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Sample records for nutritional support team

  1. State of nutrition support teams.

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    DeLegge, Mark Henry; Kelly, Andrea True; Kelley, Andrea True

    2013-12-01

    The incidence of malnutrition in hospitalized patients is relatively high (up to 55%) despite breakthroughs in nutrition support therapies. These patients have increased morbidity and mortality, extended hospital stays, and care that is associated with higher costs. These patients are often poorly managed due to inadequate nutrition assessment and poor medical knowledge and practice in the field of nutrition. Nutrition support teams (NSTs) are interdisciplinary support teams with specialty training in nutrition that are often comprised of physicians, dietitians, nurses, and pharmacists. Their role includes nutrition assessment, determination of nutrition needs, recommendations for appropriate nutrition therapy, and management of nutrition support therapy. Studies have demonstrated significant improvements in patient nutrition status and improved clinical outcomes as well as reductions in costs when patients were appropriately managed by a multispecialty NST vs individual caregivers. Despite this, there has been steady decline in the number of formal NST in recent years (65% of hospitals in 1995 to 42% in 2008) as hospitals and other healthcare organizations look for ways to cut costs. Given the importance of nutrition status on clinical outcomes and overall healthcare costs, a number of institutions have introduced and sustained strong nutrition training and support programs and teams, demonstrating both clinical and economic benefit. The benefits of NST, training and implementation strategies, and tips for justifying these clinically and economically beneficial groups to healthcare organizations and governing bodies are discussed in this review.

  2. Assistance for the Prescription of Nutritional Support Must Be Required in Nonexperienced Nutritional Teams

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    Mehdi Ouaïssi

    2013-01-01

    Full Text Available The aim of the study was to determine the current practices of nutritional support among hospitalized patients in nonspecialized hospital departments. Materials and Methods. During an observation period of 2 months, a surgeon and a gastroenterologist designated in each of the two departments concerned, not “specialized” in nutritional assistance, have treated patients in which nutritional support seemed necessary. Assessing the degree of malnutrition of the patient, the therapeutic decision and the type of product prescribed by the doctors were secondarily compared to the proposals of a structured computer program according to the criteria and standards established by the institutions currently recognized. Results. The study included 120 patients bearing a surgical disease in 86.7% of cases and 10% of medical cases. 50% of the patients had cancer. Nutritional status was correctly evaluated in 38.3% by the initial doctors’ diagnosis—consistent with the software’s evaluation. The strategy of nutrition was concordant with the proposals of the software in 79.2% of cases. Conclusions. Despite an erroneous assessment of the nutritional status in more than two-thirds of cases the strategy of nutritional management was correct in 80% of cases. Malnutrition and its consequences can be prevented in nonexperienced nutritional teams by adequate nutritional support strategies coming from modern techniques including computerized programs.

  3. Protected time for nutrition support teams: What are the benefits?

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    Ceniccola, Guilherme D; Araújo, Wilma M C; de Brito-Ashurst, Ione; Abreu, Henrique B; Akutsu, Rita de C

    2016-12-01

    Nutrition support teams (NSTs) are important and unique entities in acute care hospitals. Despite their utility, NSTs are lacking in the majority of hospitals worldwide and where they exist, most members only spend a fraction of their time working within that role. We aim to evaluate the effect of protected time on NST performance by assessing the influence of structure and process in NST activities. All large public hospitals (>250 beds) in the Brazilian Federal District were evaluated with a structured questionnaire designed to assess NST performance. The questionnaire was adapted to include the Donabedian quality processes comprising 54 questions split amongst 6 domains; mainly structure and processes. The percentage of questionnaire compliance (NST outcome) was utilized to assess differences regarding structure and process. Hospitals with protected time to NST activities (Group I) were compared to hospitals without NSTs protected times (Group II). Seven hospitals were assessed. Group I, n = 3, showed a significantly higher performance outcome than Group II, n = 4 (77.9 × 60.3; P = 0.004), and only Group I's score achieved the benchmark for quality standards (75% compliance). Significant differences between groups were also found in structure (P = 0.017) and process (P = 0.014). This study indicates that protected time for NST activities is paramount to increase NST performance and could positively influence Donabedian quality indicators. Our results highlight the importance of NSTs in large hospitals and is an advocate for public policies requiring dedicated time for NST work. Only a larger study can confirm our findings. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. All rights reserved.

  4. Nutrition support team management of enterally fed patients in a community hospital is cost-beneficial.

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    Hassell, J T; Games, A D; Shaffer, B; Harkins, L E

    1994-09-01

    To determine whether nutrition support team (NST) management of enterally fed patients is cost-beneficial and to compare primary outcomes of care between team and nonteam management. A quasi-experimental study was conducted over a 7-month period. A 400-bed community hospital. A convenience sample of 136 subjects who had received enteral nutrition support for at least 24 hours. Forty-two patients died; only their mortality data were used. Ninety-six patients completed the study. Outcomes, including cost, for enterally fed patients in two treatment groups--those managed by the nutrition support team and those managed by nonteam staff--were compared. Severity of illness level was determined for patients managed by the nutrition support team and those managed by nonteam staff. For each group, the following measures were adjusted to reflect a significant difference in average severity of illness and then compared: length of hospital stay, readmission rates, and mortality rates. Complication rates between the groups were also compared. The cost benefit was determined based on savings from the reduction in adjusted length of hospital stay. Parametric and nonparametric statistics were used to evaluate outcomes between the two groups. Differences were statistically significant for both severity of illness, which was at a higher level in the nutrition support team group (P group (P team-managed group, there was a 23% reduction in adjusted mortality rate, an 11.6% reduction in the adjusted length of hospital stay, and a 43% reduction in adjusted readmission rate. Cost-benefit analysis revealed that for every $1 invested in nutrition support team management, a benefit of $4.20 was realized. Financial and humanitarian benefits are associated with nutrition support team management of enterally fed hospitalized patients.

  5. Nutritional support team vs nonteam management of enteral nutritional support in a Veterans Administration Medical Center teaching hospital.

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    Powers, D A; Brown, R O; Cowan, G S; Luther, R W; Sutherland, D A; Drexler, P G

    1986-01-01

    One hundred one patients receiving enteral nutritional support (ENS) by tube feeding during a 5-month period were prospectively studied. Fifty patients were managed by a nutritional support team (T) and 51 patients were managed by the nonteam approach (NT). Demographics, primary diagnosis, chronic diseases, medical service, calculated basal energy expenditure (BEE), duration of ENS, and final patient disposition were recorded. Enteral formula, formula modifications, results of laboratory tests and calories delivered were obtained daily. Results of nitrogen balance studies were obtained when available and each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. No significant difference was found between the team and nonteam managed groups in regard to total feeding days, mean feeding days per patient, total laboratory tests, laboratory tests per patient or laboratory tests per day. Significantly more team patients attained 1.2 times BEE (T = 47, NT = 38, p less than 0.05) for a significantly greater period of time (T = 398 days, NT = 281 days, p less than 0.05). Significantly more team patients achieved a measured positive nitrogen balance than nonteam patients (T = 42, NT = 1, p less than 0.05). Formula modifications to correct nutritional or metabolic aberrations were made in 15 (30%) team patients and five (9.8%) nonteam patients (p less than 0.05). The number of individual abnormalities (pulmonary, mechanical, gastrointestinal, and metabolic), as well as total abnormalities occurring in the team-managed group, was significantly lower than in the nonteam managed group (160 vs 695, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

  6. The need for nutrition support teams in pediatric units: a commentary by the ESPGHAN committee on nutrition.

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    Agostoni, Carlo; Axelson, Irene; Colomb, Virginie; Goulet, Olivier; Koletzko, Berthold; Michaelsen, Kim F; Puntis, John W L; Rigo, Jacques; Shamir, Raanan; Szajewska, Hania; Turck, Dominique

    2005-07-01

    The reported prevalence of malnutrition in pediatric hospitals ranges from 15% to 30% of patients, with an impact on growth, morbidity and mortality. Major deficits in nutrition care have been highlighted in European hospitals, and the implementation of nutrition support teams (NSTs) has been suggested as a means to improve malnutrition diagnosis and nutrition care for hospitalized patients. This comment by the ESPGHAN Committee on Nutrition reviews disease related-mechanisms causing malnutrition and consequences of malnutrition and suggests a framework for implementation of NSTs in pediatric units. The recommendations by the Committee on Nutrition include: 1) Implementation of NSTs in hospitals is recommended to improve nutritional management of sick children; 2) The main tasks of the NST should include screening for nutritional risk, identification of patients who require nutritional support, provision of adequate nutritional management, education and training of hospital staff and audit of practice; 3) The NST should be multidisciplinary, with expertise in all aspects of clinical nutrition care; 4) The funds needed to support NSTs should be raised from the health care system; and 5) Further research is needed to evaluate the effects of NSTs in prevention and management of pediatric nutritional disorders, including cost effectiveness in different settings.

  7. Enteral nutritional support management in a university teaching hospital: team vs nonteam.

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    Brown, R O; Carlson, S D; Cowan, G S; Powers, D A; Luther, R W

    1987-01-01

    Current hospital cost containment pressures have prompted a critical evaluation of whether nutritional support teams render more clinically effective and efficient patient care than nonteam management. To address this question with regard to enteral feeding, 102 consecutive hospitalized patients who required enteral nutritional support (ENS) by tube feeding during a 3 1/2-month period were prospectively studied. Fifty patients were managed by a nutritional support team; the other 52 were managed by their primary physicians. Choice of enteral formula, formula modifications, frequency of laboratory tests, and amounts of energy and protein received were recorded daily. In addition, each patient was monitored for pulmonary, mechanical, gastrointestinal, and metabolic abnormalities. Team-managed (T) and nonteam-managed (NT) patients received ENS for 632 and 398 days, respectively. The average time period for ENS was significantly longer in the team-managed patients (12.6 +/- 12.1 days vs 7.7 +/- 6.2 days, p less than 0.01). Significantly more of the team patients attained 1.2 X basal energy expenditure (BEE) (37 vs 26, p less than 0.05). Total number of abnormalities in each group was similar (T = 398, NT = 390); however, the abnormalities per day were significantly lower in the team group (T = 0.63 vs NT = 0.98, p less than 0.01). Mechanical (T = 0.05 vs NT = 0.11, p less than 0.01), gastrointestinal (T = 0.99 vs NT = 0.14, p less than 0.05), and metabolic (T = 0.49 vs NT = 0.72, p less than 0.01) abnormalities per day all were significantly lower in the team-managed patients.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Organisation, regulations, preparation and logistics of parenteral nutrition in hospitals and homes; the role of the nutrition support team – Guidelines on Parenteral Nutrition, Chapter 8

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    Kester, L.

    2009-11-01

    Full Text Available PN (parenteral nutrition should be standardised to ensure quality and to reduce complications, and it should be carried out in consultation with a specialised nutrition support team whenever possible. Interdisciplinary nutrition support teams should be established in all hospitals because effectiveness and efficiency in the implementation of PN are increased. The tasks of the team include improvements of quality of care as well as enhancing the benefit to cost ratio. Therapeutic decisions must be taken by attending physicians, who should collaborate with the nutrition support team. “All-in-One” bags are generally preferred for PN in hospitals and may be industrially manufactured, industrially manufactured with the necessity to add micronutrients, or be prepared “on-demand” within or outside the hospital according to a standardised or individual composition and under consideration of sterile and aseptic conditions. A standardised procedure should be established for introduction and advancement of enteral or oral nutrition. Home PN may be indicated if the expected duration of when PN exceeds 4 weeks. Home PN is a well established method for providing long-term PN, which should be indicated by the attending physician and be reviewed by the nutrition support team. The care of home PN patients should be standardised whenever possible. The indication for home PN should be regularly reviewed during the course of PN.

  9. Managing children and adolescents on parenteral nutrition: Challenges for the nutritional support team.

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    Johnson, Tracey; Sexton, Elaine

    2006-08-01

    Managing infants, children and adolescents, ranging from premature infants to 18-year-old adolescents, on parenteral nutrition (PN) is a challenge. The ability of children to withstand starvation is limited and, unlike adults, children require nutrition for growth. PN in children is often required secondary to a congenital bowel problem rather than because of an acquired condition. Conditions requiring PN include motility disorders, congenital disorders of the intestinal epithelium and short-bowel syndrome (SBS). Intestinal failure may be temporary and children with SBS may be weaned from PN. However, other children require permanent PN. There are no comprehensive guidelines for the nutritional requirements of children and adolescents requiring PN. Practice in individual centres is based on clinical experience rather than clinical trials. Requirements are assessed on an individual basis according to age, nutritional status and clinical condition. These requirements need regular review to ensure that they remain appropriate for the changing age and weight of the child. Assessments of intakes use different methods, e.g. reference tables and predictive equations. Complications of PN include infection, accidental damage to, or removal of, the line and cholestatic liver disease. Home parenteral nutrition (HPN) is associated with fewer line infections and allows continuation of nutritional support in a more normal environment, encouraging normal development and participation in family activities. However, having a child at home on HPN is associated with physical and psychological stresses. A feeling of depression, loneliness and social isolation is common amongst children and their families. Home-care services are essential to supporting children at home and should be tailored to, and sensitive to, the individual needs of each family.

  10. Nutrition Support Team Guide to Maternal Diet for the Human-Milk-Fed Infant.

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    Copp, Kathleen; DeFranco, Emily A; Kleiman, Jeanne; Rogers, Lynette K; Morrow, Ardythe L; Valentine, Christina J

    2018-03-30

    Human milk feeding is encouraged for all infants; however, the mammary gland depends on maternal dietary intake of vitamins A, B1, B2, B6, B12, D, docosahexaenoic acid (DHA), choline, and iodine. Nutrition support team knowledge of maternal feeding guidelines for these nutrient sources can therefore impact infant intake. We hypothesized that these key nutrients for lactation in the mother's diet would be less than the dietary guidelines in the United States. This was a secondary analysis of nutrition data collected during a randomized, controlled trial. Dietary records were analyzed from 16 mothers (13 with singleton and 3 with multiple births) completing the study. Mean dietary intakes of selected nutrients were calculated and compared with the current dietary reference intakes. Mean maternal dietary intake for singletons was significantly (P vitamin A (58%), vitamin D (44%), and choline (58%);) DHA comprised only 5% of the current expert recommendation. Based on singleton recommendations, mothers to twins consumed an adequate intake except for DHA. Women providing breast milk for singleton preterm infants did not consume dietary reference intakes for key nutrients. Twin mothers' diets were adequate except for DHA, but these guidelines are based on singleton pregnancies and remain poorly understood for twin needs. The nutrition support team can have a unique role in maternal dietary education to impact human milk nutrient delivery to the infant. © 2018 American Society for Parenteral and Enteral Nutrition.

  11. Nutrition in team sports.

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    Mujika, Iñigo; Burke, Louise M

    2010-01-01

    Team sports are based on intermittent high-intensity activity patterns, but the exact characteristics vary between and within codes, and from one game to the next. Despite the challenge of predicting exact game demands, performance in team sports is often dependent on nutritional factors. Chronic issues include achieving ideal levels of muscle mass and body fat, and supporting the nutrient needs of the training program. Acute issues, both for training and in games, include strategies that allow the player to be well fuelled and hydrated over the duration of exercise. Each player should develop a plan of consuming fluid and carbohydrate according to the needs of their activity patterns, within the breaks that are provided in their sport. In seasonal fixtures, competition varies from a weekly game in some codes to 2-3 games over a weekend road trip in others, and a tournament fixture usually involves 1-3 days between matches. Recovery between events is a major priority, involving rehydration, refuelling and repair/adaptation activities. Some sports supplements may be of value to the team athlete. Sports drinks, gels and liquid meals may be valuable in allowing nutritional goals to be met, while caffeine, creatine and buffering agents may directly enhance performance. Copyright © 2011 S. Karger AG, Basel.

  12. Nutritional Support

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    Nutritional support is therapy for people who cannot get enough nourishment by eating or drinking. You may need ... absorb nutrients through your digestive system You receive nutritional support through a needle or catheter placed in your ...

  13. Successful Intervention for Pressure Ulcer by Nutrition Support Team: A Case Report

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    Shigeki Inui

    2010-07-01

    Full Text Available A 23-year-old woman with heart failure developed pressure ulcer on her sacral area due to a long-term bed rest and impaired hemodynamics. The ulcer improved only slightly after 2 months with povidone-iodine sugar ointment because of severe nausea and anorexia. Then, the nutrition support team (NST started intervention and estimated the patient’s malnutrition from her body weight (30.1 kg, body mass index (BMI (13.9, triceps skinfold thickness (TSF (3.5 mm, arm circumference (AC (17.2 cm and serum albumin (2.6 g/dl. The NST administrated an enteral nutrition formula through a nasogastric tube and tried to provide meals according to the patient’s taste. Although DESIGN score improved to 7 (DESIGN: d2e1s2i1g1n0 = 7 2 months later, severe nausea prevented the patient from taking any food perorally. However, after nasogastric decannulation, her appetite improved and 1 month later her body weight increased to 32.8 kg, her BMI to 15.2, TSF to 7.5 mm, AC to 19.7 cm and serum albumin to 4.1 g/dl, and the wound completely healed.

  14. Nutritional support teams: the cooperation among physicians and pharmacists helps improve cost-effectiveness of home parenteral nutrition (HPN).

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    Pietka, Magdalena; Watrobska-Swietlikowska, Dorota; Szczepanek, Kinga; Szybinski, Piotr; Sznitowska, Małgorzata; Kłęk, Stanisław

    2014-09-12

    Modern home parenteral nutrition (HPN) requires the preparation of tailored admixtures. The physicians' demands for their composition are often at the variance with pharmaceutical principles, which causes the necessity of either the preparation of ex tempore admixtures or stability testing ensuring long shelf life. Both approaches are not cost-effective. The aim of the study was to use the cooperation among physicians and pharmacists to assure both: cost-effectiveness and patient-tailored HPN admixtures. The first part of the study consisted of the thorough analysis of prescriptions for the most demanding 47 HPN patients (27 females and 20 males, mean age 53.1 year) treated at one HPN center to create few as possible long-shelf life admixtures. The second part of the study consisted of stability testing and modifications. The analysis showed over 137 variations needed to cover all macro- and micronutrients requirements. Their cost as ex-tempore solutions was extremely high (over 110 000 EURO/month) due to logistics and similarly high if stability test for variation were to be performed (68 500 EURO). Therefore prescription was prepared de novo within team of physicians and pharmacists and four base models were designed. Water and electrolytes, particularly magnesium and calcium showed to be the major issues. Stability tests failed in one admixture due to high electrolytes concentration. It was corrected, and the new formula passes the test. Five basic models were then used for creation of new bags. Cost of such an activity were 3 700 EURO (pcooperation within the members of nutritional support team could improve the cost-effectiveness and quality of HPN. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  15. A training program for anthropometric measurements by a dedicated nutrition support team improves nutritional status assessment of the critically ill child.

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    Valla, Frederic V; Ford-Chessel, Carole; Meyer, Rosan; Berthiller, Julien; Dupenloup, Christine; Follin-Arbelet, Nathalie; Hubert, Anna; Javouhey, Etienne; Peretti, Noel

    2015-03-01

    The cornerstone of an optimal nutrition approach in PICUs is to evaluate the nutritional status of any patient. Anthropometric measurements and nutritional indices calculation allow for nutritional status assessment, which is not often part of routine management, as it is considered difficult to perform in this setting. We designed a study to evaluate the impact of a training program by the PICU nutritional support team on the implementation of routine anthropometric measurements on our PICU. A prospective study was performed over a 2-year period, which included: a baseline evaluation of nutritional assessment, knowledge, anthropometric measurements (weight, height, and head and mid upper arm circumferences), and nutritional indices calculation in patient files. This was followed by a training program to implement the newly developed nutrition assessment guidelines, which included anthropometrical measurements and also the interpretation of these. The impact of this nutritional assessment program was reviewed annually for 2 years after the implementation. PICU--Lyon, France. PICU nursing and medical staff, and patients admitted in February 2011, 2012, and 2013. Training program. Ninety-nine percent of staff (n = 145) attended the individual teaching. We found significant progress in nutritional awareness and confidence about nutritional assessment following the teaching program. In addition, an improvement in staff knowledge about undernutrition and its consequences were found. We enrolled 41, 55, and 91 patients in 2011, 2012, and 2013, respectively. There was a significant increase in anthropometric measurements during this time: 32%, 65% (p = 0.002), and 96% in 2013 (p Nutritional indices were calculated in 20%, 74% (p nutritional assessment teaching program that highlights both the importance and techniques of anthropometrical measurements has successfully been implemented in a PICU. It managed to improve staff knowledge and nutritional practice.

  16. The successful accomplishment of nutritional and clinical outcomes via the implementation of a multidisciplinary nutrition support team in the neonatal intensive care unit.

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    Jeong, Eurim; Jung, Young Hwa; Shin, Seung Han; Kim, Moon Jin; Bae, Hye Jung; Cho, Yoon Sook; Kim, Kwi Suk; Kim, Hyang Sook; Moon, Jin Soo; Kim, Ee-Kyung; Kim, Han-Suk; Ko, Jae Sung

    2016-07-28

    Nutritional support is critical for preterm infants in the neonatal intensive care unit (NICU). A multidisciplinary nutritional support team (NST) that focuses on providing optimal and individualized nutrition care could be helpful. We conducted a thorough evaluation of clinical and nutritional outcomes in a tertiary NICU following the implementation of an NST. This study used a retrospective approach with historical comparisons. Preterm neonates nutritional outcomes were compared before and after the establishment of the NST. Medical records were reviewed, and clinical and nutritional outcomes were compared between the two groups. In total, 107 patients from the pre-NST period and 122 patients from the post-NST period were included. The cumulative energy delivery during the first week of life improved during the post-NST period (350.17 vs. 408.62 kcal/kg, p nutrition to preterm infants in the first week of life. There were also favorable clinical outcomes, such as increased weight gain and reduced length of ICU stay. Evaluable data remain sparse in the NICU setting with premature neonatal populations; therefore, the successful outcomes identified in this study may provide support for NST practices.

  17. 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.

  18. An Interdisciplinary Nutrition Support Team Improves Clinical and Hospitalized Outcomes of Esophageal Cancer Patients with Concurrent Chemoradiotherapy

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    Ming-Hua Cong

    2015-01-01

    Full Text Available Background: The prevalence of malnutrition is very high in patients with cancer. The purpose of this study was to investigate whether or not a nutrition support team (NST could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT. Methods: Between June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group. The nutritional statuses of 25 patients in the NST group were managed by the NST. The other 25 patients in the control group underwent the supervision of radiotherapy practitioners. At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay (LOS and the in-patient cost were also compared between these two groups. Results: At the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB, transferrin, and ALB parameters (P = 0.001, 0.000, and 0.000, respectively. The complication incidences, including bone marrow suppression (20% vs. 48%, P = 0.037 and complications related infections (12% vs. 44%, P = 0.012, in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs. 76%, P = 0.103. Furthermore, the average LOS was decreased by 4.5 days (P = 0.001 and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times (P > 0.05 in the NST group. Conclusions: A NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs.

  19. [The regional cooperation of medical services and a nutritional support team].

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    Maruyama, Michio

    2006-12-01

    "Community NST" is a new concept, which means a cooperation system with the hospital NST and a regional medical service. "Community NST" provides home nutritional care for the patients with nutritional problems. The function of the hospital NST for inpatients has been established in recent years. Now the patients need a continuous nutritional care not only in the hospital but at home. Percutaneous endoscopic gastrostomy (PEG) has been performed on the base of cooperation with the hospital and home care. This PEG system is one of the functions of "Community NST". The author showed several measures of "Community NST", which have been tried in the hospital.

  20. [Does the nutritional care plan and report upon discharge under the health care system substitute the nutrition support team summary at patient discharge?].

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    Hidaka, Kumi; Matsuoka, Mio; Kajiwara, Kanako; Hinokiyama, Hiromi; Mito, Saori; Doi, Seiko; Konishi, Eriko; Ibata, Takeshi; Komuro, Ryutaro; lijima, Shohei

    2013-12-01

    Our nutrition support team (NST) designed the NST summary for cooperation among personnel providing medical care for nutritional management of high-need patients in our area. After the introduction of the NST fee under the health care system, the number of summary publications decreased. The requested NST fee is necessary for publication of a nutritional care plan and report upon patient discharge. We hypothesized that the nutritional care plan and discharge report were being substituted for the NST summary at the time of patient discharge. We retrospectively investigated 192 cases with NST fee. There were only 13 cases of overlapping publication, and the NST summary was necessary for 107 of 179 cases in which no NST summary had been prepared. Since the space on the report form is limited, it can provide only limited information. However, the NST summary can convey detailed supplementary information. Therefore, there is a high need for the NST summary, and publication of NST summaries for the appropriate cases must continue.

  1. Multidisciplinary team-based approach for comprehensive preoperative pulmonary rehabilitation including intensive nutritional support for lung cancer patients.

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    Hiroaki Harada

    Full Text Available BACKGROUND: To decrease the risk of postoperative complication, improving general and pulmonary conditioning preoperatively should be considered essential for patients scheduled to undergo lung surgery. OBJECTIVE: The aim of this study is to develop a short-term beneficial program of preoperative pulmonary rehabilitation for lung cancer patients. METHODS: From June 2009, comprehensive preoperative pulmonary rehabilitation (CHPR including intensive nutritional support was performed prospectively using a multidisciplinary team-based approach. Postoperative complication rate and the transitions of pulmonary function in CHPR were compared with historical data of conventional preoperative pulmonary rehabilitation (CVPR conducted since June 2006. The study population was limited to patients who underwent standard lobectomy. RESULTS: Postoperative complication rate in the CVPR (n = 29 and CHPR (n = 21 were 48.3% and 28.6% (p = 0.2428, respectively. Those in patients with Charlson Comorbidity Index scores ≥2 were 68.8% (n = 16 and 27.3% (n = 11, respectively (p = 0.0341 and those in patients with preoperative risk score in Estimation of Physiologic Ability and Surgical Stress scores >0.3 were 57.9% (n = 19 and 21.4% (n = 14, respectively (p = 0.0362. Vital capacities of pre- and post intervention before surgery in the CHPR group were 2.63±0.65 L and 2.75±0.63 L (p = 0.0043, respectively; however, their transition in the CVPR group was not statistically significant (p = 0.6815. Forced expiratory volumes in one second of pre- and post intervention before surgery in the CHPR group were 1.73±0.46 L and 1.87±0.46 L (p = 0.0012, respectively; however, their transition in the CVPR group was not statistically significant (p = 0.6424. CONCLUSIONS: CHPR appeared to be a beneficial and effective short-term preoperative rehabilitation protocol, especially in patients with poor preoperative conditions.

  2. Multidisciplinary team-based approach for comprehensive preoperative pulmonary rehabilitation including intensive nutritional support for lung cancer patients.

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    Harada, Hiroaki; Yamashita, Yoshinori; Misumi, Keizo; Tsubokawa, Norifumi; Nakao, Junichi; Matsutani, Junko; Yamasaki, Miyako; Ohkawachi, Tomomi; Taniyama, Kiyomi

    2013-01-01

    To decrease the risk of postoperative complication, improving general and pulmonary conditioning preoperatively should be considered essential for patients scheduled to undergo lung surgery. The aim of this study is to develop a short-term beneficial program of preoperative pulmonary rehabilitation for lung cancer patients. From June 2009, comprehensive preoperative pulmonary rehabilitation (CHPR) including intensive nutritional support was performed prospectively using a multidisciplinary team-based approach. Postoperative complication rate and the transitions of pulmonary function in CHPR were compared with historical data of conventional preoperative pulmonary rehabilitation (CVPR) conducted since June 2006. The study population was limited to patients who underwent standard lobectomy. Postoperative complication rate in the CVPR (n = 29) and CHPR (n = 21) were 48.3% and 28.6% (p = 0.2428), respectively. Those in patients with Charlson Comorbidity Index scores ≥2 were 68.8% (n = 16) and 27.3% (n = 11), respectively (p = 0.0341) and those in patients with preoperative risk score in Estimation of Physiologic Ability and Surgical Stress scores >0.3 were 57.9% (n = 19) and 21.4% (n = 14), respectively (p = 0.0362). Vital capacities of pre- and post intervention before surgery in the CHPR group were 2.63±0.65 L and 2.75±0.63 L (p = 0.0043), respectively; however, their transition in the CVPR group was not statistically significant (p = 0.6815). Forced expiratory volumes in one second of pre- and post intervention before surgery in the CHPR group were 1.73±0.46 L and 1.87±0.46 L (p = 0.0012), respectively; however, their transition in the CVPR group was not statistically significant (p = 0.6424). CHPR appeared to be a beneficial and effective short-term preoperative rehabilitation protocol, especially in patients with poor preoperative conditions.

  3. Nutrition support in hospitals

    DEFF Research Database (Denmark)

    Kondrup, Jens

    2005-01-01

    Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....

  4. The nutritional intake of elderly patients with dysphagia admitted to the internal medical department of the emergency hospital was analyzed. The Fujishima dysphagia scale after care and treatment by the Nutrition Support Team was assessed.

    Science.gov (United States)

    Niwano, Mototaka

    2016-01-01

    The Nutrition Support Team (NST) assessed the severity of dysphagia in elderly patients admitted to the internal medical department, and the appropriate nutritional treatment was determined. Patients were treated with either oral nutrition (enteral nutrition, EN) or artificial alimentation (parenteral nutrition, PN). The goal of this study was to analyze whether or not the route of nutrition affected the patient discharge rates. We divided 290 elderly inpatients with dysphagia into 2 groups, the pneumonia group (200 patients) and the non-pneumonia group (90 patients). The NST estimated the swallowing function using the Fujishima dysphagia scale. Monitoring was continued until the NST care and treatment had been finalized. We further divided the pneumonia patients into two subgroups: those with a Fujishima dysphagia scale score ≤3 or ≥4 at the beginning of NST intervention. The changes in the swallowing function were analyzed.The swallowing function in the patients with a score ≥4 was significantly improved compared with that in the patients with a score ≤3. This difference, however, was not observed in the non-pneumonia group. In both the pneumonia and non-pneumonia groups, the ratio of patients discharged on oral nutrition was one-third, and the ratio of death in hospital was one-quarter, the remaining patients required artificial alimentation. Among elderly patients admitted to the internal medical department of the emergency hospital with dysphagia, one-third left the hospital with oral nutritional intake, one-quarter died in hospital, and the remaining required artificial alimentation.

  5. [Nutritional support in sepsis].

    Science.gov (United States)

    Ortiz Leyba, C; López Martínez, J; Blesa Malpica, A L

    2005-06-01

    Although it is considered that metabolic and nutritional support must be part of the management of septic patients, it has not been conclusively shown that nutritional support will improve survival or complications from sepsis. Specific data on this issue are scarce since there are few studies that have investigated specialized nutritional support in septic patients. Thus, most of the recommendations are based on outcomes obtained in severely ill patients with different pathologies. It is assumed that nutritional support should be carried out through the enteral route whenever possible, as in other critically ill patients. The energetic waste in these patients is highly variable, although in general terms the hypermetabolic situation may be classified as moderate. An adjustment factor of 1.25-1.30 is recommended for the Harris-Benedict's equation to calculate the caloric intake. Septic patients should receive a hyperproteic intake. The amount of glucose administered should not exceed 70% of non-protein calories, and lipids intake should not exceed 40%. With regards to micronutrients, it is recommended to increase the supply of those with antioxidant properties (vitamin E, carotenes, vitamin C, selenium). There are data to consider that the use of diets enriched with pharmaco-nutrients (both with parenteral and enteral routes) may be beneficial in septic patients, although there is some controversy when interpreting the outcomes.

  6. Development and Evaluation of a Home Enteral Nutrition Team

    Directory of Open Access Journals (Sweden)

    Sarah Dinenage

    2015-03-01

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

  7. What Is Nutrition Support Therapy?

    Science.gov (United States)

    ... Sponsored CE Programs Calendar of Events What Is Nutrition Support Therapy All people need food to live. ... patient populations from pediatrics to geriatrics. Key Terms: Nutrition Support Therapy The provision of enteral or parenteral ...

  8. Perioperative nutritional support.

    Science.gov (United States)

    Morán López, Jesús Manuel; Piedra León, María; García Unzueta, María Teresa; Ortiz Espejo, María; Hernández González, Miriam; Morán López, Ruth; Amado Señaris, José Antonio

    2014-01-01

    The relationship between preoperative malnutrition and morbi-mortality has been documented for years. Despite the existence of tools that allow its detection, and therefore treat this entity, their introduction into clinical practice is not wide-spread. Both perioperative insulin resistance and hyperglycemia are associated with increased perioperative morbidity and length of hospital stay. The intake of carbohydrate-rich drinks 2-4h prior to surgery reduces insulin resistance. In the immediate postoperative period, the enteral route is safe and well tolerated and its early use reduces hospital stay and postoperative complications compared with parenteral nutritional support. Inmunonutrition has been proven effective to decrease postoperative complications and hospital stay. In view of these data we opted for the adoption of these measures replacing bowel rest and the indiscriminate use of postoperative parenteral nutrition. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  9. Environmental control medical support team

    Science.gov (United States)

    Crump, William J.; Kilgore, Melvin V., Jr.

    1988-01-01

    The activities conducted in support of the Environmental Control and Life Support Team during December 7, 1987 through September 30, 1988 are summarized. The majority of the ongoing support has focused on the ECLSS area. Through a series of initial meetings with the ECLSS team and technical literature review, an initial list of critical topics was developed. Subtasks were then identified or additional related tasks received as action items from the ECLSS group meetings. Although most of the efforts focused on providing MSFC personnel with information regarding specific questions and problems related to ECLSS issues, other efforts regarding identifying an ECLSS Medical Support Team and constructing data bases of technical information were also initiated and completed. The specific tasks are as follows: (1) Provide support to the mechanical design and integration of test systems as related to microbiological concerns; (2) Assist with design of Human Subjects Test Protocols; (3) Interpretation and recommendations pertaining to air/water quality requirements; (4) Assist in determining the design specifications required as related to the Technical Demonstration Program; (5) Develop a data base of all microorganisms recovered from previous subsystem testing; (6) Estimates of health risk of individual microbes to test subjects; (7) Assist with setting limits for safety of test subjects; (8) Health monitoring of test subjects; (9) Assist in the preparation of test plans; (10) Assist in the development of a QA/QC program to assure the validity, accuracy and precision of the analyses; and (11) Assist in developing test plans required for future man in the loop testing.

  10. Nutritional support of reptile patients.

    Science.gov (United States)

    De Voe, Ryan S

    2014-05-01

    Providing nutritional support to reptile patients is a challenging and often misunderstood task. Ill reptiles are frequently anorexic and can benefit greatly from appropriate nutrition delivered via a variety of assist-feeding techniques. Neonatal reptiles can also be very challenging patients because many fail to thrive without significant efforts to establish normal feeding behaviors. This article presents ideas supporting the benefit of timely nutritional support as well as specific recommendations for implementation of assist feeding. Also discussed are a few nutritional issues that affect captive reptile species. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Impact of a multidisciplinary rehabilitation nutrition team on evaluating sarcopenia, cachexia and practice of rehabilitation nutrition.

    Science.gov (United States)

    Kokura, Yoji; Wakabayashi, Hidetaka; Maeda, Keisuke; Nishioka, Shinta; Nakahara, Saori

    2017-01-01

    To determine whether the presence of a multidisciplinary rehabilitation nutrition team affects sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. A cross-sectional study using online questionnaire among members of the Japanese Association of Rehabilitation Nutrition (JARN) was conducted. Questions were related to sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. 677 (14.7%) questionnaires were analysed. 44.5% reported that their institution employed a rehabilitation nutrition team, 20.2% conducted rehabilitation nutrition rounds and 26.1% conducted rehabilitation nutrition meetings. A total of 51.7%, 69.7%, 69.0% and 17.8% measured muscle mass, muscle strength, physical function and cachexia, respectively. For those with a rehabilitation nutrition team, 63.5%, 80.7%, 82.4% and 22.9% measured muscle mass, muscle strength, physical function and cachexia, respectively, whereas 46.7%, 78.0% and 78.1% of the respondents reported implementation of nutrition planning strategies in consideration of energy accumulation, rehabilitation training in consideration of nutritional status and use of dietary supplements, respectively. Multivariate logistic regression analysis showed that the use of a rehabilitation nutrition team independently affected sarcopenia evaluation and practice of rehabilitation nutrition but not cachexia evaluation. The presence of a multidisciplinary rehabilitation nutrition team increased the frequency of sarcopenia evaluation and practice of rehabilitation nutrition. J. Med. Invest. 64: 140-145, February, 2017.

  12. What Does Change with Nutrition Team in Intensive Care Unit?

    Directory of Open Access Journals (Sweden)

    Ahmet Fatih Yılmaz

    2016-08-01

    Full Text Available Intrroduction: Clinical nutrition is the nutrition support therapy provided to patients under medical supervision at the hospital or home setting. It is a multidisciplinary task performed under the control of the physician, dietician, pharmacist and nurse. In this study, the changes in the patient admission statistics to the general intensive care unit (GICU, the exitus ratios, decubitus ulcer formation rates, albumin use rates, duration of the hospital stay, Acute Physiology and Chronic Health Evaluation (APACHE II scores, rate of usege of parenteral and enteral products, and the change in expenses per patient within the first year of activity of the nutrition team in comparison to the previous year was presented. Material and Method: In this study a 6-bed GICU was used. The patients who was admitted through retrospective file scanning between 1 January 2012 and 31 December 2012 and between 1 January 2013 and 31 December 2013 were compared. Results: The number of the patients admitted to the GICU was 341 in 2012 and 369 in 2013. The number of the patients who died in 2012 was 86 (25.2%, while it was 106 in 2013 (28.7%. In 2012, 122 patients (35.7% had decubitus ulcers, while this number was 92 (24.7% in 2013. Human albumin usage was reduced by 23% for the 100 mL (225 in 2012, 175 in 2013 and by 33% for the 50 mL doses (122 in 2012, 82 in 2013. Duration of stay in the hospital was 6.3±0.9 vs. 5.8±0.9 (days (p=0.06. The mean APACHE II scores were observed to be 24.7±6.9 vs. 30.5±11.4 (p=0.03. When the distribution of product types were analyzed, it was observed that the ratio of parenteral products: enteral products was 2:1 in 2012, however the ratio of enteral products to parenteral products was 2:1 in 2013. The daily expense of a patient decreased from 100 TL to 55 TL. Conclusion: The nutrition team directly influences the clinical process outcomes of patients under treatment in the ICU. It was thought that using appropriate nutritional

  13. Carbohydrate Nutrition and Team Sport Performance.

    Science.gov (United States)

    Williams, Clyde; Rollo, Ian

    2015-11-01

    The common pattern of play in 'team sports' is 'stop and go', i.e. where players perform repeated bouts of brief high-intensity exercise punctuated by lower intensity activity. Sprints are generally 2-4 s long and recovery between sprints is of variable length. Energy production during brief sprints is derived from the degradation of intra-muscular phosphocreatine and glycogen (anaerobic metabolism). Prolonged periods of multiple sprints drain muscle glycogen stores, leading to a decrease in power output and a reduction in general work rate during training and competition. The impact of dietary carbohydrate interventions on team sport performance have been typically assessed using intermittent variable-speed shuttle running over a distance of 20 m. This method has evolved to include specific work to rest ratios and skills specific to team sports such as soccer, rugby and basketball. Increasing liver and muscle carbohydrate stores before sports helps delay the onset of fatigue during prolonged intermittent variable-speed running. Carbohydrate intake during exercise, typically ingested as carbohydrate-electrolyte solutions, is also associated with improved performance. The mechanisms responsible are likely to be the availability of carbohydrate as a substrate for central and peripheral functions. Variable-speed running in hot environments is limited by the degree of hyperthermia before muscle glycogen availability becomes a significant contributor to the onset of fatigue. Finally, ingesting carbohydrate immediately after training and competition will rapidly recover liver and muscle glycogen stores.

  14. Nutritional support for liver disease.

    Science.gov (United States)

    Koretz, Ronald L; Avenell, Alison; Lipman, Timothy O

    2012-05-16

    Weight loss and muscle wasting are commonly found in patients with end-stage liver disease. Since there is an association between malnutrition and poor clinical outcome, such patients (or those at risk of becoming malnourished) are often given parenteral nutrition, enteral nutrition, or oral nutritional supplements. These interventions have costs and adverse effects, so it is important to prove that their use results in improved morbidity or mortality, or both. To assess the beneficial and harmful effects of parenteral nutrition, enteral nutrition, and oral nutritional supplements on the mortality and morbidity of patients with underlying liver disease. The following computerised databases were searched: the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, and Science Citation Index Expanded (January 2012). In addition, reference lists of identified trials and review articles and Clinicaltrials.gov were searched. Trials identified in a previous systematic handsearch of Index Medicus were also considered. Handsearches of a number of medical journals, including abstracts from annual meetings, were done. Experts in the field and manufacturers of nutrient formulations were contacted for potential references. Randomised clinical trials (parallel or cross-over design) comparing groups of patients with any underlying liver disease who received, or did not receive, enteral or parenteral nutrition or oral nutritional supplements were identified without restriction on date, language, or publication status. Six categories of trials were separately considered: medical or surgical patients receiving parenteral nutrition, enteral nutrition, or supplements. The following data were sought in each report: date of publication; geographical location; inclusion and exclusion criteria; the type of nutritional support and constitution of the nutrient formulation; duration of

  15. Towards implementation of optimum nutrition and better clinical nutrition support

    NARCIS (Netherlands)

    Jonkers, C. F.; Prins, F.; van Kempen, A.; Tepaske, R.; Sauerwein, H. P.

    2001-01-01

    Clinical Nutrition Support--defined as nutrition for hospitalized patients suffering from metabolic stress--plays a limited role in the therapeutic routine of the physician. This is not surprising as most research in the field of clinical nutrition is disappointing with regard to the objective

  16. Sport-specific nutrition: practical strategies for team sports.

    Science.gov (United States)

    Holway, Francis E; Spriet, Lawrence L

    2011-01-01

    Implementation of a nutrition programme for team sports involves application of scientific research together with the social skills necessary to work with a sports medicine and coaching staff. Both field and court team sports are characterized by intermittent activity requiring a heavy reliance on dietary carbohydrate sources to maintain and replenish glycogen. Energy and substrate demands are high during pre-season training and matches, and moderate during training in the competitive season. Dietary planning must include enough carbohydrate on a moderate energy budget, while also meeting protein needs. Strength and power team sports require muscle-building programmes that must be accompanied by adequate nutrition, and simple anthropometric measurements can help the nutrition practitioner monitor and assess body composition periodically. Use of a body mass scale and a urine specific gravity refractometer can help identify athletes prone to dehydration. Sports beverages and caffeine are the most common supplements, while opinion on the practical effectiveness of creatine is divided. Late-maturing adolescent athletes become concerned about gaining size and muscle, and assessment of maturity status can be carried out with anthropometric procedures. An overriding consideration is that an individual approach is needed to meet each athlete's nutritional needs.

  17. Specialist Teams Needed to Support Youth.

    Science.gov (United States)

    Mellin, Laurel M.

    1991-01-01

    Presents seven reasons why it is important for health specialist teams to take action supporting the prevention and treatment of childhood obesity. The article offers guidelines to help parents assist their children in maintaining positive eating, exercise, and self-esteem patterns, noting sensitive intervention is preferable to imposed diets. (SM)

  18. Nutritional supportive care in children with cancer

    International Nuclear Information System (INIS)

    Riha, P.; Smisek, P.

    2013-01-01

    Appropriate nutritional support is an important part of comprehensive oncology treatment. The aim is to decrease the incidence of malnutrition. Malnourished patients are in higher risk of infectious and toxic complications, experience worse quality of life. Systematic survey of nutritional status and early nutritional intervention can eventually lead to better results of oncology treatment. We review the definitions, etiology and epidemiology of malnutrition, practical approaches to nutritional support of children with cancer. (author)

  19. Cognitive model supported team skill training

    NARCIS (Netherlands)

    Doesburg, W.A. van; Stroomer, S.M.

    2006-01-01

    Complex tasks require coordinated performance by multiple team members. To perform the task effectively each team member must not only master the individual task component but also needs to function in the overall team. To increase team performance, each team member will need to acquire the relevant

  20. [Nutritional study of a third division soccer team].

    Science.gov (United States)

    Martínez Reñón, Cristian; Sánchez Collado, Pilar

    2013-01-01

    To analyze the nutritional habits and attitudes of a semiprofessional soccer team. Nutritional study of 21 semiprofessional soccer players (18-35 years) by analyzing the daily energy intake and expenditure also the distribution of macro and micro-nutrients, differentiated type of day (normal, training or competition). The energy balance is negative in the three days studied (- 31%, - 38% and -31% respectively). There were significant differences in caloric intake between the day of competition, a normal day and a day of training. These differences are observed both in absolute values (2,438 kcal vs 2,127 y 2,221 kcal respectively) as referring to body weight (30.5 kcal/kg vs 27 y 28 kcal/kg respectively). Regarding macronutrient intake, the samples eat a diet with an insufficient amount of carbohydrates (328 g vs 371 and 540 g recommended in function of physical activity). There were no significant differences in the composition of micronutrients. The football players studied show a negative energy balance with a diet low in carbohydrates. This poor nutritional status may interfere with the development of their sporting performance and, ultimately, increase the risk of lesions. This implies the need for design and implementation of a diet and introducing nutritional education programs for these athletes. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  1. Strategies for Creating Supportive School Nutrition Environments

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2014

    2014-01-01

    Good nutrition is vital to optimal health. The school environment plays a fundamental role in shaping lifelong healthy behaviors and can have a powerful influence on students' eating habits. A supportive school nutrition environment includes multiple elements: access to healthy and appealing foods and beverages available to students in school…

  2. 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

  3. Nutritional support for malnourished patients with cancer.

    Science.gov (United States)

    Baldwin, Christine

    2011-03-01

    Cancer and its treatments frequently have a negative impact on the weight and nutritional status of patients. Weight loss is associated with reduced survival and poorer outcomes of treatment but is not well characterized and frequently confused with cachexia, which may complicate the interpretation of studies of nutritional support. The aims of this review were to examine the impact of cancer on nutritional status and to review the role of simple oral nutritional interventions and novel agents. The terms weight loss, malnutrition and cachexia refer to different entities and new definitions have recently been proposed that take account of the role of the underlying inflammatory processes. Oral nutritional interventions are widely recommended for malnourished cancer patients, but the evidence for their benefits to clinical, nutritional and patient-centred outcomes is limited. Meta-analysis has highlighted the variability in response to simple nutritional interventions of different cohorts of cancer patients and suggested that improvements in nutritional endpoints and aspects of quality of life may be achieved in some patients. Recent research has largely focused on treatments aiming to modulate the inflammatory processes associated with cachexia, but to date has not identified a single treatment with clear efficacy. Studies characterizing the potential for nutritional support in combination with anti-inflammatory agents in defined patient groups are defined to advance the evidence base in this area.

  4. [Nutritional assessment and perioperative nutritional support in gastric cancer patients].

    Science.gov (United States)

    Seo, Kyung Won; Yoon, Ki Young

    2013-04-01

    Weight loss and malnutrition are common in cancer patients. Although weight loss is predominantly due to loss of fat mass, the morbidity risk is given by the decrease in muscle mass. The assessment of nutritional status is essential for a diagnosis of nutritional compromise and required for the multidisciplinary approach. Subjective global assessment (SGA) is made by the patients nutritional symptoms and weight loss. The objective assessment, a significant weight loss (>10%) for 6 months is considered an indicator of nutritional deficiency. The mean body index, body fat mass and body protein mass are decreased as cancer stage increases. The biochemical data of albumin, cholesterol, triglyceride, Zn, transferrin, total lymphocyte count are decreased in advanced cancer stage. Daily energy intake, cabohyderate and Vit B1 intake is decreased according to cancer stage. The patients are divided into three groups according to SGA. The three groups showed a significant difference in body weight, 1 month weight loss%, 6 month weight loss%, body mass index, mid arm circumference, albumin, energy intake, as well as carbohyderate intake protein and energy malnutrition. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increase in stomach cancer associated morbidity and mortality. The authors concluded that nutritional assessment should be done in cancer patients preoperatively, and with adequate nutritional support, the morbidity and mortality would be decreased.

  5. Selected In-Season Nutritional Strategies to Enhance Recovery for Team Sport Athletes: A Practical Overview.

    Science.gov (United States)

    Heaton, Lisa E; Davis, Jon K; Rawson, Eric S; Nuccio, Ryan P; Witard, Oliver C; Stein, Kimberly W; Baar, Keith; Carter, James M; Baker, Lindsay B

    2017-11-01

    Team sport athletes face a variety of nutritional challenges related to recovery during the competitive season. The purpose of this article is to review nutrition strategies related to muscle regeneration, glycogen restoration, fatigue, physical and immune health, and preparation for subsequent training bouts and competitions. Given the limited opportunities to recover between training bouts and games throughout the competitive season, athletes must be deliberate in their recovery strategy. Foundational components of recovery related to protein, carbohydrates, and fluid have been extensively reviewed and accepted. Micronutrients and supplements that may be efficacious for promoting recovery include vitamin D, omega-3 polyunsaturated fatty acids, creatine, collagen/vitamin C, and antioxidants. Curcumin and bromelain may also provide a recovery benefit during the competitive season but future research is warranted prior to incorporating supplemental dosages into the athlete's diet. Air travel poses nutritional challenges related to nutrient timing and quality. Incorporating strategies to consume efficacious micronutrients and ingredients is necessary to support athlete recovery in season.

  6. Nutritional strategies to support concurrent training.

    Science.gov (United States)

    Perez-Schindler, Joaquin; Hamilton, D Lee; Moore, Daniel R; Baar, Keith; Philp, Andrew

    2015-01-01

    Concurrent training (the combination of endurance exercise to resistance training) is a common practice for athletes looking to maximise strength and endurance. Over 20 years ago, it was first observed that performing endurance exercise after resistance exercise could have detrimental effects on strength gains. At the cellular level, specific protein candidates have been suggested to mediate this training interference; however, at present, the physiological reason(s) behind the concurrent training effect remain largely unknown. Even less is known regarding the optimal nutritional strategies to support concurrent training and whether unique nutritional approaches are needed to support endurance and resistance exercise during concurrent training approaches. In this review, we will discuss the importance of protein supplementation for both endurance and resistance training adaptation and highlight additional nutritional strategies that may support concurrent training. Finally, we will attempt to synergise current understanding of the interaction between physiological responses and nutritional approaches into practical recommendations for concurrent training.

  7. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk

    DEFF Research Database (Denmark)

    Jie, Bin; Jiang, Zhu-Ming; Nolan, Marie T

    2012-01-01

    This multicenter, prospective cohort study evaluated the effect of preoperative nutritional support in abdominal surgical patients at nutritional risk as defined by the Nutritional Risk Screening Tool 2002 (NRS-2002).......This multicenter, prospective cohort study evaluated the effect of preoperative nutritional support in abdominal surgical patients at nutritional risk as defined by the Nutritional Risk Screening Tool 2002 (NRS-2002)....

  8. Individual autonomy in work teams : the role of team autonomy, self-efficacy, and social support

    NARCIS (Netherlands)

    Mierlo, van H.; Rutte, C.G.; Vermunt, J.K.; Kompier, M.A.J.; Doorewaard, J.A.C.M.

    2006-01-01

    Task autonomy is long recognized as a means to improve functioning of individuals and teams. Taking a multilevel approach, we unravelled the constructs of team and individual autonomy and studied the interplay between team autonomy, self-efficacy, and social support in determining individual

  9. Artificial Nutritional Support Registries: systematic review.

    Science.gov (United States)

    Castelló-Botía, I; Wanden-Berghe, C; Sanz-Valero, J

    2009-01-01

    The nutritional registries are data bases through which we obtain the information to understand the nutrition of populations. Several main nutrition societies of the world have these types of registries, outstanding the NADYA (Home artificial and Ambulatory nutrition) group in Spain. The object of this study is to determine by means of a systematic review, the existent scientific production in the international data bases referred to nutritional support registries. Descriptive transversal study of the results of a critical bibliographic research done in the bioscience data bases: MEDLINE, EMBASE, The Cochrane Library, ISI (Web of Sciences), LILACS, CINHAL. A total of 20 original articles related to nutritional registries were found and recovered. Eleven registries of eight countries were identified: Australia, Germany, Italy, Japan, Spain, Sweden, United Status and United Kingdom. The Price Index was of 65% and all the articles were published in the last 20 years. The Price Index highlights the innovativeness of this practice. The articles related to nutritional support are heterogeneous with respect to data and population, which exposes this as a limitation for a combined analysis.

  10. Ethical issues in nutritional support nursing. Withholding and withdrawing nutritional support.

    Science.gov (United States)

    Knox, L S

    1989-06-01

    A new and controversial debate in bioethics concerns the question, "Is it ever acceptable to withhold or withdraw specialized nutritional support from the dying adult patient?" In the opinion of many, the answer to this question is yes, but for only a very small number of patients. Provision of nutrition through artificial means is an invasive medical intervention. As such, procedures for supplying nutritional support impose burdens as well as provide benefits and may, under certain circumstances, be foregone. However, the needs of the vast majority of dying patients will best be served by providing specialized nutritional support.

  11. Fleet Assistance and Support Team (FAST) Lab

    Data.gov (United States)

    Federal Laboratory Consortium — The FAST team was established by PMA-264 for introduction of multistatic ASW systems into the Fleet.FAST provides Air ASW mission planning, tactics/tactical sensor...

  12. Nutritional support for children with epidermolysis bullosa.

    Science.gov (United States)

    Haynes, Lesley

    Epidermolysis bullosa (EB) comprises a rare group of genetically determined skin blistering disorders characterized by extreme fragility of the skin and mucous membranes, with recurrent blister formation. The cornerstones of management are control of infection, wound management, pain relief, promotion of optimal nutritional status and mobility, surgical intervention and provision of the best possible quality of life. There is currently no cure for EB and, throughout life, those with the more severe types are at risk of significant nutritional compromise which impacts negatively on health and overall quality of life. Nutritional support is an important facet of holistic care and the dietetic challenges can be considerable. This paper describes some of the issues involved in optimizing the nutritional status of children with this disorder.

  13. Nutrition Education by a Registered Dietitian Improves Dietary Intake and Nutrition Knowledge of a NCAA Female Volleyball Team

    Science.gov (United States)

    Valliant, Melinda W.; Pittman Emplaincourt, Heather; Wenzel, Rachel Kieckhaefer; Garner, Bethany Hilson

    2012-01-01

    Eleven female participants from a NCAA Division I volleyball team were evaluated for adequate energy and macronutrient intake during two off-seasons. Total energy and macronutrient intake were assessed by food records and results were compared against estimated needs using the Nelson equation. Dietary intervention was employed regarding the individual dietary needs of each athlete as well as a pre- and post-sports nutrition knowledge survey. Post dietary intervention, total energy, and macronutrient intake improved, as well as a significant improvement in sports nutrition knowledge (p < 0.001). Nutrition education is useful in improving dietary intake and nutrition knowledge of female athletes. PMID:22822449

  14. Nutritional support in patients with systemic sclerosis.

    Science.gov (United States)

    Ortiz-Santamaria, Vera; Puig, Celia; Soldevillla, Cristina; Barata, Anna; Cuquet, Jordi; Recasens, Asunción

    2014-01-01

    Systemic sclerosis (SSc) is a chronic multisystem autoimmune disease which involves the gastrointestinal tract in about 90% of cases. It may contribute to nutritional deterioration. To assess whether the application of a nutritional support protocol to these patients could improve their nutritional status and quality of life. Single center prospective study, performed on an outpatient basis, in a county hospital. The Malnutrition Universal Screening Tool (MUST) was used to screen risk for malnutrition. Health questionnaire SF-36 and the Hospital Anxiety and Depression Scale were used to assess quality of life and psychopathology respectively. Weight, height, energy and protein requirements, macronutrient intake and nutritional biochemical parameters were evaluated. Nutritional intervention was performed in patients at risk for malnutrition. Of the 72 patients, 12.5% were at risk for malnutrition. Iron deficiency anemia (18.35%) and vitamin D deficiency (54%) were the most frequently observed nutritional deficits. The questionnaires on psychopathology and quality of life showed a high prevalence of anxiety and depression, and lower level poor quality of life in the physical and mental component. No significant improvements were observed in the weight, food intake, nutritional biochemical parameters, psychopathology and quality of life follow-up. Dietary intervention was able to maintain body weight and food intake. Iron deficiency anemia and vitamin D deficiency improved with iron and vitamine D supplements. No deterioration was observed in psychological assessment or quality of life. Studies with larger numbers of patients are needed to assess the efficacy of this intervention. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  15. Does adding a dietician to the liaison team after discharge of geriatric patients improve nutritional outcome

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Tolstrup Andersen, Ulla; Leedo, Eva

    2015-01-01

    (70 + years and at nutritional risk) at discharge. INTERVENTIONS: Participants were randomly allocated to receive discharge Liaison-Team vs. discharge Liaison-Team in cooperation with a dietician. The dietician performed a total of three home visits with the aim of developing and implementing......OBJECTIVES: The objective was to test whether adding a dietician to a discharge Liaison-Team after discharge of geriatric patients improves nutritional status, muscle strength and patient relevant outcomes. DESIGN: Twelve-week randomized controlled trial. SETTING AND SUBJECTS: Geriatric patients...... an individual nutritional care plan. The first visit took place at the day of discharge together with the discharge Liaison-Team while the remaining visits took place approximately three and eight weeks after discharge and were performed by a dietician alone. MAIN MEASURES: Nutritional status (weight...

  16. Network-aware support for mobile distributed teams

    NARCIS (Netherlands)

    Kleij, R. van der; Jong, A. de; Brake, G.M. te; Greefe, T.E.

    2009-01-01

    An experiment evaluated network-aware support to increase understanding of the factors that are important for successful teamwork in mobile geographically dispersed teams of first responders. Participants performed a simulated search and rescue team task and were equipped with a digitized map and

  17. The Team up for School Nutrition Success Workshop Evaluation Study: Three Month Results

    Science.gov (United States)

    Cullen, Karen Weber; Rushing, Keith

    2017-01-01

    Purpose/Objectives: The purpose of this study was to evaluate the "Team Up for School Nutrition Success" pilot initiative, conducted by the Institute of Child Nutrition (ICN), on meeting the objectives of the individual action plans created by school food authorities (SFAs) during the workshop. The action plans could address improving…

  18. The Team Up for School Nutrition Success workshop evaluation study: 3-month results

    Science.gov (United States)

    The purpose of this study was to evaluate the Team Up for School Nutrition Success pilot initiative, conducted by the Institute of Child Nutrition (ICN), on meeting the objectives of the individual action plans created by school food authorities (SFAs) during the workshop. The action plans could add...

  19. [Organising nutritional support for patients with anorexia].

    Science.gov (United States)

    Satori, Nadine

    Nutritional care in the Eating Disorder unit of Sainte-Anne general hospital in Paris, is organised around a care model based on cognitive behavioural therapy. Hospitalisation is generally prepared beforehand and aims to draw on patients' resources enabling them to clarify a request for help. A care contract can be drawn up to provide step-by-step support for the patient in terms of the goals to achieve. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Hospital to home paediatric enteral nutrition--parents need support.

    LENUS (Irish Health Repository)

    Shortall, C

    2015-02-01

    This study assessed the provision of education and support to parents of children on home enteral nutrition (HEN), current dietetic support available and perceived challenges facing parents and carers. From the 39 responses (13%), 29 (83%, n = 35) parents suggested services for HEN need improvement. 29 (74%, n = 39) parents wanted more structured follow up and 22 (56%) would like one person to co-ordinate HEN, education and discharge. 7 parents (18%) reported a need for further education of health care professionals (HCP). Hospital dietitians were the most common HCPs reported to provide support to patients following discharge. Specialist paediatric HEN dietetic services working in a dedicated HEN team, who would provide accurate training and education and liaise with both parents and community care services post discharge should be in place. This would facilitate transfer to community care, reduce hospital re-admissions, outpatient department attendances and costs.

  1. Nutritional support for critically ill children.

    Science.gov (United States)

    Joffe, Ari; Anton, Natalie; Lequier, Laurance; Vandermeer, Ben; Tjosvold, Lisa; Larsen, Bodil; Hartling, Lisa

    2016-05-27

    Nutritional support in the critically ill child has not been well investigated and is a controversial topic within paediatric intensive care. There are no clear guidelines as to the best form or timing of nutrition in critically ill infants and children. This is an update of a review that was originally published in 2009. . The objective of this review was to assess the impact of enteral and parenteral nutrition given in the first week of illness on clinically important outcomes in critically ill children. There were two primary hypotheses:1. the mortality rate of critically ill children fed enterally or parenterally is different to that of children who are given no nutrition;2. the mortality rate of critically ill children fed enterally is different to that of children fed parenterally.We planned to conduct subgroup analyses, pending available data, to examine whether the treatment effect was altered by:a. age (infants less than one year versus children greater than or equal to one year old);b. type of patient (medical, where purpose of admission to intensive care unit (ICU) is for medical illness (without surgical intervention immediately prior to admission), versus surgical, where purpose of admission to ICU is for postoperative care or care after trauma).We also proposed the following secondary hypotheses (a priori), pending other clinical trials becoming available, to examine nutrition more distinctly:3. the mortality rate is different in children who are given enteral nutrition alone versus enteral and parenteral combined;4. the mortality rate is different in children who are given both enteral feeds and parenteral nutrition versus no nutrition. In this updated review we searched: the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2); Ovid MEDLINE (1966 to February 2016); Ovid EMBASE (1988 to February 2016); OVID Evidence-Based Medicine Reviews; ISI Web of Science - Science Citation Index Expanded (1965 to February 2016); Web

  2. Nutrition support in hospitalised adults at nutritional risk

    DEFF Research Database (Denmark)

    Feinberg, Joshua; Nielsen, Emil Eik; Korang, Steven Kwasi

    2017-01-01

    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. SELECTION CRITERIA: We include...... methodology. Our primary outcomes were all-cause mortality, serious adverse events, and health-related quality of life. MAIN RESULTS: 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 trials accounted...... experimental intervention (12 trials); general nutrition support (9 trials); and fortified food (2 trials). The control interventions were treatment as usual (122 trials); no intervention (107 trials); and placebo (15 trials). In 204/244 trials, the intervention lasted three days or more.We found no evidence...

