Health-related quality of life in patients with home nutritional support.

BACKGROUND: Home nutritional support (HNS) aims to improve or maintain the patient's quality of life. Given the high social cost of such treatment, however, it is important to investigate whether the perceived quality of life of patients receiving HNS does in fact reflect these objectives. The present study aimed to evaluate the health-related quality of life (HRQoL) of patients who receive HNS. METHODS: A multicentre, cross-sectional study of 267 patients was carried out. HRQoL was evaluated using the EuroQoL-5-Dimensions (EQ-5D) questionnaire. The Visual Analogue Scale (VAS) was used to complement the EQ-5D, aiming to provide an overall estimation of patient quality of life. RESULTS: The EQ-5D questionnaire showed that 25% of the subjects valued their HRQoL at between -0.08 and 0.15, 50% at between 0.16 and 0.69 and 25% at between 0.70 and 1. Results from the VAS showed that 75% of patients claimed to have a HRQoL > 40. The median for the VAS was 50. Pathologies were oncological (44.0%), neurological (36.6%) and others (19.3%). The results obtained demonstrate that neurological patients placed a lower value on their HRQoL compared to those of other groups (P < 0.001). In addition, women rated their quality of life lower than men in all pathologies (P = 0.006). CONCLUSIONS: Perceived HRQoL varied depending on pathology and sex. It was difficult to draw conclusions concerning the impact of HNS because of a lack of baseline data and relevant validated measurement tools. The present study highlights the need for more research into the relationship between HNS and HRQoL.

Artificial Nutritional Support Registries: systematic review.

INTRODUCTION: The nutritional registries are data bases through which we obtain the information to understand the nutrition of populations. Several main nutrition societies of the world have these types of registries, outstanding the NADYA (Home artificial and Ambulatory nutrition) group in Spain. The object of this study is to determine by means of a systematic review, the existent scientific production in the international data bases referred to nutritional support registries. METHODS: Descriptive transversal study of the results of a critical bibliographic research done in the bioscience data bases: MEDLINE, EMBASE, The Cochrane Library, ISI (Web of Sciences), LILACS, CINHAL. RESULTS: A total of 20 original articles related to nutritional registries were found and recovered. Eleven registries of eight countries were identified: Australia, Germany, Italy, Japan, Spain, Sweden, United Status and United Kingdom. The Price Index was of 65% and all the articles were published in the last 20 years. CONCLUSIONS: The Price Index highlights the innovativeness of this practice. The articles related to nutritional support are heterogeneous with respect to data and population, which exposes this as a limitation for a combined analysis.

[Population wills about the decisions and cares at the end of life]. / Voluntades de la población sobre los cuidados y decisiones al final de la vida.

OBJECTIVE: To know the wishes and willings of the general population at the end of life under the assumption of suffering a terminal disease. METHOD: Crosswise quanti-qualitative study. An opinion poll has been made under the assumption of suffering a terminal disease with 10 questions about the wishes of the population at the end of life Descriptive techniques have been used as well as chi(2) Pearson, chi(2) Fisher and Student's T tests for the analysis. Also, analysis of the comments contents techniques have been used. RESULTS: 403 polls have been analyzed with an age mean of 38.2 years. 63.8% of the people prefer to end their life at home IC 95%, [59.1%-68.5%]. The majority prefer their partners as care giver 43.4% IC 95% [38.6-48.3]. The 85.9% IC 95% [82.5-89.3] would not wish to be undergone to either resuscitation maneuvers or other ways to extend their lifes to the maximum. The 49.4% IC 95% [44.5-54.3] would want to receive special nutritional support. CONCLUSIONS: It was observed that the oldest population refuses to talk about their own death. The vast majority of the polled people would want to die at home with their partner's cares. Half of the people want to be feed artificially until the end of their days.

[What is the diet of the immigrant population resident in Spain? Results based on a systematic review]. / ¿Cómo es la alimentación de la población inmigrante residente en España? Resultados a partir de una revisión sistemática.

