Assessment of Nutritional Status and Its Determinants Among Students of Army Public School, Okara, Pakistan

Background: Malnutrition is a health problem affecting growth and development of young children. Children under 15 years of age are the main victims of malnutrition. Malnutrition is attributed to a series of diverse etiological factors. Objective: To determine the nutritional status of the children of various age groups of school going children of Army Public School and to find out the association of socio-demographic variables and dietary habits with nutritional status. Methodology: It was a descriptive cross-sectional study conducted at Army Public School, Okara. Sample was selected through non-probability consecutive sampling. Duration of study was 6 months (Dec 2017 to May 2018). The study was conducted after getting formal approval from Institutional Ethical Review Board AFPGMI. The children were randomly selected for study from the enrollment register available in the principal's office. Participation in the study was voluntary with guaranteed confidentiality. The participants were given full right to quit study without mentioning reason at any time during data collection. After ruling out the exclusion criteria, 500 children fulfilling inclusion criteria were selected for study. An informed written consent was obtained from all selected children and their parents to take part in the study. Data for the assessment of nutritional status was obtained using anthropometry, biochemical laboratory test and eating habits / food preferences of the children. Results: In our study, mean age of children included in the study was 9.58±1.72 years. Out of 500 children, 252 (50.2%) were male while 248 (49.8%) female. The mean height of children was 134.88±11.69 cm. The mean weight of children was 30.25±8.47 kg. The mean OFC of children was 51.43±1.75 cm. Out of total 500 children, 85 (17%) were having BMI less than 18.5, 338 (67.6%) were having BMI within 18.5–24.9 while 77 (15.4%) children having BMI within 25-29.9. None of child was observed with BMI of ≥30. Among 85 children with below normal BMI, 63 had mild malnutrition (BMI between 17-18.4), 19 had moderate malnutrition (BMI 16-16.9) while 3 had severe malnutrition (BMI < 16) Conclusion: Malnutrition is a significant public health problem among preschool and school going children. And improving socio-economic condition along with literacy of mothers and preventing infections through personal hygiene might help in improving the nutritional status of children

Scintigraphic assessment of bone status at one year following hip resurfacing : comparison of two surgical approaches using SPECT-CT scan

Objectives: To study the vascularity and bone metabolism of the femoral head/neck following hip resurfacing arthroplasty, and to use these results to compare the posterior and the trochanteric-flip approaches. Methods: In our previous work, we reported changes to intra-operative blood flow during hip resurfacing arthroplasty comparing two surgical approaches. In this study, we report the vascularity and the metabolic bone function in the proximal femur in these same patients at one year after the surgery. Vascularity and bone function was assessed using scintigraphic techniques. Of the 13 patients who agreed to take part, eight had their arthroplasty through a posterior approach and five through a trochanteric-flip approach. Results: One year after surgery, we found no difference in the vascularity (vascular phase) and metabolic bone function (delayed phase) at the junction of the femoral head/neck between the two groups of patients. Higher radiopharmaceutical uptake was found in the region of the greater trochanter in the trochanteric-flip group, related to the healing osteotomy. Conclusions: Our findings using scintigraphic techniques suggest that the greater intra-operative reduction in blood flow to the junction of the femoral head/neck, which is seen with the posterior approach compared with trochanteric flip, does not result in any difference in vascularity or metabolic bone function one year after surgery

An Investigation of Nutrition Risk among Hospitalised Older Adults Admitted to the Assessment, Treatment and Rehabilitation Wards of Waitemata District Health Board Hospitals : A Thesis Presented in Partial Fulfilment of the Requirements for the Degree of Master of Science in Nutrition and Dietetics Massey University, Albany New Zealand

Background: The proportion of older adults in New Zealand is increasing. Studies shows compromised nutrition status is prevalent in older adults, and can exacerbate poor health. It is therefore important to identify those who are malnourished, or those who are at nutrition risk for early nutrition intervention. Nutrition screening tools allow for the identification of nutrition risk status and initiation of nutritional care to result in improved health outcomes. Current data on the prevalence of nutrition risk in hospitalised older adults in New Zealand is limited. Design: Cross-sectional, observational study as part of a multicentre prospective study. Aim: To investigate the prevalence of nutrition risk among older adults (65-84 years) in the Assessment, Treatment and Rehabilitation (AT&R) wards of North Shore and Waitakere Hospitals. Potential nutrition risk factors including dysphagia risk, muscle mass and hand grip strength will also be investigated, as well as other relevant physiological and socio-demographic risk factors. Methods: Participants were recruited within five days of admission to the AT&R wards. Face-to-face interviews and assessments were conducted on the wards. A questionnaire incorporating participant characteristics, health and support data and validated screening and assessment tools were used. Nutrition risk status was assessed by the Mini Nutrition Assessment-Short Form, dysphagia risk status was assessed by the Eating Assessment Tool, cognitive status was assessed by the Montreal Cognitive Assessment and muscle mass was assessed by bioelectrical impedance analysis. Hand grip strength was measured using a hydraulic dynamometer. Results: A total of 89 participants took part in the study. Nutrition risk and malnutrition was evident in 43.8 and 27.0 percent of the study participants respectively. Indicated by the Mini-Nutrition Assessment-Short Form, participants with poor nutritional status were more likely to report reduced food intake, unintentional weight loss, requiring aid with activities of daily living, having previous dietetic input and being at risk of dysphagia compared to participants with ‘normal’ nutritional status. Conclusion: A high percentage of hospitalised older adults recently admitted to the AT&R wards had compromised nutritional status. Routine screening is highly advised to identify nutritional risk and instigate nutritional care

Ultrasound Muscle Assessment and Nutritional Status in Institutionalized Older Adults: A Pilot Study

