Differences in Nutritional Outcome Measures between Preadolescents and Adolescents with Anorexia Nervosa who received a Nasogastric Feeding Tube versus Oral Diet upon Hospital Admission

DIFFERENCES IN NUTRITIONAL OUTCOME MEASURES BETWEEN PREADOLESCENTS AND ADOLECENTS WITH ANOREXIA NERVOSA WHO RECEIVED A NASOGASTRIC FEEDING TUBE VERSUS ORAL DIET UPON HOSPITAL ADMISSION by Paige E. Herring Background: Anorexia nervosa (AN) is a disease defined by an extreme weight loss due to an intense fear of gaining weight, and it is the third most chronic disease in adolescent females. Hospitalizations are common among patients with AN due to the major consequences that can arise from this disease. Most of the complications can be resolved with significant weight gain, so hospitals have an implemented feeding protocols to optimize weight gain. Studies have shown that nasogastric (NG) feedings have resulted in a greater weight gain and reduced length of stay without significant side effects. Objective: The purpose of this study is to examine the association between demographic and clinical characteristics and mode of nutrition therapy (oral feeding vs. NG tube feedings) in a population of pre-adolescents and adolescents with a hospital admission diagnosis of AN. The clinical outcome measures are length of stay (LOS), weight gain, and suspected refeeding syndrome. Participants/Setting: The study sample includes 64 patients between the ages 9 and 20 years who have been admitted to Children’s Healthcare of Atlanta between January 1, 2014 and December 31, 2015 for clinical treatment of AN. The demographic, anthropometric, mode of nutrition therapy and clinical characteristics of the patient population were obtained. Statistical Analysis: Frequency statistics were used to describe demographic, anthropometric, mode of nutrition therapy and clinical characteristics of the patient population. A Student’s t-test was used to examine differences in continuous variables by tube feeding status, while a Mann-Whitney U test was used for the non-normally distributed variables. A Chi-square test was used to examine differences in tube feeding status by categorical variables. Results: Data were collected and analyzed for 64 patients, with a mean age of 14.6 + 2.4 years, and the majority of the population being female (93.8%) and Caucasian (92.2%). Approximately half (n=30, 47%) of the population received an NG tube during the admission. Mean discharge BMI was significantly higher in those who received an oral diet vs. NG tube (16.67 vs. 17.08, respectively; p=0.042) while weight change was significantly lower (1.3 kg vs. 2.1 kg, respectively; p=0.012) and LOS shorter (8 days vs. 11 days, respectively; p=0.002) There were no significant differences in other characteristics by mode of nutrition therapy. Conclusion: NG tube feeding is an effective method for feeding hospitalize adolescent patients with AN to yield greater weight gain results. Future studies are necessary to determine the amount of time exclusively on the NG tube, reasons for choosing NG vs. oral feedings, and other variables associated with weight gain and length of stay

Evaluating non-indigenous species management in a bayesian networks derived framework, Padilla Bay, WA

Many coastal regions are encountering issues with the introduction and spread of non-indigenous species (NIS). There are many vectors that can transport NIS to coastal areas and estuaries. In this study, I conducted a regional risk assessment using a Bayesian networks relative risk model (BN-RRM) to analyze multiple vectors of NIS introduction to Padilla Bay, Washington, a National Estuarine Research Reserve. Bayesian networks models are advantageous because they are parameterized with quantitative data and knowledge, uncertainty can be incorporated into these models, and the calculated risk is described as a distribution of risk for the various endpoints of interest. The objectives of the study were to 1) determine if the BN-RRM could be used to calculate risk from NIS introductions; 2) determine which regions and endpoints were at greatest risk from NIS introductions and impacts; and 3) examine a management option and calculate the reduction of risk to the endpoints if it were to be implemented. Efforts to manage NIS colonization include eradication of the species. This can occur at different stages of NIS invasions, such as the elimination of these species before being introduced to the habitat, or removal of the species after settlement. A management option was easily incorporated into the model to observe the risk to the endpoints if the treatment were to be implemented. This risk could then be compared to the initial risk estimates. The results from this risk assessment indicate the southern portion of Padilla Bay, Regions 3 and 4 had the greatest risk associated with them and the changes in community composition, Dungeness crab, and eelgrass were the endpoints with the most risk due to NIS introductions. The Currents node, which controls the exposure of NIS to the bay, was the parameter that had the greatest influence on risk to the endpoints. The ballast water management treatment displayed one percent reduction in risk in this Padilla Bay case study. These models provide an adaptable template for decision makers interested in managing NIS and aquatic environments in other coastal regions and large bodies of water

