Estimating the Prevalence of Muscle Wasting, Weakness, and Sarcopenia in Hemodialysis Patients.

OBJECTIVES: Haemodialysis (HD) patients suffer from nutritional problems, which include muscle wasting, weakness, and cachexia, and are associated with poor clinical outcomes. The European Working Group for Sarcopenia in Older People (EWGSOP) and Foundations for the National Institute of Health (FNIH) have developed criteria for the assessment of sarcopenia, including the use of non-invasive techniques such as bioelectrical impedance assessment (BIA), anthropometry, and hand grip strength (HGS) dynamometry. This study investigated the prevalence of muscle wasting, weakness, and sarcopenia using the EWGSOP and FNIH criteria. METHODS: BIA was performed in 24 females (f) and 63 males (m) in the post-dialysis period. Total skeletal muscle mass and appendicular skeletal muscle mass were estimated and index values (i.e., muscle mass divided by height2 [kg/m2]) were calculated (Total Skeletal Muscle Index (TSMI) and Appendicular Skeletal Muscle Index (ASMI)). Mid-arm circumference and triceps skin-fold thickness were measured and mid-upper arm muscle circumference (MUAMC) calculated. HGS was measured using a standard protocol and Jamar dynamometer. Suggested cut-points for low muscle mass and grip strength were utilized using the EWGSOP and FNIH criteria with prevalence estimated, including sarcopenia. RESULTS: The prevalence varied depending on methodology: low TSMI (moderate and severe sarcopenia combined) was 55% for whole group: 21% (f) and 68% (m). Low ASMI was 32% for whole group: 25% (f) and 35% (m). Low MUAMC was 25% for whole group: 0% (f) and 30% (m). ASMI highly correlated with Body Mass Index (r = 0.78, P < .001) and MUAMC (r = 0.68, P < .001). Muscle weakness was high regardless of cut-points used (50-71% (f); 60-79% (m)). CONCLUSIONS: Internationally, this is the first study comparing measures of muscle mass (TSMM and ASMM by BIA and MUAMC) and muscle strength (HGS) using this specific methodology in a hemodialysis population. Future work is required to confirm findings

Playing on common ground: Spaces of sport, education and corporate connectivity, contestation and creativity

In this article we examine connectivities within the ‘messy’ organizational commons of sport, education and corporate partnerships. As scholars forewarn, there are currently key stakeholders within the commons that that have set agendas, occupied ideological and physical terrain, and legitimized a presence and authority. The intertwining of organizations here is an evident function of an increased symbiosis between sport, education and governmental and non-governmental stakeholders to carve out significant sector spaces, and exert authority and power over the creation, implementation and ownership ‘collaborative’ and intersectional work. Drawing on spatial theorists, Henri Lefebvre and Yi Fu Tuan, and examples from FIFA and the IOC, we present a conceptual framework of global stakeholder relations. Focusing of processes of thought, production and action, we offer an intersectional critique of the nuances of Sport–Corporate–Education nexus and consider possibilities and potential for sport education spaces to be reconfigured ane

Conceptualizing stakeholder engagement in the context of sustainability and its assessment

Stakeholder engagement in construction projects can be conceptualized in different ways. It can be seen from a strategic management perspective aimed at capturing knowledge, increasing ownership of the project by users, reducing conflict, encouraging innovation and facilitating spin-off partnerships. From an ethical perspective, meaningful stakeholder engagement can be seen to enhance inclusive decision making, promote equity, enhance local decision making and build social capital. The benefits from both of these perspectives are vital for sustainability; however, stakeholder engagement can also be seen from the perspective of an opportunity for social learning—a social process where diverse stakeholders share a common forum, learn about each other's values, reflect upon their own values and create a shared vision and shared objectives. Dialogue is also useful in increasing awareness, changing attitudes and affecting behaviours. Existing practices view stakeholder engagement: mostly from a management perspective; sometimes from an ethical perspective; less often as a combination of the two; and rarely have any element of the social learning perspective. There is a need for an approach that combines all the three perspectives if sustainability is to be pursued. A dialogue-oriented approach to integrated sustainability assessment could provide an ideal means to do so.Stakeholder, sustainability, strategic management, ethics, social learning, dialogue, sustainability assessment,