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1.
Rev Col Bras Cir ; 48: e20213123, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34468506

RESUMO

INTRODUCTION: the attraction of women by Surgery has always existed. Although Surgery has been considered a specialty for men, several women chose it, despite gender bias issues that have persisted over many years. Several obstacles have impacted the practice of women surgeons, leading them to abandon the profession, while others, perhaps bearers of a stronger spirit, managed to overcome them, and won. OBJECTIVE: to assess the rates of perception of harassment against female surgeons as a cause of difficulty and negative feelings related to the specialty. METHODS: we conducted a quantitative and qualitative (personal accounts) research through a questionnaire via Google Forms® sent to all women surgeons registered in the Brazilian College of Surgeons and in a WhatsApp women surgeons' groups. The qualitative analysis was made with the Wordle® app. RESULTS: from 821 questionnaires sent, we obtained 232 responses (28.2%). Harassment perception during training was 49.1% (n=114). From the women surgeons who perceived harassment, 56.1% reported having undergone different training than expected, with statistical significance (p<0.001). The question of having been treated differently due to being a woman also had an impact on harassment perception (77.2% harassed vs 47.5%; p<0.001). Physical (42.1% vs 6.8%) and emotional (92.1% vs 39.8%) threats were also different between groups. CONCLUSION: women surgeons still report great harassment perception, both moral and sexual, which impacts their feelings about the specialty.


Assuntos
Assédio Sexual , Cirurgiões , Feminino , Humanos , Masculino , Percepção , Sexismo , Inquéritos e Questionários
2.
Clin Nutr ; 40(9): 5114-5121, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34461585

RESUMO

BACKGROUND & AIMS: Across the globe, the prevalence of hospital malnutrition varies greatly depending on the population served and on local socioeconomic conditions. While malnutrition is widely recognized to worsen patient outcomes and add financial burdens to healthcare systems, recent data on hospital malnutrition in Latin America are limited. Our study objectives were: (1) to quantify the prevalence of malnutrition risk in Latin American hospital wards, and (2) to explore associations between nutritional risk status, in-hospital food intake, and health outcomes. METHODS: On nutritionDay (nDay), a specific day every year, hospital wards worldwide can participate in a one-day, cross-sectional audit. We analyzed nDay data collected in ten Latin American countries from 2009 to 2015, including demographic and nutrition-related findings for adult patients (≥18 years) from 582 hospital wards/units. Based on patient-reported responses to questions related to the Malnutrition Screening Tool, we determined the prevalence of malnutrition risk (MST score ≥2). We also summarized patient-reported food intake on nDay, and we analyzed staff-collected outcome data at 30 days post-nDay. RESULTS: The prevalence of malnutrition risk in the Latin American nDay study population (N = 14,515) was 39.6%. More than 50% of studied patients ate one-half or less of their hospital meal, ate less than normal in the week before nDay, or experienced weight loss in the prior three months. The hospital-mortality hazard ratio was 3.63 (95% CI [2.71, 4.88]; P < 0.001) for patients eating one-quarter of their meal (compared with those who ate the full meal), increasing to 6.6 (95% CI [5.02, 8.7]; P < 0.0001) for patients who ate none of the food offered. CONCLUSIONS: Based on compilation of nDay surveys throughout Latin America, 2 of every 5 hospitalized patients were at risk for malnutrition. The associated risk for hospital mortality was up to 6-fold higher among patients who ate little or none of their meal on nDay. This high prevalence showed scant improvement over rates two decades ago-a compelling rationale for new focus on nutrition education and training of professionals in acute care settings.


