scholarly journals Institutionalized elderly people and malnutrition: research on the patients of a nursing home

2013 ◽  
pp. 183-192
Author(s):  
Francesco Rondoni ◽  
Giorgio Simonelli ◽  
Pietro Maria Lunghi ◽  
Francesco Rossetti ◽  
Luciano Bondi

Protein-energy malnutrition (PEM) is a common finding in hospitalized or institutionalized elderly people. In the literature, PEM is not mentioned as being related to individual ability of the patient to feed him or herself correctly. This study analyzed the 56 patients of a nursing home divided into two groups: self-sufficient and non self-sufficient regarding feeding. Levels of serum albumin, transferrin, prealbumin and hemoglobin (Hb) were examined and compared to body mass index (BMI) calculated with bioelectrical impedance analysis. Fifty-three percent of patients were self-sufficient, while 47% were not self-sufficient for feeding of which 83.3% were women and 16.7% men. Levels below the average range were 49.1% for lymphocyte count, 52.9% for serum albumin, 13.7% for serum transferrin and 52.9% for serum prealbumin. No significant differences were found in terms of patient age, while the mean values of the parameters examined in the two groups, self-sufficient and not, were lower in the patients who were not self-sufficient, even if statistical significance was not reached. Serum albumin was in inverse proportion to age (P<0.05) and 46.1% of individuals with low levels of transferrin also showed low levels of Hb. Anemia was in direct proportion (P<0.05) to age. Measurement of BMI showed values below 22.5 (cut off for risk for malnutrition) in 33.4% of the subjects examined. Of the three hematochemical parameters, analysis of a possible relationship with BMI showed only a significant and directly proportional correlation with prealbumin (P<0.05%). These data should be considered in the context of an epidemiological research study carried out in a conditioned and limited environment, where PEM, detected using hematochemical parameters, amounted to 50% of the patients, whereas BMI identified only approximately one-third of patients at risk of malnutrition. There were no statistically significant differences between men and women. Mean values of the surrogate hematochemical parameters were lower in patients non-self-sufficient for feeding, but the comparison does not reach significance due to the small sample size.

Author(s):  
Kátia Lilian Sedrez Celich ◽  
Rosa Cândida Carvalho Pereira de Melo ◽  
Mara Ambrosina de Oliveira Vargas ◽  
Francielly Zilli ◽  
Liliana Vanessa Lúcio Henriques ◽  
...  

Abstract Objective: To understand the challenges experienced by Portuguese workers in humanitude care for institutionalized elderly people during the pandemic. Method: This is a qualitative study, supported by reflections on the Humanitude Care Methodology, carried out with workers from different areas in a nursing home for elderly people in Portugal. Data collection took place between September and October 2020, from individual and online interviews. The categorization proposed by Bardin was adopted as the analysis technique. Results: Three categories emerged: (1) self-protection and of the other with the subcategories fear of being contaminated and fear of contaminating the elderly; (2) maintenance of affective relationships, broken down into the subcategories absence of family members in the nursing home and personal protective equipment as a barrier to communication and approximation; and (3) confinement of the elderly who attended the Day Center, with the subcategories lack of family support/loneliness and change in the elderly’s routine. Conclusion: The main challenges experienced by Portuguese workers are related to the necessary changes in the performance of care practices due to the use of personal protection that was not used before, limitations in affective relationships, and restrictions in interaction spaces.


2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Per Fevang ◽  
Kirsten Havemann ◽  
Børre Fevang ◽  
Arne T. Høstmark

Background. The relationship between protein energy malnutrition (PEM) and malaria is controversial. While most studies demonstrate that PEM is associated with greater malaria morbidity, some indicate that PEM may in fact have a protective effect. PEM is differentiated into three subgroups: kwashiorkor (marked protein deficiency), marasmus (calorie deficiency), and kwashiorkor/marasmus. None of the studies concerning PEM and malaria seem to distinguish between these subgroups, and significant differences in susceptibility to malaria between these subgroups may have been overlooked. Plasmodium parasites and malaria infected erythrocytes are sensitive to oxidative stress. Since kwashiorkor patients seem to display an excess of prooxidants and as serum albumin is an important antioxidant, we hypothesized that patients with different forms of PEM might have different levels of malaria parasitaemia. Methods. 72 PEM children older than 6 months admitted to Kwale Family Life Training Programme (Kenya) were included in the study. Results. Mean parasitaemia was significantly lower in the kwashiorkor group than in the marasmus group (p < 0,001). There was no correlation between serum albumin and parasitaemia. Conclusion. Our study suggests a protective effect of kwashiorkor against malaria, warranting further studies.


