Convergent and discriminant validity of the Minimal Eating Observation Form - version II: a cross-sectional study

Background: The Minimal Eating Observation Form – Version II (MEOF-II) is a brief and easy to use screening tool for eating difficulties, that is psychometrically robust. The aim of this study was to explore convergent (measuring similar constructs) and discriminant (measuring somewhat different constructs) validity of the MEOF-II to other validated dysphagia specific, activity and participation related instruments. Methods: In this cross-sectional study, participants (n = 100, mean age 72, n = 42 women), diagnosed with either chronic pulmonary disease, Parkinson´s disease, Multiple Sclerosis, or stroke were recruited from rehabilitation centres. Patient-reported outcomes and clinical-rated assessments, capturing eating ability in general and swallowing in specific, included: The Dysphagia Handicap Index (DHI), the 4-question test (4QT), the Minimal Eating Observation Form – II, the Volume – Viscosity Swallow Test (V-VST), Flexible Endoscopic Evaluation of Swallowing (FEES) documented according to the Penetration-Aspiration Scale (PAS). Type of oral intake was documented using the Functional Oral Intake Scale (FOIS). Activities in daily living was assessed with Barthel index (BI). Spearman’s correlation coefficient was used to analyze associations. The MEOF-II total score was hypothesised to have moderate correlations (r ≥ 0.3) with the other assessments, besides with PAS and FOIS (weak correlations, r &lt; 0.3). Results: In total 78 participants had any type of eating difficulties (MEOF-II), 69 reported dysphagia (4QT), 62 had dysphagia according to V-VST, 29 showed evidence of penetration/aspiration (PAS), and 31 participants had decreased oral intake ability (FOIS). The MEOF-II total score had moderate correlations with DHI, BI, 4QT, V-VST volume, and weak correlations with V-VST dysphagia and viscosity, PAS, and FOIS. Comparing a prior hypothesised correlation strengths against empirical findings showed that 83% of the hypothesised correlations were correct. Conclusions: The MEOF-II is a holistic and objective screening tool that can indicate the need for further assessment and corresponds well with the persons’ subjective experiences. MEOF-II does not specifically assess the risk for penetration/aspiration.</p

Simple Quantitative Sensory Testing Reveals Paradoxical Co-existence of Hypoesthesia and Hyperalgesia in Diabetes

Background: Diabetic neuropathy is characterized by the paradoxical co-existence of hypo- and hyperalgesia to sensory stimuli. The literature shows consistently sensory differences between healthy and participants with diabetes. We hypothesized that due to differences in pathophysiology, advanced quantitative sensory testing (QST) might reveal sensory discrepancies between type 1 (T1D) and type 2 diabetes (T2D). Furthermore, we investigated whether vibration detection thresholds (VDT) were associated with sensory response. Method: Fifty-six adults with T1D [43 years (28–58)], 99 adults with T2D [65 years (57–71)], and 122 healthy individuals [51 years (34–64)] were included. VDT, pressure pain detection thresholds (pPDT) and tolerance (pPTT), tonic cold pain (hand-immersion in iced water), and central pain mechanisms (temporal summation and conditioned pain modulation) were tested and compared between T1D and T2D. VDT was categorized into normal ( 25 V). Results: In comparison to healthy, analysis adjusted for age, BMI, and gender revealed hypoalgesia to tibial (pPDT): p = 0.01, hyperalgesia to tonic cold pain: p < 0.01, and diminished temporal summation (arm: p < 0.01; abdomen: p < 0.01). In comparison to participants with T2D, participants with T1D were hypoalgesic to tibial pPDT: p < 0.01 and pPTT: p < 0.01, and lower VDT: p = 0.02. VDT was not associated with QST responses. Conclusion: Participants with T1D were more hypoalgesic to bone pPDT and pPTT independent of lower VDT, indicating neuronal health toward normalization. Improved understanding of differentiated sensory profiles in T1D and T2D may identify improved clinical endpoints in future trials

Can protein and energy enriched soups be a tool in the nourishment of hospitalised patients in Denmark? A quality-development study

