scholarly journals Tracking and treating malnutrition: a retrospective observational study of the nutritional status of vulnerable people accessing a meals-on-wheels (MOW) service

Author(s):  
Michelle Dewar ◽  
Angela Dickinson ◽  
Nigel Smeeton

Abstract Aim: The aims of the study were to describe the characteristics of meals-on-wheels (MOW) recipients, including prevalence of malnutrition amongst those who have received input from the Nutrition and Wellbeing Service (NWS) and to explore whether the NWS had an impact on the nutritional status (malnutrition risk) of recipients over time. Background: Support services, for example, MOW, play an important role in the prevention and treatment of malnutrition in the community. In the UK, MOW services are under threat. However, little is known about how they support the health and well-being of older people. This study reports on the characteristics of MOW recipients and investigates change in nutritional status over time. Methods: A retrospective study of MOW recipients of nutritional concern who were offered a check through the NWS was conducted. Demographic, social and health information were gathered at the initial visit. Nutritional status (risk of malnutrition) was obtained using the validated Malnutrition Universal Screening Tool (MUST), at the initial and subsequent visits. Changes over time were investigated for recipients receiving at least two follow-up visits. Findings: An initial visit was made to 399 MOW recipients, and 148 recipients had two or more follow-up visits. At initial screening, 177 (44%) of recipients were at medium or high risk of malnutrition. Frailty was significantly related to malnutrition risk (P = 0.049). At follow-up, there was a reduction in malnutrition risk. Conclusions: The MOW service was associated with a reduction in malnutrition risk. By offering well-being visits within a MOW service, malnutrition can be identified early. Future studies into how MOW services might delay or prevent the need for support from acute health services and social care are warranted.

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 544-549 ◽  
Author(s):  
Elias V. Balaskas ◽  
I. Rogers Melamed ◽  
Amit Gupta ◽  
Joanne Bargman ◽  
Dimitrios G. Oreopoulos

Seventeen patients -10 females, 7 males -mean age 52 years (range: 21–77 years), on CAPD for an average of 35 months (range 10–160 months) were studied. Mean initial dose of EPO was 114±45 U/kg/week subcutaneously (range: 59–209). The dose was adjusted to achieve and maintain a target Hb of 100 g/L and Hct 30%. Fifteen of the patients (88.2%) achieved this target within 6 months [baseline to month 6 changes: Hb 72±10 g/L to 107±12 g/L (p=0.0001); Hct 22±3% to 33±4% (p=0.0001)]. Serum total protein also increased significantly over the time of EPO use (p=0.0133); changes from baseline were significant by the fourth month [68±9 g/L to 72±9 g/L (p=0.0115)]. Serum albumin also increased significantly over time (p=0.0157). The change from the baseline result (37±4 g/L) was statistically significant by month 2 (p=0.0060) and was maintained over the following 4 months [month 6 result: 40±3 g/L (p=0.0180)]. The increase was greater for 8 patients with initial serum albumin <35 g/L (mean change 5.75 g/L) than for the 9 subjects with levels >35 g/L (mean change 0.11 g/L). In a comparison group of 17 patients (matched for age, sex, duration of CAPD, underlying disease and antihypertensive treatment), who did not receive EPO treatment, albumin and protein did not appear to increase over time. Mean body weight increased from 60.9± 14.0 kg at the start to 62.1± 13.9 kg at month 6 (p=0.281) and the absolute lymphocyte count from 1.6±0.8 x 109/L to 1.8±1.0 x 109/L (p=0.0472). Serum potassium, urea, creatinine, phosphorus, cholesterol, tri. glycerides, WBC and platelets did not show significant changes over time. Serum phosphorus increased at the end of the second and third months (from 1.6±0.5 mmol/L to 1.9±0.4 and 1.8±0.4 mmol/L and then decreased at the sixth month (1.7±0.5 mmol/L); this is probably due to an increase in phosphate binders in 9 of 17 patients. An improvement in appetite, sleep and well-being, by patients’ self-assessment, was noted during the treatment. We conclude that the treatment with EPO is associated with improvement of the nutritional status of patients on CAPD.


PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258484
Author(s):  
Rhiannon Phillips ◽  
Khadijeh Taiyari ◽  
Anna Torrens-Burton ◽  
Rebecca Cannings-John ◽  
Denitza Williams ◽  
...  

