scholarly journals Factor analysis as an aid to nutritional assessment

1944 ◽  
Vol 43 (6) ◽  
pp. 395-399 ◽  
Author(s):  
W. H. Hammond
Keyword(s):  
Factor Analysis ◽  
General Health ◽  
Nutritional Assessment ◽  
Practical Importance ◽  
Clinical Signs ◽  
Individual Characteristics ◽  
Nutritional State ◽  
Nutritional Deficiencies ◽  
General Factor ◽  
Health State

1. The problem of assessing nutritional stateThis paper emphasizes the need for measurement in diagnosis and recognizes two distinct problems, those of:(a) Diagnosing specific diseases in the sense of distinct pathological conditions.(b) Assessing general malconditions where there is no sharp dividing line between the normal and the subnormal.It suggests a programme of research designed to overcome some of the difficulties inherent in (b) in the case of nutritional assessment.2. Establishing general health standardsThe first requirement is the scientific standardization of the elements making up the concept of health and good physique. This is a complex matter requiring all the help which statistical procedures can give. Moreover, we must check the reliability of the assessors and the indicators which they use before we can place any reliance on results purporting to relate to the population studied.Provisionally we begin by collecting a battery of indicators of general health; each is then given a graded assessment for each child (and the assessment is repeated to obtain its reliability), and by employing the statistical device of factor analysis we can determine what combination of symptoms will give the highest agreement with the criterion of general health abstracted from these individually imperfect measures. We are actually making explicit the stages which are normally telescoped in the method of ‘general impression’ (which is the method usually adopted in assessing general health, state of nutrition, etc., despite evidence of its unreliability). In this method a number of individual characteristics are fused together without ensuring that different observers will attach equal importance to the signs or even that they will take into account the same ones. The emphasis to be given to each symptom in the final mark is determined statistically by its agreement with the aggregate result. Some indicators may give results so unrelated to the others that they must be eliminated. Other tests, whether physiological, functional or anatomical, may later be added to the battery to reinforce it. A point of practical importance is that some readily assessable symptom or index may be found which gives results in close enough agreement with those of the standard battery to enable it to be used as a substitute, thus shortening the task of diagnosis without appreciably lessening its accuracy.An alternative criterion could, as we have seen, be the weighted combination of doctors' assessments, for by weighting the results according to each doctor's agreement with his colleagues we were able to increase the agreement between the team result and the hypothetical true mark. However, since the ordinary methods of assessment are unreliable, even the pooled results of the team do not give as good a standard as the standardized battery of tests.A third standard is sometimes possible in the form of an objective accurately measurable physiological laboratory test or anatomical index. If this is inconvenient to apply generally, any single symptom or pool may be tested by correlation with it to see if the agreement is close enough for practical purposes.3. Study of more specific nutritional defectsFactor analysis can be used to discover and assess more limited similarities than those covering the whole range of observers or test symptoms. For example, the doctors tended to show group affinities (depending possibly on their different emphasis in diagnosis) in addition to their somewhat low general conformity. Applying similar analytic methods to the study of symptoms, we might isolate specific nutritional deficiencies or it is possible that group factors may be revealed corresponding to the effects of recent or early adverse nutritional conditions respectively.Whilst the examples of analytic techniques have here been applied to illustrative cases in nutritional and general health assessment, they are equally applicable to other fields of medicine, in particular to endocrinology and to the study of predisposing conditions of disease.My thanks are due to Prof. Burt and Dr E. H. Wilkins for their suggestions for modifying my original draft. However, this in no way commits them to agreement with the views expressed here.[Note added in Proof.] Since writing this article I have had an opportunity of correlating and analysing some results of nutritional surveys involving clinical and biochemical signs of malnutrition. The evidence so far obtained indicates a rather weak general factor for clinical signs identifiable with general nutritional state. I hope to be able to give the full results when the material becomes available for publication.

scholarly journals Clinical nutritional surveys Relationship between observed signs