  3. Screening of Nutritional Risk and Nutritional Support in General Surgery Patients: A Survey from Shanghai, China

    Science.gov (United States)

    Jia, Zhen-Yi; Yang, Jun; Tong, Da-Nian; Peng, Jia-Yuan; Zhang, Zhong-Wei; Liu, Wei-Jie; Xia, Yang; Qin, Huan-long

    2015-01-01

    To determine the prevalence of nutritional risk in surgical departments and to evaluate the impact of nutritional support on clinical outcomes. The nutritional risk in different surgical diseases and the different way of nutritional support on clinical outcomes in patients at nutritional risk remain unclear. Hospitalized patients from general surgical departments were screened using the Nutritional Risk Screening (NRS) 2002 questionnaire on admission. Data were collected on nutritional risk, complications, and length of stay (LOS). Overall, 5034 patients were recruited; the overall prevalence of nutritional risk on admission were 19.2%. The highest prevalence was found among patients with gastric cancer. At-risk patients had more complications and longer LOS than nonrisk patients. Of the at-risk patients, the complication rate was significantly lower and LOS was significantly shorter in the nutritional-support group than in the no-support group (20.9 versus 30.0%, P nutrition or who received support for 5 to 7 days, or daily support entailing 16 to 25 kcal/kg of nonprotein energy. Different surgical diseases have different levels of nutritional risk. The provision of nutritional support was associated with a lower complication rate and a shorter LOS for gastric, colorectal, and HPB cancer patients at nutritional risk. The improper use of nutritional support may not improve outcomes for at-risk patients. PMID:26011204

  4. Creating and supporting a mixed methods health services research team.

    Science.gov (United States)

    Bowers, Barbara; Cohen, Lauren W; Elliot, Amy E; Grabowski, David C; Fishman, Nancy W; Sharkey, Siobhan S; Zimmerman, Sheryl; Horn, Susan D; Kemper, Peter

    2013-12-01

    To use the experience from a health services research evaluation to provide guidance in team development for mixed methods research. The Research Initiative Valuing Eldercare (THRIVE) team was organized by the Robert Wood Johnson Foundation to evaluate The Green House nursing home culture change program. This article describes the development of the research team and provides insights into how funders might engage with mixed methods research teams to maximize the value of the team. Like many mixed methods collaborations, the THRIVE team consisted of researchers from diverse disciplines, embracing diverse methodologies, and operating under a framework of nonhierarchical, shared leadership that required new collaborations, engagement, and commitment in the context of finite resources. Strategies to overcome these potential obstacles and achieve success included implementation of a Coordinating Center, dedicated time for planning and collaborating across researchers and methodologies, funded support for in-person meetings, and creative optimization of resources. Challenges are inevitably present in the formation and operation of effective mixed methods research teams. However, funders and research teams can implement strategies to promote success. © Health Research and Educational Trust.

  5. Early nutritional support in severe traumatic patients.

    Science.gov (United States)

    Chuntrasakul, C; Siltharm, S; Chinswangwatanakul, V; Pongprasobchai, T; Chockvivatanavanit, S; Bunnak, A

    1996-01-01

    Multiple trauma is associated with altered metabolism, wasting of the lean body mass and compromised wound healing. Nutritional support is one way to improve the condition of these critically ill patients. We performed a prospective randomized study on the effect of early nutritional support in severely injured patients admitted to the Division of Traumatic Surgery, Siriraj Hospital between June 1992 and January 1994. Thirty-eight severe traumatic patients with ISS between 20-40 were randomly divided into control and study group. The 17 patients in the control group were treated in the conventional method with administration of hypo caloric intravenous regimen and supplement with oral diet as soon as the bowel function was returned. The 21 patients of the study group were fed either by enteral or parenteral feeding or both with an appropriate caloric and protein requirement as soon as hemodynamic status was stabilized. We found the study group had a lower mortality rate, a lower complication rate, a shorter period of ICU stay, and an earlier weaning from the ventilator than the control group. The study group also lost less weight than the control group. Nitrogen balance in the study group was significantly lower than the control group.

  6. Selected In-Season Nutritional Strategies to Enhance Recovery for Team Sport Athletes: A Practical Overview

    OpenAIRE

    Heaton, Lisa E.; Davis, Jon K.; Rawson, Eric S.; Nuccio, Ryan P.; Witard, Oliver C.; Stein, Kimberly W.; Baar, Keith; Carter, James M.; Baker, Lindsay B.

    2017-01-01

    Team sport athletes face a variety of nutritional challenges related to recovery during the competitive season. The purpose of this article is to review nutrition strategies related to muscle regeneration, glycogen restoration, fatigue, physical and immune health, and preparation for subsequent training bouts and competitions. Given the limited opportunities to recover between training bouts and games throughout the competitive season, athletes must be deliberate in their recovery strategy. F...

  7. 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

  8. Interview: Mr. Stephen Chee, team leader, UNFPA country support team (CST) for the South Pacific.

    Science.gov (United States)

    1993-09-01

    The UNFPA country support team (CST) for the South Pacific is the action-arm at the regional level of the new Technical Support Services arrangement introduced by the agency. Operational since April 1993, the CST currently covers the following Pacific island countries or territories: the Cook Islands, the Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu, and Vanuatu. The CST office is located in Suva, Fiji, with the main goal of strengthening national capacity and building self-reliance in the countries of the region. The office in Suva is currently staffed by six highly qualified advisors with extensive experience in the population and related fields; two more advisors are expected to join the Team in early 1994. The Team is well equipped to provide countries and territories of the region with a wide range of technical support services ranging from ad hoc technical advisory services to the conceptualization and development of comprehensive population policies and programs. Services are offered in the areas of basic data collection, processing, and research in population dynamics; population policy formulation, evaluation, and implementation; family planning and maternal-child health; information, education, and communication; women in population and development; and population program management. The team also plays an advocacy role in mainstreaming population concerns into the programs and activities of international, regional, and national organizations. The team leader responds to questions about population problems experienced by the countries served, the scope of UNFPA assistance to country governments in the subregion, the importance of population information in the subregion, and how Asia-Pacific POPIN may help the team and countries served.

  9. The Ability–Motivation–Opportunity Framework for Team Innovation: Efficacy Beliefs, Proactive Personalities, Supportive Supervision and Team Innovation

    Directory of Open Access Journals (Sweden)

    Jana Krapež Trošt

    2016-01-01

    Full Text Available Based on ability–motivation–opportunity theoretical framework, the study explores the interplay among team members’ proactive personalities (abilities, collective efficacy (motivation, and supportive supervision (opportunity, and their interaction in predicting team innovation. Multi-level study of 249 employees nested within 64 teams from one German and three Slovenian hi-tech companies showed that collective efficacy was positively related to team innovation. However, the effect of collective efficacy on team innovation was weaker when high levels of supportive supervision and proactivity moderated this relationship. When teams perceived lower levels of collective efficacy, team proactivity, and supportive supervision were more important for achieving higher levels of team innovation as they were when teams perceived lower levels of motivation. We discuss theoretical and practical implications

  10. Questioning in Distributed Product Development Teams: Supporting Shared Understanding

    DEFF Research Database (Denmark)

    Cash, Philip; Ahmed-Kristensen, Saeema

    2015-01-01

    globally distributed NPD activities. Poor shared understanding can ultimately result in delays and rework. One major antecedent of shared understanding development is question asking. This work uses a quasiexperimental study to test the impact of questioning support on different types of distributed teams...

  11. Elicitation Support Requirements of Multi-Expertise Teams

    Science.gov (United States)

    Bitter-Rijpkema, Marlies; Martens, Rob; Jochems, Wim

    2005-01-01

    Tools to support knowledge elicitation are used more and more in situations where employees or students collaborate using the computer. Studies indicate that differences exist between experts and novices regarding their methods of work and reasoning. However, the commonly preferred approach tends to deal with team members as a single system with…

  12. The Behavior Intervention Support Team (BIST) Program: Underlying Theories

    Science.gov (United States)

    Boulden, Walter T.

    2010-01-01

    The Behavior Intervention Support Team (BIST) is a proactive school-wide behavior management plan for all students, emphasizing schools partnering with students and parents through caring relationships and high expectations. The BIST program is well-grounded in behavioral theory and combines strength-based and resiliency principles within the…

  13. Perception of need for nutritional support in advanced cancer patients with cachexia: a survey in palliative care settings.

    Science.gov (United States)

    Amano, Koji; Morita, Tatsuya; Miyamoto, Jiro; Uno, Teruaki; Katayama, Hirofumi; Tatara, Ryohei

    2018-03-05

    Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings. Therefore, we conducted a questionnaire to examine the relationship between the perception of need for nutritional support and cancer cachexia and the prevalence of specific needs, perceptions, and beliefs in nutritional support. We conducted a questionnaire in palliative care settings. Patients were classified into two groups: (1) non-cachexia/pre-cachexia and (2) cachexia/refractory cachexia. A total of 117 out of 121 patients responded (96.7%). A significant difference was observed in the need for nutritional support between the groups: non-cachexia/pre-cachexia (32.7%) and cachexia/refractory cachexia (53.6%) (p = 0.031). The specific needs of patients requiring nutritional support were nutritional counseling (93.8%), ideas to improve food intake (87.5%), oral nutritional supplements (83.0%), parenteral nutrition and hydration (77.1%), and tube feeding (22.9%). The top perceptions regarding the best time to receive nutritional support and the best medical staff to provide nutritional support were "when anorexia, weight loss, and muscle weakness become apparent" (48.6%) and "nutritional support team" (67.3%), respectively. The top three beliefs of nutritional treatments were "I do not wish to receive tube feeding" (78.6%), "parenteral nutrition and hydration are essential" (60.7%), and "parenteral hydration is essential" (59.6%). Patients with cancer cachexia expressed a greater need for nutritional support. They wished to receive nutritional support from medical staff when they become unable to take sufficient nourishment orally and the negative impact of cachexia becomes apparent. Most patients wished to receive parenteral nutrition and hydration.

  14. Checklist and Decision Support in Nutritional Care for Burned Patients

    Science.gov (United States)

    2016-10-01

    able to construct a checklist of a clinical and physiologic model and then a computerised decision support system that will perform two functions: the...the provision of nutritional therapy, and assessment of use by nursing and physician staff KEYWORDS Nutrition, severe burn, decision support... clinical testing. Checklist and Decision Support in Nutritional Care for Burned Patients Proposal Number: 12340011 W81XWH-12-2-0074 PI: Steven E

  15. The 4th Civil Support Team (Weapons of Mass Destruction)

    International Nuclear Information System (INIS)

    Smith, D. L.

    2007-01-01

    The 4th CST (WMD) is a 22 person joint staffed AGR (Active Guard Reserve) unit of the Georgia National Guard. The team is one of 55 CSTs that are charged with responding to a CBRNE (Chemical, Biological, Radiological, Nuclear, and High Yield Explosive) incident within the United States and its Territories. The mission statements of the CTS is to support civil authorities at a domestic CBRNE incident by identifying CBRNE agents/substances, assessing current and projected consequences, advising on response measures, and assisting with appropriate requests for state support. The team possesses the capability to deploy by sea, air, and land in response to a terrorist attack or natural disaster. The team is comprised of seven officers and fifteen non-commissioned officers who are cross trained in a variety of military disciplines. Equipment assigned to the team includes an Analytical Lab, Communications Suite, Tactical Operations Center, closed and open circuit breathing gear, portable and handheld detectors, and decon support. The CSts are activated through a state's emergency response network.(author)

  16. [Support Team for Investigator-Initiated Clinical Research].

    Science.gov (United States)

    Fujii, Hisako

    2017-07-01

    Investigator-initiated clinical research is that in which investigators plan and carry out their own clinical research in academia. For large-scale clinical research, a team should be organized and implemented. This team should include investigators and supporting staff, who will promote smooth research performance by fulfilling their respective roles. The supporting staff should include project managers, administrative personnel, billing personnel, data managers, and clinical research coordinators. In this article, I will present the current status of clinical research support and introduce the research organization of the Dominantly Inherited Alzheimer Network (DIAN) study, an investigator-initiated international clinical research study, with particular emphasis on the role of the project management staff and clinical research coordinators.

  17. Development of an Integrated Team Training Design and Assessment Architecture to Support Adaptability in Healthcare Teams

    Science.gov (United States)

    2017-10-01

    provision of training is not a major focus of this project, trainees were able to practice trauma management skills as well as leadership skills...SUBJECT TERMS Military healthcare team; Trauma teams; Team training; Teamwork; Adaptive performance; Leadership ; Simulation; Modeling; Bayesian belief...ABBREVIATIONS Healthcare team Trauma Trauma teams Team training Teamwork Adaptability Adaptive performance Leadership Simulation Modeling

  18. [Development of integrated support software for clinical nutrition].

    Science.gov (United States)

    Siquier Homar, Pedro; Pinteño Blanco, Manel; Calleja Hernández, Miguel Ángel; Fernández Cortés, Francisco; Martínez Sotelo, Jesús

    2015-09-01

    to develop an integrated computer software application for specialized nutritional support, integrated in the electronic clinical record, which detects automatically and early those undernourished patients or at risk of developing undernourishment, determining points of opportunity for improvement and evaluation of the results. the quality standards published by the Nutrition Work Group of the Spanish Society of Hospital Pharmacy (SEFH) and the recommendations by the Pharmacy Group of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) have been taken into account. According to these quality standards, the nutritional support has to include the following healthcare stages or sub-processes: nutritional screening, nutritional assessment, plan for nutritional care, prescription, preparation and administration. this software allows to conduct, in an automated way, a specific nutritional assessment for those patients with nutritional risk, implementing, if necessary, a nutritional treatment plan, conducting follow-up and traceability of outcomes derived from the implementation of improvement actions, and quantifying to what extent our practice is close to the established standard. this software allows to standardize the specialized nutritional support from a multidisciplinary point of view, introducing the concept of quality control per processes, and including patient as the main customer. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  19. Development of integrated support software for clinical nutrition

    Directory of Open Access Journals (Sweden)

    Pedro Siquier Homar

    2015-09-01

    Full Text Available Objectives: to develop an integrated computer software application for specialized nutritional support, integrated in the electronic clinical record, which detects automatically and early those undernourished patients or at risk of developing undernourishment, determining points of opportunity for improvement and evaluation of the results. Methods: the quality standards published by the Nutrition Work Group of the Spanish Society of Hospital Pharmacy (SEFH and the recommendations by the Pharmacy Group of the Spanish Society of Parenteral and Enteral Nutrition (SENPE have been taken into account. According to these quality standards, the nutritional support has to include the following healthcare stages or sub-processes: nutritional screening, nutritional assessment, plan for nutritional care, prescription, preparation and administration. Results: this software allows to conduct, in an automated way, a specific nutritional assessment for those patients with nutritional risk, implementing, if necessary, a nutritional treatment plan, conducting follow-up and traceability of outcomes derived from the implementation of improvement actions, and quantifying to what extent our practice is close to the established standard. Conclusions: this software allows to standardize the specialized nutritional support from a multidisciplinary point of view, introducing the concept of quality control per processes, and including patient as the main customer

  20. An Information Technology Tool to Support Negotiating Teams

    Directory of Open Access Journals (Sweden)

    Jose Montanana

    1995-05-01

    Full Text Available This paper discusses computer-supported large-scale negotiation, in particular, negotiation with advisers. It is claimed that better communication within negotiating teams should lead to longer, more productive sessions than the current ones. To this end, an information technology environment should be provided for the negotiation. The paper introduces SHINE, a collaborative software system developed at the University of Chile. This software has many features to allow rich interactions among advisers belonging to the same team, among negotiators and also between a negotiator and his advisers. Emphasis is placed on the design features to enable and ease these interactions. The facilities include WYSIWIS windows, enhanced electronic mail to send and receive text or video messages with several urgency levels, an evaluation procedure and various ways to state comments and ideas. SHINE has been implemented as a prototype on Sun Sparc workstations.

  1. Nutrition support of the pediatric patient with AIDS.

    Science.gov (United States)

    Bentler, M; Stanish, M

    1987-04-01

    Maintaining optimal nutrition in the pediatric patient with Acquired Immune Deficiency Syndrome (AIDS) is challenging, but it may be one of the most effective therapies. Patients experience numerous complications that compromise nutritional status. Infection, fever, diarrhea, feeding problems, and decreased intake all contribute to malnutrition, which in turn predisposes the patient even more to infection and malabsorption. Nutrition assessment should be done routinely so that new problems may be identified and treated. High-calorie, high-protein feedings, vitamin supplementation, and, when necessary, gavage feedings or parenteral nutrition are recommended to improve nutritional status and prevent further deficits. Maintaining optimal nutrition in the pediatric patient with Acquired Immune Deficiency Syndrome (AIDS) poses a significant challenge to the health care team. Patients may experience numerous complications that compromise nutritional status. The patient is at high risk for opportunistic infections, especially of the lungs, central nervous system, gastrointestinal (GI) tract, and skin. Such infections are common causes of morbidity and mortality. Impaired nutritional status may further impair the patient's immunocompetence. A study by Kotler and Gaety demonstrated severe progressive malnutrition in adult AIDS patients, with the lowest measures of lean body mass occurring in those patients close to death at the time of the study. While no studies of children with AIDS have been done to date, we have subjectively observed feeding problems, weight loss, and malnutrition in most of the patients we have seen.

  2. Nutritional support of children in the intensive care unit.

    OpenAIRE

    Seashore, J. H.

    1984-01-01

    Nutritional support is an integral and essential part of the management of 5-10 percent of hospitalized children. Children in the intensive care unit are particularly likely to develop malnutrition because of the nature and duration of their illness, and their inability to eat by mouth. This article reviews the physiology of starvation and the development of malnutrition in children. A method of estimating the nutritional requirements of children is presented. The techniques of nutritional su...

  3. 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.

  4. Nutritional support and parenteral nutrition in cancer patients: An expert consensus report.

    Science.gov (United States)

    Ocón Bretón, María Julia; Luengo Pérez, Luis Miguel; Virizuela, Juan Antonio; Álvarez Hernández, Julia; Jiménez Fonseca, Paula; Cervera Peris, Mercedes; Sendrós Madroño, María José; Grande, Enrique; Camblor Álvarez, Miguel

    2018-03-01

    Malnutrition is a common medical problem in cancer patients with a negative impact on quality of life. The aim of this study was to address different issues related to nutritional management of cancer patients in clinical practice. A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Endocrinology and Nutrition prepared a list of topics related to the nutritional status of cancer patients and grouped them into three blocks: nutritional support, parenteral nutrition (PN), and home PN (HPN). A literature review was made of articles published in Spanish, English and French until April 2017. This consensus emphasizes several key elements that help physicians standardize management of the nutritional status of cancer patients in clinical practice, and establishes common guidelines for indication, monitoring, nutritional requirements, and access routes to PN. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Sensemaking in the formation of basic life support teams

    DEFF Research Database (Denmark)

    Hallas, Peter; Lauridsen, Johnny; Brabrand, Mikkel

    2018-01-01

    well known in organizational studies. It refers to the collaborative effort among members in a dialogue to create meaning in an ambiguous situation, often by using subtle variations in the sentences in the dialogue. Sentences with high degrees of "sensemaking" activity can be thematized as "co......-orientation", "re-presentation" and/or "subordination" (among others). We sought to establish if elements of "sensemaking" occur in the formation of in-hospital cardiac arrest teams. METHODS: Videos of ten simulations of unannounced in-hospital cardiac arrests treated by basic life support (BLS) providers. We...

  6. Nutritional support of the hospitalized pattent

    African Journals Online (AJOL)

    1983-04-23

    Apr 23, 1983 ... ment in the nutritional status of cancer patients by oral feeding may be difficult ... The total number of patients requiring intravenous nutntlon for more than a .... failure, particularly as regards protein and vitamins.63 Protein .... Logan RFA, Gillon J, Ferrington C, Ferguson A. Treatment of small bowel. Crohn's ...

  7. Nutritional support in the treatment of aplastic anemia.

    Science.gov (United States)

    Jia, Li; Yu, Jingda; He, Ling; Wang, Huaxin; Jiang, Lili; Miao, Xiaoyan; Wu, Wenguo; Yang, Peiman

    2011-01-01

    Whether a specific nutritional support promotes healing of aplastic anemia (AA) patients is still unclear. Therefore, we explored the potential of a high-nucleotide, arginine, and micronutrient nutritional supplement on the nutritional rehabilitation of AA mice. The BALB/c AA mice model was treated with hypodermic injections of acetylphenylhydrazine (100 mg/kg), x-ray (2.0 Gy), and intraperitoneal injections of a cyclophosphamide (80 mg/kg) combination. Then AA mice were fed with nutritional supplements in a dose-dependent manner (1445.55, 963.7, 674.59 mg/kg/d) for 7 wk. At the end of the experimental period, mice were autopsied. A full blood count was performed, and femoral marrow cell suspensions were prepared to assess the total femoral nucleated cell count and the number of committed hemopoietic progenitor cells (colony-forming units). The pathologic changes of liver and spleen were analyzed. The significant increases of nutrient mixture groups were evident in many peripheral blood parameters. The femoral nucleated cell count and colony-forming units of nutritional supplements groups were markedly increased, compared with the AA group. Transmission electron microscopy showed that the number of mitochondria in similar bone marrow cells was increased in nutritional supplements groups. The nutritional supplements also affected the recovery of livers and spleens of AA mice. Specific nutritional supplements accelerated rehabilitation of AA mice and can be used as nutritional support in the treatment of AA. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy.

    Science.gov (United States)

    Qiu, Miaozhen; Zhou, Yi-xin; Jin, Yin; Wang, Zi-xian; Wei, Xiao-li; Han, Hong-yu; Ye, Wen-feng; Zhou, Zhi-wei; Zhang, Dong-sheng; Wang, Feng-hua; Li, Yu-hong; Yang, Da-jun; Xu, Rui-hua

    2015-07-01

    The aim of our study is firstly to evaluate the prevalence and prognostic value of nutrition risk in gastric cancer patients and secondly to explore whether the nutrition support can prolong the survival of advanced gastric cancer patients. It contained two study periods. In the first period, we prospectively evaluated the nutritional risk of gastric adenocarcinoma patients from 2009 to 2011 using the method of European Nutritional Risk Screening (NRS) 2002. The Kaplan-Meier method and log-rank test were used to evaluate the prognostic value of high nutrition risk. The second period was between 2012 and 2013. We prospectively gave the nutrition support to stage IV gastric cancer patients whose NRS is ≥3. There were 830 patients in the first period, 50.7% patients with a NRS ≥ 3. Patients with NRS ≥ 3 presented a significantly higher percentage of stage IV diseases, elevated values of C-reactive protein, and hypoproteinemia. The median survival was significantly higher in NRS nutrition support. The median survival was 14.3 and 9.6 months for patients with and without NRS shift, respectively, P = 0.001. NRS ≥ 3 was an independent adverse prognostic factor in gastric cancer patients. For stage IV patients whose NRS ≥ 3, the nutrition support might be helpful to improve the prognosis.

  9. Effect of mother support groups on nutritional status in children ...

    African Journals Online (AJOL)

    Objective: This study aimed at determining how mother support groups affect the nutrition status of children under 2 years of age ... fants should be fed exclusively on breast milk from birth ... an intervention provides long-term health benefits for.

  10. Nutrition support programs for young adult athletes.

    Science.gov (United States)

    Clark, N

    1998-12-01

    After graduating from college and entering the work force, young adult athletes often struggle with the task of fueling themselves optimally for top performance and weight control. The stresses and time constraints of work, family, and social responsibilities often result in eating fast foods on the run. These young adults can benefit from nutrition education programs in the worksite, at health clubs, in the community, and via the media. Dietitians who specialize in sport nutrition have particular appeal to these athletes, who are struggling to each well, exercise well, and stay lean yet put little time or effort into their food program. This article includes two case studies of young adults and the dietary recommendations that taught them how to make wise food choices, fuel themselves well for high energy, and control their weight.

  11. Compliance with nutrition support guidelines in acutely burned patients.

    Science.gov (United States)

    Holt, Brennen; Graves, Caran; Faraklas, Iris; Cochran, Amalia

    2012-08-01

    Adequate and timely provision of nutritional support is a crucial component of care of the critically ill burn patient. The goal of this study was to assess a single center's consistency with Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition (SCCM/ASPEN) guidelines for nutritional support in critically ill patients. Acutely burned patients >45kg in weight admitted to a regional burn center during a two-year period and who required 5 or more days of full enteral nutritional support were eligible for inclusion in this retrospective review. Specific outcomes evaluated include time from admission to feeding tube placement and enteral feeding initiation and percent of nutritional goal received within the first week of hospital stay. Descriptive statistics were used for all analyses. IRB approval was obtained. Thirty-seven patients were included in this retrospective review. Median age of patients was 44.9 years (IQR: 24.2-55.1), and median burn injury size was 30% (IQR: 19-47). Median time to feeding tube placement was 31.1h post admission (IQR: 23.6-50.2h), while median time to initiation of EN was 47.9h post admission (IQR: 32.4-59.9h). The median time required for patients to reach 60% of caloric goal was 3 days post-admission (IQR: 3-4.5). The median time for initiation of enteral nutrition was within the SCCM/ASPEN guidelines for initial nutrition in the critically ill patient. This project identified a 16h time lag between placement of enteral access and initiation of enteral nutrition. Development of a protocol for feeding tube placement and enteral nutrition management may optimize early nutritional support in the acutely injured burn patient. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  12. [Nutritional support and parenteral nutrition in the oncological patient: an expert group consensus report].

    Science.gov (United States)

    Camblor-Álvarez, Miguel; Ocón-Bretón, María Julia; Luengo-Pérez, Luis Miguel; Viruzuela, Juan Antonio; Sendrós-Maroño, María José; Cervera-Peris, Mercedes; Grande, Enrique; Álvarez-Hernández, Julia; Jiménez-Fonseca, Paula

    2018-01-10

    Malnutrition is a frequent medical problem of cancer patients that negatively impacts their quality of life. To analyze and respond to different issues related to the nutritional management of cancer patients in the clinical setting. A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Nutrition developed a list of topics related to the nutritional status of cancer patients, which were grouped into three blocks: Nutritional support; Parenteral nutrition (PN); and Home PN (HPN) in cancer patients. A literature search, which included articles published in Spanish, English, and French until February 2017, was carried out. The document was organized as a questionnaire with those questions that, according to the panel's criteria, could generate greater controversy or doubt. Of the 18 questions addressed, 9 focused on nutritional support: 5 were related to PN and 4 about HPN. Among the different recommendations, the panel emphasized that in the cancer patient, PN is indicated mainly when it is not possible to use the digestive tract and/or oral feeding and/or enteral nutrition is not sufficient or possible. Additionally, the objective of the HPN is to improve or maintain the nutritional status of a patient at home. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for the nutritional management of cancer Patients.

  13. Nutritional status and nutritional support before and after pancreatectomy for pancreatic cancer and chronic pancreatitis.

    Science.gov (United States)

    Karagianni, Vasiliki Th; Papalois, Apostolos E; Triantafillidis, John K

    2012-12-01

    Cachexia, malnutrition, significant weight loss, and reduction in food intake due to anorexia represent the most important pathophysiological consequences of pancreatic cancer. Pathophysiological consequences result also from pancreatectomy, the type and severity of which differ significantly and depend on the type of the operation performed. Nutritional intervention, either parenteral or enteral, needs to be seen as a method of support in pancreatic cancer patients aiming at the maintenance of the nutritional and functional status and the prevention or attenuation of cachexia. Oral nutrition could reduce complications while restoring quality of life. Enteral nutrition in the post-operative period could also reduce infective complications. The evidence for immune-enhanced feed in patients undergoing pancreaticoduodenectomy for pancreatic cancer is supported by the available clinical data. Nutritional support during the post-operative period on a cyclical basis is preferred because it is associated with low incidence of gastric stasis. Postoperative total parenteral nutrition is indicated only to those patients who are unable to be fed orally or enterally. Thus nutritional deficiency is a relatively widesoread and constant finding suggesting that we must optimise the nutritional status both before and after surgery.

  14. NUTRITIVE SUPPORT OF YOUNG SPORTSMEN USING A SPECIALIZED RUSSIAN PRODUCT

    Directory of Open Access Journals (Sweden)

    T. E. Borovik

    2013-01-01

    Full Text Available Organization of adequate nutrition of children and adolescents actively going in for sports is of the highest importance both for improving sports results and preserving children’s health. On the modern stage of sports neutraceuticals development, it is relevant to substantiate approaches to nutrition on all stages of the training process, develop methodological basis for individual nutrition selection and conduct demonstrative trials in order to evaluate efficacy of nutritional measures. The pediatric nutrition department of the FSBI “Scientific Center of Children’s Health” conducted a controlled trial of efficacy of a new Russian product for nutritive support of children in the training period in 2012 in order to study possibilities of nutrition optimization for young sportsmen. We noticed statistically significant alterations of bioimpedance analysis values – lean and active cell body mass – in the setting of nutrition correction – intake of 200-400 ml/day of the product for 21 days; at the same time, the fat mass remained the same. Psychological testing using WAN questionnaire (well-being, activity, mood conducted in the recovery period of the training process also revealed positive dynamics. The product may be used in the dose of 200-400 ml at any time of day; at the same time, it is most reasonable to take it as an additional food intake in the event of considerable training stress immediately before or after training, when adequate nutrition organization is hindered.

  15. The uses of an observation team with a parent support group.

    Science.gov (United States)

    O'Brien, P J

    1994-04-01

    This brief report examines the uses of an Observation Team with a Parent Support Group. In particular, attention is placed on the idea of the Observation Team acting as a Reflecting Team in the final session of the group's life. Using the Observation Team in this manner has evolved from an amalgamation of ideas from family therapy and group therapy theory.

  16. New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition.

    Science.gov (United States)

    Akbulut, Gamze

    2011-07-01

    Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer.

  17. New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition

    Science.gov (United States)

    AKBULUT, GAMZE

    2011-01-01

    Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counseling, oral supplementation, enteral or total parenteral nutrition). Nutritional support has been widely advocated as adjunctive therapy for a variety of underlying illnesses, including surgery and medical oncotherapy (radiation or chemotherapy for cancer). Glutamine, n-3 fatty acids and probiotics/prebiotics are therapeutic factors that potentially modulate gastrointestinal toxicity related to cancer treatments. Enteral and parenteral nutrition may help improve patient survival, functional status and QoL, yet the benefits appear to be primarily limited to patients with good functional status and with gastrointestinal disease affecting nutritional intake. Parenteral nutrition offers the possibility of increased or maintenance of the nutrient intake in patients for whom normal food intake is inadequate and for whom enteral nutrition is not feasible, is contraindicated or is not accepted by the patient. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with cancer. PMID:22977559

  18. TEAM.

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This document presents materials covering the television campaign against drunk driving called "TEAM" (Techniques for Effective Alcohol Management). It is noted that TEAM's purpose is to promote effective alcohol management in public facilities and other establishments that serve alcoholic beverages. TEAM sponsors are listed, including…

  19. Evaluation of nutritional support in a regional hospital.

    Science.gov (United States)

    Morán López, Jesús Manuel; Hernández González, Miriam; Peñalver Talavera, David; Peralta Watt, María; Temprano Ferreras, José Luis; Redondo Llorente, Cristina; Rubio Blanco, María Yolanda

    2018-05-08

    Disease-related malnutrition (DRM) is highly prevalent in Spanish hospitals (occurring in 1 out of every 4 patients). The 'Más Nutridos' Alliance has developed an action plan to detect and treat DRM. In Extremadura (Spain), the public health system has included nutritional screening as the only mechanism to fight malnutrition. The results of this strategy are evaluated here. An agreement study was conducted in standard clinical practice. Variables collected included the following rates: nutritional screening at entry, coded nutritional diagnoses, nutritional status assessment, nutritional requirements, successful nutritional therapy, weight and height at entry and discharge, referral to a nutritional support unit (NSU). Standards to comparison based on the results of the Netherland Program to Fight Malnutrition. Nutritional screening rate at entry was 20.5% (95% CI: 18.00-21.00). Coding and nutritional status assessment rate at entry was 13%. Weight and height were both measured in 16.5% of patients at entry and 20% at discharge. Nutritional requirements were estimated in 30% and were poorly monitored (13.3%). Only 15% of patients were referred to a NSU. Significantly lower values were found for all indicators as compared to standards, with kappa values lower than 0.2 in all cases. Data analysis showed poorer results when patients referred to the NSU were excluded. A strategy to fight malnutrition based on nutritional screening alone is highly inefficient in hospitals such as HVP. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Nutritive support in short Bowel syndrome (sbs

    Directory of Open Access Journals (Sweden)

    Simić Dušica

    2003-01-01

    Full Text Available Short bowel syndrome most commonly result after bowel resection for necrosis of the bowel. It may be caused by arterial or venous thrombosis, volvolus and in children, necrotizing enterocolitis. The other causes are Crohn,s disease intestinal atresia. The factors influencing the risk on short bowel syndrome are the remaining length of the small bowel, the age of onset, the length of the colon, the presence or absence of the ileo-coecal valve and the time after resection. Besides nutritional deficiencies there some other consequences of extensive resections of the small intestine (gastric acid hypersecretion, d-lactic acidosis, nephrolithiasis, cholelithiasis, which must be diagnosed, treated, and if possible, prevented. With current therapy most patients with short bowel have normal body mass index and good quality of life.

  1. Motivating Proteges' Personal Learning in Teams: A Multilevel Investigation of Autonomy Support and Autonomy Orientation

    Science.gov (United States)

    Liu, Dong; Fu, Ping-ping

    2011-01-01

    This study examined the roles of 3 multilevel motivational predictors in proteges' personal learning in teams: an autonomy-supportive team climate, mentors' autonomy support, and proteges' autonomy orientation. The authors followed 305 proteges in 58 teams for 12 weeks and found that all 3 predictors were positively related to the proteges'…

  2. Assessment of nutritional status of soil supporting coconut (Cocus ...

    African Journals Online (AJOL)

    AJB SERVER

    2007-02-05

    Feb 5, 2007 ... Assessment of nutritional status of soil supporting coconut ... Infact coconut plays a vital role in the ... A high fertility status of the supporting soils is required for high .... the amount/concentration of basic fertility elements of the.

  3. An action-learning model to assist Circuit Teams to support School ...

    African Journals Online (AJOL)

    EAOSA

    2016-11-17

    Nov 17, 2016 ... development of both School Management Teams and Circuit Team members. ... achieve excellence in teaching and learning (Department of Basic Education, ... indicate that support to schools, particularly rural and historically disadvantaged schools, ... promote sustainable change and enhanced academic.

  4. Development of an Integrated Team Training Design and Assessment Architecture to Support Adaptability in Healthcare Teams

    Science.gov (United States)

    2016-10-01

    chosen for their expertise and to ensure geographical representation. COMPLETED Human Research Protection Office IRB 3 The HRPO has granted exempt... taxonomy (Figure 3) can help guide the selection of appropriate training targets and can help educators target correct task complexity, appropriate...team assessment. We extended this knowledge by investigating the team science, safety science, and human factors literature. Because our work

  5. Support for Policies to Improve the Nutritional Impact of the Supplemental Nutrition Assistance Program in California

    Science.gov (United States)

    Ryan-Ibarra, Suzanne; Linares, Amanda; Induni, Marta; Sugerman, Sharon; Long, Michael W.; Rimm, Eric B.; Willett, Walter C.

    2015-01-01

    The Supplemental Nutrition Assistance Program (SNAP) provides a vital buffer against hunger and poverty for 47.6 million Americans. Using 2013 California Dietary Practices Survey data, we assessed support for policies to strengthen the nutritional influence of SNAP. Among SNAP participants, support ranged from 74% to 93% for providing monetary incentives for fruits and vegetables, restricting purchases of sugary beverages, and providing more total benefits. Nonparticipants expressed similar levels of support. These approaches may alleviate the burden of diet-related disease in low-income populations. PMID:26066922

  6. Support for Policies to Improve the Nutritional Impact of the Supplemental Nutrition Assistance Program in California.

    Science.gov (United States)

    Leung, Cindy W; Ryan-Ibarra, Suzanne; Linares, Amanda; Induni, Marta; Sugerman, Sharon; Long, Michael W; Rimm, Eric B; Willett, Walter C

    2015-08-01

    The Supplemental Nutrition Assistance Program (SNAP) provides a vital buffer against hunger and poverty for 47.6 million Americans. Using 2013 California Dietary Practices Survey data, we assessed support for policies to strengthen the nutritional influence of SNAP. Among SNAP participants, support ranged from 74% to 93% for providing monetary incentives for fruits and vegetables, restricting purchases of sugary beverages, and providing more total benefits. Nonparticipants expressed similar levels of support. These approaches may alleviate the burden of diet-related disease in low-income populations.

  7. Does Aquaculture Support the Needs of Nutritionally Vulnerable Nations?

    Directory of Open Access Journals (Sweden)

    Christopher D. Golden

    2017-05-01

    Full Text Available Aquaculture now supplies half of the fish consumed directly by humans. We evaluate whether aquaculture, given current patterns of production and distribution, supports the needs of poor and food-insecure populations throughout the world. We begin by identifying 41 seafood-reliant nutritionally vulnerable nations (NVNs, and ask whether aquaculture meets human nutritional demand directly via domestic production or trade, or indirectly via purchase of nutritionally rich dietary substitutes. We find that a limited number of NVNs have domestically farmed seafood, and of those, only specific aquaculture approaches (e.g., freshwater in some locations have the potential to benefit nutritionally vulnerable populations. While assessment of aquaculture's direct contribution via trade is constrained by data limitations, we find that it is unlikely to contribute substantially to human nutrition in vulnerable groups, as most exported aquaculture consists of high-value species for international markets. We also determine that subpopulations who benefit from aquaculture profits are likely not the same subpopulations who are nutritionally vulnerable, and more research is needed to understand the impacts of aquaculture income gains. Finally, we discuss the relationship of aquaculture to existing trends in capture fisheries in NVNs, and suggest strategies to create lasting solutions to nutritional security, without exacerbating existing challenges in access to food and land resources.

  8. The eNutrition Academy: Supporting a New Generation of Nutritional Scientists around the World12

    Science.gov (United States)

    Geissler, Catherine; Amuna, Paul; Kattelmann, Kendra K; Zotor, Francis B; Donovan, Sharon M

    2016-01-01

    Nutrition training and building capacity to provide a competent workforce to support national and regional efforts to combat malnutrition remain a major challenge in Africa and other developing regions of the world. The capacity to provide the necessary intellectual drive for nutrition research, policy, and practice in countries lacking in readiness for nutrition actions is imperative to improve the health of their people. To help address this need, the eNutrition Academy (eNA) was formed as a global partnership organization by the African Nutrition Society, the Federation of African Nutrition Societies, the Nutrition Society of the United Kingdom and Ireland, the ASN, and the International Union of Nutritional Sciences, supported by Cambridge University Press. The primary objective of this partnership is to provide an online learning platform that is free to access, enabling users to benefit from a wide range of learning materials from basic tools to more-advanced learning materials for teachers and researchers in developing countries. The goal of this article was to summarize the findings of a symposium held at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2015, which explored the themes of international capacity development, with a particular focus on the African continent, online learning, and the eNA e-learning platform. Given the vast human capacity present in Africa that is poised to create new solutions to address the public health needs of the continent, now is an opportune time to establish South-North and South-South partnerships to develop the next generation of African nutritional scientists. PMID:27180382

  9. Nutritional profile of the Brazilian Amputee Soccer Team during the precompetition period for the world championship.

    Science.gov (United States)

    Innocencio da Silva Gomes, Ainá; Gonçalves Ribeiro, Beatriz; de Abreu Soares, Eliane

    2006-10-01

    The purpose of this study was to determine the dietary and anthropometric profiles of the Brazilian amputee soccer players during the training period before the world soccer amputee championship, according to their positional roles in the game. Fifteen male athletes participated in the study. Data on height, weight, skinfold thickness, and circumferences were collected to assess nutritional status. Dietary intake was obtained by using 6-d dietary records, analyzed by a Nutrition Support Program for total energy intake, carbohydrates, proteins, lipids, vitamins, and minerals. One-way analysis of variance was used to identify differences in groups (P nutritional orientation and the lack of information about disabled sports and athletes highlights the need for more studies in this area.

  10. Nutritional support for the infant's immune system

    NARCIS (Netherlands)

    Niers, L.; Stasse-Wolthuis, M.; Rombouts, F.M.; Rijkers, G.T.

    2007-01-01

    Newborn babies possess a functional but immature immune system as a defense against a world teeming with microorganisms. Breast milk contains a number of biological, active compounds that support the infant's immune system. These include secretory immunoglobulin A (IgA), which confers specific

  11. Managing hyperglycaemia in patients with diabetes on enteral nutrition: the role of a specialized diabetes team.

    Science.gov (United States)

    Wong, V W; Manoharan, M; Mak, M

    2014-12-01

    Hyperglycaemia is commonly observed in patients with diabetes mellitus (DM) while receiving enteral nutrition (EN) in hospital, and hyperglycaemia has been shown to be associated with poor clinical outcomes. The aim of this study was to assess the glycaemic status of patients with DM who received EN during hospital admission and evaluate the impact of intervention by a specialist diabetes team (SDT) on glycaemic control and clinical outcomes of these patients. A retrospective review of patients with DM who required EN during hospital admission was conducted. We compared patient characteristics, glycaemic profile and clinical outcomes between patients who were managed by SDT and those who were managed by the admitting team. Seventy-four patients with DM on EN were included in this study, of whom 27 were managed by SDT while on EN. Compared with patients managed by the admitting team, those who were reviewed by SDT had better glycaemic control during the period of EN as well as during the 24 h after EN was ceased. These patients also had shorter length-of-stay in hospital and lower in-patient mortality. Our findings confirmed that there was a role for SDT in managing patients with DM who received EN during their hospital admission. These patients had improved glycaemic control while receiving EN and had better clinical outcomes. Further prospective studies will be required to validate the findings of this study.

  12. Effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants.

    Science.gov (United States)

    Azzeh, Firas S; Alazzeh, Awfa Y; Dabbour, Ibrahim R; Jazar, Abdelelah S; Obeidat, Ahmed A

    2014-10-01

    Infants with low birth weights are provided with hospital nutrition support to enhance their survivability and body weights. However, different hospitals have different nutrition support formulas. Therefore, the effectiveness of these nutrition support formulas should be investigated. To assess the effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants at Al-Noor hospital, Saudi Arabia. A cross-sectional study was conducted between October, 2010 and December, 2012. Three hundred newborns were recruited from Al-Noor Hospital in Makkah city, Saudi Arabia. Infants were selected according to their birth weights and were divided equally into three groups; (i) Low Birth Weight (LBW) infants (1501- 2500 g birth weight), (ii) Very Low Birth Weight (VLBW) infants (1001-1500 g birth weight) and (iii) Extremely Low Birth Weight (ELBW) infants ( 0.05) were observed among groups. Serum calcium, phosphorus and potassium levels at discharge were higher (p < 0.05) than that at birth for ELBW and VLBW groups; while sodium level decreased in ELBW group to be within normal ranges. Albumin level was improved (p < 0.05) in ELBW group. Health care management for low birth weight infants in Al-Noor Hospital was not sufficient to achieve normal growth rate for low birth weight infants, while biochemical indicators were remarkably improved in all groups. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  13. Dietetic- nutritional, physical and physiological recovery methods post-competition in team sports. A review.

    Science.gov (United States)

    Terrados, Nicolas; Mielgo-Ayuso, Juan; Delextrat, Anne; Ostojic, Sergej M; Calleja-González, Julio

    2018-03-27

    To a proper recovery, is absolutely necessary to know that athletes with enhanced recovery after maximal exercise are likely to perform better in sports. Recovery strategies are commonly used in team sports despite limited scientific evidence to support their effectiveness in facilitating optimal recovery and the players spend a much greater proportion of their time recovering than they do in training. According to authors, some studies investigated the effect of recovery strategies on physical performance in team sports, lack of experimental studies about the real origin of the fatigue, certify the need for further study this phenomenon. Thus, developing effective methods for helping athletes to recover is deemed essential. Therefore, the aim of this review is provide information for his practical application, based on scientific evidence about recovery in team sports.

  14. A Customized Workflow-Driven Instant Messaging System Support Team Communication in the Hospital.

    Science.gov (United States)

    Lee, Ying-Li; Chien, Tsai-Feng; Chen, Hsiu-Chin

    2016-01-01

    Effective communication among the healthcare team is a very important skill to support team resource management (TRM). However, we take too much effort to connect with other team members by using traditional telephone communication. In this study, we developed an instant messaging system embedded in the original hospital information system and evaluated the preliminary outcome and the usage of the system.

  15. Supporting the development of shared understanding in distributed design teams

    OpenAIRE

    Cash, Philip; Dekoninck, Elies; Ahmed-Kristensen, Saeema

    2017-01-01

    Distributed teams are an increasingly common feature of engineering design work. One key factor in the success of these teams is the development of short- and longer-term shared understanding. A lack of shared understanding has been recognized as a significant challenge, particularly in the context of globally distributed engineering activities. A major antecedent for shared understanding is question asking and feedback. Building on question-asking theory this work uses a quasi-experimental s...

  16. Supporting the development of shared understanding in distributed design teams

    DEFF Research Database (Denmark)

    Cash, Philip; Dekoninck, Elies A; Ahmed-Kristensen, Saeema

    2017-01-01

    Distributed teams are an increasingly common feature of engineeringdesign work. One key factor in the success of these teams isthe development of short- and longer-term shared understanding.A lack of shared understanding has been recognized as a significantchallenge, particularly in the context o...... directly comparing homogeneous and heterogeneousteams in the engineering design context. This has implicationsfor how distributed teams can be more effectively supportedin practice, as well as how shared understanding can be facilitated inengineering design.......Distributed teams are an increasingly common feature of engineeringdesign work. One key factor in the success of these teams isthe development of short- and longer-term shared understanding.A lack of shared understanding has been recognized as a significantchallenge, particularly in the context...... of globally distributed engineeringactivities. A major antecedent for shared understanding isquestion asking and feedback. Building on question-asking theorythis work uses a quasi-experimental study to test the impact of questioningsupport on homogeneous and heterogeneous teams. Theresults show significant...

  17. Intensive Nutritional Counselling And Support And Clinical Outcomes In Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Alessio Molfino

    2012-06-01

    In conclusion, in HD patients, nutritional counselling and nutritional support positively affect nutritional status in hypophagic patients and make the risk of morbidity and mortality in anorexic patients comparable to non-anorexic.

  18. 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

  19. Connecting the dots : supporting the implementation of teacher design teams

    NARCIS (Netherlands)

    Binkhorst, Floor

    2017-01-01

    In Teacher Design Teams (TDTs), teachers collaborate on (re)designing educational materials. Although several studies have shown that TDTs can contribute to teachers’ professional development, as well as to sustainable implementation of educational change by using the educational materials they

  20. Prospective study of nutritional support during pelvic irradiation

    International Nuclear Information System (INIS)

    Kinsella, T.J.; Malcolm, A.W.; Bothe, A. Jr.; Valerio, D.; Blackburn, G.L.

    1981-01-01

    A prospective study of nutritional support during pelvic irradiation was carried out in 32 patients with a primary pelvic malignancy and prior weight loss. Both curative and palliative patients were eligible for the study. Seventeen patients were randomized to receive intravenous hyperalimentation (IVH) and fifteen patients served as controls who were maintained on their regular diet. Patients were stratified by percent body weight loss. Tolerance to therapy was assessed by evaluation of functional status and by using nutritional parameters of body weight change, change in serum protein levels, and response to delayed hypersensitivity skin tests. The curative IVH group tolerated therapy well by both functional and nutritional measurements. All curative IVH patients completed the planned radiation therapy without a treatment break and were fully active following treatment. Patients gained an average of 4.0 kg body weight during irradiation, which was significantly different from the curative control patients. They demonstrated a significant increase in serum transferrin reflecting an improvement in visceral protein. In addition, all showed a positive response to delayed hypersensitivity skin tests at the completion of irradiation. The palliative IVH patients often did poorly because of progression of disease and demonstrated only an elevation of serum transferrin during treatment. The results in the curative IVH group suggest a potential adjunctive role for intravenous hyperalimentation in the malnourished cancer patient undergoing pelvic irradiation. Clearly, further study of nutritional support during pelvic irradiation is needed using curative patients with a single tumor type and significant prior weight loss

  1. Measuring the influence of a mutual support educational intervention within a nursing team

    Directory of Open Access Journals (Sweden)

    Renée Bridges

    2014-03-01

    Conclusion: The study demonstrates that education can have an impact on perceptions and awareness of mutual support among nursing team members. The survey instrument can be used effectively to inform leadership areas for improvement and staff development in the effort to improve team coordination and mutual support.

  2. CERN's IT Consultancy Team: a new IT project support service

    CERN Multimedia

    Ignacio Reguero, IT Department

    2016-01-01

    Newly created IT Consultancy Team provides advice on IT matters to communities at CERN starting new projects or reviewing computing activities of old.   The members of CERN's IT Consultancy Team. The consultants share their knowledge and experience to improve awareness of the IT landscape at CERN and to advise on system architecture and design to ensure best usage of existing IT services and solutions that favour, and are compatible with, the infrastructure already in place. They also help to formalise requirements and assess impact on security, software licenses and cost, especially where contacts among different services are needed and questions go beyond the current computing service offerings. For instance, the IT consultants may help answering questions like the ones below: We are starting with project X – how could we make its computing aspects compatible with the CERN IT infrastructure? E.g. if you need a web content management system favour Drupal instead of Wor...

  3. A Change in Team Culture Towards an Autonomy Supportive Working Environment - A Case Study of the Finnish Women’s National Ice Hockey Team

    OpenAIRE

    Andler, Martin

    2017-01-01

    This study presents how the change in team culture has impacted the Finnish Women’s National Ice Hockey Team. The structure of the study is based on the self-determination theory, autonomy supportive coaching and change in team culture. The sub chapters’ focus on motivation, the coaches' and athletes' role within the autonomy supportive team working environment, autonomous goal setting and transformational leadership. The subchapter for cultural change is focused on the complex on-going proce...

  4. Effects of Nutritional Support in Patients with Colorectal Cancer during Chemotherapy

    OpenAIRE

    Dobrila Dintinjana, Renata; Guina, Tina; Krznarić, Željko; Radić, Mladen; Dintinjana, Marijan

    2008-01-01

    Nutritional support, addressing the specific needs of this patient group, is required to help improve prognosis, and reduce the consequences of cancer-associated nutritional decline. Early intervention with nutritional supplementation has been shown to halt malnutrition, and may improve outcome in some patients. In our study we tried to assess the influence of nutritional support (counseling, oral liquids, megestrol acetate) on nutritional status and symptoms prevalence in patients ...

  5. Effect of nutritional support in children with spastic quadriplegia.

    Science.gov (United States)

    Soylu, Ozlem Bekem; Unalp, Aycan; Uran, Nedret; Dizdarer, Gülsen; Ozgonul, Figen Oksel; Conku, Aliye; Ataman, Hamide; Ozturk, Aysel Aydogan

    2008-11-01

    Malnutrition is a common problem in patients with cerebral palsy. We evaluated the effect of nutritional support on clinical findings in children with spastic quadriplegia. Feeding history, numbers of lower respiratory tract infections, and gastrointestinal and neurologic findings were evaluated via questionnaire. Weight, height, head circumference, midarm circumference, and triceps skinfold thickness were measured. Height for age, weight for age, weight for height, body mass index, and weight and height z-scores were calculated. Clinical findings and anthropometric parameters were re-evaluated after nutritional support for 6 months. Forty-five patients were enrolled. No difference was evident between the first and the last height z-scores of 31 patients who completed the follow-up. Weight, height, weight z-scores, weight for age, weight for height, body mass index, midarm circumference, and triceps skinfold thickness exhibited improvement. Moreover, a significant decrease in number of infections was evident. Frequency of seizures and Gross Motor Function Classification System status did not change. Constipation decreased significantly. Nutritional therapy revealed improvements in some anthropometric findings and a decrease in number of infections. Although there was no difference regarding motor development or seizure frequency, further studies with a longer follow-up are required.

  6. Green shoots of recovery: a realist evaluation of a team to support change in general practice.

    Science.gov (United States)

    Bartlett, Maggie; Basten, Ruth; McKinley, Robert K

    2017-02-08

    A multidisciplinary support team for general practice was established in April 2014 by a local National Health Service (NHS) England management team. This work evaluates the team's effectiveness in supporting and promoting change in its first 2 years, using realist methodology. Primary care in one area of England. Semistructured interviews were conducted with staff from 14 practices, 3 key senior NHS England personnel and 5 members of the support team. Sampling of practice staff was purposive to include representatives from relevant professional groups. The team worked with practices to identify areas for change, construct action plans and implement them. While there was no specified timescale for the team's work with practices, it was tailored to each. In realist evaluations, outcomes are contingent on mechanisms acting in contexts, and both an understanding of how an intervention leads to change in a socially constructed system and the resultant changes are outcomes. The principal positive mechanisms leading to change were the support team's expertise and its relationships with practice staff. The 'external view' provided by the team via its corroborative and normalising effects was an important mechanism for increasing morale in some practice contexts. A powerful negative mechanism was related to perceptions of 'being seen as a failing practice' which included expressions of 'shame'. Outcomes for practices as perceived by their staff were better communication, improvements in patients' access to appointments resulting from better clinical and managerial skill mix, and improvements in workload management. The support team promoted change within practices leading to signs of the 'green shoots of recovery' within the time frame of the evaluation. Such interventions need to be tailored and responsive to practices' needs. The team's expertise and relationships between team members and practice staff are central to success. Published by the BMJ Publishing Group

  7. Understanding Soccer Team Supporters' Behavior and Culture in a Globalized Society from Social Learning Theory

    Science.gov (United States)

    Lee, Seungbum; Han, Keunsu

    2012-01-01

    Whereas there have been many academic studies on European soccer team supporters, relatively few studies have looked at supporters in Asia, especially regarding their supporting behavior and culture. Broadly, the purpose of this paper is to describe the behavior and culture of supporters of the Korean professional soccer league (K-League).…

  8. An action-learning model to assist Circuit Teams to support School ...

    African Journals Online (AJOL)

    We report on the construction of a theoretical model to assist Circuit Teams to support School Management Teams of underperforming high schools towards whole-school development in which these improvement plans play a central role. We followed an action research design, employing qualitative data generation and ...

  9. When managers and their teams disagree: a longitudinal look at the consequences of differences in perceptions of organizational support.

    Science.gov (United States)

    Bashshur, Michael R; Hernández, Ana; González-Romá, Vicente

    2011-05-01

    The authors argue that over time the difference between team members' perception of the organizational support received by the team (or team climate for organizational support) and their manager's perception of the organizational support received by the team has an effect on important outcomes and emergent states, such as team performance and team positive and negative affect above and beyond the main effects of climate perceptions themselves. With a longitudinal sample of 179 teams at Time 1 and 154 teams at Time 2, the authors tested their predictions using a combined polynomial regression and response surface analyses approach. The results supported the authors' predictions. When team managers and team members' perceptions of organizational support were high and in agreement, outcomes were maximized. When team managers and team members disagreed, team negative affect increased and team performance and team positive affect decreased. The negative effects of disagreement were most amplified when managers perceived that the team received higher levels of support than did the team itself.

  10. Technology as Teammate: Examining the Role of External Cognition in Support of Team Cognitive Processes.

    Science.gov (United States)

    Fiore, Stephen M; Wiltshire, Travis J

    2016-01-01

    In this paper we advance team theory by describing how cognition occurs across the distribution of members and the artifacts and technology that support their efforts. We draw from complementary theorizing coming out of cognitive engineering and cognitive science that views forms of cognition as external and extended and integrate this with theorizing on macrocognition in teams. Two frameworks are described that provide the groundwork for advancing theory and aid in the development of more precise measures for understanding team cognition via focus on artifacts and the technologies supporting their development and use. This includes distinctions between teamwork and taskwork and the notion of general and specific competencies from the organizational sciences along with the concepts of offloading and scaffolding from the cognitive sciences. This paper contributes to the team cognition literature along multiple lines. First, it aids theory development by synthesizing a broad set of perspectives on the varied forms of cognition emerging in complex collaborative contexts. Second, it supports research by providing diagnostic guidelines to study how artifacts are related to team cognition. Finally, it supports information systems designers by more precisely describing how to conceptualize team-supporting technology and artifacts. As such, it provides a means to more richly understand process and performance as it occurs within sociotechnical systems. Our overarching objective is to show how team cognition can both be more clearly conceptualized and more precisely measured by integrating theory from cognitive engineering and the cognitive and organizational sciences.

  11. Annunciation - building product team capabilities to support utility operational improvement

    International Nuclear Information System (INIS)

    Doucet, R.; Brown, R.; Trask, D.; Leger, R.; Mitchel, G.; Judd, R.; Davey, E.

    2003-01-01

    The purpose of this paper is to describe an AECL initiative to enhance the capabilities to assist utilities with undertaking annunciation improvement. This initiative was undertaken to complement a recent annunciation product upgrade, and in anticipation of developing commercial opportunities to assist Canadian and foreign utilities with control room annunciation improvement. Utilities are relying more and more on external engineering product and service providers to meet their plant support needs as they reduce in-house staffing to lower ongoing support costs. This evolving commercial environment places new demands on product and service providers, and provides new opportunities for increasing the proportion of product and service provider participation in plant improvement projects. This paper outlines recent AECL experience in the annunciation product area. The paper discusses the rationale for product support capability improvement, discusses the approaches undertaken, describes lessons learned, and outlines a proposed utility support model for assisting with future annunciation improvements. (author)

  12. The IAEA Supports Member States’ Nutrition Programmes: What They Have to Say

    International Nuclear Information System (INIS)

    Ouedraogo, Jean-Bosco; Medoua, Gabriel; Hernandez Triana, Manuel; Kurpad, Anura; Aguenaou, Hassan; Elmanchawy, Imane; Winichagoon, Pattanee; Wade, Salimata; Diop, Cheikh Anta

    2014-01-01

    The following programmes are briefly described: IAEA Capacity Building in Burkina Faso; Building the Capacity to Evaluate Vitamin A Supplementation Programmes in Cameroon; Isotope Studies in Cuba Influence the National Nutrition Recommendations; The IAEA’s Collaborating Centre in Nutrition in Bangalore, India; Promoting Good Nutrition through Isotope Techniques in Morocco; Improving Nutrition in Thailand; IAEA-Supported Studies Influence Nutrition Supplementation Policy in Senegal

  13. The IAEA Supports Member States’ Nutrition Programmes: What They Have to Say

    Energy Technology Data Exchange (ETDEWEB)

    Ouedraogo, Jean-Bosco [IRSS (Burkina Faso); Medoua, Gabriel [Centre for Food and Nutrition Research, Yaoundé (Cameroon); Hernandez Triana, Manuel [Institute of Nutrition and Food Hygiene, Havana (Cuba); Kurpad, Anura [St John’s Research Institute, Bangalore (India); Aguenaou, Hassan; Elmanchawy, Imane [Joint Unit for Nutrition and Food Research at Ibn Tofaïl University, National Centre for Nuclear Energy, Sciences and Technology (CNESTEN) (Morocco); Winichagoon, Pattanee [Mahidol University, Bangkok (Thailand); Wade, Salimata; Diop, Cheikh Anta [University, Dakar (Senegal)

    2014-03-15

    The following programmes are briefly described: IAEA Capacity Building in Burkina Faso; Building the Capacity to Evaluate Vitamin A Supplementation Programmes in Cameroon; Isotope Studies in Cuba Influence the National Nutrition Recommendations; The IAEA’s Collaborating Centre in Nutrition in Bangalore, India; Promoting Good Nutrition through Isotope Techniques in Morocco; Improving Nutrition in Thailand; IAEA-Supported Studies Influence Nutrition Supplementation Policy in Senegal.

  14. Elicitation support requirements of multi-expertise teams

    NARCIS (Netherlands)

    Bitter-Rijpkema, M.; Martens, R.L.; Jochems, W.M.G.

    2005-01-01

    Tools to support knowledge elicitation are more and more used in situations where employees or students collaborate using the computer. Studies indicate that there exist differences between experts and novices regarding their methods of work and reasoning. However, the commonly preferred approach

  15. A THEORETICAL MODEL OF SOCIO-PSYCHOLOGICAL SUPPORT WORK PROCESSES FOR MANAGEMENT OF PRODUCTION TEAM

    Directory of Open Access Journals (Sweden)

    Tatyana Gennadevna Pronyushkina

    2015-10-01

    Full Text Available This article discusses the management of production team, in particular the developed theoretical model of socio-psychological support work processes for management of production team. The author of the research are formulated the purpose and objectives of social-psychological work on management of the production team. Developed in the study a theoretical model aimed at determining the conditions and the identification of features of effective management of the enterprise taking into account the socio-psychological characteristics of its staff. Tasks include: definition of the main characteristics of the production team and their severity, the analysis of these characteristics and identifying opportunities for their transformation, development of recommendations for management of social-psychological work on effects on the characteristics of the collective enterprise.Practical study of the activities of a number of businesses have shown the need to improve socio-psychological support of management processes production team: introducing a social and psychological planning team and develop the practice of sociological research on the state of the team, to ensure the smoothing of relations between workers and management through periodic meetings, creations of conditions for feedback, maintaining healthy competition among team members.

  16. Nutritional Support of the Critically Ill Pediatric Patient: Foundations and Controversies

    Directory of Open Access Journals (Sweden)

    Iván José Ardila Gómez

    2017-04-01

    Full Text Available Critically ill children require nutritional support that will give them nutritional and non-nutritional support to successfully deal with their disease. In the past few years, we have been able to better understand the pathophysiology of critical illness, which has made possible the establishment of nutritional strategies resulting in an improved nutritional status, thus optimizing the pediatric intensive care unit (PICU stay and decreasing morbidity and mortality. Critical illness is associated with significant metabolic stress. It is crucial to understand the physiological response to stress to create nutritional recommendations for critically ill pediatric patients in the PICU.

