Indications for percutaneous endoscopic gastrostomy and survival in old adults

Background : Many diseases striking old adults result in eating difficulties. Indications for selecting individuals for percutaneous endoscopic gastrostomy (PEG) are unclear and everybody may not benefit from the procedure. Objective : The aim of this study was to evaluate indications for and survival after PEG insertion in patients older than 65 years. Design and Methods : A retrospective analysis including age, gender, diagnosis, indication, and date of death was made in 201 consecutive individuals, 94 male, mean age 79±7 years, who received a nutritional gastrostomy. Results: Dysphagia was present in 86% of the patients and stroke was the most common diagnosis (49%). Overall median survival was 123 days and 30-day mortality was 22%. Patients with dementia and Mb Parkinson had the longest survival (i.e. 244 and 233 days), while those with other neurological diseases, and head and neck malignancy had the shortest (i.e. 75 and 106 days). There was no difference in mortality in patients older or younger than 80 years, except in patients with dementia. Conclusions: Old age should not be a contraindication for PEG. A high 30-day mortality indicates that there is a need of better criteria for selection and timing of PEG insertion in the elderly

Dietary differences between elderly Iranians living in Sweden and Iran a cross-sectional comparative study

<p>Abstract</p> <p>Background</p> <p>During the last decades, global migration has increased and many immigrant groups have a higher prevalence than the native born population of several cardiovascular disease risk factors, including poor dietary habits. However, it is uncertain if dietary habits in immigrant populations reflect dietary habits in their country of origin or if the current diet is a consequence of the migration and possible change of dietary habits. The aim of this study was to examine possible dietary differences between elderly Iranians living in Stockholm, Sweden with elderly Iranians living in Tehran, Iran, taking into account sex, age, marital status, and education.</p> <p>Methods</p> <p>Dietary intakes were assessed by semi - quantitative food frequency questionnaire in a cross-sectional study of 121 Iranians living in Stockholm and 52 Iranians living in Tehran, aged 60-80. Differences in dietary habits between the two groups was analysed by bootstrapped regression analyses with 1000 replications.</p> <p>Results</p> <p>Iranians living in Sweden had significantly higher intake of protein, total fat, fiber than Iranians living in Iran, but lower consumption of carbohydrates. The observed differences in intake of macronutrients were reflected in consumed amount of all food items, which were higher among Iranians living in Iran with the exception of bread and grain consumption which was lower.</p> <p>Conclusions</p> <p>There are general differences in dietary habits between Iranians living in Iran and Iranians living in Sweden. Parts of observed differences in dietary habits may reflect a favourable adoption process to the Swedish dietary habits after migration. Meanwhile other differences are point of concern in light of the high prevalence of overweight, among Iranians living in Sweden and can have unfavourable impact in particular in the context of cardiovascular health.</p

Evaluating Documentation of Dietetic Care in Swedish Medical Records

An adequate documentation in medical records is essential for patient safety and high quality care. The aim of this study was to evaluate documentation by dietitians in Swedish medical records. A retrospective audit of 147 dietetic notes in electronic medical records was performed. The audit focused at documentation of essential parts of the dietetic care, as well as other quality aspects such as lingual clarity and structure of the documentation. The nutrition intervention showed to be the most documented part of dietetic care. However, the audit showed that several important parts of nutrition care were poorly documented, for instance nearly half of the audited records had no clear nutrition problem documented, and in most of the records, the goal of nutrition intervention was missing. The study shows that Swedish dietitians need to improve documentation in medical records, as a suggestion by implementing a more structured documentation model

Evaluating Documentation of Dietetic Care in Swedish Medical Records

Abstract An adequate documentation in medical record

Fractal two-level finite-element method for two-dimensional cracks

Fractal two-level finite-element method has been extended to mode II crack problems. In order to encourage the use of this versatile tool on crack problems, some user guidelines for evaluating the stress intensity factor and for improving the convergence of stress intensity factors are suggested for structural engineers. The study is focused on (1) the effect of the numerical integration scheme on the convergency of stress intensity factors, (2) the configuration of fractal meshes, and (3) the influence of the aspect ratio of the fractal mesh on the accuracy of stress intensity factors. Both mode I and mode II two-dimensional crack problems are discussed. Examples for both the lagrangian and the serendipity types of elements are used to demonstrate the numerical efficiency and accuracy of the present method. In summary, it is not difficult to achieve accuracy within 3% error on stress intensity factors with a personal computer in a few seconds of execution time. © 1996 Microcomputers in Civil Engineering. Published by Blackwell Publishers.link_to_subscribed_fulltex

Roman Jasinsky as Icare (centre) and artists of the company as Greek Youths, in Icare, The Original Ballet Russe, Australian tour, His Majesty's Theatre, Melbourne, May 1940 (3) [picture] /

From: Icare : choreographic legend in one act / ballet and rhythms by Serge Lifar ; orchestrated by Antal Dorati.; Inscription: "4V/16".; Part of the collection: Hugh P. Hall collection of photographs, 1938-1940.; Choreography by Serge Lifar ; scenery and costumes by Sidney Nolan.; Also available in an electronic version via the internet at: http://nla.gov.au/nla.pic-vn4173875. One of a collection of photographs taken by Hugh P. Hall of 28 ballet productions performed by the Covent Garden Russian Ballet (toured Australia 1938-1939) and the Original Ballet Russe (toured Australia 1939-1940). These are the second and third of the three Ballets Russes companies which toured Australasia between 1936 and 1940. The photographs were taken from the auditorium during a live performance in His Majesty's Theatre, Melbourne and mounted on cardboard for display purposes. For conservation and storage, the photographs have been demounted. The original arrangement of the photographs has been recorded, and details are available from the Pictures Branch of the National Library