Back to basics: an audit of measurement of infant growth at presentation to hospital

2015 ◽  
Vol 39 (5) ◽  
pp. 539 ◽  
Author(s):  
Lesley Alison Williams ◽  
Robert S. Ware ◽  
Peter S. W. Davies
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Nutritional Status ◽  
Head Circumference ◽  
Growth And Development ◽  
Low Cost ◽  
Hospital Setting ◽  
Infant Growth ◽  
Anthropometric Measures ◽  
Paediatric Hospital

Objectives Infants who present or are admitted to hospital with illness or with inadequate growth and development are those most at risk of decreased nutritional status. However, not all infants who present or are admitted to hospital have their growth assessed. The aim of the present study was to identify how frequently anthropometric measurements were documented in charts of infants presenting and/or admitted to a tertiary paediatric hospital. Methods A systematic random sample of hospital charts of infants who had presented to the emergency department between 1 July 2011 and 30 June 2012 was audited retrospectively for the presence of appropriate documentation of measurement. Results In all, 465 charts were audited, representing 10% of infants who presented to the emergency department in the year. The frequency of anthropometric measures was: birthweight 103 (22%), presentation weight 275 (59%), length 8 (2%), head circumference 15 (3%), percentiles 27 (6%) and body mass index score 1 (0%). Age of the infant was significantly associated with recording of birthweight. There were no significant relationships found between gender, socioeconomic status, gestational age, delivery type and recording of diagnosis and birthweight. Conclusions Infant measurements were not recorded on many occasions. Assessment of growth as a marker of illness or nutritional deficit has been poorly assessed in this group. This is a missed opportunity to assess infant growth in this population, which has been found to be at risk of decreased nutritional status. Identification and treatment of growth deficits are a cost-effective method of optimising infant health worldwide. What is known about this topic? Infants who present or are admitted to hospital with illness or with inadequate growth and development are those most at risk of decreased nutritional status. What does this paper add? Not all infants who present or are admitted to hospital have their growth assessed. What are the implications for practitioners? It is important in a paediatric setting to identify who is responsible for measuring and recording infant growth. Measurement of weight, height and head circumference is a basic, low-cost method of measuring infant growth in the hospital setting.

scholarly journals Acute Hypoglycemia in Emergency Room: A Review

2021 ◽  
pp. 61-67
Author(s):  
Hisham Mohammed Sonbul ◽  
Faris Ali Hakami ◽  
Ibrahim Ahmed Almathami ◽  
Ahmad Yousef Basalamah ◽  
Riyad Khalid Almasaud ◽  
...  
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Nutritional Status ◽  
Emergency Room ◽  
Alcohol Intoxication ◽  
Chief Complaint ◽  
Insulin Administration ◽  
Poor Nutritional Status ◽  
Patients At Risk ◽  
Acute Hypoglycemia

Hypoglycemia is frequently encountered in the emergency department (ED) and has potential for serious morbidity. The incidence and causes of iatrogenic hypoglycemia are not known. We aim to describe how often the cause of ED hypoglycemia is iatrogenic and to identify its specific causes. Adult patients with a chief complaint or ED diagnosis of hypoglycemia, or an ED glucose value of ≤70 milligrams per deciliter (mg/dL) between 2009–2014. Two independent abstractors each reviewed charts of patients with an initial glucose ≤ 50 mg/dL, or initial glucose ≥ 70 mg/dL with a subsequent glucose ≤ 50 mg/dL, to determine if the hypoglycemia was caused by iatrogenesis. In ED patients with hypoglycemia, iatrogenic causes are relatively common. The most frequent cause was insulin administration for hyperkalemia and uncomplicated hyperglycemia. Additionally, patients at risk of hypoglycemia in the absence of insulin, including those with alcohol intoxication or poor nutritional status, should be monitored closely in the ED.

scholarly journals Hubungan antara riwayat status gizi ibu masa kehamilan dengan pertumbuhan bayi usia 9-12 bulan

2021 ◽  
Vol 14 (4) ◽  
pp. 556-563
Author(s):  
Rilyani Rilyani ◽  
Lelly Sugiyati
Keyword(s):  
Public Health ◽  
At Risk ◽  
Nutritional Status ◽  
Health Centre ◽  
Infant Growth ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Public Health Centre ◽  
Maternal Nutritional Status

