To eat or not to eat? Indicators for reduced food intake in 91,245 patients hospitalized on nutritionDays 2006-2014 in 56 countries worldwide: A descriptive analysis

Background: Inadequate nutrition during hospitalization is strongly associated with poor patient outcome, but ensuring adequate food intake is not a priority in clinical routine worldwide. This lack of priority results in inadequate and unbalanced food intake in patients and huge amounts of wasted food. Objectives: We evaluate the main factors that are associated with reduced meal intake in hospitalized patients and the differences between geographical regions. Design: We conducted a descriptive analysis of data from 9 consecutive, annual, and cross-sectional nutritionDay samples (2006-2014) in a total of 91,245 adult patients in 6668 wards in 2584 hospitals in 56 countries. A general estimation equation methodology was used to develop a model for meal intake, and P-value thresholding was used for model selection. Results: The proportion of patients who ate a full meal varied widely (24.7-61.5%) across world regions. The factors that were most strongly associated with reduced food intake on nutritionDay were reduced intake during the previous week (OR: 0.20; 95% CI: 0.17, 0.22), confinement to bed (OR: 0.49; 95% CI: 0.44, 0.55), female sex (OR: 0.53; 95% CI: 0.5, 0.56), younger age (OR: 0.74; 95% CI: 0.64, 0.85) and older age (OR: 0.80; 95% CI: 0.74; 0.88), and low body mass index (OR: 0.84; 95% CI: 0.79, 0.90). The pattern of associated factors was homogenous across world regions. Conclusions: A set of factors that are associated with full meal intake was identified and is applicable to patients hospitalized in any region of the world. Thus, the likelihood for reduced food intake is easily estimated through access to patient characteristics, independent of world regions, and enables the easy personalization of food provision

Empirical evidence of the relationship between parental and child dental fear: a structured review and meta-analysis

Background.The relationship between parental and child dental fear has been studied for over a century. During this time, the concept of dental fear as well as methodological approaches to studying dental fear in children have evolved considerably.Aim.To provide an overview of the published empirical evidence on the link between parental and child dental fear.Design.A structured literature review and meta-analysis.Results.Forty-three experimental studies from across the six continents were included in the review. The studies ranged widely with respect to research design, methods used, age of children included, and the reported link between parental and child dental fear. The majority of studies confirmed a relationship between parental and child dental fear. This relationship is most evident in children aged 8 and under. A meta-analysis of the available data also confirmed an association between parental and child dental fear.Conclusion.The narrative synthesis as well as the meta-analysis demonstrate a significant relationship between parental and child dental fear, particularly in children 8 years and younger.</p

Audio-visual recording of patient–GP consultations for research purposes:A literature review on recruiting rates and strategies

Objective: To identify ethical processes and recruitment strategies, participation rates of studies using audio or video recording of primary health care consultations for research purposes, and the effect of recording on the behaviour, attitudes and feelings of participants.Methods: A structured literature review using Medline, Embase, Cochrane Library, and Psychinfo. This was followed by extensive hand search.Results: Recording consultations were regarded as ethically acceptable with some additional safeguards recommended. A range of sampling and recruitment strategies were identified although specific detail was often lacking. Non-participation rates in audio-recording studies ranged from 3 to 83% for patients and 7 to 84% for GPs; in video-recording studies they ranged from 0 to 83% for patients and 0 to 93% for GPs. There was little evidence to suggest that recording significantly affects patient or practitioner behaviour.Conclusions: Research involving audio or video recording of consultations is both feasible and acceptable. More detailed reporting of the methodical characteristics of recruitment in the published literature is needed.Practice implications: Researchers should consider the impact of diverse sampling and recruitment strategies on participation levels. Participants should be informed that there is little evidence that recording consultations negatively affects their content or the decisions made. Researchers should increase reporting of ethical and recruitment processes in order to facilitate future reviews and meta-analyses. (C) 2008 Elsevier Ireland Ltd. All rights reserved.</p

The Patient- And Nutrition-Derived Outcome Risk Assessment Score (PANDORA): Development of a Simple Predictive Risk Score for 30-Day In-Hospital Mortality Based on Demographics, Clinical Observation, and Nutrition.

ObjectiveTo develop a simple scoring system to predict 30 day in-hospital mortality of in-patients excluding those from intensive care units based on easily obtainable demographic, disease and nutrition related patient data.MethodsScore development with general estimation equation methodology and model selection by P-value thresholding based on a cross-sectional sample of 52 risk indicators with 123 item classes collected with questionnaires and stored in an multilingual online database.SettingWorldwide prospective cross-sectional cohort with 30 day in-hospital mortality from the nutritionDay 2006-2009 and an external validation sample from 2012.ResultsWe included 43894 patients from 2480 units in 32 countries. 1631(3.72%) patients died within 30 days in hospital. The Patient- And Nutrition-Derived Outcome Risk Assessment (PANDORA) score predicts 30-day hospital mortality based on 7 indicators with 31 item classes on a scale from 0 to 75 points. The indicators are age (0 to 17 points), nutrient intake on nutritionDay (0 to 12 points), mobility (0 to 11 points), fluid status (0 to 10 points), BMI (0 to 9 points), cancer (9 points) and main patient group (0 to 7 points). An appropriate model fit has been achieved. The area under the receiver operating characteristic curve for mortality prediction was 0.82 in the development sample and 0.79 in the external validation sample.ConclusionsThe PANDORA score is a simple, robust scoring system for a general population of hospitalised patients to be used for risk stratification and benchmarking

Additional file 1: of Muscle mass, strength and functional outcomes in critically ill patients after cardiothoracic surgery: does neuromuscular electrical stimulation help? The Catastim 2 randomized controlled trial

Ultrasound scan of the left thigh at the lateral measuring point in the transverse and sagittal plane (Patient no. 104, control group) on postoperative day 3. (TIF 798 kb

Observed and predicted hospital mortality by the PANDORA score.

<p>Patients are grouped by decile-classes of predicted in-hospital mortality within 30 days after the cross-sectional survey derived from the PANDORA score for the development sample (left panel) from the years 2006–2009 (n = 43894) and the external validation sample (right panel) from the year 2012 (n = 12928). The numbers of patients in each decile (n) are given below the x-axis. Closed symbols (■) show observed mortality with 95% confidence intervals (CI) whereas open symbols (⦿) show predicted mortality. The PANDORA score has 7 indicator variables (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127316#pone.0127316.t002" target="_blank">Table 2</a>).</p

Distribution of variables for the development sample 2006–2009 and the validation sample 2012.

<p>* multiple answers possible</p><p>Distribution of variables for the development sample 2006–2009 and the validation sample 2012.</p

Flowchart of the selection process for inclusion in the PANDORA score development sample.

<p>Flowchart of the selection process for inclusion in the PANDORA score development sample.</p