26 results on '"Isenring EA"'
Search Results
2. Nutritional screening in community-dwelling older adults: a systematic literature review.
- Author
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Phillips MB, Foley AL, Barnard R, Isenring EA, and Miller MD
- Abstract
Nutrition screening is a process used to quickly identify those who may be at risk of malnutrition so that a full nutrition assessment and appropriate nutrition intervention can be provided. While many nutrition screening tools have been developed, few have been evaluated for use in older adults in the community setting. The aim of this paper is to determine the most appropriate nutrition screening tool/s, in terms of validity and reliability, for identifying malnutrition risk in older adults living in the community. Electronic databases MEDLINE, PUBMED, CINAHL and the Cochrane Library were searched for nutrition screening tools to identify malnutrition or under-nutrition for adults greater than 65 years living in the community. Ten screening tools were found for use in community-dwelling older adults and subjected to validity and/or reliability testing: Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Screening Initiative (NSI), which includes the DETERMINE Checklist and Level I and II Screen, Australian Nutritional Screening Initiative (ANSI), Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN I and SCREEN II), Short Nutritional Assessment Questionnaire (SNAQc), Simplified Nutritional Appetite Questionnaire (SNAQ), and two unnamed tools. MNA-SF appears to be the most appropriate nutrition screening tool for use in community-dwelling older adults although MUST and SCREEN II also have evidence to support their use. Further research into the acceptability of screening tools focusing on the outcomes of nutrition screening and appropriate nutrition intervention are required. [ABSTRACT FROM AUTHOR]
- Published
- 2010
3. Responsiveness and convergent validity of QLU-C10D and EQ-5D-3L in assessing short-term quality of life following esophagectomy.
- Author
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Bulamu NB, Vissapragada R, Chen G, Ratcliffe J, Mudge LA, Smithers BM, Isenring EA, Smith L, Jamieson GG, and Watson DI
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- Australia, Cost-Benefit Analysis, Female, Humans, Male, Middle Aged, Psychometrics, Reproducibility of Results, Surveys and Questionnaires, Esophagectomy, Quality of Life
- Abstract
Aim: This study assessed the responsiveness and convergent validity of two preference-based measures; the newly developed cancer-specific EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D) relative to the generic three-level version of the EuroQol 5 dimensions (EQ-5D-3L) in evaluating short-term health related quality of life (HRQoL) outcomes after esophagectomy., Methods: Participants were enrolled in a multicentre randomised controlled trial to determine the impact of preoperative and postoperative immunonutrition versus standard nutrition in patients with esophageal cancer. HRQoL was assessed seven days before and 42 days after esophagectomy. Standardized Response Mean and Effect Size were calculated to assess responsiveness. Ceiling effects for each dimension were calculated as the proportion of the best level responses for that dimension at follow-up/post-operatively. Convergent validity was assessed using Spearman's correlation and the level of agreement was explored using Bland-Altman plots., Results: Data from 164 respondents (mean age: 63 years, 81% male) were analysed. HRQoL significantly reduced on both measures with large effect sizes (> 0.80), and a greater mean difference (0.29 compared to 0.16) on QLU-C10D. Both measures had ceiling effects (> 15%) on all dimensions at baseline. Following esophagectomy, ceiling effects were observed with self-care (86%), mobility (67%), anxiety/depression (55%) and pain/discomfort (19%) dimensions on EQ-5D-3L. For QLU-C10D ceiling effects were observed with emotional function (53%), physical function (16%), nausea (35%), sleep (31%), bowel problems (21%) and pain (20%). A strong correlation (r = 0.71) was observed between EQ-5D-3L anxiety and QLU-C10D emotional function dimensions. Good agreement (3.7% observations outside the limits of agreement) was observed between the utility scores., Conclusion: The QLU-C10D is comparable to the more widely applied generic EQ-5D-3L, however, QLU-C10D was more sensitive to short-term utility changes following esophagectomy. Cognisant of requirements by policy makers to apply generic utility measures in cost effectiveness studies, the disease-specific QLU-C10D should be used alongside the generic measures like EQ-5D-3L., Trial Registration: The trial was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12611000178943) on the 15th of February 2011., (© 2021. The Author(s).)
