Dissertations / Theses: 'Methods of nutritional status assessment'

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Mselle, Laurent Sadikieli. "Validation of participatory nutrition status assessment methods in Maasai and Batemi communities of Ngorongoro, Arusha Tanzania." Thesis, McGill University, 1998. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=21610.

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A validation study was conducted in the Maasai and Batemi communities of Arusha, Tanzania between December 1996 and January 1997. The aim of this study was to compare a participatory nutrition status assessment procedure carried out by community members with an assessment completed by a professional. The study validated women (15--50 years of age) dietary intake assessments and assessed the reliability of anthropometric assessments of preschool (12--71 months) children in the hands of non-professionals. The prevalence of under-nutrition was similar for the two data sets and reliability of anthropometric measurements was found to be good except for the mid-upper-arm circumference measurement for which the difference between measurements of the professional and the nonprofessional and between two occasions differed significantly (p < 0.001). Results suggest that participatory nutrition status assessment procedure by community members is useful and fairly reliable, giving results similar to a procedure administered by a professional for some anthropometric indices. The correlation between a semi-quantitative food frequency questionnaire administered by community members and a series of three 24-h recalls administered by a professional for assessing the risk of inadequate intake was found to be weak for vitamin A and protein but moderate for iron. Spearman's rank correlation coefficients between the mean of three 24-h recalls values and semi-quantitative food frequency questionnaire estimates were 0.47 (p < 0.05) for iron, 0.29 (p < 0.05) for protein and 0.26 (p < 0.05) for vitamin A. The questionnaire produced results showing significantly higher intake estimates of protein (p < 0.001), vitamin A (p < 0.001) and iron (p < 0.01) than the average of three 24-hour recalls.

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Mselle, Laurent Sadikieli. "Validation of participatory nutrition status assessment methods in Maasai and Batemi communities of Ngorongoro, Arusha Tanzania." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0026/MQ50841.pdf.

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Simon, Jeannine. "Identification of Functional Immunological Indicators of Nutritional status during acute nutritional deprivation." Thesis, Virginia Tech, 1998. http://hdl.handle.net/10919/36605.

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Optimal functioning of the immune system is necessary for the host to be capable of mounting a sufficient immune response, especially in times of sickness and injury. Acute bouts of starvation may compromise immune function, and subsequently lead to increased susceptibility to infection. Immunocompetence has been suggested as a functional indicator of nutritional status as the function of the immune system relies upon nutrient dependent metabolic pathways and the provision of adequate nutrient substrates to synthesize its components. The sensitivity of monocyte phagocytic activity, major histocompatibility complex (MHC) class II expression, and fibronectin concentration were studied in 23 healthy cats during a 7 day period without food followed by a 7 day refeeding period. Blood samples were obtained for plasma fibronectin analysis and immune cell function tests on days 0, 4, 7, 11, and 14. A turbidimetric immunoassay was used for determination of plasma fibronectin concentration. Monocyte phagocytosis and MHC class II expression were measured using flow cytometric techniques. Weight, lymphocyte number, percent lymphocytes, white blood cell number, and serum albumin concentration were monitored throughout the study. Phagocytic activity, MHC class II expression, weight, lymphocyte number, percent lymphocytes, and white blood cell (WBC) number, decreased significantly (p<0.05) during the starvation period. Fibronectin concentration increased significantly (p<0.05) by day 4 of starvation. During refeeding there was a significant increase (p<0.05) in MHC class II expression, fibronectin concentration, weight, lymphocyte number, percent lymphocytes, and white blood cell number. Phagocytic activity decreased significantly (p<0.05) by day 11 of refeeding. Pearsons correlation analysis revealed a positive correlation (p<0.05, r=.2682) between weight change and phagocytosis. There was a positive correlation (p<0.05, r=.3588) between monocyte number and MHC class II expression, and between monocyte number and WBC number (p<0.05, r=.3506). Results indicate that maintenance of immune function is dependent upon the provision of continuous nutritional intake by the host. Plasma fibronectin, monocyte phagocytosis, MHC class II expression, and other immunological measures of health status were sensitive to acute alterations of nutritional intake and subsequent refeeding. Both phagocytic activity and MHC class II expression were found to be reliable indicators of nutritional status during acute nutritional deprivation. These data suggest that short periods of food deprivation may significantly decrease immune response.
Master of Science

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Gharib, Nadia Mohamed. "Assessment of nutritional status of school children in Bahrain." Thesis, University of Cambridge, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.614371.

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Malone, Marilyn Hinnenkamp. "Assessment of nutritional status in patients with acquired immunodeficiency syndrome (AIDS)." Thesis, Virginia Polytechnic Institute and State University, 1985. http://hdl.handle.net/10919/101449.

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A detailed nutritional assessment was carried out on thirteen patients with the Acquired Immunodeficiency Syndrome (AIDS). Estimates of body fat and skeletal muscle were measured using triceps-skinfold, mid-arm circumference, mid-arm muscle area, and creatinine height index. Body weight was compared to standards for height and sex. Serum albumin and transferrin levels were measured to estimate visceral protein stores. The average Kilocalorie and protein intake was assessed from four day records and compared to estimated Kilocalorie and protein needs. The findings of this assessment showed decreased skeletal and visceral protein stores that can be characterized as a mixed type of malnutrition, or marasmic-kwashiokor. Protein intake was also shown to be inadequate when compared to estimated protein needs for stress and/or infection. This could contribute to diminished protein stores and muscle wasting.
M.S.

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Saletti, Anja. "Nutritional status and mealtime experiences in elderly care recipients /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-121-0/.

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Faxén, Irving Gerd. "Nutritional status and cognitive function in frail elderly subjects /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7140-004-4/.

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Bannerman, Elaine. "Identification of poor nutritional status in non-institutionalised individuals >75 years old." Thesis, Open University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.389375.

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Lumbers, Margaret. "Assessment of nutritional status and clinical outcome : a study of elderly female orthopaedic patients." Thesis, University of Surrey, 1993. http://epubs.surrey.ac.uk/2214/.

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Bajaj, Honey. "Design of mobile health tools for assessment of health and nutritional status in children." Thesis, Massachusetts Institute of Technology, 2017. http://hdl.handle.net/1721.1/113507.

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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, System Design and Management Program, 2017.
Cataloged from PDF version of thesis.
Includes bibliographical references (page 71).
Introduction and Motivation: In India, more than 700,000 accredited social health activists (ASHAs) are women selected and trained to work between members of their communities and the public health system. In spite of much advancement in screening tools and best practices in the healthcare system to date, service for members of the bottom of the pyramid remains largely unchanged. ASHA workers need user friendly tools and job aids that would enable them to -- Conduct health-care screenings and consultations -- Educating communities on basic health-care practices -- Confidence to advise medical referrals for patients. Most of the existing solutions designed and deployed in the field ignore issues like context of rural/urban settings (language, living conditions), digital illiteracy, and portability. Proposed Solution: Mobile Kit for Assessment of Child Health and Nutrition In order to address the problem described above, the Mobile Technology Group, headed by Dr. Fletcher, is developing a smart phone based kit that will assist with the basic tasks that an ASHA health worker is required to perform. These measurements include: -- Baby's weight -- Baby's height -- Baby's thermal regulation (which is an indicator of health) -- Baby's cardiovascular health (heart rate, pulse oximetry) - Middle Upper Arm Circumference (MUAC), which is an indicator of the nutritional status. The electronics and computer software for these tools is being implemented by another graduate student, Xavier Soriano. However, I am responsible for the product design, interaction design, and evaluation of the technology. Primary Research Objectives: 1. To help design the non-invasive mobile based tools for assessing and health and nutritional status of children under 5 years to be used by community health workers in urban poor settlements of India 2. To test, evaluate and assess the ease of use of these tools by community health workers
by Honey Bajaj.
S.M. in Engineering and Management

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Al-Saderi, Abdullah Mohammed Ahmed. "Nutritional status assessment of the technical and vocational students' community in Riyadh, Saudi Arabia." Thesis, Liverpool John Moores University, 1991. http://researchonline.ljmu.ac.uk/5013/.

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The General Organization for Technical Education and Vocational Training, Riyadh, Saudi Arabia, has developed a special feeding program for the students at its institutions. The effects of this program on the nutritional and health status of these students have not been evaluated yet, and since no published dietary research has been performed on Technical and Vocational young adult male students, the present work was undertaken to investigate the nutritional status of this community in Riyadh, Kingdom of Saudi Arabia. After a pilot survey, it was decided to use a selfcompleted questionnaire combined with personal interview to investigate the nutritional status of 690 students randomly selected from the study population. Dietary data was collected by two methods: usual weekly intakes "diet history" and actual daily intakes "diet diary". The nutrient intakes were calculated using the unilever Dietary Analysis Program (UNIDAP). The statistical Package for the social Science (SPSS/PC+) was employed to analyse the data; statistical significance of relationships between certain sets of data was determined by chi-square analysis. Some general factors affecting the nutritional status of these students were identified, their nutritional habits and attitudes were investigated, and the average daily intakes of energy, the macronutrients, and selected micronutrients were calculated. The main results of this study shows that the majority of the study population are adolescent, moderately active individuals, and have lower than the standard range of the Body Mass Index; anaemia is the most stated health problem; meal-skipping and eating between meals are common habits amongst the students. Regarding nutrient intake, there was an energy, polyunsaturated fat, and vitamin C deficiency; adequate intake of saturated fat, dietary fibre, retinol, and zinc; more than adequate intake of protein, total fat, cholesterol, thiamin, riboflavin, calcium, and iron. Recommendations are given which aim to improve the nutrition of technical and vocational students.

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Clark, John. "Assessment of nutritional status, physical activity, social support at the Northern Kentucky Sanitation District." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1562842559108558.

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Harrison, Elizabeth. "A prospective assessment of gastrointestinal disease and nutritional status in patients with systemic sclerosis." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/a-prospective-assessment-of-gastrointestinal-disease-and-nutritional-status-in-patients-with-systemic-sclerosis(683a2e56-8b59-4202-882f-5f22a98f46e0).html.

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Background: Malnutrition and gastrointestinal (GI) involvement are common in patients with systemic sclerosis (SSc). Despite malnutrition being common, little is known about its associations and predictors. Although patients are frequently screened and assessed for malnutrition, different clinically applicable assessment modalities in SSc have not been compared. An understanding of the relationship between dietary intake and energy expenditure is important for nutritional assessment and management. However, studies have not compared these. For many years, home parenteral nutrition (HPN) has been used in patients with intestinal failure, but little outcome data exists to support its role in SSc. GI involvement results in dysmotility, the underlying mechanism for the development of which is unknown. However, autonomic dysfunction has been proposed. Aims: To explore aspects of the nutritional assessment and management of patients with SSc. To seek associations and predictors of nutritional decline. To investigate for a link between GI dysmotility and autonomic dysfunction. Methods: Study 1: A retrospective review of the survival and outcome data of patients commenced on HPN over 22 years. Study 2: An assessment of 168 patients recruited over 12 months and restudied after approximately 1 year. Assessment included demographics, clinical data, GI and functional questionnaires, nutrition screening tool, oral aperture, mid-upper arm and 4-site anthropometry, bioelectrical impedance and biochemical testing. Re-study included weight change. Study 3: A 3 day assessment of dietary intake and energy expenditure using food record charts and SenseWear® Armband involving 36 patients recruited to Study 2. Study 4: Patients and matched controls completed GI and autonomic questionnaires, an autonomic battery, a gastric emptying study and postprandial cardiovascular measures and GI sensations and symptoms scores. Results: Study 1: The cumulative probabilities of surviving on HPN at 2, 5 and 10 years were 75%, 37% and 23%. HPN-associated complication rates were low. Study 2: Nutritional screening failed to identify all patients who lost weight. Mid-arm circumference correlated with body mass index (BMI) and weight change. Four-site anthropometry correlated with BMI more strongly (r=0.65 vs. r=0.49) than bioelectrical impedance analysis. Small intestinal, but not oesophageal, involvement correlated with baseline nutritional status. No clear predictors of nutritional decline were identified. Study 3: Predicted energy intakes correlated with measured expenditures, but absolute values differed. Energy intakes did not correlate with expenditures. Study 4: Autonomic measures did not correlate with gastric emptying. However, autonomic results were hindered by patient-related and technical limitations. Conclusion: Nutritional screening tools cannot be relied upon to detect all at risk patients. MAC and 4-site anthropometry may have a role in nutritional assessment. When an accurate appreciation of energy requirements is needed, kinematic monitors should be used rather than predictive equations. For those patients who progress to intestinal failure, HPN is safe and effective. Autonomic studies were inconclusive. However, the autonomic apparatus has been refined for utilisation in more definitive studies in younger patients.

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Alharbi, Khadija A. "Assessment of nutritional status of patients on hemodilaysis: a single center study from Jeddah, Saudi Arabia." FIU Digital Commons, 2010. http://digitalcommons.fiu.edu/etd/178.

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Malnutrition (MN) is prevalent worldwide in hemodialysis patients (HDP); however it has not been assessed in HDP living in Jeddah, Saudi Arabia. The purpose of this study was to estimate the prevalence of MN in HDP at the Jeddah Kidney Center as well as to determine if the 7-point subjective global assessment (SGA) correlates with anthropometric [Body Mass Index (BMI), Tricep Skinfold Thickness (TSF), Mid-Arm Muscle Circumference (MAMC)], or biochemical (albumin) measurements. In a cross sectional, descriptive study, 270 HDP were assessed for MN. Over half of the HDP were malnourished, with 47.8% moderately and 6.3% severely malnourished. Fifty-eight percent of HDP did not adhere to their diet prescription. As albumin, BMI, TSF, and MAMC decreased, malnutrition became more severe (p < .01). Patients who were female (OR=.43, p=.001), older (OR=.45, p=.001), with no education (OR=3.10, p=.001), underweight (OR=3.56, p<.001), small TSF (OR=1.12, p=.001), and small MAMC (OR=1.15, p=.001) were more likely to be malnourished. The prevalence of MN is high in these HDP. A consistent nutritional assessment protocol is warranted and should be implemented to decrease MN in Saudi HDP.

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Dutton, Harry John. "An assessment of the nutritional status and habitat quality of a southwestern Virginia deer herd." Thesis, Virginia Polytechnic Institute and State University, 1987. http://hdl.handle.net/10919/90965.

