[Gerodontic consultation service for hospitalized geriatric patients: diagnosis and therapy (II)]

The aim of the study was to report on oral, dental and prosthetic conditions as well as therapeutic measures for temporarily institutionalized geriatric patients. The patients were referred to the dentist since dental problems were observed by the physicians or reported by the patients themselves. This resulted in a selection among the geriatric patients; but they are considered to be representative for this segment of patients exhibiting typical signs of undertreatment. The main problem was the poor retention of the prosthesis, which was associated to insufficient masticatory function and poor nutrition status. Forty-seven percent of the patients were edentulous or had maximally two radicular rests out of function. Altogether 70% of the maxillary and 51% of the mandibular jaws exhibited no more teeth. Eighty-nine percent of the patients had a removable denture, and it was observed that maxillary dentures were regularly worn in contrast to mandibular dentures. The partially edentate patients had a mean number of ten teeth, significantly more in the manidublar than maxillary jaw. Treatment consisted mainly in the adaptation and repair of dentures, tooth extractions and fillings. Only few appointments (mostly two) were necessary to improve the dental conditions, resulting in low costs. Patients without dentures or no need for denture repair generated the lowest costs. Slightly more visits were necessary for patients with dementia and musculoskeletal problems. The present findings show that regular maintenance care of institutionalized geriatric patients would limit costs in a long-term perspective, improve the oral situation and reduce the need for invasive treatment.

Schistosoma haematobium in Guinea-Bissau: unacknowledged morbidity due to a particularly neglected parasite in a particularly neglected country

Schistosomiasis is the major neglected tropical helminthic disease worldwide. Current knowledge on the epidemiology of schistosomiasis in Guinea-Bissau is scarce and regarding to the absence of Schistosoma haematobium (S.h.). Therefore, a pilot study was undertaken to assess the prevalence and morbidity due to S.h. infection in randomly selected 90 children and adolescents aged 6 to 15 years. Prevalence of S.h. infection was 20.00 % (18/90). Microhematuria was observed in 61.11 % (11/18) of S.h.-egg-excreting vs. 37.50 % (27/72) of non-S.h.-egg-excreting children p ≤ 0.01. Body mass index (BMI) was less than 15 kg/m(2) in 52/90 (57.78 %) of all children and adolescents, but this proportion increased to 66.67 % (12/18) in S.h.-infected children who were more frequently stunted and wasted than in non-infected children. The mean weight-for-age Z score (WAZ) was reduced in S.h. infected as compared to non-infected children (-1.48 ± 1.08 SD vs. -0.80 ± 1.11 SD; p ≤ 0.01). To our knowledge, this is the first epidemiologic report on S. haematobium infection in Guinea-Bissau since 22 years. Even in this relatively small study sample, it appears that S. haematobium, besides the well-known symptoms such as hematuria, leads to significant, albeit commonly unacknowledged morbidity such as stunting and wasting. These observations underscore the notion that this vulnerable but neglected population urgently needs to be targeted for implementation of measures for treatment and control.

Differential impacts of elevated CO2 and acidosis on the energy budget of gill and liver cells from Atlantic cod

Ocean acidification impacts fish and other marine species through increased seawater PCO2 levels (hypercapnia). Knowledge of the physiological mechanisms mediating effects in various tissues of fish is incomplete. Here we tested the effects of extracellular hypercapnia and acidosis on energy metabolism of gill and liver cells of Atlantic cod. Exposure media mimicked blood conditions in vivo, either during normo- or hypercapnia and at control or acidic extracellular pH (pHe). We determined metabolic rate and energy expenditure for protein biosynthesis, Na+/K+-ATPase and H+-ATPase and considered nutrition status by measurements of metabolic rate and protein biosynthesis in media with and without free amino acids (FAA). Addition of FAA stimulated hepatic but not branchial oxygen consumption. Normo- and hypercapnic acidosis as well as hypercapnia at control pHe depressed metabolic stimulation of hepatocytes. In gill cells, acidosis depressed respiration independent of PCO2 and FAA levels. For both cell types, depressed respiration was not correlated with the same reduction in energy allocated to protein biosynthesis or Na+/K+-ATPase. Hepatic energy expenditure for protein synthesis and Na+/K+- ATPase was even elevated at acidic compared to control pHe suggesting increased costs for ion regulation and cel- lular reorganization. Hypercapnia at control pHe strongly reduced oxygen demand of branchial Na+/K+-ATPase with a similar trend for H+-ATPase. We conclude that extracellular acidosis triggers metabolic depression in gill and metabolically stimulated liver cells. Additionally, hypercapnia itself seems to limit capacities for metabolic usage of amino acids in liver cells while it decreases the use and costs of ion regulatory ATPases in gill cells.