- Published
- 2021
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4. The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis.
- Author
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Lam CN, Watt AE, Isenring EA, de van der Schueren MAE, and van der Meij BS
- Subjects
- Humans, Peripheral Nervous System Diseases chemically induced, Peripheral Nervous System Diseases prevention & control, Randomized Controlled Trials as Topic, Body Weight drug effects, Dietary Supplements, Fatty Acids, Omega-3 administration & dosage, Malnutrition diet therapy, Muscle, Skeletal drug effects, Neoplasms complications, Quality of Life
- Abstract
Background & Aims: Omega-3 polyunsaturated fatty acid (PUFA) supplementation has been proposed as a potential therapy for cancer-related malnutrition, which affects up to 70% of patients with cancer. The aim of this systematic review and meta-analysis was to examine the effects of oral omega-3 PUFA supplementation on muscle maintenance, quality of life, body weight and treatment-related toxicities in patients with cancer., Methods: Randomised controlled trials in patients with cancer aged ≥18 years were retrieved from 5 electronic databases: MEDLINE (via PubMed), EMBASE, CENTRAL, CINAHL (via EBSCOhost), and Web of Science, from database inception until 31st of December 2019. The quality of included studies was assessed using the Cochrane risk of bias tool. Trials supplementing ≥600 mg/d omega-3 PUFA (oral capsules, pure fish oil or oral nutritional supplements) compared with a control intervention for ≥3 weeks were included. Meta-analyses were performed in RevMan to determine the mean differences (MD) in muscle mass, quality of life and body weight, and odds ratio (OR) for the incidence of treatment-related toxicities between omega-3 PUFA and control groups with 95% confidence intervals (CI) and I
2 for heterogeneity., Results: We included 31 publications in patients with various types of cancers and degrees of malnutrition. The Cochrane risk of bias tool graded most trials as 'unclear' or 'high' risk of bias. Meta-analyses showed no significant difference between omega-3 PUFA supplements and control intervention on muscle mass, quality of life and body weight. Oral omega-3 PUFA supplements reduced the likelihood of developing chemotherapy-induced peripheral neuropathy (OR: 0.20; 95% CI: 0.10-0.40; p < 0.001; I2 = 0%)., Conclusion: This systematic review and meta-analysis indicates that oral omega-3 PUFA supplementation does not improve muscle maintenance, quality of life or body weight in patients with cancer, but may reduce the incidence of chemotherapy-induced peripheral neuropathy. Well-designed large-scale randomised controlled trials in homogenous patient cohorts are required to confirm these findings., Competing Interests: Conflicts of interest The authors declare no conflict of interest., (Copyright © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)- Published
- 2021
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5. Cancer cachexia: an overview of diagnostic criteria and therapeutic approaches for the accredited practicing dietitian.
- Author
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van der Meij BS, Teleni L, McCarthy AL, and Isenring EA
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- Humans, Nutrition Assessment, Nutrition Therapy, Nutritional Status, Quality of Life, Cachexia diagnosis, Cachexia etiology, Cachexia physiopathology, Cachexia therapy, Neoplasms complications
- Abstract
Background: Cancer cachexia (CC) is a multifactorial syndrome characterised by ongoing skeletal muscle loss that leads to progressive functional impairment driven by reduced food intake and abnormal metabolism. Despite the traditional use of non-volitional weight loss as the primary marker of CC, there is no consensus on how to diagnose and manage CC., Methods: The aim of this narrative review was to describe and discuss diagnostic criteria and therapeutic approaches for the accredited practicing dietitian with respect to identifying and managing CC., Results: Available diagnostic criteria for cachexia include the cancer-specific (Fearon and Cachexia Score) and general criteria (Evans and Global Leadership Initiative on Malnutrition). These include phenotypic criteria [weight loss, body mass index, (objective) muscle mass assessments, quality of life] and aetiological criteria (disease burden, inflammation, energy expenditure, anorexia and inadequate food intake) and can be incorporated into the nutrition care process (NCP). This informs the nutrition diagnosis of 'chronic disease- or condition-related malnutrition (undernutrition) as related to increased nutrient needs, anorexia or diminished intake due to CC'. Optimal nutrition care and management of CC is multidisciplinary, corrects for increased energy expenditure (via immunonutrition/eicosapentaenoic acid), suboptimal protein/energy intake and poor nutrition quality of life, and includes a physical exercise intervention. Monitoring of intervention efficacy should focus on maintaining or slowing the loss of muscle mass, with weight change as an alternative gross indicator., Conclusions: Dietitians and the NCP can play an essential role with respect to identifying and managing CC, focusing on aspects of nutrition screening, assessment and intervention., (© 2020 The British Dietetic Association Ltd.)