Diet is a principal determinant of health and is interrelated with socioeconomic factors and the acculturation of immigrants. The aim of this study was to examine the existing evidence on food, nutrition, and diet amongst immigrant populations in Spain, its relationships with their countries of origin, and to evaluate the methodological quality of these studies. A systematic review was carried out that included seventeen cross-sectional studies, 71% of them were of average quality and only one was excellent; seven dealt with adolescents and ten dealt with adults, with a total of 9,871 participants. Insights on immigrant diet and nutrition were heterogeneous because the participant groups in these studies were from several different countries, each of which has distinct cultural and geographical characteristics. Adolescent diet was of lower quality, positively correlated to socioeconomic level; acculturation and length of residence were related to both positive (such as healthier dietary patterns, better adhesion to intake recommendations) and negative aspects (higher intake of meat or bakery products, lower intake of vegetables or fish, among others). Adults show a better intake of macronutrients, but a lower intake of micronutrients and non-observance of some intake recommendations; acculturation and length of residence were related to healthier dietary patterns, significantly related to type of employment. Immigrants from Mediterranean countries show a healthier diet than other immigrants, although the quality of their diet is worse than that of their peers in their countries of origin. Finally, the quality of the diet of non-Mediterranean immigrants improves when they become resident in Spain.

[Information in Home Nutrition: the importance of the registries]. / Información en Nutrición Domiciliaria: la importancia de los registros.

The importance of the registries is determined by its data. In order for a registry to meet its objectives quality in codification, transcription and analysis is essential. These premises applied to a home nutrition registry give an information able to meet all the researchers' targets. The NADYA Group registry of the Spanish Society of Parenteral and Enteral Nutrition in Spain tries to measure home artificial nutrition, its indications, methods and ways of administration and other variables. From their studies we may conclude that Parenteral Nutrition is underutilized at present, probably due to a lack of supporting structures able to meet all the needs of home patients. However, tube enteral nutrition is increasing, which represents a reduction in hospital costs and, more important represents an improvement of the patients quality of life and, in turn, also of their relatives.

[Careful! Your bibliographic references may be examined]. / Cuidado!, sus referencias bibliográficas pueden ser estudiadas.

Reference to previous work represents a conceptual association of recognized scientific ideas that are beneficial for the citing author. I.e., a reference is an express recognition of an intellectual compromise towards a previous source of information. After all, advancement of science is supported by previous research. At present, the way to know and to measure the importance of a published item comes through its posterior citations, circumstance that obliges scientific journals to control the pertinence and relevance of the cited work. Therefore, when submitting a manuscript for consideration to a scientific journal, it must be beard in mind that the included references will be examined.

[Bibliometric study of the Journal Nutrición Hospitalaria for the period 2001-2005: Part 1, Analysis of the scientific production]. / Estudio bibliométrico de la revista Nutrición Hospitalaria en el periodo 2001 a 2005: Parte I, Análisis de la producción científica.

OBJECTIVE: To assess the scientific activity and information production of the journal Nutrición Hospitalaria, for the period 2001-2005 by means of a Bibliometric study. METHOD: Cross-sectional descriptive study of the results obtained from the analysis of the articles published in the journal Nutrición Hospitalaria. The data were obtained by consulting the electronic version through the Web. In those cases in which there was a link breakdown, and thus, the inability to have access to the electronic document the printed version was consulted. All the documental possibilities were taken into account with the exception of communications to congresses. RESULTS: A total of 345 articles were published, 187 (54.20%) being original articles. The geographical distribution of the first author was Spanish in 287 articles (83.19%) and Latin American in 27 (7.83%). Most of the articles are from health care centers (172 articles (49.86%)), and the cooperation index being 4.15. Madrid is the most productive province, for both the absolute and adjusted frequencies. The median number of references per article is 18, the mean being 23.52 (95% CI 20.93 - 26.10). The predominant language was Spanish, with 308 articles (89.28%). CONCLUSION: Nutrición Hospitalaria may be considered as a reference journal regarding information and scientific communication on Nutrition for both the Spanish and Latin American communities. The bibliometric parameters studied compare with those verified for the remaining top of the list Spanish scientific journals on health sciences.

