Can Existing Knowledge on Eating Behaviors and Obesity Support People with Cystic Fibrosis Who Are Nutritionally Compromised?

Nutritional status is a key predictor of health outcomes and survival for individuals with Cystic Fibrosis (CF). A main concern is the maintenance of a healthy body weight by eating a high-energy and high-fat diet (Abbott et al., 2008). This diet is accompanied for most patients with pancreatic enzyme replacement therapy, and for some patients with fat soluble vitamins, oral supplements, and enteral tube feeding which further supports the high nutritional requirements (Powers et al., 2002). Nevertheless, inadequate intake in CF remains a major problem within CF populations due to a number of complex reasons including physiological factors such as anorexia or poor appetite (Durie and Pencharz, 1989), early satiety and abdominal pain (Pumariega et al., 1986). Social and psychological factors for inadequate intake in CF include feeling under pressure to eat (Abbott et al., 2008), and being afraid of choking (Murphy and Wootton, 1998). The latest Cystic Fibrosis Foundation Registry Report (2004) indicates that approximately 31% showed symptomatology consistent with malnutrition. This paper suggests possibilities for developing research further and enhancing behavioral interventions for malnourished individuals with CF. With a paucity of research on the experiences of eating in adults with CF, known information around eating in other populations should be explored. Findings in obesity research may provide useful suggestions for environmental and behavioral interventions with malnourished individuals until a healthy weight status is achieved

European Cystic Fibrosis Society standards of care: best practice guidelines

Specialised CF care has led to a dramatic improvement in survival in CF: in the last four decades, well above what was seen in the general population over the same period. With the implementation of newborn screening in many European countries, centres are increasingly caring for a cohort of patients who have minimal lung disease at diagnosis and therefore have the potential to enjoy an excellent quality of life and an even greater life expectancy than was seen previously. To allow high quality care to be delivered throughout Europe, a landmark document was published in 2005 that sets standards of care. Our current document builds on this work, setting standards for best practice in key aspects of CF care. The objective of our document is to give a broad overview of the standards expected for screening, diagnosis, pre-emptive treatment of lung disease, nutrition, complications, transplant/end of life care and psychological support. For comprehensive details of clinical care of CF, references to the most up to date European Consensus Statements, Guidelines or Position Papers are provided in Table 1. We hope that this best practice document will be useful to clinical teams both in countries where CF care is developing and those with established CF centres

ECFS best practice guidelines: the 2018 revision

Developments in managing CF continue to drive dramatic improvements in survival. As newborn screening rolls-out across Europe, CF centres are increasingly caring for cohorts of patients who have minimal lung disease on diagnosis. With the introduction of mutation-specific therapies and the prospect of truly personalised medicine, patients have the potential to enjoy good quality of life in adulthood with ever-increasing life expectancy. The landmark Standards of Care published in 2005 set out what high quality CF care is and how it can be delivered throughout Europe. This underwent a fundamental re-write in 2014, resulting in three documents; center framework, quality management and best practice guidelines. This document is a revision of the latter, updating standards for best practice in key aspects of CF care, in the context of a fast-moving and dynamic field. In continuing to give a broad overview of the standards expected for newborn screening, diagnosis, preventative treatment of lung disease, nutrition, complications, transplant/end of life care and psychological support, this consensus on best practice is expected to prove useful to clinical teams both in countries where CF care is developing and those with established CF centres. The document is an ECFS product and endorsed by the CF Network in ERN LUNG and CF Europe

East German managers : from Karl Marx to Adam Smith.

School of Managemen

Making middle managers? : aspects of the work of the German Chambers of Industry and Commerce

School of Managemen

Making your mark : the business environment in Germany

School of Managemen

Management education, training and development in West Germany

School of Managemen

Business cultures in Europe

xv, 373 p. : il.; 23 cm

Developing a measure of eating attitudes and behaviours in cystic fibrosis

Poor nutritional (underweight) status in cystic fibrosis (CF) is associated with poorer health outcomes and ultimately a decreased survival rate. Eating / disorders or disturbances in eating attitudes and behaviours (DEABs) may contribute to poor nutritional status in people with CF. Existing measures of DEABs developed for the general population are unsuitable for use in CF due to the different meaning of some of these items in a CF population and a failure to assess CF-related eating attitudes and behaviours (EABs). This study aimed to develop a measure of EABs likely to be associated with poor nutritional status specifically for the CF population. The study had three parts: firstly, the formal evaluation of a draft CF-eating attitudes and behaviours (CFEAB) measure's content validity via an expert evaluation of the items and a literature review and secondly, the piloting of an amended CFEAB measure with participants with CF using a cognitive interviewing procedure to assess the measure's practical ease of use and understanding. Finally, a further amended CFEAB measure was administered to a large development sample of people with CF attending routine clinics. The final CFEAB measure resulting from this displayed adequate psychometric properties with a three- factor structure ('Eating-Disorders' 'CF-related EAB' (provisionally named) and 'Appetite') with good internal consistencies for the subscales (0.92, 0.84, 0.83) and whole measure (0.90). The final CFEAB measure displayed some initial evidence of construct validity in its relationships with related variables including an existing measure of DEABs. Some ambiguities regarding the interpretation of the CFEAB measure's subscales need to be clarified, as well as further evidence for its construct validity sought, in future studies. The 3 ~ .. ----------------------------------- CFEAB measure looks promising as a tool to highlight disturbances in EABs that will benefit from further assessment and targeted interventions, as appropriate.EThOS - Electronic Theses Online ServiceGBUnited Kingdo