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To determine the causes for low hunter kill and presumed poor population growth of the white-tailed deer (Odocoileus virginianus) herd in the High Knob (HK) area of Scott and Wise Counties, Virginia, the relative abundance and nutritional status of the deer herd and the habitat quality of the HK area were studied relative to a deer herd and an area in the Stony Creek (SC) section of Giles County, Virginia, known to produce deer of good physical size and antler development and sustained high hunter harvests. Pellet-group surveys, deer collections in September and March, check station data on hunter-killed deer, soil sampling, and quantitative and qualitative forage analyses were used in assessing the HK deer herd and area. The extent to which poaching, free-roaming dogs, and winter weather might be affecting the HK deer herd also was investigated. Pellet group density was significantly lower (P = 0.004) at HK relative to SC and was believed to be indicative of a somewhat lower herd density at HK. In September, the condition of the HK deer herd was similar to that of the SC deer herd. However, the average number of parasites in the abomasums of HK deer was significantly greater (P = 0.0002) than in the abomasums of SC deer. Yearling bucks killed by hunters at HK had significantly lower eviscerated body weights (P = 0.0001), while all bucks killed by hunters at HK had smaller antler beam diameters (P = 0.006) and fewer antler points (P = 0.0001) relative to hunter-killed deer at SC. Because of an abnormally abundant acorn crop at SC in the fall of 1985 and an abnormally mild winter at HK and an abnormally severe winter at SC in 1986-87, the nutritional condition of the HK deer herd relative to the SC deer herd in March in a "normal" year was difficult to ascertain. However, it was inferred that in a "normal" year the HK deer herd would be in worse physical condition in March relative to the SC deer herd. Soil pH, organic matter, and mineral levels were significantly lower (P < 0.1) at HK than at SC. The HK area had significantly greater (P < 0.1) quantities of various vegetation categories than did the SC area in September, 1986. Quantities of common forages consumed by deer in winter were believed to be similar or slightly lower at HK than at SC. However, the average yearly biomass of acorns was believed to be substantially lower at HK than SC due to the greater percentage of the HK area comprised of yellow poplar dominated forest stands. No clear patterns between areas were evident among the forages analyzed for nutritional components. Poaching and harassment by free-roaming dogs were not believed to be substantially different between areas. However, winter weather severity was much greater at HK that at SC. Based on a 10-year average, snowfall is normally over 3X greater at HK relative to SC. Thus, it was concluded that the HK area has a reduced capacity to support highly dense deer herds due to a lack of quality forages in late fall through late winter and greater winter severity relative to SC.
M.S.

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Campbell, Katrina Louise. "Nutritional management in pre-dialysis chronic kidney disease : an investigation of methods for nutritional assessment and intervention in pre-dialysis chronic kidney disease." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16595/.

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Malnutrition is present in up to 48% of chronic kidney disease patients on the initiation of renal replacement therapy (dialysis)1. At this time, malnutrition is an independent and significant predictor of morbidity and mortality2. As a consequence of progressive deterioration in kidney function, symptoms of decreased appetite and reduced intake are common factors leading to the decline in nutritional status3. However, at present there is little evidence to inform nutrition assessment and intervention for pre-dialysis chronic kidney disease (CKD). The purpose of this study was to provide evidence for the nutritional management of CKD patients prior to dialysis with an aim to optimise nutritional status. To address this, an investigation comprising of two phases examining nutrition assessment and intervention in a sample of pre-dialysis Stage IV and V CKD patients was undertaken. Both phases of the study were conducted through Royal Brisbane and Women’s Hospital (RBWH) Department of Renal Medicine pre-dialysis clinic. Participants met the following criteria: adult (>18 years) Glomerular Filtration Rate (GFR) <30ml/min CKD, not previously seen by a dietitian for Stage IV CKD, absence of communication or intellectual impairment inhibiting their ability to undertake the intervention and an absence of malnutrition from a cause other than CKD. Phase I was a cross-sectional investigation into the performance of a range of tools assessing nutrition status, conducted at baseline of Phase II. Phase II was a randomisedcontrolled trial designed to determine if providing individual nutrition counselling with regular telephone follow-up resulted in improved body composition, nutritional status, dietary intake and quality of life, compared with standard care. A range of intermediate, clinical and patient-centred outcome measures were collected at baseline and twelve weeks. Body composition was measured by total body potassium counting (TBK), considered a gold-standard measure of body cell mass (BCM, the body’s functional metabolising tissue). Nutritional status was measured using Subjective Global Assessment (SGA) and a number of modified versions of SGA, 7-point SGA, Malnutrition Inflammation Score (MIS) and the scored Patient-Generated Subjective Global Assessment (PG-SGA). Dietary intake was measured using 3-day food records. Quality of life was measured by Kidney Disease Quality of Life Short Form version 1.3 (KDQOL-SFTM v1.3 © RAND University), combining the Short Form-36 (SF-36), with a kidney disease-specific module4. Statistical analysis was carried out using SPSS Version 13 (SPSS Inc, Chicago, IL, USA). Phase I analysis was based on descriptive and bi-variate statistics, including chi-square, t-test and ANOVA. For phase II, change variables (Week 12 – Week 0) were created for the outcome measures (BCM, SGA tools, dietary intake (energy and protein) and the 18 KDQOL-SFTM subscales). The assessment of change in outcome measures by treatment group was undertaken by ANCOVA, adjusting for baseline values. Further multivariate analysis (ANCOVA and MANCOVA models) were created for outcome variables when confounding variables were identified and adjusted for. In Phase I, 56 patients (Male n=34; age mean (±SD) 70.7 (±14.0); GFRMDRD 22.4 (±6.5) mL/min) underwent baseline assessment. In this population the prevalence of malnutrition was 19.6% (n=11, SGA B; no C ratings). Malnutrition was associated with lower body cell mass (mean BCM, 26.3 vs. 33.4 kg p=0.007), body weight (64.8 vs. 76.1 kg p=0.042), BMI (23.7 vs. 27.6 kg/m2 p=0.015) and greater weight loss over previous 6 months (-6.2 vs. -0.1 kg p=0.004). Body cell mass indexed for height (BCM-I kg/m3.5) had a relationship with MIS (r=-0.27 p=0.063) and scored PG-SGA (r=-0.27 p=0.060), but not with 7-point SGA (F(4) 2.24 p=0.080). PG-SGA best discriminated malnutrition based on a BCM-I cut-off of <5.25kg/ m3.5 of all the modified SGA tools. The scored PG-SGA including the global SGA rating is recommended for use in pre-dialysis CKD. In Phase II, 50 patients, (Male n=31 (62.0%); age 69.7 (±12.0) years; GFRMDRD 22.1 (±6.9) ml/min) completed the 12 week study period (intervention n=24; standard care n=26). At 12 weeks, there was a clinically significant improvement in all outcome measures in the intervention group. There was a 3.9% (95% CI, -1.0 to 8.7%) mean difference in change for Body Cell Mass between the treatment groups, represented by a significant decrease in the standard care group and maintenance in the intervention group. Nutritional status measured by SGA improved or was maintained (24/24) in the intervention group, however, decreased in 14% (4/26) of the standard care group. Energy intake significantly improved in the intervention group resulting in a mean difference in change of 17.7kJ/kg (8.2 to 27.2 kJ/kg). Quality of life improved significantly in 10 of the 18 sub-scales in the intervention group. Significant effect modification for gender was apparent for many of the outcome variables, with females responding most significantly to the intervention treatment. This study concluded that, overall, structured nutrition intervention limits the deterioration in nutritional status, improves dietary intake and quality of life in patients with CKD prior to the onset of renal replacement therapy. This thesis makes a significant contribution to the evidence base for nutritional management of pre-dialysis Stage IV CKD. The use of SGA for nutrition assessment and including PG-SGA to measure change is recommended for routine nutrition assessment of pre-dialysis CKD. The provision of individual nutrition counselling with regular follow-up, with a focus on promoting intake provides beneficial patient outcomes supporting optimal nutritional status in pre-dialysis CKD patients.

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Subki, Manal. "Assessment of the nutritional status of frail elderly persons participating in geriatric day hospital rehabilitation program." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33847.

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We assessed the nutritional status and physical function of 121 women (79.4 +/- 6.6 y, 26.8 +/- 5.6 kg/m2) and 61 men (78.6 +/- 8.3 y, 26.6 +/- 4.7 kg/m2) participating in the Geriatric Day Hospital. According to a composite index of malnutrition, 19% of them were found malnourished whereas the Mini-Nutritional Assessment, a validated nutritional screening tool, found that 56% of the elderly were malnourished or at risk for malnutrition. Malnourished persons, as determined by the composite index, had a lower lean body mass (LBM) by bioelectrical impedance analysis compared with the well-nourished group (40.5 +/- 9.7 vs. 42.0 +/- 8.7 kg, p = 0.0001). LBM correlated significantly with handgrip strength (r = 0.34, p = 0.0001) but not with gait speed (r = 0.04, p = 0.27). There were no significant differences between nutritional states for any of the two tests of physical function. The score of the MNA, correlated with gait speed (r = 0.24, p = 0.02) but the performance at the physical tests was not different according to the nutritional status defined by this tool. We conclude that malnutrition is relatively prevalent among frail persons participating in the Geriatric Day Hospital and that malnutrition is one among many other factors that contribute to their low level of physical performance. As such, a nutritional intervention may be of benefit in improving the physical function of frail elderly persons who are malnourished.

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Ferdous, Tamanna. "Determinants and Functional Impact of Nutritional Status Among Older Persons in Rural Bangladesh." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-107369.

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Tavel, Léonie von. "Influence of management factors on methods to evaluate the nutritional and metabolic status in dairy herds and comparison of these methods /." [S.l.] : [s.n.], 2003. http://www.zb.unibe.ch/download/eldiss/03tavel_l.pdf.

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Wood, Tamara Michelle. "Nutritional Assessment of Rural Mossi People in Burkina Faso: A Comparison of Pre- and Post-Harvest Status." UNF Digital Commons, 2000. http://digitalcommons.unf.edu/etd/287.

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The purpose of this study was to compare the nutritional status of a rural population of Mossi people in Burkina Faso during the pre- and post-harvest seasons. Comparisons were made between the sample population and the American population, between the pre- and post-harvest seasons, between males and females in the sample population and between the various age groups in the sample population. This nutritional assessment consisted of collecting demographical information, anthropometrical measurements such as weight and height, a clinical assessment to evaluate physiological signs of nutritional deficiencies and a food frequency questionnaire to describe the dietary practices of the population. Due to the potential risks of handling human blood, urine and feces, biochemical analyses were not performed in this study. Special attention was given to the nutritional problems most common in Africa: protein energy malnutrition, vitamin A deficiency, iron deficiency and goiter. Adults in this study had an average body mass index of 19.1, classifying the adult population as "underweight". The population of American adults, however, has a tendency toward a body mass index in the slightly overweight category. The BMI range of adults in the study population was 12.9 to 27.8. A total of 36.9% of the adult population presented with some level of protein energy malnutrition while only 2.7% were slightly obese. Seventy percent of children were below the 50th percentile on the 2000 Centers for Disease Control weight-for-height growth chart. A third of all children were below the 3rd percentile of weight-for-height. The vast majority of children in this study had a weight-for-height below the median, or "average", American child. The mean percent of median body weight-for-height for the child population in the lean season was 85.2% indicating that the median child in this sample population was mildly wasted. The mean percent of median weight-for-height rose to 94.6% in the post-harvest season indicating that the median child of the sample population was "normal" concerning wasting status. The results of this study indicate that this rural population of Mossi people was less well-nourished than their American counterpart and that their nutritional status differed based on season (F=[4,177] 4.77, p=.03 for adults and F=[4,51] 8.56, p=.005 for children) but not gender (F=[ 4,177] .04, p=.83 for adults and chi square= 4.37, p=.22, df=3 for children) or age group for adults (r=.l 0, p=.29). In children, nutritional status was based on age group (but contrary to the expected outcome) with prepubescent children having lower weight-for-height percentiles than the under-five population (chi square = 40.34, p=.02, df=24). Nutritional status improved as predicted during the postharvest, or plentiful, season. Due to the lack of biochemical analyses, the potential vitamin and mineral deficiencies indicated in the brief physical examination were not confirmed. Vitamin A deficiency was the most likely nutrient deficiency; symptoms occurred in 51% of the population, primarily in adults and older children. PEM, although indicated by the anthropometric measures to affect 37.1% of the adult population and 55.4% of the child population, did not greatly manifest itself in clinical symptoms. The incidence of iron deficiency anemia was also relatively low with only 7% of the population presenting with pale conjunctivae, a potential, but non-specific sign of iron deficiency anemia. The goiter rate was also very low with only two cases occurring during the post-harvest season.

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Hudgens, Jan Elizabeth. "Better nutritional status as measured by the mini nutritional assessment tool is associated with increased immune response in elderly nursing home residents with pressure ulcers." [Gainesville, Fla.] : University of Florida, 2003. http://purl.fcla.edu/fcla/etd/UFE0002240.

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Centurion, Camilla de Moura. "Avaliação nutricional e nivel socioeconomico de candidatos a transplante de figado." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309652.

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Orientador: Ilka de Fatima Santana Ferreira Boin
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: : É muito comum que candidatos a transplante hepático, portadores de doença hepática crônica, apresentem algum grau de desnutrição no período que antecede o transplante, portanto uma avaliação nutricional bem aplicada pode ser o ponto chave para uma intervenção nutricional que mantenha ou recupere uma condição nutricional satisfatória. A classe econômica é útil para oferecer uma dieta apropriada, uma vez que adesão depende da aquisição de determinados alimentos. O objetivo deste estudo foi avaliar o estado nutricional de candidatos a transplante de fígado e correlacionar o estado nutricional encontrado com os seguintes parâmetros: idade, gênero, gravidade hepática e classe econômica. Foram estudados, prospectivamente, 80 pacientes em lista de espera para transplante de fígado da Unidade de Transplante Hepático da Unicamp. Para a avaliação nutricional foram verificadas as seguintes variáveis antropométricas: peso (Kg) e altura (m), para cálculo do índice de massa corporal (IMC); circunferência do braço (cm), prega cutânea triciptal (mm), área muscular do braço (AMB) em cm2 e circunferência muscular do braço (CMB) em cm, para a Adequação de Parâmetros Antropométricos (APA). Para a avaliação da classe econômica foi utilizada a Classificação Econômica Brasil, proposto pela Associação Brasileira de Empresas de Pesquisa (ABEP). Para gravidade hepática foi aplicado score MELD e classificação de Child-Pugh. A análise estatística utilizada foi o teste do qui-quadrado, análise de variância e o coeficiente de correlação de Kappa e Pearson. Desnutrição foi encontrada em 45 pacientes (56,25%), através de APA; e com o IMC, a maioria apresentou excesso de peso (n=51; 63,75%). A concordância entre os dois métodos resultou em uma correlação intermediária (Kappa = 0,5) para valores categorizados e forte (Pearson = 0,73; p<0,05) para valores expressos em números. Em relação à classe econômica, verificou-se a prevalência das classes sociais B (36,25%) e C (47,5%); Classificação de Child-Pugh mostrou A em 20%, B em 57,5% e C em 22,5% dos avaliados. O score MELD médio foi 14.96 ± 4.27. As mulheres apresentaram 37,5% de eutrofia e foi diferente significativamente quando comparado aos homens (p<0,05). Nenhuma outra diferença estatística foi observada entre estado nutricional e os parâmetros analisados. Neste estudo observou-se que classe econômica, idade, gênero ou gravidade hepática não influenciou o estado nutricional dos pacientes avaliados, independente do método de avaliação utilizado
Abstract: Malnutrition is an usual complication in undergoing transplant patients, therefore nutritional assessment is essential for an early nutritional intervention to recuperate or maintain a sufficient weight. Economic status can be useful to offer a right nutritional guide and suppose dietary adherence taken with food acquirement and adequate nutritional status maintenance. The purpose was to evaluate nutritional of cirrhotic patients on the waiting list for liver transplantation and verify the association between found nutritional status and parameters like: age, sex, liver damage and economic status. Eighty patients on the waiting list for liver transplantation were prospectively evaluated. For nutritional status, evaluated anthropometric measures were: weight (Kg) and height (m), to establish Body Mass Index (BMI). Arm circumference (cm), Triciptal Skin Fold (mm), Muscular Arm Area (cm2) and Muscular Arm circumference (cm) were measured for Nutritional Adequacy. The patients were arranged according to Social Economic Profile classified by ABEP (Brazilian Association of Research Company) and Brazil Economical Classification (Classificação Econômica Brasil). For liver damage was applied MELD score and Child-Pugh classification. Statistic analysis was made using chi-square tests, Pearson and Kappa correlation and ANOVA (analysis of variance). Malnutrition was found in 56,25%, when Nutritional Adequacy was applied and 63,75% overweight using BMI; the correlation between the two methods resulted in an intermediate concordance (Kappa = 0.5) for those categorized and strong (Pearson = 0.73, p <0.05) for values expressed in numbers. We observed that according to Social Economic Profile we had 36.25% of the patients on group B, 47.5% on group C and 16.25% on group D. The Child-Pugh classification showed A in 20%, B in 57,5% and C in 22,5% of the patients. MELD score was 14.96 ± 4.27. Women had more preserved nutritional status when compared with men (p<0,05), when nutritional adequacy was used. No statistical association was found between nutritional status and the others parameters. The results showed that age, sex, liver damage or economic status did not influence the nutritional status of those evaluated, regardless of the method applied
Mestrado
Pesquisa Experimental
Mestre em Cirurgia

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Blaß, Sandra [Verfasser]. "Nutritional Status of Trauma Patients with Disorders in Wound Healing : Assessment and Effects of Nutrient Supplementation / Sandra Blaß." Bonn : Universitäts- und Landesbibliothek Bonn, 2012. http://d-nb.info/1043056297/34.