[Bibliometric study of the journal Nutrición Hospitalaria for the period 2001--2005: Part 2, consumption analysis; the bibliographic references]. / Estudio bibliométrico de la revista Nutrición Hospitalaria en el periodo 2001 a 2005: parte 2, análisis de consumo; las referencias bibliográficas.

OBJECTIVE: To describe and assess the consumption of the information consulted and cited in the articles published in the journal Nutrición Hospitalaria for the period 2001--2005 by means of bibliometric analysis. METHOD: Cross-sectional descriptive analysis of the results obtained from the analysis of the lists of bibliographic references of the articles published at Nutrición Hospitalaria. We studied the most cited journals, the signatures index, the type of document referred, the publication language, the distribution of geographical origin, and obsolescence and readiness index. We took into account all types of documents with the exception of Communications to Congresses. RESULTS: 345 articles were published at Nutr Hosp, containing 8,113 bibliographic references, with a median of 18, a maximum of 136 and minimum of 0 BR per article. The mean (rate of publications per published article during the specified period) is 23.52 (95% IC 20.93-26.10) and the mean at 5% is 20.66 per article. The 25th and 75th percentiles are 6 and 32, respectively, the interquartile interval being 26 BR per document. The semi-period of Burton and Kebler is 7 years and the Price Index is 38.18%. CONCLUSION: The bibliographic references, the consumption of information, of the articles published at Nutrición Hospitalaria present parameters similar to other journals on health science. However, good data on obsolescence are observed, which reveal the good validity of most of the references studied.

[Documentation and correction: the introduction letter, something more than simple protocol]. / Documentación y corrección: la carta de presentación, algo más que simple protocolo.

In 1978 the international committee of directors of medical magazines met informally in Vancouver, British Columbia (Canada), to establish, for the first time, the guidelines that, in relation to the format, the manuscripts sent to their magazines should contemplate. The group became known as Vancouver group. Their "Requirements of uniformity for the manuscripts sent to Biomedical Magazines" were published for the first time in 1979. In november of 2003 the committee published the last version, the sixth, in which the included topics go beyond the preparation of the manuscript. In any case, this last version of the "Vancouver Norms" makes expressed reference to the ethical aspects that converge when sending to publish a work. These ethical manifestations should be made explicit in the presentation letter, to which the new requirements give a special emphasis. It is necessary to establish a debate on the execution of the requirements of uniformity, as well as to begin, to continue and to vivify the reflection on the transcendence that supposes to fulfil them, with the purpose of facilitating the methodological normalization of the works subjected to publication.

[Malnutrition of home-based hospital patients]. / Desnutrición en los enfermos de hospitalización a domicilio.

OBJECTIVE: We pretend to know the nutritional state in all patients that are being treated in the the Home Care Services Hospital Based (HCSHB) units, be which is their entrance causes and we also pretend to know the prevalence of undernutrition. SECONDARY OBJECTIVE: To know the prevalence of nutritional treatments in the HCSHB units, their relationship with the nutritional state, the pathology and the patient's origin inside the sanitary environment. ENVIRONMENT: A Multicentric study, in which the HCSHB units of three hospitals of the Valencia Community have intervened. PATIENT: 40 patients that remained in that moment entered by different causes in the HCSHB units. VARIABLES: Sex, age. Origin service, pathology, Subjective Global Valuation (SGV), IMC, nutritional support, type of nutritional support, albumin, Cholesterol, lymphocytes. RESULTS: The half age has been of 77,45 years (SD 11 years) with 67,5% of males. The patients, in all the cases, came from hospital Services, being the pathology responsible for the entrance mainly the oncological 32,5%, surgical 7,5%, neurological 7,5% and 52,5% others. According to GSV 52.5% present a good nutritional status, 37.5% had a suspect of under nourishment and 10% had a clear under nourishment. The IBM for the 12.5% of the patients is < or = 20 and the IBM for the 42.5% < or = 22. The 35% were receiving nutritional support, supplements the 78% and oral enteral nutrition the 14% of the patients. We have found a lineal relation between the IBM and the levels of albumin that the patients presented, also with the figures of cholesterol and it has not been found any relationship with the lymphocytes number.

