Malnutrition in the Critically Ill Child: The Importance of Enteral Nutrition

Malnutrition affects 50% of hospitalized children and 25–70% of the critically ill children. It increases the incidence of complications and mortality. Malnutrition is associated with an altered metabolism of certain substrates, increased metabolism and catabolism depending on the severity of the lesion, and reduced nutrient delivery. The objective should be to administer individualized nutrition to the critically ill child and to be able to adjust the nutrition continuously according to the metabolic changes and evolving nutritional status. It would appear reasonable to start enteral nutrition within the first 24 to 48 hours after admission, when oral feeding is not possible. Parenteral nutrition should only be used when enteral nutrition is contraindicated or is not tolerated. Energy delivery must be individually adjusted to energy expenditure (40–65 kcal/100 calories metabolized/day) with a protein delivery of 2.5–3 g/kg/day. Frequent monitoring of nutritional and metabolic parameters should be performed

Design, methods and demographic findings of the DEMINVALL survey: a population-based study of Dementia in Valladolid, Northwestern Spain

Producción CientíficaThis article describes the rationale and design of a population-based survey of dementia in Valladolid (northwestern Spain). The main aim of the study was to assess the epidemiology of dementia and its subtypes. Prevalence of anosognosia in dementia patients, nutritional status, diet characteristics, and determinants of non-diagnosed dementia in the community were studied. The main sociodemographic, educational, and general health status characteristics of the study population are described. Methods: Cross-over and cohort, population-based study. A two-phase door-to-door study was performed. Both urban and rural environments were included. In phase 1 (February 2009 – February 2010) 28 trained physicians examined a population of 2,989 subjects (age: ≥ 65 years). The seven-minute screen neurocognitive battery was used. In phase 2 (May 2009 – May 2010) 4 neurologists, 1 geriatrician, and 3 neuropsychologists confirmed the diagnosis of dementia and subtype in patients screened positive by a structured neurological evaluation. Specific instruments to assess anosognosia, the nutritional status and diet characteristics were used. Of the initial sample, 2,170 subjects were evaluated (57% female, mean age 76.5 ± 7.8, 5.2% institutionalized), whose characteristics are described. 227 persons were excluded for various reasons. Among those eligible were 592 non-responders. The attrition bias of non-responders was lower in rural areas. 241 screened positive (11.1%). Discussion: The survey will explore some clinical, social and health related life-style variables of dementia. The population size and the diversification of social and educational backgrounds will contribute to a better knowledge of dementia in our environment. Keywords: Dementia prevalence, Epidemiology, Undiagnosed dementia, Population-based survey, Seven-minute screen, Anosognosia, Nutritional assessmen

Best Practices.COOP-TRAF JLS/2005/AGIS/156. AGIS Programme, 2005

This research has been conducted by eight partners in four European countries: in Spain, four partners have participated: Centro de Investigación en Criminología - Universidad de Castilla-La Mancha, the NGO Proyecto Esperanza, Two national police forces represented by the law enforcement units in charge of the fight against trafficking in persons: Cuerpo Nacional de Policía (Comisaría General de Extranjería y ocumentación) and Guardia Civil (Unidad de Policía Judicial). From Portugal, our partner has been the Instituto Nacional de Policia e Ciencias Criminaes. From Poland, two partners have participated: The NGO La Strada Foundation and the Warsaw University, and finally, from Italy, the NGO On the Road has been our partner. The aim of the project was to elaborate a best practices guide in order to improve preventive strategies to fight against the phenomenon of THBSE and to improve social integration and support for the victims. Public (members of law enforcement units and members of Judiciary) and private (members of the NGOs) practitioners have participated in two focus group in every country to find strategies to improve cooperation between them and to integrate their experiences and practices in proactive activities to reduce THBSE and to promote victims’ social integratio

Efektivitas implementasi pendidikan karakter berbasis layanan bimbingan klasikal dengan pendekatan experiential learning untuk meningkatkan karakter disiplin manajemen waktu (studi pra eksperimen pada siswa kelas VIII D SMP N 3 Purwantoro, Wonogiri tahun ajaran 2015/2016)

<p>(*) Significant difference (p < 0.05) from baseline, same group. (‡) p < 0.05 from hemorrhage, same group. (#) p < 0.05 from group NS.</p

Prevalence of dementia and subtypes in Valladolid, northwestern Spain: the DEMINVALL study.

OBJECTIVE:To describe the prevalence of dementia and subtypes in a general elderly population in northwestern Spain and to analyze the influence of socio-demographic factors. METHODS:Cross-sectional, two-phase, door-to-door, population-based study. A total of 870 individuals from a rural region and 2,119 individuals from an urban region of Valladolid, Spain, were involved. The seven-minute screen neurocognitive battery was used in the screening phase. A control group was included. RESULTS:A total of 2,170 individuals aged 65 to 104 years (57% women) were assessed. There were 184 subjects diagnosed with dementia. The crude prevalence was 8.5% (95% CI: 7.3-9.7). Age- and sex-adjusted prevalence was 5.5 (95% CI: 4.5-6.5). Main subtypes of dementia were: Alzheimer's disease (AD) 77.7%, Lewy Body disease, 7.6% and vascular dementia (VD) 5.9%. Crude prevalences were 6.6% (AD), 0.6% (Lewy Body disease), and 0.5% (VD). Dementia was associated with age (OR 1.14 for 1-year increase in age), female sex (OR 1.79) and the absence of formal education (OR 2.53 compared to subjects with primary education or more). CONCLUSION:The prevalence of dementia in the study population was lower than the most recent estimates for Western Europe. There was a high proportion of AD among all dementia cases and very low prevalence of VD. Old age, female sex, and low education level were independent risk factors for dementia and AD