Public perceptions of pandemic viral threats and government policies can influence adherence to containment, delay, and mitigation policies such as physical distancing, hygienic practices, use of physical barriers, uptake of testing, contact tracing, and vaccination programs. The UK COVID-19 Public Experiences (COPE) study aims to identify determinants of health behaviour using the Capability, Opportunity, Motivation (COM-B) model using a longitudinal mixed-methods approach. Here, we provide a detailed description of the demographic and self-reported health characteristics of the COPE cohort at baseline assessment, an overview of data collected, and plans for follow-up of the cohort. The COPE baseline survey was completed by 11,113 UK adult residents (18+ years of age). Baseline data collection started on the 13th of March 2020 (10-days before the introduction of the first national COVID-19 lockdown in the UK) and finished on the 13th of April 2020. Participants were recruited via the HealthWise Wales (HWW) research registry and through social media snowballing and advertising (Facebook®, Twitter®, Instagram®). Participants were predominantly female (69%), over 50 years of age (68%), identified as white (98%), and were living with their partner (68%). A large proportion (67%) had a college/university level education, and half reported a pre-existing health condition (50%). Initial follow-up plans for the cohort included in-depth surveys at 3-months and 12-months after the first UK national lockdown to assess short and medium-term effects of the pandemic on health behaviour and subjective health and well-being. Additional consent will be sought from participants at follow-up for data linkage and surveys at 18 and 24-months after the initial UK national lockdown. A large non-random sample was recruited to the COPE cohort during the early stages of the COVID-19 pandemic, which will enable longitudinal analysis of the determinants of health behaviour and changes in subjective health and well-being over the course of the pandemic.


2020 ◽  
Vol 4 (1) ◽  
pp. e000615
Author(s):  
Karen Zwi ◽  
Louise Sealy ◽  
Nora Samir ◽  
Nan Hu ◽  
Reza Rostami ◽  
...  

IntroductionImmigration detention has a profound and negative impact on the physical health, mental health, development and social-emotional well-being of children, adolescents and their families. Australian clinicians will report results from detailed health and well-being assessments of asylum seeking children and adolescents who have experienced prolonged immigration detention.Methods and analysisThis is a national, multicentre study with a longitudinal cohort design that will document health and well-being outcomes of the children and adolescents who have been detained in offshore detention on the remote island of Nauru. Outcome measures will be reported from the time arrival in Australia and repeated over a 5-year follow-up period. Measures include demographics, residency history and refugee status, physical health and well-being outcomes (including mental health, development and social-emotional well-being), clinical service utilisation and psychosocial risk and protective factors for health and well-being (eg, adverse childhood experiences). Longitudinal follow-up will capture outcomes over a 5-year period after arrival in Australia. Analysis will be undertaken to explore baseline risk and protective factors, with regression analyses to assess their impact on health and well-being outcomes. To understand how children’s outcomes change over time, multilevel regression analysis will be utilised. Structural equation modelling will be conducted to explore the correlation between baseline factors, mediational factors and outcomes to assess trajectories over time.Ethics and disseminationThis research project was approved by the Sydney Children’s Hospitals Network Human Research Ethics Committee. Subsequent site-specific approvals have been approved in 5 of the 11 governing bodies where the clinical consultations took place. In order to ensure this research is relevant and sensitive to the needs of the cohort, our research team includes an asylum seeker who has spent time in Australian immigration detention. Results will be presented at conferences and published in peer-reviewed Medline-indexed journals.


2021 ◽  
Author(s):  
Johannes H. De Kock ◽  
Helen Latham ◽  
Richard Gregory Cowden ◽  
Breda Cullen ◽  
Katia Narzisi ◽  
...  

Abstract: Background Health and social care workers(HSCWs) are at risk of experiencing adverse mental health (MH) outcomes (e.g., higher levels of anxiety and depression) as a result of the COVID-19 pandemic. This can have a detrimental impact on quality of care, the national response to the pandemic and its aftermath. Aims A longitudinal design provided follow-up evidence on the MH(changes in the prevalence of disease over time) of NHS staff working in a remote health board in Scotland during the COVID-19 pandemic and investigated the determinants of MH outcomes over time. Method A two-wave longitudinal study was conducted from July to September 2020. Participants self-reported levels of depression(PHQ-9), anxiety(GAD-7), and mental well-being(WEMWBS) at baseline and again 1.5 months later. Results The analytic sample of 169 participants, working in community(43%) and hospital(44%) settings reported substantial levels of probable clinical depression, anxiety and low mental well-being(MWB) at baseline(depression:30.8%, anxiety:20.1%, low-MWB:31.9%). Whilst the MH of participants remained mostly constant over time, the proportion of participants meeting the threshold for clinical anxiety increased to 27.2% at follow-up. Multivariable modelling indicated that working with, and disruption due to COVID-19 were associated with adverse MH changes over time. Conclusions HSCWs working in a remote area with low COVID-19 prevalence, reported similar levels of substantial anxiety and depression as those working in areas of the UK with high rates of COVID-19 infections. Efforts to support HSCW MH must remain a priority and should minimize the adverse effects of working with, and the disruption caused by the COVID-19 pandemic.