  17. Supportive Supervision: Meeting to Build Interdisciplinary Teams in the Northern Central Regional Office of the CEN CINAI

    Directory of Open Access Journals (Sweden)

    Georgianella Araya-Alegría

    2015-01-01

    Full Text Available This article is the result of a participatory action research project aimed at providing a novel approach for the Northern Central Regional Office of the CEN CINAI [Education and Nutrition Centers (CEN and the Children’s Nutrition and Comprehensive Care Centers (CINAI] to build knowledge on an unfinished process: “Supportive Supervision” (supervisión capacitante.  Based on a naturalistic premise, we tried to answer a question that guided us in the group creation and transformation, switching our meetings from a vertical standpoint to a horizontal relationship providing accompaniment, support and construction, as well as analysis and reflection. The article shows the aspects that justified the development of the participative action research process under a methodological proposal that involves those of us who participated and contributed to build knowledge with our experience and from different locations within the Region.  A total of 29 professionals participated, willing to jointly meet a purpose: construct knowledge based on team work and on a process full of uncertainty that encourages us to constantly revise what has already been built and enables us to re-read and retake what has already been written and to systematize what could not be written before. In order words, to make this process a new way of developing knowledge that implies a more concrete standpoint to understand what “Supportive Supervision” is and how it is done, with the purpose of always looking for improvement within the National Directorate of CEN CINAI.

  18. Life Support and Environmental Monitoring International System Maturation Team Considerations

    Science.gov (United States)

    Anderson, Molly; Gatens, Robyn; Ikeda, Toshitami; Ito, Tsuyoshi; Hovland, Scott; Witt, Johannes

    2016-01-01

    Human exploration of the solar system is an ambitious goal. Future human missions to Mars or other planets will require the cooperation of many nations to be feasible. Exploration goals and concepts have been gathered by the International Space Exploration Coordination Group (ISECG) at a very high level, representing the overall goals and strategies of each participating space agency. The Global Exploration Roadmap published by ISECG states that international partnerships are part of what drives the mission scenarios. It states "Collaborations will be established at all levels (missions, capabilities, technologies), with various levels of interdependency among the partners." To make missions with interdependency successful, technologists and system experts need to share information early, before agencies have made concrete plans and binding agreements. This paper provides an overview of possible ways of integrating NASA, ESA, and JAXA work into a conceptual roadmap of life support and environmental monitoring capabilities for future exploration missions. Agencies may have immediate plans as well as long term goals or new ideas that are not part of official policy. But relationships between plans and capabilities may influence the strategies for the best ways to achieve partner goals. Without commitments and an organized program like the International Space Station, requirements for future missions are unclear. Experience from ISS has shown that standards and an early understanding of requirements are an important part of international partnerships. Attempting to integrate systems that were not designed together can create many problems. Several areas have been identified that could be important to discuss and understand early: units of measure, cabin CO2 levels, and the definition and description of fluids like high purity oxygen, potable water and residual biocide, and crew urine and urine pretreat. Each of the partners is exploring different kinds of technologies

  19. Nutrition support practices in South African ICUs: Results from a ...

    African Journals Online (AJOL)

    Nurses generally appeared unaware of published nutrition guidelines. Conclusion. .... making about daily fluid volumes allocated to nutrition in most responses (51%). ...... Negative impact of hypocaloric feeding and energy balance on clinical ...

  20. Nutritional support of children with chronic liver disease

    African Journals Online (AJOL)

    The effect that chronic liver disease has on a child's nutritional status and ... even children with less severe liver disease require nutritional .... Reduced muscle bulk .... pain and fractures, palpation of the spine and assessment of pubertal stage.

  1. How Do Staff Perceive Schoolwide Positive Behavior Supports? Implications for Teams in Planning and Implementing Schools

    Science.gov (United States)

    Feuerborn, Laura L.; Tyre, Ashli D.

    2016-01-01

    Schoolwide Positive Behavior Support (SWPBS) offers an alternative to reactive and exclusionary school discipline practices. However, the shift to SWPBS requires substantial change in the practices of staff, and many leadership teams struggle to rally staff support for implementation. With a more thorough understanding of staff perceptions, level…

  2. Food banking for improved nutrition of HIV infected orphans and vulnerable children; emerging evidence from quality improvement teams in high food insecure regions of Kiambu, Kenya.

    Science.gov (United States)

    Akulima, Muhamed; Ikamati, Rudia; Mungai, Margaret; Samuel, Muhula; Ndirangu, Meshack; Muga, Richard

    2016-01-01

    Estimated 236,548 People Living with HIV (PLHIV) were in Central-Eastern Kenya in 2013. Kiambu County had 46,656 PLHIV with 42,400 (91%) adults and 4,200(9%) children (1-14yrs). Amref Health Africa in Kenya, supported through USAID-APHIAplus KAMILI project, initiated two food banks to respond to poor nutritional status of the HIV infected children. Quality Improvement Teams were used to facilitate food-banking initiatives. The study aimed at assessing and demonstrating roles of community food-banking in improving nutrition status of HIV-infected children in food insecure regions. A pre and post-test study lasting 12 months (Oct 2013 to September 2014) conducted in Kiambu County, Kenya covering 103 HIV infected children. Two assessments were conducted before and after the food banking initiative and results compared. Child Status Index (CSI) and the Middle Upper Arm Circumference (MUAC) tools were used in data collection at households. Paired T-test and Wilcoxon test were applied for analysing MUAC and CSI scores respectively using the SPSS. There was a significant improvement in the children's nutrition status from a rating of 'bad' in CSI Median (IQR) score 2(2-1) before food banking to a rating of 'fair' in CSI Median (IQR) score 3(4-3) after food banking intervention (p=banking (p=banking is a community-based nutritional intervention that can address factors of food access, affordability and availability. Food banking is a sustainable way to contribute to quality nutrition and reduced related deaths among HIV infected children.

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

    Science.gov (United States)

    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).

  4. Present Concepts in Internal Medicine, Nutritional Support Symposium. Volume 14, Number 1. Summer 1983,

    Science.gov (United States)

    1983-01-01

    esophageal reflux , increasing the risk of aspiration or esophagitis . Smaller, more flexible nasogastric feeding tubes are now available. These tubes are...malnutrition increased the severity of acquired infection, and infection itself worsened preexisting nutritional deficits. Gastro - intestinal and respiratory...deficiency and fatal cardiomyopathy in i patient on home parenteral nutrition. Gastro - erterology 83:689-693, 1982. ’o . Nutritional Support Symposiwn

  5. Nutritional support management in premature infant in a Mexican (Guanajuato) hospital.

    OpenAIRE

    Monroy-Torres, R.; Mendoza Hernández, A. N.; Ruiz González, S. R.

    2012-01-01

    Introduction: Premature infant has special nutritional and physiological recommendations. Nutritional support promotes an appropriate weight gain. While this support is monitored according to international guidelines, the metabolic and infectious complicationscan be reduced and prevented.Objective: To describe the management of nutritional support in premature infant in a Mexican (Guana juato) hospital.Methods: A descriptive cross-sectional study, where a survey of 22 questions was applied by...

  6. Study on the action guidelines for medical support team for nuclear and radiological emergency

    International Nuclear Information System (INIS)

    Liu Chang'an; Liu Ying; Geng Xiusheng

    2006-01-01

    Objective: To study the action guidelines for medical support team for nuclear and radiological emergency. Methods: It is based on the experience and lessons learned in the course of meeting the emergencies preparedness and response of nuclear and radiological emergencies in China and abroad with the reference of the relevant reports of International Atomic Energy Agency. Results: Essential requirements and practical recommendations for the roles, responsibilities, emergency preparedness, principles and procedures of medical assistance at the scene, as well as the radiological protection of medical support team were provided. Conclusion: The document mentioned above can be applied to direct the establishment, effective medical preparedness and response of the medical support team for nuclear and radiological emergency. (authors)

  7. Travelling with football teams

    African Journals Online (AJOL)

    ultimately on the performance of the teams on the playing field and not so much ... However, travelling with a football team presents the team physician .... physician to determine the nutritional ..... diarrhoea in elite athletes: an audit of one team.

  8. Are real teams healthy teams?

    NARCIS (Netherlands)

    Buljac, M.; van Woerkom, M.; van Wijngaarden, P.

    2013-01-01

    This study examines the impact of real-team--as opposed to a team in name only--characteristics (i.e., team boundaries, stability of membership, and task interdependence) on team processes (i.e., team learning and emotional support) and team effectiveness in the long-term care sector. We employed a

  9. Nutritional support in chronic obstructive pulmonary disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Collins, Peter F; Stratton, Rebecca J; Elia, Marinos

    2012-06-01

    The efficacy of nutritional support in the management of malnutrition in chronic obstructive pulmonary disease (COPD) is controversial. Previous meta-analyses, based on only cross-sectional analysis at the end of intervention trials, found no evidence of improved outcomes. The objective was to conduct a meta-analysis of randomized controlled trials (RCTs) to clarify the efficacy of nutritional support in improving intake, anthropometric measures, and grip strength in stable COPD. Literature databases were searched to identify RCTs comparing nutritional support with controls in stable COPD. Thirteen RCTs (n = 439) of nutritional support [dietary advice (1 RCT), oral nutritional supplements (ONS; 11 RCTs), and enteral tube feeding (1 RCT)] with a control comparison were identified. An analysis of the changes induced by nutritional support and those obtained only at the end of the intervention showed significantly greater increases in mean total protein and energy intakes with nutritional support of 14.8 g and 236 kcal daily. Meta-analyses also showed greater mean (±SE) improvements in favor of nutritional support for body weight (1.94 ± 0.26 kg, P groups. This systematic review and meta-analysis showed that nutritional support, mainly in the form of ONS, improves total intake, anthropometric measures, and grip strength in COPD. These results contrast with the results of previous analyses that were based on only cross-sectional measures at the end of intervention trials.

  10. Peer mentored teams to support undergraduate group work in higher education

    Science.gov (United States)

    Cinderey, Lynn Elizabeth

    This research starts with a set of practical research questions to investigate a problem which occurs in some computing undergraduate modules that use group work as part of the learning and assessment strategy. In this study final year students with experience in information systems project work and trained in team processes met with small groups of first year computing students with the aim of turning the first year project group into a team. This study seeks to explore the experience of the final year students as they take on the role of peer tutor looking at the problems they perceive within the first year teams and the skills and knowledge they use to help them. The study includes the recruitment and training of final year students (n=9) and allocation to first year teams. The final year students acted as co-researchers and team leaders in L4 Information Systems project work and recorded their thoughts and observations in a diary during the first semester of 2008/9 academic year. Diary data was supplemented by interview data from a sample of final year students (n=4). The sample was selected based on the richness of the data provided in the diaries and the number of meetings held with their teams. Rich data and thick descriptions were essential for a phenomenological examination of the experience of the final year students. A number of findings emerged. A critical approach to analysis revealed ongoing conflicts occurred across cultural divides within the first year teams that final year leaders did not articulate or appear fully aware of. This had important implications for individual team members. Other findings which relate to issues of changing levels of motivation in the teams over the ten weeks, roles adopted by the leaders, ability to systematize the project or team processes and the ability to reflect on unsuccessful strategies also had implications for peer mentoring training and support. The picture that emerged from the data suggested that lack of

  11. Supported Discharge Teams for older people in hospital acute care: a randomised controlled trial.

    Science.gov (United States)

    Parsons, Matthew; Parsons, John; Rouse, Paul; Pillai, Avinesh; Mathieson, Sean; Parsons, Rochelle; Smith, Christine; Kenealy, Tim

    2018-03-01

    Supported Discharge Teams aim to help with the transition from hospital to home, whilst reducing hospital length-of-stay. Despite their obvious attraction, the evidence remains mixed, ranging from strong support for disease-specific interventions to less favourable results for generic services. To determine whether older people referred to a Supported Discharge Team have: (i) reduced length-of-stay in hospital; (ii) reduced risk of hospital readmission; and (iii) reduced healthcare costs. Randomised controlled trial with follow-up to 6 months; 103 older women and 80 men (n = 183) (mean age 79), in hospital, were randomised to receive either Supported Discharge Team or usual care. Home-based rehabilitation was delivered by trained Health Care Assistants up to four times a day, 7 days a week, under the guidance of registered nurses, allied health and geriatricians for up to 6 weeks. Participants randomised to the Supported Discharge Team spent less time in hospital during the index admission (mean 15.7 days) in comparison to usual care (mean 21.6 days) (mean difference 5.9: 95% CI 0.6, 11.3 days: P = 0.03) and spent less time in hospital in the 6 months following discharge home. Supported discharge group costs were calculated at mean NZ$10,836 (SD NZ$12,087) compared to NZ$16,943 (SD NZ$22,303) in usual care. A Supported Discharge Team can provide an effective means of discharging older people home early from hospital and can make a cost-effective contribution to managing increasing demand for hospital beds. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  12. Tagclouds and Group Cognition: Effect of Tagging Support on Students' Reflective Learning in Team Blogs

    Science.gov (United States)

    Xie, Ying; Lin, Shu-Yuan

    2016-01-01

    We investigated the effects of supported tagging (a prompting mechanism for students to stop and think about their writing) for team blogging on undergraduate students' reflective learning and the relationship between tagclouds and group cognition. Thirty-nine students were randomly assigned to six groups and blogged for 5 weeks. Three groups were…

  13. Autonomy support and motivational responses across training and competition in individual and team sports

    NARCIS (Netherlands)

    Pol, P.K.C. van de; Kavussanu, M.; Kompier, M.A.J.

    2015-01-01

    This study examined: (a) whether athletes’ (N = 348) perceived autonomy support (i.e., showing interest in athletes’ input and praising autonomous behavior) differs across contexts (training vs. competition) and sport types (individual vs. team sports), and (b) whether the relationships between

  14. Project team formation support for self-directed learners in social learning networks

    NARCIS (Netherlands)

    Spoelstra, Howard; Van Rosmalen, Peter; Sloep, Peter

    2012-01-01

    Spoelstra, H., Van Rosmalen, P., & Sloep, P. B. (2012). Project team formation support for self-directed learners in social learning networks. In P. Kommers, P. Isaias, & N. Bessis (Eds.), Proceedings of the IADIS International Conference on Web Based Communities and Social Media (ICWBC & SM 2012)

  15. Designing, developing, and deploying systems to support human-robot teams in disaster response

    NARCIS (Netherlands)

    Kruijff, G.J.M.; Kruijff-Korbayová, I.; Keshavdas, S.; Larochelle, B.; Janíček, M.; Colas, F.; Liu, M.; Pomerleau, F.; Siegwart, R.; Neerincx, M.A.; Looije, R.; Smets, N.J.J.M.; Mioch, T.; Diggelen, J. van; Pirri, F.; Gianni, M.; Ferri, F.; Menna, M.; Worst, R.; Linder, T.; Tretyakov, V.; Surmann, H.; Svoboda, T.; Reinštein, M.; Zimmermann, K.; Petříček, T.; Hlaváč, V.

    2014-01-01

    This paper describes our experience in designing, developing and deploying systems for supporting human-robot teams during disaster response. It is based on R&D performed in the EU-funded project NIFTi. NIFTi aimed at building intelligent, collaborative robots that could work together with humans in

  16. Dietary counselling and nutritional support in oropharyngeal cancer patients treated with radiotherapy

    NARCIS (Netherlands)

    Vlooswijk, C.P.; Rooij, Van P.H.E.; Kruize, J.C.; Schuring, H.A.; Al-Mamgani, A.; Roos, De N.M.

    2016-01-01

    Background/Objectives:The need for dietary counselling and nutritional support in oropharyngeal cancer patients is generally accepted. However, evidence for the effectiveness is sparse. The aim of this study was to describe dietary counselling, nutritional support, body weight and toxicity during

  17. Conceptualization and Support of the Role of Teachers Serving as Team Leaders in a Professional Learning Community

    Science.gov (United States)

    Gordin, Lanelle

    2010-01-01

    This study presents the results of a phenomenological qualitative investigation into the new role of teachers serving as team leaders in a professional learning community, as well as the support team leaders need from members and principals to be effective. Collaborative teacher teams in 6 schools that have been developing as professional learning…

  18. Treatment of upper gastrointestinal fistula and leakage with personal stage nutrition support

    Institute of Scientific and Technical Information of China (English)

    Qun Wang; Zhi-Su Liu; Qun Qian; Quan Sun; Ding-Yu Pan; Yue-Ming He

    2008-01-01

    AIM: To investigate the feasibility of treatment for upper gastrointestinal fistula and leakage with personal stage nutrition support.METHODS: Forty-three patients with upper gastrointestinal fistula and leakage were randomly divided into two groups. Patients in group A were treated with personal stage nutrition support and patients in group B were treated with total parental nutrition (TPN) in combination with operation.Nutritional states of the candidates were evaluated by detecting albumin (Alb) and pre-Alb. The balance between nutrition and hepatic function was evaluated by measurement of aspartate aminotransferase (AST),alanine aminotransferase (ALT) and total bilirubin (Tbill) before and after operation. At the same time their complications and hospitalized time were surveyed.RESULTS: Personal stage nutrition support improved upper gastrointestinal fistula and leakage. The nutrition state and hepatic function were better in patients who received personal stage nutrition support than in those who did not receive TPN. There was no significant difference in the complication and hospitalized time in the two groups of patients.CONCLUSION: Upper gastrointestinal fistula and leakage can be treated with personal stage nutrition support which is more beneficial for the post-operation recovery and more economic than surgical operation.

  19. Electronic health record tools' support of nurses' clinical judgment and team communication.

    Science.gov (United States)

    Kossman, Susan P; Bonney, Leigh Ann; Kim, Myoung Jin

    2013-11-01

    Nurses need to quickly process information to form clinical judgments, communicate with the healthcare team, and guide optimal patient care. Electronic health records not only offer potential for enhanced care but also introduce unintended consequences through changes in workflow, clinical judgment, and communication. We investigated nurses' use of improvised (self-made) and electronic health record-generated cognitive artifacts on clinical judgment and team communication. Tanner's Clinical Judgment Model provided a framework and basis for questions in an online survey and focus group interviews. Findings indicated that (1) nurses rated self-made work lists and medication administration records highest for both clinical judgment and communication, (2) tools aided different dimensions of clinical judgment, and (3) interdisciplinary tools enhance team communication. Implications are that electronic health record tool redesign could better support nursing work.

  20. [Effect of nutritional support on survival in patients with amyotrophic lateral sclerosis].

    Science.gov (United States)

    López Gómez, J J; Ballesteros Pomar, Ma D; Vázquez Sánchez, F; Vidal Casariego, A; Calleja Fernández, A; Cano Rodríguez, I

    2011-01-01

    Malnutrition affects morbidity and mortality of patients with ALS. The nutrition unit should evaluate these patients early and regularly providing the necessary steps in the evolution of the disease. A retrospective cohort study in which we analyzed 46 patients diagnosed with ALS, 21 of them received nutritional therapy. We studied age, mode of onset, date of entry into a nutritional protocol, placement of PEG and survival. We performed a test of Breslow comparing patients who were at nutritional protocol with those not receiving nutritional support, and those who received early nutritional therapy with those with delayed nutrition. There was an increase in median survival for patients in nutritional therapy in bulbar ALS (452 vs 55 days) and in spinal ALS (1,798 vs 357 days) (p = 0.002). The median delay in the initiation of nutritional therapy in spinal ALS was 557 days while in bulbar ALS was 230 days. The survival in the spinal ALS of those who entered into nutritional protocol before the median survival was 325 days to 181 days (p = 0.09) while in bulbar ALS those who entered before had a median survival of 435 days to 177 days (p = 0.38). The entry of patients with ALS in a nutritional protocol increases survival. There is an advantage in the evolution of patients with early nutritional treatment.

  1. Successful early elemental diet nutritional support in an esophageal cancer patient

    Directory of Open Access Journals (Sweden)

    Pei-Chun Chao

    2017-06-01

    Full Text Available Our case involved a 58-year-old man with a medical history of moderately differentiated esophageal squamous cell carcinoma. Positron emission tomography (PET and computed tomography (CT scan revealed a tumor in the upper two-thirds of the esophagus, with a maximal length of 14.4 cm and at least 6 enlarged lymph nodes. Concurrent chemoradiotherapy (CCRT was performed on June 12, 2015, and a chest CT 2 weeks later revealed partial tumor response and shrinkage of the right upper paratracheal lymph node. The patient (cT3N3MO, stage III c underwent esophagectomy with gastric tube reconstruction, lymph node dissection, and jejunostomy on July 6, 2015. Bodyweight (BW loss occurred because of inadequate calorie intake. The nutrition support team (NST commenced an intervention and estimated the patient's malnutrition status from the BW loss (>8% in 3 months, body mass index (BMI, 21 kg/m2, triceps skinfold thickness (TSF, 5.7 mm, arm circumference (AC, 20 cm, and serum albumin level (2.7 g/dL. The NST administered an enteral nutrition formula with an elemental diet (Peptamen through enterostomy feeding, and provided meals according to the patient's digestive ability. The Scored Patient-Generated Subjective Global Assessment (PG-SGA improved from 13 to 5, and energy support increased from 10 to 30 kcal/kg BW, with the BMI rising from 21 to 22 kg/m2, TSF from 5.7 to 7.0 mm, AC from 20 to 21.7 cm, and serum albumin level from 2.7 to 3.1 g/dL. The patient's wound healed completely.

  2. Nutritional support in patients with colorectal cancer during chemotherapy: does it work?

    Science.gov (United States)

    Dobrila-Dintinjana, Renata; Trivanovic, Dragan; Zelić, Marko; Radić, Mladen; Dintinjana, Marijan; Petranović, Duška; Toni, Valković; Vukelic, Jelena; Matijasic, Nusa

    2013-05-01

    Early intervention with nutritional supplementation has been shown to halt malnutrition and may improve outcome in some patients with colorectal cancer. The aim of this study was to investigate whether dietary counseling, oral nutrition and megestrol acetate during chemotherapy affected nutritional status and survival in patients with advanced disease. Six hundred and twenty-eight patients with colorectal advanced disease were included in the study from January 2000 through December 2009 and divided into one of two groups. Group I consisted of 315 patients who were monitored prospectively and were given nutritional support. Group II included 313 patients without nutritional counseling and support. After the completion of chemotherapy all patients were evaluated (BMI, NST, Appetite Loss Scale and ECOG). After the completion of chemotherapy, there were lower proportions of patients in Group I with a BMI=5, loss of appetite and decreased weight gain. Nutritional counseling and supplemental feeding temporarily halted weight loss and improved appetite. This improvement may have implications for patient survival. Patients with early nutritional support lived 19.1 months while patients in the control group had a survival of 12.4 months (p=0.022). This study demonstrated that concurrent individualized dietary counseling and nutritional support are effective in improving nutritional status thereby lessening chemotherapy-induced morbidity.

  3. Nutritional Issues and Nutrition Support in Older Home Care Patients in the City of Zagreb.

    Science.gov (United States)

    Vranešić Bender, Darija; Kovačević, Marta; Hanževački, Miro; Vrabec, Božena; Benković, Vanesa; Domislović, Viktor; Krznarić, Željko

    2017-12-01

    Population aging is a global demographic trend showing continuous growth and among its consequences is a rise in malnutrition that is characteristic for the elderly. The objective of this study was to evaluate nutritional status of elderly home care patients immediately after hospital discharge and to determine factors that affect nutritional status using questionnaires based on validated tools (NRS-2002, DETERMINE checklist) and basic medical history data. The study involved 76 elderly individuals (51.3% of them older than 70) living in the City of Zagreb. The nutritional status assessment using the NRS-2002 tool showed that 57.6% of the subjects were at nutritional risk. The findings of the assessment by use of the DETERMINE tool were also unfavorable, indicating that 82.1% of persons older than 70 were categorized as being at a high nutritional risk, while 17.9% were at moderate risk. The DETERMINE checklist elements (illness; reduced intake of fruits, vegetables or dairy products; alcohol consumption; oral health problems; and weight loss) were linked to a higher NRS score. The mean number of hospital days in subjects at nutritional risk was 14.27 (the mean number in the Republic of Croatia is 8.56 days). Although the study involved a small number of subjects, the results showed a substantial presence of malnutrition among the elderly. A timely -intervention by the healthcare system and training of healthcare personnel can be a step towards achieving a better nutritional status.

  4. Nutritional support and dietary interventions following esophagectomy: challenges and solutions

    Directory of Open Access Journals (Sweden)

    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

  5. The nutrition and health profile of the Turkish female national weightlifting team who attended to pre-camp of Beijing Olympics- Pilot study

    OpenAIRE

    Gunay Ozdemir; Gülgün Ersoy

    2010-01-01

    In this study, National Turkish weightlifter female team who joined preparation camp before 2008 Beijing Olympiads nutrition habits, food intake, using of nutritional ergogenic aids, anthropometric measures and biochemical findings have been evaluated. Nine athletes who have been taken the camp participated to this study. The information were collected about their anthropometric (height, body weight, waist-hip circumference, waist / height ratio, body fat values) and biochemical measures, nut...

  6. New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition

    OpenAIRE

    AKBULUT, GAMZE

    2011-01-01

    Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of quality of life (QoL). Cancer-related malnutrition may evolve into cancer cachexia due to complex interactions between pro-inflammatory cytokines and the host metabolism. Depending on the type of cancer treatment (either curative or palliative), the clinical condition of the patient and nutritional status, adequate and patient-tailored nutritional intervention should be presc...

  7. 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...

  8. Nutritional and body composition assessment and its relationship with athletic performance in a women’s soccer team

    Directory of Open Access Journals (Sweden)

    María González-Neira

    2015-04-01

    Full Text Available Introduction: In women’s soccer, meeting the nutritional requirements could have a positive impact on athletic performance. The aim of this study was to analyze dietary intake and body composition (CC, proving their relationship with athletic performance.Material and Methods: Observational, descriptive, prospective, and correlational study performed on 17 players from Torrelodones C.F., a semi-professional team in Madrid. Weight and height were measured and the body mass index (IMC was calculated. The CC was determined by bioelectrical impedance analysis (BIA. Dietary intake was analyzed through a weekly food registry (assessed with the program DIAL and the KIDMED test. The maximum volume of oxygen (VO2 max was determined by the Course-Navette test and the rating of perceived effort test (PSE was also taken.Results: IMC was 22.80±2.9kg/m2, fat mass was 24.51±5.5% and lean mass 43.6±2.9kg. Energy intake was 1901±388 kcal. The contribution of carbohydrates accounted for 40.3±5.6%, protein 15.9±3.29%, and fat 41.8±4.1% of total kcal. There was an inverse relationship between IMC and weight, and VO2 max values. There was a significant weight loss after training (p=0.003 and after the match (p=0.008.Conclusions: Player’s diet was inadequate, not corresponding nutrient intake with their requirements, despite training in a semi-professional team. Because of the importance that nutrition plays in competition and athletic performance, investigations should continue working on an appropriate recommendation for this collective.

  9. Real-Time Support of Pediatric Diabetes Self-Care by a Transport Team

    OpenAIRE

    Franklin, Brandi E.; Crisler, S. Crile; Shappley, Rebekah; Armour, Meri M.; McCommon, Dana T.; Ferry, Robert J.

    2013-01-01

    OBJECTIVE The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. RESEARCH DESIGN AND METHODS The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis ...

  10. Supporting nutrition and health throughout the human life cycle

    International Nuclear Information System (INIS)

    2003-01-01

    The International Atomic Energy Agency is a partner in addressing nutrition and health problems in more than 50 countries in collaboration with Member State counterparts, other United Nations organizations, and donors. In the general public, few people are aware that the work of the International Atomic Energy Agency extends beyond the realms of the nuclear power and safeguarding against the misuse of radioactive materials. Indeed, for many years now Agency activities in research and technical co-operation include a strong emphasis on isotope techniques as tools to evaluate human nutritional status and the nutritional quality of foods within the context of national development programmes. These techniques are considered the best methods for measuring the uptake and bioavailability of many important vitamins and minerals. Thus, they are well-suited for determining the success of food supplementation programmes and other interventions aimed at fighting many forms of malnutrition found throughout the world. (IAEA)

  11. Enteral Nutrition Support to Treat Malnutrition in Inflammatory Bowel Disease

    Science.gov (United States)

    Altomare, Roberta; Damiano, Giuseppe; Abruzzo, Alida; Palumbo, Vincenzo Davide; Tomasello, Giovanni; Buscemi, Salvatore; Lo Monte, Attilio Ignazio

    2015-01-01

    Malnutrition is a common consequence of inflammatory bowel disease (IBD). Diet has an important role in the management of IBD, as it prevents and corrects malnutrition. It is well known that diet may be implicated in the aetiology of IBD and that it plays a central role in the pathogenesis of gastrointestinal-tract disease. Often oral nutrition alone is not sufficient in the management of IBD patients, especially in children or the elderly, and must be combined with oral supplementation or replaced with tube enteral nutrition. In this review, we describe several different approaches to enteral nutrition—total parenteral, oral supplementation and enteral tube feeding—in terms of results, patients compliance, risks and and benefits. We also focus on the home entaral nutrition strategy as the future goal for treating IBD while focusing on patient wellness. PMID:25816159

  12. Effectiveness of intervention with a perioperative multidisciplinary support team for radical esophagectomy.

    Science.gov (United States)

    Akiyama, Yuji; Iwaya, Takeshi; Endo, Fumitaka; Shioi, Yoshihiro; Kumagai, Motoi; Takahara, Takeshi; Otsuka, Koki; Nitta, Hiroyuki; Koeda, Keisuke; Mizuno, Masaru; Kimura, Yusuke; Suzuki, Kenji; Sasaki, Akira

    2017-12-01

    We aimed to evaluate the effectiveness of intervention by a perioperative multidisciplinary support team for radical esophagectomy for esophageal cancer. We retrospectively reviewed 85 consecutive patients with esophageal cancer who underwent radical esophagectomy via right thoracotomy or thoracoscopic surgery with gastric tube reconstruction. Twenty-one patients were enrolled in the non-intervention group (group N) from May 2011 to September 2012, 31 patients in the perioperative rehabilitation group (group R) from October 2012 to April 2014, and 33 patients in the multidisciplinary support team group (group S) from May 2014 to September 2015. Morbidity rates were 38, 45.2, and 42.4% for groups N, R, and S, respectively. Although there were no significant differences in the incidence of pneumonia among the groups, the durations of fever and C-reactive protein positivity were shorter in group S. Moreover, postoperative oral intake commenced earlier [5.9 (5-8) days] and postoperative hospital stay was shorter [19.6 (13-29) days] for group S. The intervention by a perioperative multidisciplinary support team for radical esophagectomy was effective in preventing the progression and prolongation of pneumonia as well as earlier ambulation, oral feeding, and shortening of postoperative hospitalization.

  13. Malnutrition and Nutritional Support in Alcoholic Liver Disease: a Review.

    Science.gov (United States)

    Chao, Andrew; Waitzberg, Dan; de Jesus, Rosangela Passos; Bueno, Allain A; Kha, Victor; Allen, Karen; Kappus, Matthew; Medici, Valentina

    2016-12-01

    Malnutrition is associated with alcoholic liver disease (ALD) and related complications such as hepatic encephalopathy and increased rate of infections. Avoidance of prolonged fasting and overly restrictive diets is important to avoid poor nutrition. Adequate intake of calories, protein, and micronutrients via frequent small meals and evening supplements and/or enteral and parenteral nutrition when indicated has been associated with reduced mortality and morbidity in patients with ALD. Modification of protein/fat sources and composition in addition to probiotic supplementation are promising interventions for decreased progression of ALD and its complications.

  14. Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Holst, Mette; Rasmussen, Henrik Højgaard

    2013-01-01

    To estimate the effectiveness of oral nutritional support compared to placebo or usual care in improving clinical outcome in older (65 years+) medical and surgical patients after discharge from hospital. Outcome goals were: re-admissions, survival, nutritional and functional status, quality of life...

  15. Transthyretin levels: Potential biomarker for monitoring nutritional support efficacy and clinical complications risk in patients receiving parenteral nutrition.

    Science.gov (United States)

    Borges de Oliveira Nascimento Freitas, Renata Germano; Hessel, Gabriel; Junqueira Vasques, Ana Carolina; Negrão Nogueira, Roberto José

    2018-04-01

    Nutritional support is an effective strategy to restore or maintain nutritional status, to reduce clinical complications, hospitalization period and the morbidity/mortality risk of hospitalized patients. So, a good marker is important to evaluate the nutritional support. This study aims to evaluate the evolution of transthyretin levels in patients receiving parenteral nutrition (PN) during 14 days. Longitudinal study of 88 hospitalized patients. The assessments and samples were taken during the first 72 h (T0), on the 7th day (T7) and 14th day (T14) of PN. This study was approved by the Ethics Committee of the School of Medical Sciences at UNICAMP (No 538/2011). The C-reactive protein (CRP) levels were high and albumin and transthyretin levels were low at baseline. From T0 to T14, only transthyretin increased (p = 0.03). According to the receiver operation characteristic (ROC) curve, we found that the transthyretin had some improvement when the CRP levels were less than 10.4 mg/dl (T7). According to the CRP/albumin ratio, all patients classified as without risk for complications were discharged from the hospital. In addition, we observed that patients with transthyretin reduction had a concomitant higher risk for complications according to their ratio CRP/albumin (p = 0.03). CRP/albumin ratio was associated with the evolution of transthyretin levels. Transthyretin values showed significant improvement in the 14 days of PN. Especially, less inflamed patients (ie CRP less than 10.4 mg/dl) improved their transthyretin levels. So, CRP value at day 7 that predicts the transthyretin and transthyretin is a good biomarker for classification of nutritional support and clinical complications risk in patients receiving PN. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  16. Team sport and coaching - a dynamic interplay supporting development of self-concept

    DEFF Research Database (Denmark)

    Ryom, Knud Eske; Wikman, Johan Michael; Stelter, Reinhard

    2018-01-01

    The purpose of this study was to investigate the effect and experience of a team sport and coaching intervention upon self-concept in a sample of male school students with primarily migrant background. A convergent parallel mixed method design was used to compare and relate a questionnaire study ...... and more supportive social environment, as the result of their participation. Implications of the presented results are discussed, as well as strategies for working with team sport and coaching in a school setting in deprived areas or beyond.......The purpose of this study was to investigate the effect and experience of a team sport and coaching intervention upon self-concept in a sample of male school students with primarily migrant background. A convergent parallel mixed method design was used to compare and relate a questionnaire study...... (SDQ-II & YSEQ) and an interview study in a quasi-experimental design. A two-year intervention period was conducted with students in 7th, 8th and 9th grade. The interventions were a two-stringed effort with team sport and group coaching introduced to the participants. Quantitative results showed...

  17. Reconceiving SNAP: Is Nutritional Assistance Really Income Support?

    Science.gov (United States)

    Besharov, Douglas J.

    2016-01-01

    Since its creation, the Supplemental Nutrition Assistance Program (SNAP) has changed from an antihunger program to an income-supplementation program. Because the program (and its predecessor Food Stamp Program) was not designed for this purpose, the result is a program that has many unintended and, many believe, negative effects. The key challenge…

  18. Agriculture for Improved Nutrition and Health: Support to the ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Agriculture has made remarkable advances in the past decades, but progress in improving the nutrition and health of the poor in developing countries is lagging behind. Long-time IDRC partner, the Consultative Group on International Agricultural Research (CGIAR) is launching 15 new cutting-edge programs to tackle the ...

  19. Position of the American Dietetic Association: local support for nutrition integrity in schools.

    Science.gov (United States)

    Bergman, Ethan A; Gordon, Ruth W

    2010-08-01

    It is the position of the American Dietetic Association (ADA) that schools and communities have a shared responsibility to provide students with access to high-quality, affordable, nutritious foods and beverages. School-based nutrition services, including the provision of meals through the National School Lunch Program and the School Breakfast Program, are an integral part of the total education program. Strong wellness policies promote environments that enhance nutrition integrity and help students to develop lifelong healthy behaviors. ADA actively supported the 2004 and proposed 2010 Child Nutrition reauthorization which determines school nutrition policy. ADA believes that the Dietary Guidelines for Americans should serve as the foundation for all food and nutrition assistance programs and should apply to all foods and beverages sold or served to students during the school day. Local wellness policies are mandated by federal legislation for all school districts participating in the National School Lunch Program. These policies support nutrition integrity,including a healthy school environment. Nutrition integrity also requires coordinating nutrition education and promotion and funding research on program outcomes. Registered dietitians and dietetic technicians, registered, and other credentialed staff, are essential for nutrition integrity in schools to perform in policy-making, management, education, and community building roles. A healthy school environment can be achieved through adequate funding of school meals programs and through implementation and evaluation of strong local wellness policies.

  20. Study protocol: cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care: cluster randomized controlled trial.

    Science.gov (United States)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe; Damsbo-Svendsen, Signe; Kreinfeldt Skovgaard Møller, Tina; Boll Hansen, Eigil; Keiding, Hans

    2014-08-28

    support.Furthermore, interviews with nursing home and home-care management, nursing staff and nutrition coordinators in both the control and intervention groups, participants in the intervention group and the involved multidisciplinary team will be performed. In this study we will evaluate in a randomized controlled trial whether multidisciplinary nutritional support is cost-effective, in undernourished older adults in home-care and nursing home and contribute to important research. ClinicalTrials.gov 2013 NCT01873456.

  1. Design and Parametric Sizing of Deep Space Habitats Supporting NASA'S Human Space Flight Architecture Team

    Science.gov (United States)

    Toups, Larry; Simon, Matthew; Smitherman, David; Spexarth, Gary

    2012-01-01

    NASA's Human Space Flight Architecture Team (HAT) is a multi-disciplinary, cross-agency study team that conducts strategic analysis of integrated development approaches for human and robotic space exploration architectures. During each analysis cycle, HAT iterates and refines the definition of design reference missions (DRMs), which inform the definition of a set of integrated capabilities required to explore multiple destinations. An important capability identified in this capability-driven approach is habitation, which is necessary for crewmembers to live and work effectively during long duration transits to and operations at exploration destinations beyond Low Earth Orbit (LEO). This capability is captured by an element referred to as the Deep Space Habitat (DSH), which provides all equipment and resources for the functions required to support crew safety, health, and work including: life support, food preparation, waste management, sleep quarters, and housekeeping.The purpose of this paper is to describe the design of the DSH capable of supporting crew during exploration missions. First, the paper describes the functionality required in a DSH to support the HAT defined exploration missions, the parameters affecting its design, and the assumptions used in the sizing of the habitat. Then, the process used for arriving at parametric sizing estimates to support additional HAT analyses is detailed. Finally, results from the HAT Cycle C DSH sizing are presented followed by a brief description of the remaining design trades and technological advancements necessary to enable the exploration habitation capability.

  2. Physiological, performance, and nutritional profile of the Brazilian Olympic Wushu (kung-fu) team.

    Science.gov (United States)

    Artioli, Guilherme Giannini; Gualano, Bruno; Franchini, Emerson; Batista, Rafael Novaes; Polacow, Viviane Ozores; Lancha, Antonio Herbert

    2009-01-01

    The purpose of the present study was to determine physiological, nutritional, and performance profiles of elite Olympic Wushu (kung-fu) athletes. Ten men and four women elite athletes took part in the study. They completed the following tests: body composition, nutritional assessment, upper-body Wingate Test, vertical jump, lumbar isometric strength, and flexibility. Blood lactate was determined at rest and after the Wingate Test. Blood lactate was also determined during a training session (combat and Taolu training). We found low body fat (men: 9.5 +/- 6.3%; women: 18.0 +/- 4.8%), high flexibility (sit-and-reach-men: 45.5 +/- 6.1 cm; women: 44.0 +/- 6.3 cm), high leg power (vertical jump-men: 37.7 +/- 8.4 cm; women: 32.3 +/- 1.1 cm), high lumbar isometric strength (men: 159 +/- 13 cm; women: 94 +/- 6 cm), moderate arm mean and peak power (Wingate Test-men: 4.1 +/- 0.4 and 5.8 +/- 0.5 Wxkg, respectively; women: 2.5 +/- 0.3 and 3.4 +/- 0.3 W.kg, respectively), and elevated blood lactate after the Wingate Test (men: 10.8 +/- 2.0 mmolxL; women: 10.2 +/- 2.0 mmolxL) and during training (combat: 12.0 +/- 1.8 mmolxL; Taolu: 7.7 +/- 3.3 mmolxL). Men athletes consume a high-fat, low-carbohydrate diet, whereas women consume a moderate, high-carbohydrate diet. Energy consumption was markedly variable. In conclusion, Olympic Wushu seems to be a highly anaerobic-dependent combat sport. Low body fat, high flexibility, leg anaerobic power, isometric strength, and moderately high arm anaerobic power seem to be important for successful competitive performance.

  3. Providing Nutritional Care in the Office Practice: Teams, Tools, and Techniques.

    Science.gov (United States)

    Kushner, Robert F

    2016-11-01

    Provision of dietary counseling in the office setting is enhanced by using team-based care and electronic tools. Effective provider-patient communication is essential for fostering behavior change: the key component of lifestyle medicine. The principles of communication and behavior change are skill-based and grounded in scientific theories and models. Motivational interviewing and shared decision making, a collaboration process between patients and their providers to reach agreement about a health decision, is an important process in counseling. The stages of change, self-determination, health belief model, social cognitive model, theory of planned behavior, and cognitive behavioral therapy are used in the counseling process. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Proteins and amino acids are fundamental to optimal nutrition support in critically ill patients

    NARCIS (Netherlands)

    Weijs, Peter JM; Cynober, Luc; DeLegge, Mark; Kreymann, Georg; Wernerman, Jan; Wolfe, Robert R

    2014-01-01

    In this review, we present the growing scientific evidence showing the importance of protein and amino acid provision in nutritional support and their impact on preservation of muscle mass and patient outcomes.

  5. Effect of nutritional support on terminally ill patients with cancer in a palliative care unit.

    Science.gov (United States)

    Amano, Koji; Morita, Tatsuya; Baba, Mika; Kawasaki, Muneyoshi; Nakajima, Shinichiro; Uemura, Minako; Kobayashi, Yuka; Hori, Moeko; Wakayama, Hiroshi

    2013-11-01

    The role of nutritional support on terminally ill patients with cancer in a palliative care unit has not been clarified. A total of 63 patients were retrospectively investigated; the patients receiving individualized nutritional support (intervention group [n = 22]) were compared to the others (control group [n = 41]). The intervention group received individualized nutritional support. There were no significant differences in the characteristics of patients between the groups. The prevalence of bedsores was significantly lower in the intervention group (14% vs 46%, P = .012). The prevalence of edema and the use of antibiotic therapies tended to be lower in the intervention group than in the control group (36% vs 54%, P = .19; 14% vs 27%, P = .34, respectively). Some terminally ill patients with cancer in a palliative care unit might benefit from nutritional support.

  6. Team Meetings within Clinical Domains - Exploring the Use of Routines and Technical Support for Communication

    Science.gov (United States)

    Groth, Kristina; Lantz, Ann; Sallnäs, Eva-Lotta; Frykholm, Oscar; Green, Anders

    Today, it is common that a team of clinicians, from different disciplines, instead of one single doctor, care for a patient. This is especially true when it concerns more complicated diseases in highly specialised health care. Going from one doctor to a team of doctors raises new dimensions/problems/issues when deciding about the diagnosis and how to treat the patient. Instead of one person deciding, based on the information given from others, a group of people need to agree on a decision. How do the participants during such decision meetings argue for their experience and skill? What kind of technologies are available and how do they support the communication in the meeting? Måseide (2006), for example, focuses on how different forms of evidence influence and regulate the judgements and decisions of medical practitioners during such meetings. Groth et al. (2008), for example, focuses on the technology used during such meetings, with a focus on audio, video, and images.

  7. Initiation of nutritional support is delayed in critically ill obese patients: a multicenter cohort study.

    Science.gov (United States)

    Borel, Anne-Laure; Schwebel, Carole; Planquette, Benjamin; Vésin, Aurélien; Garrouste-Orgeas, Maité; Adrie, Christophe; Clec'h, Christophe; Azoulay, Elie; Souweine, Bertrand; Allaouchiche, Bernard; Goldgran-Toledano, Dany; Jamali, Samir; Darmon, Michael; Timsit, Jean-François

    2014-09-01

    A high catabolic rate characterizes the acute phase of critical illness. Guidelines recommend an early nutritional support, regardless of the previous nutritional status. We aimed to assess whether the nutritional status of patients, which was defined by the body mass index (BMI) at admission in an intensive care unit (ICU), affected the time of nutritional support initiation. We conducted a cohort study that reported a retrospective analysis of a multicenter ICU database (OUTCOMEREA) by using data prospectively entered from January 1997 to October 2012. Patients who needed orotracheal intubation within the first 72 h and >3 d were included. Data from 3257 ICU stays were analyzed. The delay before feeding was different according to BMI groups (P = 0.035). The delay was longer in obese patients [BMI (in kg/m²) ≥30; n = 663] than in other patients with either low weight (BMI nutritional status and a delay in nutrition initiation was independent of potential confounding factors such as age, sex, and diabetes or other chronic diseases. In comparison with normal weight, the adjusted RR (95% CI) associated with a delayed nutrition initiation was 0.92 (0.86, 0.98) for patients with low weight, 1.00 (0.94, 1.05) for overweight patients, and 1.06 (1.00, 1.12) for obese patients (P = 0.004). The initiation of nutritional support was delayed in obese ICU patients. Randomized controlled trials that address consequences of early compared with delayed beginnings of nutritional support in critically ill obese patients are needed. © 2014 American Society for Nutrition.

  8. Computer Support for Conducting Supportability Trade-Offs in a Team Setting

    Science.gov (United States)

    1990-01-01

    with the ability of the product to be satisfactorily maintained throughout its intended useful life span with minimum expenditures of money and effort...during the pre-concept phase, thereby ensuring a reduction in cost due to reducing eventual retrofits, and a more supportable weapon system. Lauder ...It is shown that although large sums of money are expended on producing reliable components, these are vitiated if the end equipment is not exposed

  9. Supporting in grief and burnout of the nursing team from pediatric units in Chilean hospitals.

    Science.gov (United States)

    Vega, Paula Vega; Rodriguez, Rina González; Galdamez, Natalie Santibáñez; Molina, Camila Ferrada; Orellana, Javiera Spicto; Villanueva, Antonia Sateler; Melo, Jose Bustos

    2017-01-01

    Objective To know the levels of Burnout Syndrome and perception of grief support in nursing teams of oncology and pediatric intensive care in public hospitals in Chile. Method A study of descriptive cross-sectional design. The Maslach Burnout Inventory and the Grief Support Health Care Scale were applied to university-level and technical nursing professionals between March and November 2015. An analysis to compare the means was performed with use of the Student's t-test, and the level of significance was set at 5%. Results The study included 153 professionals. Results show 4% of professionals have Burnout Syndrome (BS) and 89% are at risk of having it. Oncology professionals are at higher risk as they present higher levels of emotional exhaustion and lower levels of personal fulfillment. Half of professionals have a high level of perception of grief support, which is greater in the oncology team. Conclusion Professionals working in pediatric oncology units are at increased risk of Burnout Syndrome and grief support may be a mediating factor in this process.

  10. Translational Research in Enteral and Parenteral Nutrition Support for Patients with Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Fa-liang LIN

    2015-12-01

    Full Text Available Abstract Objective: To explore the key points of the translational research in enteral and pareenteral nutrition support for patients with severe head injury (SHI, and to analyze the influence of different nutritional support routes on the prognosis of SHI patients. Methods: Totally 141 patients with severe craniocerebral injury were selected as study subjects, 47 cases for each group, and were given early enteral nutrition (EEN, delayed enteral nutrition (DEN, and parenteral nutrition (PN, respectively. The effect of different nutritional support routes on SHI patients was observed. Results: After 14 d of treatment, Glasgow coma scale (GCS scores of 3 groups were higher than treatment before (P<0.01, and with statistical differences among groups (P<0.05, or P<0.01. The levels of serum albumin, total serum protein and hemoglobin were higher in EEN group than the other groups (P<0.01. The level of serum albumin was lower in PN group than in DEN group (P<0.05. There were statistical differences in the incidence of complications among three groups (χ2=9.2487, P=0.0098. Conclusion: EEN support is more conductive to the improvement of the nutrition status, reduction of the incidence of complications, and promotion of the prognosis of SHI patients than DEN and PN.

  11. Benefits of postpyloric enteral access placement by a nutrition support dietitian.

    Science.gov (United States)

    Jimenez, L Lee; Ramage, James E

    2004-10-01

    Although enteral nutrition is considered the preferred strategy for nutrition support, it is often precluded by nasogastric feeding intolerance or the inability to place feeding access into the postpyloric position. In an effort to improve enteral nutrition (EN) outcomes at our institution, the nutrition support dietitian (NSD) began placing postpyloric feeding tubes (PPFT) in intensive care unit patients. Intensive care unit patients who received blind, bedside PPFT placements by the NSD (n = 18) were compared with a concurrent age- and diagnosis-matched control group that received standard nutritional care without NSD intervention (n = 18). Interruption of EN infusion, appropriateness of parenteral nutrition (PN) prescription (based on American Society of Parenteral and Enteral Nutrition guidelines), and incidence of ventilator-associated pneumonia (VAP), as defined by the American College of Chest Physicians practice guidelines, were determined in each group. The NSD was successful in positioning the PPFT at or distal to the third portion of the duodenum in 83% of attempts. The PPFT group demonstrated no interruption of enteral feeding compared with 56% in the control group (p VAP in the PPFT group (6% vs 28%, p = .07). Of the PN initiations in the control group, 88% were deemed to be potentially avoidable; 6 of 8 PNs were initiated because of gastric residuals. Enteral nutrition facilitated by NSD placement of postpyloric feeding access is associated with improved tube feeding tolerance and reduced PN use. Further studies are needed to evaluate a possible effect of postpyloric feeding on the incidence of VAP.

  12. Team Performance Improvement: Mediating Roles of Employee Job Autonomy and Quality of Team Leader-Member Relations in Supportive Organizations in the Korean Business Context

    Science.gov (United States)

    Song, Ji Hoon

    2011-01-01

    The purpose of this research was to examine the mediating roles of job autonomy and the quality of the leader-member relationship to explain the impact of organizational support on team performance. A total of 228 cases collected from Korean business organizations were used for data analysis. Hierarchical multiple regression, Type 1 SS-based…

  13. Relationship between social support and the nutritional status of patients receiving radiation therapy for cancer

    International Nuclear Information System (INIS)

    Pulliam, L.W.

    1985-01-01

    The purpose of this descriptive, correlational study was to ascertain if there is a relationship between social support and the nutritional status of patients receiving radiation therapy for cancer. The data collection instruments used included the Norbeck Social Support Questionnaire (NSSQ), the Personal Characteristics Form, the abbreviated Health History, the Flow Sheet for Nutritional Data, and the Interview Schedule. For the analysis of data descriptive statistics were utilized to provide a profile of subjects, and correlational statistics were used to ascertain if there were relationships among the indicators of nutritional status and the social support variables. A convenience sample was comprised of 50 cancer patients deemed curable by radiation therapy. Findings included significant decreases in anthropometric measurements and biochemical tests during therapy. Serial assessments of nutritional status, therefore, are recommended for all cancer patients during therapy in order to plan and implement strategies for meeting the self-care requisites for food and water. No statistically significant relationships were found between the social support variables as measured by the NSSQ and the indicators of nutritional status. This suggests that nurses can assist patients by fostering support from actual and potential nutritional confidants

  14. Application of spiral nasointestinal tube in enteral nutrition support for patients with extensive burn

    Directory of Open Access Journals (Sweden)

    Lai-Ping Wang

    2016-09-01

    Full Text Available Objective: To observe the effect of spiral nasointestinal tube on enteral nutrition support in patients with extensive burn. Methods: A total of 60 patients with extensive burn who were admitted in our hospital from January, 2014 to June, 2015 were included in the study and divided into the observation group and the control group with 30 cases in each group according to different catheter indwelling methods. The patients in the observation group were given spiral nasointestinal tube for enteral nutrition support, while the patients in the control group were given routine gastric tube for enteral nutrition support. The nutrition status and the occurrence rate of complications before catheter indwelling, 3, 6, and 10 d after catheter indwelling in the two groups were recorded. Results: The levels of ALB, HB, PA, and Scr 6, 10 d after catheter indwelling in the observation group were significantly higher than those in the control group (P<0.05. The occurrence rate of complications during the treatment period in the observation group was significantly lower than that in the control group (P<0.05. Conclusions: The spiral nasointestinal tube can provide the patients with extensive burn a better effective enteral nutrition support and improve the nutrition support, with a lower occurrence rate of complications, which is beneficial for the patients’ rehabilitation.

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

    Science.gov (United States)

    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.

  16. Nutritional support as an obligatory component of accompanying therapy for head and neck tumors during radiotherapy and chemoradiotherapy

    Directory of Open Access Journals (Sweden)

    A. V. Boyko

    2017-01-01

    Full Text Available The article considers supportive therapy in patients with head and neck tumors during radiotherapy and chemoradiotherapy. Special attention is given to nutritional support on every stage of patient care. The main methods of evaluation of nutritional status and risks are presented, as well as principles of clinical nutrition selection.

  17. Nutritional support for treatment of hepatic lipidosis in a llama.

    Science.gov (United States)

    Van Saun, R J; Callihan, B R; Tornquist, S J

    2000-11-15

    A 3-year-old female llama that was 3 months into her first lactation and 10 weeks pregnant was evaluated for anorexia of 24 hours' duration. On physical examination, the llama was in lateral recumbency, bradycardic, tachypneic, and hyperthermic. Palpation per rectum confirmed the presence of a possible dry fecal mass in the spiral colon. A tissue biopsy specimen of the liver was obtained, and histologic examination revealed moderate diffuse lipid accumulation within the hepatocytes. Lactated Ringer's solution was administered for rehydration, and partial parenteral nutrition was then initiated. Hepatic lipidosis is a disease characterized by abnormal accumulation of lipid in the liver and is associated with high mortality in camelids. Anorexia associated with hepatic lipidosis promotes further lipid mobilization and fatty infiltration of the liver. Partial parenteral nutrition with enteral supplementation may be used to maintain adequate energy intake and minimize further lipid mobilization. The distinctive metabolism of camelids may require higher amino acid supplementation relative to nonprotein calories in parenteral solutions than those traditionally provided to other species. Treatment with insulin may be effective

  18. Evaluation of food provision and nutrition support at the London 2012 Olympic Games: the opinion of sports nutrition experts.

    Science.gov (United States)

    Pelly, Fiona; Meyer, Nanna L; Pearce, Jeni; Burkhart, Sarah J; Burke, Louise M

    2014-12-01

    The aim of this study was to evaluate the food provision and nutrition support at the London 2012 Olympic (OG) and Paralympic Games (PG) from the perspective of sports nutrition experts attending the event. Participants (n = 15) were asked to complete an online survey and rate on a Likert scale menu qualities, food safety, sustainability practices, nutrition labeling, and provision for cultural needs, dietary regimes and specific situations. Open-ended responses were incorporated to explore expert opinion and areas for improvement. Participants rated their overall experience of the food provision as 7.6 out of 10 (range 5 to 10), with the majority (n = 11) rating it greater than 7. The variety, accessibility, presentation, temperature, and freshness of menu items rated as average to good. A below average rating was received for recovery food and beverages, provision of food for traveling to other venues, taking suitable snacks out of the dining hall and provision of food at other venues. However, the variety and accessibility of choices for Ramadan, and provision of post-competition food were rated highly. A number of comments were received about the lack of gluten free and lower energy/fat items. The inclusion of allergens on nutrition labeling was considered more important than nutrient content. While dietetic review of the menu in advance of the OG and PG is clearly a valuable process that has resulted in improvements in the food supply, there are still areas that need to be addressed that are currently not implemented during the event.

  19. From words to action: visibility of management in supporting interdisciplinary team working in an acute rehabilitative geriatric hospital.

    Science.gov (United States)

    Buttigieg, Sandra C; Cassar, Vincent; Scully, Judy W

    2013-01-01

    The following case study aims to explore management's, health professionals' and patients' experiences on the extent to which there is visibility of management support in achieving effective interdisciplinary team working, which is explicitly declared in the mission statement of a 60-bed acute rehabilitative geriatric hospital in Malta. A total of 21 semi-structured interviews were conducted with the above-mentioned key stakeholders. Three main distinct yet interdependent themes emerged as a result of thematic analysis: "managing a team-friendly hospital", "interdisciplinary team components", and "interdisciplinary team processes". The findings show that visibility of management support and its alignment with the process and content levels of interdisciplinary teamwork are key to integrated care for acute rehabilitative geriatric patients. The emerging phenomena may not be reproducible in a different context; although many of the emerging themes could be comfortably matched with the existing literature. The implications are geared towards raising the consciousness and conscientiousness of good practice in interdisciplinary teamwork in hospitals, as well as in emphasizing organizational and management support as crucial factors for team-based organizations. Interdisciplinary teamwork in acute rehabilitative geriatrics provides optimal quality and integrated health care delivery with the aim that the older persons are successfully discharged back to the community. The authors draw on solid theoretical frameworks--the complexity theory, team effectiveness model and the social identity theory--to support their major finding, namely the alignment of organizational and management support with intra-team factors at the process and content level.

  20. Home Enteral Nutrition therapy: Difficulties, satisfactions and support needs of caregivers assisting older patients.

    Science.gov (United States)

    Jukic P, Nikolina; Gagliardi, Cristina; Fagnani, Donata; Venturini, Claudia; Orlandoni, Paolo

    2017-08-01

    The purpose of this study was to comprehend and describe the views, experiences and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition. The objective was to gather empirical evidence to improve the delivery of Home Enteral Nutrition for old patients taking into account the caregivers' support needs. A qualitative methodology with focus groups as data collection method was used to collect the testimonies of 30 informal and formal caregivers of older patients treated with Home Enteral Nutrition by the Clinical Nutrition Service of INRCA (Ancona) during 2014. Quantitative methodology was used to collect socio-demographic data. Partially modified Silver's "Home Enteral Nutrition Caregiver Task Checklist" was used to identify training needs. The constant comparison method was used to code and categorize data and to develop themes of focus groups. Simple descriptive statistics were used to summarize questionnaires. Five main themes were identified from focus groups: acceptance of the therapy, skill acquisition process, need for psychological and practical support at home from healthcare professionals, lifestyle adaptation, affirmation of life and family. All caregivers testified the initial fear and refusal to manage the nutrition pump and the therapy. They expressed the need to be trained gradually, starting during a patient's hospitalization, and continuing in the community. With reference to their overall QoL, it emerged that informal caregivers suffered mostly from the reduction of their free time while formal caregivers suffered social isolation and psychological burden. For both groups the monthly home visit was the most important element of the HEN service. Informal caregivers highlighted the importance of having their loved ones at home. Unsatisfied training needs were identified by the modified Silver's "Home Enteral Nutrition Caregiver Task Checklist". This qualitative study underlined the challenges and adaptations of

  1. The evidence for the use of nutritional support in liver disease.

    Science.gov (United States)

    Koretz, Ronald L

    2014-03-01

    Although there is a well established association between malnutrition and poorer clinical outcomes in patients with liver disease, that fact alone does not prove that improving the malnutrition will improve outcome. The best way to determine if nutritional interventions are effective is to compare them to untreated control groups in well designed and executed randomized clinical trials. A recent systematic review assessed 37 trials that compared parenteral nutrition, enteral nutrition, or nutritional supplements to no nutritional therapy in patients with a variety of liver diseases. Since the publication of that review, an additional three trials have become available. Whereas all but one of the trials did have methodologic shortcomings that may have allowed the introduction of bias (which usually results in an overestimation of benefit), the trials failed to show much, if any, benefit. In fact, the single trial at low risk of bias found that more deaths occurred in the recipients of the supplements. Although malnutrition may be associated with a poor outcome, the current best evidence indicates that the provision of adjunctive nutritional support (parenteral or enteral nutrition, or nutritional supplements) to patients with a variety of liver diseases (alcoholic hepatitis, cirrhosis, hepatocellular carcinoma, liver surgery, liver transplantation, obstructive jaundice, hepatitis C antiviral treatment) does not improve clinical outcomes.

  2. A socio-psychological perspective on team ambidexterity: The contingency role of supportive leadership behaviors

    NARCIS (Netherlands)

    Jansen, J.J.P.; Kostopoulos, K.C.; Mihalache, R.O.; Papalexandris, A

    2016-01-01

    In addressing the notion of team ambidexterity, we propose that socio-psychological factors (i.e., team cohesion and team efficacy) may help team members to resolve paradoxical challenges and to combine exploratory and exploitative learning efforts. In addition, we theorize that senior executives

  3. Study Protocol: Nutritional Support in a Cross-sector Model for the Rehabilitation of Geriatric Patients

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Rask, Kø; Leedo, Eva

    2014-01-01

    Background: Hospital stays are generally getting shorter which leaves limited time to improve a poor nutritional status for geriatric patients. Therefore, it seems necessary to integrate nutritional support also in the period after discharge. Furthermore, improving cross-sector cooperation...... support to geriatric patients. This may ultimately lead to reduced health care costs, and improvement in mobility, independence and quality of life for geriatric patients at nutritional risk. Trial registration: Clinical Trials.gov NCT01776762....... in the transition of geriatric patients between hospital and home-care institutions is essential to ensure follow-up and completion of hospital (nutritional) treatment and rehabilitation of patients. In spite of many issues, i.e. the multi-morbidity, the reduced level of functioning and the excessive use...

  4. Nutrition and food technology for a Controlled Ecological Life Support System (CELSS)

    Science.gov (United States)

    Glaser, P. E.; Mabel, J. A.

    1981-01-01

    Food technology requirements and a nutritional strategy for a Controlled Ecological Life Support System (CELSS) to provide adequate food in an acceptable form in future space missions are discussed. The establishment of nutritional requirements, dietary goals, and a food service system to deliver acceptable foods in a safe and healthy form and the development of research goals and priorities were the main objectives of the study.

  5. Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences

    OpenAIRE

    Locher, Julie L.; Ritchie, Christine S.; Roth, David L.; Baker, Patricia Sawyer; Bodner, Eric V.; Allman, Richard M.

    2005-01-01

    This study examines the relationships that exist between social isolation, support, and capital and nutritional risk in older black and white women and men. The paper reports on 1000 community-dwelling older adults aged 65 and older enrolled in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal observational study of mobility among older black and white participants in the USA. Black women were at greatest nutritional risk; and black women and men were the groups mos...

