; Brunsgaard, Pernille; Garioud, Alexandre; Safi, Sanam; Lindschou, Jane; Kondrup, Jens; Gluud, Christian; Jakobsen, Janus C

2017-05-19

The prevalence of disease-related malnutrition in Western European hospitals is estimated to be about 30%. There is no consensus whether poor nutritional status causes poorer clinical outcome or if it is merely associated with it. The intention with all forms of nutrition support is to increase uptake of essential nutrients and improve clinical outcome. Previous reviews have shown conflicting results with regard to the effects of nutrition support. To assess the benefits and harms of nutrition support versus no intervention, treatment as usual, or placebo in hospitalised adults at nutritional risk. We searched Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE (Ovid SP), Embase (Ovid SP), LILACS (BIREME), and Science Citation Index Expanded (Web of Science). We also searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp); ClinicalTrials.gov; Turning Research Into Practice (TRIP); Google Scholar; and BIOSIS, as well as relevant bibliographies of review articles and personal files. All searches are current to February 2016. We include randomised clinical trials, irrespective of publication type, publication date, and language, comparing nutrition support versus control in hospitalised adults at nutritional risk. We exclude trials assessing non-standard nutrition support. We used standard methodological procedures expected by Cochrane and the Cochrane Hepato-Biliary Group. We used trial domains to assess the risks of systematic error (bias). We conducted Trial Sequential Analyses to control for the risks of random errors. We considered a P value of 0.025 or less as statistically significant. We used GRADE methodology. Our primary outcomes were all-cause mortality, serious adverse events, and health-related quality of life. We included 244 randomised clinical trials with 28,619 participants that met our inclusion criteria. We considered all trials to be at high risk of bias. Two

Social marketing approaches to nutrition and physical activity interventions in early care and education centres: a systematic review.

Science.gov (United States)

Luecking, C T; Hennink-Kaminski, H; Ihekweazu, C; Vaughn, A; Mazzucca, S; Ward, D S

2017-12-01

Social marketing is a promising planning approach for influencing voluntary lifestyle behaviours, but its application to nutrition and physical activity interventions in the early care and education setting remains unknown. PubMed, ISI Web of Science, PsycInfo and the Cumulative Index of Nursing and Allied Health were systematically searched to identify interventions targeting nutrition and/or physical activity behaviours of children enrolled in early care centres between 1994 and 2016. Content analysis methods were used to capture information reflecting eight social marketing benchmark criteria. The review included 135 articles representing 77 interventions. Two interventions incorporated all eight benchmark criteria, but the majority included fewer than four. Each intervention included behaviour and methods mix criteria, and more than half identified audience segments. Only one-third of interventions incorporated customer orientation, theory, exchange and insight. Only six interventions addressed competing behaviours. We did not find statistical significance for the effectiveness of interventions on child-level diet, physical activity or anthropometric outcomes based on the number of benchmark criteria used. This review highlights opportunities to apply social marketing to obesity prevention interventions in early care centres. Social marketing could be an important strategy for early childhood obesity prevention efforts, and future research investigations into its effects are warranted. © 2017 World Obesity Federation.

Changes in body weight, body composition and cardiovascular risk factors after long-term nutritional intervention in patients with severe mental illness: an observational study

Directory of Open Access Journals (Sweden)

Vlahavas George

2011-02-01

Full Text Available Abstract Background Compared with the general population, individuals with severe mental illness (SMI have increased prevalence rates of obesity and greater risk for cardiovascular disease. This study aimed to investigate the effects of a long term nutritional intervention on body weight, body fat and cardiovascular risk factors in a large number of patients with SMI. Methods Nine hundred and eighty-nine patients with a mean ± S.D age of 40 ± 11.7 yrs participated in a 9 mo nutritional intervention which provided personalised dietetic treatment and lifestyle counselling every two weeks. Patients had an average body mass index (BMI of 34.3 ± 7.1 kg.m-2 and body weight (BW of 94.9 ± 21.7 kg. Fasted blood samples were collected for the measurement of glucose, total cholesterol, triglycerides and HDL- cholesterol. All measurements were undertaken at baseline and at 3 mo, 6 mo and 9 mo of the nutritional intervention. Results Four hundred and twenty-three patients of 989 total patients' cases (42.8% dropped out within the first 3 months. Two hundred eighty-five completed 6 months of the program and 145 completed the entire 9 month nutritional intervention. There were progressive statistically significant reductions in mean weight, fat mass, waist and BMI throughout the duration of monitoring (p -2 (p Conclusion The nutritional intervention produced significant reductions in body weight, body fat and improved the cardiometabolic profile in patients with SMI. These findings indicate the importance of weight-reducing nutritional intervention in decreasing the cardiovascular risk in patients with SMI.

assessing nutrition intervention programmes that addressed

African Journals Online (AJOL)

2012-04-02

Apr 2, 2012 ... national nutrition strategy for combating malnutrition was ..... Efficient and effective nutrition information system for planning, policy formulation and ... Efficient and effective financial management and administration in support ...

Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial

Directory of Open Access Journals (Sweden)

Clair Null, PhD

2018-03-01

Full Text Available Summary: Background: Poor nutrition and exposure to faecal contamination are associated with diarrhoea and growth faltering, both of which have long-term consequences for child health. We aimed to assess whether water, sanitation, handwashing, and nutrition interventions reduced diarrhoea or growth faltering. Methods: The WASH Benefits cluster-randomised trial enrolled pregnant women from villages in rural Kenya and evaluated outcomes at 1 year and 2 years of follow-up. Geographically-adjacent clusters were block-randomised to active control (household visits to measure mid-upper-arm circumference, passive control (data collection only, or compound-level interventions including household visits to promote target behaviours: drinking chlorinated water (water; safe sanitation consisting of disposing faeces in an improved latrine (sanitation; handwashing with soap (handwashing; combined water, sanitation, and handwashing; counselling on appropriate maternal, infant, and young child feeding plus small-quantity lipid-based nutrient supplements from 6–24 months (nutrition; and combined water, sanitation, handwashing, and nutrition. Primary outcomes were caregiver-reported diarrhoea in the past 7 days and length-for-age Z score at year 2 in index children born to the enrolled pregnant women. Masking was not possible for data collection, but analyses were masked. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01704105. Findings: Between Nov 27, 2012, and May 21, 2014, 8246 women in 702 clusters were enrolled and randomly assigned an intervention or control group. 1919 women were assigned to the active control group; 938 to passive control; 904 to water; 892 to sanitation; 917 to handwashing; 912 to combined water, sanitation, and handwashing; 843 to nutrition; and 921 to combined water, sanitation, handwashing, and nutrition. Data on diarrhoea at year 1 or year 2 were available for 6494 children and

The effect of Integrated nutrition care intervention on the nutritional ...

African Journals Online (AJOL)

The right to adequate nutrition in children is essential for the attainment of high standards of health. The health and nutritional status of orphans and vulnerable children is important as it affects their growth, health and mental development. However, these children suffer from malnutrition as they have limited access to ...

Challenges and New Opportunities for Clinical Nutrition Interventions in the Aged123

Science.gov (United States)

Johnson, Mary Ann; Dwyer, Johanna T.; Jensen, Gordon L.; Miller, Joshua W.; Speakman, John R.; Starke-Reed, Pamela; Volpi, Elena

2011-01-01

Nutritional status plays a critical role in the prevention and management of many chronic health conditions that are common in the elderly and are likely to become more prevalent as the population ages. This paper highlights several aspects of nutrition that require additional basic science and clinical application research to improve the health and well-being of older adults. Topics addressed are selected demographic and health indices, the uncertain benefits of energy restriction in aged humans compared with other species, the impact of food insecurity on health, the relationship between dietary protein and sarcopenia, the prevention and management of obesity while maintaining muscle mass and functional status, and controversy regarding high intakes of folic acid. Research needs regarding the safety, efficacy, and application of clinical interventions related to these topics also are discussed. PMID:21270372

Effect of a multi-faceted quality improvement intervention on inappropriate antibiotic use in children with non-bloody diarrhoea admitted to district hospitals in Kenya

Directory of Open Access Journals (Sweden)

Opondo Charles

2011-11-01

Full Text Available Abstract Background There are few reports of interventions to reduce the common but irrational use of antibiotics for acute non-bloody diarrhoea amongst hospitalised children in low-income settings. We undertook a secondary analysis of data from an intervention comprising training of health workers, facilitation, supervision and face-to-face feedback, to assess whether it reduced inappropriate use of antibiotics in children with non-bloody diarrhoea and no co-morbidities requiring antibiotics, compared to a partial intervention comprising didactic training and written feedback only. This outcome was not a pre-specified end-point of the main trial. Methods Repeated cross-sectional survey data from a cluster-randomised controlled trial of an intervention to improve management of common childhood illnesses in Kenya were used to describe the prevalence of inappropriate antibiotic use in a 7-day period in children aged 2-59 months with acute non-bloody diarrhoea. Logistic regression models with random effects for hospital were then used to identify patient and clinician level factors associated with inappropriate antibiotic use and to assess the effect of the intervention. Results 9, 459 admission records of children were reviewed for this outcome. Of these, 4, 232 (44.7% were diagnosed with diarrhoea, with 130 of these being bloody (dysentery therefore requiring antibiotics. 1, 160 children had non-bloody diarrhoea and no co-morbidities requiring antibiotics-these were the focus of the analysis. 750 (64.7% of them received antibiotics inappropriately, 313 of these being in the intervention hospitals vs. 437 in the controls. The adjusted logistic regression model showed the baseline-adjusted odds of inappropriate antibiotic prescription to children admitted to the intervention hospitals was 0.30 times that in the control hospitals (95%CI 0.09-1.02. Conclusion We found some evidence that the multi-faceted, sustained intervention described in this

Benefits of nutritional intervention on nutritional status, quality of life and survival.

Science.gov (United States)

Van Eys, J

1998-01-01

Most cancers in children are acute diseases. Therefore, the incidence of malnutrition, in general, is not different from the incidence in the referral population. Some specific tumors, such as neuroblastoma and those resulting in the diencephalic syndrome, can be exceptions. By contrast, malnutrition is a frequent problem during modern intensive cancer treatment as the result of the associated anorexia, altered taste sensations and catabolic effects of drugs. In addition, there are psychogenic factors and metabolic consequences associated with the tumor itself. Nutritional support does improve the feeling of well-being and performance status, while maintaining or improving the immune competence, thereby potentially affecting survival by limiting infectious episodes. There is no convincing evidence to date that nutritional support has an antineoplastic effect per se, but deficiency of a specific nutrient might be beneficial because of a differential requirement between tumor and normal cells. Theoretically, nutritional support might enhance tumor growth but also susceptibility to chemotherapy. In either case, nutrition is a support modality that must be given with appropriate tumor-directed therapy if curative intent is the goal of treatment. Nutrition remains a consideration after therapy is completed. This generates different challenges. If further tumor-directed therapy is futile, the decision to continue nutritional support is difficult, but if the child is well, nutritional rehabilitation must be pursued. Finally, the cured child continues to benefit from dietary advice. Nutrition should be viewed for what it is: supplying the most basic need of children.

Physical and social functional abilities seem to be maintained by a multifaceted randomized controlled nutritional intervention among old (> 65 years) Danish nursing home residents

DEFF Research Database (Denmark)

Beck, Anne Marie; Damkjær, K.; Sorbye, L. W.

2010-01-01

of nutrition (chocolate, homemade oral supplements), group exercise (moderate intensity) and oral care. Measurements taken were weight, body mass index (BMI), energy and protein intake, and functional abilities (activities of daily living = ADL, cognitive performance, and social engagement). The results showed...

A cluster-randomised trial of a multifaceted quality improvement intervention in Brazilian intensive care units (Checklist-ICU trial): statistical analysis plan.

Science.gov (United States)

Damiani, Lucas P; Cavalcanti, Alexandre B; Moreira, Frederico R; Machado, Flavia; Bozza, Fernando A; Salluh, Jorge I F; Campagnucci, Valquiria P; Normilio-Silva, Karina; Chiattone, Viviane C; Angus, Derek C; Berwanger, Otavio; Chou H Chang, Chung-

2015-06-01

The Checklist During Multidisciplinary Visits for Reduction of Mortality in Intensive Care Units (Checklist- ICU) trial is a pragmatic, two-arm, cluster-randomised trial involving 118 intensive care units in Brazil, with the primary objective of determining if a multifaceted qualityimprovement intervention with a daily checklist, definition of daily care goals during multidisciplinary daily rounds and clinician prompts can reduce inhospital mortality. To describe our trial statistical analysis plan (SAP). This is an ongoing trial conducted in two phases. In the preparatory observational phase, we collect three sets of baseline data: ICU characteristics; patient characteristics, processes of care and outcomes; and completed safety attitudes questionnaires (SAQs). In the randomised phase, ICUs are assigned to the experimental or control arms and we collect patient data and repeat the SAQ. Our SAP includes the prespecified model for the primary and secondary outcome analyses, which account for the cluster-randomised design and availability of baseline data. We also detail the multiple mediation models that we will use to assess our secondary hypothesis (that the effect of the intervention on inhospital mortality is mediated not only through care processes targeted by the checklist, but also through changes in safety culture). We describe our approach to sensitivity and subgroup analyses and missing data. We report our SAP before closing our study database and starting analysis. We anticipate that this should prevent analysis bias and enhance the utility of results.