[Bibliometric study of the production and use of the Farmacia Hospitalaria journal (2004-2012)]. / Estudio bibliométrico de producción y consumo de la revista Farmacia Hospitalaria (2004-2012).

OBJECTIVE: To analyze the scientific activity and the production of information of the Farmacia Hospitalaria journal as the Spanish scientific publication of reference in the pharmaceutical area. METHODS: Transversal descriptive study of the results obtained from the bibliometric analysis of the articles published in the journal. Data was obtained from direct queries and Internet access to the scientific literature contained in the electronic version of the journal during the 2004-2012 period. RESULTS: During the period studied 756 articles were published. The number of original articles was 258 (34.12%) with a productivity index of 2.40. The number of institutions identified with published articles was 246. The predominant language was Spanish with 733 (96.96%) articles. We counted 1828 keywords, of which 527 (28.83%) coincided with MeSH. The median calculation of the obsolescence of quoted references was 10, and the Price Index was 8.81%. The percentage of selfquotes was 5.18%. CONCLUSIONS: We confirmed a low proportion of original articles and an adequate percentage of satisfactory quotable articles. The low percentage of keywords that coincide with Medical Subject Headings is noteworthy. The bibliographical references found in the articles come mainly from the English-speaking area and from journals indexed in the Journal Citation Report. The obsolescence analysis of these references produced high results.

[Presence and adequacy of the nutritional and eating disorders terminology in the Spanish and English editions of the Wikipedia]. / Presencia y adecuación de la terminología sobre desórdenes nutricionales y trastornos de la conducta alimentaria en las ediciones española e inglesa de la Wikipedia.

OBJECTIVE: To determine the presence and to assess the adequacy of the nutritional and eating disorders descriptors in the English and Spanish Wikipedia. METHOD: The terms were obtained from the thesaurus: Medical Subject Headings (MeSH) and APA-Terms. The existence of the terms was confirmed accessing to the Spanish and English editions of Wikipedia via the Internet (http://es.wikipedia.org/). The last date for consultation and calculations was June 8, 2012. RESULTS: A total of 89 descriptors were identified, being 56 (62.92%) of them as terms in the Wikipedia: 42 (47.19%) in the Spanish edition and 56 (62.92%) in English. Significant differences between the two editions were assessed (chi-square = 9.41, df = 1, P <0.001). At the same time, differences between both editions according to the number of references in each term were observed (t-Student = -2,43; gl = 84,87; p = 0,017). However, there were not differences in the status of information being update/obsolete, neither in the number of queries. CONCLUSIONS: The entries related to nutritional and eating disorders terms have not yet reached an optimum level. Differences between english and spanish Wikipedia editions are more related to criteria of content principles (term existence) than adequacy of information. The English edition of Wikipedia has a more scientific endorsement, through the references cited, than the Spanish edition.

[Bibliometric and thematic analysis of the scientific literature about omega-3 fatty acids indexed in international databases on health sciences]. / Análisis bibliométrico y temático de la producción científica sobre ácidos grasos omega-3 indizada en las bases de datos internacionales sobre ciencias de la salud.

