WorldWideScience

Sample records for tailored nutrition management

  1. Tailored nutrition education: is it really effective?

    Science.gov (United States)

    Eyles, Helen; Ni Mhurchu, Cliona

    2012-03-01

    There has been a growing interest in tailored nutrition education over the previous decade, with a number of literature reviews suggesting this intervention strategy holds considerable potential. Nevertheless, the majority of intervention trials undertaken to date have employed subjective self-report outcome measures (such as dietary recalls). The aim of the present review is to further consider the likely true effect of tailored nutrition education by assessing the findings of tailored nutrition education intervention trials where objective outcome measures (such as sales data) have been employed. Four trials of tailored nutrition education employing objective outcome measures were identified: one was undertaken in eight low-cost supermarkets in New Zealand (2010; n 1104); one was an online intervention trial in Australia (2006; n 497); and two were undertaken in US supermarkets (1997 and 2001; n 105 and 296, respectively). Findings from the high-quality New Zealand trial were negative. Findings from the US trials were also generally negative, although reporting was poor making it difficult to assess quality. Findings from the high-quality online trial were positive, although have limited generalisability for public health. Trials employing objective outcome measures strongly suggest tailored nutrition education is not effective as a stand-alone strategy. However, further large, high-quality trials employing objective outcome measures are needed to determine the true effectiveness of this popular nutrition intervention strategy. Regardless, education plays an important role in generating social understanding and acceptance of broader interventions to improve nutrition.

  2. Development of patient-centric linguistically tailored psychoeducational messages to support nutrition and medication self-management in type 2 diabetes: a feasibility study

    Directory of Open Access Journals (Sweden)

    Ellis RJB

    2014-10-01

    Full Text Available Rebecca J Bartlett Ellis,1 Ulla Connor,2 James Marshall21Indiana University School of Nursing, 2Indiana University School of Liberal Arts, International Center for Intercultural Communication, Indiana University, Indianapolis, IN, USA Purpose: This study evaluated the feasibility of developing linguistically tailored educational messages designed to match the linguistic styles of patients segmented into types with the Descriptor™, and to determine patient preferences for tailored or standard messages based on their segments. Patients and methods: Twenty patients with type 2 diabetes (T2DM were recruited from a diabetes health clinic. Participants were segmented using the Descriptor™, a language-based questionnaire, to identify patient types based on their control orientation (internal/external, agency (high/low, and affect (positive/negative, which are well studied constructs related to T2DM self-management. Two of the seven self-care behaviors described by the American Association of Diabetes Educators (healthy eating and taking medication were used to develop standard messages and then linguistically tailored using features of the six different construct segment types of the Descriptor™. A subset of seven participants each provided feedback on their preference for standard or linguistically tailored messages; 12 comparisons between standard and tailored messages were made. Results: Overall, the tailored messages were preferred to the standard messages. When the messages were matched to specific construct segment types, the tailored messages were preferred over the standard messages, although this was not statistically significant. Conclusion: Linguistically tailoring messages based on construct segments is feasible. Furthermore, tailored messages were more often preferred over standard messages. This study provides some preliminary evidence for tailoring messages based on the linguistic features of control orientation, agency, and affect

  3. Tailoring nutrition therapy to illness and recovery.

    Science.gov (United States)

    Wischmeyer, Paul E

    2017-12-28

    Without doubt, in medicine as in life, one size does not fit all. We do not administer the same drug or dose to every patient at all times, so why then would we live under the illusion that we should give the same nutrition at all times in the continuum of critical illness? We have long lived under the assumption that critical illness and trauma lead to a consistent early increase in metabolic/caloric need, the so-called "hypermetabolism" of critical illness. What if this is incorrect? Recent data indicate that early underfeeding of calories (trophic feeding) may have benefits and may require consideration in well-nourished patients. However, we must confront the reality that currently ICU nutrition delivery worldwide is actually leading to "starvation" of our patients and is likely a major contributor to poor long-term quality of life outcomes. To begin to ascertain the actual calorie and protein delivery required for optimal ICU recovery, an understanding of "starvation" and recovery from starvation and lean body mass (LBM) loss is needed. To begin to answer this question, we must look to the landmark Minnesota Starvation Study from 1945. This trial defines much of the world's knowledge about starvation, and most importantly what is required for recovery from starvation and massive LBM loss as occurs in the ICU. Recent and historic data indicate that critical illness is characterized by early massive catabolism, LBM loss, and escalating hypermetabolism that can persist for months or years. Early enteral nutrition during the acute phase should attempt to correct micronutrient/vitamin deficiencies, deliver adequate protein, and moderate nonprotein calories in well-nourished patients, as in the acute phase they are capable of generating significant endogenous energy. Post resuscitation, increasing protein (1.5-2.0 g/kg/day) and calories are needed to attenuate LBM loss and promote recovery. Malnutrition screening is essential and parenteral nutrition can be safely

  4. Tailoring Risk Management in Design

    DEFF Research Database (Denmark)

    Tegeltija, M.; Oehmen, J.; McMahon, C. A.

    2018-01-01

    While risk quantification research has grown over the last few decades, only a limited number of studies have addressed the overall process integration of these approaches in design risk management. This paper argues that the choice of risk quantification method has strong implications for several...... process aspects. We investigate current risk management maturity models and suggest an expansion to accommodate requirements originating from the choice of quantification method, and to inform the choice of quantification method, based on other process parameters, validated through 3 case companies....

  5. Use of electronic sales data to tailor nutrition education resources for an ethnically diverse population.

    Science.gov (United States)

    Eyles, H; Rodgers, A; Ni Mhurchu, C

    2010-02-01

    Nutrition education may be most effective when personally tailored. Individualised electronic supermarket sales data offer opportunities to tailor nutrition education using shopper's usual food purchases. The present study aimed to use individualised electronic supermarket sales data to tailor nutrition resources for an ethnically diverse population in a large supermarket intervention trial in New Zealand. Culturally appropriate nutrition education resources (i.e. messages and shopping lists) were developed with the target population (through two sets of focus groups) and ethnic researchers. A nutrient database of supermarket products was developed using retrospective sales data and linked to participant sales to allow tailoring by usual food purchases. Modified Heart Foundation Tick criteria were used to identify 'healthier' products in the database suitable for promotion in the resources. Rules were developed to create a monthly report listing the tailored and culturally targeted messages to be sent to each participant, and to produce automated, tailored shopping lists. Culturally targeted nutrition messages (n = 864) and shopping lists (n = 3 formats) were developed. The food and nutrient database (n = 3000 top-selling products) was created using 12 months of retrospective sales data, and comprised 60%'healthier' products. Three months of baseline sales data were used to determine usual food purchases. Tailored resources were successfully mailed to 123 Māori, 52 Pacific and 346 non-Māori non-Pacific participants over the 6-month trial intervention period. Electronic supermarket sales data can be used to tailor nutrition education resources for a large number of ethnically diverse supermarket shoppers.

  6. Tailoring Earned Value Management. General Guidelines

    National Research Council Canada - National Science Library

    2002-01-01

    Partial Contents: General Principles, A Spectrum of Implementation, OMB Guidance, A Special Note about DOD, Risk Factors to Consider, How can EVMS be tailored, Tailor EVMS to Inherent Risk, Application Thresholds-DoD...

  7. [Nutritional management in geriatric traumatology].

    Science.gov (United States)

    Singler, K; Goisser, S; Volkert, D

    2016-08-01

    The prevalence of malnutrition or the risk of malnourishment is high among orthogeriatric patients and a poor nutritional status is associated with a negative outcome. A comprehensive management of preoperative and postoperative nutritional and fluid intake in these patients can help to improve the situation. The management includes identification of patients affected, a thorough assessment of the nutritional status, work-up of possible underlying causes, documentation of nutritional and fluid intake and, most importantly, procedures to improve the preoperative and postoperative nutritional situation. This article gives an overview of the recently updated recommendations on nutritional management in orthogeriatric patients as published by the orthogeriatric working group of the German Geriatric Society.

  8. Enteral nutrition - child - managing problems

    Science.gov (United States)

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

  9. Tailoring Self-Management in Chronic Care

    NARCIS (Netherlands)

    Touwen, ID

    2016-01-01

    Self-management is nowadays seen as an important element in chronic care and therefore, self-management is increasingly embedded in chronic care guidelines; however, implementation in clinical practice is a slow and difficult process. Evidence, from research on self-management interventions, shows

  10. Pilot study of a budget-tailored culinary nutrition education program for undergraduate food science students

    Science.gov (United States)

    Kerrison, Dorothy Adair

    The primary objective of this pilot study is to provide evidence that a budget-tailored culinary nutrition program is both appropriate and applicable to undergraduate food science students both in everyday life as well as their future health careers. Two validated programs were combined into one program in order to evaluate their combined effects: Cooking With a Chef and Cooking Matters at the Store. The secondary objective of this pilot study is to evaluate the components and reliability of a questionnaire created specifically for this pilot study. A review of past literature was written, which included culinary nutrition as a source of primary prevention, the importance of incorporating cost with culinary nutrition, and the importance of incorporating cost with culinary nutrition. Based on the literature review, it was determined that a budget-tailored culinary nutrition program was appropriate and applicable to undergraduate food science students interested in pursuing health-related careers. The pilot study design was a semi-crossover study: all four groups received the program, however, two groups were first treated as the control groups. All fifty-four participants received 5 sessions of culinary nutrition information from Cooking With a Chef, collaboratively delivered by a nutrition educator and a chef, and one session of information about shopping healthy on a budget from Cooking Matters at the Store in the form of a grocery store tour led by the nutrition educator. Three questionnaires were administered to the participants that evaluated culinary nutrition and price knowledge, cooking attitudes, and opinions of the programs' relevance to participants' everyday lives and careers. Two of the questionnaires, including a questionnaire developed specifically for the pilot study, were delivered as a pre- and post-test while the third questionnaire was delivered as a post-test. Eight random participants also partook in a focus group session led by the nutrition

  11. Nutritional Aspects of Dysphagia Management.

    Science.gov (United States)

    Gallegos, C; Brito-de la Fuente, E; Clavé, P; Costa, A; Assegehegn, G

    This chapter describes the nutritional aspects of dysphagia management by starting with the definition of these two conditions (dysphagia and malnutrition) that share three main clinical characteristics: (a) their prevalence is very high, (b) they can lead to severe complications, and (c) they are frequently underrecognized and neglected conditions. From an anatomical standpoint, dysphagia can result from oropharyngeal and/or esophageal causes; from a pathophysiological perspective, dysphagia can be caused by organic or structural diseases (either benign or malignant) or diseases causing impaired physiology (mainly motility and/or perception disorders). This chapter gathers up-to-date information on the screening and diagnosis of oropharyngeal dysphagia, the consequences of dysphagia (aspiration pneumonia, malnutrition, and dehydration), and on the nutritional management of dysphagic patients. Concerning this last topic, this chapter reviews the rheological aspects of swallowing and dysphagia (including shear and elongational flows) and its influence on the characteristics of the enteral nutrition for dysphagia management (solid/semisolid foods and thickened liquids; ready-to-use oral nutritional supplements and thickening powders), with special focus on the real characteristics of the bolus after mixing with human saliva. © 2017 Elsevier Inc. All rights reserved.

  12. Precision Nutrition: A Review of Personalized Nutritional Approaches for the Prevention and Management of Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Juan de Toro-Martín

    2017-08-01

    Full Text Available The translation of the growing increase of findings emerging from basic nutritional science into meaningful and clinically relevant dietary advices represents nowadays one of the main challenges of clinical nutrition. From nutrigenomics to deep phenotyping, many factors need to be taken into account in designing personalized and unbiased nutritional solutions for individuals or population sub-groups. Likewise, a concerted effort among basic, clinical scientists and health professionals will be needed to establish a comprehensive framework allowing the implementation of these new findings at the population level. In a world characterized by an overwhelming increase in the prevalence of obesity and associated metabolic disturbances, such as type 2 diabetes and cardiovascular diseases, tailored nutrition prescription represents a promising approach for both the prevention and management of metabolic syndrome. This review aims to discuss recent works in the field of precision nutrition analyzing most relevant aspects affecting an individual response to lifestyle/nutritional interventions. Latest advances in the analysis and monitoring of dietary habits, food behaviors, physical activity/exercise and deep phenotyping will be discussed, as well as the relevance of novel applications of nutrigenomics, metabolomics and microbiota profiling. Recent findings in the development of precision nutrition are highlighted. Finally, results from published studies providing examples of new avenues to successfully implement innovative precision nutrition approaches will be reviewed.

  13. Nutritional management of encapsulating peritoneal sclerosis with ...

    African Journals Online (AJOL)

    Keywords: intradialytic parenteral nutrition, nutritional management, encapsulating peritoneal sclerosis ... reflection of fluid retention and the underlying inflammatory process, ... The patient appeared weak and frail, with severe generalised muscle ... was recommended on diagnosis of EPS to prevent further peritoneal.

  14. Toward tailored disease management for type 2 diabetes.

    Science.gov (United States)

    Elissen, Arianne M J; Duimel-Peeters, Inge G P; Spreeuwenberg, Cor; Spreeuwenberg, Marieke; Vrijhoef, Hubertus J M

    2012-10-01

    To assess the differentiated effects of population-based disease management programs (DMPs) for type 2 diabetes on intermediary clinical outcomes in The Netherlands. Data covering a period from 20 to 24 months between January 2008 and December 2010 were collected from 18 Dutch care groups (primary care provider networks that have bundled payment contracts for delivery of diabetes DMPs). Meta-analysis and meta-regression methods were used to conduct differentiated analyses of these programs' effects over time on 4 clinical indicators: glycated hemoglobin, lowdensity lipoprotein, systolic blood pressure, and body mass index. Heterogeneous average results were stratified according to various patient and process characteristics to investigate whether differences in these features could explain variation in outcomes. Between 56% and 71% of patients (N = 105,056) had valid first- and second-year measurements of the study outcomes. Although average changes in these measures over time were small, stratified analyses demonstrated that clinically relevant improvements were achieved in patients with poor first-year health values. Interactions with age, disease duration, comorbidity, and smoking status were not consistent across outcomes; nonetheless, heterogeneity in results decreased considerably when simultaneously correcting for known patient characteristics. Positive effects tended to diminish with longer length of follow-up, while greater measurement frequency was associated with improved results, especially in patients with poor health. Our data suggest that tailored disease management, in which not only evidencebased guidelines but also patient characteristics directly determine care processes, including self-management support, has great potential to improve the cost-effectiveness of current chronic care delivery.

  15. Tailoring Nutritional Advice for Mexicans Based on Prevalence Profiles of Diet-Related Adaptive Gene Polymorphisms

    Directory of Open Access Journals (Sweden)

    Claudia Ojeda-Granados

    2017-11-01

    Full Text Available Diet-related adaptive gene (DRAG polymorphisms identified in specific populations are associated with chronic disorders in carriers of the adaptive alleles due to changes in dietary and lifestyle patterns in recent times. Mexico’s population is comprised of Amerindians (AM and Mestizos who have variable AM, European (EUR and African genetic ancestry and an increased risk of nutrition-related chronic diseases. Nutritional advice based on the Mexican genome and the traditional food culture is needed to develop preventive and therapeutic strategies. Therefore, we aimed to provide a prevalence profile of several DRAG polymorphisms in the Mexican population, including Central West (CW Mexico subpopulations. Geographic heat maps were built using ArcGIS10 (Esri, Redlands, CA, USA software, based on the published data of the MTHFR C677T (rs1801133, ABCA1 Arg230Cys (rs9282541, APOE T388C (rs429358/C526T (rs7412, LCT C-13910T (rs4988235 polymorphisms and AMY1 copy number variation (CNV. Also, new data obtained by allelic discrimination-real-time polymerase chain reaction (RT-PCR assays for the MTHFR, ABCA1, and APOE polymorphisms as well as the AMY1 CNV in the CW Mexico subpopulations with different proportions of AM and EUR ancestry were included. In the CW region, the highest frequency of the MTHFR 677T, ABCA1 230C and APOE ε4 adaptive alleles was observed in the AM groups, followed by Mestizos with intermediate AM ancestry. The LCT-13910T allele frequency was highest in Mestizos-EUR but extremely low in AM, while the AMY1 diploid copy number was 6.82 ± 3.3 copies. Overall, the heat maps showed a heterogeneous distribution of the DRAG polymorphisms, in which the AM groups revealed the highest frequencies of the adaptive alleles followed by Mestizos. Given these genetic differences, genome-based nutritional advice should be tailored in a regionalized and individualized manner according to the available foods and Mexican traditional food culture that

  16. Adult classical homocystinuria requiring parenteral nutrition: Pitfalls and management.

    Science.gov (United States)

    Tran, Christel; Bonafé, Luisa; Nuoffer, Jean-Marc; Rieger, Julie; Berger, Mette M

    2017-07-25

    Homocystinuria due to cystathionine beta synthase (CBS) deficiency presents with a wide clinical spectrum. Treatment by the enteral route aims at reducing homocysteine levels by using vitamin B6, possibly methionine-restricted diet, betaine and/or folate and vitamin B 12 supplementation. Currently no nutritional guidelines exist regarding parenteral nutrition (PN) under acute conditions. Exhaustive literature search was performed, in order to identify the relevant studies describing the pathogenesis and nutritional intervention of adult classical homocystinuria requiring PN. Description of an illustrative case of an adult female with CBS deficiency and intestinal perforation, who required total PN due to contraindication to enteral nutrition. Nutritional management of decompensated classical homocystinuria is complex and currently no recommendation exists regarding PN composition. Amino acid profile and monitoring of total homocysteine concentration are the main tools enabling a precise assessment of the severity of metabolic alterations. In case of contraindication to enteral nutrition, compounded PN will be required, as described in this paper, to ensure adequate low amounts of methionine and others essential amino acids and avoid potentially fatal toxic hypermethioninemia. By reviewing the literature and reporting successful nutritional management of a decompensated CBS deficiency using tailored PN with limited methionine intake and n-3 PUFA addition, we would like to underscore the fact that standard PN solutions are not adapted for CBS deficient critical ill patients: new solutions are required. High methionine levels (>800 μmol/L) being potentially neurotoxic, there is an urgent need to improve our knowledge of acute nutritional therapy. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  17. Nutritional management in Ebola haemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Kamon Chaiyasit

    2015-06-01

    Full Text Available Ebola haemorrhagic fever is a viral infection causing a major health problem worldwide. In this short article, the authors briefly review and discuss on the nutritional management (energy, protein, fat and micronutrient in management of Ebola infection.

  18. Ruminant Nutrition Symposium: Modulation of metabolism through nutrition and management

    Science.gov (United States)

    The primary role of the dairy cow is to help provide high-quality protein and other nutrients through lactation to the human diet. It is clear that these high-producing and long lactations are stressful on the cows, and minor changes in nutrition and management can have significant impacts on profi...

  19. Managing Agricultural Biodiversity for Nutrition, Health, Livelihoods ...

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

    Managing Agricultural Biodiversity for Nutrition, Health, Livelihoods and ... on local ecosystems and human resources can provide sustainable solutions to ... and health among the rural and urban poor through increased dietary diversity.

  20. GIS tailored questionnaires for assisting health care management in distributing resources

    CSIR Research Space (South Africa)

    Herselman, M

    2010-09-01

    Full Text Available A tailored questionnaire focuses on dynamic generation of items and questions according to the location where the questionnaire is used. The approach is connected to the management of resources and the support of decision making processes which...

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

    Science.gov (United States)

    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.

  2. Nutritional management of gastrointestinal malignancies ...

    African Journals Online (AJOL)

    The evidence connecting food and gastrointestinal cancers from epidemiological studies, case-control studies, and prospective observational studies, indicates that determining the independent effects of specific nutrients is extremely diffi cult, given the many potential environmental factors to consider. The nutritional ...

  3. Improving the implementation of tailored expectant management in subfertile couples: protocol for a cluster randomized trial

    NARCIS (Netherlands)

    Boogaard, N.M. van den; Kersten, F.A.M.; Goddijn, M.; Bossuyt, P.M.; Veen, F. van der; Hompes, P.G.; Hermens, R.P.M.G.; Braat, D.D.M.; Mol, B.W.; Nelen, W.L.D.M.; et al.,

    2013-01-01

    BACKGROUND: Prognostic models in reproductive medicine can help to identify subfertile couples who would benefit from fertility treatment. Expectant management in couples with a good chance of natural conception, i.e., tailored expectant management (TEM), prevents unnecessary treatment and is

  4. Improving the implementation of tailored expectant management in subfertile couples : protocol for a cluster randomized trial

    NARCIS (Netherlands)

    van den Boogaard, Noortje M; Kersten, Fleur A M; Goddijn, Mariëtte; Bossuyt, Patrick M M; van der Veen, Fulco; Hompes, Peter G A; Hermens, Rosella P M G; Braat, Didi D M; Mol, Ben Willem J; Nelen, Willianne L D M; Hoek, Annemieke

    2013-01-01

    BACKGROUND: Prognostic models in reproductive medicine can help to identify subfertile couples who would benefit from fertility treatment. Expectant management in couples with a good chance of natural conception, i.e., tailored expectant management (TEM), prevents unnecessary treatment and is

  5. Nutritional therapy for the management of diabetic gastroparesis: clinical review

    Directory of Open Access Journals (Sweden)

    Sadiya A

    2012-09-01

    Full Text Available Amena SadiyaLifestyle Clinic, Rashid Centre for Diabetes and Research, Ministry of Health, Ajman, United Arab EmiratesAbstract: Diabetic gastroparesis (DGP, or slow emptying of the stomach, is a well-established complication of diabetes mellitus and is typically considered to occur in individuals with long-standing type 1 and type 2 diabetes mellitus. Clinical consequences of DGP include induction of gastrointestinal (GI symptoms (early satiety, abdominal distension, reflux, stomach spasm, postprandial nausea, vomiting, alteration in drug absorption, and destabilization of glycemic control (due to mismatched postprandial glycemic and insulin peaks. Effective nutritional management not only helps in alleviating the symptoms, but also in facilitating better glycemic control. Although there have been no evidence-based guidelines pertaining to the nutrition care process of the DGP, the current dietary recommendations are based on expert opinions or observational studies. The dietary management of gastroparesis needs to be tailored according to the severity of malnutrition and kind of upper GI symptom by changing the volume, consistency, frequency, fiber, fat, and carbohydrates in the meal. Small frequent meals, using more liquid calories, reducing high fat or high fiber, consuming bezoar forming foods, and adjusting meal carbohydrates based on medications or insulin helps in improving the upper GI symptoms and glycemic control. Enteral nutrition can be an option for patients who fail to stabilize their weight loss, or for those who cannot gain weight with oral feedings, while total parenteral nutrition is rarely necessary for the patient with gastroparesis.Keywords: diabetic gastroparesis, delayed gastric emptying, diabetes mellitus, bezoar, GI symptoms, glycemic control

  6. Exploring Nutrition Literacy and Knowledge among a National Sample of School Nutrition Managers

    Science.gov (United States)

    Zoellner, Jamie; Carr, Deborah

    2010-01-01

    Purpose/Objectives: The purpose of this national study was to describe nutrition literacy levels and nutrition knowledge among school nutrition (SN) managers, and explore if barriers to seeking SN information, perceived role in school wellness, and confidence in SN decision making varied by nutrition literacy and knowledge scores. Methods: An…

  7. Irritable bowel syndrome: contemporary nutrition management strategies.

    Science.gov (United States)

    Mullin, Gerard E; Shepherd, Sue J; Chander Roland, Bani; Ireton-Jones, Carol; Matarese, Laura E

    2014-09-01

    Irritable bowel syndrome is a complex disorder whose pathophysiology involves alterations in the enteric microbiota, visceral hypersensitivity, gut immune/barrier function, hypothalamic-pituitary-adrenal axis regulation, neurotransmitters, stress response, psychological factors, and more. The importance of diet in the management of irritable bowel syndrome has taken center stage in recent times as the literature validates the relationship of certain foods with the provocation of symptoms. Likewise, a number of elimination dietary programs have been successful in alleviating irritable bowel syndrome symptoms. Knowledge of the dietary management strategies for irritable bowel syndrome will help guide nutritionists and healthcare practitioners to deliver optimal outcomes. This tutorial reviews the nutrition management strategies for irritable bowel syndrome. © 2014 American Society for Parenteral and Enteral Nutrition.

  8. [Nutritional management of kidney diseases in children].

    Science.gov (United States)

    Borovik, T E; Kutafina, E K; Tsygin, A N; Sergeeva, T V; Baranov, A A; Namazova-Baranova, L S; Voznesenskaya, T S; Zakharova, I N; Semenova, N N; Zvonkova, N G; Yatsyk, S P

    2016-01-01

    The prevalence of various kidney diseases in children remains high in recent decades. Adequate nutrition management can enhance the effectiveness of drug treatment, slow the frequency of relapses andprevent the progression of the disease. The article is devoted to modern approaches to diet therapy in various kidney diseases in children with the defeat of tubular and glomerular appa ratus. For the first time the therapeutic diets for children with various kidney diseases are presented. Particular attention is paid to diet therapy in nephrotic syndrome (steroid-responsive and steroid-refractory). Dietary approaches with modern formulas for enteral nutrition in cases of steroid therapy complications in children with renal insufficiency (in predialysis stage and on dialysis) are described. Differentiated nutritional approaches for patients with different types of crystalluria are separately presented.

  9. Tailored approach to management of bilateral breast cancer in Indian women

    Directory of Open Access Journals (Sweden)

    Veda Padma Priya Selvakumar

    2015-01-01

    Conclusions: The management of BCC is complex and has to be tailored to the individual based on characteristics of index and second tumor, prior therapy, adjuvant treatment, and risk stratification. Moreover, the concordance of receptor expression is higher in synchronous cancers than metachronous cancers.

  10. Tailored expectant management: a nationwide survey to quantify patients and professionals barriers and facilitators

    NARCIS (Netherlands)

    van den Boogaard, N. M.; Musters, A. M.; Brühl, S. W.; Tankens, T.; Kremer, J. A. M.; Mol, B. W. J.; Hompes, P. G. A.; Nelen, W. L. D. M.; van der Veen, F.

    2012-01-01

    Prognostic models for natural conception help to identify subfertile couples with high chances of natural conception, who do not need fertility treatment yet. The use of such models and subsequent tailored expectant management (TEM) is not always practiced. Previous qualitative research has

  11. Tailored expectant management: a nationwide survey to quantify patients' and professionals' barriers and facilitators.

    NARCIS (Netherlands)

    Boogaard, N.M. van den; Musters, A.M.; Bruhl, S.W.; Tankens, T.; Kremer, J.A.M.; Mol, B.W.; Hompes, P.G.; Nelen, W.L.D.M.; Veen, F. van der

    2012-01-01

    BACKGROUND: Prognostic models for natural conception help to identify subfertile couples with high chances of natural conception, who do not need fertility treatment yet. The use of such models and subsequent tailored expectant management (TEM) is not always practiced. Previous qualitative research

  12. Tailored nutrition education and food assistance improve adherence to HIV antiretroviral therapy: evidence from Honduras.

    Science.gov (United States)

    Martinez, Homero; Palar, Kartika; Linnemayr, Sebastian; Smith, Alexandria; Derose, Kathryn Pitkin; Ramírez, Blanca; Farías, Hugo; Wagner, Glenn

    2014-10-01

    Food insecurity and malnutrition negatively affect adherence to antiretroviral therapy (ART) and are associated with poor HIV clinical outcomes. We examined the effect of providing household food assistance and nutrition education on ART adherence. A 12-month prospective clinical trial compared the effect of a monthly household food basket (FB) plus nutrition education (NE) versus NE alone on ART adherence on 400 HIV patients at four clinics in Honduras. Participants had been receiving ART for an average of 3.7 years and were selected because they had suboptimal adherence. Primary outcome measures were missed clinic appointments, delayed prescription refills, and self-reported missed doses of ART. These three adherence measures improved for both groups over 12 months (p < 0.01), mostly within 6 months. On-time prescription refills improved for the FB plus NE group by 19.6 % more than the group receiving NE alone after 6 months (p < 0.01), with no further change at 12 months. Change in missed appointments and self-reported missed ART doses did not significantly differ by intervention group.

  13. Weight management in obese pets: the tailoring concept and how it can improve results.

    Science.gov (United States)

    German, Alexander J

    2016-10-20

    Obesity is now recognised as the most important medical disease in pets worldwide. All current strategies for weight management involve dietary energy restriction with a purpose-formulated diet. Whilst current weight management regimes can be successful, outcomes are often disappointing with the rate of weight loss progressively slowing down as time goes on. Success is most challenging for the most obese dogs and cats that are more likely to discontinue the programme before reaching target weight. To improve outcomes, clinicians must focus carefully on better tailoring programmes, paying particular to setting an appropriate target weight so as to maximise the benefits for the individual. In this opinionated review, the author will discuss findings from recent clinical research studies examining weight management in obese dogs and cats. A strategy for tailoring weight management targets will then be discussed, illustrated with case examples.

  14. Development of a computer-tailored nutrition and physical activity intervention for lower-educated women of Dutch, Turkish and Moroccan origin using content matching and ethnic identity tailoring

    Directory of Open Access Journals (Sweden)

    Kristina Romeike

    2016-09-01

    Full Text Available Abstract Background Unhealthy dietary and physical activity (PA patterns are highly prevalent in most Western countries, especially among lower-educated and ethnic minority groups. Therefore, interventions to promote healthy eating and physical activity that can reach large numbers of lower-educated people are needed. When developing interventions, the ethnic diversity of the lower-educated population may be taken into account to make intervention material more appealing to the target group. This article describes the development and evaluation of two computer-tailored nutrition and physical activity interventions for lower-educated Dutch, Turkish and Moroccan women. One version is tailored to sociocognitive variables (traditional tailoring, while the other is additionally tailored to ethnic identity (EI-tailoring. Method Using intervention mapping, two evidence- and theory-based interventions were developed. In the traditional tailoring intervention, messages are tailored to health behavior, awareness of own behavior, attitude and self-efficacy. The behavior change techniques used to address these factors are: descriptive and evaluative feedback, arguments, modeling, goal setting, planning, barrier identification and advice on how to deal with barriers, stimulating resistance to social pressure, mobilization of social support (nontailored, active learning (nontailored and iterative feedback. In the EI-tailoring intervention, the material is additionally tailored to ethnic identity (EI. This means that recipients who feel strongly attached to their ethnic background receive different intervention material than recipients with a weak attachment to their background. This includes, for instance, the use of more traditional colors, role models that match with their origin and advice messages that refer to their ethnicity of origin. Discussion Developing an intervention that matches the needs of this specific target population was challenging due to

  15. Nutrition training improves health workers' nutrition knowledge and competence to manage child undernutrition: a systematic review.

    Science.gov (United States)

    Sunguya, Bruno F; Poudel, Krishna C; Mlunde, Linda B; Urassa, David P; Yasuoka, Junko; Jimba, Masamine

    2013-09-24

    Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on health workers' nutrition knowledge, counseling skills, and child undernutrition management practices. We conducted a literature search on nutrition interventions from PubMed/MEDLINE, CINAHL, EMBASE, ISI Web of Knowledge, and World Health Organization regional databases. The outcome variables were nutrition knowledge, nutrition-counseling skills, and undernutrition management practices of health workers. Due to heterogeneity, we conducted only descriptive analyses. Out of 3910 retrieved articles, 25 were selected as eligible for the final analysis. A total of 18 studies evaluated health workers' nutrition knowledge and showed improvement after training. A total of 12 studies with nutrition counseling as the outcome variable also showed improvement among the trained health workers. Sixteen studies evaluated health workers' child undernutrition management practices. In all such studies, child undernutrition management practices and competence of health workers improved after the nutrition training intervention. In-service nutrition training improves quality of health workers by rendering them more knowledge and competence to manage nutrition-related conditions, especially child undernutrition. In-service nutrition training interventions can help to fill the gap created by the lack of adequate nutrition training in the existing medical and nursing education system. In this way, steps can be taken toward improving the overall nutritional status of the child population.

  16. Tailoring nutritional and process variables for hyperproduction of catalase from a novel isolated bacterium Geobacillus sp. BSS-7.

    Science.gov (United States)

    Kauldhar, Baljinder Singh; Sooch, Balwinder Singh

    2016-01-14

    Catalase (EC 1.11.1.6) is one of the important industrial enzyme employed in diagnostic and analytical methods in the form of biomarkers and biosensors in addition to their enormous applications in textile, paper, food and pharmaceutical sectors. The present study demonstrates the utility of a newly isolated and adapted strain of genus Geobacillus possessing unique combination of several industrially important extremophilic properties for the hyper production of catalase. The bacterium can grow over a wide range of pH (3-12) and temperature (10-90 °C) with extraordinary capability to produce catalase. A novel extremophilic strain belonging to genus Geobacillus was exploited for the production of catalase by tailoring its nutritional requirements and process variables. One variable at a time traditional approach followed by computational designing was applied to customize the fermentation process. A simple fermentation media containing only three components namely sucrose (0.55 %, w/v), yeast extract (1.0 %, w/v) and BaCl2 (0.08 %, w/v) was designed for the hyperproduction of catalase. A controlled and optimum air supply caused a tremendous increase in the enzyme production on moving the bioprocess from the flask to bioreactor level. The present paper reports high quantum of catalase production (105,000 IU/mg of cells) in a short fermentation time of 12 h. To the best of our knowledge, there is no report in the literature that matches the performance of the developed protocol for the catalase production. This is the first serious study covering intracellular catalase production from thermophilic genus Geobacillus. An increase in intracellular catalase production by 214.72 % was achieved in the optimized medium when transferred from the shake flask to the fermenter level. The extraordinary high production of catalase from Geobacillus sp. BSS-7 makes the isolated strain a prospective candidate for bulk catalase production on an industrial scale.

  17. The impact of student diversity on interest, design, and promotion of Web-based tailored nutrition and physical activity programs for community colleges.

    Science.gov (United States)

    Quintiliani, Lisa M; De Jesus, Maria; Wallington, Sherrie Flynt

    2011-01-01

    To examine an organizational level perspective of the process of adopting Web-based tailored nutrition and physical activity programs for community college students. In this qualitative study, 21 individual key informant interviews of community college student services and health center administrators were used to examine organizational-level perceptions of interest in, design characteristics of, and ways to promote health programs. A cross-classification matrix of a priori and emergent themes related to student diversity was created to describe cross-cutting patterns. Findings revealed 5 emergent themes for consideration in program development related to student diversity: (1) multiple roles played by students, (2) limited access to financial resources, (3) varied student demographics, (4) different levels of understanding, and (5) commuting to campus. Nutrition and physical activity programs for community colleges need to specifically address the diverse nature of their students to increase the potential of adoption. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  18. Nutrition in peri-operative esophageal cancer management.

    Science.gov (United States)

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

    2017-07-01

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

  19. Management of Hyperglycemia During Enteral and Parenteral Nutrition Therapy

    Science.gov (United States)

    Umpierrez, Guillermo E.

    2013-01-01

    Hyperglycemia is a frequent complication of enteral and parenteral nutrition in hospitalized patients. Extensive evidence from observational studies indicates that the development of hyperglycemia during parenteral and enteral nutrition is associated with an increased risk of death and infectious complications. There are no specific guidelines recommending glycemic targets and effective strategies for the management of hyperglycemia during specialized nutritional support. Managing hyperglycemia in these patients should include optimization of carbohydrate content and administration of intravenous or subcutaneous insulin therapy. The administration of continuous insulin infusion and insulin addition to nutrition bag are efficient approaches to control hyperglycemia during parenteral nutrition. Subcutaneous administration of long-acting insulin with scheduled or corrective doses of short-acting insulin is superior to the sliding scale insulin strategy in patients receiving enteral feedings. Randomized controlled studies are needed to evaluate safe and effective therapeutic strategies for the management of hyperglycemia in patients receiving nutritional support. PMID:23065369

  20. Short- and medium-term efficacy of a Web-based computer-tailored nutrition education intervention for adults including cognitive and environmental feedback: randomized controlled trial.

    Science.gov (United States)

    Springvloet, Linda; Lechner, Lilian; de Vries, Hein; Candel, Math J J M; Oenema, Anke

    2015-01-19

    Web-based, computer-tailored nutrition education interventions can be effective in modifying self-reported dietary behaviors. Traditional computer-tailored programs primarily targeted individual cognitions (knowledge, awareness, attitude, self-efficacy). Tailoring on additional variables such as self-regulation processes and environmental-level factors (the home food environment arrangement and perception of availability and prices of healthy food products in supermarkets) may improve efficacy and effect sizes (ES) of Web-based computer-tailored nutrition education interventions. This study evaluated the short- and medium-term efficacy and educational differences in efficacy of a cognitive and environmental feedback version of a Web-based computer-tailored nutrition education intervention on self-reported fruit, vegetable, high-energy snack, and saturated fat intake compared to generic nutrition information in the total sample and among participants who did not comply with dietary guidelines (the risk groups). A randomized controlled trial was conducted with a basic (tailored intervention targeting individual cognition and self-regulation processes; n=456), plus (basic intervention additionally targeting environmental-level factors; n=459), and control (generic nutrition information; n=434) group. Participants were recruited from the general population and randomly assigned to a study group. Self-reported fruit, vegetable, high-energy snack, and saturated fat intake were assessed at baseline and at 1- (T1) and 4-months (T2) postintervention using online questionnaires. Linear mixed model analyses examined group differences in change over time. Educational differences were examined with group×time×education interaction terms. In the total sample, the basic (T1: ES=-0.30; T2: ES=-0.18) and plus intervention groups (T1: ES=-0.29; T2: ES=-0.27) had larger decreases in high-energy snack intake than the control group. The basic version resulted in a larger decrease in

  1. Change in quality management in diabetes care groups and outpatient clinics after feedback and tailored support.

    Science.gov (United States)

    Campmans-Kuijpers, Marjo J; Baan, Caroline A; Lemmens, Lidwien C; Rutten, Guy E

    2015-02-01

    To assess the change in level of diabetes quality management in primary care groups and outpatient clinics after feedback and tailored support. This before-and-after study with a 1-year follow-up surveyed quality managers on six domains of quality management. Questionnaires measured organization of care, multidisciplinary teamwork, patient centeredness, performance results, quality improvement policy, and management strategies (score range 0-100%). Based on the scores, responders received feedback and a benchmark and were granted access to a toolbox of quality improvement instruments. If requested, additional support in improving quality management was available, consisting of an elucidating phone call or a visit from an experienced consultant. After 1 year, the level of quality management was measured again. Of the initially 60 participating care groups, 51 completed the study. The total quality management score improved from 59.8% (95% CI 57.0-62.6%) to 65.1% (62.8-67.5%; P quality management score (P = 0.001). Of the 44 participating outpatient clinics, 28 completed the study. Their total score changed from 65.7% (CI 60.3-71.1%) to 67.3% (CI 62.9-71.7%; P = 0.30). Only the results in the domain multidisciplinary teamwork improved (P = 0.001). Measuring quality management and providing feedback and a benchmark improves the level of quality management in care groups but not in outpatient clinics. The questionnaires might also be a useful asset for other diabetes care groups, such as Accountable Care Organizations. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  2. Assessing nurses’ knowledge levels in the nutritional management of diabetes

    Directory of Open Access Journals (Sweden)

    Victor Mogre

    2015-01-01

    Full Text Available Although nutrition education for diabetes patients is the responsibility of dieticians and/or nutritionist, nurses have an important role to play. This study measured the knowledge level of nurses’ and associated factors in the nutritional management of diabetes. In this cross-sectional study a sample of 200 nurses completed a 21-item nutritional management of diabetes knowledge test developed based on the ADA and WHO guidelines for the nutritional management of diabetes. Using Cronbach's alpha, reliability was 0.62. The nurses (n = 200 had almost a 1:1 male to female ratio (n = 99, 49.5% and n = 101, 50.5% and a mean age of 27.24 ± 3.66 years. Total mean score was 12.13 ± 3.17 (44.9% correct. Over 70% of the nurses said diabetes patients could exclude any of the major nutrients from their meals. Almost 90% (n = 179 of the nurses did not know the recommended daily caloric intake of carbohydrates for diabetes patients. Higher mean scores were found in nurses who have ever had a refresher course in nutrition, ever counseled a diabetes patient and took 2–3 nutrition courses during school. Nurses’ knowledge in the nutritional management of diabetes was poor. It raises questions about the adequacy of nurses’ knowledge in the nutritional management of diabetes.

  3. Nutritional-related diseases and management: newspaper ...

    African Journals Online (AJOL)

    The study showed that many people are ignorant of the importance of eating a balanced diet and eating right to prevent nutritional diseases. This is why the newspapers topics or health tips on diet and nutrition had the highest percentage frequency, because of its importance the needed emphasis it requires. Therefore, it is ...

  4. Thailand's National Nutritional Program : Lessons in Management and Capacity Development

    OpenAIRE

    Heaver, Richard; Kachondam, Yongyout

    2002-01-01

    Thailand's community nutrition program has been the most successful in Asia. This paper looks at what made it work from a management and capacity development point of view. Key lessons are identified in the following areas: Building a strong consensus at national and local levels about the importance of nutrition as an investment in the country's future, rather than as a welfare expenditur...

  5. Nutritional evaluation and management of AKI patients.

    Science.gov (United States)

    Fiaccadori, Enrico; Maggiore, Umberto; Cabassi, Aderville; Morabito, Santo; Castellano, Giuseppe; Regolisti, Giuseppe

    2013-05-01

    Protein-energy wasting is common in patients with acute kidney injury (AKI) and represents a major negative prognostic factor. Nutritional support as parenteral and/or enteral nutrition is frequently needed because the early phases of this are often a highly catabolic state, although the optimal nutritional requirements and nutrient intake composition remain a partially unresolved issue. Nutrient needs of patients with AKI are highly heterogeneous, depending on different pathogenetic mechanisms, catabolic rate, acute and chronic comorbidities, and renal replacement therapy (RRT) modalities. Thus, quantitative and qualitative aspects of nutrient intake should be frequently evaluated in this clinical setting to achieve better individualization of nutritional support, to integrate nutritional support with RRT, and to avoid under- and overfeeding. Moreover, AKI is now considered a kidney-centered inflammatory syndrome; indeed, recent experimental data indicate that specific nutrients with anti-inflammatory effects could play an important role in the prevention of renal function loss after an episode of AKI. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  6. Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management

    OpenAIRE

    Wakabayashi, Hidetaka; Sakuma, Kunihiro

    2014-01-01

    Malnutrition and sarcopenia often occur in rehabilitation settings. The prevalence of malnutrition and sarcopenia in older patients undergoing rehabilitation is 49–67 % and 40–46.5 %, respectively. Malnutrition and sarcopenia are associated with poorer rehabilitation outcome and physical function. Therefore, a combination of both rehabilitation and nutrition care management may improve outcome in disabled elderly with malnutrition and sarcopenia. The concept of rehabilitation nutrition as a c...

  7. Managing health and safety risks: Implications for tailoring health and safety management system practices.

    Science.gov (United States)

    Willmer, D R; Haas, E J

    2016-01-01

    As national and international health and safety management system (HSMS) standards are voluntarily accepted or regulated into practice, organizations are making an effort to modify and integrate strategic elements of a connected management system into their daily risk management practices. In high-risk industries such as mining, that effort takes on added importance. The mining industry has long recognized the importance of a more integrated approach to recognizing and responding to site-specific risks, encouraging the adoption of a risk-based management framework. Recently, the U.S. National Mining Association led the development of an industry-specific HSMS built on the strategic frameworks of ANSI: Z10, OHSAS 18001, The American Chemistry Council's Responsible Care, and ILO-OSH 2001. All of these standards provide strategic guidance and focus on how to incorporate a plan-do-check-act cycle into the identification, management and evaluation of worksite risks. This paper details an exploratory study into whether practices associated with executing a risk-based management framework are visible through the actions of an organization's site-level management of health and safety risks. The results of this study show ways that site-level leaders manage day-to-day risk at their operations that can be characterized according to practices associated with a risk-based management framework. Having tangible operational examples of day-to-day risk management can serve as a starting point for evaluating field-level risk assessment efforts and their alignment to overall company efforts at effective risk mitigation through a HSMS or other processes.

  8. 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

  9. Connecting Health and Technology (CHAT): protocol of a randomized controlled trial to improve nutrition behaviours using mobile devices and tailored text messaging in young adults

    Science.gov (United States)

    2012-01-01

    Background Increasing intakes of fruits and vegetables intake, in tandem with reducing consumption of energy-dense and nutrient poor foods and beverages are dietary priorities to prevent chronic disease. Although most adults do not eat enough fruit and vegetables, teenagers and young adults tend to have the lowest intakes. Young adults typically consume a diet which is inconsistent with the dietary recommendations. Yet little is known about the best approaches to improve dietary intakes and behaviours among this group. This randomised controlled trial aims to evaluate the effectiveness of using a mobile device to assess dietary intake, provide tailored dietary feedback and text messages to motivate changes in fruit, vegetable and junk food consumption among young adults. Methods/design The CHAT project will involve the development of the mobile device food record (MDFR), and evaluation of dietary feedback and implementation of a 6-month intervention in young adults aged 18 to 30 years. The participants will be randomly assigned to one of three groups (1) Intervention Group 1: MDFR + Text Messages + Dietary Feedback; (2) Intervention Group 2: MDFR + Dietary Feedback; (3) Control Group 3: MDFR, no feedback. All groups will undertake a 3-day dietary record using the MDFR but only the Intervention Groups 1 and 2 will receive tailored dietary feedback at baseline and at 6-months which will consist of assessment of serves of fruits, vegetables and junk food in comparison to dietary recommendations. Tailored nutrition text messages will be sent to Intervention Group 1 over the 6 months. Data will be collected at baseline and again at the 6-month completion. Discussion This trial will test if applications running on mobile devices have potential to assess diet, provide tailored feedback and nutrition messages as an effective way of improving fruit and vegetable consumption and reducing energy-dense nutrient poor foods in young adults. The CHAT project will assess the

  10. Connecting Health and Technology (CHAT): protocol of a randomized controlled trial to improve nutrition behaviours using mobile devices and tailored text messaging in young adults.

    Science.gov (United States)

    Kerr, Deborah A; Pollard, Christina M; Howat, Peter; Delp, Edward J; Pickering, Mark; Kerr, Katherine R; Dhaliwal, Satvinder S; Pratt, Iain S; Wright, Janine; Boushey, Carol J

    2012-06-22

    Increasing intakes of fruits and vegetables intake, in tandem with reducing consumption of energy-dense and nutrient poor foods and beverages are dietary priorities to prevent chronic disease. Although most adults do not eat enough fruit and vegetables, teenagers and young adults tend to have the lowest intakes. Young adults typically consume a diet which is inconsistent with the dietary recommendations. Yet little is known about the best approaches to improve dietary intakes and behaviours among this group. This randomised controlled trial aims to evaluate the effectiveness of using a mobile device to assess dietary intake, provide tailored dietary feedback and text messages to motivate changes in fruit, vegetable and junk food consumption among young adults. The CHAT project will involve the development of the mobile device food record (MDFR), and evaluation of dietary feedback and implementation of a 6-month intervention in young adults aged 18 to 30 years. The participants will be randomly assigned to one of three groups (1) Intervention Group 1: MDFR + Text Messages + Dietary Feedback; (2) Intervention Group 2: MDFR + Dietary Feedback; (3) Control Group 3: MDFR, no feedback. All groups will undertake a 3-day dietary record using the MDFR but only the Intervention Groups 1 and 2 will receive tailored dietary feedback at baseline and at 6-months which will consist of assessment of serves of fruits, vegetables and junk food in comparison to dietary recommendations. Tailored nutrition text messages will be sent to Intervention Group 1 over the 6 months. Data will be collected at baseline and again at the 6-month completion. This trial will test if applications running on mobile devices have potential to assess diet, provide tailored feedback and nutrition messages as an effective way of improving fruit and vegetable consumption and reducing energy-dense nutrient poor foods in young adults. The CHAT project will assess the impact of the intervention on behavioural

  11. Connecting Health and Technology (CHAT: protocol of a randomized controlled trial to improve nutrition behaviours using mobile devices and tailored text messaging in young adults

    Directory of Open Access Journals (Sweden)

    Kerr Deborah A

    2012-06-01

    Full Text Available Abstract Background Increasing intakes of fruits and vegetables intake, in tandem with reducing consumption of energy-dense and nutrient poor foods and beverages are dietary priorities to prevent chronic disease. Although most adults do not eat enough fruit and vegetables, teenagers and young adults tend to have the lowest intakes. Young adults typically consume a diet which is inconsistent with the dietary recommendations. Yet little is known about the best approaches to improve dietary intakes and behaviours among this group. This randomised controlled trial aims to evaluate the effectiveness of using a mobile device to assess dietary intake, provide tailored dietary feedback and text messages to motivate changes in fruit, vegetable and junk food consumption among young adults. Methods/design The CHAT project will involve the development of the mobile device food record (MDFR, and evaluation of dietary feedback and implementation of a 6-month intervention in young adults aged 18 to 30 years. The participants will be randomly assigned to one of three groups (1 Intervention Group 1: MDFR + Text Messages + Dietary Feedback; (2 Intervention Group 2: MDFR + Dietary Feedback; (3 Control Group 3: MDFR, no feedback. All groups will undertake a 3-day dietary record using the MDFR but only the Intervention Groups 1 and 2 will receive tailored dietary feedback at baseline and at 6-months which will consist of assessment of serves of fruits, vegetables and junk food in comparison to dietary recommendations. Tailored nutrition text messages will be sent to Intervention Group 1 over the 6 months. Data will be collected at baseline and again at the 6-month completion. Discussion This trial will test if applications running on mobile devices have potential to assess diet, provide tailored feedback and nutrition messages as an effective way of improving fruit and vegetable consumption and reducing energy-dense nutrient poor foods in young adults. The CHAT

  12. Nutrition and Hyperglycemia Management in the Inpatient Setting (Meals on Demand, Parenteral, or Enteral Nutrition).

    Science.gov (United States)

    Drincic, Andjela T; Knezevich, Jon T; Akkireddy, Padmaja

    2017-08-01

    The goal of this paper is to provide the latest evidence and expert recommendations for management of hospitalized patients with diabetes or hyperglycemia receiving enteral (EN), parenteral (PN) nutrition support or, those with unrestricted oral diet, consuming meals on demand. Patients with and without diabetes mellitus commonly develop hyperglycemia while receiving EN or PN support, placing them at increased risk of adverse outcomes, including in-hospital mortality. Very little new evidence is available in the form of randomized controlled trials (RCT) to guide the glycemic management of these patients. Reduction in the dextrose concentration within parenteral nutrition as well as selection of an enteral formula that diminishes the carbohydrate exposure to a patient receiving enteral nutrition are common strategies utilized in practice. No specific insulin regimen has been shown to be superior in the management of patients receiving EN or PN nutrition support. For those receiving oral nutrition, new challenges have been introduced with the most recent practice allowing patients to eat meals on demand, leading to extreme variability in carbohydrate exposure and risk of hypo and hyperglycemia. Synchronization of nutrition delivery with the astute use of intravenous or subcutaneous insulin therapy to match the physiologic action of insulin in patients receiving nutritional support should be implemented to improve glycemic control in hospitalized patients. Further RCTs are needed to evaluate glycemic and other clinical outcomes of patients receiving nutritional support. For patients eating meals on demand, development of hospital guidelines and policies are needed, ensuring optimization and coordination of meal insulin delivery in order to facilitate patient safety.

  13. Nutritional management of a critically injured patient

    African Journals Online (AJOL)

    of the right leg were considered borderline in terms of viability, and fasciotomies ..... lymphoid tissue, are affected by the type and route of nutrition.8,9 The adverse ... formulations as an effective means of stress ulcer prophylaxis.8. Optimal ...

  14. Nutritional Management of Acute Diarrhea in Infants and Children.

    Science.gov (United States)

    National Academy of Sciences-National Research Council, Washington, DC. Food and Nutrition Board.

    Written primarily for health professionals advising on programs and policy related to nutrition and diarrhea therapy, this report is aimed at management of diarrhea in less-developed countries, but its information and technical insights are relevant to an understanding of diarrhea and its management throughout the world. Technical in orientation…

  15. Planned development and evaluation protocol of two versions of a web-based computer-tailored nutrition education intervention aimed at adults, including cognitive and environmental feedback.

    Science.gov (United States)

    Springvloet, Linda; Lechner, Lilian; Oenema, Anke

    2014-01-17

    Despite decades of nutrition education, the prevalence of unhealthy dietary patterns is still high and inequalities in intake between high and low socioeconomic groups still exist. Therefore, it is important to innovate and improve existing nutrition education interventions. This paper describes the development, design and evaluation protocol of a web-based computer-tailored nutrition education intervention for adults targeting fruit, vegetable, high-energy snack and fat intake. This intervention innovates existing computer-tailored interventions by not only targeting motivational factors, but also volitional and self-regulation processes and environmental-level factors. The intervention development was guided by the Intervention Mapping protocol, ensuring a theory-informed and evidence-based intervention. Two versions of the intervention were developed: a basic version targeting knowledge, awareness, attitude, self-efficacy and volitional and self-regulation processes, and a plus version additionally addressing the home environment arrangement and the availability and price of healthy food products in supermarkets. Both versions consist of four modules: one for each dietary behavior, i.e. fruit, vegetables, high-energy snacks and fat. Based on the self-regulation phases, each module is divided into three sessions. In the first session, feedback on dietary behavior is provided to increase awareness, feedback on attitude and self-efficacy is provided and goals and action plans are stated. In the second session goal achievement is evaluated, reasons for failure are explored, coping plans are stated and goals can be adapted. In the third session, participants can again evaluate their behavioral change and tips for maintenance are provided. Both versions will be evaluated in a three-group randomized controlled trial with measurements at baseline, 1-month, 4-months and 9-months post-intervention, using online questionnaires. Both versions will be compared with a generic

  16. The (cost-effectiveness of an individually tailored long-term worksite health promotion programme on physical activity and nutrition: design of a pragmatic cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Burdorf Alex

    2007-09-01

    Full Text Available Abstract Background Cardiovascular disease is the leading cause of disability and mortality in most Western countries. The prevalence of several risk factors, most notably low physical activity and poor nutrition, is very high. Therefore, lifestyle behaviour changes are of great importance. The worksite offers an efficient structure to reach large groups and to make use of a natural social network. This study investigates a worksite health promotion programme with individually tailored advice in physical activity and nutrition and individual counselling to increase compliance with lifestyle recommendations and sustainability of a healthy lifestyle. Methods/Design The study is a pragmatic cluster randomised controlled trial with the worksite as the unit of randomisation. All workers will receive a standard worksite health promotion program. Additionally, the intervention group will receive access to an individual Health Portal consisting of four critical features: a computer-tailored advice, a monitoring function, a personal coach, and opportunities to contact professionals at request. Participants are employees working for companies in the Netherlands, being literate enough to read and understand simple Internet-based messages in the Dutch language. A questionnaire to assess primary outcomes (compliance with national recommendations on physical activity and on fruit and vegetable intake will take place at baseline and after 12 and 24 months. This questionnaire also assesses secondary outcomes including fat intake, self-efficacy and self-perceived barriers on physical activity and fruit and vegetable intake. Other secondary outcomes, including a cardiovascular risk profile and physical fitness, will be measured at baseline and after 24 months. Apart from the effect evaluation, a process evaluation will be carried out to gain insight into participation and adherence to the worksite health promotion programme. A cost-effectiveness analysis and

  17. Effect of locally tailored labour management guidelines on intrahospital stillbirths and birth asphyxia at the referral hospital of Zanzibar

    DEFF Research Database (Denmark)

    Maaløe, N.; Housseine, N.; Meguid, T.

    2018-01-01

    Objective: To evaluate effect of locally tailored labour management guidelines (PartoMa guidelines) on intrahospital stillbirths and birth asphyxia. Design: Quasi-experimental pre-post study investigating the causal pathway through changes in clinical practice. Setting: Tanzanian low-resource ref......Objective: To evaluate effect of locally tailored labour management guidelines (PartoMa guidelines) on intrahospital stillbirths and birth asphyxia. Design: Quasi-experimental pre-post study investigating the causal pathway through changes in clinical practice. Setting: Tanzanian low......-resource referral hospital, Mnazi Mmoja Hospital.Population: Facility deliveries during baseline (1 October 2014 until 31 January 2015) and the 9th to 12th intervention month (1 October 2014 until 31 January 2015). Methods: Birth outcome was extracted from all cases of labouring women during baseline (n = 3690...

  18. RELATIONSHIP MARKETING RESEARCH TAILORED TO SUPPORT SALES MANAGEMENT. CASE STUDY: AN INTERNATIONAL EXPRESS LOGISTICS COMPANY IN ROMANIA

    OpenAIRE

    Pop Nicolae Alexandru; Mihoc Florin; Fotea Ioan Stefan

    2010-01-01

    Within current economy context, complexities and particularities most companies are constantly seeking to maximize effectiveness and efficiency of their business. As sales force represents for most organizations their “spearheds”and direct contact with the market, its management can be a source for customer satisfaction and overall efficiency. Relationship marketing research with all its particularities and dimensions, if tailored appropriately can explicitly pinpoint major sources of custome...

  19. Improving Distress in Dialysis (iDiD):A tailored CBT self-management treatment for dialysis patients

    OpenAIRE

    Hudson, Joanna L; Moss-Morris, Rona; Game, David; Carroll, Amy; Chilcot, Joseph

    2016-01-01

    BackgroundThere is significant psychological distress in adults with end-stage kidney disease (ESKD). However, psychological treatments tailored to address the unique challenges of kidney failure are absent. We identified psychological correlates of distress in ESKD to develop a cognitive-behavioural therapy (CBT) treatment protocol that integrates the mental health needs of patients alongside their illness self-management demands.MethodsStudies which examined relationships between distress a...

  20. Nutritional management of a patient with an open abdomen

    African Journals Online (AJOL)

    2014-08-14

    Aug 14, 2014 ... Keywords: nutritional, management, open abdomen. Introduction ... lower than required energy intake (25 kCal/kg), and increasing it to target over the ..... Trauma and surgery lead to an intense inflammatory response and possible ... state, characterised by muscle breakdown, acute protein malnutrition ...

  1. Managing Food Allergies at School: School Nutrition Professionals

    Centers for Disease Control (CDC) Podcasts

    2015-01-13

    This podcast highlights the role of school nutrition professionals in the management of food allergies in schools. It also identifies CDC food allergy resources for schools.  Created: 1/13/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/13/2015.

  2. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets.

    Science.gov (United States)

    Munns, Craig F; Shaw, Nick; Kiely, Mairead; Specker, Bonny L; Thacher, Tom D; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary; Högler, Wolfgang

    2016-02-01

    Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required.

  3. Tailored treatment strategies : a new approach for modern management of atrial fibrillation

    NARCIS (Netherlands)

    Van Gelder, I. C.; Hobbelt, A. H.; Marcos, E. G.; Schotten, U.; Cappato, R.; Lewalter, T.; Schwieler, J.; Rienstra, M.; Boriani, G.

    Atrial fibrillation (AF) is not benign. Cardiovascular diseases and risk factors differ importantly amongst patients. Careful phenotyping with the aim to start tailored therapy may improve outcome and quality of life. Furthermore, structural remodelling plays an important role in initiation and

  4. Tailoring wheat management to ENSO phases for increased wheat production in Paraguay

    Directory of Open Access Journals (Sweden)

    Melissa A. Ramirez-Rodrigues

    2014-01-01

    Full Text Available Reported regional wheat yields in Paraguay vary from 1 to 3 t/ha from year to year, but appear not to be correlated with El Niño-Southern Oscillation (ENSO phases. Historical weather data from two locations in representative wheat-growing regions of Paraguay, Encarnación-Itapúa and Ciudad del Este-Alto Paraná combined with crop modeling, were analyzed to optimize nitrogen (N fertilizer application rates according to the ENSO phase of a growing season. The ENSO phase of a growing season was defined based on the average of the sea surface temperature (SST anomalies in the Eastern Equatorial Pacific region for the period June–October using the El Niño region 3.0 index (Niño 3.0. Simulated average yields in Alto Paraná were higher in the drier and cooler La Niña wheat-growing seasons (average of 3.5 t/ha compared to the other phases (average of 3.2 t/ha and in Itapúa, in Neutral seasons (average of 3.8 t/ha compared to the other phases (average of 3.7 t/ha. Accordingly, optimal N fertilizer applications ranged between 20 and 60 kg N/ha between phases depending on the sowing date, soil type and initial amount of soil water content. Applying an ENSO or General Circulation Model (GCM-based forecast for ENSO-season-type specific N fertilizer applications resulted in benefits of >100 US$/ha when compared with current farmers’ practice of consistently low N fertilizer applications in Paraguay. When N management based on forecasts was compared with optimized N application without forecast, the benefits of the forecast was only up to 8 US$/ha. The ENSO-persistence-based forecast showed higher values than the GCM-based forecasts with two lead-times but lower skill. Using climate information can significantly increase current wheat yields and gross margins in Paraguay by tailoring N fertilizer applications to the Niño 3.0-defined ENSO phases, which can be forecasted with moderate skill at the beginning of the growing season.

  5. 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.

