Documentation and communication of nutritional care for elderly hospitalized patients: perspectives of nurses and undergraduate nurses in hospitals and nursing homes

Quotes on nutritional information between the hospital and nursing homes. (DOCX 13 kb

Fatty acids in habitual diet, plasma phospholipids, and tumour and normal colonic biopsies in young colorectal cancer patients

Fatty acid metabolism is altered in colorectal cancer (CRC). We aimed to investigate incorporation of dietary n-6 and n-3 polyunsaturated fatty acids (PUFAs) into plasma phospholipids (PLs), tumour tissue, and normal mucosa in young CRC patients. We also aimed to study differences in PUFA composition between tumour and normal mucosa, and PUFA status associated with cancer stage. Sixty-five CRC patients younger than 55 years were included in a multicenter study. We assessed dietary fatty acid composition by food-frequency questionnaire. Fatty acid composition in plasma PL (n = 65) and tumour and normal colonic biopsies (n = 32) were analysed by gas chromatography. We observed a significant correlation for docosahexaenoic acid (DHA) between dietary intake and concentration in plasma PL (weight%) (r = 0.42; P = 0.001), but not for any n-6 PUFA. Tissue concentrations of arachidonic acid, eicosapentaenoic acid, and DHA (weight%) were 1.7–2.5 times higher in tumour than normal mucosa (P ≤ 0.001). Concentrations of n-3 and n-6 PUFA in plasma PL and tissues were not related to Duke’s stage, although patients with more severe cancer stage reported higher intake of n-3 PUFA. In conclusion, we found accumulation of the longchained n-3 and n-6 PUFA in tumour tissue in young CRC patient

Food Habits and Forms of Food Insecurity among International University Students in Oslo: A Qualitative Study

A growing number of studies indicate that university students and especially international students are prone to experiencing food insecurity (FI). Still, few studies have investigated forms of FI among international students in Europe. Thus, this qualitative study aims to explore experiences regarding FI among international university students in Oslo. Sixteen semi-structured interviews were conducted between May and June 2022 and analyzed using a thematic approach. The sustainable livelihood approach (SLA) was used as a framework for analyzing and interpreting the data. The students experienced food prices as being high and found food variety at the grocery stores to be low, resulting in struggles to fulfil their food preferences and keep a varied diet. Particularly, social aspects of eating were affected due to high dining prices or inadequate cooking facilities in student homes. However, no student openly reported skipping meals and many mentioned attention for healthy eating. Considering our results, it seems of importance to give more attention to cultural and social aspects related to FI when assessing FI among international students. As the number of international students is increasing, knowing more about this phenomenon can support the promotion of initiatives addressing FI in this population.publishedVersio

Iron Status of Vegans, Vegetarians and Pescatarians in Norway

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Effect of Different Degrees of Hydrogenated Fish Oil on Intestinal Carcinogenesis in Min/+ mice

Intake of trans fatty acids from hydrogenated fish oils has been related to increased risk of coronary heart diseases. The possible effect on colorectal carcinogenesis is unclear. Materials and Methods: Multiple intestinal neoplasia (Min/+) mice were fed one of four experimental diets: either raw fish oil (FO), low (LHFO)-, high (HHFO)- or fully-hydrogenated fish oil (FFHO), from 0 to 9 weeks of age. The number and size of intestinal tumors were recorded. Results: There was no difference between the intervention groups in the numbers of developed intestinal tumors. The tumor size was statistically significantly lower in HHFO vs. the FO-group in male Min/+ mice. The HHFO and FHFO groups had lower weight gain than did the FO group (p=0.008 and p=0.04, respectively), but gender differences, due to effect of dietary intervention on weight gain, were found in Min/+ mice. Conclusion: When compared with raw fish oil, different degrees of hydrogenation of the fish oil had no effect on intestinal carcinogenesis in Min/+ mice

Daily intake of cod or salmon for 2 weeks decreases the 18:1n-9/18:0 ratio and serum triacylglycerols in healthy subjects

Intake of fish and omega-3 (n-3) fatty acids is associated with a reduced concentration of plasma triacylglycerols (TAG) but the mechanisms are not fully clarified. Stearoyl-CoA desaturase-1 (SCD1) activity, governing TAG synthesis, is affected by n-3 fatty acids. Peripheral blood mononuclear cells (PBMC) display expression of genes involved in lipid metabolism. The aim of the present study was to estimate whether intake of lean and fatty fish would influence n-3 fatty acids composition in plasma phospholipids (PL), serum TAG, 18:1n-9/18:0 ratio in plasma PL, as well as PBMC gene expression of SCD1 and fatty acid synthase (FAS). Healthy males and females (n = 30), aged 20–40, consumed either 150 g of cod, salmon, or potato (control) daily for 15 days. During intervention docosahexaenoic acid (DHA, 22:6n-3) increased in the cod group (P\0.05), while TAG concentration decreased (P\0.05). In the salmon group both eicosapentaenoic acid (EPA, 20:5n-3) and DHA increased (P\0.05) whereas TAG concentration and the 18:1n-9/ 18:0 ratio decreased (P\0.05). Reduction of the 18:1n-9/ 18:0 ratio was associated with a corresponding lowering of TAG (P\0.05) and an increase in EPA and DHA (P\0.05). The mRNA levels of SCD1 and FAS in PBMC were not significantly altered after intake of cod or salmon when compared with the control group. In conclusion, both lean and fatty fish may lower TAG, possibly by reducing the 18:1n-9/18:0 ratio related to allosteric inhibition of SCD1 activity, rather than by influencing the synthesis of enzyme protei

