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BACKGROUND: Ethical competencies dealing with decision-making for clinicians involved in artificially administered nutrition and hydration (AANH) have not been defined in the literature. Although clinical assessments identify nutrition needs and appropriate routes of nutrition administration, an assessment of the ethical, cultural, and spiritual implications of the medical nutrition therapy may be overlooked. METHODS: Eleven competency statements were developed by members of two international sections of the American Society for Parenteral and Enteral Nutrition. This descriptive cross-sectional survey study was conducted to measure the importance of the competency statements to the membership of two sections using a five-point Likert scale of 1-5 (1-low to 5-high). RESULTS: A total of 113 responses (12.5% response rate) were obtained predominantly from physicians and dietitians from 25 countries. There was a wide range of world regions of the 49% respondents outside of the United States. Means and SDs were calculated for agreement with the 11 competency statements with overall means ranging from 4.32 to 4.67. Most of the participants cared for adult/older adult patients (63.7%) exclusively, and 12.4% cared for pediatric/neonate patients exclusively; the remainder (23.9%) cared for both populations. Respondents reported they were either experienced, competent, or expert (88.6%) in dealing with ethical issues related to AANH. CONCLUSION: This international interdisciplinary group agreed that the integration of ethical, cultural, and spiritual competencies into clinical decision-making regarding artificially AANH is important.
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Introduction. Data in low- and middle-income countries on mortality and its related risk factors in patients with chronic obstructive pulmonary disease are limited. Objective. To identify the incidence of death and its relationship with variables in a Colombian population during 12 months of follow-up. Materials and methods. We carried out a retrospective study in subjects diagnosed with chronic obstructive pulmonary disease in a third-level hospital in Colombia. Odds ratios were calculated using multivariable logistic regression analysis with the outcome variable "mortality at 12 months". Results. We included 524 patients, 18.1% (95 / 524) died. The average age was 69.7 (SD = 8.92), and 59.2% (310 / 524) were women. The variables associated with mortality were age (OR = 6.54; 95% CI = 3.65-11.36; p < 0.001), years of exposure to wood smoke (OR = 4.59; 95% CI = 1.64-2.82; p = 0.002), chronic heart failure (OR = 1.81; 95% CI = 1.13-2.91; p = 0.014), cerebrovascular disease (OR = 3.35; 95% CI = 1.04-10.75; p = 0.032), and chronic kidney disease (OR = 6.96; 95% CI = 1.15-41.67; p=0.015). When adjusting the variables in the multivariate analysis, only an association was found for sex (OR = 1.55; 95% CI = 0.95-2.54; p = 0.008) and age (OR = 5.94; 95% CI = 3.3-10.69; p < 0.001). Conclusion. Age, years of exposure to wood smoke, chronic heart failure, and cerebrovascular and chronic kidney disease were the clinical variables associated with a fatal outcome. However, age and sex were the only variables related to mortality when adjusted for confounding factors.
Introducción. En los países de medianos y bajos ingresos, los datos sobre la mortalidad y los factores de riesgo en pacientes con enfermedad pulmonar obstructiva crónica son limitados. Objetivo. Identificar la incidencia de muerte y sus variables relacionadas en una población colombiana durante 12 meses de seguimiento. Materiales y métodos. Se llevó a cabo un estudio retrospectivo de sujetos con diagnóstico de enfermedad pulmonar obstructiva crónica en una clínica de tercer nivel en Colombia. Los cocientes de probabilidades se calcularon mediante un análisis de regresión logística multivariable con la variable de resultado "mortalidad a los 12 meses". Resultados. Ingresaron 524 pacientes, de los cuales el 18,1 % (95 / 524) murió. La edad promedio fue de 69,7 (DE = 8,92) y el 59,2 % (310 / 524) eran mujeres. Las variables asociadas con la mortalidad fueron la edad (OR = 6,54; IC95%: 3,65-11,36; p < 0,001), años de exposición al humo de leña (OR = 4,59; IC95%: 1,64-12,82; p = 0,002), insuficiencia cardiaca crónica (OR = 1,81; IC95%: 1,13-2,91; p = 0,014), enfermedad cerebrovascular (OR = 3,35; IC95%: 1,04-10,75; p = 0,032) y enfermedad renal crónica (OR=6,96; IC 95%:1,15-41,67; p = 0,015). Al ajustar las variables en el análisis multivariado únicamente se mostró asociación entre el sexo (OR = 1,55; IC95%: 0,95-2,54; p = 0,008) y la edad (OR = 5,94; IC95%: 3,3-10,69; p < 0,001). Conclusión. La edad, los años de exposición al humo de leña, la insuficiencia cardiaca crónica, la enfermedad cerebrovascular y la renal crónica fueron variables clínicas asociadas a un desenlace fatal. Sin embargo, la edad y el sexo fueron las únicas relacionadas con la mortalidad al ajustarlas por factores de confusión.