  6. Nutritional support of the elderly cancer patient: the role of the nurse.

    Science.gov (United States)

    Hopkinson, Jane B

    2015-04-01

    Cancer in the geriatric population is a growing problem. Malnutrition is common in cancer. A number of factors increase the risk for malnutrition in older people with cancer, including chronic comorbid conditions and normal physiological changes of aging. Nurses have an important role in the nutritional support of older cancer patients. To contribute to the improvement of nutritional support of these patients, nurses need appropriate training to be able to identify risk for malnutrition and offer a range of interventions tailored to individual need. Factors to consider in tailoring interventions include disease status, cancer site, cancer treatment, comorbidity, physiological age, method of facilitating dietary change, and family support. This article identifies ways in which nurses can contribute to the nutritional support of older cancer patients and thus help mitigate the effects of malnutrition. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Evaluation of three immobilization supports and two nutritional ...

    African Journals Online (AJOL)

    Polyurethane foam, Luffa cylindrica sponge and Ca-alginate (3% w/v) were evaluated as immobilization supports for removing reactive black 5 dye using the white rot fungus Trametes versicolor at 1, 4 and 8 days of colonization. According to statistical results, the L. cylindrica sponge was the best support at 4 days of ...

  8. Differences in quality standards when prescribing nutritional support: Differences between specialist and non-specialist physicians.

    Science.gov (United States)

    Morán López, Jesús Manuel; Piedra León, María; Enciso Izquierdo, Fidel Jesús; Luengo Pérez, Luis Miguel; Amado Señaris, José Antonio

    2016-01-01

    Adequate nutritional support includes many different aspects, but poor understanding of clinical nutrition by health care professionales often results in an inadequate prescription. A study was conducted to compare enteral and parenteral nutritional support plans prescribed by specialist and non-specialist physicians. Non-specialist physicians recorded anthropometric data from only 13.3% of patients, and none of them performed nutritional assessments. Protein amounts provided by non-specialist physicians were lower than estimated based on ESPEN (10.29g of nitrogen vs 14.62; Pspecialist group (14.88g of nitrogen; P=.072). Calorie and glutamine provision and laboratory controls prescribed by specialists were significantly closer to those recommended by clinical guidelines. Nutritional support prescribed by specialists in endocrinology and nutrition at San Pedro de Alcántara Hospital was closer to clinical practice guideline standards and of higher quality as compared to that prescribed by non-specialists. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  9. Beneficial Effect of the Nutritional Support in Children Who Underwent Hematopoietic Stem Cell Transplant.

    Science.gov (United States)

    Koç, Nevra; Gündüz, Mehmet; Tavil, Betül; Azik, M Fatih; Coşkun, Zeynep; Yardımcı, Hülya; Uçkan, Duygu; Tunç, Bahattin

    2017-08-01

    The aim of this study was to evaluate nutritional status in children who underwent hematopoietic stem cell transplant compared with a healthy control group. A secondary aim was to utilize mid-upper arm circumference as a measure of nutritional status in these groups of children. Our study group included 40 children (18 girls, 22 boys) with mean age of 9.2 ± 4.6 years (range, 2-17 y) who underwent hematopoietic stem cell transplant. Our control group consisted of 20 healthy children (9 girls, 11 boys). The children were evaluated at admission to the hospital and followed regularly 3, 6, 9, and 12 months after discharge from the hospital. In the study group, 27 of 40 patients (67.5%) received nutritional support during hematopoietic stem cell transplant, with 15 patients (56%) receiving enteral nutrition, 6 (22%) receiving total parenteral nutrition, and 6 (22%) receiving enteral and total parenteral nutrition. Chronic malnutrition rate in the study group was 47.5% on admission to the hospital, with the control group having a rate of 20%. One year after transplant, the rate decreased to 20% in the study group and 5% in the control group. The mid-upper arm circumference was lower in children in the study group versus the control group at the beginning of the study (P groups at follow-up examinations (P > .05). During follow-up, all anthropometric measurements increased significantly in both groups. Monitoring nutritional status and initiating appropriate nutritional support improved the success of hematopoietic stem cell transplant and provided a more comfortable process during the transplant period. Furthermore, mid-upper arm circumference is a more sensitive, useful, and safer parameter that can be used to measure nutritional status of children who undergo hematopoietic stem cell transplant.

  10. The effects of implementing a nutritional support algorithm in critically ill medical patients.

    Science.gov (United States)

    Sungur, Gonul; Sahin, Habibe; Tasci, Sultan

    2015-08-01

    To determine the effect of the enteral nutrition algorithm on nutritional support in critically ill medical patients. The quasi-experimental study was conducted at a medical Intensive Care Unit of a university hospital in central Anatolia region in Turkey from June to December 2008. The patients were divided into two equal groups: the historical group was fed in routine clinical applications, while the study group was fed according to the enteral nutritional algorithm. Prior to collecting data, nurses were trained interactively about enteral nutrition and the nutritional support algorithm. The nutrition of the study group was directed by the nurses. Data were recorded during 3 days of care. SPSS 22 was used for statistical analysis. The 40 patients in the study were divided into two equal groups of 20(50%) each. The energy intake of study group was 62% of the prescribed energy requirement on the 1st, 68.5% on the 2nd and 63% on the 3rd day, whereas in the historical group 38%, 56.5% and 60% of the prescribed energy requirement were met. The consumed energy of the historical group on the 1st 2nd and 3rd day was significantly different (p=0.020). In the study group, serum total protein and albumin levels decreased significantly (pgroup, any of the serum parameters did not change. Enteral nutrition-induced complications, duration of stay in intensive care unit were not significantly different between the groups (p>0.05). The use of standard algorithms for enteral nutrition may be an effective way to meet the nutritional requirements of patients.

  11. Effective Team Support: From Task and Cognitive Modeling to Software Agents for Time-Critical Complex Work Environments

    Science.gov (United States)

    Remington, Roger W. (Technical Monitor); John, Bonnie E.; Sycara, Katia

    2005-01-01

    The purpose of this research contract was to perform multidisciplinary research between CMU psychologists, computer scientists and NASA researchers to design a next generation collaborative system to support a team of human experts and intelligent agents. To achieve robust performance enhancement of such a system, we had proposed to perform task and cognitive modeling to thoroughly understand the impact technology makes on the organization and on key individual personnel. Guided by cognitively-inspired requirements, we would then develop software agents that support the human team in decision making, information filtering, information distribution and integration to enhance team situational awareness. During the period covered by this final report, we made substantial progress in completing a system for empirical data collection, cognitive modeling, and the building of software agents to support a team's tasks, and in running experiments for the collection of baseline data.

  12. Impact of a comprehensive supportive care team on management of hopelessly ill patients with multiple organ failure.

    Science.gov (United States)

    Field, B E; Devich, L E; Carlson, R W

    1989-08-01

    We developed a supportive care team for hopelessly ill patients in an urban emergency/trauma hospital. The team includes a clinical nurse specialist and a faculty physician as well as a chaplain and social worker. The supportive care team provides an alternative to intensive care or conventional ward management of hopelessly ill patients and concentrates on the physical and psychosocial comfort needs of patients and their families. We describe our experience with 20 hopelessly ill patients with multiple organ failure vs a similar group treated before the development of the supportive care team. Although there was no difference in mortality (100 percent), the length of stay in the medical ICU for patients with multiple organ failure decreased by 12 days to 6 days. Additionally, there were 50 percent fewer therapeutic interventions provided by the supportive care team vs intensive care or conventional ward treatment of multiple organ failure patients. We describe the methods that the supportive care team uses in an attempt to meet the physical and psychosocial comfort needs of hopelessly ill multiple organ failure patients and their families. This multidisciplinary approach to the care of the hopelessly ill may have applications in other institutions facing the ethical, medical, and administrative challenges raised by these patients.

  13. [Effect of positive nutritional support strategy on extrauterine growth restriction in preterm infants].

    Science.gov (United States)

    Wang, Xue-Min; Zhu, Yan-Ping; Wang, Li

    2013-12-01

    To investigate the effects of positive nutritional support in the early stage after birth on the nutritional status during hospitalization and extrauterine growth restriction (EUGR) in preterm infants. There were two groups of preterm infants. Group A (n=99) was given the previous nutritional program, while group B (n=101) was given positive nutritional support. The nutritional intake, growth rate and EUGR incidence were compared between the two groups. Compared with group A, group B had significantly higher enteral calorie intake and total calorie intake within one week after birth. Additionally, the age of first feeding, time of regaining birth weight, duration of intravenous nutrition, time to full enteral feeding, and length of hospital stay in group B were all shorter than in group A. Group B also had less physiological weight loss than group A. Among the preterm infants with a gestational age less than 32 weeks, group B had faster increases in body weight, head circumference, and body length and a lower incidence of EUGR compared with group A. Among the preterm infants with a gestational age not less than 32 weeks, group B had faster increases in body weight and a lower incidence of EUGR (evaluated based on body weight and head circumference) compared with group A. During hospitalization, group B had significantly lower incidence of feeding intolerance, necrotizing enterocolitis, and sepsis than group A. Positive nutritional support strategy, applied in preterm infants early after birth, can effectively improve their nutritional status during hospitalization and reduce the incidence of EUGR without increasing the incidence of related complications during hospitalization.

  14. The role of family nutritional support in Japanese patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Watanabe, Koin; Kurose, Takeshi; Kitatani, Naomi; Yabe, Daisuke; Hishizawa, Masahiro; Hyo, Takanori; Seino, Yutaka

    2010-01-01

    We investigated the role of family support in glycemic control by nutritional self-care behavior of Japanese patients with type 2 diabetes. One hundred twelve Japanese out-patients with type 2 diabetes were recruited for the study at Kansai Electric Power Hospital. Interviews were conducted and HbA1c and triglyceride levels were measured. HbA1c levels were significantly related to family nutritional support. Patients under 60 years old with family nutritional support showed significantly lower HbA1c than patients without family support (p1 week) showed similar outcomes in glycemic control. Patients who appreciate the support and follow the advice showed lower HbA1c (6.88 +/- 0.22%) than (7.43 +/- 0.23%) patients who appreciate the advice but sometimes feel emotional barriers. Family nutritional support is useful in improving metabolic outcome of diabetic patients. Self-care practice in disease management should be carefully adjusted to the family setting of type 2 diabetic patients. Emotional barriers to family support may affect the metabolic consequences, especially in the Japanese elderly.

  15. Development of the REFOCUS intervention to increase mental health team support for personal recovery.

    Science.gov (United States)

    Slade, Mike; Bird, Victoria; Le Boutillier, Clair; Farkas, Marianne; Grey, Barbara; Larsen, John; Leamy, Mary; Oades, Lindsay; Williams, Julie

    2015-12-01

    There is an emerging evidence base about best practice in supporting recovery. This is usually framed in relation to general principles, and specific pro-recovery interventions are lacking. To develop a theoretically based and empirically defensible new pro-recovery manualised intervention--called the REFOCUS intervention. Seven systematic and two narrative reviews were undertaken. Identified evidence gaps were addressed in three qualitative studies. The findings were synthesised to produce the REFOCUS intervention, manual and model. The REFOCUS intervention comprises two components: recovery-promoting relationships and working practices. Approaches to supporting relationships comprise coaching skills training for staff, developing a shared team understanding of recovery, exploring staff values, a Partnership Project with people who use the service and raising patient expectations. Working practices comprise the following: understanding values and treatment preferences; assessing strengths; and supporting goal-striving. The REFOCUS model describes the causal pathway from the REFOCUS intervention to improved recovery. The REFOCUS intervention is an empirically supported pro-recovery intervention for use in mental health services. It will be evaluated in a multisite cluster randomised controlled trial (ISRCTN02507940). © The Royal College of Psychiatrists 2015.

  16. UAVs Use for the Support of Emergency Response Teams Specific Missions

    Directory of Open Access Journals (Sweden)

    Sorin-Gabriel CONSTANTINESCU

    2013-03-01

    Full Text Available This article presents various methods of implementation for a new technology concerning the assessment and coordination of emergency situations, which is based upon the usage of Unmanned Aerial Vehicles (UAVs. The UAV platform is equipped with optical electronic sensors and other types of sensors, being an aerial surveillance device as efficient as any other classically piloted platform. While currently being in service as military operations support for various operation theaters, they can also be used for assisting emergency response teams, providing full national coverage. For these special response teams, the ability to carry out overview, surveillance or information gathering activities and locating fixed or mobile targets are key components for the successful accomplishment of their missions, which have the purpose of saving lives and properties and of limiting the damage done to the surrounding environment. More concretely, the presented scenarios are: response in emergency situations, extinguishing of large-scale fires, testing of chemically, biologically or radioactively polluted areas and assessment of natural disasters.

  17. Improving care in care homes: a qualitative evaluation of the Croydon care home support team.

    Science.gov (United States)

    Lawrence, Vanessa; Banerjee, Sube

    2010-05-01

    The Croydon care home support team (CHST) was developed in response to reports of patient abuse within long-term care. It presents a novel strategy for improving standards of care within care homes. A qualitative methodology was used to assess the perceived impact of the CHST. In-depth interviews were conducted with 14 care home managers and 24 members of care home staff across 14 care homes. Grounded theory principles guided the collection and analysis of the data. Reports of improved communication between staff, improved staff development and confidence, and improved quality of care point towards the effectiveness of the CHST model. The collaborative approach of the CHST was considered pivotal to its success and presented as an effective method of engaging care home managers and staff. The CHST adopted a systemic approach that placed an equal emphasis on the social, mental health and nursing needs of residents and aimed to address the whole culture of care within the individual homes. The data demonstrate the potential for specialist multi-disciplinary teams to raise standards of care across long-term care settings. Increased awareness of safeguarding issues, improved staff morale and communication and ongoing opportunities for discussion and problem solving promised to sustain improvements. Such services could be instrumental in meeting the government priority of preventing abuse among vulnerable adults.

  18. Are You Talking to Me? Dialogue Systems Supporting Mixed Teams of Humans and Robots

    Science.gov (United States)

    Dowding, John; Clancey, William J.; Graham, Jeffrey

    2006-01-01

    This position paper describes an approach to building spoken dialogue systems for environments containing multiple human speakers and hearers, and multiple robotic speakers and hearers. We address the issue, for robotic hearers, of whether the speech they hear is intended for them, or more likely to be intended for some other hearer. We will describe data collected during a series of experiments involving teams of multiple human and robots (and other software participants), and some preliminary results for distinguishing robot-directed speech from human-directed speech. The domain of these experiments is Mars-analogue planetary exploration. These Mars-analogue field studies involve two subjects in simulated planetary space suits doing geological exploration with the help of 1-2 robots, supporting software agents, a habitat communicator and links to a remote science team. The two subjects are performing a task (geological exploration) which requires them to speak with each other while also speaking with their assistants. The technique used here is to use a probabilistic context-free grammar language model in the speech recognizer that is trained on prior robot-directed speech. Intuitively, the recognizer will give higher confidence to an utterance if it is similar to utterances that have been directed to the robot in the past.

  19. An Action-Learning Model to Assist Circuit Teams to Support School Management Teams towards Whole-School Development

    Science.gov (United States)

    Van Der Vort, Geoffrey; Wood, Lesley

    2016-01-01

    The Education District and Circuit Offices in South Africa are mandated by the Department of Basic Education to support schools under their jurisdiction. Reasons for the lack of such support to schools have been highlighted in various reports and research findings. This paper examines the role that properly constructed school improvement plans,…

  20. Optimizing the Nutritional Support of Adult Patients in the Setting of Cirrhosis.

    Science.gov (United States)

    Perumpail, Brandon J; Li, Andrew A; Cholankeril, George; Kumari, Radhika; Ahmed, Aijaz

    2017-10-13

    The aim of this work is to develop a pragmatic approach in the assessment and management strategies of patients with cirrhosis in order to optimize the outcomes in this patient population. A systematic review of literature was conducted through 8 July 2017 on the PubMed Database looking for key terms, such as malnutrition, nutrition, assessment, treatment, and cirrhosis. Articles and studies looking at associations between nutrition and cirrhosis were reviewed. An assessment of malnutrition should be conducted in two stages: the first, to identify patients at risk for malnutrition based on the severity of liver disease, and the second, to perform a complete multidisciplinary nutritional evaluation of these patients. Optimal management of malnutrition should focus on meeting recommended daily goals for caloric intake and inclusion of various nutrients in the diet. The nutritional goals should be pursued by encouraging and increasing oral intake or using other measures, such as oral supplementation, enteral nutrition, or parenteral nutrition. Although these strategies to improve nutritional support have been well established, current literature on the topic is limited in scope. Further research should be implemented to test if this enhanced approach is effective.

  1. Optimizing the Nutritional Support of Adult Patients in the Setting of Cirrhosis

    Directory of Open Access Journals (Sweden)

    Brandon J. Perumpail

    2017-10-01

    Full Text Available Aim: The aim of this work is to develop a pragmatic approach in the assessment and management strategies of patients with cirrhosis in order to optimize the outcomes in this patient population. Method: A systematic review of literature was conducted through 8 July 2017 on the PubMed Database looking for key terms, such as malnutrition, nutrition, assessment, treatment, and cirrhosis. Articles and studies looking at associations between nutrition and cirrhosis were reviewed. Results: An assessment of malnutrition should be conducted in two stages: the first, to identify patients at risk for malnutrition based on the severity of liver disease, and the second, to perform a complete multidisciplinary nutritional evaluation of these patients. Optimal management of malnutrition should focus on meeting recommended daily goals for caloric intake and inclusion of various nutrients in the diet. The nutritional goals should be pursued by encouraging and increasing oral intake or using other measures, such as oral supplementation, enteral nutrition, or parenteral nutrition. Conclusions: Although these strategies to improve nutritional support have been well established, current literature on the topic is limited in scope. Further research should be implemented to test if this enhanced approach is effective.

  2. Influence of aggressive nutritional support on growth and development of very low birth weight infants.

    Science.gov (United States)

    Xu, Y M; Zhu, X P; Xiao, Z; Yu, L; Zhao, X

    2014-01-01

    To investigate the influence of the early postnatal aggressive nutritional support on the very low birth weight infants (VLBWI) during hospitalization. Surviving premature infants without obvious deformity, with gestational age more than 28 weeks and less than 32 weeks, birth weight 1,000 g to 1,500 g, admitted in NICU in Affiliated Children's Hospital of Suzhou University during 12 hours after birth and stay for two weeks or more from January 2008 to December 2011 were selected, including 44 cases (admitted from September 2010 to December 2011) in the observation group and 36 cases in the control group (admitted from January 2008 and September 2010). The infants in the observation group were treated by aggressive nutritional management, while traditional nutritional management for infants in the control group. The variations of nutritional intake, weight gain, jaundice index, blood biochemistry, serum electrolytes indexes, and complications were compared between the two groups. Compared to the control group, the average growth rate and the albumin (ALB) and prealbumin (PA) levels two week after birth and before leaving hospital of the infants in the observation group was significantly higher (p nutrition, liver function, blood lipid levels, blood glucose, blood PH, serum creatinine, urea nitrogen, and electrolytes of the first day and the seventh day after birth and the in- cidence of parenteral nutrition-associated cholestasis (PNAC) and necrotizing enterocolitis (NEC) between the two group had no difference (p > 0.05). The implementation of aggressive nutritional management on the with VLBWI was safe and effective.

  3. Nutrition

    Science.gov (United States)

    ... of States, Districts, and Schools That Required Teaching Nutrition and Dietary Behavior, by School Level 100 80 60 40 20 0 72. ... no comparable variable existed in both survey years. Nutrition Services • 68.6% of schools offered breakfast to students and 63.0% participated ...

  4. Dietitian-observed macronutrient intakes of young skill and team-sport athletes: adequacy of pre, during, and postexercise nutrition.

    Science.gov (United States)

    Baker, Lindsay B; Heaton, Lisa E; Nuccio, Ryan P; Stein, Kimberly W

    2014-04-01

    Sports nutrition experts recommend that team-sport athletes participating in intermittent high-intensity exercise for ≥1 hr consume 1-4 g carbohydrate/kg 1-4 hr before, 30-60 g carbohydrate/hr during, and 1-1.2 g carbohydrate/kg/hr and 20-25 g protein as soon as possible after exercise. The study objective was to compare observed vs. recommended macronutrient intake of competitive athletes under free-living conditions. The dietary intake of 29 skill/team-sport athletes (14-19 y; 22 male, 7 female) was observed at a sports training facility by trained registered dietitians for one 24-hr period. Dietitians accompanied subjects to the cafeteria and field/court to record their food and fluid intake during meals and practices/competitions. Other dietary intake within the 24-hr period (e.g., snacks during class) was accounted for by having the subject take a picture of the food/fluid and completing a log. For male and female athletes, respectively, the mean ± SD (and percent of athletes meeting recommended) macronutrient intake around exercise was 1.4 ± 0.6 (73%) and 1.4 ± 1.0 (57%) g carbohydrate/kg in the 4 hr before exercise, 21.1 ± 17.2 (18%) and 18.6 ± 13.2 (29%) g carbohydrate/hrr during exercise, 1.4±1.1 (68%) and 0.9± 1.0 (43%) g carbohydrate/kg and 45.2 ± 36.9 (73%) and 18.0 ± 21.2 (43%) g protein in the 1 hr after exercise. The male athletes' carbohydrate and protein intake more closely approximated recommendations overall than that of the female athletes. The most common shortfall was carbohydrate intake during exercise, as only 18% of male and 29% of female athletes consumed 3060 g carbohydrate/hr during practice/competition.

  5. Technophiles to Newbies: The Challenge of Supporting Distributed Teams to Maintain Engagement in Virtual Worlds

    Science.gov (United States)

    Griffith, Karen

    2011-01-01

    The purpose of this paper is to look for links in a virtual trainee's interest and self-efficacy in a simulated event as it relates to their previous self-reported technical skill level. Ultimately, the idea would be to provide the right amount of support at the right place at the right time to set the conditions for maximum transfer of the skill sets to the work place. An anecdotal recap of a recent experiment of a medium-scale training event produced in a virtual world will provide examples for discussion. In July 2010, a virtual training event was produced for the Air Force Research Lab's Games for Team Training (GaMeTT) at the Patriot Exercise at Volk Field in Wisconsin. There were 29 EMEDS participants who completed the simulated OCO event using the OLIVE gaming engine. Approximately 25 avatars were present at any given time; including role players, observers, coordinators and participants.

  6. Understanding and Supporting Dynamic Capabilities of Design Teams in Production of Technology-Innovation

    DEFF Research Database (Denmark)

    Jensen, Ole Kjeldal

    Rapid adaptation to a changing environment is essential for the survival of incumbent companies, but the capabilities required to lead the disruption of a technological trajectory are generally challenged by the process management activities that make the company operate efficiently within its...... current environment. This study explores the practices of engineering designers that are executing disruptive innovation projects for DONG Energy, a Danish energy utilities company. The aim of the study was to understand the role of the designer in disruptive innovation and to create a tool for supporting...... multidisciplinary design teams, while creating disruptive innovations. The results from this study are presented in five research Papers that address the following themes: 1) the willingness of engineers to follow formal procedures, 2) critical knowledge domains in front-end technology decisions, 3) knowledge...

  7. Identifying the Types of Support Needed by Interprofessional Teams Providing Pediatric End-of-Life Care: A Thematic Analysis.

    Science.gov (United States)

    Riotte, Clare O; Kukora, Stephanie K; Keefer, Patricia M; Firn, Janice I

    2018-04-01

    Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.

  8. Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals.

    Science.gov (United States)

    Banks, M D; Graves, N; Bauer, J D; Ash, S

    2013-01-01

    This study estimates the economic outcomes of a nutrition intervention to at-risk patients compared with standard care in the prevention of pressure ulcer. Statistical models were developed to predict 'cases of pressure ulcer avoided', 'number of bed days gained' and 'change to economic costs' in public hospitals in 2002-2003 in Queensland, Australia. Input parameters were specified and appropriate probability distributions fitted for: number of discharges per annum; incidence rate for pressure ulcer; independent effect of pressure ulcer on length of stay; cost of a bed day; change in risk in developing a pressure ulcer associated with nutrition support; annual cost of the provision of a nutrition support intervention for at-risk patients. A total of 1000 random re-samples were made and the results expressed as output probability distributions. The model predicts a mean 2896 (s.d. 632) cases of pressure ulcer avoided; 12, 397 (s.d. 4491) bed days released and corresponding mean economic cost saving of euros 2 869 526 (s.d. 2 078 715) with a nutrition support intervention, compared with standard care. Nutrition intervention is predicted to be a cost-effective approach in the prevention of pressure ulcer in at-risk patients.

  9. Providing nutritional support to patients with thoracic cancer: findings of a dedicated rehabilitation service.

    Science.gov (United States)

    Percival, Cheryl; Hussain, Asmah; Zadora-Chrzastowska, Sonja; White, Gillian; Maddocks, Matthew; Wilcock, Andrew

    2013-05-01

    National guidelines recommend screening patients with thoracic cancer to identify those requiring nutritional support. To help quantify this area of need, the associated workload and explore its impact, we report findings from a dedicated rehabilitation service. Patients were screened soon after diagnosis to determine the prevalence of malnutrition, and various aspects compared between malnourished and not malnourished groups. A nutritional care plan was instigated and all contacts recorded, together with follow-up body weight. Of 243 patients seen, 35% were malnourished which was associated with a palliative treatment intent (P group received oral nutritional supplements, but also experienced problems tolerating them. Over one month, neither the pattern nor magnitude of the change in weight differed between malnourished and not malnourished groups. Overall, weight was stable, increased or decreased in 52 (27%), 80 (42%) and 59 (31%) respectively, with no difference in overall survival (P = 0.16). Our data provides a pragmatic insight into the implications of following national guidance on nutritional screening and support in this patient group. Nutritional support failed to prevent weight loss in some patients, and did not appear to impact on survival; new assessments and treatments for cachexia are required. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Effect of early nutrition support on postoperative rehabilitation in patients with oral cancer

    Directory of Open Access Journals (Sweden)

    Xing-An Zhang

    2016-08-01

    Full Text Available Objective: To explore the effect of early nutrition support on the postoperative nutrition metabolism and rehabilitation in patients with oral cancer. Methods: A total of 80 patients with oral cancer who were admitted in our hospital from January, 2013 to January, 2015 were included in the study, and divided into the observation group (early nutrition support and control group (routine treatments with 40 cases in each group. The postoperative basic nutrition requirement amount in the observation group was calculated according to HarrisNenedict formula. The appropriate pharmaceutics and nutritional pathway were selected. The patients in the control group were given routine diets after operation. The levels of ALB, PAB, TRF, TCL, IgM, IgG, and IgA before and after operation in the two groups were compared. The body mass and wound healing in the two groups were recorded and compared. Results: The body mass and serum TRF level after operation in the observation group were slightly reduced, but were not significantly different from those before operation (P>0.05. The serum ALB, PAB, and TLC levels after operation in the observation group were significantly reduced when compared with before operation (P0.05, but the above indicators were significantly elevated after operation (P<0.05. The peripheral blood IgM, IgG, and IgA levels 1 week after operation in the observation group were significantly higher than those in the control group (P<0.05. The stage I healing rate of the surgical wound in the observation group was significantly higher than that in the control group (P<0.05. Conclusions: The early nutrition support can effectively enhance the postoperative nutrition status and immunological function in patients with oral cancer, and is beneficial for the postoperative rehabilitation.

  11. Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study.

    Science.gov (United States)

    Rio, Alan; Whelan, Kevin; Goff, Louise; Reidlinger, Dianne Patricia; Smeeton, Nigel

    2013-01-11

    Refeeding syndrome is a potentially life-threatening condition characterised by severe intracellular electrolyte shifts, acute circulatory fluid overload and organ failure. The initial symptoms are non-specific but early clinical features are severely low-serum electrolyte concentrations of potassium, phosphate or magnesium. Risk factors for the syndrome include starvation, chronic alcoholism, anorexia nervosa and surgical interventions that require lengthy periods of fasting. The causes of the refeeding syndrome are excess or unbalanced enteral, parenteral or oral nutritional intake. Prevention of the syndrome includes identification of individuals at risk, controlled hypocaloric nutritional intake and supplementary electrolyte replacement. To determine the occurrence of refeeding syndrome in adults commenced on artificial nutrition support. Prospective cohort study. Large, single site university teaching hospital. Recruitment period 2007-2009. 243 adults started on artificial nutrition support for the first time during that admission recruited from wards and intensive care. occurrence of the refeeding syndrome. Secondary outcome: analysis of the risk factors which predict the refeeding syndrome. Tertiary outcome: mortality due to refeeding syndrome and all-cause mortality. 133 participants had one or more of the following risk factors: body mass index 15% in the preceding 3-6 months, very little or no nutritional intake >10 days, history of alcohol or drug abuse and low baseline levels of serum potassium, phosphate or magnesium prior to recruitment. Poor nutritional intake for more than 10 days, weight loss >15% prior to recruitment and low-serum magnesium level at baseline predicted the refeeding syndrome with a sensitivity of 66.7%: specificity was >80% apart from weight loss of >15% which was 59.1%. Baseline low-serum magnesium was an independent predictor of the refeeding syndrome (p=0.021). Three participants (2% 3/243) developed severe electrolyte shifts

  12. A methodology for system-of-systems design in support of the engineering team

    Science.gov (United States)

    Ridolfi, G.; Mooij, E.; Cardile, D.; Corpino, S.; Ferrari, G.

    2012-04-01

    Space missions have experienced a trend of increasing complexity in the last decades, resulting in the design of very complex systems formed by many elements and sub-elements working together to meet the requirements. In a classical approach, especially in a company environment, the two steps of design-space exploration and optimization are usually performed by experts inferring on major phenomena, making assumptions and doing some trial-and-error runs on the available mathematical models. This is done especially in the very early design phases where most of the costs are locked-in. With the objective of supporting the engineering team and the decision-makers during the design of complex systems, the authors developed a modelling framework for a particular category of complex, coupled space systems called System-of-Systems. Once modelled, the System-of-Systems is solved using a computationally cheap parametric methodology, named the mixed-hypercube approach, based on the utilization of a particular type of fractional factorial design-of-experiments, and analysis of the results via global sensitivity analysis and response surfaces. As an applicative example, a system-of-systems of a hypothetical human space exploration scenario for the support of a manned lunar base is presented. The results demonstrate that using the mixed-hypercube to sample the design space, an optimal solution is reached with a limited computational effort, providing support to the engineering team and decision makers thanks to sensitivity and robustness information. The analysis of the system-of-systems model that was implemented shows that the logistic support of a human outpost on the Moon for 15 years is still feasible with currently available launcher classes. The results presented in this paper have been obtained in cooperation with Thales Alenia Space—Italy, in the framework of a regional programme called STEPS. STEPS—Sistemi e Tecnologie per l'EsPlorazione Spaziale is a research

  13. [Nutritional support response in critically ill patients; differences between medical and surgical patients].

    Science.gov (United States)

    Zamora Elson, M; Serón Arbeloa, C; Labarta Monzón, L; Garrido Ramírez de Arellano, I; Lander Azcona, A; Marquina Lacueva, M I; López Claver, J C; Escós Orta, J

    2012-01-01

    To assess the nutritional response of a group of critically ill patients, as well as the differences in the response to nutritional support between medical and surgical patients. One-year long retrospective study including critically ill patients on artificial nutrition for 7 days. Throughout the first week, three nutritional biochemical controls were done that included albumin, prealbumin, transferrin, cholesterol, and electrolytes. Other data gathered were: nutritional risk index, age, gender, weight, height, APACHE, delay of onset of nutritional support, access route, predicted and real caloric intake, medical or surgical patient, hospital stay, duration of the central venous catheter, urinary tube, and/or mechanical ventilation, incidence and density of incidence of nosocomial infections. Sixty-three patients were studied, 30 (47%) medical and 33 (53%) surgical/trauma patients, with a usage of EN higher among medical patients (16/30, 53% vs. 5/33, 15%), PN higher among surgical patients (25/33, 76%), and mixed nutrition similar in both groups (5 medical and 3 surgical patients) (p = 0.001). There were no differences between medical and surgical patients regarding: both predicted and real caloric and nitrogenous intake, APACHE, delay of onset of nutrition, phosphorus, magnesium or glucose levels, mortality and incidence of nosocomial infections. There were no differences either in hospital stay or use of mechanical ventilation, although these tended to be lower in surgical patients. The baseline biochemical parameters did not show differences between both groups, although they were worse among surgical patients. These patients presented during the study period steady albumin levels with improvement in the remaining parameters, whereas medical patients showed a decrease in albumin and transferrin levels, steady prealbumin levels, and slightly improvement in cholesterol levels. We have observed higher usage of PN among surgical patients, which showed worse

  14. Multidisciplinary nutritional support for undernutrition in nursing home and home-care

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe

    2016-01-01

    Objective To assess the effect of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care identified with the validated Eating Validation Scheme (EVS). Methods An 11 wk cluster randomized trial with a home-care (3 clusters) or nursing home (3 clusters.......3] versus 1.3 [0.5], P = 0.021) was observed. There was a almost significant difference in mortality (2% versus 13%, P = 0.079). Conclusions Multidisciplinary nutritional support in older adults in nursing home and home-care could have a positive effect on quality of life, muscle strength, and oral care....... means of EuroQol-5D-3L), physical performance (30-seconds chair stand), nutritional status (weight and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (participants from home-care), and mortality. Results Respectively, 55 (46 from 2 home...

  15. Can Hypocaloric, High-Protein Nutrition Support Be Used in Complicated Bariatric Patients to Promote Weight Loss?

    Science.gov (United States)

    Beebe, Mara Lee; Crowley, Nina

    2015-08-01

    Bariatric surgery, an effective treatment for morbid obesity, may result in complications that require nutrition support. Common goals for nutrition support in post-bariatric surgery patients include nutrition repletion, avoiding overfeeding, preserving lean body mass, and promoting wound healing. It is often questioned if continued weight loss can be part of the nutrition goals and if weight loss is safe for patients who become critically ill following bariatric surgery. Recent clinical practice guidelines from both the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and Society of Critical Care Medicine (SCCM) have recommended the use of hypocaloric, high-protein nutrition support in both critically and non-critically ill obese patients. Hypocaloric feedings of 50%-70% of estimated energy requirements based on predictive equations or obesity. Two small studies in complicated post-bariatric surgery patients requiring nutrition support have shown that the strategy of hypocaloric, high-protein feedings can result in positive outcomes, including positive nitrogen balance, wound healing, weight loss, and successful transition to oral diets. Additional research, including large, randomized studies, is still needed to validate these findings. However, based on a review of available clinical practice guidelines, predictive equations, indirect calorimetry, case studies, and systematic reviews, hypocaloric, high-protein nutrition support appears to at least be equal to eucaloric feedings and may be a useful tool for clinicians to achieve continued weight loss in complicated bariatric surgery patients requiring nutrition support. © 2015 American Society for Parenteral and Enteral Nutrition.

  16. Fathers' encounter of support from paediatric diabetes teams; the tension between general recommendations and personal experience.

    Science.gov (United States)

    Boman, Ase; Povlsen, Lene; Dahlborg-Lyckhage, Elisabeth; Hanas, Ragnar; Borup, Ina

    2013-05-01

    The purpose of this grounded theory study was to explore and discuss how fathers involved in caring for a child with type 1 diabetes experienced support from Swedish paediatric diabetes teams (PDTs) in everyday life with their child. Eleven fathers of children with type 1 diabetes, living in Sweden and scoring high on involvement on the Parental Responsibility Questionnaire, participated. Data were collected from January 2011 to August 2011, initially through online focus group discussions in which 6 of 19 invited fathers participated. Due to high attrition, the data collection continued in eight individual interviews. A semi-structured interview guide was used, and the fathers were asked to share experiences of their PDT's support in everyday life with their child. A simultaneous and constant comparison approach to data collection and analysis allowed the core category to emerge: the tension between general recommendations and personal experience. This core category illuminates how the fathers experienced tension between managing their unique everyday life with their child and balancing this to meet their PDT's expectations with regard to blood glucose levels. The core category was supported by two categories: the tension between the fathers'and their PDT's knowledge, whereby fathers reported discrepancies between their PDT's medical knowledge and their own unique knowledge of their child; and the tension between the fathers'and their PDT's goals, whereby the fathers identified differences between the family's and their PDT's goals. As a dimension of the core category, fathers felt trust or distrust in their PDT. We conclude that to achieve high-quality support for children with diabetes and to enhance their health and well-being, involved fathers' knowledge of their unique family situation needs to be integrated into the diabetes treatment. © 2012 Blackwell Publishing Ltd.

  17. Impact of implant-supported prostheses on nutritional status and oral health perception in edentulous patients.

    Science.gov (United States)

    El Osta, Nada; El Osta, Lana; Moukaddem, Farah; Papazian, Tatiana; Saad, Robert; Hennequin, Martine; Rabbaa Khabbaz, Lydia

    2017-04-01

    Improvement of nutritional status and perception of oral health are supposed to be different with complete conventional denture or implant-supported fixed or removable prostheses. Since no study has been conducted in Lebanon, the aim of our study was to assess the nutritional status and oral heath related quality of life (OHRQoL) in totally edentulous patients after treatment with complete denture or implant supported-prostheses. This was an observational clinical prospective study. A convenient sample of Lebanese people aged 60 years or more was selected between September 2013 and July 2015 from the Departments of removable and fixed prosthesis at Saint-Joseph University of Beirut. The treatment options included complete denture, implant-supported complete denture and implant-supported fixed prostheses. Nutritional status and OHRQoL were assessed with the Mini-Nutritional Assessment Index (MNA) and the Geriatric Oral Health Assessment Index (GOHAI) respectively at Baseline (first visit before treatment), 2-3 weeks after treatment (t1), 3 months (t2) and 6 months (t3) after treatment. Fifty-one participants (mean age: 69.39 ± 7.164 years) were included. The results have shown an improvement over time in nutritional status and OHRQoL for all treatment groups. However, 2-3 weeks after treatment the number of participants at risk of malnutrition was higher with complete removable denture, intermediate with implant-supported complete denture and lower with implant-supported fixed prostheses (p-value = 0.049). Moreover, the mean GOHAI score was significantly lower over time with complete removable denture compared to implant-supported prostheses (p-value nutritional status for implant supported-prostheses compared to conventional removable dentures. Therefore, it is fundamental that dentists communicate with their patients about implant treatment to understand their expectations, to explain the outcomes and achieve the desired clinical result. Copyright © 2017

  18. A fuzzy logic decision support system for assessing clinical nutritional risk

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Hadianfard

    2015-04-01

    Full Text Available Introduction: Studies have indicated a global high prevalence of hospital malnutrition on admission and during hospitalization. Clinical Nutritional Risk Screen (CNRS is a way to identify malnutrition and manage nutritional interventions. Several traditional and non-computer based tools have been suggested for screening nutritional risk levels. The present study was an attempt to employ a computer based fuzzy model decision support system as a nutrition-screening tool for inpatients. Method: This is an applied modeling study. The system architecture was designed based on the fuzzy logic model including input data, inference engine, and output. A clinical nutritionist entered nineteen input variables using a windows-based graphical user interface. The inference engine was involved with knowledge obtained from literature and the construction of ‘IF-THEN’ rules. The output of the system was stratification of patients into four risk levels from ‘No’ to ‘High’ where a number was also allocated to them as a nutritional risk grade. All patients (121 people admitted during implementing the system participated in testing the model. The classification tests were used to measure the CNRS fuzzy model performance. IBM SPSS version 21 was utilized as a tool for data analysis with α = 0.05 as a significance level. Results: Results showed that sensitivity, specificity, accuracy, and precision of the fuzzy model performance were 91.67% (±4.92, 76% (±7.6, 88.43% (±5.7, and 93.62% (±4.32, respectively. Instant performance on admission and very low probability of mistake in predicting malnutrition risk level may justify using the model in hospitals. Conclusion: To conclude, the fuzzy model-screening tool is based on multiple nutritional risk factors, having the capability of classifying inpatients into several nutritional risk levels and identifying the level of required nutritional intervention.

  19. Real-time support of pediatric diabetes self-care by a transport team.

    Science.gov (United States)

    Franklin, Brandi E; Crisler, S Crile; Shappley, Rebekah; Armour, Meri M; McCommon, Dana T; Ferry, Robert J

    2014-01-01

    OBJECTIVE The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. RESEARCH DESIGN AND METHODS The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis (DKA) and cost savings generated from reduced referrals to the emergency department (ED) and on-call endocrinologist. We generated descriptive statistics to characterize the study population and ED visits for DKA and constructed logistic regression models to examine associations of pager use and likelihood of ED visitation and nonelective inpatient admission from an ED for DKA. RESULTS Pager users comprised 30% of the patient population. They were younger but had more established diabetes than nonusers. While pager users were 2.75 times more likely than nonusers to visit the ED for DKA (P management models supported by allied health personnel.

  20. Real-Time Support of Pediatric Diabetes Self-Care by a Transport Team

    Science.gov (United States)

    Franklin, Brandi E.; Crisler, S. Crile; Shappley, Rebekah; Armour, Meri M.; McCommon, Dana T.; Ferry, Robert J.

    2014-01-01

    OBJECTIVE The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. RESEARCH DESIGN AND METHODS The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis (DKA) and cost savings generated from reduced referrals to the emergency department (ED) and on-call endocrinologist. We generated descriptive statistics to characterize the study population and ED visits for DKA and constructed logistic regression models to examine associations of pager use and likelihood of ED visitation and nonelective inpatient admission from an ED for DKA. RESULTS Pager users comprised 30% of the patient population. They were younger but had more established diabetes than nonusers. While pager users were 2.75 times more likely than nonusers to visit the ED for DKA (P management models supported by allied health personnel. PMID:23959568

  1. Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing.

    Science.gov (United States)

    Cereda, Emanuele; Klersy, Catherine; Andreola, Manuela; Pisati, Roberto; Schols, Jos M G A; Caccialanza, Riccardo; D'Andrea, Federico

    2017-02-01

    The Oligo Element Sore Trial has shown that supplementation with a disease-specific nutritional formula enriched with arginine, zinc, and antioxidants improves pressure ulcer (PU) healing in malnourished patients compared to an isocaloric-isonitrogenous support. However, the use of such a nutritional formula needs to be supported also by a cost-effectiveness evaluation. This economic evaluation - from a local healthcare system perspective - was conducted alongside a multicenter, randomized, controlled trial following a piggy-back approach. The primary efficacy endpoint was the percentage of change in PU area at 8 weeks. The cost analysis focused on: the difference in direct medical costs of local PU care between groups and incremental cost-effectiveness ratio (ICER) of nutritional therapy related to significant study endpoints (percentage of change in PU area and ≥40% reduction in PU area at 8 weeks). Although the experimental formula was more expensive (mean difference: 39.4 Euros; P costs of local PU care (difference, -74.3 Euros; P = 0.013). Therefore, given its efficacy it proved to be a cost-effective intervention. The robustness of these results was confirmed by the sensitivity analyses. The use of a disease-specific oral nutritional formula not only results in better healing of PUs, but also reduces the costs of local PU care from a local healthcare system perspective. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  2. Proteins and amino acids are fundamental to optimal nutrition support in critically ill patients

    NARCIS (Netherlands)

    Weijs, P.J.M.; Cynober, L.; DeLegge, M.; Kreymann, G.; Wernerman, J.; Wolfe, R.R.

    2014-01-01

    Proteins and amino acids are widely considered to be subcomponents in nutritional support. However, proteins and amino acids are fundamental to recovery and survival, not only for their ability to preserve active tissue (protein) mass but also for a variety of other functions. Understanding the

  3. Significant Published Articles for Pharmacy Nutrition Support Practice in 2014 and 2015.

    Science.gov (United States)

    Dickerson, Roland N; Kumpf, Vanessa J; Blackmer, Allison B; Bingham, Angela L; Tucker, Anne M; Ybarra, Joseph V; Kraft, Michael D; Canada, Todd W

    2016-07-01

    To assist the pharmacy clinician engaged in nutrition support in staying current with the most pertinent literature. Several experienced board-certified clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2014 and 2015 that they considered to be important to their practice. Only those articles available in print format were considered for potential inclusion. Articles available only in preprint electronic format were not evaluated. The citation list was compiled into a single spreadsheet where the author participants were asked to ascertain whether they considered the paper important to nutrition support pharmacy practice. A culled list of publications was then identified whereby the majority of author participants (at least 5 out of 8) considered the paper to be important. A total of 108 articles were identified; 36 of which were considered to be of high importance. An important guideline article published in early 2016, but not ranked, was also included. The top-ranked articles from the primary literature were reviewed. It is recommended that the informed pharmacist, who is engaged in nutrition support therapy, be familiar with the majority of these articles.

  4. Six Characteristics of Nutrition Education Videos That Support Learning and Motivation to Learn

    Science.gov (United States)

    Ramsay, Samantha A.; Holyoke, Laura; Branen, Laurel J.; Fletcher, Janice

    2012-01-01

    Objective: To identify characteristics in nutrition education video vignettes that support learning and motivation to learn about feeding children. Methods: Nine focus group interviews were conducted with child care providers in child care settings from 4 states in the western United States: California, Idaho, Oregon, and Washington. At each focus…

  5. Nutrition Education and Support Program for Community-Dwelling Adults with Intellectual Disabilities

    Science.gov (United States)

    Humphries, Kathleen; Traci, Meg Ann; Seekins, Tom

    2008-01-01

    To test the efficacy, acceptability, and appropriateness of a nutrition education and support program, 4 community-based group homes for adults with intellectual or developmental disabilities participated in a pilot intervention with extended baseline period and pre--post-test design. Adults (N = 32) with intellectual or developmental…

  6. Nutritional Support and Oral Intake after Gastric Resection in Five Northern European Countries

    DEFF Research Database (Denmark)

    Lassen, K; Dejong, C H C; Ljungqvist, O

    2005-01-01

    a conservative trend was noticeable in the use of nasogastric decompression tubes and 'nil-by-mouth' regimens. Nutritional support during the first 5 days is generally offered in Denmark, but not in Scotland. Drinking at will is generally allowed in Denmark and Norway by the first postoperative day. Eating...

  7. Effects of preoperative nutritional support on colonic anastomotic healing in malnourished rats.

    Science.gov (United States)

    Gündoğdu, Rıza Haldun; Yaşar, Uğur; Ersoy, Pamir Eren; Ergül, Emre; Işıkoğlu, Semra; Erhan, Atilla

    2015-01-01

    It has been proven that malnutrition increases postoperative morbidity and mortality, and it may also negatively affect wound healing in the gastrointestinal tract. In the literature, there is only one study evaluating the effects of preoperative nutritional support on colonic anastomotic healing under malnourished conditions. In order to improve the data on this topic, an experimental study was planned to evaluate the effects of preoperative nutritional support on colonic anastomotic healing in malnourished rats. The study included 18 male Wistar albino rats divided into 3 groups. The control (C) group was fed ad libitum for 21 days. The malnutrition (M) group and preoperative nutrition (P) group were given 50% of the daily food consumed by the rats in Group C for 21 days to induce malnutrition. At the end of 21 days, Group P was fed ad libitum for 7 days (preoperative nutritional support). Colonic transection and end-to-end anastomosis was performed at 21 days in Group C and Group M and at 28 days in Group P. The rats were sacrificed at postoperative 4 days, anastomotic bursting pressure was measured, and samples were taken to analyze tissue hydroxyproline levels. Anastomotic bursting pressure was significantly higher in Group C than in Group M and Group P (pGroup P than in Group M (pGroup P were found to be significantly higher than those in Group M and Group C (pnutritional support increases collagen synthesis in the colon and positively affects anastomotic healing under malnourished conditions.

  8. Advantages of enteral nutrition over parenteral nutrition

    OpenAIRE

    Seres, David S.; Valcarcel, Monika; Guillaume, Alexandra

    2013-01-01

    It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition.

  9. Formulation Assessment and Support Team (FAST) for the Asteroid Redirect Mission (ARM)

    Science.gov (United States)

    Mazanek, Daniel D.; Abell, Paul; Reeves, David M.; NASA Asteroid Redirect Mission (ARM) Formulation Assessment and Support Team (FAST)

    2016-10-01

    The Formulation Assessment and Support Team (FAST) for the Asteroid Redirect Mission (ARM) was a two-month effort, chartered by NASA, to provide timely inputs for mission requirement formulation in support of the Asteroid Redirect Robotic Mission (ARRM) Requirements Closure Technical Interchange Meeting held December 15-16, 2015. Additionally, the FAST was tasked with developing an initial list of potential mission investigations and providing input on potential hosted payloads and partnerships. The FAST explored several aspects of potential science benefits and knowledge gain from the ARM. Expertise from the science, engineering, and technology communities was represented in exploring lines of inquiry related to key characteristics of the ARRM reference target asteroid (2008 EV5) for engineering design purposes. Specific areas of interest included target origin, spatial distribution and size of boulders, surface geotechnical properties, boulder physical properties, and considerations for boulder handling, crew safety, and containment. In order to increase knowledge gain potential from the mission, opportunities for partnerships and accompanying payloads that could be provided by domestic and international partners were also investigated. The ARM FAST final report was publicly released on February 18, 2016 and represents the FAST's final product. The report and associated public comments are being used to support mission requirements formulation and serve as an initial inquiry to the science and engineering communities relating to the characteristics of the ARRM reference target asteroid. This report also provides a suggested list of potential investigations sorted and grouped based on their likely benefit to ARM and potential relevance to NASA science and exploration goals. These potential investigations could be conducted to reduce mission risks and increase knowledge return in the areas of science, planetary defense, asteroid resources and in-situ resource

  10. Weapons of Mass Destruction Civil Support Teams (WMD-CST): A Necessary Failure

    National Research Council Canada - National Science Library

    Walker, Larry

    2001-01-01

    .... Unfortunately, poor program management, ineffective equipment acquisition and unclear command and control structures have made the current version of the WMD-CST teams ineffective and inspire fear...

  11. [Transdisciplinary Approach for Sarcopenia. Effect of nutritional support for the prevention of sarcopenia].

    Science.gov (United States)

    Nishioka, Hiroaki

    2014-10-01

    Sarcopenia is defined as the age-related loss of muscle mass and function. Sarcopenia is closely related with decreased physical function, fall, bone fracture, osteoporosis, and insulin resistance, which lead to increased morbidity and mortality in elderly people. The pathogenesis of sarcopenia is complex and multifactorial, which remains not to be fully understood. Inappropriate food intake and reduced physical activity are known to increase the risk of developing sarcopenia. Resistance training and nutritional support have been shown to be an effective intervention for prevention of sarcopenia. Protein, especially branched chain amino acid, and vitamin D have been reported to improve sarcopenia. The intervention together with nutrition and exercise are more effective.

  12. PATHOPHYSIOLOGY OF POSTOPERATIVE STRESS REACTION AND MODERN APPROACHES TO NUTRITIVE SUPPORT FOR CHILDREN IN POSTOPERATIVE PERIOD

    Directory of Open Access Journals (Sweden)

    P.V. Shumilov

    2010-01-01

    Full Text Available Enteral nutrition is a method best adjusted to human physiology for correcting disorders of homeostasis in the postoperative period. Untimely and inadequate correction of these disorders may fatally affect a child’s health and rates of the child’s further development. Understanding the laws of stress response generation is important in selecting an optimal nutritive support in the postoperative period. It is necessary to take account of neuro-endocrine-immune response, changing metabolism and an impaired function of the gastrointestinal tract. Modern methods of diagnostics and treatment make it possible to resolve most of the arising issues, but it requires physicians to take a comprehensive approach and have knowledge in many areas of theoretical and practical medicine. Key words: stress, metabolism, children, enteral nutrition. (Pediatric Pharmacology. – 2010; 7(3:36-45

  13. Effect of intensive nutritional counseling and support on clinical outcomes of hemodialysis patients.

    Science.gov (United States)

    Molfino, Alessio; Chiappini, Maria Grazia; Laviano, Alessandro; Ammann, Thomas; Bollea, Maria Rosa; Alegiani, Filippo; Rossi Fanelli, Filippo; Muscaritoli, Maurizio

    2012-10-01

    Protein-energy wasting is frequently found in patients on hemodialysis (HD). Anorexia and hypophagia contribute to malnutrition and increased morbidity and mortality, but the clinical impact of correcting hypophagia remains uncertain. We evaluated whether the correction of hypophagia influences morbidity and mortality in anorexic patients on HD. Thirty-four patients on HD were enrolled in a 2-y follow-up program including regular nutritional assessments. Patients not meeting the nutritional requirements during the follow-up received nutritional counseling, consisting of advice, individually tailored diets, and, for a failed dietary intervention, artificial nutrition. Biochemical, anthropometric, and body composition parameters, morbidity, and mortality were recorded in all patients at 12 and 24 mo. At baseline, 14 patients (41%) were anorexic, and 20 patients (59%) were non-anorexic. Anorexic patients were hypophagic and presented with a decreased fat-free mass. After 12 and 24 mo, cholesterol, albumin, lymphocyte count, and body mass index did not differ between the groups, whereas fat-free mass (percentage) in supplemented anorexic patients significantly improved in no longer differing from non-anorexic patients (65.8 ± 4.4 versus 65.4 ± 8.9, respectively, P = NS; 65.8 ± 4.4 versus 66.7 ± 10.78, respectively, P = NS). Morbidity and mortality were not different between the two groups. In patients on HD, nutritional counseling and nutritional support positively affect the nutritional status in hypophagic patients and make the risk of morbidity and mortality in anorexic patients comparable to those of non-anorexic patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Supporting Distributed Team Working in 3D Virtual Worlds: A Case Study in Second Life

    Science.gov (United States)

    Minocha, Shailey; Morse, David R.

    2010-01-01

    Purpose: The purpose of this paper is to report on a study into how a three-dimensional (3D) virtual world (Second Life) can facilitate socialisation and team working among students working on a team project at a distance. This models the situation in many commercial sectors where work is increasingly being conducted across time zones and between…

  15. The transplant team's support of kidney transplant recipients to take their prescribed medications: a collective responsibility.

    Science.gov (United States)

    Williams, Allison; Low, Jac Kee; Manias, Elizabeth; Crawford, Kimberley

    2016-08-01

    To obtain an understanding of how health professionals support the kidney transplant patient to take their medications as prescribed long term. Kidney transplantation requires stringent adherence to complex medication regimens to prevent graft rejection and to maintain general well-being. Medication nonadherence is common in kidney transplantation, emerging in the first few months post-transplantation, leading to poor patient outcomes. Exploratory qualitative design. Five focus groups were conducted with a total of seven renal nurse transplant coordinators, two renal transplant nurse unit managers, seven nephrologists, seven pharmacists, four social workers, and one consumer representative representing all five hospitals offering adult kidney transplantation in Victoria, Australia in 2014. The views of two general practitioners who were unable to attend the focus groups were incorporated into the data set. All data underwent thematic analysis. Analysis revealed that adherence was a collective responsibility involving the whole of the transplant team and the patient via education blitz in hospital, identifying and managing nonadherence, promotion of self-advocacy, and the partnership between the patient and health professional. Patients were directed how to take their complex medications to be self-empowered, yet the partnership between the patient and health professional limited the patient's voice. Although medication adherence was a collective responsibility, communication was often one-way chiefly as a result of staffing and time constraints, hindering effective partnerships necessary for medication adherence. Expert skills in communication and adherence counselling are necessary to identify barriers affecting medication adherence. Patients need to be systematically screened, prepared and supported long-term within an accommodating healthcare system for the reality of caring for their transplanted kidney. Kidney transplant recipients require systematic

  16. Diet and Nutrition (Parkinson's Disease)

    Science.gov (United States)

    ... Living With Parkinson's › Managing Parkinson's › Diet & Nutrition Diet & Nutrition 1. Maintain Health 2. Ease PD Symptoms 3. ... your team Seek reliable information about diet and nutrition from your medical team and local resources. Please ...

  17. An evidence-based approach to perioperative nutrition support in the elective surgery patient.

    Science.gov (United States)

    Miller, Keith R; Wischmeyer, Paul E; Taylor, Beth; McClave, Stephen A

    2013-09-01

    In surgical practice, great attention is given to the perioperative management of the elective surgical patient with regard to surgical planning, stratification of cardiopulmonary risk, and postoperative assessment for complication. However, growing evidence supports the beneficial role for implementation of a consistent and literature-based approach to perioperative nutrition therapy. Determining nutrition risk should be a routine component of the preoperative evaluation. As with the above issues, this concept begins with the clinician's first visit with the patient as risk is assessed and the severity of the surgical insult considered. If the patient is an appropriate candidate for benefit from preoperative support, a plan for initiation and reassessment should be implemented. Once appropriate nutrition end points have been achieved, special consideration should be given to beneficial practices the immediate day preceding surgery that may better prepare the patient for the intervention from a metabolic standpoint. In the operating room, consideration should be given to the potential placement of enteral access during the index operation as well as judicious and targeted intraoperative resuscitation. Immediately following the intervention, adequate resuscitation and glycemic control are key concepts, as is an evidence-based approach to the early advancement of an enteral/oral diet in the postoperative patient. Through the implementation of perioperative nutrition therapy plans in the elective surgery setting, outcomes can be improved.

  18. eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management

    Directory of Open Access Journals (Sweden)

    Rollo ME

    2016-11-01

    Full Text Available Megan E Rollo,1 Elroy J Aguiar,2 Rebecca L Williams,1 Katie Wynne,3 Michelle Kriss,3 Robin Callister,4 Clare E Collins1 1School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia; 2Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA; 3Department of Diabetes and Endocrinology, John Hunter Hospital, Hunter New England Health, New Lambton, NSW, Australia;\t4School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia Abstract: Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM behaviors that require tailored education and support. Electronic health (eHealth technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided. Keywords: diabetes self-management, eHealth, nutrition, physical activity, smartphones, wearables

  19. It Is Not Only Mentoring: The Combined Influences of Individual-Level and Team-Level Support on Job Performance

    Science.gov (United States)

    van Emmerik, I. J. Hetty

    2008-01-01

    Purpose: The paper aims to follow social exchange theory and group social capital theory, to predict positive relationships between (informal) mentoring and various support resources for two types of performance (i.e. perceptions of individual and team performance). Design/methodology/approach: The associations of individual-level mentoring and…

  20. Student Support Teams: Helping Students Succeed in General Education Classrooms or Working To Place Students in Special Education?

    Science.gov (United States)

    Logan, Kent R.; Hansen, Carol D.; Nieminen, Paul K.; Wright, E. Heath

    2001-01-01

    A study involving 24 elementary teachers found they were not using Student Support Teams (SST) as designed. Teachers believed the primary purpose of SST was to test and place students into special education, referred students with whom they had not been successful, and believed there was a covert evaluation process. (Contains references.)…

  1. Supporting teachers’ collaboration in design teams to develop Technological Pedagogical Content Knowledge: the case of science teachers in Tanzania

    NARCIS (Netherlands)

    Kafyulilo, Ayoub; Fisser, Petra; Voogt, Joke; McBride, R.; Searson, M.

    2013-01-01

    This study assessed the effect of support on the teachers’ collaboration in design teams and development of Technological Pedagogical Content Knowledge (TPACK). The study was carried out in two secondary schools in Tanzania: Chang’ombe and Jitegemee secondary schools. From each school 10 teachers

  2. Interprofessional education and social interaction: The use of automated external defibrillators in team-based basic life support.

    Science.gov (United States)

    Onan, Arif; Simsek, Nurettin

    2017-04-01

    Automated external defibrillators are pervasive computing devices designed for the treatment and management of acute sudden cardiac arrest. This study aims to explain users' actual use behavior in teams formed by different professions taken after a short time span of interaction with automated external defibrillator. Before the intervention, all the participants were certified with the American Heart Association Basic Life Support for healthcare providers. A statistically significant difference was revealed in mean individual automated external defibrillator technical skills between uniprofessional and interprofessional groups. The technical automated external defibrillator team scores were greater for groups with interprofessional than for those with uniprofessional education. The nontechnical automated external defibrillator skills of interprofessional and uniprofessional teams revealed differences in advantage of interprofessional teams. Students positively accept automated external defibrillators if well-defined and validated training opportunities to use them expertly are available. Uniprofessional teams were successfully supported by their members and, thereby, used automated external defibrillator effectively. Furthermore, the interprofessional approach resulted in as much effective teamwork as the uniprofessional approach.

  3. [Influence of clinical nutritional support on the effects of mechanical ventilation].

    Science.gov (United States)

    Xu, Xiujuan; Zhang, Geng; Hu, Mahong; Ji, Chunlian; Meng, Jianbiao; Lai, Zhizhen; Dai, Muhua; Pang, Lisha; Zhang, Wei

    2018-03-01

    To study the influence of clinical nutritional support on the effects of mechanical ventilation (MV), and to find the factors affecting the outcome of patients undergoing MV. A case-control study was conducted. The clinical data of 235 patients undergoing MV admitted to intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2017 were retrospectively analyzed. The patients were divided into two groups according to whether weaning successfully within 7 days. The clinical data of patients in the two groups were collected including gender, age, acute physiology and chronic health evaluation II (APACHE II) score, underlying disease, nutritional indicators, nutritional support, and complications. The outcome of withdrawal within 7 days was served as a dependent variable, all observed indicators were served as independent variables, and Logistic regression analysis was carried out to screen the influencing factors of the weaning results within 7 days. 235 patients undergoing MV were enrolled, 128 patients were successfully withdrawn within 7 days, and 107 were unsuccessfully withdrawn. Compared with the successful weaning group, the patients of weaning failure group were older, and had higher APACHE II score and lower albumin (Alb) and hemoglobin (Hb), more patients with internal medical underlying diseases and receiving parenteral nutrition (PN) and mixed nutrition, and the incidences of secondary infection, vomiting, abdominal distension, abnormal bowel sound, gastric retention, and diarrhea were higher. However, there was no statistical significance in gender between the two groups. The variables of statistical significance in univariate analysis were enrolled in the multifactor analysis model showing that age [odds ratio (OR) = 1.269, 95% confidence interval (95%CI) = 1.119-1.439, P nutrition (EN; OR = 0.191, 95%CI = 0.098-0.372, P nutrition (OR = 0.375, 95%CI = 0.150-0.938, P = 0.037) were protective factors of successful weaning

  4. Parenteral nutrition support for patients with pancreatic cancer--improvement of the nutritional status and the therapeutic outcome.