Improved confidence in performing nutrition and physical activity behaviours mediates behavioural change in young adults: Mediation results of a randomised controlled mHealth intervention.

Science.gov (United States)

Partridge, Stephanie R; McGeechan, Kevin; Bauman, Adrian; Phongsavan, Philayrath; Allman-Farinelli, Margaret

2017-01-01

The burden of weight gain disproportionally affects young adults. Understanding the underlying behavioural mechanisms of change in mHealth nutrition and physical activity interventions designed for young adults is important for enhancing and translating effective interventions. First, we hypothesised that knowledge, self-efficacy and stage-of-change for nutrition and physical activity behaviours would improve, and second, that self-efficacy changes in nutrition and physical activity behaviours mediate the behaviour changes observed in an mHealth RCT for prevention of weight gain. Young adults, aged 18-35 years at risk of weight gain (n = 250) were randomly assigned to an mHealth-program, TXT2BFiT, consisting of a three-month intensive phase and six-month maintenance phase or to a control group. Self-reported online surveys at baseline, three- and nine-months assessed nutrition and physical activity behaviours, knowledge, self-efficacy and stage-of-change. The mediating effect of self-efficacy was assessed in multiple PROCESS macro-models for three- and nine-month nutrition and physical activity behaviour change. Young adults randomised to the intervention increased and maintained knowledge of fruit requirements (P = 0.029) compared to controls. Intervention participants' fruit and takeaway behaviours improved to meet recommendations at nine months, with a greater proportion progressing to action or maintenance stage-of-change (P behaviours did not meet recommendations, thereby halting progress to action or maintenance stage-of-change. Indirect effects of improved nutrition and physical activity behaviours at three- and nine-months in the intervention group were explained by changes in self-efficacy, accounting for 8%-37% of the total effect. This provides insights into how the mHealth intervention achieved part of its effects and the importance of improving self-efficacy to facilitate improved eating and physical activity behaviours in young adults

The effects of a nutrition education intervention on vending machine sales on a university campus.

Science.gov (United States)

Brown, Mary V; Flint, Matthew; Fuqua, James

2014-01-01

To determine the effects of a nutrition information intervention on the vending machine purchases on a college campus. Five high-use vending machines were selected for the intervention, which was conducted in the fall of 2011. Baseline sales data were collected in the 5 machines prior to the intervention. At the time of the intervention, color-coded stickers were placed near each item selection to identify less healthy (red), moderately healthy (yellow), and more healthy (green) snack items. Sales data were collected during the 2-week intervention. Purchases of red- and yellow-stickered foods were reduced in most of the machines; moreover, sales of the green-stickered items increased in all of the machines. The increased purchases of healthier snack options demonstrate encouraging patterns that support more nutritious and healthy alternatives in vending machines.

A multifaceted hospital-wide intervention increases hand hygiene ...

African Journals Online (AJOL)

Hospital-acquired infections remain a global concern, with prevalence .... precautionary measures such as hand washing. A baseline audit in. 2014 on hand hygiene at GSH reflected an average performance of. 34% for the hospital. ..... hand hygiene intervention based on WHO and continuous improvement methodology.

Brain imaging and human nutrition: which measures to use in intervention studies?

Science.gov (United States)

Sizonenko, Stéphane V; Babiloni, Claudio; Sijben, John W; Walhovd, Kristine B

2013-09-01

Throughout the life span, the brain is a metabolically highly active organ that uses a large proportion of total nutrient and energy intake. Furthermore, the development and repair of neural tissue depend on the proper intake of essential structural nutrients, minerals, and vitamins. Therefore, what we eat, or refrain from eating, may have an important impact on our cognitive ability and mental performance. Two of the key areas in which diet is thought to play an important role are in optimizing neurodevelopment in children and in preventing neurodegeneration and cognitive decline during aging. From early development to aging, brain imaging can detect structural, functional, and metabolic changes in humans and modifications due to altered nutrition or to additional nutritional supplementation. Inclusion of imaging measures in clinical studies can increase understanding with regard to the modification of brain structure, metabolism, and functional endpoints and may provide early sensitive measures of long-term effects. In this symposium, the utility of existing brain imaging technologies to assess the effects of nutritional intervention in humans is described. Examples of current research showing the utility of these markers are reviewed.

Communicating actionable nutrition messages: challenges and opportunities.

Science.gov (United States)

Goldberg, Jeanne P; Sliwa, Sarah A

2011-02-01

As long as health communications have existed in the USA, Americans have faced the task of sorting the agenda of the source from the advice it provides. That task has become more complicated as advances in the science of nutrition and the technology used to present it have heightened the complexity of nutrition communications. Getting consumers to adopt a healthier diet has been a protracted undertaking with limited successes along the way. The obesity epidemic has added urgency to this discourse: not only do we need to eat better, but most of us also need to eat less. This paper reviews the dynamics that have made the communication of accurate and actionable health behaviour information an ongoing challenge, and outlines strategies for moving ahead. It considers the interplay of four sets of factors: the evolutionary nature of the science on which recommendations are based; the many sources of communication about that science; the agendas or motivations of each source; and finally the multifaceted nature of consumers, the recipients of these communications. Communication alone has not been, and will not be, sufficient for consumers to adopt the behavioural changes endorsed by experts. Broad environmental interventions coupled with individual skills development will need to be part of the process. Ultimately, it is the consumer who decides what is for dinner. Media literacy will play a critical role in building consumer efficacy in sorting fact from fiction in order to select food for a healthful diet.

Physical Activity and Nutrition Health Promotion Interventions: What Is Working for People with Intellectual Disabilities?

Science.gov (United States)

Heller, Tamar; McCubbin, Jeffrey A.; Drum, Charles; Peterson, Jana

2011-01-01

A scoping review of studies on physical activity and nutrition health promotion interventions for individuals with intellectual disabilities was conducted. Searches included MEDLINE, PsycINFO, and CINAHL databases from 1986 through July 2006. The final number included 11 articles comprising 12 studies. Generally, this review indicated some…

Sustained benefits of a community dietetics intervention designed to improve oral nutritional supplement prescribing practices.

LENUS (Irish Health Repository)

Kennelly, S

2011-10-01

Healthcare professionals working in the community do not always prescribe oral nutritional supplements (ONS) according to best practice guidelines for the management of malnutrition. The present study aimed to determine the impact of a community dietetics intervention on ONS prescribing practices and expenditure 1 year later.

The efficacy of a nutrition education intervention to prevent risk of malnutrition for dependent elderly patients receiving Home Care: A randomized controlled trial.

Science.gov (United States)

Fernández-Barrés, Sílvia; García-Barco, Montse; Basora, Josep; Martínez, Teresa; Pedret, Roser; Arija, Victoria

2017-05-01

To assess the effect of a nutrition education intervention included in the Home Care Program for caregivers to prevent the increasing risk of malnutrition of dependent patients at risk of malnutrition. Randomized controlled multicenter trial of 6 months of duration and 12 months follow-up. 10 Primary Care Centers, Spain. Patients enrolled in the Home Care Program between January 2010 and March 2012, who were dependent and at risk of malnutrition, older than 65, and had caregivers (n=190). The nurses conducted initial educational intervention sessions for caregivers and then monitored at home every month for 6 months. The nutritional status was assessed using the Mini Nutritional Assessment test (primary outcome), diet, anthropometry, and biochemical parameters (albumin, prealbumin, hemoglobin and cholesterol). Other descriptive and outcome measures were recorded: current medical history, Activities of daily living (Barthel test), cognitive state (Pfeiffer test), and mood status (Yesavage test). All the measures were recorded in a schedule of 0-6-12 months. 173 individuals participated after exclusions (intervention n=101; control n=72). Mean age was 87.8±8.9years, 68.2% were women. Difference were found between the groups for Mini Nutritional Assessment test score change (repeated measures ANOVA, F=10.1; PNutritional Assessment test score of the participants in the intervention group. The egg consumption (F=4.1; P=0.018), protein intake (F=3.0; P=0.050), polyunsaturated fatty acid intake (F=5.3; P=0.006), folate (F=3.3; P=0.041) and vitamin E (F=6.4; P=0.002) showed significant group×time interactions. A nutrition education intervention for caregivers halted the tendency of nutritional decline, and reduced the risk of malnutrition of older dependent patients. Clinical Trial Registration-URL: www.clinicaltrials.gov. Identifier: NCT01360775. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Actively promote nutrition and health surveillance, achieve the national nutrition and health goals].

Science.gov (United States)

Ding, Gangqiang; Zhao, Wenhua; Chen, Junshi

2016-03-01

The results of Chinese Nutrition and Health Surveillance (2010-2012) showed that the anemia prevalence in China reduced significantly compared with 2002, and people's nutrition and health status have improved. Unbalanced diet still exist, such as low intake of vegetables and fruits, and high intake of salt. The serum total cholesterol level and the prevalence of hypercholesterolemia and borderline high cholesterolemia were high among urban adults, and more attention should be paid for high serum total cholesterol level among older adults. These results are significant to the development of nutrition and health intervention strategy, carry out nutrition intervention and the achievement of national nutrition and health goals.

Interventions for dysphagia and nutritional support in acute and subacute stroke.

Science.gov (United States)

Geeganage, Chamila; Beavan, Jessica; Ellender, Sharon; Bath, Philip M W

2012-10-17

Dysphagia (swallowing problems) are common after stroke and can cause chest infection and malnutrition. Dysphagic, and malnourished, stroke patients have a poorer outcome. To assess the effectiveness of interventions for the treatment of dysphagia (swallowing therapy), and nutritional and fluid supplementation, in patients with acute and subacute (within six months from onset) stroke. We searched the Cochrane Stroke Group Trials Register (February 2012), MEDLINE (1966 to July 2011), EMBASE (1980 to July 2011), CINAHL (1982 to July 2011) and Conference Proceedings Citation Index- Science (CPCI-S) (1990 to July 2011). We also searched the reference lists of relevant trials and review articles, searched Current Controlled Trials and contacted researchers (July 2011). For the previous version of this review we contacted the Royal College of Speech and Language Therapists and equipment manufacturers. Randomised controlled trials (RCTs) in dysphagic stroke patients, and nutritional supplementation in all stroke patients, where the stroke occurred within six months of enrolment. Two review authors independently applied the inclusion criteria, assessed trial quality, and extracted data, and resolved any disagreements through discussion with a third review author. We used random-effects models to calculate odds ratios (OR), 95% confidence intervals (95% CI), and mean differences (MD). The primary outcome was functional outcome (death or dependency, or death or disability) at the end of the trial. We included 33 studies involving 6779 participants.Swallowing therapy: acupuncture, drug therapy, neuromuscular electrical stimulation, pharyngeal electrical stimulation, physical stimulation (thermal, tactile), transcranial direct current stimulation, and transcranial magnetic stimulation each had no significant effect on case fatality or combined death or dependency. Dysphagia at end-of-trial was reduced by acupuncture (number of studies (t) = 4, numbers of participants (n) = 256

The effect of a nutrition education program on the nutritional knowledge, hemoglobin levels, and nutritional status of Nicaraguan adolescent girls.

Science.gov (United States)

Moore, Jean Burley; Pawloski, Lisa; Rodriguez, Claudia; Lumbi, Laura; Ailinger, Rita

2009-01-01

The purpose of this study was to examine the effect of a community-based nutrition education program on the nutritional knowledge, hemoglobin levels, and nutritional status of Nicaraguan adolescent girls and the nutritional knowledge of their mothers. Self-care deficit nursing theory was used in this study. This longitudinal study used a mixed quantitative/qualitative design to study the effect of the nutrition education program. The nonprobability sample consisted of 182 adolescent girls and 67 of their mothers. The setting for the study was a community (barrio) in Managua, Nicaragua. INTERVENTION/MEASUREMENT: A team of nurse and nutrition researchers created the nutrition education program designed to improve girls' and mother's nutrition-related self-care operations. Data collection was carried out for 4 years for girls and 2 years for mothers in Managua, Nicaragua, using questionnaires, a HemoCue, and anthropometric measures. The findings of this study were that girls' and mothers' nutritional knowledge scores significantly improved in most cases after participation in the nutrition intervention program. Girls' hemoglobin levels did not significantly improve and their nutritional status findings were mixed. Girls and mothers described what dietary changes girls made and why.

Nutrition interventions for children aged less than 5 years following natural disasters: a systematic review protocol.

