BITTER PEPTIDES, OCCURRENCE AND STRUCTURE

The bitter taste of many protein rich foods resides in the peptide fraction. 61 bitter tasting peptides, isolated from natural systems, and 145 bitter tasting synthetic peptides are reviewed. The relationships between average hydrophobicity and bitter taste are then discusse

Migration et santé: perception du cancer par des migrants et des professionnels établis en Valais

La migration a toujours été au coeur des débats. La Suisse est depuis de nombreuses années une terre d’accueil pour beaucoup de migrants de toutes origines. Qu’en est-il de leurs conditions de vie en Suisse ? Ce travail se penche sur la perception du cancer parmi quatre populations principalement présentes en Valais (Portugal, Erythrée, Somalie, Kosovo). L’objectif de cette recherche est d’améliorer la prise en charge de ces patients par les assistantes sociales du milieu de la santé en leur apportant de meilleurs outils et connaissances culturels de ces populations face au cancer et aux problématiques qu’il amène. Ce projet s’appuie sur les témoignages d’assistantes sociales, de patients, mais également d’autres membres du réseau tels que des interprètes communautaires (IC) et d’un médecin, afin d’avoir un regard global sur cette problématique. Cette recherche s’intéresse également à la question de la codépendance chez les divers professionnels qui accompagnent ces migrants durant la maladie

Dehydration and Malnutrition in Residential Care: Recommendations for Strategies for Improving Practice Derived from a Scoping Review of Existing Policies and Guidelines

Preventing malnutrition and dehydration in older care home residents is a complex task, with both conditions remaining prevalent, despite numerous guidelines spanning several decades. This policy-mapping scoping review used snowballing search methods to locate publicly-available policies, reports and best practice guidelines relating to hydration and nutrition in UK residential care homes, to describe the existing knowledge base and pinpoint gaps in practice, interpretation and further investigation. The findings were synthesised narratively to identify solutions. Strategies for improvements to nutritional and hydration care include the development of age and population-specific nutrient and fluid intake guidelines, statutory regulation, contractual obligations for commissioners, appropriate menu-planning, the implementation and auditing of care, acknowledgment of residents’ eating and drinking experiences, effective screening, monitoring and treatment and staff training. The considerable body of existing knowledge is failing to influence practice, relating to translational issues of implementing knowledge into care at the point of delivery, and this is where future research and actions should focus

Population-specific Mini Nutritional Assessment can improve mortality-risk-predicting ability in institutionalised older Taiwanese

The study determined whether a new version of the Mini Nutritional Assessment that adopted population-specific anthropometric cut-points would improve the mortality-predicting ability in institutionalised Taiwanese older people.Routine screening is the key for detecting emerging malnutrition, but the tool must be simple, reliable and easy-to-use to be well accepted. The Mini Nutritional Assessment can meet these requirements, but for non-Western populations, modifications based on anthropometric considerations are needed.The study purposively sampled 208 residents, aged >65 years, of a long-term care institution in Central Taiwan. Subjects were free of acute infection/disease and able to communicate. A university human-subject-study ethics committee approved the protocol.The study included biochemical measurements and a structured questionnaire for eliciting personal data and answers to questions in the Mini Nutritional Assessment. Follow-up survival/mortality was tracked for two consecutive six-month periods and analysed according to nutritional statuses graded with the original or a modified Mini Nutritional Assessment. The modified version adopted population-specific anthropometric cut-points and was without body mass index.The modification improved the mortality-predictive ability. Mortality rates for the first six months were 8·7, 3·9 and 0% according to the original Mini Nutritional Assessment and 10·6, 3·4 and 0% according to the modified version for subjects rated malnourished, at risk of malnutrition and normal, respectively. The mortality-predictive ability of both versions weakened after six months.Both versions can predict follow-up mortality, but the modified version has improved ability. For best results, the tool should be applied every six months or less (shorter for more frail older people) to screen for new cases of at-risk individuals.The Mini Nutritional Assessment that adopts population-specific anthropometric cut-points may have improved nutritional-risk and mortality-risk predictive abilities. The tool can help care-workers detect emerging nutritional problems and enable timely intervention. Routine use of the tool may help improve the quality of care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79325/1/j.1365-2702.2010.03299.x.pd

A modified Mini Nutritional Assessment without BMI can effectively assess the nutritional status of neuropsychiatric patients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72790/1/j.1365-2702.2008.02686.x.pd