  6. Tailored Communication Within Mobile Apps for Diabetes Self-Management: A Systematic Review.

    Science.gov (United States)

    Holmen, Heidi; Wahl, Astrid Klopstad; Cvancarova Småstuen, Milada; Ribu, Lis

    2017-06-23

    The prevalence of diabetes is increasing and with the requirements for self-management and risk of late complications, it remains a challenge for the individual and society. Patients can benefit from support from health care personnel in their self-management, and the traditional communication between patients and health care personnel is changing. Smartphones and apps offer a unique platform for communication, but apps with integrated health care personnel communication based on patient data are yet to be investigated to provide evidence of possible effects. Our goal was to systematically review studies that aimed to evaluate integrated communication within mobile apps for tailored feedback between patients with diabetes and health care personnel in terms of (1) study characteristics, (2) functions, (3) study outcomes, (4) effects, and (5) methodological quality. A systematic literature search was conducted following our International Prospective Register of Systematic Reviews (PROSPERO) protocol, searching for apps with integrated communication for persons with diabetes tested in a controlled trial in the period 2008 to 2016. We searched the databases PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central, Excerpta Medica database (EMBASE), ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform. The search was closed in September 2016. Reference lists of primary articles and review papers were assessed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we applied the Cochrane risk of bias tool to assess methodological quality. We identified 2822 citations and after duplicate removal, we assessed 1128 citations. A total of 6 papers were included in this systematic review, reporting on data from 431 persons participating in small trials of short

  7. Nutritional management of Eosinophilic Gastroenteropathies: Case series from the community

    Directory of Open Access Journals (Sweden)

    Basilious Alfred

    2011-05-01

    Full Text Available Abstract Eosinophilic gastroenteropathies, such as eosinophilic esophagitis and eosinophilic colitis, have classically been treated with swallowed inhaled corticosteroids or oral corticosteroids. More recent studies have found elimination and elemental diets to be effective treatment alternatives to steroids. In this case series we describe the treatment of three children using nutritional management in a community setting. Elimination diets and elemental diets based on patch testing and skin prick tests reduced the eosinophil counts to normal levels in all three children. Food items which tested positive were then reintroduced while symptoms and eosinophil counts were monitored. Nutritional management of eosinophilic esophagitis and eosinophilic colitis was found to be effective in reducing symptoms. However, obstacles facing patients who choose this type of therapy include limitations due to the cost of repeated endoscopies, palatability of elimination/elemental diets and the availability of subspecialists trained in management (e.g. Allergy, Gastroenterology, and Pathology. It may be a worthwhile endeavour to overcome these obstacles as nutritional management minimizes the potential long-term effects of chronic steroid therapy.

  8. Randomised controlled trial of tailored interventions to improve the management of anxiety and depressive disorders in primary care

    Directory of Open Access Journals (Sweden)

    Terluin Berend

    2011-07-01

    Full Text Available Abstract Background Anxiety and depressive disorders are highly prevalent disorders and are mostly treated in primary care. The management of these disorders by general practitioners is not always consistent with prevailing guidelines because of a variety of factors. Designing implementation strategies tailored to prospectively identified barriers could lead to more guideline-recommended care. Although tailoring of implementation strategies is promoted in practice, little is known about the effect on improving the quality of care for the early recognition, diagnosis, and stepped care treatment allocation in patients with anxiety or depressive disorders in general practice. This study examines whether the tailored strategy supplemented with training and feedback is more effective than providing training and feedback alone. Methods In this cluster randomised controlled trial, a total of 22 general practices will be assigned to one of two conditions: (1 training, feedback, and tailored interventions and (2 training and feedback. The primary outcome measure is the proportion of patients who have been recognised to have anxiety and/or depressive disorder. The secondary outcome measures in patients are severity of anxiety and depressive symptoms, level of functioning, expectation towards and experience with care, quality of life, and economic costs. Measures are taken after the start of the intervention at baseline and at three- and six-month follow-ups. Secondary outcome measures in general practitioners are adherence to guideline-recommended care in care that has been delivered, the proportion of antidepressant prescriptions, and number of referrals to specialised mental healthcare facilities. Data will be gathered from the electronic medical patient records from the patients included in the study. In a process evaluation, the identification of barriers to change and the relations between prospectively identified barriers and improvement

  9. Advances in the nutritional and pharmacological management of phenylketonuria

    Science.gov (United States)

    Ney, Denise M.; Blank, Robert D.; Hansen, Karen E.

    2014-01-01

    Structural Abstract Purpose of review The purpose is to discuss advances in the nutritional and pharmacological management of phenylketonuria (PKU). Recent findings Glycomacropeptide (GMP), a whey protein produced during cheese production, is a low-phe intact protein that represents a new dietary alternative to synthetic amino acids (AAs) for people with PKU. Skeletal fragility is a long-term complication of PKU that based on murine research, appears to result from both genetic and nutritional factors. Skeletal fragility in murine PKU is attenuated with the GMP diet, compared with an AA diet, allowing greater radial bone growth. Pharmacologic therapy with tetrahydrobiopterin (BH4), acting as a molecular chaperone for phenylalanine hydroxylase, increases tolerance to dietary phe in some individuals. Large neutral AAs (LNAA) inhibit phe transport across the intestinal mucosa and blood brain barrier; LNAA are most effective for individuals unable to comply with the low-phe diet. Summary Although a low-phe synthetic AA diet remains the mainstay of PKU management, new nutritional and pharmacological treatment options offer alternative approaches to maintain lifelong low phe concentrations. GMP medical foods provide an alternative to AA formula that may improve bone health, and BH4 permits some individuals with PKU to increase tolerance to dietary phe. Further research is needed to characterize the long-term efficacy of these new approaches for PKU management. PMID:24136088

  10. Organization of managed clinical networking for home parenteral nutrition.

    Science.gov (United States)

    Baxter, Janet P; McKee, Ruth F

    2006-05-01

    Home parenteral nutrition (HPN) is an established treatment for intestinal failure, and organization of HPN is variable throughout the UK and Europe. Managed clinical networking is the single most important feature of the UK National Health Service strategy for acute services in Scotland and has the potential to improve the management of HPN patients. This review addresses the role of managed clinical networking in HPN and compares outcome data between centres. The Scottish HPN Managed Clinical Network has published the main body of the current literature supporting the concept of managed clinical networking in this context. The Network is responsible for the organization and quality assurance of HPN provision in Scotland, and has been established for 5 years. It has captured significant patient data for the purpose of clinical audit and illustrates that this is an effective model for the management of this patient population. This review provides advice for other areas wishing to improve equity of access, and to smooth the patient journey between primary, secondary and tertiary health care in the context of artificial nutrition support.

  11. RELATIONSHIP MARKETING RESEARCH TAILORED TO SUPPORT SALES MANAGEMENT. CASE STUDY: AN INTERNATIONAL EXPRESS LOGISTICS COMPANY IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Fotea Ioan Stefan

    2010-07-01

    Full Text Available Within current economy context, complexities and particularities most companies are constantly seeking to maximize effectiveness and efficiency of their business. As sales force represents for most organizations their “spearheds”and direct contact with the market, its management can be a source for customer satisfaction and overall efficiency. Relationship marketing research with all its particularities and dimensions, if tailored appropriately can explicitly pinpoint major sources of customer satisfaction and dissatisfaction. Focus of contemporary relationship marketing is the customer viewed across lifetime as a profit source and partner rather than on short term for singular transactions. Research findings help the organization better manage its sales force and generate customer satisfaction, retention and loyalty and maximize profits while achieving superior efficiency.

  12. The nutritional management of gastrointestinal tract disorders in companion animals.

    Science.gov (United States)

    Guilford, W G; Matz, M E

    2003-12-01

    Dietary protein, carbohydrates, fats and fibre have marked influences on gastrointestinal tract function and dysfunction. This article reviews the nutritional management of common gastrointestinal disorders in companion animals and introduces some of the current areas of research including probiotics, prebiotics, protein-hydrolysate diets, immunonutrition and dietary fibre. Nutritional management of oesophageal disease revolves around varying the consistency of the diet and feeding the animal from an elevated container. Provision of bowel rest remains the mainstay of the management of acute gastroenteritis but food-based oral rehydration solutions are a useful adjunct. The recommended diet for chronic small bowel diarrhoea is a highly digestible, hypoallergenic, gluten-free, low-lactose and low-fat diet with modest amounts of fermentable fibre. The use of probiotics in the management of diarrhoea in companion animals has not yet been shown to be beneficial. It is likely that prebiotics will prove more effective than probiotics in the prevention of enteropathogenic infections. Approximately 50% of cats in New Zealand that suffer from chronic idiopathic vomiting or diarrhoea will respond to a novel-protein-elimination diet and approximately 30% meet the diagnostic criteria for food sensitivity. Growing evidence supports the use of protein-hydrolysate diets in the management of inflammatory bowel disease and further advances in immunonutrition are expected. The dietary management of colitis should include a hypoallergenic diet with a fermentable fibre source. Manipulation of the diet provides clinicians a powerful therapeutic strategy to be used alone or concurrently with drug therapy in the management of gastrointestinal disorders.

  13. Clinical nutrition managers have access to sources of empowerment.

    Science.gov (United States)

    Mislevy, J M; Schiller, M R; Wolf, K N; Finn, S C

    2000-09-01

    To ascertain perceived access of dietitians to power in the workplace. The conceptual framework was Kanter's theory of organizational power. The Conditions for Work Effectiveness Questionnaire was used to measure perceived access to sources of power: information, support, resources, and opportunities. Demographic data were collected to identify factors that may enhance empowerment. The questionnaire was sent to a random sample of 348 dietitians chosen from members of the Clinical Nutrition Management dietetic practice group of the American Dietetic Association. Blank questionnaires were returned by 99 (28.4%) people not working as clinical nutrition managers, which left 249 in the sample. Descriptive statistics were used to organize and summarize data. One-way analysis of variance and t tests were performed to identify differences in responses based on levels of education, work setting, and information technology skills. Usable questionnaires were received from 178 people (71.5%). On a 5-point scale, scores for access to information (mean +/- standard deviation [SD] = 3.8 +/- 0.7), opportunity (mean +/- SD = 3.6 +/- 0.7), support (mean +/- SD = 3.2 +/- 0.9), and resources (mean +/- SD = 3.1 +/- 0.8) demonstrated that clinical nutrition managers perceived themselves as having substantial access to sources of empowerment. Those having higher levels of education, working in larger hospitals, having better-developed information technology skills, and using information technology more frequently had statistically significant higher empowerment scores (P = leadership roles in today's health care settings. Their power may be enhanced by asserting more pressure to gain greater access to sources of power: support, information, resources, and opportunities.

  14. Assessment and management of nutrition and growth in Rett syndrome

    Science.gov (United States)

    Leonard, Helen; Ravikumara, Madhur; Baikie, Gordon; Naseem, Nusrat; Ellaway, Carolyn; Percy, Alan; Abraham, Suzanne; Geerts, Suzanne; Lane, Jane; Jones, Mary; Bathgate, Katherine; Downs, Jenny

    2014-01-01

    Objectives We developed recommendations for the clinical management of poor growth and weight gain in Rett syndrome through evidence review and the consensus of an expert panel of clinicians. Methods Initial draft recommendations were created based upon literature review and 34 open-ended questions where the literature was lacking. Statements and questions were made available to an international, multi-disciplinary panel of clinicians in an online format and a Microsoft Word formatted version of the draft via email. Input was sought using a 2-stage modified Delphi process to reach consensus agreement. Items included clinical assessment of growth, anthropometry, feeding difficulties and management to increase caloric intake, decrease feeding difficulties and consideration of gastrostomy. Results Agreement was achieved on 101/112 statements. A comprehensive approach to the management of poor growth in Rett syndrome is recommended that takes into account factors such as feeding difficulties and nutritional needs. A BMI of approximately the 25th centile can be considered as a reasonable target in clinical practice. Gastrostomy is indicated for very poor growth, if there is risk of aspiration and if feeding times are prolonged. Conclusions These evidence- and consensus-based recommendations have the potential to improve care of nutrition and growth in a rare condition and stimulate research to improve the current limited evidence base. PMID:24084372

  15. Applicability Evaluation of Job Standards for Diabetes Nutritional Management by Clinical Dietitian.

    Science.gov (United States)

    Baek, Young Jin; Oh, Na Gyeong; Sohn, Cheong-Min; Woo, Mi-Hye; Lee, Seung Min; Ju, Dal Lae; Seo, Jung-Sook

    2017-04-01

    This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical dietitians of 40 tertiary hospitals, 47 general hospitals, and 9 hospitals. Based on each 5-point scale, the importance of overall duty was 4.4 ± 0.5, performance was 3.6 ± 0.8, and difficulty was 3.1 ± 0.7. 'Nutrition intervention' was 4.5 ± 0.5 for task importance, 'nutrition assessment' was 4.0 ± 0.7 for performance, and 'nutrition diagnosis' was 3.4 ± 0.9 for difficulty. These 3 items were high in each category. Based on the grid diagram, the tasks of both high importance and high performance were 'checking basic information,' 'checking medical history and therapy plan,' 'decision of nutritional needs,' 'supply of foods and nutrients,' and 'education of nutrition and self-management.' The tasks with high importance but low performance were 'derivation of nutrition diagnosis,' 'planning of nutrition intervention,' 'monitoring of nutrition intervention process.' The tasks of both high importance and high difficulty were 'derivation of nutrition diagnosis,' 'planning of nutrition intervention,' 'supply of foods and nutrients,' 'education of nutrition and self-management,' and 'monitoring of nutrition intervention process.' The tasks of both high performance and high difficulty were 'documentation of nutrition assessment,' 'supply of foods and nutrients,' and 'education of nutrition and self-management.'

  16. Effectiveness of a tailored intervention to improve cardiovascular risk management in primary care: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Huntink, Elke; Heijmans, Naomi; Wensing, Michel; van Lieshout, Jan

    2013-12-17

    Cardiovascular disease (CVD) is an important worldwide cause of mortality. In The Netherlands, CVD is the leading cause of death for women and the second cause of death for men. Recommendations for diagnosis and treatment of CVD are not well implemented in primary care. In this study, we aim to examine the effectiveness of a tailored implementation program targeted at practice nurses to improve healthcare for patients with (high risk for) CVD. A two-arm cluster randomized trial is planned. We offer practice nurses a tailored program to improve adherence to six specific recommendations related to blood pressure and cholesterol target values, risk profiling and lifestyle advice. Practice nurses are offered training and feedback on their motivational interviewing technique and an e-learning program on cardiovascular risk management (CVRM). They are also advised to screen for the presence and severity of depressive symptoms in patients. We also advise practice nurses to use selected E-health options (selected websites and Twitter-consult) in patients without symptoms of depression. Patients with mild depressive symptoms are referred to a physical exercise group. We recommend referring patients with major depressive symptoms for assessment and treatment of depressive symptoms if appropriate before starting CVRM. Data from 900 patients at high risk of CVD or with established CVD will be collected in 30 general practices in several geographical areas in The Netherlands. The primary outcome measure is performance of practice nurses in CVRM and reflects application of recommendations for personalized counselling and education of CVRM patients. Patients' health-related lifestyles (physical exercise, diet and smoking status) will be measured with validated questionnaires and medical record audit will be performed to document estimated CVD risk. Additionally, we will survey and interview participating healthcare professionals for exploration of processes of change. The control

  17. Nutrition services in managed care: new paradigms for dietitians.

    Science.gov (United States)

    Laramee, S H

    1996-04-01

    Managed care systems are transforming the health care system in the United States. Dietitians will need to review practice opportunities in new and different settings, and develop additional skills to make a successful transition to the transformed health care environment. The shift in health care financing from a fee-for-service model to a capitated system will have the most dramatic impact on the profession. Not all the answers are available, but the focus for the future is clear--customer satisfaction, outcomes research, and cost-effective nutrition services.

  18. Nutritional Management of Overweight and Obesity in Dogs and Cats

    Directory of Open Access Journals (Sweden)

    Sorana Teodora MATEI

    2017-05-01

    Full Text Available Some of the most common nutritional disorders are overweight and obesity, a proportion of approximately 59% of dogs and cats being affected. A permanent challenge for vets is weight management, including the prevention and treatment of overweight and obesity. Corporeal score and body-weight loss in dogs and cats have been monitored by feeding various diets. The study was conducted on a total of 10 animals (6 dogs and 4 cats, monitoring the effect of three types of food for dogs and two types for cats suffering from overweight and obesity.  Cooked food, dry food diet and premium dry food were investigated. We determined the quality and gross chemical composition of food and we measured corporeal score, weekly weight loss percentage and the number of calories consumed daily. We also appreciated the quality of life and activity level of the animals at the beginning and at the end of the trial. Nutritional management of investigated diets for overweight and obesity in dogs and cats revealed that through the smallest caloric restriction, dry food diet presented the highest efficiency, dogs and cats loosing weight steadily without losing muscle mass. Although the satiety effect occurs when the animals reach their ideal weight, the Rebound effect was not present.

  19. Good clinical practice guide for opioids in pain management: the three Ts - titration (trial, tweaking (tailoring, transition (tapering

    Directory of Open Access Journals (Sweden)

    Flaminia Coluzzi

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Achieving good clinical practice in the use of opioids as part of a comprehensive pain management regimen can face significant challenges. Despite guidelines from governmental and pain society/organization sources, there are still significant hurdles. A review of some basic tenets of opioid analgesia based on current published knowledge and experiences about this important healthcare imperative is warranted. CONTENT: Consistent with guidelines, the literature supports using the lowest total opioid dose that provides adequate pain control with the fewest adverse effects. Titration (or trial during opioid initiation is a way of starting low and going slow (and assessing the appropriateness of a specific opioid and formulation. Recognizing that multiple factors contribute to an individual's personal experience of pain, the physical, psychological, social, cultural, spiritual, pharmacogenomic, and behavioral factors of the individual patient should be taken into account (tweaking, or tailoring. Finally, for those patients for whom transition (tapering from opioid is desired, doing so too rapidly can have negative consequences and minimization of problems during this step can be achieved by proper tapering. CONCLUSION: We conclude that a simultaneously aggressive, yet conservative, approach is advocated in the literature in which opioid therapy is divided into three key steps (the 3 T's: titration (or trial, tweaking (or tailoring, and transition (or tapering. Establishment of the 3 T's along with the application of other appropriate good medical practice and clinical experience/judgment, including non-pharmacologic approaches, can assist healthcare providers in the effort to achieve optimal management of pain.

  20. Improving Distress in Dialysis (iDiD): A tailored CBT self-management treatment for patients undergoing dialysis.

    Science.gov (United States)

    Hudson, Joanna L; Moss-Morris, Rona; Game, David; Carroll, Amy; Chilcot, Joseph

    2016-12-01

    There is significant psychological distress in adults with end-stage kidney disease (ESKD). However, psychological treatments tailored to address the unique challenges of kidney failure are absent. We identified psychological correlates of distress in ESKD to develop a cognitive-behavioural therapy (CBT) treatment protocol that integrates the mental health needs of patients alongside their illness self-management demands. Studies which examined relationships between distress and psychological factors that apply in the context of ESKD including: health threats, cognitive illness representations and illness management behaviours were narratively reviewed. Review findings were translated into a CBT formulation model to inform the content of a renal-specific seven session CBT treatment protocol, which was commented on and refined by patient representatives. Health threats related to distress were grouped into four themes including: acute ESKD events, loss of role, uncertainty and illness self-management. Having pessimistic illness and treatment perceptions were associated with elevated distress. Non-adherence and avoidance behaviours were related to feelings of distress, whereas cognitive reappraisal, acceptance, social support and assertiveness were associated with less distress. The dialysis-specific CBT formulation identifies the importance of targeting ESKD-specific correlates of distress to allow the delivery of integrated mental and physical health care. The 'Improving Distress in Dialysis (iDiD)' treatment protocol now requires further evaluation in terms of content, feasibility and potential efficacy. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  1. Minimally invasive and surgical management strategies tailored to the severity of acute diverticulitis.

    LENUS (Irish Health Repository)

    McDermott, F D

    2014-01-01

    The severity of acute diverticulitis ranges from mild, simple inflammation to pericolic abscesses, or perforation with faeculent peritonitis. Treatment of diverticulitis has evolved towards more conservative and minimally invasive strategies. The aim of this review is to highlight recent concepts and advances in management.

  2. 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 ...

  3. Nutrition management for head and neck cancer patients improves clinical outcome and survival.

    Science.gov (United States)

    Müller-Richter, Urs; Betz, C; Hartmann, S; Brands, R C

    2017-12-01

    Up to 80% of patients with head and neck cancers are malnourished because of their lifestyle and the risk factors associated with this disease. Unfortunately, nutrition management systems are not implemented in most head and neck cancer clinics. Even worse, many head and neck surgeons as well as hospital management authorities disregard the importance of nutrition management in head and neck cancer patients. In addition, the often extensive resection and reconstruction required for tumors in the upper aerodigestive tract pose special challenges for swallowing and sufficient food intake, placing special demands on nutrition management. This article presents the basics of perioperative metabolism and nutrition management of head and neck cancer patients and makes recommendations for clinical practice. Implementing a nutrition management system in head and neck cancer clinics will improve the clinical outcome and the survival of the patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Nutritional management of acute pancreatitis in a human ...

    African Journals Online (AJOL)

    2013-08-26

    Aug 26, 2013 ... one-day history of severe abdominal pain and difficulty breathing. In casualty, the ... parenteral nutrition (TPN) was made, and a central venous port (CVP) .... catheter-related sepsis and metabolic disturbances, if nutritional.

  5. [BALANCED SCORECARD AS A MANAGEMENT TOOL IN CLINICAL NUTRITION].

    Science.gov (United States)

    Gutiérrez López, Cristina; Mauriz, Jose L; Culebras, Jesús M

    2015-07-01

    Nowadays, balanced scorecards have updated traditional management systems in the business sector. In this way, Kaplan and Norton propose performance measurement through several perspectives with a logical sequence: internal processes and learning impact client services, so that financial performance is affected. The aim of the present paper is to analyze the main characteristics of balanced scorecard when it is applied to non-for-profit companies and, specifically to the health sector in the clinical nutrition field. This model improves the economic vision of management with clinical indicators that represent healthcare professional's perspective. The balanced scorecard would allow a proper monitoring and tracking system for the main healthcare indicators. This contributes to a better control in comparison with standards that are associated with adequate quality assistance. Owing to the role of management accounting and cost calculations, the definition of healthcare professionals as clients or users, and clinical results relevance, it is necessary to adapt the balanced scorecard to the specific characteristics of the clinical field, redefining both perspectives and indicators. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. Effects of a Tailored Incredible Years Teacher Classroom Management Programme on On-Task Behaviour of School Children with ADHD in Addis Ababa

    Science.gov (United States)

    Mohammed, Feruz

    2018-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is a persistent pattern of behaviours characterized by inattention, hyperactivity and impulsivity. This study evaluates the effects of a tailored Incredible Years Teacher Classroom Management (IYTCM) programme aimed to improve participating children's on-task behaviour in a group of 6 to 10 year old…

  7. Initial nutritional management during noninvasive ventilation and outcomes: a retrospective cohort study.

    Science.gov (United States)

    Terzi, Nicolas; Darmon, Michael; Reignier, Jean; Ruckly, Stéphane; Garrouste-Orgeas, Maïté; Lautrette, Alexandre; Azoulay, Elie; Mourvillier, Bruno; Argaud, Laurent; Papazian, Laurent; Gainnier, Marc; Goldgran-Toledano, Dan; Jamali, Samir; Dumenil, Anne-Sylvie; Schwebel, Carole; Timsit, Jean-François

    2017-11-29

    Patients starting noninvasive ventilation (NIV) to treat acute respiratory failure are often unable to eat and therefore remain in the fasting state or receive nutritional support. Maintaining a good nutritional status has been reported to improve patient outcomes. In the present study, our primary objective was to describe the nutritional management of patients starting first-line NIV, and our secondary objectives were to assess potential associations between nutritional management and outcomes. Observational retrospective cohort study of a prospective database fed by 20 French intensive care units. Adult medical patients receiving NIV for more than 2 consecutive days were included and divided into four groups on the basis of nutritional support received during the first 2 days of NIV: no nutrition, enteral nutrition, parenteral nutrition only, and oral nutrition only. Of the 16,594 patients admitted during the study period, 1075 met the inclusion criteria; of these, 622 (57.9%) received no nutrition, 28 (2.6%) received enteral nutrition, 74 (6.9%) received parenteral nutrition only, and 351 (32.7%) received oral nutrition only. After adjustment for confounders, enteral nutrition (vs. no nutrition) was associated with higher 28-day mortality (adjusted HR, 2.3; 95% CI, 1.2-4.4) and invasive mechanical ventilation needs (adjusted HR, 2.1; 95% CI, 1.1-4.2), as well as with fewer ventilator-free days by day 28 (adjusted relative risk, 0.7; 95% CI, 0.5-0.9). Nearly three-fifths of patients receiving NIV fasted for the first 2 days. Lack of feeding or underfeeding was not associated with mortality. The optimal route of nutrition for these patients needs to be investigated.

  8. A crew resource management program tailored to trauma resuscitation improves team behavior and communication.

    Science.gov (United States)

    Hughes, K Michael; Benenson, Ronald S; Krichten, Amy E; Clancy, Keith D; Ryan, James Patrick; Hammond, Christopher

    2014-09-01

    Crew Resource Management (CRM) is a team-building communication process first implemented in the aviation industry to improve safety. It has been used in health care, particularly in surgical and intensive care settings, to improve team dynamics and reduce errors. We adapted a CRM process for implementation in the trauma resuscitation area. An interdisciplinary steering committee developed our CRM process to include a didactic classroom program based on a preimplementation survey of our trauma team members. Implementation with new cultural and process expectations followed. The Human Factors Attitude Survey and Communication and Teamwork Skills assessment tool were used to design, evaluate, and validate our CRM program. The initial trauma communication survey was completed by 160 team members (49% response). Twenty-five trauma resuscitations were observed and scored using Communication and Teamwork Skills. Areas of concern were identified and 324 staff completed our 3-hour CRM course during a 3-month period. After CRM training, 132 communication surveys and 38 Communication and Teamwork Skills observations were completed. In the post-CRM survey, respondents indicated improvement in accuracy of field to medical command information (p = 0.029); accuracy of emergency department medical command information to the resuscitation area (p = 0.002); and team leader identity, communication of plan, and role assignment (p = 0.001). After CRM training, staff were more likely to speak up when patient safety was a concern (p = 0.002). Crew Resource Management in the trauma resuscitation area enhances team dynamics, communication, and, ostensibly, patient safety. Philosophy and culture of CRM should be compulsory components of trauma programs and in resuscitation of injured patients. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Tailored Panel Management: A Theory-Based Approach to Building and Maintaining Participant Commitment to a Longitudinal Study.

    Science.gov (United States)

    Estrada, Mica; Woodcock, Anna; Schultz, P Wesley

    2014-02-01

    Many psychological processes unfold over time, necessitating longitudinal research designs. Longitudinal research poses a host of methodological challenges, foremost of which is participant attrition. Building on Dillman's work, we provide a review of how social influence and relationship research informs retention strategies in longitudinal studies. Objective: We introduce the tailored panel management (TPM) approach, which is designed to establish communal norms that increase commitment to a longitudinal study, and this commitment, in turn, increases response rates and buffers against attrition. Specifically, we discuss practices regarding compensation, communication, consistency, and credibility that increase longer term commitment to panel participation. Research design: Throughout the article, we describe how TPM is being used in a national longitudinal study of undergraduate minority science students. TheScienceStudy is a continuing panel, which has 12 waves of data collected across 6 academic years, with response rates ranging from 70% to 92%. Although more than 90% of participants have either left or graduated from their undergraduate degree program, this highly mobile group of people remains engaged in the study. TheScienceStudy has usable longitudinal data from 96% of the original panel. Conclusion: This article combines social psychological theory, current best practice, and a detailed case study to illustrate the TPM approach to longitudinal data collection. The approach provides guidance for other longitudinal researchers, and advocates for empirical research into longitudinal research methodologies. © The Author(s) 2014.

  10. A 100-Year Review: Calf nutrition and management.

    Science.gov (United States)

    Kertz, A F; Hill, T M; Quigley, J D; Heinrichs, A J; Linn, J G; Drackley, J K

    2017-12-01

    The first calf paper, published in the May 1919 issue of the Journal of Dairy Science (JDS), described factors affecting birth body weight of different breeds of calves. Other studies were done on nonmilk ingredients, growth charts were developed, and early weaning was followed to conserve milk fed to calves. Calf papers did not report use of statistics to control or record variation or to determine whether treatment means were different. Many experiments were more observational than comparative. Typically fewer than 5 calves, and sometimes 1 or 2 calves, were used per treatment. During the next 20 yr, calf studies increased and included colostrum feeding, milk and milk replacer feeding, minerals and vitamins, and fats and oils. Many concepts fundamental to current knowledge and understanding of digestion, rumen development, and milk replacer formulation were developed during this period. In addition, the concept of using antibiotic growth promoters in dairy calf diets was first evaluated and developed during the 1950s. During the 20-yr period of January 1957 through December 1976, a large number of universities in the United States and 1 in Canada contributed almost 150 papers on a variety of calf-related topics. These topics included genetics, physiology of the calf, review of calf immunity, antibiotic feeding, and milk replacer ingredients. This became the golden era of calf rumen development studies, which also engendered studies of calf starter rations and ingredients. A classic review of management, feeding, and housing studies summarized research related to calf feeding and management systems up to that point with an emphasis on maintaining calf growth and health while reducing labor and feed costs. It was also during this period that metric measurements replaced English units. In the 20-yr period from 1977 to 1996, more than 400 articles on calf nutrition and management were published in JDS. With the growing research interest in calves, a paper outlining

  11. 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...

  12. Values expressed through intergenerational family food and nutrition management systems among African American women.

    Science.gov (United States)

    Ahye, Brenda A; Devine, Carol M; Odoms-Young, Angela M

    2006-01-01

    This grounded theory investigation aimed to understand intergenerational family roles and the food management strategies of African American women from a social-ecological perspective. Thirty women from 10 low/moderate-income 3-generation urban families participated in interviews covering roles, health, nutrition, and food management strategies. Four dynamic family systems for managing food and nutrition emerged from qualitative data analysis. Participants expressed values of responsibility, social connections, caretaking, reward, and equal opportunity, and fulfilling responsibilities for family care, connections, and finances. These values and systems provide a basis for culturally appropriate, interpersonal-level nutrition interventions among African American women that build on family structures, needs, and resources.

  13. Primary care randomised controlled trial of a tailored interactive website for the self-management of respiratory infections (Internet Doctor).

    Science.gov (United States)

    Little, Paul; Stuart, Beth; Andreou, Panayiota; McDermott, Lisa; Joseph, Judith; Mullee, Mark; Moore, Mike; Broomfield, Sue; Thomas, Tammy; Yardley, Lucy

    2016-04-20

    To assess an internet-delivered intervention providing advice to manage respiratory tract infections (RTIs). Open pragmatic parallel group randomised controlled trial. Primary care in UK. Adults (aged ≥18) registered with general practitioners, recruited by postal invitation. Patients were randomised with computer-generated random numbers to access the intervention website (intervention) or not (control). The intervention tailored advice about the diagnosis, natural history, symptom management (particularly paracetamol/ibuprofen use) and when to seek further help. Primary: National Health Service (NHS) contacts for those reporting RTIs from monthly online questionnaires for 20 weeks. Secondary: hospitalisations; symptom duration/severity. Results 3044 participants were recruited. 852 in the intervention group and 920 in the control group reported one or more RTIs, among whom there a modest increase in NHS Direct contacts in the intervention group (intervention 44/1734 (2.5%) versus control 24/1842 (1.3%); multivariate Risk Ratio (RR) 2.53 (95% CI 1.10 to 5.82, p=0.029)). Conversely reduced contact with doctors occurred (283/1734 (16.3%) vs 368/1845 (20.0%); risk ratio 0.71, 0.53 to 0.95, p=0.019). Reduction in contacts occurred despite slightly longer illness duration (11.3 days versus 10.9 days respectively; multivariateestimate 0.48 days longer (-0.16 to 1.12, p=0.141) and more days of illness rated moderately bad or worse illness (0.53 days; 0.12 to 0.94, p=0.012). The estimate of slower symptom resolution in the intervention group was attenuated when controlling for whether individuals had used webpages which advocated ibuprofen use (length of illness 0.22 days, −0.51 to 0.95, p=0.551; moderately bad or worse symptoms 0.36 days, −0.08 to 0.80, p=0.105). There was no evidence of increased hospitalisations (risk ratio 0.13; 0.02 to 1.01; p=0.051). An internet-delivered intervention for the self-management of RTIs modifies help-seeking behaviour, and does

  14. Dietary Management in Hyperlipidemia. Nutrition in Primary Care Series, Number 12.

    Science.gov (United States)

    Gallagher-Allred, Charlette R.; Townley, Nancy A.

    Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

  15. Dietary Management in Obesity. Nutrition in Primary Care Series, Number 9.

    Science.gov (United States)

    Gallagher-Allred, Charlette R.; Townley, Nancy A.

    Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

  16. Systems biology of personalized nutrition

    NARCIS (Netherlands)

    Ommen, B. van; Broek, T. van den; Hoogh, I. de; Erk, M. van; Someren, E. van; Rouhani-Rankouhi, T.; Anthony, J.C.; Hogenelst, K.; Pasman, W.; Boorsma, A.; Wopereis, S.

    2017-01-01

    Personalized nutrition is fast becoming a reality due to a number of technological, scientific, and societal developments that complement and extend current public health nutrition recommendations. Personalized nutrition tailors dietary recommendations to specific biological requirements on the

  17. SAJCN(V23_supp) p62-64 Nutritional manage.indd

    African Journals Online (AJOL)

    jenny

    Invited communication: Nutritional management of gastrointestinal malignancies ... 10% of initial body weight, and have shown a reduced oral energy ... due to the malignancy induced inflammatory response in advanced ... muscle mass.1.

  18. The (cost-)effectiveness of an individually tailored long-term worksite health promotion programme on physical activity and nutrition: design of a pragmatic cluster randomised controlled trial

    NARCIS (Netherlands)

    S.J.W. Robroek (Suzan); F.J. Bredt (Folef); A. Burdorf (Alex)

    2007-01-01

    textabstractCardiovascular disease is the leading cause of disability and mortality in most Western countries. The prevalence of several risk factors, most notably low physical activity and poor nutrition, is very high. Therefore, lifestyle behaviour changes are of great importance. The worksite

  19. Crops nutrition management as measures for climate change adaptation

    Science.gov (United States)

    Hladkikh, Yevheniia

    2017-04-01

    The main feature of climate change in most countries worldwide is the increasing frequency of extreme weather events such as unpredictable floods, droughts and another abiotic stress for crops. It is not surprising that most countries are interested in technologies for adapting agriculture to climate change, and Ukraine is no exception. But traditional measures which exist in the world practice do not sufficiently take into account the importance of interactions between soil and plants. For example, from 138 projects of the European Climate Adaption Platform only 16 are correlated with the soil, but only one of them investigates the interaction in "soil-plant" system. In this connection, the main aim of our research was to determine the effectiveness of agrochemical techniques in plant nutrition management for crops adaptation to extreme weather fluctuations. The influence of different agrochemical measures in "soil-plant" system on the resilience of crops to different climate conditions of the growing season were investigated in a long-term field experiment that was started in 1969. The experiment was on a Chernozem at the Grakivske Experimental Station in Kharkiv region, Ukraine. Soil samples were taken during the growing season from field under different crops. Soil and plant samples analyses included macro- and micronutrients content, soil moisture. Research in the field experiment has demonstrated a close correlation between the average annual rainfall and content of available forms of macronutrients in the soil (especially for nitrate nitrogen the correlation coefficient was 0.98). Studies have shown that increasing the annual rainfall by 100 mm increases the content of nitrate nitrogen in the soil at 7 mg per kg. Another correlation has shown that the decrease amount of precipitation reduces the range of the N:P and consequently the availability of these elements to crops. Thus, in drought conditions, efficiency of the use of available nutrients by crops

  20. Nutrition management in enhanced recovery after abdominal pancreatic surgery.

    Science.gov (United States)

    Márquez Mesa, Elena; Baz Figueroa, Caleb; Suárez Llanos, José Pablo; Sanz Pereda, Pablo; Barrera Gómez, Manuel Ángel

    Multimodal rehabilitation programs are perioperative standardized strategies with the objective of improving patient recovery, and decreasing morbidity, hospital stay and health cost. The nutritional aspect is an essential component of multimodal rehabilitation programs and therefore nutritional screening is recommended prior to hospital admission, avoiding pre-surgical fasting, with oral carbohydrate overload and early initiation of oral intake after surgery. However, there are no standardized protocols of diet progression after pancreatic surgery. A systematic review was been performed of papers published between 2006 and 2016, describing different nutritional strategies after pancreatic surgery and its possible implications in postoperative outcome. The studies evaluated are very heterogeneous, so conclusive results could not be drawn on the diet protocol to be implemented, its influence on clinical variables, or the need for concomitant artificial nutrition. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Nutrition in the management of cirrhosis and its neurological complications.

    Science.gov (United States)

    Bémeur, Chantal; Butterworth, Roger F

    2014-06-01

    Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation. Nutritional recommendations target the optimal supply of adequate substrates related to requirements linked to energy, protein, carbohydrates, lipids, vitamins and minerals. Some issues relating to malnutrition in chronic liver disease remain to be addressed including the development of an appropriate well-validated nutritional assessment tool, the identification of mechanistic targets or therapy for sarcopenia, the development of nutritional recommendations for obese cirrhotic patients and liver-transplant recipients and the elucidation of the roles of vitamin A hepatotoxicity, as well as the impact of deficiencies in riboflavin and zinc on clinical outcomes. Early identification and treatment of malnutrition in chronic liver disease has the potential to lead to better disease outcome as well as prevention of the complications of chronic liver disease and improved transplant outcomes.

  2. Enhancing the role of nutrition professionals in weight management: A cross-sectional survey.

    Science.gov (United States)

    Bleich, Sara N; Bandara, Sachini; Bennett, Wendy; Cooper, Lisa A; Gudzune, Kimberly A

    2015-02-01

    (1) To determine the nonphysician health profession perceived as best qualified to provide weight management. (2) To examine nutrition professionals' current practice characteristics and perceived challenges and solutions for obesity care. (3) To examine the association between nutrition professionals' quality of training and self-efficacy in weight management. A 2014 national cross-sectional online survey of 500 U.S. nonphysician health professionals (100 from each: nutrition, nursing, behavioral/mental health, exercise, pharmacy) was analyzed. Nutrition professionals most commonly self-identified as the most qualified group to help patients lose weight (92%), sentiments supported by other health professionals (57%). The most often cited challenge was lack of patient adherence (87%). Among nutrition professionals, 77% reported receiving high-quality training in weight loss counseling. Nutrition professionals who reported high-quality training were significantly more likely to report confidence (95% vs. 48%) and success (74 vs. 50%) in helping obese patients lose weight (Pweight management counseling to obese patients. Yet nutrition professionals' receipt of high-quality weight management training appears critical to their success in helping patients lose weight. © 2014 The Obesity Society.

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

    Science.gov (United States)

    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.

  4. MEDICAL NUTRITION THERAPY IN MANAGEMENT OF EATING DISORDERS

    Directory of Open Access Journals (Sweden)

    Miloš Pavlović

    2009-01-01

    Full Text Available The treatment of eating disorders demands a comprehensive medical approach, where a dietitian has an important role, primarily due to numerous instances of malnutrition. The objective of this paper was to recapitulate the research findings and clinical evidence which show the importance of medical nutrition therapy in the treatment of eating disorders; furthermore, they present significant guidelines for clinical practice. The research methods have entailed a thorough exploration of literature available at research data bases. The results of the research studies published so far have unambiguously pointed out that, when eating disorders are concerned, there is an urgent need for a diet therapy in order for the patient to restore the appropriate body weight as well as normal eating habits. On the one hand, certain authors suggest returning to normal nutritional habits immediately, whereas, on the other hand, certain others advocate a diet therapy program, that is, a gradual process of recovery. Patients incapable of oral food intake receive enteral nutrition. Parenteral nutrition is applied for recovering the lost electrolytes and fluids, but it should be applied rarely, primarily in states of urgency. For patients suffering from eating disorders the increase in weight indicates good chances of recovery; therefore, the patient’s nutritional status should be carefully and continuously noted. Finally, it is important that our country, too, should adopt a carefully prescribed and conducted diet therapy as an obligatory step in the treatment of patients with eating disorders.

  5. Exploring individual cognitions, self-regulation skills, and environmental-level factors as mediating variables of two versions of a Web-based computer-tailored nutrition education intervention aimed at adults: A randomized controlled trial.

    Science.gov (United States)

    Springvloet, Linda; Lechner, Lilian; Candel, Math J J M; de Vries, Hein; Oenema, Anke

    2016-03-01

    This study explored whether the determinants that were targeted in two versions of a Web-based computer-tailored nutrition education intervention mediated the effects on fruit, high-energy snack, and saturated fat intake among adults who did not comply with dietary guidelines. A RCT was conducted with a basic (tailored intervention targeting individual cognitions and self-regulation), plus (additionally targeting environmental-level factors), and control group (generic nutrition information). Participants were recruited from the general Dutch adult population and randomly assigned to one of the study groups. Online self-reported questionnaires assessed dietary intake and potential mediating variables (behavior-specific cognitions, action- and coping planning, environmental-level factors) at baseline and one (T1) and four (T2) months post-intervention (i.e. four and seven months after baseline). The joint-significance test was used to establish mediating variables at different time points (T1-mediating variables - T2-intake; T1-mediating variables - T1-intake; T2-mediating variables - T2-intake). Educational differences were examined by testing interaction terms. The effect of the plus version on fruit intake was mediated (T2-T2) by intention and fruit availability at home and for high-educated participants also by attitude. Among low/moderate-educated participants, high-energy snack availability at home mediated (T1-T1) the effect of the basic version on high-energy snack intake. Subjective norm mediated (T1-T1) the effect of the basic version on fat intake among high-educated participants. Only some of the targeted determinants mediated the effects of both intervention versions on fruit, high-energy snack, and saturated fat intake. A possible reason for not finding a more pronounced pattern of mediating variables is that the educational content was tailored to individual characteristics and that participants only received feedback for relevant and not for all

  6. A critique of the design, implementation, and delivery of a culturally-tailored self-management education intervention: a qualitative evaluation.

    Science.gov (United States)

    Sidhu, Manbinder S; Gale, Nicola K; Gill, Paramjit; Marshall, Tom; Jolly, Kate

    2015-02-07

    Self-management education is at the forefront of addressing the increasing prevalence of chronic diseases. For those at greatest risk, such as minority-ethnic and/or socio-economically deprived groups, self-management education can be culturally-tailored to encourage behavioural change. Yet, the application of culturally appropriate material and expertise within health promotion services continues to be debated. We critique the design, implementation, and delivery of a culturally-tailored self-management intervention, with particular focus on the experiences of lay educators. A mixed methods qualitative evaluation was undertaken to understand self-management service provision to culturally diverse communities (i.e. how components such as lay workers, group-based design, and culturally-appropriate educational material are intended to encourage behavioural change). We interviewed lay educators delivering the Chronic Disease Educator programme along with attendees, whilst observing workshops. Data were thematically analysed using a content-based constant comparison approach through a number of interpretative analytical stages. Lay educators felt part of the local community, relating to attendees from different races and ethnicities. However, lay educators faced challenges when addressing health beliefs and changing lifestyle practices. Culturally-tailored components aided communication, with educator's cultural awareness leading to close relationships with attendees, while the group-based design facilitated discussions of the emotional impact of illness. Lay educators bring with them a number of nuanced skills and knowledge when delivering self-management education. The development and training required for this role is inhibited by financial constraints at policy-level. The interpretation of being from the 'community' links with the identity and status of the lay role, overlapping notions of race, ethnicity, and language.

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

    Science.gov (United States)

    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)

  8. Nutritional management and growth in children with chronic kidney disease.

    Science.gov (United States)

    Rees, Lesley; Jones, Helen

    2013-04-01

    Despite continuing improvements in our understanding of the causes of poor growth in chronic kidney disease, many unanswered questions remain: why do some patients maintain a good appetite whereas others have profound anorexia at a similar level of renal function? Why do some, but not all, patients respond to increased nutritional intake? Is feed delivery by gastrostomy superior to oral and nasogastric routes? Do children who are no longer in the 'infancy' stage of growth benefit from enteral feeding? Do patients with protein energy wasting benefit from increased nutritional input? How do we prevent obesity, which is becoming so prevalent in the developed world? This review will address these issues.

  9. [Nutritional Assessment and Management for Patients with Chronic Liver Disease].

    Science.gov (United States)

    Lee, Tae Hee

    2018-04-25

    When liver disease is severe, the prognosis can be worse if the patient is malnourished. Adequate nutritional support for patients with liver diseases can improve the patient's condition and prognosis. In the case of liver cirrhosis, malnutrition can occur due to a variety of causes, including poor oral intake, maldigestion, malabsorption, associated renal disease, and metabolic abnormalities. For a nutritional assessment, it is important to check the dietary intake, change in body composition, including anthropometry, and a functional assessment of muscle. Counselling and oral or enteral nutrition is preferred over parenteral nutrition as in other diseases. If esophageal varices are present, care should be taken when installing a feeding tube, but if there are ascites, percutaneous endoscopic gastrostomy is contraindicated because of the risk of complications. Calories of 30-35 kcal/kg/day and protein from 1.2 to 1.5 g/kg/day are appropriate. Protein restriction is unnecessary unless the hepatic encephalopathy is severe. A late evening snack and branched chain amino acids can be helpful. In the case of cholestasis, the supply of manganese and copper should be restricted. Sarcopenia in patients with liver cirrhosis is also prevalent and associated with the prognosis.

  10. Food and Nutrition Services Quality Control Management Program.

    Science.gov (United States)

    Wimsatt-Fraim, Teresa S.

    A program was conducted to improve the quality of food service through the training of 44 food and nutrition service employees in a 200-bed hospital. A 12-week quality control program was implemented to address four key areas: food temperatures, food accuracy, food quality, and dietary personnel. Learning strategies, emphasizing critical thinking…

  11. The management of perioperative nutrition in patients with end stage liver disease undergoing liver transplantation.

    Science.gov (United States)

    Zhang, Qi-Kun; Wang, Meng-Long

    2015-10-01

    Malnutrition is found in almost 100% of patients with end stage liver disease (ESLD) awaiting transplantation and malnutrition before transplantation leads to higher rates of post-transplant complications and worse graft survival outcomes. Reasons for protein energy malnutrition include several metabolic alterations such as inadequate intake, malabsorption, and overloaded expenditure. And also, stress from surgery, gastrointestinal reperfusion injury, immunosuppressive therapy and corticosteriods use lead to delayed bowl function recovery and disorder of nutrients absorption. In the pretransplant phase, nutritional goals include optimization of nutritional status and treatment of nutrition-related symptoms induced by hepatic decompensation. During the acute post-transplant phase, adequate nutrition is required to help support metabolic demands, replenish lost stores, prevent infection, arrive at a new immunologic balance, and promote overall recovery. In a word, it is extremely important to identify and correct nutritional deficiencies in this population and provide an adequate nutritional support during all phases of liver transplantation (LT). This study review focuses on prevalence, nutrition support, evaluation, and management of perioperative nutrition disorder in patients with ESLD undergoing LT.

  12. Alpharma Beef Cattle Nutrition Symposium: implications of nutritional management for beef cow-calf systems.

    Science.gov (United States)

    Funston, R N; Summers, A F; Roberts, A J

    2012-07-01

    The beef cattle industry relies on the use of high-forage diets to develop replacement females, maintain the cow herd, and sustain stocker operations Forage quantity and quality fluctuate with season and environmental conditions Depending on class and physiological state of the animal, a forage diet may not always meet nutritional requirements, resulting in reduced ADG or BW loss if supplemental nutrients are not provided It is important to understand the consequences of such BW loss and the economics of providing supplementation to the beef production system Periods of limited or insufficient nutrient availability can be followed by periods of compensatory BW gain once dietary conditions improve This may have less impact on breeding animals, provided reproductive efficiency is not compromised, where actual BW is not as important as it is in animals destined for the feedlot A rapidly evolving body of literature is also demonstrating that nutritional status of cows during pregnancy can affect subsequent offspring development and production characteristics later in life The concept of fetal programming is that maternal stimuli during critical periods of fetal development have long-term implications for offspring Depending on timing, magnitude, and duration of nutrient limitation or supplementation, it is possible that early measures in life, such as calf birth BW, may be unaffected, whereas measures later in life, such as weaning BW, carcass characteristics, and reproductive traits, may be influenced This body of research provides compelling evidence of a fetal programming response to maternal nutrition in beef cattle Future competitiveness of the US beef industry will continue to be dependent on the use of high-forage diets to meet the majority of nutrient requirements Consequences of nutrient restriction or supplementation must be considered not only on individual animal performance but also the developing fetus and its subsequent performance throughout life.

  13. Evaluation of a tailored implementation strategy to improve the management of patients with chronic obstructive pulmonary disease in primary care: a study protocol of a cluster randomized trial.

    Science.gov (United States)

    Godycki-Cwirko, Maciek; Zakowska, Izabela; Kosiek, Katarzyna; Wensing, Michel; Krawczyk, Jaroslaw; Kowalczyk, Anna

    2014-04-04

    Chronic obstructive pulmonary disease (COPD) remains a major health problem, strongly related to smoking. Despite the publication of practice guidelines on prevention and treatment, not all patients with the disease receive the recommended healthcare, particularly with regard to smoking cessation advice where applicable. We have developed a tailored implementation strategy for enhancing general practitioners' adherence to the disease management guidelines. The primary aim of the study is to evaluate the effects of this tailored implementation intervention on general practitioners' adherence to guidelines. A pragmatic two-arm cluster randomized trial has been planned to compare care following the implementation of tailored interventions of four recommendations in COPD patients against usual care. The study will involve 18 general practices (9 in the intervention group and 9 in the control group) in Poland, each with at least 80 identified (at the baseline) patients with diagnosed COPD. The nine control practices will provide usual care without any interventions. Tailored interventions to implement four recommendations will be delivered in the remaining nine practices. At follow-up after nine months, data will be collected for all 18 general practices. The primary outcome measure is physicians' adherence to all four recommendations: brief anti-smoking advice, dyspnea assessment, care checklist utilization and demonstration to patients of correct inhaler use. This measurement will be based on data extracted from identified patients' records. Additionally, we will survey and interview patients with chronic obstructive pulmonary disease about the process of care. The results of this trial will be directly applicable to primary care in Poland and add to the growing body of evidence on interventions to improve chronic illness care. This trial has been registered with Clinical Trials Protocol Registration System. NCT01893476.

  14. Nutritional management of anorexic patients with and without fluoxetine: 1-year follow-up.

    Science.gov (United States)

    Ruggiero, Giovanni M; Mauri, Massimo C; Omboni, Anna C; Volonteri, Lucia S; Dipasquale, Savina; Malvini, Lara; Redaelli, Gabriella; Pasqualinotto, Lucia; Cavagnini, Francesco

    2003-05-01

    This study evaluated the efficacy of nutritional management with and without fluoxetine (FLX) in anorexia nervosa diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Twenty-one patients, with a mean body mass index (BMI) of 15.21+/-2.33 kg/m(2), were treated with nutritional management and FLX at a mean dosage of 30.00+/-9.35 mg (pharmacological group); seventy-four patients, with a mean BMI of 14.24+/-2.16 kg/m(2), were treated only with nutritional management (nutritional group). Clinical evaluation was carried out under single-blind conditions at basal time and after 3, 6, and 12 months by a structured clinical interview, the Eating Disorder Interview based on Longitudinal Interval Follow-Up Evaluation (EDI-LIFE) and using a self-reported questionnaire, the Eating Disorder Inventory (EDI). BMI significantly increased in both the two treatment groups. In addition, the increase shown by the pharmacological group appeared near the beginning of treatment (i.e., at T1) and it was significantly higher than the increase shown by the nutritional group. Physical exercise showed a significant decrease in the pharmacological treatment group. On the other hand, fear of fatness and the scores of the subscales of the EDI significantly decreased in the nutritional treatment group. In terms of weight, the pharmacological group presented the higher amount of therapeutic success.

  15. Nutrition economics: an innovative approach to informed public health management.

    Science.gov (United States)

    Nuijten, Mark; Lenoir-Wijnkoop, Irene

    2011-09-01

    The role of nutrition to optimize the use of scarce resources through its linkage with health and welfare should be considered of interest by healthcare decision makers. A favorable impact of food on non-communicable disorders and general health status will improve healthcare expenditure and quality of life.In health economics, an analysis of the costs and effects of a healthcare technology by means of a cost-effectiveness analysis has become an established tool. Projections about the effectiveness and expected costs of an intervention can be modeled using realistic and explicit assumptions based on outcomes from randomized clinical studies. However, the use of health economic techniques to assess costs and effects is not solely restricted to classic healthcare products such as medicines. To illustrate this we used two published cost-effectiveness studies, which consider respectively a preventive treatment against severe respiratory syncytial virus infection in children at high risk of hospitalization and the use of prebiotics for the primary prevention of atopic dermatitis.These examples illustrate that there is a parallel between the methodologies for extrapolation of intermediate outcomes to long-term outcomes between a cost-effectiveness analysis for pharmaceutical or nutrition, as long as the clinical evidence for nutrition fulfils the requirements for pharmaceuticals. Another requirement is that there is clinical widely accepted evidence that matches a comparable level of epidemiological observations about the link between short-term and long-term outcomes.Better understanding of how nutritional status and behavior may interplay with the socioeconomic environment will ultimately contribute to preserving the sustainability of healthcare provisions. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Diabetes Nutrition Therapy: Effectiveness, Macronutrients, Eating Patterns and Weight Management.

    Science.gov (United States)

    Franz, Marion J

    2016-04-01

    Diabetes nutrition therapy provided for individuals with diabetes must be based on research documenting effectiveness. The roles of differing macronutrient percentages, eating patterns and weight loss interventions are controversial. A review of research related to these topics is summarized. Clinical trials as well as systematic reviews and Cochrane reviews report an approximately 1-2% lowering of hemoglobin A1c as well as other beneficial outcomes from nutrition therapy interventions, depending on the type and duration of diabetes and level of glycemic control. There are no ideal percentages of macronutrients or eating patterns or both that apply to all persons with diabetes. Clinical trials demonstrate the effectiveness of modest weight loss and physical activity for the prevention or delay of type 2 diabetes. However, as the disease progresses, weight loss interventions may or may not result in beneficial glycemic and other metabolic outcomes. To be effective, diabetes nutrition therapy must be individualized. Treatment goals, personal preferences (eg, tradition, culture, religion, health beliefs and economics) and the individual׳s ability and willingness to make lifestyle changes all must be considered when educating or counseling individuals with diabetes. A healthy eating pattern emphasizing nutrient-dense foods in appropriate portion sizes, regular physical activity and support are important. A reduced energy intake for persons with prediabetes or type 2 diabetes and matching insulin to planned carbohydrate intake for insulin users is nutrition therapy interventions shown to be effective in achieving glycemic and other metabolic outcomes. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  17. [Consensus document about the nutritional evaluation and management of eating disorders: anorexia nervosa].

    Science.gov (United States)

    Gómez-Candela, Carmen; Palma Milla, Samara; Miján-de-la-Torre, Alberto; Rodríguez Ortega, Pilar; Matía Martín, Pilar; Loria Kohen, Viviana; Campos Del Portillo, Rocío; Martín-Palmero, Ángela; Virgili Casas, M ª Nuria; Martínez Olmos, Miguel Á; Mories Álvarez, M ª Teresa; Castro Alija, M ª José; Martín-Palmero, Ángela

    2018-03-07

    Anorexia nervosa is the most common psychiatric disease among young women and it is assumed to be of multifactorial origin. Diagnostic criteria have recently been modified; therefore amenorrhea has ceased to be a part of them. This disease shows a large variability in its presentation and severity which conditions different therapeutic approaches and the need to individualize the treatment, thus it is indispensable a multidisciplinary approach. The goals are to restore nutritional status (through an individualized diet plan based on a healthy consumption pattern), treat complications and comorbidities, nutritional education (based on healthy eating and nutritional patterns), correction of compensatory behaviors and relapse prevention. The treatment will vary according to the patient's clinical situation, and it may be performed in outpatient clinics (when there is clinical stability), in a day hospital or ambulatory clinic (intermediate mode between traditional outpatient treatment and hospitalization) or hospitalization (when there is outpatient management failure or presence of serious medical or psychiatric complications). Artificial nutrition using oral nutritional supplements, enteral nutrition and exceptionally parenteral nutrition may be necessary in certain clinical settings. In severely malnourished patients the refeeding syndrome should be avoided. Anorexia nervosa is associated with numerous medical complications which determines health status, life quality, and is closely related to mortality. There is little clinical evidence to assess the results of different treatments in anorexia nervosa, when most of the recommendations are being based on expert consensus.

  18. Huntington Disease - principles and practice of nutritional management.

    Science.gov (United States)

    Zukiewicz-Sobczak, Wioletta; Król, Renata; Wróblewska, Paula; Piątek, Jacek; Gibas-Dorna, Magdalena

    2014-01-01

    Huntington disease (HD) is a degenerative brain disease clinically manifested by the characteristic triad: physical symptoms including involuntary movements and poor coordination, cognitive changes with less ability to organize routine tasks, and some emotional and behavioral disturbances. For patients with HD, feeding is one of the problems they have to face. People with HD often have lower than average body weight and struggle with malnutrition. As a part of therapy, good nutrition is an intervention maintaining health and functional ability for maximally prolonged time. In the early stages of HD, small amounts of blenderized foods given orally are recommended. In more advanced stages, enteral nutrition is essential using gastric, or jejunal tubes for short term. Most severe cases require gastrostomy or gastrojejunostomy. Although enteral feeding is well tolerated by most of the patients, a number of complications may occur, including damage to the nose, pharynx, or esophagus, aspiration pneumonia, sinusitis, metabolic imbalances due to improper nutrient and fluid supply, adverse effects affecting gastrointestinal system, and refeeding syndrome. Copyright © 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  19. Evaluation of a Web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial.

    Science.gov (United States)

    Yardley, Lucy; Joseph, Judith; Michie, Susan; Weal, Mark; Wills, Gary; Little, Paul

    2010-12-15

    There has been relatively little research on the role of web-based support for self-care in the management of minor, acute symptoms, in contrast to the wealth of recent research into Internet interventions to support self-management of long-term conditions. This study was designed as an evaluation of the usage and effects of the "Internet Doctor" website providing tailored advice on self-management of minor respiratory symptoms (eg, cough, sore throat, fever, runny nose), in preparation for a definitive trial of clinical effectiveness. The first aim was to evaluate the effects of using the Internet Doctor webpages on patient enablement and use of health services, to test whether the tailored, theory-based advice provided by the Internet Doctor was superior to providing a static webpage providing the best existing patient information (the control condition). The second aim was to gain an understanding of the processes that might mediate any change in intentions to consult the doctor, by comparing changes in relevant beliefs and illness perceptions in the intervention and control groups, and by analyzing usage of the Internet Doctor webpages and predictors of intention change. Participants (N = 714) completed baseline measures of beliefs about their symptoms and self-care online, and were then automatically randomized to the Internet Doctor or control group. These measures were completed again by 332 participants after 48 hours. Four weeks later, 214 participants completed measures of enablement and health service use. The Internet Doctor resulted in higher levels of satisfaction than the control information (mean 6.58 and 5.86, respectively; P = .002) and resulted in higher levels of enablement a month later (median 3 and 2, respectively; P = .03). Understanding of illness improved in the 48 hours following use of the Internet Doctor webpages, whereas it did not improve in the control group (mean change from baseline 0.21 and -0.06, respectively, P = .05). Decline

  20. Family physicians clinical aptitude for the nutritional management of type 2 diabetes mellitus in Guadalajara, Mexico.

    Science.gov (United States)

    Cabrera Pivaral, C E; Gutiérrez Roman, E A; Gonzalez Pérez, G; Gonzalez Reyes, F; Valadez Toscano, F; Gutiérrez Ruvalcaba, C; Rios Riebeling, C D

    2008-02-01

    There are 180,000 new Diabetes Mellitus cases in Mexico each year (1). This chronic, complex and multifactor disease requires an adequate nutritional management plan to be prescribed by family physicians. They should be trained to identify the potential difficulties in the patient's dietary schedule and orientate their management from an integrative point of view. The purpose of this study was to detect and measure family physician's clinical aptitudes for the nutritional management of Type 2 diabetes, in a representative family physician's sample from five Family Medicine Units of the Mexican Institute of Social Security in Guadalajara, Jalisco, Mexico. A structured and validated instrument was applied to 117 physicians from a total of 450 in Guadalajara, Jalisco. The main study variable was clinical aptitude for nutritional management of Type 2 diabetes. Aptitude levels were defined by an ordinal scale and related to the other variables using the median, Mann-Whitney's U test and Kruskal Wallis (KW) test. Global results showed a median of 30 points that relates to a low and a very low aptitude level for the 72% of physicians without statistical significance (KW: p>0.05) with the rest of variables. These results reflect family physician's difficulties to orientate the nutritional management of Type 2 diabetes, as well as the lack of work environments that facilitate case reflection and formative educational strategies.

  1. Clinical nutrition and foodservice personnel in teaching hospitals have different perceptions of total quality management performance.

    Science.gov (United States)

    Chong, Y; Unklesbay, N; Dowdy, R

    2000-09-01

    To investigate the perceived total quality management (TQM) performance of their department by clinical nutrition managers and dietitians, and foodservice managers and supervisors, in hospital food and nutrition service departments. Using a 2-part questionnaire containing items about 3 constructs of TQM performance and demographic characteristics, participants rated their perceptions of TQM performance. Employees in 7 Council of Teaching Hospitals. Of the 128 possible respondents, 73 (57%) completed the study. Correlation analysis to identify relationships between demographic characteristics and TQM performance. Analysis of variance to investigate statistical differences among hospitals and between subject groups and types of employment positions. Three TQM constructs--organization, information, and quality management--were evaluated. The clinical nutrition manager and dietitian group had mean ratings between 3.1 and 4.7 (5-point Likert scale); the foodservice manager and supervisor group had mean ratings from 2.7 to 4.0. Education level was significantly correlated (r = 0.44) to performance of employee training in the clinical nutrition group. The number of employees directly supervised was negatively correlated (r = -0.21) to the performance of employee training in the foodservice group. As the dynamic roles of dietitians change, many dietitians will occupy management positions in organizations such as restaurants, health food stores, food processing/distribution companies, and schools. This study demonstrates how a TQM survey instrument could be applied to clinical nutrition and foodservice settings. Dietitians will need to assess TQM in their workplace facilities, especially because of the direct links of TQM to productivity and client satisfaction.