    Science.gov (United States)

    Richter, Eva; Denecke, Almut; Klapdor, Silke; Klapdor, Rainer

    2012-05-01

    , body cell mass (BCM), extracellular mass (ECM), cell content and ECM/BCM Index). Two patients, who were receiving PN for over two or three periods, showed reproducibility of the results; while when PN was interrupted all BIA parameters degraded and they ameliorated with the restart of PN. Gr2: In these patients PN was started in the late stage of the tumor disease in order to allow for a--from the retrospective point of view--last, but ineffective chemotherapy. The data indicated that the weight loss could be retarded, even if the effects on body weight and BIA parameters were found to be less pronounced compared to Gr1. The mean energy supply of both groups, however, was similar: 8,823 kcal (Gr1) per week compared to 9,572 kcal (Gr2) per week. The majority of patients claimed to be quicker and more powerful under PN and to some extent the appetite was enhanced. A timely onset of PN with sufficient calories leads to an improved nutritional status of patients with PaCa disease. PN enhances the quality of life, the administration of tumor therapy without interruption and therefore may lead to a better success of the entire therapy. For late-stage tumor patients (Gr2) the quality of life can, at least, be improved. The success of PN is significantly dependent upon the patients' compliance, which could be achieved through intensive consulting and support of all patients and their relatives.

  5. Effect of nutrition support on immunity in paediatric patients with beta-thalassaemia major.

    Science.gov (United States)

    Tienboon, Prasong

    2003-01-01

    Nutritional deficiencies have been variably observed in thalassaemia and the aetiology of many of the immune abnormalities in thalassaemic children are poorly defined. Therefore, we tested the hypothesis that certain immune abnormalities have a nutritional basis. Nutritional status, selective quantitative and functional indices of immunity were studied in twelve children (7 females, 5 males; mean age 28 months, SD 5 and range 19.8-35.5), with thalassaemia major before and after a one month period of intensive nutrition support (the study diet consisted of 'Enfapro' liquid formula (Mead Johnson) with added dextrose and corn oil to achieve a caloric density of 1.1 kcal/cc in addition to vitamins and minerals). Each child was provided approximately 150 kcal/day and 4 g of protein/day. Lymphocyte proliferation to Concanavalin A (Con A) (P = 0.008) and Purified Protein Derivative (PPD) (P = 0.002) was depressed upon entry into the study, however the response to Con A attained normal values by the end of the intervention. Compared to baselines, the proliferative response to Con A (P = 0.005) and Phytohemagglutinin A (PHA) (P = 0.031) both improved after the nutrition support. Although there was no general correlation of zinc status with lymphocyte proliferation, normal baseline zinc status was associated with improvement of proliferation. The %CD4 increased (P = 0.036), primarily because of a decrease in total lymphocytes and to lesser extent a decrease in CD8 lymphocytes. Serum immunoglobulin concentrations were found to be elevated on admission but were not significantly affected by the nutrition intervention. C3 concentrations were uniformly depressed on admission but increased by the end of the study protocol (P = 0.037). C4 and CH50 activity were not significantly influenced by the intervention. In conclusion, children with beta thalassaemia have abnormalities of lymphocyte function as well as key complement components that are responsive to nutrition support. In

  6. Zouerate 1978: Supporting Air Operations, an Army Team Amidst France's African Strategy

    National Research Council Canada - National Science Library

    Voute, Philippe

    1997-01-01

    .... To help this country, in 1977-1978, France carried out operation Lamantin. It consisted of surveillance and attack aircraft stationed in Senegal, and small Army teams deployed in Mauritanian garrisons...

  7. An action-learning model to assist Circuit Teams to support School ...

    African Journals Online (AJOL)

    EAOSA

    2016-11-17

    Nov 17, 2016 ... In some cases, the circuit managers were so incompetent that ... Teams. This paper builds on work previously published in this regard (Van der Voort & Wood,. 2014). ... whole-school development, since “school success is.

  8. Structure, organisation and clinical outcomes in cancer patients of hospital support teams in Spain.

    Science.gov (United States)

    Tuca-Rodriguez, Albert; Gómez-Batiste, Xavier; Espinosa-Rojas, Jose; Martínez-Muñoz, Marisa; Codorniu, Nuria; Porta-Sales, Josep

    2012-12-01

    To describe the structure, characteristics of patients and basic clinical outcomes in cancer patients receiving care from palliative care hospital support teams (HSTs) in Spain. A multi-centre observational two phase study. Phase I: A descriptive survey of all HSTs in Spain. Phase II: A quasi-experimental prospective cohort study to describe the clinical outcomes, symptom severity and survival. 60 HSTs in Spain met the inclusion criteria. All HSTs were multidisciplinary with wide experience (mean 6.8 years). HSTs coverage was 21.5% of all cancer deaths in Spain. A total number of 364 advanced cancer patients were included in the cohort study; 76% were classified as moderate or high complexity. Overall, 64% were male subjects and the most frequent primary cancer site was lung (26%). Half of the patients had no detailed information about cancer staging and only 19% knew their short-term prognosis. The mean length of intervention was 6.5 days (mean three visits per patient). Outcomes were: 34% deaths during the admission process; 38% were discharged home; and 28% were transferred to another medium-term-stay specialist unit. The main symptoms were pain (68%), dyspnoea (43%), vomiting (24%), anorexia (72%), asthenia (78%), insomnia (50%), anxiety (45%) and depression (35%). After the HSTs intervention, the symptom severity was significantly reduced (p<0.001) for all symptoms, except for weakness and anorexia. The mean survival from inclusion was 111 days. Palliative intervention of HSTs is characterised by being adjusted to patient needs and short duration. Their care was focused on the preterminal phase of cancer patients of moderate-high complexity.

  9. Introducing embedded indigenous psychological support teams: a suggested addition to psychological first aid in an international context.

    Science.gov (United States)

    Edwards-Stewart, Amanda; Ahmad, Zeba S; Thoburn, John W; Furman, Rich; Lambert, Ashly J; Shelly, Lauren; Gunn, Ginger

    2012-01-01

    The current article introduces Embedded Indigenous Psychological Support Teams (IPST) as a possible addition to current disaster relief efforts. This article highlights psychological first aid in an international context by drawing on mainstream disaster relief models such as The American Red Cross, Critical Incident Stress Management, and Flexible Psychological First Aid. IPST are explained as teams utilizing techniques from both CISM and FPFA with a focus on resiliency. It is currently theorized that in utilizing IPST existing disaster relief models may be more effective in mitigating negative physical or mental health consequences post-disaster.

  10. Nutritional support in patients with severe acute pancreatitis Soporte nutricional en pacientes con pancreatitis aguda grave

    Directory of Open Access Journals (Sweden)

    Mónica Marcela Peláez Hernández

    2007-04-01

    Full Text Available Severe acute pancreatitis is associated with a systemic inflammatory response leading to a hypermetabolic, hypercatabolic condition; for those reasons, patients suffering from this disease require an excellent artificial nutritional support in order to maintain the structural integrity and the function of vital organs with minimal pancreatic secretion. Total parenteral nutrition has been the standard practice in the treatment of patients with severe acute pancreatitis because of the favorable outcomes of early nutritional support while avoiding pancreatic stimulation; however, recent evidence suggests there are potentially greater benefits with enteral as compared with parenteral nutrition, including fewer septic and metabolic complications and lesser costs. That is why present guidelines for the management of acute pancreatitis recommend that enteral instead of parenteral nutrition be used in patients with severe acute pancreatitis. La pancreatitis aguda, especialmente en su forma grave, está asociada con una respuesta inflamatoria sistémica que lleva a un estado de hipermetabolismo e hipercatabolismo, en el que se requiere un excelente soporte nutricional que permita mantener la integridad estructural y la función de los órganos vitales con un estímulo mínimo de la secreción pancreática. La nutrición parenteral total era el soporte de elección, que permitía obtener todos los beneficios de la nutrición temprana sin estimular la secreción pancreática; pero la evidencia actual muestra mayores beneficios con la nutrición enteral, porque se asocia con menos complicaciones infecciosas y metabólicas y con disminución en los costos. Por ello las guías actuales de tratamiento de la pancreatitis aguda grave recomiendan como primera elección el soporte nutricional enteral.

  11. Effects of enteral nutritional support on malnourished patients with inflammatory bowel disease by subjective global assessment.

    Science.gov (United States)

    Sökülmez, Pınar; Demirbağ, Ali Eba; Arslan, Perihan; Dişibeyaz, Selçuk

    2014-10-01

    To investigate the prevalence of malnutrition in patients with inflammatory bowel disease (IBD) by subjective global assessment (SGA) and the effects of oral nutritional support on the clinical parameters, consumption of energy, macronutrients and fiber intake in the Study and Control groups, prospectively. A total of 38 (28 Male; 10 Female) hospitalized patients with moderate or severe IBD (13 with Crohn's disease (CD); 25 with Ulcerative colitis (UC)) were included. At stage 1, the disease severity, clinical symptoms and, signs, food consumption and nutritional status by using subjective global assessment (SGA) were recorded. At stage 2, the patients were blindly randomized into a Study Group and Controls. In the Study Group, a standard enteral product was added into the regulated hospital diets, but for the Controls, deficits were regulated by only hospital diets for 3 weeks. the independent variables were the group, the disease and its activity, age, Body body mass index (BMI), weight loss history, the hospitalization period; the dependent variables were SGA, bowel movements, change in nutritional status, disease severity, clinical findings, and also consumption of macronutrients. Prevalance of malnutrition (SGA-B or SGA-C) for all the patients was 92.1% at the beginning and 71.1% at the end of study. Improvements in disease activity score for the patients with UC were statistically significant in both the Study Group and the Controls (p=0.006 for the Study Group and p=0.001 for the Controls, respectively). Macronutrients, total and water soluble fiber consumption levels improved, with statistically significant differences for all the groups. The prevalence of malnutrition is a major problem in patients with IBD. Not only the regulation of hospital food, but also enteral nutritional support, improved their levels of malnutrition, as well as their energy, macronutrients, and fiber consumption, and SGA is an easy method for nutritional monitoring.

  12. Application of semi-automated ultrasonography on nutritional support for severe acute pancreatitis.

    Science.gov (United States)

    Li, Ying; Ye, Yu; Yang, Mei; Ruan, Haiying; Yu, Yuan

    2018-04-25

    To evaluate the application value of semi-automated ultrasound on the guidance of nasogastrojejunal tube replacement for patients with acute severe pancreatitis (ASP), as well as the value of the nutritional support for standardized treatment in clinical practice. The retrospective research was performed in our hospital, and 34 patients suffering from ASP were enrolled into this study. All these identified participants ever received CT scans in order to make definitive diagnoses. Following, these patients received semi-automated ultrasound examinations within 1 days after their onset, in order to provide enteral nutrititon treatment via nasogastrojejunal tube, or freehand nasogastrojejunal tube replacement. In terms of statistical analysis, the application value of semi-automated ultrasound guidance on nasogastrojejunal tube replacement was evaluated, and was compared with tube replacement of no guidance. After cathetering, the additional enteral nutrition was provided, and its therapeutic effect on SAP was analyzed in further. A total of 34 patients with pancreatitis were identified in this research, 29 cases with necrosis of pancreas parenchyma. After further examinations, 32 cases were SAP, 2 cases were mild acute pancreatitis. When the firm diagnosis was made, additional enteral nutrition (EN) was given, all the patient conditions appeared good, and they all were satisfied with this kind of nutritional support. According to our clinical experience, when there was 200-250 ml liquid in the stomach, the successful rate of intubation appeared higher. Additionally, the comparison between ultrasound-guided and freehand nasogastrojejunal tube replacement was made. According to the statistical results, in terms of the utilization ratio of nutritional support, it was better in ultrasound-guided group, when compared with it in freehand group, within 1 day, after 3 days and after 7 days (7/20 versus 2/14; P groups was not statistically different (P > 0.05). It can

  13. The effects of the formula of amino acids enriched BCAA on nutritional support in traumatic patients.

    Science.gov (United States)

    Wang, Xin-Ying; Li, Ning; Gu, Jun; Li, Wei-Qin; Li, Jie-Shou

    2003-03-01

    To investigate the formula of amino acid enriched BCAA on nutritional support in traumatic patients after operation. 40 adult patients after moderate or large abdominal operations were enrolled in a prospective, randomly and single-blind-controlled study, and received total parenteral nutrition (TPN) with either formula of amino acid (AA group, 20 cases) or formula of amino acid enriched BCAA (BCAA group, 20 cases). From the second day after operation, total parenteral nutrition was infused to the patients in both groups with equal calorie and equal nitrogen by central or peripheral vein during more than 12 hours per day for 6 days. Meanwhile, nitrogen balance was assayed by collecting 24 hours urine for 6 days. The markers of protein metabolism were investigated such as amino acid patterns, levels of total protein, albumin, prealbumin, transferrin and fibronectin in serum. The positive nitrogen balance in BCAA group occurred two days earlier than that in AA group. The serum levels of total protein and albumin in BCAA group were increased more obviously than that in AA group. The concentration of valine was notably increased and the concentration of arginine was markedly decreased in BCAA group after the formula of amino acids enriched BCAA transfusion. The formula of amino acid enriched BCAA may normalize the levels of serum amino acids, reduce the proteolysis, increase the synthesis of protein, improve the nutritional status of traumatic patients after operation.

  14. Nutritional support contributes to recuperation in a rat model of aplastic anemia by enhancing mitochondrial function.

    Science.gov (United States)

    Yang, Guang; Zhao, Lifen; Liu, Bing; Shan, Yujia; Li, Yang; Zhou, Huimin; Jia, Li

    2018-02-01

    Acquired aplastic anemia (AA) is a hematopoietic stem cell disease that leads to hematopoietic disorder and peripheral blood pancytopenia. We investigated whether nutritional support is helpful to AA recovery. We established a rat model with AA. A nutrient mixture was administered to rats with AA through different dose gavage once per day for 55 d. Animals in this study were assigned to one of five groups: normal control (NC; group includes normal rats); AA (rats with AA); high dose (AA + nutritional mixture, 2266.95 mg/kg/d); medium dose (1511.3 mg/kg/d); and low dose (1057.91 mg/kg/d). The effects of nutrition administration on general status and mitochondrial function of rats with AA were evaluated. The nutrient mixture with which the rats were supplemented significantly improved weight, peripheral blood parameters, and histologic parameters of rats with AA in a dose-dependent manner. Furthermore, we observed that the number of mitochondria in the liver, spleen, kidney, and brain was increased after supplementation by transmission electron microscopy analysis. Nutrient administration also improved mitochondrial DNA content, adenosine triphosphate content, and membrane potential but inhibited oxidative stress, thus, repairing the mitochondrial dysfunction of the rats with AA. Taken together, nutrition supplements may contribute to the improvement of mitochondrial function and play an important role in the recuperation of rats with AA. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Effect of mother support groups on nutritional status in children under two years of age in Laisamis village, Kenya

    OpenAIRE

    Undlien, Mattias; Viervoll, Håvard-Amund

    2016-01-01

    Background: To deal with the ongoing malnutrition problem in many parts of Kenya, the government has initialized preventive actions such as mother support groups to improve health and nutrition among children. Few studies have evaluated the effectiveness of such interventions as mother support groups. Objective: This study aimed at determining how mother support groups affect the nutrition status of children under 2 years of age. Methods: A total of 41 children participated. Anthropometric me...

  16. Creating a culture to support patient safety. The contribution of a multidisciplinary team development programme to collaborative working.

    Science.gov (United States)

    Benson, Anne

    2010-01-01

    Effective teamwork is crucial for ensuring the provision of safe high quality care. Teams whose members collaborate through questioning, reflecting on and reviewing their work, offering each other feedback and where reporting is encouraged are more likely to promote a safe environment of care. This paper describes a multidisciplinary development programme intended to increase team effectiveness. The teams that took part developed their ability to work collaboratively together with levels of open dialogue, critical reflection and direct feedback increasing. The paper goes on to discuss aspects of the programme which were helpful in enabling these positive changes and concludes with a number of recommendations for those commissioning and facilitating team development initiatives. These include: the need for people from different disciplines and different levels within the hierarchy to spend time reviewing their work together, the need to explicitly address issues of power and authority, the usefulness taking an action orientated approach and requiring participants to work on real issues together, the importance of providing sufficient time and resource to support people to work with the challenges associated with implementing change and addressing team dynamics, The importance of skilled facilitation.

  17. Forget (a while) the World Cup... support the CERN football team

    CERN Multimedia

    2006-01-01

    Teammates celebrate their victory and bring home the trophy. During this year's World Cup, it seems unlikely that there could exist a team that everyone would unanimously cheer for...at least, at CERN. Yet, the CERN FC team made up of various nationalities (Austrian, Belgian, English, French, Italian, Norwegian, Portuguese, Spanish, Swedish, Swiss,) won this year's Association Genevoise de Football Corporatif (AGFC) Championship, a championship for companies in Geneva. In 2002 the CERN Football team was re-formed and entered in the AGFC after a number of years in the wilderness. The team quickly progressed from Division D as a result of three successive promotions and competed in League A (the top flight) for the first time in 2005. CERN FC history was made two weeks ago. Having qualified for the end-of-season playoffs by finishing second in its regular season group, on Thursday 15 June the team qualified for the AGFC Division A Championship final by beating the Geneva Police 2-0 in the semi-final at Stade M...

  18. The AGING Initiative experience: a call for sustained support for team science networks.

    Science.gov (United States)

    Garg, Tullika; Anzuoni, Kathryn; Landyn, Valentina; Hajduk, Alexandra; Waring, Stephen; Hanson, Leah R; Whitson, Heather E

    2018-05-18

    Team science, defined as collaborative research efforts that leverage the expertise of diverse disciplines, is recognised as a critical means to address complex healthcare challenges, but the practical implementation of team science can be difficult. Our objective is to describe the barriers, solutions and lessons learned from our team science experience as applied to the complex and growing challenge of multiple chronic conditions (MCC). MCC is the presence of two or more chronic conditions that have a collective adverse effect on health status, function or quality of life, and that require complex healthcare management, decision-making or coordination. Due to the increasing impact on the United States society, MCC research has been identified as a high priority research area by multiple federal agencies. In response to this need, two national research entities, the Healthcare Systems Research Network (HCSRN) and the Claude D. Pepper Older Americans Independence Centers (OAIC), formed the Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative to build nationwide capacity for MCC team science. This article describes the structure, lessons learned and initial outcomes of the AGING Initiative. We call for funding mechanisms to sustain infrastructures that have demonstrated success in fostering team science and innovation in translating findings to policy change necessary to solve complex problems in healthcare.

  19. A clinical audit of the nutritional status and need for nutrition support amongst head and neck cancer patients treated with radiotherapy

    Directory of Open Access Journals (Sweden)

    E Jeffery

    2012-01-01

    Full Text Available Radiotherapy is an effective treatment for head and neck cancers but patients often experience side effects which lead to weight loss. Nutrition intervention in the form of counselling or oral nutrition support (ONS is frequently needed for these patients. For some patients, tube feeding is required to minimise weight loss during treatment.MethodData was collected on 48 patients who received radiotherapy to the head and neck region over a nine-month period (June 2009–March 2010. Retrospective data collection was commenced in July 2010. Each patient’s Diet Therapy Department record was reviewed. Main outcome measures were: 1 type of nutrition support; 2 percentage weight change during treatment; and 3 Patient-Generated Subjective Global Assessment Global (PG-SGA rating.ResultsOn initial assessment 28 (77.8% patients were classified as well nourished using the PG-SGA. Mean weight loss during radiotherapy was 5.74%. Risk factors for the need for ONS and enteral nutrition support (ENS were older age, presence of nutrition impact symptoms, high-risk tumour sites, advanced disease and chemotherapy. No significant difference was shown in weight loss between ONS and ENS groups.ConclusionThis study identified the need for early dietetic intervention for high nutritional risk groups of head and neck cancer patients to prevent significant weight loss. Pre-treatment nutritional status did not influence weight loss during treatment. ONS alone cannot prevent significant weight loss in patients with multiple nutrition impact symptoms. Early enteral feeding should be considered in this group of patients.

  20. Enhancing the intrinsic work motivation of community nutrition educators: how supportive supervision and job design foster autonomy.

    Science.gov (United States)

    Dickin, Katherine L; Dollahite, Jamie S; Habicht, Jean-Pierre

    2011-01-01

    Mixed-methods research investigated the work motivation of paraprofessional community nutrition educators (CNEs) delivering a long-running public health nutrition program. In interviews, CNEs (n = 9) emphasized "freedom," supportive supervision, and "making a difference" as key sources of motivation. Community nutrition educator surveys (n = 115) confirmed high levels of autonomy, which was associated with supervisors' delegation and support, CNE decision-making on scheduling and curricula, and job satisfaction. Supervisors (n = 32) rated CNEs' job design as having inherently motivating characteristics comparable to professional jobs. Supervisory strategies can complement job design to create structured, supportive contexts that maintain fidelity, while granting autonomy to paraprofessionals to enhance intrinsic work motivation.

  1. Ubiquitous computing to support co-located clinical teams: using the semiotics of physical objects in system design.

    Science.gov (United States)

    Bang, Magnus; Timpka, Toomas

    2007-06-01

    Co-located teams often use material objects to communicate messages in collaboration. Modern desktop computing systems with abstract graphical user interface (GUIs) fail to support this material dimension of inter-personal communication. The aim of this study is to investigate how tangible user interfaces can be used in computer systems to better support collaborative routines among co-located clinical teams. The semiotics of physical objects used in team collaboration was analyzed from data collected during 1 month of observations at an emergency room. The resulting set of communication patterns was used as a framework when designing an experimental system. Following the principles of augmented reality, physical objects were mapped into a physical user interface with the goal of maintaining the symbolic value of those objects. NOSTOS is an experimental ubiquitous computing environment that takes advantage of interaction devices integrated into the traditional clinical environment, including digital pens, walk-up displays, and a digital desk. The design uses familiar workplace tools to function as user interfaces to the computer in order to exploit established cognitive and collaborative routines. Paper-based tangible user interfaces and digital desks are promising technologies for co-located clinical teams. A key issue that needs to be solved before employing such solutions in practice is associated with limited feedback from the passive paper interfaces.

  2. Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs.

    Science.gov (United States)

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

    2012-04-01

    Older people are vulnerable to malnutrition which leads to increased health care costs. The aim of this study was to evaluate the cost-effectiveness of nutritional supplementation from a societal perspective. This randomized controlled trial included hospital admitted malnourished elderly (≥ 60 y) patients. Patients in the intervention group received nutritional supplementation (energy and protein enriched diet, oral nutritional support, calcium-vitamin D supplement, telephone counselling by a dietician) until three months after discharge from hospital. Patients in the control group received usual care (control). Primary outcomes were Quality Adjusted Life Years (QALYs), physical activities and functional limitations. Measurements were performed at hospital admission and three months after discharge. Data were analyzed according to the intention-to-treat principle and multiple imputation was used to impute missing data. Incremental cost-effectiveness ratios were calculated and bootstrapping was applied to evaluate cost-effectiveness. Cost-effectiveness was expressed by cost-effectiveness planes and cost-effectiveness acceptability curves. 210 patients were included, 105 in each group. After three months, no statistically significant differences in quality of life and physical activities were observed between groups. Functional limitations decreased significantly more in the intervention group (mean difference -0.72, 95% CI-1.15; -0.28). There were no differences in costs between groups. Cost-effectiveness for QALYs and physical activities could not be demonstrated. For functional limitations we found a 0.95 probability that the intervention is cost-effective in comparison with usual care for ceiling ratios > €6500. A multi-component nutritional intervention to malnourished elderly patients for three months after hospital discharge leads to significant improvement in functional limitations and is neutral in costs. A follow-up of three months is probably too

  3. [Effect of different nutritional support on pancreatic secretion in acute pancreatitis].

    Science.gov (United States)

    Achkasov, E E; Pugaev, A V; Nabiyeva, Zh G; Kalachev, S V

    To develop and justify optimal nutritional support in early phase of acute pancreatitis (AP). 140 AP patients were enrolled. They were divided into groups depending on nutritional support: group I (n=70) - early enteral tube feeding (ETF) with balanced mixtures, group II (n=30) - early ETF with oligopeptide mixture, group III (n=40) - total parenteral nutrition (TPN). The subgroups were also isolated depending on medication: A - Octreotide, B - Quamatel, C - Octreotide + Quamatel. Pancreatic secretion was evaluated by using of course of disease, instrumental methods, APUD-system hormone levels (secretin, cholecystokinin, somatostatin, vasointestinal peptide). ETF was followed by pancreas enlargement despite ongoing therapy, while TPN led to gradual reduction of pancreatic size up to normal values. α-amylase level progressively decreased in all groups, however in patients who underwent ETF (I and II) mean values of the enzyme were significantly higher compared with TPN (group III). Secretin, cholecystokinin and vasointestinal peptide were increasing in most cases, while the level of somatostatin was below normal in all groups. Enteral tube feeding (balanced and oligopeptide mixtures) contributes to pancreatic secretion compared with TPN, but this negative impact is eliminated by antisecretory therapy. Dual medication (Octreotide + Quamatel) is more preferable than monotherapy (Octreotide or Quamatel).

  4. Chemotherapy-Related Toxicity, Nutritional Status and Quality of Life in Precachectic Oncologic Patients with, or without, High Protein Nutritional Support. A Prospective, Randomized Study.

    Science.gov (United States)

    Ziętarska, Monika; Krawczyk-Lipiec, Joanna; Kraj, Leszek; Zaucha, Renata; Małgorzewicz, Sylwia

    2017-10-11

    Cancer disease is usually associated with impaired nutritional status, which is one of the factors contributing to deterioration of the results of surgery, chemotherapy or radiotherapy. The aim of the study was to determine whether nutritional support with high protein (ONS) in adult oncologic patients in the first step of cancer cachexia-asymptomatic precachexia, has an influence on the toxicity of systemic therapy. However, secondary endpoints were established: to determine whether high protein ONS influences the nutritional status, the quality of life, and the performance status. A total of 114 persons aged 40-84 years old with colorectal cancer were examined. Based on the randomization, 47 patients were qualified to the interventional group (ONS group) and 48 to Control group. To evaluate the nutritional status NRS-2002 (Nutritional Risk Screening), SGA (Subjective Global Assessment), SCRINIO (SCReenIng the Nutritional status In Oncology) Working Group classification, VAS (Visual Analog Scale) for appetite was used. FAACT (Functional Assessment of Anorexia/Cachexia Therapy) questionnaire was used for assessment of the quality of life. The health status of patients was evaluated based on the Karnofsky Performance Scale. Anthropometric measurements were done. Severe complications of chemotherapy, which caused the end of treatment, a slight complication of the gastrointestinal tract such as diarrhea grade 2 according to ECOG (Eastern Cooperative Oncology Group) score regardless of the studied group, were observed. There were no statistical differences in the number and severity of the observed complications, i.e., neutropenia, leucopenia, thrombocytopenia, anemia, abdominal pain, nausea and vomiting, and diarrhea. During the follow-up the significant changes of SGA, VAS, albumin and prealbumin were observed between groups. In the ONS group an improvement in nutritional status was noticed (increased appetite VAS, p = 0.05; increased points in SGA, p = 0.015, and

  5. Chemotherapy-Related Toxicity, Nutritional Status and Quality of Life in Precachectic Oncologic Patients with, or without, High Protein Nutritional Support. A Prospective, Randomized Study

    Directory of Open Access Journals (Sweden)

    Monika Ziętarska

    2017-10-01

    Full Text Available Background: Cancer disease is usually associated with impaired nutritional status, which is one of the factors contributing to deterioration of the results of surgery, chemotherapy or radiotherapy. Objectives: The aim of the study was to determine whether nutritional support with high protein (ONS in adult oncologic patients in the first step of cancer cachexia—asymptomatic precachexia, has an influence on the toxicity of systemic therapy. However, secondary endpoints were established: to determine whether high protein ONS influences the nutritional status, the quality of life, and the performance status. Materials and Methods: A total of 114 persons aged 40–84 years old with colorectal cancer were examined. Based on the randomization, 47 patients were qualified to the interventional group (ONS group and 48 to Control group. To evaluate the nutritional status NRS-2002 (Nutritional Risk Screening, SGA (Subjective Global Assessment, SCRINIO (SCReenIng the Nutritional status In Oncology Working Group classification, VAS (Visual Analog Scale for appetite was used. FAACT (Functional Assessment of Anorexia/Cachexia Therapy questionnaire was used for assessment of the quality of life. The health status of patients was evaluated based on the Karnofsky Performance Scale. Anthropometric measurements were done. Results: Severe complications of chemotherapy, which caused the end of treatment, a slight complication of the gastrointestinal tract such as diarrhea grade 2 according to ECOG (Eastern Cooperative Oncology Group score regardless of the studied group, were observed. There were no statistical differences in the number and severity of the observed complications, i.e., neutropenia, leucopenia, thrombocytopenia, anemia, abdominal pain, nausea and vomiting, and diarrhea. During the follow-up the significant changes of SGA, VAS, albumin and prealbumin were observed between groups. In the ONS group an improvement in nutritional status was noticed

  6. Supporting a 1:1 Program with a Student Technology Team

    Science.gov (United States)

    Peterson, Lana; Scharber, Cassandra

    2017-01-01

    Purpose: The purpose of this paper is to describe the practice of using student technology teams (STTs) offered at a high school within a 1:1 district. Design/methodology/approach: This qualitative case study (Merriam, 1998, 2009) documents how an STT program functioned in 2015-2016 academic year. Findings: Findings show the STT provided a rich…

  7. Supporting South Asian carers and those they care for: the role of the primary health care team.

    OpenAIRE

    Katbamna, Savita; Bhakta, Padma; Ahmad, Waqar; Baker, Richard; Parker, Gillian

    2002-01-01

    BACKGROUND: Demographic and socioeconomic changes have increased policy interest in informal carers. However, despite the multicultural nature of British society, most research in this field has been in majority communities. AIM: To explore the role of the primary health care team (PHCT) in supporting carers from British South Asian communities. DESIGN OF STUDY: Qualitative study. SETTING: Four South Asian communities in Leicestershire and West Yorkshire. METHODS: Focus groups and in-depth in...

  8. [Curative effect analysis of bile reinfusion combined with enteral nutrition support before surgery of hilar cholangiocarcinoma].

    Science.gov (United States)

    Song, P; Mao, L; Bian, X J; Zhou, T; Fan, Y Y; Zhang, J; Xie, M; Qiu, Y D

    2018-05-01

    Objective: To investigate the clinical effect of bile reinfusion combined with enteral nutrition support before surgery for hilar cholangiocarcinoma. Methods: A retrospective analysis of patients with hilar cholangiocarcinoma who underwent surgical treatment at Nanjing Drum Tower Hospital Hepato-biliary-pancreatic Surgery Department from July 2010 to August 2017 was completed.A total of 52 cases were finally enrolled in our study.All the patients included, on the basis of whether they received preoperative drainage and bile reinfusion, were divided into non-drainage group( n =15) and drainage group( n =37). Differences of clinical indicators, including operation time, intraoperative bleeding and serum liver function index levels at day 1, 3, 7 postoperative, postoperative complications(liver failure, biliary fistula, pleural effusion, peritoneal effusion, abdominal cavity infection, death in hospital), tumor classification, R0 resection, postoperative hospitalization time between the 2 groups were analyzed. At the same time, in the drainage group, patients were divided into non-enteral nutrition subgroup( n =13) and enteral nutrition subgroup( n =24) according to whether they received enteral nutrition before operation. The normal distribution data of the group was statistically analyzed by independent sample t test, the non-normal distribution data of the group was statistically analyzed by rank-sum test. The count data was statistically analyzed by non-calibration and correction of the square test. Results: There was no statistically significant difference in general infomation such as age, gender, and serum liver function between non-drainage group and drainage group( P >0.05). There was no statistically significant difference in general information such as age, gender, and serum liver function between non-enteral nutrition group and enteral nutrition group( P >0.05). The rate of vascular resection and reconstruction(33.3%) and operating time(10.8(2.2)h) in

  9. Role of the team of scientific and technical commissioning support (TSTCS) during Mochovce NPP unit 3 and 4 commissioning

    International Nuclear Information System (INIS)

    Hermansky, J.; Prachar, M.; Sedlacek, M.; Petenyi, V.

    2011-01-01

    The Team of Scientific and Technical Commissioning Support (TSTCS) shall provide an independent support for the Mochovce NPP 3 and 4 Commissioning Department during Mochovce Units 3 and 4 commissioning. This independent support will be in line with the Mochovce NPP 3 and 4 Directive 'Non-active tests and commissioning' and it will be carried out in form of professional and expert works focusing on supervision of fulfilment of requirements for nuclear safety observance. The TSTCS duty to provide for such services during NPP commissioning is specified by Slovak Regulatory Body legislation. The independent TSTCS will supervise; - fulfilment of requirements for nuclear safety during preparation and implementation of commissioning tests; -scientific and technical level of commissioning programmes, and reflection on nuclear safety requirements in commissioning programmes,- commissioning process and test results. Main standpoints of the Team activities for individual unit commissioning stages will be; - assesment of the selected programs of functional tests in installations having an impact on nuclear safety and evaluation of the results of these tests; - assesment of the programs of physics and power commissioning, - assesment of the unit preparedness before fuel loading start; - assesment of the unit preparedness for performing initial criticality and low power commissioning and power commissioning stages; - evaluation of the results of physics and power commissioning stages and sub-stages; - final evaluation of the results from implementing the physics and power commissioning stages. The paper also presents a short description of the Team scope activities, the Team organisation, and a procedure for issuing of standpoints to individual unit commissioning stages. (Authors)

  10. Working with 'hands-off' support: a qualitative study of multidisciplinary teams' experiences of home rehabilitation for older people.

    Science.gov (United States)

    Randström, Kerstin Björkman; Wengler, Yvonne; Asplund, Kenneth; Svedlund, Marianne

    2014-03-01

    There is a move towards the provision of rehabilitation for older people in their homes. It is essential to ensure that rehabilitation services promote independence of older people. The aim of the study was to explore multidisciplinary teams' experiences of home rehabilitation for older people. Five focus groups were conducted with multidisciplinary teams based in a municipality in Sweden, covering seven different professions. In total, 28 participants volunteered to participate in these interviews. Interviews were transcribed verbatim and analysed according to content analysis. Two main categories, as well as four subcategories, emerged. The first main category, having a rehabilitative approach in everyday life, consisted of the subcategories: 'giving 'hands-off' support' and 'being in a home environment'. The second main category, working across professional boundaries, consisted of the subcategories: 'coordinating resources' and 'learning from each other'. Common goals, communication skills and role understanding contributed to facilitating the teams' performances of rehabilitation. A potential benefit of home rehabilitation, because the older person is in a familiar environment, is to work a rehabilitative approach into each individual's activity in their everyday life in order to meet their specific needs. At an organisational level, there is a need for developing services to further support older people's psychosocial needs during rehabilitation. Team performance towards an individual's rehabilitation should come from an emerged whole and not only from the performance of a specific professional approach depending on the traditional role of each profession. A rehabilitative approach is based on 'hands-off' support in order to incorporate an individual's everyday activities as a part of their rehabilitation. © 2012 Blackwell Publishing Ltd.

  11. Cost-effectiveness Analysis of Nutritional Support for the Prevention of Pressure Ulcers in High-Risk Hospitalized Patients.

    Science.gov (United States)

    Tuffaha, Haitham W; Roberts, Shelley; Chaboyer, Wendy; Gordon, Louisa G; Scuffham, Paul A

    2016-06-01

    To evaluate the cost-effectiveness of nutritional support compared with standard care in preventing pressure ulcers (PrUs) in high-risk hospitalized patients. An economic model using data from a systematic literature review. A meta-analysis of randomized controlled trials on the efficacy of nutritional support in reducing the incidence of PrUs was conducted. Modeled cohort of hospitalized patients at high risk of developing PrUs and malnutrition simulated during their hospital stay and up to 1 year. Standard care included PrU prevention strategies, such as redistribution surfaces, repositioning, and skin protection strategies, along with standard hospital diet. In addition to the standard care, the intervention group received nutritional support comprising patient education, nutrition goal setting, and the consumption of high-protein supplements. The analysis was from a healthcare payer perspective. Key outcomes of the model included the average costs and quality-adjusted life years. Model results were tested in univariate sensitivity analyses, and decision uncertainty was characterized using a probabilistic sensitivity analysis. Compared with standard care, nutritional support was cost saving at AU $425 per patient and marginally more effective with an average 0.005 quality-adjusted life years gained. The probability of nutritional support being cost-effective was 87%. Nutritional support to prevent PrUs in high-risk hospitalized patients is cost-effective with substantial cost savings predicted. Hospitals should implement the recommendations from the current PrU practice guidelines and offer nutritional support to high-risk patients.

  12. eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management.

    Science.gov (United States)

    Rollo, Megan E; Aguiar, Elroy J; Williams, Rebecca L; Wynne, Katie; Kriss, Michelle; Callister, Robin; Collins, Clare E

    2016-01-01

    Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM) behaviors that require tailored education and support. Electronic health (eHealth) technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided.

  13. A quick guide to ethical theory in healthcare: solving ethical dilemmas in nutrition support situations.

    Science.gov (United States)

    Ferrie, Suzie

    2006-04-01

    Ethical dilemmas can be challenging for the nutrition support clinician who is accustomed to evidence-based practice. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle's virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, nonmaleficence, and justice). Adopting a step-by-step approach can simplify the process of resolving ethical problems.

  14. Nutritional support in children and young people with cancer undergoing chemotherapy.

    Science.gov (United States)

    Ward, Evelyn J; Henry, Lisa M; Friend, Amanda J; Wilkins, Simone; Phillips, Robert S

    2015-08-24

    It is well documented that malnutrition is a common complication of paediatric malignancy and its treatment. Malnutrition can often be a consequence of cancer itself or a result of chemotherapy. Nutritional support aims to reverse malnutrition seen at diagnosis, prevent malnutrition associated with treatment and promote weight gain and growth. The most effective and safe forms of nutritional support in children and young people with cancer are not known. To determine the effects of any form of parenteral (PN) or enteral (EN) nutritional support, excluding vitamin supplementation and micronutrient supplementation, in children and young people with cancer undergoing chemotherapy and to determine the effect of the nutritional content of PN and EN. This is an update of a previous Cochrane review. We searched the following databases for the initial review: CENTRAL (The Cochrane Library, Issue 2, 2009), MEDLINE (1950 to 2006), EMBASE (1974 to 2006), CINAHL (1982 to 2006), the National Research Register (2007) and Dissertations & Theses (2007). Experts in the field were also contacted for information on relevant trials. For this update, we searched the same electronic databases from 2006 to September 2013. We also scrutinised the reference lists of included articles to identify additional trials. Randomised or quasi-randomised controlled trials comparing any form of nutritional support with another, or control, in children or young people with cancer undergoing chemotherapy. Two authors independently selected trials. At least two authors independently assessed quality and extracted data. We contacted trialists for missing information. The current review included the eight trials from the initial review and six new trials which randomised 595 participants (group, whereas mean change in serum albumin was significantly greater for that group (MD 0.47, 95% CI 0.13 to 0.81, P = 0.008). Another trial with few participants found an increase in mean energy intake

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

    Science.gov (United States)

    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.

  16. Working toward resilience: a retrospective report of actions taken in support of a New York school crisis team following 9/11.

    Science.gov (United States)

    Johnson, Kendall; Luna, Joanne M Tortorici

    2011-01-01

    A retrospective report details external support rendered to a Lower Manhattan school crisis team following the 9/11/01 terrorist attack on the World Trade Center This analysis occasions an opportunity for consideration of working assumptions, the formative use of data to plan support actions, and the subsequent emergence of a collaborative approach to post-disaster team support in school settings. The nature of assessment and nature of subsequent service delivery illustrates a community resilience-based approach to school crisis management. Recommendations for such work are based upon mixed qualitative and quantitative data gathered from on-scene team members as part of the ongoing support effort.

  17. Effect of mother support groups on nutritional status in children under two years of age in Laisamis village, Kenya.

    Science.gov (United States)

    Undlien, Mattias; Viervoll, Håvard-Amund; Rostad, Berit

    2016-12-01

    In tackling the ongoing malnutrition problem in many parts of Kenya, the government has initialized preventive actions such as mother support groups in order to improve health and nutrition among children. Few studies have evaluated the effectiveness of such intervention. This study aimed at determining how mother support groups affect the nutrition status of children under 2 years of age. 41 children participated. Anthropometric measurements were taken of the children once a month during 12 months. Medical history, nutrition status and socioeconomic factors were collected by interviews with the mothers. The children were divided into two groups depending on their mother's assigned group; mother support group or not. Nutritional status was significantly better among children in the mother support group (P=0.001). There were significantly more children with severe acute malnutrition among the children not in support group (P=0.040). The mean height (P=0.001) and mean weight (P=0.0281) were significantly higher among children in the non-support group. Mother support groups may have a beneficial effect on the nutritional status of children under 2 years of age. Cases of severe acute malnutrition seemed to be less prevalent in children whose mothers attend mother support groups.

  18. Evaluating team-based inter-professional advanced life support training in intensive care-a prospective observational study.

    Science.gov (United States)

    Brewster, D J; Barrett, J A; Gherardin, E; O'Neill, J A; Sage, D; Hanlon, G

    2017-01-01

    Recent focus on national standards within Australian hospitals has prompted a focus on the training of our staff in advanced life support (ALS). Research in critical care nursing has questioned the traditional annual certification of ALS competence as the best method of delivering this training. Simulation and team-based training may provide better ALS education to intensive care unit (ICU) staff. Our new inter-professional team-based advanced life support program involved ICU staff in a large private metropolitan ICU. A prospective observational study using three standardised questionnaires and two multiple choice questionnaire assessments was conducted. Ninety-nine staff demonstrated a 17.8% (95% confidence interval 4.2-31, P =0.01) increase in overall ICU nursing attendance at training sessions. Questionnaire response rates were 93 (94%), 99 (100%) and 60 (61%) respectively; 51 (52%) staff returned all three. Criteria were assessed by scores from 0 to 10. Nurses reported improved satisfaction with the education program (9.4 to 7.1, P versus 7.9 and 8.2, P versus 7.4 and 7.8, P versus 8.1, P =0.04). The new program cost approximately an extra $16,500 in nursing salaries. We concluded that team-based, inter-professional ALS training produced statistically significant improvements in nursing attendance, satisfaction with ALS education, confidence and role understanding compared to traditional ALS training.

  19. Is the support that dental registrants in difficulty receive from postgraduate dental teams and other sources adequate?

    Science.gov (United States)

    Pearce, M; Agius, S J; Macfarlane, J; Taylor, N

    2017-05-26

    Objective The aim of this research was to investigate the views of dental registrants in difficulty (DRiDS) on the support they received from postgraduate dental teams (PgDT) in Health Education England (HEE) and other sources. These data were complemented by the views of those appointed from the PgDT to support them on the service they provide.Method Qualitative data were collected by recording one-to-one semi structured telephone interviews, lasting approximately 30 minutes, with registrants in difficulty and supporters purposefully sampled from across England and Wales. Recordings were transcribed and the interview data analysed for recurring discourses and themes using thematic framework analysis.Setting and subjects All regional leads for DRiDs services in PgDT across the UK were asked to invite the DRiDs they were in contact with and the supporters they had appointed to contact the research team. Attempts were made to contact all who returned consent forms and six DRiDs and 11 supporters were eventually interviewed.Results Overall the DRiDs thought that the PgDT were very helpful. They were in many cases the only source of expert support and advice, particularly with regard to developing a personal development plan and collecting evidence about their practice to present to the regulator. There was a good match between the qualities that DRiDs wanted their supporters to have and the strengths supporters felt they brought to the role. The DRiDs had mixed views about the support provided by their indemnifiers and could not identify any other organisations that provided support once conditions had been imposed. Some had the support of peers; but both DRiDs and supporters felt there was a need for further support in addition to the educational support provided by PgDT and legal support provided by the indemnifier.Conclusion The DRiDS regarded the PgDT as their primary source of support and, in general, were very satisfied with the character and competence of the

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

    Science.gov (United States)

    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

  1. Mobile application for guidance and provision of toddler's nutrition to support e-PKK

    Science.gov (United States)

    Rochimah, S.; Sianipar, F. Y.; Anggraini, R. N. E.

    2016-01-01

    Pembinaan Kesejahteraan Keluarga(PKK)is an Indonesian community with women as its member, especially housewife. It has many purposes, such ascollaborating the knowledges among members, monitoring children's health, supporting healthy life style in the family. This article is part of our research in building e-PKK, an integrated application to support many activities in PKK's business processes. In this paper we build a module to guide and provise toddler's nutrition to be used by mother. This application is very useful since baby's growth phase is an important phase to be noticed by mother.Using this application, mother can easily obtain baby's growth information whenever and wherever they are via their smartphone. This mobile device applications using backward chaining and forward chaining method. Backward chaining method is a method that uses a goal-based approach, while the forward chaining conducting a set of data for later inference process to find optimal conclusion. Moreover, this apllication provides recommendations of groceries, recipes, as well as the suitability of foodstuffs according to the age of early baby's growth and the type of baby's allergic. In addition, it also provide information about baby's nutrition, growth benchmarks, and first aid. Besides, the application can be used to monthly baby growth record like Kartu Menuju Sehat (KMS) or Growth Monitoring Card, storing toddlers weighing, immunization and provision of vitamin A. An additional feature of this application is the complaints system, where other can ask directly to health care center about toddlers’ growth.

  2. Parenteral nutrition support for patients with pancreatic cancer. Results of a phase II study

    Directory of Open Access Journals (Sweden)

    Riess Hanno

    2010-03-01

    Full Text Available Abstract Background Cachexia is a common problem in patients (pts suffering from upper gastrointestinal cancer. In addition, most of these patients suffer from malabsorption and stenosis of the gastrointestinal tract due to their illness. Various methods of supplementary nutrition (enteral, parenteral are practised. In patients with advanced pancreatic cancer (APC, phase angle, determined by bio-electrical impedance analysis (BIA, seems to be a survival predictor. The positive influence of BIA determinate predictors by additional nutrition is currently under discussion. Methods To examine the impact of additional parenteral nutrition (APN we assessed outpatients suffering from APC and progressive cachexia. The assessment based on the BIA method. Assessment parameters were phase angle, ECM/BCM index (ratio of extracellular mass to body cell mass, and BMI (body mass index. Patients suffering from progressive weight loss in spite of additional enteral nutritional support were eligible for the study. Results Median treatment duration in 32 pts was 18 [8-35] weeks. Response evaluation showed a benefit in 27 pts (84% in at least one parameter. 14 pts (43.7% improved or stabilised in all three parameters. The median ECM/BCM index was 1.7 [1.11-3.14] at start of APN and improved down to 1.5 [1.12-3.36] during therapy. The median BMI increased from 19.7 [14.4-25.9] to 20.5 [15.4-25.0]. The median phase angle improved by 10% from 3.6 [2.3-5.1] to 3.9 [2.2-5.1]. Conclusions We demonstrated the positive impact of APN on the assessed parameters, first of all the phase angle, and we observed at least a temporary benefit or stabilisation of the nutritional status in the majority of the investigated patients. Based on these findings we are currently investigating the impact of APN on survival in a larger patient cohort. Trial registration ClinicalTrials.gov Identifier: NCT00919659

  3. The first 500 days of life: policies to support maternal nutrition

    Directory of Open Access Journals (Sweden)

    John B. Mason

    2014-06-01

    Full Text Available Background: From conception to 6 months of age, an infant is entirely dependent for its nutrition on the mother: via the placenta and then ideally via exclusive breastfeeding. This period of 15 months – about 500 days – is the most important and vulnerable in a child's life: it must be protected through policies supporting maternal nutrition and health. Those addressing nutritional status are discussed here. Objective and design: This paper aims to summarize research on policies and programs to protect women's nutrition in order to improve birth outcomes in low- and middle-income countries, based on studies of efficacy from the literature, and on effectiveness, globally and in selected countries involving in-depth data collection in communities in Ethiopia, India and Northern Nigeria. Results of this research have been published in the academic literature (more than 30 papers. The conclusions now need to be advocated to policy-makers. Results: The priority problems addressed are: intrauterine growth restriction (IUGR, women's anemia, thinness, and stunting. The priority interventions that need to be widely expanded for women before and during pregnancy, are: supplementation with iron–folic acid or multiple micronutrients; expanding coverage of iodine fortification of salt particularly to remote areas and the poorest populations; targeted provision of balanced protein energy supplements when significant resources are available; reducing teenage pregnancies; increasing interpregnancy intervals through family planning programs; and building on conditional cash transfer programs, both to provide resources and as a platform for public education. All these have known efficacy but are of inadequate coverage and resourcing. The next steps are to overcome barriers to wide implementation, without which targets for maternal and child health and nutrition (e.g. by WHO are unlikely to be met, especially in the poorest countries. Conclusions: This

  4. Relationship between ways of nutritional support and immune function in patients with malignant obstructive jaundice after PTCD

    Directory of Open Access Journals (Sweden)

    YANG Shenghua

    2014-11-01

    Full Text Available ObjectiveTo investigate the clinical effect of different nutritional therapies on the immune function of patients with malignant obstructive jaundice after percutaneous transhepatic cholangiodrainage (PTCD. MethodsA total of 50 patients with malignant obstructive jaundice who were admitted to our hospital from January 2009 to March 2013 were randomly divided into two groups according to the admission order. The patients in group A (n=25 received enteral nutritional support after PTCD, and those in group B (n=25 received total parenteral nutritional support after PTCD. Intra-group and inter-group comparisons were made in terms of jaundice clearance, nutritional indices, and body’s immune function on preoperative day 1 and postoperative day 7; comparison between the two groups was made by t test. ResultsAmong the 50 patients who underwent PTCD, 39 (78% had good drainage, while 11 (22% did not reach the expectation, of which, 5 (10% were in group A and 6 (12% in group B. In both groups, the nutritional indices on postoperative day 7 were significantly higher than those on preoperative day 1(P<0.05, but no significant difference in these indices was observed between group A and group B on postoperative day 7 (P>0.05. The immune function of patients in both groups was significantly improved following PTCD and nutritional support (P<0.05, but there was no significant difference between the two groups (P>0.05. Although the same scheme of nutritional support was used, there were 11 patients who did not achieve the expected jaundice clearance after PTCD and had limited improvement in immune function compared with those who had complete jaundice clearance (all P<0.05. ConclusionJaundice clearance is closely related to PTCD in patients with malignant obstructive jaundice, but not markedly associated with the ways of nutritional support.

  5. Improvement of nutritional support strategies after surgery for benign liver tumor through nutritional risk screening: a prospective, randomized, controlled, single-blind clinical study.

    Science.gov (United States)

    Lu, Xin; Li, Ying; Yang, Huayu; Sang, Xinting; Zhao, Haitao; Xu, Haifeng; Du, Shunda; Xu, Yiyao; Chi, Tianyi; Zhong, Shouxian; Yu, Kang; Mao, Yilei

    2013-02-01

    The rising of individualized therapy requires nutritional risk screening has become a major topic for each particular disease, yet most of the screenings were for malignancies, less for benign diseases. There is no report on the screening of patients with benign liver tumors postoperatively. We aim to evaluate the nutritional support strategies post operation for benign liver tumors through nutritional risk screening. In this prospective, randomized, controlled study, 95 patients who underwent hepatectomy for benign tumors were divided into two groups. Fifty patients in the control group were given routine permissive underfeeding nutritional supply (75 kJ/kg/d), and 45 patients in the experimental group were given lower energy (42 kJ/kg/d) in accordance of their surgical trauma. Routine blood tests, liver/kidney function were monitored before surgery and at the day 1, 3, 5, 9 after surgery, patients were observed for the time of flatus, complications, length of hospitalization (LOH), nutrition-related costs, and other clinical parameters. This completed study is registered with Clinicaltrials.gov, number NCT01292330. The nutrition-related expenses (494.0±181.0 vs. 1,514.4±348.4 RMB, Pgroup were significantly lower than those in the control group. Meanwhile, the lowered energy supply after the surgeries did not have adverse effects on clinical parameters, complications, and LOH. Patient with benign liver tumors can adopt an even lower postoperative nutritional supply that close to that for mild non-surgical conditions, and lower than the postoperative permissive underfeeding standard.

  6. Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: neurocritical patient.

    Science.gov (United States)

    Acosta Escribano, J; Herrero Meseguer, I; Conejero García-Quijada, R

    2011-11-01

    Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calorie intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL.

  7. [Nutrition therapy of cancer patients].

    Science.gov (United States)

    Lövey, József

    2017-09-20

    The majority of cancer patients becomes malnourished during the course of their disease. Malnutrition deteriorates the efficiency of all kinds of oncologic interventions. As a consequence of it, treatment-related toxicity increases, hospital stay is lengthened, chances of cure and survival as well as the quality of life of the patients worsen. Nutritional status therefore influences all aspects of outcome of oncology care. In spite of this the use of nutritional therapy varies across health care providers but its application is far from being sufficient during active oncology interventions as well as rehabilitation and supportive care. It threatens not only the outcome and quality of life of cancer patients but also the success of oncologic treatments which often demand high input of human and financial resources. Meanwhile application of nutritional therapy is legally regulated in Hungary and a very recent update of the European guideline on cancer patient nutrition published in 2017 is available. Moreover, cost effectiveness of nutritional therapy has been proven in a number of studies. In this review we present the basics of nutritional therapy including nutritional screening and evaluation, nutritional plan, the role of nutrition support teams, oral, enteral and parenteral nutrition, the use of different drugs and special nutrients and the follow-up of the patients.

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

    International Nuclear Information System (INIS)

    Szeluga, D.J.

    1985-01-01

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

  9. Development of Nutrition Education Using support tools to select a well-balanced diet in the Homemaking in Elementary School

    OpenAIRE

    Itou, Keiko; Yamaguchi, Satoshi; Yamamoto, Nami; Ishida, Hiroko

    2015-01-01

    The implementation plan of the nutrition education for children of 5th graders of the elementary school using the support tools to select a well-balanced diet was developed and practiced. The children’ behavior in the learning process were recorded and analyzed to empirically examine the effect of the nutrition education on the students in their learning process of nutrition knowledge as well as in their acquiring process of behavior to arrange a well-balanced diet.   The results were as ...

  10. Personal and organisational vision supporting leadership in a team-based transport environment

    Directory of Open Access Journals (Sweden)

    Theuns F.J. Oosthuizen

    2012-11-01

    Full Text Available Leadership in an operational environment requires operational employees to take on responsibility as leaders. This leadership role could vary from self-leadership to team leadership with personal and organisational vision as key drivers for operational leadership performance. The research population included operational employees working in a transport environment who attended a leadership development seminar. A census was conducted using a questionnaire-based empirical research approach. Data analysis was conducted using SPSS, and the results were analysed. Responses indicate the development of an awareness of the importance of values and vision in order to establish effective leadership practices through the leadership development programme. Research confirmed the importance of vision as a key driver in operational leadership in this context. Further skill development is required on how to align personal values and vision with that of the organisation (department within which operational employees function.

  11. Relationship between ways of nutritional support and immune function in patients with malignant obstructive jaundice after PTCD

    OpenAIRE

    YANG Shenghua

    2014-01-01

    ObjectiveTo investigate the clinical effect of different nutritional therapies on the immune function of patients with malignant obstructive jaundice after percutaneous transhepatic cholangiodrainage (PTCD). MethodsA total of 50 patients with malignant obstructive jaundice who were admitted to our hospital from January 2009 to March 2013 were randomly divided into two groups according to the admission order. The patients in group A (n=25) received enteral nutritional support after PTCD, and t...

  12. Focused and Corrective Feedback Versus Structured and Supported Debriefing in a Simulation-Based Cardiac Arrest Team Training: A Pilot Randomized Controlled Study.

    Science.gov (United States)

    Kim, Ji-Hoon; Kim, Young-Min; Park, Seong Heui; Ju, Eun A; Choi, Se Min; Hong, Tai Yong

    2017-06-01

    The aim of the study was to compare the educational impact of two postsimulation debriefing methods-focused and corrective feedback (FCF) versus Structured and Supported Debriefing (SSD)-on team dynamics in simulation-based cardiac arrest team training. This was a pilot randomized controlled study conducted at a simulation center. Fourth-year medical students were randomly assigned to the FCF or SSD group, with each team composed of six students and a confederate. Each team participated in two simulations and the assigned debriefing (FCF or SSD) sessions and then underwent a test simulation. Two trained raters blindly assessed all of the recorded simulations using checklists. The primary outcome was the improvement in team dynamics scores between baseline and test simulation. The secondary outcomes were improvements before and after training in team clinical performance scores, self-assessed comprehension of and confidence in cardiac arrest management and team dynamics, as well as evaluations of the postsimulation debriefing intervention. In total, 95 students participated [FCF (8 teams, n = 47) and SSD (8 teams, n = 48)]. The SSD team dynamics score during the test simulation was higher than at baseline [baseline: 74.5 (65.9-80.9), test: 85.0 (71.9-87.6), P = 0.035]. However, there were no differences in the improvement in the team dynamics or team clinical performance scores between the two groups (P = 0.328, respectively). There was no significant difference in improvement in team dynamics scores during the test simulation compared with baseline between the SSD and FCF groups in a simulation-based cardiac arrest team training in fourth-year Korean medical students.

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

    Science.gov (United States)

    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.

  14. Using the analytic hierarchy process to support teams in defining new product objectives

    NARCIS (Netherlands)

    Hummel, J.M.; Verkerke, G.J.; van Rossum, W.; Rakhorst, G.; Hummel, J.M.

    2001-01-01

    Defining new product objectives is a critical problem solving activity to new product success. The analytic hierarchy process appears to be an adequate technique for multi-criteria decision analysis to support the definition of new product objectives. To illustrate this support, we applied this

  15. Shifting Spaces and Emerging Voices: Participation, Support, and Conflict in One School Administrative Team

    Science.gov (United States)

    Austin, Manila S.; Harkins, Debra A.

    2008-01-01

    Research Findings: Collaborative work and supportive relationships are highly valued by teachers and school administrators. Collaboration, however, necessitates constructive conflict resolution (P. M. Senge, 1990); yet conflict is often experienced as interpersonally threatening and undermining supportive working conditions. This contradiction is…

  16. Pharmacological and nutritive support of patients with benign prostatic hyperplasia and chronic prostatitis

    Directory of Open Access Journals (Sweden)

    A. B. Bat'ko

    2015-01-01

    Full Text Available The articles presents a view of the pharmacological and nutritive therapy of the most frequent diseases of males, which are benign prostatic hyperplasia and chronic prostatitis. A modern man is in constant deficiency of various biologically active substances, with the lack of them in food and without generating of sufficient quantity of coenzymes and enzymes. In the author,s opinion, complex drugs that contain highquality biological extracts may provide the substances required for prevention and slowing down the progress of benign prostatic hyperplasia and chronic prostatitis to the male organism. Study of biological activity of food supplement Andro-PRO (Russia that contain the elements required for normalization of the functional state of the prostate was performed. Application of the drug favors positive dynamics of clinical symptoms of the studied nosological entities and has restorative effect on the function of the glandular tissue of the prostate. Analysis of modern references, primary results of clinical studies show the necessity of pharmacological and nutritive support of patients with asymptomatic progress of benign prostatic hyperplasia and chronic prostatitis with the drug. Application of drug studied is efficient and safe, which is confirmed with improvement of indicators and life quality assessment, positive clinical dynamics, and absence of side effects. 

  17. Changes in body composition of cancer patients following combined nutritional support

    International Nuclear Information System (INIS)

    Cohn, S.H.; Vartsky, D.; Vaswani, A.N.; Sawitsky, A.; Rai, K.; Gartenhaus, W.; Yasumura, S.; Ellis, K.J.

    1982-01-01

    The effects of combined nutritional support (parenteral, enteral, and oral) were measured in cancer patients unable to maintain normal alimentation.Changes in body composition were quantified by measurement of total body levels of nitrogen, potassium, water, and fat. The protein-calorie intake of the patients was also evaluated by dietary survey (4-day recall). Standard anthropometric and biochemical measurements for nutritional assessment were obtained for comparison. The dietary evaluation indicated that the dietary supplementation for all patients was more than adequate to meet their energy requirements. Determination of body composition indicated that change in body weight was equal to the sum of the changes in body protein, total body water, and total body fat. Information on the nature of the tissue gained was obtained by comparison of body composition data with the ratio of protein:water:lean body mass for normal tissue. The mean gain of protein in the cancer patients was quite small (0.3-0.6 kg). The main change in body weight appeared to be the result of gains in body water and body fat. The total body nitrogen to potassium ratio served to define the extent of tissue anabolism following hyperalimentation. The ratio dropped in the cancer patients following hyperalimentation toward the value of the control subjects on ad libitum diets. Total body nitrogen was determined by prompt gamma neutron activation analysis, total body potassium by whole-body counting

  18. Decision Support for Software Process Management Teams: An Intelligent Software Agent Approach

    National Research Council Canada - National Science Library

    Church, Lori

    2000-01-01

    ... to market, eliminate redundancy, and ease job stress. This thesis proposes a conceptual model for software process management decision support in the form of an intelligent software agent network...

  19. Carbon Capture Multidisciplinary Simulation Center Trilab Support Team (TST) Fall Meeting 2016 Report

    Energy Technology Data Exchange (ETDEWEB)

    Draeger, Erik W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-01-03

    The theme of this year’s meeting was “Predictivity: Now and in the Future”. After welcoming remarks, Erik Draeger gave a talk on the NNSA Labs’ history of predictive simulation and the new challenges faced by upcoming architecture changes. He described an example where the volume of analysis data produced by a set of inertial confinement fusion (ICF) simulations on the Trinity machine was too large to store or transfer, and the steps needed to reduce it to a manageable size. He also described the software re-engineering plan for LLNL’s suite of multiphysics codes and physics packages with a new push toward common components, making collaboration with teams like the CCMSC who already have experience trying to architect complex multiphysics code infrastructure on next-generation architectures all the more important. Phil Smith then gave an overview outlining the goals of the project, namely to accelerate development of new technology in the form of high efficiency carbon capture pulverized coal power generation as well as further optimize existing state of the art designs. He then presented a summary of the Center’s top-down uncertainty quantification approach, in which ultimate target predictivity informs uncertainty targets for lower-level components, and gave data on how close all the different components currently are to their targets. Most components still need an approximately two-fold reduction in uncertainty to hit the ultimate predictivity target, but the current accuracy is already rather impressive.

