Adherence to nutrition supplements among patients with a fall-related lower limb fracture

Background The purpose of this study was to provide a detailed evaluation of adherence to nutrition supplements by patients with a lower limb fracture. Methods These descriptive data are from 49 nutritionally“ at-risk” patients aged 70+ years admitted to the hospital after a fall-related lower limb fracture and allocated to receive supplementation as part of a randomized, controlled trial. Supplementation commenced on day 7 and continued for 42 days. Prescribed volumes aimed to meet 45% of individually estimated theoretical energy requirements to meet the shortfall between literature estimates of energy intake and requirements. The supplement was administered by nursing staff on medication rounds in the acute or residential care settings and supervised through thrice-weekly home visits postdischarge. Results Median daily percent of the prescribed volume of nutrition supplement consumed averaged over the 42 days was 67% (interquartile range [IQR], 31–89, n = 49). There was no difference in adherence for gender, accommodation, cognition, or whether the supplement was self-administered or supervised. Twenty-three participants took some supplement every day, and a further 12 missed <5 days. For these 35 “nonrefusers,” adherence was 82% (IQR, 65–93), and they lost on average 0.7% (SD, 4.0%) of baseline weight over the 6 weeks of supplementation compared with a loss of 5.5% (SD, 5.4%) in the “refusers” (n = 14, 29%), p = .003. Conclusions We achieved better volume and energy consumption than previous studies of hip fracture patients but still failed to meet target supplement volumes prescribed to meet 45% of theoretical energy requirements. Clinicians should consider alternative methods of feeding such as a nasogastric tube, particularly in those patients where adherence to oral nutrition supplements is poor and dietary intake alone is insufficient to meet estimated energy requirements.

An assessment of the potential of family day care as a nutrition promotion setting in South Australia

Articles > Journals > Health journals > Nutrition & Dietetics: The Journal of the Dieticians Association of Australia articles > March 2003 Article: An assessment of the potential of Family Day Care as a nutrition promotion setting in South Australia. (Original Research). Article from:Nutrition & Dietetics: The Journal of the Dieticians Association of Australia Article date:March 1, 2003 Author:Daniels, Lynne A.; Franco, Bunny; McWhinnie, Julie-Anne CopyrightCOPYRIGHT 2006 Dietitians Association of Australia. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights or concerns about this content should be directed to customer service. (Hide copyright information) Related articles Ads by Google TAFE Child Care Courses Government accredited courses. Study anytime, anywhere. www.seeklearning.com.au Get Work in Child Care Certificate III Children's Services 4 Day Course + Take Home Assessment HBAconsult.com.au Abstract Objective: To assess the potential role of Family Day Care in nutrition promotion for preschool children. Design and setting: A questionnaire to examine nutrition-related issues and practices was mailed to care providers registered in the southern region of Adelaide, South Australia. Care providers also supplied a descriptive, qualitative recall of the food provided by parents or themselves to each child less than five years of age in their care on the day closest to completion of the questionnaire. Subjects: 255 care providers. The response rate was 63% and covered 643 preschool children, mean 4.6 (SD 2.8) children per carer. Results: There was clear agreement that nutrition promotion was a relevant issue for Family Day Care providers. Nutrition and food hygiene knowledge was good but only 54% of respondents felt confident to address food quality issues with parents. Sixty-five percent of respondents reported non-neutral approaches to food refusal and dawdling (reward, punishment, cajoling) that overrode the child's control of the amount eaten. The food recalls indicated that most children (> 75%) were offered fruit at least once. Depending on the hours in care, (0 to 4, 5 to 8, greater than 8 hours), 20%, 32% and 55%, respectively, of children were offered milk and 65%, 82% and 87%, respectively, of children were offered high fat and sugar foods. Conclusions: Questionnaire responses suggest that many care providers are committed to and proactive in a range of nutrition promotion activities. There is scope for strengthening skills in the management of common problems, such as food refusal and dawdling, consistent with the current evidence for approaches to early feeding management that promote the development of healthy food preferences and eating patterns. Legitimising and empowering care providers in their nutrition promotion role requires clear policies, guide lines, adequate pre- and in-service training, suitable parent materials, and monitoring.