  2. Management of Parenteral Nutrition in Hospitalized Adult Patients [Formula: see text].

    Science.gov (United States)

    Mundi, Manpreet S; Nystrom, Erin M; Hurley, Daniel L; McMahon, M Molly

    2017-05-01

    Despite the high prevalence of malnutrition in adult hospitalized patients, surveys continue to report that many clinicians are undertrained in clinical nutrition, making targeted nutrition education for clinicians essential for best patient care. Clinical practice models also continue to evolve, with more disciplines prescribing parenteral nutrition (PN) or managing the cases of patients who are receiving it, further adding to the need for proficiency in general PN skills. This tutorial focuses on the daily management of adult hospitalized patients already receiving PN and reviews the following topics: (1) PN basics, including the determination of energy and volume requirements; (2) PN macronutrient content (protein, dextrose, and intravenous fat emulsion); (3) PN micronutrient content (electrolytes, minerals, vitamins, and trace elements); (4) alteration of PN for special situations, such as obesity, hyperglycemia, hypertriglyceridemia, refeeding, and hepatic/renal disease; (5) daily monitoring and adjustment of PN formula; and (6) PN-related complications (PN-associated liver disease and catheter-related complications).

  3. Chilean Nutrition Management Protocol for Patients With Phenylketonuria

    Directory of Open Access Journals (Sweden)

    Gabriela Castro

    2017-02-01

    Full Text Available Since neonatal screening and early nutritional treatment began, it has been possible to reverse the neurological damage that phenylketonuria (PKU causes. Scientific evidence gathered over more than 50 years on the monitoring of individuals with PKU indicates that a phenylalanine level of about 6 mg/dL (360 µmol/L is ideal and points to the necessity of starting a long-term phenylalanine-restricted diet in which blood phenylalanine level should stay between 2 and 6 mg/dL (120-360 µmol/L. This article aims to establish the general basis for proper monitoring of people with PKU and provide a useful tool for clinicians overseeing treatment. We hope to establish similar criteria throughout Latin America and create a uniform protocol in order to have comparative monitoring results for the region.

  4. Major intestinal complications of radiotherapy. Management and nutrition

    Energy Technology Data Exchange (ETDEWEB)

    Deitel, M.; To, T.B.

    1987-12-01

    Hospitalization was required in 57 patients for intestinal injuries following radiotherapy for carcinoma of the cervix, endometrium, ovary, bladder, rectum, and other primary sites. Intestinal complications included stenosis, perforation, rectal ulcer, and rectovaginal, ileovaginal, and ileovesical fistula; 27 patients had multiple intestinal complications. Operation was necessary in 33 patients, as follows: bowel resections, 18; colostomy alone, five; adhesiolysis, five; ileocolic bypass, three; and Hartmann's procedure for sigmoid perforation, two. Five anastomotic leaks and six postoperative deaths occurred. Causes of death among the remaining patients included residual cancer (ten), de novo bowel cancer (two), radiation injury (four), and unrelated causes (six). Resection to uninvolved bowel, omental wrap of anterior resection anastomosis, avoidance of unnecessary adhesiolysis, and long-tube orientation seemed to contribute to successful operations. Nutritional support was used for repletion, post-operative fistulas, and short-gut syndrome.

  5. Major intestinal complications of radiotherapy. Management and nutrition

    International Nuclear Information System (INIS)

    Deitel, M.; To, T.B.

    1987-01-01

    Hospitalization was required in 57 patients for intestinal injuries following radiotherapy for carcinoma of the cervix, endometrium, ovary, bladder, rectum, and other primary sites. Intestinal complications included stenosis, perforation, rectal ulcer, and rectovaginal, ileovaginal, and ileovesical fistula; 27 patients had multiple intestinal complications. Operation was necessary in 33 patients, as follows: bowel resections, 18; colostomy alone, five; adhesiolysis, five; ileocolic bypass, three; and Hartmann's procedure for sigmoid perforation, two. Five anastomotic leaks and six postoperative deaths occurred. Causes of death among the remaining patients included residual cancer (ten), de novo bowel cancer (two), radiation injury (four), and unrelated causes (six). Resection to uninvolved bowel, omental wrap of anterior resection anastomosis, avoidance of unnecessary adhesiolysis, and long-tube orientation seemed to contribute to successful operations. Nutritional support was used for repletion, post-operative fistulas, and short-gut syndrome

  6. The effectiveness of a semi-tailored facilitator-based intervention to optimise chronic care management in general practice

    DEFF Research Database (Denmark)

    Due, Tina Drud; Thorsen, Thorkil; Kousgaard, Marius Brostrøm

    2014-01-01

    BACKGROUND: The Danish health care sector is reorganising based on disease management programmes designed to secure integrated and high quality chronic care across hospitals, general practitioners and municipalities. The disease management programmes assign a central role to general practice; and...

  7. The school nutrition program's role in weight management of 4th grade elementary students

    Science.gov (United States)

    We are attempting to uncover the school nutrition program's role in weight management of 4th grade elementary students. Data was collected within a time frame for the food frequency questionnaire (FFQ) set at two months at the WT Cheney Elementary School and South Wood Elementary for 4th grade stud...

  8. Nutritional management of acute kidney injury in the critically ill: A ...

    African Journals Online (AJOL)

    The primary goals of nutritional management of AKI patients are to attenuate protein (muscle) catabolism, and to replace micronutrient losses, specifically folic acid, thiamine and selenium, while being mindful of the potentially harmful effects of excessive vitamin C and vitamin A in retinol form. Hence, it is prudent, if standard ...

  9. 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

  10. Nutritional management of chronic renal failure by dietitians – the ...

    African Journals Online (AJOL)

    Nicky

    The objective of this descriptive study was to assess the practices of South African dietitians ... The most frequently used approaches in the management of protein-energy malnutrition ..... lower metabolic needs than lean body mass, and will.

  11. E-Rehabilitation - an Internet and mobile phone based tailored intervention to enhance self-management of cardiovascular disease: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Antypas, Konstantinos; Wangberg, Silje C

    2012-07-09

    Cardiac rehabilitation is very important for the recovery and the secondary prevention of cardiovascular disease, and one of its main strategies is to increase the level of physical activity. Internet and mobile phone based interventions have been successfully used to help people to achieve this. One of the components that are related to the efficacy of these interventions is tailoring of content to the individual. This trial is studying the effect of a longitudinally tailored Internet and mobile phone based intervention that is based on models of health behaviour, on the level of physical activity and the adherence to the intervention, as an extension of a face-to-face cardiac rehabilitation stay. A parallel group, cluster randomized controlled trial. The study population is adult participants of a cardiac rehabilitation programme in Norway with home Internet access and mobile phone, who in monthly clusters are randomized to the control or the intervention condition. Participants have access to a website with information regarding cardiac rehabilitation, an online discussion forum and an online activity calendar. Those randomized to the intervention condition, receive in addition tailored content based on models of health behaviour, through the website and mobile text messages. The objective is to assess the effect of the intervention on maintenance of self-management behaviours after the rehabilitation stay. Main outcome is the level of physical activity one month, three months and one year after the end of the cardiac rehabilitation programme. The randomization of clusters is based on a true random number online service, and participants, investigators and outcome assessor are blinded to the condition of the clusters. The study suggests a theory-based intervention that combines models of health behaviour in an innovative way, in order to tailor the delivered content. The users have been actively involved in its design, and because of the use of Open

  12. E-Rehabilitation – an Internet and mobile phone based tailored intervention to enhance self-management of Cardiovascular Disease: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Antypas Konstantinos

    2012-07-01

    Full Text Available Abstract Background Cardiac rehabilitation is very important for the recovery and the secondary prevention of cardiovascular disease, and one of its main strategies is to increase the level of physical activity. Internet and mobile phone based interventions have been successfully used to help people to achieve this. One of the components that are related to the efficacy of these interventions is tailoring of content to the individual. This trial is studying the effect of a longitudinally tailored Internet and mobile phone based intervention that is based on models of health behaviour, on the level of physical activity and the adherence to the intervention, as an extension of a face-to-face cardiac rehabilitation stay. Methods/Design A parallel group, cluster randomized controlled trial. The study population is adult participants of a cardiac rehabilitation programme in Norway with home Internet access and mobile phone, who in monthly clusters are randomized to the control or the intervention condition. Participants have access to a website with information regarding cardiac rehabilitation, an online discussion forum and an online activity calendar. Those randomized to the intervention condition, receive in addition tailored content based on models of health behaviour, through the website and mobile text messages. The objective is to assess the effect of the intervention on maintenance of self-management behaviours after the rehabilitation stay. Main outcome is the level of physical activity one month, three months and one year after the end of the cardiac rehabilitation programme. The randomization of clusters is based on a true random number online service, and participants, investigators and outcome assessor are blinded to the condition of the clusters. Discussion The study suggests a theory-based intervention that combines models of health behaviour in an innovative way, in order to tailor the delivered content. The users have been actively

  13. Efficacy of 'Tailored Physical Activity' or 'Chronic Pain Self-Management Program' on return to work for sick-listed citizens: design of a randomised controlled trial.

    Science.gov (United States)

    Andersen, Lotte Nygaard; Juul-Kristensen, Birgit; Roessler, Kirsten Kaya; Herborg, Lene Gram; Sørensen, Thomas Lund; Søgaard, Karen

    2013-01-23

    Pain affects quality of life and can result in absence from work. Treatment and/or prevention strategies for musculoskeletal pain-related long-term sick leave are currently undertaken in several health sectors. Moreover, there are few evidence-based guidelines for such treatment and prevention. The aim of this study is to evaluate the efficacy of 'Tailored Physical Activity' or 'Chronic Pain Self-Management Program' for sick-listed citizens with pain in the back and/or the upper body. This protocol describes the design of a parallel randomised controlled trial on the efficacy of 'Tailored Physical Activity' or a 'Chronic Pain Self-management Program' versus a reference group for sick-listed citizens with complaints of pain in the back or upper body. Participants will have been absent from work due to sick-listing for 3 to 9 weeks at the time of recruitment. All interventions will be performed at the 'Health Care Center' in the Sonderborg Municipality, and a minimum of 138 participants will be randomised into one of the three groups.All participants will receive 'Health Guidance', a (1.5-hour) individualised dialogue focusing on improving ways of living, based on assessments of risk behavior, motivation for change, level of self-care and personal resources. In addition, the experimental groups will receive either 'Tailored Physical Activity' (three 50-minute sessions/week over 10 weeks) or 'Chronic Pain Self-Management Program' (2.5-hours per week over 6 weeks). The reference group will receive only 'Health Guidance'.The primary outcome is the participants' sick-listed status at 3 and 12 months after baseline. The co-primary outcome is the time it takes to return to work. In addition, secondary outcomes include anthropometric measurements, functional capacity and self-reported number of sick days, musculoskeletal symptoms, general health, work ability, physical capacity, kinesiophobia, physical functional status, interpersonal problems and mental disorders. There

  14. The effectiveness of a semi-tailored facilitator-based intervention to optimise chronic care management in general practice: a stepped-wedge randomised controlled trial.

    Science.gov (United States)

    Due, Tina Drud; Thorsen, Thorkil; Kousgaard, Marius Brostrøm; Siersma, Volkert Dirk; Waldorff, Frans Boch

    2014-04-09

    The Danish health care sector is reorganising based on disease management programmes designed to secure integrated and high quality chronic care across hospitals, general practitioners and municipalities. The disease management programmes assign a central role to general practice; and in the Capital Region of Denmark a facilitator-based intervention was undertaken to support the implementation of the programmes in general practice. The purpose of the study was to assess the effectiveness of this semi-tailored facilitator-based intervention. The study was a stepped-wedge, randomised, controlled trial among general practices in the Capital Region of Denmark. The intervention group was offered three one-hour visits by a facilitator. The intervention was semi-tailored to the perceived needs as defined by each general practice, and the practices could choose from a list of possible topics. The control group was a delayed intervention group. The primary outcome was change in the number of annual chronic disease check-ups. Secondary outcomes were: changes in the number of annual check-ups for type 2 diabetes (DM2) and chronic obstructive pulmonary disease (COPD); changes in the number of spirometry tests, changes in the use of ICPC diagnosis coding and patient stratification; sign-up for a software program for patient overview; and reduction in number of practices with few annual chronic disease check-ups. We randomised 189 general practices: 96 practices were allocated to the intervention group and 93 to the delayed intervention group. For the primary outcome, 94 and 89 practices were analysed. Almost every outcome improved from baseline to follow-up in both allocation groups. At follow-up there was no difference between allocation groups for the primary outcome (p = 0.1639). However, some secondary outcomes favoured the intervention: a higher reported use of ICPC diagnosis coding for DM2 and COPD (p = 0.0050, p = 0.0243 respectively), stratification for COPD (p = 0

  15. [IMPLEMENTATION OF A QUALITY MANAGEMENT SYSTEM IN A NUTRITION UNIT ACCORDING TO ISO 9001:2008].

    Science.gov (United States)

    Velasco Gimeno, Cristina; Cuerda Compés, Cristina; Alonso Puerta, Alba; Frías Soriano, Laura; Camblor Álvarez, Miguel; Bretón Lesmes, Irene; Plá Mestre, Rosa; Izquierdo Membrilla, Isabel; García-Peris, Pilar

    2015-09-01

    the implementation of quality management systems (QMS) in the health sector has made great progress in recent years, remains a key tool for the management and improvement of services provides to patients. to describe the process of implementing a quality management system (QMS) according to the standard ISO 9001:2008 in a Nutrition Unit. the implementation began in October 2012. Nutrition Unit was supported by Hospital Preventive Medicine and Quality Management Service (PMQM). Initially training sessions on QMS and ISO standards for staff were held. Quality Committee (QC) was established with representation of the medical and nursing staff. Every week, meeting took place among members of the QC and PMQM to define processes, procedures and quality indicators. We carry on a 2 months follow-up of these documents after their validation. a total of 4 processes were identified and documented (Nutritional status assessment, Nutritional treatment, Monitoring of nutritional treatment and Planning and control of oral feeding) and 13 operating procedures in which all the activity of the Unit were described. The interactions among them were defined in the processes map. Each process has associated specific quality indicators for measuring the state of the QMS, and identifying opportunities for improvement. All the documents associated with requirements of ISO 9001:2008 were developed: quality policy, quality objectives, quality manual, documents and records control, internal audit, nonconformities and corrective and preventive actions. The unit was certified by AENOR in April 2013. the implementation of a QMS causes a reorganization of the activities of the Unit in order to meet customer's expectations. Documenting these activities ensures a better understanding of the organization, defines the responsibilities of all staff and brings a better management of time and resources. QMS also improves the internal communication and is a motivational element. Explore the satisfaction

  16. Chapter 14. Nutritive principles in restoration and management

    Science.gov (United States)

    Bruce L. Welch

    2004-01-01

    Most range management or revegetation programs are aimed at providing forage to support the needs of range animals. Among these needs are supplying the nutrients required to drive the physiological processes of the animal body. One major principle in this report is that there is no "perfect forage species" that will supply all the nutrients needed by any...

  17. Newer Nutritional basis in the management of Rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Sharat Agarwal

    2010-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic inflammatory autoimmune disorder culminating in joint destruction with functional impairment & deformities. This disease is associated with poor nutritional status in relation to various nutrients due to not only because of increased requirements & reduction in their absorption but also due to disease modifying anti-rheumatoid drugs (DMARD’s, Non-steroidal Anti-inflammatory Drugs (NSAID’s & corticosteroids prescribed to alleviate symptoms of this disease. This results in associated side effects like gastrointestinal bleeding & bone loss (osteoporosis. Supplementation with long chain n-3 polyunsaturated fatty acids (PUFA has constantly demonstrated an improvement in symptoms & reduction in dosages of NSAID’s. Such a supplementation can be provided with the use of fish oils which have an anti-inflammatory potential. Vitamin C (ascorbic acid use has been found to augment the anti-oxidant defenses, so also the use of Vitamin E (tocopherol which has got antiinflammatory action. Beneficial effects of Vitamin B6 (pyridoxal 5-phosphate used in conjunction with folate & Vitamin B12 have been documented in those group of RA patients with high homocysteine metabolism, there by reducing the cardiovascular risk in these patients. In addition role of Selenium, Iron, Zinc, Calcium, and Vitamin D has been discussed in this review article. Besides adding certain nutrients in food, elimination of certain foods like red meat, dairy products, cereals & wheat gluten have shown improvement in progression of this disease. This article emphasizes the need for dietary supervision in the hands of expert dietician, of the Rheumatoid arthritis patients.

  18. Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer

    International Nuclear Information System (INIS)

    Sakuragi, Noriaki

    2007-01-01

    Lymph node metastasis (LNM), together with parametrial infiltration and positive surgical margins, is an important prognostic factor in cervical cancer. The incidence of LNM increases with International Federation of Gynecology and Obstetrics (FIGO) stage, with rates being 12%-22% in stage Ib, 10%-27% in stage IIa, and 34%-43% in stage IIb. Radical hysterectomy and pelvic lymphadenectomy are widely used treatments for early-stage (Ib to IIa) cervical cancer, as well as for stage IIb disease, in some European and Asian countries. In several types of cancer, the therapeutic significance of systematic lymphadenectomy has been demonstrated by recent reports showing that a larger number of lymph nodes removed relates to better survival. In cervical cancer, a significant relationship between the number of lymph nodes removed and disease-free survival has been reported in node-positive patients. Preoperative evaluation of nodal status with computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) imaging techniques is not sensitive enough to replace the histological examination of dissected nodes. The sentinel node procedure may be an alternative to systematic lymphadenectomy to reduce treatment-related morbidity, but more work on this is needed. Although the presence of LNM does not change FIGO staging, it will modulate postoperative therapy. Progression-free and overall survivals were significantly improved by the addition of chemotherapy to adjuvant radiotherapy after radical hysterectomy and lymphadenectomy. Adjuvant chemotherapy combined solely with radical hysterectomy and systematic lymphadenectomy may also provide a survival benefit. In conclusion, efforts to establish more tailored surgical strategies, by introducing advanced imaging technologies and molecular diagnostic procedures, are needed for cervical cancer. (author)

  19. Analysis of the nutritional management practices in intensive care: Identification of needs for improvement.

    Science.gov (United States)

    Lázaro-Martín, N I; Catalán-González, M; García-Fuentes, C; Terceros-Almanza, L; Montejo-González, J C

    2015-12-01

    To analyze the nutritional management practices in Intensive Care (ICU) to detect the need for improvement actions. Re-evaluate the process after implementation of improvement actions. Prospective observational study in 3 phases: 1) observation; 2) analysis, proposal development and dissemination; 3) analysis of the implementation. ICU of a hospital of high complexity. Adult ICU forecast more than 48h of artificial nutrition. Parenteral nutrition (PN), enteral nutrition (EN) (type, average effective volume, complications) and average nutritional ratio. A total of 229 patients (phase 1: 110, phase 3: 119). After analyzing the initial results, were proposed: increased use and precocity of EN, increased protein intake, nutritional monitoring effectiveness and increased supplementary indication NP. The measures were broadcast at specific meetings. During phase 3 more patients received EN (55.5 vs. 78.2%, P=.001), with no significant difference in the start time (1.66 vs. 2.33 days), duration (6.82 vs. 10,12 days) or complications (37,7 vs. 47,3%).Use of hyperproteic diets was higher in phase 3 (0 vs. 13.01%, P<.05). The use of NP was similar (48.2 vs. 48,7%) with a tendency to a later onset in phase 3 (1.25±1.25 vs. 2.45±3.22 days). There were no significant differences in the average nutritional ratio (0.56±0.28 vs. 0.61±0.27, P=.56). The use of EN and the protein intake increased, without appreciating effects on other improvement measures. Other methods appear to be necessary for the proper implementation of improvement measures. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  20. Nutritional screening and dietitian consultation rates in a geriatric evaluation and management unit.

    Science.gov (United States)

    Dent, Elsa; Wright, Olivia; Hoogendijk, Emiel O; Hubbard, Ruth E

    2018-02-01

    Nutritional screening may not always lead to intervention. The present study aimed to determine: (i) the rate of nutritional screening in hospitalised older adults; (ii) whether nutritional screening led to dietitian consultation and (iii) factors associated with malnutrition. In this prospective study of patients aged ≥70 years admitted to a Geriatric Evaluation and Management Unit (GEMU), malnutrition was screened for using the Mini Nutritional Assessment Short Form (MNA-SF) and identified using the Mini Nutritional Assessment (MNA). Of the 172 patients participating in the study, 53 (30.8%) patients were malnourished, and 84 (48.8%) were at risk of malnutrition. Mean (SD) age was 85.2 (6.4 years), with 131 patients (76.2%) female. Nutritional screening was performed for all patients; however, it was incomplete in 59 (34.3%) because of omission of the anthropometric measurement. Overall, 62 (36.0%) of the total number of patients were seen by the dietitian, which included 26 (49%) of malnourished patients, 27 (32%) of at-risk patients and 9 (26%) of the well-nourished patients. No patients lost >1% of body weight during GEMU stay. Malnourished patients were more likely to be frail, have poor appetite, depression, and have lower levels of: albumin, cognition, physical function, grip strength and quality of life. The full benefits of nutritional screening by MNA-SF may not be realised if it does not result in malnourished patients receiving a dietitian consultation. However, it is possible that enrichment of the foodservice with high protein/high-energy options minimised patient weight loss in the GEMU. © 2017 Dietitians Association of Australia.

  1. A cost management model for hospital food and nutrition in a public hospital.

    Science.gov (United States)

    Neriz, Liliana; Núñez, Alicia; Ramis, Francisco

    2014-11-13

    In Chile, the use of costing systems in the public sector is limited. The Ministry of Health requires hospitals to manage themselves with the aim of decentralizing health care services and increasing their quality. However, self-management with a lack of accounting information is almost impossible. On the other hand, nutrition department costs have barely been studied before, and there are no studies specifically for activity based costing (ABC) systems. ABC focuses on the process and traces health care activities to gain a more accurate measurement of the object costs and the financial performance of an organization. This paper uses ABC in a nutrition unit of a public hospital of high complexity to determine costs associated with the different meals for inpatients. The paper also provides an activity based management (ABM) analysis for this unit. The results show positive effects on the reduction of costs for the nutrition department after implementing ABC/ABM. Therefore, there are opportunities to improve the profitability of the area and the results could also be replicated to other areas in the hospital. ABC shed light on the amount of nutritionist time devoted to completing paperwork, and as a result, system changes were introduced to reduce this burden and allow them to focus on more relevant activities. Additional efficiencies were achieved through the elimination of non-value adding activities and automation of reports. ABC reduced the cost of the nutrition department and could produce similar results in other areas of the hospital. This is a practical application of a financial management tool, ABC, which would be useful for hospital managers to reduce costs and improve the management of the unit. This paper takes ABC and examines its use in an area, which has had little exposure to the benefits of this tool.

  2. HealthTWITTER Initiative: Design of a Social Networking Service Based Tailored Application for Diabetes Self-Management.

    Science.gov (United States)

    Kim, Hye Hyeon; Seo, Hwa Jeong

    2014-07-01

    Diabetes is a chronic disease of continuously increasing prevalence. It is a disease with risks of serious complications, thus warranting its long-term management. However, current health management and education programs for diabetes mainly consist of one-way communication, and systematic social support backup to solve diabetics' emotional problems is insufficient. According to individual behavioral changes based on the Transtheoretical Model, we designed a non-drug intervention, including exercise, and applied it to a mobile based application. For effective data sharing between patients and physicians, we adopted an SNS function for our application in order to offer a social support environment. To induce continual and comprehensive care for diabetes, rigorous self-management is essential during the diabetic's life; this is possible through a collaborative patient-physician healthcare model. We designed and developed an SNS-based diabetes self-management mobile application that supports the use of social groups, which are present in three social GYM types. With simple testing of patients in their 20s and 30s, we were able to validate the usefulness of our application. Mobile gadget-based chronic disease symptom management and intervention has the merit that health management can be conducted anywhere and anytime in order to cope with increases in the demand for health and medical services that are occurring due to the aging of the population and to cope with the surge of national medical service costs. This patient-driven and SNS-based intervention program is expected to contribute to promoting the health management habits of diabetics, who need to constantly receive health guidance.

  3. A Nursing Management Model to Increase Medication Adherence and Nutritional Status of Patients with Pulmonary TB

    Directory of Open Access Journals (Sweden)

    Eka Mishbahatul Mar’ah Has

    2015-04-01

    Full Text Available Introduction: High dropout rate, inadequate treatment, and resistance to medication, still become an obstacle in the treatment of pulmonary TB. Pulmonary TB patient care management at home can be done actively through telenursing. N-SMSI (Ners-Short Message Service Intervention is one of community nursing intervention, in which community nurses send short messages to remind patients to take medication and nutrition. The aim of this study was to analyze the effect of nursing management model N-SMSI to increased medication adherence and nutritional status of patients with pulmonary TB. Method: This study was used prospective design. The populations were new pulmonary TB patient at intensive phase, at Puskesmas Pegirian Surabaya. Samples were taken by purposive sampling technique; consist of 30 people, divided into treatment and control groups. The independent variable was N-SMSI. The dependent variables were medication adherence collected by using questionnaire and nutritional status by using measurement of body weight (kg. The data were then analyzed by using Wilcoxon Signed Rank Test, Mann Whitney, and Independent t-test with α ≤ 0.05 Result: The results of wilcoxon signed rank test had showed difference in the nutritional status of the treatment group before and after intervention, with p = 0.001. It’s similar with the control group, with p = 0.002. Mann whitney test results had showed no signifi cant difference in nutritional status between treatment and control group, as indicated by the value of p=0.589. While independent t-test had showed difference in compliance between treatment and control group, with p=0.031. Conslusion: N-SMSI can improve medication adherence of patient with Pulmonary TB. This model can be developed by nurse as alternative methods to improve medication adherence in patients with Pulmonary TB. Further research should modify nursing management model which can improve the nutritional status of patient with Pulmonary

  4. Effect of behavioral stage-based nutrition education on management of osteodystrophy among hemodialysis patients, Lebanon.

    Science.gov (United States)

    Karavetian, Mirey; de Vries, Nanne; Elzein, Hafez; Rizk, Rana; Bechwaty, Fida

    2015-09-01

    Assess the effect of intensive nutrition education by trained dedicated dietitians on osteodystrophy management among hemodialysis patients. Randomized controlled trial in 12 hospital-based hemodialysis units equally distributed over clusters 1 and 2. Cluster 1 patients were either assigned to usual care (n=96) or to individualized intensive staged-based nutrition education by a dedicated renal dietitian (n=88). Cluster 2 patients (n=210) received nutrition education from general hospital dietitians, educating their patients at their spare time from hospital duties. Main outcomes were: (1) dietary knowledge(%), (2) behavioral change, (3) serum phosphorus (mmol/L), each measured at T0 (baseline), T1 (post 6 month intervention) and T2 (post 6 month follow up). Significant improvement was found only among patients receiving intensive education from a dedicated dietitian at T1; the change regressed at T2 without statistical significance: knowledge (T0: 40.3; T1: 64; T2: 63) and serum phosphorus (T0: 1.79; T1: 1.65; T2: 1.70); behavioral stages changed significantly throughout the study (T0: Preparation, T1: Action, T2: Preparation). The intensive protocol showed to be the most effective. Integrating dedicated dietitians and stage-based education in hemodialysis units may improve the nutritional management of patients in Lebanon and countries with similar health care systems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Job sharing in clinical nutrition management: a plan for successful implementation.

    Science.gov (United States)

    Visocan, B J; Herold, L S; Mulcahy, M J; Schlosser, M F

    1993-10-01

    While women continue to enter the American work force in record numbers; many experience difficulty in juggling career and family obligations. Flexible scheduling is one option used to ease work and family pressures. Women's changing work roles have potentially noteworthy implications for clinical nutrition management, a traditionally female-dominated profession where the recruitment and retention of valued, experienced registered dietitians can prove to be a human resources challenge. Job sharing, one type of flexible scheduling, is applicable to the nutrition management arena. This article describes and offers a plan for overcoming obstacles to job sharing, including determining feasibility, gaining support of top management, establishing program design, announcing the job share program, and using implementation, monitoring, and fine-tuning strategies. Benefits that can be derived from a successful job share are reduced absenteeism, decreased turnover, enhanced recruitment, improved morale, increased productivity, improved job coverage, and enhanced skills and knowledge base. A case study illustrates one method for achieving job sharing success in clinical nutrition management.

  6. Nutritional approaches in the risk reduction and management of Alzheimer's disease.

    Science.gov (United States)

    Mi, Weiqian; van Wijk, Nick; Cansev, Mehmet; Sijben, John W C; Kamphuis, Patrick J G H

    2013-09-01

    Alzheimer's disease (AD) is a heterogeneous and devastating neurodegenerative disease with increasing socioeconomic burden for society. In the past 30 y, notwithstanding advances in the understanding of the pathogenesis of the disease and consequent development of therapeutic approaches to novel pathogenic targets, no cure has so far emerged. This contribution focuses on recent nutritional approaches in the risk reduction and management of AD with emphasis on factors providing a rationale for nutritional approaches in AD, including compromised nutritional status, altered nutrient uptake and metabolism, and nutrient requirements for synapse formation. Collectively these factors are believed to result in specific nutritional requirement in AD. The chapter also emphasizes investigated nutritional interventions in patients with AD, including studies with single nutrients and with the specific nutrient combination Fortasyn Connect and discusses the current shift of paradigm to intervene in earlier stages of AD, which offers opportunities for investigating nutritional strategies to reduce the risk for disease progression. Fortasyn Connect was designed to enhance synapse formation and function in AD by addressing the putative specific nutritional requirements and contains docosahexaenoic acid, eicosapentaenoic acid, uridine-5'-mono-phosphate, choline, phospholipids, antioxidants, and B vitamins. Two randomized controlled trials (RCTs) with the medical food Souvenaid, containing Fortasyn Connect, showed that this intervention improved memory performance in mild, drug-naïve patients with AD. Electroencephalography outcome in one of these clinical studies suggests that Souvenaid has an effect on brain functional connectivity, which is a derivative of changed synaptic activity. Thus, these studies suggest that nutritional requirements in AD can be successfully addressed and result in improvements in behavioral and neuro-physiological alterations that are characteristic to AD

  7. Dental and nutritional management of the head and neck cancer patient

    International Nuclear Information System (INIS)

    Lee, W. Robert; Sandow, Pamela L.; Moore, Giselle J.

    1997-01-01

    This course will examine the expected acute and late normal tissue toxicities associated with the delivery of high dose radiation therapy to the head and neck region. The purpose of this course will be to identify strategies to reduce radiotherapy-related toxicity without compromising adequate tumor treatment. A multidisciplinary approach will be emphasized and the following topics will be addressed: 1) Appropriate dental evaluation prior to the institution of treatment, oral care during radiation therapy and management of dental complications following completion of treatment. 2) Treatment techniques that accurately localize the target tissue, displace normal tissues from high dose volume and reduce the volume of normal tissue included in the radiation portals. 3) The investigative use of radioprotective agents. 4) The nutritional management of head and neck cancer patients including enteral and parenteral nutrition. 5) The use of medications to reduce the severity of acute symptomatology before, during and after radiation therapy

  8. Dental and nutritional management of the head and neck cancer patient

    International Nuclear Information System (INIS)

    Lee, W. Robert; Sandow, Pamela L.; Moore, Giselle J.

    1996-01-01

    This course will examine the expected acute and late normal tissue toxicities associated with the delivery of high dose radiation therapy to the head and neck region. The purpose of this course will be to identify strategies to reduce radiotherapy-related toxicity without compromising adequate tumor treatment. A multidisciplinary approach will be emphasized and the following topics will be addressed: 1) Appropriate dental evaluation prior to the institution of treatment, oral care during radiation therapy and management of dental complications following completion of treatment. 2) Treatment techniques that accurately localize the target tissue, displace normal tissues from high dose volume and reduce the volume of normal tissue included in the radiation portals. 3) The investigative use of radioprotective agents. 4) The nutritional management of head and neck cancer patients including enteral and parenteral nutrition. 5) The use of medications to reduce the severity of acute symptomatology before, during and after radiation therapy

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

    Science.gov (United States)

    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)

  10. Usability and Acceptance of the Librarian Infobutton Tailoring Environment: An Open Access Online Knowledge Capture, Management, and Configuration Tool for OpenInfobutton.

    Science.gov (United States)

    Jing, Xia; Cimino, James J; Del Fiol, Guilherme

    2015-11-30

    The Librarian Infobutton Tailoring Environment (LITE) is a Web-based knowledge capture, management, and configuration tool with which users can build profiles used by OpenInfobutton, an open source infobutton manager, to provide electronic health record users with context-relevant links to online knowledge resources. We conducted a multipart evaluation study to explore users' attitudes and acceptance of LITE and to guide future development. The evaluation consisted of an initial online survey to all LITE users, followed by an observational study of a subset of users in which evaluators' sessions were recorded while they conducted assigned tasks. The observational study was followed by administration of a modified System Usability Scale (SUS) survey. Fourteen users responded to the survey and indicated good acceptance of LITE with feedback that was mostly positive. Six users participated in the observational study, demonstrating average task completion time of less than 6 minutes and an average SUS score of 72, which is considered good compared with other SUS scores. LITE can be used to fulfill its designated tasks quickly and successfully. Evaluators proposed suggestions for improvements in LITE functionality and user interface.

  11. Patients' and professionals' barriers and facilitators of tailored expectant management in subfertile couples with a good prognosis of a natural conception.

    Science.gov (United States)

    van den Boogaard, N M; van den Boogaard, E; Bokslag, A; van Zwieten, M C B; Hompes, P G A; Bhattacharya, S; Nelen, W; van der Veen, F; Mol, B W J

    2011-08-01

    European guidelines on fertility care emphasize that subfertile couples should receive information about their chances of a natural conception and should not be exposed to unnecessary treatments and risks. Prognostic models can help to estimate their chances and select couples with a good prognosis for tailored expectant management (TEM). Nevertheless, TEM is not always practiced. The aim of this study was to identify any barriers or facilitators for TEM among professionals and subfertile couples. A qualitative study was performed with semi-structured in-depth interviews of 21 subfertile patients who were counselled for TEM and three focus-group interviews of 21 professionals in the field of reproductive medicine. Two theoretical models were used to guide the interviews and the analyses. The primary outcome was the set of identified barriers and facilitators which influence implementation of TEM. Among the subfertile couples, main barriers were a lack of confidence in natural conception, a perception that expectant management is a waste of time, inappropriate expectations prior to the first consultation, misunderstanding the reason for expectant management and overestimation of the success rates of treatment. Both couples and professionals saw the lack of patient information materials as a barrier. Among professionals, limited knowledge about prognostic models leading to a decision in favour of treatment was recognized as a main barrier. A main facilitator mentioned by the professionals was better management of patients' expectations. We identified several barriers and facilitators which can be addressed to improve the implementation of TEM. These should be taken into account when designing future implementation strategies.

  12. The public health nutrition intervention management bi-cycle: a model for training and practice improvement.

    Science.gov (United States)

    Hughes, Roger; Margetts, Barrie

    2012-11-01

    The present paper describes a model for public health nutrition practice designed to facilitate practice improvement and provide a step-wise approach to assist with workforce development. The bi-cycle model for public health nutrition practice has been developed based on existing cyclical models for intervention management but modified to integrate discrete capacity-building practices. Education and practice settings. This model will have applications for educators and practitioners. Modifications to existing models have been informed by the authors' observations and experiences as practitioners and educators, and reflect a conceptual framework with applications in workforce development and practice improvement. From a workforce development and educational perspective, the model is designed to reflect adult learning principles, exposing students to experiential, problem-solving and practical learning experiences that reflect the realities of work as a public health nutritionist. In doing so, it assists the development of competency beyond knowing to knowing how, showing how and doing. This progression of learning from knowledge to performance is critical to effective competency development for effective practice. Public health nutrition practice is dynamic and varied, and models need to be adaptable and applicable to practice context to have utility. The paper serves to stimulate debate in the public health nutrition community, to encourage critical feedback about the validity, applicability and utility of this model in different practice contexts.

  13. Delivery and Evaluation of Training for School Nutrition Administrators and Managers on Meeting Special Food and Nutrition Needs of Students in the School Setting

    Science.gov (United States)

    Oakley, Charlotte B.; Knight, Kathy; Hobbs, Margie; Dodd, Lacy M.; Cole, Janie

    2011-01-01

    Purpose/Objectives: The purpose of this investigation was to complete a formal evaluation of a project that provided specialized training for school nutrition (SN) administrators and managers on meeting children's special dietary needs in the school setting. Methods: The training was provided as part of the "Eating Good and Moving Like We…

  14. Tailoring ISO/IEC 27001 for SMEs: A Guide to Implement an Information Security Management System in Small Settings

    Science.gov (United States)

    Valdevit, Thierry; Mayer, Nicolas; Barafort, Béatrix

    While Information Security Management Systems (ISMS) are being adopted by the biggest IT companies, it remains quite difficult for smaller entities to implement and maintain all the requirements of ISO/IEC 27001. In order to increase information security in Luxembourg, the Public Research Centre Henri Tudor has been charged by the Luxembourg Ministry of Economy and Foreign Trade to find solutions to facilitate ISMS deployment for SMEs. After an initial experiment aiming at assisting a SME in getting the first national ISO/IEC 27001 certification for a private company, an implementation guide for deploying an ISMS, validated by local experts and experimented in SMEs, has been released and is presented in this paper.

  15. Barriers to Enrollment in a Pharmacist-Led Fitness, Nutrition, and Weight Management Coaching Program

    Directory of Open Access Journals (Sweden)

    Matthew J Lengel

    2017-01-01

    Full Text Available Objectives: To investigate barriers to utilization of a pharmacist-led fitness, nutrition, and weight management coaching program, as well as describe patient reported expectations and explore the patient characteristics potentially associated with a higher willingness to participate in the future. Design: Cross-sectional, descriptive study using an anonymous, electronic survey. Setting: A large, national, grocery store chain. Participants: Employee benefit plan members, eligible for a pharmacist-led fitness, nutrition, and weight management (FNWM coaching program, who were not currently or previously enrolled in the program, and met coaching program qualifications. Intervention: Peer-reviewed, electronic survey administered and collected using an Internet survey analysis software. Main Outcome Measures: Barriers to enrollment in the pharmacist-led fitness, nutrition, and weight management coaching program. Results: Of 1,130 emailed employees, 352 responded and 133 met study inclusion criteria and completed the whole survey. Of those who fit inclusion criteria, the majority (53.4% of the respondents were aware of the coaching program (75.2% and expressed interest in future participation (53.4%. “I am already taking steps to improve my health” and “I do not have time to participate in the program” were the highest rated barriers for both those interested and not interested in participating in the coaching program. The majority of participants believed pharmacists were qualified to provide the coaching service (78.2% and preferred one-on-one coaching with the pharmacist (67.7%. Key topics respondents wanted the pharmacist to cover included general diet and nutrition, weight management strategies, and vitamins and supplements. Conclusion: The two major barriers reported in the study were lack of time and the use of other health improvement methods; however, a large number of respondents indicated future interest in participating. Future

  16. The Adjunctive Role of Nutritional Therapy in the Management of Phlegmon in Two Children with Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Andrew S. Day

    2017-09-01

    Full Text Available Crohn’s disease may be complicated by the development of penetrating (fistulizing or structuring complications. The presentation of an intra-abdominal phlegmon or abscess with or without an associated fistula has traditionally required surgical intervention. This series of two cases illustrates a beneficial role of non-surgical management, with parenteral and then enteral nutrition playing central roles. This report further elaborates the potential adjunctive role of enteral nutrition in the management of this complication of CD.

  17. MANAGEMENT OF NUTRITION FOR INFANTS WITHIN THE LIMITS OF MEDICO-SOCIAL PEDIATRIC SERVICE

    Directory of Open Access Journals (Sweden)

    A. Z. Farrakhov

    2013-01-01

    Full Text Available The questions of support of infants with complete and high-quality nutrition as a measure of national medico-social service when switching to artificial or mixed feeding are discussed in the article. The data on the main approaches to support of the infants of the first 3 years of life with specialized nutrition in the Russian Federation is represented. The authors describe such causes of inefficiency of activity of municipal «milk kitchens» as lack of standards for children food products, out of date production technologies, risk of contamination and of breaking the sanitary regulations, irrational usage of resources and low consumer qualities of the service. Necessity of development of new approaches to provide infants with free milk products is demonstrated. Branch target program «Bәlәkәch — Malysh» on free provision of infants of the first 3 years of life with special milk products and milk formulas on pediatrician prescriptions in order to improve the quality of life and health condition, patronized by the President of the Republic of Tatarstan, is characterized, as well as its first results are assessed in the article. The main directions of this program are listed. The comparative characteristic of certain indices of the new scheme of management of free milk nutrition for infants during the period of 2011–2013 are shown. The measures of this program aimed at widening of amount of children receiving free nutrition, increase of quantity of consumed milk products, ensuring of regularity of service, significant decrease of federal resources expenses and providing of precise compliance of standard expanses and improvement of the quality of milk nutrition for children through provision them with appropriate and high-quality products are proved to be very effective.

  18. Effects of a tailored lifestyle self-management intervention (TALENT) study on weight reduction: a randomized controlled trial.

    Science.gov (United States)

    Melchart, Dieter; Löw, Peter; Wühr, Erich; Kehl, Victoria; Weidenhammer, Wolfgang

    2017-01-01

    Overweight and obesity are globally increasing risk factors for diseases in the context of metabolic syndrome. A randomized controlled trial was conducted to investigate whether there are any existing differences between two lifestyle intervention strategies with respect to weight reduction after 1 year. A total of 166 subjects with a body mass index of 28-35 kg/m 2 were enrolled in this trial at seven study centers; 109 were randomly allocated to the intervention group (comprehensive lifestyle modification program: web-based Individual Health Management [IHM]) with 3-month reduction phase plus 9-month maintenance phase, and 57 were allocated to the control group (written information with advice for healthy food habits: usual care [UC]). Body weight, waist circumference, blood pressure, laboratory findings, and bioimpedance analysis used to determine body composition were measured at baseline and after 3, 6, 9, and 12 months. The primary outcome parameter was body weight at month 12 compared to baseline. With respect to baseline status there were no statistically significant differences between the groups. Based on the intent-to-treat population, body weight showed a mean decrease of 8.7 kg (SD 6.1) in the intervention group (IHM) and 4.2 kg (SD 5) in the control group (UC) at month 12. This statistically significant difference ( P <0.001) was confirmed by various sensitivity analyses. Body mass index, waist circumference, high-density lipid cholesterol, body fat, and the ratio of fat and body cell mass improved to a significantly higher degree in the IHM group. IHM proved to be superior to UC in weight reduction after 1 year. With a mean loss of about 10% of the baseline weight, a clinically high relevant risk reduction for cardio-metabolic diseases is achievable.

  19. Impact of nutrition management in patients with head and neck cancers treated with irradiation: is the nutritional intervention useful?

    International Nuclear Information System (INIS)

    Garabige, V.; Giraud, P.; Jaulerry, C.; Brunin, F.; Rycke, Y. de; Girod, A.; Jouffroy, T.; Rodriguez, J.

    2007-01-01

    Aims. The head and neck tumors are most often associated with a precarious nutritional status. Radiotherapy increases the risk of de-nutrition because of its secondary effects on the secretory and sensorial mucous membranes. The purpose of our retrospectively study was to evaluate the interest of a precocious and regular nutritional therapy on the ability to maintain the nutritional status of the patient during the radiotherapy. Patients and methods. The fifty-two patients included in the survey have been classified retrospectively in two different groups based on their observance to the nutritional therapy: group 1 'good observance', group 2 'bad observance'. Results. The 31 patients of group 1 have lost an average of 1.9 kg by the end of the irradiation, whereas the 21 patients of group 2 have lost an average of 6.1 kg (p < 0.001). The almost stability in weight of patients in group 1 was linked to a lower frequency of breaks in the radio-therapy (6 vs 33% p = 0.03) and in a decrease in grade of inflammatory, mucous membranes (10% of grade 3 in group 1 vs 52% in group 2, p = 0.006). The quantity of calories ingested in form of nutritional supplements was greater in group 1 and consequently enabled patients to stabilized their weight (1200 calories in group 1 versus 850 calories in group 2, p < 0.005). Conclusions. The given nutritional advice and the prescription of adapted nutritional supplements consequently allowed limiting efficiently the weight lost during the irradiation and the grade of mucositis. The systematization of a precocious nutritional therapy for patients irradiated for head and neck tumors seems absolutely essential. (authors)

  20. Perspectives on the Nutritional Management of Metabolic Syndrome in Asia: People, Practice and Programmes

    Directory of Open Access Journals (Sweden)

    Phing Chee Huei

    2017-03-01

    Full Text Available Numerous Asian countries have a high prevalence of metabolic syndrome, also associated with cardiovascular disease and diabetes mellitus. Healthcare expenditure varies among Asian countries, and is influenced by poverty factor and large populations. The effect of metabolic syndrome on nutritional management in Asia demonstrates the essential for clinicians to equalize the needs for higher standards of dietetics practice; as they execute optimal care processes with the aim of improving outcomes, alongside setting of workforce limitations, inadequate expertise in metabolic syndrome nutrition practice, as well as ethnic diversity among Asians. This paper presents some aspects of dietetics practice and the possibility that an alteration in practice is mandatory if dietitians are to play an active role in preventing or decelerating the evolution of the metabolic syndrome.

  1. Nutritional management of breastfeeding infants for the prevention of common nutrient deficiencies and excesses

    Directory of Open Access Journals (Sweden)

    Jin Soo Moon

    2011-07-01

    Full Text Available Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to control children’s daily sedentary life style and their intakes of high caloric foods in order to prevent obesity. Recent assessment of breastfeeding in Korea has shown that the rate is between 63% and 89%; thus, up-to-dated evidence-based nutritional management of breastfeeding infants to prevent common nutrient deficiencies or excesses should be taught to all clinicians and health care providers.

  2. Use of an esophagostomy tube as a method of nutritional management in raptors: a case series.

    Science.gov (United States)

    Huynh, Minh; Sabater, Mikel; Brandão, João; Forbes, Neil A

    2014-03-01

    We determined if esophagostomy tube placement is feasible for nutritional support in raptors. The clinical data were reviewed from 18 raptors admitted between 2006 and 2012, and in which esophagostomy tubes were placed. Indications for tube placement, complications associated with its placement and management, duration of treatment, and changes in patient body weight were evaluated. The most common indication was nutritional and medical support in stressed hospitalized animals, and intensive care cases. Complications were regurgitation, unexpected removal, and misplacement of the tube. The esophagostomy tube was well tolerated in all but 2 cases. A tube was replaced once in 2 patients. Five birds died during the treatment course. Mortality was not associated with the placement of the tube. Average duration of tube placement was 6.1 +/- 3.7 days. Most birds did not gain any weight with use of the feeding tubes. Esophagostomy tubes are well tolerated in raptors, but further studies are needed to demonstrate their efficiency.

  3. [Evaluation of the Food and Nutrition Surveillance System (SISVAN) in food and nutritional management services in the State of Minas Gerais, Brazil].

    Science.gov (United States)

    Rolim, Mara Diana; Lima, Sheyla Maria Lemos; de Barros, Denise Cavalcante; de Andrade, Carla Lourenço Tavares

    2015-08-01

    The scope of this article is to evaluate the SISVAN as a tool for planning, management and evaluation of food and nutrition actions in primary healthcare in the Unified Health System (SUS). It involved a cross-sectional study composed of a stratified random sample of the municipalities in the State of Minas Gerais. The subjects of the research were municipal officials of SISVAN who filled out a structured questionnaire. Descriptive analysis of the data was performed with the construction of simple and bivariate tables. It was observed that those responsible for SISVAN, collect (50%) and input (55%) weight, height, and food consumption data; whereas 53%, 59% and 71% do not analyze and do not recommend or perform nutrition actions, respectively. This being the case, most of those responsible do not use the information for planning, management and evaluation of food and nutrition traits. The findings show that the SISVAN is not used to its full potential; the data generated have not been used for planning, management and evaluation of nutrition services in primary healthcare in the SUS.

  4. Tailoring Earth Observation To Ranchers For Improved Land Management And Profitability: The VegMachine Online Project

    Science.gov (United States)

    Scarth, P.; Trevithick, B.; Beutel, T.

    2016-12-01

    , organisations supporting land management initiatives in Great Barrier Reef catchments, by students developing tools to understand land condition and degradation and the underlying data and APIs are supporting several other land condition mapping tools.

  5. The home management of Artificial Nutrition: a survey among doctors and nurses.

    Science.gov (United States)

    Gamberi, Sara; Calamassi, Diletta; Coletta, David; Dolenti, Silvia; Valoriani, Alice; Tarquini, Roberto

    2017-08-23

    The management of Artificial Nutrition (NA), especially in the home environment (HAN) requires specific skills in order to ensure the correct therapeutic education, prevention of complications and the provision of appropriate treatment to the person. The aim of this survey was to identify the perceptions of nurses and doctors, as well as comparing to their perceived competence in NA and the gap between their perceived versus actual knowledge and management methods. This observational study was conducted in a Tuscan health region of Italy, involving 50 Home Care Services nurses and 50 general practitioners. Participants were asked to complete an online questionnaire that was constructed for purpose. The results show that for the management of the person with NA, both for doctors and for nurses show great variability in responses. Less than half of those providing care make assessments of nutritional status and dysphagia as well as the possibility of re-feeding by natural means in NA patients. Care providers expressed uncertainty as to which professional should carry out such assessments. A mismatch was also evident between the skills possessed and the self-assessments performed regarding their knowledge base of NA. Almost all of doctors of nurses indicated a desire to participate in training events relating to NA. The results highlight the need for caregivers to have specific operating protocols. The results also highlight the need to aim to work as a team, emphasizing the importance of basic communication as well as the need for clarity as to the responsibilities and roles of the professionals involved.Key words: Artificial Nutrition, Nurses, Doctors, home management, skills, training, team.

  6. Tailored Porous Materials

    Energy Technology Data Exchange (ETDEWEB)

    BARTON,THOMAS J.; BULL,LUCY M.; KLEMPERER,WALTER G.; LOY,DOUGLAS A.; MCENANEY,BRIAN; MISONO,MAKOTO; MONSON,PETER A.; PEZ,GUIDO; SCHERER,GEORGE W.; VARTULI,JAMES C.; YAGHI,OMAR M.

    1999-11-09

    Tailoring of porous materials involves not only chemical synthetic techniques for tailoring microscopic properties such as pore size, pore shape, pore connectivity, and pore surface reactivity, but also materials processing techniques for tailoring the meso- and the macroscopic properties of bulk materials in the form of fibers, thin films and monoliths. These issues are addressed in the context of five specific classes of porous materials: oxide molecular sieves, porous coordination solids, porous carbons, sol-gel derived oxides, and porous heteropolyanion salts. Reviews of these specific areas are preceded by a presentation of background material and review of current theoretical approaches to adsorption phenomena. A concluding section outlines current research needs and opportunities.

  7. Applications of nanotechnology in gastric cancer: detection and prevention by nutrition.

    Science.gov (United States)

    Elingarami, Sauli; Liu, Ming; Fan, Jing; He, Nongyue

    2014-01-01

    New and emerging technologies, such as nanotechnology, have the potential to advance nutrition science by assisting in the discovery, development, and delivery of several intervention strategies to improve health and reduce the risk and complications of several diseases, including gastric cancer. This article reviews gastric cancer in relation to nutrition, discussing gastric carcinogenesis in-depth in relation to prevention of the disease by nutrition, as well as current detection approaches using nanotechnology. The current status of molecular nutritional biomarkers for gastric cancer is also discussed, as well as future strategies for the tailored management of gastric cancer.

  8. Experiences and Perceptions of Adults Accessing Publicly Available Nutrition Behavior-Change Mobile Apps for Weight Management.

    Science.gov (United States)

    Lieffers, Jessica R L; Arocha, Jose F; Grindrod, Kelly; Hanning, Rhona M

    2018-02-01

    Nutrition mobile apps have become accessible and popular weight-management tools available to the general public. To date, much of the research has focused on quantitative outcomes with these tools (eg, weight loss); little is known about user experiences and perceptions of these tools when used outside of a research trial environment. Our aim was to understand the experiences and perceptions of adult volunteers who have used publicly available mobile apps to support nutrition behavior change for weight management. We conducted one-on-one semi-structured interviews with individuals who reported using nutrition mobile apps for weight management outside of a research setting. Twenty-four healthy adults (n=19 females, n=5 males) who had used publicly available nutrition mobile apps for weight management for ≥1 week within the past 3 to 4 months were recruited from the community in southern Ontario and Edmonton, Canada, using different methods (eg, social media, posters, and word of mouth). Interviews were audiorecorded, transcribed verbatim, and transcripts were verified against recordings. Data were coded inductively and organized into categories using NVivo, version 10 (QSR International). Participants used nutrition apps for various amounts of time (mean=approximately 14 months). Varied nutrition apps were used; however, MyFitnessPal was the most common. In the interviews, the following four categories of experiences with nutrition apps became apparent: food data entry (database, data entry methods, portion size, and complex foods); accountability, feedback, and progress (goal setting, accountability, monitoring, and feedback); technical and app-related factors; and personal factors (self-motivation, privacy, knowledge, and obsession). Most participants used apps without professional or dietitian support. This work reveals that numerous factors affect use and ongoing adherence to use of nutrition mobile apps. These data are relevant to professionals looking to

  9. Nutrition Advice and Recipes

    Science.gov (United States)

    ... Sign-Up Home Patient Information Nutrition Advice & Recipes Nutrition Advice & Recipes This is a very important section ... information on all aspects of daily life, including nutrition, medical treatments, pain management, and practical tips. For ...

  10. Artificial Hydration and Nutrition

    Science.gov (United States)

    ... Crisis Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight Loss and Diet Plans ... Your Health Resources Healthcare Management Artificial Hydration and Nutrition Artificial Hydration and Nutrition Share Print Patients who ...

  11. Preventing the obesity epidemic by second generation tailored health communication: an interdisciplinary review.

    Science.gov (United States)

    Enwald, Heidi Päivyt Karoliina; Huotari, Maija-Leena Aulikki

    2010-06-28

    The prevention of obesity and health concerns related to obesity are major challenges worldwide. The use of eHealth communication and the tailoring of information delivered via the Internet at the individual level may increase the effectiveness of interventions. Mastering behaviors related to nutrition, physical activity, and weight management are the main issues in preventing obesity, and the need for interdisciplinary knowledge within this area is obvious. The objectives were to review the literature on tailored health communication and to present an interdisciplinary analysis of studies on "second" generation tailored interventions aimed at behavior change in nutrition, physical activity, or weight management. A literature search was conducted of the main electronic information sources on health communication. Selection criteria were defined, and 23 intervention studies were selected. The content analysis focused on the following: study designs, objectives of behavior change, target groups, sample sizes, study lengths, attrition rates, theories applied, intervention designs, computer-based channels used, statistically significant outcomes from the perspective of tailoring, and possible biases of the studies. However, this was not a structured meta-analysis and cannot be replicated as such. Of the 23 studies, 21 were randomized controlled trials, and all focused on behavior change: 10 studies focused on behavior change in nutrition, 7 on physical activity, 2 on nutrition and physical activity, and 4 on weight management. The target groups and the number of participants varied: 8 studies included more than 500 participants, and 6 studies included less than 100. Most studies were short; the duration of 20 studies was 6 months or less. The Transtheoretical Model was applied in 14 of the 23 studies, and feedback as a tailoring mechanism was used in addition to an Internet site (or program) in 15 studies and in addition to email in 11 studies. Self-reporting was used

  12. Assessment and management of nutrition in older people and its importance to health

    Directory of Open Access Journals (Sweden)

    Tanvir Ahmed

    2010-07-01

    Full Text Available Tanvir Ahmed, Nadim HaboubiAdult and Elderly Medicine, Nevill Hall Hospital, Abergavenny, Wales, UKAbstract: Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements.Keywords: malnutrition, older people, anorexia of aging, sarcopinia, nutritional assessment

  13. The effect of nutritional management of the dairy cow on reproductive efficiency.

    Science.gov (United States)

    Roche, James F

    2006-12-01

    that attenuate the production of F2alpha can improve CR. The increased metabolic clearance rate of progesterone (P4), which decreases blood concentrations during early embryo cleavage up to the blastocyst stage is associated with decreased CRs. In conclusion, poor nutritional management of the dairy cow, particularly before and after calving, is a key driver of infertility.

  14. Continuous tailoring activities in software engineering

    OpenAIRE

    Ribaud , Vincent; Saliou , Philippe

    2004-01-01

    International audience; Software activities belong to different processes. Tailoring software processes aims to relate the operational software processes of an organization to the effective project. With the information technology industry moving ever faster, established positions are undergoing constant evolutionary change. The failure of a complex tailoring process of a management information system is reported. There is a need to adopt software processes that can operate under constant cha...

  15. Identification of quality indicators for the nutritional management of adult hospitalized patients by a modified Delphi process.

    Science.gov (United States)

    Verbanck, L; De Waele, J; Duysburgh, I; Van Looy, L; Ysebaert, D; Merckx, L; Ferdinande, P

    2015-01-01

    The aim of this study was to identify quality indicators (QI) that measure or evaluate the quality of nutritional management of the adult hospitalized patient irrespective of the primary disease or surgical condition. During a modified Delphi procedure consisting of three rounds a 48 member expert panel selected quality indicators applicable to the subject focusing on validity and feasibility from a list of 89 candidate indicators, retrieved from the literature and completed by expert opinion. The following top ten of QIs were selected (weight between brackets): (1) Priority use of enteral route in the absence of contra indications (.95); (2) Patients with malnutrition (risk) receive a nutrition care plan or Nutritional Support (NS) (.935); (3) The hospital has a formulary on enteral formulas, parenteral nutrition (PN) solutions and nutritional supplements (.93); (4) The hospital has a designated nutrition support service (or team) (.922); (5) The hospital has written policies and procedures for the provision of nutrition support therapy (.9); (6) In hospitalized patients on PN the plasma triglycerides are checked weekly (.894); (7) Presence of a protocol for enteral drug administration through a feeding tube (.885); (8) Frequency of periodic reassessment of patients on NS (.883); (9) Enteral and PN orders are regularly revised and adjusted (daily/weekly/twice a week)(.88); (10) There is a hospital wide consensus on the screening method(s) for malnutrition (.88). Using a three round modified Delphi approach a list of ten best scoring QIs for the management of the adult hospitalized patient was established.

  16. Risk factors for occurrence of displaced abomasum and their relation to nutritional management of Holstein dairy cattle

    OpenAIRE

    Behluli, Behlul; Musliu, Arben; Sherifi, Kurtesh; Youngs, Curtis R.; Rexhepi, Agim

    2017-01-01

    The aim of the present study was to identify nutritional risk factors for the occurrence of displaced abomasum (DA) in Holstein dairy cattle raised in regions with highly variable nutritional management. Feeding program data were collected from 30 dairy farms throughout Kosovo via use of a standardized questionnaire, and an AgriNIR™ Analyser was used to analyze the nutrient composition of forage (hay, corn silage) fed to cattle on those farms. A diagnosis of DA was made via auscultation/percu...

  17. The effectiveness, reproducibility, and durability of tailored mobile coaching on diabetes management in policyholders: A randomized, controlled, open-label study.

    Science.gov (United States)

    Lee, Da Young; Park, Jeongwoon; Choi, Dooah; Ahn, Hong-Yup; Park, Sung-Woo; Park, Cheol-Young

    2018-02-26

    This randomized, controlled, open-label study conducted in Kangbuk Samsung Hospital evaluated the effectiveness, reproducibility, and durability of tailored mobile coaching (TMC) on diabetes management. The participants included 148 Korean adult policyholders with type 2 diabetes divided into the Intervention-Maintenance (I-M) group (n = 74) and Control-Intervention (C-I) group (n = 74). Intervention was the addition of TMC to typical diabetes care. In the 6-month phase 1, the I-M group received TMC, and the C-I group received their usual diabetes care. During the second 6-month phase 2, the C-I group received TMC, and the I-M group received only regular information messages. After the 6-month phase 1, a significant decrease (0.6%) in HbA1c levels compared with baseline values was observed in only the I-M group (from 8.1 ± 1.4% to 7.5 ± 1.1%, P < 0.001 based on a paired t-test). At the end of phase 2, HbA1c levels in the C-I group decreased by 0.6% compared with the value at 6 months (from 7.9 ± 1.5 to 7.3 ± 1.0, P < 0.001 based on a paired t-test). In the I-M group, no changes were observed. Both groups showed significant improvements in frequency of blood-glucose testing and exercise. In conclusion, addition of TMC to conventional treatment for diabetes improved glycemic control, and this effect was maintained without individualized message feedback.