Assuntos
Dieta/mortalidade , Mortalidade Hospitalar/tendências , Hospitais/estatística & dados numéricos , Pacientes Internados/estatística & dados numéricos , Desnutrição/mortalidade , Adulto , Idoso , Estudos Transversais , Ingestão de Alimentos , Feminino , Humanos , América Latina/epidemiologia , Masculino , Desnutrição/diagnóstico , Refeições , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estado Nutricional , Avaliação de Resultados em Cuidados de Saúde , Prevalência , Modelos de Riscos Proporcionais , Medição de Risco , Perda de Peso , Adulto Jovem
3.
Clin Nutr ESPEN ; 42: 195-200, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33745577

RESUMO

BACKGROUND AND AIM: In Mexico, about half of hospitalized patients are malnourished or at risk of malnutrition upon hospital admission, while many others experience deterioration of their nutritional status while in the hospital. Such patients often experience poor health outcomes and have increased hospital costs. The aim of our budget-impact analysis was to estimate potential savings associated with the implementation of a Mexican hospital-based program of nutrition care for patients at malnutrition risk or malnourished. METHODS: The budget-impact model was based on data published previously. Our model compared patients assigned to receive individualized early nutrition therapy (initiated within 24-48 h of hospital admission) with those who received standard delayed nutrition therapy (not initiated early). Outcomes included length of stay, infectious complications, and 30-day readmissions. We modeled a 30-day time-horizon, estimated event probabilities on the basis of published data, and projected costs in 2020 US dollars. RESULTS: Average total healthcare costs over 30-days were $3527 for patients with early nutrition therapy vs $6032 for patients with standard nutrition therapy-a savings of $2505 per early nutrition-treated patient (41.5% lower). Cost differences between the groups were $2336 vs $3065 for hospital-associated costs (23.8% lower), $262 vs $780 for 30-day readmissions (66.4% lower) and $1348 for malnutrition-associated infections. Applying these potential savings from individualized early nutrition care to a one-year estimate of 3.22 million Mexican hospital patients with malnutrition or its risk, the total overall savings for public health expenditures was equivalent to $8.1 billion per year or 32.1% of total healthcare expenditures. CONCLUSIONS: The results demonstrated the potential for hospital-based nutrition care programs to reduce costs of patient hospitalizations. These notable findings provide a rationale for Mexican healthcare institutions to implement programs of comprehensive nutrition-focused care for inpatients with malnutrition or its risk. To this end, we advise implementation of professional programs for education and training in order to increase awareness of patients' nutritional needs and to better prepare clinical personnel to identify, treat, and monitor patients at-risk/malnourished.


Assuntos
Desnutrição , Terapia Nutricional , Atenção à Saúde , Hospitais , Humanos , Desnutrição/epidemiologia , Desnutrição/terapia , Estado Nutricional
4.
Rev. Col. Bras. Cir ; 48: e20213123, 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1351525

RESUMO

ABSTRACT Introduction: the attraction of women by Surgery has always existed. Although Surgery has been considered a specialty for men, several women chose it, despite gender bias issues that have persisted over many years. Several obstacles have impacted the practice of women surgeons, leading them to abandon the profession, while others, perhaps bearers of a stronger spirit, managed to overcome them, and won. Objective: to assess the rates of perception of harassment against female surgeons as a cause of difficulty and negative feelings related to the specialty. Methods: we conducted a quantitative and qualitative (personal accounts) research through a questionnaire via Google Forms® sent to all women surgeons registered in the Brazilian College of Surgeons and in a WhatsApp women surgeons' groups. The qualitative analysis was made with the Wordle® app. Results: from 821 questionnaires sent, we obtained 232 responses (28.2%). Harassment perception during training was 49.1% (n=114). From the women surgeons who perceived harassment, 56.1% reported having undergone different training than expected, with statistical significance (p<0.001). The question of having been treated differently due to being a woman also had an impact on harassment perception (77.2% harassed vs 47.5%; p<0.001). Physical (42.1% vs 6.8%) and emotional (92.1% vs 39.8%) threats were also different between groups. Conclusion: women surgeons still report great harassment perception, both moral and sexual, which impacts their feelings about the specialty.