Science.gov (United States)

Pradhan, Pranil Man Singh; Dhital, Rolina; Subhani, Huma

2015-11-30

Malnutrition among children is a serious public health problem in the aftermath of any natural disaster. We will review the various nutrition interventions for children aged natural disasters occurred and analyse the effect on nutrition-related outcomes. We will conduct a systematic review on nutrition intervention studies following natural disasters that were published between January 2000 and December 2015. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Cochrane Risk of Bias (RoB) tool will be used for randomised controlled trials and Risk of Bias Assessment for Non-Randomized Studies (RoBANS) will be used for non-randomised studies. The quality of evidence will be assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines. If sufficient data are available, we will conduct meta-analyses to establish the relationship between nutrition interventions and nutrition outcome indicators. All statistical analyses will be performed using Review Manager (Rev Man) V.5.3 for Windows. Heterogeneity of the data will be tested using the standard χ(2) test. A fixed-effect model will be used for the studies with high heterogeneity (p value>0.10, I(2)≤50%). For dichotomous and continuous data, relative risk (RR) and mean difference with 95% CI will be used respectively. Subgroup analysis will be performed for studies with low heterogeneity (p value ≤0.10). We will use Z score with the level of significance set at p value <0.05 to test the total effect. Funnel plots will be used to detect publication bias. As primary data will not be collected, formal ethical approval will not be required. The results will be disseminated by publication in peer-reviewed journals, conference presentations and the media. International Prospective Register for Systematic Reviews (PROSPERO) number CRD42015023243 was registered on 1 June 2015. Published by the BMJ Publishing Group

Protein energy wasting in chronic kidney disease: An update with focus on nutritional interventions to improve outcomes

Directory of Open Access Journals (Sweden)

Yashpal P Jadeja

2012-01-01

Full Text Available Protein-energy wasting (PEW is common in patients with chronic kidney disease (CKD. PEW is one of the strongest predictors of mortality in patients with CKD. The International Society of Renal Nutrition and Metabolism (ISRNM expert panel has defined PEW as a, "state of decreased body stores of protein and energy fuels (body protein and fat masses". The ISRNM panel has also proposed diagnostic criteria of PEW with four categories. Cachexia is a severe form of PEW. The proposed causes of PEW are multi-factorial and include nutritional and non-nutritional mechanisms. The literature indicates that PEW can be mitigated or corrected with an appropriate diet and enteral nutritional support that targets dietary protein intake. Dietary requirements and enteral nutritional support must also be considered in patients with CKD and diabetes mellitus and in children with CKD, in addition to dialysis patients. Features of ideal dietary supplement have also been discussed. Dietary interventions such as enteral feeding with high-protein meals or supplements might improve the nutritional status and outcomes in dialysis patients.

Using the RE-AIM Framework in formative evaluation and program planning for a nutrition intervention in the Lower Mississippi Delta.

Science.gov (United States)

Huye, Holly F; Connell, Carol L; Crook, LaShaundrea B; Yadrick, Kathy; Zoellner, Jamie

2014-01-01

Identification of prominent themes to be considered when planning a nutrition intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Qualitative formative research. Women's social and civic organizations in the Lower Mississippi Delta. Thirty-seven (5 white and 32 black) women with a college degree or higher. Impact of dietary and contextual factors related to the Lower Mississippi Delta culture on intervention planning. Case analysis strategy using question-by-question coding. Major themes that emerged were "healthy eating focus" and "promoting a healthy lifestyle" when recruiting organizations (Reach); "positive health changes" as a result of the intervention (Effectiveness); "logistics: time commitment, location, and schedule" to initiate a program (Adoption); "expense of healthy foods" and "cooking and meal planning" as barriers to participation (Implementation); and "resources and training" and "motivation" as necessary for program continuation (Maintenance). The "health of the Delta" theme was found across all dimensions, which reflected participants' compassion for their community. Results were used to develop an implementation plan promoting optimal reach, effectiveness, adoption, implementation, and maintenance of a nutrition intervention. This research emphasizes the benefits of formative research using a systematic process at organizational and individual levels. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Short-term oral nutritional intervention with protein and vitamin D decreases falls in malnourished older adults

NARCIS (Netherlands)

Neelemaat, Floor; Lips, Paul; Bosmans, Judith E; Thijs, Abel; Seidell, Jaap C; van Bokhorst-de van der Schueren, Marian A E

OBJECTIVES: To evaluate the effects of a short-term nutritional intervention with protein and vitamin D on falls in malnourished older adults. DESIGN: Randomized controlled trial. SETTING: From hospital admission until 3 months after discharge. PARTICIPANTS: Malnourished older adults (≥ 60) newly

Evaluation of an effective multifaceted implementation strategy for elective single-embryo transfer after in vitro fertilization.

Science.gov (United States)

Kreuwel, I A M; van Peperstraten, A M; Hulscher, M E J L; Kremer, J A M; Grol, R P T M; Nelen, W L D M; Hermens, R P M G

2013-02-01

What is the relationship between the rate of elective single-embryo transfer (eSET) and couples' exposure to different elements of a multifaceted implementation strategy? Additional elements in a multifaceted implementation strategy do not result in an increased eSET rate. A multifaceted eSET implementation strategy with four different elements is effective in increasing the eSET rate by 11%. It is unclear whether every strategy element contributes equally to the strategy's effectiveness. An observational study was performed among 222 subfertile couples included in a previously performed randomized controlled trial. Of the 222 subfertile couples included, 109 couples received the implementation strategy and 113 couples received standard IVF care. A multivariate regression analysis assessed the effectiveness of four different strategy elements on the decision about the number embryos to be transferred. Questionnaires evaluated the experiences of couples with the different elements. Of the couples who received the implementation strategy, almost 50% (52/109) were exposed to all the four elements of the strategy. The remaining 57 couples who received two or three elements of the strategy could be divided into two further classes of exposure. Our analysis demonstrated that additional elements do not result in an increased eSET rate. In addition to the physician's advice, couples rated a decision aid and a counselling session as more important for their decision to transfer one or two embryos, compared with a phone call and a reimbursement offer (P implementation strategy does not always result in an increased effectiveness, which is in concordance with recent literature. This in-depth evaluation of a multifaceted intervention strategy could therefore help to modify strategies, by making them more effective and less expensive.

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.

Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder—A Randomized, Controlled 12-Month Trial

Directory of Open Access Journals (Sweden)

James B. Adams

2018-03-01

Full Text Available This study involved a randomized, controlled, single-blind 12-month treatment study of a comprehensive nutritional and dietary intervention. Participants were 67 children and adults with autism spectrum disorder (ASD ages 3–58 years from Arizona and 50 non-sibling neurotypical controls of similar age and gender. Treatment began with a special vitamin/mineral supplement, and additional treatments were added sequentially, including essential fatty acids, Epsom salt baths, carnitine, digestive enzymes, and a healthy gluten-free, casein-free, soy-free (HGCSF diet. There was a significant improvement in nonverbal intellectual ability in the treatment group compared to the non-treatment group (+6.7 ± 11 IQ points vs. −0.6 ± 11 IQ points, p = 0.009 based on a blinded clinical assessment. Based on semi-blinded assessment, the treatment group, compared to the non-treatment group, had significantly greater improvement in autism symptoms and developmental age. The treatment group had significantly greater increases in EPA, DHA, carnitine, and vitamins A, B2, B5, B6, B12, folic acid, and Coenzyme Q10. The positive results of this study suggest that a comprehensive nutritional and dietary intervention is effective at improving nutritional status, non-verbal IQ, autism symptoms, and other symptoms in most individuals with ASD. Parents reported that the vitamin/mineral supplements, essential fatty acids, and HGCSF diet were the most beneficial.

Impact of a Short-Term Nutrition Education Child Care Pilot Intervention on Preschool Children's Intention To Choose Healthy Snacks and Actual Snack Choices.

Science.gov (United States)

Joseph, Laura S; Gorin, Amy A; Mobley, Stacey L; Mobley, Amy R

2015-10-01

Novel interventions within child care settings are needed for childhood obesity prevention. The aim of this study was to determine the impact of a short-term nutrition education pilot intervention on preschool-age children's snack food choices. Children ages 3-5 years (n = 49) from one child care setting participated in a short-term nutrition education intervention (nine 30-minute interactive lessons) taught over a 2-week period. Pre-post assessments included snack knowledge and snack preference questionnaires and an observed snack selection trial to allow children to choose between a healthy and unhealthy snack choice similar to the current food environment. Children's height and weight were measured and BMI z-scores calculated. Parental reports of demographics and child's food preferences were also collected at baseline. Children significantly improved their preference of healthier snacks (p = 0.03) and the ability to distinguish them (p = 0.03) from other snacks. However, they did not significantly improve (p > 0.05) their snack choice between a healthy and unhealthy choice immediately after the short-term nutrition education program. Children who were younger (p = 0.003) or who had higher nutrition knowledge scores (p = 0.002) were more likely to select the healthy snack after the intervention. This study provides evidence that a short-term nutrition education program improves preschool children's knowledge about healthy snacks, but does not translate to immediate healthier snack selections for all children. Future research should investigate the optimal duration of a nutrition education program in a child care setting and other external influences (parents, policy) most influential on snack choice and eventual obesity risk.

Nutrition in peri-operative esophageal cancer management.

Science.gov (United States)

Steenhagen, Elles; van Vulpen, Jonna K; van Hillegersberg, Richard; May, Anne M; Siersema, Peter D

2017-07-01

Nutritional status and dietary intake are increasingly recognized as essential areas in esophageal cancer management. Nutritional management of esophageal cancer is a continuously evolving field and comprises an interesting area for scientific research. Areas covered: This review encompasses the current literature on nutrition in the pre-operative, peri-operative, and post-operative phases of esophageal cancer. Both established interventions and potential novel targets for nutritional management are discussed. Expert commentary: To ensure an optimal pre-operative status and to reduce peri-operative complications, it is key to assess nutritional status in all pre-operative esophageal cancer patients and to apply nutritional interventions accordingly. Since esophagectomy results in a permanent anatomical change, a special focus on nutritional strategies is needed in the post-operative phase, including early initiation of enteral feeding, nutritional interventions for post-operative complications, and attention to long-term nutritional intake and status. Nutritional aspects of pre-optimization and peri-operative management should be incorporated in novel Enhanced Recovery After Surgery programs for esophageal cancer.

The effects of nutritional guideline implementation on nursing home staff performance: a controlled trial.

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Törmä, Johanna; Winblad, Ulrika; Saletti, Anja; Cederholm, Tommy

2017-08-29

Suboptimal nutritional practices in elderly care settings may be resolved by an efficient introduction of nutritional guidelines. To compare two different implementation strategies, external facilitation (EF) and educational outreach visits (EOVs), when introducing nutritional guidelines in nursing homes (NHs), and study the impact on staff performance. A quasi-experimental study with baseline and follow-up measurements. The primary outcome was staff performance as a function of mealtime ambience and food service routines. The EF strategy was a 1-year, multifaceted intervention that included support, guidance, practice audit and feedback in two NH units. The EOV strategy comprised one-three-hour lecture about nutritional guidelines in two other NH units. Both strategies were targeted to selected NH teams, which consisted of a unit manager, a nurse and 5-10 care staff. Mealtime ambience was evaluated by 47 observations using a structured mealtime instrument. Food service routines were evaluated by 109 food records performed by the staff. Mealtime ambience was more strongly improved in the EF group than in the EOV group after the implementation. Factors improved were laying a table (p = 0.03), offering a choice of beverage (p = 0.02), the serving of the meal (p = 0.02), interactions between staff and residents (p = 0.02) and less noise from the kitchen (p = 0.01). Food service routines remained unchanged in both groups. An EF strategy that included guidance, audit and feedback improved mealtime ambience when nutritional guidelines were introduced in a nursing home setting, whereas food service routines were unchanged by the EF strategy. © 2017 Nordic College of Caring Science.

Evaluation of Fast Food Behavior in Pre-School Children and Parents Following a One-Year Intervention with Nutrition Education

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Yongqing Gao

2014-06-01

Full Text Available A community-based intervention study was conducted to assess a nutrition education intervention on western style fast food consumption among Chinese children and parents. Eight kindergartens from three district areas of Hefei City (a total of 1252 children aged 4–6 years and their parents were randomly selected. Descriptive and analytical statistical methods were used to evaluate the baseline, midterm, and final western style fast food knowledge, attitude, and practice in both parents and children were used to identify and compare the knowledge, attitude, and practice in the parents and children. Parents and children were divided into “intervention” and “control” groups based on nutrition education status. Consumption of western style fast food at breakfast in Chinese children and parents is not high. The main reasons for this in children is that consumption of western style fast food is not viewed as “food”, but rather as a “gift” or “interesting”. The time of children’s consumption of western style fast food is mostly likely to be in the weekends. The nutrition education modified the parents’ western style fast food behavior (p < 0.01, although it did not change significantly in children. The healthy nutrition concept should be built up among Chinese, especially in children. Insights from the families provide leads for future research and ideas for the nutrition education.

A home-based nutrition intervention to increase consumption of fruits, vegetables, and calcium-rich foods in community dwelling elders.