Soil management system effects on N availability and tree productivity in chestnut planatations under Mediterranean conditions

Soil tillage with chisel ploughing is the conventional soil management system in chestnut stands for fruit production in Northern Portugal. A study was developed to assess the effects of three soil management systems on in situ soil N mineralization dynamics, tree nutrition status and fruit productivity, in a 50-yr old chestnut stand. The treatments were: conventional tillage with a chisel ploughing twice a year (CT), no-tillage with rainfed improved pasture with leguminous and grasses plants (NIP), and no-tillage with spontaneous herbaceous vegetation - natural pasture (NP). The CT treatment showed a strong increase of the soil N mineral concentration following soil disturbance by tillage, but the cumulative net N mineralized along the year was significantly lower (51.8 kg ha-1) than in the NIP (85.1 kg ha-1) treatment. The NP treatment (65.9 kg ha-1) did not cause a reduction in the soil N mineralization when compared to the CT treatment. The mineralization rate (g mineralized N kg-1 total N) in 2004 was about 26, 30 and 38 in the treatments CT, NP and NIP, respectively. Treatments showed different soil N dynamics, the proportion of mineralized NO3--N being lower in the NP (10-48%) than in CT and NIP treatments (53-74%). Our study indicates that no-tillage systems improve the tree nutrition status and enhance productivity

Nutritional status and dietary intake of acute care patients : results from the Nutrition Care Day Survey 2010

Background & aims: One aim of the Australasian Nutrition Care Day Survey was to determine the nutritional status and dietary intake of acute care hospital patients. Methods: Dietitians from 56 hospitals in Australia and New Zealand completed a 24-h survey of nutritional status and dietary intake of adult hospitalised patients. Nutritional risk was evaluated using the Malnutrition Screening Tool. Participants ‘at risk’ underwent nutritional assessment using Subjective Global Assessment. Based on the International Classification of Diseases (Australian modification), participants were also deemed malnourished if their body mass index was <18.5 kg/m2. Dietitians recorded participants’ dietary intake at each main meal and snacks as 0%, 25%, 50%, 75%, or 100% of that offered. Results: 3122 patients (mean age: 64.6 ± 18 years) participated in the study. Forty-one percent of the participants were “at risk” of malnutrition. Overall malnutrition prevalence was 32%. Fifty-five percent of malnourished participants and 35% of well-nourished participants consumed ≤50% of the food during the 24-h audit. “Not hungry” was the most common reason for not consuming everything offered during the audit. Conclusion: Malnutrition and sub-optimal food intake is prevalent in acute care patients across hospitals in Australia and New Zealand and warrants appropriate interventions.

Nutritonal status of adult ewes during early and mid-pregnancy. 1. Effects of plane of nutrition on ewe reproduction and offspring performance to weaning