RESUMO Introdução: a atração das mulheres pela Cirurgia sempre existiu. Embora a Cirurgia seja considerada especialidade para homens, várias mulheres a escolheram, apesar de questões de preconceito de gênero que têm se mantido ao longo de vários anos. Vários obstáculos têm impactado na prática das cirurgiãs, levando-as a abandonar a profissão, mas outras, talvez, as de espírito mais forte, conseguiram superá-los e venceram. Objetivo: avaliar a taxas de percepção de assédio contra cirurgiãs como causa de dificuldade e sentimentos negativos relacionados com a especialidade. Método: pesquisa, quantitativa e qualitativa (relatos pessoais), realizada por meio de questionário via Google Forms® enviado para todas as cirurgiãs registradas no Colégio Brasileiro de Cirurgiões e em grupo WhatsApp de cirurgiãs. A análise qualitativa foi feita com o aplicativo Wordle®. Resultados: Foram enviados 821 questionários e obtidas 232 respostas (28,2%). A percepção de assédio durante o treinamento foi de 49.1% (n=114). As cirurgiãs com percepção de assédio foram estatisticamente aquelas que reportaram ter tido treinamento diferente do que ansiavam (56,1%) (p<0,001). O quesito tratamento distinto por ser mulher também impactou na percepção do assédio (77,2% assediadas vs 47,5%; p<0,001). Ameaça física (42,1% vs 6,8%) e emocional (92,1% vs 39,8%) também foram distintas entre os grupos. Conclusão: cirurgiãs ainda reportam grande percepção de assédio moral e sexual, o que impacta na forma de encarar a profissão.


Assuntos
Humanos , Masculino , Feminino , Assédio Sexual , Cirurgiões , Percepção , Inquéritos e Questionários , Sexismo
5.
JPEN J Parenter Enteral Nutr ; 44(8): 1369-1375, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32833241

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has reached worldwide, and until a vaccine is found, it will continue to cause significant morbidity and mortality. The clinical presentation of COVID-19 ranges from that of being asymptomatic to developing a fatal illness characterized by multiple organ involvement. Approximately 20% of the patients will require hospitalization; one-quarter of hospitalized patients will develop severe COVID-19 requiring admission to the intensive care unit, most frequently, with acute respiratory failure. An ongoing effort is being made to identify the patients that will develop severe COVID-19. Overall, patients present with 3 different phenotypes of nutrition risk: (1) the frail older patient, (2) the patient with severe ongoing chronic illness, and (3) the patient with severe and morbid obesity. These 3 phenotypes represent different nutrition risks and diverse nutrition interventions. This article explores the different potential approaches to nutrition intervention in patients with COVID-19, evaluating, in this process, the challenges faced in the implementation of guidelines written by different societies.


Assuntos
COVID-19/terapia , Cuidados Críticos , Fragilidade , Terapia Nutricional , Estado Nutricional , Apoio Nutricional , Obesidade , Idoso , Doença Crônica , Coronavirus , Estado Terminal , Idoso Fragilizado , Hospitalização , Humanos , Unidades de Terapia Intensiva , Desnutrição/prevenção & controle , Pandemias , Guias de Prática Clínica como Assunto , Medição de Risco , Índice de Gravidade de Doença
7.
JPEN J Parenter Enteral Nutr ; 44(6): 992-1003, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32529700

RESUMO

BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) created a consensus-based framework consisting of phenotypic and etiologic criteria to record the occurrence of malnutrition in adults. This is a minimum set of practicable indicators for use in characterizing a patient/client as malnourished, considering the global variations in screening and nutrition assessment, and to be used across different healthcare settings. As with other consensus-based frameworks for diagnosing disease states, these operational criteria require validation and reliability testing, as they are currently based solely on expert opinion. METHODS: Several forms of validation and reliability are reviewed in the context of GLIM, providing guidance on how to conduct retrospective and prospective studies for criterion and construct validity. RESULTS: There are some aspects of GLIM that require refinement; research using large databases can be employed to reach this goal. Machine learning is also introduced as a potential method to support identification of the best cut points and combinations of indicators for use with the different forms of malnutrition, which the GLIM criteria were created to denote. It is noted as well that validation and reliability testing need to occur in a variety of sectors and populations and with diverse persons using GLIM criteria. CONCLUSION: The guidance presented supports the conduct and publication of quality validation and reliability studies for GLIM.