2021 ◽  
Vol 42 (2) ◽  
pp. 12-19
Author(s):  
Ana Lúcia Schaefer Ferreira de Mello ◽  
Dalva Maria Pereira Padilha

Following the population-aging phenomenon, the number and the demands for nursing homes is increasing. Generally, oral health condition of institutionalized elderly people is poor and the maintenance of good patterns of oral hygiene is a problem. The aim of this study is to describe the oral hygiene conditions of elderly people who live in small (< 20) nursing homes of Porto Alegre-RS and to establish the relationship with independents variables: sex, age, time of institutionalization and level of dependence of the residents and number of care givers and price charged by the institutions. Oral hygiene conditions were verified through dental and denture plaque index. The mean obtained to teeth plaque scores was 2.24 (Sillnes and Löe index) and on dentures was 7.14 (Ambjornsen index). The poor oral hygiene condition is prevalent on the examined population when analyzed the independent variables sex, age, time of institutionalization, price, and number of caregivers because it was not demonstrated statistical significance related to the presence or the quantity of plaque on teeth and dentures (p>0,05). The level of dependence was the variable that presented statistical signficant (p=0,024). Independent elders showed lower means of dental plaque when compared to the moderate dependent or dependent elders. It is concluded that oral hygiene condition of this institutionalized elderly people is poor and need multidisciplinary and interinstitutional actions to revert this frame of continued neglect.


2006 ◽  
Vol 76 (6) ◽  
pp. 359-366 ◽  
Author(s):  
Rodríguez-Rodríguez ◽  
Ortega ◽  
López-Sobaler ◽  
Aparicio ◽  
Bermejo ◽  
...  

This study investigated the relationship between the intake of antioxidant nutrients and the suffering of cataracts in 177 institutionalized elderly people (61 men and 116 women) aged ≥ 65 years. Dietary intake was monitored for 7 consecutive days using a "precise individual weighing" method. Subjects, who during their earlier years were exposed by their work to sunlight, had a greater risk of suffering cataracts (OR = 3.2; Cl: 1.1–9.3, P < 0.05) than those who worked indoors. A relationship was found between increased vitamin C intake and a reduced prevalence of cataracts (i.e., when comparing those above P95 for vitamin C intake with those below P5; (OR = 0.08; Cl: 0.01–0.75, P 0.05). Among subjects with cataracts, 12.1% had vitamin C intakes of < 61 mg/day (P10) and only 2.2% had intakes of > 183 mg/day (P95) (p < 0.01). Subjects who consumed > 3290 μg/day (P95) of lutein were less likely to have cataracts (OR = 0.086; Cl: 0.007–1.084; p < 0.05) than those whose consumption was < 256 μg/day (P5). In men, high intakes of zeaxanthin seemed to provide a protective effect against the problem (OR = 0.96; Cl: 0.91–0.99; p < 0.05). The results suggest an association exists between exposure to sunlight and the development of cataracts, and that vitamin C, lutein, and zeaxanthin offer some protection against this disorder.


Author(s):  
Thomaz R. Mostardeiro ◽  
Ananya Panda ◽  
Robert J. Witte ◽  
Norbert G. Campeau ◽  
Kiaran P. McGee ◽  
...  

Abstract Purpose MR fingerprinting (MRF) is a MR technique that allows assessment of tissue relaxation times. The purpose of this study is to evaluate the clinical application of this technique in patients with meningioma. Materials and methods A whole-brain 3D isotropic 1mm3 acquisition under a 3.0T field strength was used to obtain MRF T1 and T2-based relaxometry values in 4:38 s. The accuracy of values was quantified by scanning a quantitative MR relaxometry phantom. In vivo evaluation was performed by applying the sequence to 20 subjects with 25 meningiomas. Regions of interest included the meningioma, caudate head, centrum semiovale, contralateral white matter and thalamus. For both phantom and subjects, mean values of both T1 and T2 estimates were obtained. Statistical significance of differences in mean values between the meningioma and other brain structures was tested using a Friedman’s ANOVA test. Results MR fingerprinting phantom data demonstrated a linear relationship between measured and reference relaxometry estimates for both T1 (r2 = 0.99) and T2 (r2 = 0.97). MRF T1 relaxation times were longer in meningioma (mean ± SD 1429 ± 202 ms) compared to thalamus (mean ± SD 1054 ± 58 ms; p = 0.004), centrum semiovale (mean ± SD 825 ± 42 ms; p < 0.001) and contralateral white matter (mean ± SD 799 ± 40 ms; p < 0.001). MRF T2 relaxation times were longer for meningioma (mean ± SD 69 ± 27 ms) as compared to thalamus (mean ± SD 27 ± 3 ms; p < 0.001), caudate head (mean ± SD 39 ± 5 ms; p < 0.001) and contralateral white matter (mean ± SD 35 ± 4 ms; p < 0.001) Conclusions Phantom measurements indicate that the proposed 3D-MRF sequence relaxometry estimations are valid and reproducible. For in vivo, entire brain coverage was obtained in clinically feasible time and allows quantitative assessment of meningioma in clinical practice.


