Nutritional aspects of psychiatric disorders.

As most diet therapy texts provide little information about psychiatric illnesses and their treatment, this article is intended as a brief introduction for dietitians. Several psychiatric illnesses, including schizophrenia, mood disorders, eating disorders, and substance abuse, may adversely affect food intake and nutritional status. The drugs used to treat those disorders similarly have effects on appetite and gastrointestinal function and interact with food and nutrients. Antipsychotics, antidepressants, and monoamine oxidase inhibitors (MAOIs) cause dry mouth, constipation, and weight gain. Lithium may cause nausea, vomiting, diarrhea, polydipsia, and weight gain. MAOIs have well-known interactions with foods containing tyramine. Lithium interacts with dietary sodium and caffeine; decreasing dietary intakes of those substances may produce lithium toxicity. Despite claims to the contrary, major psychiatric illnesses cannot be cured by nutritional therapies alone. Dietitians can, however, play an important role as part of a multidisciplinary team in the treatment of patients with psychiatric illness. Such a role includes nutrition assessment and monitoring, nutrition interventions, patient and staff education, and some forms of psychotherapy, including supportive and behavioral therapies for patients with eating disorders.

Anthropometric measurements and their interpretation: principles, practices, and problems.

As many as 50 per cent of hospitalized patients are estimated, in some surveys, to suffer from protein-calorie malnutrition. Anthropometry provides at least one quick and easy way to assess a patient's protein and calorie reserves. The measurements most commonly obtained are height, weight, triceps skinfold thickness, and upper arm circumference. An alternate method is suggested that compares these measurements with percentiles rather than, as in the current method, with percentages of the standard.

Validity of anthropometric norms used in the assessment of hospitalized patients.

To assess the validity of standards for weight, arm circumference, triceps skinfold, and arm muscle circumference commonly used to assess the nutritional status of hospitalized patients, these standards were applied to data for the normal U.S. population. Moderate depletion was defined as a value between 60 and 90 percent of the standard; severe depletion was defined as a value below 60 percent of the standard. The standards themselves were found to differ substantially from the population averages, and this method of classifying an individual does not take into account the fact that there is more variation in the population for some measures than for others. As a result, the proportion of individuals classified as depleted varied greatly between measures and also between sexes and ages. Over half of all young women would be classified as moderately depleted based on the arm muscle circumference. Over half of young men would be classified as depleted based on the tricep skinfold, and half of these would be classified as severely depleted. It is recommended that the use of these standards and this method of interpretation be abandoned and replaced by the use of tables of percentiles for the U.S. population.

Prevalence of upper respiratory pathogens in four management models for unowned cats in the Southeast United States.

Upper respiratory infection (URI) is a pervasive problem in cats and impacts the capacity and cost of sheltering programs. This study determined the pattern of respiratory pathogens in cats with and without clinical signs of URI in four different models for managing unowned cats, namely, (1) short-term animal shelters (STS), (2) long-term sanctuaries (LTS), (3) home-based foster care programs (FCP), and (4) trap-neuter-return programs for community cats (TNR). Conjunctival and oropharyngeal swabs from 543 cats, approximately half of which showed clinical signs of URI, were tested for feline herpes virus-1 (FHV), feline calicivirus (FCV), Chlamydia felis, Bordetella bronchiseptica, Mycoplasma felis, and canine influenza virus by real-time PCR. FHV (59%, 41%) and B. bronchiseptica (33%, 24%) were more prevalent in both clinically affected and nonclinical cats, respectively, in STS than other management models. FCV (67%, 51%) and M. felis (84%, 86%) were more prevalent in LTS than any other management model. Clinically affected cats in FCP were more likely to carry FHV (23%, 6%), C. felis (24%, 10%), or M. felis (58%, 38%) than were nonclinical cats. Clinically affected cats in TNR were more likely to carry FCV (55%, 36%) or C. felis (23%, 4%) than were nonclinical cats. The prevalence of individual pathogens varied between different management models, but the majority of the cats in each model carried one or more respiratory pathogens regardless of clinical signs. Both confined and free-roaming cats are at risk of developing infectious respiratory disease and their health should be protected by strategic vaccination, appropriate antibiotic therapy, effective biosecurity, feline stress mitigation, and alternatives to high-density confinement.

A community health practicum model for baccalaureate nursing students.

This article describes the evolution of a practicum for baccalaureate nursing students in a Department of Veterans Affairs home care program. The model includes direct patient care, support to caregivers, and assessment and referral to community resources. Students also assess communities and conduct teaching projects to targeted populations.