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Bernstein, A; Nelson, Miriam E; Tucker, Katherine L; Layne, Jennifer; Johnson, Elizabeth; Nuernberger, Andrea; Castaneda, Carmen; Judge, James O; Buchner, David; Singh, Maria Fiatarone

2002-10-01

To increase fruit, vegetable, and calcium-rich food consumption in community-dwelling, functionally impaired elderly. Six-month, home-based nutrition intervention study. Seventy men and women older than age 69 years were randomized to either a nutrition education intervention (n = 38) or a control group that received an exercise intervention (n = 32). Nutrition education was designed to increase fruit, vegetable, and calcium-rich food consumption. Food intake was assessed by a food frequency questionnaire. Fasting blood measures of nutrients and carotenoids were performed. Statistical Analysis Two-group randomized controlled trial with pre-test and post-test design and intention-to-treat analysis. Analysis of covariance to was used to assess differences between the two groups. Baseline and change partial correlation coefficients were performed between intake and blood nutrient levels. Paired t tests were conducted to test within-group changes. Compared with the exercise group, subjects in nutrition group increased their self-reported intake of fruits by 1.1 +/- 0.2 (mean +/- SEM) servings per day (2.8 to 3.9, P = .01), vegetables 1.1 +/- 0.2 servings per day (2.3 to 3.4, P = .001), and milk/dairy 0.9 +/- 0.2 servings per day (3.0 to 3.9, P = .001). There was an increase in the dietary intake of alpha-carotene and beta-carotene in the nutrition group and this correlated with the increase in blood concentrations of alpha-carotene and beta-carotene (P foods. Recommendations for increasing consumption of fruits, vegetables, and calcium-rich foods should be specific and individualized to meet the dietary pattern and lifestyle of the individual. Compliance should be encouraged with record keeping as well as through continuous monitoring and positive reinforcement.

Effect of nutritional supplement combined with exercise intervention on sarcopenia in the elderly: A meta-analysis

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Dan Luo

2017-10-01

Full Text Available Objectives: This systematic review was conducted to explore whether nutritional supplement can improve the benefits of exercise intervention on sarcopenia in the elderly. Methods: Databases, including PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, WANFANG, and VIP, were searched. All related papers with randomized controlled trials (RCT methodology that were included in the databases from inception to 19 July 2016 were selected for the study. The tool “assessing risk of bias” from Cochrane Handbook 5.10 was used to evaluate the quality of included papers. A meta-analysis of eligible studies was performed using Stata12.0. Data that we were unable to convene or merge were subjected to descriptive analysis. Results: Six trials were included in our study, which included 429 elderly patients with sarcopenia. The overall methodological quality of the trials was moderate. Compared with the exercise group, patients who were given nutritional supplements gained a bigger boost in fat-free mass (standard mean difference (SMD = 5.78, 95% CI: 5.17 to 6.40, P = 0.000 and muscle mass (SMD = 2.048, 95% CI: 0.907 to 3.189, P = 0.000, as well as showed enhancement of keen extension strength (SMD = 1.08, 95% CI: 0.71 to 1.45, P = 0.000 and usual walk speed (SMD = 0.570, 95% CI: 0.19 to 0.95, P = 0.003. Conclusion: Nutritional supplementation may magnify the effect of exercise intervention on sarcopenia elderly in terms of muscle mass, muscle strength, and physical performance. Inconsistencies were present among research studies. More robust studies are needed to determine the most suitable type of nutrient and target population and to explore the actual role of combined intervention in managing sarcopenia in the elderly. Keywords: Sarcopenia, Exercise, Nutritional status, Meta-analysis

Multistrategy childcare-based intervention to improve compliance with nutrition guidelines versus usual care in long day care services: a study protocol for a randomised controlled trial

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Seward, Kirsty; Finch, Meghan; Wiggers, John; Wyse, Rebecca; Jones, Jannah; Gillham, Karen; Yoong, Sze Lin

2016-01-01

Introduction Interventions to improve child diet are recommended as dietary patterns developed in childhood track into adulthood and influence the risk of chronic disease. For child health, childcare services are required to provide foods to children consistent with nutrition guidelines. Research suggests that foods and beverages provided by services to children are often inconsistent with nutrition guidelines. The primary aim of this study is to assess, relative to a usual care control group, the effectiveness of a multistrategy childcare-based intervention in improving compliance with nutrition guidelines in long day care services. Methods and analysis The study will employ a parallel group randomised controlled trial design. A sample of 58 long day care services that provide all meals (typically includes 1 main and 2 mid-meals) to children while they are in care, in the Hunter New England region of New South Wales, Australia, will be randomly allocated to a 6-month intervention to support implementation of nutrition guidelines or a usual care control group in a 1:1 ratio. The intervention was designed to overcome barriers to the implementation of nutrition guidelines assessed using the theoretical domains framework. Intervention strategies will include the provision of staff training and resources, audit and feedback, ongoing support and securing executive support. The primary outcome of the trial will be the change in the proportion of long day care services that have a 2-week menu compliant with childcare nutrition guidelines, measured by comprehensive menu assessments. As a secondary outcome, child dietary intake while in care will also be assessed. To assess the effectiveness of the intervention, the measures will be undertaken at baseline and ∼6 months postbaseline. Ethics and dissemination The study was approved by the Hunter New England Human Research Ethics Committee. Study findings will be disseminated widely through peer-reviewed publications. PMID

Effect of integrated responsive stimulation and nutrition interventions in the Lady Health Worker programme in Pakistan on child development, growth, and health outcomes: a cluster-randomised factorial effectiveness trial.

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Yousafzai, Aisha K; Rasheed, Muneera A; Rizvi, Arjumand; Armstrong, Robert; Bhutta, Zulfiqar A

2014-10-04

Stimulation and nutrition delivered through health programmes at a large scale could potentially benefit more than 200 million young children worldwide who are not meeting their developmental potential. We investigated the feasibility and effectiveness of the integration of interventions to enhance child development and growth outcomes in the Lady Health Worker (LHW) programme in Sindh, Pakistan. We implemented a community-based cluster-randomised effectiveness trial through the LHW programme in rural Sindh, Pakistan, with a 2 × 2 factorial design. We randomly allocated 80 clusters (LHW catchments) of children to receive routine health and nutrition services (controls; n=368), nutrition education and multiple micronutrient powders (enhanced nutrition; n=364), responsive stimulation (responsive stimulation; n=383), or a combination of both enriched interventions (n=374). The allocation ratio was 1:20 (ie, 20 clusters per intervention group). The data collection team were masked to the allocated intervention. All children born in the study area between April, 2009, and March, 2010, were eligible for enrolment if they were up to 2·5 months old without signs of severe impairments. Interventions were delivered by LHWs to families with children up to 24 months of age in routine monthly group sessions and home visits. The primary endpoints were child development at 12 and 24 months of age (assessed with the Bayley Scales of Infant and Toddler Development, Third Edition) and growth at 24 months of age. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT007159636. 1489 mother-infant dyads were enrolled into the study, of whom 1411 (93%) were followed up until the children were 24 months old. Children who received responsive stimulation had significantly higher development scores on the cognitive, language, and motor scales at 12 and 24 months of age, and on the social-emotional scale at 12 months of age, than did those who

Interventions for the cessation of non-nutritive sucking habits in children.

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Borrie, Felicity R P; Bearn, David R; Innes, Nicola P T; Iheozor-Ejiofor, Zipporah

2015-03-31

Comforting behaviours, such as the use of pacifiers (dummies, soothers), blankets and finger or thumb sucking, are common in babies and young children. These comforting habits, which can be referred to collectively as 'non-nutritive sucking habits' (NNSHs), tend to stop as children get older, under their own impetus or with support from parents and carers. However, if the habit continues whilst the permanent dentition is becoming established, it can contribute to, or cause, development of a malocclusion (abnormal bite). A diverse variety of approaches has been used to help children with stopping a NNSH. These include advice, removal of the comforting object, fitting an orthodontic appliance to interfere with the habit, application of an aversive taste to the digit or behaviour modification techniques. Some of these interventions are easier to apply than others and less disturbing for the child and their parent; some are more applicable to a particular type of habit.  The primary objective of the review was to evaluate the effects of different interventions for cessation of NNSHs in children. The secondary objectives were to determine which interventions work most quickly and are the most effective in terms of child and parent- or carer-centred outcomes of least discomfort and psychological distress from the intervention, as well as the dental measures of malocclusion (reduction in anterior open bite, overjet and correction of posterior crossbite) and cost-effectiveness. We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 8 October 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 9), MEDLINE via OVID (1946 to 8 October 2014), EMBASE via OVID (1980 to 8 October 2014), PsycINFO via OVID (1980 to 8 October 2014) and CINAHL via EBSCO (1937 to 8 October 2014), the US National Institutes of Health Trials Register (Clinical Trials.gov) (to 8 October 2014) and the WHO

Preconceptional nutrition and pregnancy outcomes: review and Dietitian-Nutritionist intervention proposal

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Lucia Fernández Molina

2016-02-01

Full Text Available The nutritional status of the mother before and during pregnancy has been observed in recent years as one of the most influential environmental factors on fetal development. This study focuses on the early stages of gestation or periconception period: preconception, conception, implantation, embryogenesis and placentation; since they represent a critical step in pregnancy outcomes. After an extensive literature review of 66 studies published between 1990 and 2015, iron, iodine, omega 3 fatty acids, folic acid and other B vitamins, minerals and micronutrients for which more evidence of a positive relationship with the development of the offspring were found. The approach of a dietary intervention by the dietitian, both individually and collectively, in the preconception period in women of childbearing age and/or pregnancy intentions is proposed in this study, being able to continue the intervention in periods of gestation, breastfeeding, postpartum and even offspring, causing long-term benefits, which are likely to remain and manifest throughout an individual’s life.

A nutrition and conditioning intervention for natural bodybuilding contest preparation: case study.

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Robinson, Scott Lloyd; Lambeth-Mansell, Anneliese; Gillibrand, Gavin; Smith-Ryan, Abbie; Bannock, Laurent

2015-01-01

Bodybuilding competitions are becoming increasingly popular. Competitors are judged on their aesthetic appearance and usually exhibit a high level of muscularity and symmetry and low levels of body fat. Commonly used techniques to improve physique during the preparation phase before competitions include dehydration, periods of prolonged fasting, severe caloric restriction, excessive cardiovascular exercise and inappropriate use of diuretics and anabolic steroids. In contrast, this case study documents a structured nutrition and conditioning intervention followed by a 21 year-old amateur bodybuilding competitor to improve body composition, resting and exercise fat oxidation, and muscular strength that does not involve use of any of the above mentioned methods. Over a 14-week period, the Athlete was provided with a scientifically designed nutrition and conditioning plan that encouraged him to (i) consume a variety of foods; (ii) not neglect any macronutrient groups; (iii) exercise regularly but not excessively and; (iv) incorporate rest days into his conditioning regime. This strategy resulted in a body mass loss of 11.7 kg's, corresponding to a 6.7 kg reduction in fat mass and a 5.0 kg reduction in fat-free mass. Resting metabolic rate decreased from 1993 kcal/d to 1814 kcal/d, whereas resting fat oxidation increased from 0.04 g/min to 0.06 g/min. His capacity to oxidize fat during exercise increased more than two-fold from 0.24 g/min to 0.59 g/min, while there was a near 3-fold increase in the corresponding exercise intensity that elicited the maximal rate of fat oxidation; 21% V̇O2max to 60% V̇O2max. Hamstring concentric peak torque decreased (1.7 to 1.5 Nm/kg), whereas hamstring eccentric (2.0 Nm/kg to 2.9 Nm/kg), quadriceps concentric (3.4 Nm/kg to 3.7 Nm/kg) and quadriceps eccentric (4.9 Nm/kg to 5.7 Nm/kg) peak torque all increased. Psychological mood-state (BRUMS scale) was not negatively influenced by the intervention and all values relating to the Athlete

Assessment of nutritional status in the elderly: a proposed function-driven model.

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Engelheart, Stina; Brummer, Robert

2018-01-01

There is no accepted or standardized definition of 'malnutrition'. Hence, there is also no definition of what constitutes an adequate nutritional status. In elderly people, assessment of nutritional status is complex and is complicated by multi-morbidity and disabilities combined with nutrition-related problems, such as dysphagia, decreased appetite, fatigue, and muscle weakness. We propose a nutritional status model that presents nutritional status from a comprehensive functional perspective. This model visualizes the complexity of the nutritional status in elderly people. The presented model could be interpreted as the nutritional status is conditional to a person's optimal function or situation. Another way of looking at it might be that a person's nutritional status affects his or her optimal situation. The proposed model includes four domains: (1) physical function and capacity; (2) health and somatic disorders; (3) food and nutrition; and (4) cognitive, affective, and sensory function. Each domain has a major impact on nutritional status, which in turn has a major impact on the outcome of each domain. Nutritional status is a multifaceted concept and there exist several knowledge gaps in the diagnosis, prevention, and optimization of treatment of inadequate nutritional status in elderly people. The nutritional status model may be useful in nutritional assessment research, as well as in the clinical setting.

Rationale and clinical data supporting nutritional intervention in Alzheimer's disease.

