A simple nutrition screening tool for hemodialysis nurses

Objective : To assess the reliability of a nurse-performed nutrition screening tool (NST) for hemodialysis (HD) patients to identify nutritionally at-risk patients.

Design : Tool reliability assessment.

Setting and Participants : The setting was nine non-hospital private (n = 3) and public (n = 6) HD units in Australia (two rural and seven metropolitan). Participants were 112 HD patients.

Results : A total of 112 HD patients (male = 65, female = 47) from 9 non-hospital HD units in Australia (seven metropolitan and two rural) were screened with the NST and the outcome of dietitian referral compared with Standard Dietitians Assessment. The mean age of patients was 57.6 years. Overall, the NST showed a sensitivity of 0.84 (range, 0.71 to 0.94; P < .05) and a specificity of 0.9 (range, 0.82 to 0.98; P < .05). The NST was more sensitive (sensitivity, 0.93 [range, 0.87 to 0.99; P < .05]) and was more specific for men (specificity, 0.92 [range, 0.85 to 0.99; P < .05]). Specificity was very strong in metropolitan patients (specificity, 0.94 [range, 0.87 to 1.01; P < .05]).

Conclusions : The tool was more sensitive and specific than the NST previously reported by the same investigators. The tool is particularly specific in that it screens those patients not requiring dietitian intervention. The use of this tool may benefit HD units that do not have on-site or regular dietetic support to prioritize patients needing dietitian intervention.

Review : nurses can improve patient nutrition in intensive care

Aims and objectives. To review the literature and identify opportunities for nutritional practice improvement in the critically ill and opportunities to improve nurses’ knowledge relating to enteral feeding.

Background. The literature reports varying nutritional practices in intensive care.

Design. Systematic review.

Methods. A systematic search, selection, analysis and review of nursing, medical and dietetic primary research articles was undertaken. Fifteen studies met the selection criteria.

Results. Delivery of nutrition to the critically ill varied widely. Patients were frequently underfed and less frequently, overfed. Both under- and overfeeding have been linked with unacceptable consequences including infections, extended weaning from mechanical ventilation, increased length of stay and increased mortality. Underfeeding was related to slow initiation and advancement of nutrition support and avoidable feed interruptions. The most common reasons for interrupting feeds were gastrointestinal intolerance and fasting for procedures. Certain nursing practices contributed to underfeeding such as the management of gastric residual volumes.

Conclusions. Consistent and reliable nutrition support in intensive care units is hampered by a lack of evidence leading to varying nutrition practices. Factors impeding delivery of enteral nutrition were considered avoidable. A new concept of a therapeutic range of energy delivery in the critically ill has emerged implying the need for re-evaluation of energy recommendations and improved delivery of enteral nutrition.

Relevance to clinical practice. This review supports the multi-disciplinary development and implementation of an evidence-based enteral feeding protocol in intensive care units as a strategy to improve adequacy of nutritional intake. Critical care nurses are well placed to improve this process.

Dietary sodium intake is associated with total fluid and sugar-sweetened beverage consumption in US children and adolescents aged 2 - 18 y : NHANES 2005 - 2008

Background: Increasing dietary sodium drives the thirst response. Because sugar-sweetened beverages (SSBs) are frequently consumed by children, sodium intake may drive greater consumption of SSBs and contribute to obesity risk.

Objective: We examined the association between dietary sodium, total fluid, and SSB consumption in a nationally representative sample of US children and adolescents aged 2–18 y.

Design: We analyzed cross-sectional data from NHANES 2005–2008. Dietary sodium, fluid, and SSB intakes were assessed with a 24-h dietary recall. Multiple regression analysis was used to assess associations between sodium, fluid, and SSBs adjusted for age, sex, race-ethnic group, body mass index (BMI), socioeconomic status (SES), and energy intake.