  18. Towards Tailored Patient’s Management Approach: Integrating the Modified 2010 ACR Criteria for Fibromyalgia in Multidimensional Patient Reported Outcome Measures Questionnaire

    Directory of Open Access Journals (Sweden)

    Yasser El Miedany

    2016-01-01

    Full Text Available Objectives. To assess the validity, reliability, and responsiveness to change of a patient self-reported questionnaire combining the Widespread Pain Index and the Symptom Severity Score as well as construct outcome measures and comorbidities assessment in fibromyalgia patients. Methods. The PROMs-FM was conceptualized based on frameworks used by the WHO Quality of Life tool and the PROMIS. Initially, cognitive interviews were conducted to identify item pool of questions. Item selection and reduction were achieved based on patients as well as an interdisciplinary group of specialists. Rasch and internal consistency reliability analyses were implemented. The questionnaire included the modified ACR criteria main items (Symptom Severity Score and Widespread Pain Index, in addition to assessment of functional disability, quality of life (QoL, review of the systems, and comorbidities. Every patient completed HAQ and EQ-5D questionnaires. Results. A total of 146 fibromyalgia patients completed the questionnaire. The PROMs-FM questionnaire was reliable as demonstrated by a high standardized alpha (0.886–0.982. Content construct assessment of the functional disability and QoL revealed significant correlation (p<0.01 with both HAQ and EQ-5D. Changes in functional disability and QoL showed significant (p<0.01 variation with diseases activity status in response to therapy. There was higher prevalence of autonomic symptoms, CVS risk, sexual dysfunction, and falling. Conclusions. The developed PROMs-FM questionnaire is a reliable and valid instrument for assessment of fibromyalgia patients. A phased treatment regimen depending on the severity of FMS as well as preferences and comorbidities of the patient is the best approach to tailored patient management.

  19. Integrated Assessment of Pharmacological and Nutritional Cardiovascular Risk Management : Blood Pressure Control in the DIAbetes and LifEstyle Cohort Twente (DIALECT)

    NARCIS (Netherlands)

    Gant, Christina M.; Binnenmars, S. Heleen; van den Berg, Else; Bakker, Stephan J. L.; Navis, Gerjan; Laverman, Gozewijn D.

    2017-01-01

    Cardiovascular risk management is an integral part of treatment in Type 2 Diabetes Mellitus (T2DM), and requires pharmacological as well as nutritional management. We hypothesize that a systematic assessment of both pharmacological and nutritional management can identify targets for the improvement

  20. Dental and nutritional management of the head and neck cancer patient

    International Nuclear Information System (INIS)

    Lee, W. Robert; Sandow, Pamela L.; Moore, Giselle J.

    1995-01-01

    This course will examine the expected acute and late normal tissue toxicities associated with the delivery of high dose radiation therapy to the head and neck region. The purpose of this course will be to identify strategies to reduce radiotherapy-related toxicity without compromising adequate tumor treatment. A multidisciplinary approach will be emphasized and the following topics will be addressed: 1) Appropriate dental evaluation prior to the institution of treatment, oral care during radiation therapy and management of dental complications following completion of treatment. 2) Treatment techniques that accurately localize the target tissue, displace normal tissues from high dose volume and reduce the volume of normal tissue included in the radiation portals. 3) The investigative use of radioprotective agents. 4) Optimal integration of radiotherapy with surgery and/or chemotherapy. 5) The nutritional management of head and neck cancer patients including enteral and parenteral nutrition. 6) The use of medications to reduce the severity of acute symptomatology before, during and after radiation therapy

  1. Enteral Nutrition in the Management of Pediatric and Adult Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Tawnya Hansen

    2018-04-01

    Full Text Available Genetic and environmental factors are thought to profoundly influence the pathophysiology of Crohn’s disease (CD. Changes in dietary and hygiene patterns affect the interactions between the immune system and environment. The gut microbiome is responsible for mediating host immune response with significant dysbiosis observed in individuals with CD. Diet therapy using exclusive enteral nutrition (EEN has been studied as primary therapy for the management of CD. EEN may cultivate the presence of beneficial microbiota, improve bile acid metabolism, and decrease the number of dietary microparticles possibly influencing disease and immune activity. In this review, we will address the current evidence on EEN in the management of adult and pediatric CD. In adults, EEN appears to be moderately beneficial for the induction of remission of CD; however, its use is understudied and underutilized. Stronger evidence is in place to support the use of EEN in pediatric CD with the added benefit of nutrition support and steroid-sparing therapy during the growth phase. Overall, EEN is an established therapy in inducing CD remission in the pediatric population while its role as primary therapy of adult Crohn’s disease remains to be defined.

  2. Nutrition management guideline for maple syrup urine disease: an evidence- and consensus-based approach.

    Science.gov (United States)

    Frazier, Dianne M; Allgeier, Courtney; Homer, Caroline; Marriage, Barbara J; Ogata, Beth; Rohr, Frances; Splett, Patricia L; Stembridge, Adrya; Singh, Rani H

    2014-07-01

    In an effort to increase harmonization of care and enable outcome studies, the Genetic Metabolic Dietitians International (GMDI) and the Southeast Regional Newborn Screening and Genetics Collaborative (SERC) are partnering to develop nutrition management guidelines for inherited metabolic disorders (IMD) using a model combining both evidence- and consensus-based methodology. The first guideline to be completed is for maple syrup urine disease (MSUD). This report describes the methodology used in its development: formulation of five research questions; review, critical appraisal and abstraction of peer-reviewed studies and unpublished practice literature; and expert input through Delphi surveys and a nominal group process. This report includes the summary statements for each research question and the nutrition management recommendations they generated. Each recommendation is followed by a standardized rating based on the strength of the evidence and consensus used. The application of technology to build the infrastructure for this project allowed transparency during development of this guideline and will be a foundation for future guidelines. Online open access of the full, published guideline allows utilization by health care providers, researchers, and collaborators who advise, advocate and care for individuals with MSUD and their families. There will be future updates as warranted by developments in research and clinical practice. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Nutrition in inflammatory bowel disease

    Science.gov (United States)

    Martínez Gómez, María Josefa; Melián Fernández, Cristóbal; Romeo Donlo, María

    2016-07-12

    Inflammatory bowel disease (IBD) is a chronic pathology that has an outbreaks course that in recent years have seen an increase in incidence, especially at younger ages. Malnutrition is frequently associated with this condition, therefore, it is very important to ensure a right nutritional intervention, especially in pediatric patients, to ensure an optimal growth and also an improvement in the clinic. Our goal will be updated the role of nutrition in this disease and in its treatment based on the published evidence. Malnutrition in these patients is frequent and is influenced by various factors such as, decreased food intake, increased nutrient requirements, increased protein loss and malabsorption of nutrients. Therefore there should be a nutritional monitoring of all of them, in which anthropometric measurements, laboratory tests and densitometry were made to establish the needs and sufficient caloric intake tailored to each patient. The use of enteral nutrition as a treatment in Crohn’s disease with mild to moderate outbreak in child population, is amply demonstrated, has even shown to be superior to the use of corticosteroids. Therefore we can conclude by stressing that nutritional intervention is a mainstay in the management of patients with IBD, which aims to prevent and / or control disease-related malnutrition to decrease morbidity and mortality and improve quality of life.

  4. 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.

  5. Nutrition management methods effective in increasing weight, survival time and functional status in ALS patients: a systematic review.

    Science.gov (United States)

    Kellogg, Jaylin; Bottman, Lindsey; Arra, Erin J; Selkirk, Stephen M; Kozlowski, Frances

    2018-02-01

    Poor prognosis and decreased survival time correlate with the nutritional status of patients with amyotrophic lateral sclerosis (ALS). Various studies were reviewed which assessed weight, body mass index (BMI), survival time and ALS functional rating scale revised (ALSFRS-R) in order to determine the best nutrition management methods for this patient population. A systematic review was conducted using CINAHL, Medline, and PubMed, and various search terms in order to determine the most recent clinical trials and observational studies that have been conducted concerning nutrition and ALS. Four articles met criteria to be included in the review. Data were extracted from these articles and were inputted into the Data Extraction Tool (DET) provided by the Academy of Nutrition and Dietetics (AND). Results showed that nutrition supplementation does promote weight stabilisation or weight gain in individuals with ALS. Given the low risk and low cost associated with intervention, early and aggressive nutrition intervention is recommended. This systematic review shows that there is a lack of high quality evidence regarding the efficacy of any dietary interventions for promoting survival in ALS or slowing disease progression; therefore more research is necessary related to effects of nutrition interventions.

  6. Use of isotope and radiation methods in soil and water management and crop nutrition. Manual

    International Nuclear Information System (INIS)

    2001-01-01

    This publication is a replacement for the IAEA Training Course Series No. 2 'Use of Nuclear Techniques in Studies of Soil-Plant Relationships' published in 1990. This edition, prepared by staff of the Soil Science Unit, Seibersdorf, and the Soil and Water Management and Crop Nutrition Section, Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture, Vienna, differs in many respects from its predecessor both in terms of content and objectives. The earlier publication provided basic information for use in interregional training courses held at regular intervals at the Seibersdorf Laboratories. Since the discontinuation of these training courses in 1996, the need for dissemination of up to date information to Member States has become more acute, particularly in view of the evolution of new methodologies during the past decade and new applications of existing methodologies to monitor the dynamics of soil, water and nutrients in cropping systems, and to pilot test interventions to conserve the natural resource base and optimize the availability of water and nutrients to crops. The present publication attempts to fulfill a part of this need. The manual provides an overview of the use of nuclear techniques in soil science and plant nutrition, balancing the need for a comprehensive coverage of a multitude of techniques involving isotopic tracers and sealed or unsealed sources, while giving sufficient depth to be of practical value to the end-users - students, technicians, scientists in national agricultural research systems and fellowship trainees. In this respect it is important to emphasize that nuclear techniques do not in themselves provide solutions to real world problems - they provide tools which when used in conjunction with other techniques, provide precise and specific information necessary to understand system dynamics and hence the value of alternative management practices to improve system productivity and resource conservation. This publication

  7. Use of isotope and radiation methods in soil and water management and crop nutrition. Manual

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-12-01

    This publication is a replacement for the IAEA Training Course Series No. 2 'Use of Nuclear Techniques in Studies of Soil-Plant Relationships' published in 1990. This edition, prepared by staff of the Soil Science Unit, Seibersdorf, and the Soil and Water Management and Crop Nutrition Section, Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture, Vienna, differs in many respects from its predecessor both in terms of content and objectives. The earlier publication provided basic information for use in interregional training courses held at regular intervals at the Seibersdorf Laboratories. Since the discontinuation of these training courses in 1996, the need for dissemination of up to date information to Member States has become more acute, particularly in view of the evolution of new methodologies during the past decade and new applications of existing methodologies to monitor the dynamics of soil, water and nutrients in cropping systems, and to pilot test interventions to conserve the natural resource base and optimize the availability of water and nutrients to crops. The present publication attempts to fulfill a part of this need. The manual provides an overview of the use of nuclear techniques in soil science and plant nutrition, balancing the need for a comprehensive coverage of a multitude of techniques involving isotopic tracers and sealed or unsealed sources, while giving sufficient depth to be of practical value to the end-users - students, technicians, scientists in national agricultural research systems and fellowship trainees. In this respect it is important to emphasize that nuclear techniques do not in themselves provide solutions to real world problems - they provide tools which when used in conjunction with other techniques, provide precise and specific information necessary to understand system dynamics and hence the value of alternative management practices to improve system productivity and resource conservation. This publication

  8. A practical approach to the nutritional management of chronic kidney disease patients in Cape Town, South Africa.

    Science.gov (United States)

    Ameh, Oluwatoyin I; Cilliers, Lynette; Okpechi, Ikechi G

    2016-07-08

    The multi-racial and multi-ethnic population of South Africa has significant variation in their nutritional habits with many black South Africans undergoing a nutritional transition to Western type diets. In this review, we describe our practical approaches to the dietary and nutritional management of chronic kidney disease (CKD) patients in Cape Town, South Africa. Due to poverty and socio-economic constraints, significant challenges still exist with regard to achieving the nutritional needs and adequate dietary counselling of many CKD patients (pre-dialysis and dialysis) in South Africa. Inadequate workforce to meet the educational and counselling needs of patients, inability of many patients to effectively come to terms with changing body and metabolic needs due to ongoing kidney disease, issues of adherence to fluid and food restrictions as well as adherence to medications and in some cases the inability to obtain adequate daily food supplies make up some of these challenges. A multi-disciplinary approach (dietitians, nurses and nephrologists) of regularly reminding and educating patients on dietary (especially low protein diets) and nutritional needs is practiced. The South African Renal exchange list consisting of groups of food items with the same nutritional content has been developed as a practical tool to be used by dietitians to convert individualized nutritional prescriptions into meal plan to meet the nutritional needs of patients in South Africa. The list is currently utilized in counselling CKD patients and provides varied options for food items within the same group (exchangeable) as well as offering ease for the description of suitable meal portions (sizes) to our patients. Regular and continuous education of CKD patients by a multi-disciplinary team in South Africa enables our patients to meet their nutritional goals and retard CKD progression. The South African renal exchange list has proved to be a very useful tool in meeting this need.

  9. Nutritional management and follow up of infants and children with food allergy: Italian Society of Pediatric Nutrition/Italian Society of Pediatric Allergy and Immunology Task Force Position Statement.

    Science.gov (United States)

    Giovannini, Marcello; D'Auria, Enza; Caffarelli, Carlo; Verduci, Elvira; Barberi, Salvatore; Indinnimeo, Luciana; Iacono, Iride Dello; Martelli, Alberto; Riva, Enrica; Bernardini, Roberto

    2014-01-03

    Although the guidelines on the diagnosis and treatment of food allergy recognize the role of nutrition, there is few literature on the practical issues concerning the nutritional management of children with food allergies. This Consensus Position Statement focuses on the nutritional management and follow-up of infants and children with food allergy.It provides practical advices for the management of children on exclusion diet and it represents an evidence-based consensus on nutritional intervention and follow-up of infants and children with food allergy. Children with food allergies have poor growth compared to non-affected subjects directly proportional to the quantity of foods excluded and the duration of the diet. Nutritional intervention, if properly planned and properly monitored, has proven to be an effective mean to substantiate a recovery in growth. Nutritional intervention depends on the subject's nutritional status at the time of the diagnosis. The assessment of the nutritional status of children with food allergies should follow a diagnostic pathway that involves a series of successive steps, beginning from the collection of a detailed diet-history. It is essential that children following an exclusion diet are followed up regularly. The periodic re-evaluation of the child is needed to assess the nutritional needs, changing with the age, and the compliance to the diet. The follow- up plan should be established on the basis of the age of the child and following the growth pattern.

  10. Assessment and management of nutrition in older people and its importance to health.

    Science.gov (United States)

    Ahmed, Tanvir; Haboubi, Nadim

    2010-08-09

    Nutrition is an important element of health in the older population and affects the aging process. The prevalence of malnutrition is increasing in this population and is associated with a decline in: functional status, impaired muscle function, decreased bone mass, immune dysfunction, anemia, reduced cognitive function, poor wound healing, delayed recovery from surgery, higher hospital readmission rates, and mortality. Older people often have reduced appetite and energy expenditure, which, coupled with a decline in biological and physiological functions such as reduced lean body mass, changes in cytokine and hormonal level, and changes in fluid electrolyte regulation, delay gastric emptying and diminish senses of smell and taste. In addition pathologic changes of aging such as chronic diseases and psychological illness all play a role in the complex etiology of malnutrition in older people. Nutritional assessment is important to identify and treat patients at risk, the Malnutrition Universal Screening Tool being commonly used in clinical practice. Management requires a holistic approach, and underlying causes such as chronic illness, depression, medication and social isolation must be treated. Patients with physical or cognitive impairment require special care and attention. Oral supplements or enteral feeding should be considered in patients at high risk or in patients unable to meet daily requirements.

  11. Skin Lesions Associated with Nutritional Management of Maple Syrup Urine Disease

    Directory of Open Access Journals (Sweden)

    Jaraspong Uaariyapanichkul

    2017-01-01

    Full Text Available Introduction. Maple syrup urine disease (MSUD is an inborn error of branched chain amino acids (BCAAs metabolism. We report an infant with MSUD who developed 2 episodes of cutaneous lesions as a result of isoleucine deficiency and zinc deficiency, respectively. Case Presentation. A 12-day-old male infant was presented with poor milk intake and lethargy. The diagnosis of MSUD was made based on clinical and biochemical data. Management and Outcome. Specific dietary restriction of BCAAs was given. Subsequently, natural protein was stopped as the patient developed hospital-acquired infections which resulted in an elevation of BCAAs. Acrodermatitis dysmetabolica developed and was confirmed to be from isoleucine deficiency. At the age of 6 months, the patient developed severe lethargy and was on natural protein exclusion for an extended period. Despite enteral supplementation of zinc sulfate, cutaneous manifestations due to zinc deficiency occurred. Discussion. Skin lesions in MSUD patients could arise from multiple causes. Nutritional deficiency including isoleucine and zinc deficiencies can occur and could complicate the treatment course as a result of malabsorption, even while on enteral supplementation. Parenteral nutrition should be considered and initiated accordingly. Clinical status, as well as BCAA levels, should be closely monitored in MSUD patients.

  12. Nutritional Management of Insulin Resistance in Nonalcoholic Fatty Liver Disease (NAFLD

    Directory of Open Access Journals (Sweden)

    Judith Wylie-Rosett

    2013-10-01

    Full Text Available Nonalcoholic fatty liver disease (NAFLD is an emerging global health concern. It is the most common form of chronic liver disease in Western countries, affecting both adults and children. NAFLD encompasses a broad spectrum of fatty liver disease, ranging from simple steatosis (NAFL to nonalcoholic steatohepatitis (NASH, and is strongly associated with obesity, insulin resistance, and dyslipidemia. First-line therapy for NAFLD includes weight loss achieved through diet and physical activity. However, there is a lack of evidenced-based dietary recommendations. The American Diabetes Association’s (ADA recommendations that aim to reduce the risk of diabetes and cardiovascular disease may also be applicable to the NAFLD population. The objectives of this review are to: (1 provide an overview of NAFLD in the context of insulin resistance, and (2 provide a rationale for applying relevant aspects of the ADA recommendations to the nutritional management of NAFLD.

  13. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management

    Science.gov (United States)

    Birnkrant, David J; Bushby, Katharine; Bann, Carla M; Apkon, Susan D; Blackwell, Angela; Brumbaugh, David; Case, Laura E; Clemens, Paula R; Hadjiyannakis, Stasia; Pandya, Shree; Street, Natalie; Tomezsko, Jean; Wagner, Kathryn R; Ward, Leanne M; Weber, David R

    2018-01-01

    Since the publication of the Duchenne muscular dystrophy (DMD) care considerations in 2010, multidisciplinary care of this severe, progressive neuromuscular disease has evolved. In conjunction with improved patient survival, a shift to more anticipatory diagnostic and therapeutic strategies has occurred, with a renewed focus on patient quality of life. In 2014, a steering committee of experts from a wide range of disciplines was established to update the 2010 DMD care considerations, with the goal of improving patient care. The new care considerations aim to address the needs of patients with prolonged survival, to provide guidance on advances in assessments and interventions, and to consider the implications of emerging genetic and molecular therapies for DMD. The committee identified 11 topics to be included in the update, eight of which were addressed in the original care considerations. The three new topics are primary care and emergency management, endocrine management, and transitions of care across the lifespan. In part 1 of this three-part update, we present care considerations for diagnosis of DMD and neuromuscular, rehabilitation, endocrine (growth, puberty, and adrenal insufficiency), and gastrointestinal (including nutrition and dysphagia) management. PMID:29395989

  14. Nutritional and Weight-Management Behaviors in Low-Income Women Trying to Conceive

    Science.gov (United States)

    Berenson, Abbey B.; Pohlmeier, Ali M.; Laz, Tabassum H.; Rahman, Mahbubur; McGrath, Christine J.

    2014-01-01

    Objective To evaluate the nutritional habits and weight management strategies of women trying to conceive as compared to women not trying to conceive. Methods This was a cross-sectional survey of health behaviors including nutritional habits and weight management strategies of women aged 16–40 years who were low-income, racially diverse, (n=1,711) and attending reproductive health clinics. Multivariable logistic regression analyses were performed to examine the association between pregnancy intention and various health behaviors after adjusting for demographic variables, gravidity, and obesity status. Results At total of 8.9% (n=153) of the participants stated they were trying to get pregnant. Women trying to conceive were more likely than those not trying to have participated in a number of unhealthy weight loss practices in the past year. These included taking diet pills, supplements or herbs (13.5% vs. 8.8%; adjusted odds ratio (aOR) 1.97, 95% confidence interval (CI) 1.11–3.49;), using laxatives or diuretics or inducing vomiting (7.7% vs. 3.0%; aOR 2.70, CI 1.23–5.91;), and fasting for 24 hours (10.7% vs. 5.5%; aOR 2.15, CI 1.03–4.51;). There were no significant differences between the two groups in amount of exercise, current smoking status or current alcohol consumption Further, fruit, green salad and other vegetables, and intake of soda and fast food were unrelated to pregnancy intention. Conclusion This study highlights that women trying to conceive are more likely to participate in unhealthy and potentially dangerous weight loss practices than women not trying to conceive. PMID:25162259

  15. Nutritional and weight management behaviors in low-income women trying to conceive.

    Science.gov (United States)

    Berenson, Abbey B; Pohlmeier, Ali M; Laz, Tabassum H; Rahman, Mahbubur; McGrath, Christine J

    2014-09-01

    To evaluate the nutritional habits and weight management strategies of women trying to conceive as compared with women not trying to conceive. This was a cross-sectional survey of health behaviors including nutritional habits and weight management strategies of women aged 16-40 years who were low income, racially diverse, (n=1,711), and attending reproductive health clinics. Multivariable logistic regression analyses were performed to examine the association between pregnancy intention and various health behaviors after adjusting for demographic variables, gravidity, and obesity status. A total of 8.9% (n=153) of the participants stated they were trying to get pregnant. Women trying to conceive were more likely than those not trying to have participated in a number of unhealthy weight loss practices in the past year. These included taking diet pills, supplements, or herbs (13.5% compared with 8.8%; adjusted odds ratio [OR] 1.97, 95% confidence interval [CI] 1.11-3.49), using laxatives or diuretics or inducing vomiting (7.7% compared with 3.0%; adjusted OR 2.70, CI 1.23-5.91), and fasting for 24 hours (10.7% compared with 5.5%; adjusted OR 2.15, CI 1.03-4.51). There were no significant differences between the two groups in amount of exercise, current smoking status, or current alcohol consumption Furthermore, fruit, green salad and other vegetables, and intake of soda and fast food were unrelated to pregnancy intention. This study highlights that women trying to conceive are more likely to participate in unhealthy and potentially dangerous weight loss practices than women not trying to conceive. II.

  16. Variation in Broccoli Cultivar Phytochemical Content under Organic and Conventional Management Systems: Implications in Breeding for Nutrition

    NARCIS (Netherlands)

    Renaud, E.N.C.; Lammerts Van Bueren, E.; Myers, J.R.; Caldas Paulo, M.J.; Eeuwijk, van F.A.; Zhu, N.; Juvik, J.A.

    2014-01-01

    Organic agriculture requires cultivars that can adapt to organic crop management systems without the use of synthetic pesticides as well as genotypes with improved nutritional value. The aim of this study encompassing 16 experiments was to compare 23 broccoli cultivars for the content of

  17. School Nutrition Employees' Perceptions of Farm to School (FTS) Activities Differ Based on Management Type and FTS Participation Length

    Science.gov (United States)

    Kang, Sangwook; Arendt, Susan W.; Stokes, Nathan M.

    2016-01-01

    Purpose: The purpose of this study was to explore school nutrition employees' perceptions of FTS activities and whether the numbers of activities differ based on management type of school foodservice operation and length of FTS participation. Methods: The state with the most FTS programs from each of the eight national FTS regions was selected. A…

  18. A retrospective study on the influence of nutritional status on pain management in cancer patients using the transdermal fentanyl patch.

    Science.gov (United States)

    Takahashi, Hiroaki; Chiba, Takeshi; Tairabune, Tomohiko; Kimura, Yusuke; Wakabayashi, Go; Takahashi, Katsuo; Kudo, Kenzo

    2014-01-01

    It is unknown whether nutritional status influences pain intensity in cancer patients receiving a transdermal fentanyl patch (FP). This study aimed to determine whether nutritional status is associated with pain intensity and to evaluate the influence of changes in nutritional status on pain intensity in cancer patients receiving transdermal FP treatment. We included 92 patients receiving transdermal FP treatment for the first time with switching from oxycodone. The patients were classified into low- and normal-nutrition groups based on their nutritional status, which was assessed according to the Nutrition Risk Screening 2002 (NRS 2002) parameters. The pain intensity of each patient was evaluated by a numeric rating scale (11-point scale from 0 to 10). NRS 2002 score and pain intensity were obtained on day 3 after the FP was applied to the skin. Pain intensities were significantly higher among patients in the low-nutrition group than among patients in the normal-nutrition group. NRS 2002 scores showed a significant positive correlation with the pain intensities. In 52 of 92 patients, who were evaluated using the NRS 2002 score and pain intensity on day 30 after FP application, the changes in NRS 2002 scores were significantly related to changes in pain intensities (odds ratio, 30.0; 95% confidence interval, 4.48-200.97; p=0.0005). These results suggest that an increase in the NRS 2002 score is a risk factor for an increase in pain intensity in cancer patients receiving FP treatment. Malnutrition may lead to poor pain management in cancer patients receiving FP treatment.

  19. A Nutritional Management Analysis of the Transhumant Sheep and Goat Farms in the Region of Sterea Ellada-Greece

    Directory of Open Access Journals (Sweden)

    ANNA SIASIOU

    2015-05-01

    Full Text Available Transhumance is the seasonal movement of herds between different summer and winter pastures. The main reason of practice of this farming system is the need for a more efficient exploitation of vegetation to meet the nutritional needs of the reared animals. The aim of this paper is to investigate nutritional management practices of transhumant herds in the region of Sterea Ellada.  In the analysis, emphasis is given in the calculation of the coverage of nutritional needs of the reared animals by supplementary feed, translated as Metabolized energy (ME, Digestible Crude Protein (DGP and Dry Matter (DM. Nutritional management is studied in four basic productive stages of ewes and dams. All necessary data were collected from a sample of 140 transhumant herders, via an exhaustive questionnaire that covered all aspects of the production of the farms and managerial practices. Data were subsequently analyzed with descriptive statistic methods. Analysis reveals that grazing tends to be the main nutritional source as approximately 30-50% of the needs of the reared animals on lowlands and more than 90% on uplands is considered to be covered by grazing

  20. Focus on metabolic and nutritional correlates of polycystic ovary syndrome and update on nutritional management of these critical phenomena.

    Science.gov (United States)

    Rondanelli, Mariangela; Perna, Simone; Faliva, Milena; Monteferrario, Francesca; Repaci, Erica; Allieri, Francesca

    2014-12-01

    Polycystic ovary syndrome (PCOS) is associated with numerous metabolic morbidities (insulin resistance (IR), central obesity) and various nutritional abnormalities (vitamin D deficit, mineral milieu alterations, omega6/omega3 PUFA ratio unbalance). We performed a systematic literature review to evaluate the till-now evidence regarding: (1) the metabolic and nutritional correlates of PCOS; (2) the optimum diet therapy for the treatment of these abnormalities. This review included 127 eligible studies. In addition to the well-recognized link between PCOS and IR, the recent literature underlines that in PCOS there is an unbalance in adipokines (adiponectin, leptin, visfatin) production and in omega6/omega3 PUFA ratio. Given the detrimental effect of overweight on these metabolic abnormalities, a change in the lifestyle must be the cornerstone in the treatment of PCOS patients. The optimum diet therapy for the PCOS treatment must aim at achieving specific metabolic goals, such as IR improvement, adipokines secretion and reproductive function. These goals must be reached through: accession of the patient to hypocaloric dietary program aimed at achieving and/or maintaining body weight; limiting the consumption of sugar and refined carbohydrates, preferring those with lower glycemic index; dividing the food intake in small and frequent meals, with high caloric intake at breakfast; increasing their intake of fish (4 times/week) or taking omega3 PUFA supplements; taking Vitamin D and chromium supplementation, if there are low serum levels. Lifestyle intervention remains the optimal treatment strategy for PCOS women. A relatively small weight loss (5 %) can improve IR, hyperandrogenism, menstrual function, fertility.

  1. The talent study: a multicentre randomized controlled trial assessing the impact of a 'tailored lifestyle self-management intervention' (talent) on weight reduction.

    Science.gov (United States)

    Melchart, Dieter; Doerfler, Wolfgang; Eustachi, Axel; Wellenhofer-Li, Yanqing; Weidenhammer, Wolfgang

    2015-01-01

    Overweight is considered an important risk factor for diseases in the context of metabolic syndrome. Lifestyle modifications are the means of choice to reduce weight in persons with a Body Mass Index of 28 to 35. The study examines whether there are any differences between two intervention strategies regarding weight reduction in overweight persons. The study is a multicentre randomized controlled trial with observation duration of 12 months. Eight study centres are involved to include a minimal sample size of 150 participants. Randomization ratio is 2:1. Feasible persons are checked according to inclusion and exclusion criteria and after given informed consent are assigned randomly to one of two intervention programs: A) intervention group: comprehensive lifestyle modification program (Individual Health Management IHM) with 3 months reduction phase plus 9 months maintaining phase, B) control group: written information with advice for healthy food habits (Usual care UC). Participants of the IHM group have access to a web-based health portal and join 3 full-day and 10 two-hour training sessions during the first 3 months. During the remaining 9 months four refresh trainings will be performed. There are 3 different diet strategies (fasting, two-day diet, meal replacement) for free choice. Participants of the control group are provided with acknowledged rules for healthy food according to the German Nutrition Society (DGE). Examinations are conducted at baseline, after 3, 6, 9 and 12 months. They include body weight, waist circumference, blood pressure, laboratory findings and a bio-impedance analysis to measure body composition. Statistical analysis of the primary outcome 'change of body weight after 12 months' is based on ITT population including analysis of variance of the weight differences between month 0 and 12 with the factors 'group', 'baseline value' and 'study centre'. Secondary outcomes will be analyzed exploratively. The monitoring of the study will

  2. Tailored reflectors for illumination.

    Science.gov (United States)

    Jenkins, D; Winston, R

    1996-04-01

    We report on tailored reflector design methods that allow the placement of general illumination patterns onto a target plane. The use of a new integral design method based on the edge-ray principle of nonimaging optics gives much more compact reflector shapes by eliminating the need for a gap between the source and the reflector profile. In addition, the reflectivity of the reflector is incorporated as a design parameter. We show the performance of design for constant irradiance on a distant plane, and we show how a leading-edge-ray method may be used to achieve general illumination patterns on nearby targets.

  3. Effects of previous grazing nutrition and management on feedlot performance of cattle.

    Science.gov (United States)

    Drouillard, J S; Kuhl, G L

    1999-01-01

    Management strategies designed to improve grazing animal performance can influence feedlot performance and carcass traits both positively and negatively. In spite of the economic relevance of potential interactions between grazing and finishing performance, controlled experiments evaluating integrated production systems are limited in number. Effects of grazing treatments can result from, or be overshadowed by, changes in gut fill, thus making it difficult to assign precise costs to different phases of production. Published reports have considered the effects of stocking rate, duration of grazing, forage characteristics, supplementation, and growth-promoting implants on subsequent finishing performance. Improvements in cattle performance attributed to changes in stocking rate generally have been neutral to positive with respect to effects on finishing performance. Comparisons among forages have led to the suggestion that forage species may contribute to differences in gastrointestinal fill of grazing cattle, thereby influencing gain and efficiency during the subsequent finishing phase. Creep-feeding suckling calves generally has increased preweaning performance but has had relatively little influence on performance during the subsequent finishing phase. Grain supplementation of stocker cattle during the grazing period has improved grazing performance, but effects on subsequent feedlot performance have been inconsistent. Potential carryover effects from protein and mineral supplementation also have been inconclusive. Lack of congruence among studies is puzzling but may be the consequence of highly varied production systems, differences in experimental procedures, and changes in gut fill or mass of internal organs. Based on the studies reviewed, the expression or absence of compensatory growth during the finishing phase appears to be related to the nutritional quality of forages utilized in the grazing period, with higher quality forages tending to yield greater

  4. 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 ...

  5. An update on diet and nutritional factors in systemic lupus erythematosus management.

    Science.gov (United States)

    Aparicio-Soto, Marina; Sánchez-Hidalgo, Marina; Alarcón-de-la-Lastra, Catalina

    2017-06-01

    Systemic lupus erythematosus (SLE) is a chronic inflammatory and autoimmune disease characterised by multiple organ involvement and a large number of complications. SLE management remains complicated owing to the biological heterogeneity between patients and the lack of safe and specific targeted therapies. There is evidence that dietary factors can contribute to the geoepidemiology of autoimmune diseases such as SLE. Thus, diet therapy could be a promising approach in SLE owing to both its potential prophylactic effects, without the side effects of classical pharmacology, and its contribution to reducing co-morbidities and improving quality of life in patients with SLE. However, the question arises as to whether nutrients could ameliorate or exacerbate SLE and how they could modulate inflammation and immune function at a molecular level. The present review summarises preclinical and clinical experiences to provide the reader with an update of the positive and negative aspects of macro- and micronutrients and other nutritional factors, including dietary phenols, on SLE, focusing on the mechanisms of action involved.

  6. Parenteral nutrition.

    Science.gov (United States)

    Inayet, N; Neild, P

    2015-03-01

    Over the last 50 years, parenteral nutrition has been recognised as an invaluable and potentially lifesaving tool in the physician's arsenal in the management of patients with intestinal failure or inaccessibility; however, it may also be associated with a number of potentially life-threatening complications. A recent NCEPOD report (2010) identified a number of inadequacies in the overall provision and management of parenteral nutrition and recommendations were made with the aim of improving clinical practice in the future. This paper focuses on the practical aspects relating to parenteral nutrition for adults, including important concepts, such as patient selection, as well as general management. We also explore the various pitfalls and potential complications and how these may be minimised.

  7. Changes in Nutritional and Functional Status in Longer Stay Patients Admitted to a Geriatric Evaluation and Management Unit.

    Science.gov (United States)

    Whitley, A; Skliros, E; Graven, C; McIntosh, R; Lasry, C; Newsome, C; Bowie, A

    2017-01-01

    Malnutrition and functional decline are common in older inpatients admitted to subacute care settings. However the association between changes in nutritional status and relevant functional outcomes remains under-researched. This study examined changes in nutritional status, function and mobility in patients admitted to a Geriatric Evaluation and Management (GEM) unit who had a length of stay (LOS) longer than 21 days. A prospective, observational study. Two GEM units at St Vincent's Hospital Melbourne, Australia. Patients admitted to the GEM units who stayed longer than 21 days were included in the study. Patients were assessed on admission and prior to discharge using the Subjective Global Assessment (SGA), Functional Independence Measure (FIM) motor domain and the Modified Elderly Mobility Scale (MEMS). Fifty-nine patients (Mean age 84.0 ± 7 years) met the required length of stay and were included in the study. Fifty-four per cent (n=32) were malnourished on admission (SGA B/C) and 44% (n=26) were malnourished on discharge. Twenty-two per cent (n=13) improved SGA category, 75% remained stable (n=44) and 3% deteriorated (n=2) from admission to discharge. Total Motor FIM scores significantly increased from admission to discharge in both the improved (pnutritional status groups. Subjects who improved in nutritional status had a significantly higher MEMS score at discharge (pnutritional status at the time of discharge. Improvement in nutritional status was associated with greater improvement in mobility scores. Further studies are required to investigate the effectiveness of nutrition interventions, which will inform models of care aiming to optimise nutritional, functional, and associated clinical outcomes in patients admitted to GEM units.

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

    OpenAIRE

    Yavuz Topcu; Mehmet Toparlak; Muhlis Macit

    2016-01-01

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

  9. Tailored Random Graph Ensembles

    International Nuclear Information System (INIS)

    Roberts, E S; Annibale, A; Coolen, A C C

    2013-01-01

    Tailored graph ensembles are a developing bridge between biological networks and statistical mechanics. The aim is to use this concept to generate a suite of rigorous tools that can be used to quantify and compare the topology of cellular signalling networks, such as protein-protein interaction networks and gene regulation networks. We calculate exact and explicit formulae for the leading orders in the system size of the Shannon entropies of random graph ensembles constrained with degree distribution and degree-degree correlation. We also construct an ergodic detailed balance Markov chain with non-trivial acceptance probabilities which converges to a strictly uniform measure and is based on edge swaps that conserve all degrees. The acceptance probabilities can be generalized to define Markov chains that target any alternative desired measure on the space of directed or undirected graphs, in order to generate graphs with more sophisticated topological features.

  10. Academy of Nutrition and Dietetics: standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in adult weight management.

    Science.gov (United States)

    Jortberg, Bonnie; Myers, Eileen; Gigliotti, Linda; Ivens, Barbara J; Lebre, Monica; Burke March, Susan; Nogueira, Isadora; Nwankwo, Robin; Parkinson, Meredith R; Paulsen, Barbara; Turner, Tonya

    2015-04-01

    Weight management encompasses the inter-relationship of nutrition, physical activity, and health behavior change. Nutrition is key for the prevention and treatment of obesity and chronic disease and maintenance of overall health. Thus, the Weight Management Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (RDNs) in Adult Weight Management as a resource for RDNs working in weight management. This document allows RDNs to assess their current skill levels and to identify areas for further professional development in this expanding practice area. This document describes the current standards for weight management practice for RDNs. The Standards of Practice represent the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance consist of six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standard can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for RDNs working in weight management. The Standards of Practice and Standards of Professional Performance are complementary resources for the Registered Dietitian Nutritionist in weight management. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  11. Home parenteral nutrition in management of patients with severe radiation enteritis

    International Nuclear Information System (INIS)

    Lavery, I.C.; Steiger, E.; Fazio, V.W.

    1980-01-01

    Five patients who would have been unable to survive because of intestinal complications of radiation therapy were able to lead an otherwise normal life with the use of parenteral nutrition administered at home. One patient died of recurrent carcinoma of the cervix after 14 months. Another patient died as the result of a totally avoidable pharmaceutical error after 2 1/2 years. The remaining three are still disease free without morbidity relating to the parenteral nutrition

  12. Reprint of: Nutrition in the Management of Cirrhosis and its Neurological Complications.

    Science.gov (United States)

    Bémeur, Chantal; Butterworth, Roger F

    2015-03-01

    Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation. Nutritional recommendations target the optimal supply of adequate substrates related to requirements linked to energy, protein, carbohydrates, lipids, vitamins and minerals. Some issues relating to malnutrition in chronic liver disease remain to be addressed including the development of an appropriate well-validated nutritional assessment tool, the identification of mechanistic targets or therapy for sarcopenia, the development of nutritional recommendations for obese cirrhotic patients and liver-transplant recipients and the elucidation of the roles of vitamin A hepatotoxicity, as well as the impact of deficiencies in riboflavin and zinc on clinical outcomes. Early identification and treatment of malnutrition in chronic liver disease has the potential to lead to better disease outcome as well as prevention of the complications of chronic liver disease and improved transplant outcomes.

  13. A pilot study of an online workplace nutrition program: the value of participant input in program development.

    Science.gov (United States)

    Cousineau, Tara; Houle, Brian; Bromberg, Jonas; Fernandez, Kathrine C; Kling, Whitney C

    2008-01-01

    Tailored nutrition Web programs constitute an emerging trend in obesity prevention. Initial investment in innovative technology necessitates that the target population be well understood. This pilot study's purpose was to determine the feasibility of a workplace nutrition Web program. Formative research was conducted with gaming industry employees and benefits managers to develop a consensus on workplace-specific nutrition needs. A demonstration Web program was piloted with stakeholders to determine feasibility. Indiana, Mississippi, Nevada, and New Jersey gaming establishments. 86 employees, 18 benefits managers. Prototype Web program. Concept mapping; 16-item nutrition knowledge test; satisfaction. Concept mapping was used to aggregate importance ratings on programmatic content, which informed Web program curriculum. Chi-square tests were performed postintervention to determine knowledge improvement. (1) Employees and benefits managers exhibited moderate agreement about content priorities for the program (r = 0.48). (2) There was a significant increase in employees' nutrition knowledge scores postintervention (t = 7.16, df = 36, P benefit managers do not necessarily agree on the priority of nutrition-related content, suggesting a need for programs to appeal to various stakeholders. Computer-based approaches can address various stakeholder health concerns via tailored, customized programming.

  14. Production and nutritional value of the wheat silage managed with different cutting systems

    Directory of Open Access Journals (Sweden)

    Rodolfo Carletto

    2017-03-01

    Full Text Available Winter cereals are mainly used for human and animal nutrition and several studies are now exploring their potential as conserved forage (hay and silage. Among the winter cereal species available for cultivation in the south of Brazil, which is major winter cereals producer in the country, the wheat cv. BRS Umbu has attracted special attention. However, few studies have investigated the potential of this cultivar for silage production. The aim of this study was to evaluate the production and quality of silage from the dual-purpose wheat, BRS Umbu, subjected to different cut managements treatments: T1 - without cut (control, T2 - one cut and T3 - two cuts. Each plot represented an experimental unit in a randomized block design, with 5 replicates per treatment. Two representative samples were collected from each plot to determine morphological segmentation (stem, leaf and ear and dry matter (DM content of the whole plant and its morphological components. At the time of opening of the silos, food chemical analysis and pH determination were performed. Forage mass production decreased by 26.88% and 67.82%, respectively, with one and two cuts, compared to control. The DM content of the ensiled plant was 49.9 g kg-1 for the control, 54.7 g kg-1 with one cut and 63.2 g kg-1 with two cuts, at the time of ensiling. Management cuts changed the morphological components of the plants, with a lower proportion of stem (28% in plants subjected to two cuts. The control treatment showed fewer leaves in ensiled plant (9.6% and intermediate amount of stalk (52.8%, and was significantly different (p 0.05 was observed for mineral matter (MM, crude protein (CP and hemicellulose (HEM between the different cutting regimens. However, neutral detergent fiber (NDF and acid detergent fiber (ADF decreased (p < 0.05 as the number of cuts increased. The control treatment showed higher NDF and ADF content (563.2 and 357.9 g kg-1 DM, respectively and lower amount of total

  15. Glycomacropeptide for nutritional management of phenylketonuria: a randomized, controlled, crossover trial12

    Science.gov (United States)

    Stroup, Bridget M; Clayton, Murray K; Murali, Sangita G; Rice, Gregory M; Rohr, Frances; Levy, Harvey L

    2016-01-01

    Background: To prevent cognitive impairment, phenylketonuria requires lifelong management of blood phenylalanine (Phe) concentration with a low-Phe diet. The diet restricts intake of Phe from natural proteins in combination with traditional amino acid medical foods (AA-MFs) or glycomacropeptide medical foods (GMP-MFs) that contain primarily intact protein and a small amount of Phe. Objective: We investigated the efficacy and safety of a low-Phe diet combined with GMP-MFs or AA-MFs providing the same quantity of protein equivalents in free-living subjects with phenylketonuria. Design: This 2-stage, randomized crossover trial included 30 early-treated phenylketonuria subjects (aged 15–49 y), 20 with classical and 10 with variant phenylketonuria. Subjects consumed, in random order for 3 wk each, their usual low-Phe diet combined with AA-MFs or GMP-MFs. The treatments were separated by a 3-wk washout with AA-MFs. Fasting plasma amino acid profiles, blood Phe concentrations, food records, and neuropsychological tests were obtained. Results: The frequency of medical food intake was higher with GMP-MFs than with AA-MFs. Subjects rated GMP-MFs as more acceptable than AA-MFs and noted improved gastrointestinal symptoms and less hunger with GMP-MFs. ANCOVA indicated no significant mean ± SE increase in plasma Phe (62 ± 40 μmol/L, P = 0.136), despite a significant increase in Phe intake from GMP-MFs (88 ± 6 mg Phe/d, P = 0.026). AA-MFs decreased plasma Phe (−85 ± 40 μmol/L, P = 0.044) with stable Phe intake. Blood concentrations of Phe across time were not significantly different (AA-MFs = 444 ± 34 μmol/L, GMP-MFs = 497 ± 34 μmol/L), suggesting similar Phe control. Results of the Behavior Rating Inventory of Executive Function were not significantly different. Conclusions: GMP-MFs provide a safe and acceptable option for the nutritional management of phenylketonuria. The greater acceptability and fewer side effects noted with GMP-MFs than with AA-MFs may enhance

  16. Building a Tailored, Patient-Guided, Web-Based Self-Management Intervention 'ReumaUitgedaagd!' for Adults With a Rheumatic Disease: Results of a Usability Study and Design for a Randomized Control Trail.

    Science.gov (United States)

    Ammerlaan, Judy W; Mulder, Olga K; de Boer-Nijhof, Nienke C; Maat, Bertha; Kruize, Aike A; van Laar, Jaap; van Os-Medendorp, Harmieke; Geenen, Rinie

    2016-06-23

    The chronic nature of rheumatic diseases imposes daily challenges upon those affected and causes patients to make daily decisions about the way they self-manage their illness. Although there is attention to self-management and evidence for the desirability of tailored interventions to support people with a rheumatic disease, interventions based on individual needs and preferences are scarce. To provide a systematic and comprehensive description of the theoretical considerations for building a Web-based, expert, patient-guided, and tailored intervention for adult patients with a rheumatic disease. Also, to present the results of a usability study on the feasibility of this intervention, and its study design in order to measure the effectiveness. To fit the intervention closely to the autonomy, needs, and preferences of the individual patient, a research team comprising patient representatives, health professionals, Web technicians, and communication experts was formed. The research team followed the new guidance by the Medical Research Council (MRC) for developing and evaluating complex interventions as a guide for the design of the intervention. Considerations from self-determination theory and a comprehensive assessment of preferences and needs in patients with a rheumatic disease guided the development of the Web-based intervention. The usability study showed that the intervention was useful, easy to use, and accepted and appreciated by the target group of patients. The planned randomized controlled trial is designed to be conducted among 120 adults with a rheumatic disease, who are assigned to the self-management intervention or a self-help control group. Both groups will be asked to formulate personal goals they want to achieve concerning their self-management. Progress toward the personal goal is the primary outcome measure of this study. Self-reported Web-based measures will be assessed before randomization at baseline, and 3 and 6 months after randomization

  17. Employee Perceptions of Workplace Health Promotion Programs: Comparison of a Tailored, Semi-Tailored, and Standardized Approach.

    Science.gov (United States)

    Street, Tamara D; Lacey, Sarah J

    2018-04-28

    In the design of workplace health promotion programs (WHPPs), employee perceptions represent an integral variable which is predicted to translate into rate of user engagement (i.e., participation) and program loyalty. This study evaluated employee perceptions of three workplace health programs promoting nutritional consumption and physical activity. Programs included: (1) an individually tailored consultation with an exercise physiologist and dietitian; (2) a semi-tailored 12-week SMS health message program; and (3) a standardized group workshop delivered by an expert. Participating employees from a transport company completed program evaluation surveys rating the overall program, affect, and utility of: consultations ( n = 19); SMS program ( n = 234); and workshops ( n = 86). Overall, participants’ affect and utility evaluations were positive for all programs, with the greatest satisfaction being reported in the tailored individual consultation and standardized group workshop conditions. Furthermore, mode of delivery and the physical presence of an expert health practitioner was more influential than the degree to which the information was tailored to the individual. Thus, the synergy in ratings between individually tailored consultations and standardized group workshops indicates that low-cost delivery health programs may be as appealing to employees as tailored, and comparatively high-cost, program options.

  18. [Consensus document about the nutritional evaluation and management of eating disorders: bulimia nervosa, binge eating disorder, and others].

    Science.gov (United States)

    Gómez Candela, Carmen; Palma Milla, Samara; Miján-de-la-Torre, Alberto; Rodríguez Ortega, Pilar; Matía Martín, Pilar; Loria Cohen, Viviana; Campos Del Portillo, Rocío; Virgili Casas, M ª Nuria; Martínez Olmos, Miguel Á; Mories Álvarez, M ª Teresa; Castro Alija, M ª José; Martín-Palmero, Ángela

    2018-03-07

    Bulimia nervosa and binge eating disorder are unique nosological entities. Both show a large variability related to its presentation and severity which involves different therapeutic approaches and the need to individualize the treatment, thus it is indispensable a multidisciplinary approach. Patients with bulimia nervosa may suffer from malnutrition and deficiency states or even excess weight, while in binge eating disorders, it is common overweight or obesity, which determine other comorbidities. Many of the symptoms and complications are associated with compensatory behaviors. There are many therapeutic tools available for the treatment of these patients. The nutritional approach contemplates the individualized dietary advice which guarantees an adequate nutritional state and nutritional education. Its objective is to facilitate the voluntary adoption of eating behaviors that promote health and allow the long-term modification of eating habits and the cessation of purgatory and bingeing behaviors. Psychological support is a first-line treatment and it must address the frequent disorder of eating behavior and psychiatric comorbidities. Psychotropic drugs are effective and widely used although these drugs are not essential. The management is carried out mainly at an outpatient level, being the day hospital useful in selected patients. Hospitalization should be reserved to correct serious somatic or psychiatric complications or as a measure to contain non-treatable conflict situations. Most of the guidelines' recommendations are based on expert consensus, with little evidence which evaluates clinical results and cost-effectiveness.

  19. Challenges in the management of nutritional disorders and communicable diseases in child day care centers: a quantitative and qualitative approach.

    Science.gov (United States)

    Konstantyner, Tulio; Konstantyner, Thais Cláudia Roma de Oliveira; Toloni, Maysa Helena Aguiar; Longo-Silva, Giovana; Taddei, José Augusto de Aguiar Carrazedo

    2017-03-01

    In Brazil, although many children from low income families attend day care centers with appropriate hygiene practices and food programs, they have nutritional disorders and communicable diseases. This quantitative and qualitative cross-sectional study identified staff challenges in child day care centers and suggested alternative activity management to prevent nutritional disorders and communicable diseases. The study included 71 nursery teachers and 270 children from public and philanthropic day care centers (teacher to child ratios of 1:2.57 and 1:6.40, respectively). Interviews and focus groups were conducted with teachers and parents, and anthropometry and blood samples were drawn from the children by digital puncture. Children in philanthropic child day care centers were more likely to be hospitalized due to communicable diseases. Teachers from philanthropic child day care centers had lower age, income and education and higher work responsibilities based on the number of children and working time. The focus groups characterized institutions with organized routines, standard food practices, difficulties with caretaking, and lack of training to provide healthcare to children. Strategies to improve children's health in day care settings should focus on training of teachers about healthcare and nutrition.

  20. Evaluation of validity of Integrated Management of Childhood Illness guidelines in identifying edema of nutritional causes among Egyptian children.

    Science.gov (United States)

    El Habashy, Safinaz A; Mohamed, Maha H; Amin, Dina A; Marzouk, Diaa; Farid, Mohammed N

    2015-12-01

    The aim of this study was to assess the validity of the Integrated Management of Childhood Illness (IMCI) algorithm to detect edematous type of malnutrition in Egyptian infants and children ranging in age from 2 months to 5 years. This study was carried out by surveying 23 082 children aged between 2 months and 5 years visiting the pediatric outpatient clinic, Ain Shams University Hospital, over a period of 6 months. Thirty-eight patients with edema of both feet on their primary visit were enrolled in the study. Every child was assessed using the IMCI algorithm 'assess and classify' by the same physician, together with a systematic clinical evaluation with all relevant investigations. Twenty-two patients (57.9%) were proven to have nutritional etiology. 'Weight for age' sign had a sensitivity of 95.5%, a specificity of 56%, and a diagnostic accuracy of 78.95% in the identification of nutritional edema among all cases of bipedal edema. Combinations of IMCI symptoms 'pallor, visible severe wasting, fever, diarrhea', and 'weight for age' increased the sensitivity to 100%, but with a low specificity of 38% and a diagnostic accuracy of 73.68%. Bipedal edema and low weight for age as part of the IMCI algorithm can identify edema because of nutritional etiology with 100% sensitivity, but with 37% specificity. Revisions need to be made to the IMCI guidelines published in 2010 by the Egyptian Ministry of Health in the light of the new WHO guidelines of 2014.

  1. [Nutrition management in obese patients with type 2 diabetes mellitus after laparoscopic sleeve gastrectomy].

    Science.gov (United States)

    Tang, Weihong; Chen, Yuhua; Pan, Meizhen; Chen, Lihua; Zhang, Lele; Wang, Tingfeng; Zhang, Xiong; Zhang, Peng; Zheng, Chengzhu; Yu, Bo

    2017-04-25

    To explore the value of nutrition management in obese patients with type 2 diabetes mellitus(T2DM) after laparoscopic sleeve gastrectomy(LSG). Clinical data of 22 obese T2DM patients undergoing LSG from March 2013 to July 2015 in Fudan University Pudong Medical Center were collected. All the patients strictly followed the specialized instruction by nutritionists: diabetic and low calorie diet 3347.2 to 5020.8 kJ (800 to 1200 kcal) per day before the operation; low calorie liquid diet 2510.4 kJ(600 kcal) per day before operation for promoting gastric emptying; fasting diet before postoperative ventilation; clear liquid diet 1673.6 to 2510.4 kJ (400 to 600 kcal) per day after postoperative ventilation (liquid intake >2000 ml); low fat liquid diet 2928.8 to 3765.6 kJ (700 to 900 kcal) per day (protein 60 g per day at least, 2000 ml liquid) 2 weeks after the operation; semi-liquid diet 1 month after operation and gradually normal diet. All the 22 patients were followed up at 1 week, 1, 3, 6 months after operation on time. Changes of body weight, waist circumference, hip circumference, body mass index(BMI), blood glucose indexes induding fasting blood glucose(FBG), 2-hour postparandial blood glucose(PBG), fasting C-peptide, 2-hour postprandial C-peptide, fasting serum inculin(FINS), 2-hour postprandial inculin(INS), HbAlc, blood pressure and blood lipid indexes were observed and analyzed before and 1 week, 1, 3, 6 months after operation. The average age of 22 patients (10 men and 12 women) was 38.6 years (18 to 66 years). The duration of diabetes varied from 1 month to 15 years. Comorbidity included 12 patients of high blood pressure, 14 of fatty liver, 1 of coronary heart disease, 1 of gout, 1 of chronic thyroiditis and 1 of menstrual disorder. LSG was performed successfully in all the patients and no severe complications and transference to laparotomy occurred. As compared to pre-operation, at 6 months after operation, the average body weight decreased from (103.9±20

  2. Yin Yang 1 and Adipogenic Gene Network Expression in Longissimus Muscle of Beef Cattle in Response to Nutritional Management

    OpenAIRE

    Sonia J. Moisá; Daniel W. Shike; William T. Meteer; Duane Keisler; Dan B. Faulkner; Juan J. Loor

    2013-01-01

    Among 36 differentially-expressed genes during growth in longissimus muscle (LM) of Angus steers, Yin Yang 1 (YY1) had the most relationships with other genes including some associated with adipocyte differentiation. The objective of this study was to examine the effect of nutritional management on mRNA expression of YY1 along with its targets genes PPARG, GTF2B, KAT2B, IGFBP5 and STAT5B. Longissimus from Angus and Angus ? Simmental steers (7 total/treatment) on early weaning plus high-starch...

  3. 2015 EAL evidence-based nutrition practice guildeline for the management of hypertension in adults

    Science.gov (United States)

    Hypertension (HTN) or high blood pressure (BP) is one of the most prevalent forms of cardiovascular disease and occurs in approximately one of every three adults in the United States. Nutrition therapy is an important component of treatment. The purpose of this Evidence Analysis Library (EAL) gui...

  4. The use of nutritional guidance within chiropractic patient management: a survey of 333 chiropractors from the ACORN practice-based research network.

    Science.gov (United States)

    Lee, Mi Kyung; Amorin-Woods, Lyndon; Cascioli, Vincenzo; Adams, Jon

    2018-01-01

    Food consumption and nutritional status affect an individual's health throughout their life-course and an unhealthy diet is a major risk factor for the current global burden of chronic disease. The promotion of health and good nutrition through healthy eating requires the active involvement of all health professionals including chiropractors. This paper reports findings from the first nationally representative examination of the use of nutritional guidance within chiropractic patient management in Australia. A sample of 1000 practising chiropractors was randomly selected from the Australian Chiropractic Research Network (ACORN) practice-based research network database for a cross-sectional study and 33% participated in the online survey in November 2016. The questionnaire, based on previous designs used in similar surveys and nutrition resources developed by the National Health and Medical Research Council, was pretested prior to the survey. Pearson's Chi square and bivariate logistic regression were undertaken to explore relationships with variables of interest. The demographic details of the respondents are similar to those of the chiropractic workforce registered in Australia. Most chiropractors provided nutritional advice as part of their patient care and around a quarter provided specific dietary advice to their patients, including the use of nutrition supplements. Nutrition-related conditions most commonly encountered by the chiropractors were musculoskeletal, usually inflammatory in origin. Common nutritional assessment methods used included questioning patients to assess their nutritional and health status and physical appearance. Most of the participants provided nutritional resources to their patients in their clinics. However, the Australian Dietary Guidelines and the accompanying Australian Guide to Healthy Eating were not well utilised by the respondents. Australian chiropractors often referred patients with nutrition issues to qualified dietitians and

  5. NutriSonic web expert system for meal management and nutrition counseling with nutrient time-series analysis, e-food exchange and easy data transition.

    Science.gov (United States)

    Hong, Soon-Myung; Cho, Jee-Ye; Lee, Jin-Hee; Kim, Gon; Kim, Min-Chan

    2008-01-01

    This study was conducted to develop the NutriSonic Web Expert System for Meal Management and Nutrition Counseling with Analysis of User's Nutritive Changes of selected days and food exchange information with easy data transition. This program manipulates a food, menu and meal and search database that has been developed. Also, the system provides a function to check the user's nutritive change of selected days. Users can select a recommended general and therapeutic menu using this system. NutriSonic can analyze nutrients and e-food exchange ("e" means the food exchange data base calculated by a computer program) in menus and meals. The expert can insert and store a meal database and generate the synthetic information of age, sex and therapeutic purpose of disease. With investigation and analysis of the user's needs, the meal planning program on the internet has been continuously developed. Users are able to follow up their nutritive changes with nutrient information and ratio of 3 major energy nutrients. Also, users can download another data format like Excel files (.xls) for analysis and verify their nutrient time-series analysis. The results of analysis are presented quickly and accurately. Therefore it can be used by not only usual people, but also by dietitians and nutritionists who take charge of making a menu and experts in the field of food and nutrition. It is expected that the NutriSonic Web Expert System can be useful for nutrition education, nutrition counseling and expert meal management.

  6. Nutritional surveillance.

    Science.gov (United States)

    Mason, J B; Mitchell, J T

    1983-01-01

    The concept of nutritional surveillance is derived from disease surveillance, and means "to watch over nutrition, in order to make decisions that lead to improvements in nutrition in populations". Three distinct objectives have been defined for surveillance systems, primarily in relation to problems of malnutrition in developing countries: to aid long-term planning in health and development; to provide input for programme management and evaluation; and to give timely warning of the need for intervention to prevent critical deteriorations in food consumption. Decisions affecting nutrition are made at various administrative levels, and the uses of different types of nutritional surveillance information can be related to national policies, development programmes, public health and nutrition programmes, and timely warning and intervention programmes. The information should answer specific questions, for example concerning the nutritional status and trends of particular population groups.Defining the uses and users of the information is the first essential step in designing a system; this is illustrated with reference to agricultural and rural development planning, the health sector, and nutrition and social welfare programmes. The most usual data outputs are nutritional outcome indicators (e.g., prevalence of malnutrition among preschool children), disaggregated by descriptive or classifying variables, of which the commonest is simply administrative area. Often, additional "status" indicators, such as quality of housing or water supply, are presented at the same time. On the other hand, timely warning requires earlier indicators of the possibility of nutritional deterioration, and agricultural indicators are often the most appropriate.DATA COME FROM TWO MAIN TYPES OF SOURCE: administrative (e.g., clinics and schools) and household sample surveys. Each source has its own advantages and disadvantages: for example, administrative data often already exist, and can be

  7. Self-Management Support Program for Patients With Cardiovascular Diseases: User-Centered Development of the Tailored, Web-Based Program Vascular View

    NARCIS (Netherlands)

    Puijk-Hekman, S.; Gaal, B. van; Bredie, S.J.H.; Nijhuis-Van der Sanden, M.W.G.; Dulmen, A.M. van

    2017-01-01

    BACKGROUND: In addition to medical intervention and counseling, patients with cardiovascular disease (CVD) need to manage their disease and its consequences by themselves in daily life. OBJECTIVE: The aim of this paper is to describe the development of "Vascular View," a comprehensive,

  8. The Significance of Tailored, Web-Based Information on Experiences Regarding Perceived Self-Management in Ovarian Cancer Patients in the Diagnostic Phase-An Experimental Study

    DEFF Research Database (Denmark)

    Thygesen, Marianne Kirstine; Holt, Kamila Adellund; Mogensen, Ole

    2016-01-01

    provided data for statistical analysis. Patients’ difference in change in Sense of Coherence over time was statistically significant in favor of those who had used the website (mean difference 4.42, pwebsite prevented a decrease in self-management of Danish...... of a healthcare-professional developed website, available to both patients and relatives, on patients’ experienced self-management before surgery for ovarian cancer. In an experimental study, Danish women with ovarian cancer were consecutively included if they would participate and had a relative, willing...... to offer attention to the cancer situation. The control group had standard care, the intervention group plus their relatives had additional access to a website with cancer-specific physical, psychical, and practical information. The validated questionnaires Cancer Behavior Inventory and Sense of Coherence...