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Engelborghs, S; Gilles, C; Ivanoiu, A; Vandewoude, M

2014-01-01

Adequate nutrition plays an important role in the maintenance of cognitive function, particularly during aging. Malnutrition is amongst the risk factors for developing mild cognitive impairment (MCI) and Alzheimer's disease (AD). Epidemiological studies have associated deficiencies in some nutrients with a higher risk of cognitive dysfunction and/or AD. Cognitive decline in AD is correlated with synaptic loss and many of the components required to maintain optimal synaptic function are derived from dietary sources. As synapses are part of the neuronal membrane and are continuously being remodelled, the availability of sufficient levels of nutritional precursors (mainly uridine monophosphate, choline and omega-3 fatty acids) to make the phospholipids required to build neuronal membranes may have beneficial effects on synaptic degeneration in AD. In addition, B-vitamins, phospholipids and other micronutrients act as cofactors to enhance the supply of precursors required to make neuronal membranes and synapses. Despite this, no randomized controlled trial has hitherto provided evidence that any single nutrient has a beneficial effect on cognition or lowers the risk for AD. However, a multi-target approach using combinations of (micro)nutrients might have beneficial effects on cognitive function in neurodegenerative brain disorders like AD leading to synaptic degeneration. Here we review the clinical evidence for supplementation, based on a multi-target approach with a focus on key nutrients with a proposed role in synaptic dysfunction. Based on preclinical evidence, a nutrient mixture, Souvenaid(®) (Nutricia N.V., Zoetermeer, The Netherlands) was developed. Clinical trials with Souvenaid(®) have shown improved memory performance in patients with mild AD. Further clinical trials to evaluate the effects of nutritional intervention in MCI and early dementia due to AD are on-going.

Position of the Academy of Nutrition and Dietetics: interventions for the prevention and treatment of pediatric overweight and obesity.

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Hoelscher, Deanna M; Kirk, Shelley; Ritchie, Lorrene; Cunningham-Sabo, Leslie

2013-10-01

It is the position of the Academy of Nutrition and Dietetics that prevention and treatment of pediatric overweight and obesity require systems-level approaches that include the skills of registered dietitians, as well as consistent and integrated messages and environmental support across all sectors of society to achieve sustained dietary and physical-activity behavior change. This position paper provides guidance and recommendations for levels of intervention targeting overweight and obesity prevention and treatment from preschool age through adolescence. Methods included a review of the literature from 2009 to April 2012, including the Academy's 2009 evidence analysis school-based reviews. Multicomponent interventions show the greatest impact for primary prevention; thus, early childhood and school-based interventions should integrate behavioral and environmental approaches that focus on dietary intake and physical activity using a systems-level approach targeting the multilevel structure of the socioecological model as well as interactions and relationships between levels. Secondary prevention and tertiary prevention/treatment should emphasize sustained family-based, developmentally appropriate approaches that include nutrition education, dietary counseling, parenting skills, behavioral strategies, and physical-activity promotion. For obese youth with concomitant serious comorbidities, structured dietary approaches and pharmacologic agents should be considered, and weight-loss surgery can be considered for severely obese adolescents. Policy and environmental interventions are recommended as feasible and sustainable ways to support healthful lifestyles for children and families. The Academy supports commitment of resources for interventions, policies, and research that promote healthful eating and physical-activity behaviors to ensure that all youth have the opportunity to achieve and maintain a weight that is optimal for health. Copyright © 2013 Academy of

Interventions in maternal and infant nutrition in the first 1000 days with a focus on socio-economic status

DEFF Research Database (Denmark)

Robertson, Aileen; Sarki, Mahesh; Lobstein, Tim

-conceptual nutrition of parents-to-be will have follow-on benefits for the child, and for their children in turn. Such policies can help EU Member States to decrease the risk of childhood obesity, improve maternal health, and reduce health disparities in the most disadvantaged groups. This life-course approach...... in pregnancy and continuing after birth and those starting after birth but before age 2 years. The first review3 included: prevention of childhood overweight or obesity as an outcome, identifies gaps in current research, and discusses conceptual frameworks and opportunities for future interventions. The review...... that reducing maternal pre-conceptual overweight, gestational weight gain, and healthy infant weight gain by implementing nutrition recommendations shows promise for childhood obesity prevention. Policy interventions on marketing of breast-milk substitutes appear to influence socio-economic differences...

Impact of internet vs traditional Special Supplemental Nutrition Program for Women, Infants, and Children nutrition education on fruit and vegetable intake.

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Bensley, Robert J; Anderson, Judith V; Brusk, John J; Mercer, Nelda; Rivas, Jason

2011-05-01

The purpose of this project was to compare the impact of Internet nutrition education to traditional nutrition education on Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participant fruit and vegetable consumption. Interventions were delivered at 15 WIC clinics after normal WIC clinic operations or delivered online. A total of 692 and 872 participants from eight WIC agencies self-enrolled into two phases. A quasi-experimental design using an interrupted time series to determine the impact of two methods of nutrition education and follow-up nutrition counseling was used. Data were collected online and at Michigan WIC clinics during 2005-2007 at 3-month intervals during a 9-month period (per phase). Two Internet nutrition education modules were compared to WIC traditional nutrition education, which included either group classes or a self-guided nutrition education information mall. All interventions were based on the same program learning objectives. Optional motivational negotiation counseling followed 3 months post-intervention. Stage of change progression, belief in ability to change, and fruit and vegetable consumption were measured at baseline, immediately after the intervention, and 3 and 6 months post-intervention. Significance (PInternet group experienced substantial positive differences in stage of change progression, perception that the intervention was helpful and easy to use, and fruit and vegetable consumption. Traditional nutrition education required follow-up counseling to achieve fruit and vegetable consumption levels similar to the Internet nutrition education group. Based on these findings, this study supports Internet nutrition education as a viable alternative to traditional nutrition education for increasing fruit and vegetable consumption in some WIC clients. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Position of the American Dietetic Association: Nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and other eating disorders.

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2006-12-01

It is the position of the American Dietetic Association that nutrition intervention, including nutritional counseling, by a registered dietitian (RD) is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders during assessment and treatment across the continuum of care. Diagnostic criteria for eating disorders provide important guidelines for identification and treatment. However, it is thought that a continuum of disordered eating may exist that ranges from persistent dieting to subthreshold conditions and then to defined eating disorders, which include anorexia nervosa, bulimia nervosa, and binge eating disorder. Understanding the complexities of eating disorders, such as influencing factors, comorbid illness, medical and psychological complications, and boundary issues, is critical in the effective treatment of eating disorders. The nature of eating disorders requires a collaborative approach by an interdisciplinary team of psychological, nutritional, and medical specialists. The RD is an integral member of the treatment team and is uniquely qualified to provide medical nutrition therapy for the normalization of eating patterns and nutritional status. RDs provide nutritional counseling, recognize clinical signs related to eating disorders, and assist with medical monitoring while cognizant of psychotherapy and pharmacotherapy that are cornerstones of eating disorder treatment. Specialized resources are available for RDs to advance their level of expertise in the field of eating disorders. Further efforts with evidenced-based research must continue for improved treatment outcomes related to eating disorders along with identification of effective primary and secondary interventions.

School-Based Nutrition Education Intervention Using Social Cognitive Theory for Overweight and Obese Iranian Adolescent Girls: A Cluster Randomized Controlled Trial.

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Bagherniya, Mohammad; Sharma, Manoj; Mostafavi Darani, Firoozeh; Maracy, Mohammad Reza; Safarian, Mohammad; Allipour Birgani, Ramesh; Bitarafan, Vida; Keshavarz, Seyed Ali

2017-10-01

Background Nowadays childhood obesity has become one the most challenging issue which is considered as a principle public health problem all around the world. This study was conducted with the aim of evaluating the impact of a 7-month school-based nutrition education intervention using social cognitive theory (SCT) to prevent obesity among overweight and obese adolescent girls. Method In this cluster randomized community trial after choosing schools, a total of 172 overweight and obese girl students participated in the study (87 in the intervention and 85 in the control group). A 7-month intervention based on SCT for students, their parents, and teachers was conducted. At baseline and end of the study, body mass index (BMI), waist circumstances (WCs), dietary intake, and psychological questionnaires regarding the SCT constructs were obtained. Results After 7 months, the mean of BMI and WCs reduced in the intervention group from 29.47 (4.05) to 28.5 (4.35) and from 89.65 (8.15) to 86.54 (9.76), respectively, but in comparison to the control group, they were not statistically significant ( p values .127 and .504, respectively). In the intervention group, nutritional behaviors and most of the psychological variables (self-efficacy, social support, intention, and situation) were improved in favor of the study and they were significant in comparison to the control group ( p < .05). Conclusion Although school-based nutrition education intervention using SCT did not change significantly BMI and WCs among the targeted population in this study, dietary habits as well as psychological factors improved significantly in the intervention group. This trial was registered in Iranian Registry of Clinical Trials, www.irct.ir (IRCT2013103115211N1).

A Prospective Randomized Controlled Trial to Study the Impact of a Nutrition-Sensitive Intervention on Adult Women With Cancer Cachexia Undergoing Palliative Care in India.

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Kapoor, Neha; Naufahu, Jane; Tewfik, Sundus; Bhatnagar, Sushma; Garg, Rakesh; Tewfik, Ihab

2017-03-01

Advanced cancer patients with disease progression develop cachexia. Nevertheless, cancer patients at nutritional risk have shown improved body weight and quality of life with oral nutritional supplements. This was a randomized controlled trial in adult female cancer patients (n = 63) attending palliative clinics, with symptoms of cachexia. Eligible patients were randomly distributed into control (n = 33) and intervention (n = 30) groups. Both groups were provided with nutritional and physical activity counseling, but the intervention group received an additional 100 g of Improved Atta (IAtta) for 6 months daily consumption. This study was designed to assess the efficacy of IAtta (with counseling) in enhancing the health status of cachexic patients. Anthropometric measurements, dietary intake, physical activity level and quality of life parameters were assessed at baseline, after 3 months, and at the end of 6 months. Patients in the control group (n = 15) had significantly decreased body weight ( P = .003), mid-upper-arm circumference ( P = .002), and body fat ( P = .002) by the end of intervention. A trend of body weight gain in the intervention group (n = 17; P = .08) and significant increase of body fat ( P = .002) was observed; moreover, patients reported a significant improvement in fatigue ( P = .002) and appetite scores ( P = .006) under quality-of-life domains at the end of intervention. Embedding a nutrition-sensitive intervention ( IAtta ) within Indian palliative care therapy may improve quality of life and stabilize body weight in cancer cachexia patients.

[Quality control an assessment system. Its location within a program for food, nutrition and metabolic intervention].

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Santana Porbén, S

2012-01-01

A design proposal for a HQCAS Hospital Quality Control and Assessment System of the nutritional and feeding care processes conducted in a hospital environment is presented in this article. The design proposal is accompanied of the results of inspections conducted by the hospital NST Nutritional Support Group between 2005-2010. The system design includes quality policies that should rule the useful and safe conduction of such processes, the recording and documentary foundations of the System, and the quality control and assessment exercises for the continuous verification of such established policies. The current state of the conduction of these processes was documented from secondary records opened by the NST after satisfying consultation requests from the medical care teams of the institution. Inspections conducted by the NST revealed that less than half of clinical charts contained information minimally enough for elaborating nutritional judgments, almost one-fifth of the assisted patients were on Nils Per Oris, for whom no nutritional support schemes were prescribed, and a low prescription and usage of artificial nutrition schemes. Corrective measures adopted by the NST served to significantly increase the rates of successful completion of inspected processes. Quality assurance of feeding and nutritional care processes is a practical as well as an intellectual activity subjected to constant remodeling, in order to always warrant the fulfillment of quality policies advanced by the NST, and thus, that the patient benefits from the prescribed nutritional intervention strategy.

The cost-benefit of federal investment in preventing Clostridium difficile infections through the use of a multifaceted infection control and antimicrobial stewardship program.

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Slayton, Rachel B; Scott, R Douglas; Baggs, James; Lessa, Fernanda C; McDonald, L Clifford; Jernigan, John A

2015-06-01

To determine the potential epidemiologic and economic value of the implementation of a multifaceted Clostridium difficile infection (CDI) control program at US acute care hospitals Markov model with a 5-year time horizon Patients whose data were used in our simulations were limited to hospitalized Medicare beneficiaries ≥65 years old. CDI is an important public health problem with substantial associated morbidity, mortality, and cost. Multifaceted national prevention efforts in the United Kingdom, including antimicrobial stewardship, patient isolation, hand hygiene, environmental cleaning and disinfection, and audit, resulted in a 59% reduction in CDI cases reported from 2008 to 2012. Our analysis was conducted from the federal perspective. The intervention we modeled included the following components: antimicrobial stewardship utilizing the Antimicrobial Use and Resistance module of the National Healthcare Safety Network (NHSN), use of contact precautions, and enhanced environmental cleaning. We parameterized our model using data from CDC surveillance systems, the AHRQ Healthcare Cost and Utilization Project, and literature reviews. To address uncertainty in our parameter estimates, we conducted sensitivity analyses for intervention effectiveness and cost, expenditures by other federal partners, and discount rate. Each simulation represented a cohort of 1,000 hospitalized patients over 1,000 trials. RESULTS In our base case scenario with 50% intervention effectiveness, we estimated that 509,000 CDI cases and 82,000 CDI-attributable deaths would be prevented over a 5-year time horizon. Nationally, the cost savings across all hospitalizations would be $2.5 billion (95% credible interval: $1.2 billion to $4.0 billion). The potential benefits of a multifaceted national CDI prevention program are sizeable from the federal perspective.

Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study.

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Yamada, Minoru; Nishiguchi, Shu; Fukutani, Naoto; Aoyama, Tomoki; Arai, Hidenori

2015-08-01

The aim of the Intervention by Nutrition and Exercise (INE) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults. A cluster-randomized controlled trial. This trial recruited community-dwelling adults aged 65 years and older in Japan. The 227 participants were cluster randomized into a walking and nutrition (W/N) group (n = 79), a walking (W) group (n = 71), and a control (C) group (n = 77). We analyzed the physical and biochemical measurements in this substudy. Six months of mail-based intervention (a pedometer-based walking program and nutritional supplementation). The skeletal muscle mass index (SMI) using the bioelectrical impedance data acquisition system, biochemical measurements, such as those of insulinlike growth factor (IGF-1), dehydroepiandrosterone sulfate (DHEA-S), and 25-hydroxy vitamin D (25[OH]D), as well as frailty, were assessed by the Cardiovascular Health Study criteria. Participants in the W/N and W groups had significantly greater improvements in SMI, IGF-1, and 25(OH)D (P < .05) than those in the C group. Participants in the W/N group had significantly greater improvements in DHEA-S (P < .05) than in the other groups. These effects were more pronounced in frail, older adults. These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults, particularly in those who are frail. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Systematic review of the design, implementation and effectiveness of mass media and nutrition education interventions for infant and young child feeding.

Science.gov (United States)

Graziose, Matthew M; Downs, Shauna M; O'Brien, Quentin; Fanzo, Jessica

2018-02-01

To systematically review the design, implementation and effectiveness of mass media and nutrition education interventions for improving infant and young child feeding (IYCF) practices and related psychosocial factors. A search of PubMed, Embase and PsycINFO databases, a Google search, and a consultation with experts in the field of IYCF performed in July 2016. Low- and middle-income countries, as defined by the World Bank Group. Eligible studies: included a mass media component (with or without nutrition education); conducted a pre-post evaluation (with or without a control group); assessed IYCF knowledge, attitudes, beliefs and/or practices; and were published in English between 2000 and present. Eighteen unique studies were identified that examined the effect of mass media (types included: television; print; voice and/or SMS (text) messages; radio; megaphones/loudspeakers; videos; social media; songs/dramas) and nutrition education interventions on IYCF practices within thirteen countries. Of these, fifteen studies reported improvements in breast- and/or complementary feeding practices, using indicators recommended by the WHO, and six studies reported improvements in related psychosocial factors. However, little detail was provided on the use of formative research, a formal behaviour change theory and behaviour change techniques. Few studies reported both dose delivered and participants' exposure to the intervention. Despite evidence of effectiveness, few common elements in the design of interventions were identified. Future research should consistently report these details to open the 'black box' of IYCF interventions, identify effective design components and ensure replicability.

Effects of a nutritional intervention program based on the self-determination theory and promoting the Mediterranean diet

OpenAIRE

Vicky Leblanc; Catherine Bégin; Anne-Marie Hudon; Marie-Michelle Royer; Louise Corneau; Sylvie Dodin; Simone Lemieux

2015-01-01

Our objective was to determine gender differences in the impact of a nutritional intervention based on the self-determination theory and promoting the Mediterranean diet on changes in eating-related self-determined motivation and adherence to the Mediterranean diet. Changes in eating-related self-determined motivation were larger in men than in women in response to the intervention and at follow-up, but the magnitude of change decreased with time in both genders. Changes in eating-related sel...

Expanding collaborative care: integrating the role of dietitians and nutrition interventions in services for people with mental illness.

Science.gov (United States)

Teasdale, Scott B; Latimer, Geogina; Byron, Annette; Schuldt, Vanessa; Pizzinga, Josephine; Plain, Janice; Buttenshaw, Kerryn; Forsyth, Adrienne; Parker, Elizabeth; Soh, Nerissa

2018-02-01

This article aims to draw mental health clinicians' attention to the connections between nutrition and mental health, and the roles that Accredited Practising Dietitians play in improving mental and physical health through dietary change. Selective narrative review. Unhealthy dietary practices are common in high prevalence and severe mental illness. Epidemiological evidence demonstrates that nutrients and dietary patterns impact on mental health. In addition, poor physical health is well documented in people with mental illness and the greatest contributor to the mortality gap. Dietary intervention studies demonstrate improved mental and physical health outcomes. Accredited Practising Dietitians translate nutrition science into practical advice to improve the nutritional status of patients with mental illness, and prevent and manage comorbidities in a variety of care settings. Medical Nutrition Therapy offers opportunities to improve the physical and mental health of people living with mental illness.

Effectiveness of a Lifestyle Intervention in Patients with Type 2 Diabetes: The Physical Activity and Nutrition for Diabetes in Alberta (PANDA) Trial.

Science.gov (United States)

Asaad, Ghada; Soria-Contreras, Diana C; Bell, Rhonda C; Chan, Catherine B

2016-09-27

Type 2 diabetes (T2D) patients often find integrating a new dietary pattern into their lifestyle challenging; therefore, the PANDA (Physical Activity and Nutrition for Diabetes in Alberta) menu plan intervention was developed to help people incorporate the Canadian Diabetes Association (CDA) nutrition therapy guidelines into their daily lives. The menu plan focused on recipes and foods that were accessible, available and acceptable to Albertans. The objective was to evaluate the effectiveness of the intervention on blood glucose control and dietary adherence and quality among patients with T2D. Participants with T2D ( n = 73) enrolled in a single-arm incorporating interactive education based on a four-week menu plan that incorporated the recommendations of the CDA nutrition therapy guidelines. Post-intervention follow-up was conducted at three and six months. After three months, there were beneficial changes in A1c (-0.7%), body mass index (BMI, -0.6 kg/m²), diastolic blood pressure (-4 mmHg), total cholesterol (-63 mg/dL), HDL- (+28 mg/dL) and LDL-cholesterol (-89 mg/dL), Healthy Eating Index (+2.1 score) and perceived dietary adherence (+8.5 score) (all p intervention was effective in improving glycemic control and diet quality. The results suggest that a dietary intervention incorporating interactive education sessions focused on menu planning with familiar, accessible foods may be effective for diabetes management.

Nutrition training improves health workers' nutrition knowledge and competence to manage child undernutrition: a systematic review.

Science.gov (United States)

Sunguya, Bruno F; Poudel, Krishna C; Mlunde, Linda B; Urassa, David P; Yasuoka, Junko; Jimba, Masamine

2013-09-24

Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on health workers' nutrition knowledge, counseling skills, and child undernutrition management practices. We conducted a literature search on nutrition interventions from PubMed/MEDLINE, CINAHL, EMBASE, ISI Web of Knowledge, and World Health Organization regional databases. The outcome variables were nutrition knowledge, nutrition-counseling skills, and undernutrition management practices of health workers. Due to heterogeneity, we conducted only descriptive analyses. Out of 3910 retrieved articles, 25 were selected as eligible for the final analysis. A total of 18 studies evaluated health workers' nutrition knowledge and showed improvement after training. A total of 12 studies with nutrition counseling as the outcome variable also showed improvement among the trained health workers. Sixteen studies evaluated health workers' child undernutrition management practices. In all such studies, child undernutrition management practices and competence of health workers improved after the nutrition training intervention. In-service nutrition training improves quality of health workers by rendering them more knowledge and competence to manage nutrition-related conditions, especially child undernutrition. In-service nutrition training interventions can help to fill the gap created by the lack of adequate nutrition training in the existing medical and nursing education system. In this way, steps can be taken toward improving the overall nutritional status of the child population.

HOW TO DESIGN NUTRITIONAL INTERVENTION TRIALS TO SLOW COGNITIVE DECLINE IN APPARENTLY HEALTHY POPULATIONS AND APPLY FOR EFFICACY CLAIMS: A STATEMENT FROM THE INTERNATIONAL ACADEMY ON NUTRITION AND AGING TASK FORCE

Science.gov (United States)

Ferry, M.; Coley, N.; Andrieu, S.; Bonhomme, C.; Caubere, J.P.; Cesari, M.; Gautry, J.; Garcia Sanchez, I.; Hugonot, L.; Mansuy, L.; Pahor, M.; Pariente, J.; Ritz, P.; Salva, A.; Sijben, J.; Wieggers, R.; Ythier-Moury, P.; Zaim, M.; Zetlaoui, J.; Vellas, B.

2015-01-01

Interventions are crucial as they offer simple and inexpensive public health solutions that will be useful over the long term use. A Task Force on designing trials of nutritional interventions to slow cognitive decline in older adults was held in Toulouse in September 2012. The aim of the Task Force was to bring together leading experts from academia, the food industry and regulatory agencies to determine the best trial designs that would enable us to reach our goal of maintaining or improving cognitive function in apparently healthy aging people. An associated challenge for this Task Force was to determine the type of trials required by the Public Food Agencies for assessing the impact of nutritional compounds in comparison to well established requirements for drug trials. Although the required quality of the study design, rationale and statistical analysis remains the same, the studies designed to show reduction of cognitive decline require a long duration and the objectives of this task force was to determine best design for these trials. Two specific needs were identified to support trials of nutritional interventions: 1- Risk- reduction strategies are needed to tackle the growing burden of cognitive decline that may lead to dementia, 2- Innovative study designs are needed to improve the quality of these studies. PMID:23933873

COST-EFFECTIVENESS OF A 3-MONTH INTERVENTION WITH ORAL NUTRITIONAL SUPPLEMENTS IN DISEASE RELATED MALNUTRITION: A RANDOMIZED CONTROLLED PILOT STUDY

OpenAIRE

Norman , Kristina; Pirlich , Matthias; Smoliner , Christine; Kilbert , Anne; Schulzke , Jörg-Dieter; Ockenga , Johann; Lochs , Herbert; Reinhold , Thomas

2011-01-01

Abstract Background: Nutritional intervention with oral nutritional supplements (ONS) has been shown to increase quality of life in malnourished patients. We investigated whether post-hospital supplementation with ONS is cost-effective according to international benchmarks in malnourished patients. Methods: 114 malnourished patients (50.6?16.1 years, 63 female) with benign gastrointestinal disease were included and randomised to receive either ONS for three months and dietary co...

Effect of a nutrition education programme on nutritional status of ...

African Journals Online (AJOL)

Background. Globally, the prevalence of chronic and acute malnutrition and micronutrient deficiency is high in young children, especially in developing countries. Nutrition education is an important intervention to address these challenges. Objective. To determine the nutritional (anthropometric and micronutrient) status of ...

Tailored nutrition education: is it really effective?

Science.gov (United States)

Eyles, Helen; Ni Mhurchu, Cliona

2012-03-01

There has been a growing interest in tailored nutrition education over the previous decade, with a number of literature reviews suggesting this intervention strategy holds considerable potential. Nevertheless, the majority of intervention trials undertaken to date have employed subjective self-report outcome measures (such as dietary recalls). The aim of the present review is to further consider the likely true effect of tailored nutrition education by assessing the findings of tailored nutrition education intervention trials where objective outcome measures (such as sales data) have been employed. Four trials of tailored nutrition education employing objective outcome measures were identified: one was undertaken in eight low-cost supermarkets in New Zealand (2010; n 1104); one was an online intervention trial in Australia (2006; n 497); and two were undertaken in US supermarkets (1997 and 2001; n 105 and 296, respectively). Findings from the high-quality New Zealand trial were negative. Findings from the US trials were also generally negative, although reporting was poor making it difficult to assess quality. Findings from the high-quality online trial were positive, although have limited generalisability for public health. Trials employing objective outcome measures strongly suggest tailored nutrition education is not effective as a stand-alone strategy. However, further large, high-quality trials employing objective outcome measures are needed to determine the true effectiveness of this popular nutrition intervention strategy. Regardless, education plays an important role in generating social understanding and acceptance of broader interventions to improve nutrition.

Multifaceted academic detailing program to increase pharmacotherapy for alcohol use disorder: interrupted time series evaluation of effectiveness.

