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1.
J Affect Disord ; 344: 510-518, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37852584

RESUMO

BACKGROUND: The reward/circadian rhythm model of bipolar spectrum disorders (BSDs) posits that when individuals with hypersensitive reward systems encounter reward-relevant events, they experience social and circadian rhythm disruption, leading to mood symptoms. The aim of the current study is to test an element of this theoretical model by investigating changes in social rhythms during and after an ecologically-valid reward-relevant event and evaluating whether the strength of these associations differ by trait reward sensitivity and BSD diagnostic group. METHODS: Young adults from three groups (low BSD risk with moderate reward sensitivity [MRew], high BSD risk with high reward sensitivity [HRew], and high reward sensitivity with BSD [HRew+BSD]) completed a reward responsiveness task and 20-day ecological momentary assessment study structured around a participant-specific goal occurring on day 15. Social rhythm disruption (SRD) and social rhythm regularity (SRR) were assessed daily. Multilevel models examined whether reward sensitivity and group moderated associations between study phase (baseline [days 1-5], goal-striving [days 16-20], or outcome [days 16-20]) and social rhythms. RESULTS: Participants experienced greater SRD after the goal-striving event during the outcome phase, compared to the baseline phase. The HRew+BSD group had significant decreases in SRR during the outcome phase, and this pattern differed significantly from the low-risk and high-risk groups. Greater task reward responsiveness also was associated with significant decreases in SRR during the outcome phase. LIMITATIONS: This study did not test whether social rhythm irregularity was associated with subsequent mood change. CONCLUSIONS: Participants exhibited social rhythm changes over the course of this ecologically valid goal-striving period, providing evidence for the interplay between reward-activating events and social rhythms. The HRew+BSD group showed a distinct pattern in which their social rhythms were more irregular after completing reward-relevant goal-striving that was not observed for the low-BSD risk or high-BSD risk groups. These findings provide additional support for Interpersonal and Social Rhythms Therapy.


Assuntos
Transtorno Bipolar , Adulto Jovem , Humanos , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/terapia , Objetivos , Avaliação Momentânea Ecológica , Motivação , Recompensa
2.
Appl Ergon ; 114: 104136, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37716079

RESUMO

A firefighter's situation awareness (SA) is considered crucial to making effective tactical decisions and actions at the scene. Despite the importance of the firefighter's SA, there have been limited research efforts to understand what cues and information firefighters use to assess ongoing situations and predict future conditions. In addition to fire events, contemporary firefighters respond to an increasing volume of non-fire incidents. Thus, this study aims to identify firefighters' SA during three fire incidents (single house fire, vehicle fire, and passenger aircraft fire) and three non-fire incidents (medical emergency, hazardous materials, and urban search and rescue). A goal-directed task analysis was conducted via focus group discussions with eight career firefighters. Findings indicate that firefighters build their SA by processing various cues from hazards (e.g., fire, ignition source), humans (e.g., occupants, bystanders, drivers, passengers), spatial elements (e.g., building structure, location of hazards), and surrounding conditions (e.g., traffic, weather). Our findings provide insights into SA measurement, SA-oriented work processes, training for SA, and designing technologies to support firefighters' SA during all-hazard responses.


Assuntos
Bombeiros , Incêndios , Exposição Ocupacional , Humanos , Objetivos , Conscientização , Emergências , Grupos Focais
3.
Ann Ig ; 36(1): 60-71, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37724579

RESUMO

Background: Universities are critical in educating tomorrow's citizens and achieving the Sustainable Development Goals of the United Nations Organization. The aim of this study was to investigate the integration of these goals in the curricula of an Italian university. Study design: Cross-sectional study. Methods: In February 2021, as part of the annual Syllabus preparation for each course, the teaching staffs at the University of Udine (Italy) were asked to complete an additional section in which they could indicate up to three Sustainable Development Goals for their courses. Descriptive statistics, Chi-square test and logistic regression were performed to determine whether the professors' sex, age, or department affected the likelihood of mentioning Sustainable Development Goals. Results: In 723 courses, 360/1040 professors 59% male, mean age 53 years (range 30-73), mentioned one (29%), two (23%), or three (31%) Sustainable Development Goals. No Sustainable Development Goals were mentioned in 16% of courses, the majority of which were from the Mathematical, Computer and Physical Sciences Department (58%). The top six Sustainable Development Goals quoted were: Good health and well-being (35%), Responsible consumption and production (22%), Quality education (17%), Industry, innovation and infrastructure (13%), Gender equality (13%), Decent work and economic growth (13%). The least frequently mentioned Goal was Life below water (1%). Women (p<0.0001) and senior professors (p=0.0148) were more likely to consider at least one of the Sustainable Development Goals, while Mathematical, Computer and Physical Sciences Department showed a negative correlation (p<0.0001). Conclusions: Gaps were identified with respect to specific Sustainable Development Goals, but discrepancies between departments may indicate deficits in respondent awareness. A transparent description of the Sustainable Development Goals in courses is recommended, to increase students' and university's engagement in sustainability.