  20. Leadership training and delivery prospects of team leaders in Communication Network Support Services Limited, Ilorin

    Directory of Open Access Journals (Sweden)

    Abdulahi G. Olatunji

    2017-10-01

    Full Text Available Training and development of staff has been one of the key focuses of every human resources department of any formal work organisation. This is as a result of the realisation that training is an important determinant of people’s behaviour as well as their general delivery ability at work. In realisation of this, intellectuals and researchers in industrial relations generally have put vested interest in the phenomena of training and work delivery ability. However, despite the enormous volume of literatures available in this regard, very few among them have specifically examined the importance of leadership training as a possible determinant of work delivery. Thus, this study is an attempt to cover this gap. In order to achieve this objective, survey design was used as the research design for the study. A questionnaire was used to elicit information from the respondents, while simple random sampling technique was used to select the study sample. Frequency distribution and percentage were used as descriptive tools, while chi-square was used as an inferential statistical tool in the study. The study found out that leadership training has a significant relationship with the identified work delivery elements measured in the study. The study concluded that leadership training has a significant effect on delivery ability of team leaders and thus recommended that leadership training should be given utmost priority in work organisations so that work delivery prospects of the employees could be realised.

  1. The proliferation of multidisciplinary team meetings (MDTMs): how can radiology departments continue to support them all?

    International Nuclear Information System (INIS)

    Balasubramaniam, Ravivarma; Subesinghe, Manil; Smith, Jonathan T.

    2015-01-01

    To quantify the changes in multidisciplinary team meeting (MDTM) workload for consultant radiologists working in a single UK tertiary referral cancer institution, assess its impact and suggest solutions to these challenges. The annual number of MDTM cases was collated over a 5-year period (2009 - 2013). Qualitative information was obtained through questionnaire-based interviews of 47 consultant radiologists. Data analysed included number of MDTMs involved with, type of MDTM (oncological or non-oncological), time allocation for preparation and perceived deficiencies in the current MDTM. Thirteen thousand and forty-nine cases were discussed in MDTMs in 2009 with a continued yearly increase over the 5-year period. Fifty-five percent of MDTM attendances were at oncological MDTMs. Consultant radiologists attended a median of two MDTMs per week, each requiring 4 hours time commitment; 60 % used out-of-hours time for MDTM preparation. The most frequently cited MDTM deficiency was lack of sufficient clinical input. The MDTM is a challenging but worthwhile demand on the modern radiologist's time. Solutions to the increasing MDTM workload include demonstration of the benefits of MDTMs to hospital administrators to justify additional resources required, improving MDTM efficiency and ensuring this increased workload is accurately represented and remunerated in individual job plans. (orig.)

  2. The proliferation of multidisciplinary team meetings (MDTMs): how can radiology departments continue to support them all?

    Energy Technology Data Exchange (ETDEWEB)

    Balasubramaniam, Ravivarma; Subesinghe, Manil; Smith, Jonathan T. [St. James' University Hospital, Leeds Teaching Hospitals NHS Trust, Department of Clinical Radiology, Leeds (United Kingdom)

    2015-12-15

    To quantify the changes in multidisciplinary team meeting (MDTM) workload for consultant radiologists working in a single UK tertiary referral cancer institution, assess its impact and suggest solutions to these challenges. The annual number of MDTM cases was collated over a 5-year period (2009 - 2013). Qualitative information was obtained through questionnaire-based interviews of 47 consultant radiologists. Data analysed included number of MDTMs involved with, type of MDTM (oncological or non-oncological), time allocation for preparation and perceived deficiencies in the current MDTM. Thirteen thousand and forty-nine cases were discussed in MDTMs in 2009 with a continued yearly increase over the 5-year period. Fifty-five percent of MDTM attendances were at oncological MDTMs. Consultant radiologists attended a median of two MDTMs per week, each requiring 4 hours time commitment; 60 % used out-of-hours time for MDTM preparation. The most frequently cited MDTM deficiency was lack of sufficient clinical input. The MDTM is a challenging but worthwhile demand on the modern radiologist's time. Solutions to the increasing MDTM workload include demonstration of the benefits of MDTMs to hospital administrators to justify additional resources required, improving MDTM efficiency and ensuring this increased workload is accurately represented and remunerated in individual job plans. (orig.)

  3. Assessment of the Pre-operative Nutritional Status of Patients who were Scheduled for Elective Surgery and Determination of Nutritional Support Requirements

    Directory of Open Access Journals (Sweden)

    Bahri Özer

    2016-12-01

    Full Text Available Aim: We aimed to evaluate the nutritional status with clinical, antropometric and laboratory methods in patients who were scheduled for elective surgery. Methods: Retrospective evaluation of 90 patients in a period of 4 years was performed. Patients with tumors (group 1 were compared with controls (group 2 in regard to nutritional status. Student t-test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results: The mean age of patients in group 1 (3 males, 8 females and group 2 (35 males, 44 females was 62.8±11.0 and 47.7±16.2 years, respectively. The mean body mass index (BMI was 30.1±6.6. Triceps thickness and circumference of the upper mid-arm were 2.2±0.8 and 28.6±4.2 cm, respectively. All patients had a Subjective Global Assessment (SGA score A, but two patients were classified as having moderate nutritional risk according to Nutritional Risk Screening (NRS 2002. The mean length of hospital stay was 2.6±2.4 days. Complications were observed in four patients of group 2 and in two patients of group 1. Gender, SGA score, albumin, prealbumin, BMI, triceps thickness, circumference of the upper mid-arm and complication rates were statistically similar between the groups. There was a statistically significant difference in age, NRS 2002, gastrointestinal system findings, length of hospital stay, sedimentation and fasting blood glucose levels between the groups. Conclusion: Patients with nutritional risk can be detected using the NRS 2002. Nutritional support was necessary in 2% of all cases and in 18% of group 1 patients. However, advantages of antropometric measurements, biochemical tests, BMI and SGA could not be shown.

  4. The role of nutritional support in the physical and functional recovery of critically ill patients: a narrative review.

    Science.gov (United States)

    Bear, Danielle E; Wandrag, Liesl; Merriweather, Judith L; Connolly, Bronwen; Hart, Nicholas; Grocott, Michael P W

    2017-08-26

    The lack of benefit from randomised controlled trials has resulted in significant controversy regarding the role of nutrition during critical illness in terms of long-term recovery and outcome. Although methodological caveats with a failure to adequately appreciate biological mechanisms may explain these disappointing results, it must be acknowledged that nutritional support during early critical illness, when considered alone, may have limited long-term functional impact.This narrative review focuses specifically on recent clinical trials and evaluates the impact of nutrition during critical illness on long-term physical and functional recovery.Specific focus on the trial design and methodological limitations has been considered in detail. Limitations include delivery of caloric and protein targets, patient heterogeneity, short duration of intervention, inappropriate clinical outcomes and a disregard for baseline nutritional status and nutritional intake in the post-ICU period.With survivorship at the forefront of critical care research, it is imperative that nutrition studies carefully consider biological mechanisms and trial design because these factors can strongly influence outcomes, in particular long-term physical and functional outcome. Failure to do so may lead to inconclusive clinical trials and consequent rejection of the potentially beneficial effects of nutrition interventions during critical illness.

  5. Combined enteral feeding and total parenteral nutritional support improves outcome in surgical intensive care unit patients.

    Science.gov (United States)

    Hsu, Min-Hui; Yu, Ying E; Tsai, Yueh-Miao; Lee, Hui-Chen; Huang, Ying-Che; Hsu, Han-Shui

    2012-09-01

    For intensive care unit (ICU) patients with gastrointestinal dysfunction and in need of total parenteral nutrition (TPN) support, the benefit of additional enteral feeding is not clear. This study aimed to investigate whether combined TPN with enteral feeding is associated with better outcomes in surgical intensive care unit (SICU) patients. Clinical data of 88 patients in SICU were retrospectively collected. Variables used for analysis included route and percentage of nutritional support, total caloric intake, age, gender, body weight, body mass index, admission diagnosis, surgical procedure, Acute Physiology and Chronic Health Evaluation (APACHE) II score, comorbidities, length of hospital stay, postoperative complications, blood glucose values and hospital mortality. Wound dehiscence and central catheter infection were observed more frequently in the group of patients receiving TPN calories less than 90% of total calorie intake (p = 0.004 and 0.043, respectively). APACHE II scores were higher in nonsurvivors than in survivors (p = 0.001). More nonsurvivors received TPN calories exceeding 90% of total calorie intake and were in need of dialysis during ICU admission (p = 0.005 and 0.013, respectively). Multivariate analysis revealed that the percentage of TPN calories over total calories and APACHE II scores were independent predictors of ICU mortality in patients receiving supplementary TPN after surgery. In SICU patients receiving TPN, patients who could be fed enterally more than 10% of total calories had better clinical outcomes than patients receiving less than 10% of total calorie intake from enteral feeding. Enteral feeding should be given whenever possible in severely ill patients. 2012 Published by Elsevier B.V

  6. Crusader Automated Docking System: Technology support for the Crusader Resupply Team. Interim report, Ammunition Logistics Program

    Energy Technology Data Exchange (ETDEWEB)

    Kring, C.T.; Varma, V.K.; Jatko, W.B.

    1995-11-01

    The US Army and Team Crusader (United Defense, Lockheed Martin Armament Systems, etc.) are developing the next generation howitzer, the Crusader. The development program includes an advanced, self-propelled liquid propellant howitzer and a companion resupply vehicle. The resupply vehicle is intended to rendezvous with the howitzer near the battlefront and replenish ammunition, fuel, and other material. The Army has recommended that Crusader incorporate new and innovative technologies to improve performance and safety. One conceptual design proposes a robotic resupply boom on the resupply vehicle to upload supplies to the howitzer. The resupply boom would normally be retracted inside the resupply vehicle during transit. When the two vehicles are within range of the resupply boom, the boom would be extended to a receiving port on the howitzer. In order to reduce exposure to small arms fire or nuclear, biological, and chemical hazards, the crew would remain inside the resupply vehicle during the resupply operation. The process of extending the boom and linking with the receiving port is called docking. A boom operator would be designated to maneuver the boom into contact with the receiving port using a mechanical joystick. The docking operation depends greatly upon the skill of the boom operator to manipulate the boom into docking position. Computer simulations at the National Aeronautics and Space Administration have shown that computer-assisted or autonomous docking can improve the ability of the operator to dock safely and quickly. This document describes the present status of the Crusader Autonomous Docking System (CADS) implemented at Oak Ridge National laboratory (ORNL). The purpose of the CADS project is to determine the feasibility and performance limitations of vision systems to satisfy the autonomous docking requirements for Crusader and conduct a demonstration under controlled conditions.

  7. Experimental Products Development Team (EPDT) Supporting New AWIPS . Part 2; Capabilities

    Science.gov (United States)

    Burks, Jason E.

    2015-01-01

    In 2012, the Experimental Products Development Team (EPDT) was formed within NASA's Short-term Prediction Research and Transition (SPoRT) Center to create training for development of plug-ins to extend the National Weather Service (NWS) Advanced Weather Interactive Processing System (AWIPS) version 2. The broader atmospheric science community had a need for AWIPS II development training being created at SPoRT and EPDT was expanded to include other groups who were looking for training. Since the expansion of the group occurred, EPDT has provided AWIPS II development training to over thirty participants spanning a wide variety of groups such as NWS Systems Engineering Center, NWS Meteorological Development Laboratory, and several NOAA Cooperative Institutes. Participants within EPDT solidify their learning experience through hands-on learning and by participating in a "code-sprint" in which they troubleshoot existing and develop plug-ins. The hands-on learning workshop is instructor lead with participants completing exercises within the AWIPS II Development Environment. During the code sprints EPDT groups work on projects important to the community and have worked on various plug-ins such as an RGB image recipe creation tool, and an mPing (crowd sourced precipitation type reporting system) ingest and display. EPDT has developed a well-defined training regime which prepares participants to fully develop plug-ins for the extendible AWIPS II architecture from ingest to the display of new data. SPoRT has hosted 2 learning workshops and 1 code sprint over the last two years, and continues to build and shape the EPDT group based on feedback from previous workshops. The presentation will provide an overview of EPDT current and future activities, and best practices developed within EPDT.

  8. The proliferation of multidisciplinary team meetings (MDTMs): how can radiology departments continue to support them all?

    Science.gov (United States)

    Balasubramaniam, Ravivarma; Subesinghe, Manil; Smith, Jonathan T

    2015-12-01

    To quantify the changes in multidisciplinary team meeting (MDTM) workload for consultant radiologists working in a single UK tertiary referral cancer institution, assess its impact and suggest solutions to these challenges. The annual number of MDTM cases was collated over a 5-year period (2009 - 2013). Qualitative information was obtained through questionnaire-based interviews of 47 consultant radiologists. Data analysed included number of MDTMs involved with, type of MDTM (oncological or non-oncological), time allocation for preparation and perceived deficiencies in the current MDTM. Thirteen thousand and forty-nine cases were discussed in MDTMs in 2009 with a continued yearly increase over the 5-year period. Fifty-five percent of MDTM attendances were at oncological MDTMs. Consultant radiologists attended a median of two MDTMs per week, each requiring 4 hours time commitment; 60 % used out-of-hours time for MDTM preparation. The most frequently cited MDTM deficiency was lack of sufficient clinical input. The MDTM is a challenging but worthwhile demand on the modern radiologist's time. Solutions to the increasing MDTM workload include demonstration of the benefits of MDTMs to hospital administrators to justify additional resources required, improving MDTM efficiency and ensuring this increased workload is accurately represented and remunerated in individual job plans. • MDTMs improve cancer outcomes and are being recommended for non-oncological conditions. • MDTM cases have more than doubled over 5 years at our institution. • Incorporating MDTM workload into current consultant radiologist job plans is difficult. • Solutions include demonstrating MDTM related benefits, improved efficiency, and accurate job planning.

  9. Supporting rural remote physicians to conduct a study and write a paper: experience of Clinical Research Support Team (CRST)-Jichi.

    Science.gov (United States)

    Matsubara, S; Ohkuchi, A; Kamesaki, T; Ishikawa, S; Nakamura, Y; Matsumoto, M

    2014-01-01

    Jichi Medical University (JMU) is the only medical school in Japan that is devoted solely to producing rural and remote doctors. To support research activities of its graduates, mainly young graduates under obligatory rural service, JMU established a voluntary team, Clinical Research Support Team (CRST)-Jichi. CRST-Jichi consists of current and past JMU faculty members; all of them are specialists of certain medical fields and many are also graduates of JMU who have completed rural service. A client who asks the CRST for advice on study design or editing a paper emails the CRST to ask for support in conducting a study. Then, core members of the CRST assign the job to a registered specialist of the corresponding topic, who becomes a 'responsible supporter' and continues to support the client until a paper has been published. During the 3 years from July 2010, 12 English papers have been published in international peer-review journals, two Japanese papers in domestic journals, and 13 studies are in progress. Ninety-one percent of clients were satisfied with the service, and eighty-two percent considered their papers would not have been published if they had not used the service. Sense of commitment, existence of JMU-graduated specialists, and quick response were reported by clients as major strengths of CRST-Jichi. The experience of CRST-Jichi can potentially be transferred to not only other Japanese medical schools with rural doctor production programs, which are now rapidly increasing as part of a national policy, but also rural medical education systems in other countries.

  10. Surgery in esophageal and gastric cancer patients: what is the role for nutrition support in your daily practice?

    Science.gov (United States)

    Mariette, Christophe; De Botton, Marie-Laure; Piessen, Guillaume

    2012-07-01

    Cancers of the esophagus and stomach have a major impact on patients' nutritional status by virtue of these organs' inherent digestive functions. Many patients with these cancers will require surgical intervention, which imposes further metabolic demands and compounds preexisting nutritional disorders. Patients with esophagogastric cancer are likely to have lost weight by the time the diagnosis is made. This fact alone is of clinical importance, because it is well known that patients who have lost weight will have higher operative mortality and morbidity rates than patients who maintain their weight. Initial assessment of patients with esophagogastric cancer should include a routine evaluation of nutritional status. This will allow the identification of patients who are at risk of complications, particularly in the postoperative setting. These patients should be targeted for specific nutritional support.

  11. Main strategies of specialists’ team work on psychosocial support for women with alopecia

    Directory of Open Access Journals (Sweden)

    V. V. Zhyvylko

    2017-06-01

    Full Text Available In compliance with the principles of bioethics and deontology, during  2013-2017, acomprehensive examination of women with a diagnosis of «total alopecia» was conducted on the basis of the Center for Reconstructive and Restorative Medicine of the Clinic of theOdessaNationalMedicalUniversity. 233 women aged 22 - 45 years old were examined. 76 persons had passed outpatient comprehensive course of author therapy, and 62 persons received treatment in accordance with the «Clinical protocol» but did not receive comprehensive psychosocial assistance. The patients under examination had violations in  psycho-emotional, personal level, level of social functioning. A range of measures of psychosocial support, aimed at providing qualified transdisciplinary help to the patients and their families have been worked out. Their effectiveness is proved on the basis of evidence-based medicine. Within the framework of the research the peculiarities of the psychoemotional sphere of women with total alopecia are determined. Scientifically substantiated, developed and implemented in practice psychosocial support of women with total alopecia, which consisted of psycho-corrective measures using modern mobile e-health technologies. Approbation of measures of psychosocial support showed their effectiveness in 70,89% of cases (р≤0,05. Due to the allocation and systematization of predictors, provocative and supporting factors of diseases, the system of modular medical and social prevention of total alopecia in women was developed, which includes three modules: universal, indicative and selective prevention.

  12. A Team Formation and Project-based Learning Support Service for Social Learning Networks

    NARCIS (Netherlands)

    Spoelstra, Howard; Van Rosmalen, Peter; Van de Vrie, Evert; Obreza, Matija; Sloep, Peter

    2014-01-01

    The Internet affords new approaches to learning. Geographically dispersed self-directed learners can learn in computer-supported communities, forming social learning networks. However, self-directed learners can suffer from a lack of continuous motivation. And surprisingly, social learning networks

  13. Medical Issues: Nutrition

    Science.gov (United States)

    ... support & care > living with sma > medical issues > nutrition Nutrition Good nutrition is essential to health and growth. ... must make decisions based on their own needs. Nutrition Considerations Since we are still waiting for clinical ...

  14. Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: randomized controlled trial.

    NARCIS (Netherlands)

    Verheijden, M.W.; Bakx, J.C.; Akkermans, R.; Hoogen, van den H.; Godwin, M.; Rosser, W.; Staveren, van W.A.; Weel, van C.

    2004-01-01

    Background: Using the Internet may prove useful in providing nutrition counselling and social support for patients with chronic diseases. Objective: We evaluated the impact of Web-based nutrition counselling and social support on social support measures, anthropometry, blood pressure, and serum

  15. Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: randomized controlled trial.

    NARCIS (Netherlands)

    Verheijden, M.E.; Bakx, J.C.; Akkermans, R.P.; Hoogen, H.J.M. van den; Godwin, N.M.; Rosser, W.W.; Staveren, W.A. van; Weel, C. van

    2004-01-01

    BACKGROUND: Using the Internet may prove useful in providing nutrition counselling and social support for patients with chronic diseases. OBJECTIVE: We evaluated the impact of Web-based nutrition counselling and social support on social support measures, anthropometry, blood pressure, and serum

  16. Web-based targeted nutrition counselling and social support for patients at increased cardiovascular risk in general practice: Randomized controlled trial

    NARCIS (Netherlands)

    Verheijden, M.; Bakx, J.C.; Akkermans, R.; Hoogen, H. van den; Godwin, N.M.; Rosser, W.; Staveren, W. van; Weel, C. van

    2004-01-01

    Background: Using the Internet may prove useful in providing nutrition counselling and social support for patients with chronic diseases. Objective: We evaluated the impact of Web-based nutrition counselling and social support on social support measures, anthropometry, blood pressure, and serum

  17. Social value of a nutritional counselling and support program for breastfeeding in urban poor settings, Nairobi.

    Science.gov (United States)

    Goudet, Sophie; Griffiths, Paula L; Wainaina, Caroline W; Macharia, Teresia N; Wekesah, Frederick M; Wanjohi, Milka; Muriuki, Peter; Kimani-Murage, Elizabeth

    2018-04-02

    In Kenya, poor maternal nutrition, suboptimal infant and young child feeding practices and high levels of malnutrition have been shown among the urban poor. An intervention aimed at promoting optimal maternal infant and young child nutrition (MIYCN) practices in urban poor settings in Nairobi, Kenya was implemented. The intervention involved home-based counselling of pregnant and breastfeeding women and mothers of young children by community health volunteers (CHVs) on optimal MIYCN practices. This study assesses the social impact of the intervention using a Social Return on Investment (SROI) approach. Data collection was based on SROI methods and used a mixed methods approach (focus group discussions, key informant interviews, in-depth interviews, quantitative stakeholder surveys, and revealed preference approach for outcomes using value games). The SROI analysis revealed that the MIYCN intervention was assessed to be highly effective and created social value, particularly for mothers and their children. Positive changes that participants experienced included mothers being more confident in child care and children and mothers being healthier. Overall, the intervention had a negative social impact on daycare centers and on health care providers, by putting too much pressure on them to provide care without providing extra support. The study calculated that, after accounting for discounting factors, the input ($USD 419,716) generated $USD 8 million of social value at the end of the project. The net present value created by the project was estimated at $USD 29.5 million. $USD 1 invested in the project was estimated to bring USD$ 71 (sensitivity analysis: USD$ 34-136) of social value for the stakeholders. The MIYCN intervention showed an important social impact in which mothers and children benefited the most. The intervention resulted in better perceived health of mothers and children and increased confidence of mothers to provide care for their children, while it

  18. Danish evidence-based clinical guideline for use of nutritional support in pulmonary rehabilitation of undernourished patients with stable COPD

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Iepsen, Ulrik Winning; Topperup, Randi

    2015-01-01

    Background and aims Disease-related under-nutrition is a common problem in individuals with COPD. The rationale for nutritional support in pulmonary rehabilitation therefore seems obvious. However there is limited evidence regarding the patient-relevant outcomes i.e. activities of daily living (ADL......) or quality of life. Therefore the topic was included in The Danish Health and Medicines Authority's development of an evidence-based clinical guideline for rehabilitation of patients with stable COPD. Methods The methods were specified by The Danish Health and Medicines Authority as part of a standardized...... studies had been published. There were evidence of moderate quality that nutritional support for undernourished patients with COPD lead to a weight gain of 1.7 kg (95% confidence interval: 1.3 to 2.2 kg), but the effect was quantified as a mean change from baseline, which is less reliable. There were...

  19. A Reflection on the Work of an Educational Psychologist in Providing Supervision for a Team of Community Based Support Workers, Supporting Families with Vulnerable Adolescents at Risk of Exclusion from School

    Science.gov (United States)

    Maxwell, Tim

    2013-01-01

    The evolving role of the educational psychologist (EP) is discussed with an emphasis on the supervision provided for a team of support workers for vulnerable adolescents, working within a Local Service Team. This development is considered in the context of the Every Child Matters (DfES, 2004) agenda and the Farrell, Woods, Lewis, Rooney, Squire…

  20. Adding A Dietician to the Liaison-Team after Discharge of Geriatric Patients at Nutritional Risk May Save Health Care Costs

    DEFF Research Database (Denmark)

    Pohju, Anne; Belqaid, Kerstin; Brandt, Christopher

    2016-01-01

    with (intervention group, IG) or without a dietitian (control group, CG). The IG received three home visits by the dietitian during a 12-week period. Data included in the economic analysis was time spent by the dietitian, use of oral nutritional supplements (ONS) and number of hospitalization days. Results......: Of the 71 included patients, 34 were in the IG, 30 patients received all three dietitian visits. Cumulated number of hospitalization days was 172 in the IG and 415 in the CG. Use of ONS was 48 % in the IG and 17% in the CG (P=0.001). Estimated cost for the dietitian and ONS combined in the IG was €9......,416 compared to €1,150 (ONS only) in the CG. For hospitalizations, estimated cost was €92,020 in the IG and €220,025 in the CG. Cost savings added up to €3,048 per patient in the IG. Conclusion: Adding a dietitian to a Danish geriatric discharge Liaison-Team decreased health care costs...

  1. CERN’s Rugby Club to play the Swiss Cup semi-finals: come and support the CERN team!

    CERN Multimedia

    2011-01-01

    On Saturday 25 June, the CERN’s Rugby Club will be playing in the Swiss Cup semi-final against the Hermance Rugby Club. Although the CERN club has had a less than stellar year in the Swiss national first division, they earned a place in the Cup semi-final after beating Bern 30 – 0 and La Chaux-de-Fonds 38 – 7. The club last made it to the Swiss Cup semi-finals in 2002, where they lost to Hermance (the most successful Swiss rugby club, followed closely by CERN’s). Show your support for the CERN team and help them reach the Swiss Cup final by going to the 25 June match at 15.00 in the CERN pitch.  

  2. Creating supportive nutrition environments for population health impact and health equity: an overview of the Nutrition and Obesity Policy Research and Evaluation Network's efforts.

    Science.gov (United States)

    Blanck, Heidi M; Kim, Sonia A

    2012-09-01

    Childhood obesity is a major threat to individual health and society overall. Policies that support healthier food and beverage choices have been endorsed by many decision makers. These policies may reach a large proportion of the population or in some circumstances aim to reduce nutrition disparities to ensure health equity. The Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) evaluates policy as a tool to improve food and beverage environments where Americans live, work, play, and learn. The network aspires to address research and evaluation gaps related to relevant policies, create standardized research tools, and help build the evidence base of effective policy solutions for childhood obesity prevention with a focus on reach, equity, cost effectiveness, and sustainability. Published by Elsevier Inc.

  3. Strengthening policy research on infant and young child feeding: An imperative to support countries in scaling up impact on nutrition.

    Science.gov (United States)

    Menon, Purnima; Thow, Anne Marie

    2017-06-13

    Enabling policy environments for nutrition require require evidence to support best practice and engagement with political and policy contexts, as well as leadership, resourcing, advocacy, and technical support. However, research on nutrition policy contexts is limited. The papers in this special supplement on policy contexts for infant and young child feeding (IYCF) in South Asia makes a valuable contribution to understanding the policy landscape and political dynamics in the region and the global literature. Studies included in this special supplement analyzed policy content and stakeholder influence on IYCF in Bangladesh, India, Nepal, Pakistan and Sri Lanka, and assess the role of advocacy in addressing multiple elements of the policy environment. These analyses highlight opportunities to harmonize and manage the demands and interests of multiple actors while strengthening policy to strategically support optimal IYCF as the ultimate goal. They also provide robust examples of research on policy environments and policy change. Further investments in research on policy contexts for nutrition can help to understand and support continued progress towards improved actions for nutrition.

  4. Study protocol: cost-effectiveness of transmural nutritional support in malnourished elderly patients in comparison with usual care.

    NARCIS (Netherlands)

    Neelemaat, F.; Thijs, A.; Seidell, J.C.; Bosmans, J.E.; van Bokhorst-de van der Schueren, M.A.E.

    2010-01-01

    Background. Malnutrition is a common consequence of disease in older patients. Both in hospital setting and in community setting oral nutritional support has proven to be effective. However, cost-effectiveness studies are scarce. Therefore, the aim of our study is to investigate the effectiveness

  5. Strengthening policy research on infant and young child feeding: An imperative to support countries in scaling up impact on nutrition

    Directory of Open Access Journals (Sweden)

    Purnima Menon

    2017-06-01

    Full Text Available Abstract Enabling policy environments for nutrition require require evidence to support best practice and engagement with political and policy contexts, as well as leadership, resourcing, advocacy, and technical support. However, research on nutrition policy contexts is limited. The papers in this special supplement on policy contexts for infant and young child feeding (IYCF in South Asia makes a valuable contribution to understanding the policy landscape and political dynamics in the region and the global literature. Studies included in this special supplement analyzed policy content and stakeholder influence on IYCF in Bangladesh, India, Nepal, Pakistan and Sri Lanka, and assess the role of advocacy in addressing multiple elements of the policy environment. These analyses highlight opportunities to harmonize and manage the demands and interests of multiple actors while strengthening policy to strategically support optimal IYCF as the ultimate goal. They also provide robust examples of research on policy environments and policy change. Further investments in research on policy contexts for nutrition can help to understand and support continued progress towards improved actions for nutrition.

  6. Study protocol : cost-effectiveness of transmural nutritional support in malnourished elderly patients in comparison with usual care

    NARCIS (Netherlands)

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

    2010-01-01

    BACKGROUND: Malnutrition is a common consequence of disease in older patients. Both in hospital setting and in community setting oral nutritional support has proven to be effective. However, cost-effectiveness studies are scarce. Therefore, the aim of our study is to investigate the effectiveness

  7. A 24-h a la carte food service as support for patients at nutritional risk

    DEFF Research Database (Denmark)

    Munk, T; Seidelin, Winnie; Rosenbom, E

    2013-01-01

    Undernutrition and insufficient energy and protein intake is a common problem in hospitalised patients. The aim of this pilot study was to investigate whether a novel hospital menu would be an effective strategy for increasing nutritional intake in patients at nutritional risk.......Undernutrition and insufficient energy and protein intake is a common problem in hospitalised patients. The aim of this pilot study was to investigate whether a novel hospital menu would be an effective strategy for increasing nutritional intake in patients at nutritional risk....

  8. Nutrition and the science of disease prevention: a systems approach to support metabolic health

    Science.gov (United States)

    Bennett, Brian J.; Hall, Kevin D.; Hu, Frank B.; McCartney, Anne L.; Roberto, Christina

    2017-01-01

    Progress in nutritional science, genetics, computer science, and behavioral economics can be leveraged to address the challenge of noncommunicable disease. This report highlights the connection between nutrition and the complex science of preventing disease and discusses the promotion of optimal metabolic health, building on input from several complementary disciplines. The discussion focuses on (1) the basic science of optimal metabolic health, including data from gene–diet interactions, microbiome, and epidemiological research in nutrition, with the goal of defining better targets and interventions, and (2) how nutrition, from pharma to lifestyle, can build on systems science to address complex issues. PMID:26415028

  9. The Open Science Grid – Support for Multi-Disciplinary Team Science – the Adolescent Years

    CERN Multimedia

    CERN. Geneva

    2012-01-01

    As it enters adolescence the Open Science Grid (OSG) is bringing a maturing fabric of Distributed High Throughput Computing (DHTC) services that supports an expanding HEP community to an increasingly diverse spectrum of domain scientists. Working closely with researchers on campuses throughout the US and in collaboration with national cyberinfrastructure initiatives, we transform their computing environment through new concepts, advanced tools and deep experience. We discuss examples of these including: the pilot-job overlay concepts and technologies now in use throughout OSG and delivering 1.4 Million CPU hours/day; the role of campus infrastructures- built out from concepts of sharing across multiple local faculty clusters (made good use of already by many of the HEP Tier-2 sites in the US); the work towards the use of clouds and access to high throughput parallel (multi-core and GPU) compute resources; and the progress we are making towards meeting the data management and access needs of non-HEP communiti...

  10. The Open Science Grid – Support for Multi-Disciplinary Team Science – the Adolescent Years

    International Nuclear Information System (INIS)

    Bauerdick, Lothar; Ernst, Michael; Fraser, Dan; Livny, Miron; Pordes, Ruth; Sehgal, Chander; Würthwein, Frank

    2012-01-01

    As it enters adolescence the Open Science Grid (OSG) is bringing a maturing fabric of Distributed High Throughput Computing (DHTC) services that supports an expanding HEP community to an increasingly diverse spectrum of domain scientists. Working closely with researchers on campuses throughout the US and in collaboration with national cyberinfrastructure initiatives, we transform their computing environment through new concepts, advanced tools and deep experience. We discuss examples of these including: the pilot-job overlay concepts and technologies now in use throughout OSG and delivering 1.4 Million CPU hours/day; the role of campus infrastructures- built out from concepts of sharing across multiple local faculty clusters (made good use of already by many of the HEP Tier-2 sites in the US); the work towards the use of clouds and access to high throughput parallel (multi-core and GPU) compute resources; and the progress we are making towards meeting the data management and access needs of non-HEP communities with general tools derived from the experience of the parochial tools in HEP (integration of Globus Online, prototyping with IRODS, investigations into Wide Area Lustre). We will also review our activities and experiences as HTC Service Provider to the recently awarded NSF XD XSEDE project, the evolution of the US NSF TeraGrid project, and how we are extending the reach of HTC through this activity to the increasingly broad national cyberinfrastructure. We believe that a coordinated view of the HPC and HTC resources in the US will further expand their impact on scientific discovery.

  11. The Open Science Grid - Support for Multi-Disciplinary Team Science - the Adolescent Years

    Science.gov (United States)

    Bauerdick, Lothar; Ernst, Michael; Fraser, Dan; Livny, Miron; Pordes, Ruth; Sehgal, Chander; Würthwein, Frank; Open Science Grid

    2012-12-01

    As it enters adolescence the Open Science Grid (OSG) is bringing a maturing fabric of Distributed High Throughput Computing (DHTC) services that supports an expanding HEP community to an increasingly diverse spectrum of domain scientists. Working closely with researchers on campuses throughout the US and in collaboration with national cyberinfrastructure initiatives, we transform their computing environment through new concepts, advanced tools and deep experience. We discuss examples of these including: the pilot-job overlay concepts and technologies now in use throughout OSG and delivering 1.4 Million CPU hours/day; the role of campus infrastructures- built out from concepts of sharing across multiple local faculty clusters (made good use of already by many of the HEP Tier-2 sites in the US); the work towards the use of clouds and access to high throughput parallel (multi-core and GPU) compute resources; and the progress we are making towards meeting the data management and access needs of non-HEP communities with general tools derived from the experience of the parochial tools in HEP (integration of Globus Online, prototyping with IRODS, investigations into Wide Area Lustre). We will also review our activities and experiences as HTC Service Provider to the recently awarded NSF XD XSEDE project, the evolution of the US NSF TeraGrid project, and how we are extending the reach of HTC through this activity to the increasingly broad national cyberinfrastructure. We believe that a coordinated view of the HPC and HTC resources in the US will further expand their impact on scientific discovery.

  12. Is Omega-3 Fatty Acids Enriched Nutrition Support Safe for Critical Ill Patients? A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2014-05-01

    Full Text Available Objective: To systematically review the effects of omega-3 poly unsaturated fatty acids (FA enriched nutrition support on the mortality of critically illness patients. Methods: Databases of Medline, ISI, Cochrane Library, and Chinese Biomedicine Database were searched and randomized controlled trials (RCTs were identified. We enrolled RCTs that compared fish oil enriched nutrition support and standard nutrition support. Major outcome is mortality. Methodological quality assessment was conducted based on Modified Jadad’s score scale. For control heterogeneity, we developed a method that integrated I2 test, nutritional support route subgroup analysis and clinical condition of severity. RevMan 5.0 software (The Nordic Cochrane Centre, Copenhagen, Denmark was used for meta-analysis. Results: Twelve trials involving 1208 patients that met all the inclusion criteria. Heterogeneity existed between the trials. A random model was used, there was no significant effect on mortality RR, 0.82, 95% confidence interval (CI (0.62, 1.09, p = 0.18. Knowing that the route of fish oil administration may affect heterogeneity, we categorized the trials into two sub-groups: parenteral administration (PN of omega-3 and enteral administration (EN of omega-3. Six trials administered omega-3 FA through PN. Pooled results indicated that omega-3 FA had no significant effect on mortality, RR 0.76, 95% CI (0.52, 1.10, p = 0.15. Six trials used omega-3 fatty acids enriched EN. After excluded one trial that was identified as source of heterogeneity, pooled data indicated omega-3 FA enriched EN significant reduce mortality, RR=0.69, 95% CI [0.53, 0.91] (p = 0.007. Conclusion: Omega-3 FA enriched nutrition support is safe. Due to the limited sample size of the included trials, further large-scale RCTs are needed.

  13. Team Leader Structuring for Team Effectiveness and Team Learning in Command-and-Control Teams

    Science.gov (United States)

    van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien

    2017-01-01

    Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader’s verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time. PMID:28490856

  14. Team Leader Structuring for Team Effectiveness and Team Learning in Command-and-Control Teams.

    Science.gov (United States)

    van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien

    2017-04-01

    Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader's verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time.

  15. Nutritional support and dietary interventions for women with polycystic ovary syndrome

    OpenAIRE

    Papavasiliou,Kleopatra; Papakonstantinou,Emilia

    2017-01-01

    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 tissu...

  16. Rehabilitation and nutritional support for sarcopenic dysphagia and tongue atrophy after glossectomy: A case report.

    Science.gov (United States)

    Hashida, Nao; Shamoto, Hiroshi; Maeda, Keisuke; Wakabayashi, Hidetaka; Suzuki, Motoyuki; Fujii, Takashi

    2017-03-01

    Swallowing dysfunction is related to long-term weight loss and reduced body mass index in patients with head and neck cancer. We describe a 76-y-old woman who had severe sarcopenic dysphagia and atrophy of the reconstructed tongue for 17 mo after subtotal glossectomy due to tongue cancer and lost 14 kg during that period. Upon admission, the patient received diagnoses of malnutrition in the context of social or environmental circumstances with insufficient energy intake, loss of muscle mass, localized fluid accumulation, weight loss, and sarcopenia due to reduced skeletal muscle mass (skeletal muscle index protein intake to 70.3 g/d by supplying sufficient excess energy, and provided physical therapy and dysphagia rehabilitation to improve sarcopenia, atrophy of the reconstructed tongue, and dysphagia. After 20 mo of treatment, she was considered to be no longer malnourished (11 kg weight gain) and without sarcopenia (skeletal muscle index 4.01 cm 2 /m 2 ), and the volume of the reconstructed tongue was increased. Sarcopenia and atrophy of the reconstructed tongue may cause dysphagia after glossectomy due to tongue cancer. Additionally, nutritional support and rehabilitation could improve such dysphagia. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Working group reports: Evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project

    Science.gov (United States)

    The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm an...

  18. Early nutritional support and physiotherapy improved long-term self-sufficiency in acutely ill older patients.

    Science.gov (United States)

    Hegerová, Petra; Dědková, Zuzana; Sobotka, Luboš

    2015-01-01

    An acute disease is regularly associated with inflammation, decreased food intake, and low physical activity; the consequence is loss of muscle mass. However, the restoration of muscle tissue is problematic, especially in older patients. Loss of muscle mass leads to further decrease of physical activity which leads, together with recurring disease, to the progressive muscle mass loss accompanied by loss of self-sufficiency. Early nutrition support and physical activity could reverse this situation. Therefore, the aim of this study was to determine whether an active approach based on early nutritional therapy and exercise would influence the development of sarcopenia and impaired self-sufficiency during acute illness. Two hundred patients >78 y were admitted to a hospital internal medicine department and participated in a prospective, randomized controlled study. The patients were randomized to a control group receiving standard treatment (n = 100) or to an intervention group (n = 100). The intervention consisted of nutritional supplements (600 kcal, 20 g/d protein) added to a standard diet and a simultaneous intensive rehabilitation program. The tolerance of supplements and their influence on spontaneous food intake, self-sufficiency, muscle strength, and body composition were evaluated during the study period. The patients were then regularly monitored for 1 y post-discharge. The provision of nutritional supplements together with early rehabilitation led to increased total energy and protein intake while the intake of standard hospital food was not reduced. The loss of lean body mass and a decrease in self-sufficiency were apparent at discharge from the hospital and 3 mo thereafter in the control group. Nutritional supplementation and the rehabilitation program in the study group prevented these alterations. A positive effect of nutritional intervention and exercise during the hospital stay was apparent at 6 mo post-discharge. The early nutritional intervention

  19. Supporting South Asian carers and those they care for: the role of the primary health care team.

    Science.gov (United States)

    Katbamna, Savita; Bhakta, Padma; Ahmad, Waqar; Baker, Richard; Parker, Gillian

    2002-04-01

    Demographic and socioeconomic changes have increased policy interest in informal carers. However, despite the multicultural nature of British society, most research in this field has been in majority communities. To explore the role of the primary health care team (PHCT) in supporting carers from British South Asian communities. Qualitative study. Four South Asian communities in Leicestershire and West Yorkshire. Focus groups and in-depth interviews were used to assess male and female carers, supported by a literature review. Failure to recognise carers' needs, gaps in service provision, and communication and language issues compromised carers' ability to care. While some carers were positive about the PHCT role, the main weaknesses concerned poor consultation, PHCT attitudes towards carers, and access to appropriate services. South Asian carers' experiences largely parallel those of others, but there are some issues that are distinct, namely, language and communication barriers, culturally inappropriate services, and implicit or explicit racism. The multi-ethnic nature of Great Britain requires that professional practice enhances the ability of minority ethnic communities to provide informal care. The findings underline the important role of the PHCT in ensuring that carers' needs are taken seriously and that appropriate services reach them.

  20. Effect of immune nutritional support on immune function and inflammatory factor in postoperative patients with gastric cancer

    Directory of Open Access Journals (Sweden)

    Hua-Jia Dai

    2016-05-01

    Full Text Available Objective: To investigate the effect of immune nutritional support on immune function and inflammatory factor in postoperative patients with gastric cancer. Methods: A total of 100 patients with gastric cancer were selected and randomly divided into the observation group and the control group with 50 cases in each group. The control group received routine perioperative enteral and parenteral nutrition, on the basis of conventional nutritional support, and the observation group was given enteral nutrition emulsion immune support. Then, the immune function and the inflammatory factor of postoperative day 1 and day 7 were compared between the two groups. Results: (1 With the preoperative data as the basis, the levels of serum IgG, IgA, C3 and C4 decreased at the postoperative day 1 and then increased at the postoperative day 7, while the level of IgM showed an increasing trend and then a decreasing trend in the two groups, and the corresponding figures for the postoperative day 1 and day 7 were statistically different between the two groups. In the observation group, the levels of IgG, IgA, C3 and C4 were higher, while the level of IgM was lower at the postoperative day 1 and day 7 than that in the control group, and the differences were statistically significant; (2 With the preoperative data as the basis, the levels of serum TNF-α, IL-6 and CRP significantly increased at the postoperative day 1 and then decreased at the postoperative day 7 in the two groups, and the corresponding figures for the postoperative day 1 and day 7 in the observation group were lower than those in the control group, and the differences were statistically significant. Conclusion: Immune nutritional support can help to reduce the damage of immune function and the inflammatory response induced by surgery in patients with gastric cancer, which is worthy of clinical application.

  1. [Impact of quality improvement process upon the state of nutritional support in a critical care unit].

    Science.gov (United States)

    Martinuzzi, A; Ferraresi, E; Orsati, M; Palaoro, A; Chaparro, J; Alcántara, S; Amin, C; Feller, C; Di Leo, M E; Guillot, A; García, V

    2012-01-01

    In a preceding article the state of Nutritional support (NS) in an Intensive Care Unit (ICU) was documented [Martinuzzi A et al. Estado del soporte nutricional en una unidad de Cuidados críticos. RNC 2011; 20: 5-17]. In this follow-up work we set to assess the impact of several organizational, recording and educational interventions upon the current state of NS processes. Interventions comprised presentation of the results of the audit conducted at the ICU before the institution's medical as well as paramedical personnel; their publication in a periodical, peer-reviewed journal; drafting and implementation of a protocol regulating NS schemes to be carried out at the ICU; and conduction of continuous education activities on Nutrition (such as "experts talks", interactive courses, and training in the implementation of the NS protocol). The state of NS processes documented after the interventions was compared with the results annotated in the preceding article. Study observation window ran between March the 1st, 2011 and May 31th, 2011, both included. Study series differed only regarding overall-mortality: Phase 1: 40.0% vs. Phase 2: 20.5%; Difference: 19.5%; Z = 1.927; two-tailed-p = 0.054. Interventions resulted in a higher fulfillment rate of the prescribed NS indication; an increase in the number of patients receiving ≥ 80% of prescribed energy; and a reduction in the number of NS lost days. Mortality was (numerically) lower in patients in which the prescribed NS scheme was fulfilled, NS was early initiated, and whom received ≥ 80% of prescribed energy. Adopted interventions had no effect upon average energy intakes: Phase 1: 574.7 ± 395.3 kcal/24 h⁻¹ vs. Phase 2: 591.1 ± 315.3 kcal/24 h⁻¹; two-tailed-p > 0.05. Educational, recording and organizational interventions might result in a better conduction of NS processes, and thus, in a lower mortality. Hemodynamic instability is still the most formidable obstacle for initiating and completing NS.

  2. Energy intake and sources of nutritional support in patients with head and neck cancer--a randomised longitudinal study.

    Science.gov (United States)

    Silander, E; Jacobsson, I; Bertéus-Forslund, H; Hammerlid, E

    2013-01-01

    Malnutrition decreases the cancer patient's ability to manage treatment, affects quality of life and survival, and is common among head and neck (HN) cancer patients due to the tumour location and the treatment received. In this study, advanced HN cancer patients were included and followed during 2 years in order to measure their energy intake, choice of energy sources and to assess problems with dysphagia. The main purpose was to explore when and for how long the patients had dysphagia and lost weight due to insufficient intake and if having a PEG (percutaneous endoscopic gastrostomy) in place for enteral nutrition made a difference. One hundred thirty-four patients were included and randomised to either a prophylactic PEG for early enteral feeding or nutritional care according to clinical praxis. At seven time points weight, dysphagia and energy intake (assessed as oral, nutritional supplements, enteral and parenteral) were measured. Both groups lost weight the first six months due to insufficient energy intake and used enteral nutrition as their main intake source; no significant differences between groups were found. Problems with dysphagia were vast during the 6 months. At the 6-, 12- and 24-month follow-ups both groups reached estimated energy requirements and weight loss ceased. Oral intake was the major energy source after 1 year. HN cancer patients need nutritional support and enteral feeding for a long time period during and after treatment due to insufficient energy intake. A prophylactic PEG did not significantly improve the enteral intake probably due to treatment side effects.

  3. LHCb support team - technical

    CERN Multimedia

    Rademakers, F

    2009-01-01

    Pictures 1-4: Cédric Fournier Pictures 5-7: Patrick Vallet Pictures 8-11: Franck Lamour, Patrick Vallet, Bernard Chadaj, Gérard Decreuse, Cédric Fournier and Bernard Corajod Pictures 12-15: Franck Lamour Pictures 16-18: Bernard Chadaj Pictures 19-22: Bernard Corajod and Gérard Decreuse

  4. Effect of early fasting and total parenteral nutrition support on the healing of incision and nutritional status in patients after sacrectomy.

    Science.gov (United States)

    Gao, S; Zheng, Y; Liu, X; Tian, Z; Zhao, Y

    2018-03-19

    Surgical site infection is one of the most common complications for patients after sacrectomy, which often accompanied by poor wound healing, sinus formation and serious metabolic disturbance. We tried to avoid the surgical site infection caused by feces during early period after surgery through early fasting and total parenteral nutrition (TPN) support, then compared the clinical results of these patients with other patients that received enteral nutrition (EN) early after sacrectomy. Forty-eight patients after sacrectomy (the level of sacrectomy above S 2 ) were randomly divided into two groups: TPN group and EN group. The patients of two groups received different nutrition support from the first day to the seventh day after surgery, then the factors such as nutritional and metabolic status after surgery, incidence of complications as well as the time of incision healing and hospitalization were observed. The p-value of total serum protein, albumin, serum alanine aminotransferase, total bilirubin at seventh day after sacrectomy between TPN group and EN group is <0.0005. The p-value of hemoglobin at seventh day after sacrectomy between TPN group and EN group is 0.001. The p-value of total serum protein at fourteenth day after sacrectomy between TPN group and EN group is 0.003. The p-value of albumin and total bilirubin at fourteenth day after sacrectomy between TPN group and EN group is 0.001. The p-value of hemoglobin, serum alanine aminotransferase at fourteenth day after sacrectomy between TPN group and EN group is <0.0005. The incidence of gastrointestinal complication and delay of apparition of feces in EN group were lower than that in TPN group (p=0.041, p<0.0005). The incidence of surgical site infection, the time of incision healing and hospitalization in TPN group were lower than that in EN group (p=0.048, p=0.008, p<0.0005). The method of fasting and supported by TPN during the early period after sacrectomy contribute to the incision healing, meanwhile

  5. [Clinical observation of preoperative administration of enteral nutrition support in gastric cancer patients at risk of malnutrition].

    Science.gov (United States)

    Chen, Bo; Zhou, Yong; Yang, Ping; Qin, Xian-peng; Li, Ning-ning; He, Dan; Feng, Jin-yan; Yan, Chuan-jing; Wu, Xiao-ting

    2013-11-01

    To evaluate safety and efficacy of preoperative administration of enteral nutrition support in gastric cancer patients at risk of malnutrition. A single center randomized controlled clinical trial was performed in 60 gastric cancer patients in West China Hospital from May to October 2012. Thirty patients were given enteral nutrition support(Ensure(R)) manufactured by Abbott Laboratories for ten consecutive days before surgical operation in the treatment group, and 30 patients were given an isocaloric and isonitrogenous homogenized diet in the control group for 10 days as well. The laboratory parameters of nutritional status and hepatorenal function were observed and compared between the two groups on admission, preoperative day 1 and postoperative day 3, respectively. Clinical observations, such as nausea and vomiting, were carried out until patients were discharged. Before the intervention, there were no significant differences in the baseline characteristics between the two groups. The levels of serum albumin [(33.9±5.6) g/L vs. (31.0±5.3) g/L, P0.05). Moreover, two patients with nausea and one with vomiting in each group were found. In clinical observation period, no severe treatment-related adverse event were observed. The enteral supplement with Ensure(R) in gastric cancer patients at risk of malnutrition during preoperative period is effective and safe, which is superior to homogenized diet and an appropriate choice for gastric cancer patients with nutritional risk.

  6. Nutritional support of estuary perch ( Macquaria colonorum) in a temperate Australian inlet: Evaluating the relative importance of invasive Spartina

    Science.gov (United States)

    Hindell, J. S.; Warry, F. Y.

    2010-12-01

    The invasive saltmarsh grass Spartina is widely considered a threat to the health of coastal ecosystems in south-eastern Australia, however, the ecological impacts of Spartina on estuarine communities are poorly understood. The largest infestation of Spartina in Victoria occurs in Anderson Inlet. The relative contribution of Spartina, vs. non-invasive autotrophs, to the nutrition of an estuarine fish, Macquaria colonorum was assessed using stable isotopes and gut content analyses. The δ 13C and δ 15N compositions of autotrophs and M. colonorum varied spatially across the study area. Based on gut content analyses, adults and juveniles were between two and three trophic levels above autotrophs. Isosource modelling of δ 13C signatures, suggested several autotrophs contributed to the nutrition of M. colonorum with a combination of seagrass and Spartina likely important contributors, particularly for adults. Isotopic sulphur was subsequently used to distinguish between seagrass and Spartina. Modelling of δ 13C and δ 34S signatures of M. colonorum and a subset of autotrophs again indicated a combination of seagrass and Spartina was likely a major contributor to nutritional support of M. colonorum. Given the limited areal extent of seagrass within Anderson Inlet, current Spartina eradication programs may compromise the nutritional support of M. colonorum.

  7. Team cohesion and team success in sport.

    Science.gov (United States)

    Carron, Albert V; Bray, Steven R; Eys, Mark A

    2002-02-01

    The main aim of this study was to examine the relationship between task cohesiveness and team success in elite teams using composite team estimates of cohesion. A secondary aim was to determine statistically the consistency (i.e. 'groupness') present in team members' perceptions of cohesion. Elite university basketball teams (n = 18) and club soccer teams (n = 9) were assessed for cohesiveness and winning percentages. Measures were recorded towards the end of each team's competitive season. Our results indicate that cohesiveness is a shared perception, thereby providing statistical support for the use of composite team scores. Further analyses indicated a strong relationship between cohesion and success (r = 0.55-0.67). Further research using multi-level statistical techniques is recommended.

  8. FEATURES OF INTENSIVE NUTRITIONAL SUPPORT OF PREMATURE INFANTS IN INTENSIVE CARE UNIT (PART 1

    Directory of Open Access Journals (Sweden)

    K.V. Romanenko

    2011-01-01

    Full Text Available The article presents the modern approaches to preterm infants feeding, principles of parenteral and enteral nutrition. The importance of adequate control of deficit status in preterm infants at different periods of developmental care is marked. Arguments for using the enriched milk or specialized formulas for prematurity during the in-clinic and out-clinic periods of care are provided.Key words: premature infants, enteral nutrition, formulas for premature infants, breast milk, breast milk enriches.

  9. Intensive Nutritional Counselling And Support And Clinical Outcomes In Hemodialysis Patients

    OpenAIRE

    Alessio Molfino; Alessandro Laviano; Maria Grazia Chiappini; Thomas Amman; Filippo Rossi Fanelli; Maurizio Muscaritoli

    2012-01-01

    Protein-energy wasting is frequently found in haemodialysis (HD) patients. Anorexia and hypophagia contribute to malnutrition, increased morbidity and mortality, but the clinical impact of correcting hypophagia remains uncertain. We evaluated whether correction of hypophagia influences morbidity and mortality in anorexic HD patients. Thirty-four HD patients were enrolled in a 2-year follow-up programme including regular nutritional assessment. Patients not meeting nutritional requirements dur...

  10. Endogenous Nutritive Support after Traumatic Brain Injury: Peripheral Lactate Production for Glucose Supply via Gluconeogenesis.

    Science.gov (United States)

    Glenn, Thomas C; Martin, Neil A; McArthur, David L; Hovda, David A; Vespa, Paul; Johnson, Matthew L; Horning, Michael A; Brooks, George A

    2015-06-01

    We evaluated the hypothesis that nutritive needs of injured brains are supported by large and coordinated increases in lactate shuttling throughout the body. To that end, we used dual isotope tracer ([6,6-(2)H2]glucose, i.e., D2-glucose, and [3-(13)C]lactate) techniques involving central venous tracer infusion along with cerebral (arterial [art] and jugular bulb [JB]) blood sampling. Patients with traumatic brain injury (TBI) who had nonpenetrating head injuries (n=12, all male) were entered into the study after consent of patients' legal representatives. Written and informed consent was obtained from healthy controls (n=6, including one female). As in previous investigations, the cerebral metabolic rate (CMR) for glucose was suppressed after TBI. Near normal arterial glucose and lactate levels in patients studied 5.7±2.2 days (range of days 2-10) post-injury, however, belied a 71% increase in systemic lactate production, compared with control, that was largely cleared by greater (hepatic+renal) glucose production. After TBI, gluconeogenesis from lactate clearance accounted for 67.1% of glucose rate of appearance (Ra), which was compared with 15.2% in healthy controls. We conclude that elevations in blood glucose concentration after TBI result from a massive mobilization of lactate from corporeal glycogen reserves. This previously unrecognized mobilization of lactate subserves hepatic and renal gluconeogenesis. As such, a lactate shuttle mechanism indirectly makes substrate available for the body and its essential organs, including the brain, after trauma. In addition, when elevations in arterial lactate concentration occur after TBI, lactate shuttling may provide substrate directly to vital organs of the body, including the injured brain.

  11. Team Effectiveness and Team Development in CSCL

    Science.gov (United States)

    Fransen, Jos; Weinberger, Armin; Kirschner, Paul A.

    2013-01-01

    There is a wealth of research on computer-supported cooperative work (CSCW) that is neglected in computer-supported collaborative learning (CSCL) research. CSCW research is concerned with contextual factors, however, that may strongly influence collaborative learning processes as well, such as task characteristics, team formation, team members'…

  12. Evaluating Effect of Objectives, Obstacles, Drivers, Team Dynamics and Organizational Support on ICT Effectiveness by Fuzzy DEMATEL

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Keramati

    2012-12-01

    Full Text Available Due to different effects of ICT on varied aspects of performing the duties in organizations, governments have been intending to use ICT in the recent years very dramatically. The significant issue to which we should pay attention is the using of ICT without directing attention towards the mutual effects of different ICT domains shall be resulted in malfunction and inefficiency of organizations in carrying out their tasks. Therefore, the present research tried to develop a systematic structure in ICT domain and analyze the various ICT domains in order to identify the penetrating and penetrated factors (cause and effect. In doing so, at the present research firstly by the usage of other researchers' results and achievements, it was attempted to specify the different ICT domains including objectives, obstacles, drivers, team dynamics and organizational support and then another elements so-called ICT effectiveness was added in order to study the effect of above-mentioned factors on ICT effectiveness. Then, standard fuzzy DEMATEL technique questionnaire was distributed among 35 persons of experts working in ICT and IT fields to gather required information and data. After gathering required data and information, they were analyzed through DEMATEL techniques in fuzzy states, respectively. The results obtained from the DEMATEL technique in fuzzy state reveal that in ICT domain, the objectives were determined as the most penetrating elements into other elements of ICT domain and the drivers were the most penetrable element in ICT domain too.

  13. Psychosocial Influences on children’s identification with sports teams: a case study of Australian Rules football supporters

    NARCIS (Netherlands)

    Spaaij, R.; Anderson, A.

    2010-01-01

    The article examines the socialization of children into identification with a sports team. It presents a sociological approach which extends the insights obtained from research into psychological aspects of sports team identification. A conceptual model is presented which proffers an explanation of

  14. When Teams Fail to Self-Regulate: Predictors and Outcomes of Team Procrastination Among Debating Teams.

    Science.gov (United States)

    Van Hooft, Edwin A J; Van Mierlo, Heleen

    2018-01-01

    Models of team development have indicated that teams typically engage in task delay during the first stages of the team's life cycle. An important question is to what extent this equally applies to all teams, or whether there is variation across teams in the amount of task delay. The present study introduces the concept of team procrastination as a lens through which we can examine whether teams collectively engage in unplanned, voluntary, and irrational delay of team tasks. Based on theory and research on self-regulation, team processes, and team motivation we developed a conceptual multilevel model of predictors and outcomes of team procrastination. In a sample of 209 student debating teams, we investigated whether and why teams engage in collective procrastination as a team, and what consequences team procrastination has in terms of team member well-being and team performance. The results supported the existence of team procrastination as a team-level construct that has some stability over time. The teams' composition in terms of individual-level trait procrastination, as well as the teams' motivational states (i.e., team learning goal orientation, team performance-approach goal orientation in interaction with team efficacy) predicted team procrastination. Team procrastination related positively to team members' stress levels, especially for those low on trait procrastination. Furthermore, team procrastination had an indirect negative relationship with team performance, through teams' collective stress levels. These findings add to the theoretical understanding of self-regulatory processes of teams, and highlight the practical importance of paying attention to team-level states and processes such as team goal orientation and team procrastination.

  15. [Team Collaboration in Home Medical Care to Support Patients at the End-of-Life - Review of Service Personnel Meeting on Discharge Day].

    Science.gov (United States)

    Ogiwara, Miyoko; Irino, Hiromi; Yamaoka, Keita; Fujimaki, Yoko; Watanabe, Mutsuko; Yamamoto, Takeshi; Hirohara, Masayoshi; Kushida, Kazuki

    2018-03-01

    Due to the rising number of patients at the terminal stage or with high dependence on medical care, the cooperation of 2 teams, the hospital discharge support team and the home support team, has become very important. The recent spread of the Internet has enabled both patients and their families who have chosen home care to obtain a wide range of information about home services, as well as diseases, and form a picture of what will happen. However, there are actually many cases in which patients and families find that things are not as they imagined, and they are uneasy and unsure of what to do. Here, we report a case in which the mismatch between the patient's and family's expectations created an unsatisfactory care situation.

  16. Predictors of public support for nutrition-focused policy, systems and environmental change strategies in Los Angeles County, 2013.

    Science.gov (United States)

    Robles, Brenda; Kuo, Tony

    2017-01-13

    Since 2010, federal and local agencies have invested broadly in a variety of nutrition-focused policy, systems and environmental change (PSE) initiatives in Los Angeles County (LAC). To date, little is known about whether the public supports such efforts. We address this gap in the literature by examining predictors of support for a variety of PSEs. Voters residing in LAC (n=1007) were randomly selected to participate in a cross-sectional telephone survey commissioned by the LAC Department of Public Health. The survey asked questions about attitudes towards the obesity epidemic, nutrition knowledge and behaviours, public opinions about changing business practices/government policies related to nutrition, and sociodemographics. A factor analysis informed outcome variable selection (ie, type of PSEs). Multivariable regression analyses were performed to examine predictors of public support. Predictors in the regression models included (primary regressor) community economic hardship; (control variables) political affiliation, sex, age, race and income; and (independent variables) perceptions about obesity, perceived health and weight status, frequency reading nutrition labels, ease of finding healthy and unhealthy foods, and food consumption behaviours (ie, fruit and vegetables, non-diet soda, fast-food and sit-down restaurant meals). 3 types of PSE outcome variables were identified: promotional/incentivising, limiting/restrictive and business practices. Community economic hardship was not found to be a significant predictor of public support for any of the 3 PSE types. However, Republican party affiliation, being female and perceiving obesity as a serious health problem were. These findings have implications for public health practice and community planning in local health jurisdictions. 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/.

  17. Study protocol: Cost-effectiveness of transmural nutritional support in malnourished elderly patients in comparison with usual care

    Directory of Open Access Journals (Sweden)

    van Bokhorst-de van der Schueren Marian AE

    2010-02-01

    Full Text Available Abstract Background Malnutrition is a common consequence of disease in older patients. Both in hospital setting and in community setting oral nutritional support has proven to be effective. However, cost-effectiveness studies are scarce. Therefore, the aim of our study is to investigate the effectiveness and cost-effectiveness of transmural nutritional support in malnourished elderly patients, starting at hospital admission until three months after discharge. Methods This study is a randomized controlled trial. Patients are included at hospital admission and followed until three months after discharge. Patients are eligible to be included when they are ≥ 60 years old and malnourished according to the following objective standards: Body Mass Index (BMI in kg/m2 Conclusion In this randomized controlled trial we will evaluate the effect of transmural nutritional support in malnourished elderly patients after hospital discharge, compared to usual care. Primary endpoints of the study are changes in activities of daily living, body weight, body composition, quality of life, and muscle strength. An economic evaluation will be performed to evaluate the cost-effectiveness of the intervention in comparison with usual care. Trial registration Netherlands Trial Register (ISRCTN29617677, registered 14-Sep-2005

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

    Directory of Open Access Journals (Sweden)

    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

  19. Interdisciplinary Health Team Care: Proceedings of the Annual Conference (8th, Columbus, Ohio, September 18-20, 1986).

    Science.gov (United States)

    Brunner, Marjorie L., Ed.; Casto, R. Michael, Ed.