1947 ◽  
Vol 45 (1) ◽  
pp. 65-69 ◽  
Author(s):  
E. W. Adcock ◽  
W. H. Hammond ◽  
H. E. Magee
Keyword(s):  
Clinical Sign ◽  
Nutritional Assessment ◽  
Clinical Signs ◽  
General Factor ◽  
General State ◽  
Muscular Development ◽  
Nutritional Factor ◽  
Clinical Survey ◽  
High Degree ◽  
The Relationship

The findings of clinical nutrition surveys of 3351 children aged 8–15 years and of 3326 adults, of both sexes, were analysed statistically to ascertain the relationship existing between nutritional grade (good, fair and poor) and the incidence of a variety of clinical signs (pityriasis, folliculosis, gingivitis, etc.) observed at the time of the medical examination but not taken into account in grading the subjects according to their state of nutrition.The analysis showed negligible correlations between the clinical signs singly and collectively and the clinician's nutritional grade. Further, when we compared the incidence of each clinical sign and the nutritional state as a combination of all the clinical signs (i.e. the general nutritional factor), there was negligible agreement as shown by the low general factor saturation coefficients, thus suggesting that the presence of these signs is not a dependable expression of the general state of nutrition.A special clinical survey of 1067 children was carried out to provide data which would throw light on the relationship between the criteria (posture, muscular development, etc.) which the clinician consciously takes into account but does not as a rule record in deciding the nutritional grade, and the nutritional grade itself. The grading criteria in the survey were separately assessed and recorded and so also were the usual clinical signs (pityriasis, gingivitis, etc.).For the grading criteria there was a high degree of correlation between each one and the nutritional grade and also between each one and the combined pool of all the criteria. The clinical signs showed only negligible correlations with each other, with the nutritional grade or with any of the grading criteria.It would seem, therefore, that nutritional assessment as at present understood is determined mainly by the value placed on the grading criteria (posture, muscular development, etc.), and to a negligible extent or not at all by the presence or absence of clinical signs (pityriasis, folliculosis, gingivitis, etc.).

scholarly journals Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi
Keyword(s):  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Nutritional Assessment ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Rare Condition ◽  
Pediatric Emergency ◽  
Ear Infections ◽  
The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

Analyzing common approaches of accident models for risk management in socio-technical systems

2021 ◽  
Author(s):  
M. Kiwan ◽  
D.V. Berezkin ◽  
M. Raad ◽  
B. Rasheed
Keyword(s):  
Risk Management ◽  
Complex Systems ◽  
Human Error ◽  
Practical Importance ◽  
Individual Characteristics ◽  
Sociotechnical Systems ◽  
Technical Aspects ◽  
The Social ◽  
Technical Systems ◽  
Traditional Approaches

Statement of a problem. One of the main tasks today is to prevent accidents in complex systems, which requires determining their cause. In this regard, several theories and models of the causality of accidents are being developed. Traditional approaches to accident modeling are not sufficient for the analysis of accidents occurring in complex environments such as socio-technical systems, since an accident is not the result of individual component failure or human error. Therefore, we need more systematic methods for the investigation and modeling of accidents. Purpose. Conduct a comparative analysis of accident models in complex systems, identify the strengths and weaknesses of each of these models, and study the feasibility of their use in risk management in socio-technical systems. The paper analyzes the main approaches of accident modeling and their limitations in determining the cause-and-effect relationships and dynamics of modern complex systems. the methodologies to safety and accident models in sociotechnical systems based on systems theory are discussed. The complexity of sociotechnical systems requires new methodologies for modeling the development of emergency management. At the same time, it is necessary to take into account the socio-technical system as a whole and to focus on the simultaneous consideration of the social and technical aspects of the systems. When modeling accidents, it is necessary to take into account the social structures and processes of social interaction, the cultural environment, individual characteristics of a person, such as their abilities and motivation, as well as the engineering design and technical aspects of systems. Practical importance. Based on analyzing various techniques for modeling accidents, as well as studying the examples used in modeling several previous accidents and review the results of this modeling, it is concluded that it is necessary to improve the modeling techniques. The result was the appearance of hybrid models of risk management in socio-technical systems, which we will consider in detail in our next work.