Maternal nutritional status during pregnancy and effects on growth among infants 9-12 monthsBackground: Maternal nutritional status during pregnancy needs attention because it affects the development of the fetus they are carrying. During pregnancy are at risk of experiencing of chronic energy deficiency (CED) in adults if they have LILA <23.5 cm are at risk of maternal death, preterm delivery/low birth weight (LBW), death and impaired growth and development of infant. Base on data in Way Panji Public Health Centre reported that among maternal during pregnancy were of 43 (29.05%) who has LILA <23.5 cm.Purpose: To determine the relationship between maternal nutritional status during pregnancy and infant growth at the Way Panji Community Health Centre coverage area.Method: A quantitative by cross-sectional research, the population in this study were of 143 respondent as all maternal who had an infant aged 9-12 months in May 2020. Both of them observed such as a history of maternal nutritional status during pregnancy and infant growth when aged 9-12 months and bivariate analysis (Chi-Square).Results: Showing that the frequency distribution of maternal nutritional status during pregnancy, mostly with has sufficient in nutrition of 113 (79.0%) respondents and they have an infant with a normal growth of 107 (74.8%). There is a relationship between maternal nutritional status during pregnancy and infant growth (p-value 0.000: OR 5,314).Conclusion: There is a relationship between maternal nutritional status during pregnancy and infant growth in Way Panji Public Health Center coverage area Lampung-Indonesia. Suggestions to public health centre management to increase the promotion programme of maternal nutritional status during pregnancy and preventing poor growing of the infant by providing leaflets or posters also supplement nutritions for maternal during pregnancy.Keywords: Maternal; Nutritional status; Pregnancy; Infant; GrowthPendahuluan: Gizi ibu hamil perlu mendapat perhatian karena sangat berpengaruh pada perkembangan janin yang dikandungnya, Wanita hamil berisiko mengalami KEK jika memiliki LILA < 23,5 cm. ibu hamil dengan KEK berisiko melahirkan bayi berat lahir rendah (BBLR). BBLR akan membawa risiko kematian, dan gangguan pertumbuhan dan perkembangan anak. KEK juga dapat menjadi penyebab tidak langsung kematian ibu. Data dari Puskesmas Way Panji mengatakan bahwa terdapat 43 orang (29,05%) yang berisiko KEK dengan LILA < 23,5 cm.Tujuan: Diketahui Hubungan Status Gizi Ibu Masa Kehamilan Dengan Pertumbuhan Bayi Di Puskesmas Way Panji Kecamatan Way Panji Kabupaten Lampung Selatan Metode: Jenis penelitian kuantitatif dengan menggunakan metode penelitian crossectional , Subyek dalam penelitian ini adalah Ibu Masa Kehamilan, Variabel dependen : Pertumbuhan bayi, variabel independent : gizi ibu saat hamil,   populasinya paraibu yang telah melahirkan dan bayinya usia 9-12 bulan dengan total sampel berjumlah 143 responden/bayi, dilakukan pada bulan Juli-Agustus 2020, dengan analisa univariat dan bivariat (Chi-Square).Hasil: Didapatkan Distribusi frekuensi status gizi ibu masa kehamilan, sebagian besar dengan gizi baik yaitu sebanyak 113 (79,0%)  responden. pertumbuhan bayi kategori normal yaitu sebanyak 107 (74,8%). Ada hubungan status gizi ibu masa kehamilan dengan pertumbuhan bayi  (p-value 0.000 :  OR 5,314).Simpulan: Ada hubungan status gizi ibu masa kehamilan dengan pertumbuhan bayi di Puskesmas Way Panji, Disarankan kepadapihak manajemen Puskesmas setempat supaya dapat meningkatan upaya promosi guna penurunan kejadian pertumbuhan bayi yang abnormal dan membantu terpenuhinya kebutuhan gizi atau nutrisi pada saat ibu dalam masa kehamilan dengan cara pemberian leaflet atau poster.

scholarly journals E-Bike Injuries: Experience from an Urban Emergency Department—A Retrospective Study from Switzerland