Good nutrition for good surgery: clinical and quality of life outcomes

Undernutrition is common in patients admitted for surgery and is often unrecognised, untreated and worsens in hospital. The complex synergistic relationship between nutritional status and the physiological responses to surgery puts patients at high nutritional risk. There are clear prospective associations between inadequate nutritional status and the risk of poorer outcomes for surgical patients, including infection, complications and length of stay. However, practically and ethically evidence that nutritional interventions can significantly reduce these poor outcomes is difficult to obtain. Nevertheless health professionals have a duty of care to ensure our patients are properly fed, by whatever means, to meet their physiological requirements.

Evaluation of fruit and vegetable intakes of Australian adults: the nutrition survey 1995

Objective: To evaluate the fruit and vegetable intakes of Australian adults aged 19-64 years. Methods: Intake data were collected as part of the National Nutrition Survey 1995 representing all Australian States and Territories, including city, metropolitan, rural and remote areas. Dietary intake of 8,891 19-to-64 year-olds was assessed using a structured 24-hour recall. Intake frequency was assessed as the proportion of participants consuming fruit and vegetables on the day prior to interview and variety was assessed as the number of subgroups of fruit and vegetables consumed. Intake levels were compared with the recommendations of the Australian Guide to Healthy Eating (AGHE). Results: Sixty-two per cent of participants consumed some fruit and 89% consumed some vegetables on the day surveyed. Males were less likely to consume fruit and younger adults less likely to consume fruit and vegetables compared with females and older adults respectively. Variety was primarily low (1 subcategory) for fruit and medium (3-4 subcategories) for vegetables. Thirty-two per cent of adults consumed the minimum two serves of fruit and 30% consumed the minimum five serves of vegetables as recommended by the AGHE. Eleven per cent of adults met the minimum recommendations for both fruit and vegetables. Conclusion: A large proportion of adults have fruit and vegetable intakes below the AGHE minimum recommendations. Implications: A nationally integrated, longterm campaign to increase fruit and vegetable consumption, supported by policy changes to address structural barriers to consumption, is vital to improve fruit and vegetable consumption among adults

Raman spectroscopic study of the hydroxy-arsenate mineral pharmacolite Ca(HAsO4)•2H2O : implications for aquifer and sediment remediation

The removal of arsenate anions from aqueous media, sediments and wasted soils is of environmental significance. The reaction of gypsum with the arsenate anion results in pharmacolite mineral formation, together with related minerals. Raman and infrared spectroscopy have been used to study the mineral pharmacolite Ca(HAsO4)•2H2O. The mineral is characterised by an intense Raman band at 865 cm-1 assigned to the (AsO4)3- symmetric stretching mode. The equivalent infrared band is found at 864 cm-1. The low intensity Raman band at 886 cm-1 provides evidence for (AsO3OH)2-. A series of overlapping bands in the 300 to 450 cm-1 are attributed to ν2 and ν4 bending modes. Prominent Raman bands at around 3187 cm-1 are assigned to water OH stretching vibrations and the two sharp bands at 3425 and 3526 cm-1 to the OH stretching vibrations of (HOAsO3) units.

Raman spectroscopic study of the antimonate mineral bottinoite Ni[Sb2(OH)12].6H2O and in comparison with brandholzite Mg[Sb5+2(OH)12]•6H2O