    The following are among the 40 papers included in this proceedings: "Code of Ethics for Interdisciplinary Care" (Thomasma); "Training Model for Increasing Team Excellence and Efficiency" (Clayton, Lund); "Organizational Structures of Health Care Teams" (Farrell, Schmitt, Heinemann); "Nutrition Support Practice" (Johnson); "Dividing up the Work on…

  20. Supporting and improving community health services-a prospective evaluation of ECHO technology in community palliative care nursing teams.

    Science.gov (United States)

    White, Clare; McIlfatrick, Sonja; Dunwoody, Lynn; Watson, Max

    2015-12-01

    Project ECHO (Extension for Community Healthcare Outcomes) uses teleconferencing technology to support and train healthcare providers (HCPs) remotely, and has improved care across the USA. A 6-month pilot was trialled in a community palliative care nursing setting to determine if ECHO would be effective in the UK in providing education and support to community hospice nurses (CHN). The pilot involved weekly 2 hour sessions of teaching and case-based discussions facilitated by hospice staff linking with nine teams of CHN using video conferencing technology. A mixed-methods prospective longitudinal cohort study was used to evaluate the pilot. Each CHN provided demographic data, and completed a written knowledge assessment and a self-efficacy tool before and after the pilot. Two focus groups were also performed after the pilot. 28 CHNs completed the evaluation. Mean knowledge score improved significantly from 71.3% to 82.7% (p=0.0005) as did overall self-efficacy scores following the ECHO pilot. Pre-ECHO (p=0.036) and Retro-Pretest ECHO (p=0.0005) self-efficacy were significantly lower than post-ECHO. There was no significant difference between Pretest and Retro-Pretest ECHO self-efficacy (p=0.063). 96% recorded gains in learning, and 90% felt that ECHO had improved the care they provided for patients. 83% would recommend ECHO to other HCPs. 70% stated the technology used in ECHO had given them access to education that would have been hard to access due to geography. This study supports the use of Project ECHO for CHNs in the UK by demonstrating how a 6-month pilot improved knowledge and self-efficacy. As a low-cost high-impact model, ECHO provides an affordable solution to addressing growing need. 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/

  1. Perioperative ω-3 Polyunsaturated Fatty Acid Nutritional Support in Gastrointestinal Cancer Surgical Patients

    DEFF Research Database (Denmark)

    Ma, Ying-Jie; Liu, Lian; Xiao, Jing

    2016-01-01

    journals. Randomized controlled trials (RCTs) examining the effects of n-3 PUFA intake relative to conventional nutrition in surgical patients were included. The main outcomes were the duration of systemic inflammatory response syndrome (SIRS), length of hospital stay (LOS), serum C-reactive protein (CRP.......22), and serum CRP levels (MD, -3.97 mg/l; 95% CI, -7.88 to -0.07) compared with consumption of conventional nutrition, as well as reduced incidence of postoperative infectious complications (risk ratio, 0.66; 95% CI, 0.49-0.87). This systematic evaluation suggests that n-3 PUFA significantly reduces...

  2. Cheap Talk: “Team Factors and Management Practices Influence on Team Trust”

    OpenAIRE

    Doris Padmini Selvaratnam; Aini Aman; Muhamad Maziz Mahyuddin Bin Kamaludin; Gary Lynn; Richard Reilly

    2016-01-01

    Team trust has been cited as a contributing factor towards team performance. This paper looks at the antecedents of team trust and to what extent they influence team trust. The antecedents of team trust are team factors like team autonomy, team stability and team member experience; and the management practices are top management involvement and management support. The results demonstrated that team factors and management practices influence team trust individually. The key find...

  3. International Review Team (IRT) Safety Case Recommendations for the Yucca Mountain Total System Performance Assessment (TSPA) Supporting the Site Recommendation

    International Nuclear Information System (INIS)

    Van Luik, Abraham E.

    2004-01-01

    The session started with Abe Van Luik (IGSC Chair, US-DOE-YM, USA) who presented the feedback of the international peer review of the US-DOE Yucca Mountain TSPA (Total System Performance Assessment) supporting the successful designation of the site by the Congress and the President of the U.S. In particular, he listed key implications of the IRT (International Review team) recommendations on the forthcoming US-DOE documentation of its case for safety to be submitted to the regulator, the U.S. Nuclear Regulatory Commission, mainly: - The documentation submitted to the licensing authority should address technical aspects and compliance with regulatory criteria. - That documentation should reflect sound science and good engineering practice; it should present detailed and rigorous modelling. - In addition, it should present both quantitative and qualitative arguments, make a statement on why there can be confidence in the face of uncertainty, acknowledge remaining issues and provide the strategy to resolve them. - Demonstrating understanding is as important as demonstrating compliance. - There is a need to provide a clear explanation of the case made to the regulator for more general audiences to complement the large amount of technical documents that will be produced. The US-DOE response to these recommendations for the License Application, which is under preparation, is that the recommendations will be implemented to the maximum extent possible. In subsequent discussion, with respect to the License Application, it was acknowledged that detailed guidance from the U.S. regulator was very useful, and guidance of this type would be generally useful. At the current time, the words 'safety case' are not mentioned in U.S. regulations, but if one reads both the regulation and guidance documents it becomes evident that all aspects of a safety case need to be provided in the License Application and its accompanying documents

  4. A 24-h a la carte food service as support for patients at nutritional risk: a pilot study.

    Science.gov (United States)

    Munk, T; Seidelin, W; Rosenbom, E; Nielsen, A L; Klausen, T W; Nielsen, M A; Thomsen, T

    2013-06-01

    Undernutrition and insufficient energy and protein intake is a common problem in hospitalised patients. The aim of this pilot study was to investigate whether a novel hospital menu would be an effective strategy for increasing nutritional intake in patients at nutritional risk. A historically controlled intervention pilot study was conducted. Forty patients at nutritional risk were offered a novel hospital menu as a supplement to the ordinary hospital menu. The menu consisted of 36 naturally energy-enriched small dishes served on demand 24 h a day. Energy and protein intake were calculated as the mean over a period of 3 days. No significant difference in energy and protein intake was observed between the groups; however, a significant (P = 0.001) time gradient in total energy intake was observed in the intervention group. Moreover, a significant (P = 0.03) time gradient in energy intake received from the novel menu was observed. The dishes from the novel menu were mainly ordered from 11.00 h to 14.00 h and from 17.00 h to 18.00 h. No overall significant differences in energy and protein intake between the groups were found. However, the present pilot study revealed a significant time gradient in total energy intake (P = 0.001) and in energy intake from the novel menu (P = 0.03). This indicates the need to include a run-in period when investigating novel hospital menus as a support for patients at nutritional risk. Additionally, food service, available 24 h a day, appears to be unnecessary. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

  5. Concluding remarks: nutritional strategies to support the adaptive prolonged exercise training

    NARCIS (Netherlands)

    van Loon, L.J.C.; Tipton, K.D.; Loon, L.J.C. van; Meeusen, R.

    2013-01-01

    Nutrition plays a key role in allowing the numerous training hours to be translated into useful adaptive responses of various tissues in the athlete. Research over the last decade has shown many examples of the dietary interventions to modulate the skeletal muscle adaptive response prolonged

  6. Nutrition to Support Recovery from Endurance Exercise: Optimal Carbohydrate and Protein Replacement.

    Science.gov (United States)

    Moore, Daniel R

    2015-01-01

    Proper nutrition is vital to optimize recovery after endurance exercise. Dietary carbohydrate and protein provide the requisite substrates to enhance glycogen resynthesis and remodel skeletal muscle proteins, respectively, both of which would be important to rapidly restore muscle function and performance. With short recovery windows (optimal ingestion of both carbohydrate and protein.

  7. Animal behaviour and animal nutrition science working together to support livestock production

    NARCIS (Netherlands)

    Edwards, S.A.; Spoolder, H.A.M.

    2016-01-01

    Within livestock production and welfare science, many of the interesting and important questions lie at the interface of traditional fields of study and benefit from an interdisciplinary approach. The effects of nutrition on the behaviour of animals have been widely studied. They range from the

  8. Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs

    NARCIS (Netherlands)

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

    2012-01-01

    BACKGROUND & AIMS: Older people are vulnerable to malnutrition which leads to increased health care costs. The aim of this study was to evaluate the cost-effectiveness of nutritional supplementation from a societal perspective. DESIGN: This randomized controlled trial included hospital admitted

  9. Practices in relation to nutritional care and support--report from the Council of Europe

    NARCIS (Netherlands)

    Beck, Anne Marie; Balknäs, Ulla Nilsson; Camilo, Maria Ermelinda; Fürst, Peter; Gentile, Maria Gabriella; Hasunen, Kaija; Jones, Liz; Jonkers-Schuitema, Cora; Keller, Ulrich; Melchior, Jean-Claude; Mikkelsen, Bent Egberg; Pavcic, Marusa; Schauder, Peter; Sivonen, Lauri; Zinck, Orla; Øien, Henriette; Ovesen, Lars

    2002-01-01

    Disease-related undernutrition is significant in European hospitals but is seldom treated. In 1999, the Council of Europe decided to collect information regarding Nutrition programmes in hospitals and for this purpose a network consisting of national experts from 12 of the Partial Agreement member

  10. Nutritional support for patients sustaining traumatic brain injury: a systematic review and meta-analysis of prospective studies.

    Directory of Open Access Journals (Sweden)

    Xiang Wang

    Full Text Available BACKGROUND: In traumatic brain injury (TBI, the appropriate timing and route of feeding, and the efficacy of immune-enhancing formulae have not been well established. We performed this meta-analysis aiming to compare the effects of different nutritional support modalities on clinical outcomes of TBI patients. METHODS: We systematically searched Pubmed, Embase, and the Cochrane Library until October, 2012. All randomized controlled trials (RCTs and non-randomized prospective studies (NPSs that compared the effects of different routes, timings, or formulae of feeding on outcomes in TBI patients were selected. The primary outcomes included mortality and poor outcome. The secondary outcomes included the length of hospital stay, the length of ventilation days, and the rate of infectious or feeding-related complications. FINDINGS: 13 RCTs and 3 NPSs were included. The pooled data demonstrated that, compared with delayed feeding, early feeding was associated with a significant reduction in the rate of mortality (relative risk [RR] = 0.35; 95% CI, 0.24-0.50, poor outcome (RR = 0.70; 95% CI, 0.54-0.91, and infectious complications (RR = 0.77; 95% CI, 0.59-0.99. Compared with enteral nutrition, parenteral nutrition showed a slight trend of reduction in the rate of mortality (RR = 0.61; 95% CI, 0.34-1.09, poor outcome (RR = 0.73; 95% CI, 0.51-1.04, and infectious complications (RR = 0.89; 95% CI, 0.66-1.22, whereas without statistical significances. The immune-enhancing formula was associated with a significant reduction in infection rate compared with the standard formula (RR = 0.54; 95% CI, 0.35-0.82. Small-bowel feeding was found to be with a decreasing rate of pneumonia compared with nasogastric feeding (RR = 0.41; 95% CI, 0.22-0.76. CONCLUSION: After TBI, early initiation of nutrition is recommended. It appears that parenteral nutrition is superior to enteral nutrition in improving outcomes. Our results lend support to

  11. Submissions to the Australian and New Zealand Review of Food Labelling Law and Policy support traffic light nutrition labelling.

    Science.gov (United States)

    White, John; Signal, Louise

    2012-10-01

    Food labels to support healthier choices are an important potential intervention for improving population health by reducing obesity and diet-related disease. This study examines the use of research evidence about traffic light nutrition labelling in submissions to the Review of Food Labelling Law and Policy conducted in Australia and New Zealand. Content analysis of final submissions to the Review and a literature review of documents reporting research evidence about traffic light labelling. Sixty-two submitters to the Review were categorised as 'supporters' of traffic light labelling and 29 as 'opponents'. Supporters focused on studies showing traffic light labels were better than other systems at helping consumers identify healthier food options. Opponents cited evidence that traffic light labels were no better than other systems in this respect and noted a lack of evidence that they led to changes in food consumption. A literature review demonstrated that, as a group, submitters had drawn attention to most of the relevant research evidence on traffic light labelling. Both supporters and opponents were, however, selective in their use of evidence. The weight of evidence suggested that traffic light labelling has strengths in helping consumers to identify healthier food options. Further research would be valuable in informing the development of an interpretive front-of-pack labelling system. The findings have significant implications for the development of front-of-pack nutrition labelling currently being considered in Australia and New Zealand. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

  12. Independence From Parenteral Nutrition and Intravenous Fluid Support During Treatment With Teduglutide Among Patients With Intestinal Failure Associated With Short Bowel Syndrome

    DEFF Research Database (Denmark)

    Iyer, Kishore R; Kunecki, Marek; Boullata, Joseph I

    2017-01-01

    BACKGROUND: In phase III clinical studies, treatment with teduglutide was associated with clinically meaningful reductions (≥20% from baseline) in parenteral support (PS; parenteral nutrition and/or intravenous fluids) requirements in adult patients with intestinal failure associated with short...

  13. When Teams Fail to Self-Regulate: Predictors and Outcomes of Team Procrastination Among Debating Teams

    Science.gov (United States)

    Van Hooft, Edwin A. J.; Van Mierlo, Heleen

    2018-01-01

    Models of team development have indicated that teams typically engage in task delay during the first stages of the team’s life cycle. An important question is to what extent this equally applies to all teams, or whether there is variation across teams in the amount of task delay. The present study introduces the concept of team procrastination as a lens through which we can examine whether teams collectively engage in unplanned, voluntary, and irrational delay of team tasks. Based on theory and research on self-regulation, team processes, and team motivation we developed a conceptual multilevel model of predictors and outcomes of team procrastination. In a sample of 209 student debating teams, we investigated whether and why teams engage in collective procrastination as a team, and what consequences team procrastination has in terms of team member well-being and team performance. The results supported the existence of team procrastination as a team-level construct that has some stability over time. The teams’ composition in terms of individual-level trait procrastination, as well as the teams’ motivational states (i.e., team learning goal orientation, team performance-approach goal orientation in interaction with team efficacy) predicted team procrastination. Team procrastination related positively to team members’ stress levels, especially for those low on trait procrastination. Furthermore, team procrastination had an indirect negative relationship with team performance, through teams’ collective stress levels. These findings add to the theoretical understanding of self-regulatory processes of teams, and highlight the practical importance of paying attention to team-level states and processes such as team goal orientation and team procrastination. PMID:29674991

  14. When Teams Fail to Self-Regulate: Predictors and Outcomes of Team Procrastination Among Debating Teams

    Directory of Open Access Journals (Sweden)

    Edwin A. J. Van Hooft

    2018-04-01

    Full Text Available Models of team development have indicated that teams typically engage in task delay during the first stages of the team’s life cycle. An important question is to what extent this equally applies to all teams, or whether there is variation across teams in the amount of task delay. The present study introduces the concept of team procrastination as a lens through which we can examine whether teams collectively engage in unplanned, voluntary, and irrational delay of team tasks. Based on theory and research on self-regulation, team processes, and team motivation we developed a conceptual multilevel model of predictors and outcomes of team procrastination. In a sample of 209 student debating teams, we investigated whether and why teams engage in collective procrastination as a team, and what consequences team procrastination has in terms of team member well-being and team performance. The results supported the existence of team procrastination as a team-level construct that has some stability over time. The teams’ composition in terms of individual-level trait procrastination, as well as the teams’ motivational states (i.e., team learning goal orientation, team performance-approach goal orientation in interaction with team efficacy predicted team procrastination. Team procrastination related positively to team members’ stress levels, especially for those low on trait procrastination. Furthermore, team procrastination had an indirect negative relationship with team performance, through teams’ collective stress levels. These findings add to the theoretical understanding of self-regulatory processes of teams, and highlight the practical importance of paying attention to team-level states and processes such as team goal orientation and team procrastination.

  15. Preventing hospital malnutrition: a survey on nutritional policies in an Italian University Hospital.

    Science.gov (United States)

    Annetta, M G; Pittiruti, M; De Rosa, S; Franchi, P; Pintaudi, G; Caricato, A; Antonelli, M

    2015-11-01

    A proper strategy for fighting hospital malnutrition should include nutritional screening of all hospitalized patients, adequate utilization of the Hospital facilities - such as Clinical Nutrition Services or Nutrition Teams - and an adequate algorithm for the adoption of proper nutrition support (oral, enteral or parenteral) with proper timing. The main aim of the present study was to investigate the current policies of different non-intensive wards of our institution (a 1100 beds University Hospital) in terms of prevention of hospital malnutrition. We conducted a one-day survey to verify the current policies of nutritional screening and the indication to nutritional support in adult patients, interviewing nurses and physicians of our non-intensive hospital wards. A total of 29 wards were considered, which sum up to 755 hospitalized patients. We found that nutritional screening at admission is routinely assessed only in 41% of wards and that oral nutrient intake is controlled regularly only in 72%. Indication to clinical nutrition support and specifically to artificial nutrition is not consistent with the current international guidelines. Only 14% of patients were receiving artificial nutrition at the moment of the survey and the majority of them were given parenteral nutrition rather than enteral feeding. Our survey confirmed that in large hospitals the main barriers to the fight against hospital malnutrition are the lack of knowledge and/or commitment by nurses and physicians as well as the lack of well-defined hospital policies on early nutritional screening, surveillance of nutritional status and indication to nutrition support.

  16. [Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): neurocritical patient].

    Science.gov (United States)

    Acosta Escribano, J; Herrero Meseguer, I; Conejero García-Quijada, R

    2011-11-01

    Neurocritical patients require specialized nutritional support due to their intense catabolism and prolonged fasting. The preferred route of nutrient administration is the gastrointestinal route, especially the gastric route. Alternatives are the transpyloric route or mixed enteral-parenteral nutrition if an effective nutritional volume of more than 60% cannot be obtained. Total calore intake ranges from 20-30 kcal/kg/day, depending on the period of the clinical course, with protein intake higher than 20% of total calories (hyperproteic diet). Nutritional support should be initiated early. The incidence of gastrointestinal complications is generally higher to other critically-ill patients, the most frequent complication being an increase in gastric residual volume. As in other critically-ill patients, glycemia should be closely monitored and maintained below 150 mg/dL. Copyright © 2011 Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L. All rights reserved.

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

    OpenAIRE

    Kiss, Nicole

    2016-01-01

    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 neg...

  18. Critical evaluation of the role of nutritional support for radiation therapy patients

    International Nuclear Information System (INIS)

    Pezner, R.; Archambeau, J.O.

    1985-01-01

    Nutritional intake or absorption may be compromised by radiation therapy (RT) when large portions of the gastrointestinal tract are treated. Dietary counseling, oral supplements, tube feedings and intravenous hyperalimentation (IVH) have been employed to limit weight loss and lessen intestinal RT side effects. Unfortunately, no prospective study reviewed has shown improved tumor control or patient survival. Special diets and IVH have also been employed in select patients to relieve chronic malabsorption from severe radiation enteritis

  19. Support for maternal manipulation of developmental nutrition in a facultatively eusocial bee, Megalopta genalis (Halictidae)

    OpenAIRE

    Kapheim, Karen M.; Bernal, Sandra P.; Smith, Adam R.; Nonacs, Peter; Wcislo, William T.

    2011-01-01

    Developmental maternal effects are a potentially important source of phenotypic variation, but they can be difficult to distinguish from other environmental factors. This is an important distinction within the context of social evolution, because if variation in offspring helping behavior is due to maternal manipulation, social selection may act on maternal phenotypes, as well as those of offspring. Factors correlated with social castes have been linked to variation in developmental nutrition...

  20. Teams make it work: how team work engagement mediates between social resources and performance in teams.

    Science.gov (United States)

    Torrente, Pedro; Salanova, Marisa; Llorens, Susana; Schaufeli, Wilmar B

    2012-02-01

    In this study we analyze the mediating role of team work engagement between team social resources (i.e., supportive team climate, coordination, teamwork), and team performance (i.e., in-role and extra-role performance) as predicted by the Job Demands-Resources Model. Aggregated data of 533 employees nested within 62 teams and 13 organizations were used, whereas team performance was assessed by supervisor ratings. Structural equation modeling revealed that, as expected, team work engagement plays a mediating role between social resources perceived at the team level and team performance as assessed by the supervisor.

  1. 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

  2. Transforming Virtual Teams

    DEFF Research Database (Denmark)

    Bjørn, Pernille

    2005-01-01

    Investigating virtual team collaboration in industry using grounded theory this paper presents the in-dept analysis of empirical work conducted in a global organization of 100.000 employees where a global virtual team with participants from Sweden, United Kingdom, Canada, and North America were...... studied. The research question investigated is how collaboration is negotiated within virtual teams? This paper presents findings concerning how collaboration is negotiated within a virtual team and elaborate the difficulties due to invisible articulation work and managing multiple communities...... in transforming the virtual team into a community. It is argued that translucence in communication structures within the virtual team and between team and management is essential for engaging in a positive transformation process of trustworthiness supporting the team becoming a community, managing the immanent...

  3. Clinical significance of determination of changes of immuno-function parameters in patients with acute severe brain lnjury on different froms of nutritional support

    International Nuclear Information System (INIS)

    Ma Jun; Qian Quanan; Ma Yunbao; Zhang Xiaoyi; Zhu Jin

    2009-01-01

    Objective: To study the relationship between different forms of nutritional support and changes of serum nutritional as well as immuno-function parameters in patients with acute severe brain injury. Methods: Serum levels of total protein, albumin, hemoglobin, transferrin (with biochemistry), immunoglobulins IgA, IgG, IgM (with immuno-turbidimetry) and cytokines IL-2, IL-6, IL-8 (with RIA) were determined in 64 patients with acute severe brain injury both before and after 7 ∼ 10ds' nutritional support. The 64 patients were divided into two groups:1) experimental group, n=30, receiving parentral (70%) plus partial enteral (30%) feedings 2) control group, n=34, receiving total parenteral untritional support exclusively with equal mitrogen and calorie intake in all the 64 patients. Results: The serum levels of total protein, albumin, Hb and transferrin as well as other parameter in both groups before nutritional support were about the same. After the course of nutritional support, the serum levels of total protein and albumin changed little in both groups, but the Hb and transferritin levels in both groups increased significantly (P<0.05) with the levels significantly higher in the experimental group than those in the control group (P also <0.05). The serum immunoglobulins IgA, IgM levels changed verd littel, except that the IgG levels increased significantly in the experimental group after treatment (P<0.05) and were significantly higher than those in control group (P also <0.05). The serum cytokins levels in the control group changed little after the course of nutritional support, but the levels in the experimental group were greatly normalized and decreased significantly after treatment (P also <0.05). Conclusion: Parenteral combined with partial enteral nutritional support could improve the nutritional as well as immuno-function status better than exclusive TPN did in patients with acute severe brain injury. (authors)

  4. Asteroid team

    International Nuclear Information System (INIS)

    Matson, D.L.

    1988-01-01

    The purpose of this task is to support asteroid research and the operation of an Asteroid Team within the Earth and Space Sciences Division at the Jet Propulsion Laboratory (JPL). The Asteroid Team carries out original research on asteroids in order to discover, better characterize and define asteroid properties. This information is needed for the planning and design of NASA asteroid flyby and rendezvous missions. The asteroid Team also provides scientific and technical advice to NASA and JPL on asteroid related programs. Work on asteroid classification continued and the discovery of two Earth-approaching M asteroids was published. In the asteroid photometry program researchers obtained N or Q photometry for more than 50 asteroids, including the two M-earth-crossers. Compositional analysis of infrared spectra (0.8 to 2.6 micrometer) of asteroids is continuing. Over the next year the work on asteroid classification and composition will continue with the analysis of the 60 reduced infrared spectra which we now have at hand. The radiometry program will continue with the reduction of the N and Q bandpass data for the 57 asteroids in order to obtain albedos and diameters. This year the emphasis will shift to IRAS follow-up observations; which includes objects not observed by IRAS and objects with poor or peculiar IRAS data. As in previous year, we plan to give top priority to any opportunities for observing near-Earth asteroids and the support (through radiometric lightcurve observations from the IRTF) of any stellar occultations by asteroids for which occultation observation expeditions are fielded. Support of preparing of IRAS data for publication and of D. Matson for his participation in the NASA Planetary Astronomy Management and Operations Working Group will continue

  5. Asteroid team

    Science.gov (United States)

    Matson, D. L.

    1988-01-01

    The purpose of this task is to support asteroid research and the operation of an Asteroid Team within the Earth and Space Sciences Division at the Jet Propulsion Laboratory (JPL). The Asteroid Team carries out original research on asteroids in order to discover, better characterize and define asteroid properties. This information is needed for the planning and design of NASA asteroid flyby and rendezvous missions. The asteroid Team also provides scientific and technical advice to NASA and JPL on asteroid related programs. Work on asteroid classification continued and the discovery of two Earth-approaching M asteroids was published. In the asteroid photometry program researchers obtained N or Q photometry for more than 50 asteroids, including the two M-earth-crossers. Compositional analysis of infrared spectra (0.8 to 2.6 micrometer) of asteroids is continuing. Over the next year the work on asteroid classification and composition will continue with the analysis of the 60 reduced infrared spectra which we now have at hand. The radiometry program will continue with the reduction of the N and Q bandpass data for the 57 asteroids in order to obtain albedos and diameters. This year the emphasis will shift to IRAS follow-up observations; which includes objects not observed by IRAS and objects with poor or peculiar IRAS data. As in previous year, we plan to give top priority to any opportunities for observing near-Earth asteroids and the support (through radiometric lightcurve observations from the IRTF) of any stellar occultations by asteroids for which occultation observation expeditions are fielded. Support of preparing of IRAS data for publication and of D. Matson for his participation in the NASA Planetary Astronomy Management and Operations Working Group will continue.

  6. Danish evidence-based clinical guideline for use of nutritional support in pulmonary rehabilitation of undernourished patients with stable COPD.

    Science.gov (United States)

    Beck, Anne Marie; Iepsen, Ulrik Winning; Tobberup, Randi; Jørgensen, Karsten Juhl

    2015-02-01

    Disease-related under-nutrition is a common problem in individuals with COPD. The rationale for nutritional support in pulmonary rehabilitation therefore seems obvious. However there is limited evidence regarding the patient-relevant outcomes i.e. activities of daily living (ADL) or quality of life. Therefore the topic was included in The Danish Health and Medicines Authority's development of an evidence-based clinical guideline for rehabilitation of patients with stable COPD. The methods were specified by The Danish Health and Medicines Authority as part of a standardized approach to evidence-based national clinical practice guidelines. They included formulation of a PICO with pre-defined criteria for the Population, Intervention, Control and Outcomes. Existing guidelines or systematic reviews were used after assessment using the AGREE II tool or AMSTAR, if possible. We identified primary studies by means of a systematic literature search (July to December 2013), and any identified studies were then quality assessed using the Cochrane risk of bias tool and the GRADE approach. The extracted data on our pre-defined outcomes were summarized in meta-analyses when possible, or meta-analyses from existing guidelines or systematic reviews were adapted. The results were used for labeling and wording of the recommendations. Data from 12 randomized controlled trials were included in a systematic review, which formed the basis for our recommendations as no new primary studies had been published. There were evidence of moderate quality that nutritional support for undernourished patients with COPD lead to a weight gain of 1.7kg (95% confidence interval: 1.3 to 2.2kg), but the effect was quantified as a mean change from baseline, which is less reliable. There were evidence of moderate quality that nutritional therapy does not increase in the 6 minute walking distance of 13 m (95% confidence interval: -27 to 54 m) when results in the intervention and control groups were

  7. Exercise and nutrition for head and neck cancer patients: a patient oriented, clinic-supported randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Capozzi Lauren C

    2012-10-01

    Full Text Available Abstract Background Research on physical activity and nutrition interventions aimed at positively impacting symptom management, treatment-related recovery and quality of life has largely excluded head and neck (HN cancer populations. This translates into a lack of clinical programming available for these patient populations. HN cancer patients deal with severe weight loss, with more than 70% attributed to lean muscle wasting, leading to extended recovery times, decreased quality of life (QoL, and impaired physical functioning. To date, interventions to address body composition issues have focused solely on diet, despite findings that nutritional therapy alone is insufficient to mitigate changes. A combined physical activity and nutrition intervention, that also incorporates important educational components known to positively impact behaviour change, is warranted for this population. Our pilot work suggests that there is large patient demand and clinic support from the health care professionals for a comprehensive program. Methods/Design Therefore, the purpose of the present study is to examine the impact and timing of a 12-week PA and nutrition intervention (either during or following treatment for HN cancer patients on body composition, recovery, serum inflammatory markers and quality of life. In addition, we will examine the impact of a 12-week maintenance program, delivered immediately following the intervention, on adherence, patient-reported outcomes (i.e., management of both physical and psychosocial treatment-related symptoms and side-effects, as well as return to work. Discussion This research will facilitate advancements in patient wellness, survivorship, and autonomy, and carve the path for a physical-activity and wellness-education model that can be implemented in other cancer centers. Trial registration Current Controlled Trials NCT01681654

  8. Work engagement supports nurse workforce stability and quality of care: nursing team-level analysis in psychiatric hospitals.

    Science.gov (United States)

    Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S

    2013-10-01

    Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. © 2012 John Wiley & Sons Ltd.

  9. Nutritional support and dietary interventions for women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    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 

  10. Beneficial effect of nutritional supportive plan among under-nourished children in poor families in Iran with collaborating Ministry of Health and Emam Khomeini

    International Nuclear Information System (INIS)

    Minaei, Mina; Zarei, Maryam; Araste, Razieh; Kamali, Behroo

    2014-01-01

    Full text: Malnutrition in the form of Protein – Energy Malnutrition (PEM) and micro nutrient deficiencies, is one of the most important health problems in developing countries, Iran included. The purpose of this study was to improve nutritional status among under-nourished children in poor families. Methods: A total of 50,000 children under 5 (girls and boys) in 30 provinces in Iran which suffered by moderate and severe malnutrition participated (<-2SD weight for age) in this program. Malnourished children belong to poor families were determined; weights and heights were measured and anthropometric indicators were determined based on WHO, 2007. Then, these malnourished children were introduced to Imam Khomeini Foundation. Khomeini Foundation as one of the biggest NGO in Iran which supports poor families since 1979. This study collaborated with Ministry of Welfare, Ministry of Health and Emam Khomeini. They have started to receive monthly supportive food basket which could support their daily nutritional requirements. This basket included (meat, egg, cheese, legumes, milk, tuna fish, chicken, liquid oil). Along with food support community health workers were actively involved with counseling of mothers on the nutritional requirements of children. Nutritional support cut for whoever has been improved nutritional status. However, nutritional education still had continued. Results: The results of monitoring & evaluation (according to anthropometric indicators) of this plan have shown around more than 45% of children that received food basket had consistently improved nutritional status. Conclusion: Likewise other intervention nutrition programs in developing countries this project showed that inter sector collaboration have been the best way for decreasing malnutrition in children. (author)

  11. Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel.

    Science.gov (United States)

    Keller, H H; Vesnaver, E; Davidson, B; Allard, J; Laporte, M; Bernier, P; Payette, H; Jeejeebhoy, K; Duerksen, D; Gramlich, L

    2014-04-01

    Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care. Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically. Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care. The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed. © 2013 The British Dietetic Association Ltd.

  12. Can existing mobile apps support healthier food purchasing behaviour? Content analysis of nutrition content, behaviour change theory and user quality integration.

    Science.gov (United States)

    Flaherty, Sarah-Jane; McCarthy, Mary; Collins, Alan; McAuliffe, Fionnuala

    2018-02-01

    To assess the quality of nutrition content and the integration of user quality components and behaviour change theory relevant to food purchasing behaviour in a sample of existing mobile apps. Descriptive comparative analysis of eleven mobile apps comprising an assessment of their alignment with existing evidence on nutrition, behaviour change and user quality, and their potential ability to support healthier food purchasing behaviour. Mobile apps freely available for public use in GoogePlay were assessed and scored according to agreed criteria to assess nutrition content quality and integration of behaviour change theory and user quality components. A sample of eleven mobile apps that met predefined inclusion criteria to ensure relevance and good quality. The quality of the nutrition content varied. Improvements to the accuracy and appropriateness of nutrition content are needed to ensure mobile apps support a healthy behaviour change process and are accessible to a wider population. There appears to be a narrow focus towards behaviour change with an overemphasis on behavioural outcomes and a small number of behaviour change techniques, which may limit effectiveness. A significant effort from the user was required to use the mobile apps appropriately which may negatively influence user acceptability and subsequent utilisation. Existing mobile apps may offer a potentially effective approach to supporting healthier food purchasing behaviour but improvements in mobile app design are required to maximise their potential effectiveness. Engagement of mobile app users and nutrition professionals is recommended to support effective design.

  13. Effect of nutritional support on mitochondrial complex I activity in malnourished patients with anorexia nervosa.

    Science.gov (United States)

    De-Mateo-Silleras, Beatriz; Alonso-Torre, Sara R; Redondo-del-Río, Paz; Jeejeebhoy, Khursheed; Miján-de-la-Torre, Alberto

    2013-11-01

    Previous studies have shown a reduction in lymphocyte mitochondrial complex I activity (CIA) in malnourished patients, which is restored after refeeding. Our aim was to evaluate the usefulness of CIA as an indicator of nutritional status in anorexia nervosa patients. Twelve malnourished anorexia nervosa females (mean age, 24.5 years) were admitted to the Eating Disorders Unit. Basal and weekly anthropometrics, bioelectric impedance (BIA), body composition, and CIA were performed until discharge. Patients were matched to 25 healthy females and refeeding was adjusted according to the Unit's protocol. Statistics were used as appropriated and significance was reached at p anorexia nervosa have lower CIA than controls that is not recovered after refeeding. This could be because of a low FFM exacerbated by physical inactivity while in hospital.

  14. Management Teams

    CERN Document Server

    Belbin, R Meredith Meredith

    2012-01-01

    Meredith Belbin's work on teams has become part of everyday language in organizations all over the world. All kinds of teams and team behaviours are covered. At the end of the book is a self-perception inventory so that readers can match their own personalities to particular team roles. Management Teams is required reading for managers concerned with achieving results by getting the best from their key personnel.

  15. Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?

    Directory of Open Access Journals (Sweden)

    Naberhuis JK

    2017-08-01

    Full Text Available Jane K Naberhuis,1 Vivienne N Hunt,2 Jvawnna D Bell,3 Jamie S Partridge,3 Scott Goates,3 Mark JC Nuijten4 1Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA; 2Abbott Nutrition, Research and Development, Singapore; 3Abbott Nutrition, Research and Development, Columbus, OH, USA; 4A2M (Ars Accessus Medica, Amsterdam, The Netherlands Background and aims: As policy-makers assess the value of money spent on health care, research in the field of health economics is expanding rapidly. This review covers a period of 10 years and seeks to characterize the publication of papers at the intersection of health economics and nutrition. Methods: Relevant publications on nutrition care were identified in the medical literature databases using predetermined search criteria. These included nutritional interventions linked to health economic terms with inclusion criteria requiring original research that included clinical outcomes and cost analyses, subjects’ ages ≥18 years, and publications in English between January 2004 and October 2014. Results: Of the 5,646 publications identified in first-round searches, 274 met the specified inclusion criteria. The number of publications linking nutrition to economic outcomes has increased markedly over the 10-year period, with a growing number of studies in both developed and developing countries. Most studies were undertaken in Europe (39% and the USA and Canada (28%. The most common study setting was hospital (62% followed by community/noninstitutional care (30%. Of all the studies, 12% involved the use of oral nutritional supplements, and 13% involved parenteral nutrition. The economic outcomes consistently measured were medical care costs (53% of the studies, hospital length of stay (48%, hospital readmission rates (9%, and mortality (25%. Conclusion: The number of publications focused on the economics of nutrition interventions has increased dramatically in recent years

  16. Study protocol: cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care: cluster randomized controlled trial

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe

    2014-01-01

    BACKGROUND: Older adults in nursing home and home-care are a particularly high-risk population for weight loss or poor nutrition. One negative consequence of undernutrition is increased health care costs. Several potentially modifiable nutritional risk factors increase the likelihood of weight loss......-effectiveness of nutritional support among undernourished older adults and none of these have used such a multidisciplinary approach. METHODS: An 11 week cluster randomized trial to assess the cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home...... older adults in home-care and nursing home and contribute to important research. TRIAL REGISTRATION: ClinicalTrials.gov 2013 NCT01873456....

  17. Women's autonomy and social support and their associations with infant and young child feeding and nutritional status: community-based survey in rural Nicaragua.

    OpenAIRE

    Ziaei, S; Contreras, M; Zelaya Blandón, E; Persson, L.Å,; Hjern, A; Ekström, EC

    2014-01-01

    To evaluate the associations of women's autonomy and social support with infant and young child feeding practices (including consumption of highly processed snacks and sugar-sweetened beverages) and nutritional status in rural Nicaragua. Cross-sectional study. Feeding practices and children's nutritional status were evaluated according to the WHO guidelines complemented with information on highly processed snacks and sugar-sweetened beverages. Women's autonomy was assessed by a seventeen-item...

  18. Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?

    OpenAIRE

    Naberhuis,Jane K; Hunt,Vivienne; Bell,Jvawnna; Partridge,Jamie; Goates,Scott; Nuijten,Mark

    2017-01-01

    Jane K Naberhuis,1 Vivienne N Hunt,2 Jvawnna D Bell,3 Jamie S Partridge,3 Scott Goates,3 Mark JC Nuijten4 1Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA; 2Abbott Nutrition, Research and Development, Singapore; 3Abbott Nutrition, Research and Development, Columbus, OH, USA; 4A2M (Ars Accessus Medica), Amsterdam, The Netherlands Background and aims: As policy-makers assess the value of money spent on health care, researc...

  19. Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?

    OpenAIRE

    Naberhuis JK; Hunt VN; Bell JD; Partridge JS; Goates S; Nuijten MJC

    2017-01-01

    Jane K Naberhuis,1 Vivienne N Hunt,2 Jvawnna D Bell,3 Jamie S Partridge,3 Scott Goates,3 Mark JC Nuijten4 1Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA; 2Abbott Nutrition, Research and Development, Singapore; 3Abbott Nutrition, Research and Development, Columbus, OH, USA; 4A2M (Ars Accessus Medica), Amsterdam, The Netherlands Background and aims: As policy-makers assess the value of money spent on health care, research in the fie...

  20. The difference is more than floating: factors affecting breast cancer survivors' decisions to join and maintain participation in dragon boat teams and support groups.

    Science.gov (United States)

    McDonough, Meghan H; Patterson, Michelle C; Weisenbach, Beth B; Ullrich-French, Sarah; Sabiston, Catherine M

    2018-03-09

    Peer support can be helpful in rehabilitation from breast cancer, but participation in peer support groups is low. Groups that provide support opportunities in physical activity contexts are an attractive alternative for some survivors. This study examined survivors' reasons for joining and maintaining participation on a dragon boat team, along with perceptions of barriers and attractions to traditional peer support groups. Seventeen breast cancer survivors were interviewed on five occasions over their first two seasons of a newly formed dragon boating team to explore their perceptions of peer support groups and dragon boating. Data were inductively analyzed using thematic analysis. Categories surrounding physical, psychological, social and community features were identified with several themes emerging within each. Advantages of dragon boating included opportunities to get a combination of physical, psychosocial and community benefits; health improvement and behavior change; and obtaining social support without the focus being on cancer. Peer support groups were identified as having advantages for forming relationships and avoiding barriers associated with physical activity. While neither type of program meets all needs, practical considerations are identified for incorporating advantages of both programs to improve participation. Implications for rehabilitation Further understanding of perceptions, and attractions and challenges to taking part in group programs will inform development of accessible programs that target multiple rehabilitation needs. Physical activity can provide a positive, alternative focus that takes the emphasis off of cancer, which is more accessible to some survivors. Physical activity also provides opportunities to build relationships around a common, positive goal, which can be a foundation for providing support for coping with cancer.

  1. Technical support to the ER program subsurface technologies team leader. Final report, March 15, 1993--March 15, 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    This research included development of a new geologic sample management facility and associated quality assurance systems for the LANL Environmental Restoration Program. Additional work with the LANL Environmental Restoration Program included the development of Sampling and Analysis Plans (SAP) for various Operable Units for the Laboratory. The PI (Davidson) served as the sample curation/sample management specialist on the ER program Subsurface Studies Technical Team. Specialization in Field Unit Data Base systems was the focus of the work towards the end of the contract. A document is included which provides the Statement of Policy for the management of borehole samples collected during environmental restoration activities at LANL.

  2. Technical support to the ER program subsurface technologies team leader. Final report, March 15, 1993 - March 15, 1998

    International Nuclear Information System (INIS)

    1998-01-01

    This research included development of a new geologic sample management facility and associated quality assurance systems for the LANL Environmental Restoration Program. Additional work with the LANL Environmental Restoration Program included the development of Sampling and Analysis Plans (SAP) for various Operable Units for the Laboratory. The PI (Davidson) served as the sample curation/sample management specialist on the ER program Subsurface Studies Technical Team. Specialization in Field Unit Data Base systems was the focus of the work towards the end of the contract. A document is included which provides the Statement of Policy for the management of borehole samples collected during environmental restoration activities at LANL

  3. Team Learning Ditinjau dari Team Diversity dan Team Efficacy

    OpenAIRE

    Pohan, Vivi Gusrini Rahmadani; Ancok, Djamaludin

    2010-01-01

    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  4. Team Learning Ditinjau dari Team Diversity dan Team Efficacy

    OpenAIRE

    Vivi Gusrini Rahmadani Pohan; Djamaludin Ancok

    2015-01-01

    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  5. A Lifetime Pursuit of a Sports Nutrition Practice.

    Science.gov (United States)

    Erdman, Kelly Anne

    2015-09-01

    Sports nutrition in Canada has significantly evolved over the years from providing fundamental training dietary advice to applied precise assessment of nutritional status in a variety of settings, especially with the establishment of Canadian Sport Institutes and Centres across Canada. This progression has enhanced the level of dietary support to manage athletes' nutrition in a holistic perspective. Athletes are now educated about food fundamentals (acquiring foods, menu planning, preparing, food safety), personal accountability of hydration and energy monitoring (urinary and body weight assessments), individualized supplementation protocols, and customized nutrition for variable daily training environments according to their Yearly Training Plan. Sport dietitians are an important member of Integrated Sport Teams where collaboration exists amongst professionals who coordinate the athletes' personalized training and performance programming. Dietitians in sport are encouraged to continue to lobby for nutrition programming at the elite, varsity, provincial, and club levels to ensure that athletes receive accurate guidance from nutrition experts.

  6. Using Beta-Version mHealth Technology for Team-Based Care Management to Support Stroke Prevention: An Assessment of Utility and Challenges.

    Science.gov (United States)

    Ramirez, Magaly; Wu, Shinyi; Ryan, Gery; Towfighi, Amytis; Vickrey, Barbara G

    2017-05-23

    Beta versions of health information technology tools are needed in service delivery models with health care and community partnerships to confirm the key components and to assess the performance of the tools and their impact on users. We developed a care management technology (CMT) for use by community health workers (CHWs) and care managers (CMs) working collaboratively to improve risk factor control among recent stroke survivors. The CMT was expected to enhance the efficiency and effectiveness of the CHW-CM team. The primary objective was to describe the Secondary Stroke Prevention by Uniting Community and Chronic Care Model Teams Early to End Disparities (SUCCEED) CMT and investigate CM and CHW perceptions of the CMT's usefulness and challenges for team-based care management. We conducted qualitative interviews with all users of the beta-version SUCCEED CMT, namely two CMs and three CHWs. They were asked to demonstrate and describe their perceptions of the CMT's ease of use and usefulness for completing predefined key care management activities. They were also probed about their general perceptions of the CMT's information quality, ease of use, usefulness, and impact on CM and CHW roles. Interview transcripts were coded using a priori codes. Coded excerpts were grouped into broader themes and then related in a conceptual model of how the CMT facilitated care management. We also conducted a survey with 14 patients to obtain their perspective on CHW tablet use during CHW-patient interactions. Care managers and community health workers expressed that the CMT helped them keep track of patient interactions and plan their work. It guided CMs in developing and sharing care plans with CHWs. For CHWs, the CMT enabled electronic collection of clinical assessment data, provided decision support, and provided remote access to patients' risk factor values. Long loading times and downtimes due to outages were the most significant challenges encountered. Additional issues

  7. FERMENTED SOYBEAN CAKE AND ALBUMIN FORMULA AS NUTRITIONAL SUPPORT PREVENTS PROTEIN ENERGY MALNUTRITION AND AKI IN STROKE PATIENTS

    Directory of Open Access Journals (Sweden)

    Nanny Djaya

    2012-06-01

    Natrium and Kalium, could be corrected with appropriate nutritional support (adequate calorie, protein and mineral and therefore prevents acute kidney injury and protein energy malnutrition in elderly patients with anorexia.

  8. The nutritional adequacy of a limited vegan diet for a controlled ecological life-support system

    Science.gov (United States)

    Saha, P. R.; Trumbo, P. R.

    Purdue University, as well as the Johnson and Kennedy Space Centers and NASA Ames Research Center, are investigating approximately 5-10 plants that will be grown hydroponically to provide not only the energy and nutrients, but also the oxygen for humans habitating in Mars and lunar bases. The growth and nutritional status of rats fed either a control diet (adequate in all macro- and micronutrients) or a strict vegetarian diet consisting of 5 (vegan-5) or 10 (vegan-10) candidate crop species were investigated. In addition, vegan-10 diets were supplemented with mineral and/or vitamin mix at a level similar to the control diets to assess the effect of supplementation on nutrient status. The assessment of inedible plant material as an alternative food source was also investigated. Results of this study demonstrated that consumption of the vegan-10 diet significantly improved weight gain of rats compared to that for rats fed the vegan-5 diet. Mineral supplementation, at a level present in the control diet, to the vegan-10 diet improved growth and nutrient status, but growth was significantly lower compared to the control-fed rats. Inclusion of inedible plant material, high in ash content, improved some indices of nutrient status, without improving growth.

  9. Too little, too late: comparison of nutritional status and quality of life of nutrition care and support recipient and non-recipients among HIV-positive adults in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Oketch, Jecinter Akinyi; Paterson, Marie; Maunder, Eleni Winfred; Rollins, Nigel Campbell

    2011-03-01

    Compare the nutritional vulnerability, risk of malnutrition, nutritional status and quality of life (QoL) between recipients and non-recipients of nutrition care and support (NCS) of HIV-positive adults. In 2009, a household-based cross-sectional study of HIV-positive adults, NCS recipients (n=97) and non-NCS recipients (n=203) from KwaZulu-Natal was conducted. Nutritional vulnerability (socio-economic status; food security; self-reported health status; nutritional knowledge and attitude), risk of malnutrition (nutrition assessment screening tool), anthropometry (body mass index; mid-upper arm circumference; waist-to-hip ratio) and QoL (general health; self-care; physical functioning) were compared between the two groups. Although the result suggests a modest impairment of QoL, NCS recipients were twice as likely to have severe impairment of general health; self-care functioning and QoL. Overweight and obesity were common despite indications of high prevalence of food insecurity, possible-risk of malnutrition and diets predominantly of cereals. NCS recipients were more frequently taking anti-retroviral drugs, receiving social grants, reporting good eating plans and owning kitchen gardens. Non-NCS recipients had been generally sick, reported fatigue, nausea, appetite loss and diarrhoea. NCS recipients were twice as likely to experience oral thrush. Contextual factors such as low dietary diversity and household food insecurity that exacerbates nutritional vulnerability and malnutrition should be considered when providing NCS to fully achieve nutritional recovery and QoL of HIV-positive adults. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  10. ISOLDE PH team, from left to right: Jennifer Weterings (user support), Susanne Kreim (research fellow), Marek Pfützner (scientific associate), Maria Garcia Borge (team leader), Elisa Rapisarda (research fellow) , Magdalena Kowalska (physics coordinator), Jan Kurcewicz (applied fellow), Monika Stachura (applied fellow). Not in the photo: Kara Lynch (PhD student).

    CERN Multimedia

    Visual Media Office

    2013-01-01

    ISOLDE PH team, from left to right: Jennifer Weterings (user support), Susanne Kreim (research fellow), Marek Pfützner (scientific associate), Maria Garcia Borge (team leader), Elisa Rapisarda (research fellow) , Magdalena Kowalska (physics coordinator), Jan Kurcewicz (applied fellow), Monika Stachura (applied fellow). Not in the photo: Kara Lynch (PhD student).

  11. Team Sports

    Science.gov (United States)

    ... Games. USA Hockey offers additional information and resources. Softball It's not easy to field full teams of ... an annual tournament sponsored by the National Wheelchair Softball Association , where thirty or so teams show up ...

  12. Trust in agile teams

    DEFF Research Database (Denmark)

    Tjørnehøj, Gitte; Fransgård, Mette; Skalkam, Signe

    2012-01-01

    actions influenced this. We see two important lessons from the analysis. First the agile practices of daily Scrum and self organizing team can empower DSD teams to manage their own development of trust and thereby alleviate the obstacles of DSD. Second if management fails to support the development...

  13. Case Study: Nutritional and Lifestyle Support to Reduce Infection Incidence in an International-Standard Premier League Soccer Player.

    Science.gov (United States)

    Ranchordas, Mayur K; Bannock, Laurent; Robinson, Scott L

    2016-04-01

    Professional soccer players are exposed to large amounts of physiological and psychological stress, which can increase infection risk and threaten availability for training and competition. Accordingly, it is important for practitioners to implement strategies that support player well-being and prevent illness. This case study demonstrates how a scientifically supported and practically applicable nutrition and lifestyle strategy can reduce infection incidence in an illness-prone professional soccer player. In the 3 months before the intervention, the player had 3 upper-respiratory tract infections (URTIs) and subsequently missed 3 competitive matches and 2 weeks' training. He routinely commenced morning training sessions in the fasted state and was estimated to be in a large daily energy deficit. Throughout the 12-week intervention, the amount, composition, and timing of energy intake was altered, quercetin and vitamin D were supplemented, and the player was provided with a daily sleep and hygiene protocol. There was a positive increase in serum vitamin D 25(OH) concentration from baseline to Week 12 (53 n·mol-1 to 120 n·mol-1) and salivary immunoglobulin-A (98 mg·dl-1 to 135 mg·dl-1), as well as a decline in the number of URTI symptoms (1.8 ± 2.0 vs. 0.25 ± 0.5 for Weeks 0-4 and Weeks 8-12, respectively). More important, he maintained availability for all training and matches over the 12-week period. We offer this case study as a real-world applied example for other players and practitioners seeking to deploy nutrition and lifestyle strategies to reduce risk of illness and maximize player availability.

  14. Support for maternal manipulation of developmental nutrition in a facultatively eusocial bee, Megalopta genalis (Halictidae).

    Science.gov (United States)

    Kapheim, Karen M; Bernal, Sandra P; Smith, Adam R; Nonacs, Peter; Wcislo, William T

    2011-06-01

    Developmental maternal effects are a potentially important source of phenotypic variation, but they can be difficult to distinguish from other environmental factors. This is an important distinction within the context of social evolution, because if variation in offspring helping behavior is due to maternal manipulation, social selection may act on maternal phenotypes, as well as those of offspring. Factors correlated with social castes have been linked to variation in developmental nutrition, which might provide opportunity for females to manipulate the social behavior of their offspring. Megalopta genalis is a mass-provisioning facultatively eusocial sweat bee for which production of males and females in social and solitary nests is concurrent and asynchronous. Female offspring may become either gynes (reproductive dispersers) or workers (non-reproductive helpers). We predicted that if maternal manipulation plays a role in M. genalis caste determination, investment in daughters should vary more than for sons. The mass and protein content of pollen stores provided to female offspring varied significantly more than those of males, but volume and sugar content did not. Sugar content varied more among female eggs in social nests than in solitary nests. Provisions were larger, with higher nutrient content, for female eggs and in social nests. Adult females and males show different patterns of allometry, and their investment ratio ranged from 1.23 to 1.69. Adult body weight varied more for females than males, possibly reflecting increased variation in maternal investment in female offspring. These differences are consistent with a role for maternal manipulation in the social plasticity observed in M. genalis.

  15. Is there a role for a primary health nurse in a learning support team in a disadvantaged high school? Evaluation of a pilot study.

    Science.gov (United States)

    Dennis, Sarah; Noon, Ted; Liaw, Siaw Teng

    2016-02-01

    Disadvantaged children experience more health problems and have poorer educational outcomes compared with students from advantaged backgrounds. This paper presents the quantitative and qualitative findings from a pilot study to determine the impact of the Healthy Learner model, where an experienced primary care nurse was embedded in a learning support team in a disadvantaged high school. Students entering high school with National Assessment Program, Literacy and Numeracy (NAPLAN) scores in the lowest quartile for the school were assessed by the nurse and identified health issues addressed. Thirty-nine students were assessed in 2012-13 and there were up to seven health problems identified per student, ranging from serious neglect to problems such as uncorrected vision or hearing. Many of these problems were having an impact on the student and their ability to engage in learning. Families struggled to navigate the health system, they had difficulty explaining the student's problems to health professionals and costs were a barrier. Adding a nurse to the learning support team in this disadvantaged high school was feasible and identified considerable unmet health needs that affect a student's ability to learn. The families needed extensive support to access any subsequent health care they required.

  16. Facilitating Fresh: State Laws Supporting School Gardens Are Associated With Use of Garden-Grown Produce in School Nutrition Services Programs.

    Science.gov (United States)

    Turner, Lindsey; Leider, Julien; Piekarz, Elizabeth; Schermbeck, Rebecca M; Merlo, Caitlin; Brener, Nancy; Chriqui, Jamie F

    2017-06-01

    To examine whether state laws are associated with the presence of school gardens and the use of garden-grown produce in school nutrition services programs. Nationally representative data from the School Health Policies and Practices Study 2014 were combined with objectively coded state law data regarding school gardens. Outcomes were: (1) the presence of a school garden at each school (n = 419 schools), and (2) the use of garden-grown items in the school nutrition services program. Multivariate logistic regression was used to examine each outcome. Contextual covariates included school level, size, locale, US Census region, student race/ethnic composition, and percentage of students eligible for free and reduced-priced meals. State law was not significantly associated with whether schools had a garden, but it was associated with whether schools used garden-grown items in nutrition services programs (odds ratio, 4.21; P garden-grown items in nutrition services programs was 15.4% among schools in states with a supportive law, vs 4.4% among schools in states with no law. State laws that support school gardens may facilitate the use of garden-grown items in school nutrition service programs. Additional research is needed regarding the types of messaging that might be most effective for motivating school administrators to appreciate the value of school gardens. In addition, another area for further research pertains to scaling garden programs for broader reach. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

  17. Sports nutrition

    Directory of Open Access Journals (Sweden)

    Tomanić Milena

    2016-01-01

    Full Text Available Due to higher energy consumption, physically active people have higher nutritional requirements. In addition to other important factors for sports, such as good health and physical predisposition, adequate nutrition is a fundamental component. Sports nutrition must be well planned and individually adapted based on physical characteristics, tendencies towards gaining or losing weight, frequency, duration and intensity of training sessions. Studies have shown that a well-balanced ratio of macro and micronutrients, with the support of supplements and adequate hydration, can significantly improve athletic performance and plays a key role in achieving better results. An optimally designed nutritional program, with realistic and achievable goals, which complements a well-planned training program, is the basis for success in sports. Only when nutritional requirements are met, deficits can be prevented and performance in sport pushed to the limit.

  18. Enteral Nutrition Support for Abdominal Compartment Syndrome in Morbidly Obese Patient : A Case Report from a Medical Intensive Care Unit (ICU

    Directory of Open Access Journals (Sweden)

    Nurul Huda Razalli

    2018-01-01

    Full Text Available Compartment syndrome occurs when pressure within a closed muscle or bone compartment builds to dangerous levels. This pressure can decrease blood flow to nerve and muscle cells, leading to ischemia and organ dysfunction. Challenges in providing enteral nutrition for abdominal compartment syndrome (ACS patients include the increase risk for developing gastrointestinal symptoms such as diarrhea, constipation and distention. There are limited reports available on the nutritional management of ACS patients in the ICU especially those with morbid obesity condition to guide dietitians in providing nutritional support for these patients.  Here, we report the enteral nutrition management of a mechanically ventilated, morbidly obese patient with ACS in a critical care setting by adopting postpyloric feeding, using prokinetic agents and implementing PO2/FiO2 ratio calculation for prescription of most suitable enteral formula.

  19. The oncologist as coordinator of the nutritional approach.

    Science.gov (United States)

    Bozzetti, Federico

    2015-04-01

    Although the nutritional approach, especially when delivered through a gastric or jejunal tube or in a central vein, is handled by the nutritional support team or a specialist in nutrition, it is the responsibility of the oncologist, who knows the natural history of the disease and the impact of the oncologic therapy, to identify the potential candidates for the nutritional support, to recommend the nutritional strategy and to integrate it within the oncologic program. If gastrointestinal function is preserved, the initial nutritional approach should be through oral supplementation, followed by tube feeding if previous attempts are unsuccessful or upper gastrointestinal tract is not accessible. Parenteral nutrition is the obligatory resort when patients are (sub)obstructed but it may also be a practical way to integrate an insufficient oral nutrient intake (so called "supplemental" parenteral nutrition). Depending on the patient's condition and the disease's stage, artificial nutrition may have a "permissive" role in patients receiving aggressive oncologic therapy or represent just a supportive treatment in patients likely to succumb from starvation sooner than from tumor progression. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Nutritional and cultural aspects of plant species selection for a controlled ecological life support system

    Science.gov (United States)

    Hoff, J. E.; Howe, J. M.; Mitchell, C. A.

    1982-01-01

    The feasibility of using higher plants in a controlled ecological life support system is discussed. Aspects of this system considered important in the use of higher plants include: limited energy, space, and mass, and problems relating to cultivation and management of plants, food processing, the psychological impact of vegetarian diets, and plant propagation. A total of 115 higher plant species are compared based on 21 selection criteria.

  1. Pregnancy Exercise and Nutrition With Smartphone Application Support: A Randomized Controlled Trial.

    Science.gov (United States)

    Kennelly, Maria A; Ainscough, Kate; Lindsay, Karen L; OʼSullivan, Elizabeth; Gibney, Eileen R; McCarthy, Mary; Segurado, Ricardo; DeVito, Giuseppe; Maguire, Orla; Smith, Thomas; Hatunic, Mensud; McAuliffe, Fionnuala M

    2018-05-01

    To evaluate the effect of a healthy lifestyle package (an antenatal behavior change intervention supported by smartphone application technology) on the incidence of gestational diabetes mellitus (GDM) in overweight and obese women. Women with body mass indexes (BMIs) 25-39.9 were enrolled into this randomized controlled trial. The intervention consisted of specific dietary and exercise advice that addressed behavior change supported by a tailor-designed smartphone application. Women in the control group received usual care. The primary outcome was the incidence of GDM at 28-30 weeks of gestation. To reduce GDM from 15% to 7.2%, we estimated that 506 women would be required to have 80% power to detect this effect size at a significance of .05, that is, 253 in each group. Between March 2013 and February 2016, 565 women were recruited with a mean BMI of 29.3 and mean gestational age of 15.5 weeks. The incidence of GDM did not differ between the two groups, 37 of 241 (15.4%) in the intervention group compared with 36 of 257 (14.1%) in the control group (relative risk 1.1, 95% CI 0.71-1.66, P=.71). A mobile health-supported behavioral intervention did not decrease the incidence of GDM. ISRCTN registry, https://www.isrctn.com/, ISRCTN29316280.

  2. Working group reports: evaluation of the evidence to support practice guidelines for nutritional care of preterm infants-the Pre-B Project.

    Science.gov (United States)

    Raiten, Daniel J; Steiber, Alison L; Carlson, Susan E; Griffin, Ian; Anderson, Diane; Hay, William W; Robins, Sandra; Neu, Josef; Georgieff, Michael K; Groh-Wargo, Sharon; Fenton, Tanis R

    2016-02-01

    The "Evaluation of the Evidence to Support Practice Guidelines for the Nutritional Care of Preterm Infants: The Pre-B Project" is the first phase in a process to present the current state of knowledge and to support the development of evidence-informed guidance for the nutritional care of preterm and high-risk newborn infants. The future systematic reviews that will ultimately provide the underpinning for guideline development will be conducted by the Academy of Nutrition and Dietetics' Evidence Analysis Library (EAL). To accomplish the objectives of this first phase, the Pre-B Project organizers established 4 working groups (WGs) to address the following themes: 1) nutrient specifications for preterm infants, 2) clinical and practical issues in enteral feeding of preterm infants, 3) gastrointestinal and surgical issues, and 4) current standards of infant feeding. Each WG was asked to 1) develop a series of topics relevant to their respective themes, 2) identify questions for which there is sufficient evidence to support a systematic review process conducted by the EAL, and 3) develop a research agenda to address priority gaps in our understanding of the role of nutrition in health and development of preterm/neonatal intensive care unit infants. This article is a summary of the reports from the 4 Pre-B WGs. © 2016 American Society for Nutrition.

  3. Improving Care Teams' Functioning: Recommendations from Team Science.

    Science.gov (United States)

    Fiscella, Kevin; Mauksch, Larry; Bodenheimer, Thomas; Salas, Eduardo

    2017-07-01

    Team science has been applied to many sectors including health care. Yet there has been relatively little attention paid to the application of team science to developing and sustaining primary care teams. Application of team science to primary care requires adaptation of core team elements to different types of primary care teams. Six elements of teams are particularly relevant to primary care: practice conditions that support or hinder effective teamwork; team cognition, including shared understanding of team goals, roles, and how members will work together as a team; leadership and coaching, including mutual feedback among members that promotes teamwork and moves the team closer to achieving its goals; cooperation supported by an emotionally safe climate that supports expression and resolution of conflict and builds team trust and cohesion; coordination, including adoption of processes that optimize efficient performance of interdependent activities among team members; and communication, particularly regular, recursive team cycles involving planning, action, and debriefing. These six core elements are adapted to three prototypical primary care teams: teamlets, health coaching, and complex care coordination. Implementation of effective team-based models in primary care requires adaptation of core team science elements coupled with relevant, practical training and organizational support, including adequate time to train, plan, and debrief. Training should be based on assessment of needs and tasks and the use of simulations and feedback, and it should extend to live action. Teamlets represent a potential launch point for team development and diffusion of teamwork principles within primary care practices. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  4. Early enteral immune nutrition support after radical operation for gastric cancer on promoting the recovery of gastrointestinal function and immune function

    Directory of Open Access Journals (Sweden)

    Zhi-Gang Li

    2016-05-01

    Full Text Available Objective: To analyze the effect of early enteral immune nutrition support after radical operation for gastric cancer on the recovery of gastrointestinal function and immune function. Methods: A total of 106 cases of patients received radical operation for gastric cancer in our hospital were selected as research subjects, and according to different ways of postoperative nutrition intervention, all patients were divided into observation group (n=50 and control group (n=56. Control group received conventional enteral nutrition intervention, observation group received postoperative early enteral immune nutrition support, and then differences in postoperative intestinal mucosa barrier function, gastrointestinal hormone levels, immune function levels and nutrition-related indicator values were compared between two groups. Results: After observation group received enteral immune nutrition intervention, serum DAO, PS and D-lactate levels as well as urine L/M ratio were lower than those of control group; serum GAS, CCK, MTL and SP values of observation group after intervention were higher than those of control group, and GLU, VIP, GIP and SS values were lower than those of control group; CD4, IgG, NK cell, C3, C4, CH50 and S-IgA levels of observation group after intervention were higher than those of control group; serum ALB, PRE, TRF and RBP levels of observation group after intervention were higher than those of control group. Conclusion: Early enteral immune nutrition support after radical operation for gastric cancer is conducive to the recovery of gastrointestinal function and the promotion of immune state, eventually promotes patients’ postoperative overall recovery and has active clinical significance.