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sylvana Papoutsi ◽  
Luca Martinolli ◽  
Christian Tasso Braun ◽  
Aristomenis K. Exadaktylos
Keyword(s):  
Emergency Department ◽  
Healthy Lifestyle ◽  
Low Cost ◽  
Hospital Setting ◽  
Time Period ◽  
Electric Bicycle ◽  
Rapid Transition ◽  
The Mean ◽  
Increasing Demand ◽  
Human Powered

Background. Between 2005 and 2012, annual sales of E-bikes in Switzerland increased from 1,792 to 52,941. This continuous and rapid transition from human-powered bicycles to an electric bicycle technology may indicate the increasing demand for low-cost transportation technology in combination with a healthy lifestyle.Material and Methods. In the present study, from April 2012 to September 2013, we retrospectively analysed E-bike accidents treated in the Emergency Department of our hospital by focusing on the following parameters: age, gender, time, period, and cause of the accident, as well as injury and outcome.Results. Patients were predominantly male. The mean age of injured E-cyclists was 47.5 years. The main causes of injury were self-accident. Most injuries were to the head/neck. The mean ISS was 8.48. The outcome showed that 9 patients were treated as outpatients, 9 were inpatients, and 5 patients were kept in the Intensive Care Unit (ICU). Only six patients underwent surgery (S).Discussion. This is the first attempt to evaluate E-bike injuries in Switzerland in an acute hospital setting. Since there is increasing popular preference for E-bikes as means of transportation and injuries to the head or neck are prevalent among E-cyclists, the hazard should not to be underestimated.

scholarly journals Malnutrition and obesity in community-dwelling older adults: concomitant conditions? (PEN-3S study)

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Teresa Madeira ◽  
Catarina Peixoto-Plácido ◽  
Nuno Sousa-Santos ◽  
Nuno Mendonça ◽  
Osvaldo Santos ◽  
...  
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Community Dwelling ◽  
Screening Tools ◽  
World Health ◽  
Anthropometric Measures ◽  
Community Dwelling Older Adults

AbstractBoth malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The aim of this study was to characterise the nutritional status of community-dwelling older adults (≥ 65 years old) living in Portugal. The study included a nationally representative sample of randomly selected community-dwelling older adults. Trained nutritionists collected data through face-to-face structured interviews regarding sociodemographic characteristics, nutritional status and anthropometric measures (namely, weight and height), among other variables of the PEN-3S study. Nutritional status was assessed by the 18-item Mini Nutritional Assessment (full MNA®), in which a lower score indicates worse nutritional status. The World Health Organisation's (WHO) BMI cut-offs for adults were followed (obesity: BMI ≥ 30Kg/m2). MNA and BMI categories estimates (95% CI) were obtained using Complex Samples analysis (SPSS® 24.0). Non-difference between sexes was analysed with Chi-square tests. Complete information was available for 1110 community-dwelling participants (mean age: 75.9 ± 8.1 years; 48.9% women; 71.4% attended school for < 5 years). According to the MNA, 0.5% (95%CI: 0.2–1.7) were classified as malnourished and 16.0% (12.9–19.7) were at risk of malnutrition. Following WHO's BMI criteria, 0.6% (0.2–1.5) had a BMI ≤ 18.5Kg/m2, 41.9% (37.9–46.0) had a BMI between 25–30Kg/m2, and 36.7% (32.8–40.9) presented a BMI ≥ 30Kg/m2. The prevalence of risk of malnutrition was significantly higher for women (20.1%, 95%CI: 15.4–25.9) than men (10.4%, 7.6–14.1; p < 0.001). The prevalence of obesity was also significantly higher for women (42.2%, 35.9–48.7 versus 29.3%, 24.8–34.2; p = 0.007). Moreover, 13.9% (9.2–20.4) were simultaneously at risk of malnutrition and had a BMI ≥ 30Kg/m2, while no one in this BMI category was classified as malnourished. Although appropriate BMI cut-offs for older adults are still uncertain, these results highlight that a high BMI does not exclude the risk of malnutrition, particularly in women. Therefore, health professionals should routinely screen for malnutrition using multi-component, validated screening tools, irrespective of the BMI. In fact, malnutrition is preventable if detected on time and effective interventions exist. The concomitant presence of malnutrition and obesity may pose additional challenges to the treatment.