Science.gov (United States)

Harris, Alex H S; Bowe, Thomas; Hagedorn, Hildi; Nevedal, Andrea; Finlay, Andrea K; Gidwani, Risha; Rosen, Craig; Kay, Chad; Christopher, Melissa

2016-09-15

Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard of care, yet knowledge and use of these medications are very low across diverse settings. This study evaluated the overall effectiveness a multifaceted academic detailing program to address this persistent quality problem in the US Veterans Health Administration (VHA), as well as the context and process factors that explained variation in effectiveness across sites. An interrupted time series design, analyzed with mixed-effects segmented logistic regression, was used to evaluate changes in level and rate of change in the monthly percent of patients with a clinically documented AUD who received naltrexone, acamprosate, disulfiram, or topiramate. Using data from a 20 month post-implementation period, intervention sites (n = 37) were compared to their own 16 month pre-implementation performance and separately to the rest of VHA. From immediately pre-intervention to the end of the observation period, the percent of patients in the intervention sites with AUD who received medication increased over 3.4 % in absolute terms and 68 % in relative terms (i.e., 4.9-8.3 %). This change was significant compared to the pre-implementation period in the intervention sites and secular trends in control sites. Sites with lower pre-implementation adoption, more person hours of detailing, but fewer people detailed, had larger immediate increases in medication receipt after implementation. The average number of detailing encounters per person was associated with steeper increases in slope over time. This study found empirical support for a multifaceted quality improvement strategy aimed at increasing access to and utilization of pharmacotherapy for AUD. Future studies should focus on determining how to enhance the programs effects, especially in non-responsive locations.

Effectiveness of Dietetic Intervention on Nutritional Status and Hydration Status in Continuous Ambulatory Peritoneal Dialysis (CAPD Patients

Directory of Open Access Journals (Sweden)

H.M. LAM

2012-06-01

Full Text Available In Hong Kong, more than 3,000 patients with end-stage renal failure (ESRF on CAPD in 20091. Protein-energy malnutrition and volume overload are common problems in CAPD patients and associated with high morbidity and mortality2-6. Hyperphosphatemia is also a frequent complication in Chinese CAPD patients and is associated with development of renal bone disease or osteodystrophy7. The Kidney Dialysis Outcomes Quality Initiative (KDOQI guidelines suggested a combination of valid, complementary measures should be used to assess nutritional status in CAPD patients and anthropometric measurements are valid and clinically useful indicators of protein-energy nutritional status in maintenance dialysis patients8. Bioelectrical Impedance Analysis (BIA, which is a simple, inexpensive and non-invasive method, provides another powerful tool for monitoring of nutrition and hydration in CAPD patients9—10. The objective of this study is to evaluate the effectiveness of dietetic intervention in a local acute hospital on nutritional status and hydration status of patients on CAPD in outpatient setting. This is a retrospective study of 22 ESRF patients receiving dietetic intervention during CAPD training from February 2010 to January 2011. Patients with cognitive impairment or contraindicated with bioimepdence analysis (BIA were excluded. Baseline demographic and clinical data were retrieved from the dietetic consultation record and the electronic records in Clinical Management System (CMS. The parameters related to the nutrition and hydration status in the first and follow-up dietetic consultation were also collected from the record. They included the dietary protein and energy intakes estimated from the dietary history, anthropometric measurements such as weight, height, body mass index (BMI, skeletal muscle mass (SMM, body fat mass (BFM, body fat percentage (BF%, intracellular water (ICW, extracellular water (ECW measured by body composition analyzer (In

Multifaceted Approaches to Music Information Retrieval

NARCIS (Netherlands)

Liem, C.C.S.

2015-01-01

Music is a multifaceted phenomenon: beyond addressing our auditory channel, the consumption of music triggers further senses. Also in creating and communicating music, multiple modalities are at play. Next to this, it allows for various ways of interpretation: the same musical piece can be performed

Antimicrobial and nutritional interventions in early life

DEFF Research Database (Denmark)

Jensen, Michael Ladegaard

Necrotizing enterocolitis (NEC) is the most common gastrointestinal disorder in premature newborn infants, yet there is still no well-established prevention strategy or treatment for this disease. The pathogenesis of NEC remains to be fully elucidated; however, prematurity, enteral nutrition...... with regard to challenge dose and supportive nutrition was done and presented in Paper IV....

Effect of a School-based Nutrition Education Program on the Nutritional Status of Primary School Children

Directory of Open Access Journals (Sweden)

Parisa Keshani

2016-02-01

Full Text Available Background and Objectives: Regarding the high prevalence of unhealthy food habits among Iranian children, we aimed to assess the effect of a school-based nutrition education program on nutritional status of primary school students in Shiraz. Materials and Methods: This randomized educational controlled trial was carried out on 221 primary school age children selected by cluster sampling in the elementary schools of Shiraz-Iran. The intervention consisted of 6 nutrition education sessions carried out through one year for children, using active learning methods. Mothers’ education was carried out in person in both lecture and question-answer sessions also via sending text messages and pamphlets. Weight, height and waist circumference (WC of children were measured before and after the intervention. Also a 168-item food frequency questionnaire was completed. Two separate nutrition knowledge questionnaires were filled up by children and their mothers. Data were analyzed using SPSS version 16. Results: 171 children (83 in the case and 88 in the control group, aged 9.5-10.5 years, completed the study. Anthropometric and nutritional knowledge of the participants in both the intervention and control groups was significantly increased. Weight, height, WC and nutritional knowledge increased significantly more in the intervention group compared to the controls. Consumption of fruits and vegetables decreased in the intervention group while plain sugar and fast foods intake increased among the controls. There were no significant differences between the changes in the intake of any of the food groups in the two groups. Conclusions: In conclusion, the designed nutrition education program could increase students’ nutritional knowledge, and lead to a non-significant change towards reducing the consumption of unhealthy foods such as fast foods, sweets and salty snacks.

Effect of nutrition changes on foods selected by students in a middle school-based diabetes prevention intervention program: the HEALTHY experience.

Science.gov (United States)

Mobley, Connie C; Stadler, Diane D; Staten, Myrlene A; El Ghormli, Laure; Gillis, Bonnie; Hartstein, Jill; Siega-Riz, Anna Maria; Virus, Amy

2012-02-01

The HEALTHY primary prevention trial developed an integrated multicomponent intervention program to moderate risk factors for type 2 diabetes in middle schools. The nutrition component aimed to improve the quality of foods and beverages served to students. Changes in the School Breakfast Program (SBP), National School Lunch Program (NSLP), and à la carte venues are compared to the experience of control schools. The intervention was implemented in 21 middle schools from winter 2007 through spring 2009 (following a cohort of students from sixth through eighth grades); 21 schools acted as observed controls. The nutrition component targeted school food service environmental change. Data identifying foods and nutrients served (selected by students for consumption) were collected over a 20-day period at baseline and end of study. Analysis compared end of study values for intervention versus control schools. Intervention schools more successfully limited dessert and snack food portion size in NSLP and à la carte and lowered fat content of foods served. Servings of high-fiber grain-based foods and/or legumes were improved in SBP but not NSLP. Intervention and control schools eliminated >1% fat milk and added-sugar beverages in SBP, but intervention schools were more successful in NSLP and à la carte. The HEALTHY program demonstrated significant changes in the nutritional quality of foods and beverages served in the SBP, NSLP, and à la carte venues, as part of an effort to decrease childhood obesity and support beneficial effects in some secondary HEALTHY study outcomes. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

A clinical nutritional information system with personalized nutrition assessment.

Science.gov (United States)

Kuo, Su-E; Lai, Hui-San; Hsu, Jen-Ming; Yu, Yao-Chang; Zheng, Dong-Zhe; Hou, Ting-Wei

2018-03-01

Traditional nutrition evaluations not only require the use of numerous tables and lists to provide sufficient recommendations for patients' diets but are also very time-consuming due to cross-referencing and calculations. To personalize patient assessments, this study implemented a Clinical Nutritional Information System (CNIS) to help hospital dietitians perform their daily work more effectively in terms of time management and paper work. The CNIS mainly targets in-patients who require cancer-nutrition counselling. The development of the CNIS occurred in three phases. Phase 1 included system design and implementation based on the Nutrition Care Process and Model (NCPM) and the Patient Nutrition Care Process. Phase 2 involved a survey to characterize the efficiency, quality and accuracy of the CNIS. In Phase 3, a second survey was conducted to determine how well dietitians had adapted to the system and the extent of improvement in efficiency after the CNIS had been available online for three years. The work time requirements decreased by approximately 58% with the assistance of the CNIS. Of the dietitians who used the CNIS, 95% reported satisfaction, with 91.66% indicating that the CNIS was really helpful in their work. However, some shortcomings were also evident according to the results. Dietitians favoured the standardization of nutritional intervention and monitoring. The CNIS meets the needs of dietitians by increasing the quality of nutritional interventions by providing accurate calculations and cross-referencing for information regarding patients' conditions, with the benefit of decreasing the processing time, such as handwritten documentation. In addition, the CNIS also helps dietitians statistically analyse each patient's personal nutritional needs to achieve nutritional improvement. Copyright © 2017 Elsevier B.V. All rights reserved.

Nutritional supplementation for Alzheimer's disease?

Science.gov (United States)

Shea, Thomas B; Remington, Ruth

2015-03-01

Evidence for the benefit of nutrition in Alzheimer's disease continues to accumulate. Many studies with individual vitamins or supplements show marginal, if any, benefit. However, new findings with combinatorial formulations demonstrate improvement in cognitive performance and behavioral difficulties that accompany Alzheimer's disease. Herein, we review some of the most recent clinical advances and summarize supportive preclinical studies. We present novel positive effects on Alzheimer's disease derived from diet, trace elements, vitamins and supplements. We discuss the inherent difficulty in conducting nutritional studies because of the variance in participants' nutritional history, versus pharmacological interventions in which participants are naive to the intervention. We examine the evidence that epigenetics play a role in Alzheimer's disease and how nutritional intervention can modify the key epigenetic events to maintain or improve cognitive performance. Overall consideration of the most recent collective evidence suggests that the optimal approach for Alzheimer's disease would seem to combine early, multicomponent nutritional approaches (a Mediterranean-style diet, multivitamins and key combinatorial supplements), along with lifestyle modifications such as social activity and mental and physical exercise, with ultimate addition of pharmacological agents when warranted.

Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: a cluster randomised controlled trial

Directory of Open Access Journals (Sweden)

Stephen P Luby, ProfMD

2018-03-01

Full Text Available Summary: Background: Diarrhoea and growth faltering in early childhood are associated with subsequent adverse outcomes. We aimed to assess whether water quality, sanitation, and handwashing interventions alone or combined with nutrition interventions reduced diarrhoea or growth faltering. Methods: The WASH Benefits Bangladesh cluster-randomised trial enrolled pregnant women from villages in rural Bangladesh and evaluated outcomes at 1-year and 2-years' follow-up. Pregnant women in geographically adjacent clusters were block-randomised to one of seven clusters: chlorinated drinking water (water; upgraded sanitation (sanitation; promotion of handwashing with soap (handwashing; combined water, sanitation, and handwashing; counselling on appropriate child nutrition plus lipid-based nutrient supplements (nutrition; combined water, sanitation, handwashing, and nutrition; and control (data collection only. Primary outcomes were caregiver-reported diarrhoea in the past 7 days among children who were in utero or younger than 3 years at enrolment and length-for-age Z score among children born to enrolled pregnant women. Masking was not possible for data collection, but analyses were masked. Analysis was by intention to treat. This trial is registered at ClinicalTrials.gov, number NCC01590095. Findings: Between May 31, 2012, and July 7, 2013, 5551 pregnant women in 720 clusters were randomly allocated to one of seven groups. 1382 women were assigned to the control group; 698 to water; 696 to sanitation; 688 to handwashing; 702 to water, sanitation, and handwashing; 699 to nutrition; and 686 to water, sanitation, handwashing, and nutrition. 331 (6% women were lost to follow-up. Data on diarrhoea at year 1 or year 2 (combined were available for 14 425 children (7331 in year 1, 7094 in year 2 and data on length-for-age Z score in year 2 were available for 4584 children (92% of living children were measured at year 2. All interventions had high adherence

Nutritional support as an adjunct to radiation therapy

International Nuclear Information System (INIS)

Donaldson, S.S.

1984-01-01

Patients with malignancies which are treated with therapeutic radiation are at risk for nutritional problems, both from their underlying malignancy as well as from their treatment. These effects may be acute or chronic and relate to the site of the tumor and regions irradiated. There is a large experience with nutritional intervention in irradiated patients, including oral feedings and enteral and parenteral nutritional support. The indications for the specific administration of nutritional support during radiotherapy depend on the nutritional status of the patient and the area irradiated, as well as the individual prognosis. Patients who are malnourished at the time of treatment are most likely to profit from nutritional intervention. To date, prospective randomized trials of nutritional support in patients undergoing radiotherapy fail to show a benefit of routine adjuvant nutritional intervention in terms of improved response and tolerance to treatment, improved local control or survival rates, or reduction of complications from therapy

Nutritional counselling in primary health care: a randomized comparison of an intervention by general practitioner or dietician

DEFF Research Database (Denmark)

Willaing, Ingrid; Ladelund, Steen; Jørgensen, Torben

2004-01-01

AIMS: To compare health effects and risk reduction in two different strategies of nutritional counselling in primary health care for patients at high risk of ischaemic heart disease. METHODS: In a cluster-randomized trial 60 general practitioners (GPs) in the Copenhagen County were randomized...... to give nutritional counselling or to refer patients to a dietician. Patients were included after opportunistically screening (n=503 patients), and received nutritional counselling by GP or dietician over 12 months. Health effects were measured by changes in weight, waist circumference and blood lipids....... Risk of cardiovascular disease was calculated by The Copenhagen Risk Score. Data on use of medicine and primary health care was obtained from central registers. RESULTS: Altogether 339 (67%) patients completed the intervention. Weight loss was larger in the dietician group (mean 4.5 kg vs. 2.4 kg...