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Enfermedad Pulmonar Obstructiva Crónica , Humanos , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Colombia/epidemiología , Femenino , Masculino , Estudios Retrospectivos , Anciano , Persona de Mediana Edad , Factores de Riesgo , Factores de Edad , Anciano de 80 o más AñosRESUMEN
Resumen Introducción. En los países de medianos y bajos ingresos, los datos sobre la mortalidad y los factores de riesgo en pacientes con enfermedad pulmonar obstructiva crónica son limitados. Objetivo. Identificar la incidencia de muerte y sus variables relacionadas en una población colombiana durante 12 meses de seguimiento. Materiales y métodos. Se llevó a cabo un estudio retrospectivo de sujetos con diagnóstico de enfermedad pulmonar obstructiva crónica en una clínica de tercer nivel en Colombia. Los cocientes de probabilidades se calcularon mediante un análisis de regresión logística multivariable con la variable de resultado "mortalidad a los 12 meses". Resultados. Ingresaron 524 pacientes, de los cuales el 18,1 % (95 / 524) murió. La edad promedio fue de 69,7 (DE = 8,92) y el 59,2 % (310 / 524) eran mujeres. Las variables asociadas con la mortalidad fueron la edad (OR = 6,54; IC95%: 3,65-11,36; p < 0,001), años de exposición al humo de leña (OR = 4,59; IC95%: 1,64-12,82; p = 0,002), insuficiencia cardiaca crónica (OR = 1,81; IC95%: 1,13-2,91; p = 0,014), enfermedad cerebrovascular (OR = 3,35; IC95%: 1,04-10,75; p = 0,032) y enfermedad renal crónica (OR=6,96; IC 95%:1,15- 41,67; p = 0,015). Al ajustar las variables en el análisis multivariado únicamente se mostró asociación entre el sexo (OR = 1,55; IC95%: 0,95-2,54; p = 0,008) y la edad (OR = 5,94; IC95%: 3,3-10,69; p < 0,001). Conclusión. La edad, los años de exposición al humo de leña, la insuficiencia cardiaca crónica, la enfermedad cerebrovascular y la renal crónica fueron variables clínicas asociadas a un desenlace fatal. Sin embargo, la edad y el sexo fueron las únicas relacionadas con la mortalidad al ajustarlas por factores de confusión.
Abstract Introduction. Data in low- and middle-income countries on mortality and its related risk factors in patients with chronic obstructive pulmonary disease are limited. Objective. To identify the incidence of death and its relationship with variables in a Colombian population during 12 months of follow-up. Materials and methods. We carried out a retrospective study in subjects diagnosed with chronic obstructive pulmonary disease in a third-level hospital in Colombia. Odds ratios were calculated using multivariable logistic regression analysis with the outcome variable "mortality at 12 months". Results. We included 524 patients, 18.1% (95 / 524) died. The average age was 69.7 (SD = 8.92), and 59.2% (310 / 524) were women. The variables associated with mortality were age (OR = 6.54; 95% CI = 3.65-11.36; p < 0.001), years of exposure to wood smoke (OR = 4.59; 95% CI = 1.64-2.82; p = 0.002), chronic heart failure (OR = 1.81; 95% CI = 1.132.91; p = 0.014), cerebrovascular disease (OR = 3.35; 95% CI = 1.04-10.75; p = 0.032), and chronic kidney disease (OR = 6.96; 95% CI = 1.15-41.67; p=0.015). When adjusting the variables in the multivariate analysis, only an association was found for sex (OR = 1.55; 95% CI = 0.95-2.54; p = 0.008) and age (OR = 5.94; 95% CI = 3.3-10.69; p < 0.001). Conclusion. Age, years of exposure to wood smoke, chronic heart failure, and cerebrovascular and chronic kidney disease were the clinical variables associated with a fatal outcome. However, age and sex were the only variables related to mortality when adjusted for confounding factors.