  9. Diagnosis tools useful in the management of nitrogen nutrition in Urochloa

    Directory of Open Access Journals (Sweden)

    Valdinei Tadeu Paulino

    2012-12-01

    Full Text Available The N management on pasture requires methods for analyzing and predicting the need for fertilization, aiming at greater efficiency of fertilizer application, adjusting the forage requirements for biomass productivity with quality and sustainability. Nitrogen Nutrition Index (NNI defined as the ratio between the actual N concentration and the N concentration critical, corresponding to the actual standing biomass. NNI is an indicator well connected with the physiological regulation of N concentration, but it cannot be used directly in farm conditions. Leaf N concentration has been shown to be with greenness (chlorophyll meter readings, as measured by SPAD 502, giving instantaneous values that could be used for estimating directly the N concentration and indirectly the NNI. The main of this work was to test the usefulness N concentration and SPAD to diagnose the N status of four genotypes Urochloa. The experimental design was a randomized block in a factorial 4 x 4, genotypes of Urochloa (U. brizantha cv. Piata, U. brizantha cv. Marandu, and two hybrids H69 and H12 and nitrogen levels (0, 75, 150 and 225 mg dm-3 whose source urea, with five replications, in pots (3.34 dm3 with Psament soil. Evaluations were performed on plants aged 52 days after sowing. Data were analyzed by the mixed procedure of SAS V. 9.2; average qualitative treatments were compared by Tukey test at 5% probability. The degrees of freedom related to N rates (quantitative treatment were decomposed into orthogonal polynomials; to obtain the best equation fits the data. It is known that chlorophyll meter readings express indirectly the amount of chlorophyll in the plant tissue, and as nitrogen is a component of the chlorophyll molecule, the concentration of this nutrient in the tissue is positively correlated with the SPAD values, several studies have confirmed this fact . The SPAD values were found to be in the range 17.4 to 36.0 for H69, 24.2 to 36.6 for H12, 28.2 to 44.89 to

  10. Nutrition: a promising route for prevention and management of obesity-related nonalcoholic fatty liver disease.

    Science.gov (United States)

    Tarantino, Giovanni

    2014-11-01

    When dealing with the treatment of obesity-linked illnesses - in particular nonalcoholic fatty liver disease - beyond diet, various nutritional ingredients are reported to be useful as silymarin, spirulina, choline, folic acid, methionine and vitamin E, all of them showing promising but not definite results. An emerging field of study is represented by prebiotics/probiotics and restoration of normal gut flora, which could play a fundamental role diet and various its components. It is noteworthy to point out that both improving or reducing the severity of nonalcoholic fatty liver disease bear a positive consequence on evolution of atherosclerosis and its cardiovascular-associated disease, such as coronary artery disease, even though the involved immunologic mechanisms are gaining greater credit in the most recent literature, without excluding the role of nutrition in modulating the acquired immunity in this condition.

  11. Management issues related to effectively implementing a nutrition education program using peer educators.

    Science.gov (United States)

    Taylor, T; Serrano, E; Anderson, J

    2001-01-01

    To explore the influence of administrative aspects of a nutrition education program with peer educators delivering the program. Telephone interviews with peer educators trained to deliver La Cocina Saludable, a nutrition education program for Hispanics. Open- and closed-ended questions. Abuelas (grandmothers) recruited and trained as peer educators for the program. The sample included peer educators no longer teaching (22%), currently teaching (30%), and who never taught after training. Motives and incentives for becoming peer educators, challenges for peer educators, and reasons peer educators withdrew from the program. Descriptive statistics were used to analyze quantitative data from the closed-ended questions. Qualitative analysis was applied to data from open-ended questions. Working with community and learning about nutrition were prime motivators. Recruiting participants and coordination of classes appeared to be major challenges. Personal issues and traveling in a large geographic area were cited as the main reasons for quitting. The effectiveness of using peer educators for La Cocina Saludable may be improved through empowerment, additional training, a structured and equitable reimbursement system, and assistance to carry out administrative tasks.

  12. Nutritional management to optimize fertility of dairy cows in pasture-based systems.

    Science.gov (United States)

    Butler, S T

    2014-05-01

    The efficiency of milk production in pasture-based systems is heavily influenced by calving pattern, necessitating excellent reproductive performance in a short-breeding season. Where grazed pasture is the major component of the diet, cows are underfed relative to their intake potential. The cow responds by reducing milk output, but fertility is generally better than high intake confinement systems that achieve greater milk production per cow. A number of studies have identified body condition score (BCS) measurements that are related to likelihood of both submission and conception. Blood metabolites and metabolic hormones linked to fertility outcomes are now well characterized. In general, fertility variables have favourable associations with circulating concentrations of glucose, insulin and IGF-1 and unfavourable associations with non-esterified fatty acids, β-hydroxybutyrate and endogenous growth hormone. Nutritional strategies to impact these metabolic indicators have been utilized, but effects on herd fertility are inconsistent. Simply supplementing cows with additional energy in the form of standard concentrates does not appear to have a pronounced effect on fertility. Energy from additional concentrates fed during lactation is preferentially partitioned towards extra milk production rather than BCS repletion. The higher the genetic merit for milk production, the greater the partitioning of additional nutrients to the mammary gland. This review outlines the unique nutritional challenges of pasture-based systems, the role of specific metabolic hormones and metabolites in regulating reproductive function, and nutritional strategies to improve herd fertility.

  13. Integrated Assessment of Pharmacological and Nutritional Cardiovascular Risk Management: Blood Pressure Control in the DIAbetes and LifEstyle Cohort Twente (DIALECT

    Directory of Open Access Journals (Sweden)

    Christina M. Gant

    2017-07-01

    Full Text Available Cardiovascular risk management is an integral part of treatment in Type 2 Diabetes Mellitus (T2DM, and requires pharmacological as well as nutritional management. We hypothesize that a systematic assessment of both pharmacological and nutritional management can identify targets for the improvement of treatment quality. Therefore, we analysed blood pressure (BP management in the DIAbetes and LifEstyle Cohort Twente (DIALECT. DIALECT is an observational cohort from routine diabetes care, performed at the ZGT Hospital (Almelo and Hengelo, The Netherlands. BP was measured for 15 minutes with one minute intervals. Sodium and potassium intake was derived from 24-hour urinary excretion. We determined the adherence to pharmacological and non-pharmacological guidelines in patients with BP on target (BP-OT and BP not on target (BP-NOT. In total, 450 patients were included from August 2009 until January 2016. The mean age was 63 ± 9 years, and the majority was male (58%. In total, 53% had BP-OT. In those with BP-NOT, pharmacological management was suboptimal (zero to two antihypertensive drugs in 62% of patients, and nutritional guideline adherence was suboptimal in 100% of patients (only 8% had a sodium intake on target, 66% had a potassium intake on target, 3% had a sodium-to-potassium ratio on target, and body mass index was <30 kg/m2 in 35%. These data show pharmacological undertreatment and a low adherence to nutritional guidelines. Uncontrolled BP is common in T2DM, and our data show a window of opportunity for improving BP control, especially in nutritional management. To improve treatment quality, we advocate to incorporate the integrated monitoring of nutritional management in quality improvement cycles in routine care.

  14. Worsening Renal Function during Management for Chronic Heart Failure with Reduced Ejection Fraction: Results From the Pro-BNP Outpatient Tailored Chronic Heart Failure Therapy (PROTECT) Study.

    Science.gov (United States)

    Ibrahim, Nasrien E; Gaggin, Hanna K; Rabideau, Dustin J; Gandhi, Parul U; Mallick, Aditi; Januzzi, James L

    2017-02-01

    To assess prognostic meaning of worsening renal failure (WRF) occurring during management of chronic heart failure (HF) with reduced ejection fraction. When WRF develops during titration of HF medical therapy, it commonly leads to less aggressive care. A total of 151 patients enrolled in a prospective, randomized study of standard of care (SOC) HF therapy versus SOC plus a goal N-terminal pro-B type natriuretic peptide (NT-proBNP) renal function. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Nutritional evaluation of patients receiving dialysis for the management of protein-energy wasting: what is old and what is new?

    Science.gov (United States)

    Riella, Miguel C

    2013-05-01

    Advances in the nutritional support of hospitalized patients in the early 1970s led to the recognition that tools were needed to evaluate the nutritional status of patients. The observation that malnutrition in patients receiving dialysis was associated with increased morbidity and mortality prompted many expert groups to develop nutritional scoring systems to be applied in these patients. Given the diverse and confusing terminologies that emerged from these publications, the International Society of Renal Nutritional and Metabolism convened an expert panel to recommend a new nomenclature and preferred methods to evaluate the nutritional status of patients with chronic kidney disease (CKD). The new and inclusive term protein-energy wasting (PEW) refers to a systematically defined condition based on certain criteria and reflects malnutrition and wasting caused not only by inadequate nutrient intake but also by depletion resulting from the inflammatory and noninflammatory conditions that prevail in this population. Serial assessment of nutritional status for detection and management of PEW is recommended using old and new scoring tools, including the Subjective Global Assessment (SGA), malnutrition inflammation score (MIS), Geriatric Nutritional Risk Index (GNRI), and PEW definition criteria. These tools, which are reliable methods and predictors of outcomes, are reviewed in this article. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  16. Management of nutritional rickets in Indian children: a randomized controlled trial.

    Science.gov (United States)

    Aggarwal, Varun; Seth, Anju; Marwaha, Raman K; Sharma, Bhavna; Sonkar, Pitamber; Singh, Satveer; Aneja, Satinder

    2013-04-01

    Rickets is usually attributed to vitamin D deficiency. However, recent studies have implicated dietary calcium deficiency in its etiology. Information on relative efficacy of calcium, vitamin D or both together in healing of rickets is limited. To study effect of treatment with calcium, vitamin D or a combination of these two on healing of nutritional rickets in young children. Randomized controlled trial. Sixty-seven cases of nutritional rickets in the age group of 6 months to 5 years were randomly allocated to receive vitamin D (600 000 IU single intramuscular dose), calcium (75 mg/kg/day elemental calcium orally) or a combination of the above two for a period of 12 weeks. The demographic parameters, nutritional status, dietary calcium and phytate intake were assessed for all. Radiographs (wrist and knee) and biochemical parameters (serum calcium, inorganic phosphate, alkaline phosphatase, 25-hydroxycholecalciferol and parathyroid hormone) were evaluated at baseline, 6 and 12 weeks for evidence of healing. Mean dietary intake of calcium in all cases was low (204 ± 129 mg/day). Mean serum 25-hydroxycholecalciferol D level was 15.9 ± 12.4 ng/ml, and 82.1% of patients had serum vitamin D levels rickets was observed in all treatment groups, albeit to a variable extent. The combined end point of normal serum alkaline phosphatase and complete radiological healing at 12 weeks was observed in 50% subjects on combination therapy as compared with 15.7% subjects on vitamin D alone and 11.7% on calcium alone. Children with rickets had a low serum vitamin D level and a low dietary calcium intake. The best therapeutic response was seen with a combination of vitamin D and calcium than either of them given alone. CTRI/2010/091/000448.

  17. Assessing the nutritional status of older individuals in family practice: Evaluation and implications for management.

    Science.gov (United States)

    Mastronuzzi, Tecla; Paci, Claudio; Portincasa, Piero; Montanaro, Nicoletta; Grattagliano, Ignazio

    2015-12-01

    Malnutrition is emerging as a multidimensional concern of ageing with a high prevalence among nursing home residents. This study investigated the extent of malnutrition among old subjects in family practice and its relationship with major complications. Over 75 years old subjects (n = 274) filled the Mini Nutritional Assessment questionnaire. Appearance of major events in the following 6 months were registered. MNA scored were 11.5 ± 3.1, with 175 (64%) subjects showing no malnutrition, 69 (25%) resulted at risk, and 30 (11%) malnourished. Within at risk group, 1.4% was resident, 7% bed rested, 8% had a history of major bone fracture, 33% was demented and 24.6% hospitalized at least once in the last year. Among malnourished patients, 10% was resident, ten bed rested with 70% showing multiple bedsores, 20% have had bone fractures, 60% were demented and 13% hospital admitted in the previous year. In over 90% of them, malnutrition had neither diagnosed nor considered before. During follow-up, a significantly higher number of major events including death occurred in the malnourished group. By multivariate logistic regression, n = 56 (20.4%) patients resulted at risk of major complications. The sensitivity of the questionnaire in identifying these patients was 84% with the cut-off value of 7 associated with the highest prediction (positive predictive value, 0.92; negative predictive value, 0.71) yielding a specificity of 92%. The prevalence of malnutrition is high among older subjects in the setting of family practice. The Mini Nutritional Assessment allows to identify malnourished subjects better than BMI and effectively predicts the risk of major events. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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

    Science.gov (United States)

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

    2016-06-01

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

  19. Management of Ready-to-Use Parenteral Nutrition in Newborns: Systematic Review.

    Science.gov (United States)

    Mena, Karen Daniela Romero; Espitia, Olga Lucia Pinzón; Vergara, José Alejandro Daza

    2018-04-27

    Parenteral support has increased the possibility of neonatal recovery. However, complications associated with its use have been documented. One commercial method developed to decrease the complications of this type of support is the ready-to-use parenteral nutrition (PN), a 3-chamber bag that provides a complete nutrient mix. This systematic review seeks, through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, to establish the benefits in newborns. Seven databases and gray literature were used. The search was limited to publications from 2007-2017 and to articles written in English, Spanish, and Portuguese. Articles that did not meet the inclusion criteria and studies with low quality evaluated with the Scottish Intercollegiate Guidelines Network guidelines, which were without information about the study or analytical methods, were excluded. A total of 24,193 articles were obtained, which were initially evaluated by title and abstract according to the inclusion criteria. A total of 24,167 articles were discarded, obtaining 27 eligible for follow-up evaluation. After a detailed evaluation of the full text, 13 articles were selected. It was found that ready-to-use PN has the potential benefit to reduce the risks for infections, provide an adequate supply of nutrients, generate growth within the expected range, provide ease of use, decrease prescription errors, and potentially reduce costs. It is necessary to evaluate the short- and long-term impact of its use. © 2018 American Society for Parenteral and Enteral Nutrition.

  20. Management of Cancer Cachexia and Guidelines Implementation in a Comprehensive Cancer Center: A Physician-Led Cancer Nutrition Program Adapted to the Practices of a Country.

    Science.gov (United States)

    Senesse, Pierre; Isambert, Agnès; Janiszewski, Chloé; Fiore, Stéphanie; Flori, Nicolas; Poujol, Sylvain; Arroyo, Eric; Courraud, Julie; Guillaumon, Vanessa; Mathieu-Daudé, Hélène; Colasse, Sophie; Baracos, Vickie; de Forges, Hélène; Thezenas, Simon

    2017-09-01

    Cancer-associated cachexia is correlated with survival, side-effects, and alteration of the patients' well-being. We implemented an institution-wide multidisciplinary supportive care team, a Cancer Nutrition Program (CNP), to screen and manage cachexia in accordance with the guidelines and evaluated the impact of this new organization on nutritional care and funding. We estimated the workload associated with nutrition assessment and cachexia-related interventions and audited our clinical practice. We then planned, implemented, and evaluated the CNP, focusing on cachexia. The audit showed a 70% prevalence of unscreened cachexia. Parenteral nutrition was prescribed to patients who did not meet the guideline criteria in 65% cases. From January 2009 to December 2011, the CNP team screened 3078 inpatients. The screened/total inpatient visits ratio was 87%, 80%, and 77% in 2009, 2010, and 2011, respectively. Cachexia was reported in 74.5% (n = 2253) patients, of which 94.4% (n = 1891) required dietary counseling. Over three years, the number of patients with artificial nutrition significantly decreased by 57.3% (P < 0.001), and the qualitative inpatients enteral/parenteral ratio significantly increased: 0.41 in 2009, 0.74 in 2010, and 1.52 in 2011. Between 2009 and 2011, the CNP costs decreased significantly for inpatients nutritional care from 528,895€ to 242,272€, thus financing the nutritional team (182,520€ per year). Our results highlight the great benefits of implementing nutritional guidelines through a physician-led multidisciplinary team in charge of nutritional care in a comprehensive cancer center. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Cover crops for managing weeds, soil chemical fertility and nutritional status of organically grown orange orchard in Sicily

    Directory of Open Access Journals (Sweden)

    Rosario Paolo Mauro

    2015-06-01

    Full Text Available Cover crops can offer significant advantages in the agronomic management of citrus orchards in Mediterranean environments. Therefore, a three-year research was conducted in eastern Sicily aimed at studying the effects of four cover crop sequences (Sinapis arvensis-Trigonella foenum-graecum-T. foenum-graecum; Medicago scutellata-Avena sativa-Lolium perenne; Vicia faba minor-A. sativa-A. sativa; A. sativa-V. faba. minor-L. perenne on weeds, major soil chemical properties and nutritional status of an organically grown orange orchard. The results highlighted that, among the studied cover crop sequences, Vicia faba-Avena-Avena was the most beneficial for weeds control within the orchard (92%, of cover crop cover, and 586 and 89 g DW m–2 of cover crop aboveground biomass and weeds aboveground biomass, respectively. Overall, the chemical fertility of the soil was positively influenced. In particular, it was observed an increase of the content of total nitrogen and available phosphorus in the soil by both Sinapis-Trigonella-Trigonella (0.75 g kg–1 and 59.0 mg kg–1, respectively and Vicia faba-Avena-Avena (0.70 g kg–1 and 56.0 mg kg–1, respectively cover crop sequences. Medicago-Avena-Lolium sequence seemed to be the most useful to ensure a better nutritional status of the orange orchard.

  2. Real-life setting in data collection. The role of nutrition knowledge whilst selecting food products for weight management purposes in a supermarket environment.

    Science.gov (United States)

    Saarela, Anna-Maria; Lapveteläinen, Anja T; Mykkänen, Hannu M; Kantanen, Teuvo T; Rissanen, Riitta L

    2013-12-01

    The aim was to explore the role of consumers' nutrition knowledge while selecting foods for weight management and the predominating food selection factors by combining quantitative and qualitative methodology in a real-life setting during two consecutive shopping tasks given in a supermarket. Thirty-six consumers were given a list of 11 products and asked to think-aloud while selecting (i) a product they usually buy and (ii) a product they use for weight management. After the consecutive shopping tasks, the subjects were interviewed and asked to answer a nutrition knowledge questionnaire. The subjects were categorized by the difference in the energy contents of their selections and the food selection criteria. The energy contents of the selections for weight management were reduced by 10-46%. Ten subjects with the greatest difference between the energy contents of their selections had higher level in nutrition knowledge and mentioned less nutritional issues during the selections than ten subjects with the smallest such differences. Taste was an important product selection criterion by the former group, while the latter focused primarily on price. Nutrition knowledge is interrelated with personal factors and selection goals. It is not necessarily utilized consistently when selecting food products. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Neonates need tailored drug formulations.

    Science.gov (United States)

    Allegaert, Karel

    2013-02-08

    Drugs are very strong tools used to improve outcome in neonates. Despite this fact and in contrast to tailored perfusion equipment, incubators or ventilators for neonates, we still commonly use drug formulations initially developed for adults. We would like to make the point that drug formulations given to neonates need to be tailored for this age group. Besides the obvious need to search for active compounds that take the pathophysiology of the newborn into account, this includes the dosage and formulation. The dosage or concentration should facilitate the administration of low amounts and be flexible since clearance is lower in neonates with additional extensive between-individual variability. Formulations need to be tailored for dosage variability in the low ranges and also to the clinical characteristics of neonates. A specific focus of interest during neonatal drug development therefore is a need to quantify and limit excipient exposure based on the available knowledge of their safety or toxicity. Until such tailored vials and formulations become available, compounding practices for drug formulations in neonates should be evaluated to guarantee the correct dosing, product stability and safety.

  4. Association between the Family Nutrition and Physical Activity Screening Tool and obesity severity in youth referred to weight management.

    Science.gov (United States)

    Tucker, Jared M; Howard, Kathleen; Guseman, Emily H; Yee, Kimbo E; Saturley, Heather; Eisenmann, Joey C

    The Family Nutrition and Physical Activity Screening Tool (FNPA) evaluates family behavioural and environmental factors associated with pediatric obesity, but it is unknown if FNPA scores differ among youth across obesity severities. Our aim was to determine the association between the FNPA and obesity severity in youth referred to weight management. Upon initiating treatment, height, weight, and the FNPA were collected according to standard procedures. Cut-points for overweight/obesity, severe obesity (SO) class 2, and SO class 3 were calculated. FNPA scores were compared across weight status groups using analysis of covariance, and odds of SO across FNPA quartiles were evaluated with multiple logistic regression. Participants included 564 5-18year old who initiated treatment and completed the FNPA. After adjustment, FNPA scores differed by weight status with higher/healthier scores in youth with overweight/obesity (56.6±8.5) when compared to those with SO class 2 (55.0±7.1; p=0.015) or SO class 3 (53.6±9.0; p<0.001). Compared to those in the highest FNPA quartile, youth in the 2nd quartile had 1.8 (95% CI: 1.1, 2.9) times higher odds of SO, and those in the lowest FNPA quartile had 2.1 (95% CI: 1.3, 3.4) times higher odds of SO. Youth with SO had unhealthier subscale scores among 6 of 10 constructs, including nutritional, physical activity, sedentary, and sleep behaviours. Results suggest a consistent inverse relationship between the FNPA and adiposity among youth presenting for weight management. The FNPA is a useful metric for programs and clinicians targeting family behaviours and the home environment to combat obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  5. Mechanisms of Sucrose and Non-Nutritive Sucking in Procedural Pain Management in Infants

    Directory of Open Access Journals (Sweden)

    Sharyn Gibbins

    2001-01-01

    Full Text Available The administration of sucrose with and without non-nutritive sucking (NNS has been examined for relieving procedural pain in newborn infants. The calming and pain-relieving effects of sucrose are thought to be mediated by endogenous opioid pathways activated by sweet taste. The orogustatory effects of sucrose have been demonstrated in animal newborns, and in preterm and full term human infants during painful procedures. In contrast to sucrose, the analgesic effects of NNS are hypothesized to be activated through nonopioid pathways by stimulation of orotactile and mechanoreceptor mechanisms. Although there is uncertainty as to whether the effects of sucrose and NNS are synergistic or additive, there is sufficient evidence to support the efficacy of combining the two interventions for procedural pain relief in infants. In this review article, the underlying mechanisms of sucrose and NNS, separately and in combination for relieving procedural pain in preterm and full term infants, are examined. Clinical and research implications are addressed.

  6. Nutrition and parturition date effects on elk: potential implications for research and management.

    Science.gov (United States)

    John G. Cook; Bruce K. Johnson; Rachel C. Cook; Robert A. Riggs; Tim DelCurto; Larry D. Bryant; Larry L. Irwin

    2004-01-01

    Understanding and managing those mechanisms that affect population dynamics comprise, perhaps, the most fundamental aspect of wildlife management (Caughley 1977). Biologists generally categorize these mechanisms as either top-down (predator-driven) or bottom-up (habitat- or animal-density driven). Bottom-up influences involve imbalances between increasing animal...

  7. Pre-school manager training: a cost-effective tool to promote nutrition- and health-related practice improvements in the Irish full-day-care pre-school setting.

    LENUS (Irish Health Repository)

    Johnston Molloy, Charlotte

    2013-10-18

    To evaluate the impact on nutrition- and health-related practice of two methods of delivery of a nutrition and health intervention in Irish full-day-care pre-schools: training of pre-school managers only or training of managers and their staff.

  8. Nutrition Interventions for Prevention and Management of Childhood Obesity: What Do Parents Want from an eHealth Program?

    Directory of Open Access Journals (Sweden)

    Tracy Burrows

    2015-12-01

    Full Text Available With the growth of Internet technologies, offering interventions for child and family weight management in an online format may address barriers to accessing services. This study aimed to investigate (i whether an eHealth family healthy lifestyle program would be of interest to parents; and (ii preferences and/or expectations for program components and features. Parents of children aged four to18 years were recruited through social media and completed an online survey (54 items including closed and open-ended questions. Responses were collated using descriptive statistics and thematic analysis. Seventy-five participants were included (92% mothers, mean age 39.1 ± 8.6 years, mean BMI 27.6 ± 6.3 kg/m2. The index child had a mean age of 11 ± 6.2 years with 24% overweight/obese. The majority of parents (90.3% reported interest in an online program, with preference expressed for a non-structured program to allow flexibility users to log-on and off as desired. Parents wanted a program that was easy to use, practical, engaging, endorsed by a reputable source, and able to provide individual tailoring and for their children to be directly involved. The current study supports the need for online delivery of a healthy lifestyle program that targets greater parental concerns of diet rather than child weight.

  9. [Beliefs and knowledge of a group of doctors about the nutritional management of the child with acute diarrhea].

    Science.gov (United States)

    Corral-Terrazas, Martha; Martínez, Homero; Flores-Huerta, Samuel; Duque-L, Ma Ximena; Turnbull, Bernardo; Levario-Carrillo, Margarita

    2002-01-01

    To identify the beliefs and knowledge of a group of rural physicians on the dietary management of children under five years of age, with acute diarrhea. Physicians' dietary management was compared with that recommended by the World Health Organization. A cognitive anthropology study was carried out from July to December 1998, on ten physicians that care for the infant population ascribed to Hospital Rural IMSS-Solidaridad of San Juanito Bocoyna, Chihuahua, Mexico. Data were collected through focus groups, case vignettes, free listing, pile sorting, and a semi-structured questionnaire, and then cross-referred. The physicians recognized the negative impact of diarrhea on the nutritional state of the child, but not all of them evaluated this state. Prevailing interventions were antibiotic therapy, fluid management, and feeding recommendations. Among the latter, the most consistent were breastfeeding, delayed feeding, and gradual feeding. The obtained information is in conflict with WHO's recommendations, specially with that of sustained feeding. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

  10. Medical nutrition therapy is the essential cornerstone for effective treatment of "refractory" severe hypertriglyceridemia regardless of pharmaceutical treatment: Evidence from a Lipid Management Program.

    Science.gov (United States)

    Rhodes, Katherine S; Weintraub, Martha; Marchlewicz, Elizabeth H; Rubenfire, Melvyn; Brook, Robert D

    2015-01-01

    Patients with refractory severe hypertriglyceridemia are at risk of pancreatitis and cardiovascular disease. The role of individualized nutrition therapy in these patients independent of pharmaceutical treatment has not been documented. To document the effect of nutrition intervention on severe hypertriglyceridemia regardless of medication status or prior nutrition counseling. Outcomes of new patients with triglycerides ≥ 500 mg/dL presenting to a Lipid Management Program over a 6-year period were tracked. Patients received comprehensive laboratory assessment, nutrition assessment, and initiation of an individualized diet intervention before seeing the lipidologist. Clinical and behavioral outcomes were recorded. In all, 168 patients (117 men; mean age, 49.03 ± 11.22 years; body mass index, 32.61 ± 5.85 kg/m(2); 110 (65.5%) on lipid-lowering medications) returned for assessment of nutrition intervention. Triglycerides were reduced from median (interquartile range) 961.5 (611.5-1785.3) to 493.0 (337-736.3) mg/dL (P severe hypertriglyceridemia independent of lipid-lowering medication(s) and prior nutrition counseling. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  11. Macronutrient Composition and Management of Non-Insulin-Dependent Diabetes Mellitus (NIDDM): A New Paradigm for Individualized Nutritional Therapy in Diabetes Patients.

    Science.gov (United States)

    Koloverou, Efi; Panagiotakos, Demosthenes B

    2016-01-01

    Medical nutrition therapy constitutes an important lifestyle intervention in diabetes management. Several nutrition patterns have been effective in improving diabetes control, but there has been a debate about the optimal macronutrient composition in diabetes meal planning. For many years, the recommended diets for persons with and without diabetes were similar, i.e. heart-healthy and low in fat. For almost three decades, carbohydrates have been lauded, lipids demonized, and proteins considered of little importance. However, in the past few years, this concept has been questioned and reassessed. Modern nutritional recommendations for people with diabetes are headed towards individualization, but lack specific guidelines. Nutritional algorithms may help nutritionists in diabetes meal planning. This review aims to discuss: 1) the effects of the three major macronutrients (carbohydrates, proteins, and lipids) on glucose levels, 2) current recommendations for macronutrient intake for people with diabetes, and 3) specific parameters that need to be taken into consideration when determining the macronutrient composition for a person with diabetes, for example body mass index, degree of insulin resistance, HbA1c value, and lipid profile (especially triglycerides and HDL cholesterol). These aspects are analyzed in the context of the results of recent studies, especially randomized controlled trials (RCTs). Finally, we introduce an individualized nutritional concept that proposes carbohydrate over lipid restriction, substitution of SFAs with MUFAs and PUFAs, and adequate intake of dietary fiber, which are key factors in optimizing diabetes management.

  12. Tailoring surgical management of dislocated clavicle fractures

    NARCIS (Netherlands)

    Wijdicks, F.J.G.

    2013-01-01

    In this thesis literature research and clinical studies are presented to assist physicians in the decision making process for surgical treatment of dislocated midshaft clavicle fractures (DMCF). In Chapter 1 an introduction is given regarding the background, aim and outline of this thesis. Chapter 2

  13. Practical approaches to the nutritional management of nonalcoholic fatty liver disease

    Directory of Open Access Journals (Sweden)

    Leila Freidoony

    2014-12-01

    Full Text Available Nonalcoholic fatty liver disease (NAFLD is the hepatic manifestation of metabolic syndrome and a serious health burden worldwide which increases risk of cirrhosis, type 2 diabetes mellitus (T2DM, and cardiovascular complications. Current epidemics of obesity, unhealthy dietary patterns, and sedentary lifestyles, all contribute to the high prevalence of NAFLD. Dietary patterns and nutrients are important contributors to the development, progression, and treatment of NAFLD. A healthy diet is beneficial for all NAFLD patients beyond weight reduction. Generally, hypercaloric diets, especially rich in trans/saturated fat and cholesterol, high consumption of red and processed meat, and fructose-sweetened beverages seem to increase the risk of progression toward nonalcoholic steatohepatitis (NASH, whereas reducing caloric intake and high-glycemic index (GI foods, increasing consumption of monounsaturated fatty acids, omega-3 fatty acids, fibers, and specific protein sources such as fish and poultry have preventive and therapeutic effects. Therefore, nutrition serves as a major route of prevention and treatment of NAFLD, and patients with NAFLD should have an individualized diet recommendation. In this review, the evidence linking macronutrients to NAFLD are discussed.

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

    Directory of Open Access Journals (Sweden)

    Yavuz Topcu

    2016-02-01

    Full Text Available The aim of the study is to evaluate all the factors determining the milk production and yield decisions with regard to the nutrition and feeding programs affecting the integrated management strategies on the success of the dairy farms with culture breed cattle under the pasture-based and indoor barn-based production systems. For these aims, data obtained from the individual interviews conducted at the dairy farms with 100 culture breed cattle were used for Principal Component and Multiple Regression Analyses. The results of the study highlighted that while there were linear positive relationships among liquid assets of farms value, concentrate feed and fodder intake of dairy cattle, milk sale price, forage crop support, additional feeding and their types at pasture and milk yields per dairy cattle at the dairy farms; there were inverse relationships among hay intake of dairy cattle, lactation period, pasture planning, culture breed cattle support and those. The farmers could increase the successes of the dairy farms by increasing the technical and economic effectiveness under the integrated management pattern approaches at those with culture breed cattle.

  15. Effect of the Strong4Life School Nutrition Program on Cafeterias and on Manager and Staff Member Knowledge and Practice, Georgia, 2015.

    Science.gov (United States)

    Rajbhandari-Thapa, Janani; Bennett, Ashley; Keong, Farrah; Palmer, Wendy; Hardy, Trisha; Welsh, Jean

    The goal of the Strong4Life School Nutrition Program is to promote healthy eating in school cafeterias in Georgia by training school nutrition managers and staff members to implement changes in the cafeteria to nudge children to make healthier choices. The objective of our study was to evaluate program effect on (1) school nutrition manager and staff member knowledge of evidence-based strategies and their self-efficacy to make positive changes, (2) the school cafeteria environment, and (3) National School Lunch Program participation. We assessed changes in participant knowledge, beliefs, and self-efficacy by administering a survey before and after training (February-July 2015); a follow-up survey (3 school months posttraining) assessed changes in the cafeteria. A total of 842 school nutrition managers and staff members were trained and completed pre- and posttraining surveys; 325 managers completed the follow-up survey. We used cafeteria records from a subsample of the first schools trained (40 intervention and 40 control) to assess National School Lunch Program participation. From pretraining to posttraining, we found a significant increase in manager and staff member (n = 842) knowledge of strategies for enhancing taste perception through the use of creative menu item names (from 78% to 95%, P managers (n = 325) reported increased use of evidence-based serving strategies: visibility (from 84% to 96% for placing healthy options in >2 locations, P managers and staff members in Smarter Lunchrooms Movement techniques may be an effective way to make changes in the school cafeteria environment to encourage healthier choices among students. Additional studies allowing time for more complex changes to be implemented are needed to assess the full effect of the program.

  16. Organic Highbush Blueberry Production Systems Research – Management of Plant Nutrition, Irrigation Requirements, and Weeds

    Science.gov (United States)

    A 0.4 ha planting of blueberry was established in October 2006 to evaluate the effects of cultivar (Duke and Liberty), bed type (flat versus raised beds), weed management (sawdust mulch and hand-weed control; sawdust+compost mulch with acetic acid, flaming, and hand control used as needed; and weed ...

  17. Development of the management for parenteral nutrition traceability in a standard hospital

    Directory of Open Access Journals (Sweden)

    Beatriz Bernabeu Soria

    2015-11-01

    Full Text Available Objective: to develop the traceability control and the hazard analysis in the processes of parenteral nutrients (PN. Method: a standardized graphical notation was generated, describing in detail each of the stages in the overall process. The presence of hazards was analysed by sequencing decisions. The existence of Control Points (CP or Critical Control Points (CCP was estimated by Criticality Index (CI for each hazard taking into account the probability of occurrence and the severity of the damage. The threshold for the IC was set in 6. Results: a specific flow chart for the management and traceability of PN was obtained, defining each of the stages in CPs (validation and transcription of the prescription and administration or CCPs (preparation, storage and infusion pump –flow and filter-. Stages regarding the delivery, the recovery and the recycle of the packing material of PNs are not considered CPs and, therefore, they were not included in the dashboard. Conclusions: PN must be dealt with in the frame of a standardized management system in order to improve patient safety, clinical relevance, maximize resource efficiency and minimize procedural issues. The proposed system provides a global management model whose steps are fully defined, allowing monitoring and verification of PN. It would be convenient to make use of a software application to support the monitoring of the traceability management and to store the historical records in order to evaluate the system.

  18. Organic blueberry production systems: management of plant nutrition, irrigation requirements, and weeds

    Science.gov (United States)

    A long-term systems trial was established to evaluate management practices for organic production of northern highbush blueberry (Vaccinium corymbosum L.). The factorial experiment included two planting bed treatments (flat and raised beds), source and rate of fertilizer (feather meal and fish emuls...

  19. Diet & Nutrition

    Science.gov (United States)

    ... Nutrition Share this page Facebook Twitter Email Diet & Nutrition Eating healthy to take charge of your health. Shelly Diagnosed in 2006 Diet & Nutrition Take Control of Your Weight Portion Control Low ...

  20. Tailoring Small IT Projects in the Project Planning Phase

    Science.gov (United States)

    Mulhearn, Michael F.

    2011-01-01

    Project management (PM) and systems engineering (SE) are essential skills in information technology (IT). There is an abundance of information available detailing the comprehensive bodies of knowledge, standards, and best practices. Despite the volume of information, there is surprisingly little information about how to tailor PM and SE tasks for…

  1. Special Food and Nutrition Needs in School Nutrition Programs

    Science.gov (United States)

    Molaison, Elaine Fontenot; Nettles, Mary Frances

    2010-01-01

    Purpose/Objectives: The purpose of this research was to determine the prevalence of special food and/or nutrition needs in school nutrition programs. In addition, researchers focused on the issues surrounding these needs and the role of the school nutrition (SN) directors and managers in meeting these needs. Methods: An expert panel was used to…

  2. Practice Paper of the Academy of Nutrition and Dietetics: Role of the Registered Dietitian Nutritionist in the Diagnosis and Management of Food Allergies.

    Science.gov (United States)

    Collins, Sherry Coleman

    2016-10-01

    Incidence of food allergy has increased significantly over the past decade and represents an important health issue for millions of Americans. Diagnosis of immunoglobulin E-mediated food allergies is sometimes difficult because blood and skin tests have high rates of false positives, and oral food challenges are uncommon due to the expense and potential for serious reactions. Accurate diagnosis is crucial to avoid unnecessary dietary restriction, especially in children. Because registered dietitian nutritionists often work independently, receiving referrals for dietary education and guidance for a patient who is followed by one or several other practitioners, navigating the data available and making the appropriate follow-up contact optimizes treatment. The purpose of this paper is to provide guidance to the registered dietitian nutritionists and nutrition and dietetics technician, registered on appropriate and evidence-based nutrition counseling for diagnosis and management of food allergies. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  3. The impact of longitudinal intestinal lengthening and tailoring on liver function in short bowel syndrome.

    Science.gov (United States)

    Reinshagen, K; Zahn, K; Buch, C von; Zoeller, M; Hagl, C I; Ali, M; Waag, K-L

    2008-08-01

    Short bowel syndrome is a functional or anatomic loss of major parts of the small bowel leading to severe malnutrition. The limiting factor for the survival of these patients remains parenteral nutrition-related liver damage leading to end-stage liver failure. Longitudinal intestinal lengthening and tailoring (LILT) has been proven to enhance peristalsis, to decrease bacterial overgrowth and to extend the mucosal contact time for the absorption of nutrients. The aim of this study was to show the impact of LILT on the development of parenteral nutrition-related liver damage. A cohort of 55 patients with short bowel syndrome managed with LILT in our institution between 1987 and 2007 was retrospectively reviewed. LILT was performed at a mean age of 24 months (range 4 - 150 months). Mean follow-up time was 83.76 months (range 5 - 240 months). We obtained reliable data from 31 patients with regard to liver enzymes and function parameters in blood samples before LILT and at the present time. Liver biopsy was performed in 14 patients prior to LILT. Liver enzymes ALAT (mean 121 U/l), ASAT (mean 166 U/l) and bilirubin (mean 2.49 mg/dl) were elevated preoperatively in 27/31 children. After the lengthening procedure, ALAT (mean 50 U/l), ASAT (mean 63 U/l) and bilirubin (mean 1.059 mg/dl) normalized except in 5 of 8 patients who could not be weaned from parenteral nutrition after LILT. Liver function parameters such as the international normal ratio (INR) were slightly elevated in 5/31 patients. Albumin was generally low, probably due to parenteral nutrition. Liver biopsy was performed in 14 patients preoperatively, showing 4 patients with low-grade, 6 patients with intermediate and 4 patients with high-grade fibrosis. End-stage liver disease with cirrhosis was an exclusion criterion for LILT. All patients with liver fibrosis showed a normalization of liver enzymes when they were weaned from parenteral nutrition. But patients with higher grade liver fibrosis tend to develop

  4. Deep drawing simulation of Tailored Blanks

    NARCIS (Netherlands)

    van den Berg, Albert; Meinders, Vincent T.; Stokman, B.

    1998-01-01

    Tailored blanks are increasingly used in the automotive industry. A tailored blank consists of different metal parts, which are joined by a welding process. These metal parts usually have different material properties. Hence, the main advantage of using a tailored blank is to provide the right

  5. Variation in broccoli cultivar phytochemical content under organic and conventional management systems: implications in breeding for nutrition.

    Science.gov (United States)

    Renaud, Erica N C; Lammerts van Bueren, Edith T; Myers, James R; Paulo, Maria João; van Eeuwijk, Fred A; Zhu, Ning; Juvik, John A

    2014-01-01

    Organic agriculture requires cultivars that can adapt to organic crop management systems without the use of synthetic pesticides as well as genotypes with improved nutritional value. The aim of this study encompassing 16 experiments was to compare 23 broccoli cultivars for the content of phytochemicals associated with health promotion grown under organic and conventional management in spring and fall plantings in two broccoli growing regions in the US (Oregon and Maine). The phytochemicals quantified included: glucosinolates (glucoraphanin, glucobrassicin, neoglucobrassin), tocopherols (δ-, γ-, α-tocopherol) and carotenoids (lutein, zeaxanthin, β-carotene). For glucoraphanin (17.5%) and lutein (13%), genotype was the major source of total variation; for glucobrassicin, region (36%) and the interaction of location and season (27.5%); and for neoglucobrassicin, both genotype (36.8%) and its interactions (34.4%) with season were important. For δ- and γ-tocopherols, season played the largest role in the total variation followed by location and genotype; for total carotenoids, genotype (8.41-13.03%) was the largest source of variation and its interactions with location and season. Overall, phytochemicals were not significantly influenced by management system. We observed that the cultivars with the highest concentrations of glucoraphanin had the lowest for glucobrassicin and neoglucobrassicin. The genotypes with high concentrations of glucobrassicin and neoglucobrassicin were the same cultivars and were early maturing F1 hybrids. Cultivars highest in tocopherols and carotenoids were open pollinated or early maturing F1 hybrids. We identified distinct locations and seasons where phytochemical performance was higher for each compound. Correlations among horticulture traits and phytochemicals demonstrated that glucoraphanin was negatively correlated with the carotenoids and the carotenoids were correlated with one another. Little or no association between

  6. Variation in Broccoli Cultivar Phytochemical Content under Organic and Conventional Management Systems: Implications in Breeding for Nutrition

    Science.gov (United States)

    Renaud, Erica N. C.; Lammerts van Bueren, Edith T.; Myers, James R.; Paulo, Maria João; van Eeuwijk, Fred A.; Zhu, Ning; Juvik, John A.

    2014-01-01

    Organic agriculture requires cultivars that can adapt to organic crop management systems without the use of synthetic pesticides as well as genotypes with improved nutritional value. The aim of this study encompassing 16 experiments was to compare 23 broccoli cultivars for the content of phytochemicals associated with health promotion grown under organic and conventional management in spring and fall plantings in two broccoli growing regions in the US (Oregon and Maine). The phytochemicals quantified included: glucosinolates (glucoraphanin, glucobrassicin, neoglucobrassin), tocopherols (δ-, γ-, α-tocopherol) and carotenoids (lutein, zeaxanthin, β-carotene). For glucoraphanin (17.5%) and lutein (13%), genotype was the major source of total variation; for glucobrassicin, region (36%) and the interaction of location and season (27.5%); and for neoglucobrassicin, both genotype (36.8%) and its interactions (34.4%) with season were important. For δ- and γ- tocopherols, season played the largest role in the total variation followed by location and genotype; for total carotenoids, genotype (8.41–13.03%) was the largest source of variation and its interactions with location and season. Overall, phytochemicals were not significantly influenced by management system. We observed that the cultivars with the highest concentrations of glucoraphanin had the lowest for glucobrassicin and neoglucobrassicin. The genotypes with high concentrations of glucobrassicin and neoglucobrassicin were the same cultivars and were early maturing F1 hybrids. Cultivars highest in tocopherols and carotenoids were open pollinated or early maturing F1 hybrids. We identified distinct locations and seasons where phytochemical performance was higher for each compound. Correlations among horticulture traits and phytochemicals demonstrated that glucoraphanin was negatively correlated with the carotenoids and the carotenoids were correlated with one another. Little or no association between

  7. The integration of diet and nutrition lifestyle management strategies into the dental office visit for diabetes risk reduction and management.

    Science.gov (United States)

    Bruno, Maura

    2012-12-01

    The incidence of diabetes and prediabetes in the United States continues to increase. Oral health care professionals (OHCPs) play a role in diabetes screening and education. The author presents and explores diet and lifestyle management strategies OHCPs can provide to patients who have prediabetes and type 2 diabetes mellitus (T2DM). Modest weight loss (7 percent of body weight) and regular physical activity (150 minutes per week) are important in the prevention and treatment of prediabetes and T2DM. Following a carbohydrate-controlled diet that is limited in fat and cholesterol will help patients with T2DM achieve normoglycemia and reduce their risk of developing diabetes complications. The importance of using these strategies can be reinforced by OHCPs during office visits. OHCPs can collaborate with registered dietitians to improve the outcome of oral health through diabetes prevention, education and management. Being familiar with risk factors for T2DM and recommendations for lifestyle modification strategies to prevent T2DM may help OHCPs educate patients and refer them for appropriate treatment and therapy.

  8. Time series with tailored nonlinearities

    Science.gov (United States)

    Räth, C.; Laut, I.

    2015-10-01

    It is demonstrated how to generate time series with tailored nonlinearities by inducing well-defined constraints on the Fourier phases. Correlations between the phase information of adjacent phases and (static and dynamic) measures of nonlinearities are established and their origin is explained. By applying a set of simple constraints on the phases of an originally linear and uncorrelated Gaussian time series, the observed scaling behavior of the intensity distribution of empirical time series can be reproduced. The power law character of the intensity distributions being typical for, e.g., turbulence and financial data can thus be explained in terms of phase correlations.

  9. Four years of North American registry home parenteral nutrition outcome data and their implications for patient management

    International Nuclear Information System (INIS)

    Howard, L.; Heaphey, L.; Fleming, C.R.; Lininger, L.; Steiger, E.

    1991-01-01

    The OASIS Registry started annual collection of longitudinal data on patients on home parenteral nutrition (HPN) in 1984. This report describes outcome profiles on 1594 HPN patients in seven disease categories. Analysis showed clinical outcome was principally a reflection of the underlying diagnosis. Patients with Crohn's disease, ischemic bowel disease, motility disorders, radiation enteritis, and congenital bowel dysfunction all had a fairly long-term clinical outcome, whereas those with active cancer and acquired immunodeficiency syndrome (AIDS) had a short-term outcome. The long-term group had a 3-year survival rate of 65 to 80%, they averaged 2.6 complications requiring hospitalization per year, and 49% experienced complete rehabilitation. The short-term group had a mean survival of 6 months; they averaged 4.6 complications per year and about 15% experienced complete rehabilitation. The registry data also indicated HPN was used for 19,700 patients in 1987 with therapy growth averaging about 8% per year. This growth was chiefly from new cancer patients. The number of new patients with long-term disorders in whom HPN was initiated appeared rather constant. The authors conclude that these clinical outcome assessments justify HPN for long-term patients, but the utility and appropriateness of HPN for the cancer and AIDS patients remains uncertain and requires further study. Medical, social, and fiscal aspects of HPN management in long-term and short-term patients appear to involve quite separate considerations

  10. Yin yang 1 and adipogenic gene network expression in longissimus muscle of beef cattle in response to nutritional management.

    Science.gov (United States)

    Moisá, Sonia J; Shike, Daniel W; Meteer, William T; Keisler, Duane; Faulkner, Dan B; Loor, Juan J

    2013-01-01

    Among 36 differentially-expressed genes during growth in longissimus muscle (LM) of Angus steers, Yin Yang 1 (YY1) had the most relationships with other genes including some associated with adipocyte differentiation. The objective of this study was to examine the effect of nutritional management on mRNA expression of YY1 along with its targets genes PPARG, GTF2B, KAT2B, IGFBP5 and STAT5B. Longissimus from Angus and Angus × Simmental steers (7 total/treatment) on early weaning plus high-starch (EWS), normal weaning plus starch creep feeding (NWS), or normal weaning without starch creep feeding (NWN) was biopsied at 0, 96, and 240 days on treatments. Results suggest that YY1 does not exert control of adipogenesis in LM, and its expression is not sensitive to weaning age. Among the YY1-related genes, EWS led to greater IGFBP5 during growing and finishing phases. Pro-adipogenic transcriptional regulation was detected in EWS due to greater PPARG and VDR at 96 and 240 d vs. 0 d. GTF2B and KAT2B expression was lower in response to NWS and EWS than NWN, and was most pronounced at 240 d. The increase in PPARG and GTF2B expression between 96 and 240 d underscored the existence of a molecular programming mechanism that was sensitive to age and dietary starch. Such response partly explains the greater carcass fat deposition observed in response to NWS.

  11. Tailoring CSR Strategy to Company Size?

    Directory of Open Access Journals (Sweden)

    Alexandra ZBUCHEA

    2017-09-01

    Full Text Available Corporate Social Responsibility (CSR is one of the most debated topics in the academic and professional business literature, being analyzed in a myriad of perspectives, from philosophy, to marketing, management practice, managerial strategies or financial impact. The very term of CSR implies that involving with society in a structural way that is part of a business DNA is or should be understood as a characteristic of big size companies (e.g. ‘corporations’. Academic literature and financial reports show a direct relationship between a company size and its CSR budget, therefore some conclusions have been taken that CSR is effective mostly in cases of big budgets and, consequently, of big companies. Academic research also tends to favor large corporations. Most of the literature on CSR is dedicated to large companies. Nevertheless, in the past decade, increasingly more studies have investigated the social responsibility assumed by other types of companies (such as SMEs, by public institutions or by nonprofit organizations. Our present empirical analysis based on structured academic literature review (comprehensive selection of relevant international papers and content analysis demonstrates that CSR should go beyond the classical understanding of the ‘corporation’ concept and that it should be tailored to SMEs as well. Innovation and top management support are the drivers of effective CSR adoption by SMEs, for positive results meeting specific business model requirements, as well as for society. Going beyond social responsibility as a philosophical duty, correctly tailored CSR strategies can be efficient for small and medium enterprises in meeting strategic business objectives.

  12. Effect of Nutritional Management on Yield and Yield Components of Roselle (Hibiscus sabdariffa as a Medicinal Plant in Mashhad Condition

    Directory of Open Access Journals (Sweden)

    P Rezvani Moghaddam

    2018-02-01

    Full Text Available Introduction Roselle (Hibiscus sabdariffa is an annual plant with a height of about 64 to 429 cm belongs to Malvaceae family. Roselle is self-pollinated and sensitive to cold. Sepals of Roselle are used in food and pharmaceutical industries. It has been reported that Roselle is not native to Iran but it is cultivated extensively in Sistan and Baluchistan province, Iran. In order to achieve high quality and quantity yield of Roselle sepal it is necessary to improve nutritional systems of plant. Proper management of soil fertility and plant nutrition can preserve environment, improve biodiversity and also increase inputs efficiency. Results showed that use of nutritional resources will improve plant growth. Organic fertilizers such as compost can improve soil fertility as an important source of food that increase yield of plants. Nabila and Aly (2002 observed that use of hen and cow manure increased plant height, number of lateral branches, numbers of fruit and sepal yield of Roselle. Each plant species has the maximum potential in favorable conditions. Therefore, evaluation the effect of climatic and agronomic factors and nutritional management for plants is essential. This experiment was conducted to evaluate the yield and yield components of Roselle in response to use of single and combined nutritional resources. Materials and Methods In order to study the effects of single and combined organic, biological and chemical fertilizers on yield and yield components of Roselle (Hibiscus sabdariffa, a field experiment was conducted with 12 treatments based on a Randomized Complete Block Design with three replications at Research Station, Faculty of Agriculture, Ferdowsi University of Mashhad, Iran, in 2013-2014. Treatments included: 1- mycorrhiza (Glomus intraradices, 2- cow manure, 3- chemical fertilizer, 4- vermicompost, 5- chemical fertilizer + cow manure, 6- chemical fertilizer + vermicompost, 7- chemical fertilizer + mycorrhiza, 8- cow manure

  13. Management of the General Process of Parenteral Nutrition Using mHealth Technologies: Evaluation and Validation Study.

    Science.gov (United States)

    Cervera Peris, Mercedes; Alonso Rorís, Víctor Manuel; Santos Gago, Juan Manuel; Álvarez Sabucedo, Luis; Wanden-Berghe, Carmina; Sanz-Valero, Javier

    2018-04-03

    Any system applied to the control of parenteral nutrition (PN) ought to prove that the process meets the established requirements and include a repository of records to allow evaluation of the information about PN processes at any time. The goal of the research was to evaluate the mobile health (mHealth) app and validate its effectiveness in monitoring the management of the PN process. We studied the evaluation and validation of the general process of PN using an mHealth app. The units of analysis were the PN bags prepared and administered at the Son Espases University Hospital, Palma, Spain, from June 1 to September 6, 2016. For the evaluation of the app, we used the Poststudy System Usability Questionnaire and subsequent analysis with the Cronbach alpha coefficient. Validation was performed by checking the compliance of control for all operations on each of the stages (validation and transcription of the prescription, preparation, conservation, and administration) and by monitoring the operative control points and critical control points. The results obtained from 387 bags were analyzed, with 30 interruptions of administration. The fulfillment of stages was 100%, including noncritical nonconformities in the storage control. The average deviation in the weight of the bags was less than 5%, and the infusion time did not present deviations greater than 1 hour. The developed app successfully passed the evaluation and validation tests and was implemented to perform the monitoring procedures for the overall PN process. A new mobile solution to manage the quality and traceability of sensitive medicines such as blood-derivative drugs and hazardous drugs derived from this project is currently being deployed. ©Mercedes Cervera Peris, Víctor Manuel Alonso Rorís, Juan Manuel Santos Gago, Luis Álvarez Sabucedo, Carmina Wanden-Berghe, Javier Sanz-Valero. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 03.04.2018.

  14. Tailoring PKI for the battlespace

    Science.gov (United States)

    Covey, Carlin R.

    2003-07-01

    A Public Key Infrastructure (PKI) can provide useful communication protections for friendly forces in the battlespace. The PKI would be used in conjunction with communication facilities that are accorded physical and Type-1 cryptographic protections. The latter protections would safeguard the confidentiality and (optionally) the integrity of communications between enclaves of users, whereas the PKI protections would furnish identification, authentication, authorization and privacy services for individual users. However, Commercial-Off-the-Shelf (COTS) and most Government-Off-the-Shelf (GOTS) PKI solutions are not ideally tailored for the battlespace environment. Most PKI solutions assume a relatively static, high-bandwidth communication network, whereas communication links in the battlespace will be dynamically reconfigured and bandwidth-limited. Most enterprise-wide PKI systems assume that users will enroll and disenroll at an orderly pace, whereas the battlespace PKI "enterprise" will grow and shrink abruptly as units are deployed or withdrawn from the battlespace. COTS and GOTS PKIs are seldom required to incorporate temporary "enterprise mergers", whereas the battlespace "enterprise" will need to incorporate temporary coalitions of forces drawn from various nations. This paper addresses both well-known and novel techniques for tailoring PKI for the battlespace environment. These techniques include the design of the security architecture, the selection of appropriate options within PKI standards, and some new PKI protocols that offer significant advantages in the battlespace.

  15. State of nutrition support teams.

    Science.gov (United States)

    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.

  16. Comprehensive Performance Nutrition for Special Operations Forces.

    Science.gov (United States)

    Daigle, Karen A; Logan, Christi M; Kotwal, Russ S

    2015-01-01

    Special Operations Forces (SOF) training, combat, and contingency operations are unique and demanding. Performance nutrition within the Department of Defense has emphasized that nutrition is relative to factors related to the desired outcome, which includes successful performance of mentally and physically demanding operations and missions of tactical and strategic importance, as well as nonoperational assignments. Discussed are operational, nonoperational, and patient categories that require different nutrition strategies to facilitate category-specific performance outcomes. Also presented are 10 major guidelines for a SOF comprehensive performance nutrition program, practical nutrition recommendations for Special Operators and medical providers, as well as resources for dietary supplement evaluation. Foundational health concepts, medical treatment, and task-specific performance factors should be considered when developing and systematically implementing a comprehensive SOF performance nutrition program. When tailored to organizational requirements, SOF unit- and culture-specific nutrition education and services can optimize individual Special Operator performance, overall unit readiness, and ultimately, mission success. 2015.

  17. Tailor-welded blanks and their production

    Science.gov (United States)

    Yan, Qi

    2005-01-01

    Tailor welded blanks had been widely used in the automobile industry. A tailor welded blank consists of several flat sheets that were laser welded together before stamping. A combination of different materials, thickness, and coatings could be welded together to form a blank for stamping car body panels. As for the material for automobile industry, this technology was one of the development trend for automobile industry because of its weight reduction, safety improvement and economical use of materials. In this paper, the characters and production of tailor welded blanks in the market were discussed in detail. There had two major methods to produce tailor welded blanks. Laser welding would replace mesh seam welding for the production of tailor welded blanks in the future. The requirements on the edge preparation of unwelded blanks for tailor welded blanks were higher than the other steel processing technology. In order to produce the laser welded blank, there had the other process before the laser welding in the factory. In the world, there had three kinds of patterns for the large volume production of tailor welded blanks. In China, steel factory played the important role in the promotion of the application of tailor welded blanks. The competition for the supply of tailor welded blanks to the automobile industry would become fierce in the near future. As a result, the demand for the quality control on the production of tailor welded blanks would be the first priority concern for the factory.

  18. Nutritional Habits in Management of Shigellosis in Children with Helicobacter Pylori Infection

    Directory of Open Access Journals (Sweden)

    N.Yu. Kurlan

    2016-08-01

    Full Text Available The ways of improving of diet management in children with Shigellosis infected with H. pylori were determined. The study involved 29 children with H. pylori infection aged from 1 to 10, who were hospitalized in the Regional Children’s Infectious Diseases Hospital (Kharkiv and had a diagnosis of Shigellosis sonnei of moderate severity. The children were divided into two groups depending on the feeding mode. The first group was represented by 13 children, who were undergone standard treatment. The second group included 16 children who had two days prolonged gradual increase in the volume of food at each feeding, and decreased number of feedings per day. Children of the second group received aluminum phosphate from the first day and after discharge they were advised to keep on the regime of feeding «more frequently, but in small portions». A longer duration of the symptoms of bowel dysfunction and vomiting, pain in periumbilical area, bloating, changes in fecal examination in the form of the presence of undigested food in children of the first group were revealed. Patients of the second group regained their weight in much shorter period. Rational diet therapy makes it possible to prevent recrudescence of shi­gellosis in children at early stages of recovery. Studies have shown that early detection of H. pylori infection in children with shigellosis as well as timely correction of feeding have a positive effect on recovery of functional activity of digestive processes, faster normalization of clinical and laboratory parameters of patients, contribute to regression of clinical symptoms of the underlying disease.

  19. [Nutrigenomics - perspectives of personalized nutrition].

    Science.gov (United States)

    Kapka-Skrzypczak, Lucyna; Niedźwiecka, Joanna; Cyranka, Małgorzata; Kruszewski, Marcin K; Skrzypczak, Maciej; Wojtyła, Andrzej

    2011-01-01

    Currently used dietary recommendations and requirements are generalized. It applies to both healthy and ailing individuals. These recommendations are meant to avert leading chronic illnesses such as: type 2 diabetes mellitus, obesity, hyperlipidemia, cardiovascular diseases and hypertension. In the future it might be possible to give dietary advice tailored to every - sick and healthy - individual. Nutrigenomics and nutrigenetics are two fields derived from nutrition science and genetics. Their main goal is to elucidate the influence of interactions between genes and diet on individuals' health. This paper shows the examples of metabolic response changes according to diet and chosen gene polymorphisms. It will enable an effective prevention or management of chronic diseases by accurate diet and lifestyle matched to an individual's genetic makeup. It could be useful especially to define predisposition for type 2 diabetes mellitus in young children. It will be possible to change their diet and lifestyle so that they could avoid this chronic disease. There will also be a possibility to detect early the beginning of the illness and choose/select proper treatment. It is important because type 2 diabetes mellitus frequency is up to 90% of all cases of diabetes mellitus. It's often diagnosed too late and a lot of patients have already developed complications caused by this disease. Successful dietotherapy will also be available in such disease entities as dyslipidemias, hypertension and micro- , macronutrients and vitamins defficiences.

  20. Taming Parasites by Tailoring Them

    Directory of Open Access Journals (Sweden)

    Bingjian Ren

    2017-07-01

    Full Text Available The next-generation gene editing based on CRISPR (clustered regularly interspaced short palindromic repeats has been successfully implemented in a wide range of organisms including some protozoan parasites. However, application of such a versatile game-changing technology in molecular parasitology remains fairly underexplored. Here, we briefly introduce state-of-the-art in human and mouse research and usher new directions to drive the parasitology research in the years to come. In precise, we outline contemporary ways to embolden existing apicomplexan and kinetoplastid parasite models by commissioning front-line gene-tailoring methods, and illustrate how we can break the enduring gridlock of gene manipulation in non-model parasitic protists to tackle intriguing questions that remain long unresolved otherwise. We show how a judicious solicitation of the CRISPR technology can eventually balance out the two facets of pathogen-host interplay.

  1. Improving occupational physicians' adherence to a practice guideline : feasibility and impact of a tailored implementation strategy

    NARCIS (Netherlands)

    Joosen, Margot C. W.; van Beurden, Karlijn M.; Terluin, Berend; van Weeghel, Jaap; Brouwers, Evelien P. M.; van der Klink, Jac J. L.

    2015-01-01

    Background: Although practice guidelines are important tools to improve quality of care, implementation remains challenging. To improve adherence to an evidence-based guideline for the management of mental health problems, we developed a tailored implementation strategy targeting barriers perceived

  2. Dietary Therapy and Nutrition Management of Eosinophilic Esophagitis: A Work Group Report of the American Academy of Allergy, Asthma, and Immunology.

    Science.gov (United States)

    Groetch, Marion; Venter, Carina; Skypala, Isabel; Vlieg-Boerstra, Berber; Grimshaw, Kate; Durban, Raquel; Cassin, Alison; Henry, Michelle; Kliewer, Kara; Kabbash, Lynda; Atkins, Dan; Nowak-Węgrzyn, Anna; Holbreich, Mark; Chehade, Mirna

    Eosinophilic esophagitis (EoE) is a chronic/immune-antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. Dietary elimination therapy has been shown to be an effective, drug-free prescription for the treatment of EoE. A range of different dietary elimination therapies have been used. Regardless of the elimination diet chosen, dietary therapy requires in-depth nutrition assessment and management. Elimination diets are not without risk and may impact nutritional status, eating pleasure, and overall quality of life. With adequate guidance, dietary therapy can be effective and nutritionally balanced, and the adverse impact on lifestyle can be minimized. This work group report addresses the potential challenges of implementing an elimination diet for the management of EoE and provides instructions and tools for physicians, dietitians, and other allied health professionals to help guide them in planning elimination diets for both children and adults. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  3. Nutrition Basics

    Science.gov (United States)

    ... and Shareables Autoimmune Diseases Breastfeeding Cancer Fitness and Nutrition Heart Disease and Stroke HIV and AIDS Mental ... health topic Autoimmune Diseases Breastfeeding Cancer Fitness and Nutrition Heart Disease and Stroke HIV and AIDS Mental ...

