Critical Role of Nutrition in Improving Quality of Care: An Interdisciplinary Call to Action to Address Adult Hospital Malnutrition

AbstractThe current era of health care delivery, with its focus on providing high-quality, affordable care, presents many challenges to hospital-based health professionals. The prevention and treatment of hospital malnutrition offers a tremendous opportunity to optimize the overall quality of patient care, improve clinical outcomes, and reduce costs. Unfortunately, malnutrition continues to go unrecognized and untreated in many hospitalized patients. This article represents a call to action from the interdisciplinary Alliance to Advance Patient Nutrition to highlight the critical role of nutrition intervention in clinical care and to suggest practical ways to promptly diagnose and treat malnourished patients and those at risk for malnutrition. We underscore the importance of an interdisciplinary approach to addressing malnutrition both in the hospital and in the acute post-hospital phase. It is well recognized that malnutrition is associated with adverse clinical outcomes. Although data vary across studies, available evidence shows that early nutrition intervention can reduce complication rates, length of hospital stay, readmission rates, mortality, and cost of care. The key is to systematically identify patients who are malnourished or at risk and to promptly intervene. We present a novel care model to drive improvement, emphasizing the following six principles: (1) create an institutional culture where all stakeholders value nutrition; (2) redefine clinicians' roles to include nutrition care; (3) recognize and diagnose all malnourished patients and those at risk; (4) rapidly implement comprehensive nutrition interventions and continued monitoring; (5) communicate nutrition care plans; and (6) develop a comprehensive discharge nutrition care and education plan

Preparation of Pectin–ZnO Nanocomposite

Pectin–ZnO nanocomposite was prepared in the aqueous solution condition at room temperature. The Fourier transform infrared, X-ray diffraction, and transmission electron microscope (TEM) measurements confirmed the nanoscaled structure of pectin–ZnO composite. According to the TEM observation, the average composite granules size was about 150 nm and the embedded ZnO nanoparticles were uniform with an average diameter of 70 nm

Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou (Burkina Faso)

<p>Abstract</p> <p>Background</p> <p>Malnutrition is still highly prevalent in developing countries. Schoolchildren may also be at high nutritional risk, not only under-five children. However, their nutritional status is poorly documented, particularly in urban areas. The paucity of information hinders the development of relevant nutrition programs for schoolchildren. The aim of this study carried out in Ouagadougou was to assess the nutritional status of schoolchildren attending public and private schools.</p> <p>Methods</p> <p>The study was carried out to provide baseline data for the implementation and evaluation of the Nutrition Friendly School Initiative of WHO. Six intervention schools and six matched control schools were selected and a sample of 649 schoolchildren (48% boys) aged 7-14 years old from 8 public and 4 private schools were studied. Anthropometric and haemoglobin measurements, along with thyroid palpation, were performed. Serum retinol was measured in a random sub-sample of children (N = 173). WHO criteria were used to assess nutritional status. Chi square and independent t-test were used for proportions and mean comparisons between groups.</p> <p>Results</p> <p>Mean age of the children (48% boys) was 11.5 ± 1.2 years. Micronutrient malnutrition was highly prevalent, with 38.7% low serum retinol and 40.4% anaemia. The prevalence of stunting was 8.8% and that of thinness, 13.7%. The prevalence of anaemia (p = 0.001) and vitamin A deficiency (p < 0.001) was significantly higher in public than private schools. Goitre was not detected. Overweight/obesity was low (2.3%) and affected significantly more children in private schools (p = 0.009) and younger children (7-9 y) (p < 0.05). Thinness and stunting were significantly higher in peri-urban compared to urban schools (p < 0.05 and p = 0.004 respectively). Almost 15% of the children presented at least two nutritional deficiencies.</p> <p>Conclusion</p> <p>This study shows that malnutrition and micronutrient deficiencies are also widely prevalent in schoolchildren in cities, and it underlines the need for nutrition interventions to target them.</p

Two ultraviolet radiation datasets that cover China

Ultraviolet (UV) radiation has significant effects on ecosystems, environments, and human health, as well as atmospheric processes and climate change. Two ultraviolet radiation datasets are described in this paper. One contains hourly observations of UV radiation measured at 40 Chinese Ecosystem Research Network stations from 2005 to 2015. CUV3 broadband radiometers were used to observe the UV radiation, with an accuracy of 5%, which meets the World Meteorology Organization's measurement standards. The extremum method was used to control the quality of the measured datasets. The other dataset contains daily cumulative UV radiation estimates that were calculated using an all-sky estimation model combined with a hybrid model. The reconstructed daily UV radiation data span from 1961 to 2014. The mean absolute bias error and root-mean-square error are smaller than 30% at most stations, and most of the mean bias error values are negative, which indicates underestimation of the UV radiation intensity. These datasets can improve our basic knowledge of the spatial and temporal variations in UV radiation. Additionally, these datasets can be used in studies of potential ozone formation and atmospheric oxidation, as well as simulations of ecological processes