  5. Teaming up

    DEFF Research Database (Denmark)

    Warhuus, Jan; Günzel-Jensen, Franziska; Robinson, Sarah

    2016-01-01

    types of team formation: random teacher pre-assigned, student selection, and teacher directed diversity. In each of these modules, ethnographic methods (interviews and observations) were employed. Additionally, we had access to students learning logs, formative and summative assessments, and final exams...... functioning entrepreneurial student teams as most teams lack personal chemistry which makes them anchor their work too much in a pre-defined project. In contrast, we find that students that can form their own teams aim for less diverse teams than what is achieved by random assignment. However, the homophily......Questions we care about (Objectives): When students have to work on challenging tasks, as it is often the case in entrepreneurship classrooms that leverage experiential learning, team success becomes central to the students learning. Yet, the formation of teams is often left up to the students...

  6. Forging Provincial Reconstruction Teams

    National Research Council Canada - National Science Library

    Honore, Russel L; Boslego, David V

    2007-01-01

    The Provincial Reconstruction Team (PRT) training mission completed by First U.S. Army in April 2006 was a joint Service effort to meet a requirement from the combatant commander to support goals in Afghanistan...

  7. Implementation of Nutrition Support Guidelines May Affect Energy and Protein Intake in the Pediatric Intensive Care Unit.

    Science.gov (United States)

    Kyle, Ursula G; Lucas, Laura A; Mackey, Guisela; Silva, Jaime C; Lusk, Jennifer; Orellana, Renan; Shekerdemian, Lara S; Coss-Bu, Jorge A

    2016-05-01

    Critically ill children are at risk of developing malnutrition, and undernutrition is a risk factor for morbidity and mortality. The study evaluated changes in the energy and protein intake before and after implementation of nutrition support (NS) guidelines for a pediatric critical care unit (PICU). This retrospective study documented energy and protein intake for the first 8 days of PICU stay. Basal metabolic rate and protein needs were estimated by Schofield and American Society for Parenteral and Enteral Nutrition Guidelines, respectively. Three hundred thirty-five children from August to December 2012 (pre-implementation) and 185 from October to December 2013 (post-implementation). Implementation of NS Guidelines. Changes in actual energy and protein intake in the post- compared with the pre-Implementation period. Unpaired t tests, Pearson's χ(2) (unadjusted analysis) were used. Logistic regressions were used to estimate odds ratios and 95% confidence intervals for protein and energy intake, adjusted for age, sex, and Pediatric Risk of Mortality score. After the implementation of guidelines, significant improvements were seen during days 5 through 8 in energy intake among children 2 years of age and older, and in protein intake in both age groups (Pprotein deficit/kg/day, as follows: younger than 2-year-olds, -1.5±0.7 g/kg/day vs -1.3±0.8 g/kg/day, P=0.02; 2-year-olds or older, -1.0±0.6 g/kg/day vs -0.7±0.8 g/kg/day, P=0.01; and for the energy deficit/kg/d in 2-year-olds and older, -17.2±13.6 kcal/kg/day vs -13.3±18.1 kcal/kg/day, unpaired t test, P=0.07, in the pre- vs post-implementation period, respectively. The implementation of NS guidelines was associated with improvements in total energy in 2-year-olds and older and protein in younger than 2 and 2 years and older children by days 5 through 8, and protein deficits were significantly lower in the post- vs the pre-implementation period. The implementation of NS guidelines may have had a

  8. Comparative study of cognitive-behavioral psychotherapy and nutritional support in patients with different types of eating disorders.

    Science.gov (United States)

    Larrañaga, Alejandra; Fluiters, Enrique; Docet, María F; Fernández Sastre, José Luis; García-Mayor, Ricardo V

    2014-09-09

    There are several psychological approaches to treat ED with efficacy being revealed by empirical research; however none of them are universally accepted. The objective was to compare response to Cognitive Behavioral Therapy in patients with different clinical forms of Eating Disorders. Seventy-four patients diagnosed with eating disorders, 32 with Anorexia nervosa (AN), 19 with Bulimia nervosa (BN) and 23 with Eating disorders not otherwise specified (EDNOS) were included. This is a prospective and comparative study. Patients were treated by psychotherapy, nutritional treatment and pharmacotherapy. The recovery rates in the groups of patients with AN, BN and EDNOS were 14 (43.7%), 8 (42.1%), 10 (43.4%), respectively, p>0.05. The rates of improvement were 14 (43.7%), 10 (52.6%), 12 (52.1%) for AN, BN and EDNOS, respectively, p>0.05. Finally, the rate of patients who had poor outcome were 3 (9.3%), 1 (5.2%), and 1 (4.3%), p>0.05, for AN, BN, and EDNOS, respectively. Cox regression analysis showed that the age of disease onset and no use of psychotropic drugs predicted a good response in patients with ED. The treatment response to Cognitive Behavioral Therapy, nutritional support and psychotropic drugs in the majority of patients was favorable and similar in most patients with different types of Eating Disorders. Furthermore, a young age and no use of psychotropic drugs predict a favorable outcome in patients with ED. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  9. Supporting recovery in patients with psychosis through care by community-based adult mental health teams (REFOCUS): a multisite, cluster, randomised, controlled trial.

    Science.gov (United States)

    Slade, Mike; Bird, Victoria; Clarke, Eleanor; Le Boutillier, Clair; McCrone, Paul; Macpherson, Rob; Pesola, Francesca; Wallace, Genevieve; Williams, Julie; Leamy, Mary

    2015-06-01

    Mental health policy in many countries is oriented around recovery, but the evidence base for service-level recovery-promotion interventions is lacking. We did a cluster, randomised, controlled trial in two National Health Service Trusts in England. REFOCUS is a 1-year team-level intervention targeting staff behaviour to increase focus on values, preferences, strengths, and goals of patients with psychosis, and staff-patient relationships, through coaching and partnership. Between April, 2011, and May, 2012, community-based adult mental health teams were randomly allocated to provide usual treatment plus REFOCUS or usual treatment alone (control). Baseline and 1-year follow-up outcomes were assessed in randomly selected patients. The primary outcome was recovery and was assessed with the Questionnaire about Processes of Recovery (QPR). We also calculated overall service costs. We used multiple imputation to estimate missing data, and the imputation model captured clustering at the team level. Analysis was by intention to treat. This trial is registered, number ISRCTN02507940. 14 teams were included in the REFOCUS group and 13 in the control group. Outcomes were assessed in 403 patients (88% of the target sample) at baseline and in 297 at 1 year. Mean QPR total scores did not differ between the two groups (REFOCUS group 40·6 [SD 10·1] vs control 40·0 [10·2], adjusted difference 0·68, 95% CI -1·7 to 3·1, p=0·58). High team participation was associated with higher staff-rated scores for recovery-promotion behaviour change (adjusted difference -0·4, 95% CI -0·7 to -0·2, p=0·001) and patient-rated QPR interpersonal scores (-1·6, -2·7 to -0·5, p=0·005) at follow-up than low participation. Patients treated in the REFOCUS group incurred £1062 (95% CI -1103 to 3017) lower adjusted costs than those in the control group. Although the primary endpoint was negative, supporting recovery might, from the staff perspective, improve functioning and reduce needs

  10. The development of social relationships, social support, and posttraumatic growth in a dragon boating team for breast cancer survivors.

    Science.gov (United States)

    McDonough, Meghan H; Sabiston, Catherine M; Ullrich-French, Sarah

    2011-10-01

    Physical activity experiences may contribute to psychological and social wellbeing among breast cancer survivors. The main purpose of the current study was to qualitatively explore the development of social relationships, social support, and posttraumatic growth among breast cancer survivors participating in a dragon boat program over 19 months. Guided by interpretative phenomenological analysis (Smith, Flowers, & Larkin, 2009), semistructured interviews were conducted with 17 breast cancer survivors on five occasions over their first two seasons of dragon boating. Narrative accounts were developed for each participant, and four profiles emerged describing processes of social and posttraumatic growth development over time: "developing a feisty spirit of survivorship," "I don't want it to be just about me," "it's not about the pink it's about the paddling," and "hard to get close." Profiles were discussed in terms of developing social relationships and support, providing support to others, physicality and athleticism, and negative interactions and experiences.

  11. Artificial intelligence: Neural network model as the multidisciplinary team member in clinical decision support to avoid medical mistakes.

    Science.gov (United States)

    Buzaev, Igor Vyacheslavovich; Plechev, Vladimir Vyacheslavovich; Nikolaeva, Irina Evgenievna; Galimova, Rezida Maratovna

    2016-09-01

    The continuous uninterrupted feedback system is the essential part of any well-organized system. We propose aLYNX concept that is a possibility to use an artificial intelligence algorithm or a neural network model in decision-making system so as to avoid possible mistakes and to remind the doctors to review tactics once more in selected cases. aLYNX system includes: registry with significant factors, decisions and results; machine learning process based on this registry data; the use of the machine learning results as the adviser. We show a possibility to build a computer adviser with a neural network model for making a choice between coronary aortic bypass surgery (CABG) and percutaneous coronary intervention (PCI) in order to achieve a higher 5-year survival rate in patients with angina based on the experience of 5107 patients. The neural network was trained by 4679 patients who achieved 5-year survival. Among them, 2390 patients underwent PCI and 2289 CABG. After training, the correlation coefficient ( r ) of the network was 0.74 for training, 0.67 for validation, 0.71 for test and 0.73 for total. Simulation of the neural network function has been performed after training in the two groups of patients with known 5-year outcome. The disagreement rate was significantly higher in the dead patient group than that in the survivor group between neural network model and heart team [16.8% (787/4679) vs. 20.3% (87/428), P  = 0.065)]. The study shows the possibility to build a computer adviser with a neural network model for making a choice between CABG and PCI in order to achieve a higher 5-year survival rate in patients with angina.

  12. Artificial intelligence: Neural network model as the multidisciplinary team member in clinical decision support to avoid medical mistakes

    Directory of Open Access Journals (Sweden)

    Igor Vyacheslavovich Buzaev

    2016-09-01

    Full Text Available Objective: The continuous uninterrupted feedback system is the essential part of any well-organized system. We propose aLYNX concept that is a possibility to use an artificial intelligence algorithm or a neural network model in decision-making system so as to avoid possible mistakes and to remind the doctors to review tactics once more in selected cases. Method: aLYNX system includes: registry with significant factors, decisions and results; machine learning process based on this registry data; the use of the machine learning results as the adviser. We show a possibility to build a computer adviser with a neural network model for making a choice between coronary aortic bypass surgery (CABG and percutaneous coronary intervention (PCI in order to achieve a higher 5-year survival rate in patients with angina based on the experience of 5107 patients. Results: The neural network was trained by 4679 patients who achieved 5-year survival. Among them, 2390 patients underwent PCI and 2289 CABG. After training, the correlation coefficient (r of the network was 0.74 for training, 0.67 for validation, 0.71 for test and 0.73 for total. Simulation of the neural network function has been performed after training in the two groups of patients with known 5-year outcome. The disagreement rate was significantly higher in the dead patient group than that in the survivor group between neural network model and heart team [16.8% (787/4679 vs. 20.3% (87/428, P = 0.065]. Conclusion: The study shows the possibility to build a computer adviser with a neural network model for making a choice between CABG and PCI in order to achieve a higher 5-year survival rate in patients with angina. Keywords: Coronary artery bypass grafting, Percutaneous coronary intervention, Artificial intelligence, Decision making

  13. Personality and community prevention teams: Dimensions of team leader and member personality predicting team functioning.

    Science.gov (United States)

    Feinberg, Mark E; Kim, Ji-Yeon; Greenberg, Mark T

    2008-11-01

    The predictors and correlates of positive functioning among community prevention teams have been examined in a number of research studies; however, the role of personality has been neglected. In this study, we examined whether team member and leader personality dimensions assessed at the time of team formation predicted local prevention team functioning 2.5-3.5 years later. Participants were 159 prevention team members in 14 communities participating in the PROSPER study of prevention program dissemination. Three aspects of personality, aggregated at the team level, were examined as predictors: Openness to Experience, Conscientiousness, and Agreeableness. A series of multivariate regression analyses were performed that accounted for the interdependency of five categories of team functioning. Results showed that average team member Openness was negatively, and Conscientiousness was positively linked to team functioning. The findings have implications for decisions about the level and nature of technical assistance support provided to community prevention teams.

  14. Evaluation of nutritional status and support in children with congenital heart disease.

    Science.gov (United States)

    Blasquez, A; Clouzeau, H; Fayon, M; Mouton, J-B; Thambo, J-B; Enaud, R; Lamireau, T

    2016-04-01

    The objective of this disease was to determine the prevalence of malnutrition in children with congenital heart disease (CHD). A total of 125 children with CHD, under 6 months of age, were divided into four groups: no pulmonary hypertension (PH) or cyanosis (group 1, n=47), isolated cyanosis (group 2, n=52), isolated PH (group 3, n=16), and PH and cyanosis (group 4, n=10). Six children died at 6 months (n=4), 12 months (n=1) and 19 months (n=1). The remaining children were followed-up for 24 months. Prevalence of moderate to severe malnutrition (weight/weight for height groups. Moderate or severe malnutrition was more frequent in group 4 (100%) compared with others groups (group 1, 20%; group 2, 16.7% and group 3, 50%; Pgroup 3 (71.4%) and group 4 (75%) than in group 1 (28%) and 2 (28.6%) (Pgroup 4 and rarely in other groups (group 1, 15.8%; group 2, 8.6% and group 3, 11.1%; Pgroups 3 (33.3%) and 4 (50%) than in groups 1 (15.8%) or 2 (14.3%; Pnutritional support.

  15. Pregnancy, exercise and nutrition research study with smart phone app support (Pears): Study protocol of a randomized controlled trial.

    Science.gov (United States)

    Kennelly, Maria A; Ainscough, Kate; Lindsay, Karen; Gibney, Eileen; Mc Carthy, Mary; McAuliffe, Fionnuala M

    2016-01-01

    Maternal adiposity confers an increased risk of GDM in pregnancy. A low glycemic index (GI) dietary intervention has been found to improve glucose homeostasis and reduce gestational weight gain. Mobile Health (mHealth) Technology-assisted interventions are becoming commonplace as an aid to treating many chronic diseases. The aim of this study is to assess the impact of a 'healthy lifestyle package' with mHealth smart phone technology as support compared with usual care on the incidence of GDM in an overweight and obese pregnant population. We propose a randomized controlled trial of an mHealth assisted healthy lifestyle intervention package versus standard obstetric care in pregnant women with a BMI ≥25kg/m(2)-39.9kg/m(2). Patients are randomized to control or intervention group in a 1:1 ratio. The intervention arm healthy lifestyle package includes a motivational counseling session to encourage behavior change, involving targeted, low GI nutritional advice and daily physical activity prescription delivered before 18weeks gestation, as well as a smart phone app to provide ongoing healthy lifestyle advice and support throughout pregnancy. The primary outcome is the incidence of GDM at 29weeks' gestation and power analysis indicates that 253 women are required in each group to detect a difference. This will be the first clinical trial to evaluate the effectiveness of a smart phone technology-assisted targeted healthy lifestyle intervention, which is grounded in behavior change theories and techniques, to support antenatal management of an overweight and obese pregnant population in preventing GDM. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Comparison of traditional advanced cardiac life support (ACLS) course instruction vs. a scenario-based, performance oriented team instruction (SPOTI) method for Korean paramedic students.

    Science.gov (United States)

    Lee, Christopher C; Im, Mark; Kim, Tae Min; Stapleton, Edward R; Kim, Kyuseok; Suh, Gil Joon; Singer, Adam J; Henry, Mark C

    2010-01-01

    Current Advanced Cardiac Life Support (ACLS) course instruction involves a 2-day course with traditional lectures and limited team interaction. We wish to explore the advantages of a scenario-based performance-oriented team instruction (SPOTI) method to implement core ACLS skills for non-English-speaking international paramedic students. The objective of this study was to determine if scenario-based, performance-oriented team instruction (SPOTI) improves educational outcomes for the ACLS instruction of Korean paramedic students. Thirty Korean paramedic students were randomly selected into two groups. One group of 15 students was taught the traditional ACLS course. The other 15 students were instructed using a SPOTI method. Each group was tested using ACLS megacode examinations endorsed by the American Heart Association. All 30 students passed the ACLS megacode examination. In the traditional ACLS study group an average of 85% of the core skills were met. In the SPOTI study group an average of 93% of the core skills were met. In particular, the SPOTI study group excelled at physical examination skills such as airway opening, assessment of breathing, signs of circulation, and compression rates. In addition, the SPOTI group performed with higher marks on rhythm recognition compared to the traditional group. The traditional group performed with higher marks at providing proper drug dosages compared to the SPOTI students. However, the students enrolled in the SPOTI method resulted in higher megacode core compliance scores compared to students trained in traditional ACLS course instruction. These differences did not achieve statistical significance due to the small sample size. Copyright 2010 Elsevier Inc. All rights reserved.

  17. Nutrition quality control in the prescription and administration of parenteral nutrition therapy for hospitalized patients.

    Science.gov (United States)

    Shiroma, Glaucia Midori; Horie, Lilian Mika; Castro, Melina Gouveia; Martins, Juliana R; Bittencourt, Amanda F; Logullo, Luciana; Teixeira da Silva, Maria de Lourdes; Waitzberg, Dan L

    2015-06-01

    Nutrition quality control in parenteral nutrition therapy (PNT) allows the identification of inadequate processes in parenteral nutrition (PN). The objective of this study was to assess the quality of PNT at a hospital with an established nutrition support team (NST). This observational, longitudinal, analytical, and prospective study examined 100 hospitalized PNT adult patients under the care of an NST for 21 days or until death/hospital discharge. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) 2007 guidelines for PNT prescription were followed. PNT indications were not in accordance with the A.S.P.E.N. 2007 guidelines in 15 patients. Among the remaining 85 patients, 48 (56.5%) did not receive adequate PNT (≥80% of the total volume prescribed). Non-NST medical orders, progression to and from enteral nutrition, changes in the central venous catheter, unknown causes, and operational errors (eg, medical prescription loss, PN nondelivery, pharmacy delays, inadequate PN bag temperature) were associated with PNT inadequacy (P nutrition therapy related to estimated energy expenditure and protein requirements and glycemia levels reached the expected targets; however, the central venous catheter infection rate was higher than 6 per 1000 catheters/d and did not meet the expected targets. Despite an established NST, there was a moderate level of PNT inadequacy in indications, administration, and monitoring. It is important to establish periodic meetings among different health professionals who prescribe and deliver PNT to define responsibilities and protocols. © 2015 American Society for Parenteral and Enteral Nutrition.

  18. Prosthetic outcome, patient complaints, and nutritional effects on elderly patients with magnet-retained, implant-supported overdentures--a 1-year report.

    Science.gov (United States)

    Khoo, Huan Ding; Chai, John; Chow, Tak Wah

    2013-01-01

    To study the changes in treatment outcomes of complete dentures and magnet-retained, implant-supported overdentures in a group of elderly patients. In this nonrandomized trial, 43 edentulous patients (14 men and 29 women) were fitted with complete dentures followed by implant-supported mandibular overdenture in a sequential model. Treatment outcomes used for analysis included objective assessment of denture quality (Woelfel's index), patient satisfaction, nutritional status, body mass index (BMI), and serum albumin level. The McNemar test was used to determine if significant differences in the Woelfel's index and nutritional status existed at different treatment phases. Repeated measures ANOVA and multiple pairwise comparison tests were used to analyze patient satisfaction. BMI status and serum albumin level at different treatment phases were analyzed with one-way ANOVA and Tukey post hoc test. At the 1-year follow-up, significant improvements were recorded for the objective assessment of denture quality and patient complaints (P .05) CONCLUSIONS: The present study demonstrated that in elderly patients with stable health and nutritional status, complete dentures made in a university clinic brought about overall improvement in denture quality and reduction in denture complaint score. Insertion of mandibular implant-supported overdentures further improved the mandibular denture quality and reduced the mandibular denture complaint score. In this group of patients, no improvement in BMI, serum albumin value, and nutritional status were documented.

  19. Project TEAMS (Talking about Eating, Activity, and Mutual Support: a randomized controlled trial of a theory-based weight loss program for couples

    Directory of Open Access Journals (Sweden)

    Amy A. Gorin

    2017-09-01

    Full Text Available Abstract Background Obesity risk is shared between spouses, yet existing weight loss programs focus on individuals and not the marital dyad. Given the interdependence of weight in couples, weight management outcomes might be improved by targeting joint weight loss and the creation of an interpersonal milieu that supports long-term behavior change. According to Self-Determination Theory (SDT, greater autonomous self-regulation of behaviors, and subsequently better treatment outcomes, are observed in needs supportive environments in which personally meaningful choice is supported and criticism and control are minimized. Correlational analyses confirm these pathways in weight management, with needs support from one’s spouse or partner emerging as a distinct predictor of weight loss success. Research is now needed to establish causal links and to develop and test weight loss interventions designed to facilitate the needs supportive behavior of spouses. Methods Project TEAMS (Talking about Eating, Activity, and Mutual Support is a randomized controlled trial testing a couples-based intervention, grounded in SDT, designed to change the social context of weight loss by training spouses to provide needs support for each other’s eating and physical activity behavior. Sixty-four couples will be randomized to either 6 months of behavioral weight loss treatment informed by SDT (SDT-WL or to 6 months of standard behavioral weight loss treatment (BWL. Couples will attend weekly sessions for 6 months and will be assessed at 0, 3, 6, and 12 months. By bolstering needs support, SDT-WL is predicted to increase autonomous self-regulation and perceived competence and produce greater weight loss and maintenance than standard behavioral treatment. Exploratory analyses will examine the SDT process model prediction that the influence of needs support on treatment outcomes will be mediated by autonomous self-regulation and perceived competence. Discussion This

  20. Project TEAMS (Talking about Eating, Activity, and Mutual Support): a randomized controlled trial of a theory-based weight loss program for couples.

    Science.gov (United States)

    Gorin, Amy A; Powers, Theodore A; Gettens, Katelyn; Cornelius, Talea; Koestner, Richard; Mobley, Amy R; Pescatello, Linda; Medina, Tania Huedo

    2017-09-29

    Obesity risk is shared between spouses, yet existing weight loss programs focus on individuals and not the marital dyad. Given the interdependence of weight in couples, weight management outcomes might be improved by targeting joint weight loss and the creation of an interpersonal milieu that supports long-term behavior change. According to Self-Determination Theory (SDT), greater autonomous self-regulation of behaviors, and subsequently better treatment outcomes, are observed in needs supportive environments in which personally meaningful choice is supported and criticism and control are minimized. Correlational analyses confirm these pathways in weight management, with needs support from one's spouse or partner emerging as a distinct predictor of weight loss success. Research is now needed to establish causal links and to develop and test weight loss interventions designed to facilitate the needs supportive behavior of spouses. Project TEAMS (Talking about Eating, Activity, and Mutual Support) is a randomized controlled trial testing a couples-based intervention, grounded in SDT, designed to change the social context of weight loss by training spouses to provide needs support for each other's eating and physical activity behavior. Sixty-four couples will be randomized to either 6 months of behavioral weight loss treatment informed by SDT (SDT-WL) or to 6 months of standard behavioral weight loss treatment (BWL). Couples will attend weekly sessions for 6 months and will be assessed at 0, 3, 6, and 12 months. By bolstering needs support, SDT-WL is predicted to increase autonomous self-regulation and perceived competence and produce greater weight loss and maintenance than standard behavioral treatment. Exploratory analyses will examine the SDT process model prediction that the influence of needs support on treatment outcomes will be mediated by autonomous self-regulation and perceived competence. This study addresses the fundamental importance of interpersonal

  1. The holistic management of consequences of cancer treatment by a gastrointestinal and nutrition team: a financially viable approach to an enormous problem?

    Science.gov (United States)

    Muls, Ann C; Lalji, Amyn; Marshall, Christopher; Butler, Lewis; Shaw, Clare; Vyoral, Susan; Mohammed, Kabir; Andreyev, H Jervoise N

    2016-06-01

    There is no national NHS tariff to fund services for patients experiencing long-term bowel and nutritional problems after cancer treatment. In this paper, we report the clinical characteristics and outcomes of patients referred to our service and the estimated cost of a completed episode of care. Patient characteristics, symptom severity, investigations, diagnoses, number of clinic visits and referrals elsewhere were recorded in a prospective cohort study. During 2013-14, 325 patients completed assessment and treatment. The majority of original cancer diagnoses were urological (43%) and gynaecological (21%). A median of six investigations were requested. 62% were found to have three or more new diagnoses including small intestinal bacterial overgrowth (46%), vitamin D deficiency (38%), bile acid malabsorption (28%), gastritis (22%), radiation-induced bleeding (20%), vitamin B12 deficiency (17%), pelvic floor weakness (17%), colorectal polyps (13%) and pancreatic insufficiency (5%). A median of three visits were required and all commonly reported gastrointestinal symptoms improved by discharge. The mean episode of care per patient was costed at £1,563. Effective amelioration of chronic gastrointestinal toxicity after cancer treatment costs substantially less than treating the cancer in the first place and requires an NHS tariff. © 2016 Royal College of Physicians.

  2. Teaming up

    DEFF Research Database (Denmark)

    Warhuus, Jan; Günzel-Jensen, Franziska; Robinson, Sarah

    or pre-arranged at random. Therefore we investigate the importance of team formation in the entrepreneurial classroom and ask: (i) What are the underlying factors that influence outcomes of teamwork in student groups? (ii) How does team formation influence student perception of learning?, and (iii) Do...... different team formation strategies produce different teamwork and learning outcomes? Approach: We employed a multiple case study design comprising of 38 student teams to uncover potential links between team formation and student perception of learning. This research draws on data from three different....... A rigorous coding and inductive analysis process was undertaken. Pattern and relationship coding were used to reveal underlying factors, which helped to unveil important similarities and differences between student in different teams’ project progress and perception of learning. Results: When students...

  3. The Tokai-mura JCO criticality accident and the activities of the accident countermeasure support team of Electric Power Companies, Japan

    International Nuclear Information System (INIS)

    Ogawa, Junko

    2000-01-01

    A criticality accident occurred at the JCO Tokai-mura nuclear fuel processing plant on September 30, 1999. This accident brought the damages which were unrivaled in the history of atomic energy development in Japan, seriously influencing the citizen life to such an extent as requesting for 320,000 inhabitants within 10 kilometers radius to stay indoors for as long as 18 hours. However, it could be said that though three workers suffered fatal injuries, no substantial hazards were made upon the regional inhabitants due to little release of radioactive substances. This video recorded the activities of the Accident Countermeasure Support Team of the Electric Power Companies immediately after the accident occurred, showing the chronological overview of the particulars of the accident. (author)

  4. Effects of a Home-Based and Volunteer-Administered Physical Training, Nutritional, and Social Support Program on Malnutrition and Frailty in Older Persons: A Randomized Controlled Trial.

    Science.gov (United States)

    Luger, Eva; Dorner, Thomas Ernst; Haider, Sandra; Kapan, Ali; Lackinger, Christian; Schindler, Karin

    2016-07-01

    The aim of this study was to examine the effects of a home-based and volunteer-administered physical training and nutritional intervention program compared with social support intervention on nutritional and frailty status in prefrail and frail community-dwelling older persons. This was a randomized controlled trial in which community-dwelling persons (mean age = 83 years) were recruited and randomly assigned to the physical training and nutritional intervention group (PTN, n = 39) and the social support group (SoSu, n = 41). The study was conducted by trained lay nonprofessionals. The community-dwelling older persons in both groups were visited twice a week by trained nonprofessional volunteers (buddies) in Vienna, Austria. Eighty prefrail and frail adults aged 65 years or older. In the PTN group, both the buddies and older persons performed 6 strength exercises within a circuit training session and discussed nutrition-related aspects. The active control group (SoSu) had the opportunity to perform cognitive training in addition to the social contact. Outcome measures as nutritional (Mini Nutritional Assessment long form [MNA-LF]) and frailty status (Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe [SHARE-FI]) were obtained at baseline and after 12 weeks. Significant improvements in the MNA-LF score (1.54 points, 95% confidence interval [CI] 0.51-2.56; P = .004) and the SHARE-FI score (-0.71 discrete factor score values, 95% CI -1.07, -0.35; P group after 12 weeks. In both groups, the prevalence of impaired nutritional status and frailty decreased significantly over time. The prevalence of impaired nutritional status decreased by 25% in the PTN group and by 23% in the SoSu group. Moreover, the prevalence of frailty decreased by 17% in the PTN group and by 16% in the SoSu group. The presence of impaired nutritional status at baseline was independently associated with greater changes in the nutritional

  5. Women's autonomy and social support and their associations with infant and young child feeding and nutritional status: community-based survey in rural Nicaragua.

    Science.gov (United States)

    Ziaei, Shirin; Contreras, Mariela; Zelaya Blandón, Elmer; Persson, Lars-Åke; Hjern, Anders; Ekström, Eva-Charlotte

    2015-08-01

    To evaluate the associations of women's autonomy and social support with infant and young child feeding practices (including consumption of highly processed snacks and sugar-sweetened beverages) and nutritional status in rural Nicaragua. Cross-sectional study. Feeding practices and children's nutritional status were evaluated according to the WHO guidelines complemented with information on highly processed snacks and sugar-sweetened beverages. Women's autonomy was assessed by a seventeen-item questionnaire covering dimensions of financial independence, household-, child-, reproductive and health-related decision making and freedom of movement. Women's social support was determined using the Duke-UNC Functional Social Support Questionnaire. The scores attained were categorized into tertiles. Los Cuatro Santos area, rural Nicaragua. A total of 1371 children 0-35 months of age. Children of women with the lowest autonomy were more likely to be exclusively breast-fed and continue to be breast-fed, while children of women with middle level of autonomy had better complementary feeding practices. Children of women with the lowest social support were more likely to consume highly processed snacks and/or sugar-sweetened beverages but also be taller. While lower levels of autonomy and social support were independently associated with some favourable feeding and nutrition outcomes, this may not indicate a causal relationship but rather that these factors reflect other matters of importance for child care.

  6. Use of a Shared Mental Model by a Team Composed of Oncology, Palliative Care, and Supportive Care Clinicians to Facilitate Shared Decision Making in a Patient With Advanced Cancer.

    Science.gov (United States)

    D'Ambruoso, Sarah F; Coscarelli, Anne; Hurvitz, Sara; Wenger, Neil; Coniglio, David; Donaldson, Dusty; Pietras, Christopher; Walling, Anne M

    2016-11-01

    Our case describes the efforts of team members drawn from oncology, palliative care, supportive care, and primary care to assist a woman with advanced cancer in accepting care for her psychosocial distress, integrating prognostic information so that she could share in decisions about treatment planning, involving family in her care, and ultimately transitioning to hospice. Team members in our setting included a medical oncologist, oncology nurse practitioner, palliative care nurse practitioner, oncology social worker, and primary care physician. The core members were the patient and her sister. Our team grew organically as a result of patient need and, in doing so, operationalized an explicitly shared understanding of care priorities. We refer to this shared understanding as a shared mental model for care delivery, which enabled our team to jointly set priorities for care through a series of warm handoffs enabled by the team's close proximity within the same clinic. When care providers outside our integrated team became involved in the case, significant communication gaps exposed the difficulty in extending our shared mental model outside the integrated team framework, leading to inefficiencies in care. Integration of this shared understanding for care and close proximity of team members proved to be key components in facilitating treatment of our patient's burdensome cancer-related distress so that she could more effectively participate in treatment decision making that reflected her goals of care.

  7. Pioneering the Transdisciplinary Team Science Approach: Lessons Learned from National Cancer Institute Grantees.

    Science.gov (United States)

    Vogel, Amanda L; Stipelman, Brooke A; Hall, Kara L; Nebeling, Linda; Stokols, Daniel; Spruijt-Metz, Donna

    2014-01-01

    The National Cancer Institute has been a leader in supporting transdisciplinary (TD) team science. From 2005-2010, the NCI supported Transdisciplinary Research on Energetic and Cancer I (TREC I), a center initiative fostering the TD integration of social, behavioral, and biological sciences to examine the relationships among obesity, nutrition, physical activity and cancer. In the final year of TREC I, we conducted qualitative in-depth-interviews with 31 participating investigators and trainees to learn more about their experiences with TD team science, including challenges, facilitating factors, strategies for success, and impacts. Five main challenges emerged: (1) limited published guidance for how to engage in TD team science, when TREC I was implemented; (2) conceptual and scientific challenges inherent to efforts to achieve TD integration; (3) discipline-based differences in values, terminology, methods, and work styles; (4) project management challenges involved in TD team science; and (5) traditional incentive and reward systems that do not recognize or reward TD team science. Four main facilitating factors and strategies for success emerged: (1) beneficial attitudes and beliefs about TD research and team science; (2) effective team processes; (3) brokering and bridge-building activities by individuals holding particular roles in a research center; and (4) funding initiative characteristics that support TD team science. Broad impacts of participating in TD team science in the context of TREC I included: (1) new positive attitudes about TD research and team science; (2) new boundary-crossing collaborations; (3) scientific advances related to research approaches, findings, and dissemination; (4) institutional culture change and resource creation in support of TD team science; and (5) career advancement. Funding agencies, academic institutions, and scholarly journals can help to foster TD team science through funding opportunities, institutional policies on

  8. Supporting Nutrition: Understanding Tubefeeding

    Science.gov (United States)

    ... eating. Tube feeding has given me a general boost in growth and an overall confidence in how I look and feel. From Maggie’s mother: When ... Steven “Tube feeding has given me a general boost in growth and an overall confidence in how I look and feel.“ Maggie, age 16 Beforehand, ...

  9. Nutritional support in the tertiary care of patients affected by chronic renal insufficiency: report of a step-wise, personalized, pragmatic approach.

    Science.gov (United States)

    Cupisti, Adamasco; D'Alessandro, Claudia; Di Iorio, Biagio; Bottai, Anna; Zullo, Claudia; Giannese, Domenico; Barsotti, Massimiliano; Egidi, Maria Francesca

    2016-09-06

    Dietary treatment is helpful in CKD patients, but nutritional interventions are scarcely implemented. The main concern of the renal diets is its feasibility with regards to daily clinical practice especially in the elderly and co-morbid patients. This study aimed to evaluate the effects of a pragmatic, step-wise, personalized nutritional support in the management of CKD patients on tertiary care. This is a case-control study. It included 823 prevalent out-patients affected by CKD stage 3b to 5 not-in-dialysis, followed by tertiary care in nephrology clinics; 305 patients (190 males, aged 70 ± 12 years) received nutritional support (nutritional treatment Group, NTG); 518 patients (281 males, aged 73 ± 13 years) who did not receive any dietary therapy, formed the control group (CG). In the NTG patients the dietary interventions were assigned in order to prevent or correct abnormalities and to maintain a good nutritional status. They included manipulation of sodium, phosphate, energy and protein dietary intakes while paying special attention to each patient's dietary habits. Phosphate and BUN levels were lower in the NTG than in the CG, especially in stage 4 and 5. The prevalence of hyperphosphatemia was lower in the NTG than in CG in stage 5 (13.3 % vs 53.3 %, p < 001, respectively), in stage 4 (4.1 % vs 18.3 % vs, p < 0.001) and stage 3b (2.8 % vs 9.5 % p < 0.05). Serum albumin was higher in NTG than in CG especially in stage 5 . The use of calcium-free intestinal phosphate binders was significantly lower in NTG than in CG (11 % vs 19 % p < 0.01), as well as that of Erythropoiesis stimulating agents (11 % vs 19 %, p < 0.01), and active Vitamin D preparations (13 % vs 21 %, p < 0.01). This case-control study shows the usefulness of a nutritional support in addition to the pharmacological good practice in CKD patients on tertiary care. Lower phosphate and BUN levels are obtained together with maintenance of serum albumin

  10. Cost-effectiveness and value of information analysis of nutritional support for preventing pressure ulcers in high-risk patients: implement now, research later.

    Science.gov (United States)

    Tuffaha, Haitham W; Roberts, Shelley; Chaboyer, Wendy; Gordon, Louisa G; Scuffham, Paul A

    2015-04-01

    Pressure ulcers are a major cause of mortality, morbidity, and increased healthcare cost. Nutritional support may reduce the incidence of pressure ulcers in hospitalised patients who are at risk of pressure ulcer and malnutrition. To evaluate the cost-effectiveness of nutritional support in preventing pressure ulcers in high-risk hospitalised patients, and to assess the value of further research to inform the decision to implement this intervention using value of information analysis (VOI). The analysis was from the perspective of Queensland Health, Australia using a decision model with evidence derived from a systematic review and meta-analysis. Resources were valued using 2014 prices and the time horizon of the analysis was one year. Monte Carlo simulation was used to estimate net monetary benefits (NB) and to calculate VOI measures. Compared with standard hospital diet, nutritional support was cost saving at AU$425 per patient, and more effective with an average 0.005 quality-adjusted life years (QALY) gained. At a willingness-to-pay of AU$50,000 per QALY, the incremental NB was AU$675 per patient, with a probability of 87 % that nutritional support is cost-effective. The expected value of perfect information was AU$5 million and the expected value of perfect parameter information was highest for the relative risk of developing a pressure ulcer at AU$2.5 million. For a future trial investigating the relative effectiveness of the interventions, the expected net benefit of research would be maximised at AU$100,000 with 1,200 patients in each arm if nutritional support was perfectly implemented. The opportunity cost of withholding the decision to implement the intervention until the results of the future study are available would be AU$14 million. Nutritional support is cost-effective in preventing pressure ulcers in high-risk hospitalised patients compared with standard diet. Future research to reduce decision uncertainty is worthwhile; however, given the

  11. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition.

    Science.gov (United States)

    Mehta, Nilesh M; Skillman, Heather E; Irving, Sharon Y; Coss-Bu, Jorge A; Vermilyea, Sarah; Farrington, Elizabeth Anne; McKeever, Liam; Hall, Amber M; Goday, Praveen S; Braunschweig, Carol

    2017-07-01

    role of supplemental parenteral nutrition has been highlighted, and a delayed approach appears to be beneficial. Immunonutrition cannot be currently recommended. Overall, the pediatric critical care population is heterogeneous, and a nuanced approach to individualizing nutrition support with the aim of improving clinical outcomes is necessary.

  12. Virtual Teams.

    Science.gov (United States)

    Geber, Beverly

    1995-01-01

    Virtual work teams scattered around the globe are becoming a feature of corporate workplaces. Although most people prefer face-to-face meetings and interactions, reality often requires telecommuting. (JOW)

  13. Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sandra Haider

    Full Text Available The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35 conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23 received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2 to 3.0 pg/l (min-max = 2.0-20.8, and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9 to 0.3 mg/dl (min-max = 0.1-3.0 after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45 were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

  14. Change in inflammatory parameters in prefrail and frail persons obtaining physical training and nutritional support provided by lay volunteers: A randomized controlled trial.

    Science.gov (United States)

    Haider, Sandra; Grabovac, Igor; Winzer, Eva; Kapan, Ali; Schindler, Karin Emmi; Lackinger, Christian; Titze, Sylvia; Dorner, Thomas Ernst

    2017-01-01

    The aim of the study was to compare the effects of home visits with physical training and nutritional support on inflammatory parameters to home visits with social support alone within a randomized controlled trial. Prefrail and frail persons received home visits from lay volunteers twice a week for 12 weeks. Participants in the physical training and nutritional intervention group (PTN, n = 35) conducted two sets of six strength exercises and received nutritional support. The social support group (SoSu, n = 23) received visits only. TNF-α, IL-6, CRP, and total leukocyte count were assessed at baseline and after 12 weeks. Changes over time within groups were analyzed with paired t-tests; differences between groups were analyzed with ANCOVA for repeated measurements. In the PTN group, IL-6 and CRP remained stable, whereas in the SoSu group, IL-6 increased significantly from a median value of 2.6 pg/l (min-max = 2.0-10.2) to 3.0 pg/l (min-max = 2.0-20.8), and CRP rose from 0.2 mg/dl (min-max = 0.1-0.9) to 0.3 mg/dl (min-max = 0.1-3.0) after 12 weeks. In CRP, a significant difference between groups was found. TNF-α and total leukocyte count did not change in either the PTN group or the SoSu group. Persons showing an increase in physical performance (OR 4.54; 95% CI = 1.33-15.45) were more likely to have constant or decreased IL-6 values than persons who showed no improvement. In conclusion, in non-robust older adults, a physical training and nutritional support program provided by lay volunteers can delay a further increase in some inflammatory parameters.

  15. Effects of preventive versus "on-demand" nutritional support on paid labour productivity, physical exercise and performance status during PEG-interferon-containing treatment for hepatitis C.

    Science.gov (United States)

    Huisman, Ellen J; van Meer, Suzanne; van Hoek, Bart; van Soest, Hanneke; van Nieuwkerk, Karin M J; Arends, Joop E; Siersema, Peter D; van Erpecum, Karel J

    2016-04-01

    Deterioration of nutritional status during PEG-interferon containing therapy for chronic hepatitis C can be ameliorated by preventive nutritional support. We aimed to explore whether such support also affects paid labour productivity, physical exercise and performance status. In this prospective randomized controlled trial (J Hepatol 2012;57:1069-75), 53 patients with chronic hepatitis C had been allocated to "on demand" support (n=26: nutritional intervention if weight loss>5%) or preventive support (n=27: regular dietary advice plus energy- and protein-rich evening snack) during PEG-interferon-containing therapy. Paid labour productivity, physical exercise and performance status were evaluated at baseline, after 24 and (if applicable) after 48 weeks of treatment. At baseline, 46% of patients performed paid labour and 62% performed some kind of physical exercise. Furthermore, most patients were able to carry out normal activity with only minor symptoms of disease (mean Karnofsky performance score: 94). Decreases of paid labour productivity (-21% vs. -70%, P=0.003), physical exercise activity (-43% vs. -87%, P=0.005) and Karnofsky performance scores (-12% vs. -24%, Plabour productivity, physical exercise and performance status during PEG-interferon-containing treatment for chronic hepatitis C. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. INTRAUTERINE GROWTH RETARDATION AND ITS IMPACT ON CHILDREN'S HEALTH IN LATER LIFE. THE POSSIBILITY OF NUTRITIONAL SUPPORT

    Directory of Open Access Journals (Sweden)

    T. V. Belousova

    2015-01-01

    Full Text Available The sources of development, homeostasis and metabolism habits, long-term effects on the health of infants delivered with intrauterine growth retardation are considered. Principals and aspects of nutrition choice for these particular infants as well as some controversial aspects on this topic are discussed. Research data represents nutrition of newborns and up to 3 months infants, including those with the IGR and moderate postnatal inanition, fed with goat milk based formula, containing pre- and probiotics. 

  17. Community And Stakeholder Engagement With A University-Based Storm Research Team And Program During Events: Progressive Awareness, Cooperation And Mutual Support.

    Science.gov (United States)

    Gayes, P. T.; Bao, S.; Yan, T.; Pietrafesa, L. J.; Hallstrom, J.; Stirling, D.; Mullikin, T.; McClam, M.; Byrd, M.; Aucoin, K.; Marosites, B.

    2017-12-01

    HUGO: The HUrricane Genesis and Outlook program is a research initiative spanning new approaches to Atlantic tropical season outlooking to a storm event-related interactively coupled model system. In addition to supporting faculty and student academic research it has progressively been engaged by diverse regional interests in the public and private sector. The seasonal outlook incorporates 22 regional-to-global climate drivers developed from the historical storm database and has shown good skill related to historical storm seasons within the development of the model as well as the last several years in an outlook capacity. The event scale model is a based upon a fully interactively coupled model system incorporating ocean, atmosphere, wave and surge/flood models. The recent cluster of storms impacting the Southeast US provided an opportunity to test the model system and helped develop strong collaborative interests across diverse groups seeking to facilitate local capacity and access to additional storm-related information, observations and expertise. The SC State Guard has actively engaged the HUGO team in carrying out their charge in emergency responders planning and activities during several recent storms and flooding events. They were instrumental in developing support to expand observational systems aiding model validation and development as well as develop access pathways for deployment of new observational technology developed through NSF sponsored projects (Intelligent River and Hurricane-RAPID) with ISENSE at Florida Atlantic University to advance observational capability and density especially during or immediately following events. At the same time an increasing number of county-level emergency and environmental managers and private sector interests have similarly been working collaborately towards expanding observational systems contributing to the goals of the growing storm-oriented cooperative and as well as broader national MesoUS goals. Collectively

  18. Collocation Impact on Team Effectiveness

    Directory of Open Access Journals (Sweden)

    M Eccles

    2010-11-01

    Full Text Available The collocation of software development teams is common, specially in agile software development environments. However little is known about the impact of collocation on the team’s effectiveness. This paper explores the impact of collocating agile software development teams on a number of team effectiveness factors. The study focused on South African software development teams and gathered data through the use of questionnaires and interviews. The key finding was that collocation has a positive impact on a number of team effectiveness factors which can be categorised under team composition, team support, team management and structure and team communication. Some of the negative impact collocation had on team effectiveness relate to the fact that team members perceived that less emphasis was placed on roles, that morale of the group was influenced by individuals, and that collocation was invasive, reduced level of privacy and increased frequency of interruptions. Overall through it is proposed that companies should consider collocating their agile software development teams, as collocation might leverage overall team effectiveness.

  19. Translating research into practice: evaluation of an e-learning resource for health care professionals to provide nutrition advice and support for cancer survivors.

    Science.gov (United States)

    Murphy, Jane; Worswick, Louise; Pulman, Andy; Ford, Grainne; Jeffery, Jaana

    2015-01-01

    Nurses and other allied health professionals are in a key position to provide appropriate and consistent advice on nutritional issues to support cancer survivors. However gaps in their nutrition knowledge and education warrant the need for enhanced learning as part of their Continued Professional Development (CPD). In the UK there are currently no formally recognised nutrition education programmes. Therefore e-learning offers a solution to provide flexible learning to target this need. This study aimed to develop and evaluate the efficacy of a freely available, internet-based learning resource, for nurses and allied health professionals who provide nutrition, diet and lifestyle advice for cancer survivors. It sought to explore the attitudes and conceptions of the resource and current knowledge base of those involved in the care pathway for cancer survivors. The design and development of the e-learning resource were informed by the best available research and policy evidence and in a format to facilitate on-line learning. A robust evaluation strategy incorporated focus groups and telephone interviews to gain in depth insights into the experiences of using the resource. Themes included 'Plugging a Gap' which shows an improved knowledge base for nutrition. Information was 'All in One Place' showing that the resource was valued as being within a 'trusted' organisation. 'Everyone Benefits' illustrates how learners felt that the resource provided them with an evidence base, whilst the 'Current and Live' theme captured how professionals felt about the information being up-to-date. The project has shown the benefits of interprofessional working to develop an e-learning resource for Health Care Professionals to support cancer survivors in following healthier lifestyles. Positive attitudes and potential improvements in the knowledge base and changes for professional practice were demonstrated. Further research is required to gauge sustained impact in the work environment by

  20. Data Teams for School Improvement

    Science.gov (United States)

    Schildkamp, Kim; Poortman, Cindy L.; Handelzalts, Adam

    2016-01-01

    The use of data for educational decision making has never been more prevalent. However, teachers and school leaders need support in data use. Support can be provided by means of professional development in the form of "data teams". This study followed the functioning of 4 data teams over a period of 2 years, applying a qualitative case…

  1. Clinical practice guidelines from the French Health High Authority: nutritional support strategy in protein-energy malnutrition in the elderly.

    Science.gov (United States)

    Raynaud-Simon, Agathe; Revel-Delhom, Christine; Hébuterne, Xavier

    2011-06-01

    These guidelines were produced at the request of the General Directorate of Health within the scope of the French Nutrition and Health Program (PNNS). They concern the management of malnutrition in elderly persons living at home, in institutional care, or in hospital. They belong to a recent series of studies published by ANAES(1) or HAS. Preceding studies concerned the "Diagnostic assessment of protein-energy malnutrition in hospitalized adults" (ANAES, September 2003) and the work conducted by the Committee for the Assessment of Devices and Health Technologies (CEPP) on "Reimbursement procedures for dietary foods for special medical purposes for nutritional supplementation and home enteral nutrition" (HAS, September 2006). The objective of these guidelines is to develop a tool for identifying and managing elderly subjects who are malnourished or at risk of malnutrition. Copyright © 2010. Published by Elsevier Ltd.

  2. 'To be a woman is to make a plan': a qualitative study exploring mothers' experiences of the Child Support Grant in supporting children's diets and nutrition in South Africa.

    Science.gov (United States)

    Zembe-Mkabile, Wanga; Surender, Rebecca; Sanders, David; Swart, Rina; Ramokolo, Vundli; Wright, Gemma; Doherty, Tanya

    2018-04-24

    Food security and good nutrition are key determinants of child well-being. There is strong evidence that cash transfers such as South Africa's Child Support Grant (CSG) have the potential to help address some of the underlying drivers of food insecurity and malnutrition by providing income to caregivers in poor households, but it is unclear how precisely they work to affect child well-being and nutrition. We present results from a qualitative study conducted to explore the role of the CSG in food security and child well-being in poor households in an urban and a rural setting in South Africa. Mt Frere, Eastern Cape (rural area); Langa, Western Cape (urban township). CSG recipient caregivers and community members in the two sites . We conducted a total of 40 in-depth interviews with mothers or primary caregivers in receipt of the CSG for children under the age of 5 years. In addition, five focus group discussions with approximately eight members per group were conducted. Data were analysed using manifest and latent thematic content analysis methods. The CSG is too small on its own to improve child nutrition and well-being. Providing for children's diets and nutrition competes with other priorities that are equally important for child well-being and nutrition. In addition to raising the value of the CSG so that it is linked to the cost of a nutritious basket of food, more emphasis should be placed on parallel structural solutions that are vital for good child nutrition outcomes and well-being, such as access to free quality early child development services that provide adequate nutritious meals, access to adequate basic services and the promotion of appropriate feeding, hygiene and care practices. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Team Learning and Team Composition in Nursing

    Science.gov (United States)

    Timmermans, Olaf; Van Linge, Roland; Van Petegem, Peter; Elseviers, Monique; Denekens, Joke

    2011-01-01

    Purpose: This study aims to explore team learning activities in nursing teams and to test the effect of team composition on team learning to extend conceptually an initial model of team learning and to examine empirically a new model of ambidextrous team learning in nursing. Design/methodology/approach: Quantitative research utilising exploratory…

  4. DIFFERENT DIMENSIONS OF TEAMS

    OpenAIRE

    Goparaju Purna SUDHAKAR

    2013-01-01

    Popularity of teams is growing in 21st Century. Organizations are getting their work done through different types of teams. Teams have proved that the collective performance is more than the sum of the individual performances. Thus, the teams have got different dimensions such as quantitative dimensions and qualitative dimensions. The Quantitative dimensions of teams such as team performance, team productivity, team innovation, team effectiveness, team efficiency, team decision making and tea...

  5. TEAM ORGANISERING

    DEFF Research Database (Denmark)

    Levisen, Vinie; Haugaard, Lena

    2004-01-01

    organisation som denne? Når teams i samtiden anses for at være en organisationsform, der fremmer organisatorisk læring, beror det på, at teamet antages at udgøre et ikke-hierarkisk arbejdsfællesskab, hvor erfaringer udveksles og problemer løses. Teamorganisering kan imidlertid udformes på mange forskellige...

  6. Nutritional Status Assessment During the Phase IIA and Phase III Lunar/Mars Life Support Test Project

    Science.gov (United States)

    Smith, Scott M.; Block, Gladys; Davis-Street, Janis E.; DeKerlegand, Diane E.; Fanselow, Stephanie A.; Fesperman, J. Vernell; Gillman, Patricia L.; Nillen, Jeannie I.; Rice, Barbara L.; Smith, Myra D.

    2000-01-01

    Nutrition is a critical concern for extended-duration space missions (Smith and Lane, 1999). Loss of body weight is a primary consequence of altered nutrition, and is frequently observed during space flight (Smith and Lane; 1999). Other existing dietary concerns for space flight include excessive intakes of sodium and iron, and insufficient intakes of water and vitamin D (Smith and Lane, 1999). Furthermore, dependence on closed or semi-closed food systems increases the likelihood of inadequate intakes of key nutrients. This is a significant concern for extended-duration space missions. Space nutrition research often necessitates detailed recording of all food consumption. While this yields extremely accurate data, it requires considerable time and effort, and thus is not suitable for routine medical monitoring during space flight. To alleviate this problem, a food frequency questionnaire (FFQ) was designed to provide a quick and easy, yet reasonably accurate, method for crewmembers to provide dietary intake information to the ground. We report here a study which was designed to assess nutritional status before, during, and after the 60-d and 91-d chamber stays. An additional goal of the study was to validate a food frequency questionnaire designed specifically for use with space flight food systems.

  7. Survival in Malnourished Older Patients Receiving Post-Discharge Nutritional Support; Long-Term Results of a Randomized Controlled Trial

    NARCIS (Netherlands)

    Neelemaat, F; van Keeken, S; Langius, J A E; de van der Schueren, M A E; Thijs, A; Bosmans, J E

    2017-01-01

    BACKGROUND: Previous analyses have shown that a post-discharge individualized nutritional intervention had positive effects on body weight, lean body mass, functional limitations and fall incidents in malnourished older patients. However, the impact of this intervention on survival has not yet been

  8. Survival in Malnourished Older Patients Receiving Post-Discharge Nutritional Support; Long-Term Results of a Randomized Controlled Trial.

    Science.gov (United States)

    Neelemaat, F; van Keeken, S; Langius, J A E; de van der Schueren, M A E; Thijs, A; Bosmans, J E

    2017-01-01

    Previous analyses have shown that a post-discharge individualized nutritional intervention had positive effects on body weight, lean body mass, functional limitations and fall incidents in malnourished older patients. However, the impact of this intervention on survival has not yet been studied. The objective of this randomized controlled study was to examine the effect of a post-discharge individualized nutritional intervention on survival in malnourished older patients. Malnourished older patients, aged ≥ 60 years, were randomized during hospitalization to a three-months post-discharge nutritional intervention group (protein and energy enriched diet, oral nutritional supplements, vitamin D3/calcium supplement and telephone counseling by a dietitian) or to a usual care regimen (control group). Survival data were collected 4 years after enrollment. Survival analyses were performed using intention-to-treat analysis by Log-rank tests and Cox regression adjusted for confounders. The study population consisted of 94 men (45%) and 116 women with a mean age of 74.5 (SD 9.5) years. There were no statistically significant differences in baseline characteristics. Survival data was available in 208 out of 210 patients. After 1 and 4 years of follow-up, survival rates were respectively 66% and 29% in the intervention group (n=104) and 73% and 30% in the control group (n=104). There were no statistically significant differences in survival between the two groups 1 year (HR= 0.933, 95% CI=0.675-1.289) and 4 years after enrollment (HR=0.928, 95% CI=0.671-1.283). The current study failed to show an effect of a three-months post-discharge multi-component nutritional intervention in malnourished older patients on long-term survival, despite the positive effects on short-term outcome such as functional limitations and falls.

  9. The association of Socio-demographics characteristics and social support from family and community with depression: The National Health and Nutrition Examination Survey 2005-2006

    Directory of Open Access Journals (Sweden)

    Erfan Ayubi

    2012-01-01

    Full Text Available Aims & objectives: Protective effect of social support networks on depressive symptoms has been reported. The aim of this study was to examine the association between depressive symptoms and social support from family and community using data from the National Health and Nutrition Examination Survey (NHANES 2005-2006. Methodology: This is a cross-sectional population-based study of 10,348 people participating in the NHANES 2005-2006. Participants were interviewed on their level of social support and depressive symptoms. Logistic regression and analysis of variance was used to assess the effects of demographic variables and social support with depression. Results: Bing married and having a high education level is inversely related to depressive symptoms. Also social supports from family had protective effect on depression symptoms and impacts of each family member were different. It also became clear that family support in associated with social support had a protective effect on the emergence of depressive symptoms. In this effect, the interaction between spouse and professional support on depressive symptoms were more prominent. In addition to, interaction between children’s emotional support and religious practices was important. Conclusion: The result of this study adherent with the protective theory of social support on depression.

  10. The association of Socio-demographics characteristics and social support from family and community with depression: The National Health and Nutrition Examination Survey 2005-2006

    Directory of Open Access Journals (Sweden)

    Kavitha Dinesh

    2012-03-01

    Full Text Available Aims & objectives: Protective effect of social support networks on depressive symptoms has been reported. The aim of this study was to examine the association between depressive symptoms and social support from family and community using data from the National Health and Nutrition Examination Survey (NHANES 2005-2006. Methodology: This is a cross-sectional population-based study of 10,348 people participating in the NHANES 2005-2006. Participants were interviewed on their level of social support and depressive symptoms. Logistic regression and analysis of variance was used to assess the effects of demographic variables and social support with depression. Results: Bing married and having a high education level is inversely related to depressive symptoms. Also social supports from family had protective effect on depression symptoms and impacts of each family member were different. It also became clear that family support in associated with social support had a protective effect on the emergence of depressive symptoms. In this effect, the interaction between spouse and professional support on depressive symptoms were more prominent. In addition to, interaction between children’s emotional support and religious practices was important. Conclusion: The result of this study adherent with the protective theory of social support on depression.

  11. Initiating Nutritional Support Before 72 Hours Is Associated With Favorable Outcome After Severe Traumatic Brain Injury in Children: A Secondary Analysis of a Randomized, Controlled Trial of Therapeutic Hypothermia.

    Science.gov (United States)

    Meinert, Elizabeth; Bell, Michael J; Buttram, Sandra; Kochanek, Patrick M; Balasubramani, Goundappa K; Wisniewski, Stephen R; Adelson, P David

    2018-04-01

    To understand the relationship between the timing of initiation of nutritional support in children with severe traumatic brain injury and outcomes. Secondary analysis of a randomized, controlled trial of therapeutic hypothermia (Pediatric Traumatic Brain Injury Consortium: Hypothermia, also known as "the Cool Kids Trial" (NCT 00222742). Fifteen clinical sites in the United States, Australia, and New Zealand. Inclusion criteria included 1) age less than 18 years, 2) postresuscitation Glasgow Coma Scale less than or equal to 8, 3) Glasgow Coma Scale motor score less than 6, and 4) available to be randomized within 6 hours after injury. Exclusion criteria included normal head CT, Glasgow Coma Scale equals to 3, hypotension for greater than 10 minutes ( 30 min), pregnancy, penetrating injury, and unavailability of a parent or guardian to consent at centers without emergency waiver of consent. Therapeutic hypothermia (32-33°C for 48 hr) followed by slow rewarming for the primary study. For this analysis, the only intervention was the extraction of data regarding nutritional support from the existing database. Timing of initiation of nutritional support was determined and patients stratified into four groups (group 1-no nutritional support over first 7 d; group 2-nutritional support initiated group 3-nutritional support initiated 48 to group 4-nutritional support initiated 72-168 hr after injury). Outcomes were also stratified (mortality and Glasgow Outcomes Scale-Extended for Pediatrics; 1-4, 5-7, 8) at 6 and 12 months. Mixed-effects models were performed to define the relationship between nutrition and outcome. Children (n = 90, 77 randomized, 13 run-in) were enrolled (mean Glasgow Coma Scale = 5.8); the mortality rate was 13.3%. 57.8% of subjects received hypothermia Initiation of nutrition before 72 hours was associated with survival (p = 0.01), favorable 6 months Glasgow Outcomes Scale-Extended for Pediatrics (p = 0.03), and favorable 12 months Glasgow

  12. Influence of macrolides, nutritional support and respiratory therapies in diabetes and normal glucose tolerance in cystic fibrosis. A retrospective analysis of a cohort of adult and younger patients.

    Science.gov (United States)

    Megías, Marta Cano; Albarrán, Olga González; Vasco, Pablo Guisado; Ferreiro, Adelaida Lamas; Carro, Luis Maiz

    2015-01-01

    The development of cystic fibrosis related diabetes is associated with increased morbidity and mortality, worse nutritional status and lung function decline. It is known that patients with cystic fibrosis have a chronic inflammation status and that β pancreatic cells are very sensitive to oxidative stress. So these inflammatory mediators could contribute to the onset of progressive pancreatic fibrosis and, hence, to impair glucose metabolism. So, it could be hypothesized that the treatment with macrolides would protect and preserve β-cell function by decreasing pro-inflammatory cytokines and free oxidative radicals. We retrospectively analyzed a cohort of 64 patients affected of cystic fibrosis, older than 14 years, by using the first pathological 2-h oral glucose tolerance test; peripheral insulin resistance was calculated using the homeostasis model assessment for insulin resistance (HOMA - IR) and pancreatic β-cell function was estimated according to Wareham. The influence of macrolides, microbiological colonization, nutritional support and related clinical parameters were analyzed. Comparing CFRD without FPG and NGT, and after adjustment for microbial colonization, the significance of the use of macrolides was lost (p=0.1), as a risk or protective factor for any of the studied groups. Non-significative associations were found in the use of macrolides, inhaled corticosteroids and nutritional support therapies within the different disorders of carbohydrate metabolism. The anti-inflammatory and immunomodulating effect of macrolides did not seem to affect the β cell function or insulin resis