The objective of this study was to determine the effects of plane of nutrition during early and mid-pregnancy on the performance of mature ewes and their offspring. From day 0 to day 39 post mating (early pregnancy, EP), 82 multiparous ewes were fed to provide either 60% (low, L), 100% (medium, M) or 200% (high, H) of predicted metabolisable energy (ME) requirements for maintenance, following a synchronised mating. From day 40 to day 90 (mid-pregnancy, MP), ewes were provided with either 80% (M) or 140% (H) of ME requirements. After 90 days of gestation, all ewes were fed to meet requirements for late pregnancy. During EP, mean live weight (LW) and body condition score (BCS) change of ewes were -6.3, -0.8 and +6.0kg and -0.02, +0.10 and +0.22 units in the L-, M- and H-EP treatments, respectively. During MP, mean LW and BCS change were -0.8 and +4.9kg and -0.09 and +0.09 units in the M- and H-MP treatments, respectively (P 0. 05) on conception rate, although there tended to be an inverse relationship (P = 0.085) between plane of nutrition in EP and plasma progesterone concentrations at day 42 of gestation. EP nutrition influenced foetal development with lambs from ewes offered diet L-EP being smaller (P

Assessment of long chain n-3 polyunsaturated fatty acid status and clinical outcome in adults receiving home parenteral nutrition

Background & aims: Long term parenteral nutrition rarely supplies the long chain n-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA). The aim of this study was to assess long chain n-3 PUFA status in patients receiving home parenteral. nutrition (HPN). Methods: Plasma phospholipid fatty acids were measured in 64 adult HPN patients and compared with 54 age, sex and BMI matched controls. Logistic regression analysis was used to identify factors related to plasma fatty acid fractions in the HPN patients, and to identify factors associated with the risk of clinical. complications. Results: Plasma phospholipid fractions of EPA, DPA and DHA were significantly tower in patients receiving HPN. Factors independently associated with tow fractions included high parenteral energy provision, tow parenteral lipid intake, tow BMI and prolonged duration of HPN. Long chain n-3 PUFA fractions were not associated with incidence of either central venous catheter associated infection or central venous thrombosis. However, the fraction of EPA were inversely associated with plasma alkaline phosphatase concentrations. Conclusions: This study demonstrates abnormal long chain n-3 PUFA profiles in patients receiving HPN. Reduced fatty acid intake may be partly responsible. Fatty acid metabolism may also be altered. (C) 2008 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Analysis of dietary pattern impact on weight status for personalised nutrition through on-line advice: the Food4Me Spanish cohort

Obesity prevalence is increasing. The management of this condition requires a detailed analysis of the global risk factors in order to develop personalised advice. This study is aimed to identify current dietary patterns and habits in Spanish population interested in personalised nutrition and investigate associations with weight status. Self-reported dietary and anthropometrical data from the Spanish participants in the Food4Me study, were used in a multidimensional exploratory analysis to define specific dietary profiles. Two opposing factors were obtained according to food groups’ intake: Factor 1 characterised by a more frequent consumption of traditionally considered unhealthy foods; and Factor 2, where the consumption of “Mediterranean diet” foods was prevalent. Factor 1 showed a direct relationship with BMI (β = 0.226; r2 = 0.259; p < 0.001), while the association with Factor 2 was inverse (β = −0.037; r2 = 0.230; p = 0.348). A total of four categories were defined (Prudent, Healthy, Western, and Compensatory) through classification of the sample in higher or lower adherence to each factor and combining the possibilities. Western and Compensatory dietary patterns, which were characterized by high-density foods consumption, showed positive associations with overweight prevalence. Further analysis showed that prevention of overweight must focus on limiting the intake of known deleterious foods rather than exclusively enhance healthy products.

The effect of complex workplace dietary interventions on employees dietary behaviours, nutrition knowledge and health status