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Odencrants, Sigrid. "The complexity of nutritional status for persons with chronic obstructive pulmonary disease : a nursing challenge." Doctoral thesis, Örebro : Örebro universitetsbibliotek Örebro University Library, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-1769.

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Ferdous, Tamanna. "Prevalence of malnutrition and determinants of nutritional status among elderly people : a population-based study in rural Bangladesh /." Stockholm, 2007. http://diss.kib.ki.se/2007/91-7357-069-9/.

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Zukeran, Mariana Staut. "Identificação da fragilidade em idosos a partir do risco nutricional." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/89/89131/tde-29062017-154749/.

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Introdução: Dentre os desfechos negativos que acometem os idosos, a síndrome da fragilidade é preocupante, pois tem como consequências piora da funcionalidade, comorbidades e antecipação da morte. Assim, sua prevenção e detecção precoces são essenciais para a saúde pública. A identificação desta síndrome tem sido mais comumente realizada por meio dos critérios de Fried et al. (2001), os quais necessitam de equipamentos específicos e equipe especializada. Por sua vez, o estado nutricional parece estar fortemente associado ao desenvolvimento da fragilidade. Portanto, este trabalho tem o objetivo de investigar a associação existente entre o risco nutricional e a identificação de fragilidade. Métodos: Foram estudados pacientes em ambulatório de geriatria, e foram aplicados os critérios de Fried et al. (2001), a Mini Avaliação Nutricional (MAN), nas suas formas reduzida e completa (MAN-R e MAN-C), e algumas medidas antropométricas. Os dados foram avaliados quanto à normalidade (teste Shapiro-Wilk); a sensibilidade e a especificidade da MAN em detectar a fragilidade foram medidas por meio da curva Receiver Operating Characteristics (ROC). Resultados: A amostra final foi composta por 422 (72,8%) mulheres e 158 (27,2%) homens. A prevalência de fragilidade foi de 41,1% (n=256) e pré fragilidade de 45,0% (n=261). A MAN-R identificou 78 (13,4%) idosos desnutridos e 258 (44,5%) sob risco de desnutrição. O melhor ponto de corte para fragilidade nas mulheres foi ≤=24,5 pontos (AUC=0,849; sensibilidade=79,7 e especificidade=78,3) para MAN-C e ≤=11,0 pontos (AUC=0,795; sensibilidade=69,0 e especificidade=80,4) para a MAN-R. Dentre os homens, os melhores pontos de corte foram ≤=23,0 (AUC=0,877; sensibilidade=79,2 e especificidade=88,2) para MAN-C e ≤=11 (AUC=0,821; sensibilidade=81,9 e especificidade=76,5) para MAN-R. Ambas as formas da MAN não apresentaram associação significativa para identificação da pré fragilidade. Conclusão: Foi verificada associação significativa entre a MAN e a presença da síndrome da fragilidade, porém não com o estado de pré-fragilidade. Ambas as versões, reduzida e completa, foram adequadas para identificação da fragilidade. A MAN-C demonstra correlação mais alta do que a MAN-R e indica pontos de corte diferentes de acordo com o gênero.
Background: The frailty syndrome is a concern among the elderly due to some negative outcomes such as loss of functionality, comorbidities and anticipation of death. Thus, its prevention and early detection are essential for public health. Fried et al. (2001) criterion has been used to identify this syndrome; however, it requires specific equipment and specialized team. The nutritional status is strongly associated with the development of frailty. Therefore, this study aims to investigate the association between nutritional risk and the identification of frailty. Methods: We studied patients in a geriatrics outpatient clinic, in which Fried criterion, the Mini-Nutritional Assessment (MNA), on both short form (MNA-SF) and long form (MNA-LF), and anthropometric measurements were applied. The data were analyzed according to normality (Shapiro-Wilk test), and MNA\'s ability to detect frailty was measured by Receiver Operating Characteristics (ROC) curves. Results: The final sample was composed by 422 (72.9%) women and 158 (27.2%) men. The prevalence of frailty was 41.1% (n=256) and pre-frailty was 45.0% (n=261). The MAN-SF identified 78 (13.4%) malnourished and 258 (44.5%) at risk of malnutrition. The best cut-off point to frailty in women was ≤=24.5 points (AUC=0.849; sensitivity=79.7 and specificity=78.3) for MAN-LF and ≤=11 points (AUC=0.795; sensitivity=69.0 and specificity=80.4) for MAN-SF. Among the men, the best cut-off point were ≤=23.0 (AUC=0.877; sensitivity=79.2 and specificity=88.2) for MAN-LF and ≤=11 points (AUC=0.821; sensitivity=81.9 and specificity=76.5) for MAN-SF. Both MNA forms did not present significant association to detect pre-frailty. Conclusion: MNA forms presented significant association to detect frailty, although neither is suitable to detect pre-frailty. MNA-LF shows a higher correlation than MNA-SF e indicates different cut-off points according to gender.

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Knight, Caroline L. "Antenatal characterisation and postnatal validation of fetal nutritional status using novel fetal imaging methods, neonatal body composition data, and anthropometry." Thesis, University of Oxford, 2014. https://ora.ox.ac.uk/objects/uuid:11107be6-35ea-4d6d-9161-ddee4cde1b3e.

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Background: Fetal growth restricted (FGR) infants have increased perinatal morbidity and mortality risks. Standard fetal biometry may identify some FGR babies; amniotic fluid measurement and Doppler assessment of blood vessels provide additional, functional assessments, but are often normal in babies with late-onset FGR who are difficult to diagnose. A marker reflecting nutritional status should help to identify FGR fetuses, enabling effective intervention: increased monitoring or delivery and neonatal management. Arm and/or thigh measurements have previously shown potential in 2D and 3D. Limb fat volume has never been measured and could provide an in utero marker of fetal nutritional status. Aims: 1. To develop an ultrasound scanning protocol to acquire 2D images and 3D volumes of fetal arms and thighs. 2. To develop method(s), suitable for use in clinical practice, to measure fat in these images and volumes. 3. To assess the reproducibility of these methods. 4. To assess the validity of these methods by comparing them with MRI images of fetal limb fat. 5. To use these methods in a healthy population to develop reference ranges. 6. To correlate these methods with validated neonatal measurements, to assess whether the antenatal methods reflect neonatal body composition. 7. To apply these methods to longitudinal prospective ultrasound images from multiple countries to assess SGA fetuses. Method: Ultrasound imaging protocols were developed to obtain accurate images and volumes of fetal arms and thighs. Segmentation tools were designed with biomedical engineers to measure fat, lean and limb compartments, and applied to 2D images and 3D volumes (n=500), with calculation of reference centiles in optimally healthy women (INTERGROWTH-21st study) and MRI validation of the ultrasound measurements. Additional methods were assessed: a two-ellipse method, and a three-thickness Fetal Fat Index (FFI). Reproducibility was assessed using Bland-Altman plots and ICCs. Fetal measurements were correlated with neonatal body composition data and anthropometry. Third trimester fetal thigh fat volumes were compared in sub-cohorts of AGA and SGA fetuses. Results: Reference centiles were calculated for novel fractional arm and leg volumes (fat and lean), from 16 to 41 weeks. 2D reference ranges were also calculated. The FFI technique - quick, simple, 2D - correlated well with fat area and fat volume. DXA analyses showed a strong correlation between neonatal limb and whole body fat. Correlation analyses showed that infants with above- and below-average arm circumferences have significantly different amounts of arm fat as early as 30-35 weeks. The strength of correlation between antenatal limb fat and neonatal PEA POD whole body fat increased with increasing gestational age. Scans at 30-34 weeks showed a significant difference in fractional thigh fat between those who would be born SGA compared with AGA. Conclusion: This thesis explores, in detail, the measurement of fetal arm and thigh fat using 2D and 3D ultrasound, and demonstrates that it is correlated to neonatal body composition thus allowing 'fetal body composition' to be established as a research tool; the ultimate aim is to be able to distinguish growth-restricted fetuses from those of normal nutritional status. Novel measurements have been developed, acquisition protocols described, reproducibility assessed, and reference centiles calculated in an optimally healthy population: 2D Fetal Fat Index, 3D fractional limb fat and lean volumes, and limb fat (2D and 3D) as a percentage.

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Sales, Cristiane Hermes. "Avaliação do status de magnésio em pacientes com diabetes mellitus tipo 2." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/9/9132/tde-23012009-115003/.

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Foi desenvolvido um estudo observacional de corte transversal, com o objetivo de avaliar o status em Mg de pacientes com diabetes mellitus tipo 2. A amostra foi composta por 51 indivíduos de ambos os gêneros, com idade média de 53,6 ± 10,5 anos, os quais foram selecionados no Ambulatório de Endocrinologia do Hospital Universitário Onofre Lopes (HUOL) Natal/RN. O projeto foi aprovado pelos Comitês de Ética em Pesquisa do HUOL e da Faculdade de Ciências Farmacêuticas da USP. Os pacientes foram submetidos à avaliação antropométrica, dietética, do controle glicêmico, função renal, perfil lipídico, Mg plasmático, eritrocitário, urinário e dietético. Foi observada ingestão adequada de macronutrientes, contudo baixo consumo dietético de Mg e de fibras. Identificou-se, ainda, controle glicêmico e perfil lipídico insatisfatórios e função renal sem alterações significativas. Quanto ao status de Mg, 70,6 % da amostra apresentaram algum dos parâmetros bioquímicos relativos a este mineral abaixo dos valores de referência, sendo estes menores nos indivíduos que tinham mais complicações metabólicas e presença de microalbuminúria. Foram observadas correlações inversas entre o Mg plasmático com a glicemia de jejum (r = -0,281, p = 0,046) e a pós-prandial (r = -0,322, p = 0,021), e correlações positivas entre o Mg urinário com a glicemia de jejum (r = 0,291, p = 0,038), a circunferência abdominal (r = 0,288, p = 0,041) e o IMC (r = 0,282, p = 0,045). Deste modo, foram diagnosticadas alterações no status de Mg, as quais foram mais evidentes nos pacientes que tinham mais complicações, demonstrando a associação dos fatores relacionados com essa doença e o Mg.
A cross-sectional study was carried out to evaluate Mg status in patients with type 2 diabetes mellitus. The sample comprehended 51 individuals, both male and female, aged 53.6 ± 10.5 years, selected from the Endocrinology Clinic of the University Hospital Onofre Lopes (HUOL) in Natal/RN, Brazil. The project was approved by the Commission on Ethics in Research of the HUOL and Faculty of Pharmaceutical Sciences of the University of São Paulo. The patients were assessed concerning anthropometry, diet, blood-glucose control, kidney functioning and lipid profile, besides plasma, erythrocyte, urinary and dietary Mg. An adequate intake of macronutrients and a low consumption of dietary Mg and fibers were observed. Unsatisfactory blood-glucose control and lipid profiles, besides kidney functioning without significant alterations, were also observed. Concerning Mg status, 70.6% of the sample presented biochemical parameters for this mineral below the reference values, and such parameters were lower in individuals with more extensive metabolic complications and microalbuminury. Inverse correlations between plasma Mg with fasting (r = -0.281, p = 0.046) and postprandial plasma glucose (r = -0.322, p = 0.021), and a positive correlation between urinary Mg with fasting plasma glucose (r = 0.291, p = 0.038), waist circumference (r = 0.288, p = 0.041) and body weight index (r = 0.282, p = 0.045) were observed. Therefore, alterations in Mg status were detected in the studied population. Such alterations were more evident in patients with more extensive complications, thus demonstrating the association of factors related to this disease and Mg.

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Reis, Lígia Cardoso dos. "Perfil nutricional de crianças e adolescentes portadores de HIV em acompanhamento ambulatorial." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/6/6133/tde-11092008-163951/.

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Introdução - Deficiências nutricionais derivadas da infecção por HIV são mais severas em crianças em relação aos adultos. Assim, a população pediátrica HIV+ necessita de adequado monitoramento nutricional a fim de direcionar a terapia e garantir melhor qualidade de vida. Objetivo - Caracterizar o perfil nutricional de crianças e adolescentes HIV+ em acompanhamento ambulatorial, segundo antropometria, análise da composição corporal por bioimpedância (BIA) e exames bioquímicos, e avaliar a relação das características nutricionais com o tempo e tipo de terapia medicamentosa. Métodos - Estudo descritivo do tipo transversal, em que 119 pacientes de 6 a 19 anos foram submetidos a antropometria (peso, altura, circunferência da cintura, pregas cutâneas tricipital e subescapular) e análise da composição corporal por BIA. Também foi realizada entrevista com o responsável pelo paciente para avaliação de fatores sócio-demográficos, obstétricos e clínicos. Para definição do histórico clínico e laboratorial, os prontuários foram analisados para obtenção da data do diagnóstico, esquema medicamentoso adotado nos últimos três anos e resultados de exames bioquímicos. Resultados - A avaliação da composição corporal por BIA foi capaz de identificar excesso de gordura corporal total em 30% das meninas e 26% dos meninos. Em contrapartida, 33,6% apresentaram sinais de depleção do tecido adiposo na região tricipital, sugerindo lipoatrofia. Em relação aos parâmetros bioquímicos, 16,7% dos pacientes foram diagnosticados com resistência à insulina, 35,6% com triglicérides elevados, 33,9% com colesterol total elevado, 9,7% com alterações nos níveis de LDL e 81,4% com concentrações reduzidas de HDL. As crianças consistiram no grupo com maior prevalência de dislipidemia e melhor estado imunológico, sugerindo maior vulnerabilidade aos antiretrovirais. Observou-se que os usuários dos esquemas terapêuticos alternativos e tríplices, ambos com inibidores de protease, apresentaram as maiores concentrações médias de triglicérides e, as menores de HDL-colesterol. Conclusões - As classes mais utilizadas no tratamento dos pacientes (inibidores de protease e inibidores nucleosídeos de transcriptase reversa) foram associadas ao prejuízo na manutenção de níveis adequados de lípides séricos, ainda que os medicamentos não tenham sido relacionados a alterações nos parâmetros antropométricos. Contudo, sabe-se que a dislipidemia pode preceder o desenvolvimento de alterações clínicas características da lipodistrofia em portadores de HIV, indicando, a necessidade de se realizar intervenções nutricionais desde o início da doença.
Introduction - Nutritional deficiencies derived from HIV infection are more aggressive in children than adults. Thus, HIV-infected children and adolescents need proper nutrition monitoring to guide the therapy and provide better quality of life. Objective - To characterize the nutritional profile of HIV-infected children and adolescents assisted on outpatient service, according to anthropometry, bioimpedance analysis (BIA) and biochemical parameters, and to analyze the relation among the nutritional characteristics, period and type of antiretroviral therapy (ART). Methods - The study had a cross-sectional design, with 119 patients between 6 to 19 years old. They were submitted to anthropometric measures (weight, height, waist circumference, triceps and subescapular skinfolds thickness) and BIA analysis. The patient\'s caregivers were interviewed to collect social, demographic, obstetric and clinical data, and signed the informed consent. All the records were analyzed to check the diagnosis date, type of drug treatment during the last three years, and biochemical parameters. Results - There weren\'t detected significant alterations in anthropometric measurements, although BIA detected in 30% of girls and 26% of boys a high body fat percentual. However, 33,6% had fat wasting sign in the triceps, which is a lipoatrophy characteristic. Insulin resistance was seen in 16,7% of the patients, high blood triglycerides level in 35,6%, total cholesterol in 33,9%, LDL in 9,7% and low blood HDL level in 81,4%. Children were the group with higher prevalence of dyslipidemia and better immunologic status, so they seemed to be more vulnerable to ART. Patients treated with alternative and triple combination regimens, both with protease inhibitors, had the highest levels of triglycerides and the lowest of HDL. Conclusions - The most administered drugs to the patients (protease inhibitors and nucleoside reverse transcriptase inhibitors) were associated to dyslipidemia, even though these medicines hadn\'t been related to anthropometric deficits. However, lipid metabolism disturbances may precede the development of clinical problems involved in lipodystrophy syndrome in HIVinfected children and adolescents, indicating that nutritional intervention since the beginning of disease is necessary.