Comparison of amantadine, orphenadrine, and placebo in the control of phenothiazine-induced Parkinsonism

1972 ◽  
Vol 2 (4) ◽  
pp. 406-413 ◽  
Author(s):  
R. H. S. Mindham ◽  
R. Gaind ◽  
B. H. Anstee ◽  
Lorna Rimmer
Keyword(s):  
Nervous System ◽  
Practical Importance ◽  
Clinical Signs ◽  
Drug Induced ◽  
Double Blind ◽  
Fluphenazine Decanoate ◽  
Cholinergic Drugs ◽  
Blind Comparison ◽  
Pharmacologically Active ◽  
Active Substances

SynopsisA double-blind comparison was made of the effects of amantadine hydrochloride, orphenadrine hydrochloride, and placebo in the control of the effects on the extrapyramidal nervous system of fluphenazine decanoate. Patients were assessed with regard to the main symptoms of Parkinsonism, the leading clinical signs, performance in walking, writing and squeezing, changes in mood, and unwanted effects of medication. Neither of the pharmacologically active substances was superior to placebo. Attention is drawn to the paucity of evidence for the effectiveness of anti-cholinergic drugs in both Parkinson's disease and in drug-induced Parkinsonism. The special difficulties in performing trials of substances used in relieving the unwanted effects of other drugs are discussed in relationship to defects in methodology in both this and earlier trials. The findings of the present study are not conclusive but show a clear need for further research in this field. The possible theoretical and practical importance of such research is discussed.

Nursing assessment

2021 ◽  
pp. 201-210
Author(s):  
Jennie Burch ◽  
Brigitte Collins
Keyword(s):  
Clinical Practice ◽  
Physical Examination ◽  
General Health ◽  
Nutritional Assessment ◽  
Health Assessment ◽  
Digital Rectal Examination ◽  
Assessment Methods ◽  
Patient History ◽  
Nursing Assessment ◽  
Rectal Examination

The nursing assessment chapter explores the essential processes required to enable nurses to effectively assess patients and subsequently plan care. Undertaking a general patient history is important to determine a general health assessment. Additionally, there are a number of additional assessments that can be undertaken to gain greater understanding of specific gastrointestinal systems, such as a gastrointestinal assessment, a liver assessment, or a nutritional assessment. After performing an assessment through the use of questions, to gain more details about the patient and any condition they might be presenting with, a physical examination is necessary of the abdomen and rectum; a digital rectal examination may be undertaken. Succinct explorations on the various assessment methods that nurses use to evaluate the needs of patients can be reviewed when necessary within clinical practice by the nurse.

scholarly journals Nutritional Deficiencies Associated to Bariatric Surgery

2013 ◽  
Vol 20 (2) ◽  
pp. 157-164 ◽  
Author(s):  
Cornelia Zetu ◽  
Rubin Munteanu ◽  
Raluca Parasca ◽  
Constantin Ionescu-Tîrgovişte
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Nutritional Deficiencies ◽  
Micronutrient Deficiencies ◽  
Epidemic Disease ◽  
Surgical Options ◽  
Clinical Signs And Symptoms ◽  
Fat Soluble Vitamins

Abstract Obesity is an epidemic disease, increasingly addressed through surgical options for weight loss. Benefits of these surgical procedures, such as weight loss and improvement of obesity-related co-morbidities, are well established. However, postoperative complications do occur. Deficiencies in micronutrients, which include water and fat-soluble vitamins and minerals, are common after bariatric surgery. Recognition of the clinical signs and symptoms of micronutrient deficiencies is important to minimize long-term adverse effects.