Background The growing prevalence and associated burden of diet-related non-communicable diseases is a global public health concern. The environments in which people live and work influences their dietary behaviours. Aim The focus of this thesis was on the effectiveness of complex workplace dietary interventions. The comparative effectiveness of a complex workplace environmental dietary modification intervention and an educational intervention were assessed both alone and in combination relative to a control workplace setting. Methods The systematic review was guided by the PRISMA statement. In a cluster controlled trial, four workplaces were purposively allocated to control, nutrition education alone (Education), environmental dietary modification alone (Environment) and nutrition education and environmental dietary modification (Combined intervention). The interventions were guided by the MRC framework. In the control workplace, data were collected at baseline and follow-up. In the intervention related sub-study, the relationships between nutrition knowledge, diet quality and hypertension were examined. Results The systematic review provided limited evidence. In the FCW study, 850 employees aged 18-64 years were recruited at baseline with N(response rate %) in each workplace as follows: Control: 111(72%), Education: 226(71%), Environment: 113(91%), Combined intervention: 400(61%). Complete follow-up data was obtained for 517 employees (61%). There were significant positive changes in dietary intakes of saturated fat(p=0.013), salt(p=0.010) and nutrition knowledge(p=0.034) between baseline and follow-up at 7-9 months in the combined intervention versus the control workplace in the fully adjusted multivariate analysis. Small but significant changes in BMI(-1.2kg/m2 (p=0.047) were also observed in the combined intervention. In the sub-study, nutrition knowledge was positively significantly associated with diet quality and blood pressure but no evidence of a mediation effect of the DASH score was detected between nutrition knowledge and blood pressure. Conclusion This thesis provides critical evidence on the effectiveness of complex workplace dietary interventions in a manufacturing working population.

Biofloc contribution to antioxidant defence status, lipid nutrition and reproductive performance of broodstock of the shrimp Litopenaeus stylirostris: Consequences for the quality of eggs and larvae

The aim of this study was to determine biofloc contributions to the antioxidant status and lipid nutrition of broodstock of Litopenaeus stylirostris in relationship with their reproductive performance and the health of larvae produced. Shrimp broodstock reared with Biofloc technology (BFT) compared to Clear water (CW) exhibited a higher health status with (i) a better final survival rate during the reproduction period (52.6% in CW against 79.8% in BFT); (ii) higher glutathione level (GSH) and total antioxidant status (TAS), reduced oxidized/reduced glutathione ratio and a higher spawning rate and frequency as well as higher gonado-somatic index and number of spawned eggs. Finally, larvae from broodstock from BFT exhibited higher survival rates at the Zoe 2 (+ 37%) and Post Larvae 1 (+ 51%) stages when compared with those from females from CW treatment. The improved reproductive performance of the broodstock and higher larvae survival rate resulting from BFT treatment may be linked to the dietary supplement obtained by the shrimp from natural productivity during BFT rearing. Indeed, our study confirms that biofloc particulates represent a potential source of dietary glutathione and a significant source of lipids, particularly essential phospholipids and n-3 highly unsaturated fatty acids (HUFA) for shrimps. Thus, broodstock from BFT treatment accumulated phospholipids, n-3 HUFA and arachidonic acid, which are necessary for vitellogenesis, embryogenesis and pre-feeding larval development. The predominant essential fatty acids, arachidonic acid (ARA), eicopentaeonic acid (EPA) and docosahexaenoic acid (DHA), had levels in the eggs that were, respectively, 2.5, 2.8 and 3 fold higher for BFT compared to the CW treatment. Statement of Relevance Today, the influence of biofloc technology on shrimp broodstock is not enough described and no information was available on the larvae quality. Moreover, two key pieces of new information emerge from the present study. Firstly, biofloc is a source of further dietary lipids that can act as energetic substrates, but also as a source of phospholipids and essential fatty acids necessary to sustain reproduction, embryonic and larval development. Second, improving the reproduction of the broodstock also leads to an improvement in the quality of the larvae. We think that our research is new and important to increase knowledge on biofloc topic. We believe the paper will contribute to the development of more efficient and therefore more sustainable systems.