Assuntos
Desnutrição Proteico-Calórica , Adulto , Humanos , Liderança , Desnutrição/diagnóstico , Estado Nutricional , Estudos Prospectivos , Desnutrição Proteico-Calórica/diagnóstico , Reprodutibilidade dos Testes , Estudos Retrospectivos
9.
Rev Col Bras Cir ; 47: e20202536, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32236295

RESUMO

The current world Covid-19 pandemic has been the most discussed topic in the media and scientific journals. Fear, uncertainty, and lack of knowledge about the disease may be the significant factors that justify such reality. It has been known that the disease presents with a rapidly spreading, it is significantly more severe among the elderly, and it has a substantial global socioeconomic impact. Besides the challenges associated with the unknown, there are other factors, such as the deluge of information. In this regard, the high number of scientific publications, encompassing in vitro, case studies, observational and randomized clinical studies, and even systematic reviews add up to the uncertainty. Such a situation is even worse when considering that most healthcare professionals lack adequate knowledge to critically appraise the scientific method, something that has been previously addressed by some authors. Therefore, it is of utmost importance that expert societies supported by data provided by the World Health Organization and the National Health Department take the lead in spreading trustworthy and reliable information. The Brazilian College of Surgeons suggests in this document various initiatives that may help surgeons, healthcare providers, and patients who will have to face a surgical event under the pandemic.


A atual pandemia do novo coronavírus, Covid-19, tem sido o assunto mais discutido no momento, tanto na mídia como em periódicos científicos. O medo, a incerteza e o desconhecimento sobre o comportamento da doença são os fatores preponderantes que podem justificar essa realidade. Sabe-se de antemão que a enfermidade tem grande disseminação, é mais grave entre idosos e está associada a grande impacto socioeconômico mundial. Além dos desafios em lidar com o desconhecido, há outros relacionados com a sobrecarga de informação e nesse quesito, a grande quantidade de estudos científicos, que englobam pesquisas in vitro, relatos de casos, estudos observacionais e randomizados, além de revisões sistemáticas complementam o panorama de dúvidas. Essa situação é piorada porque o conhecimento sobre o método científico não é dominado pela maioria dos profissionais de saúde, algo que há muito já vem sendo divulgado por vários autores. De sorte que em função desta realidade, torna-se fundamental que sociedades de especialidades apoiadas por dados da Organização Mundial da Saúde e do Ministério da Saúde assumam a liderança da divulgação da informação correta e confiável. O Colégio Brasileiro de Cirurgiões sugere neste documento medidas que podem auxiliar cirurgiões e outros profissionais de saúde, assim como pacientes, em caso de necessidade cirúrgica, a lidar com a atual pandemia.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Cirurgiões , Procedimentos Cirúrgicos Operatórios/normas , Brasil/epidemiologia , COVID-19 , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/normas , Humanos , Pneumonia Viral/epidemiologia , Fatores de Risco
10.
Clin Nutr ; 39(9): 2896-2901, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917050

RESUMO

BACKGROUND & AIMS: Between 30 and 50% of Colombian patients are malnourished or at-risk of malnutrition on hospital admission. Malnutrition is associated with poor outcomes and increased costs. We used cost modeling to estimate savings that could be derived from implementation of a nutrition therapy program for patients at malnutrition risk. METHODS: The budget impact analysis was performed using previously-published outcomes data. Outcomes included length of stay, 30-day readmissions, and infectious/non-infectious complications. We developed a Markov model that compared patients who were assigned to receive early nutrition therapy (started within 24-48 h of hospital admission) with those assigned to receive standard nutrition therapy (not started early). Our model used a 60-day time-horizon and estimated event probabilities based on published data. RESULTS: Average total costs over 60 days were $3770 US dollars for patients with delayed nutrition therapy vs $2419 for patients with early nutrition therapy-a savings of $1351 (35.8% decrease) per nutrition-treated patient. Cost differences between the groups were: $2703 vs $1600 for hospital-associated costs; $883 vs $665 for readmissions; and $176 vs $94 for complications. Taken broadly, the potential costs savings from a nutrition care program for an estimated 638,318 hospitalized Colombian patients at malnutrition risk is $862.6 million per year. CONCLUSIONS: Our budget impact analysis demonstrated the potential for hospital-based nutrition care programs to improve health outcomes and reduce healthcare costs for hospitalized patients in Colombia. These findings provide a rationale for implementing comprehensive nutrition care in Colombian hospitals.