2021 ◽  
pp. 039156032110351
Author(s):  
Alessandro Uleri ◽  
Rodolfo Hurle ◽  
Roberto Contieri ◽  
Pietro Diana ◽  
Nicolòmaria Buffi ◽  
...  

Background: Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease. Objective: To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC). Methods: We retrospectively analyzed clinical and pathological data of 139 consecutive patients who underwent RC at our institution. Logistic regression models (LRMs) were fitted to test the above-mentioned outcomes. Results: A total of 139 consecutive patients underwent RC at our institution. Eighty-six (61.9%) patients had a locally-advanced disease. NLR (2.53 and 3.07; p = 0.005) and DRR (1 and 1.17; p = 0.01) were significantly higher in patients with locally-advanced disease as compared to organ-confined disease. In multivariable LRMs, an increasing DRR was an independent predictor of locally-advanced disease (OR = 3.91; 95% CI: 1.282–11.916; p = 0.017). Similarly, an increasing NLR was independently related to presence of locally-advanced disease (OR = 1.28; 95% CI: 1.027–1.591; p = 0.028). In univariate LRMs, patients with DRR > 1.21 had a higher risk of locally advanced disease (OR = 2.83; 95% CI: 1.312–6.128; p = 0.008). Similarly, in patients with NLR > 3.47 there was an increased risk of locally advanced disease (OR = 3.02; 95% CI: 1.374–6.651; p = 0.006). In multivariable LRMs, a DRR > 1.21 was an independent predictor of locally advanced disease (OR = 2.66; 95% CI: 1.12–6.35; p = 0.027). Similarly, an NLR > 3.47 was independently related to presence of locally advanced disease (OR = 2.24; 95% CI: 0.95–5.25; p = 0.065). No other covariates such as gender, BMI, neoadjuvant chemotherapy or diabetes reached statistical significance. The AUC of the multivariate LRM to assess the risk of locally advanced disease was 0.707 (95% CI: 0.623–0.795). Limitations include the retrospective nature of the study and the relatively small sample size.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1378.2-1379
Author(s):  
L. Gupta ◽  
U. Kumar ◽  
A. Anuja ◽  
P. Sharma ◽  
A. Guleria ◽  
...  

Background:We have previously found promise in NMR as a tool to distinguish sera of active from inactive inflammatory myositis (IIM)1. To understand the changes previously found in sera and urine we studied muscle tissue of patients with myositis.Objectives:To identify differences in metabolome on inflamed muscle tissues of patients with active myositis from that of healthy controls and infectious polymyositis.Methods:Muscle (n=17) from patients classifiable as myositis by the ACR-EULAR criteria [34 years (23.5 - 50.5 IQR), M/F 1:3] were compared with healthy controls [n=11, age= 44 (35-50) years, M/F-1:1]. Two disease controls with infectious polymyositis were also compared. Findings were applied to muscle biopsy tissues of two patients with established myositis and superadded infections (HBV, Histoplasmosis) to assess discriminatory potential.Metabolic profiles were obtained at 800 MHZ NMR spectrometer and compared using multivariate partial least-squares discriminant analysis (PLS-DA). The discriminatory metabolites were identified based on variable importance in projection (VIP) statistics and further evaluated for statistical significance (p-value <0.05). Paired T tests, ANNOVA and correlation of individual metabolites were done after normalizing for formate.Results:Metabolomics profiles in IIM were distinct from healthy controls (Fig. 1A).Of the various discriminatory metabolites (Fig. 1B), Succinate had the highest discriminatory potential (AUC 0.8, P=0.01) followed by citrate, glycine, glycerol, glucose, creatine and lactate. (Fig. 1C) Both glucose and creatine were decreased in IIM (Fig. 1D,E) and this was uniform across all types of IIM. However, glycine levels differed across different myositis subsets supporting the fact that they might differ in pathogenesis. (Fig. 1E) Amongst various serum biomarkers of muscle disease and damage, serum Aspartate Transaminase correlated with glutamate (r=0.6, p=0.01), and serum creatinine correlated negatively with glycerol (r-0.8, p=0.04),Biopsies of infectious polymyositis suggested difference in spectra from IIM (Fig. 2A). Trends were observed towards lower succinate and higher citrate levels suggesting metabolomics could possibly be useful to differentiate the two. Muscle of both patients with IIM with superadded infectious polymyositis also exhibited low succinate and elevated citrate.Conclusion:Muscle metabolomics of active myositis is distinctive. Amino acids and creatine are lower in diseases muscle suggesting active breakdown and loss, in turn explaining previous findings of low levels in serum in active disease. Certain metabolite composition differ in different types of myositis supporting different pathogenesis.Infectious polymyositis might exhibit different metabolome from IIM with potential as a biomarker though this needs to be confirmed in larger numbers.Disclosures:Funded by APLAR research grant 2017 awarded to Dr Latika Gupta.References:[1]Gupta L, Kumar D, Gulerai A, Kumar U, Misra R. “NMR-Based Serum, Urine and Muscle Metabolomics in Inflammatory Myositis for Diagnosis and Activity Assessment: Serum Metabolomics Can Differentiate Active from Inactive Myositis” Oral presentation at the ACR, Atlanta 2019.Acknowledgments:MSA and metabolomics supported by APLAR research grant.Disclosure of Interests:None declared