scholarly journals A digital dietary assessment tool may help identify malnutrition and nutritional deficiencies in hospitalized patients

2021 ◽  
Vol 7 ◽  
Author(s):  
Adam Bernstein ◽  
Randall Moore ◽  
Lauren Rhee ◽  
Dina Aronson ◽  
David Katz
Keyword(s):  
At Risk ◽  
Nutritional Status ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Hospitalized Patients ◽  
Nutritional Deficiencies ◽  
Study Cohort ◽  
Nutrient Deficiencies ◽  
Historical Cohort ◽  
Patients At Risk

Malnutrition is common among hospitalized patients and associated with longer hospital stays, higher rates of rehospitalization, and increased mortality. Validated questionnaires of varying sensitivity and specificity to help identify patients at risk of malnutrition have been developed, but none has been broadly adopted. Tools to identify patients at risk for malnutrition should be quick, inexpensive, easy to administer and use, not require specialized nutrition knowledge, and provide results which can be entered into an electronic medical record; ideally, the tool should be deployed within 24 hours of admission and repeated if warranted. We hypothesize that a novel digital nutrition assessment tool which uses the Diet Quality Photo Navigation (DQPN) method, can help triage hospitalized patients toward further evaluation of nutritional status. We further propose that micronutrient deficiencies may be identified at the same time as malnutrition and that the reimbursement and cost savings from DQPN will prove substantially greater than the combined costs of its use and triggered dietitian consult. Deploying DQPN upon admission will represent an addition to standard hospital intake procedure that is frictionless for patients and health professionals, and one which may be overseen by clerical rather than clinical staff. The digital format of DQPN, which can be integrated into electronic medical records, will facilitate easier tracking and management of nutritional status over the course of hospitalization and post-discharge. To evaluate the hypotheses, DQPN will be deployed in a hospital setting to a group of patients who will also be seen by a registered dietitian to assess the nutritional status of each patient. Receiver operating characteristic curves will determine the point, or criterion, at which maximal true positivity rate and least false positivity rate for a diagnosis of malnutrition and specific nutrient deficiencies align. The study cohort will also be compared to a matched historical cohort to compare total medical spend and reimbursement between the intervention cohort and matched control. Testing of these hypotheses will thus allow for insight into whether DQPN may be used to identify malnutrition and nutrient deficiencies in hospitalized patients and, in so doing, improve patient outcomes, reduce healthcare utilization, and bring financial benefit to hospitals.

Exploring the Validity and Operational Impact of Using Allied Health Assistants to Conduct Dysphagia Screening for Low-Risk Patients Within the Acute Hospital Setting

2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  
Keyword(s):  
At Risk ◽  
Allied Health ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Low Risk ◽  
False Negatives ◽  
Exact Agreement ◽  
Risk Patients ◽  
Impact Phase ◽  
Operational Impact

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.

A High Masticatory Muscle Tone Predicts the Risk of Malnutrition and Frailty in Inpatient Older Adults: A Cross-Sectional Study

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Yin-Hwa Shih ◽  
Zhen-Rong Hong ◽  
Shih-Min Hsia ◽  
Shang-Yu Yang ◽  
Tzong-Ming Shieh
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Nutritional Status ◽  
Masseter Muscle ◽  
Muscle Tone ◽  
Handgrip Strength ◽  
Muscle Performance ◽  
Masticatory Muscle ◽  
Masticatory Performance ◽  
Poor Nutritional Status