Results: Of 6400 participants, 51.3% (n = 3230) were males, and the average (±SEM) age was 10.1 ± 0.1 y. The average sodium intake was 3056 ± 48 mg/d (equivalent to 7.8 ± 0.1 g salt/d). Dietary sodium intake was positively associated with fluid consumption (r = 0.42, P < 0.001). After adjustment for age, sex, race-ethnic group, SES, and BMI, each additional 390 mg Na/d (1 g salt/d) was associated with a 74-g/d greater intake of fluid (P < 0.001). In consumers of SSBs (n = 4443; 64%), each additional 390 mg Na/d (1 g salt/d) was associated with a 32-g/d higher intake of SSBs (P < 0.001) adjusted for age, sex, race-ethnic group, SES, and energy intake.

Conclusions: Dietary sodium is positively associated with fluid consumption and predicted SSB consumption in consumers of SSBs. The high dietary sodium intake of US children and adolescents may contribute to a greater consumption of SSBs identifying a possible link between dietary sodium intake and excess energy intake.

Nutrition, management and other environmental influences on the quality and production of mohair and cashmere with particular reference to mediterranean and annual temperate climatic zones : a review

Goat fibre production is affected by genetic and environmental influences. Environmental influences which are the subject of this review include bio–geophysical factors (photoperiod, climate–herbage system and soil–plant trace nutrient composition), nutrition factors and management factors. Nutrition and management influences discussed include rate of stocking, supplementary feeding of energy and protein, liveweight change, parturition and management during shearing. While experimental data suggest affects of seasonal photoperiod on the growth of mohair and cashmere are large, these results may have confounded changes in temperature with photoperiod. The nutritional variation within and among years is the most important climatic factor influencing mohair and cashmere production and quality. Mohair quality and growth is affected significantly by rate of stocking and during periods of liveweight loss by supplementary feeding of either energy or protein. Strategic use of supplements, methods for rapid introduction of cereal grains, influence of dietary roughage on intake and the economics of supplementary feeding are discussed. Cashmere production of young, low producing goats does not appear to be affected by energy supplementation, but large responses to energy supplementation have been measured in more productive cashmere goat strains. The designs of these cashmere nutrition experiments are reviewed. Evidence for the hypothesis that energy-deprived cashmere goats divert nutrients preferentially to cashmere growth is reviewed. The influence and potential use of liveweight manipulation in affecting mohair and cashmere production and quality are described. Estimates of the energy requirements for the maintenance of fibre goats and the effect of pregnancy and lactation on mohair and cashmere growth are summarised. The effects and importance of management and hygiene during fibre harvesting (shearing) in producing quality fibre is emphasised. The review concludes that it is important to assess the results of scientific experiments for the total environmental content within which they were conducted. The review supports the view that scientific experiments should use control treatments appropriate to the environment under study as well as having controls relevant for other environments. In mediterranean and annual temperate environments, appropriate controls are liveweight loss and liveweight maintenance treatments. Mohair producers must graze goats at moderate rates of stocking to maximise animal welfare, but in so doing, they will produce heavier goats and coarser mohair. In mediterranean and annual temperate environments, seasonal changes in liveweight are large and influence both quality and production of mohair and cashmere. Mohair and cashmere producers can manipulate liveweight by supplementary feeding energy during dry seasons to minimise liveweight loss, but the economics of such feeding needs to be carefully examined. Strategic benefits can be obtained by enhancing the growth of young does prior to mating and for higher producing cashmere goats.

Is iron and zinc nutrition a concern for vegetarian infants and young children in industrialized countries?

