Terminologija klinične prehrane: Motnje prehranjenosti in s prehranjenostjo povezana stanja

Izhodišča: Prehransko stanje posameznika uvrščamo med ključne dejavnike njegovega zdravja. Za učinkovito individualno in multidisciplinarno obravnavo stanj, povezanih s prehranskim stanjem posameznika, moramo dobro poznati terminologijo klinične prehrane. Ker je klinična prehrana kot medicinska stroka razvita tudi pri nas, v tujini pa so tovrstni terminološki dokumenti že na voljo, želimo tudi v Sloveniji na podlagi konsenza oblikovati enotno terminologijo. Metode: Prispevek je osnovan na podlagi eksplicitnega terminološkega dogovora. K sodelovanju smo povabili obsežno skupino relevantnih slovenskih strokovnjakov s kliničnih, predkliničnih in drugih področij, ki so povezana z dejavnostjo klinične prehrane v medicini, pri oblikovanju pa je sodeloval tudi terminolog s področja medicine. Kot izhodišče smo izbrali terminološke smernice Evropskega združenja za klinično prehrano in presnovo ter ob njih upoštevali najnovejša strokovna priporočila za posamezne pojme. Avtorji so bili v stiku prek osebnih srečanj in elektronske pošte. Pri končnem oblikovanju konsenza je sodelovalo 42 avtorjev iz 19 slovenskih ustanov. Rezultati: Predstavljamo temeljne pojme, terminološke definicije in pripadajoče slovenske termine s področja klinične prehrane. Opredelili smo osnovne motnje prehranjenosti – podhranjenost, prekomerno hranjenost, neravnovesje mikrohranil in sindrom ponovnega hranjenja. Poleg tega smo opredelili tudi s prehranjenostjo povezana stanja – sarkopenijo in krhkost. Osnovne pojme smo podprli s kliničnim kontekstom, v katerem nastopajo. Zaključki: Poenoteno razumevanje osnovnih patoloških stanj, ki jih obravnava klinična prehrana, je izhodišče za nadaljnji razvoj stroke, poleg tega pa je podlaga tudi za prehransko obravnavo in učinkovito prehransko oskrbo

Terminologija klinične prehrane: Prehranska obravnava – presejanje prehranske ogroženosti in prehranski pregled

Izhodišča: Pomembno vlogo pri prehranski obravnavi imata tako presejanje prehranske ogroženosti kot prehranski pregled, na podlagi katerega lahko postavimo diagnozo motnje prehranjenosti ali s prehranjenostjo povezane motnje. Ocena posameznikovega prehranskega stanja, ki jo pridobimo s prehransko obravnavo, je namreč ključna za načrtovanje učinkovite prehranske oskrbe. Za razvoj področja je pomembno, da so vsi termini, ki se uporabljajo pri kliničnem delu, usklajeni. Taki terminološki dokumenti v mednarodnem prostoru že obstajajo, smiselni pa so tudi za slovenščino in naše okolje. Metode: Prispevek temelji na eksplicitnem terminološkem dogovoru skupine 42 relevantnih slovenskih strokovnjakov iz 19 slovenskih ustanov. Osnova oblikovanja terminoloških smernic je terminološki dokument Evropskega združenja za klinično prehrano in presnovo, pri čemer so bili upoštevani tudi novejši izsledki klinične prehrane. Rezultati: Predstavljeni so slovenski termini in terminološke definicije s področja klinične prehrane. Opredeljeni so osnovni pojmi s področja prehranske obravnave, ki je praviloma del medicinske obravnave. Predstavljena sta pojma prehranska ogroženost in presejanje prehranske ogroženosti, ob čemer so navedeni tudi različni presejalni testi za presejanje prehranskih motenj in s prehranjenostjo povezanih stanj. Podrobno so opredeljeni tudi prehranski pregled in njegovi sestavni deli. Zaključki: Tako presejanje prehranske ogroženosti kot prehranski pregled sta bistvena za diagnostično obravnavo v okviru klinične prehrane, poenoteno razumevanje terminologije pa omogoča primerno prepoznavo patoloških stanj pri bolnikih in pripravo ustreznega načrta prehranskih ukrepov

Management of frailty at individual level – clinical management: Systematic literature review