- Published
- 2021
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6. Replicating group-based education interventions for the management of type 2 diabetes: a review of intervention reporting.
- Author
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Odgers-Jewell K, Ball LE, Reidlinger DP, Isenring EA, Thomas R, and Kelly JT
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- Humans, Diabetes Mellitus, Type 2 therapy, Documentation standards, Patient Education as Topic methods, Research Report standards
- Abstract
Aims: To assess the completeness of reporting of group-based education interventions for the management of type 2 diabetes., Methods: A previous systematic review of group-based education programmes for adults with type 2 diabetes identified eligible intervention studies. Data were extracted and assessed using the Template for Intervention Description and Replication ('TIDieR') checklist. Missing data were sourced from other published material, or by contacting authors., Results: Fifty-three publications describing 47 studies were included. No publications sufficiently described all items. Authors of 43 of the 47 included studies (91%) were contacted via e-mail to obtain missing data in order to complete the TIDieR checklist. Seven (16%) did not respond. Additional data were obtained for 33/47 studies (70%). Most studies (45/47, 96%) described the intervention duration and frequency, detailed the procedures and rationale (40/47, 85%), provided a brief intervention name and explained any individual tailoring (38/47, 81%), defined whether providers received training and adequately described how the programme was delivered (37/47, 79%). However, few described any modifications (28/47, 60%), whether the intervention was delivered as planned (27/47, 57%), where it was delivered (21/47, 45%), whether materials were provided (19/47, 40%), and who delivered the intervention (13/47, 28%)., Conclusions: Group-based education interventions for the management of type 2 diabetes are poorly reported. To translate effective research into practice, practitioners need sufficient detail to implement evidence-based interventions. Researcher adoption of the TIDieR checklist will assist the translation and replication of published interventions., (© 2019 Diabetes UK.)
- Published
- 2020
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7. Multicentre factorial randomized clinical trial of perioperative immunonutrition versus standard nutrition for patients undergoing surgical resection of oesophageal cancer.
- Author
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Mudge LA, Watson DI, Smithers BM, Isenring EA, Smith L, and Jamieson GG
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- Aged, Double-Blind Method, Female, Follow-Up Studies, Humans, Incidence, Intention to Treat Analysis, Male, Middle Aged, Postoperative Complications epidemiology, Postoperative Complications immunology, Prospective Studies, Quality of Life, Treatment Outcome, Adenocarcinoma surgery, Enteral Nutrition methods, Esophageal Neoplasms surgery, Esophagectomy, Immunotherapy methods, Perioperative Care methods, Postoperative Complications prevention & control
- Abstract
Background: Preoperative immunonutrition has been proposed to reduce the duration of hospital stay and infective complications following major elective surgery in patients with gastrointestinal malignancy. A multicentre 2 × 2 factorial RCT was conducted to determine the impact of preoperative and postoperative immunonutrition versus standard nutrition in patients with oesophageal cancer., Methods: Patients were randomized before oesophagectomy to immunonutrition (IMPACT
® ) versus standard isocaloric/isonitrogenous nutrition, then further randomized after operation to immunonutrition versus standard nutrition. Clinical and quality-of-life outcomes were assessed at 14 and 42 days after operation on an intention-to-treat basis. The primary outcome was the occurrence of infective complications. Secondary outcomes were other complications, duration of hospital stay, mortality, nutritional and quality-of-life outcomes (EuroQol EQ-5D-3 L™, European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and EORTC QLQ-OES18). Patients and investigators were blinded until the completion of data analysis., Results: Some 278 patients from 11 Australian sites were randomized; two were excluded and data from 276 were analysed. The incidence of infective complications was similar for all groups (37 per cent in perioperative standard nutrition group, 51 per cent in perioperative immunonutrition group, 34 per cent in preoperative immunonutrition group and 40 per cent in postoperative immunonutrition group; P = 0·187). There were no significant differences in any other clinical or quality-of-life outcomes., Conclusion: Use of immunonutrition before and/or after surgery provided no benefit over standard nutrition in patients undergoing oesophagectomy. Registration number: ACTRN12611000178943 ( https://www.anzctr.org.au)., (© 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.)- Published
- 2018
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8. Serum vitamin D decreases during chemotherapy: an Australian prospective cohort study.