  4. Nutritional Support

    Science.gov (United States)

    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 ...

  5. Nutritional supplements

    DEFF Research Database (Denmark)

    Petersen, Gry Bjerg; Andersen, Jens Rikardt

    2015-01-01

    Background: Several studies have indicated that cancer patients have significantly altered taste sensitivity without specifying the preferences. One of the related problems is low compliance to nutritional therapy with oral nutritional supplements (ONS) in patients suffering severe weight loss...

  6. Food Products Made With Glycomacropeptide, a Low Phenylalanine Whey Protein, Provide a New Alternative to Amino Acid-Based Medical Foods for Nutrition Management of Phenylketonuria

    Science.gov (United States)

    Van Calcar, Sandra C.; Ney, Denise M.

    2012-01-01

    Phenylketonuria (PKU), an inborn error in phenylalanine (phe) metabolism, requires lifelong nutrition management with a low-phe diet, which includes a phe-free amino acid-based medical formula to provide the majority of an individual’s protein needs. Compliance with this diet is often difficult for older children, adolescents and adults with PKU. The whey protein glycomacropeptide (GMP) is ideally suited for the PKU diet since it is naturally low in phe. Nutritionally complete, acceptable medical foods and beverages can be made with GMP to increase the variety of protein sources for the PKU diet. As an intact protein, GMP improves protein utilization and increases satiety compared with amino acids. Thus, GMP provides a new, more physiologic source of low-phe dietary protein for those with PKU. PMID:22818728

  7. Nutrition interventions in the workplace: Evidence of best practice ...

    African Journals Online (AJOL)

    The following were key success factors: i) there was a nutrition and physical activity component; ii) dietitians were involved in nutrition education; iii) changes occurred in the cafeteria/canteen, which increased the availability of healthy food options and advertised them accordingly; iv) tailored feedback on diet (and clinical ...

  8. Molecular tailoring of solid surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Evenson, Simon Alan

    1997-07-01

    The overall performance of a material can be dramatically improved by tailoring its surface at the molecular level. The aim of this project was to develop a universal technique for attaching dendrimers (well-defined, nanoscale, functional polymers) and Jeffamines (high molecular weight polymer chains) to the surface of any shaped solid substrate. This desire for controlled functionalization is ultimately driven by the need to improve material compatibility in various biomedical applications. Atomic force microscopy (AFM) was used initially to study the packing and structure of Langmuir-Blodgett films on surfaces, and subsequently resulted in the first visualization of individual, spherically shaped, nanoscopic polyamidoamine dendrimers. The next goal was to develop a methodology for attaching such macromolecules to inert surfaces. Thin copolymer films were deposited onto solid substrates to produce materials with a fixed concentration of surface anhydride groups. Vapor-phase functionalization reactions were then carried out with trifluorinated amines to confirm the viability of this technique to bond molecules to surfaces. Finally, pulsed plasma polymerization of maleic anhydride took this approach one stage further, by forming well-adhered polymer films containing a predetermined concentration of reactive anhydride groups. Subsequent functionalization reactions led to the secure attachment of dendrimers and Jeffamines at any desired packing density. An alternative route to biocompatibilization used 1,2-ethanedithiol to yield thiolated surfaces containing very high polymeric sulfur : carbon ratios. (author)

  9. Molecular tailoring of solid surfaces

    International Nuclear Information System (INIS)

    Evenson, Simon Alan

    1997-01-01

    The overall performance of a material can be dramatically improved by tailoring its surface at the molecular level. The aim of this project was to develop a universal technique for attaching dendrimers (well-defined, nanoscale, functional polymers) and Jeffamines (high molecular weight polymer chains) to the surface of any shaped solid substrate. This desire for controlled functionalization is ultimately driven by the need to improve material compatibility in various biomedical applications. Atomic force microscopy (AFM) was used initially to study the packing and structure of Langmuir-Blodgett films on surfaces, and subsequently resulted in the first visualization of individual, spherically shaped, nanoscopic polyamidoamine dendrimers. The next goal was to develop a methodology for attaching such macromolecules to inert surfaces. Thin copolymer films were deposited onto solid substrates to produce materials with a fixed concentration of surface anhydride groups. Vapor-phase functionalization reactions were then carried out with trifluorinated amines to confirm the viability of this technique to bond molecules to surfaces. Finally, pulsed plasma polymerization of maleic anhydride took this approach one stage further, by forming well-adhered polymer films containing a predetermined concentration of reactive anhydride groups. Subsequent functionalization reactions led to the secure attachment of dendrimers and Jeffamines at any desired packing density. An alternative route to biocompatibilization used 1,2-ethanedithiol to yield thiolated surfaces containing very high polymeric sulfur : carbon ratios. (author)

  10. Formability of stainless steel tailored blanks

    DEFF Research Database (Denmark)

    Bagger, Claus; Gong, Hui; Olsen, Flemming Ove

    2004-01-01

    In a number of systematic tests, the formability of tailored blanks consisting of even and different combinations of AISI304 and AISI316 in thickness of 0.8 mm and 1.5 mm have been investigated. In order to analyse the formability of tailored blanks with different sheet thickness, a method based ...

  11. 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.

  12. Sports Nutrition Food Industry Chain Development Research

    OpenAIRE

    Jie Yin

    2015-01-01

    Through the study of Henan sports nutrition food industry chain optimization, the study analyses development advantage and competitive advantage of Henan in sports nutrition food industry chain and existing problems and challenges in Henan sports nutrition food industry chain and at the same time introduces the theory of supply chain management to the development of sports nutrition food industry chain, clearly optimizes countermeasures of sports nutrition food industry chain. Pointing out sp...

  13. Nutrition Labeling

    DEFF Research Database (Denmark)

    Grunert, Klaus G

    2013-01-01

    because consumers will avoid products that the label shows to be nutritionally deficient, but also because food producers will try to avoid marketing products that appear, according to the label, as nutritionally problematic, for example, because of a high content of saturated fat or salt. Nutrition......Nutrition labeling refers to the provision of information on a food product’s nutritional content on the package label. It can serve both public health and commercial purposes. From a public health perspective, the aim of nutrition labeling is to provide information that can enable consumers...... to make healthier choices when choosing food products. Nutrition labeling is thus closely linked to the notion of the informed consumer, that chooses products according to their aims, on the basis of the information at their disposal. Because many consumers are assumed to be interested in making healthy...

  14. assessing nutrition intervention programmes that addressed

    African Journals Online (AJOL)

    2012-04-02

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

  15. Early postoperative enteral nutrition is useful for recovering gastrointestinal motility and maintaining the nutritional status.

    Science.gov (United States)

    Kawasaki, Naruo; Suzuki, Yutaka; Nakayoshi, Tomoko; Hanyu, Nobuyoshi; Nakao, Masatoshi; Takeda, Akihiro; Furukawa, Yoshiyuki; Kashiwagi, Hideyuki

    2009-01-01

    The efficacy of enteral nutrition in postoperative nutritional management is known, but the effects on gastrointestinal motility and nutrition have not yet been elucidated. The purpose of this study was to compare the effects of enteral and parenteral nutrition soon after open abdominal surgery on gastrointestinal motility and nutritional status. A partial resection of rectum models was prepared to compare two types of nutrient administration: enteral nutrition and total parenteral nutrition. The differences between the effects of nutrition types in terms of gastrointestinal motility and nutritional status were investigated. Enteral nutrition contributed to recovery of gastrointestinal motility and maintenance of nutritional status. Enteral nutrition should therefore be initiated soon after surgery if the gastrointestinal tract is available.

  16. [Challenges and development of a nutritional management service system home page that targets personal computer novices 65 years of age or older].

    Science.gov (United States)

    Sato, Kimiko; Hosokawa, Atsushi; Nishida, Seiji; Kariya, Akemi; Imaizumi, Satoshi

    2014-01-01

    We intended to develop contents for nutritional management for elderly people using the Internet, and to consider factors relatied to the promotion of Information and Communication Technology (ICT) use. A questionnaire survey was carried out consisting of items on diet support conditions and promoting the use of ICT by the elderly. Then, we developed a nutritional management system using a home page on a trial basis, after which n we studied the need, operability and environmental support of this system. Regarding the state of ICT use more than one- half of the respondents were daily users of the Internet 62.4%, and mobile phones 65.2%. On the four items on diet, such as "buy the same food, forget to buy food", 22.7%responded that "forget to buy food", which was the highest, and interest in "lunch home delivery" showed a low percentage. Among the respondents 19.6% answer "yes" to the question that memory, "have trouble remembering where you put things" and 13.4% responded that they forget to take medicine". There was a positive correlation of what with five items on operability, "What is simple and easy to use is good" and the effectiveness of personal computers and mobile phones has been shown. In addition, 32.3% responded "When the operation is difficult, the use becomes inconvenient". It was suggested that by setting up an opportunity to experience the effectiveness and the satisfaction of using a system that addresses elderly people's concerns, we can modify attitudes and provide motivation, reducing the sense of weakness or irrelevance that can hinder the use of a nutritional management system. It was suggested that along with the sense of effectiveness of screen displays with color instructions and simple design that match the physical characteristics of the elderly, the sense of being able to operate the system afterwards will affect the need for ICT use and utilization rate.

  17. Nutritional Ecology and Human Health.

    Science.gov (United States)

    Raubenheimer, David; Simpson, Stephen J

    2016-07-17

    In contrast to the spectacular advances in the first half of the twentieth century with micronutrient-related diseases, human nutrition science has failed to stem the more recent rise of obesity and associated cardiometabolic disease (OACD). This failure has triggered debate on the problems and limitations of the field and what change is needed to address these. We briefly review the two broad historical phases of human nutrition science and then provide an overview of the main problems that have been implicated in the poor progress of the field with solving OACD. We next introduce the field of nutritional ecology and show how its ecological-evolutionary foundations can enrich human nutrition science by providing the theory to help address its limitations. We end by introducing a modeling approach from nutritional ecology, termed nutritional geometry, and demonstrate how it can help to implement ecological and evolutionary theory in human nutrition to provide new direction and to better understand and manage OACD.

  18. EFSA Panel on Dietetic Products, Nutrition and Allerg ies (NDA) ; Guidance on the scientific requirements for health claims related to appetite ratings, weight management, and blood glucose concentrations

    DEFF Research Database (Denmark)

    Tetens, Inge

    The European Food Safety Authority (EFSA) asked the Panel on Dietetic Products, Nutrition and Allergies (NDA) to draft guidance on scientific requirements for health claims related to appetite ratings, weight management, and blood glucose concentrations. This guidance has been drawn from scientific...... and studies/outcome measures which are acceptable. Rather, it presents examples drawn from evaluations already carried out in order to illustrate the approach of the Panel, as well as some examples which are currently under consideration within ongoing evaluations. A draft of this guidance document, endorsed...

  19. Predictors of nutritional recovery time and survival status among children with severe acute malnutrition who have been managed in therapeutic feeding centers, Southern Ethiopia: retrospective cohort study.

    Science.gov (United States)

    Gebremichael, Delelegn Yilma

    2015-12-21

    Malnutrition remains to be one of the most common causes of morbidity and mortality among children in developing countries. The prevalence of wasting in Ethiopia remained about 10 % for the past ten years. Mortality rate of children with severe acute malnutrition treated in inpatient set ups has remained unacceptably high. A retrospective cohort study was conducted in Southern Ethiopia. The study population were children with severe acute malnutrition aged from 6 to 59 months who have been managed at Karat and Fasha stabilization centers between September 30, 2013, and Sep. 29, 2014. The total sample size was 420 and pretested questionnaire was used. Kaplan Meier analysis was used to estimate time to nutritional recovery and Cox proportional-hazard regression analysis was carried out to determine independent predictors. Nutritional recovery rate was 3.61 per 100 person day observations. Median nutritional recovery time was 22 and 29 days for edematous malnourished and severely wasted children respectively. The independent predictors of nutritional recovery rate were: stabilization center (AHR = 1.4, 95 % CI: 1.1-1.7), malnutrition status (AHR = 1.8, 95 % CI: 1.3-2.4), weight (AHR = 1.5, 95 % CI: 1.2-1.9), mid- upper arm circumference (AHR = 1.4, 95 % CI: 1.1-1.9), inpatient complications (AHR = 2.2, 95 % CI: 1.4-3.5) and did not lose edema within four days of inpatient treatment (AHR = 2.3, 95 % CI: 1.1-4.8). The findings of this study confirm the probability of surviving gets slimmer with inpatient complications and staying longer in stabilization centers. So, to prevent complications and enhance recovery rate due emphasis should be given in improving early detection and treatment of severely malnourished children in Ethiopia.

  20. Nutrition in Diabetes.

    Science.gov (United States)

    Hamdy, Osama; Barakatun-Nisak, Mohd-Yusof

    2016-12-01

    Medical nutrition therapy (MNT) is a key component of diabetes management. The importance of balancing macronutrients, reducing carbohydrate load, lowering glycemic index, and implementing an overall healthy dietary pattern are emerging as better approaches for MNT in diabetes. Recent research points to improved glycemic control, reduction in body weight, and improvement in many cardiovascular risk factors when these approaches are provided by registered dietitians or health care providers. This review article discusses the current evidence about the role of sensible nutrition in diabetes management. Specific eating plans for weight reduction and for patients with type 1 diabetes are also discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. 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...

  2. Metabonomics in neonatal nutrition research

    Directory of Open Access Journals (Sweden)

    Serge Rezzi

    2015-10-01

    Full Text Available Maternal obesity and early post-natal nutrition might associate with increased obesity risk in later life. We have investigated the effect of breastfeeding and infant formulas differing in protein content on the urinary and fecal metabolism of term infants born from overweight and obese mothers using a metabonomic approach. Metabolic differences were observed between breast and formula fed infants both in urine and stool samples. Metabolic profiles of formula fed infants exhibited a distinct metabolic pattern that was associated with the processing of dietary proteins from the host and the gut microbiota. Metabonomics appears as a powerful tool to measure the physiological response to infant formula versus the gold standard breastfeeding. In future, nutritional phenotyping will combine metabonomics and nutritional profiling to study specific nutritional requirements and measure the efficacy of tailored nutritional interventions on growth and development endpoints. It will then open novel opportunities to develop targeted nutritional solutions for health maintenance and disease prevention. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

  3. Improving nutrition through nuclear science

    International Nuclear Information System (INIS)

    2003-06-01

    Good nutrition is essential to health and quality of life. As a United Nations agency dedicated to helping Member States achieve their social and economic goals, the International Atomic Energy Agency (IAEA) recognizes the importance of good nutrition and is working to address the problems underlying poor nutrition. In fact, many Agency activities serve basic human needs, by applying nuclear science to increase food production, improve health care, improve management of water resources, and assess sources of environmental pollution. Global progress in reducing malnutrition throughout the human life cycle has been slow and patchy. In its 2000 Report on the World Nutrition Situation, the United Nations Sub Committee on Nutrition estimated that in developing countries 182 million children under five years of age are chronically undernourished and 150 million are underweight. An estimated 30 million infants are born each year with impaired growth due to poor nutrition during pregnancy. Worldwide, renewed international commitments have been made to address this situation, and the IAEA is a vital partner in these efforts. Nuclear science provides valuable tools for monitoring factors that influence nutrition, such as micronutrients, body composition, and breast milk uptake. Through its sub-programme on nutrition, the Agency is helping countries to use isotope applications and other nuclear techniques to their nutritional problems and is supporting leading-edge research on the interaction between nutrition and environmental pollution and infection with the ultimate goal of improving human nutrition

  4. [Discharge planning in which a discharge planning nurse was involved in the choice of nutrition management for an elderly person with dementia].

    Science.gov (United States)

    Tanaka, Yuko; Ohori, Yoko; Seshimo, Akiyoshi

    2013-12-01

    A discharge planning nurse at an acute care hospital conducted discharge planning for an elderly person with dementia who is in his/her 90s and his/her family. The nurse was involved in the choice of nutrition management method and was able to support the family's decision-making. The family had high expectations for oral ingestion, and there was disparity between those expectations and the actual state of the disease, in which aspiration occurred frequently. The nurse respected the family's wishes, but also helped the family to correctly understand the state of the disease and to make satisfactory choices about future daily life. In order to guarantee safety, the discharge planning nurse held a conference with people related to homecare, such as the home-visiting physician, the home-visiting nurse, and the care manager. As a result of the conference, that family was able to feel satisfied with and choose gastrostomy as the nutrition method. The current situation was better understood because information was shared with the community, and the confidence in the community was strengthened by giving consideration to the family's burden. It was reconfirmed that the cooperation of local staff members is useful in discharge planning.

  5. Nutritional sub-fertility in the dairy cow: towards improved reproductive management through a better biological understanding

    DEFF Research Database (Denmark)

    Friggens, Nic; Disenhaus, C; Petit, H V

    2010-01-01

    for the dairy producer. In this study we focus on understanding the overall biological phenomena associated with nutritional sub-fertility rather than the underlying multiplicity of physiological interactions (already described in a number of recent studies). These phenomena are important because they represent...... the natural adaptations of the animal for dealing with variations in the nutritional environment. They can also be used to monitor and modulate reproductive performance on-farm. There is an underlying trade-off between two aspects of reproduction: investment in the viability of the current calf and investment...... embryos, which are of poorer quality, than do non-lactating cows. The same applies to high- compared to medium-genetic merit cows. Another important biological property is the adaptive use of body reserves in support of reproduction. Orchestrated endocrine changes in pregnancy and lactation facilitate...

  6. [Consensus document about the nutritional evaluation and management of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder, and others].

    Science.gov (United States)

    Gómez Candela, Carmen; Palma Milla, Samara; Miján-de-la-Torre, Alberto; Rodríguez Ortega, Pilar; Matía Martín, Pilar; Loria Kohen, Viviana; Campos Del Portillo, Rocío; Virgili Casas, M ª Nuria; Martínez Olmos, Miguel Á; Mories Álvarez, M ª Teresa; Castro Alija, M ª José; Martín-Palmero, Ángela

    2018-03-07

    Eating disorders (ED) are characterized by persistent changes in eating habits that negatively affect a person's health and psychosocial abilities. They are considered psychiatric disorders, highly variable in their presentation and severity, with a huge impact on nutrition, which conditions various therapeutic approaches within a key multidisciplinary context. A group of experts in nutrition, we decided to set up a task force adscribed to the "Sociedad Española de Nutrición Parenteral y Enteral" (SENPE), which has stated as one of its goals the development of a consensus document to generate a protocol based on the best scientific evidence and professional experience available in order to improve health care in this field.

  7. Soil management, fertilization and plant nutrition in organic systems in Spain: A review of the research in last 20 years

    Science.gov (United States)

    Gonzalvez, Victor; Raigon Jiménez, M.° Dolores

    2016-04-01

    organic plant health and plant protection. In total 12 % of the papers presented in these events were devoted to soil conservation, soil fertility and plant nutrition management. We have analyzed this papers contributions dividing in five categories: a) organic and mineral fertilization; b) general evaluation of soil fertility under organic management; c) compost making and compost types; d) soil conservation and fertilization; e) crop fertilization and food quality The results shows that over 20 % of the total papers presented were related to general aspects of crop fertilization in 16% types of vegetables crops, 14% on arable crops and pastures and 8% on perennial crops (almonds, citrus, vineyards, olive trees, and banana) have been presented. Most studies were done on vegetables and very few on nutrient balance have been published. Some papers deal with cover crops. The soil fertility impact of organic farming compared with conventional is focused is included in nearly 30 % of all the scientific papers presented. Compost from different crop residues and the effects on soil and on different crops, including waste sludge (not allowed in organic farming) have been researched. Also some studies deal with how to use the residues of the olive oil mills or residues of vineyards as organic fertilizer. Some of the most recent studies are focused on how compost can control pest and diseases in crop cultivation. Another type of study has analyzed the soil disinfection potential of manure with high exposition to the sun (high temperature) to be used in greenhouses. Few studies are concentrated in the application of mycorrhizae to enhance the capacity of the plants to absorber nutrients from soil. We found some few studies on biofertilisers, but there are many different inputs being offered to organic farmers as natural fertilizer. Soil conservation and organic fertilisation studies are scarce and not sufficiently detailed. Finally we found a five category of very few studies on

  8. Position statement: hypoglycemia management in patients with diabetes mellitus. Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition.

    Science.gov (United States)

    Mezquita-Raya, Pedro; Reyes-García, Rebeca; Moreno-Pérez, Óscar; Muñoz-Torres, Manuel; Merino-Torres, Juan Francisco; Gorgojo-Martínez, Juan José; Jódar-Gimeno, Esteban; Escalada San Martín, Javier; Gargallo-Fernández, Manuel; Soto-Gonzalez, Alfonso; González Pérez de Villar, Noemí; Becerra Fernández, Antonio; Bellido Guerrero, Diego; Botella-Serrano, Marta; Gómez-Peralta, Fernando; López de la Torre Casares, Martín

    2013-11-01

    To provide practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition. Recommendations were formulated according to the Grading of Recommendations, Assessment, Development, and Evaluation system to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (PubMed). Papers in English and Spanish with publication date before 15 February 2013 were included. For recommendations about drugs only those approved by the European Medicines Agency were included. After formulation of recommendations, they were discussed by the Working Group. The document provides evidence-based practical recommendations for evaluation and management of hypoglycemia in patients with diabetes mellitus. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

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

    Science.gov (United States)

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

    2013-12-01

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

  10. [Community Nutrition].

    Science.gov (United States)

    Aranceta, Javier

    2004-06-01

    In the last 20 years, Public Health Nutrition focused mainly on the qualitative aspects which may influence the onset of chronic diseases, quality of life, physical and mental performance and life expectancy. This applied knowledge organised as part of preventive and health promotion programs led to the development of Community Nutrition. The aim of Community Nutrition actions is to adequate lifestyles related to food consumption patterns in order to improve the quality of life and contribute to health promotion of the population in the community where programs and services are delivered. Key functions to develop in a Community Nutrition Unit consist in the identification and assessment of nutrition problems in the community as well as the design, implementation and evaluation of intervention programs by means of appropriate strategies. These should aim at different populations groups and settings, such as work places, schools, high risk groups or the general public. Nowadays, Community Nutrition work efforts should focus on three main aspects: nutrition education in schools and in the community; food safety and food security and the development and reinforcement of food preparation skills across all age groups. Social catering services, either in schools, the work place or at the community level, need to ensure adequate nutritional supply, provide foods contributing to healthy eating practices as well as to enhance culinary traditions and social learning. Food safety and food security have become a top priority in Public Health. The concepts referes to the availability of food safe and adequate as well as in sufficient amount in order to satisfy nutrition requirements of all individuals in the community. Social changes along new scientific developments will introduce new demands in Community Nutrition work and individual dietary counselling will become a key strategy. In order to face new challenges, community nutrition pactitioners require a high quality

  11. Sports Nutrition.

    Science.gov (United States)

    Missouri State Dept. of Health, Jefferson City.

    This guide deals with various aspects of sports and nutrition. Twelve chapters are included: (1) "Sports and Nutrition"; (2) "Eat to Compete"; (3) "Fit Folks Need Fit Food"; (4) "The Food Guide Pyramid"; (5) "Fat Finder's Guide"; (6) "Pre- and Post-Event Meals"; (7) "Tips for the…

  12. Nutritional epigenetics

    Science.gov (United States)

    This chapter is intended to provide a timely overview of the current state of research at the intersection of nutrition and epigenetics. I begin by describing epigenetics and molecular mechanisms of eigenetic regulation, then highlight four classes of nutritional exposures currently being investiga...

  13. Tailoring of mobility advices to consumers. Executive summary; Tailoring van mobiliteitsadviezen aan consumenten. Managementsamenvatting

    Energy Technology Data Exchange (ETDEWEB)

    De Weerdt, I.; Jonkers, R. [ResCon, Haarlem (Netherlands)

    2003-09-01

    An outline is given of the options to apply so-called computer tailoring in the field of mobility. A feasibility study has been carried out for the realization of a computerized tailored mobility programme. Tailoring is a method, based on social-scientific theories on behavioral change, by means of which information is tailored to individual circumstances, preferences and motivation. [Dutch] De mogelijkheden van computer tailoring (tailoring is een methodiek die gebaseerd is op sociaal-wetenschappelijke theorieen over gedragsverandering, waarbij de aangeboden informatie is afgestemd op individuele omstandigheden, preferenties en motivaties) op het gebied van mobiliteit worden verkend. Er is een haalbaarheidsonderzoek uitgevoerd ter voorbereiding op de realisatie van een computer tailored mobiliteitsprogramma. In dit onderzoek is nagegaan: of consumenten belangstelling hebben voor informatie op maat over mobiliteit; waar consumenten zelf de meeste mogelijkheden zien om hun mobiliteitspatroon te veranderen (en dus meer duurzame mobiliteitsopties toe te passen); hoe het gedrag van consumenten m.b.t. mobiliteit d.m.v. een tailoring systeem gericht beinvloed kan worden; of er organisaties te vinden zijn die de exploitatie van een tailoring systeem m.b.t. mobiliteit op zich zouden willen nemen; of de ontwikkeling van een dergelijk systeem kosten effectief kan zijn.

  14. Tailoring of mobility advices to consumers. A determinants survey; Tailoring van mobiliteitsadviezen aan consumenten. Een determinantenonderzoek

    Energy Technology Data Exchange (ETDEWEB)

    De Weerdt, I.; Jonkers, R. [ResCon, Haarlem (Netherlands)

    2003-08-01

    An outline is given of the options to apply so-called computer tailoring in the field of mobility. A feasibility study has been carried out for the realization of a computerized tailored mobility programme. Tailoring is a method, based on social-scientific theories on behavioral change, by means of which information is tailored to individual circumstances, preferences and motivation. [Dutch] De mogelijkheden van computer tailoring (tailoring is een methodiek die gebaseerd is op sociaal-wetenschappelijke theorieen over gedragsverandering, waarbij de aangeboden informatie is afgestemd op individuele omstandigheden, preferenties en motivaties) op het gebied van mobiliteit worden verkend. Er is een haalbaarheidsonderzoek uitgevoerd ter voorbereiding op de realisatie van een computer tailored mobiliteitsprogramma. In dit onderzoek is nagegaan: of consumenten belangstelling hebben voor informatie op maat over mobiliteit; waar consumenten zelf de meeste mogelijkheden zien om hun mobiliteitspatroon te veranderen (en dus meer duurzame mobiliteitsopties toe te passen); hoe het gedrag van consumenten m.b.t. mobiliteit d.m.v. een tailoring systeem gericht beinvloed kan worden; of er organisaties te vinden zijn die de exploitatie van een tailoring systeem m.b.t. mobiliteit op zich zouden willen nemen; of de ontwikkeling van een dergelijk systeem kosten effectief kan zijn.

  15. 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.

  16. Can metabotyping help deliver the promise of personalised nutrition?

    Science.gov (United States)

    O'Donovan, Clare B; Walsh, Marianne C; Gibney, Michael J; Gibney, Eileen R; Brennan, Lorraine

    2016-02-01

    Over a decade since the completion of the human genome sequence, the promise of personalised nutrition available to all has yet to become a reality. While the definition was originally very gene-focused, in recent years, a model of personalised nutrition has emerged with the incorporation of dietary, phenotypic and genotypic information at various levels. Developing on from the idea of personalised nutrition, the concept of targeted nutrition has evolved which refers to the delivery of tailored dietary advice at a group level rather than at an individual level. Central to this concept is metabotyping or metabolic phenotyping, which is the ability to group similar individuals together based on their metabolic or phenotypic profiles. Applications of the metabotyping concept extend from the nutrition to the medical literature. While there are many examples of the metabotype approach, there is a dearth in the literature with regard to the development of tailored interventions for groups of individuals. This review will first explore the effectiveness of personalised nutrition in motivating behaviour change and secondly, examine potential novel ways for the delivery of personalised advice at a population level through a metabotyping approach. Based on recent findings from our work, we will demonstrate a novel strategy for the delivery of tailored dietary advice at a group level using this concept. In general, there is a strong emerging evidence to support the effectiveness of personalised nutrition; future work should ascertain if targeted nutrition can motivate behaviour change in a similar manner.

  17. Experiences with nutrition-related information during antenatal care of pregnant women of different ethnic backgrounds residing in the area of Oslo, Norway.

    Science.gov (United States)

    Garnweidner, Lisa M; Sverre Pettersen, Kjell; Mosdøl, Annhild

    2013-12-01

    to explore experiences with nutrition-related information during routine antenatal care among women of different ethnical backgrounds. individual interviews with seventeen participants were conducted twice during pregnancy. Data collection and analysis were inspired by an interpretative phenomenological approach. participants were purposively recruited at eight Mother and Child Health Centres in the area of Oslo, Norway, where they received antenatal care. participants had either immigrant backgrounds from African and Asian countries (n=12) or were ethnic Norwegian (n=5). Participants were pregnant with their first child and had a pre-pregnancy Body Mass Index above 25 kg/m(2). participants experienced that they were provided with little nutrition-related information in antenatal care. The information was perceived as presented in very general terms and focused on food safety. Weight management and the long-term prevention of diet-related chronic diseases had hardly been discussed. Participants with immigrant backgrounds appeared to be confused about information given by the midwife which was incongruent with their original food culture. The participants were actively seeking for nutrition-related information and had to navigate between various sources of information. the midwife is considered a trustworthy source of nutrition-related information. Therefore, antenatal care may have considerable potential to promote a healthy diet to pregnant women. Findings suggest that nutrition communication in antenatal care should be more tailored towards women's dietary habits and cultural background, nutritional knowledge as well as level of nutrition literacy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Age Nutrition Chirugie (ANC) study: impact of a geriatric intervention on the screening and management of undernutrition in elderly patients operated on for colon cancer, a stepped wedge controlled trial.

    Science.gov (United States)

    Dupuis, Marine; Kuczewski, Elisabetta; Villeneuve, Laurent; Bin-Dorel, Sylvie; Haine, Max; Falandry, Claire; Gilbert, Thomas; Passot, Guillaume; Glehen, Olivier; Bonnefoy, Marc

    2017-01-07

    Undernutrition prior to major abdominal surgery is frequent and increases morbidity and mortality, especially in older patients. The management of undernutrition reduces postoperative complications. Nutritional management should be a priority in patient care during the preoperative period. However undernutrition is rarely detected and the guidelines are infrequently followed. Preoperative undernutrition screening should allow a better implementation of the guidelines. The ANC ("Age Nutrition Chirurgie") study is an interventional, comparative, prospective, multicenter, randomized protocol based on the stepped wedge trial design. For the intervention, the surgeon will inform the patient of the establishment of a systematic preoperative geriatric assessment that will allow the preoperative diagnosis of the nutritional status and the implementation of an adjusted nutritional support in accordance with the nutritional guidelines. The primary outcome measure is to determine the impact of the geriatric intervention on the level of perioperative nutritional management, in accordance with the current European guidelines. The implementation of the intervention in the five participating centers will be rolled-out sequentially over six time periods (every six months). Investigators must recommend that all patients aged 70 years or over and who are consulting for a surgery for a colorectal cancer should consider participating in this study. The ANC study is based on an original methodology, the stepped wedge trial design, which is appropriate for evaluating the implementation of a geriatric and nutritional assessment during the perioperative period. We describe the purpose of this geriatric intervention, which is expected to apply the ESPEN and SFNEP recommendations through the establishment of an undernutrition screening and a management program for patients with cancer. This intervention should allow a decrease in patient morbidity and mortality due to undernutrition. This

  19. eHealth and the use of individually tailored information: A systematic review.

    Science.gov (United States)

    Conway, Nicholas; Webster, Clare; Smith, Blair; Wake, Deborah

    2017-09-01

    Tailored messages are those that specifically target individuals following an assessment of their unique characteristics. This systematic review assesses the evidence regarding the effectiveness of tailoring within eHealth interventions aimed at chronic disease management. OVID Medline/Embase databases were searched for randomised control trials, controlled clinical, trials, before -after studies, and time series analyses from inception - May 2014. Objectively measured clinical processes/outcomes were considered. Twenty-two papers were eligible for inclusion: 6/22 used fully tailored messaging and 16/22 used partially tailored messages. Two studies isolated tailoring as the active component. The remainder compared intervention with standard care. In all, 12/16 studies measuring clinical processes and 2/6 studies reporting clinical outcomes showed improvements, regardless of target group. Study quality was low and design did not allow for identification of interventions' active component. Heterogeneity precluded meta-analysis. This review has demonstrated that there is a lack of evidence to suggest that tailoring within an eHealth context confers benefit over non-tailored eHealth interventions.

  20. STOSS THERAPY AND WEEKLY VITAMIN D THERAPY IN THE MANAGEMENT OF NUTRITIONAL RICKETS IN CHILDREN- A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Madhava Vijayakumar

    2017-01-01

    Full Text Available BACKGROUND The Aim of the study is to study the risk factors of nutritional rickets in children of age 1-5 years and to compare the effectiveness of classical single mega dose vitamin D administration (stoss therapy and weekly cholecalciferol administration. METHODS 50 children of age group 1-5 year with clinical, biochemical and radiological features of nutritional rickets and an equal number of age and gender matched control were included in the study. Their risk factors were compared. Those children with rickets were divided randomly into two groups of equal numbers. For one group, single oral dose of 6,00,000 IU of vitamin D and for the other group, weekly oral dose of 60,000 IU of vitamin D was administered for 8 weeks. All children were given calcium supplementation. Regular follow up was done at 1, 2, 6, 9 and 12 months and the improvement was assessed clinically, radiologically and as per the laboratory results. RESULTS Major risk factors for the development of nutritional rickets were prematurity, low birth weight, high birth order, consumption of complementary feeds poor in calcium, lack of adequate sunlight exposure and prolonged exclusive breast feeding. Response to treatment was comparable both clinically and as per the investigation results among those who received single massive dose and those on weekly vitamin D therapy. CONCLUSION Increased birth order, prematurity and low birth weight were important risk factors for rickets. Inadequate dietary calcium and inadequate sunlight exposure increased chance of getting rickets. Supplementation of vitamin D and calcium were protective. Inadequate maternal sunlight exposure, lack of antenatal and post-natal calcium and vitamin D supplementation showed a significant association with rickets. The most common clinical feature of rickets was bow legs. Both massive single dose therapy and weekly vitamin D administration were equally effective and revealed no significant difference in clinical

  1. Nutritional sub-fertility in the dairy cow: towards improved reproductive management through a better biological understanding.

    Science.gov (United States)

    Friggens, N C; Disenhaus, C; Petit, H V

    2010-07-01

    There has been a significant decline in the reproductive performance of dairy cattle in recent decades. Cows, take longer time to return to the oestrus after calving, have poorer conception rates, and show fewer signs of oestrus. Achieving good reproductive performance is an increasing challenge for the dairy producer. In this study we focus on understanding the overall biological phenomena associated with nutritional sub-fertility rather than the underlying multiplicity of physiological interactions (already described in a number of recent studies). These phenomena are important because they represent the natural adaptations of the animal for dealing with variations in the nutritional environment. They can also be used to monitor and modulate reproductive performance on-farm. There is an underlying trade-off between two aspects of reproduction: investment in the viability of the current calf and investment in future offspring. As the investment in, and viability of, the current calf is related to maternal milk production, we can expect that level of milk production per se has effects on subsequent reproductive performance (investment in future offspring). Lactating cows have a lower proportion of viable embryos, which are of poorer quality, than do non-lactating cows. The same applies to high- compared to medium-genetic merit cows. Another important biological property is the adaptive use of body reserves in support of reproduction. Orchestrated endocrine changes in pregnancy and lactation facilitate the deposition of body lipid during pregnancy and mobilisation in early lactation. When the cow fails to accumulate the reserves she needs to safeguard reproduction she delays committing to further reproductive investment. But how does the cow 'know' that she is failing in energy terms? We argue that the cow does this by 'monitoring' both the body fat mobilisation and body fatness. Excessive body fat mobilisation indicates that current conditions are worse than

  2. Nanoparticles and their tailoring with laser light

    International Nuclear Information System (INIS)

    Hubenthal, Frank

    2009-01-01

    Monodisperse noble metal nanoparticles are of tremendous interest for numerous applications, such as surface-enhanced Raman spectroscopy, catalysis or biosensing. However, preparation of monodisperse metal nanoparticles is still a challenging task, because typical preparation methods yield nanoparticle ensembles with broad shape and/or size distributions. To overcome this drawback, tailoring of metal nanoparticles with laser light has been developed, which is based on the pronounced shape- and size-dependent optical properties of metal nanoparticles. I will demonstrate that nanoparticle tailoring with ns-pulsed laser light is a suitable method to prepare nanoparticle ensembles with a narrow shape and/or size distribution. While irradiation with ns-pulsed laser light during nanoparticle growth permits a precise shape tailoring, post-grown irradiation allows a size tailoring. For example, the initial broad Gaussian size distribution of silver nanoparticles on quartz substrates with a standard deviation of σ= 30% is significantly reduced to as little as σ= 10% after tailoring. This paper addresses teachers of undergraduate and advanced school level as well as students. It assumes some fundamental knowledge in solid-state physics, thermodynamics and resonance vibration.

  3. The management of conflict in nutrition policy formulation: choosing growth-monitoring indicators in the context of dual burden.

    Science.gov (United States)

    Hoey, Lesli; Pelletier, David L

    2011-06-01

    We argue in this paper that a shared desire to find a solution to malnutrition and agreement at a broad level concerning priority, evidence-based interventions are important but not sufficient conditions for effective policy development. This paper illustrates this point, and draws out general implications, through a detailed analysis of a case in which conflict emerged when committed nutrition policy actors began discussing the details of program design and implementation. The case involves one country's effort to select "the best" anthropometric indicator for use in its national child growth-monitoring program. In this case the interested parties approached this deceptively simple decision for different reasons, using different sources and standards of evidence and focusing their attention on opposite, but equally critical, operational considerations, while being heavily influenced by global, national, and interorganizational events and relationships. We suggest that actors seeking to translate political commitment for nutrition into effective action should recognize the technical and sociopolitical complexity of seemingly simple decisions related to intervention design and employ more systematic, intentional, and inclusive decision-making procedures. Without attention to such practical matters, the current window of opportunity to reduce malnutrition on a global scale may quickly close.

  4. Importance of nutrition in pediatric oncology

    OpenAIRE

    P C Rogers

    2015-01-01

    A nutritional perspective within pediatric oncology is usually just related to the supportive care aspect during the management of the underlying malignancy. However, nutrition has a far more fundamental importance with respect to a growing, developing child who has cancer as well as viewing cancer from a nutritional cancer control perspective. Nutrition is relevant to all components of cancer control including prevention, epidemiology, biology, treatment, supportive care, rehabilitation, and...

  5. The Economy of Persistence: Mario the Tailor

    Directory of Open Access Journals (Sweden)

    Prudence Black

    2016-03-01

    Full Text Available Mario Conte has had a tailor shop in King Street, Newtown since the mid 1960s. Taking an interview with Mario as its point of departure, this article describes the persistence of a skilled worker whose practices and techniques remain the same in a world that has long changed. While inattentive to what rules might be used to decorate a shop window, Mario continues to make and sew in the way that he learnt in post-war Italy. Mario’s persistence could be described as all the skills and other elements that need to be in place to keep him working, in particular the tradition of tailoring techniques he has remained true to over the last fifty years. The hand stitching of his tailoring is like a metronome of that persistence.

  6. How nutritional risk is assessed and managed in European hospitals: a survey of 21,007 patients findings from the 2007-2008 cross-sectional nutritionDay survey

    NARCIS (Netherlands)

    Schindler, Karin; Pernicka, Elisabeth; Laviano, Alessandro; Howard, Pat; Schütz, Tatjana; Bauer, Peter; Grecu, Irina; Jonkers, Cora; Kondrup, Jens; Ljungqvist, Olle; Mouhieddine, Mohamed; Pichard, Claude; Singer, Pierre; Schneider, Stéphane; Schuh, Christian; Hiesmayr, Michael

    2010-01-01

    Recognition and treatment of undernutrition in hospitalized patients are not often a priority in clinical practice. We investigated how the nutritional risk of patients is determined and whether such assessment influences daily nutritional care across Europe and in Israeli hospitals. 1217 units from

  7. Tailoring group velocity by topology optimization

    DEFF Research Database (Denmark)

    Stainko, Roman; Sigmund, Ole

    2007-01-01

    The paper describes a systematic method for the tailoring of dispersion properties of slab-based photonic crystal waveguides. The method is based on the topology optimization method which consists in repeated finite element frequency domain analyses. The goal of the optimization process is to come...... up with slow light, zero group velocity dispersion photonic waveguides or photonic waveguides with tailored dispersion properties for dispersion compensation purposes. An example concerning the design of a wide bandwidth, constant low group velocity waveguide demonstrate the e±ciency of the method....

  8. Space Nutrition

    Science.gov (United States)

    Smith, Scott M.

    2009-01-01

    Optimal nutrition will be critical for crew members who embark on space exploration missions. Nutritional assessment provides an opportunity to ensure that crewmembers begin their missions in optimal nutritional status, to document changes during a mission and, if necessary, to provide intervention to maintain that status throughout the mission, and to assesses changes after landing in order to facilitate the return to their normal status as soon as possible after landing. We report here the findings from our nutritional assessment of astronauts who participated in the International Space Station (ISS) missions, along with flight and ground-based research findings. We also present ongoing and planned nutrition research activities. These studies provide evidence that bone loss, compromised vitamin status, and oxidative damage are the critical nutritional concerns for space travelers. Other nutrient issues exist, including concerns about the stability of nutrients in the food system, which are exposed to longterm storage and radiation during flight. Defining nutrient requirements, and being able to provide and maintain those nutrients on exploration missions, will be critical for maintaining crew member health.

  9. [Chonic diarrhea and malabsorption due to common variable immunodeficiency, gastrectomy and giardiasis infection: a difficult nutritional management].

    Science.gov (United States)

    Domínguez-López, M E; González-molero, I; Ramírez-Plaza, C P; Soriguer, F; Olveira, G

    2011-01-01

    Gastric cancer is a frequent cause of cancer-related mortality in the world. Surgery is the only potentially curative therapy, although the adverse effects of surgery are common and considerable. Common variable immunodeficiency is in many cases cause of gastrointestinal system problems such as chronic diarrhea caused by infestation with giardia lamblia, nodular lymphoid hiperplasia ad loss of villi leading frequently to malapsortion and malnutrition. Nutritional deficiencies due to malapsorption (postgastrectomy and secondary to loss of villi, giardiasis and common variable inmunodeficiency) are common. We present the case of a patient with gastric cancer who underwent a gastrectomy with common variable hipogammaglobulinemia and chronic infestation by giardia lamblia, with serious diarrhea resistant to treatment and malabsorption.

  10. Tailoring endocrine treatment for early breast cancer

    NARCIS (Netherlands)

    Fontein, Duveken Berthe Yvonne

    2014-01-01

    This thesis describes several important aspects of adjuvant endocrine therapy for postmenopausal women with endocrine-sensitive, early-stage breast cancer. In our ongoing efforts to tailor treatment so as to provide the best possible care to each of our patients, we studied the influence of various

  11. Tinker Tailor Robot Pi -- The Project

    Science.gov (United States)

    Bianchi, Lynne

    2017-01-01

    Tinker Tailor Robot Pi (TTRP) is an innovative curriculum development project, which started in September 2014. It involves in-service primary and secondary teachers, university academic engineers, business partners and pupils at Key Stages 1, 2 and 3 (ages 5-14). The focus of the work has been to explore how a pedagogy for primary engineering…

  12. LIFE-STYLE SEGMENTATION WITH TAILORED INTERVIEWING

    NARCIS (Netherlands)

    KAMAKURA, WA; WEDEL, M

    The authors present a tailored interviewing procedure for life-style segmentation. The procedure assumes that a life-style measurement instrument has been designed. A classification of a sample of consumers into life-style segments is obtained using a latent-class model. With these segments, the

  13. Update on 13C-labelling of plant materials through the use of walk-in growth chambers [Activities of the Soil and Water Management and Crop Nutrition Laboratory, Seibersdorf

    International Nuclear Information System (INIS)

    Mayr, Leo; Resch, Christian; Weltin, Georg; Dercon, Gerd

    2014-01-01

    In 2013, the Soil and Water Management & Crop Nutrition Laboratory installed a pair of walk-in growth chambers with an effective volume of about 12 m 3 each. These growth chambers with temperature, relative humidity and carbon dioxide (CO 2 ) control, are being used within the framework of research activities for improving climate-smart agriculture in Member States

  14. Update on {sup 13}C-labelling of plant materials through the use of walk-in growth chambers [Activities of the Soil and Water Management and Crop Nutrition Laboratory, Seibersdorf

    Energy Technology Data Exchange (ETDEWEB)

    Mayr, Leo; Resch, Christian; Weltin, Georg; Dercon, Gerd [Soil and Water Management and Crop Nutrition Laboratory, Joint FAO/IAEA Division for Nuclear Techniques in Food and Agriculture, Seibersdorf (Austria)

    2014-07-15

    In 2013, the Soil and Water Management & Crop Nutrition Laboratory installed a pair of walk-in growth chambers with an effective volume of about 12 m{sup 3} each. These growth chambers with temperature, relative humidity and carbon dioxide (CO{sub 2}) control, are being used within the framework of research activities for improving climate-smart agriculture in Member States.

  15. Monitoring Healthy Metabolic Trajectories with Nutritional Metabonomics

    Directory of Open Access Journals (Sweden)

    Sebastiano Collino

    2009-09-01

    Full Text Available Metabonomics is a well established analytical approach for the analysis of physiological regulatory processes via the metabolic profiling of biofluids and tissues in living organisms. Its potential is fully exploited in the field of “nutrimetabonomics” that aims at assessing the metabolic effects of active ingredients and foods in individuals. Yet, one of the greatest challenges in nutrition research is to decipher the critical interactions between mammalian organisms and environmental factors, including the gut microbiota. “Nutrimetabonomics” is today foreseen as a powerful approach for future nutritional programs tailored at health maintenance and disease prevention.

  16. Monitoring Healthy Metabolic Trajectories with Nutritional Metabonomics

    Science.gov (United States)

    Collino, Sebastiano; Martin, François-Pierre J.; Kochhar, Sunil; Rezzi, Serge

    2009-01-01

    Metabonomics is a well established analytical approach for the analysis of physiological regulatory processes via the metabolic profiling of biofluids and tissues in living organisms. Its potential is fully exploited in the field of “nutrimetabonomics” that aims at assessing the metabolic effects of active ingredients and foods in individuals. Yet, one of the greatest challenges in nutrition research is to decipher the critical interactions between mammalian organisms and environmental factors, including the gut microbiota. “Nutrimetabonomics” is today foreseen as a powerful approach for future nutritional programs tailored at health maintenance and disease prevention. PMID:22253970

  17. Context, confidentiality, and consent in tailored health communications: a cautionary note.

    Science.gov (United States)

    Orleans, C T

    1999-01-01

    This article highlights key contextual factors that emerge when the evolution of tailored health communications is viewed against the backdrop of dynamic changes in the nation's health care system--including the shift from fee-for-service medicine to managed care and the proliferation of direct-to-consumer and tailored marketing strategies in the pharmaceutical industry. It focuses on contextual variables with potential to significantly mediate the impact of personally tailored health advice--including those related to confidentiality, privacy, and informed consent and to the perceived aims, intents, and sources of tailored health messages. To protect the future of tailored health messages, more research attention must be given to defining these contextual factors and understanding the roles that they play and the ways in which they can be controlled to assure the best outcomes. Such research could point the way towards a set of empirical and ethical "best practices" based on a scientific understanding of how to maximize the benefits, and minimize the potential harms, of the widescale use of tailored health communications.

  18. 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.

  19. 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

  20. Nutritional status, exclusive breastfeeding and management of acute respiratory illness and diarrhea in the first 6 months of life in infants from two regions of Indonesia.

    Science.gov (United States)

    Oktaria, V; Lee, K J; Bines, J E; Watts, E; Satria, C D; Atthobari, J; Nirwati, H; Kirkwood, C D; Soenarto, Y; Danchin, M H

    2017-12-21

    Infant morbidity and mortality rates remain high in Indonesia, with acute respiratory illnesses (ARI) and diarrhea the leading two health problems in children under 5 years. We aimed to describe the nutritional status, feeding practice and case management of ARI and diarrhea of infants from two regions of Indonesia during the first 6 months of life. This study was an observational study conducted in parallel to an immunogenicity and efficacy trial of an oral rotavirus vaccine (RV3-BB) in the Klaten and Yogyakarta regions, Indonesia. Mothers were interviewed at 3 time points: within the first 6 days of their infant's life, and at 8-10 and 22-24 weeks of age. Questions asked included pregnancy history, infant nutritional status, feeding status and health of infants within up to 2 weeks prior to the assessment. Between February 2013 and January 2014, 233 mother-infant pairs were recruited. 60% (136/223) of infants were exclusively breastfed (EBF) until 6 months of age with the strongest support for EBF reported by mothers themselves 70% (101/223) and 25% (36/223) from their partners. At 6 months, 6% (14/223) of infants were underweight and severely underweight; 4% (8/ 223) wasted and severely wasted; and 12% (28/223) were stunted and severely stunted. Non-recommended medication use was high, with 54% (21/39) of infants with reported cough within 2 weeks of an assessment receiving cough medication, 70% (27 /39) an antihistamine, 26% (10/39) a mucolytic and 15% (6 /39) an oral bronchodilator. At age 22-24 week, infants with reported diarrhea within 2 weeks of an assessment had low use of oral rehydration solutions (ORS) (3/21;14%) and zinc therapy (2/ 21;10%). In this unique observational study, breastfeeding rates of 60% at 6 months were below the Indonesian national target of >75%. Adherence to WHO guidelines for management of ARI and diarrhea was poor, with high use of non-recommended cough medications and oral bronchodilators in the first 6 months of life

  1. Organic highbush blueberry production systems research – management of plant nutrition, irrigation requirements, weeds, and economic sustainability

    Science.gov (United States)

    A 0.4 ha planting was established in October 2006 to evaluate the effects of cultivar (Duke and Liberty), bed type ("flat ground" and raised beds), weed management [sawdust mulch and hand weed control; compost plus sawdust mulch with acetic acid, flaming, and hand control used as needed; and landsca...

  2. Dairy cow nutrition

    OpenAIRE

    Tame, Mike

    2008-01-01

    This review pulls together the results of over 40 research projects and brings us up to date with the latest in thinking on dairy cow nutrition, incorporates the findings of a wide range of organic trials and draws some clear recommendations on appropriate strategies for forage type and management, supplementary feeding, ration formulation and farming systems. It raises important issues around sustainability versus optimum production and highlights future research priorities.

  3. Smartphone Applications for Promoting Healthy Diet and Nutrition: A Literature Review

    Science.gov (United States)

    Coughlin, Steven S.; Whitehead, Mary; Sheats, Joyce Q.; Mastromonico, Jeff; Hardy, Dale; Smith, Selina A.

    2015-01-01

    Background Rapid developments in technology have encouraged the use of smartphones in health promotion research and practice. Although many applications (apps) relating to diet and nutrition are available from major smartphone platforms, relatively few have been tested in research studies in order to determine their effectiveness in promoting health. Methods In this article, we summarize data on the use of smartphone applications for promoting healthy diet and nutrition based upon bibliographic searches in PubMed and CINAHL with relevant search terms pertaining to diet, nutrition, and weight loss through August 2015. Results A total of 193 articles were identified in the bibliographic searches. By screening abstracts or full-text articles, a total of three relevant qualitative studies and 9 randomized controlled trials were identified. In qualitative studies, participants preferred applications that were quick and easy to administer, and those that increase awareness of food intake and weight management. In randomized trials, the use of smartphone apps was associated with better dietary compliance for lower calorie, low fat, and high fiber foods, and higher physical activity levels (p=0.01-0.02) which resulted in more weight loss (p=0.042-<0.0001). Discussion Future studies should utilize randomized controlled trial research designs, larger sample sizes, and longer study periods to better establish the diet and nutrition intervention capabilities of smartphones. There is a need for culturally appropriate, tailored health messages to increase knowledge and awareness of health behaviors such as healthy eating. Smartphone apps are likely to be a useful and low-cost intervention for improving diet and nutrition and addressing obesity in the general population. Participants prefer applications that are quick and easy to administer and those that increase awareness of food intake and weight management. PMID:26819969

  4. Aeroelastic tailoring of composite aircraft wings

    Science.gov (United States)

    Mihaila-Andres, Mihai; Larco, Ciprian; Rosu, Paul-Virgil; Rotaru, Constantin

    2017-07-01

    The need of a continuously increasing size and performance of aerospace structures has settled the composite materials as the preferred materials in aircraft structures. Apart from the clear capacity to reduce the structural weight and with it the manufacture cost and the fuel consumption while preserving proper airworthiness, the prospect of tailoring a structure using the unique directional stiffness properties of composite materials allows an aerospace engineer to optimize aircraft structures to achieve particular design objectives. This paper presents a brief review of what is known as the aeroelastic tailoring of airframes with the intent of understanding the evolution of this research topic and at the same time providing useful references for further studies.

  5. Nutrition and Diet

    Science.gov (United States)

    ... Thai HbH:Vietnamese Relevant links Living with Thalassemia NUTRITION AND EXERCISE ▶ Nutrition and Diet ▶ Diet for the ... Thalassemia (for providers) Exercise for Patients with Thalassemia Nutrition and Diet Nutritional deficiencies are common in thalassemia, ...

  6. 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 ...

  7. Sports Nutrition: A Modern Approach to Teaching Foods in High School Home Economics.

    Science.gov (United States)

    Metzger, Sheryl

    1991-01-01

    In a program designed to couple the awareness of the relationship between nutrition and physical activity, the principles of nutrition were tailored to individual athletes, and students were encouraged to develop a diet that adheres to U.S. Department of Agriculture guidelines as modified for body type, activity level, and sport. (JOW)

  8. An Adolescent Nutrition Learning Model to Facilitate Behavior Change in Overweight Teens

    Science.gov (United States)

    Young, Kimberly J.; Ramsay, Samantha A.; Holyoke, Laura B.

    2016-01-01

    Understanding the process by which adolescents learn about nutrition is necessary for developing tailored education that leads to sustainable behavior change. Teens aged 15-17 participating in an obesity prevention program were interviewed. From the data, three themes emerged and informed development of an adolescent nutrition learning model. The…

  9. Tailoring electronic structure of polyazomethines thin films

    OpenAIRE

    J. Weszka; B. Hajduk; M. Domański; M. Chwastek; J. Jurusik; B. Jarząbek; H. Bednarski; P. Jarka

    2010-01-01

    Purpose: The aim of this work is to show how electronic properties of polyazomethine thin films deposited by chemical vapor deposition method (CVD) can be tailored by manipulating technological parameters of pristine films preparation as well as modifying them while the as-prepared films put into iodine atmosphere.Design/methodology/approach: The recent achievements in the field of designing and preparation methods to be used while preparing polymer photovoltaic solar cells or optoelectronic ...

  10. Process evaluation of a tailored mobile health intervention aiming to reduce fatigue in airline pilots

    Directory of Open Access Journals (Sweden)

    Alwin van Drongelen

    2016-08-01

    Full Text Available Abstract Background MORE Energy is a mobile health intervention which aims to reduce fatigue and improve health in airline pilots. The primary objective of this process evaluation was to assess the reach, dose delivered, compliance, fidelity, barriers and facilitators, and satisfaction of the intervention. The second objective was to investigate the associations of adherence to the intervention with compliance and with participant satisfaction. Thirdly, we investigated differences between the subgroups within the target population. Methods The intervention consisted of a smartphone application, supported by a website. It provided advice on optimal light exposure, sleep, nutrition, and physical activity, tailored to flight and personal characteristics. The reach of the intervention was determined by comparing the intervention group participants and the airline pilots who did not participate. The dose delivered was defined as the total number of participants that was sent an instruction email. Objective compliance was measured through the Control Management System of the application. To determine the fidelity, an extensive log was kept throughout the intervention period. Subjective compliance, satisfaction, barriers, facilitators, and adherence were assessed using online questionnaires. Associations between the extent to which the participants applied the advice in daily life (adherence, compliance, and satisfaction were analysed as well. Finally, outcomes of participants of different age groups and haul types were compared. Results A total of 2222 pilots were made aware of the study. From this group, 502 pilots met the inclusion criteria and did agree to participate. The reach of the study proved to be 22 % and the dose delivered was 99 %. The included pilots were randomized into the intervention group (n = 251 or the control group (n = 251. Of the intervention group participants, 81 % consulted any advice, while 17 % did this during

  11. Process evaluation of a tailored mobile health intervention aiming to reduce fatigue in airline pilots.

    Science.gov (United States)

    van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; Smid, Tjabe; van der Beek, Allard J

    2016-08-26

    MORE Energy is a mobile health intervention which aims to reduce fatigue and improve health in airline pilots. The primary objective of this process evaluation was to assess the reach, dose delivered, compliance, fidelity, barriers and facilitators, and satisfaction of the intervention. The second objective was to investigate the associations of adherence to the intervention with compliance and with participant satisfaction. Thirdly, we investigated differences between the subgroups within the target population. The intervention consisted of a smartphone application, supported by a website. It provided advice on optimal light exposure, sleep, nutrition, and physical activity, tailored to flight and personal characteristics. The reach of the intervention was determined by comparing the intervention group participants and the airline pilots who did not participate. The dose delivered was defined as the total number of participants that was sent an instruction email. Objective compliance was measured through the Control Management System of the application. To determine the fidelity, an extensive log was kept throughout the intervention period. Subjective compliance, satisfaction, barriers, facilitators, and adherence were assessed using online questionnaires. Associations between the extent to which the participants applied the advice in daily life (adherence), compliance, and satisfaction were analysed as well. Finally, outcomes of participants of different age groups and haul types were compared. A total of 2222 pilots were made aware of the study. From this group, 502 pilots met the inclusion criteria and did agree to participate. The reach of the study proved to be 22 % and the dose delivered was 99 %. The included pilots were randomized into the intervention group (n = 251) or the control group (n = 251). Of the intervention group participants, 81 % consulted any advice, while 17 % did this during four weeks or more. Fidelity was 67 %. The

  12. Management, nutrition, and lactation performance are related to bulk tank milk de novo fatty acid concentration on northeastern US dairy farms.

    Science.gov (United States)

    Woolpert, M E; Dann, H M; Cotanch, K W; Melilli, C; Chase, L E; Grant, R J; Barbano, D M

    2016-10-01

    This study investigated the relationship of management practices, dietary characteristics, milk composition, and lactation performance with de novo fatty acid (FA) concentration in bulk tank milk from commercial dairy farms with Holstein, Jersey, and mixed-breed cows. It was hypothesized that farms with higher de novo milk FA concentrations would more commonly use management and nutrition practices known to optimize ruminal conditions that enhance de novo synthesis of milk FA. Farms (n=44) located in Vermont and northeastern New York were selected based on a history of high de novo (HDN; 26.18±0.94g/100g of FA; mean ± standard deviation) or low de novo (LDN; 24.19±1.22g/100g of FA) FA in bulk tank milk. Management practices were assessed during one visit to each farm in March or April, 2014. Total mixed ration samples were collected and analyzed for chemical composition using near infrared spectroscopy. We found no differences in days in milk at the farm level. Yield of milk fat, true protein, and de novo FA per cow per day were higher for HDN versus LDN farms. The HDN farms had lower freestall stocking density (cows/stall) than LDN farms. Additionally, tiestall feeding frequency was higher for HDN than LDN farms. No differences between HDN and LDN farms were detected for dietary dry matter, crude protein, neutral detergent fiber, starch, or percentage of forage in the diet. However, dietary ether extract was lower for HDN than LDN farms. This research indicates that overcrowded freestalls, reduced feeding frequency, and greater dietary ether extract content are associated with lower de novo FA synthesis and reduced milk fat and true protein yields on commercial dairy farms. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  13. Tailored information about cancer risk and screening: a systematic review.

    NARCIS (Netherlands)

    Albada, A.; Ausems, M.G.E.M.; Bensing, J.M.; Dulmen, S. van

    2009-01-01

    OBJECTIVE: To study interventions that provide people with information about cancer risk and about screening that is tailored to their personal characteristics. We assess the tailoring characteristics, theory base and effects on risk perception, knowledge and screening behavior of these

  14. Tailored Trustworthy Spaces: Solutions for the Smart Grid

    Data.gov (United States)

    Networking and Information Technology Research and Development, Executive Office of the President — The NITRD workshop on Tailored Trustworthy Spaces: Solutions for the Smart Grid was conceived by the Federal government to probe deeper into how Tailored Trustworthy...

