A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting

Background: Accurate diagnosis is a key step in managing protein-energy malnutrition. This review seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of protein-energy malnutrition in community-living older adults. Methods: A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence. Results: There were 6,412 records identified, of which eight papers were included. Two studies evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA andSGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95%CI: 1.55-2.39]; P Conclusions: Due to the small number of studies identified and no evaluation of the predictive validity of tools other than the MNA, there is insufficient evidence to recommend a particular nutrition assessment tool for diagnosing protein-energy malnutrition in older adults in the community setting. High quality diagnostic accuracy studies are needed for all nutrition assessment tools used in older community samples, including measuring of health outcomes subsequent to nutrition assessment by the SGA and PG-SGA

A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo Study)

Background & aims: Malnutrition is a significant barrier to healthy and independent ageing in older adults who live in their own homes, and accurate diagnosis is a key step in managing the condition. However, there has not been sufficient systematic review or pooling of existing data regarding malnutrition diagnosis in the geriatric community setting. The current paper was conducted as part of the MACRo (Malnutrition in the Ageing Community Review) Study and seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of protein-energy malnutrition in the general older adult community. Methods: A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence. Results: There were 6412 records identified, of which 104 potentially eligible records were screened via full text. Eight papers were included; two which evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six which evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA and SGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95% CI: 1.55–2.39]; P < 0.00001; n = 2013 participants; n = 4 studies; I2: 0%). The quality of the body of evidence for the predictive validity of the MNA in detecting risk of poor physical function was very low (SMD: 1.02 [95%CI: 0.24–1.80]; P = 0.01; n = 4046 participants; n = 3 studies; I2:89%). Conclusions: Due to the small number of studies identified and no evaluation of the predictive validity of tools other than the MNA, there is insufficient evidence to recommend a particular nutrition assessment tool for diagnosing PEM in older adults in the community. High quality diagnostic accuracy studies are needed for all nutrition assessment tools used in older community samples, including measuring of health outcomes subsequent to nutrition assessment by the SGA and PG-SGA

Assessing Input Brand Loyalty among U.S. Agricultural Producers

This study explores the prevalence and determinants of brand loyalty for agricultural input products. Results suggest that loyalty for both expendable and capital inputs is high among commercial agricultural producers in the United States. Producer attitudes, beliefs, and some demographic characteristics are useful identifiers of brand loyalty among commercial producers.brand loyalty, dealer loyalty, capital inputs, expendable inputs, farmer purchase decisions, Agricultural Finance, Consumer/Household Economics, Marketing, Q10, Q13, Q14,

Assessing Agricultural Input Brand Loyalty Among U.S. Mid-Size and Commercial Producers

This study explores the prevalence and determinants of brand loyalty for agricultural input products. Results suggest that loyalty for both expendable and capital inputs is high among commercial farmers. Farmer attitudes, beliefs, and some demographic characteristics are useful identifiers of brand loyal farmers.brand loyalty, capital inputs, expendable inputs, farmer purchase decisions, Farm Management,

The Nature of Deeply Buried Ultraluminous Infrared Galaxies: A Unified Model for Highly Obscured Dusty Galaxy Emission

We present models of deeply buried ultraluminous infrared galaxy (ULIRG) spectral energy distributions (SEDs) and use them to construct a three-dimensional diagram for diagnosing the nature of observed ULIRGs. Our goal is to construct a suite of SEDs for a very simple model ULIRG structure, and to explore how well this simple model can (by itself) explain the full range of observed ULIRG properties. We use our diagnostic to analyze archival Spitzer Space Telescope IRS spectra of ULIRGs and find that: (1) In general, our model does provide a comprehensive explanation of the distribution of mid-IR ULIRG properties; (2) >75% (in some cases 100%) of the bolometric luminosities of the most deeply buried ULIRGs must be powered by a dust-enshrouded active galactic nucleus; (3) an unobscured "keyhole" view through <~10% of the obscuring medium surrounding a deeply buried ULIRG is sufficient to make it appear nearly unobscured in the mid-IR; and (4) the observed absence of deeply buried ULIRGs with large PAH equivalent widths is naturally explained by our models showing that deep absorption features are "filled-in" by small quantities of foreground unobscured PAH emission (e.g., from the host galaxy disk) at the level of ~1% the bolometric nuclear luminosity. The modeling and analysis we present will also serve as a powerful tool for interpreting the high angular resolution spectra of high-redshift sources to be obtained with the James Webb Space Telescope.Comment: 20 pages, 14 figures. Accepted for publication in the Ap