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The COVID-19 pandemic resulted in significant disruptions for children and youth around the world, especially given school closures and shifts in teaching modes (on-line and hybrid). However, the impact of these disruptions remains unclear given data limitations such as a reliance on cross-sectional and/or short-interval surveys as well as a lack of broad indicators of key outcomes of interest. The current research employs a quasi-experimental design by using an Australian four-year longitudinal survey with student responses from Grade 7 to 10 (aged 12-15 years old) (N = 8,735 from 20 schools) in one education jurisdiction. Responses are available pre-pandemic (2018 and 2019) and during the pandemic (2020 and 2021). Importantly the survey included measures of well-being, mental health and learning engagement as well as potential known school-environment factors that could buffer against adversity: school climate and school identification. The findings were generally in line with key hypotheses; 1) during COVID-19 students' learning engagement and well-being significantly declined and 2) students with more positive school climate or stronger school identification pre-COVID-19 fared better through the disruption of the pandemic. However, these same students suffered from a steeper decline in well-being and engagement which may be explained through the impact of losing meaningful social or group connections. This decline was evident after controlling for gender, academic grade (as a proxy of age), parental education, and socioeconomic status. It is concluded that investing in the social environment of schools is important in crisis preparedness and can facilitate better crisis response among youth.
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COVID-19 , Salud Mental , Instituciones Académicas , Humanos , COVID-19/epidemiología , COVID-19/psicología , COVID-19/prevención & control , Adolescente , Estudios Longitudinales , Masculino , Femenino , Instituciones Académicas/organización & administración , Niño , Australia/epidemiología , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Factores Protectores , Aprendizaje , SARS-CoV-2 , Pandemias , Medio Social , Identificación Social , Encuestas y CuestionariosRESUMEN
The plexiform fibromyxoma is a rare mesenchymal tumor in adults that generally originates in the antrum of stomach, being its occurrence in pediatric patients exceptional. It was classified as a distinct entity by World Health Organization in 2010. No recurrences and metastases have been documented in many of the reported patients to date, being the surgical treatment curative. We report the case of a 3-month-old infant who presented to the emergency department with an episode of intestinal subocclusion requiring an emergent surgery. During the surgical intervention, a mass was identified in the jejunum, causing partial occlusion of its lumen. The surgical pathology report revealed an infiltrative tumor composed of spindle-shaped cells disposed in a stroma with a plexiform pattern alternating myxoid areas. These findings and the immunohistochemical characteristics of the neoplastic cells led to classify the tumor as a plexiform fibromyxoma. A description of the immunophenotype of this tumor is made and differential diagnosis with other gastrointestinal tumors is also discussed.
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Fibroma , Neoplasias de los Tejidos Blandos , Neoplasias Gástricas , Humanos , Lactante , Fibroma/cirugía , Fibroma/diagnóstico , Fibroma/patología , Neoplasias Gástricas/diagnósticoRESUMEN
Introduction: The Latin American Federation of Nutritional Therapy, Clinical Nutrition, and Metabolism - FELANPE, was founded in 1988. It brings together interdisciplinary societies and associations in Clinical Nutrition and Nutritional Therapy from Latin America and the Caribbean, as well as Spain and Portugal. Currently, it comprises representations from 18 countries. The objectives of the Federation are described, taking into account the assumed commitment. This is an observational cross-sectional, multicenter study that included 132 hospitals with more than 100 beds, of high complexity, both state-owned and private, from 14 countries in Latin America that are members of FELANPE. The study assessed hospital characteristics, implementation of nutritional assessment, nutritional diagnosis of patients, the team responsible for nutritional therapy, nutritional therapy (oral, enteral, and parenteral), monitoring, and nutritional follow-up. For this purpose, a digital questionnaire and an explanatory video were designed and validated to ensure the quality of the collected data. Validation was carried out through a pilot study conducted in Paraguay, approved by the Ethics Committee for Research at the Faculty of Medical Sciences of the National University of Asunción. The current research has the approval of the Research Ethics Committee of the Faculty of Chemical Sciences of the National University of Asunción and the Ethics Committee of FELANPE. The results presented at the XVIII Latin American Congress of FELANPE in Asunción, Paraguay, on October 12, 2023, serve as a basis for characterizing the implementation of Parenteral and Enteral Nutritional Therapy (medical nutritional therapy) in hospitals in Latin America and are used as technical support for the present Asunción Commitment.