&nbsp; Baggrund: Patienters fødevare- og smagspræferencer ændres ofte med stigende alder og sygdom. Dette studie har till formål at undersøge proteinberigede supper som et alternativ eller supplement til standard protein drikke hos svært syge danske patienter. &nbsp;&nbsp;&nbsp; Metode: Forbedringsmodellen (Plan-Do-Study-Act cycle) er anvendt til at evaluere de berigede supper og inkluderede tre sessioner (session 1-3). Session 1) 18 svært syge patienter indlagt mere end 24 timer på Regions Hospital Nordjylland fik i vilkårlig rækkefølge serveret 6 forskellige proteinberigede supper (0,1-0,2 dl) med og uden topping og skulle efterfølgende bedømme supperne på en VAS-skala. Session 2) Borgere med kronisk obstruktive lungelidelse (KOL) deltog i et gruppeinterview om fødevarepræferencer ved svær sygdom i hjemmet eller under indlæggelse. Session 3) Supperne blev modificeret ud fra erfaringer fra session 1-2 og testet igen på en tilsvarende patientgruppe som i session 1, som evaluerede supperne ud fra en 5-punkts Likert skala med ansigter. &nbsp; Resultater: Session 1: I session 1 kunne størstedelen af data ikke indhentes på grund af at patienter 1) faldt i søvn, 2) ikke kunne anvende VAS skalaen, 3) oplevede manglende smags- og lugtesans, 4) ikke kunne tygge eller anvende ske. I session 2 foretrak deltagerne i gruppeinterviewene varme måltider, tyk konsistens og at det krævede begrænset energi at spise måltidet samt at der ikke indgik nødder. I session 3 var det muligt at indhente pålidelige resultater. Gennemsnitsscoren for kærnemælks-, tomat- og kartoffelsuppe var henholdsvis 4,7, 3,8 og 4,2 ud af 5. Tyk og sød suppe var det foretrukne valg. Konklusion: Studiet viste, at svært syge patienter oplevede det var vanskeligt at holde sig vågne under måltiderne, føre maden til munden, de var stakåndede, udmattede af at tygge og manglede smags- og lugtesans.&nbsp; Protein- og energiberigede supper er tilfredsstillende og blev rangeret højt på smagsoplevelse. Fremadrettet virker proteinberigede supper i små portioner som en god mulighed for at imødekomme mange af de problemer disse patienter oplever

Convergent and discriminant validity of the Minimal Eating Observation Form – version II: a cross-sectional study

Abstract Background The Minimal Eating Observation Form – Version II (MEOF-II) is a brief and easy to use screening tool for eating difficulties, that is psychometrically robust. The aim of this study was to explore convergent (measuring similar constructs) and discriminant (measuring somewhat different constructs) validity of the MEOF-II to other validated dysphagia specific, activity and participation related instruments. Methods In this cross-sectional study, participants (n = 100, mean age 72, n = 42 women), diagnosed with either chronic pulmonary disease, Parkinson´s disease, Multiple Sclerosis, or stroke were recruited from rehabilitation centres. Patient-reported outcomes and clinical-rated assessments, capturing eating ability in general and swallowing in specific, included: The Dysphagia Handicap Index (DHI), the 4-question test (4QT), the Minimal Eating Observation Form – II, the Volume – Viscosity Swallow Test (V-VST), Flexible Endoscopic Evaluation of Swallowing (FEES) documented according to the Penetration-Aspiration Scale (PAS). Type of oral intake was documented using the Functional Oral Intake Scale (FOIS). Activities in daily living was assessed with Barthel index (BI). Spearman’s correlation coefficient was used to analyze associations. The MEOF-II total score was hypothesised to have moderate correlations (r ≥ 0.3) with the other assessments, besides with PAS and FOIS (weak correlations, r

Convergent and discriminant validity of the Minimal Eating Observation Form – version II: a cross-sectional study

Abstract Background The Minimal Eating Observation Form – Version II (MEOF-II) is a brief and easy to use screening tool for eating difficulties, that is psychometrically robust. The aim of this study was to explore convergent (measuring similar constructs) and discriminant (measuring somewhat different constructs) validity of the MEOF-II to other validated dysphagia specific, activity and participation related instruments. Methods In this cross-sectional study, participants (n = 100, mean age 72, n = 42 women), diagnosed with either chronic pulmonary disease, Parkinson´s disease, Multiple Sclerosis, or stroke were recruited from rehabilitation centres. Patient-reported outcomes and clinical-rated assessments, capturing eating ability in general and swallowing in specific, included: The Dysphagia Handicap Index (DHI), the 4-question test (4QT), the Minimal Eating Observation Form – II, the Volume – Viscosity Swallow Test (V-VST), Flexible Endoscopic Evaluation of Swallowing (FEES) documented according to the Penetration-Aspiration Scale (PAS). Type of oral intake was documented using the Functional Oral Intake Scale (FOIS). Activities in daily living was assessed with Barthel index (BI). Spearman’s correlation coefficient was used to analyze associations. The MEOF-II total score was hypothesised to have moderate correlations (r ≥ 0.3) with the other assessments, besides with PAS and FOIS (weak correlations, r