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Ramírez, Téllez John Gabriel. "Adressing the reliability of data-poor stock assessment methods to provide advice on the status of small-scale fisheries." Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/668302.

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Small-scale fishers are often identified as key players in the recovery of overexploited fish and invertebrate stocks supplying food for rural people and contributing to achieving healthy marine ecosystems. Stocks harvested by small-scale fisheries tend to be largely unassessed, but methods based on the data-limited toolbox exist that help provide information on exploitation status for fished stocks that do not have historical time series of catches, as usually occur in small-scale fisheries. Many of the data-limited methods follow length-based assessment approaches, which assume steady state, use at least length structure derived from fishery and knowledge on the life history parameters of the fished species. Accordingly, this thesis aimed at addressing the reliability of data-poor stock assessment methods in providing advice on the status of small-scale fisheries lacking knowledge of catch history. The data-rich bottom trawl fishery for European hake (Merluccius merluccius) in GSA 06 (Northwest Mediterranean Sea) was assumed as data-limited. This case study allowed me to test the performance of the pseudo-cohort Virtual Population Analysis (VPA) when input data are considered well known and unbiased. The same fishery but held in GSA 01 (Southwest Mediterranean Sea) was used as data-limited case study to introduce the uncertainty derived from parameterizing the length-based spawning potential ratio (LB-SPR) model with two contrasting growth hypotheses. Acknowledging challenges faced by stock assessment of small-scale fisheries around the world, I considered high input-data bias and large outputs uncertainty. The effect of biases in fishery data and uncertainty in life-history parameters on the outputs of the pseudo-cohort VPA model was explored by assessing the small-scale Wayuu fisheries for lane snapper (Lutjanus synagris) and white grunt (Haemulon plumierii) in the northern Colombian Caribbean Sea. An extreme, but common, case of uncertainty in small-scale fisheries was explored through assessing the beach fishery of the Peruvian grunt (Anisotremus scapularis) in the central coast of Peru on the Pacific Ocean, holding poor information on life-history parameters and catches. My findings indicate that the pseudo-cohort VPA may offer useful information regarding the exploitation trend but the absolute values of the indicators do not accurately express the fishing mortality and stock size among years for the European hake. The SPR estimates for this species is not specially linked to the growth hypothesis, and estimates of the ratio of fishing mortality to natural mortality (F/M) and the SPR value depend on the sample size and representation of the stock structure. The contribution of the information derived from the participatory monitoring of small-scale fisheries in Colombia, instead of using only official fishery data, largely demonstrated an improving picture of the exploitation of the lane snapper and white grunt. The uncertainty related to estimates of the von Bertalanffy growth parameters and natural mortality of the Peruvian grunt could be addressed but an accurate definition of SPR was not straightforwardly achieved. This thesis highlights that the data-limited methods assuming a steady state might contribute to defining the status of the small-scale fisheries. However, the stock status is importantly affected by bias in the input data, the available knowledge on the assessed fisheries and how fishery fit the model assumptions.
Los pescadores artesanales se identifican generalmente como actores claves en la recuperación de poblaciones sobreexplotadas, en el suministro de alimento a poblaciones rurales y en contribuir a alcanzar ecosistemas marinos saludables. Las poblaciones que son extraídas por las pesquerías artesanales (denominadas pesquerías de pequeña escala) tienden a carecer de evaluación. Sin embargo, algunos métodos de evaluación que se incluyen en el grupo “datos limitados” ayudan a suministrar información sobre el estado de estas pesquerías cuando no poseen información histórica de capturas. Muchos de los métodos limitados en datos y basados en estructura de tallas asumen estado de equilibrio. Estos métodos usan al menos como datos de entrada la estructura de tallas que provienen de la pesquería y el conocimiento disponible sobre los parámetros de historia de vida de las especies pescadas. Por todo lo expuesto anteriormente, el propósito de esta tesis es direccionar la fiabilidad de los métodos limitados en datos para proporcionar información sobre el estado de poblaciones que no cuentan con información histórica de capturas. La pesquería de merluza (Merluccius merluccius) de arrastre en GSA 06 (Mar Mediterráneo noroeste) “rica en datos” se asumió limitada en datos. Este caso de estudio me permitió probar el desempeño del Análisis de Población Virtual (VPA por sus siglas en inglés) basado en pseudo cohortes cuando los datos de entrada se asumen bien conocidos y libres de sesgos. Esta misma pesquería pero llevada a cabo en GSA 01 (suroeste del Mar Mediterraneo) también fue usada como un estudio de caso limitado en datos. Esto con el propósito de explorar la incertidumbre producida por el modelo que determina la proporción del potencial reproductor que es basada en tallas (LB-SPR por sus siglas en inglés) cuando son consideradas dos hipótesis de crecimiento contrastantes. Reconociendo los desafíos que enfrenta la evaluación de las pesquerías artesanales alrededor del mundo, yo consideré el análisis de sesgos relevantes en los datos que alimentan el modelo así como una gran incertidumbre en los resultados de evaluación. De esta manera, el efecto de los sesgos en la información proveniente de las pesquerías y la incertidumbre en los parámetros de historia de vida sobre los resultados del VPA basado en pseudo cohortes se exploró a través de la evaluación de las pesquerías Wayuu del pargo rayado (Lutjanus synagris) y la boca colorada (Haemulon plumierii) en el norte del Mar Caribe colombiano. Posteriormente, un extremo pero común caso de incertidumbre en pesquerías artesanales se consideró a través de la evaluación de la pesquería de playa de la chita (Anisotremus scapularis) en la costa central de Perú en el Océano Pacífico. Esta pesquería posee limitada información sobre la historia de vida de la especie y sobre las capturas producidas por la pesquería. Mis hallazgos indican que el VPA basado en pseudo-cohortes puede ofrecer información útil respecto a la tendencia de explotación de la pesquería, pero los valores absolutos no expresan apropiadamente la mortalidad por pesca ni el tamaño de la población entre años para la merluza. El valor de SPR para esta misma especie no se vincula a la hipótesis de crecimiento asumida y las estimaciones de la proporción de mortalidad por pesca respecto a la mortalidad natural (F/M) y el valor de SPR dependen del tamaño de la muestra y de la representación de la estructura de tallas del stock. La contribución de la información derivada del monitoreo participativo de la pesca artesanal en Colombia demuestra mejoramiento de la imagen de explotación del pargo rayado y la boca colorada que no cuando solo se usa información oficial. De otro lado, encontré que la incertidumbre relacionada con los parámetros de crecimiento de von Bertalanffy y la mortalidad natural de la chita puede ser direccionada pero una definición precisa del valor de SPR no se obtiene fácilmente. Esta tesis resalta que lo métodos limitados en datos que asumen estado de equilibrio pueden contribuir a definir el estado de explotación de las pesquerías artesanales. Sin embargo, el estado de la población se encuentra afectado de manera importante por los sesgos de los datos que alimentan el modelo, el conocimiento disponible sobre la pesquería evaluada y el cómo la pesquería se ajusta a los supuestos de los modelos de evaluación.

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Harrington, Dominic Jon. "Development of chromatographic methods for the urinary metabolites of vitamin K and their utility for vitamin K status assessment." Thesis, King's College London (University of London), 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.420476.

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Mamhidir, Anna-Greta. "Meeting ethical and nutritional challenges in elder care : the life world and system world of staff and high level decision-makers /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-943-2/.

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Lammes, Eva. "Nutrition, energy metabolism and body composition in the frail elderly /." Stockholm, 2007. http://diss.kib.ki.se/2006/91-7357-058-3/.

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Mota, Marília Alonso. "Concordância entre os métodos de avaliação nutricional em crianças e adolescentes com paralisia cerebral." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/28356.

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Objetivos: Verificar a concordância entre as curvas da Organização Mundial da Saúde (OMS) e do Centers for Disease Control and Prevention (CDC) às curvas específicas para crianças com paralisia cerebral (PC); verificar a concordância entre o diagnóstico nutricional das curvas específicas e prega cutânea tricipital (PCT) e circunferência do braço (CB); Avaliar a concordância entre altura aferida e altura estimada por equação em crianças com PC; Verificar a concordância do diagnóstico nutricional através das curvas de portadores de PC com anemia, deficiência de ferro, hipoalbuminemia e raquitismo; Verificar a correlação entre o valor energético da ingestão alimentar e taxa metabólica basal obtida através da bioimpedância elétrica. Métodos: Foi estudado antropometria, altura estimada, capacidade funcional, exames laboratoriais, bioimpedância elétrica e aplicado o recordatório alimentar de 24 horas nas crianças e adolescentes portadores de (PC). O estudo foi realizado com pacientes com diagnóstico de PC de um hospital escola. Para a análise estatística foram utilizados Kappa, teste de Wilcoxom, gráfico de Bland & Altman e Mcnemar, teste qui-quadrado e coeficiente de Spearmann. O estudo obteve a aprovação do Comitê Ética e Pesquisa sob o número 08-569. Resultados: Foram avaliados 47 pacientes, cuja idade mediana foi 6,5 anos (IQ: 3,9 – 9,6). As curvas da OMS/CDC classificaram mais pacientes “com déficit nutricional” do que a curva específica para PC (para todos os parâmetros κ ≤0,49; P≤0,26). A CB e PCT superestimaram a ocorrência de “Com déficit nutricional” (k ≤ 0,71; P ≤ 0,46 para todas as concordâncias). Para a concordância entre as alturas a mediana de diferença foi de – 0,38 (IQ: -2,61 – 3,32) cm. Em 40,4% dos participantes a altura estimada errou em mais de 3 cm (para mais ou para menos) o valor da altura aferida. Não se obteve concordância entre o estado nutricional e presença de anemia, deficiência de ferro, hipoalbuminemia e raquitismo(p≤1 para todas concordâncias). Não houve correlação entre a taxa metabólica basal e a ingestão alimentar. Conclusão: Os métodos de avaliação nutricional que se baseiam em crianças saudáveis superestimam o diagnóstico de déficit nutricional em crianças com PC. Mas independente de seu estado nutricional, em sua maioria, apresentam anemia ou deficiência de ferro. Além disso, apresentam uma alta ingestão alimentar em relação a baixa taxa metabólica basal.
Objectives: To determine the agreement between the curves of the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) to specific curves for children with CP and check the agreement between the nutritional diagnosis of the specific curves and triceps skinfold (TSF) and arm circumference (AC); evaluate the agreement between measured height and height estimated by the equation in children with CP; determine the agreement of nutritional diagnosis through curves of CP patients with anemia, iron deficiency, and hypoalbuminemia raquitismoa; correlation between the energy value of food intake and basal metabolic rate obtained by bioelectrical impedance. Methods: We studied anthropometry, estimated height, functional capacity, laboratory tests, bioelectrical impedance analysis and applied the 24-hour dietary recall in children and adolescents with CP. The study was conducted with the population of PC in a university hospital. For statistical analysis we used Kappa, Wilcoxon test, Bland & Altman and McNemar test, Chi-square and Spearman coefficient. The study was approved by the Research Ethics Committee. Results: We evaluated 47 patients whose age was 6.5 years (IQ: 3.9 - 9.6). The curves of the WHO / CDC classified more patients “nutritional deficit" than the specific curve for PC (for all parameters κ ≤ 0.49, P ≤ 0.26). AC TSF and overestimated the occurrence of "with nutritional deficit" (k ≤ 0.71, P ≤ 0.46 for all matches). For agreement between the heights of the median difference was - 0.38 (IQ: -2.61 - 3.32) cm. In 40.4% of participants estimated the time missed by more than 3 cm (more or less) the value of the height measured. No agreement was obtained between nutritional status and presence of anemia, iron deficiency, rickets and hypoalbuminemia (p ≤ 1 for all matches). There was no correlation between basal metabolic rate and food intake. Conclusion: The nutritional assessment methods that rely on healthy children overestimate the diagnosis of malnutrition in children with CP. But regardless of their nutritional status, most of them have anemia or iron deficiency. They will also have a high feed intake in relation to low basal metabolic rate.

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Vallandro, Juliana Paludo. "Comparação de diferentes métodos de avaliação nutricional não invasiva em crianças hospitalizadas." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2016. http://hdl.handle.net/10183/157611.