2021 ◽  
pp. 193979092110435
Author(s):  
J. Ryan Poling ◽  
Joshua N. Hook ◽  
Judson Poling

American men experience worse outcomes on a wide range of health and well-being variables compared to women, including disease, educational problems, violence, addiction, suicide, unemployment, and life expectancy. Because of this, organizations have created programs that focus on helping men both psychologically and spiritually; however, it is important to assess the effectiveness of these programs. The Crucible Project, founded in 2002, attempts to facilitate the development of integrity, courage, and grace in men using a weekend retreat format. The purpose of this pilot study was to explore the effect of the weekend retreat on participants’ authenticity, assertiveness, and willingness to forgive (i.e. empirical constructs analogous to integrity, courage, and grace, respectively). Participants ( N = 22) completed measures before the weekend retreat (Time 1), immediately after the weekend retreat (Time 2), and at a 1-month follow-up (Time 3). Results indicate that weekend retreat participants demonstrated a significant increase in scores on measures of authenticity and willingness to forgive and a trend toward increased scores on the measure of assertiveness over time. We conclude by discussing limitations of the study, areas for future research, and implications for spiritual and character development.


2017 ◽  
Author(s):  
Gabriel Marais ◽  
Rebecca Shankland ◽  
Pascale Haag ◽  
Robin Fiault ◽  
Bridget Juniper

In France, little data are available on mental health and well-being in academia, and nothing has been published about PhD students. From studies abroad, we know that doing a PhD is a difficult experience resulting in high attrition rates with significant financial and human costs. Here we focused on PhD students in biology at university Lyon 1. A first study aimed at measuring the mental health and well-being of PhD students using several generalist and PhD-specific tools. Our results on 136 participants showed that a large fraction of the PhD students experience abnormal levels of stress, depression and anxiety, and their mean well-being score is significantly lower than that of a British reference sample. French PhD student well-being is specifically affected by career uncertainty, perceived lack of progress in the PhD and perceived lack of competence, which points towards possible cultural differences of experiencing a PhD in France and the UK. In a second study, we carried out a positive psychology intervention. Comparing the scores of the test and control groups showed a clear effect of the intervention on reducing anxiety. We discuss our results and the possible future steps to improve French PhD students’ well-being.


Author(s):  
Christopher Hood ◽  
Rozana Himaz

This chapter draws on historical statistics reporting financial outcomes for spending, taxation, debt, and deficit for the UK over a century to (a) identify quantitatively and compare the main fiscal squeeze episodes (i.e. major revenue increases, spending cuts, or both) in terms of type (soft squeezes and hard squeezes, spending squeezes, and revenue squeezes), depth, and length; (b) compare these periods of austerity against measures of fiscal consolidation in terms of deficit reduction; and (c) identify economic and financial conditions before and after the various squeezes. It explores the extent to which the identification of squeeze episodes and their classification is sensitive to which thresholds are set and what data sources are used. The chapter identifies major changes over time that emerge from this analysis over the changing depth and types of squeeze.


Author(s):  
Ruvimbo Machaka ◽  
Ruth Barley ◽  
Laura Serrant ◽  
Penny Furness ◽  
Margaret Dunham

AbstractThe Global North has over the years been a popular destination for migrants from the Global South. Most of the migrants are in their reproductive ages who go on to bear and raise children. The differences and subjectivity in the context of their experiences may have an impact on how they ensure that their children have the best possible health and well-being. This paper synthesises 14 qualitative research papers, conducted in 6 Global North countries. We gathered evidence on settled Southern African migrants experiences of bearing and raising children in Global North destination countries and how they conceptualise sustaining children’s health and well-being. Results of the review indicated a concerning need for support in sustaining children’s health and well-being. Cultural and religious beliefs underpin how the parents in these studies raise their children. More research is needed which engages with fathers and extended family.


1983 ◽  
Vol 3 (3) ◽  
pp. 138-141 ◽  
Author(s):  
Brigitte Heide ◽  
Andreas Pierratos ◽  
Ramesh Khanna ◽  
Jean Pettit ◽  
Raymond Ogilvie ◽  
...  

Nutritional follow-up of 20 CAPD patients for 18–24 months showed a decrease in total body nitrogen, increase in total body potassium and body weight, and a decrease in protein intake over time. There was no correlation between changes in TBN and the biochemical parameters measured. Serial dietetic assessments and measurements of total body nitrogen as well as adherence to an adequate protein intake will assist in the prevention of malnutrition in CAPD patients.


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