Decade-long unsustainable vegetation management practices increase macronutrient losses from the plant-soil system in the Taklamakan Desert

Arid ecosystems are characterized by low availability and mobility of soil nutrients and slow geochemical cycles. Management of native vegetation in such ecosystems for fuel, livestock grazing, and other agricultural activities (burning and cutting) may threaten semi-natural communities due to the changes in nutrient cycles and soil fertility. Alhagi sparsifolia is a dominant perennial legume in the Taklamakan Desert of northwestern China and has been used as fodder for livestock and plays a crucial ecological role in stabilizing dunes in the oasis-desert ecotone. We evaluated the effects of long-term (12 years) burning and cutting of plant biomass on the mineral nutrition of A. sparsifolia and associated soils at two depths (0–50 and 50–100 cm) in the field conditions following the block design experiment. We found that burning effects tended to be restricted to the topsoil (0–50 cm), and the concentration of many micro-and macronutrients was increased. Burning was associated with a decrease in plant nitrogen (N) and phosphorus (P) concentration, whereas concentrations of other micro-and macronutrients increased; overall, burning reduced foliar stocks of N, P, and potassium (K). Annual cutting elicited smaller increases in soil mineral (total sulfur, total P, calcium, magnesium, and available P and K) concentrations than burning, and soil enzymatic activities increased. There were contrasting response patterns of leaf N and P concentration and macro-and micronutrients between the two management approaches. Burning and cutting reduced leaf N and P concentrations, while changes in root and shoot N and P concentrations depended on treatments. Thus, burning and cutting of A. sparsifolia impact organ nutrient stoichiometry (increased losses of macronutrients from arid plant-soil ecosystems) and nutritional quality (for feeding livestock), particularly due to predicted rises in extreme climatic events under climate change that are expected to increase risks of soil erosion, however, impacts on native trophic webs remain unclear

Barriers to Oral Medication Adherence for Adolescents with Inflammatory Bowel Disease

Objective To identify family-reported, adherence-related barriers for adolescents with inflammatory bowel disease (IBD) and examine their relationship to 6-MP/azathioprine and 5-ASA medication adherence. Methods Participants included 74 adolescents, aged 13–17 years, diagnosed with IBD and their caregivers. Adolescents and caregivers jointly completed a measure of barriers to medication adherence. Adherence to medication was measured by family-report, pill-count, and serum assay. Results Families endorsed one to seven total barriers to medication adherence. The most commonly reported barriers included forgetting, being away from home, and interference with an activity. Neither demographic nor disease severity variables were related to the total number of reported barriers. Fewer total reported barriers was related to better adherence by adolescent and maternal report. Conclusion Most families experience at least one barrier to treatment adherence. Effective problem-solving around these barriers and its integration into future treatment protocols may help improve medication adherence in the pediatric IBD population

Strigolactones can be a potential tool to fight environmental stresses in arid lands

Altres ajuts: the Fundación Ramón Areces grant CIVP20A6621.Background: environmental stresses pose a significant threat to plant growth and ecosystem productivity, particularly in arid lands that are more susceptible to climate change. Strigolactones (SLs), carotenoid-derived plant hormones, have emerged as a potential tool for mitigating environmental stresses. - Methods: this review aimed to gather information on SLs' role in enhancing plant tolerance to ecological stresses and their possible use in improving the resistance mechanisms of arid land plant species to intense aridity in the face of climate change. - Results: roots exude SLs under different environmental stresses, including macronutrient deficiency, especially phosphorus (P), which facilitates a symbiotic association with arbuscular mycorrhiza fungi (AMF). SLs, in association with AMF, improve root system architecture, nutrient acquisition, water uptake, stomatal conductance, antioxidant mechanisms, morphological traits, and overall stress tolerance in plants. Transcriptomic analysis revealed that SL-mediated acclimatization to abiotic stresses involves multiple hormonal pathways, including abscisic acid (ABA), cytokinins (CK), gibberellic acid (GA), and auxin. However, most of the experiments have been conducted on crops, and little attention has been paid to the dominant vegetation in arid lands that plays a crucial role in reducing soil erosion, desertification, and land degradation. All the environmental gradients (nutrient starvation, drought, salinity, and temperature) that trigger SL biosynthesis/exudation prevail in arid regions. The above-mentioned functions of SLs can potentially be used to improve vegetation restoration and sustainable agriculture. - Conclusions: resent review concluded that knowledge on SL-mediated tolerance in plants is developed, but still in-depth research is needed on downstream signaling components in plants, SL molecular mechanisms and physiological interactions, efficient methods of synthetic SLs production, and their effective application in field conditions. This review also invites researchers to explore the possible application of SLs in improving the survival rate of indigenous vegetation in arid lands, which can potentially help combat land degradation problems