Perceptions of Malawian nurses about nursing interventions for malnourished children and their parents.

In developing countries, malnutrition among children is a major public-health issue. The aim of the study was to describe perceptions of Malawian nurses about nursing interventions for malnourished children and their parents. A qualitative method was used. Data were collected and analyzed according to the phenomenographic research approach. Twelve interviews were performed with 12 nurses at a rural hospital in northern Malawi, Southeast Africa. Through the analysis, two major concepts, comprising four categories of description, emerged: managing malnutrition today and promotion of a favourable nutritional status. The categories of description involved identification and treatment of malnutrition, education during treatment, education during prevention, and assurance of food security. The participating nurses perceived education to be the most important intervention, incorporated in all areas of prevention and treatment of malnutrition. Identification and treatment of malnutrition, education during treatment, education to prevent malnutrition, and assurance of food security were regarded as the most important areas of intervention.

Weight loss, body fat mass, and leptin in Parkinson's disease.

Weight loss is a common problem in Parkinson's disease (PD), but the causative mechanisms behind this weight loss are unclear. We compared 26 PD patients with sex and age matched healthy controls. Examinations were repeated at baseline, after one and after two years. Body fat mass was measured by Dual X-ray Absorptiometry (DXA). Seventy three per cent of the PD patients lost body weight. Loss of body fat mass constituted a considerable part of the loss of body weight. In the patients who lost weight, serum leptin levels were lower than in those who did not lose weight. The relationship between low body fat mass and low leptin levels seems to be relevant, at least for female PD patients. It is reasonable to believe that low leptin levels in these patients could be secondary to the decreased body fat mass.

Avoidance of solid food in weight losing older patients with Parkinson's disease.

AIM: The aim of this paper was to investigate to what extent parkinsonian symptoms, including mild dysphagia and other eating problems, could influence the choice of consistency and the amount of food intake and if this could be related to weight loss as an expression of the underlying neurodegenerative process. BACKGROUND: Previous studies show that patients with Parkinson's disease tend to lose body weight even early during the disease. DESIGN: The design was a longitudinal prospective study. METHODS: Twenty-six free-living Parkinson's disease patients and 26 age- and sex-matched controls were investigated twice, with one-year apart, with focus on Parkinson's disease symptoms, as well as swallowing function. Intake of food items and food consistency were assessed by food records, completed over three consecutive days at each investigation. RESULTS: In patients with weight loss, motor symptoms, problems with activities of daily living and problems with eating, related to motor symptoms, increased and they had more dysphagia compared with their controls. They consumed lower amounts of fluid and solid food on both investigated occasions, compared with their controls. Multiple regression analysis showed that weight loss was associated with female gender, eating difficulties related to activities of daily living and preference towards soft food, but negatively correlated with age. CONCLUSION: Parkinson's disease patients with weight loss seemed to avoid solid food, partly because of eating difficulties. Eating problems, as well as weight loss, could be because of the underlying disease, even when it is not at an advanced stage. RELEVANCE TO CLINICAL PRACTICE: Caring for patients with Parkinson's disease should not only include medical treatment, but also support for adequate food intake to prevent weight loss.

Estimation of energy intake in clinical practice: a comparison between a food record protocol and a precoded food record book.

The aim of this study was to compare energy intake estimated from a clinical food record protocol (CFRP) with that from a precoded food record book (PFRB) as reference method. Food and fluid consumption were recorded in 10 older patients using a CFRP in parallel with a PFRB during a 6-day period. The results showed that there were no significant differences in mean energy intake estimated from the CFRP as compared with that estimated from the PFRB. The correlation coefficient between the calculated daily energy intake from the CFRP and PFRB was 0.96. The differences in energy intake (kcal/day) between the CFRP and PFRB, plotted against their mean value for 10 patients, showed that results were within the limits of agreement (mean +/- 2SD) for nine patients. The differences in each day's energy intake between the two methods plotted against their mean value showed that 97% of the estimated daily energy intake was within the limits of agreement. The weighted kappa between the two methods was 0.76. The CFRP would seem to be acceptable for the estimation of mean energy intake in the hospital setting.

Eating difficulties, assisted eating and nutritional status in elderly (> or = 65 years) patients in hospital rehabilitation.

This study describes frequencies and associations between eating difficulties, assisted eating and nutritional status in 520 elderly patients in hospital rehabilitation. Eating difficulties were observed during a meal and nutritional status was assessed with Subjective Global Assessment form. Eighty-two percent of patients had one or more eating difficulties, 36% had assisted eating and 46% malnutrition. Three components of eating were focused upon ingestion, deglutition, and energy (eating and intake). Deglutition and ingestion difficulties and low energy were associated with assisted eating, and low energy associated with malnutrition. Underestimation of low energy puts patients at risk of having or developing malnutrition.