Comparison of a Standardized High-Fat Meal versus a High-Fat Meal Scaled to Body Mass for Measuring Postprandial Triglycerides: A Randomized Crossover Study

Post-meal triglycerides are an independent cardiovascular disease (CVD) risk factor, but the ideal high-fat meal formulation has yet to be standardized and is one challenge prohibiting widespread clinical adoption of postprandial triglyceride assessment. Two general approaches often used are giving individuals a high-fat meal scaled to body weight or a standardized high-fat meal containing a set fat bolus. A recent expert panel statement has endorsed the latter, specifying 75 g of fat as an appropriate fat dosage. Despite this recommendation, no study to date has tested whether there is a difference in postprandial triglycerides or if risk classification is affected based on these different approaches. We recruited 16 generally healthy individuals with roughly equal distribution among body mass index (BMI)class (n = 5–6/per BMI category) and sex (n = 2–3 M/F) within each BMI class. Each participant underwent two abbreviated fat tolerance tests separated by ~1 week: one with a scaled to body weight high-fat meal (9 kcal/kg; 70% fat) and a standardized meal containing 75 g of fat (70% fat). Fasting, 4 h, and absolute change in triglycerides across the entire sample and within each BMI category were similar regardless of high-fat meal. Only one participant with obesity had discordant postprandial responses between the fat tolerance tests (i.e., different CVD risk classification). These findings suggest that, within a certain range of fat intake, generally healthy individuals will have a similar postprandial triglyceride response. Considering the greater convenience of utilizing standardized high-fat meals, our data suggest that a standardized high-fat meal may be acceptable for large-scale studies and clinical implementation.

Development of a Risk Classifier as a Stage of Successful Risk Management

The article gives the analysis of approaches to risk classification at industrial enterprise. Based on the findings, conclusions about advantages and disadvantages were drawn up, as well as the possibilities for its application at nuclear enterprises are formulated. The authors propose an original personalized approach to risk classifier development, which takes into account the nuclear industry specifics. An example of an algorithm for risk classifier development based on above-mentioned approach for the enterprise of the Rosatom State Corporation is given. This example can be used in various industries and may be of interest to risk management researchers and specialists.

Risk classification in a pediatric service: evaluation of the structure, process, and outcome

ABSTRACT Objectives: to evaluate a pediatric risk evaluation and classification service in the aspects of structure, process, and outcome. Methods: a cross-sectional, descriptive, and exploratory study in which qualitative data complement the results. Data collection by non-participant observation, interview, and consultation of medical records. Results: we observed two hundred and four visits. The service works in a makeshift room and without privacy. The nurses did not use various materials/equipment available for evaluation, rarely performed a physical examination, used the interview most of the time, and did not consult the protocol. Parents/companions received no information, and medical records showed incomplete records. Nurses classified 69.1% of the children as non-emergency. The most frequent outcome of the visits was discharge. Conclusions: the service showed weaknesses in the physical structure, in the risk classification process, and the outcomes, but it presents a good resolution in the assistance. We recommend a revision in the protocol used and sensitize nurses about the work process and communication with parents/companions.

O enfermeiro na aplicação da escala de classificação de risco de manchester: revisão integrativa / The nurse in the application of the manchester risk classification scale: integrative review

O presente estudo teve como objetivo identificar o papel do profissional enfermeiro na aplicação do Sistema de Classificação de Risco de Manchester em unidades de urgência e emergência. A metodologia adotada foi a revisão integrativa, sendo utilizadas as bases de dados LILACS, MEDLINE e BDENF, via Biblioteca Virtual em Saúde (BVS). Através dos descritores em saúde Triagem, Serviço Hospitalar de Emergência, Enfermagem e Papel do Profissional de Enfermagem, foram selecionados seis artigos, tendo como recorte temporal os últimos dez anos (2010 a 2020). O enfermeiro tem sua atuação na classificação de risco de pacientes em departamentos de emergência aprovada e respaldada pelo Conselho Federal de Enfermagem. Infere-se que sua atribuição contempla tanto a implementação deste processo, quanto a capacitação da equipe e a aplicação da escala. Destaca-se ainda, a necessidade de conhecimento e atualização sobre a temática. Elenca-se também, a existência de algumas dificuldades, resultantes de variáveis que vão desde a estrutura física e tecnológica, aos recursos humanos. As pesquisas incluídas neste trabalho demonstraram que o enfermeiro tem papel primordial, sendo o protagonista do processo e tornando-o mais ágil, qualificado, seguro e humano.

The Evolution of Gender-and Trauma-Responsive Criminal Justice Interventions for Women

For over five decades, the development of risk classification assessments, corrections-based treatment, and the associated outcome research have been focused on men. Thus, it is no surprise that existing treatment frameworks and correctional policies have been established from a male perspective.