In Search of Professional Dispositions that Yield Cultural Relevance in Primary Grade Pedagogy: A Cautionary Tale of One Kindergarten Teacher

Primary grade teachers are challenged to establish firm learning foundations for all children, yet for many teachers cultural diversity makes this a complex pedagogical challenge. It is widely assumed that the success with which teachers meet this challenge is reflected in their dispositions toward diversity, and ultimately toward culturally relevant pedagogy as a professional orientation. This article describes a multi-year study of cultural relevance in early mathematics teaching. Using the case of one kindergarten teacher who exhibited positive dispositions toward cultural relevance, the authors examine factors that seemed to work against its adoption in her pedagogy

Hybrid TiO2 Solar Cells Produced from Aerosolized Nanoparticles of Water-Soluble Polythiophene Electron Donor Layer

Hybrid solar cells (HSCs) with water soluble polythiophene sodium poly[2-(3-thienyl)-ethyloxy-4-butylsulfonate] (PTEBS) thin films produced using electrospray deposition (ESD) were fabricated, tested, and modeled and compared to devices produced using conventional spin coating. A single device structure of FTO/TiO2/PTEBS/Au was used to study the effects of ESD of the PTEBS layer on device performance. ESD was found to increase the short circuit current density (Jsc) by a factor of 2 while decreasing the open circuit voltage (Voc) by half compared to spin coated PTEBS films. Comparable efficiencies of 0.009% were achieved from both device construction types. Current-voltage curves were modeled using the characteristic solar cell equation and showed a similar increase in generated photocurrent with an increase by two orders of magnitude in the saturation current in devices from ESD films. Increases in Jsc are attributed to an increase in the interfacial contact area between the TiO2 and PTEBS layers, while decreases in Voc are attributed to incomplete film formation from ESD

A global analysis of bird plumage patterns reveals no association between habitat and camouflage

Evidence suggests that animal patterns (motifs) function in camouflage. Irregular mottled patterns can facilitate concealment when stationary in cluttered habitats, whereas regular patterns typically prevent capture during movement in open habitats. Bird plumage patterns have predominantly converged on just four types—mottled (irregular), scales, bars and spots (regular)—and habitat could be driving convergent evolution in avian patterning. Based on sensory ecology, we therefore predict that irregular patterns would be associated with visually noisy closed habitats and that regular patterns would be associated with open habitats. Regular patterns have also been shown to function in communication for sexually competing males to stand-out and attract females, so we predict that male breeding plumage patterns evolved in both open and closed habitats. Here, taking phylogenetic relatedness into account, we investigate ecological selection for bird plumage patterns across the class Aves. We surveyed plumage patterns in 80% of all avian species worldwide. Of these, 2,756 bird species have regular and irregular plumage patterns as well as habitat information. In this subset, we tested whether adult breeding/non-breeding plumages in each sex, and juvenile plumages, were associated with the habitat types found within the species’ geographical distributions. We found no evidence for an association between habitat and plumage patterns across the world’s birds and little phylogenetic signal. We also found that species with regular and irregular plumage patterns were distributed randomly across the world’s eco-regions without being affected by habitat type. These results indicate that at the global spatial and taxonomic scale, habitat does not predict convergent evolution in bird plumage patterns, contrary to the camouflage hypothesis.This research was funded by an Entente Cordiale Scholarship to M.S., a Biotechnology and Biological Sciences Research Council studentship to K.L.A.M. and the Cambridge Overseas Trust to T-L.G