To deliver quality management of a frail individual, a clinician should understand the concept of frailty, be aware of its epidemiology and be able to screen for frailty and assess it when it is present, and, finally, to recommend successful interventions

Implementation of geriatric care models in Europe (imAGE.eu): a cross-sectional survey in eight countries

To access publisher's full text version of this article click on the hyperlink belowPurpose Despite the beneficial impact of comprehensive geriatric assessment (CGA) for older patients in the hospital, it is not clear to what extent these models have been implemented in European hospitals. This study aims to map the implementation status of CGA-based models of care in general hospitals in Europe. Methods A cross-sectional survey study was conducted in autumn 2017 to map the implementation status of CGA-based care models in general hospitals (n = 178) in Belgium, Denmark, Estonia, Greece, Iceland, Ireland, Malta, and Slovenia. Results Acute geriatric units are implemented in all of the Belgian and the majority of Danish hospitals, but are scarce in Malta, Estonia, Slovenia and Greece. Geriatric rehabilitation units are most common in Ireland (63.6%) and Iceland (75%). In-hospital multidisciplinary geriatric consultation teams are widely implemented in Belgium (100%), Ireland (72.7%) and Denmark (59.1%), but are rare in Malta, Iceland, Estonia and Greece. Transitional care programs to ensure continuity of care after discharge are present in 60.1% of all hospitals. The intention to implement any of these care models in the next 5 years ranges from 10.3 to 25.4% and is the highest for co-management (36.5%), systematic screening of ED patients (36.2%) and transitional care programs (29.6%). Conclusions A great variety in the implementation of CGA-based care models was observed among the surveyed EU countries with the uptake being the highest in Belgium, Denmark and Ireland. A supportive legislative framework and a residency training in geriatrics favor the implementation of the geriatric care models.Gerontology and Geriatrics research unit of the University of Leuven in Belgiu

Start low, go slow, but look far : the case of geriatric medicine in Balkan countries

Key summary pointsAim To briefly present the current situation regarding Geriatric Medicine in Balkan countries and discuss possible perspectives of development by exchange and interaction with countries with more developed Geriatric Medicine. Findings Balkan countries seem to encounter similar difficulties and share common challenges regarding under- and post-graduate education in geriatric medicine, accessibility to comprehensive geriatric assessment and response to special needs of older people in various clinical settings. Proposed solutions need to be pragmatic, effective, applicable in harmony with available services and adjusted to each country's special context. Message InterEuropean networking, cooperation among countries under the auspices of EuGMS, and suitable application of experience from countries with developed Geriatrics, could contribute to the development of Geriatric Medicine in Balkan countries as well. Purpose To present an insight of the situation of geriatric medicine in Balkan countries, as it was presented in the context of the 2nd pre-congress seminar of the 16th European Geriatric Medicine Society (EuGMS) Congress Athens 2021. Methods Representatives from 8 Balkan countries (Albania, Croatia, Greece, Republic of North Macedonia, Romania, Serbia, Slovenia, Turkey) answered 3 questions to reflect the state of geriatric medicine in their country: education on geriatrics; systems/methods for assessment of functional status and frailty; pre-operative risk assessment. An open discussion followed. Results Undergraduate education in geriatric medicine seems underestimated in medical faculties of Balkan countries, whereas a high heterogeneity is observed at a post-graduate level. Only a few Balkan countries have geriatric medicine as a recognized medical specialty or subspecialty. Functional status and frailty are only sporadically assessed, and pre-operative risk assessment is very rarely performed with a geriatric focus. Scarcity of expertise and structures relevant to geriatric medicine seems to be common. Developing a training curriculum and geriatrics-related structures are two interconnected aspects. Cooperation among physicians and multidisciplinary teams are essential for the practice of geriatric medicine. A functional geriatric network is eventually necessary and ambulatory geriatric expertise is probably a feasible and clinically relevant starting point. Providing pragmatic solutions to the pressing challenges in variable clinical settings, supplementing and working in harmony with existing components of each health system, is probably the most convincing strategy to gain political support in developing geriatric medicine. Conclusion Balkan countries share common experiences and challenges in developing geriatrics. Whilst the principles of geriatric medicine are perhaps universal, proposed solutions should be adapted to each country's specific circumstances. Cooperation of the Balkan countries could promote in each the development of geriatric medicine. EuGMS is willing to foster relevant actions