<b><i>Introduction:</i></b> The prevalence of malnutrition among inpatient older adults is as high as 20∼50%. Masticatory performance is known to affect the nutritional status of individuals. However, an objective measurement to reflect the real status of masticatory muscle performance is lacking at the bedside. <b><i>Methods:</i></b> This pilot study analyzed the masticatory performance using surface electromyography (sEMG) of masticatory muscles that measures both muscle strength and muscle tone at the bedside. The nutritional status was measured using the Mini Nutritional Assessment tool. The handgrip strength was measured using a hand dynamometer. The statistical data were analyzed using SPSS 25 software. <b><i>Results:</i></b> The data revealed that female inpatient older adults more frequently had substandard handgrip strength (<i>p</i> = 0.028), an at-risk and poor nutritional status (<i>p</i> = 0.005), and a higher masseter muscle tone (<i>p</i> = 0.024). Inpatient older adults with an at-risk and poor nutritional status had an older age (<i>p</i> = 0.016), lower handgrip strength (<i>p</i> = 0.001), and higher average masseter muscle tone (<i>p</i> = 0.01). A high masseter muscle tone predicted the risk of having an at-risk and poor nutritional status. The at-risk or poor nutritional status predicted having a substandard handgrip strength by 5-fold. <b><i>Conclusions:</i></b> A high masticatory muscle tone predicts malnutrition and frailty. Medical professionals should combat masticatory dysfunction-induced malnutrition by detecting masticatory muscle performance using sEMG and referring patients to dental professionals. Additionally, encouraging inpatient older adults to perform oral motor exercise is recommended.

scholarly journals Guided Self-help Teletherapy for Behavioural Difficulties in Children with Epilepsy

2021 ◽  
Author(s):  
Sophie Bennett ◽  
Isobel Heyman ◽  
Sophia Varadkar ◽  
Anna Coughtrey ◽  
Fahreen Walji ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Unmet Need ◽  
Hospital Setting ◽  
Physical And Mental Health ◽  
Paediatric Hospital ◽  
Complex Needs ◽  
Self Help ◽  
Behavioural Difficulties

AbstractBehavioural difficulties impact greatly upon quality of life for children with chronic illness and their families but are often not identified or adequately treated, possibly due to the separation of physical and mental health services. This case study describes the content and outcomes of guided self-help teletherapy for behavioural difficulties in a child with epilepsy and complex needs using an evidence-based behavioural parenting protocol delivered within a paediatric hospital setting. Behavioural difficulties and progress towards the family’s self-identified goals were monitored at each session. Validated measures of mental health and quality of life in children were completed before and after intervention and satisfaction was measured at the end of treatment. Measures demonstrated clear progress towards the family’s goals and reduction in weekly ratings of behavioural difficulties. This case demonstrates that a guided self-help teletherapy approach delivered from within the paediatric setting may be one way of meeting unmet need.

scholarly journals A Mental Health Drop-In Centre Offering Brief Transdiagnostic Psychological Assessment and Treatment in a Paediatric Hospital Setting: A One-Year Descriptive Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5369
Author(s):  
Matteo Catanzano ◽  
Sophie D Bennett ◽  
Marc S Tibber ◽  
Anna E Coughtrey ◽  
Holan Liang ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Psychological Assessment ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Considerable Proportion ◽  
Paediatric Hospital ◽  
Cognitive Behaviour ◽  
Assessment And Treatment ◽  
One Year

Aim: This study was part of a broader project to examine the acceptability, feasibility and impact of a transdiagnostic mental health drop-in centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long-term physical health conditions (LTCs). The aims of this investigation were to characterise: (i) the use of such a centre, (ii) the demographics and symptoms of those presenting to the centre, and (iii) the types of support that are requested and/or indicated. Methods: A mental health “booth” was located in reception of a national paediatric hospital over one year. Characteristics of young people with LTCs and their siblings/parents attending the booth were defined. Emotional/behavioural symptoms were measured using standardised questionnaires including the Strengths and Difficulties Questionnaire (SDQ). Participants subsequently received one of four categories of intervention: brief transdiagnostic cognitive behaviour therapy (CBT), referral to other services, neurodevelopmental assessment or signposting to resources. Results: One hundred and twenty-eight participants were recruited. The mean age of young people was 9.14 years (standard deviation: 4.28); 61% identified as white and 45% were male. Over half of young people recruited scored in the clinical range with respect to the SDQ. Presenting problems included: anxiety (49%), challenging behaviour (35%), low mood (22%) and other (15%). Conclusions: A considerable proportion of young people with LTC in a paediatric hospital scored in the clinical range for common mental health problems, indicating a potential for psychological interventions.

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