  15. Effect of some management and nutritional factors on the fertility of milking cows under traditional husbandry system in Sudan

    International Nuclear Information System (INIS)

    Ahmed, Hassaballa Shams Eldin

    1998-04-01

    Six farms (A, B, C, D, E and F) of the intensive system type were selected. They were located 50 km south of Khartoum. Nutritional parameters with respect to metabolizable energy intake (MEI)and crude protein (CP) concentration of the diet were investigated . Other managerial practices were also closely examined. Cows that recently calved were monitored throughout the study period (300 days) for days to first progesterone (P 4 ) rise and days to conception using radioimmunoassay (RIA) technique and rectal palpation. The above fertility parameters were correlated with either body condition score (BCS) or body weight (Bwt) at calving, 30, 60 and 90 days from calving. Similar correlations were done after pooling all farms together excluding farm E which consisted of the pure exotic breed. Likewise same correlations were done for the cows grouped according to calving during wet and dry summer. Milk yield at 30, 60 and 90 days from calving were also correlated with days to first P 4 rise and days to conception. Regression analysis were carried out for correlations which showed high or moderate relationships. The interval from caving to ovulation or conception varied within and between farms. Farm E showed the shortest (17) days to first P 4 rise while farm C showed the longest days. Likewise farm E showed the shortest (56) days to conception while farm F showed the longest (161) days. However farm F, showed the lowest conception rate and highest percentage of anestrus cows. Best conception rates within 90 days postpartum were observed in farm C followed by farm E, B, A, D and F. Days to conception was negatively correlated (P 4 rise was negatively correlated (P<0.004, r=0.99) with body score at calving (BCS.Calv), but positively correlated with Bwt.Calv. (P<0.08, r=0.91), body weight change at 30 days from calving (P<0.13, r=0.86), and body weight change at 60 days from calving (P<0.08, r=0.91). No significant difference (P=0.29) between wet and dry summer for days to

  16. Nutrition and Allergic Diseases

    Directory of Open Access Journals (Sweden)

    R.J.J. van Neerven

    2017-07-01

    Full Text Available The development of IgE-mediated allergic diseases is influenced by many factors, including genetic and environmental factors such as pollution and farming, but also by nutrition. In the last decade, substantial progress has been made in our understanding of the impact that nutrition can have on allergic diseases. Many studies have addressed the effect of breastfeeding, pre-, pro- and synbiotics, vitamins and minerals, fiber, fruit and vegetables, cow’s milk, and n-3 fatty acids, on the development of allergies. In addition, nutrition can also have indirect effects on allergic sensitization. This includes the diet of pregnant and breastfeeding women, which influences intrauterine development, as well as breastmilk composition. These include the diet of pregnant and breastfeeding women that influences intrauterine development as well as breastmilk composition, effects of food processing that may enhance allergenicity of foods, and effects via modulation of the intestinal microbiota and their metabolites. This editorial review provides a brief overview of recent developments related to nutrition and the development and management of allergic diseases.

  17. [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.

  18. Association Between Nutrition Status and Cognitive Impairment Among Chinese Nonagenarians and Centenarians

    Directory of Open Access Journals (Sweden)

    Shan Hai

    2017-12-01

    Conclusion: Among Chinese nonagenarians and centenarians, there were significant associations between nutrition status and cognitive impairment. Further studies should evaluation if maintaining a good nutritional status or nutritional intervention may be effective in the management and prevention of cognitive impairment.

  19. Lay Health Influencers: How They Tailor Brief Tobacco Cessation Interventions

    Science.gov (United States)

    Yuan, Nicole P.; Castaneda, Heide; Nichter, Mark; Nichter, Mimi; Wind, Steven; Carruth, Lauren; Muramoto, Myra

    2012-01-01

    Interventions tailored to individual smoker characteristics have increasingly received attention in the tobacco control literature. The majority of tailored interventions are generated by computers and administered with printed materials or web-based programs. The purpose of this study was to examine the tailoring activities of community lay…

  20. A transatlantic survey of nutrition practice in acute pancreatitis.

    LENUS (Irish Health Repository)

    Duggan, SN

    2012-08-01

    Many guidelines exist for the nutritional management of acute pancreatitis; however, little is known regarding current practice. We aimed to investigate feeding practices, including the use of parenteral\\/enteral nutrition.

  1. Effects of processing on nutritional composition and quality

    Indian Academy of Sciences (India)

    The effects of processing on the nutritional composition and quality evaluation of ... P ≤ 0.01 ) differences in total dry matter and total sugar content between samples, ... Faculty of Tourism and Hospitality Management, Department of Nutrition, ...

  2. Volume 14 No. 2 April 2014 IMPLEMENTING NUTRITION ...

    African Journals Online (AJOL)

    Cameron

    2014-04-02

    Apr 2, 2014 ... and a pilot project for community management of severe acute ..... The divided responsibility of the NTO between nutrition and disease .... essential for effectively delivering nutrition programs and deserve urgent attention.

  3. Nutritional Metabolomics

    DEFF Research Database (Denmark)

    Gürdeniz, Gözde

    strategy influences the patterns identified as important for the nutritional question under study. Therefore, in depth understanding of the study design and the specific effects of the analytical technology on the produced data is extremely important to achieve high quality data handling. Besides data......Metabolomics provides a holistic approach to investigate the perturbations in human metabolism with respect to a specific exposure. In nutritional metabolomics, the research question is generally related to the effect of a specific food intake on metabolic profiles commonly of plasma or urine....... Application of multiple analytical strategies may provide comprehensive information to reach a valid answer to these research questions. In this thesis, I investigated several analytical technologies and data handling strategies in order to evaluate their effects on the biological answer. In metabolomics, one...

  4. How nutritional status, diet and dietary supplements can affect autism. A review.

    Science.gov (United States)

    Kawicka, Anna; Regulska-Ilow, Bozena

    2013-01-01

    Autism is a neurodevelopmental disorder with symptoms arising that are apparent throughout the patient's lifespan. Autism Spectrum Disorders (ASD) are characterised by impaired social and communication interactions as well as restricted, repetitive interests and behaviour. Currently in Poland, about 50 000 people suffer from autism, of which 1/5 are children. Epidemiological studies show that the incidence of autism is increasing, which may be due to the diagnostic category of ASD having been developed. Of vital importance in the treatment of autism, is early diagnosis which is conducive to more rapidly improving the quality of patients' health. It is believed that both genetic and environmental factors may affect the development of the disease. Moreover, expert opinion emphasises the importance of making an adequate diagnosis when the first symptoms of autism start appearing which can be both psychological, gastro-intestinal and metabolic ones. Conventional treatment is based on the combination of behavioural and dietary therapy together with pharmacotherapy. For example, adapting an appropriate diet could help alleviate the disease severity, as well as the psychological and gastrointestinal symptoms. Much scientific research has indicated that pathogenesis of autism may have a beginning already in foetal life. During pregnancy, specialists should take special heed of metabolic disorders, which can increase the risk ofASD in children. One of the dietician's tasks are to properly assess the nutritional status of mothers before and during pregnancy, thereby allowing changes in nutrition to be made wherever necessary in order that metabolic indicators be improved. Thus an important part of autism therapy is the improving patient's nutritional status to prevent the onset of gastrointestinal symptoms. Adopting diets and tailored to individual disease symptoms, is linked to the nutritional requirements and food preferences of the patient. Specialists also emphasise that

  5. Nutritional Biochemistry

    Science.gov (United States)

    Smith, Scott M.

    2010-01-01

    This slide presentation reviews some of the effects that space flight has on humans nutritional biochemistry. Particular attention is devoted to the study of protein breakdown, inflammation, hypercatabolism, omega 3 fatty acids, vitamin D, calcium, urine, folate and nutrient stability of certain vitamins, the fluid shift and renal stone risk, acidosis, iron/hematology, and the effects on bone of dietary protein, potassium. inflammation, and omega-3 fatty acids

  6. WEIGHT LOSS IN A YOUNG PATIENT WITH TYPE 2 DIABETES: CHALLENGES OF DIABETES MANAGEMENT USING ONLINE PROGRAM OF GOOD NUTRITION (CASE REPORT).

    Science.gov (United States)

    Krylov, V

    2018-04-01

    A 31-year-old male with a history of obesity, type 2 diabetes mellitus (T2DM) and hypercholesterolemia came to our clinic for medical weight-loss management. According to his initial anthropometric measurements (weight - 193 kg, height - 181 cm, and body mass index (BMI) - 58 kg/m2) patient had morbid obesity. In order to educate our patient about good nutrition, physical activity and the need of sun exposure we used an online system based on the video lessons, full of humor, pictures, and cartoons. Even one month of watching the short educational movies was sufficient for the patient to form the habits of healthy eating, including restriction of fat and digestible carbohydrates and increase in daily consumption of low-fat dairy products, slow carbohydrates, protein and fiber. Endocrinologist was regularly available for any questions and inquiries that the patient might have had. In addition to the dietary recommendations subcutaneous liraglutide 2.4 mg daily was initiated. After 8 months of treatment the patient has lost 58 kg and reached the body weight of 135 kg; moreover, he had motivation to continue losing weight.

  7. An Overview of Plant Phenolic Compounds and Their Importance in Human Nutrition and Management of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Derong Lin

    2016-10-01

    Full Text Available In this paper, the biosynthesis process of phenolic compounds in plants is summarized, which includes the shikimate, pentose phosphate and phenylpropanoid pathways. Plant phenolic compounds can act as antioxidants, structural polymers (lignin, attractants (flavonoids and carotenoids, UV screens (flavonoids, signal compounds (salicylic acid and flavonoids and defense response chemicals (tannins and phytoalexins. From a human physiological standpoint, phenolic compounds are vital in defense responses, such as anti-aging, anti-inflammatory, antioxidant and anti-proliferative activities. Therefore, it is beneficial to eat such plant foods that have a high antioxidant compound content, which will cut down the incidence of certain chronic diseases, for instance diabetes, cancers and cardiovascular diseases, through the management of oxidative stress. Furthermore, berries and other fruits with low-amylase and high-glucosidase inhibitory activities could be regarded as candidate food items in the control of the early stages of hyperglycemia associated with type 2 diabetes.

  8. Nutrition in Africa.

    Science.gov (United States)

    Murray-lee, M

    1989-07-01

    Village women have adopted techniques set down by UNICEF in achieving higher food production and, ultimately, self sufficiency. Women's cooperatives integrate kitchen gardening and irrigated agriculture in an effort to combat the complex nutritional problems in Africa. Projects also offered training in a variety of areas including management of plots, labor-saving technology--diesel-driven grinding mills, rice husking, machines, wells with hand pumps, motor pumps for irrigation, all geared towards women benefitting themselves by growing their own food and furthering their children's health and development. Projects such as the one in Senegal were undertaken in other regions of Africa, like the Sahel and the Wadis--low-lying areas. From these projects, aid agencies and governments have suggested a number of recommendations in seeking a solution to Africa's nutritional problems. 1st, a balance between production of cash crops and food for consumption is called for. 2nd, research is necessary to improve the quality of locally grown food as much as livestock. 3rd, governments should extend surface area cultivation, 4th, more research on the advantage of indigenous food plants, 5th, women should be in on all levels of decision making in food production, 6th, governments should increase women farmer's efficiency, and further women's access to land and credit and 7th, women should be provided with increased educational opportunities. Nutrition in developing countries cannot be viewed as an isolated phenomenon--solutions to nutritional development should include all aspects of the problem including health and nutrition education, growth monitoring, water supply, literacy, technological know-how, and agricultural and plant and soil conservation.

  9. Climate change and nutrition: creating a climate for nutrition security.

    Science.gov (United States)

    Tirado, M C; Crahay, P; Mahy, L; Zanev, C; Neira, M; Msangi, S; Brown, R; Scaramella, C; Costa Coitinho, D; Müller, A

    2013-12-01

    Climate change further exacerbates the enormous existing burden of undernutrition. It affects food and nutrition security and undermines current efforts to reduce hunger and promote nutrition. Undernutrition in turn undermines climate resilience and the coping strategies of vulnerable populations. The objectives of this paper are to identify and undertake a cross-sectoral analysis of the impacts of climate change on nutrition security and the existing mechanisms, strategies, and policies to address them. A cross-sectoral analysis of the impacts of climate change on nutrition security and the mechanisms and policies to address them was guided by an analytical framework focused on the three 'underlying causes' of undernutrition: 1) household food access, 2) maternal and child care and feeding practices, 3) environmental health and health access. The analytical framework includes the interactions of the three underlying causes of undernutrition with climate change,vulnerability, adaptation and mitigation. Within broad efforts on climate change mitigation and adaptation and climate-resilient development, a combination of nutrition-sensitive adaptation and mitigation measures, climate-resilient and nutrition-sensitive agricultural development, social protection, improved maternal and child care and health, nutrition-sensitive risk reduction and management, community development measures, nutrition-smart investments, increased policy coherence, and institutional and cross-sectoral collaboration are proposed as a means to address the impacts of climate change to food and nutrition security. This paper proposes policy directions to address nutrition in the climate change agenda and recommendations for consideration by the UN Framework Convention on Climate Change (UNFCCC). Nutrition and health stakeholders need to be engaged in key climate change adaptation and mitigation initiatives, including science-based assessment by the Intergovernmental Panel on Climate Change (IPCC

  10. 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.

  11. Advances in Precision Medicine: Tailoring Individualized Therapies.

    Science.gov (United States)

    Matchett, Kyle B; Lynam-Lennon, Niamh; Watson, R William; Brown, James A L

    2017-10-25

    The traditional bench-to-bedside pipeline involves using model systems and patient samples to provide insights into pathways deregulated in cancer. This discovery reveals new biomarkers and therapeutic targets, ultimately stratifying patients and informing cohort-based treatment options. Precision medicine (molecular profiling of individual tumors combined with established clinical-pathological parameters) reveals, in real-time, individual patient's diagnostic and prognostic risk profile, informing tailored and tumor-specific treatment plans. Here we discuss advances in precision medicine presented at the Irish Association for Cancer Research Annual Meeting, highlighting examples where personalized medicine approaches have led to precision discovery in individual tumors, informing customized treatment programs.

  12. Functions of myosin motors tailored for parasitism

    DEFF Research Database (Denmark)

    Mueller, Christina; Graindorge, Arnault; Soldati-Favre, Dominique

    2017-01-01

    Myosin motors are one of the largest protein families in eukaryotes that exhibit divergent cellular functions. Their roles in protozoans, a diverse group of anciently diverged, single celled organisms with many prominent members known to be parasitic and to cause diseases in human and livestock......, are largely unknown. In the recent years many different approaches, among them whole genome sequencing, phylogenetic analyses and functional studies have increased our understanding on the distribution, protein architecture and function of unconventional myosin motors in protozoan parasites. In Apicomplexa......, myosins turn out to be highly specialized and to exhibit unique functions tailored to accommodate the lifestyle of these parasites....

  13. The use of instrumented gait analysis for individually tailored interdisciplinary interventions in children with cerebral palsy

    DEFF Research Database (Denmark)

    Rasmussen, Helle Mätzke; Pedersen, Niels Wisbech; Overgaard, Søren

    2015-01-01

    in gait following individually tailored interventions when IGA is used are superior to those following ‘care as usual’. Methods/Design A prospective, single blind, randomised, parallel group study will be conducted. Children aged 5 to 8 years with spastic CP, classified at Gross Motor Function...... Classification System levels I or II, will be included. The interventions under investigation are: 1) individually tailored interdisciplinary interventions based on the use of IGA, and 2) ‘care as usual’. The primary outcome is gait measured by the Gait Deviation Index. Secondary outcome measures are: walking......Abstract Background Children with cerebral palsy (CP) often have an altered gait. Orthopaedic surgery, spasticity management, physical therapy and orthotics are used to improve the gait. Interventions are individually tailored and are planned on the basis of clinical examinations and standardised...

  14. Diabetes Self-Management Education and Medical Nutrition Therapy Improve Patient Outcomes: A Pilot Study Documenting the Efficacy of Registered Dietitian Nutritionist Interventions through Retrospective Chart Review.

    Science.gov (United States)

    Marincic, Patricia Z; Hardin, Amie; Salazar, Maria V; Scott, Susan; Fan, Shirley X; Gaillard, Philippe R

    2017-08-01

    Diabetes self-management education (DSME) and medical nutrition therapy (MNT) improve patient outcomes; poor reimbursement limits access to care. Our aim was to develop methodology for tracking patient outcomes subsequent to registered dietitian nutritionist interventions, document outcomes for patients with type 2 diabetes attending an American Diabetes Association-recognized program, and obtain outcome data to support reimbursement and public policy initiatives to improve patient access to DSME and MNT. Retrospective chart review. A random sample of 100 charts was chosen from the electronic medical records of patients with type 2 diabetes completing DSME and individualized MNT, June 2013 to 2014. Data were extracted on body mass index (calculated as kg/m 2 ), weight, hemoglobin A1c, blood glucose, and lipids. Mixed-model analysis of variance was used to determine differences between means for continuous variables; McNemar's tests and γ-statistic trend analysis were used to assess frequency of patients reaching glycemic targets. Significant weight loss was observed from baseline (94.3±21.1 kg) to end of program (91.7±21.2 kg [-1.6±3.9 kg]; P0.05). Significant hemoglobin A1c reduction was observed from baseline (8.74%±2.30%) to end of program (6.82%±1.37% [-1.92%±2.25%]; Phemoglobin A1c targets (≤7.0%) vs 27% at baseline (P=0.008). When stratified by diet alone and diet plus drug therapy, patients exhibited a 1.08%±1.20% (Phemoglobin A1c, respectively. Triglycerides decreased from baseline 181.6±75.5 mg/dL (2.0±0.9 mmol/L) to 115.8±48.1 mg/dL (1.3±0.5mmol/L) (P=0.023). High-density lipoprotein increased from 41.4±12.4 mg/dL (1.1±0.3 mmol/L) to 47.3±12.4 mg/dL (1.2±0.3 mmol/L) (P=0.007). Retrospective chart review provides an operational model for abstracting existing patient outcome data subsequent to registered dietitian nutritionist interventions. In support of universal reimbursement and patient access to DSME with supplemental individualized

  15. A clinical nutritional information system with personalized nutrition assessment.

    Science.gov (United States)

    Kuo, Su-E; Lai, Hui-San; Hsu, Jen-Ming; Yu, Yao-Chang; Zheng, Dong-Zhe; Hou, Ting-Wei

    2018-03-01

    Traditional nutrition evaluations not only require the use of numerous tables and lists to provide sufficient recommendations for patients' diets but are also very time-consuming due to cross-referencing and calculations. To personalize patient assessments, this study implemented a Clinical Nutritional Information System (CNIS) to help hospital dietitians perform their daily work more effectively in terms of time management and paper work. The CNIS mainly targets in-patients who require cancer-nutrition counselling. The development of the CNIS occurred in three phases. Phase 1 included system design and implementation based on the Nutrition Care Process and Model (NCPM) and the Patient Nutrition Care Process. Phase 2 involved a survey to characterize the efficiency, quality and accuracy of the CNIS. In Phase 3, a second survey was conducted to determine how well dietitians had adapted to the system and the extent of improvement in efficiency after the CNIS had been available online for three years. The work time requirements decreased by approximately 58% with the assistance of the CNIS. Of the dietitians who used the CNIS, 95% reported satisfaction, with 91.66% indicating that the CNIS was really helpful in their work. However, some shortcomings were also evident according to the results. Dietitians favoured the standardization of nutritional intervention and monitoring. The CNIS meets the needs of dietitians by increasing the quality of nutritional interventions by providing accurate calculations and cross-referencing for information regarding patients' conditions, with the benefit of decreasing the processing time, such as handwritten documentation. In addition, the CNIS also helps dietitians statistically analyse each patient's personal nutritional needs to achieve nutritional improvement. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Nutritional requirements of the critically ill patient.

    Science.gov (United States)

    Chan, Daniel L

    2004-02-01

    The presence or development of malnutrition during critical illness has been unequivocally associated with increased morbidity and mortality in people. Recognition that malnutrition may similarly affect veterinary patients emphasizes the need to properly address the nutritional requirements of hospitalized dogs and cats. Because of a lack in veterinary studies evaluating the nutritional requirements of critically ill small animals, current recommendations for nutritional support of veterinary patients are based largely on sound clinical judgment and the best information available, including data from experimental animal models and human studies. This, however, should not discourage the veterinary practitioner from implementing nutritional support in critically ill patients. Similar to many supportive measures of critically ill patients, nutritional interventions can have a significant impact on patient morbidity and may even improve survival. The first step of nutritional support is to identify patients most likely to benefit from nutritional intervention. Careful assessment of the patient and appraisal of its nutritional needs provide the basis for a nutritional plan, which includes choosing the optimal route of nutritional support, determining the number of calories to provide, and determining the composition of the diet. Ultimately, the success of the nutritional management of critically ill dogs and cats will depend on close monitoring and frequent reassessment.

  17. A vegetarian dietary pattern as a nutrient-dense approach to weight management: an analysis of the national health and nutrition examination survey 1999-2004.

    Science.gov (United States)

    Farmer, Bonnie; Larson, Brian T; Fulgoni, Victor L; Rainville, Alice J; Liepa, George U

    2011-06-01

    Population-based studies have shown that vegetarians have lower body mass index than nonvegetarians, suggesting that vegetarian diet plans may be an approach for weight management. However, a perception exists that vegetarian diets are deficient in certain nutrients. To compare dietary quality of vegetarians, nonvegetarians, and dieters, and to test the hypothesis that a vegetarian diet would not compromise nutrient intake when used to manage body weight. Cross-sectional analysis of National Health and Nutrition Examination Survey (1999-2004) dietary and anthropometric data. Diet quality was determined using United States Department of Agriculture's Healthy Eating Index 2005. Participants included adults aged 19 years and older, excluding pregnant and lactating women (N = 13,292). Lacto-ovo vegetarian diets were portrayed by intakes of participants who did not eat meat, poultry, or fish on the day of the survey (n = 851). Weight-loss diets were portrayed by intakes of participants who consumed 500 kcal less than their estimated energy requirements (n = 4,635). Mean nutrient intakes and body mass indexes were adjusted for energy, sex, and ethnicity. Using analysis of variance, all vegetarians were compared to all nonvegetarians, dieting vegetarians to dieting nonvegetarians, and nondieting vegetarians to nondieting nonvegetarians. Mean intakes of fiber, vitamins A, C, and E, thiamin, riboflavin, folate, calcium, magnesium, and iron were higher for all vegetarians than for all nonvegetarians. Although vegetarian intakes of vitamin E, vitamin A, and magnesium exceeded that of nonvegetarians (8.3 ± 0.3 vs 7.0 ± 0.1 mg; 718 ± 28 vs 603 ± 10 μg; 322 ± 5 vs 281 ± 2 mg), both groups had intakes that were less than desired. The Healthy Eating Index score did not differ for all vegetarians compared to all nonvegetarians (50.5 ± 0.88 vs 50.1 ± 0.33, P = 0.6). These findings suggest that vegetarian diets are nutrient dense, consistent with dietary guidelines, and

  18. Deep Drawing of High-Strength Tailored Blanks by Using Tailored Tools

    Directory of Open Access Journals (Sweden)

    Thomas Mennecart

    2016-01-01

    Full Text Available In most forming processes based on tailored blanks, the tool material remains the same as that of sheet metal blanks without tailored properties. A novel concept of lightweight construction for deep drawing tools is presented in this work to improve the forming behavior of tailored blanks. The investigations presented here deal with the forming of tailored blanks of dissimilar strengths using tailored dies made of two different materials. In the area of the steel blank with higher strength, typical tool steel is used. In the area of the low-strength steel, a hybrid tool made out of a polymer and a fiber-reinforced surface replaces the steel half. Cylindrical cups of DP600/HX300LAD are formed and analyzed regarding their formability. The use of two different halves of tool materials shows improved blank thickness distribution, weld-line movement and pressure distribution compared to the use of two steel halves. An improvement in strain distribution is also observed by the inclusion of springs in the polymer side of tools, which is implemented to control the material flow in the die. Furthermore, a reduction in tool weight of approximately 75% can be achieved by using this technique. An accurate finite element modeling strategy is developed to analyze the problem numerically and is verified experimentally for the cylindrical cup. This strategy is then applied to investigate the thickness distribution and weld-line movement for a complex geometry, and its transferability is validated. The inclusion of springs in the hybrid tool leads to better material flow, which results in reduction of weld-line movement by around 60%, leading to more uniform thickness distribution.

  19. Nutrition Care Process Implementation: Experiences in Various Dietetics Environments in Sweden.

    Science.gov (United States)

    Lövestam, Elin; Boström, Anne-Marie; Orrevall, Ylva

    2017-11-01

    The Nutrition Care Process (NCP) and Nutrition Care Process Terminology (NCPT) are currently being implemented by nutrition and dietetics practitioners all over the world. Several advantages have been related to this implementation, such as consistency and clarity of dietetics-related health care records and the possibility to collect and research patient outcomes. However, little is known about dietitians' experiences of the implementation process. The aim of this qualitative study was to explore Swedish dietitians' experiences of the NCP implementation process in different dietetics environments. Thirty-seven Swedish dietitians from 13 different dietetics workplaces participated in seven focus group discussions that were audiotaped and carefully transcribed. A thematic secondary analysis was performed, after which all the discussions were re-read, following the implementation narrative from each workplace. In the analysis, The Promoting Action on Research Implementation in Health Services implementation model was used as a framework. Main categories identified in the thematic analysis were leadership and implementation strategy, the group and colleagues, the electronic health record, and evaluation. Three typical cases are described to illustrate the diversity of these aspects in dietetics settings: Case A represents a small hospital with an inclusive leadership style and discussion-friendly culture where dietitians had embraced the NCP/NCPT implementation. Case B represents a larger hospital with a more hierarchical structure where dietitians were more ambivalent toward NCP/NCPT implementation. Case C represents the only dietitian working at a small multiprofessional primary care center who received no dietetics-related support from management or colleagues. She had not started NCP/NCPT implementation. The diversity of dietetics settings and their different prerequisites should be considered in the development of NCP/NCPT implementation strategies. Tailored

  20. Effects of tailored message education about breast cancer risk appraisal for obese Korean women.

    Science.gov (United States)

    Park, Somi; Chung, ChaeWeon; Cochrane, Barbara B

    2013-11-01

    To examine the effects of tailored message education about breast cancer risk in obese Korean women. Pretest/post-test with two comparison treatments. Rural community settings in South Korea. Non-random sample of 64 obese women. Based on the Health Belief Model, tailored message education involved a one-session individual approach addressing cognitive, emotional, and behavioral domains. The comparison group received a one-time standard education group session. Data on breast cancer risk factors and mammography findings were recorded. Knowledge, awareness, emotional barriers, self-efficacy, and intent to screen and prevent breast cancer. Compared to standard education, tailored message education showed significantly higher score changes on awareness of personal risk (F = 5.21, p message education targeting breast cancer and risk associated with obesity is useful in breast cancer screening education. Future studies should incorporate individualized messages on nutrition, exercise, and cultural barriers to reduce breast cancer risk in obese women. Individual educational strategies can effectively enhance breast cancer prevention and early screening. Public and preventive education should include a focus on cultural, cognitive, and emotional domains. For obese women, a heightened awareness and self-efficacy may influence screening behaviors.

  1. Nutrition for Young Men

    Science.gov (United States)

    ... Healthy Aging Nutrition for Young Men Print Email Nutrition for Young Men Reviewed by Taylor Wolfram, MS, ... 2017 XiXinXing/iStock/Thinkstock For many young men, nutrition isn't always a focus. There are many ...

  2. Nutrition Following Pancreatic Surgery

    Science.gov (United States)

    ... BACK Contact Us DONATE NOW GENERAL DONATION PURPLESTRIDE Nutrition Following Pancreatic Surgery Home Facing Pancreatic Cancer Living with Pancreatic Cancer Diet and Nutrition Nutrition Following Pancreatic Surgery Ver esta página en ...

  3. Tailoring superelasticity of soft magnetic materials

    Science.gov (United States)

    Cremer, Peet; Löwen, Hartmut; Menzel, Andreas M.

    2015-10-01

    Embedding magnetic colloidal particles in an elastic polymer matrix leads to smart soft materials that can reversibly be addressed from outside by external magnetic fields. We discover a pronounced nonlinear superelastic stress-strain behavior of such materials using numerical simulations. This behavior results from a combination of two stress-induced mechanisms: a detachment mechanism of embedded particle aggregates and a reorientation mechanism of magnetic moments. The superelastic regime can be reversibly tuned or even be switched on and off by external magnetic fields and thus be tailored during operation. Similarities to the superelastic behavior of shape-memory alloys suggest analogous applications, with the additional benefit of reversible switchability and a higher biocompatibility of soft materials.

  4. Engineering tailored nanoparticles with microbes: quo vadis?

    Science.gov (United States)

    Prasad, Ram; Pandey, Rishikesh; Barman, Ishan

    2016-01-01

    In the quest for less toxic and cleaner methods of nanomaterials production, recent developments in the biosynthesis of nanoparticles have underscored the important role of microorganisms. Their intrinsic ability to withstand variable extremes of temperature, pressure, and pH coupled with the minimal downstream processing requirements provide an attractive route for diverse applications. Yet, controlling the dispersity and facile tuning of the morphology of the nanoparticles of desired chemical compositions remains an ongoing challenge. In this Focus Review, we critically review the advances in nanoparticle synthesis using microbes, ranging from bacteria and fungi to viruses, and discuss new insights into the cellular mechanisms of such formation that may, in the near future, allow complete control over particle morphology and functionalization. In addition to serving as paradigms for cost-effective, biocompatible, and eco-friendly synthesis, microbes hold the promise for a unique template for synthesis of tailored nanoparticles targeted at therapeutic and diagnostic platform technologies. © 2015 Wiley Periodicals, Inc.

  5. Tailored vacuum chambers for ac magnets

    International Nuclear Information System (INIS)

    Harvey, A.

    1985-01-01

    The proposed LAMPF-II accelerator has a 60-Hz booster synchrotron and a 3-Hz main ring. To provide a vacuum enclosure inside the magnets with low eddy-current losses and minimal field distortion, yet capable of carrying rf image currents and providing beam stabilization, we propose an innovative combination pipe. Structurally, the enclosure is high-purity alumina ceramic, which is strong, radiation resistant, and has good vacuum properties. Applied to the chamber are thin, spaced, silver conductors using adapted thick-film technology. The conductor design can be tailored to the stabilization requirements, for example, longitudinal conductors for image currents, circumferential for transverse stabilization. The inside of the chamber has a thin, resistive coating to avoid charge build-up. The overall 60-Hz power loss is less than 100 W/m

  6. Computer-Tailored Intervention for Juvenile Offenders

    Science.gov (United States)

    LEVESQUE, DEBORAH A.; JOHNSON, JANET L.; WELCH, CAROL A.; PROCHASKA, JANICE M.; FERNANDEZ, ANNE C.

    2012-01-01

    Studies assessing the efficacy of juvenile justice interventions show small effects on recidivism and other outcomes. This paper describes the development of a prototype of a multimedia computer-tailored intervention (“Rise Above Your Situation”or RAYS) that relies on an evidence-based model of behavior change, the Transtheoretical Model, and expert system technology to deliver assessments, feedback, printed reports, and counselor reports with intervention ideas. In a feasibility test involving 60 system-involved youths and their counselors, evaluations of the program were favorable: 91.7% of youths agreed that the program could help them make positive changes, and 86.7% agreed that the program could give their counselor helpful information about them. PMID:23264754

  7. Optimizing Tailored Health Promotion for Older Adults

    Science.gov (United States)

    Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L. S.; Seidell, Jacob C.; Slaets, Joris P. J.; Smits, Carolien H. M.

    2016-01-01

    Objective: This study explores older adults’ perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative study, 18 semi-structured interviews were carried out with older adults (aged 55-98) living in the Netherlands. The framework analysis method was used to analyze the transcripts. Results: Three themes emerged from the data—(a) healthy living: daily routines and staying active, (b) enacting healthy living: accepting and adapting, (c) interaction with health professionals with regard to healthy living: autonomy and reciprocity. Discussion: Older adults experience healthy living in a holistic way in which they prefer to live active and independent lives. Health professionals should focus on building an equal relationship of trust and focus on positive health outcomes, such as autonomy and self-sufficiency when communicating about healthy living. PMID:28138485

  8. Synroc tailored waste forms for actinide immobilization

    Energy Technology Data Exchange (ETDEWEB)

    Gregg, Daniel J.; Vance, Eric R. [Australian Nuclear Science and Technology Organisation, Kirrawee (Australia). ANSTOsynroc, Inst. of Materials Engineering

    2017-07-01

    Since the end of the 1970s, Synroc at the Australian Nuclear Science and Technology Organisation (ANSTO) has evolved from a focus on titanate ceramics directed at PUREX waste to a platform waste treatment technology to fabricate tailored glass-ceramic and ceramic waste forms for different types of actinide, high- and intermediate level wastes. The particular emphasis for Synroc is on wastes which are problematic for glass matrices or existing vitrification process technologies. In particular, nuclear wastes containing actinides, notably plutonium, pose a unique set of requirements for a waste form, which Synroc ceramic and glass-ceramic waste forms can be tailored to meet. Key aspects to waste form design include maximising the waste loading, producing a chemically durable product, maintaining flexibility to accommodate waste variations, a proliferation resistance to prevent theft and diversion, and appropriate process technology to produce waste forms that meet requirements for actinide waste streams. Synroc waste forms incorporate the actinides within mineral phases, producing products which are much more durable in water than baseline borosilicate glasses. Further, Synroc waste forms can incorporate neutron absorbers and {sup 238}U which provide criticality control both during processing and whilst within the repository. Synroc waste forms offer proliferation resistance advantages over baseline borosilicate glasses as it is much more difficult to retrieve the actinide and they can reduce the radiation dose to workers compared to borosilicate glasses. Major research and development into Synroc at ANSTO over the past 40 years has included the development of waste forms for excess weapons plutonium immobilization in collaboration with the US and for impure plutonium residues in collaboration with the UK, as examples. With a waste loading of 40-50 wt.%, Synroc would also be considered a strong candidate as an engineered waste form for used nuclear fuel and highly

  9. Setting global research priorities for integrated community case management (iCCM: Results from a CHNRI (Child Health and Nutrition Research Initiative exercise

    Directory of Open Access Journals (Sweden)

    Kerri Wazny

    2014-11-01

    Full Text Available Aims: to systematically identify global research gaps and resource priorities for integrated community case management (iCCM. Methods: an iCCM Child Health and Nutrition Research Initiative (CHNRI Advisory Group, in collaboration with the Community Case Management Operational Research Group (CCM ORG identified experts to participate in a CHNRI research priority setting exercise. These experts generated and systematically ranked research questions for iCCM. Research questions were ranked using a “Research Priority Score” (RPS and the “Average Expert Agreement” (AEA was calculated for every question. Our groups of experts were comprised of both individuals working in Ministries of Health or Non Governmental Organizations (NGOs in low– and middle–income countries (LMICs and individuals working in high–income countries (HICs in academia or NGO headquarters. A Spearman's Rho was calculated to determine the correlation between the two groups' research questions' ranks. Results: The overall RPS ranged from 64.58 to 89.31, with a median score of 81.43. AEA scores ranged from 0.54 to 0.86. Research questions involving increasing the uptake of iCCM services, research questions concerning the motivation, retention, training and supervision of Community Health Workers (CHWs and concerning adding additional responsibilities including counselling for infant and young child feeding (IYCF and treatment of severe acute malnutrition (SAM ranked highly. There was weak to moderate, statistically significant, correlation between scores by representatives of high–income countries and those working in–country or regionally (Spearman's ρ = 0.35034, P < 0.01. Conclusions: Operational research to determine optimal training, supervision and modes of motivation and retention for the CHW is vital for improving iCCM, globally, as is research to motivate caregivers to take advantage of iCCM services. Experts working in–country or regionally in

  10. Nutrition during lactation

    National Research Council Canada - National Science Library

    Committee on Nutritional Status During Pregnancy and Lactation, Institute of Medicine

    On the basis of a comprehensive literature review and analysis, Nutrition During Lactation points out specific directions for needed research in understanding the relationship between the nutrition...

  11. Molecular tailoring approach for exploring structures, energetics and ...

    Indian Academy of Sciences (India)

    Administrator

    Keywords. Molecular clusters; linear scaling methods; molecular tailoring approach (MTA); Hartree– ..... energy decomposition analysis also performed and which clearly ... through molecular dynamics simulation furnished by. Takeguchi,. 46.

  12. Nutritional management after total laryngectomy

    African Journals Online (AJOL)

    28 September 2010 with a known diagnosis of cancer of the larynx. The patient, who underwent a total laryngectomy on 13 October, had a tracheostomy inserted .... status, leading to improved quality of life and better response to treatment.4.

  13. Clinical nutrition knowledge of gastroenterology fellows: is there anything omitted?

    Science.gov (United States)

    Eslamian, Ghazaleh; Jacobson, Kevan; Hekmatdoost, Azita

    2013-01-01

    Despite the increased emphasis on chronic non-communicable diseases, there are notable deficits about nutrition education in many medicine training programs particularly gastroenterology fellowship programs. In the present cross-sectional study, we examined the nutritional knowledge related to clinical nutrition among Iranian gastroenterology fellows. Thirty-six gastroenterology fellows currently enrolled in a gastroenterology fellowship program completed a questionnaire, including two sections. The first of which assessed the gastroenterology fellows experience about nutrition training, nutrition management of patients with gastrointestinal (GI) disorders and evaluating perceived nutrition education needs. The second section consisted of multiple choice questions that assessed nutritional knowledge. A total of 32 gastroenterology fellows completed the first section. The majority of gastroenterology fellows failed to partake in any nutrition education during their fellowship training particularly for inpatients despite the availability to participate in the nutrition training especially for the purpose of nutrition support. Mean correct response rates for the second section was 38%. The highest mean score was seen in nutrition assessment (48.1%), followed by scores of 40.5% in nutrition support, 37.0% nutrition in GI disease, and 25.0% in micro and macronutrients. Iranian gastroenterology fellows have serious deficits in their nutrition knowledge. This study paves the way for the development of an education program to improve nutritional knowledge of gastroenterology fellows.

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

    Science.gov (United States)

    Thorne, Frances; Baldwin, Christine

    2014-06-01

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

  15. Promoting a Culture of Tailoring for Systems Engineering Policy Expectations

    Science.gov (United States)

    Blankenship, Van A.

    2016-01-01

    NASA's Marshall Space Flight Center (MSFC) has developed an integrated systems engineering approach to promote a culture of tailoring for program and project policy requirements. MSFC's culture encourages and supports tailoring, with an emphasis on risk-based decision making, for enhanced affordability and efficiency. MSFC's policy structure integrates the various Agency requirements into a single, streamlined implementation approach which serves as a "one-stop-shop" for our programs and projects to follow. The engineers gain an enhanced understanding of policy and technical expectations, as well as lesson's learned from MSFC's history of spaceflight and science missions, to enable them to make appropriate, risk-based tailoring recommendations. The tailoring approach utilizes a standard methodology to classify projects into predefined levels using selected mission and programmatic scaling factors related to risk tolerance. Policy requirements are then selectively applied and tailored, with appropriate rationale, and approved by the governing authorities, to support risk-informed decisions to achieve the desired cost and schedule efficiencies. The policy is further augmented by implementation tools and lifecycle planning aids which help promote and support the cultural shift toward more tailoring. The MSFC Customization Tool is an integrated spreadsheet that ties together everything that projects need to understand, navigate, and tailor the policy. It helps them classify their project, understand the intent of the requirements, determine their tailoring approach, and document the necessary governance approvals. It also helps them plan for and conduct technical reviews throughout the lifecycle. Policy tailoring is thus established as a normal part of project execution, with the tools provided to facilitate and enable the tailoring process. MSFC's approach to changing the culture emphasizes risk-based tailoring of policy to achieve increased flexibility, efficiency

  16. Nutritional practices in full-day-care pre-schools.

    LENUS (Irish Health Repository)

    Jennings, A

    2011-06-01

    Full-day-care pre-schools contribute significantly to the nutritional intake and acquisition of dietary habits of the pre-school child. The present study investigated nutritional practices in full-day-care pre-schools in Dublin, Ireland, aiming to determine the nutritional support that pre-school managers deem necessary, thereby facilitating the amelioration of existing pre-school nutritional training and practices.

  17. Nutritional status, growth and disease management in children with single and dual diagnosis of type 1 diabetes mellitus and coeliac disease.

    Science.gov (United States)

    Mackinder, Mary; Allison, Gavin; Svolos, Vaios; Buchanan, Elaine; Johnston, Alison; Cardigan, Tracey; Laird, Nicola; Duncan, Hazel; Fraser, Karen; Edwards, Christine A; Craigie, Ian; McGrogan, Paraic; Gerasimidis, Konstantinos

    2014-05-28

    The consequences of subclinical coeliac disease (CD) in Type 1 diabetes mellitus (T1DM) remain unclear. We looked at growth, anthropometry and disease management in children with dual diagnosis (T1DM + CD) before and after CD diagnosis. Anthropometry, glycated haemoglobin (HbA1c) and IgA tissue transglutaminase (tTg) were collected prior to, and following CD diagnosis in 23 children with T1DM + CD. This group was matched for demographics, T1DM duration, age at CD diagnosis and at T1DM onset with 23 CD and 44 T1DM controls. No differences in growth or anthropometry were found between children with T1DM + CD and controls at any time point. Children with T1DM + CD, had higher BMI z-score two years prior to, than at CD diagnosis (p 1). BMI z-score change one year prior to CD diagnosis was lower in the T1DM + CD than the T1DM group (p = 0.009). At two years, height velocity and change in BMI z-scores were similar in all groups. No differences were observed in HbA1c between the T1DM + CD and T1DM groups before or after CD diagnosis. More children with T1DM + CD had raised tTg levels one year after CD diagnosis than CD controls (CDx to CDx + 1 yr; T1DM + CD: 100% to 71%, p = 0.180 and CD: 100% to 45%, p 1); by two years there was no difference. No major nutrition or growth deficits were observed in children with T1DM + CD. CD diagnosis does not impact on T1DM glycaemic control. CD specific serology was comparable to children with single CD, but those with dual diagnosis may need more time to adjust to gluten free diet.

  18. Human Motion Capture Data Tailored Transform Coding.

    Science.gov (United States)

    Junhui Hou; Lap-Pui Chau; Magnenat-Thalmann, Nadia; Ying He

    2015-07-01

    Human motion capture (mocap) is a widely used technique for digitalizing human movements. With growing usage, compressing mocap data has received increasing attention, since compact data size enables efficient storage and transmission. Our analysis shows that mocap data have some unique characteristics that distinguish themselves from images and videos. Therefore, directly borrowing image or video compression techniques, such as discrete cosine transform, does not work well. In this paper, we propose a novel mocap-tailored transform coding algorithm that takes advantage of these features. Our algorithm segments the input mocap sequences into clips, which are represented in 2D matrices. Then it computes a set of data-dependent orthogonal bases to transform the matrices to frequency domain, in which the transform coefficients have significantly less dependency. Finally, the compression is obtained by entropy coding of the quantized coefficients and the bases. Our method has low computational cost and can be easily extended to compress mocap databases. It also requires neither training nor complicated parameter setting. Experimental results demonstrate that the proposed scheme significantly outperforms state-of-the-art algorithms in terms of compression performance and speed.

  19. Tailorable software architectures in the accelerator control system environment

    International Nuclear Information System (INIS)

    Mejuev, Igor; Kumagai, Akira; Kadokura, Eiichi

    2001-01-01

    Tailoring is further evolution of an application after deployment in order to adapt it to requirements that were not accounted for in the original design. End-user tailorability has been extensively researched in applied computer science from HCl and software engineering perspectives. Tailorability allows coping with flexibility requirements, decreasing maintenance and development costs of software products. In general, dynamic or diverse software requirements constitute the need for implementing end-user tailorability in computer systems. In accelerator physics research the factor of dynamic requirements is especially important, due to frequent software and hardware modifications resulting in correspondingly high upgrade and maintenance costs. In this work we introduce the results of feasibility study on implementing end-user tailorability in the software for accelerator control system, considering the design and implementation of distributed monitoring application for 12 GeV KEK Proton Synchrotron as an example. The software prototypes used in this work are based on a generic tailoring platform (VEDICI), which allows decoupling of tailoring interfaces and runtime components. While representing a reusable application-independent framework, VEDICI can be potentially applied for tailoring of arbitrary compositional Web-based applications

  20. Deep drawing simulations of tailored blanks and experimental verification

    NARCIS (Netherlands)

    Meinders, Vincent T.; van den Berg, Albert; Huetink, Han

    2000-01-01

    Tailored Blanks are increasingly used in the automotive industry. A combination of different materials, thickness, and coatings can be welded together to form a blank for stamping car body panels. The main advantage of using Tailored Blanks is to have specific characteristics at particular parts of

  1. Tailoring self-assembled monolayers at the electrochemical interface

    Indian Academy of Sciences (India)

    Administrator

    (SAMs) for functionalisation with different receptors, catalytic materials, biomolecules, enzymes, anti- gen-antibody, etc for various applications. ... and tailoring of SAMs by incorporation of suitable recognition elements. ... compatible with most organic functional groups and ...... the interfacial architecture can be tailored using.

  2. SAP R/3 An IT-plague or the answer to the Tailors dream?

    DEFF Research Database (Denmark)

    Koch, Christian

    1999-01-01

    The IT-market of ERP-systems have significantly changed over the last 10 years. At least in Denmark manufacturing enterprises used to close "partner like" collaboration with their IT-supplier, now face mass produced packaged software. This challenges the skills of technology managers, can they cope...... with the IT-plague, do they suffer from the "power of default",i.e. the use of standard settings of parameters?- or can they tailor anything to anybody?...

  3. Universal versus tailored solutions for alleviating disruptive behavior in hospitals.

    Science.gov (United States)

    Berman-Kishony, Talia; Shvarts, Shifra

    2015-01-01

    Disruptive behavior among hospital staff can negatively affect quality of care. Motivated by a standard on disruptive behavior issued by The Joint Commission (LD 3.10), as well as the desire to improve patient care, minimize liability, and improve staff retention, hospitals are setting policies to prevent and resolve disruptive behaviors. However, it is unknown whether uniform conflict management tools are equally effective among different hospital settings. We surveyed residents and nurses to identify similarities and differences among hospital departments in the antecedents, characteristics, and outcomes of disruptive behaviors, and in the effectiveness of conflict management tools. We used a quantitative questionnaire-based assessment to examine conflict perceptions in eight different hospital departments at Rambam Medical Center in Haifa, Israel. Most participants (89 %) reported witnessing disruptive behavior either directly or in other parties; the most significant causes were identified as intense work, miscommunication, and problematic personalities. The forms of these behaviors, however, varied significantly between departments, with some more prone to expressed conflicts, while others were characterized by hidden disruptive behaviors. These outcomes were correlated by the antecedents to disruptive behavior, which in turn affected the effectiveness of alleviating strategies and tools. Some tools, such as processes for evaluating complaints, teamwork and conflict management courses, and introducing a behavioral mission statement, are effective across many antecedents. Other tools, however, are antecedent-specific, falling into two principal categories: tools directly removing a specific problem and tools that offer a way to circumvent the problem. Conflict resolution tools and strategies, based on residents and nurse perceptions, may be more effective if tailored to the specific situation, rather than using a "one-size-fits-all" approach.

  4. Does tailoring really make a difference? : the development and evaluation of tailored interventions aimed at benzodiazepine cessation

    NARCIS (Netherlands)

    Wolde, Geeske Brecht ten

    2008-01-01

    Because of the problems associated with chronic benzodiazepine use, there is impetus to prevent and reduce chronic benzodiazepine use. The overall aim was to develop a 'tailor-made' intervention in order to reduce chronic use. Before developing tailored patient education, it is first of all

  5. [Nutrition in inflammatory bowel disease].

    Science.gov (United States)

    Banai, János

    2009-05-03

    Aetiology of inflammatory bowel disease (IBD) is complex and probably multifactorial. Nutrition has been proposed to be an important aetiological factor for development of IBD. Several components of the diet (such as sugar, fat, fibre, fruit and vegetable, protein, fast food, preservatives etc.) were examined as possible causative agents for IBD. According to some researchers infant feeding (breast feeding) may also contribute to the development of IBD. Though the importance of environmental factors is evidenced by the increasing incidence in developed countries and in migrant population in recent decades, the aetiology of IBD remained unclear. There are many theories, but as yet no dietary approaches have been proved to reduce the risk of developing IBD. The role of nutrition in the management of IBD is better understood. The prevention and correction of malnutrition, the provision of macro- and micronutrients and vitamins and the promotion of optimal growth and development of children are key points of nutritional therapy. In active disease, the effective support of energy and nutrients is a very important part of the therapy. Natural and artificial nutrition or the combination of two can be chosen for supporting therapy of IBD. The author summarises the aetiological and therapeutic role of nutrition in IBD.

  6. Aging, Nutritional Status and Health

    Directory of Open Access Journals (Sweden)

    Wilma Leslie

    2015-07-01

    Full Text Available The older population is increasing worldwide and in many countries older people will outnumber younger people in the near future. This projected growth in the older population has the potential to place significant burdens on healthcare and support services. Meeting the diet and nutrition needs of older people is therefore crucial for the maintenance of health, functional independence and quality of life. While many older adults remain healthy and eat well those in poorer health may experience difficulties in meeting their nutritional needs. Malnutrition, encompassing both under and over nutrition increases health risks in the older population. More recently the increase in obesity, and in turn the incidence of chronic disease in older adults, now justifies weight management interventions in obese older adults. This growing population group is becoming increasingly diverse in their nutritional requirements. Micro-nutrient status may fluctuate and shortfalls in vitamin D, iron and a number of other nutrients are relatively common and can impact on well-being and quality of life. Aging presents a number of challenges for the maintenance of good nutritional health in older adults.

  7. Inflammatory bowel diseases: principles of nutritional therapy

    Directory of Open Access Journals (Sweden)

    Campos Fábio Guilherme

    2002-01-01

    Full Text Available Inflammatory Bowel Diseases - ulcerative colitis and Crohn's disease- are chronic gastrointestinal inflammatory diseases of unknown etiology. Decreased oral intake, malabsorption, accelerated nutrient losses, increased requirements, and drug-nutrient interactions cause nutritional and functional deficiencies that require proper correction by nutritional therapy. The goals of the different forms of nutritional therapy are to correct nutritional disturbances and to modulate inflammatory response, thus influencing disease activity. Total parenteral nutrition has been used to correct and to prevent nutritional disturbances and to promote bowel rest during active disease, mainly in cases of digestive fistulae with high output. Its use should be reserved for patients who cannot tolerate enteral nutrition. Enteral nutrition is effective in inducing clinical remission in adults and promoting growth in children. Due to its low complication rate and lower costs, enteral nutrition should be preferred over total parenteral nutrition whenever possible. Both present equal effectiveness in primary therapy for remission of active Crohn's disease. Nutritional intervention may improve outcome in certain individuals; however, because of the costs and complications of such therapy, careful selection is warranted, especially in patients presumed to need total parenteral nutrition. Recent research has focused on the use of nutrients as primary treatment agents. Immunonutrition is an important therapeutic alternative in the management of inflammatory bowel diseases, modulating the inflammation and changing the eicosanoid synthesis profile. However, beneficial reported effects have yet to be translated into the clinical practice. The real efficacy of these and other nutrients (glutamine, short-chain fatty acids, antioxidants still need further evaluation through prospective and randomized trials.

  8. Ceramic laminates with tailored residual stresses

    Directory of Open Access Journals (Sweden)

    Baudín, C.

    2009-12-01

    Full Text Available Severe environments imposed by new technologies demand new materials with better properties and ensured reliability. The intrinsic brittleness of ceramics has forced scientists to look for new materials and processing routes to improve the mechanical behaviour of ceramics in order to allow their use under severe thermomechanical conditions. The laminate approach has allowed the fabrication of a new family of composite materials with strength and reliability superior to those of monolithic ceramics with microstructures similar to those of the constituent layers. The different ceramic laminates developed since the middle 1970´s can be divided in two large groups depending on whether the development of residual stresses between layers is the main design tool. This paper reviews the developments in the control and tailoring of residual stresses in ceramic laminates. The tailoring of the thickness and location of layers in compression can lead to extremely performing structures in terms of strength values and reliability. External layers in compression lead to the strengthening of the structure. When relatively thin and highly compressed layers are located inside the material, threshold strength, crack bifurcation and crack arrest during fracture occur.

    Las severas condiciones de trabajo de las nuevas aplicaciones tecnológicas exigen el uso de materiales con mejores propiedades y alta fiabilidad. La potencialidad de uso de materiales frágiles, como los cerámicos, en estas aplicaciones exige el desarrollo de nuevos materiales y métodos de procesamiento que mejoren su comportamiento mecánico. El concepto de material laminado ha permitido la fabricación de una nueva familia de materiales con tensiones de fractura y fiabilidad superiores a las de materiales monolíticos con microestructuras similares a las de las láminas que conforman el laminado. Los distintos materiales laminados desarrollados desde mediados de los años 70 se pueden

  9. Thin tailored composite wing for civil tiltrotor

    Science.gov (United States)

    Rais-Rohani, Masoud

    1994-01-01

    The tiltrotor aircraft is a flight vehicle which combines the efficient low speed (i.e., take-off, landing, and hover) characteristics of a helicopter with the efficient cruise speed of a turboprop airplane. A well-known example of such vehicle is the Bell-Boeing V-22 Osprey. The high cruise speed and range constraints placed on the civil tiltrotor require a relatively thin wing to increase the drag-divergence Mach number which translates into lower compressibility drag. It is required to reduce the wing maximum thickness-to-chord ratio t/c from 23% (i.e., V-22 wing) to 18%. While a reduction in wing thickness results in improved aerodynamic efficiency, it has an adverse effect on the wing structure and it tends to reduce structural stiffness. If ignored, the reduction in wing stiffness leads to susceptibility to aeroelastic and dynamic instabilities which may consequently cause a catastrophic failure. By taking advantage of the directional stiffness characteristics of composite materials the wing structure may be tailored to have the necessary stiffness, at a lower thickness, while keeping the weight low. The goal of this study is to design a wing structure for minimum weight subject to structural, dynamic and aeroelastic constraints. The structural constraints are in terms of strength and buckling allowables. The dynamic constraints are in terms of wing natural frequencies in vertical and horizontal bending and torsion. The aeroelastic constraints are in terms of frequency placement of the wing structure relative to those of the rotor system. The wing-rotor-pylon aeroelastic and dynamic interactions are limited in this design study by holding the cruise speed, rotor-pylon system, and wing geometric attributes fixed. To assure that the wing-rotor stability margins are maintained a more rigorous analysis based on a detailed model of the rotor system will need to ensue following the design study. The skin-stringer-rib type architecture is used for the wing

  10. Tailoring magnetism by light-ion irradiation

    International Nuclear Information System (INIS)

    Fassbender, J; Ravelosona, D; Samson, Y

    2004-01-01

    Owing to their reduced dimensions, the magnetic properties of ultrathin magnetic films and multilayers, e.g. magnetic anisotropies and exchange coupling, often depend strongly on the surface and interface structure. In addition, chemical composition, crystallinity, grain sizes and their distribution govern the magnetic behaviour. All these structural properties can be modified by light-ion irradiation in an energy range of 5-150 keV due to the energy loss of the ions in the solid along their trajectory. Consequently the magnetic properties can be tailored by ion irradiation. Similar effects can also be observed using Ga + ion irradiation, which is the common ion source in focused ion beam lithography. Examples of ion-induced modifications of magnetic anisotropies and exchange coupling are presented. This review is limited to radiation-induced structural changes giving rise to a modification of magnetic parameters. Ion implantation is discussed only in special cases. Due to the local nature of the interaction, magnetic patterning without affecting the surface topography becomes feasible, which may be of interest in applications. The main patterning technique is homogeneous ion irradiation through masks. Focused ion beam and ion projection lithography are usually only relevant for larger ion masses. The creation of magnetic feature sizes below 50 nm is shown. In contrast to topographic nanostructures the surrounding area of these nanostructures can be left ferromagnetic, leading to new phenomena at their mutual interface. Most of the material systems discussed here are important for technological applications. The main areas are magnetic data storage applications, such as hard magnetic media with a large perpendicular magnetic anisotropy or patterned media with an improved signal to noise ratio and magnetic sensor elements. It will be shown that light-ion irradiation has many advantages in the design of new material properties and in the fabrication technology of

  11. Nutrition Tailored to the Individual Not Just Yet; Realigning Nutrigenomic Science with Contemporary Society

    NARCIS (Netherlands)

    Vrieze, de J.; Bouwman, L.I.; Komduur, R.H.; Pin, R.; Ronteltap, A.; Vandebergh, R.; Dam, van Frans; Penders, B.

    2009-01-01

    About a decade ago, scientists and science journalists presented nutrigenomics as a grand promise that each of us would soon know which foods fit in our personal healthy diet. Meanwhile, expectations have been adjusted to fit a changed reality. Simultaneously, societal issues surrounding

  12. Bariatric Surgery and Precision Nutrition.

    Science.gov (United States)

    Nicoletti, Carolina F; Cortes-Oliveira, Cristiana; Pinhel, Marcela A S; Nonino, Carla B

    2017-09-06

    This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient's genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance.

  13. Bariatric Surgery and Precision Nutrition

    Directory of Open Access Journals (Sweden)

    Carolina F. Nicoletti

    2017-09-01

    Full Text Available This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient’s genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance.

  14. Bariatric Surgery and Precision Nutrition

    Science.gov (United States)

    Nicoletti, Carolina F.; Cortes-Oliveira, Cristiana; Pinhel, Marcela A. S.; Nonino, Carla B.

    2017-01-01

    This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient’s genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance. PMID:28878180

  15. [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.

  16. Automatically producing tailored web materials for public administration

    Science.gov (United States)

    Colineau, Nathalie; Paris, Cécile; Vander Linden, Keith

    2013-06-01

    Public administration organizations commonly produce citizen-focused, informational materials describing public programs and the conditions under which citizens or citizen groups are eligible for these programs. The organizations write these materials for generic audiences because of the excessive human resource costs that would be required to produce personalized materials for everyone. Unfortunately, generic materials tend to be longer and harder to understand than materials tailored for particular citizens. Our work explores the feasibility and effectiveness of automatically producing tailored materials. We have developed an adaptive hypermedia application system that automatically produces tailored informational materials and have evaluated it in a series of studies. The studies demonstrate that: (1) subjects prefer tailored materials over generic materials, even if the tailoring requires answering a set of demographic questions first; (2) tailored materials are more effective at supporting subjects in their task of learning about public programs; and (3) the time required to specify the demographic information on which the tailoring is based does not significantly slow down the subjects in their information seeking task.

  17. Tailoring Thermal Radiative Properties with Doped-Silicon Nanowires

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Zhuomin [Georgia Inst. of Technology, Atlanta, GA (United States)

    2017-08-28

    Aligned doped-silicon nanowire (D-SiNW) arrays form a hyperbolic metamaterial in the mid-infrared and have unique thermal radiative properties, such as broadband omnidirectional absorption, low-loss negative refraction, etc. A combined theoretical and experimental investigation will be performed to characterize D-SiNW arrays and other metamaterials for tailoring thermal radiative properties. Near-field thermal radiation between anisotropic materials with hyperbolic dispersions will also be predicted for potential application in energy harvesting. A new kind of anisotropic metamaterial with a hyperbolic dispersion in a broad infrared region has been proposed and demonstrated based on aligned doped-silicon nanowire (D-SiNW) arrays. D-SiNW-based metamaterials have unique thermal radiative properties, such as broadband omnidirectional absorption whose width and location can be tuned by varying the filling ratio and/or doping level. Furthermore, high figure of merit (FOM) can be achieved in a wide spectral region, suggesting that D-SiNW arrays may be used as a negative refraction material with much less loss than other structured materials, such as layered semiconductor materials. We have also shown that D-SiNWs and other nanostructures can significantly enhance near-field thermal radiation. The study of near-field radiative heat transfer between closely spaced objects and the electromagnetic wave interactions with micro/nanostructured materials has become an emerging multidisciplinary field due to its importance in advanced energy systems, manufacturing, local thermal management, and high spatial resolution thermal sensing and mapping. We have performed extensive study on the energy streamlines involving anisotropic metamaterials and the applicability of the effective medium theory for near-field thermal radiation. Graphene as a 2D material has attracted great attention in nanoelectronics, plasmonics, and energy harvesting. We have shown that graphene can be used to

  18. Nutrition therapy issues in esophageal cancer.

    Science.gov (United States)

    Miller, Keith R; Bozeman, Matthew C

    2012-08-01

    Esophageal cancer has traditionally been a disease with poor long term outcomes in terms of both survival and quality of life. In combination with surgical and pharmacologic therapy, nutrition support has been demonstrated to improve patient tolerance of treatment, quality of life, and longterm outcomes. An aggressive multi-disciplinary approach is warranted with nutrition support remaining a cornerstone in management. Historically, nutrition support has focused on adequate caloric provision to prevent weight loss and allow for tolerance of treatment regimens. Alterations in metabolism occur in these patients making their use of available calories inefficient and the future of nutritional support may lie in the ability to alter this deranged metabolism. The purpose of this article is to review the current literature surrounding the etiology, treatment, and role of nutrition support in improving outcomes in esophageal cancer.

  19. Clinical nutrition in the hepatogastroenterology curriculum

    DEFF Research Database (Denmark)

    Mulder, Chris J J; Wanten, Geert J A; Semrad, Carol E

    2016-01-01

    of Gastroenterology and Hepatology has defined specific expertise areas in Advanced endoscopy, hepatology, digestive oncology and clinical nutrition, training for the latter topic is lacking in the current hepatogastroenterology (HGE) curriculum. Given its relevance for HGE practice, and being at the core...... of gastrointestinal functioning, there is an obvious need for training in nutrition and related issues including the treatment of disease-related malnutrition and obesity and its associated metabolic derangements. This document aims to be a starting point for the integration of nutritional expertise in the HGE...... curriculum, allowing a central role in the management of malnutrition and obesity. We suggest minimum endpoints for nutritional knowledge and expertise in the standard curriculum and recommend a focus period of training in nutrition issues in order to produce well-trained HGE specialists. This article...

  20. Nutrition in Patients with Gastric Cancer: An Update.

    Science.gov (United States)

    Rosania, Rosa; Chiapponi, Costanza; Malfertheiner, Peter; Venerito, Marino

    2016-05-01

    Nutritional management of patients with gastric cancer (GC) represents a challenge. This review provides an overview of the present evidence on nutritional support in patients with GC undergoing surgery as well as in those with advanced disease. For patients undergoing surgery, the preoperative nutritional condition directly affects postoperative prognosis, overall survival and disease-specific survival. Perioperative nutritional support enriched with immune-stimulating nutrients reduces overall complications and hospital stay but not mortality after major elective gastrointestinal surgery. Early enteral nutrition after surgery improves early and long-term postoperative nutritional status and reduces the length of hospitalization as well. Vitamin B12 and iron deficiency are common metabolic sequelae after gastrectomy and warrant appropriate replacement. In malnourished patients with advanced GC, short-term home complementary parenteral nutrition improves the quality of life, nutritional status and functional status. Total home parenteral nutrition represents the only modality of caloric intake for patients with advanced GC who are unable to take oral or enteral nutrition. Early evaluations of nutritional status and nutritional support represent key aspects in the management of GC patients with both operable and advanced disease.