Well-planned vegetarian diets are considered adequate for all stages of the life cycle, despite limited data on the zinc status of vegetarians during early childhood. The bioavailability of iron and zinc in vegetarian diets is poor because of their higher content of absorption inhibitors such as phytate and polyphenols and the absence of flesh foods. Consequently, children as well as adult vegetarians often have lower serum ferritin concentrations than omnivores, which is indicative of reduced iron stores, despite comparable intakes of total iron; hemoglobin differences are small and rarely associated with anemia. However, data on serum zinc concentrations, the recommended biomarker for identifying population groups at elevated risk of zinc deficiency, are sparse and difficult to interpret because recommended collection and analytic procedures have not always been followed. Existing data indicate no differences in serum zinc or growth between young vegetarian and omnivorous children, although there is some evidence of low serum zinc concentrations in vegetarian adolescents. Some vegetarian immigrants from underprivileged households may be predisposed to iron and zinc deficiency because of nondietary factors such as chronic inflammation, parasitic infections, overweight, and genetic hemoglobin disorders. To reduce the risk of deficiency, the content and bioavailability of iron and zinc should be enhanced in vegetarian diets by consumption of fortified cereals and milk, by consumption of leavened whole grains, by soaking dried legumes before cooking and discarding the soaking water, and by replacing tea and coffee at meals with vitamin C-rich drinks, fruit, or vegetables. Additional recommended practices include using fermented soy foods and sprouting at least some of the legumes consumed. Fortified foods can reduce iron deficiency, but whether they can also reduce zinc deficiency is less certain. Supplements may be necessary for vegetarian children following very restricted vegan diets.

Great 'app-eal' but not there yet: a review of iPhone nutrition applications relevant to child weight management

Aims: There is increasing interest in the use of smartphone applications (apps) for delivering child obesity management interventions and supporting lifestyle behaviour change; however, there has been very little academic research on their development. Our aim is to review nutrition-related apps designed for children currently available in Australia for their usefulness in education or support behavioural interventions for child obesity. Methods: Apps available for download in iTunes Australia between 2 April and 3 June 2013 which were suitable for children >12 years were identified. Key words were chosen to identify apps applicable to children, focusing on nutrition. Results: A total of 27 apps were included. Most apps (24/27) were not based on evidence-informed recommendations. A third of apps were developed in the USA (n = 10; 37%) and were free (67%), nine apps required upfront payment, with a mean cost of $A2.80 (range $A0.99-$A7.49). The most common nutrition features were the promotion of energy balance (n = 12 apps) and guidance on appropriate portion size (n = 15). The most common behaviour change feature was goal setting (n = 15). The five apps that scored most highly against the characteristics reviewed were: Calorie Counter Pro by My Net Diary, Weight Watchers, Swap It Don't Stop It, Control My Weight by CalorieKing and Rate What I Ate-Photo Diet Tracker. Conclusions: Very few apps were identified that could be used in education or support behavioural interventions for child obesity. There is a need to harness this technology and evaluate the applicability and use within childhood obesity research interventions.

Total gastrectomy with substitution of stomach by jejunal pouch with and without duodenal passage. Study in rats

A comparison was done between the F. Paulino jejunal pouch (FP) and a jejunal pouch (JP) as esophagusduodenum interpositional graft, for replacing the stomach after total gastrectomy. It was investigated the effect of the two procedures on esophagus histology, nutritional state and serum gastrin in rats. Methods: Male Wistar rats weighing 282±17g were randomly submitted to sham operation (S), FP and JP after total gastrectomy. After eight weeks the rats were killed with overdose of anesthetic and tissue was taken from the distal esophagus for histology. Serum levels of total proteins, albumin, iron, transferring, folate, cobalamine, calcium, as well as serum gastrin were determined. Survival was considered. Results: Fourty six rats were operated and thirty survived for eight weeks. Five (33.3%) died after FP and 11 (52.3%) after JP (p<0.05). Postoperative esophagitis occurred in 6 JP rats. At 8th week, no difference was observed on body weight when compared FP and JP rats (p>0.05). The JP rats had a significant decrease in serum albumin, glucose, transferrin, iron, folate and calcium, compared to sham (p<0.05). Serum gastrin, iron and calcium were significantly higher in JP rats than in FP rats (p<0.05). In FP rats, transferrin and cobalamine showed significant decrease comparing the preoperative with 8th week levels (p<0.05). Conclusion: F. Paulino pouch in rats had lower mortality than JP, and esophagitis was not detected in it. JP rats had serum gastrin, iron and calcium unaffected, possibly because of preservation of duodenal passage

IgA sérica, secretora, IgE total e estado nutricional em crianças com infecções por enteroparasitas