Assuntos
Estudantes , Desenvolvimento Sustentável , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Universidades , Estudos Transversais , Itália , Objetivos
4.
J Environ Manage ; 349: 119458, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37918233

RESUMO

Anaerobic Digestion (AD) technology emerges as a viable solution for managing municipal organic waste, offering pollution reduction and the generation of biogas and fertilisers. This study reviews the research works for the advancements in AD implementation to effectively impact the UN Sustainable Development Goals (SDGs). Furthermore, the study critically analyses responsible waste management that contributes to health and safety, elevating quality of life in both rural and urban areas and, finally, creates a map of AD outputs onto all 17 SDGs. Finally, the assessment employs the three sustainability pillars (i.e., economic, environmental, and social perspectives) to examine the direct and indirect links between AD and all 17 UN SDGs. The findings reveal substantial progress, such as poverty reduction through job creation, bolstering economic growth (SDGs 1, 8, 10, 12), enhancing agricultural productivity (SDG 2), advancing renewable energy usage and diminishing reliance on fossil fuels (SDG 7), fostering inclusive education and gender equality (SDGs 4, 5, 9), combating climate change (SDG 13), transforming cities into sustainable and harmonious environments (SDGs 11, 16, 17), and curbing environmental pollution (SDGs 3, 6, 12, 14, 15). Nonetheless, the study highlights the need for further efforts to achieve the SDG targets, particularly in part of liquid and solid fertilisers as the AD outputs.


Assuntos
Qualidade de Vida , Desenvolvimento Sustentável , Anaerobiose , Fertilizantes , Cidades , Objetivos
5.
J Palliat Care ; 39(1): 3-12, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36594209

RESUMO

Objective: This study aims to evaluate the potential impact of addressing goals-of-care (GOC) with selected patients in the emergency department (ED), GOC documentation, hospital utilization, and patient satisfaction. Method: This is a single-center, retrospective, and prospective, observational convenience-sample study. ED registered nurses (ED RNs) received standardized GOC conversation training. Their selection criteria included a selection interview, a minimum of 3 years of ED clinical experience, and current employment in the ED. ED RNs used a standardized GOC questionnaire. Patient inclusion criteria included age ≥18 years and one or more of the following: chronic kidney disease ≥ stage III, congestive heart failure with an ejection fraction ≤ 40%, chronic obstructive pulmonary disease with home oxygen use, and/or malignancy with metastasis. GOC conversations were recorded in the electronic medical record (EMR). Physician Orders for Life-Sustaining Treatment (POLST) forms were completed as appropriate. Select individual patient data for the 12 months prior to the conversation were compared with the following 12 months. Results: Over 6 months, 94 of 133 patients who were approached consented to the GOC discussion with the RN. All 94 enrolled patients had their GOC recorded into the EMR. One-third already had a completed POLST form prior to ED arrival. 50% without a POLST on ED arrival left with a completed POLST. Eighty-four patients survived the index visit and 46 patients survived to study completion. Patient satisfaction with the interaction was high: In the cohort who survived past the index visit, 95% rated their experience at 4/5 or 5/5 (Likert scale, 5: strongly agree, 1: strongly disagree). In the survival-to-study completion cohort, 100% rated their experience as 4/5 or 5/5. Subsequent median ED visits decreased by 15% (1.0-4.0 interquartile range). There were no statistically significant changes in hospitalizations (both decreased by 25%, 0-3.0) or intensive care unit admissions (0%, 0-0). Conclusions: An ED RN-led GOC conversation had high patient satisfaction and 100% GOC documentation in the EMR. There was a significant increase in ED POLST form completion. There were no significant changes noted in subsequent hospitalizations, length of hospitalization, or intensive care unit utilization.