Diagnostic performance of the Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) and Nutritional Risk Screening 2002 (NRS 2002) among hospital inpatients - a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The usefulness of the nutritional screening tool Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) relative to Nutritional Risk Screening 2002 (NRS 2002) remains untested. Here we attempted to fill this gap by testing the diagnostic performance and user-friendliness of the MEONF-II and the NRS 2002 in relation to the Mini Nutritional Assessment (MNA) among hospital inpatients.</p> <p>Methods</p> <p>Eighty seven hospital inpatients were assessed for nutritional status with the 18-item MNA (considered as the gold standard), and screened with the NRS 2002 and the MEONF-II.</p> <p>Results</p> <p>The MEONF-II sensitivity (0.61), specificity (0.79), and accuracy (0.68) were acceptable. The corresponding figures for NRS 2002 were 0.37, 0.82 and 0.55, respectively. MEONF-II and NRS 2002 took five minutes each to complete. Assessors considered MEONF-II instructions and items to be easy to understand and complete (96-99%), and the items to be relevant (87%). For NRS 2002, the corresponding figures were 75-93% and 79%, respectively.</p> <p>Conclusions</p> <p>The MEONF-II is an easy to use, relatively quick and sensitive screening tool to assess risk of undernutrition among hospital inpatients. With respect to user-friendliness and sensitivity the MEONF-II seems to perform better than the NRS 2002, although larger studies are needed for firm conclusions. The different scoring systems for undernutrition appear to identify overlapping but not identical patient groups. A potential limitation with the study is that the MNA was used as gold standard among patients younger than 65 years.</p

Probiotic yogurt in the elderly with intestinal bacterial overgrowth: endotoxaemia and innate immune functions

A study was conducted in healthy elderly living independently in senior housing to assess the impact of a probiotic yoghurt supplement on small intestinal bacterial overgrowth. Twenty-three participants with positive and thirteen participants with negative hydrogen breath test were studied before and after a period of 4 weeks of probiotic yoghurt administration. Intestinal permeability, plasma endotoxin levels, phagocytic activity of leucocytes, cytokine production by monocytes and free radical response of neutrophils were determined. Intestinal permeability was similar for the two groups and was unaffected by probiotic treatment. Both plasma endotoxin levels and the basal phagocytic activity of leucocytes decreased after yoghurt intake in the two groups. Exposure of monocytes and neutrophils ex vivo led to an increased cytokine response and free radical response, respectively. The normalisation of the various cytokine responses was more apparent in the group with positive breath test. In addition, the plasma levels of lipoplysaccharide binding protein and soluble CD14, lipoplysaccharide pattern recognition receptors and surrogate markers of lipoplysaccharide permeability were diminished by the end of the study. In conclusion, probiotic administration in the elderly normalises the response to endotoxin, and modulates activation markers in blood phagocytes, and therefore may help reduce low-grade chronic inflammatio

Perceptions and experiences of frailty interventions:quantitative and qualitative results from a survey of partners within the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA)

The European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) was launched by the European Commission in 2011 to promote innovation in ageing research. This paper explores the experiences of partners delivering frailty interventions within Europe, registering their programmes with the EIP-AHA. Data were collected using an online survey from 21 partners in seven countries. A mixed-method approach was used with inductive thematic analysis of free-text responses to improve data richness. Responses indicated that there was a lack of consistency between EIP-AHA partners in methods of defining, screening and measuring for frailty and pre-frailty. Open responses to survey questions about intervention facilitators, moderators and barriers were coded into two themes: working with stakeholders and project management. We concluded that EIP-AHA partners are providing interventions addressing physical, cognitive and wellbeing elements of frailty. However, there needs to be an increase in the proportion of interventions that consistently apply valid methods of screening and/or measuring frailty and pre-frailty. Most, but not all projects are targeting pre-frail older adults, suggesting an appropriate balance of prevention in a useful ‘intervention window’ but also a growing understanding that frailty at later stages is amenable to intervention. Findings suggest design manipulations to improve outcomes and adherence to interventions, specifically inclusion of a perceived benefit/reward for older adults, e.g. a social aspect or health-care promotion

Malnutrition in healthcare settings and the role of gastrostomy feeding

Malnutrition can adversely affect physical and psychological function, influencing both morbidity and mortality. Despite the prevalence of malnutrition and its associated health and economic costs, malnutrition remains under-detected and under-treated in differing healthcare settings. For a subgroup of malnourished individuals, a gastrostomy (a feeding tube placed directly into the stomach) may be required to provide long-term nutritional support. In this review we explore the spectrum and consequences of malnutrition in differing healthcare settings. We then specifically review gastrostomies as a method of providing nutritional support. The review highlights the origins of gastrostomies, and discusses how endoscopic and radiological advances have culminated in an increased demand and placement of gastrostomy feeding tubes. Several studies have raised concerns about the benefits derived following this intervention and also about the patients selected to undergo this procedure. These studies are discussed in detail in this review, alongside suggestions for future research to help better delineate those who will benefit most from this intervention, and improve understanding about how gastrostomies influence nutritional outcomes