Muscle thickness, measured by ultrasonography, has been investigated for nutritional assessment in older adults, however the associations between muscle ultrasound parameters in the lower limb and nutritional status have not been studied. The aim of this study was to investigate the relationship between muscle thickness echo intensity (EI), and nutritional status in home care residents. A cross sectional study was conducted involving 19 older adults from a home care in Malaga (Spain). We evaluated lower leg muscles by ultrasound, anthropometric data, physical function (measured by gait speed and the Short Physical Performance Battery), strength (handgrip and knee extensors strength) and nutritional status across the Mini-Nutritional Assessment Short-Form (MNA-SF). We found that muscle thickness assessed by ultrasonography independently predicts nutritional status by MNA-SF and after adjusting for handgrip strength or age and sex. As secondary findings, we found relations between strength, functional capacity and the MNA-SF test. These results suggest that lower leg muscle ultrasound parameters could be used as a low-cost objective method for muscle evaluation in nutritional assessment in older adults

Age as a determinant of nutritional status: A cross sectional study

Background Undenutrition is known to be prevalent and largely unrecognised in older patients; however, aberrations in indicators of nutritional status may simply reflect effects of age and/or functional disability. Objective The aim of this study was to measure the effect, if any of age on nutritional status in older patients. Design 445 randomly selected hospitalised patients consented to nutritional status assessment derived from anthropometric, haematological, and biochemical data within 72 hours of admission. Nutritional status was compared between those age < 75 years and those aged 75 years or more. Using multiple regression models, we measured the association between age and nutritional assessment variables after adjusting for disability, chronic illness, medications, smoking and tissue inflammation. Results Body weight, body mass index, mid-upper arm circumference, haemoglobin, serum albumin and plasma ascorbic acid were all significantly lower in people aged ≥ 75 years compared with those < 75 years of age. Although riboflavin (vitamin B2), 25OH VitD3, red-cell folate and vitamin B12 concentrations were lower in those aged ≥ 75 years, differences were not statistically significant. After adjusting for disability and co-morbidity in a multivariate analysis, age alone had a significant and independent effect on important anthropometric and biochemical nutritional assessment variables. Conclusion Increasing age is independently associated with poor nutritional status. This may partly explain the poor clinical outcome in older patients

Disease and psychological status in ankylosing spondylitis.

Objectives. Psychological factors may be important in the assessment and management of ankylosing spondylitis (AS). Our primary objective was to describe associations between disease and psychological status in AS, using AS-specific assessment tools and questionnaires. Our secondary objectives were to identify patient subgroups based on such associations and to determine the stability of the measures over time. Methods. A total of 110 patients were assessed at 6-monthly intervals up to four times using tools to measure disease [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Metrology Index (BASMI)], psychological [Hospital Anxiety and Depression Questionnaire (HADS), Health Locus of Control—Form C Questionnaire (HLC-C)] and generic health [Short form (SF)-36] status. Results. Eighty-nine participants completed all four assessments. Throughout the study, BASDAI, BASFI and BASMI scores correlated significantly with anxiety, depression, internality and health status, but not with levels of belief in chance or powerful others. Clinically anxious or depressed subgroups had significantly worse BASDAI and BASFI, but not BASMI, scores. BASMI scores were the least closely linked to psychological status. Mean scores for disease, psychological and health status were clinically stable over the 18 months period. Conclusions. Disease status scores in AS correlated significantly with anxiety, depression, internality and health status. Interpretation of AS disease scores should take an account of psychological status and the choice of measures used. These findings have important potential applications in AS management and monitoring, including the identification of patients for biological therapies

The River Lune strategic stock assessment survey 1991 with particular reference to salmonids

In the past stock assessment surveys were generally reactive in response to a particular problem e.g. a pollution incident and as such were limited in the information they provided. A programme of strategic stock assessment would be more beneficial, providing up to date information on the status and composition of the stock. On a national level this could reveal trends in population dynamics and enable comparisons to be made between key rivers and between regions. The Stock Assessment Task Group (1991) has recommended annual strategic surveys for juvenile salmonids and triennial strategic surveys for coarse fish and non- migratory salmonids. The aim of this pilot study was to gain information on species distribution and their relative abundance within the River Lune catchment, and to compare the findings with the surveys carried out between 1981-1985. This would provide valuable information on the current status of the stock and provide an indication of the resources required to conduct such strategic surveys on other river catchments in the North West Region of the National Rivers Authority

Editorial: Bridging the gap between policy and science in assessing the health status of marine ecosystems

Human activities,both established and emerging, increasingly affect the provision of marine ecosystem services that deliver societal and economic benefits. Monitoring the status of marine ecosystems and determining how human activities change their capacity to sustain benefits for society requires an evidence-based Integrated Ecosystem Assessment approach that incorporates knowledge of ecosystem functioning and services).Although,there are diverse methods to assess the status of individual ecosystem components, none assesses the health of marine ecosystems holistically, integrating information from multiple ecosystem components. Similarly,while acknowledging the availability of several methods to measure single pressures and assess their impacts, evaluation of cumulative effects of multiple pressures remains scarce.Therefore,an integrative assessment requires us to first understand the response of marine ecosystems to human activities and their pressures and then develop innovative, cost-effective monitoring tools that enable collection of data to assess the health status of large marine areas. Conceptually, combining this knowledge of effective monitoring methods with cost-benefit analyses will help identify appropriate management measures to improve environmental status economically and efficiently. The European project DEVOTES (DEVelopment Of innovative Tools for understanding marine biodiversity and assessing good Environmental Status) specifically addressed these topics in order to support policymakers and managers in implementing the European Marine Strategy Framework Directive. Here, we synthesize our main innovative findings, placing these within the context of recent wider research, and identifying gaps and the major future challenges