Malnourished patients on hemodialysis improve after receiving a nutritional intervention

INTRODUCTION: Malnutrition is multifactorial and may be modified by nutritional intervention. We aimed to assess the impact of an intervention on the nutritional status of malnourished hemodialysis patients and their acceptance of a non-industrialized nutritional supplement. METHODS: 18 patients were studied, they were selected from a previous nutritional assessment where nutritional risk was defined as: subjective global assessment > 15 plus one criterion for malnutrition. The following variables were assessed: anthropometric parameters, subjective global assessment, dietary intake, six-minute walking test, quality of life (SF-36), and biochemical tests. Patients were randomized to either Control or Intervention Groups. The Intervention Group received a dietetic supplement during dialysis containing 355 kcal, prepared from simple ingredients. After three months, subjects from the Control Group and other patients also considered at nutritional risk underwent the same intervention. The study groups were compared after three months, and all patients were analyzed before and after the intervention. RESULTS: Fifteen men and three women, aged 56.4 ± 15.6 years-old, nine in each group, were studied. The Intervention Group showed an improvement in the subjective global assessment (p = 0.04). There were differences in role physical and bodily pain domains of SF-36, with improvement in the Intervention Group and worsening in the Control Group (p = 0.034 and p = 0.021). Comparisons before and after intervention for all patients showed improvement in the subjective global assessment (16.18 ± 4.27 versus 14.37 ± 4.20, p = 0.04), and in the six-minute walking test (496.60 ± 132.59 versus 547.80 ± 132.48 m; p = 0.036). The nutritional supplement was well tolerated by all patients, and it did not cause side effects. CONCLUSIONS: The nutritional intervention improved the subjective global assessment and quality of life of hemodialysis patients at short-term. A global intervention by a dietitian produced specific and nonspecific positive effects in the whole group. Nutritional supplementation was feasible, palatable, and had low cost. Its clinical impact and effectiveness need to be further assessed in a larger group of patients at long-term.

Construction de l'Est et de l'Ouest : vers des compétences interculturelles. Un exemple de recherche à Hong-Kong en situation de mobilité académique

Numerous scholars have already stressed the need to prepare students prior to academic mobility (Abdallah-Pretceille, 2003; Jackson, 2013, for example) in order to face hypermodernity (Aubert, 2004). As per the new mobilities paradigm (Urry, 2007), this implies considering individuals at the centre of political and institutional issues. Furthermore, the multiplicity of terminology of references towards academic mobility, and intercultural competences, justifies this research. The theory, for this doctoral dissertation, applies “renewed interculturality” (Dervin, 2012), a move away from a culturalist approach. Intercultural competences are therefore defined as a stepping back from discourses on the Other that may emerge during encounters. In order to collect the data, six focus groups have been organised with two batches of students from a Higher Education Institution in Hong-Kong, an “education hub” (Dervin & Machart, 2014) that is striving to be competitive particularly in increasing the number of incomingand outcoming students. Training and education to interculturality have been implemented prior to academic mobility in order to observe the impact on participants’ discourses before and after the mobility. Theories of enunciation and dialogism represent the methodology allowing us to compare and analyse the reported voices in the participants’ discourse and their prosodic realisation (Martin & White, 2005) before and after the experience of academic mobility. I have attempted to observe the dialogic space available to welcome the Other during encounters in the participants’ discourse. The results seem to underline the increased number of reported voices in participants’ discourse after study abroad, but as the space opened for negotiation is instable and depends on the interlocutors and the voices addressed, consequently, further research appears necessary to study the influences of a preparation prior to mobility on the contraction or expansion of heteroglossia. All in all, this doctoral dissertation aimed to renew preparation

Le Nouvel éducateur rationnel : recherche des éléments constitutifs de l'éducation correspondante à l'usage de la liberté : science de la vie, science de la liberté, science de la pensée, science de l'amour / rédactrice en chef : Lydie Martial

1912/08 (A1,N8)-1912/09 (A1,N9).