Infections for intestinal parasites are one of the main morbidade causes in humans and, its relationships with socioeconomic levels and hygiene conditions in countries in development are already very established. Many works, even so, they are being accomplished to elucidate the complex interactions among nutrition, these infections and answer imunológica, because it is seen that malnutrition commits the immunity increasing the susceptibilidade for infectious diseases and these for its time can harm the state human nutricional. It is known that sponge helmínticos they stimulate synthesis of IgE so much policlonal as specific for the same ones and that IgA secretora, main imunoglobulina of defense of the mucous ones, can act against protozoa as the Giardia lamblia and against helmintos as Trichuris tichiura and Strongyloides stercorales. Some studies show that the malnutrition energy protéica influences in the production of these answers, but some authors show results divergentes. In this work it was evaluated the levels of total IgE, IgA sérica and secretora, contagem of sanguine eosinófilos, levels of proteins séricas and state nutricional, in 103 children of low socioeconomic level, to discover a correlation between those and infection for enteroparasitas. They participated in the study children of both sexes, with age of 3 to 6 years, visitors of the same creche and residents in a neighborhood with precarious hygiene conditions and basic saneamento, in the city of Christmas. The obtained results showed that the faulty environmental and socioeconomic conditions favored to a high infection frequency for enteroparasitas, mainly Trichuris trichiura and Ascaris lumbricoides between the helmintos and Endolimax sleep and Giárdia lamblia among the protozoa. Light malnutrition without deficit protéico was observed in 30% of the children, which didn't also present significant deficiencies of IgA sérica and secretora. The sponged children

Effect of liming on the mineral nutrition and yield of growing guava trees in a typic hapludox soil

High soil acidity influences the availability of mineral nutrients and increases that of toxic aluminium (Al), which has a jeopardizing effect on plant growth. The objective of this research was to evaluate the effects of soil liming on the development of guava (Psidium guajava L.) plants, on soil chemical characteristics, and on fruit yield. The experiment was carried out at the Bebedouro Citrus Experimental Station, state of São Paulo, Brazil, in a Typic Hapludox soil, from August 1999 to March 2003. The treatments consisted of limestone dose: D0 = zero; D1 = half dose; D2 = total dose; D3 = 1.5 times the dose, and D4 = 2 times the dose to raise the V value to 70%. The doses corresponded to zero, 1.85, 3.71, 5.56, and 7.41tha(-1) applied to the upper soil layer (0-30cm deep) before planting. The results showed that liming caused an improvement in the evaluated soil chemical characteristics up to a depth of 60cm in soil samples both in the line and between lines. The highest fruit yields were obtained when the base saturation reached a value of 55% in the line and 62% between the lines. Foliar levels of calcium (Ca) and magnesium (Mg) were 8.8 and 2.5gkg-1, respectively. The highest limestone dose maintained the soil base saturation (at the layer of 0-20cm) in the line close to 55% during at least 40 months after the incorporation of limestone.

Sunflower meal in commercial layer diets formulated on total and digestible amino acids basis

An experiment was conduced to evaluate the inclusion of sunflower meal (SBM) in commercial layer diets formulated on total or digestible amino acids basis. One hundred forty-four 41-week-old Lohmann LSL layers were distributed in a completely randomized experimental design in a 2 x 4 factorial arrangement with three replications of six birds each. Treatments consisted of a combination of four SBM inclusion levels SBM(0%, 4%, 8%, and 12%) and feed formulation according two amino acid recommendations (total or digestible). The experimental period was divided into five periods of fourteen days. Performance parameters (egg production, feed intake, feed conversion, egg mass) were evaluated for each period. In the last two days of each period, three eggs per replication were collected to evaluate egg quality (Haugh units, specific gravity, egg weight, eggshell thickness, and eggshell percentage). Hens fed on total amino acid recommendation presented the highest values for egg weight. Diets formulated on digestible amino acids basis showed an improvement in eggshell percentage and egg specific gravity. SBM addition in commercial layer diets did not influence performance; however, increasing SBM dietary levels SBM improved eggshell quality.