Barriers to nutritional care for the undernourished hospitalised elderly: perspectives of nurses

Aims and objectives: To identify what nurses experience as barriers to ensuring adequate nutritional care for the undernourished hospitalized elderly. Background: Undernutrition occurs frequently among the hospitalised elderly and can result in a variety of negative consequences if not treated. Nevertheless, undernutrition is often unrecognised and undertreated. Nurses have a great responsibility for nutritional care, as this is part of the patient's basic needs. Exploring nurses' experiences of preventing and treating undernourishment among older patients in hospitals is therefore highly relevant. Design: A focus group study was employed based on a hermeneutic phenomenological methodological approach. Methods: Four focus group interviews with totally 16 nurses working in one large university hospital in Norway were conducted in spring 2012. The nurses were recruited from seven somatic wards, all with a high proportion of older (=70 years) inpatients. The data were analysed in the three interpretative contexts: self-understanding, a critical common-sense understanding and a theoretical understanding. Results: We identified five themes that reflect barriers the nurses experience in relation to ensuring adequate nutritional care for the undernourished elderly: loneliness in nutritional care, a need for competence in nutritional care, low flexibility in food service practices, system failure in nutritional care and nutritional care is being ignored. Conclusions: The results imply that nutritional care at the university hospital has its limits within the hospital structure and organisation, but also regarding the nurses' competence. Moreover, the barriers revealed that the undernourished elderly are not identified and treated properly as stipulated in the recommendations in the national guidelines on the prevention and treatment of undernutrition. Relevance to clinical practice: The barriers revealed in this study are valuable when considering improvements to nutritional care practices on hospital wards to enable undernourished older inpatients to be identified and treated properly

Is Interprofessional Learning Only Meant for Professions Within Healthcare? - A Qualitative Analysis of Associations with the Term Interprofessional Collaborative Learning Among Professional Students

Purpose: The main goal of interprofessional learning (IPL) is to help students from different professions develop a common understanding of how to work together in future interprofessional collaboration (IPC). When IPL courses are extended beyond healthcare study programmes to include students from education and social care study programmes, the complexity increases. Since lack of communication and collaboration among professionals is a major challenge in welfare services, there is a need to explore professional students’ associations with IPL. Thus, this study aims to explore what students in healthcare, teaching education and social care study programmes associate with the term “interprofessional collaborative learning”. Participants and Methods: The study used student data from an ongoing IPL study at one of the largest state universities in Norway. Students from healthcare, social care and educational teaching bachelor programmes answered the following open-ended question in an online cross-sectional evaluation survey: “What do you associate with the term interprofessional collaborative learning?” We analysed data qualitatively from first- (n = 261) and second-year students (n = 97) collected during December 2019 and 2020. Most second-year students took an IPL course during their first year of study. Results: Overall, the students across all professions expressed positive associations with IPL. The most eminent category was that students associated IPL with collaboration, followed by learning and learning how to collaborate. First-year students were also associated with gaining and sharing knowledge and competencies with IPL. Understanding roles was eminent among second-year students in teaching education. Conclusion: This study supports the importance of IPL across different educational backgrounds since students seemed to have positive associations with the term and a common understanding that IPL involves several professions. The finding that teacher students highlighted the understanding of roles when working with children, young adults and their families, further supports expanding IPL beyond specialised professions within healthcare

Barriers to nutritional care for the undernourished hospitalised elderly: perspectives of nurses

Aims and objectives To identify what nurses experience as barriers to ensuring adequate nutritional care for the undernourished hospitalized elderly. Background Undernutrition occurs frequently among the hospitalised elderly and can result in a variety of negative consequences if not treated. Nevertheless, undernutrition is often unrecognised and undertreated. Nurses have a great responsibility for nutritional care, as this is part of the patient's basic needs. Exploring nurses' experiences of preventing and treating undernourishment among older patients in hospitals is therefore highly relevant. Design A focus group study was employed based on a hermeneutic phenomenological methodological approach. Methods Four focus group interviews with totally 16 nurses working in one large university hospital in Norway were conducted in spring 2012. The nurses were recruited from seven somatic wards, all with a high proportion of older (≥70 years) inpatients. The data were analysed in the three interpretative contexts: self-understanding, a critical common-sense understanding and a theoretical understanding. Results We identified five themes that reflect barriers the nurses experience in relation to ensuring adequate nutritional care for the undernourished elderly: loneliness in nutritional care, a need for competence in nutritional care, low flexibility in food service practices, system failure in nutritional care and nutritional care is being ignored. Conclusions The results imply that nutritional care at the university hospital has its limits within the hospital structure and organisation, but also regarding the nurses' competence. Moreover, the barriers revealed that the undernourished elderly are not identified and treated properly as stipulated in the recommendations in the national guidelines on the prevention and treatment of undernutrition. Relevance to clinical practice The barriers revealed in this study are valuable when considering improvements to nutritional care practices on hospital wards to enable undernourished older inpatients to be identified and treated properly