Introducción: La Federación Latinoamericana de Terapia Nutricional, Nutrición Clínica y Metabolismo FELANPE, fue fundada en el año 1988. Reúne a Sociedades y Asociaciones Interdisciplinarias de Nutrición Clínica y Terapia Nutricional de América Latina y el Caribe, además de España y Portugal. Actualmente la conforman representaciones de 18 países. Se describen los objetivos de la Federación teniendo en cuenta el compromiso asumido. Se trata de estudio observacional transversal, multicéntrico en que se incluyeron 132 hospitales con más de 100 camas, de alta complejidad, estatales y privados de 14 países de Latinoamérica miembros de FELANPE. Se evaluaron las características del hospital, la implementación de la valoración nutricional, el diagnóstico nutricional de pacientes, el equipo responsable de la terapia nutricional, la terapéutica nutricional (oral, enteral y parenteral), la monitorización y el seguimiento nutricional. Para tal, se diseñó y validó un cuestionario digital y un video explicativo para garantizar la calidad de los datos recolectados. La validación se efectúo mediante un estudio piloto realizado en Paraguay, aprobado por el Comité de Ética en la Investigación de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción. La investigación actual cuenta con la aprobación del Comité de Ética de Investigación de la Facultad de Ciencias Químicas de la Universidad Nacional de Asunción y del Comité de Ética de FELANPE. Los resultados presentados en el XVIII Congreso Latinoamericano de FELANPE, en Asunción del Paraguay, el 12 de octubre del 2023, sirven como base para caracterizar la implementación de la Terapia Nutricional Parenteral y Enteral (terapia nutricional médica) en Hospitales de Latinoamérica y son utilizados como sustento técnico del presente Compromiso de Asunción.
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Apoyo Nutricional , Nutrición Parenteral , Humanos , Estudios Transversales , Proyectos Piloto , Apoyo Nutricional/métodos , Nutrición Parenteral/métodos , Evaluación NutricionalRESUMEN
There are widespread concerns about a decline in young people's mental health. One promising direction to address this issue involves group memberships and social identity processes. Despite progress, there are several issues in current theory and research including (1) whether the number of groups to which an individual belongs is related to more positive well-being, (2) better understanding the relationship between group memberships and social identification processes and (3) the need for more comprehensive longitudinal methods. The goal of this study was to address these issues using a three-wave longitudinal design (n = 1331) conducted with high-school students. Both the number and importance (an indicator of social identification) of student extracurricular activities (ECA) were assessed as predictors of six well-being outcomes. Importantly, we also assessed whether identification with the school as the context in which the ECAs were situated mediated this association. Results show that, generally, the number of group memberships had no direct effect on well-being, however, there was a consistent mediation via school identification. When considering number and importance of one model (comprising a subsample) importance emerged as the key predictor. Such findings advance understanding of the social identity and well-being relationship and have practical implications.
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Instituciones Académicas , Estudiantes , Humanos , Adolescente , Identificación Social , Procesos de GrupoRESUMEN
BACKGROUND: Despite advancements in the global dialog surrounding sex and gender equity, an important gap persists with women markedly underrepresented in major roles within health care leadership. OBJECTIVES: We examined the extent of women's representation in prominent positions within parenteral and enteral nutrition (PEN) societies worldwide over a span of 2 decades. DESIGN: This retrospective analysis explored the sex distribution of society chairs, conference presidents, and editor-in-chief positions across 64 PEN societies between 2003 and 2022. Additionally, data on the first and last authors of endorsed clinical guidelines were collected from the 2 leading societies. RESULTS: Over the past 20 y, women held society chair positions in 34.4% of cases. The representation shifted from 30% during the decade from 2003 to 2012 to 40.5% from 2013 to 2022. Throughout these years, the numbers consistently ranged from 0 to 10; however, the median shifted upward from 1 during the first decade to 4 in the subsequent decade (P = 0.04). Of 420 congress presidencies, â¼30% were women. In endorsed guidelines, women were the first authors in 27.1% of cases (P < 0.001) and the last in 28.9% (P < 0.001) compared with men. Of the 123 journal editor-in-chief positions, women occupied 23 (18.7%). CONCLUSION: Over the last 2 decades, women have been consistently underrepresented in prominent leadership roles in PEN societies globally. Although there has been a noticeable shift toward more women in chair positions, true sex equality remains elusive. Moreover, sex disparities are even more pronounced in positions, such as conference presidents, authors of major guidelines, and editors-in-chief of society-affiliated journals. These data underscore the pressing need to enhance efforts toward sex equality across these domains.