Assuntos
Hospitalização/estatística & dados numéricos , Desnutrição/prevenção & controle , Desnutrição/terapia , Terapia Nutricional/métodos , Colômbia , Redução de Custos , Análise Custo-Benefício , Custos de Cuidados de Saúde , Custos Hospitalares/estatística & dados numéricos , Hospitalização/economia , Humanos , Tempo de Internação , Desnutrição/economia , Terapia Nutricional/economia , Estado Nutricional , Readmissão do Paciente/economia , Readmissão do Paciente/estatística & dados numéricos , Quinolinas
11.
Nutrition ; 69: 110581, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31622908

RESUMO

Malnutrition is a common comorbidity in patients with cancer, with determinants linked to the patients, the tumor, and the treatment. Cancer malnutrition, also called cachexia, represents the chronic form of disease-related malnutrition with chronic inflammation, and strongly impairs the prognosis. Reduced muscle mass, otherwise called sarcopenia in these patients, is a feature of malnutrition and thus of cancer cachexia that may appear before weight loss, and has a strong negative effect on prognosis, as well. The reported global prevalence of loss of muscle mass is 39%, whereas the prevalence of malnutrition in important cohorts varies from 25% to 70%. This is mostly due to the very different screening and diagnostic tools used throughout the world. The recent Global Leadership Initiative on Malnutrition has become a consensus alternative to standardize how malnutrition may be diagnosed based on etiologic and phenotypic criteria available everywhere, from rich to poor countries. This will lead to an easier diagnosis of cancer malnutrition that itself will help us speak the same language worldwide.


Assuntos
Caquexia/epidemiologia , Saúde Global/estatística & dados numéricos , Desnutrição/epidemiologia , Neoplasias/complicações , Sarcopenia/epidemiologia , Caquexia/etiologia , Humanos , Desnutrição/etiologia , Prevalência , Sarcopenia/etiologia , Perda de Peso
12.
Clin Nutr ; 39(3): 705-707, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31029478

RESUMO

This opinion paper aims at discussing the deluge of meta-analyses in current health sciences, and the publication of seven different ones covering diverse topics in nutrition sciences in the December issue of Clinical Nutrition. Several key aspects are raised regarding this type of study with the goal of raising awareness among clinicians who rely on these studies to summarize what they assume it is the best evidence towards application to patient care.


Assuntos
Metanálise como Assunto , Ciências da Nutrição/métodos , Humanos
14.
Rev. Col. Bras. Cir ; 47: e20202536, 2020. graf
Artigo em Português | LILACS | ID: biblio-1091924

RESUMO

RESUMO A atual pandemia do novo coronavírus, Covid-19, tem sido o assunto mais discutido no momento, tanto na mídia como em periódicos científicos. O medo, a incerteza e o desconhecimento sobre o comportamento da doença são os fatores preponderantes que podem justificar essa realidade. Sabe-se de antemão que a enfermidade tem grande disseminação, é mais grave entre idosos e está associada a grande impacto socioeconômico mundial. Além dos desafios em lidar com o desconhecido, há outros relacionados com a sobrecarga de informação e nesse quesito, a grande quantidade de estudos científicos, que englobam pesquisas in vitro, relatos de casos, estudos observacionais e randomizados, além de revisões sistemáticas complementam o panorama de dúvidas. Essa situação é piorada porque o conhecimento sobre o método científico não é dominado pela maioria dos profissionais de saúde, algo que há muito já vem sendo divulgado por vários autores. De sorte que em função desta realidade, torna-se fundamental que sociedades de especialidades apoiadas por dados da Organização Mundial da Saúde e do Ministério da Saúde assumam a liderança da divulgação da informação correta e confiável. O Colégio Brasileiro de Cirurgiões sugere neste documento medidas que podem auxiliar cirurgiões e outros profissionais de saúde, assim como pacientes, em caso de necessidade cirúrgica, a lidar com a atual pandemia.