A Youth Mentor-Led Nutritional Intervention in Urban Recreation Centers: A Promising Strategy for Childhood Obesity Prevention in Low-Income Neighborhoods

Science.gov (United States)

Sato, Priscila M.; Steeves, Elizabeth A.; Carnell, Susan; Cheskin, Lawrence J.; Trude, Angela C.; Shipley, Cara; Mejía Ruiz, M. J.; Gittelsohn, Joel

2016-01-01

B'More Healthy Community for Kids (BHCK) is an ongoing multi-level intervention to prevent childhood obesity in African-American low-income neighborhoods in Baltimore city, MD. Although previous nutrition interventions involving peer mentoring of youth have been successful, there is a lack of studies evaluating the influence of cross-age peers…

The Evidence for Dietary Interventions and Nutritional Supplements as Treatment Options in Multiple Sclerosis: a Review.

Science.gov (United States)

Mische, Leah J; Mowry, Ellen M

2018-03-17

This review aims to critically evaluate published studies examining diets and nutritional supplements (excepting vitamin D) for the impact on prevention and prognosis of multiple sclerosis (MS). There is a negative relationship between the Mediterranean diet and vascular disease, and vascular co-morbidities are associated with a worse MS prognosis. Low-fat, fish-based diets, sodium-restricted diets, calorie restriction, the paleo diet, and gluten-free diets have been examined, mostly in observational studies; results are inconclusive. With regard to nutritional supplements, pilot data show a possible benefit of biotin with respect to disability worsening in people with progressive MS (PMS). The best designed randomized controlled trials (RCTs) for PUFA supplementation have not shown significant impact, but several weaker RCTs have. Many other nutritional supplements have been tested, including several anti-oxidants. While some early studies show positive results, no result has been definitive. Unfortunately, there is no strong evidence for a direct benefit of any given dietary intervention on MS risk or prognosis. However, due to its relationship with vascular co-morbidities, the Mediterranean diet has the strongest rationale for employment in PwMS. Higher-quality clinical trials are needed to ascertain the possible benefits of nutritional supplements.

Eating patterns among heroin users: a qualitative study with implications for nutritional interventions.

Science.gov (United States)

Neale, Joanne; Nettleton, Sarah; Pickering, Lucy; Fischer, Jan

2012-03-01

To provide new insights into heroin users' eating patterns in order to inform nutritional interventions. Seventy-seven audio-recorded in-depth interviews which elicited detailed data on eating patterns. Community and residential drug services, pharmacies and peer support groups in Southern England, UK. Forty current or ex-heroin users (21 men and 19 women), of whom 37 (20 men and 17 women) were re-interviewed after 3 months. Audio data transcribed verbatim, coded systematically and analysed inductively. Heroin users' eating patterns were influenced by individual, social, cultural, economic and environmental factors. During active heroin use, participants consumed quick, convenient, cheap and sweet foods, ate infrequently and had little interest in food. Eating patterns often improved during stays in residential services and after heroin cessation. Ex-heroin users began to take pleasure in food preparation and eating and identified therapeutic benefits to cooking. Initially, weight gain was experienced positively, but subsequently generated anxieties as participants, particularly women, struggled to control their appetite and worried about becoming overweight. Findings complement and add to previous research and sociological and anthropological literatures. Heroin users have dysfunctional eating patterns that are amenable to change and community and residential services could enable them to experience the many health, psychological and social benefits of improved eating practices. Nutritional interventions need to be tailored to individual needs and circumstances, but also monitored and evaluated so that there is a future evidence base. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Age Nutrition Chirugie (ANC) study: impact of a geriatric intervention on the screening and management of undernutrition in elderly patients operated on for colon cancer, a stepped wedge controlled trial.

Science.gov (United States)

Dupuis, Marine; Kuczewski, Elisabetta; Villeneuve, Laurent; Bin-Dorel, Sylvie; Haine, Max; Falandry, Claire; Gilbert, Thomas; Passot, Guillaume; Glehen, Olivier; Bonnefoy, Marc

2017-01-07

Undernutrition prior to major abdominal surgery is frequent and increases morbidity and mortality, especially in older patients. The management of undernutrition reduces postoperative complications. Nutritional management should be a priority in patient care during the preoperative period. However undernutrition is rarely detected and the guidelines are infrequently followed. Preoperative undernutrition screening should allow a better implementation of the guidelines. The ANC ("Age Nutrition Chirurgie") study is an interventional, comparative, prospective, multicenter, randomized protocol based on the stepped wedge trial design. For the intervention, the surgeon will inform the patient of the establishment of a systematic preoperative geriatric assessment that will allow the preoperative diagnosis of the nutritional status and the implementation of an adjusted nutritional support in accordance with the nutritional guidelines. The primary outcome measure is to determine the impact of the geriatric intervention on the level of perioperative nutritional management, in accordance with the current European guidelines. The implementation of the intervention in the five participating centers will be rolled-out sequentially over six time periods (every six months). Investigators must recommend that all patients aged 70 years or over and who are consulting for a surgery for a colorectal cancer should consider participating in this study. The ANC study is based on an original methodology, the stepped wedge trial design, which is appropriate for evaluating the implementation of a geriatric and nutritional assessment during the perioperative period. We describe the purpose of this geriatric intervention, which is expected to apply the ESPEN and SFNEP recommendations through the establishment of an undernutrition screening and a management program for patients with cancer. This intervention should allow a decrease in patient morbidity and mortality due to undernutrition. This

Planned development and evaluation protocol of two versions of a web-based computer-tailored nutrition education intervention aimed at adults, including cognitive and environmental feedback.

Science.gov (United States)

Springvloet, Linda; Lechner, Lilian; Oenema, Anke

2014-01-17

Despite decades of nutrition education, the prevalence of unhealthy dietary patterns is still high and inequalities in intake between high and low socioeconomic groups still exist. Therefore, it is important to innovate and improve existing nutrition education interventions. This paper describes the development, design and evaluation protocol of a web-based computer-tailored nutrition education intervention for adults targeting fruit, vegetable, high-energy snack and fat intake. This intervention innovates existing computer-tailored interventions by not only targeting motivational factors, but also volitional and self-regulation processes and environmental-level factors. The intervention development was guided by the Intervention Mapping protocol, ensuring a theory-informed and evidence-based intervention. Two versions of the intervention were developed: a basic version targeting knowledge, awareness, attitude, self-efficacy and volitional and self-regulation processes, and a plus version additionally addressing the home environment arrangement and the availability and price of healthy food products in supermarkets. Both versions consist of four modules: one for each dietary behavior, i.e. fruit, vegetables, high-energy snacks and fat. Based on the self-regulation phases, each module is divided into three sessions. In the first session, feedback on dietary behavior is provided to increase awareness, feedback on attitude and self-efficacy is provided and goals and action plans are stated. In the second session goal achievement is evaluated, reasons for failure are explored, coping plans are stated and goals can be adapted. In the third session, participants can again evaluate their behavioral change and tips for maintenance are provided. Both versions will be evaluated in a three-group randomized controlled trial with measurements at baseline, 1-month, 4-months and 9-months post-intervention, using online questionnaires. Both versions will be compared with a generic

Effectiveness of multidisciplinary nutritional care on nutritional intake, nutritional status and quality of life in patients with hip fractures: a controlled prospective cohort study

NARCIS (Netherlands)

Hoekstra, Jellie C.; Goosen, Jon H. M.; de Wolf, G. Sander; Verheyen, Cees C. P. M.

2011-01-01

The purpose of this study was to determine the effectiveness of a multidisciplinary intervention program on nutritional intake and of nutritional intake on nutritional status and quality of life in older patients treated for a hip fracture. A controlled prospective cohort study included 66 patients

Influences of Constructivist-Oriented Nutrition Education on Urban Middle School Students' Nutrition Knowledge, Self-Efficacy, and Behaviors

Science.gov (United States)

McCaughtry, Nate; Fahlman, Mariane; Martin, Jeffrey J.; Shen, Bo

2011-01-01

Background: Health professionals are looking to nutrition-based youth health interventions in K-12 schools to combat the growing obesity crisis; however, none have explored the influences of interventions guided by constructivist learning theory. Purpose: This study examined the influences of a constructivist-oriented nutrition education program…

Obesity: a systematic review on parental involvement in long-term European childhood weight control interventions with a nutritional focus

OpenAIRE

Kruk, J J; Kortekaas, F; Lucas, C; Jager-Wittenaar, H

2013-01-01

In Europe, about 20% of children are overweight. Focus on parental responsibility is an effective method in weight control interventions in children. In this systematic review we describe the intensity of parental involvement and behaviour change aimed at parents in long-term European childhood weight control interventions. We include European Union studies targeting parents in order to improve children's weight status in multi-component (parental, behaviour change and nutrition) health promo...

Improving patient-centeredness of fertility care using a multifaceted approach: study protocol for a randomized controlled trial

Directory of Open Access Journals (Sweden)

Huppelschoten Aleida G

2012-09-01

Full Text Available Abstract Background Beside traditional outcomes of safety and (cost-effectiveness, the Institute of Medicine states patient-centeredness as an independent outcome indicator to evaluate the quality of healthcare. Providing patient-centered care is important because patients want to be heard for their ideas and concerns. Healthcare areas associated with high emotions and intensive treatment periods could especially benefit from patient-centered care. How care can become optimally improved in patient-centeredness is unknown. Therefore, we will conduct a study in the context of Dutch fertility care to determine the effects of a multifaceted approach on patient-centeredness, patients’ quality of life (QoL and levels of distress. Our aims are to investigate the effectiveness of a multifaceted approach and to identify determinants of a change in the level of patient-centeredness, patients’ QoL and distress levels. This paper presents the study protocol. Methods/Design In a cluster-randomized trial in 32 Dutch fertility clinics the effects of a multifaceted approach will be determined on the level of patient-centeredness (Patient-centredness Questionnaire – Infertility, patients’ QoL (FertiQoL and levels of distress (SCREENIVF. The multifaceted approach includes audit and feedback, educational outreach visits and patient-mediated interventions. Potential determinants of a change in patient-centeredness, patients’ QoL and levels of distress will be collected by an addendum to the patients’ questionnaire and a professionals’ questionnaire. The latter includes the Organizational Culture Assessment Instrument about the clinic’s culture as a possible determinant of an increase in patient-centered care. Discussion The study is expected to yield important new evidence about the effects of a multifaceted approach on levels of patient-centeredness, patients’ QoL and distress in fertility care. Furthermore, determinants associated with a change

Event-rate and delta inflation when evaluating mortality as a primary outcome from randomized controlled trials of nutritional interventions during critical illness: a systematic review.

Science.gov (United States)

Summers, Matthew J; Chapple, Lee-anne S; McClave, Stephen A; Deane, Adam M

2016-04-01

There is a lack of high-quality evidence that proves that nutritional interventions during critical illness reduce mortality. We evaluated whether power calculations for randomized controlled trials (RCTs) of nutritional interventions that used mortality as the primary outcome were realistic, and whether overestimation was systematic in the studies identified to determine whether this was due to overestimates of event rate or delta. A systematic review of the literature between 2005 and 2015 was performed to identify RCTs of nutritional interventions administered to critically ill adults that had mortality as the primary outcome. Predicted event rate (predicted mortality during the control), predicted mortality during intervention, predicted delta (predicted difference between mortality during the control and intervention), actual event rate (observed mortality during control), observed mortality during intervention, and actual delta (difference between observed mortality during the control and intervention) were recorded. The event-rate gap (predicted event rate minus observed event rate), the delta gap (predicted delta minus observed delta), and the predicted number needed to treat were calculated. Data are shown as median (range). Fourteen articles were extracted, with power calculations provided for 10 studies. The predicted event rate was 29.9% (20.0–52.4%), and the predicted delta was 7.9% (3.0–20.0%). If the study hypothesis was proven correct then, on the basis of the power calculations, the number needed to treat would have been 12.7 (5.0–33.3) patients. The actual event rate was 25.3% (6.1–50.0%), the observed mortality during the intervention was 24.4% (6.3–39.7%), and the actual delta was 0.5% (−10.2–10.3%), such that the event-rate gap was 2.6% (−3.9–23.7%) and delta gap was 7.5% (3.2–25.2%). Overestimates of delta occur frequently in RCTs of nutritional interventions in the critically ill that are powered to determine a mortality

A situation analysis of public health interventions, barriers, and opportunities for improving maternal nutrition in Bihar, India.