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Introdução: Atualmente, existem vários métodos úteis para a avaliação nutricional (AvN) de crianças hospitalizadas, contudo ainda não há um método considerado padrão-ouro para classificação do estado nutricional da população pediátrica, assim como para a identificação da desnutrição. Objetivo: Comparar diferentes métodos de AvN não invasiva em crianças hospitalizadas. Métodos: Estudo transversal com pacientes de 4 a 8,9 anos internados em um hospital pediátrico do Sul do Brasil. A amostragem foi realizada por conveniência, e a coleta de dados ocorreu entre dezembro de 2014 a fevereiro de 2016. Excluíram-se pacientes internados em unidade de terapia intensiva e sem condições de alimentação por via oral. Foram coletadas informações gerais, socioeconômicas e dados antropométricos. Também foram aplicados os questionários de Avaliação Subjetiva Global pediátrica (ASGped) e STRONGkids. Os dados clínicos foram coletados do prontuário eletrônico do paciente. O protocolo de estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Sul (parecer número 657.000), e pelo Comitê de Ética em Pesquisa da Irmandade da Santa Casa de Misericórdia de Porto Alegre (parecer número 906.461). Resultados: Um total de 455 crianças foi incluído no estudo, com média de idade de 75,0 ± 17,2 meses. A mediana do tempo de internação foi de 6 dias (4–10). As enfermidades que mais motivaram a internação foram: cirúrgicas (22,3%, n=103), pulmonares (19,3%, n=88), neurológicas (13,8%, n=63), oncológicas (7,9%, n=36) e gastroenterológicas (6,8%, n=31). Ao redor de 76% (341 de 455) das crianças encontravam-se eutróficas de acordo com o indicador índice de massa corporal/idade (IMC/I), 19,8% (n=89) apresentavam excesso de peso e 4,4% (n=20) estavam desnutridas. Conforme a ferramenta de triagem nutricional STRONGkids, 27,3% (n=124) das crianças apresentaram risco nutricional (RN) baixo, 64,8% (n=295) RN médio e 7,9% (n=36) RN alto. Por outro lado, ASGped classificou 86,8% (n=393) dos pacientes como bem nutridos, 12,4% (n=56) como moderadamente desnutridos e 0,9% (n=4) como gravemente desnutridos. Constatou-se que a desnutrição pela ASGped se associou de forma significativa com o maior tempo de permanência hospitalar (p <0,001). Óbito e reinternação hospitalar em 6 meses não se associaram com a desnutrição pela ANSGped. O tempo de internação hospitalar mostrou-se maior à medida que o RN aumentava, assim como a probabilidade de óbito e reinternação foi maior nas crianças com RN alto (p = <0,001) pela STRONGkids. Observou-se associação significativa entre a desnutrição moderada e grave, pela ASGped, e risco nutricional alto, através da STRONGkids, com EMAP reduzida (p<0,001). Quanto aos desfechos clínicos, observou-se tempo de internação maior nos pacientes com EMAP diminuída (p=0,001). Conclusão: Levando-se em consideração a antropometria e a ASGped, a maioria das crianças avaliadas encontrava-se eutrófica no momento da admissão hospitalar. A desnutrição e o RN estiveram associados a um maior tempo de internação hospitalar. A EMAP mostrou-se um método eficiente na detecção de desnutrição em pacientes pediátricos internados.
Introduction: Currently, there are several useful methods for nutritional assessment of children; however, there still is no gold-standard method for assessing the nutritional status of the pediatric population and for identifying malnutrition. Objective: To compare different methods of non-invasive nutritional assessment of hospitalized children. Methods: Cross-sectional study with 4-8.9-years old patients admitted to a pediatric hospital in Southern Brazil. The method used was convenience sampling, and the data was collected between December 2014 and February 2016. Patients in the intensive care unit and incapable of being orally fed were excluded from the research. General and socioeconomic information, as well as anthropometric data were collected. The Pediatric Subjective Global Assessment (SGA) and STRONGkids questionnaires were also applied. The clinical data were collected from the patients' digital medical records. The study protocol was approved by the Research Ethics Committee of the Federal University of Rio Grande do Sul (protocol 657,000) and by the Research Ethics Committee of the Santa Casa de Misericórdia of Porto Alegre (protocol 906,461). Results: A total of 455 children were included in the study, with a mean age of 75.0 ± 17.2 months. The median of hospital stay was 6 days (4–10). The most frequent reasons for hospitalization were surgical procedures (22.3%, n=103), and pulmonary (19.3%, n=88), neurological (13.8%, n=63), oncological (7.9%, n=36) and gastroenterological (6.8%, n=31) diseases. Of these, 75.8% (n=341) were eutrophic, according to the body mass index/age (BMI/A) parameter, 19.8% (n=89) were overweight, and 4.4% (n=20) were malnourished. According to the nutritional screening tool STRONGkids, 27.3% (n=124) of the children showed low nutritional risk (NR), 64.8% (n=295) moderate NR, and 7.9% (n=36) high NR. On the other hand, the GSNA ranked 86.8% (n=393) of the patients as eutrophic, 12.4% (n=56) as moderately malnourished, and 0.9% (n=4) as severely malnourished. In addition, it was found that malnutrition by pediatric SGA was significantly associated with a longer hospital stay. Death and hospital readmission at six months were not associated with malnutrition by pediatric SGA (p <0,001). The hospital stay was higher as the NR increased, as well as the probability of death and re-hospitalization was higher in children with high NR (p = <0.001) by STRONGkids. There was also a significant association between moderate and severe malnutrition, by SGA Ped, and high nutritional risk, through STRONGkids, with reduced EMAP (p <0.001). Regarding clinical outcomes, a longer hospital stay was observed in patients with impaired EMAP (p = 0.001). Conclusion: When considering anthropometry and pediatric SGA, most children evaluated were eutrophic at the time of hospital admission. Malnutrition and NR were associated with longer hospital stay. The use of EMAP has proven to be an efficient method for the detection of malnutrition in hospitalized pediatric patients.

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Mattos, Cecilia Helena Peinado de Sampaio. "Impacto da demência devido à Doença de Alzheimer em estágio inicial sobre o estado nutricional de idosos." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/17/17138/tde-27012015-113225/.

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O comprometimento do estado nutricional (EN) é um achado frequente em idosos que apresentam demência devido à Doença de Alzheimer (DA), e pode se agravar com a progressão da doença. O objetivo foi identificar as principais alterações do estado nutricional nas fases iniciais da demência devido à DA. Participaram do estudo 38 idosos, alocados em dois grupos: Controle, composto por 19 idosos saudáveis, e grupo Doença de Alzheimer, composto por 19 idosos que apresentavam a demência em estágio inicial (CDR-1), sem comorbidades. Foi realizada avaliação do estado nutricional utilizando a Mini-Avaliação Nutricional (MAN), além do exame de bioimpedância para análise da composição corporal dos idosos. A média de idade do grupo controle foi de 68,6 ± 6,2 anos, e do grupo DA foi de 75,4 ± 4,2 anos (p<0,01). O IMC médio do grupo controle foi 25,2 ± 3,2, enquanto do grupo DA foi 22,9 ± 3,9(p=0,06). Não foi observada diferença significativa em relação à composição corporal entre os grupos. De acordo com a MAN, todos os idosos do grupo controle apresentavam estado nutricional normal. No grupo DA, 11 (57,9%) apresentavam estado nutricional normal, 7 (36,8%) estavam em risco nutricional e 1 (5,3%) estava desnutrido. Em relação ao escore da MAN, o grupo controle apresentou média de 27,7 ± 1,7 pontos, enquanto o DA apresentou 23,2 ± 4,4 pontos (p<0,01). Dados da literatura corroboram com os resultados encontrados, e indicam que a demência devido a Doença de Alzheimer em fase inicial já pode estar associada ao comprometimento do estado nutricional.
The impairment of the nutritional status (NS) is a frequent finding in elder patients with dementia due to Alzheimer\'s disease (AD), and may worsen with the progression of said dementia. The purpose was to identify the main changes in the nutritional status in the early stages of the dementia due to AD. Thirty-eight elderly patients were enrolled in the study; being assigned to two groups: Control, composed of 19 healthy elderly patients, and Alzheimer\'s disease group, composed of 19 elderly patients who experienced early stages of dementia (CDR-1), with no comorbidities. The evaluation of the nutritional status was performed using the Mini Nutritional Assessment (MNA), in addition to the bioimpedance analysis for body composition evaluation in the elderly. The average age of the control group was 68.6 ± 6.2 years, and the AD group was 75.4 ± 4.2 years (p<0,01). The average BMI of the control group was 25.2 ± 3.2, while the AD group was 22.9 ± 3.9 (p=0,06). There was no significant difference observed in relation to the body composition between groups. According to the MNA, all patients in the control group presented with normal nutritional status. In the AD group, 11 (57.9%) presented with normal nutritional status, 7 (36.8%) were at nutritional risk, and one (5.3%) experienced malnutrition, in relation to the MNA score, whilst AD reported 23.2± 4.4 points (p<0.01). Literature data supports the results found, and indicate that dementia, due to early stages of Alzheimer\'s disease, may already be associated with the impairment of the nutritional status.

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Delagrange, Susan L. "An assessment of the anthropometric status and self-reported nutritional intake and physical activity level of students in fourth, sixth, and eighth grades in Wells County, Indiana." Virtual Press, 2006. http://liblink.bsu.edu/uhtbin/catkey/1339143.

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The purpose of this study was to assess the nutritional practices, physical activity level, and anthropometric measurements of students in grades 4, 6, and 8 in Wells County, IN. The sample included all students enrolled in these grades in the fall of 2002. Parental consent to complete the School Physical Activity and Nutrition (SPAN) survey used to collect food and activity practices and to measure heights and weights was obtained for 670 of the 1,248 students. Individuals were classified into weight groups using the CDC growth charts. Thirty-eight percent of all students were "at risk for overweight" or were "overweight." Students reported spending 3.3 hours of screen time per day. Males consumed more grains and legumes, and participated in more physical activities, than females. Normal weight students consumed more grains and dairy products than overweight students. There were few statistically significant differences by weight classification. Programs that encourage increasing physical activity, decreasing screen time, and making healthier food choices should be emphasized in this community.
Department of Family and Consumer Sciences

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Marshall, David T. "Testing the Ability of Two Series of Models to Predict High School Graduation Status." VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/4756.

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The purpose of this study was to create and test two series of predictive models aimed at projecting high school graduation status. Secondary data were obtained in partnership with an urban school district. All of the predictor variables included in the models tested in this study were academic and nonacademic variables that were found to be significant predictors of high school graduation in previous empirical work. In the first series of models tested, individual academic and nonacademic variables were tested together along with school-level variables. Eighth and ninth grade variables were tested separately to avoid multicollinearity issues. The second series of models tested included similar individual-level academic and nonacademic variables, along with community-level predictors to analyze their ability to predict high school graduation status. Logistic regression and multilevel logistic regression analyses were conducted to analyze the data. The model including community-level predictors yielded a pseudo R-squared value of .40, approximating that 40% of the variance was explained by the predictors in the model. Most of the individual predictors included in the models yielded findings similar to those found in previous literature on high school graduation status projection; however, this was not true for all of the predictor variables included. These differences highlight the tension that can exist between generalizability and local specificity. Significant findings from studies utilizing large nationally-representative longitudinal datasets and other large data sources do not always generalize to settings with samples that differ demographically. This study represents a first step in a line of research aimed at developing a better understanding of high school graduation status, particularly in challenging school contexts.

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Wolf, Miriam Regina 1962. "Avaliação do programa Bolsa Família sob a ótica do estado nutricional dos beneficiários." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308302.

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Orientador: Antonio de Azevedo Barros Filho
Dissertação (Mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-21T21:53:22Z (GMT). No. of bitstreams: 1 Wolf_MiriamRegina_M.pdf: 846436 bytes, checksum: 587b61fd7eddde79c6e4d7d216a04e56 (MD5) Previous issue date: 2013
Resumo: O Programa Bolsa Família (PBF) instituído em 2001 no Brasil é o único programa de âmbito nacional para o enfrentamento das questões relacionadas ao estado nutricional das crianças. Embora venha se expandindo ano após ano, ainda são poucas as avaliações no que se refere à repercussão nas condições de saúde e nutrição da população. O objetivo deste estudo é verificar o impacto do PBF no estado nutricional das crianças beneficiárias. Método: Inicialmente foi realizado um estudo de revisão sistemática com o objetivo de obter informações do estado nutricional dos beneficiários. Na sequência por meio de levantamento de dados secundários do Sistema de Vigilância Alimentar e Nutricional (SISVAN) de Blumenau-SC foi realizado um estudo de coorte longitudinal, comparando a evolução do estado nutricional das crianças beneficiárias e não beneficiárias do Programa Bolsa Família, durante os anos de 2006 a 2008. Resultado: Em ambos os trabalhos pode-se verificar que os dados não permitem concluir se o PBF modificou ou não o estado nutricional dos beneficiários
Abstract: The ¨Bolsa Família¨ Program (PBF) established in 2001 is the only nationwide program for dealing with issues related to food and nutrition. Although it will be expanding, there are few reviews regarding the impacts on health and nutrition. The objective of this study is to assess the impact of PBF on nutritional status of children beneficiaries. Method: Initially was made a systematic review study in order to obtain information of the nutritional status of the beneficiaries. Following through secondary survey data of system for food and nutritional surveillance (SISVAN) of Blumenau-SC was conducted a longitudinal cohort study, comparing the evolution of the nutritional status of children beneficiaries and non-beneficiaries of ¨Bolsa Família¨, during the years 2006 and 2008. Results: both studies don't allow to conclude that the PBF changed or not the nutritional status of the beneficiaries
Mestrado
Saude da Criança e do Adolescente
Mestra em Ciências

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Santos, Elcio Ferreira dos. "Avaliações bioquímicas e fisiológicas para previsão de desordens nutricionais de macronutrientes no desenvolvimento inicial do pinhão-manso." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/64/64134/tde-17042014-101328/.

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No Brasil, vários trabalhos com pinhão-manso (Jatropha curcas L.) têm estudado a avaliação do estado nutricional, porém são poucas as investigações objetivando caracterizar a marcha de absorção, bem como as respostas bioquímicas e fisiológicas desta espécie ao manejo nutricional. antecipadamente o estado nutricional das plantas. Desse modo, o objetivou-se com este estudo avaliar a marcha de absorção no desenvolvimento inicial do pinhão-manso (Jatropha curcas L.), bem como as omissões de N, P, K, Ca, Mg e de S no crescimento inicial e no comportamento bioquímico e fisiológico dessa espécie e, por fim, prever os quadros sintomatológicos das deficiências. Para alcançar os objetivos propostos foram realizados dois experimentos simultâneos, conduzidos em casa de vegetação, sendo que as plantas foram cultivadas individualmente em vasos contendo solução nutritiva. No primeiro experimento - referente à marcha de absorção - a plantas foram cultivadas em solução nutritiva completa, sendo que as plantas eram retiradas a cada 14 dias para a determinação do acúmulo de massa seca e macronutrientes. No segundo experimento as plantas foram cultivadas em solução completa (controle) e omissão individual de N, P, K, Ca, Mg e de S. Neste experimento foram realizados testes bioquímicos e fisiológicas para a previsão de desordens nutricionais aos 20, 30, 40 e 120 dias após o inicio dos tratamentos. As primeiras manifestações de deficiência foram observadas para o Ca e N, seguidas das de Mg e K, contudo não foram observados sintomas de carência de P e S. As atividades das enzimas redutase do nitrato, da fosfatase ácida e da peroxidase, bem como a avaliação das concentrações de poliaminas, efetuadas no início do desenvolvimento das plantas, demonstraram ser indicadores para previsão das desordens nutricionais de N, P e K, respectivamente. As omissões individuais dos macronutrientes limitaram o desenvolvimento inicial do pinhão-manso, reduziram os teores de clorofila e a taxa fotossintética de forma distinta. Porém, a omissão de Ca foi a que mais limitou o desenvolvimento dessa espécie para todas as variáveis avaliadas
In Brazil, several studies with physic nut (Jatropha curcas L.) have studied the assessment of nutritional status, but there are few investigations aiming to characterize the uptake and the biochemical and physiological responses to nutritional management of this species, for the purpose of prediction the nutritional status of plants. Thus, the objective with this study was to evaluate the uptake in the initial development of physic nut (Jatropha curcas L.), as well as the omission of N, P, K, Ca, Mg and S, to physiological and biochemical assessments, and finally, predicting symptomatology frames deficiencies. To achieve the proposed objectives two experiments were conducted in a greenhouse. The plants were grown individually in pots containing nutrient solution. In the first experiment - uptake of macronutrients - the plants were grown in complete nutrient solution, whereas plants were taken every 14 days for the determination of dry matter and macronutrients accumulation. In the second experiment, the plants were grown in complete solution (control) and the omission of N, P , K , Ca , Mg and S. In this experiment biochemical and physiological tests were performed for predicting nutritional disorders at 20, 30, 40 and 120 days after initiation of treatment. The first manifestations of deficiency were observed for Ca and N, followed by Mg and K, but don\'t were observed symptoms of P and S deficiency. The activities of nitrate reductase, acid phosphatase and peroxidase, as well as the assessment of concentrations of polyamines, made in the early development of the plant, proved to forecast indicators of nutritional disorders of N, P and K, respectively. The individual macronutrients omissions limited the initial development of physic nut, in addition, reduced chlorophyll content and photosynthetic rate differently. However, the omission of Ca was the most limited growth of this species for all variables

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Fink, Jaqueline da Silva. "Desenvolvimento de um novo instrumento de avaliação nutricional de adultos hospitalizados baseado nas questões da avaliação subjetiva global." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/131166.