2019 ◽  
Vol 25 (3) ◽  
pp. 271-286 ◽  
Author(s):  
Kristi N. Lavigne ◽  
Victoria L. Whitaker ◽  
Dustin K. Jundt ◽  
Mindy K. Shoss

Purpose The purpose of this paper is to examine the relationship between job insecurity and adaptive performance (AP), contingent on changes to core work tasks, which we position as a situational cue to employees regarding important work behaviors. Design/methodology/approach Employees and their supervisors were invited to participate in the study. Supervisors were asked to provide ratings of employees’ AP and changes to core tasks; employees reported on job insecurity. Findings As predicted, changes to core tasks moderated the relationship between job insecurity and AP. Job insecurity was negatively related to AP for those experiencing low levels of change, but was not related to AP for those experiencing high levels of change. Counter to expectations, no main effect of job insecurity was found. Research limitations/implications This study employed a fairly small sample of workers from two organizations, which could limit generalizability. Practical implications The study identifies changes to core tasks as a boundary condition for the job insecurity–AP relationship. Findings suggest that organizations may not observe deleterious consequences of job insecurity on AP when changes to core tasks are high. Originality/value Few researchers have examined boundary conditions of the impact of job insecurity on AP. Furthermore, inconsistent findings regarding the link between job insecurity and AP have emerged. This study fills the gap and expands upon previous research by examining changes to core tasks as a condition under which job insecurity does not pose an issue for AP.


2011 ◽  
Vol 6 (2) ◽  
pp. 252-277 ◽  
Author(s):  
Stephen T. Ziliak

AbstractStudent's exacting theory of errors, both random and real, marked a significant advance over ambiguous reports of plant life and fermentation asserted by chemists from Priestley and Lavoisier down to Pasteur and Johannsen, working at the Carlsberg Laboratory. One reason seems to be that William Sealy Gosset (1876–1937) aka “Student” – he of Student'st-table and test of statistical significance – rejected artificial rules about sample size, experimental design, and the level of significance, and took instead an economic approach to the logic of decisions made under uncertainty. In his job as Apprentice Brewer, Head Experimental Brewer, and finally Head Brewer of Guinness, Student produced small samples of experimental barley, malt, and hops, seeking guidance for industrial quality control and maximum expected profit at the large scale brewery. In the process Student invented or inspired half of modern statistics. This article draws on original archival evidence, shedding light on several core yet neglected aspects of Student's methods, that is, Guinnessometrics, not discussed by Ronald A. Fisher (1890–1962). The focus is on Student's small sample, economic approach to real error minimization, particularly in field and laboratory experiments he conducted on barley and malt, 1904 to 1937. Balanced designs of experiments, he found, are more efficient than random and have higher power to detect large and real treatment differences in a series of repeated and independent experiments. Student's world-class achievement poses a challenge to every science. Should statistical methods – such as the choice of sample size, experimental design, and level of significance – follow the purpose of the experiment, rather than the other way around? (JEL classification codes: C10, C90, C93, L66)


2015 ◽  
Vol 36 (3) ◽  
pp. 202-206 ◽  
Author(s):  
Maria Helena Barbosa ◽  
Alisson F. Bolina ◽  
Raíssa B. Luiz ◽  
Karoline F. de Oliveira ◽  
Jair S. Virtuoso ◽  
...  

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