OBJECTIVE: To evaluate by bibliometric and thematic analysis the scientific literature on omega-3 fatty acids indexed in international databases on health sciences and to establish a comparative base for future analysis. METHOD: Searches were conducted with the descriptor (MeSH, as Major Topic) "Fatty Acids, Omega-3" from the first date available until December 31, 2010. Databases consulted: MEDLINE (via PubMed), EMBASE, ISI Web of Knowledge, CINAHL and LILACS. RESULTS: The most common type of document was originals articles. Obsolescence was set at 5 years. The geographical distribution of authors who appear as first author was EEUU and the articles were written predominantly in English. The study population was 90.98% (95% CI 89.25 to 92.71) adult humans. The documents were classified into 59 subject areas and the most studied topic 16.24% (95% CI 14.4 to 18.04) associated with omega-3, was cardiovascular disease. CONCLUSION: This study indicates that the scientific literature on omega-3 fatty acids is a full force area of knowledge. The Anglo-Saxon institutions dominate the scientific production and it is mainly oriented to the study of cardiovascular disease.

[Quality of life questionnaire related to nutritional status]. / Cuestionario de calidad de vida relacionado con el estado nutricional (CaVEN).

OBJECTIVE: To build and validate an instrument to measure the perceived quality of life in the nutritional status. MATERIAL AND METHODS: By focal groups and interviews with nutrition experts, the dimensions with greater affectation were identified. After the judge test, the CaVEN questionnaire was defined. For its valuation a multicentric study was performed, participating 7 Spanish hospitals. The internal structure of the questionnaire was evaluated by explanatory factorial analysis. Reliability was tested using the Cronbach α coefficient and the validity of the criteria with the nutritional Gold Standards. RESULTS: A questionnaire of 26 items with 6 health dimensions was built. It was applied to 68 patients that were valued in the Nutrition Units. The test KMO was 0.756, showing a good accuracy in the Factorial Analysis. The existence of principal dimension of inertia was found (Bartlett p < 0.01). The 6 dimensions showed an accumulative variance of 77.670. It was observed a direct relationship in the Subjective Global Valuation and CaVEN (p < 0.01) and with the "Mini Nutritional Assessment Short" (p = 0.02), which was interpreted as the greater affectation of the nutritional status, the lower the quality of life detected by the CaVEN. CONCLUSIONS: The CaVEN questionnaire has proved a useful tool for assessing the quality of life related to nutritional status, even in groups with little nutritional alterations.

[Wikipedia and wikinutrition: key tools for the global promotion of nutrition]. / Wikipedia y Wikinutrición: herramientas clave para la promoción global de la nutrición.

Wikipedia is an encyclopedia collaboratively edited by volunteers from around the world built on the Web since 2003. Today is the sixth most visited site on the Internet, making it the biggest hit of participatory democracy in the field of information dissemination. The English edition, with more than 3 million items, has become an indispensable part of the Internet and the largest and most popular reference work. In this context, it could be argued that Wikipedia is a valuable tool for the general knowledge of the nutritional sciences terminology. At the same time, it does not only facilitate access to knowledge but also can generate it. It also permits to socialize these spaces for collaboration and development, contributing therefore to disclose science to the society. Consequently, in this article we present and discuss the main features of Wikipedia, emphasizing above all its role in food science and nutrition.

[Adverse effects of parenteral nutrition in cancer patients: systematic review]. / Efectos adversos de la nutrición parenteral en pacientes oncológicos: revisión sistemática.

Malnutrition in hospitals is of great concern in patients with cancer. This malnutrition in cancer leads to higher risk of complications, and worse response to treatments and outcomes. Parenteral nutrition (PN) in cancer is controversial due to the heterogeneous results found in scientific literature. This is the reason why the evaluation of adverse events of PN, its incidence and severity, is crucial when prescribing PN in cancer patients. This evaluation of adverse events of PN is the aim of the present systematic review of the randomized clinical trials (RCT) written in any language found in several databases. From the 74 articles found in our search, only 13 RCT (18 different types of cancer) met the criteria to be selected for the systematic review. These RCT included 669 patients receiving central PN in whom 225 adverse events (33.63%) of PN were described, and 92 patients with peripheral PN, with 54 adverse events (58.70%). There were no adverse events in a control group of 47 patients receiving parenteral fluids. We conclude that scientific literature is very heterogeneous and evaluate complications of parenteral nutrition only as a secondary aim. We think necessary that further research do define complications of parenteral nutrition homogeneously and study them as a main objective.