Assuntos
Planejamento Antecipado de Cuidados , Objetivos , Adolescente , Humanos , Comunicação , Serviço Hospitalar de Emergência , Planejamento de Assistência ao Paciente , Estudos Prospectivos , Estudos Retrospectivos , Adulto
8.
Dev Med Child Neurol ; 66(1): 70-81, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37431682

RESUMO

AIM: To evaluate the factor structure of the 49 goal prioritization questions of the Gait Outcome Assessment List (GOAL). METHOD: This was a retrospective review of 622 consecutive individuals diagnosed with cerebral palsy (median = 11 years 2 months, SD = 6 years 0 months, 370 male), who underwent a routine clinical gait analysis at a specialty center and completed the validated GOAL. To assess dimensionality, we performed exploratory and confirmatory factor analyses on the goal ratings of its 49 gait-related items. For internal consistency, we calculated Cronbach's alpha. We created standardized goal scores for each factor and determined floor and ceiling effects according to the Gross Motor Function Classification System (GMFCS). RESULTS: Factor analyses suggested that the GOAL's 49 goal prioritization items represented eight factors, one more than the original GOAL validation because pain and fatigue were separated into distinct factors. Cronbach alphas were acceptably high (≥0.80) across factors except for use of braces and mobility aids (α = 0.68). Goal importance varied across domains and GMFCS levels. INTERPRETATION: The GOAL can be expanded as a tool to better understand goal priorities in ambulatory individuals with cerebral palsy. These scores can be used to guide clinical conversations and provide more focus than previously available when faced with 49 individual goals. Scores can also be aggregated across relevant populations for larger-scale studies. WHAT THIS PAPER ADDS: The goal items of the Gait Outcomes Assessment List (GOAL) can be reduced into eight goal domains. Pain and fatigue represent distinct goal domains. The level of goal importance varies across GOAL domains and Gross Motor Function Classification System levels.


Assuntos
Paralisia Cerebral , Humanos , Masculino , Objetivos , Marcha , Avaliação de Resultados em Cuidados de Saúde , Dor
10.
Behav Brain Res ; 458: 114761, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-37977341

RESUMO

In laboratory animals, there are numerous demonstrations that past exposure to drugs of abuse can lead to devaluation impairments weeks after the final drug exposure, with the majority of these demonstrations examining effects of exposure to psychostimulants. There has been minimal investigation into whether prior exposure to opiates can lead to devaluation impairments. Here, we first trained female rats that two separate cuelights predicted two different foods and measured Pavlovian goal-tracking responses (Experiment 1) or trained female rats to press two levers to earn two different foods and measured this operant response (Experiment 2). In both experiments, we subsequently gave the rats injections of fentanyl twice daily for 6 days, and then tested rats for conditioned responses after satiation on one of the foods 48-h after the final injection. We found that rats were impaired in the expression of devaluation in the Pavlovian task after fentanyl exposure, but were unimpaired in the expression of devaluation in the operant task. The pattern of results is most consistent with an impairment in lateral orbitofrontal cortex function, but additional research is needed to determine the neurobiological cause of this pattern of results.


Assuntos
Estimulantes do Sistema Nervoso Central , Condicionamento Operante , Ratos , Feminino , Animais , Ratos Long-Evans , Objetivos , Estimulantes do Sistema Nervoso Central/farmacologia , Condicionamento Clássico/fisiologia
12.
BMC Anesthesiol ; 23(1): 397, 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-38049713