Emotion and Behavior: A General Factor of Personality From the EAS Temperament Survey and the Strengths and Difficulties Questionnaire

2012 ◽  
Vol 15 (5) ◽  
pp. 668-671 ◽  
Author(s):  
Livia Veselka ◽  
Julie Aitken Schermer ◽  
Caroline Just ◽  
Yoon-Mi Hur ◽  
J. Philippe Rushton ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Individual Differences ◽  
Social Desirability ◽  
Principal Factor ◽  
Strengths And Difficulties Questionnaire ◽  
General Factor ◽  
Order Dimension ◽  
General Factor Of Personality ◽  
Strengths And Difficulties ◽  
And Behavior

The mothers of 603 pairs of 3- to 13-year-old twins in Korea completed the Emotionality, Activity, Sociability (EAS) Temperament Survey and the Strengths and Difficulties Questionnaire in reference to their twins. Principal factor analysis of the seven scales comprising these measures yielded a general factor on which all the scales had moderate to large loadings. Univariate behavioral genetic analyses showed that individual differences on this general factor could best be accounted for by additive genetic and non-shared environmental effects, with a heritability of 53%. The results strengthen the construct validity of the general factor of personality (GFP) by extracting this higher-order dimension from disparate measures, and have implications regarding social desirability criticisms applied to the GFP theory.

Nutritional assessment

2018 ◽  
Author(s):  
John Puntis
Keyword(s):  
Nutritional Assessment ◽  
Protein Energy Malnutrition ◽  
Growth Failure ◽  
Developed Countries ◽  
Nutritional Deficiencies ◽  
Negative Effects ◽  
Healthy Life ◽  
Protein Energy ◽  
Nutritional Needs ◽  
Routine Assessment

Routine assessment of nutritional status should be part of normal practice when seeing any patient. The purpose is to document objective nutritional parameters (e.g. anthropometry), identify nutritional deficiencies, and establish nutritional needs. Protein–energy malnutrition has many adverse consequences including growth failure (identified by reference to standard growth charts). Worldwide, malnutrition contributes to a third of deaths in children under 5 years of age, and one in nine people don’t have enough food to lead an active and healthy life. In developed countries, malnutrition complicates both acute and chronic illness with negative effects on outcomes. In clinical practice, a useful approach to nutritional assessment is to consider three elements: ‘what you are’ (i.e. body habitus—underweight for height; short for age; etc.), ‘what you can do’ (functional activity), and ‘what you eat’ (current nutritional intake).

scholarly journals Clinicohaematological study of anaemia in antenatal patients

2020 ◽  
Vol 9 (4) ◽  
pp. 1603
Author(s):  
Veena Gupta ◽  
Karishma Sharma ◽  
Amrita Chaurasia
Keyword(s):  
Analytical Study ◽  
Economic Status ◽  
Clinical Signs ◽  
Developed Countries ◽  
Nutritional Deficiencies ◽  
Deficiency Anemia ◽  
Third Trimester ◽  
Maternal Morbidity And Mortality ◽  
Different Types ◽  
Socio Demographic Factors

Background: According to WHO, approximately 75% of pregnant women in developing countries and 18% in developed countries are anaemic. In India prevalence of anaemia is reported to be 33%-89% and is one of the important causes of maternal morbidity and mortality. The present study was done with the objective to study the socio-demographic factors related to anemia and the distribution of different types of anaemia in antenatal patients.Methods: A prospective analytical study was done on 205 pregnant females who presented with anemia (Hb <11 gm/dl) in 1st, 2nd and early 3rd trimester (up to 30 weeks of gestation) in the department of obstetrics and gynecology of Swaroop Rani Nehru Hospital, Prayagraj from September 2017 to September 2018.Results: The rural background with lower socio-economic status comprised majority of the anemic patients (65.9%) with the major cause being iron deficiency anemia (68.8%). The patients mainly presented with anemia at late second or early third trimester (82.4%). Clinical signs like pallor, oedema and symptoms like palpitations and dyspnoea were more associated with severe anemia than mild and moderate anemia.Conclusions: Anemia prevention and prompt detection is the need of the hour with effective management. In India, major cause of anaemia are nutritional deficiencies which can be treated by proper diet and medications. The advises of routine iron supplementation during pregnancy, regardless of whether the mother is anemic or not, is strongly recommended by this study. 

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