• Title/Summary/Keyword: clinical nutrition management

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Impact of Clinical, Laboratory and Fluid Therapy Variables on Hospital Length of Stay for Children with Acute Pancreatitis

  • Shahein, Abdul R.;Quiros, J. Antonio;Arbizu, Ricardo A.;Jump, Candi;Lauzon, Steven D.;Baker, Susan S.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.4
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    • pp.356-365
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    • 2020
  • Purpose: There have been many efforts to develop generalizable severity markers in children with acute pancreatitis (AP). Expert opinion panels have developed consensus guidelines on management but it is unclear if these are sufficient or valid. Our study aims to assess the effect of clinical and laboratory variables, in addition to treatment modality on hospital length of stay (LOS) as a proxy variable for severity in pediatric patients admitted with AP. Methods: We conducted a retrospective chart review of patients between ages of 0-18 years, who were admitted with AP at 2 institutions between 2013-2018, John R. Oishei Children's Hospital (Buffalo, NY, USA) and Medical University of South Carolina Children's Hospital (Charleston, SC, USA). We constructed three linear regression models to analyze the effect of clinical signs of organ dysfunction, laboratory markers and fluid intake on hospital LOS. Results: Ninety-two patients were included in the study. The mean age was 12 years (range, 7.6-17.4 years), 55% were females, and median LOS was 3 days. The most frequent cause of AP was idiopathic. Our study showed that elevated blood urea nitrogen (BUN) on admission (p<0.005), tachycardia that lasted for ≥48 hours (p<0.001) and need for fluid resuscitation were associated with increase LOS. Total daily fluid intake above maintenance did not have a significant effect on the primary outcome (p=0.49). Conclusion: Elevated serum BUN on admission, persistent tachycardia and need for fluid resuscitation were associated with increase LOS in pediatric AP. Daily total fluid intake above recommended maintenance did not reduce LOS.

Comparison of Students' Satisfaction with a Meal of College Foodservice by Operating System (대학급식소의 운영형태에 따른 음식만족도 비교분석)

  • Ly Sun Yung;Kim Su-Hyun;Kwon Sunja
    • Korean Journal of Community Nutrition
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    • v.10 no.3
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    • pp.319-330
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    • 2005
  • College foodservice (FS) demands highly-developed operation technique which can provide adequate nutrients to their students, as well as to guide better eating habits and to meet students' various desires. The purpose of this study was to provide basic data to improve college FS satisfaction with food items by comparing 2 contract-managed and 2 self-operated college FS in Daejeon and Chungnam area. According to the results, $\59.1%$ of students frequently (over 3 times per week) took meals at college cafeteria and the main reason for using college cafeteria was the low-price of meal, although the students' Satisfaction degree with price of meal was lower in contract-managed FS than in self-operated FS. There were no differences in the food satisfaction degrees with overall appraisal of food items between 2 operating systems of college FS, but the satisfaction degrees with all food items were high in male as compared with female. The higher the negative self-perceived clinical symptoms scores, the lower the satisfaction with foods, which suggests that the health state of students was one of the factors that influenced college FS satisfaction. According to stepwise multiple regression analysis,'taste of boiled rice', 'overall appraisal of boiled rice', 'overall appraisal of soup', and 'variety of side dish', in decreasing order, were the most relatively important attributes for overall customer satis-faction with food taste of college FS. Finally, there should be further studies on important management factors to improve college FS satisfaction according to 2 operating system.

Nutrition Education for Female Immigrants in Multicultural Families Using a Multicultural Approach: In-depth Interviews with Female Immigrants and Nutrition Education Professionals (다문화 시각에서 접근한 다문화 가정의 결혼이주여성을 위한 영양교육 방안 - 결혼이주여성 및 영양교육 전문가를 대상으로 한 심층인터뷰 -)

  • Kim, Ji-Eun;Kim, Ji-Myung;Seo, Sun-Hee
    • Journal of Nutrition and Health
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    • v.44 no.4
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    • pp.312-325
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    • 2011
  • The purpose of this study was to investigate dietary behaviors and nutritional knowledge among immigrant women in multicultural families. In addition, this study reveals a necessity for nutrition education, which is apparent to both immigrant women living in multicultural families as well as nutrition education experts. The survey was conducted with 30 immigrant women within multicultural families in Seoul. The dietary behaviors of the women were significantly different by their period of residence. The longer they had resided in Korea, the higher their dietary behavior score. However, there was no significant difference in nutrition knowledge by their period of residence. This study also conducted in-depth personal interviews with 8 immigrant women who lived in Seoul, and with 4 nutrition education experts. These interviews were performed to provide profound insights regarding the content and means of nutrition education for immigrant women. Nutrition education for immigrant women living in multicultural families should proceed at a basic level in terms of language and content, using bilingual (Korean and their native language) education materials. Education topics and content need to be developed differently according to the level of Korean comprehension and period of residence in Korea. Also, this multicultural approach should be adapted when planning nutrition education since immigrant women have various acculturation levels, and the content and means of education should be adjusted to these acculturation levels. Management after nutrition education is necessary for immigrant women who do not have sufficient understanding of the Korean language. Practical educational methods such as real cooking practices and food purchasing simulations must be developed. Finally, the results suggest that the government needs to establish a systematic plan for nutrition education among immigrant women living in multicultural families. Policy support such as training nutrition educators on multicultural individuals residing in Korea is necessary for active and effective nutritional education.