Raman spectra of bottinoite Ni[Sb(OH)6].6H2O were studied, and related to the molecular structure of the mineral. An intense sharp Raman band at 618 cm-1 is attributed to the SbO symmetric stretching mode. The low intensity band at 735 cm-1 is ascribed to the SbO antisymmetric stretching vibration. Low intensity Raman bands were found at 501, 516 and 578 cm-1. Four Raman bands observed at 1045, 1080, 1111 and 1163 cm-1 are assigned to δ SbOH deformation modes. A complex pattern resulting from the overlapping band of the water and hydroxyl units is observed. Raman bands are observed at 3223, 3228, 3368, 3291, 3458 and 3510 cm-1. The first two Raman bands are assigned to water stretching vibrations. The two higher wavenumber Raman bands observed at 3466 and 3552 cm-1 and two infrared bands at 3434 and 3565 cm-1 are assigned to the stretching vibrations of the hydroxyl units. Observed Raman and infrared bands are connected with O-H…O hydrogen bonds and their lengths 2.72, 2.79, 2.86, 2.88 and 3.0 Å (Raman) and 2.73, 2.83 and 3.07 Å (infrared).

Raman spectroscopic study of the uranyl titanate mineral betafite (Ca,U)2(Ti,Nb)2O6(OH) –Effect of Metamictization

Raman spectra of the uranyl titanate mineral betafite were obtained and related to the mineral structure. A comparison is made with the spectra of uranyl oxyhydroxide hydrates. Observed bands are attributed to the (UO2)2+ stretching and bending vibrations, U-OH bending vibrations, H2O and (OH)- stretching, bending and libration modes. U-O bond lengths in uranyls and O-H…O bond lengths are calculated from the wavenumbers assigned to the stretching vibrations. Raman bands of betafite are comparable with those of the uranyl oxyhydroxides. The mineral betafite is metamict as is evidenced by the intensity of the UO stretching and bending modes being of lower intensity than expected and with bands that are significantly broader.

Raman spectroscopic study of the uranyl titanate mineral holfertite CaxU2-xTi(O8-xOH4x)•3H2O and the lack of metamictization

Raman spectra of the uranyl titanate mineral holfertite CaxU2-xTi(O8-xOH4x)•3H2O were analysed and related to the mineral structure. Observed bands are attributed to the TiO and (UO2)2+ stretching and bending vibrations, U-OH bending vibrations, H2O stretching, bending. The mineral holfertite is metamict as is evidenced by order/disorder of the mineral. Unexpectedly the Raman spectrum of holfertite does not show any metamictization. The intensity of the UO stretching and bending modes show normal intensity and the bands are sharp.

The effect of metamictization on the Raman spectroscopy of the uranyl titanate mineral davidite (La,Ce)(Y,U,Fe2+)(Ti,Fe3+)20(O,OH)38

Raman spectra of the uranyl titanate mineral davidite-(La) (La,Ce)(Y,U,Fe2+)(Ti,Fe3+)20(O,OH)38 were analysed and related to the mineral structure. Observed bands are attributed to the TiO and (UO2)2+ stretching and bending vibrations, U-OH bending vibrations, H2O and (OH)- stretching, bending and libration modes. U-O bond lengths in uranyls and O-H…O bond lengths are calculated from the wavenumbers assigned to the stretching vibrations. Raman bands of davidite-(La) are in harmony with those of the uranyl oxyhydroxides. The mineral davidite-(La) is metamict as is evidenced by the intensity of the UO stretching and bending modes being of lower intensity than expected and with bands that are significantly broader.

Dussertite BaFe3+3(AsO4)2(OH)5 : a Raman spectroscopic study of a hydroxy-arsenate mineral