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Base teórica: Desnutrição é mundialmente prevalente em hospitais, e contribui para o aumento da morbimortalidade dos pacientes. Métodos de avaliação do estado nutricional estão disponíveis, mas são limitados quanto à viabilidade em contexto hospitalar. A Avaliação Subjetiva Global (ASG) é uma ferramenta válida que, na falta de um padrão-ouro, é considerada padrão de referência para avaliação nutricional de pacientes hospitalizados. Entretanto, a validade da ASG limita-se à experiência do avaliador em lidar com a subjetividade do método, para a correta elaboração do diagnóstico. Objetivo: Desenvolver e verificar o desempenho de um novo instrumento de avaliação nutricional, com base na Teoria de Resposta ao Item (TRI), a partir das questões da ASG, em pacientes adultos hospitalizados. Métodos: Estudo de coorte retrospectivo, composto por base secundária de dados, formada por adultos hospitalizados incluídos entre outubro de 2005 e junho de 2006. Os pacientes foram avaliados nas primeiras 72 horas após sua admissão hospitalar quanto a características clínicas e nutricionais, incluindo a aplicação da ASG, conforme prevista pelos seus autores de origem. Dividiu-se a amostra aleatoriamente, de maneira que dois terços dos pacientes compusessem a amostra de desenvolvimento do novo instrumento, e um terço a amostra de verificação do seu desempenho. O instrumento de avaliação nutricional proposto foi desenvolvido através da utilização dos modelos cumulativos da TRI. A capacidade do instrumento em diagnosticar corretamente o estado nutricional foi comparada a valores de exames laboratoriais, índice de massa corporal e ocorrência de desfechos clínicos, por meio de testes para igualdade de proporções. Resultados: De um total de 1503 pacientes avaliados, a média de idade foi de 55,5±16,1 (19-94) anos, 52,7% do sexo feminino. Primeiramente, mantiveram-se no modelo estatístico as questões da ASG qualitativas e mais informativas, excluindo-se as quantitativas e que apresentassem informações semelhantes. Pacientes com dados faltantes também foram excluídos, compondo uma amostra de 826 indivíduos para o desenvolvimento do novo instrumento de avaliação nutricional e 407 para a amostra de verificação do seu desempenho. A etapa de ajuste dos itens demonstrou pouca contribuição de questões relativas à diarreia, capacidade funcional e edemas para o diagnóstico nutricional. Ainda, itens relativos à perda de peso, ingestão alimentar e demanda metabólica apresentaram melhor desempenho dicotomizados. As questões mais informativas para a diferenciação do estado nutricional entre os pacientes foram, respectivamente, perda de gordura, perda muscular e perda de peso. Após ajuste dos itens, propôs-se o “Escore de Avaliação Nutricional” (Nutritional Assessment Score - NAS), com reduzido número de questões, e menos itens politômicos, em comparação à ASG. O NAS mostrou-se relacionado a variáveis clinicamente relevantes (óbito, infecção, longa permanência hospitalar, albumina sérica e índice de massa corporal), em ambas as amostras. Conclusão: Os resultados apontam para a validade do NAS em detectar, de maneira acurada, o estado nutricional de pacientes hospitalizados. Seu desenvolvimento sinaliza avanço na busca por um método de avaliação nutricional factível e com menos suscetibilidade a erros decorrentes de subjetividade, em comparação à ASG.
Background: Malnutrition is prevalent in hospitals worldwide, and contributes to an increase of morbidity and mortality in patients. Nutritional status evaluation methods are available, but are limited as to their feasibility in hospital environment. The Subjective Global Assessment (SGA) is a valid tool that, in the absence of a “gold” standard tool, is considered the “reference standard” for nutrition assessment in hospitalized patients. Nevertheless, the validity of SGA is limited to the expertise of the evaluator in dealing with the method’s subjectivity, for the correct elaboration of the diagnosis. Objective: To develop and verify the performance of a new nutrition assessment tool, based in the Item Response Theory (IRT), from the SGA questionnaire, in hospitalized adults. Methods: Retrospective cohort study, composed by secondary database, formed by hospitalized adults included between October 2005 and June 2006. Patients were evaluated in the first 72 hours of hospital admission as to their clinical and nutritional characteristics, including the use of SGA, in accordance to its original authors. The sample was divided at random in a way that two-thirds of the patients made up the sample for the development of the new tool, and the remaining one-third of the sample for the performance verification tool. The proposed nutritional assessment tool was developed using cumulative models of the IRT. The tool’s capacity in diagnosing correctly the nutritional status was compared to laboratorial data, body mass index and occurrence of clinical outcomes through proportion equality tests. Results: From a total of 1503 evaluated patients, the average age was 55,5±16,1 (19-94), and 52,7% were women. First of all, the qualitative and more informative questions in SGA were kept in the statistic model, excluding the quantitative questions and those which presented similar information. Patients with missing data were also excluded, leaving a sample of 826 individuals for the development of the new assessment tool, and 407 for the performance verification tool. In the item adjustment stage, questions related to diarrhea, functional capacity and edemas were of little contribution to the nutritional diagnosis. Moreover, items related to weight loss, food intake and metabolic demand showed better performance dichotomized. The most informative questions to perceive nutritional status amongst patients were, respectively, fat loss, muscle wasting and weight loss. After adjusting the items, the Nutritional Assessment Score – NAS was suggested, with a reduced number of questions and less polytomic items in comparison to SGA. The NAS was related with clinically relevant variables (death, infection, long length of stay, serum albumin and body mass index), in both samples. Conclusion: The results point to the validity of NAS in detecting, accurately, the nutritional status of hospitalized patients. Its development signals a breakthrough in the search for a nutritional assessment method feasible and less susceptible to errors due to subjectivity, in comparison to SGA.

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Michelazzo, Fernanda Beraldo. "Avaliação da ingestão e do estado nutricional em relação ao zinco de jovens na faixa escolar." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/9/9132/tde-06072017-163507/.

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São poucas as investigações do estado nutricional de escolares, especialmente aqueles na faixa etária entre 9 e 12 anos que especifiquem o estágio de maturação sexual e que sejam norteados por parâmetros bioquímicos de avaliação de estado nutricional relativo a minerais, especialmente em relação ao zinco. ° presente estudo teve como objetivo avaliar o estado nutricional relativo ao zinco de escolares neste estágio de vida, de duas redes de ensino, pública e particular, de São João da Boa Vista/ SP, em três momentos ao longo de um ano (T1, T2 e T3), com intervalos de 4 meses. Para a avaliação antropométrica foram utilizados o IMC e a porcentagem de gordura corporal, esta última por meio da aferição de dobras cutâneas. A ingestão dietética foi analisada por programa de computador a partir de um recordatório de 24h e dois registros alimentares, e sua adequação foi avaliada pelas DRls(IOM, 2000). As concentrações de zinco plasmática, urinária e eritrocitária foram determinadas por espectrofotômetro de absorção atômica (comprimento de onda = 213,9 nm). Dos escolares avaliados, 19% estavam com o IMC≤P15, sendo predominantemente do sexo feminino e da rede particular, 53% estavam com IMC=P15>P50Investigations on the nutritional status of schoolchildren are rare, especially those ones for children between 9 and 12 years old which indicate their pubertal maturation, and are directed by biochemical parameters of nutritional status in relation to minerais, mainly zinco The objective of the present study was the evaluation of the nutritional status of zinc at schoolchildren aged between 9 and 12 year old at public and private schools in São João da Boa Vista, SP (Brazil) considering three different times along one year (T1 , T2 e T3), with 4 months interval each. The anthropometric evaluation was done by body mass index (BMI) and the percentage of total body fat, this one by skinfold measurements. A software analyzed diet information based on one 24h recall and 2-d food records, and its adequacy was evaluated by DRls (10M, 2000). Zinc nutritional status was evaluated by zinc determination in plasma, erythrocyte, and 24h urine, by atomic absorption spectrophotometry (Iambda = 213.9 nm). Out of the schoolchildren evaluated 19% presented BMI≤P15, being the majority female attending private schools, 53% showed BMI=P15>P50

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Rocha, Ariana Vieira. "Estado nutricional relativo ao selênio de crianças residentes em duas localidades de Rondônia, Amazônia Ocidental." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/9/9132/tde-26012017-172245/.

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Estudos sobre o estado nutricional da população de Rondônia são escassos, principalmente nas localidades ribeirinhas mais isoladas. Estas populações estão expostas a vários fatores ambientais que podem interferir no seu estado nutricional. Portanto, o objetivo principal deste estudo foi avaliar o estado nutricional relativo ao selênio de crianças ribeirinhas de 3 a 9 anos de idade residentes nas localidades de Demarcação, no Rio Machado e Gleba do Rio Preto, no Rio Preto. O método utilizado para avaliação do selênio foi a espectrometria de absorção atômica por geração de hidretos acoplada à cela de quartzo (HGQTAAS). Das 42 crianças estudadas, 74% pertenciam à localidade Demarcação e 26% à Gleba do Rio Preto. De acordo com os pontos de cortes estabelecidos para antropometria, a maioria das crianças das duas localidades apresentou eutrofia. Em relação aos níveis de selênio no plasma, 84% das crianças de Demarcação apresentaram concentrações abaixo do valor de referência, e 16% apresentaram concentrações normais. Por outro lado, as crianças da Gleba do Rio Preto apresentaram concentrações elevadas e acima dos valores de referência estabelecidos. Nos eritrócitos. 45% das crianças residentes na Demarcação apresentaram concentrações baixas do mineral e as demais, níveis normais. Na Gleba, 45% apresentaram concentrações normais e as demais, concentrações acima dos valores de referência. O consumo médio de selênio em Demarcação foi de 41,8µg/dia e na Gleba do Rio Preto, de 179,0µg/dia. Houve correlação significativa apenas entre o consumo de selênio e a concentração deste elemento nos eritrócitos, nas crianças de Demarcação. Desta maneira, conclui-se que as crianças estudadas apresentaram diferenças em relação ao estado nutricional para selênio, as crianças de Demarcação apresentando um estado entre deficiência e normalidade, e as da Gleba do Rio Preto, sujeitas a um possível risco de excesso com possibilidade de efeitos adversos. As concentrações de mercúrio nos cabelos das crianças e em peixes da região foram determinadas por espectrometria de absorção atômica com geração de vapor frio (CV AAS), visando estudar a interação deste elemento com o selênio, e os resultados confirmaram esta possível relação. A maioria das crianças de ambas as localidades apresentou níveis elevados deste metal nos cabelos, assim como foram elevadas as concentrações nos peixes da região. As crianças da Gleba do Rio Preto apresentaram níveis superiores às de Demarcação.
Studies about the nutritional status of population from Rondônia State are scarce, mainly at more isolated riverine places. Populations from these communities are exposed to several environmental factors that interfere in the nutritional status. Thus, the aim of this study was to evaluate the selenium nutritional status of riverine children aged between 3-9 years from Demarcação, placed at Madeira River, and from Gleba do Rio Preto, placed at Rio Preto River. The selenium was analyzed by hydride generation (quartz cell) atomic absorption spectrometry (HGQTAAS). From the 42 evaluated children, 74% of them resided at the first community and the others, at the second one. According to the established cut-offs for anthropometry, the most part of the children from both places were eutrophic. In relation to the plasma selenium levels, 84% of the children from Demarcação presented low levels, while the others 16% had normal levels. On the other hand, all children from Gleba do Rio Preto presented high plasma selenium levels, exceeding the established reference values. In the case of the erythrocyte levels, the percentage of normal and low selenium concentrations in those children from Demarcação was 55% and 45%, respectively. At Gleba do Rio Preto there were high selenium erythrocyte levels in 55% of the children. The mean selenium intake from diet was 41.8 µg/day at Demarcação, and 179.0 µg/day at Gleba do Rio Preto. There was a significant correlation only between the selenium ingested by diet and the erythrocyte selenium levels in those children from Demarcação. Taking the results together, it is possible to conc1ude that the studied children presented differences in relation to the selenium nutritional status with those from Demarcação showing a status between deficiency and normality, and those from Gleba do Rio Preto, a possible risk of excess, being liable to adverse effects. The hair and fishes mercury concentrations were determined intending to study the interaction between this metal with selenium, and the obtained results corroborated this possible relation. The great majority of the children from both places showed high hair mercury levels, as well as the fishes of that region. Children from Gleba do Rio Preto presented higher levels than those from Demarcação.

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Oliveira, Niara Carla de. "Estado nutricional de pacientes com lesão por pressão." Faculdade de Medicina de São José do Rio Preto, 2017. http://hdl.handle.net/tede/439.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Inadequate nutrition is often associated with the loss of the damping effect of fat mass on bone prominence, physical weakness, dehydration and edema. It also reduces skin resistance, mobility and impairs the immune system, which contributes to the development of pressure injuries. Adequate dietary intake and assessment of food intake are significant preventive factors for LPP development. The objectives of the study were to evaluate the nutritional profile of patients with pressure injury and the relationship between nutritional parameters and the occurrence of pressure injuries in hospitalized and outpatient patients. Material and methods: In the first stage of the study, patients were monitored at home by teams of Family Health of São José do Rio Preto. In the second stage, the patient was evaluated at the Base Hospital and at the Wound Dressing and Wound Clinic of the Base Hospital. Where all patients were bedridden and had pressure injuries. Results: The majority had LPP stage 2, followed by stage 3 and 4. By ANSG 50% were considered at nutritional risk and the other 50% with malnutrition. According to the anthropometric indicators, 16.7% were eutrophic, 25% were at nutritional risk and 58.3% were undernourished. The patients ingested 1465.3 ± 459 (SD) calories / day and 54.1 + 26.9 (SD) g protein / day. In the second stage of the study, a prospective study was carried out in a school hospital and in the outpatient clinic of the same institution of São José do Rio Preto - SP, totaling 30 patients with pressure injury independent of the evolution stage. There was a predominance of LPP stage 3 (14 patients - 46.67%), with most lesions in the sacral region (24-80.00%), followed by trochanter (8- 26.67%). LPP predominated in female subjects (P <0.04). There were significant correlations between the total number of lesions and the BMI (P <0.04); subscapular skin fold (P <0.04) and sum of cutaneous folds (P <0.04). Conclusion: A poor nutritional status seems to be directly associated with the presence of LPP and, associated with other aggravating factors, is a risk factor for development.
A nutrição inadequada é frequentemente associada com a perda do efeito de amortecimento da massa de gordura sobre as proeminências ósseas, fraqueza física, desidratação e edema. Também reduz a resistência da pele, a mobilidade e a prejudica o sistema imunológico, o que contribui para o desenvolvimento de lesões por pressão. A ingestão dietética adequada e avaliação da ingestão alimentar são fatores significativamente preventivos para desenvolvimento de LPP. Os objetivos do trabalho foram avaliar o perfil nutricional de pacientes com lesão por pressão e a relação entre parâmetros nutricionais e a ocorrência de lesões por pressão em pacientes hospitalizados e ambulatoriais. Material e Métodos: Na primeira etapa do trabalho foram avaliados pacientes acompanhados no domicílio por equipes de Saúde da Família de São José do Rio Preto. Na segunda etapa foram avaliados paciente atendidos no Hospital de Base e no Ambulatório de Curativos e Feridas do Hospital de Base. Onde todos os pacientes era acamados e possuíam lesões por pressão. Resultados: A maioria apresentava LPP estágio 2, seguida por estágio 3 e 4. Pela ANSG 50% foram considerados em risco nutricional e os outros 50% com desnutrição. Pelos indicadores antropométricos 16,7% eram eutróficos, 25% em risco nutricional e 58,3% desnutridos. Os pacientes ingeriam 1465,3 ± 459 (DP) calorias/dia e 54,1 + 26,9 (DP) g de proteína/dia. Na segunda etapa do trabalho, foi realizado estudo prospectivo em um hospital escola e no ambulatório da mesma instituição de São José do Rio Preto - SP, totalizando 30 pacientes com lesão por pressão independente do estágio de evolução. Houve predomínio de LPP estágio 3 (14 pacientes - 46,67%), sendo a maioria de lesões em região sacral (24- 80,00%), seguida de trocânter (8- 26,67%). As LPP predominaram em pessoas do sexo feminino (P<0,04). Houve presença de correlações significativas entre o número total de lesões e o IMC (P<0,04); prega cutânea subescapular (P<0,04) e somatório das pregas cutâneas (P<0,04). Conclusão: Um estado nutricional ruim parece estar diretamente associado à presença de LPP e, associado a outros agravantes, é um fator de risco para o desenvolvimento.