Nutrition education programs necessary for social welfare facilities for persons with disabilities: a cross-sectional study

  • Jinkyung Kim;Min-Sun Jeon
    • Korean Journal of Community Nutrition
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    • v.29 no.1
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    • pp.1-15
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    • 2024
  • Objectives: This study investigated the need for nutrition education aimed at improving the health of residents and users of social welfare facilities for persons with disability and aimed to provide basic information for developing a nutrition education program that meets the needs of the field. Methods: Altogether, 249 employees working in social welfare facilities for people with disabilities were included in the study. Data on the health status of residents/users, meal management, nutritional education, nutritional education needs, and awareness of nutritional education were obtained through online surveys. A descriptive analysis was conducted to analyze the demographic characteristics, needs, and perceptions of the respondents, and independent t-tests and χ2 tests were performed to analyze and compare the differences between residential and daycare facilities. Results: The majority of residents/users of social welfare facilities for persons with disabilities have developmental disabilities. When educating residents with residents/users of social welfare facilities, 'personal hygiene' was the most necessary topic, followed by 'obesity management' education. Regarding the methods of providing education, face-to-face lectures demonstrated a high demand. They responded that when nutrition education experts provide nutrition education to people with disabilities, they must understand 'the physical characteristics of persons with disabilities' and have the ability to determine appropriate nutrition for such people. The most appropriate nutrition program training would be twice a year, lasting 30 min to 1 h per training session. Conclusions: It will present a direction for operating a nutrition education program for persons with disabilities that meets their needs of social welfare facilities and ultimately contribute to the establishment and activation of nutrition education tailored to welfare facilities for such individuals in Korea.

Individualized diabetes nutrition education improves compliance with diet prescription

  • Lim, Hae-Mi;Park, Ji-Eun;Choi, Young-Ju;Huh, Kap-Bum;Kim, Wha-Young
    • Nutrition Research and Practice
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    • v.3 no.4
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    • pp.315-322
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    • 2009
  • This study was designed to evaluate the effect of individualized diabetes nutrition education. The nutrition education program was open to all type 2 diabetes patients visiting the clinic center and finally 67 patients agreed to join the program. To compare with 67 education group subjects, 34 subjects were selected by medical record review. The education program consisted of one class session for 1-2 hours long in a small group of 4~5 patients. A meal planning using the food exchange system was provided according to the diet prescription and food habits of each subject. Measurements of clinical outcomes and dietary intakes were performed at baseline and 3 months after the education session. After 3 months, subjects in education group showed improvement in dietary behavior and food exchange knowledge. In education group, intakes of protein, calcium, phosphorus, vitamin $B_2$, and folate per 1,000 kcal/day were significantly increased and cholesterol intake was significantly decreased. They also showed significant reductions in body weight, body mass index (BMI), and fasting blood concentrations of glucose (FBS), HbA1c, total cholesterol, and triglyceride. However, no such improvements were observed in control group. To evaluate telephone consultation effect, after the nutrition education session, 34 subjects of the 67 education group received telephone follow-up consultation once a month for 3 months. The others (33 subjects) had no further contact after the nutrition education session. Subjects in the telephone follow-up group showed a decrease in BMI, FBS, and HbA1c. Moreover, the subjects who did not receive telephone follow-up also showed significant decreases in BMI and FBS. These results indicated that our individually planned education program for one session was effective in rectifying dietary behavior problems and improving food exchange knowledge, and quality of diet, leading to an improvement in the clinical outcomes. In conclusion, our individualized nutrition education was effective in adherence to diet recommendation and in improving glycemic control and lipid concentrations, while follow-up by telephone helped to encourage the adherence to diet prescription.

Optimizing Nutrition Support in Cancer Care

  • Menon, Kavitha Chandrasekhara
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2933-2934
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    • 2014
  • Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.