The mineral dussertite, a hydroxy-arsenate mineral of formula BaFe3+3(AsO4)2(OH)5, has been studied by Raman complimented with infrared spectroscopy. The spectra of three minerals from different origins were investigated and proved quite similar, although some minor differences were observed. In the Raman spectra of Czech dussertite, four bands are observed in the 800 to 950 cm-1 region. The bands are assigned as follows: the band at 902 cm-1 is assigned to the (AsO4)3- ν3 antisymmetric stretching mode, at 870 cm-1 to the (AsO4)3- ν1 symmetric stretching mode, and both at 859 cm-1 and 825 cm-1 to the As-OM2+/3+ stretching modes/and or hydroxyls bending modes. Raman bands at 372 and 409 cm-1 are attributed to the ν2 (AsO4)3- bending mode and the two bands at 429 and 474 cm-1 are assigned to the ν4 (AsO4)3- bending mode. An intense band at 3446 cm-1 in the infrared spectrum and a complex set of bands centred upon 3453 cm-1 in the Raman spectrum are attributed to the stretching vibrations of the hydrogen bonded (OH)- units and/or water units in the mineral structure. The broad infrared band at 3223 cm-1 is assigned to the vibrations of hydrogen bonded water molecules. Raman spectroscopy identified Raman bands attributable to (AsO4)3- and (AsO3OH)2- units.

Raman spectroscopic study of the mineral thorikosite Pb3(OH)(SbO3,AsO3)Cl2 : a mineral of archaeological significance

The mineral thorikosite Pb3(OH)(SbO3,AsO3)Cl2 is named after the ancient city of Thorikos, in the region of Attica, where the ancient mine sites dating back to the bronze ages are found. Raman spectra of the antimonate bearing mineral thorikosite Pb3(OH)(SbO3,AsO3)Cl2 were studied, and related to the structure of the mineral. Two intense Raman peaks are observed at 596 and 730 cm-1 and are assigned to the Sb3+O3 and As3+O3 stretching vibrations. A peak at 1085 cm-1 is assigned to the Sb3+OH deformation mode. Raman band at 325 cm-1 is assigned to an OAsO bending vibration of the As3+O3 units and the bands at 269 and 275 cm-1 are attributed to the OSbO bending modes of the Sb3+O3 units. The intense Raman bands at 112 and 133 cm-1 are associated with PbCl stretching modes. Minerals such as nealite and thorikosite are minerals of archaeological significance. Yet no spectroscopic studies of these minerals have been undertaken.

The mineral nealite Pb4Fe2+(AsO3)2Cl4•2H2O : a Raman spectroscopic study

The mineral nealite Pb4Fe2+(AsO3)2Cl4•2H2O is of archaeological significance as it is man made mineral formed through the dumping of mine wastes in the sea. The mineral has been studied by Raman spectroscopy. Raman spectroscopy identifies intense Raman bands at 708 and 732 cm-1 assigned to AsO33- stretching vibrations. In addition low intensity bands are observed at 604 and 632 cm-1 which are attributed to As2O42- symmetric and antisymmetric stretching modes. Low intensity Raman band is observed at 831 cm-1 and is assigned to the AsO44- stretching vibration. Intense Raman bands at 149 and 183 cm-1 are attributed to M-Cl stretching vibrations. Raman spectroscopy identifies arsenic anions in different oxidation states in the mineral. The molecular structure of the mineral nealite, as indicated by Raman spectroscopy, is more complex than has been reported by previous studies.

Raman spectroscopic study of a hydroxy-arsenate mineral containing bismuth-atelestite Bi2O(OH)(AsO4)

The Raman spectrum of atelestite Bi2O(OH)(AsO4), a hydroxy-arsenate mineral containing bismuth, has been studied in terms of spectra-structure relations. The studied spectrum is compared with the Raman spectrum of atelestite downloaded from the RRUFF database. The sharp intense band at 834 cm-1 is assigned to the 1 AsO43- (A1) symmetric stretching mode and the three bands at 767, 782 and 802 cm-1 to the 3 AsO43- antisymmetric stretching modes. The bands at 310, 324, 353, 370, 395, 450, 480 and 623 cm-1 are assigned to the corresponding ν4 and ν2 bending modes and Bi-O-Bi (vibration of bridging oxygen) and Bi-O (vibration of non-bridging oxygen) stretching vibrations. Lattice modes are observed at 172, 199 and 218 cm-1. A broad low intensity band at 3095 cm-1 is attributed to the hydrogen bonded OH units in the atelestite structure. A weak band at 1082 cm-1 is assigned to  (Bi-OH) vibration.