NUTRITION AND HEALTH STATUS OF HIV-INFECTED ADULTS ON ARVS AT AMREF CLINIC KIBERA URBAN SLUM, KENYA

The health of people living with HIV and AIDS (PLWHA) is nutritionally challenged in many nations of the world. The scourge has reduced socio-economic progress globally and more so in sub-Saharan Africa (SSA) where its impact has been compounded by poverty and food insecurity. Good nutrition with proper drug use improves the quality of life for those infected but it is not known how PLWHA exposed to chronic malnutrition and food shortages from developing nations adjust their nutrition with use of Anti-Retro-viral Drugs (ARVs). This study assessed nutritional status, dietary practices, and dietary management of common illnesses that hinder daily food intake by the patients and use of ARVs with food recommendations provided by the health care givers. A descriptive case study design was used to sample 120 HIV-infected patients using systematic sampling procedure. These patients sought health care from an urban slum, Kibera AMREF clinic. Data were collected by anthropometric measurements, bio-chemical analysis, semi-structured questionnaire and secondary data. The Statistical Package for Social Sciences (SPSS) and the Nutri-Survey software packages were used to analyze data. Dietary intakes of micro-nutrients were inadequate for >70% of the patients when compared to the Recommended Daily Requirements. When Body Mass Indices (BMI) were used, only 6.7% of the respondents were underweight (BMI<18.5kg/m2) and 9.2% were overweight (BMI> 25kg/m2), serum albumin test results (mean 3.34±0.06g/dl) showed 60.8% of the respondents were protein deficient and this was confirmed by low dietary protein intakes. The BMI was not related to dietary nutrient intakes, serum albumin and CD4 cell counts (p>0.05). It appeared that there was no significant difference in BMI readings at different categories of CD4 cell count (p>0.05) suggesting that the level of immunity did not affect weight gain with ARV as observed in many studies from developed countries. Malnutrition was, therefore, evident among the 60.8% of the cases as identified by serum albumin tests and food intake was not adequate (68%) for the patients as they ate once a day due to lack of food. National food and nutrition policy should incorporate food security boosting guidelines for the poor people infected with HIV and using ARVs.

Nutritional status and information needs of medical oncology patients receiving treatment at an Australian public hospital

This study aimed to identify: i) the prevalence of malnutrition according to the scored Patient Generated-Subjective Global Assessment (PG-SGA); ii) utilization of available nutrition resources; iii) patient nutrition information needs; and iv) external sources of nutrition information. An observational, cross-sectional study was undertaken at an Australian public hospital on 191 patients receiving oncology services. According to PG-SGA, 49% of patients were malnourished and 46% required improved symptom management and/or nutrition intervention. Commonly reported nutrition-impact symptoms included: peculiar tastes (31%), no appetite (24%) and nausea (24%). External sources of nutrition information were accessed by 37%, with popular choices being media/internet (n=19) and family/friends (n=13). In a sub-sample (n=65), 32 patients were aware of the available nutrition resources, 23 thought the information sufficient and 19 patients had actually read them. Additional information on supplements and modifying side effects was requested by 26 patients. Malnutrition is common in oncology patients receiving treatment at an Australian public hospital and almost half require improved symptom management and/or nutrition intervention. Patients who read the available nutrition information found it useful, however awareness of these nutrition resources and the provision of information on supplementation and managing symptoms requires attention.

A multilevel study of area socio-economic status and food purchasing behaviour

Objective: This study examined the association between area socioeconomic status (SES) and food purchasing behaviour.----- Setting: Melbourne city, Australia, 2003.----- Participants: Residents of 2,564 households located in 50 small areas.----- Design: Data were collected by mail survey (64.2% response rate). Area SES was indicated by the proportion of households in each area earning less than Aus$400 per week, and individual-level socioeconomic position was measured using education, occupation, and household income. Food purchasing was measured on the basis of compliance with dietary guideline recommendations (for grocery foods) and variety of fruit and vegetable purchase. Multilevel regression examined the association between area SES and food purchase after adjustment for individual-level demographic (age, sex, household composition) and socioeconomic factors.----- Results: Residents of low SES areas were significantly less likely than their counterparts in advantaged areas to purchase grocery foods that were high in fibre and low in fat, salt, and sugar; and they purchased a smaller variety of fruits. There was no evidence of an association between area SES and vegetable variety.----- Conclusions In Melbourne, area SES was associated with some food purchasing behaviours independent of individual-level factors, suggesting that areas in this city may be differentiated on the basis of food availability, accessibility, and affordability, making the purchase of some types of foods more difficult in disadvantaged areas.