RESUMO

BACKGROUND AND OBJECTIVE: The effectiveness of goal-directed fluid therapy (GDFT) in promoting postoperative recovery remains unclear, the aim of this study was to evaluate the effect of GDFT on length of hospital stay and postoperative recovery of GI function in patients undergoing major abdominal oncologic surgery. METHODS: In this randomized, double- blinded, controlled trial, adult patients scheduled for elective major abdominal surgery with general anesthesia, were randomly divided into the GDFT protocol (group G) or conventional fluid therapy group (group C). Patients in group C underwent conventional fluid therapy based on mean arterial pressure (MAP) and central venous pressure (CVP) whereas those in group G received GDFT protocol associated with the SVV less than 12% and the cardiac index (CI) was controlled at a minimum of 2.5 L/min/m2. The primary outcomes were the length of hospital stay and postoperative GI function. RESULTS: One hundred patients completed the study protocol. The length of hospital stay was significantly shorter in group G compared with group C [9.0 ± 5.8 days versus 12.0 ± 4.6 days, P = 0.001]. Postoperative gastrointestinal dysfunction (POGD) occurred in two of 50 patients (4%) in group G and 16 of 50 patients (32%) in the control group (P < 0.001). GDFT significantly also shorten time to first flatus by 11 h (P = 0.009) and time to first tolerate oral diet by 2 days (P < 0.001). CONCLUSIONS: Guided by SVV and CI, the application of GDFT has the potential to expedite postoperative recovery of GI function and reduce hospitalization duration after major abdominal surgery. TRIAL REGISTRATION: This study was registered on www. CLINICALTRIALS: gov on 07/05/2019 with registration number: NCT03940144.


Assuntos
Abdome , Objetivos , Adulto , Humanos , Tempo de Internação , Volume Sistólico , Abdome/cirurgia , Hidratação/métodos , Complicações Pós-Operatórias/epidemiologia
13.
Medicine (Baltimore) ; 102(48): e36083, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38050312

RESUMO

BACKGROUND: This research addresses inadequate understanding of interventional prenatal diagnosis, preoperative anxiety psychological problems in pregnant women undergoing interventional prenatal diagnosis, proposing a health education mode combined AIDET standard communication and King's theory of goal attainment approach to potentially improve health education outcomes, anxiety psychological problems, and patient satisfaction. METHODS: A convenient sampling method was used to select a total of 300 pregnant women who were ready to undergo interventional prenatal diagnosis. They were randomly divided into a implementation group and a control group, with 150 pregnant women in each group. The control group used the communication mode of the traditional process of nurse-patient communication. The implementation group used the AIDET standard communication health education model under the King theory of goal attainment in the process of nurse-patient communication and the interventional prenatal diagnosis health education content questionnaire, the pregnant women's satisfaction questionnaire, state anxiety scale, and disease uncertainty scale were used for evaluation. RESULTS: The results of the interventional prenatal diagnosis health education questionnaire, the results of pregnant women's anxiety, the results of pregnant women's disease uncertainty, the results of pregnant women's satisfaction, the implementation group all were better than the control group (P < .05). CONCLUSION: Using the AIDET standard communication health education model under the King theory of goal attainment in nurse-patient communication is conducive to the rapid establishment of a harmonious and trusting nurse-patient relationship between pregnant women and nurses, helping pregnant women and nurses jointly promote the establishment and implementation of health education goals, helping to improve pregnant women's acceptance of information related to interventional prenatal diagnosis, health education and the procedure of walking on the day of surgery. It helps enhance the effectiveness of health education and satisfaction, reducing pregnant women's uncertainty about the disease, their unfamiliarity with the surgery environment and surgery procedure, and their preoperative anxiety.


Assuntos
Objetivos , Gestantes , Gravidez , Feminino , Humanos , Gestantes/psicologia , Diagnóstico Pré-Natal/psicologia , Educação em Saúde , Comunicação
14.
Front Endocrinol (Lausanne) ; 14: 1183075, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37941902

RESUMO

Background: Heart failure with preserved ejection fraction (HFpEF), a major cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), is frequently coexisted with obesity, poor glycemic, blood pressure (BP), and/or lipid control. We aimed to investigate the associations of nonalcoholic fatty liver disease (NAFLD) and its advanced fibrosis with HFpEF according to obesity, glycated hemoglobin A1c (HbA1c), BP, and low-density lipoprotein cholesterol (LDL-C) goal achievement status in T2DM patients. Methods: A total of 2,418 T2DM patients who were hospitalized were cross-sectionally assessed. Liver fibrosis was evaluated by non-invasive biomarkers. Logistic regression analysis was used to evaluate the independent and combined associations of fibrosis status and diabetic care goal attainments with HFpEF risk. Results: Simple steatosis was not associated with HFpEF risk compared with patients without steatosis, while advanced liver fibrosis was found to have significantly higher odds for HFpEF risk (odds ratio,1.59; 95% confidence interval, 1.22-2.08). Advanced fibrosis in NAFLD was significantly associated with an increased risk of HFpEF, regardless of obesity status, HbA1c, BP, and LDL-C goal achievement status. P values for the interactions between fibrosis status and HbA1c control status, fibrosis status and BP control status, fibrosis status and LDL-C control status, and fibrosis status and body mass index (BMI) status on HFpEF risk were 0.021, 0.13, 0.001, and 0.23, respectively. Conclusion: In patients with T2DM, advanced hepatic fibrosis was significantly associated with HFpEF risk, irrespective of obesity status, HbA1c, BP, and LDL-C goal attainment status. Further, HbA1c and LDL-C goal attainment status modified this association.