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Zorlini, Renata. "Perfil nutricional pre-operatorio de mulheres com cancer ginecologico e mamario." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311114.

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Orientador: Maria Salete Costa Gurgel
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Introdução: As mulheres com câncer ginecológico ou de mama apresentam, freqüentemente, alterações do estado nutricional como a desnutrição e a obesidade, devido à própria doença como também ao tratamento a que são submetidas: cirurgia, quimioterapia e/ou radioterapia. Tais alterações podem trazer complicações no pós-operatório como aumento do período de hospitalização, dos custos hospitalares e piora do prognóstico. Para identificar este problema, a avaliação nutricional pode ser o melhor método para tratar os distúrbios nutricionais, como a desnutrição e/ou a obesidade, melhorar a resposta terapêutica e o prognóstico das pacientes. Objetivo: Identificar o perfil nutricional pré-operatório de mulheres com câncer ginecológico ou mamário e correlacioná-lo à localização e estádio da doença e tratamentos oncológicos (quimioterapia e/ou radioterapia) prévios. Sujeitos e Métodos: Trata-se de um estudo de corte transversal com 250 mulheres avaliadas no pré-operatório de cirurgias oncologicas no CAISM/Unicamp, pelo Índice de Massa Corpórea e pela Avaliação Nutricional Subjetiva Global, no período de agosto de 2003 a abril de 2005. Para análise dos dados foram aplicados os testes Qui-Quadrado e Índice de Concordância entre os dois métodos, assumindo-se o nível de significância de 5%. Resultados: O câncer da mama foi o mais freqüente, predominando em 56,2%. A mediana da idade foi de 52 anos; em cerca de 57% dos casos a neoplasia se restringia aos estádios clínicos 0, I e II, e 77% das mulheres não realizaram outro tratamento oncológico pré-cirurgico. A Avaliação Nutricional Subjetiva Global detectou 76% de mulheres eutróficas e 24% desnutridas, enquanto o Índice de Massa Corpórea identificou 34% de mulheres eutróficas, 3,6% desnutridas e 62,4% com sobrepeso/obesidade. A concordância do diagnóstico de eutrofia e desnutrição pelos dois métodos foi baixa [63,8%; kappa (IC 95%) = 0,0884 (-0,07 ¿ 0,24)]. Não foram observadas correlações entre as avaliações nutricionais e os tratamentos prévios e estádios da doença. Quanto à localização anatômica, segundo a Avaliação Nutricional Subjetiva Global, as mulheres com câncer do corpo do útero eram mais desnutridas que as demais (p=0,02). Conclusões: Os achados sugerem que uma avaliação mais criteriosa deva ser empregada para identificação do estado nutricional pré-operatório em mulheres com câncer ginecológico ou mamário. Palavras-chave: perfil nutricional; avaliação nutricional; desnutrição; obesidade; câncer ginecológico; câncer de mama; pré-operatório
Abstract: Introduction: The oncologic patient often undergoes several surgical procedures and nutritional status is usually altered during hospitalization, resulting in a worse prognosis. The association between cancer and malnutrition or obesity has many consequences, including increased risk of infection, increased length of hospitalization, poor wound healing, reduction in muscle function and its consequences, thus affecting response to therapy. Objective: To identify the preoperative nutritional profile of women with gynecologic or breast cancer, in correlation with disease site and staging as well as previous treatments. Subjects and Methods: A cross-sectional study of 250 women evaluated by Body Mass Index and Subjective Global Assessment from August 2003 to April 2005. For data analysis, the chi-square test was applied and the agreement between the diagnoses of normal nutrition and malnutrition was calculated by both methods using kappa coefficient and its 95% confidence interval. Results: Breast cancer was the most frequent cancer, predominating in 56.2%. The median age of the patients was 52 years. In about 57% of these women, the tumor was restricted to clinical stages 0, I and II and 77% of the women had not undergone any other oncologic treatment prior to surgery. Subjective Global Assessment detected 76% of nourished women and 24% undernourished women, while Body Mass Index identified 34% of nourished women, 3.6% undernourished women and 62.4% overweight/obese women. A low level of diagnostic agreement between normal nutrition and malnutrition by both methods was observed (63.8%; kappa (95% CI) = 0.0884 (-0.07 ¿ 0.24). No correlation between nutritional evaluation and previous treatment and disease staging was observed. Concerning anatomic site, it was subjectively observed that women with cancer of the uterine corpus were more malnourished than the rest (p=0.02). Conclusions: The findings suggest that a more careful evaluation should be employed to identify preoperative nutritional status in women with gynecologic or breast cancer. Keywords: nutritional profile; assessment; malnutrition; obesity; gynecologic cancer; breast cancer; preoperative
Mestrado
Ciencias Biomedicas
Mestre em Tocoginecologia

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Flores, Luz Mérida Rondán. "Avaliação do estado nutricional relativo ao zinco de um grupo de estudantes universitárias da Universidade de São Paulo." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/9/9132/tde-24112017-120844/.

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Pesquisas experimentais e clinicas recentes têm reforçado a importância do zinco na nutrição humana, no entanto, grupos populacionais sadios podem apresentar deficiência deste micronutriente. Este trabalho avaliou o estado nutricional de um grupo de estudantes universitárias da Universidade de São Paulo em relação ao zinco. Participaram trinta e oito estudantes de sexo feminino, com faixa etária de 19 a 31 anos, que não fizeram uso de suplemento vitamínico mineral contendo zinco. A média de IMC das participantes foi de 20,8. O consumo alimentar, avaliado por meio de três registros alimentares e analisado pelo programa Virtual Nutri (1.0), demonstrou que o consumo energético médio foi cerca de 1735,2 ± 132,9 kcal, a distribuição dos macronutrientes foi cerca de 62,7% de carboidratos, 11,4% de proteína e 26% de lipídeos. A ingestão média de zinco foi de 6,9 ±1,5 mg/dia. A concentração plasmática de zinco foi de 81,17 ± 14,7 µg/dL e a eritrocitária foi de 41,4 ± 8,5 µgZn/gHb. Na urina de 24 horas as médias de concentração foram 271,78 ± 175 µg/ dia. A atividade da CuZn-SOD foi de 1110,91 ± 310 U/gHb. Por estes resultados observou-se que a distribuição dos macronutrientes encontra-se adequada às recomendações, entretanto com baixo valor energético e a ingestão de zinco apresenta-se insuficiente. Com relação aos valores sanguíneos do mineral embora a média esteja dentro dos valores de normalidade, cerca de 32% apresentaram valores abaixo de 75 µg/dL, o mesmo ocorrendo em relação ao zinco eritrocitário, onde 52,6% apresentavam valores abaixo de 40 µgZn/gHb. O zinco urinário também for baixo para 65,8% das estudantes. Houve correlação entre os valores de ingestão do zinco e sua concentração sangüínea. A atividade da CuZn-SOD apresentou correlação com o zinco no plasma. De acordo com estes resultados observa-se que a maioria das participantes deste estudo estava mantendo a homeostase em relação a este mineral, entretanto com baixas reservas e algumas delas em estado de deficiência.
Recent experimental and clinical researches are emphasizing the importance of the zinc in the human nutrition; yet, populational groups may present deficiency of this nutrient. This work evaluated the nutritional status of a group of the University of Sao Paulo students, in relation to the zinc. Thirty-eight students participated in the study, all female, aged from 19 to 31 years, which made use of vitaminic-mineral supplement containing zinc. The average IMC of the participants was 20,8. The alimentary consumption, evaluated by means of three alimentary registers, analyzed by the software Virtual Nutri (1.0), demonstrated that the mean energetic consumption was of 1735,2 ± 132,9 kcal, the macronutrient distribution was of 62,7% of carbohydrates, 11,4% of proteins and 26% of lipids. The ingestion of zinc was of 6,9 ±1,5 mg/day in average. The plasmatic concentration of zinc was of 81,17 ± 14,7 µg/dL and erythrocytary concentration was of 41,4 ± 8,5 µgZn/gHb. In the 24 hour urine the mean concentrations were of 271,78 ± 175 µg/ day. The activity of CuZn-SOD was of 1110,91 ± 310 U/gHb. From these results, it could be observed that the macronutrient distribution agreed with the recommendations, however with low energetic value and insufficient zinc ingestion. With relation to the blood mineral values, although the average were positioned within a normal range, about 32% of the patients presented values lower than 75 µg/dL, the same happening with the \"erythrocytary\" zinc, where 52,6% presented values lower than 40 µgZn/gHb. The zinc in the urine was, as well, low for 65,8% of the students. There was correlation between the ingestion of zinc and its blood concentration values. The activity of the CuZn-SOD presented correlation with zinc in the plasma. According to these results, it could be concluded that the majority of the participants in the study was keeping the \"homeostasis\" in relation to this mineral, even so with low supplies and, in certain cases, with deficiency.

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47

Cardoso, Silvana da Silva. "Avaliação nutricional de pacientes com lesão renal aguda de um hospital de ensino." Faculdade de Medicina de São José do Rio Preto, 2014. http://hdl.handle.net/tede/323.

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Introduction: The nutritional status is relevant to improve the quality of life of Acute Kidney Failure (AKF) patients, not only to maintain life, but also in the therapeutic context. Objectives: To identify the nutritional intervention to improve the quality of life of AKF patients in a literature review, to assess and associate the nutritional status of AKF patients with the sociodemographic and clinical characteristics and nutritional parameters at a teaching hospital in the State of São Paulo, Brazil. Method: An integrative review was undertaken in the databases Latin American and Caribbean Health Science Literature (LILACS) e Medical Literature Analysis and Retrieval System on-line (MEDLINE) between January 2008 and July 2013. Cross-sectional study of 102 AKF patients at a teaching hospital in the interior of the State of São Paulo, attended by the inter-consultation team from the nephrology service between June and December 2013. The data collection instruments were a form with the sociodemographic, clinical and nutritional variables and the Global Subjective Assessment, modified to assess and interpret the nutritional status. Results: The integrative review of 14 articles demonstrated that the effective nutritional interventions to improve the quality of life of AKF patients are daily nutritional monitoring and nutritional therapy. Few studies were verified about nutritional interventions in AKF patients to improve the quality of life, published particularly in 2009 and in specialized nutrition and nephrology journals. The sociodemographic profile of AKF patients was female (62.75%), with a partner (60.78%), inactive (63.73%), with a mean age of 62.46±16.94 years. The clinical parameters were: non-smokers (88.24%), non-alcohol consumers (84.31%), preliminary kidney disease (50.98%), non-diabetic (55.48%), hypertensive (56.86%), non-dyslipidemic (88.24%), non-obese (90.20%) and from a clinical specialty (59.80%). The nutritional parameters showed the use of an oral diet (85.29%), weight loss superior to 10% (70.59%) and interpreted as mild risk/malnutrition (91.18%). The variables current weight (P=0.048) and systolic blood pressure (P=0.041) were influenced by the patients’ nutritional status. The results showed no significant association between the nutritional status and the other sociodemographic and clinical variables and nutritional parameters assessed. Conclusion: Good nutritional conditions influence the improvement in the quality of life of AKF patients. The assessment of the nutritional status and the monitoring of acute renal patients are fundamental for the early detection of malnutrition and prevention of morbidities and mortality.
Introdução: O estado nutricional é relevante para melhora da qualidade de vida de pacientes com Lesão Renal Aguda (LRA) não apenas na manutenção da vida, como no cenário terapêutico. Sendo que o interesse por este assunto faz com que em paralelo haja mudanças na morbimortalidade e com isso mostra um aumento na prevalência das doenças crônicas, como na lesão renal Objetivos: Identificar as intervenções nutricionais para melhora da qualidade de vida de pacientes com LRA em uma revisão de literatura, avaliar e associar o estado nutricional dos pacientes com LRA em relação às características sóciodemográficas, clínicas e os parâmetros nutricionais de um hospital de ensino do interior paulista. Métodos: Estudo de revisão integrativa foi realizado nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Medical Literature Analysis and Retrieval Sistem on-line (MEDLINE) no período de janeiro de 2008 a julho de 2013. Estudo transversal com 102 pacientes com LRA de um Hospital de Ensino do interior paulista atendidos pela equipe de interconsulta do serviço de nefrologia no período de junho a dezembro de 2013. Foram utilizados como instrumentos de coleta de dados, um formulário com as variáveis sóciodemográficas, clínicas, nutricionais e a Avaliação Subjetiva Global modificada para avaliar e interpretar o estado nutricional. Resultados: A revisão integrativa com 14 artigos demonstrou que as intervenções nutricionais efetivas para melhora da qualidade de vida dos pacientes com LRA são o acompanhamento nutricional diário e terapia nutricional. Verificaram-se poucos estudos sobre as intervenções nutricionais no paciente com LRA para melhora da qualidade de vida, com destaque no ano de 2009 e em periódicos especializados de nutrição e nefrologia. O perfil sóciodemográfico dos pacientes com LRA foi do sexo feminino (62,75%), com companheiro (60,78%), inativo (63,73%), com idade média de 62,46±16,94 anos. Os parâmetros clínicos foram: não tabagista (88,24%), não etilista (84,31%), de etiologia pré-renal (50,98%), não diabético (55,48%), hipertenso (56,86%), não dislipidêmico (88,24%), não obeso (90,20%) e de especialidade clínica (59,80%). Parâmetros nutricionais apresentaram a utilização de dieta oral (85,29%), a perda de peso maior que 10% (70,59%) e com interpretação de risco/desnutrição leve (91,18%). As variáveis peso atual (P=0,048) e a pressão arterial sistólica (P=0,041) foram influenciadas pelo estado nutricional dos pacientes. Os resultados mostraram que não houve associação significativa entre o estado nutricional e as demais variáveis sociodemográficas, clínicas e parâmetros nutricionais avaliadas. Conclusão: Boas condições nutricionais impactam na melhora da qualidade de vida dos pacientes com LRA. A avaliação do estado nutricional e a monitorizarão em pacientes renais agudos são imprescindíveis para a detecção precoce da desnutrição e na prevenção da morbimortalidade.

