scholarly journals Beyond Refeeding: The Effect of Including a Dietitian in Eating Disorder Treatment. A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4490
Author(s):  
Yive Yang ◽  
Janet Conti ◽  
Caitlin M. McMaster ◽  
Phillipa Hay
Keyword(s):  
Eating Disorder ◽  
Multidisciplinary Team ◽  
Consistent Finding ◽  
Eating Disorder Treatment ◽  
Life Threatening ◽  
Definition Of ◽  
Index Weight ◽  
Outcome Type ◽  
Validated Instrument

Eating disorders are potentially life-threatening mental health disorders that require management by a multidisciplinary team including medical, psychological and dietetic specialties. This review systematically evaluated the available literature to determine the effect of including a dietitian in outpatient eating disorder (ED) treatment, and to contribute to the understanding of a dietitian’s role in ED treatment. Six databases and Google Scholar were searched for articles that compared treatment outcomes for individuals receiving specialist dietetic treatment with outcomes for those receiving any comparative treatment. Studies needed to be controlled trials where outcomes were measured by a validated instrument (PROSPERO CRD42021224126). The searches returned 16,327 articles, of which 11 articles reporting on 10 studies were included. Two studies found that dietetic intervention significantly improved ED psychopathology, and three found that it did not. Three studies reported that dietetic input improved other psychopathological markers, and three reported that it did not. One consistent finding was that dietetic input improved body mass index/weight and nutritional intake, although only two and three studies reported on each outcome, respectively. A variety of instruments were used to measure each outcome type, making direct comparisons between studies difficult. Furthermore, there was no consistent definition of the dietetic components included, with many containing psychological components. Most studies included were also published over 20 years ago and are now out of date. Further research is needed to develop consistent dietetic guidelines and outcome measures; this would help to clearly define the role of each member of the multidisciplinary team, and particularly the role of dietitians, in ED treatment.

Miscellaneous

2020 ◽  
pp. 165-174
Author(s):  
Helen Jefferis ◽  
Natalia Price
Keyword(s):  
Multidisciplinary Team ◽  
Synthetic Mesh ◽  
Vaginal Mesh ◽  
Subspecialty Training ◽  
Advanced Training ◽  
Definition Of

This chapter covers the definition of a urogynaecologist and current training routines, including the specialty, advanced training skills modules (ATSMs), and specific subspecialty training. The composition and role of both local and regional multidisciplinary team (MDT) is described. Finally, the current controversies around the use of synthetic mesh, and the current UK suspension of all vaginal mesh use for both prolapse and incontinence, is covered.

Psychiatric Disorders in Pediatric Psycho-Oncology

2021 ◽  
pp. 696-702
Author(s):  
Julia A. Kearney ◽  
Meredith E. MacGregor ◽  
Maryland Pao
Keyword(s):  
Multidisciplinary Team ◽  
Psychiatric Symptoms ◽  
Psychosocial Oncology ◽  
Children And Youth ◽  
Psychiatric Expertise ◽  
Treatment Considerations ◽  
Life Threatening ◽  
Clinically Significant ◽  
Pediatric Consultation

For patients and families affected by pediatric cancer, distress is often part of a larger picture of adjustment and resiliency. Pediatric psychosocial oncology clinicians should be proficient in recognizing clinically significant psychiatric symptoms, syndromes and disorders, in order to differentiate these from normal distress and adjustment. Access to child and adolescent psychiatric expertise is an essential component of care for children with cancer and their families. It is feasible and important to differentiate psychiatric syndromes from normal trajectories of adjustment to a life-threatening diagnosis. The chapter reviews psychiatric presentations in children, and youth with cancer and treatment considerations, with a focus on the role of the pediatric consultation-liaison/psycho-oncology psychiatrist on a multidisciplinary team.

scholarly journals Affective predictors of the severity and change in eating psychopathology in residential eating disorder treatment: The role of social anxiety

2018 ◽  
Vol 26 (1) ◽  
pp. 66-78 ◽  
Author(s):  
Kathryn E. Smith ◽  
Tyler B. Mason ◽  
Rachel C. Leonard ◽  
Chad T. Wetterneck ◽  
Brad E. R. Smith ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Social Anxiety ◽  
Eating Psychopathology ◽  
Eating Disorder Treatment ◽  
Disorder Treatment ◽  
Affective Predictors

The Role of Spirituality in Eating Disorder Treatment and Recovery

2010 ◽  
pp. 367-385 ◽  
Author(s):  
Michael E. Berrett ◽  
Randy K. Hardman ◽  
P. Scott Richards
Keyword(s):  
Eating Disorder ◽  
Eating Disorder Treatment ◽  
Disorder Treatment

scholarly journals Micronutrients in Sepsis and COVID-19: A Narrative Review on What We Have Learned and What We Want to Know in Future Trials