ABSTRACT The current world Covid-19 pandemic has been the most discussed topic in the media and scientific journals. Fear, uncertainty, and lack of knowledge about the disease may be the significant factors that justify such reality. It has been known that the disease presents with a rapidly spreading, it is significantly more severe among the elderly, and it has a substantial global socioeconomic impact. Besides the challenges associated with the unknown, there are other factors, such as the deluge of information. In this regard, the high number of scientific publications, encompassing in vitro, case studies, observational and randomized clinical studies, and even systematic reviews add up to the uncertainty. Such a situation is even worse when considering that most healthcare professionals lack adequate knowledge to critically appraise the scientific method, something that has been previously addressed by some authors. Therefore, it is of utmost importance that expert societies supported by data provided by the World Health Organization and the National Health Department take the lead in spreading trustworthy and reliable information. The Brazilian College of Surgeons suggests in this document various initiatives that may help surgeons, healthcare providers, and patients who will have to face a surgical event under the pandemic.


Assuntos
Humanos , Pneumonia Viral/prevenção & controle , Procedimentos Cirúrgicos Operatórios/normas , Guias de Prática Clínica como Assunto , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Cirurgiões , Pneumonia Viral/epidemiologia , Brasil/epidemiologia , Fatores de Risco , Pessoal de Saúde/normas , Infecções por Coronavirus/epidemiologia
16.
JPEN J Parenter Enteral Nutr ; 43(1): 32-40, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30175461

RESUMO

BACKGROUND: This initiative aims to build a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. METHODS: The Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. Empirical consensus was reached through a series of face-to-face meetings, telephone conferences, and e-mail communications. RESULTS: A 2-step approach for the malnutrition diagnosis was selected, that is, first screening to identify at risk status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. Potential criteria were subjected to a ballot among GLIM participants that selected 3 phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and 2 etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least 1 phenotypic criterion and 1 etiologic criterion should be present. Phenotypic metrics for grading severity are proposed. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. The recommended approach supports classification of malnutrition into four etiology-related diagnosis categories. CONCLUSIONS: A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The construct should be re-considered every 3-5 years.


Assuntos
Consenso , Desnutrição/diagnóstico , Programas de Rastreamento , Avaliação Nutricional , Estado Nutricional , Guias de Prática Clínica como Assunto , Adulto , Idoso , Índice de Massa Corporal , Caquexia/diagnóstico , Feminino , Humanos , Liderança , Masculino , Desnutrição/etiologia , Pessoa de Meia-Idade , Músculos , Fenótipo , Sarcopenia/diagnóstico , Sociedades Científicas , Perda de Peso
20.
J Am Med Dir Assoc ; 15(8): 544-50, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24997720

RESUMO

The prevalence of malnutrition ranges up to 50% among patients in hospitals worldwide, and disease-related malnutrition is all too common in long-term and other health care settings as well. Regrettably, the numbers have not improved over the past decade. The consequences of malnutrition are serious, including increased complications (pressure ulcers, infections, falls), longer hospital stays, more frequent readmissions, increased costs of care, and higher risk of mortality. Yet disease-related malnutrition still goes unrecognized and undertreated. To help improve nutrition care around the world, the feedM.E. (Medical Education) Global Study Group, including members from Asia, Europe, the Middle East, and North and South America, defines a Nutrition Care Pathway that is simple and can be tailored for use in varied health care settings. The Pathway recommends screen, intervene, and supervene: screen patients' nutrition status on admission or initiation of care, intervene promptly when needed, and supervene or follow-up routinely with adjustment and reinforcement of nutrition care plans. This article is a call-to-action for health caregivers worldwide to increase attention to nutrition care.


Assuntos
Procedimentos Clínicos , Prática Clínica Baseada em Evidências , Pacientes Internados , Transtornos Nutricionais/prevenção & controle , Melhoria de Qualidade , Saúde Global , Humanos , Terapia Nutricional , Estado Nutricional , Cultura Organizacional
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