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Castro, Tatiana Mazza de. "Avaliação nutricional do paciente com doença hepática crônica." Universidade do Estado do Rio de Janeiro, 2009. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=5061.

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Além de muito freqüente, a desnutrição associa-se a morbi/mortalidade em pacientes com doenças hepáticas crônicas. A avaliação do estado nutricional em hepatopatas é difícil pela sobrecarga hídrica e pela alteração na síntese protéica, fatores que alteram os parâmetros tradicionalmente usados na avaliação nutricional. Os objetivos são:a)avaliar o estado nutricional, através da AGS, antropometria, do escore de Mendenhall e da combinação de todos os instrumentos, em pacientes com doença hepática crônica; b)correlacionar o estado nutricional com a gravidade de doença hepática crônica; c)determinar a contribuição da dinamometria do aperto de mão para a avaliação do estado nutricional. Foram incluídos 305 pacientes portadores de doenças hepáticas crônicas, com idade de 18-80 anos, atendidos no ambulatório de doenças hepatobiliares do Hospital Universitátio Pedro Ernesto. A gravidade da doença hepática foi avaliada pela classificação de Child-Pugh e escore de Meld. Foram aferidos parâmetros antropométricos (peso, altura, índice de massa corporal, prega cutânea triciptal, circunferência do braço, circunferência muscular do braço), parâmetros bioquímicos (albumina e contagem total de linfócitos), Avaliação Global Subjetiva, escore de Mendenhall e força do aperto de mão pela dinamometria. Os valores da porcentagem de adequação dos parâmetros foram utilizados para a classificação da desnutrição. Consideramos todos os pacientes com porcentagens de adequação abaixo de 90% como desnutridos. Foi criado o escore risco de desnutrição que se caracterizou pela alteração em qualquer um dos parâmetros da avaliação nutricional. Cerca de 53% dos pacientes eram do sexo masculino, 43% portadores de cirrose hepática, 80% com etiologia viral e média de idade de 54 12 anos. Houve relação estatisticamente significativa entre a classificação funcional da doença hepática e a AGS, o escore de Mendenhall e o de risco de desnutrição. A avaliação isolada da antropometria não se correlacionou com a classificação funcional. Segundo a AGS, a prevalência de desnutrição foi de 10% na hepatopatia não cirrótica, 16% na cirrose compensada e 94% na cirrose descompensada. Segundo o escore de Mendenhall, as cifras foram de 31%, 38% e 56%, respectivamente. Segundo o novo escore, as cifras foram de 52%, 60% e 96%, respectivamente. Embora tenha havido uma redução estatisticamente significativa da força muscular com o agravamento do estado nutricional, não foi possível estabelecer um ponto de corte para os valores da dinamometria. A análise do desempenho do percentual de adequação da força muscular como critério diagnóstico de pacientes sob risco de desnutrição revelou provavelmente 56% de falso-positivos e 24% de falso-negativos. A grande variação na prevalência de desnutrição em pacientes com doença hepática depende do instrumento de avaliação nutricional usado e da classificação funcional da doença hepática. Não surpreendentemente, os escores combinados detectaram as maiores taxas de prevalência de desnutrição. Houve associação significativa entre o estado nutricional e a gravidade da doença hepática. O aumento das taxas de prevalência de desnutrição trazido pela dinamometria ocorreu às custas de resultados falso-positivos.
Malnutrition is often present and under diagnosed in patients with chronic liver diseases. Many of the traditional methods used to evaluate nutritional status may be altered by edema, ascites, and protein deficit caused by liver disfunction. To compare different methods to assess nutritional status; to correlate nutritional status with severity of liver dysfunction, and to determine the role of handgrip strength to nutritional assessment in patients with chronic liver disease. This prospective, cross-sectional study evaluated 305 consecutive outpatients adults with chronic liver disease. The severity of liver dysfunction was assessed by Child`s classification and Meld score. The nutritional assessment was evaluated by subjective global assessment (SGA), anthropometry, handgrip strength, Mendenhall score, and a new malnutrition score (defined by alteration in any nutritional parameter). The anormality of all parameters was considered when the adequation percentage was under 90%. Fifty-three percent of patients were male, 43% had liver cirrhosis, 80% had viral etiology, with a mean age of 54 12 years. There was a significative relationship between the severity of liver dysfunction and SGA, Mendenhall score, and the new malnutrition score. The isolated assessment of anthropometry had no relationship with the severity of liver dysfunction. According to SGA, the prevalence of malnutrition was 10% for non-cirrhotic hepatic disease, 16% for compensated cirrhosis, and 94% for descompensated cirrhosis. According to Mendenhall score, the rates were 31%, 38%, and 56%, respectively. According to the new malnutrition score, the rates were 52%, 60%, and 96%, respectively. Although there had had a significant reduction in handgrip strength with the severity of malnutrition, we cant establish a cut-off value. The performance of handgrip strength adequation percentage as a criteria for diagnosing malnutrition showed 56% of false-positive and 24% of false-negative results. The prevalence of malnutrition is variable in patients with chronic liver diseases. It depends on the method used to evaluate nutritional status and the severity of liver dysfunction. Not surprisingly, the scores who combined multiple parameters of nutritional assessment showed the higher prevalence of malnutrition. There was a significant association between nutritional status and severity of liver dysfunction. If we add the measurement of handgrip strength to nutritional assessment, the prevalence rates of malnutrition will increase because of false-positive results.

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Schmidt, Kelen Heinrich. "Programa Bolsa Família na coorte de nascimentos de Pelotas, 2004: focalização e impactos no IMC/Idade, obesidade e composição corporal de crianças." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/6/6138/tde-09032016-141700/.

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Introdução: O Programa Bolsa Família é a principal estratégia brasileira para amenizar a pobreza e vulnerabilidade social, com diferentes impactos na vida dos beneficiários. O aumento da renda, em função do benefício, poderia trazer resultados positivos na alimentação, uma vez que possibilitam uma maior diversidade da dieta. Porém, poderia trazer resultados negativos como a ingestão excessiva de energia e consequente aumento da adiposidade. As avaliações dos impactos do programa em termos de obesidade e massa gorda de crianças são inexistentes. Objetivo: Avaliar o impacto do Programa Bolsa Família no estado nutricional (IMC/idade) e na composição corporal aos 6 anos de idade entre as crianças da Coorte de Nascimentos de Pelotas (RS), 2004. Métodos: Os dados foram provenientes da integração dos bancos da Coorte de Nascimentos de Pelotas de 2004 e do Cadastro Único do Governo Federal. Foi realizada análise descritiva da cobertura e focalização do programa, com informações do nascimento e dos 6 anos de idade (n=4231). Considerou-se focalização o percentual de elegíveis entre o total de beneficiários e cobertura o percentual de famílias elegíveis que são beneficiárias do programa. Nos modelos de impacto (n=3446), as exposições principais foram o recebimento do benefício: beneficiário em 2010, no período de 2004-2010; o valor médio mensal recebido e o tempo de recebimento. Foram gerados modelos de regressão linear para os desfechos score-Z do índice de massa corporal por idade (IMC/I), percentual e índice de massa gorda (IMG), e percentual e índice de massa livre de gordura (IMLG); e de Poisson, com ajuste robusto, para o desfecho obesidade (score-Z IMC/I 2), todos estratificados por sexo. As informações antropométricas e de composição corporal (BOD POD) foram obtidas do acompanhamento aos 6-7 anos de idade. Potenciais fatores de confusão foram identificados por modelo hierárquico e por um diagrama causal (DAG). Para analisar os impactos foram usadas como medidas de efeito a diferença de médias na regressão linear múltipla (IMC/I, por cento MG, IMG, por cento MLG e IMLG, variáveis contínuas) e a razão de prevalência (obesidade, variável binária). Para permanecer no modelo, considerou-se valor p0,20. A análise dos dados foi realizada por meio do software STATA. Resultados: Entre 2004-2010, a proporção de famílias beneficiárias na coorte aumentou (11 por cento para 34 por cento ) enquanto, de acordo com a renda familiar, a proporção de famílias elegíveis diminui (29 por cento para 16 por cento ). No mesmo período, a cobertura do programa aumentou tanto pela renda familiar quanto pelo IEN. Já a focalização caiu de 78 por cento para 32 por cento de acordo com a renda familiar e, de acordo com o IEN, manteve-se em 37 por cento . A média (não ajustada) de IMC e de MG dos não beneficiários foi superior a dos não beneficiários tanto em meninos quanto em meninas. Meninos do 3º tercil de valor per capita recebido e meninas com menos de 7 meses de benefício em 2010 tiveram IMC maior do que, respectivamente, aqueles dos demais tercis e daquelas com mais de 7 meses de benefício em 2010; esse padrão foi semelhante para obesidade. Meninas não beneficiárias tiveram MG maior do que as beneficiárias e superior também aos meninos, independente de ser beneficiário ou não. Em relação à MLG observou-se um comportamento contrário, no qual meninas beneficiárias tiveram maior MLG, quando comparadas com meninas não beneficiárias e, meninos quando comparados com meninas. Nos modelos de regressão ajustados, não houve diferença significativa entre beneficiários e não beneficiários em nenhum desfecho. Conclusões: De acordo com os resultados, as famílias que receberam maiores valores per capita parecem incluir crianças com maior média de IMC. O programa, nessa análise, parece não ter impacto sobre a composição corporal das crianças, nem em termos de massa gorda, tampouco em termos de massa livre de gordura.
Introduction: the Bolsa Família Program (BFP) is the main Brazilian strategy to alleviate poverty and social vulnerability, with different impacts on the lives of beneficiaries. The increase of income, depending on the benefit, could bring positive results in food consumption, since enable greater dietary diversity. However, it could bring negative results as excessive intake of energy and consequent increased adiposity. The evaluations of the impacts of the program in terms of obesity and fat mass of children are nonexistent. Objective: to evaluate the impact of BFP in nutritional status (BMI/A) and body composition to 6 years of age among children of the Cohort of Births of Pelotas (RS), 2004. Methods: data were obtained from the integration of the banks of the cohort of births of 2004 pellets and Single Record of the Federal Government. Descriptive analysis was performed of the coverage and focus of the program, with information of birth and 6 years of age (n=4231). Effect models (n=3446), the main exhibition were the approaches of the receipt of the benefit: beneficiary in 2010, in the 2004-2010 period; average monthly value and time of receipt. Linear regression models were generated for the Z-score outcomes of the body mass index for age illness (BMI/A), percentage and fat mass index (FMI), and percentage and fat-free mass index (FFMI); and Poisson, with robust adjustment for obesity outcome (score-Z BMI/A 2), all stratified by sex. The information and measurements of body composition (BOD POD) were obtained from monitoring to 6-7 years of age. Potential confounding factors were identified by hierarchical model and a causal diagram (DAG). The measures used were the average difference in multiple linear regressions (BMI/A, FM, FMI, FFM, FFMI, continuous variables) and the ratio of prevalence (obesity, binary variable). To stay at the model considered value p 0.20. Data analysis was performed using STATA software. Results: Between 2004-2010, the proportion of recipient families has increased (11 per cent to 34 per cent ); by family income eligible families number decreases (29 per cent to 16 per cent ). The coverage of the program increased both by family income as by IEN. The focus fell from 78 per cent to 32 per cent (household income) and remained at 37 per cent (IEN). The average (not adjusted) of BMI and FM of non-beneficiaries was higher in boys and girls. Boys of 3 tercil per capita value received and girls under the age of 7 months of 2010 had BMI greater benefit; this pattern was similar for obesity. Non-beneficiary girls had FM larger than the beneficiary and also higher than the boys, regardless of whether or not the beneficiary. Regarding the FFM observed a contrary behavior, in which beneficiaries girls had higher FFM, compared to non-beneficiary girls and boys compared to girls. In adjusted regression models, there was no significant difference between beneficiaries and non-beneficiaries in any outcome. Conclusions: there is evidence that the families who received largest per capita values include children with a higher average BMI. Although children beneficiaries have indexes under fat mass, the generated models showed that the program also has no effect on the fatfree mass.

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Valla, Frédéric. "Évaluation nutritionnelle systémique de l’enfant en réanimation pédiatrique." Thesis, Lyon, 2019. http://www.theses.fr/2019LYSE1281/document.

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La malnutrition à l’admission en réanimation pédiatrique est fréquente et associée à une augmentation de la morbi-mortalité. Néanmoins, la plupart des études, limitées à une évaluation statique du statut nutritionnel, ne permettent pas une analyse fine de l’impact de la malnutrition. Une approche systémique associerait en plus d’une évaluation nutritionnelle statique, une analyse dynamique dans le temps, une analyse de la composition corporelle et une analyse physiopathologique et étiologique. Cette approche globale a été appliquée dans 4 études prospectives observationnelles, incluant des enfants sévèrement agressés de plus de 36 semaines d’âge corrigé. Il en ressort que la dénutrition globale à l’admission est fréquente (23,7%) et que la cassure des courbes de croissance avant l’admission est associée à une augmentation de la durée de séjour de 3 jours. L’enfant sévèrement agressé présente à l’admission des taux plasmatiques abaissés de 6 micronutriments impliqués dans le stress oxydant (Sélénium, Zinc, Cuivre, Vitamines C, E et bêta-carotène), proportionnellement au nombre de défaillances d’organe. La dénutrition globale et la fonte musculaire acquises en cours de séjour sont des phénomènes fréquents, précoces et importants, associés à une durée de séjour prolongée. Les changements métaboliques liés à l’agression sévère conduisent à une dénutrition. Ces processus adaptatifs sont parfois dépassés et la dénutrition pourra à son tour aggraver le pronostic. La bonne compréhension de la physiopathologie sous-jacente et un suivi systémique et systématique du statut nutritionnel sont les éléments indispensables à l’évaluation des stratégies nutritionnelles
Malnutrition at pediatric Intensive care unit (PICU) admission is frequent and associated with impaired outcomes. However, most studies have focused solely on a static definition. A holistic approach would improve the description of malnutrition: this would include both a static and dynamic assessment of nutritional status, together with body composition assessment and with malnutrition classified based on its patho-physiology and etiology. This holistic assessment of malnutrition has been applied and examined in four observational studies which included critically ill children older than 36 gestational weeks (corrected age). These found that malnutrition was frequent at PICU admission (27.3%) and faltering growth prior to PICU admission was associated with an increased length of PICU stay (+3 days). Critically ill children present at admission with decreased plasma levels of 6 micro-nutrients (Selenium, Copper, Zinc, Vitamin C, E and beta-carotene) involved in anti-oxidative stress pathways. Nutritional status deterioration during PICU stay, and associated muscle mass loss occurred frequently and were intense. This early phenomenon was associated with extended length of PICU stay. A profound critical illness related metabolic shift leads to malnutrition as an adaptive process. However, malnutrition may also negatively impact on outcomes in this setting. These studies have led to a clearer understanding of the underlying patho-physiology. This, combined with a more systematic and holistic nutritional assessment, will enable implementation and assessment of nutritional strategies aiming to improve the functional outcome of critically ill children

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