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Nutrición Enteral , Liderazgo , Masculino , Humanos , Femenino , Estudios Retrospectivos , Sociedades MédicasRESUMEN
Cultivating Limnospira maxima, renowned for its abundant proteins and valuable pigments, faces substantial challenges rooted in the limited understanding of its optimal growth parameters, associated high costs, and constraints in the procurement of traditional nitrogen sources, particularly NaNO3. To overcome these challenges, we conducted a comprehensive 4 × 3 factorial design study. Factors considered included white, red, blue, and yellow light spectra, along with nitrogen sources NaNO3 and KNO3, as well as a nitrogen-free control, for large-scale implementation. Optimal growth, measured by Optical Density, occurred with white and yellow light combined with KNO3 as the nitrogen source. These conditions also increased dry weight and Chl-a content. Cultures with nitrogen deprivation exhibited high values for these variables, attributed to carbon accumulation in response to nitrogen scarcity. Phycocyanin, a crucial pigment for nutrition and industry, reached its highest levels in cultures exposed to white light and supplemented with KNO3, with an impressive content of 384.11 g kg-1 of dry weight. These results highlight the efficacy and cost-efficiency of using a combination of white light and KNO3 for large-scale L. maxima cultivation. This strategy offers promising opportunities to address global food security challenges and enhance the production of industrially relevant pigments.
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Mental illness in adolescents is on the rise, thus it is vital to study factors that can improve youth mental health. The extant theory and research have identified both social (school climate; school identification) and individual (resilience) constructs as protectors of mental health. However, these protective factors remain in silo and require further integration. To address this issue, the present study proposed and investigated an integrative model in which social factors (i.e., school climate, school identification) nurture individual (i.e., resilience) protective factors, which in turn impact adolescent mental health. Using three-wave longitudinal data (2017-2019) from school students (Grades 7-8; N = 1,357), we found evidence supporting the integrated model examining five dimensions of mental health: anxiety, depression, happiness, life satisfaction, and positive affect. Greater Wave 1 school climate predicted greater identification 1 year later, which in turn predicted greater resilience. Furthermore, greater resilience predicted lower depression and anxiety, and greater happiness, life satisfaction, and positive affect 1 year later. These results support efforts to strengthen the school climate and reconceptualize resilience as an outcome of social processes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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STUDY DESIGN: Expert opinion, feedback, revisions, and final consensus. OBJECTIVES: To update the International Spinal Cord Injury Pain Basic Data Set (ISCIPBDS version 2.0) and incorporate suggestions from the SCI pain clinical and research community with respect to overall utility. SETTING: International. METHODS: The ISCIPBDS working group evaluated these suggestions and made modifications. The revised ISCIPBDS (Version 3.0) was then reviewed by members of the International SCI Data Sets Committee, the American Spinal Injury Association (ASIA) Board, the International Spinal Cord Society (ISCoS) Executive and Scientific Committees, individual reviewers and societies, and posted on the ASIA and ISCoS websites for 1 month to elicit comments before final approval by ASIA and ISCoS. RESULTS: The ISCIPBDS (Version 3.0) was updated to make the dataset more flexible and useful: 1. The assessment can be based on the patient's perception of several of his/her "worst" pain(s) or based on the International SCI Pain (ISCIP) Classification-defined or other pain types, depending on the specific research questions or clinical needs. 2. Pain interference should usually be rated for overall pain but may also be used for specific pain problems if needed. 3. An optional pain drawing was added to complement the check box documentation of pain location. 4. Data categories consistent with the Extended Pain Dataset list of current treatments were added. 5. Several new training cases were added.
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Traumatismos de la Médula Espinal , Humanos , Masculino , Femenino , Estados Unidos , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/epidemiología , Traumatismos de la Médula Espinal/terapia , Dolor/diagnóstico , Dolor/etiología , Bases de Datos FactualesRESUMEN
The potential of CdS quantum dots for biomedical and bioimaging applications depends on their cytotoxicity, which can be modulated by coating molecules. Using sulfur as a precursor can be used along with cadmium nitrate to synthesize CdS quantum dots with the fungus Fusarium oxysporum f. sp. lycopersici. The latter replaces pure chemical sulfur as a precursor for CdS quantum dot synthesis, thus transforming waste into a value-added product, increasing sustainability, reducing the environmental impact of the process through the implementation of green synthesis techniques, and contributing to the circular economy. Therefore, we compared the cytotoxicity on HT-29 cells of biogenic, and chemical CdSQDs, synthesized by a chemical method using pure sulfur. Biogenic and chemical CdSQDs had diameters of 4.08 ± 0.07 nm and 3.2 ± 0.20 nm, Cd/S molar ratio of 43.1 and 1.1, Z-potential of - 14.77 ± 0.64 mV and - 5.52 ± 1.11 mV, and hydrodynamic diameters of 193.94 ± 3.71 nm and 152.23 ± 2.31 nm, respectively. The cell viability improved 1.61 times for biogenic CdSQDs over chemical CdSQDs, while cytotoxicity, measured as IC50, diminished 1.88-times. The lower cytotoxicity of biogenic CdSQDs was attributed to their organic coating consisting of lipids, amino acids, proteins, and nitrate groups that interacted with CdS through -OH and -SH groups. Therefore, the biogenic synthesis of CdSQDs has repurposed a pathogenic fungus, taking advantage of the biomolecules it secretes, to transform hazardous sulfur waste and metal ions into stable CdSQDs with advantageous structural and cytotoxic properties for their potential application in biomedicine and bioimaging.