Assuntos
Diabetes Mellitus Tipo 2 , Insuficiência Cardíaca , Hepatopatia Gordurosa não Alcoólica , Humanos , Diabetes Mellitus Tipo 2/complicações , Hepatopatia Gordurosa não Alcoólica/complicações , Insuficiência Cardíaca/complicações , Volume Sistólico/fisiologia , Hemoglobinas Glicadas , LDL-Colesterol , Objetivos , Cirrose Hepática/complicações , Obesidade/complicações
15.
BMC Oral Health ; 23(1): 851, 2023 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-37951858

RESUMO

OBJECTIVE: This study explored the achievement of primary and secondary goals and factors influencing their achievement in regenerative endodontic procedures (REPs) for immature permanent teeth. METHODS: Dental records of all patients who received REPs for immature permanent teeth at the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology between January 2012 and January 2023 were retrieved. The evaluation of the primary goal was based on medical and radiographic records. The achievement of the primary goal was defined as the absence of clinical signs and symptoms, such as pain, swelling, or sinus tract and the absence of periapical radiolucency, as assessed on postoperative periapical radiographs. The achievement of secondary goal represented increased root wall thickness and/or increased root length, that is, continued root development. Periapical radiographs before and after treatment were used to evaluate the achievement of the secondary goal. The secondary goal was required to be achieved alongside the achievement of primary goal. RESULTS: A total of 436 teeth (136 anterior and 300 posterior teeth) were included in this study, 96.1% of which demonstrated achievement of the primary goal. Signs of failure (17 teeth) included crown fracture and uncontrolled and recurrent periapical lesions. In addition, 77.8% of teeth demonstrated achievement of the secondary goal, and more than half of the teeth exhibited a complete root development. Evaluation factors included patients' age, sex, tooth type, etiology, preoperative periapical lesion, duration of clinical signs and symptoms, follow-up period, and stage of root development. The achievement of the primary and secondary goals were significantly related to age and tooth type (p < 0.05). CONCLUSIONS: Children with a younger initial visit age are more likely to achieve primary and secondary goals. Additionally, posterior teeth had an advantage over anterior teeth in achieving primary and secondary goals.


Assuntos
Endodontia Regenerativa , Tratamento do Canal Radicular , Criança , Humanos , Tratamento do Canal Radicular/métodos , Estudos Retrospectivos , Endodontia Regenerativa/métodos , Objetivos , Raiz Dentária/diagnóstico por imagem
16.
Sci Rep ; 13(1): 19701, 2023 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-37952024

RESUMO

During social interactions, we continuously integrate current and previous information over varying timescales to infer other people's action intentions. Motor cognition theories argue for a hierarchical organization of goal-directed actions based on temporal scales. Accordingly, transient motor primitives are represented at lower levels of the hierarchy, a combination of primitives building motor sequences at subordinate levels, and more stable overarching action goals at superordinate levels. A neural topography of hierarchal timescales for information accumulation was previously shown in the visual and auditory domains. However, whether such a temporal hierarchy can also account for observed goal-directed action representations in motor pathways remains to be determined. Thus, the current study examined the neural architecture underlying the processing of observed goal-directed actions using inter-subject correlation (ISC) of fMRI activity. Observers (n = 24) viewed sequential hand movements presented in their intact order or piecewise scrambled at three timescales pertaining to goal-directed action evolution (Primitives: ± 1.5 s, Sub-Goals: ± 4 s, and High-Goals: ± 10 s). The results revealed differential intrinsic temporal capacities for integrating goal-directed action information across brain areas engaged in action observation. Longer timescales (> ± 10 s) were found in the posterior parietal and dorsal premotor compared to the ventral premotor (± 4 s) and anterior parietal (± 1.5 s) cortex. Moreover, our results revealed a hemispheric bias with more extended timescales in the right MT+, primary somatosensory, and early visual cortices compared to their homotopic regions in the left hemisphere. Our findings corroborate a hierarchical neural mapping of observed actions based on temporal scales of goals and provide further support for a ubiquitous time-dependent neural organization of information processing across multiple modalities.


