Nutritional management of children with cerebral palsy: a practical guide

Peer reviewedFinal Published versio

Assessment of growth and nutrition in children with cerebral palsy

This manuscript provides an update on the assessment of growth and nutrition in children with cerebral palsy and children with similar neurodevelopmental disabilities. Topics include the assessment of linear growth using segmental measures, avoidance of commonly used tools to assess nutritional status in typically developing children that are not valid in this population of children and how to use other nutritional assessment tools that have been developed specific to this population of children

Medical, surgical, and health outcomes of gastrostomy feeding

A prospective controlled study with repeated measures before and after surgery examined the medical, surgical, and health outcomes of gastrostomy for children with disabilities at a tertiary paediatric referral centre in the North Thames area, UK. Anthropometric measures included weight, mid-upper-arm and head circumference. Five-day prospective food diaries were completed and data on physical health and surgical outcomes recorded. Seventy-six children participated and underwent gastrostomy (44 males, 32 females; median age 3 y 4 mo, range 4 mo-17 y 5 mo), and 35/76 required an anti-reflux procedure. Categories of disability were: cerebral palsy (32/76), syndrome of chromosomal or other genetic origin (25/76), slowly progressive degenerative disease (11/76), and unconfirmed diagnosis (8/76). Most children had gross motor difficulties (99%) and were non-ambulant (83%). Oromotor problems were identified in 78% of children, 69% aspirated, and 65% were fed nasogastrically before surgery. The mean weight before surgery was -2.84 standard deviation score (SDS; SD 2.21, range -9.8 to 3.4). Two-thirds of children achieved catch-up growth postoperatively: weight-for-age (mean difference 0.51 SDS, 95% CI 0.23-0.79, p=0.001) and mid-upper arm circumference (mean difference 1.12 cm, 95% confidence interval 0.50-1.75, p=0.001). Health gains included a reduction in drooling, secretions, vomiting, and constipation. Major surgical complications were found in 13/74 children. The study provides evidence that catch-up growth and health gains are possible following gastrostomy

TQM practices and knowledge sharing: An empirical study of Malaysia’s manufacturing organizations

The purpose of this paper is to examine the multidimensionality of TQM practices and its relationship with knowledge sharing as perceived by middle management employees in Malaysia's ISO 9001:2000 certified firms of manufacturing sectors. The data which were collected from a survey of 129 middle management employees in Malaysia were used to test the proposed research framework. Furthermore, confirmatory factor analysis was performed to evaluate the reliability and validity of the measurement model, and the structural analysis was used to examine the research framework. The analytical results revealed that training and development, customer focus, and teamwork showed a positive association with middle management employees' knowledge sharing. This analysis is vital for senior managers of TQM companies that want to establish a knowledge sharing capability. Senior managers could focus their efforts on implementing TQM practices for building competitive knowledge sharing competencies

Subcutaneous adipose tissue-derived stem cells: advancement and applications in regenerative medicine

Stem cell research has been hailed for its potential to revolutionize the field of regenerative medicine with the ability to regenerate damaged and diseased organs. In addition to offering unprecedented hope in treating many debilitating diseases, stem cells have advanced our understanding of basic biological processes. Intense study on stem cells in the past decade has kindled worthy knowledge about developmental, morphological, and physiological processes that form the basis of tissue and organ formation, maintenance, repair, and regeneration. Today’s medicine generally tries to support or treat injured tissues and organs, but stem cells simply replace them. Stem cell research is complicated and rapidly changing. The correlation of stem cell technology with tissue repair still has a long way to go. Since embryonic stem cells are a thorn inside when it comes to the ethics of therapeutics, stem cells isolated from adult tissues sidestep this issue entirely and have become a potent contemporary source of stem cells for tissue repair and regeneration. Conceptually and from a practical standpoint, the bone marrow has been the most influential source of stem cells that offers a possibility of being used in a wide range of therapeutics. Clinical situations frequently demand stem cells with dependable quality and quantity to treat disorders of cellular degeneration. Challenges to bring advances to the clinical mount have expanded rapidly, engendering new perspectives concerning the identity, origin, and full therapeutic potential of various tissue-specific stem cells