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 419
Author(s):  
Matteo Rossetti ◽  
Gennaro Martucci ◽  
Christina Starchl ◽  
Karin Amrein
Keyword(s):  
Host Response ◽  
Energy Homeostasis ◽  
High Energy ◽  
Free Radical Damage ◽  
Recent Advancement ◽  
Life Threatening ◽  
Cellular Hypoxia ◽  
Definition Of ◽  
Radical Damage

Sepsis remains the leading cause of mortality in hospitalized patients, contributing to 1 in every 2–3 deaths. From a pathophysiological view, in the recent definition, sepsis has been defined as the result of a complex interaction between host response and the infecting organism, resulting in life-threatening organ dysfunction, depending on microcirculatory derangement, cellular hypoxia/dysoxia driven by hypotension and, potentially, death. The high energy expenditure driven by a high metabolic state induced by the host response may rapidly lead to micronutrient depletion. This deficiency can result in alterations in normal energy homeostasis, free radical damage, and immune system derangement. In critically ill patients, micronutrients are still relegated to an ancillary role in the whole treatment, and always put in a second-line place or, frequently, neglected. Only some micronutrients have attracted the attention of a wider audience, and some trials, even large ones, have tested their use, with controversial results. The present review will address this topic, including the recent advancement in the study of vitamin D and protocols based on vitamin C and other micronutrients, to explore an update in the setting of sepsis, gain some new insights applicable to COVID-19 patients, and to contribute to a pathophysiological definition of the potential role of micronutrients that will be helpful in future dedicated trials.

Refeeding Patients with Moderate and Severe Eating Disorders: A Retrospective Cohort Study

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Rabito GS ◽  
◽  
Blalock DV ◽  
Beaty LR ◽  
Harr BL ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Liver Function Tests ◽  
Registered Dietitians ◽  
Refeeding Syndrome ◽  
Eating Disorder Treatment ◽  
Meal Plan ◽  
Nutrition Rehabilitation ◽  
Life Threatening ◽  
Weight Restoration ◽  
Elevated Liver Function Tests

Background: Anorexia Nervosa (AN) is a life-threatening mental illness that can cause significant medical complications, including the potentially fatal refeeding syndrome. Registered dietitians (RDs) are a critical part of an eating disorder multidisciplinary team that focuses treatment on safe weight restoration and nutrition rehabilitation. Method: This study is a description of how the nutrition rehabilitation protocol of 395 adult patients diagnosed with AN and admitted to residential eating disorder treatment is implemented, how the protocol is sustained throughout a patient’s treatment stay to achieve desired weight gain, and how the patients’ biochemical and clinical progress proceeded between admission and discharge, including laboratory results and body mass index (BMI). Results: One hundred twenty-six patients required phosphorus supplementation for refeeding hypophosphatemia (RH); admission BMI was not significantly different between those with and without RH. The 15% of patients who required enteral nutrition at any point during their admission gained significantly less weight than patients who only received an oral meal plan. 34.4% of patients admitted with starvation induced hepatitis, 28.6% experienced refeeding hepatitis at some point, 21.0% of patients had elevated liver function tests 2 weeks into refeeding and 28.6% at discharge. Conclusions: This study demonstrated overall effectiveness in achieving weight restoration goals with aggressive kcal increases without a single incidence of refeeding syndrome and infrequent RH. No significant biochemical changes were observed during refeeding. With close medical supervision and concurrent RD oversight, a refeeding approach with consistent calorie increases that is more aggressive than previously recommended appears to be safe.

Challenges of Fear Conditioning Research in the Age of RDoC

2017 ◽  
Vol 225 (3) ◽  
pp. 189-199 ◽  
Author(s):  
Tina B. Lonsdorf ◽  
Jan Richter
Keyword(s):  
Fear Conditioning ◽  
Clinical Diagnosis ◽  
Research Domain Criteria ◽  
Major Focus ◽  
The Future ◽  
Definition Of ◽  
Methodological Considerations ◽  
Research Domain

Abstract. As the criticism of the definition of the phenotype (i.e., clinical diagnosis) represents the major focus of the Research Domain Criteria (RDoC) initiative, it is somewhat surprising that discussions have not yet focused more on specific conceptual and procedural considerations of the suggested RDoC constructs, sub-constructs, and associated paradigms. We argue that we need more precise thinking as well as a conceptual and methodological discussion of RDoC domains and constructs, their interrelationships as well as their experimental operationalization and nomenclature. The present work is intended to start such a debate using fear conditioning as an example. Thereby, we aim to provide thought-provoking impulses on the role of fear conditioning in the age of RDoC as well as conceptual and methodological considerations and suggestions to guide RDoC-based fear conditioning research in the future.

Cost-utility analysis of eating disorder treatment

2011 ◽  
Author(s):  
V. Pohjolainen ◽  
P. Rasanen ◽  
R. P. Roine ◽  
H. Sintonen ◽  
K. Wahlbeck ◽  
...  
Keyword(s):  
Eating Disorder ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
Eating Disorder Treatment ◽  
Disorder Treatment
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