Assuntos
Objetivos , Desempenho Psicomotor , Humanos , Mapeamento Encefálico , Córtex Cerebral , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética
18.
PLoS One ; 18(11): e0288588, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37943869

RESUMO

BACKGROUND: The "Ending the HIV Epidemic" (EHE) initiative seeks to reduce new HIV infections in the U.S. by prioritizing federal resources towards highly impacted populations. Antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) are essential for reaching EHE goals. Adolescents are often at increased risk for HIV because they may lack agency in negotiating their sexual partnerships and may not have the same access to treatment and prevention as adults. This study estimates the potential contribution of expanded PrEP coverage among adolescents ages 15-17 to achieving the EHE goals in the South. METHODS: An HIV-transmission model was built to simulate the HIV epidemic in the South. Increased ART and PrEP uptake were systematically varied with and without PrEP eligibility including individuals age<18. RESULTS: Prioritizing PrEP for adolescents had a negligible impact on incidence. At 50% uptake among eligible adolescents and 90% ART coverage, including adolescents only improved the percentage of infections averted from 80.1% to 80.3%. In 10 of 15 scenarios explored, there was no reduction in new infections when PrEP eligibility was expanded to include adolescents age<18. At 95% ART coverage at the population-level incidence among adolescents declined by over 80%, but PrEP uptake among adolescents did not contribute to additional declines in incidence among adolescents. CONCLUSIONS: Prioritizing PrEP for adolescents did not significantly contribute to reaching EHE incidence reductions goal. Focusing resources to specific adolescent populations at risk, such sexual minority males in high incidence settings, will remain an important public health goal outside the context of EHE.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Adulto , Masculino , Humanos , Adolescente , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/tratamento farmacológico , Objetivos , Incidência , Fármacos Anti-HIV/uso terapêutico
19.
J Nutr Health Aging ; 27(10): 833-841, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37960906

RESUMO

OBJECTIVES: To assess if nutritional interventions informed by indirect calorimetry (IC), compared to predictive equations, show greater improvements in achieving weight goals, muscle mass, strength, physical and functional performance. DESIGN: Quasi-experimental study. SETTING AND PARTICIPANTS: Geriatric rehabilitation inpatients referred to dietitian. INTERVENTION AND MEASUREMENTS: Patients were allocated based on admission ward to either the IC or equation (EQ) group. Measured resting metabolic rate (RMR) by IC was communicated to the treating dietitian for the IC group but concealed for the EQ group. Achieving weight goals was determined by comparing individualised weight goals with weight changes from inclusion to discharge (weight gain/loss: >2% change, maintenance: ≤2%). Muscle mass, strength, physical and functional performance were assessed at admission and discharge. Food intake was assessed twice over three-days at inclusion and before discharge using plate waste observation. RESULTS: Fifty-three patients were included (IC n=22; EQ n=31; age: 84.3±8.4 years). The measured RMR was lower than the estimated RMR within both groups [mean difference IC -282 (95%CI -490;-203), EQ -273 (-381;-42) kcal/day)] and comparable between-groups (median IC 1271 [interquartile range 1111;1446] versus EQ 1302 [1135;1397] kcal/day, p=0.800). Energy targets in the IC group were lower than the EQ group [mean difference -317 (95%CI -479;-155) kcal/day]. There were no between-group differences in energy intake, achieving weight goals, changes in muscle mass, strength, physical and functional performance. CONCLUSIONS: In geriatric rehabilitation inpatients, nutritional interventions informed by IC compared to predictive equations showed no greater improvement in achieving weight goals, muscle mass, strength, physical and functional performance. IC facilitates more accurate determination of energy targets in this population. However, evidence for the potential benefits of its use in nutrition interventions was limited by a lack of agreement between patients' energy intake and energy targets.


Assuntos
Metabolismo Energético , Pacientes Internados , Humanos , Idoso , Idoso de 80 Anos ou mais , Metabolismo Energético/fisiologia , Calorimetria Indireta , Objetivos , Metabolismo Basal/fisiologia , Redução de Peso , Índice de Massa Corporal
20.
Fam Pract Manag ; 30(6): 27-29, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37963260
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