Intestinal Hypoganglionosis Leading to Intestinal Failure and the Compassionate Use of OmegavenTM

  • Khalaf, Racha;Karjoo, Sara;Danielson, Paul;Wilsey, Michael;Shakeel, Fauzia
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.1
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    • pp.55-60
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    • 2017
  • Intestinal hypoganglionosis is a rare innervation disorder that provides numerous nutritional, medical and surgical challenges. In this case report, we present a case of a newborn with intestinal hypoganglionosis leading to intestinal failure and intestinal failure-associated liver disease who responded to $Omegaven^{TM}$, a fat emulsion comprised of omega-3 fatty acids. $Omegaven^{TM}$ has been shown to be beneficial in the management of cholestatic liver injury. Clinical success with $Omegaven^{TM}$ was seen in this patient with a clear decrease in aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and complete resolution of cholestasis with a direct bilirubin of zero within two weeks of initiation of $Omegaven^{TM}$. No current guidelines for the diagnosis and management of hypoganglionosis are available. We recommend a multidisciplinary approach and the use of novel therapies such as fat emulsions composed of omega-3 fatty acids for improved patient outcomes. Appropriate compassionate use protocols should be obtained from the Food and Drug Administration prior to initiation of $Omegaven^{TM}$.

A Study on Nutritional Status and Clinical Practice of Neurosurgical Tube-fed Patients (신경외과에 입원한 경관급식 환자의 영양지원 실태와 영양상태에 관한 연구)

  • 박명희;안정옥
    • Korean Journal of Community Nutrition
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    • v.3 no.3
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    • pp.430-439
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    • 1998
  • This study was performed to investigate the nutritional status of neurosurgical tube-fed patients. The objective of this study was to improve the nutrition management of tube-fed patients. The current practices of tube feeding and enteral nutrition formula as for 95 patients in the hospital were examined by reviewing patients charts, and interviewing patients, nurses and their family members. The results are summarized as follows ; 57.9% of patients that received the formula showed a decrease in mental status. Among the subjects, 55.7% had nervous system diseases due to old age. Most of the tube-fed patients were hospitalized in the emergency room and while hospitalized, the status of their respiratory organ was abnormal. The method of tube-feeding was by Bolus injection and the type of the tube was a 16Fr size silicone tube. The amount of the injection per day while tube-feeding was on average 1424kcal for men and 1322kcal for women and the calories per day ranged from 1000-1500kcal(50.5%). The injection volume averaged 332.7ml and 45% of patients received more than 300ml per injection. The tube feeding intake rate was 127.9ml/min with 50% of subjects in the range of 50-100ml/min and 10% at 20ml/min. The longer the hospitalization, the older age, coma status, and the higher tube feeding rate, the more decreased were the biochemical parameters.

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Management of Gastrointestinal Foreign Bodies with Brief Review of the Guidelines

  • Kaan Demiroren
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.1
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    • pp.1-14
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    • 2023
  • Foreign body (FB) ingestion is a common health problem that affects children more than adults. According to gastroenterologists' guidelines, the management of FB ingestion differs slightly between adult and children. This review aimed to compile adult and children guidelines and establish an understandable association to reveal the requirements and timing of the endoscopic procedure, which is the most effective and least complicated technique for gastrointestinal FBs. Coins, pins, and chicken and fish bones have been the most commonly ingested FBs. However, with their increasing use in recent years, large batteries with lithiumion conversion, stronger magnets composed of rare earth metals, such as neodymium, and superabsorbent objects have become the most morbid and mortal, necessitating new management strategies. Although the approach to gastrointestinal FBs is controversial, with different treatment options available in different disciplines, many studies have demonstrated the efficacy and safety of endoscopic procedures. Many factors influence the timing of endoscopy, including the nature, size, and location of the ingested object and the patient's clinical condition.

Job Analysis of School and Hospital Dietitians : Factor Analysis of Human Attributes (학교 및 병원 영양사의 직무분석 : 인적특성의 요인구조 비교)

  • 송은승;김명소
    • Korean Journal of Community Nutrition
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    • v.4 no.3
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    • pp.431-440
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    • 1999
  • This study was mainly done by factors analyzing to find out the structure and the dimension of the results of a previous study; analyzing the school and hospital dietitians'human attributes needed for successful job performance(Song 1998). The results were as follows: 1) Through factor analysis, the 12 knowledge items were categorized into 4 groups ; ‘basic knowledge of food and nutrition’, ‘knowledge of clinical nutrition and diet therapy’, ‘knowledge of medial science’, and ‘knowledge from experience and common sense’. These 4 knowledge factors were more frequently used and importantly recognized by hospital dietians compared with school dietitians. 2) The 38 skill and ability items were categorized into 7 groups ; ‘ability of program development and research’, ‘ability of counseling and nutrition education’, ‘ability of production control and facility management’, ‘ability to use computer’, ‘ability to cooperate with others’, ‘ability to manage consignment marketing’, and ‘ability of managing situations and informations’. Different skills and abilities were required for each group. 3) The 11 personality items were categorized as 3 groups ; ‘respoinsibility and sincerity’, ‘positive personality’, and ‘affirmative and inquisitive personality’.

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