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Fusarium , Puntos Cuánticos , Puntos Cuánticos/toxicidad , Puntos Cuánticos/química , Hongos , AzufreRESUMEN
This commentary represents a dialogue on key aspects of disease-related malnutrition (DRM) from leaders and experts from academia, health across disciplines, and several countries across the world. The dialogue illuminates the problem of DRM, what impact it has on outcomes, nutrition care as a human right, and practice, implementation, and policy approaches to address DRM. The dialogue allowed the germination of an idea to register a commitment through the Canadian Nutrition Society and the Canadian Malnutrition Task Force in the UN/WHO Decade of Action on Nutrition to advance policy-based approaches for DRM. This commitment was successfully registered in October 2022 and is entitled CAN DReaM (Creating Alliances Nationally for Policy in Disease-Related Malnutrition). This commitment details five goals that will be pursued in the Decade of Action on Nutrition. The intent of this commentary is to record the proceedings of the workshop as a stepping stone to establishing a policy-based approach to DRM that is relevant in Canada and abroad.
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Desnutrición , Terapia Nutricional , Humanos , Canadá , Desnutrición/diagnóstico , Estado Nutricional , AlimentosRESUMEN
Access to nutritional care is frequently limited or denied to patients with disease-related malnutrition (DRM), to those with the inability to adequately feed themselves or to maintain their optimal healthy nutritional status which goes against the fundamental human right to food and health care. That is why the International Working Group for Patient's Right to nutritional care is committed to promote a human rights based approach (HRBA) in the field of clinical nutrition. Our group proposed to unite efforts by launching a global call to action against disease-related malnutrition through The International Declaration on the Human Right to Nutritional Care signed in the city of Vienna during the 44th ESPEN congress on September 5th 2022. The Vienna Declaration is a non-legally binding document that sets a shared vision and five principles for implementation of actions that would promote the access to nutritional care. Implementation programs of the Vienna Declaration should be promoted, based on international normative frameworks as The United Nations (UN) 2030 Agenda for Sustainable Development, the Rome Declaration of the Second International Conference on Nutrition and the Working Plan of the Decade of Action on Nutrition 2016-2025. In this paper, we present the general background of the Vienna Declaration, we set out an international normative framework for implementation programs, and shed a light on the progress made by some clinical nutrition societies. Through the Vienna Declaration, the global clinical nutrition network is highly motivated to appeal to public authorities, international governmental and non-governmental organizations and other scientific healthcare societies on the importance of optimal nutritional care for all patients.
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Desnutrición , Humanos , Desnutrición/diagnóstico , Desnutrición/prevención & control , Apoyo Nutricional , Estado Nutricional , Derechos Humanos , Naciones UnidasRESUMEN
BACKGROUND: Schools are increasingly recognized as key facilitators of child and youth well-being. Much attention has been directed to the school social environment and the areas of school climate or school connectedness/identification. Drawing on the social identity approach and related work, it has been argued that school social identification may be the mechanism or process through which school climate comes to impact individual student functioning (Applied Psychology, 28, 2009, 171). Much of the previous research on social identity and well-being, though, is limited because it is cross-sectional. AIMS, SAMPLE & METHODS: This current study aims to advance understanding of the relationships between school climate, school identification and positive and negative well-being. It adopts a three-wave longitudinal sample of Australian students (N = 6537 wave 3, grades 7-10) and incorporates a range of control variables. Multilevel modelling (MLM) is used to test relationships of interest. RESULTS AND CONCLUSIONS: In line with predictions, school identification was a significant mediator of the relationship between school climate and the well-being dimensions of positive affect and depression (but not anxiety). The substantial theoretical and practical implications of this research are discussed, including the role of the school social environment in helping young people successfully transition to adulthood.