  1. Management of pharynx fistula after upper digestive tract instrumentation

    Directory of Open Access Journals (Sweden)

    Bogdan Popescu

    2017-05-01

    Full Text Available Pharynx fistula is a pathological state that can pose serious problems for both physician and patient and can lead up to the death of the patient in complicated cases. The authors describe a series of guidelines for the management of the pharynx fistula regarding the complications of the instrumentation of the upper digestive tract. Most of the cases that are addressed to our clinic can be treated with a conservative approach and a nutrition therapy plan tailored to each case. In selected cases surgery is the method of choice for therapy. The management of the pharynx fistula can be well managed in a multidisciplinary approach using resources from the E.N.T. and H.N.S. department and more important from the ICU department.

  2. socio-economic determinants of nutritional status of women

    African Journals Online (AJOL)

    mr

    7. SOCIO-ECONOMIC DETERMINANTS OF NUTRITIONAL STATUS OF ... 90% of domestic responsibilities and are national resource managers and environmental ..... Education exposes one to better ways of managing resources and doing ... human nutrition basics, as well as rules for healthy eating. ... Second Edition.

  3. Peritoneal Dialysis Tailored to Pediatric Needs

    Directory of Open Access Journals (Sweden)

    C. P. Schmitt

    2011-01-01

    Full Text Available Consideration of specific pediatric aspects is essential to achieve adequate peritoneal dialysis (PD treatment in children. These are first of all the rapid growth, in particular during infancy and puberty, which must be accompanied by a positive calcium balance, and the age dependent changes in body composition. The high total body water content and the high ultrafiltration rates required in anuric infants for adequate nutrition predispose to overshooting convective sodium losses and severe hypotension. Tissue fragility and rapid increases in intraabdominal fat mass predispose to hernia and dialysate leaks. Peritoneal equilibration tests should repeatedly been performed to optimize individual dwell time. Intraperitoneal pressure measurements give an objective measure of intraperitoneal filling, which allow for an optimized dwell volume, that is, increased dialysis efficiency without increasing the risk of hernias, leaks, and retrofiltration. We present the concept of adapted PD, that is, the combination of short dwells with low fill volume to promote ultrafiltration and long dwells with a high fill volume to improve purification within one PD session. The use of PD solutions with low glucose degradation product content is recommended in children, but unfortunately still not feasible in many countries.

  4. Semiconductor quantum optics with tailored photonic nanostructures

    International Nuclear Information System (INIS)

    Laucht, Arne

    2011-01-01

    the understanding of coupling phenomena between excitons in self-assembled quantum dots and optical modes of tailored photonic nanostructures realized on the basis of two-dimensional photonic crystals. While we highlight the potential for advanced applications in the direction of quantum optics and quantum computation, we also identify some of the challenges which will need to be overcome on the way. (orig.)

  5. [Tailored cranioplasty using CAD-CAM technology].

    Science.gov (United States)

    Vitanovics, Dusán; Major, Ottó; Lovas, László; Banczerowski, Péter

    2014-11-30

    The majority of cranial defects are results of surgical intervention. The defect must be covered within resonable period of time usually after 4-6 week given the fact that the replacement of bone improve the brain circulation. Number of surgical techniques and materials are available to perform cranioplasty. Due to favorable properties we chosed ultra high molecular weight polyethylene as material. In this paper the authors show a procedure which allows tailored artificial bone replacement using state of art medical and engineering techniques. between 2004 and 2012, 19 patients were operated on cranial bone defect and a total of 22 3D custom-designed implants were implanted. The average age of patients was 35.4 years. In 12 patients we performed primary cranioplasty, while seven patients had the replacement at least once. Later the implants had to be removed due to infection or other causes (bone necrosis, fracture). All patients had native and bone-windowed 1 mm resolution CT. The 3D design was made using the original CT images and with design program. Computer controlled lathe was used to prepare a precise-fitting model. During surgery, the defect was exposed and the implant was fixed to normal bone using mini titanium plates and screws. All of our patients had control CT at 3, 6 and 12 months after surgery and at the same time neurological examination. Twenty-one polyethylene and one titanium implants were inserted. The average follow-up of the patients was 21.5 months, ranged from two to 96 months. We follow 12 patients (63.15%) more than one year. No intraoperative implant modifications had to be made. Each of the 22 implant exactly matched the bone defect proved by CT scan. No one of our patients reported aesthetic problems and we did not notice any kind of aesthetic complication. We had short term complication in three cases due to cranioplasty, subdural, epidural haemorrhage and skin defect. Polyethylene is in all respects suitable for primary and secondary

  6. Semiconductor quantum optics with tailored photonic nanostructures

    Energy Technology Data Exchange (ETDEWEB)

    Laucht, Arne

    2011-06-15

    single photon emission into the waveguide. The results obtained during the course of this thesis contribute significantly to the understanding of coupling phenomena between excitons in self-assembled quantum dots and optical modes of tailored photonic nanostructures realized on the basis of two-dimensional photonic crystals. While we highlight the potential for advanced applications in the direction of quantum optics and quantum computation, we also identify some of the challenges which will need to be overcome on the way. (orig.)

  7. Tailored Materials for High Efficiency CIDI Engines

    Energy Technology Data Exchange (ETDEWEB)

    Grant, G.J.; Jana, S.

    2012-03-30

    The overall goal of the project, Tailored Materials for High Efficiency Compression Ignition Direct Injection (CIDI) Engines, is to enable the implementation of new combustion strategies, such as homogeneous charge compression ignition (HCCI), that have the potential to significantly increase the energy efficiency of current diesel engines and decrease fuel consumption and environmental emissions. These strategies, however, are increasing the demands on conventional engine materials, either from increases in peak cylinder pressure (PCP) or from increases in the temperature of operation. The specific objective of this project is to investigate the application of a new material processing technology, friction stir processing (FSP), to improve the thermal and mechanical properties of engine components. The concept is to modify the surfaces of conventional, low-cost engine materials. The project focused primarily on FSP in aluminum materials that are compositional analogs to the typical piston and head alloys seen in small- to mid-sized CIDI engines. Investigations have been primarily of two types over the duration of this project: (1) FSP of a cast hypoeutectic Al-Si-Mg (A356/357) alloy with no introduction of any new components, and (2) FSP of Al-Cu-Ni alloys (Alloy 339) by physically stirring-in various quantities of carbon nanotubes/nanofibers or carbon fibers. Experimental work to date on aluminum systems has shown significant increases in fatigue lifetime and stress-level performance in aluminum-silicon alloys using friction processing alone, but work to demonstrate the addition of carbon nanotubes and fibers into aluminum substrates has shown mixed results due primarily to the difficulty in achieving porosity-free, homogeneous distributions of the particulate. A limited effort to understand the effects of FSP on steel materials was also undertaken during the course of this project. Processed regions were created in high-strength, low-alloyed steels up to 0.5 in

  8. Nutrition knowledge and nutritional status of primary school children ...

    African Journals Online (AJOL)

    2010-01-04

    Jan 4, 2010 ... b Research Fellow, CSL, Vaal University of Technology, South Africa ... Keywords: primary school children; nutrition knowledge; nutritional status. Nutrition ... research on basic nutrition education focusing on adolescents has.

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

    Science.gov (United States)

    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.

  10. 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.

  11. Optimising preterm nutrition: present and future

    LENUS (Irish Health Repository)

    Brennan, Ann-Marie

    2016-04-01

    The goal of preterm nutrition in achieving growth and body composition approximating that of the fetus of the same postmenstrual age is difficult to achieve. Current nutrition recommendations depend largely on expert opinion, due to lack of evidence, and are primarily birth weight based, with no consideration given to gestational age and\\/or need for catch-up growth. Assessment of growth is based predominately on anthropometry, which gives insufficient attention to the quality of growth. The present paper provides a review of the current literature on the nutritional management and assessment of growth in preterm infants. It explores several approaches that may be required to optimise nutrient intakes in preterm infants, such as personalising nutritional support, collection of nutrient intake data in real-time, and measurement of body composition. In clinical practice, the response to inappropriate nutrient intakes is delayed as the effects of under- or overnutrition are not immediate, and there is limited nutritional feedback at the cot-side. The accurate and non-invasive measurement of infant body composition, assessed by means of air displacement plethysmography, has been shown to be useful in assessing quality of growth. The development and implementation of personalised, responsive nutritional management of preterm infants, utilising real-time nutrient intake data collection, with ongoing nutritional assessments that include measurement of body composition is required to help meet the individual needs of preterm infants.

  12. Can Deterrence Be Tailored? Strategic Forum, Number 225, January 2007

    National Research Council Canada - National Science Library

    Bunn, M. E

    2007-01-01

    .... The Bush administration has outlined a concept for tailored deterrence to address the distinctive challenges posed by advanced military competitors, regional powers armed with weapons of mass destruction (WMD...

  13. Microbial production of polyhydroxybutyrate with tailor-made properties: an integrated modelling approach and experimental validation.

    Science.gov (United States)

    Penloglou, Giannis; Chatzidoukas, Christos; Kiparissides, Costas

    2012-01-01

    The microbial production of polyhydroxybutyrate (PHB) is a complex process in which the final quantity and quality of the PHB depend on a large number of process operating variables. Consequently, the design and optimal dynamic operation of a microbial process for the efficient production of PHB with tailor-made molecular properties is an extremely interesting problem. The present study investigates how key process operating variables (i.e., nutritional and aeration conditions) affect the biomass production rate and the PHB accumulation in the cells and its associated molecular weight distribution. A combined metabolic/polymerization/macroscopic modelling approach, relating the process performance and product quality with the process variables, was developed and validated using an extensive series of experiments and measurements. The model predicts the dynamic evolution of the biomass growth, the polymer accumulation, the consumption of carbon and nitrogen sources and the average molecular weights of the PHB in a bioreactor, under batch and fed-batch operating conditions. The proposed integrated model was used for the model-based optimization of the production of PHB with tailor-made molecular properties in Azohydromonas lata bacteria. The process optimization led to a high intracellular PHB accumulation (up to 95% g of PHB per g of DCW) and the production of different grades (i.e., different molecular weight distributions) of PHB. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Avoiding a knowledge gap in a multiethnic statewide social marketing campaign: is cultural tailoring sufficient?

    Science.gov (United States)

    Buchthal, O Vanessa; Doff, Amy L; Hsu, Laura A; Silbanuz, Alice; Heinrich, Katie M; Maddock, Jay E

    2011-03-01

    In 2007, the State of Hawaii, Healthy Hawaii Initiative conducted a statewide social-marketing campaign promoting increased physical activity and nutrition. The campaign included substantial formative research to develop messages tailored for Hawaii's multiethnic Asian and Pacific Islander populations. The authors conducted a statewide random digital dialing telephone survey to assess the campaign's comparative reach among individuals with different ethnicities and different levels of education and income. This analysis suggests that the intervention was successful in reaching its target ethnic audiences. However, a knowledge gap related to the campaign appeared among individuals with incomes less than 130% of the poverty level and those with less than a high school education. These results varied significantly by message and the communication channel used. Recall of supermarket-based messages was significantly higher among individuals below 130% of the poverty level and those between 18 and 35 years of age, 2 groups that showed consistently lower recall of messages in other channels. Results suggest that cultural tailoring for ethnic audiences, although important, is insufficient for reaching low-income populations, and that broad-based social marketing campaigns should consider addressing socioeconomic status-related channel preferences in formative research and campaign design.

  15. Age- and sex-tailored serum phosphate thresholds do not improve cardiovascular risk estimation in CKD.

    Science.gov (United States)

    Ferraro, Pietro Manuel; Bonello, Monica; Gambaro, Alessia; Sturniolo, Antonio; Gambaro, Giovanni

    2011-01-01

    Disordered metabolism of phosphorus is one of the hallmarks of chronic kidney disease (CKD), resulting in increased cardiovascular morbidity and mortality. Age and sex may affect the metabolism of phosphorus and subsequently its serum level. We evaluated if age- and sex-specific cutoffs for hyperphosphatemia may define cardiovascular risk better than the current guideline cutoffs. We used data from 16,834 subjects participating in the 1999-2006 National Health and Nutrition Examination Survey (NHANES); the prevalence of self-reported cardiovascular disease (CVD) and mortality rates were analyzed in CKD patients for both the classic definitions (CH; i.e., NKF-KDOQI and K-DIGO) and a tailored definition (TH) of hyperphosphatemia by means of regression models adjusted for age, sex, race/ethnicity, smoking status and body mass index. The cutoffs for TH were represented by the 95th percentile of an age- and sex-matched non-CKD population. Serum phosphorus levels showed an inverse correlation with age (r = -0.12; pdefinition and CVD was marginally better compared with the CH definition (odds ratio [OR] = 1.49, 95% confidence interval [95% CI], 1.04-2.13; p=0.030 vs. OR=1.55, 95% CI, 0.98-2.44; p = 0.059), the TH model was not superior in predicting CVD or mortality. Our data suggest that a tailored, age- and sex-specific definition of hyperphosphatemia is not superior to conventional definitions in predicting cardiovascular events in patients with CKD.

  16. Tailoring rice flour structure by rubbery milling for improved gluten-free baked goods.

    Science.gov (United States)

    Brütsch, Linda; Tribolet, Liliane; Isabettini, Stéphane; Soltermann, Patrick; Baumann, Andreas; Windhab, Erich J

    2018-05-10

    Ever-growing demand for gluten-free products calls for the development of novel food processing techniques to widen the range of existing baked goods. Extensive research has been targeted towards recipe optimization, widely neglecting the tailoring potential of process-induced structuring of gluten-free raw materials. Herein, we address this shortcoming by demonstrating the potential of rubbery milling for the generation of structure and techno-functionality in breads obtained from a variety of rice flour types. Moisture and temperature induced state transitions during milling were exploited to tailor the physicochemical properties of the flour. Moisture addition during conditioning of the different rice varieties and milling in the rubbery state considerably decreased starch damage due to more gentle disintegration. The degree of starch damage dictated the water absorption capacity of the rice flour types. Flour types with reduced starch damage upon milling offered lower dough densities, yielding bread loafs with a higher volume and better appearance. The choice of rice variety enables fine-tuning of the final product quality by influencing the dough viscoelasticity, which defines the final loaf volume. Whole grain rice flour dramatically increased the loaf volume, whilst simultaneously offering nutritional benefits. Combining the proposed functionalised flour types with current and future advances in product recipes paves the way towards optimised gluten-free goods.

  17. Effects of tailoring ingredients in auditory persuasive health messages on fruit and vegetable intake

    NARCIS (Netherlands)

    Elbert, Sarah P.; Dijkstra, Arie; Rozema, Andrea

    2017-01-01

    Objective: Health messages can be tailored by applying different tailoring ingredients, among which personalisation, feedback and adaptation. This experiment investigated the separate effects of these tailoring ingredients on behaviour in auditory health persuasion. Furthermore, the moderating

  18. Nutrition and athletic performance

    Science.gov (United States)

    Exercise - nutrition; Exercise - fluids; Exercise - hydration ... Bird R. Nutrition. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; ...

  19. Nutrition and OI

    Science.gov (United States)

    Nutrition and OI Introduction To promote bone development and optimal health, children and adults with osteogenesis imperfecta ( ... no foods or supplements that will cure OI. Nutrition Related Problems Difficulties eating solid food have been ...

  20. Nutrition.gov

    Science.gov (United States)

    ... Gov Sites FAQ Contact Us En Español Search Nutrition.Gov Search all USDA Advanced Search Browse by ... FAQs USDA Research, Education, and Economics Resources Welcome Nutrition.gov is a USDA-sponsored website that offers ...

  1. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  2. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  3. Living with COPD: Nutrition

    Science.gov (United States)

    ... Diseases > Lung Disease Lookup > COPD > Living With COPD Nutrition and COPD Most people are surprised to learn ... asking your doctor or visiting the Academy of Nutrition and Dietetics at EatRight.org . Be sure to ...

  4. Cooking utensils and nutrition

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002461.htm Cooking utensils and nutrition To use the sharing features on this page, please enable JavaScript. Cooking utensils can have an effect on your nutrition. ...

  5. Nutrition and Myasthenia Gravis

    Science.gov (United States)

    Good nutrition is important for everyone. This is especially true when you have a chronic disorder like myasthenia gravis ( ... difficulty with chewing and swallowing may interfere with nutrition and create safety issues. Diet modifications may be ...

  6. Stroke Prevention & Treatment: Diet & Nutrition

    Science.gov (United States)

    ... Prevention & Treatment: Diet & Nutrition Stroke Prevention & Treatment: Diet & Nutrition A healthy diet can reduce your risk for ... Treatment How does a stroke affect eating and nutrition? Stroke can devastate a person's nutritional health because ...

  7. 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....

  8. Tailoring of EIA-649-1: Definition of Major (Class I) Engineering Change Proposal

    Science.gov (United States)

    2015-05-15

    MISSILE SYSTEMS CENTER TAILORING TAILORING OF EIA -649-1: DEFINITION OF MAJOR (CLASS I) ENGINEERING CHANGE PROPOSAL APPROVED FOR...PUBLIC RELEASE; DISTRIBUTION IS UNLIMITED 1 Tailoring of EIA -649-1: Definition of Major (Class I) ECP. 1. Intent of this Tailoring Document...This tailoring document remedies a requirements gap in the industry consensus standard, EIA -649-1: 2015. Specifically, this tailoring provides a

  9. Diet and Nutrition

    Science.gov (United States)

    ... Stories Español Eye Health / Tips & Prevention Food and Nutrition Sections Diet and Nutrition Can Fish Oil Help ... Cataract Prevention in the Produce Aisle Diet and Nutrition Leer en Español: Dieta y nutrición May. 24, ...

  10. Nutrition Guide for Toddlers

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Nutrition Guide for Toddlers KidsHealth / For Parents / Nutrition Guide ... español Guía de nutrición para sus hijos pequeños Nutrition Through Variety Growth slows somewhat during the toddler ...

  11. Public Health Nutrition Education

    DEFF Research Database (Denmark)

    Torheim, Liv Elin; Birgisdottir, Bryndis Eva; Robertson, Aileen

    2016-01-01

    , Oslo, Norway, 2Unit for Nutrition Research, Landspitali University Hospital , 3Department of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland, 4Global Nutrition and Health, Metropolitan University College, Copenhagen, Denmark, 5School of Hospitality, culinary arts and meal science...

  12. Nutrition for Sport Success.

    Science.gov (United States)

    Nutrition Foundation, Inc., Washington, DC.

    This guidebook presents basic facts about nutrition, focusing upon the nutritional needs of athletes. Information is given on: (1) the importance of water, salt and other electrolytes, and treating and preventing heat disorders; (2) nutrition for training and performance, the best diet, caloric and energy requirements for various and specific…

  13. Tailoring hospital marketing efforts to physicians' needs.

    Science.gov (United States)

    Mackay, J M; Lamb, C W

    1988-12-01

    Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.

  14. Parenteral nutrition in intestinal failure

    Directory of Open Access Journals (Sweden)

    Kurkchubasche AG

    2015-01-01

    Full Text Available Arlet G Kurkchubasche,1 Thomas J Herron,2 Marion F Winkler31Department of Surgery and Pediatrics, 2Department of Surgery, Alpert Medical School of Brown University, 3Department of Surgery/Nutritional Support Service, Rhode Island Hospital, Providence, RI, USAAbstract: Intestinal failure is a consequence of extensive surgical resection resulting in anatomic loss and/or functional impairment in motility or absorptive capacity. The condition is clinically characterized by the inability to maintain fluid, energy, protein, electrolyte, or micronutrient balance when on a conventionally accepted, normal diet. Parenteral nutrition (PN is the cornerstone of management until intestinal adaptation returns the patient to a PN-independent state. Intestinal length, residual anatomic segments and motility determine the need for and duration of parenteral support. The goals of therapy are to provide sufficient nutrients to enable normal growth and development in children, and support a healthy functional status in adults. This review addresses indications for PN, the formulation of the PN solution, patient monitoring, and considerations for prevention of PN-associated complications. With the ultimate goal of achieving enteral autonomy, the important role of diet, pharmacologic interventions, and surgery is discussed.Keywords: intestinal failure, short-bowel syndrome, parenteral nutrition, home nutrition support, intestinal rehabilitation

  15. [Nutritional risk screening and its clinical significance in 706 children hospitalized in the surgical department].

    Science.gov (United States)

    Peng, Lu-Ting; Li, Rong; Zhao, Wei-Hua; Chen, Yin-Hua; Li, Xiao-Mei; Chen, Meng-Ying; Cao, Jia; Li, Xiao-Nan

    2013-10-01

    To investigate nutritional risk and its relationship with clinical outcome in children hospitalized in the surgical department, and to provide a scientific basis for clinical nutrition management. Nutritional risk screening was performed on 706 children hospitalized in the surgical department using the Screening Tool for Risk on Nutritional Status and Growth. The data on nutritional support during hospitalization, incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses were recorded. Of the 706 cases, 11.5% had high nutritional risk, 46.0% had moderate nutritional risk, and 42.5% had low nutritional risk. Congenital hypertrophic pyloric stenosis, intestinal obstruction and congenital heart disease were the three most common types of high nutritional risk. The incidence of high nutritional risk was significantly higher in infants than in other age groups (Pnutritional risk received parenteral nutrition. Children with high nutritional risk were significantly more likely to have weight loss than children with low nutritional risk (Pnutritional risk had significantly increased incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses compared with those with moderate or low nutritional risk (Pnutritional risk is seen in children hospitalized in the surgical department. Nutritional risk score is correlated with clinical outcome. Nutritional support for these children is not yet properly provided. Nutritional risk screening and standard nutritional support should be widely applied among hospitalized children.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Management of protein-energy wasting in non-dialysis-dependent chronic kidney disease: reconciling low protein intake with nutritional therapy1234

    Science.gov (United States)

    Kovesdy, Csaba P; Kopple, Joel D; Kalantar-Zadeh, Kamyar

    2013-01-01

    Protein-energy wasting (PEW), characterized by a decline in body protein mass and energy reserves, including muscle and fat wasting and visceral protein pool contraction, is an underappreciated condition in early to moderate stages of chronic kidney disease (CKD) and a strong predictor of adverse outcomes. The prevalence of PEW in early to moderate CKD is ≥20–25% and increases as CKD progresses, in part because of activation of proinflammatory cytokines combined with superimposed hypercatabolic states and declines in appetite. This anorexia leads to inadequate protein and energy intake, which may be reinforced by prescribed dietary restrictions and inadequate monitoring of the patient's nutritional status. Worsening uremia also renders CKD patients vulnerable to potentially deleterious effects of uncontrolled diets, including higher phosphorus and potassium burden. Uremic metabolites, some of which are anorexigenic and many of which are products of protein metabolism, can exert harmful effects, ranging from oxidative stress to endothelial dysfunction, nitric oxide disarrays, renal interstitial fibrosis, sarcopenia, and worsening proteinuria and kidney function. Given such complex pathways, nutritional interventions in CKD, when applied in concert with nonnutritional therapeutic approaches, encompass an array of strategies (such as dietary restrictions and supplementations) aimed at optimizing both patients’ biochemical variables and their clinical outcomes. The applicability of many nutritional interventions and their effects on outcomes in patients with CKD with PEW has not been well studied. This article reviews the definitions and pathophysiology of PEW in patients with non-dialysis-dependent CKD, examines the current indications for various dietary modification strategies in patients with CKD (eg, manufactured protein-based supplements, amino acids and their keto acid or hydroxyacid analogues), discusses the rationale behind their potential use in

  18. Soft, fortified ice-cream for head and neck cancer patients: a useful first step in nutritional and swallowing difficulties associated with multi-modal management.

    Science.gov (United States)

    Trinidade, Aaron; Martinelli, Katrina; Andreou, Zenon; Kothari, Prasad

    2012-04-01

    Patients with head and neck cancer have complex swallowing and nutritional concerns. Most patients are malnourished, and treatment modalities within the aerodigestive tract have profound effects on future swallowing and nutrition. The objective of this study is to investigate whether the introduction of fortified soft ice-cream to post-operative head and neck cancer patients would increase compliance with oral-feeding regimes. Using a questionnaire study, an ice-cream machine that produces fortified soft ice-cream was introduced onto our ward, and 30 patients were asked to fill out questionnaires based on their experience in addition to their oral-feeding regime. Results indicate that overall patient satisfaction and compliance with oral-feeding regimes increased: 77% felt that the taste was excellent and also felt that it was easy to eat; 60% felt that it eased the symptoms associated with their symptoms, in particular its cold temperature. We conclude from the results that the inability of patients undergoing multi-modal treatment for upper aerodigestive tract cancer to enjoy normal foods and its effects on their quality of life is underestimated. Providing a food to that is palatable, familiar and acceptable as it is safe and nutritionally sound can increase compliance with oral-feeding regimes. The ice-cream was safe to use in the early post-operative period, especially soothing in patients undergoing upper aerodigestive radiotherapy and high in protein and calorific content. Our practice may have wider benefits, including patients with oral and oropharyngeal infections, the elderly and patients with neurological dysphagia resulting from stroke.

  19. Management of protein-energy wasting in non-dialysis-dependent chronic kidney disease: reconciling low protein intake with nutritional therapy.

    Science.gov (United States)

    Kovesdy, Csaba P; Kopple, Joel D; Kalantar-Zadeh, Kamyar

    2013-06-01

    Protein-energy wasting (PEW), characterized by a decline in body protein mass and energy reserves, including muscle and fat wasting and visceral protein pool contraction, is an underappreciated condition in early to moderate stages of chronic kidney disease (CKD) and a strong predictor of adverse outcomes. The prevalence of PEW in early to moderate CKD is ≥20-25% and increases as CKD progresses, in part because of activation of proinflammatory cytokines combined with superimposed hypercatabolic states and declines in appetite. This anorexia leads to inadequate protein and energy intake, which may be reinforced by prescribed dietary restrictions and inadequate monitoring of the patient's nutritional status. Worsening uremia also renders CKD patients vulnerable to potentially deleterious effects of uncontrolled diets, including higher phosphorus and potassium burden. Uremic metabolites, some of which are anorexigenic and many of which are products of protein metabolism, can exert harmful effects, ranging from oxidative stress to endothelial dysfunction, nitric oxide disarrays, renal interstitial fibrosis, sarcopenia, and worsening proteinuria and kidney function. Given such complex pathways, nutritional interventions in CKD, when applied in concert with nonnutritional therapeutic approaches, encompass an array of strategies (such as dietary restrictions and supplementations) aimed at optimizing both patients' biochemical variables and their clinical outcomes. The applicability of many nutritional interventions and their effects on outcomes in patients with CKD with PEW has not been well studied. This article reviews the definitions and pathophysiology of PEW in patients with non-dialysis-dependent CKD, examines the current indications for various dietary modification strategies in patients with CKD (eg, manufactured protein-based supplements, amino acids and their keto acid or hydroxyacid analogues), discusses the rationale behind their potential use in patients

  20. Enteral versus parenteral nutrition in cancer patients: evidences and controversies.

    Science.gov (United States)

    Cotogni, Paolo

    2016-01-01

    The debate over the use of enteral nutrition (EN) and parenteral nutrition (PN) is an old but evergreen and hot topic. Since many years, studies comparing EN and PN have been a pivotal 'leitmotif' in the published literature on artificial nutrition (AN). Actually, there is a background misunderstanding in this debate; specifically, that EN and PN are competitors in the choice of the route for delivering nutrition support in cancer patients. Conversely, EN and PN have specific indications and contraindications. This review has the purpose to discuss the indications and complications as well as pros and cons of EN and PN in cancer patients, the crucial role of nutrition support in oncology patients during anticancer treatments and throughout the course of disease, and, finally, the role of AN in advanced cancer patients. In summary, we have no evidence-based data able to definitively indicate the optimal method for delivering AN in cancer patients. EN and PN have to be considered equally effective in maintaining or improving nutritional status in cancer patients. Besides, this review strongly supports the recommendation that a baseline nutritional assessment should be carried out by a healthcare professional expert in AN for all cancer patients at the time of diagnosis or anticancer treatment plan, taking the nutritional status, estimated duration of AN, AN-related potential benefits and possible complications into consideration on an individual basis. Moreover, the patient symptoms, performance status, estimated life expectancy, and mainly, will or preferences have to be evaluated and incorporated into the nutrition support plan before the definitive choice of the route for delivering nutrients is decided. Finally, applying a decision-making process tailored to patient needs-regardless of whether receiving or not anticancer treatment-allows to choose reasonably the optimal nutritional support strategy.

  1. Capacity development in food composition database management and nutritional research and education in Central and Eastern European, Middle Eastern and North African countries.

    Science.gov (United States)

    Gurinović, M; Witthöft, C M; Tepšić, J; Ranić, M; Hulshof, P J M; Hollman, P C; Porubska, J; Gohar, A; Debeljak-Martačić, J; Petrović-Oggiano, G; Novaković, R; Glibetić, M; Oshaug, A

    2010-11-01

    Capacity development (CD) in food and nutrition is much more than formal training and includes human resource development, and organisational, institutional and legal framework development with the aim of enhancing nutrition-relevant knowledge and skills to support infrastructural development. The goal of the European Food Information Resource (EuroFIR) Network of Excellence has been to develop and integrate food composition data throughout Europe. EuroFIR joined forces in CD with the United Nations (UN) University and UN System Standing Committee on Nutrition, the Network for Capacity Development in Nutrition in Central and Eastern Europe, the Central and Eastern European Countries Food Data Systems network and with the Middle East and North African Capacity Building Initiative. The aim of this paper is to discuss an inventory of the status of food composition databases (FCDBs) and the training needs of compilers in non-EuroFIR countries in Central and Eastern Europe (CEE) and in the Middle East and North Africa (MENA), and to present the CD achieved through EuroFIR and other network collaborations. Two online questionnaires were created addressing the FCDB status and specific training needs in countries of the targeted regions. Data were collected during 2006-2008 and then analysed. Subsequently, CD activities were organised. Contacts were established in 19 CEE and 7 MENA countries, of which several had national food composition tables, but no electronic versions. Education, training, workshops, networking and the sharing of experiences were uniformly requested. Subsequently, CD activities in EuroFIR were organised focussing on food composition courses, exchange visits, workshops and individual training for PhD students, junior scientists and other staff categories, as well as conferences linked to food composition research and food information. To facilitate CD activities, EuroFIR has signed a Memorandum of Understanding with the Czech Republic, Hungary

  2. Enteral nutrition in surgery

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  3. Estado nutricional e carência de ferro em crianças freqüentadoras de creche antes e 15 meses após intervenção nutricional Nutritional status and iron deficiency among children enrolled in a day care center before and after 15 months of nutritional management

    Directory of Open Access Journals (Sweden)

    Terezinha Soares Biscegli

    2008-06-01

    Full Text Available OBJETIVO: Comparar o estado nutricional e a prevalência de carência de ferro em crianças freqüentadoras de creche antes e 15 meses após orientação nutricional e intervenção terapêutica. MÉTODOS: Estudo coorte com 52 crianças de 32 a 78 meses de idade, freqüentadoras de uma creche em Catanduva, São Paulo, avaliadas em dois períodos: antes e 15 meses após receberem tratamento para anemia e correção das alterações no estado nutricional. O estado nutricional das crianças foi avaliado por meio da curva da Organização Mundial de Saúde (2006. O diagnóstico de carência de ferro foi realizado por dosagem de hemoglobina e nível de ferritina sérica. Dados adicionais das crianças não eutróficas foram obtidos por meio de entrevistas com suas mães. RESULTADOS: Observou-se 2% de desnutrição aguda e 8% de obesidade, não havendo diferença significante entre os dois períodos. 12% das crianças apresentaram anemia, havendo diminuição do número de crianças com anemia após o tratamento. Dois novos casos de obesidade e cinco de carência de ferro surgiram durante o período de intervenção nutricional. Das oito crianças com alterações nutricionais no período inicial, 63% das mães procuraram atendimento médico para tratamento. CONCLUSÕES: O tratamento dos distúrbios nutricionais e da carência de ferro diminuiu o número de crianças afetadas. O aparecimento de novos casos de obesidade e anemia serve de alerta para a necessidade de outras medidas preventivas tanto na creche como no âmbito familiar.OBJECTIVE: To compare the nutritional status and the prevalence of iron deficiency among children enrolled in a day care center before and after 15 months of nutritional management. METHODS: Cohort study of 52 children, aged 32 to 78 months, evaluated before and after treatment of anemia and nutritional disturbs in a no-profit day care center in Catanduva, São Paulo, Brazil. The nutritional status was classified according

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

    Science.gov (United States)

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

    2012-04-01

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

  5. Social marketing nutrition education for low-income population.

    Science.gov (United States)

    Hagues, Rachel; Stotz, Sarah; Childers, Austin; Phua, Joe; Hibbs, Judy; Murray, Deborah; Lee, Jung Sun

    2018-01-01

    As access to healthy food (or lack thereof) could be considered a social justice issue, social workers should be concerned about this issue and willing to collaborate with colleagues of various disciplines to address it. This study was a formative evaluation conducted to understand best practices, recommendations, and feasibility of a social-marketing-based nutrition education program tailored to the needs of adults with limited income. The authors report findings from focus groups conducted with Cooperative Extension Agents (CEAs) and region coordinators (n = 45) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) (n = 69) eligible participants to inform the development of a social marketing nutrition intervention for SNAP-Ed in Georgia. Barriers to healthy eating included cultural preferences, costs of healthy food, lack of time, and lack of availability. Social marketing has a potential to deliver effective and efficient SNAP-Ed targeted to large, limited-resource Georgians. Segmenting the low-income population based on geographical location as well as best methods for outreach can allow tailored messages to meet identified needs, lifestyles, and other variables that make these individuals most likely to respond to the program. Food security and nutrition education are topics of concern for all health care professionals interested in addressing complex health issues of many low-income adults.

  6. Design and results of a culturally tailored cancer outreach project by and for Micronesian women.

    Science.gov (United States)

    Aitaoto, Nia; Braun, Kathryn L; Estrella, Julia; Epeluk, Aritae; Tsark, JoAnn

    2012-01-01

    In 2005, approximately 26% of Micronesian women aged 40 or older in Hawai'i used mammography for breast cancer screening. We describe an 18-month project to increase screening participation in this population by tailoring educational materials and using a lay educator approach. New immigrants to Hawai'i are Marshallese from the Republic of the Marshall Islands and Chuukese, Pohnpeians, and Kosraeans from the Federated States of Micronesia. In Hawai'i, these 4 groups refer to themselves collectively as Micronesians, although each group has its own distinct culture and language. From 2006 through 2007, we applied principles of community-based participatory research--trust building, joint assessment, cultural tailoring of materials, and skills transfer--to develop and track the reach of Micronesian women lay educators in implementing a cancer awareness program among Micronesian women living in Hawai'i. Using our tailored in-language materials, 11 lay educators (5 Chuukese, 3 Marshallese, 2 Pohnpeians, and 1 Kosraean) provided one-on-one and small group in-language cancer information sessions to 567 Micronesian women (aged 18-75 years). Among the 202 women aged 40 or older eligible for mammography screening, 166 (82%) had never had a mammogram and were assisted to screening appointments. After 6 months, 146 (88%) of the 166 had received a mammogram, increasing compliance from 18% to 90%. Lay educators reported increases in their skills and their self-esteem and want to extend their skills to other health issues, including diabetes management and immunization. Tailoring materials and using the lay educator model successfully increased participation in breast cancer screening. This model may work in other communities that aim to reduce disparities in access to cancer screening.

  7. Tailoring reablement: A grounded theory study of establishing reablement in a community setting in Norway.

    Science.gov (United States)

    Moe, Cathrine; Brinchmann, Berit Støre

    2018-01-01

    Reablement is an interprofessional, home-based rehabilitation service that aims to enable senior residents to cope with everyday life and to prevent functional impairments. Systematic accounts of what practitioners actually do when establishing reablement are lacking. This study aims to generate a grounded theory of practitioners' patterns of action when establishing reablement. The study is located in Norway, and grounded theory is the methodological approach. Data were collected from January 2014 to August 2016 through participant observations, focus group interviews and individual interviews. Informants are municipal healthcare employees in different organisational areas associated with the process of establishing reablement services (managers of conventional home care and representatives from the administration and service-provider offices). Altogether, 17 individuals are interviewed. The empirical data are analysed several times using open, selective and theoretical coding. The grounded theory, "tailoring reablement," includes three phases-replicating, adapting and establishing-and the strategies of collaborating, developing knowledge, habituating and filtering. The theory of tailoring reablement also includes the impact of the contextual factors. The study seeks to bridge the gap between research and practice. The theory of tailoring reablement emerges from an inductive approach and theorises participants' actions. The theory focuses on the phases from innovation to implementation. Establishing a new service model in a complex welfare setting requires a wide range of actors and agencies. Tailoring reablement also requires flexibility and professional autonomy. It is important to create terms and conditions for this within a stringent health and care service. The insights of this study have implications for practice development of reablement and can fit other public sector fields. © 2017 The Authors. Health and Social Care in the Community Published by John

  8. Shape-Tailored Features and their Application to Texture Segmentation

    KAUST Repository

    Khan, Naeemullah

    2014-04-01

    Texture Segmentation is one of the most challenging areas of computer vision. One reason for this difficulty is the huge variety and variability of textures occurring in real world, making it very difficult to quantitatively study textures. One of the key tools used for texture segmentation is local invariant descriptors. Texture consists of textons, the basic building block of textures, that may vary by small nuisances like illumination variation, deformations, and noise. Local invariant descriptors are robust to these nuisances making them beneficial for texture segmentation. However, grouping dense descriptors directly for segmentation presents a problem: existing descriptors aggregate data from neighborhoods that may contain different textured regions, making descriptors from these neighborhoods difficult to group, leading to significant errors in segmentation. This work addresses this issue by proposing dense local descriptors, called Shape-Tailored Features, which are tailored to an arbitrarily shaped region, aggregating data only within the region of interest. Since the segmentation, i.e., the regions, are not known a-priori, we propose a joint problem for Shape-Tailored Features and the regions. We present a framework based on variational methods. Extensive experiments on a new large texture dataset, which we introduce, show that the joint approach with Shape-Tailored Features leads to better segmentations over the non-joint non Shape-Tailored approach, and the method out-performs existing state-of-the-art.

  9. Recovery of nutritional metabolism after liver transplantation.

    Science.gov (United States)

    Sugihara, Kohei; Yamanaka-Okumura, Hisami; Teramoto, Arisa; Urano, Eri; Katayama, Takafumi; Morine, Yuji; Imura, Satoru; Utsunomiya, Tohru; Shimada, Mitsuo; Takeda, Eiji

    2015-01-01

    Perioperative nutritional assessment is critically important to reflect nutritional management because liver transplantation (LTx) often is undertaken in patients with poor nutritional status. The aim of this study was to evaluate nutritional status, including the non-protein respiratory quotient (npRQ), resting energy expenditure (REE), nitrogen balance, and blood biochemical parameters in patients before and after LTx. Fourteen patients undergoing LTx and 10 healthy controls were enrolled in this study. The npRQ and REE were measured using indirect calorimetry before LTx and at 2, 3, and 4 wk after the procedure. Blood biochemistry and nitrogen balance calculated by 24-h urine collection were performed concurrently with indirect calorimetric measurement; the results were compared between the two groups. Before LTx, npRQ was significantly lower and serum non-esterified fatty acid levels were significantly higher in the patients than in the controls. Furthermore, a negative nitrogen balance was observed in the patients. These, however, improved significantly at 4 wk after LTx. REE did not significantly increase compared with the preoperative values in recipients. Blood biochemistry showed gradually increasing levels of serum cholinesterase and albumin. These failed to reach to normal levels by 4 wk post-transplant. The findings revealed that improvement of nutritional metabolism after LTx may require 4 wk. Additional nutritional strategies, therefore, may be needed to minimize catabolic state during the early post-transplant period. Adequate, individualized nutritional guidance before and after LTx should be performed in these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2013-01-29

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

  11. Performance of a community-based health and nutrition-education intervention in the management of diarrhoea in a slum of Delhi, India.

    Science.gov (United States)

    Pahwa, Smriti; Kumar, Geeta Trilok; Toteja, G S

    2010-12-01

    Diarrhoeal infections are the fifth leading cause of death worldwide and continue to take a high toll on child health. Mushrooming of slums due to continuous urbanization has made diarrhoea one of the biggest public-health challenges in metropolitan cities in India. The objective of the study was to carry out a community-based health and nutrition-education intervention, focusing on several factors influencing child health with special emphasis on diarrhoea, in a slum of Delhi, India. Mothers (n=370) of children, aged >12-71 months, identified by a door-to-door survey from a large urban slum, were enrolled in the study in two groups, i.e. control and intervention. To ensure minimal group interaction, enrollment for the control and intervention groups was done purposively from two extreme ends of the slum cluster. Baseline assessment of knowledge, attitudes, and practices on diarrhoea-related issues, such as oral rehydration therapy (ORT), oral rehydration salt (ORS), and continuation of breastfeeding during diarrhoea, was carried out using a pretested questionnaire. Thereafter, mothers (n=195) from the intervention area were provided health and nutrition education through fortnightly contacts achieved by two approaches developed for the study--'personal discussion sessions' and 'lane approach'. The mothers (n=175) from the control area were not contacted. After the intervention, there was a significant (p=0.000) improvement in acquaintance to the term 'ORS' (65-98%), along with its method of reconstitution from packets (13-69%); preparation of home-made sugar-salt solution (10-74%); role of both in the prevention of dehydration (30-74%) and importance of their daily preparation (74-96%); and continuation of breastfeeding during diarrhoea (47-90%) in the intervention area. Sensitivity about age-specific feeding of ORS also improved significantly (p=0.000) from 13% to 88%. The reported usage of ORS packets and sugar-salt solution improved significantly from 12% to 65

  12. SPORT NUTRITION KNOWLEDGE OF COACHES

    Directory of Open Access Journals (Sweden)

    Ivan Vasiljević

    2014-06-01

    Full Text Available Introduction: Decades of research support the theory that when there are sports competitions the question of what to eat and drink in order to enhance sport performance. Nutrition is one of the most important factors in achieving top performance athletes. According to most studies conducted in the world's top athletes receive information from their coaches when it comes to sports nutrition, especially of the coaches involved in fitness training. (Burns, Schiller, Merrick & Wolf, 2004.The aim of this study was to determine the knowledge of sports nutrition in sports coaching. Mthods: The sample was composed of 30 licensed coaches from Montenegro (football, handball, basketball, volleyball, athletics and tennis. Knowledge of sports nutrition was tested by means of a standardized questionnaire. The questionnaire was designed to determine the knowledge manager on sports nutrition, the ingredients that are necessary in order to provide a sufficient amount of energy to training and competition, the dietary supplements, meal prior to the competition as well as dehydration and rehydration during training and competition. The survey was anonymous. The data were analyzed by statistical methods, using the statistical software STATISTICA for WINDOWS. Results: According to the results as a whole, it can be concluded that the trainer's knowledge of sports nutrition at a satisfactory level. Out of 600 responses was achieved 469 correct answers, or 78.1%. However, when looking at individual responses then satisfaction with the relative high percentage loss since the observed large gaps on very important issues related to sports nutrition. Discussion: By analyzing and comparing research results (Matkovic, Prince & Cigrovski, 2006 that in a sample of 56 coaches basketball and skiing, received 77.8% of correct answers and insight into the results of our study, it is clear that the results of the approximate value of both work, which is an indicator of quality

  13. 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...

  14. Building Tailorable Hypermedia Systems: The embedded-interpreter approach

    DEFF Research Database (Denmark)

    Grønbæk, Kaj; Malhotra, Jawahar

    1994-01-01

    This paper discusses an approach for developing dynamically tailorable hypermedia systems in an object-oriented environment. The approach is aimed at making applications developed in compiled languages like Beta and C++ tailorable at run-time. The approach is based on use of: 1) a hypermedia...... application framework (DEVISE Hyper-media), and 2) an embeddable interpreter for the framework language. A specific hypermedia system is instantiated from the framework with the interpreter embedded in the executable. The specific hypermedia system has a number of “open points” which can be filled via......-type. The paper describes the framework and illustrates how the interpreter is integrated. It describes steps involved in tailoring a specific hypermedia system with a new drawing media-type, where graphical objects can be endpoints for links. Since the hypermedia framework uses a persistent object...

  15. Effects of oral nutritional supplementation in the management of malnutrition in hospital and post-hospital discharged patients in India: a randomised, open-label, controlled trial.

    Science.gov (United States)

    Huynh, D T T; Devitt, A A; Paule, C L; Reddy, B R; Marathe, P; Hegazi, R A; Rosales, F J

    2015-08-01

    Hospital malnutrition is a significant problem that still remains under-recognised and under-treated in India. The present study assessed the effects of oral nutritional supplementation (ONS) in conjunction with dietary counselling versus dietary counselling (control) alone in malnourished patients when given in hospital and post-hospital discharge. The present study was conducted in nine private and four public hospitals. Patients from various medical wards were screened for malnutrition using modified Subjective Global Assessment (mSGA) and randomised to control (n = 106) or ONS (n = 106) for 12 weeks. Two servings (460 mL) of ONS were prescribed daily, providing 432 kcal, 16 g of protein and 28 micronutrients. The primary outcome was weight gain over 12 weeks. Other outcomes included change in body mass index (BMI), serum pre-albumin, albumin and C-reactive protein levels, energy and nutrient intakes, and handgrip strength at weeks 4, 8 and 12, as well as mSGA score at week 12. The mean age of patients was 39 years. Fifty-five percent were males and 90.3% were moderately malnourished (mSGA score B) at baseline. At week 12, ONS significantly improved certain parameters compared to control: weight (2.0 versus 0.9 kg; P energy intake per day (560 versus 230 kcal; P energy intake and weight in malnourished Indian patients. Those patients with poorer functional status at baseline demonstrated the most benefit. © 2014 The Authors Maternal & Child Nutrition Published by John Wiley & Sons Ltd.

  16. Healthy Harlem: empowering health consumers through social networking, tailoring and web 2.0 technologies.

    Science.gov (United States)

    Khan, Sharib A; McFarlane, Delano J; Li, Jianhua; Ancker, Jessica S; Hutchinson, Carly; Cohall, Alwyn; Kukafka, Rita

    2007-10-11

    Consumer health informatics has emerged as a strategy to inform and empower patients for self management of their health. The emergence of and explosion in use of user-generated online media (e.g.,blogs) has created new opportunities to inform and educate people about healthy living. Under a prevention research project, we are developing a website that utilizes social content collaboration mediums in conjunction with open-source technologies to create a community-driven resource that provides users with tailored health information.

  17. Optimizing patient nutrition

    DEFF Research Database (Denmark)

    Geiker, Nina Rica Wium

    (Paper I). The present study is, to my knowledge, the only study investigating the validity of performed nutritional risk screenings by comparing them with medical records. Eight per cent of patients were correctly screened for nutritional risk. A total of 24% of 2393 patients were nutritionally screened......Malnutrition, under-nutrition and/or obesity, may develop due to disease but may also cause disease. The prevalence of under-nutrition among hospitalized patients is high: 40-60% are either already under-nourished on admittance or at-risk of becoming malnourished. As in the general population...... of prescription medication, and take longer to recover. Acknowledging the adverse effects of malnutrition on health, since 2006 it has been mandatory to screen all patients for nutritional risk within 24 hours of admittance at all hospitals in the Capital Region, Denmark. The compliance to and the validity...

  18. 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.

  19. Tailor-made finance versus tailor-made care. Can the state strengthen consumer choice in healthcare by reforming the financial structure of long-term care?

    Science.gov (United States)

    Grit, K; de Bont, A

    2010-02-01

    Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six long-term care institutions. With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of 'need' is transformed into the principle of 'economic demand'. Financial instruments not only act as a countervailing power against providers insufficiently client-oriented, but are also used by providers to reinforce their own positions vis-à-vis demanding clients. Tailor-made finance is not the same as tailor-made care.

  20. Medical students' perceptions regarding the importance of nutritional knowledge and their confidence in providing competent nutrition practice.

    Science.gov (United States)

    Perlstein, R; McCoombe, S; Shaw, C; Nowson, C

    2016-11-01

    The objective of this study was to examine the perceived importance, knowledge and confidence in nutritional management in a sample of Australian medical students undertaking a 4-year postgraduate medical degree. In 2015, students in years 1-4 were anonymously surveyed to assess students' perceived importance of nutrition, and knowledge and confidence in nutritional management. A total of 131 first and second year (preclinical/yr 1-2) medical students (46% response rate) and 66 third and fourth year (clinical/yr 3-4) students (24% response rate) completed the questionnaire. Most preclinical students agreed that medical graduates should understand nutritional issues in managing cardiovascular disease (99%), type 2 diabetes (93%), coeliac disease (95%), and renal impairment (97%). However, students were limited in their confidence to demonstrate this knowledge (range of confidence: 26%-41%) for individual medical conditions. This improved for students in the clinical context of years 3 and 4, although it was still not optimal (range 26%-81%). Few year 3 and 4 students reported confidence in knowledge related to medicolegal issues, respiratory disease, nutritional guidelines and nutrition assessment (all 80%) reported confidence in the dietary management of type 2 diabetes, cardiovascular disease and coeliac disease and >60% indicated they would refer onto nutrition professionals. This cohort of postgraduate medical students recognize the importance of nutrition in disease. The number of students reporting increased confidence in nutritional management of a few select diseases where dietary management is one of the cornerstones of treatment (e.g. type 2 diabetes) rises throughout the course. However, students reported lower levels of knowledge in diseases where diet is secondary to other treatments and preventative strategies (e.g. respiratory disease). Filling the gap by integrating the nutritional management into the range of common chronic diseases during training

  1. Nutritional assessment of athletes

    National Research Council Canada - National Science Library

    Driskell, Judy A; Wolinsky, Ira

    2011-01-01

    "Evaluating dietary intake, determining energy metabolism, and conducting other nutritional assessments are essential in understanding the relationships between diet, exercise, health, and physical...

  2. Introduction to clinical nutrition

    National Research Council Canada - National Science Library

    Sardesai, Vishwanath M

    2012-01-01

    .... Introduction to Clinical Nutrition, Third edition discusses the physiologic and metabolic interrelationships of all nutrients and their roles in health maintenance and the prevention of various...

  3. What Is Enteral Nutrition?

    Science.gov (United States)

    ... Solution Center NOVEL Project Parenteral Nutrition Resources Intravenous Lipid Emulsions (ILE) Video Series SmartPN Practice and Research Toolkits Publications & ASPEN Journals Journal of Parenteral and ...

  4. Tailored Web-Based Interventions for Pain: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Martorella, Geraldine; Boitor, Madalina; Berube, Melanie; Fredericks, Suzanne; Le May, Sylvie; Gélinas, Céline

    2017-11-10

    Efforts have multiplied in the past decade to underline the importance of pain management. For both acute and chronic pain management, various barriers generate considerable treatment accessibility issues, thereby providing an opportunity for alternative intervention formats to be implemented. Several systematic reviews on Web-based interventions with a large emphasis on chronic pain and cognitive behavioral therapy have been recently conducted to explore the influence of these interventions on pain management However, to our knowledge, the specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated. The primary aim of this systematic review was to answer the following research question: What is the effect of tailored Web-based pain management interventions for adults on pain intensity compared with usual care, face-to-face interventions, and standardized Web-based interventions? A secondary aim was to examine the effects of these interventions on physical and psychological functions. We conducted a systematic review of articles published from January 2000 to December 2015. We used the DerSimonian-Laird random effects models with 95% confidence intervals to calculate effect estimates for all analyses. We calculated standardized mean differences from extracted means and standard deviations, as outcome variables were measured on different continuous scales. We evaluated 5 different outcomes: pain intensity (primary outcome), pain-related disability, anxiety, depression, and pain catastrophizing. We assessed effects according to 3 time intervals: short term (Web-based intervention showed benefits immediately after, with small effect sizes (Web-based interventions did not prove to be more efficacious than standardized Web-based interventions in terms of pain intensity, pain-related disability, anxiety, and depression. An interesting finding was that some efficacy was shown on pain

  5. European consumers and nutrition labelling

    DEFF Research Database (Denmark)

    Wills, Josephine M.; Grunert, Klaus G.; Celemín, Laura Fernández

    2009-01-01

    Nutrition labelling of food in Europe is not compulsory, unless a nutrition or health claim is made for the product. The European Commission is proposing mandatory nutrition labelling, even front of pack labelling with nutrition information. Yet, how widespread is nutrition labelling in the EU...

  6. Effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour: study protocol

    Directory of Open Access Journals (Sweden)

    Laan Eva K

    2012-03-01

    Full Text Available Abstract Background Physical inactivity, unhealthy dietary habits, smoking and high alcohol consumption are recognized risk factors for cardiovascular disease and cancer. Web-based health risk assessments with tailored feedback seem promising in promoting a healthy lifestyle. This study evaluates the effectiveness of a web-based health risk assessment with individually-tailored feedback on lifestyle behaviour, conducted in a worksite setting. Methods/Design The web-based health risk assessment starts with a questionnaire covering socio-demographic variables, family and personal medical history, lifestyle behaviour and psychological variables. Prognostic models are used to estimate individual cardiovascular risks. In case of high risk further biometric and laboratory evaluation is advised. All participants receive individually-tailored feedback on their responses to the health risk assessment questionnaire. The study uses a quasi-experimental design with a waiting list control group. Data are collected at baseline (T0 and after six months (T1. Within each company, clusters of employees are allocated to either the intervention or the control group. Primary outcome is lifestyle behaviour, expressed as the sum of five indicators namely physical activity, nutrition, smoking behaviour, alcohol consumption, and symptoms of burnout. Multilevel regression analysis will be used to answer the main research question and to correct for clustering effects. Baseline differences between the intervention and control group in the distribution of characteristics with a potential effect on lifestyle change will be taken into account in further analyses using propensity scores. Discussion This study will increase insight into the effectiveness of health risk assessments with tailored feedback and into conditions that may modify the effectiveness. This information can be used to design effective interventions for lifestyle behaviour change among employees. Trial

  7. Food & Nutrition: Nourish Your Body

    Science.gov (United States)

    Food & Nutrition: Nourish Your Body; food & nutrition; food and nutrition; food and nutrition articles; information about nutrition; health & nutrition; health and nutrition; health and nutrition articles; health and nutrition facts; health nutrition; nutrition and health; nutrition health; nutrition health articles; healthy; a healthy diet; diet healthy; eating healthy; healthy diet; healthy diets; nutrition diet; diet and nutrition; diet and nutrition articles; diet and nutrition article; diet nutrition; nutrition and diet; article on nutrition; article about nutrition; articles on nutrition; facts about nutrition; good nutrition; nutrition article; nutrition articles; healthy tips; eat healthy tips; eating healthy tips; healthy diet tips; healthy eating tip; healthy eating tips; healthy food tips; should eat; reasons why you should eat healthy; why people should eat healthy; why should I eat healthy; why should people eat healthy; why should we eat healthy; why should you eat healthy; why we should eat healthy; why you should eat healthy; healthy diet; a healthy diet; diets healthy eating; eat a healthy diet; eat healthy diet; eating a healthy diet; eating healthy diet; eating healthy diets; healthy diet; way to eat; best way to eat healthy; easy way to eat healthy; easy ways to eat healthy; healthy way of eating; healthy way to eat; healthy ways of eating; healthy ways to eat; ways to eat healthy; benefits; benefits eating healthy; benefits for eating healthy; benefits from eating healthy; benefits of eating healthy; benefits of healthy eating; benefits on eating healthy; benefits to eating healthy; eating healthy benefits; health benefits of eating healthy; eat healthier; eat healthier; eating healthier; healthier eating; healthier ways to eat; how can I eat healthier; how do I eat healthier; how to eat healthier; how to start eating healthier; tips to eat healthier; ways to start eating healthier

  8. Immediate preoperative enteral nutrition (preoperative enteral nutrition

    Directory of Open Access Journals (Sweden)

    Lađević Nebojša

    2017-01-01

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

  9. Managing legume pests in sub-Saharan Africa: Challenges and prospects for improving food security and nutrition through agro-ecological intensification

    OpenAIRE

    Belmain, S.R.; Haggar, J.; Holt, J.; Stevenson, P.C.

    2013-01-01

    Pest management technology has been through a number of advances that have, perhaps, moved away from the mass extermination of pests achieved through the advent of synthetic chemicals in the latter half of the 20th century to more agro-ecologically sensitive innovations that attempt to regulate pest populations by interfering with their breeding, attracting predators or repelling the pests from crops whilst attracting them to other plants. However, pest management is more than technology inno...

  10. Nutrition in Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Agata Anna Salwa

    2018-03-01

    Full Text Available Introduction and purpose of the work. Diabetic kidney disease usually occurs at a late stage of diabetes and is often the result of long-term disease failure. As in diabetes alone, the diet used by the patient has a significant influence on how quickly the nephropathy will proceed. The aim of the study is to present issues related to dietary management in kidney diseases being complication of diabetes. . Brief description of the state of knowledge. People with type 2 diabetes usually struggle with overweight or obesity and hypertension. Obesity is one of the factors that causes the progression of diabetic kidney disease. A diet for such people requires a negative energy balance. Insulin itself increases appetite and the frequent occurrence of hypoglycaemia is the reason for increasing the number of meals. Summary. Diet is a very important element in the treatment of diabetes. It determines the maintenance of proper blood glucose and lipid (lipid levels and optimal blood pressure values. A well-chosen diet reduces the risk of diabetic complications, as well as reduces the risk of vascular diseases. The right model of nutrition also plays an important role in the prevention and treatment of chronic diabetes complications.

  11. Microstructural gradients in thin hard coatings -- tailor-made

    DEFF Research Database (Denmark)

    Pantleon, Karen; Oettel, Heinrich

    1998-01-01

    ) alternating sputtering with and without substrate voltage and (c) pulsed bias voltage. On the basis of X-ray diffraction measurements, it is demonstrated that residual stress gradients and texture gradients can be designed tailor-made. Furthermore, results of microhardness measurements and scratch tests...

  12. Tailorable Trimethyl chitosans as adjuvant for intranasal immunization

    NARCIS (Netherlands)

    Verheul, R.J.

    2010-01-01

    Tailorable Trimethyl Chitosans as Adjuvant for Intranasal Immunization Active vaccination has proven to be the most (cost) effective tool in the fight against infectious diseases. Nowadays, most vaccines are administered via parenteral injection. However, the risk of contaminated needles and need

  13. Enabling Tailored Music Programs in Elementary Schools: An Australian Exemplar

    Science.gov (United States)

    McFerran, Katrina Skewes; Crooke, Alexander Hew Dale

    2014-01-01

    Participation in meaningful school music programs is the right of all children. Although music education is widely supported by policy, significant gaps exist in practice in most developed Western countries. These gaps mean the extrinsic and intrinsic benefits associated with participation in tailored programs are not equally available to all…

  14. Tailored Cloze: Improved with Classical Item Analysis Techniques.

    Science.gov (United States)

    Brown, James Dean

    1988-01-01

    The reliability and validity of a cloze procedure used as an English-as-a-second-language (ESL) test in China were improved by applying traditional item analysis and selection techniques. The 'best' test items were chosen on the basis of item facility and discrimination indices, and were administered as a 'tailored cloze.' 29 references listed.…

  15. Comparing tailored and untailored text messages for smoking cessation

    DEFF Research Database (Denmark)

    Skov-Ettrup, L S; Ringgaard, L W; Dalum, P

    2014-01-01

    The aim was to compare the effectiveness of untailored text messages for smoking cessation to tailored text messages delivered at a higher frequency. From February 2007 to August 2009, 2030 users of an internet-based smoking cessation program with optional text message support aged 15-25 years were...... of text messages increases quit rates among young smokers....

  16. Tailoring Dispersion properties of photonic crystal waveguides by topology optimization

    DEFF Research Database (Denmark)

    Stainko, Roman; Sigmund, Ole

    2007-01-01

    based design updates. The goal of the optimization process is to come up with slow light, zero group velocity dispersion photonic waveguides or photonic waveguides with tailored dispersion properties for dispersion compensation purposes. Two examples concerning reproduction of a specific dispersion...

  17. Excellent bonding behaviour of novel surface-tailored fibre ...

    Indian Academy of Sciences (India)

    Administrator

    tured completely before pull-out, leading to full utilization of its tensile strength, and ... Composite rods; surface tailoring; cementitious matrix; pull-out test; bonding characteristics. 1. ... machine (Lloyd LR50K) at a speed of 0∙5 mm/min with a.

  18. Promotion of Active Aging using a tailored recommendation system

    NARCIS (Netherlands)

    Cabrita, M.; Vollenbroek-Hutten, Miriam Marie Rosé

    Active Aging deals with the support and integration of the elderly population in a society focusing on improving physical and mental well-being. Persuasive technology provides solutions for tailored interventions aiming at maintaining an active lifestyle. The present paper introduces the initial

  19. Understanding the impact of graphene sheet tailoring on the ...

    Indian Academy of Sciences (India)

    Tailoring the channel decreases mobility and transmission probability to a great ... AGNR was used throughout the text so N denotes the number of dimer lines. Figure 2. .... ber of dimer lines and z is a positive integer) and through local density ...

  20. Application-Tailored I/O with Streamline

    NARCIS (Netherlands)

    de Bruijn, W.J.; Bos, H.J.; Bal, H.E.

    2011-01-01

    Streamline is a stream-based OS communication subsystem that spans from peripheral hardware to userspace processes. It improves performance of I/O-bound applications (such as webservers and streaming media applications) by constructing tailor-made I/O paths through the operating system for each