Drinking in pregnancy: shifting towards the 'precautionary' principle

Debate rages both in academic circles and in the media over communicating messages to the public regarding alcohol consumption during pregnancy. This chapter considers how research-based evidence is translated into risk communications through three key mechanisms: ‘official’ publications and guidance issued by government departments or health authorities; websites run by advocacy groups; and midwives at the front line in delivering advice to women. The focus is on the UK, and, to a lesser extent, other countries (USA, Australia, New Zealand), where the ‘risk narrative’ around drinking in pregnancy and pressures towards adopting the ‘precautionary principle’ have emerged and strengthened over recent decades

Design of linear and nonlinear control systems via state variable feedback, with applications in nuclear reactor control

Linear and nonlinear control systems via state variable feedback with applications in nuclear reactor contro

Reflexiones y recomendaciones sobre el uso de métodos retrospectivos verbales en la investigación en interpretación bilateral

Retrospective verbal process tracing is a popular research method in Interpreting Studies, employed by a growing number of scholars, particularly in studies of conference interpreting, but, to date, it has not been widely employed in studies of dialogue interpreting. This paper begins by introducing process-tracing methodologies, defining types of verbal process tracing, and presenting a brief critical review of publications employing this research methodology. The bulk of the article provides concrete, practical information and guidance for scholars of dialogue interpreting who are interested in employing retrospective process tracing in their research. We discuss the theoretical underpinnings of the method, methodological considerations that must be taken into account in the design and procedure of such studies, data analysis and reporting on the basis of retrospective process tracing, and recommendations for best practices.El seguimiento retrospectivo verbal de procesos se utiliza cada vez más en los Estudios de Interpretación, sobre todo en lainterpretación de conferencias. Con todo, este método se hautilizado poco hasta la fecha en el campo de la interpretación bilateral. En la primera parte de este artículo,presentaremos los métodos de seguimiento de procesos, definiremos los tipos de seguimiento verbal de procesos y examinaremos brevemente algunos estudios que han empleado estos métodos. El objetivo principal es ofrecer recomendaciones concretas y prácticas que puedan resultar útiles para aquellos investigadores en interpretación bilateral que se interesen por estos métodos. Presentaremos las bases teóricas, las consideraciones metodológicas relevantes para el diseño y el procedimiento de tales estudios, el proceso de análisis y presentación de los datos obtenidos a través del seguimiento retrospectivo y algunas recomendaciones de buenas prácticas

Making the Most of Retrospective Process Tracing in Dialogue Interpreting Research

Abstract: Retrospective verbal process tracing is a popular research method in Interpreting Studies, employed by a growing number of scholars, particularly in studies of conference interpreting, but, to date, it has not been widely employed in studies of dialogue interpreting. This paper begins by introducing process-tracing methodologies, defining types of verbal process tracing, and presenting a brief critical review of publications employing this research methodology. The bulk of the article provides concrete, practical information and guidance for scholars of dialogue interpreting who are interested in employing retrospective process tracing in their research. We discuss the theoretical underpinnings of the method, methodological considerations that must be taken into account in the design and procedure of such studies, data analysis and reporting on the basis of retrospective process tracing, and recommendations for best practices.Resumen: El seguimiento retrospectivo verbal de procesos se utiliza cada vez más en los Estudios de Interpretación, sobre todo en la interpretación de conferencias. Con todo, este método se ha utilizado poco hasta la fecha en el campo de la interpretación bilateral. En la primera parte de este artículo, presentaremos los métodos de seguimiento de procesos, definiremos los tipos de seguimiento verbal de procesos y examinaremos brevemente algunos estudios que han empleado estos métodos. El objetivo principal es ofrecer recomendaciones concretas y prácticas que puedan resultar útiles para aquellos investigadores en interpretación bilateral que se interesen por estos métodos. Presentaremos las bases teóricas, las consideraciones metodológicas relevantes para el diseño y el procedimiento de tales estudios, el proceso de análisis y presentación de los datos obtenidos a través del seguimiento retrospectivo y algunas recomendaciones de buenas prácticas

Thermal design for areas of interference heating on actively cooled hypersonic aircraft

Numerous actively cooled panel design alternatives for application in regions on high speed aircraft that are subject to interference heating effects were studied. Candidate design concepts were evaluated using mass, producibility, reliability and inspectability/maintainability as figures of merit. Three design approaches were identified as superior within certain regimes of the matrix of design heating conditions considered. Only minor modifications to basic actively cooled panel design are required to withstand minor interference heating effects. Designs incorporating internally finned coolant tubes to augment heat transfer are recommended for moderate design heating conditions. At severe heating conditions, an insulated panel concept is required