Commercial laying hen diets formulated according to different recommendations of total and digestible amino acids

An experiment was conducted to evaluate different commercial laying hen diets formulated based on recommendations for total and digestible amino acids. One hundred and twenty Lohmann LSL commercial laying hens aged 25 weeks were distributed in a completely randomized experimental design involving five replications of six birds in four treatments. Diet formulation on a total amino acid basis followed the recommendations of NRC (1994) and Rostagno et al. (2000), whereas formulation on digestible amino acids basis was according to Rostagno et al. (2000) and Degussa (1997) recommendations. The experimental period was divided into five periods of fourteen days. Performance parameters (egg production, feed intake, feed conversion, egg mass) were evaluated for each period, and on the last two days of each period, three eggs per replication were collected to evaluate egg quality parameters (Haugh unit, egg specific gravity, egg weight, eggshell thickness and percentage). Means were compared by orthogonal contrasts. Results on feed intake, egg production, egg mass, feed conversion and egg specific gravity showed that total amino acid recommendations promoted better bird responses than digestible amino acid recommendations.

The importance of endogenous nutrition of chicks from divergent strains for growing tested by deutectomy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Antioxidant activity, ascorbic acid and total phenol of exotic fruits occurring in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Correlação linear e espacial entre a produtividade de forragem, a porosidade total e a densidade do solo de Pereira Barreto (SP)

Em relação aos sistemas de manejo adotados pelo homem, a porosidade total e a densidade do solo são atributos ativamente alterados, refletindo decisivamente sobre a produtividade vegetal agrícola. No ano agrícola de 2005, na Fazenda Bonança, no município de Pereira Barreto, Estado de São Paulo, Brasil, foram analisadas a produtividade de forragem do milho outonal (MSF) no sistema plantio direto irrigado, a porosidade total (PT) e a densidade do solo (DS) em profundidade, em um Latossolo Vermelho distrófico. O objetivo foi estudar a variabilidade e as correlações lineares e espaciais entre os atributos da planta e do solo, visando selecionar um indicador da qualidade física do solo de boa representatividade para produtividade da forragem. Foi instalada a malha geoestatística, para coleta de dados do solo e planta, contendo 125 pontos amostrais, numa área de 2.500 m². Os atributos estudados, além de não terem variado aleatoriamente, apresentaram variabilidade dos dados entre média e baixa e seguiram padrões espaciais bem definidos, com alcance entre 6,8 e 23,7 m. Por sua vez, a correlação linear entre o atributo da planta e os do solo, em razão do elevado número de observações, foi baixa. As observações de melhor correlação com a MSF foram a DS1 e a PT1. Entretanto, do ponto de vista espacial, houve excelente correlação inversa entre a MSF e a DS1, assim como entre a DS1 e a PT1. Nos sítios onde a DS1 aumentou (1,45-1,64 kg dm-3) a MSF variou entre 11.653 e 14.552 kg ha-1; já naqueles onde diminuiu (1,35-1,45 kg dm-3) a MSF, ficou entre 14.552 e 17.450 kg ha-1. Portanto, a densidade global, avaliada na camada de 0-0,10 m (DS1), apresentou-se como satisfatório indicador da qualidade física do solo de Pereira Barreto (SP), quando destinado à produtividade de forragem do milho outonal.

Bromeliad-living spiders improve host plant nutrition and growth

Although bromeliads are believed to obtain nutrients from debris deposited by animals in their rosettes, there is little evidence to support this assumption. Using stable isotope methods, we found that the Neotropical jumping spider Psecas chapoda (Salticidae), which lives strictly associated with the terrestrial bromeliad Bromelia balansae, contributed 18% of the total nitrogen of its host plant in a greenhouse experiment. In a one-year field experiment, plants with spiders produced leaves 15% longer than plants from which the spiders were excluded. This is the first study to show nutrient provisioning in a spider-plant system. Because several animal species live strictly associated with bromeliad rosettes, this type of facultative mutualism involving the Bromeliaceac may be more common than previously thought.