- Author
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Isenring EA, Teleni L, Woodman RJ, Kimlin MG, Walpole E, Karapetis CS, Shawgi S, Kichenadasse G, Marshall S, and Koczwara B
- Subjects
- Australia, Cohort Studies, Female, Humans, Male, Middle Aged, Neoplasms blood, Nutritional Status, Prospective Studies, Neoplasms complications, Neoplasms drug therapy, Nutrition Surveys statistics & numerical data, Vitamin D blood, Vitamin D Deficiency blood, Vitamin D Deficiency complications
- Abstract
Background and Objectives: Vitamin D plays an important role in bone and muscle function, and cell prolifera-tion. The impact of chemotherapy and associated behavioural changes such as fatigue and sun avoidance on vit-amin D (25(OH) D) is unknown. This study aims to evaluate variations in serum vitamin D during chemotherapy and the predictive value of latitude, season and pre-existing vitamin D deficiency., Methods and Study Design: A 12-week prospective cohort study was conducted in chemotherapy-naïve patients in two Australian locations with different sun exposure. Vitamin D deficiency was defined as ≤25 nmol/L and insufficiency 26-50 nmol/L 25(OH) D. Demographics, chemotherapy regimen, nutritional status, sun exposure, geographic location, and sea-son were collected at baseline, 6 and 12 weeks after commencing chemotherapy., Results: Eighty-five patients (μ55.3±13.4 years of age; 49% female) were recruited, 96% Caucasian. Fifty-four patients were treated with cura-tive intent (mostly for breast [n=29] or colorectal [n=12] cancers). At baseline, 10 patients were vitamin D defi-cient and 33 were insufficient. Mean serum 25(OH) D (nmol/L) was higher at latitude -27.5o (Brisbane) than lati-tude -34.9o (Adelaide) (μ61.9±22.1 vs μ42.2±19.2, p<0.001) and varied according to season (spring: μ46.9±20.3, summer: μ50.8±18.2, autumn: μ76.4±25.2, winter: μ36.5±15.7, p<0.001). Serum 25(OH) D decreased with chemotherapy (baseline: μ49.2±22.3, 6-weeks: μ40.9±19.0, 12-weeks: μ45.9±19.7, p=0.05), with a significant and more rapid decline in winter and autumn (p=0.03)., Conclusions: Chemotherapy is associated with a decrease in serum vitamin D, particularly during winter and autumn. Investigations into the underlying mechanism and as-sociated potential outcomes with this decrease requires further investigation.
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- 2018
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9. Group-based education for patients with type 2 diabetes: a survey of Australian dietitians.
- Author
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Odgers-Jewell K, Isenring EA, Thomas R, and Reidlinger DP
- Subjects
- Australia, Evidence-Based Practice, Health Care Surveys, Humans, Nutritionists, Diabetes Mellitus, Type 2 prevention & control, Group Processes, Patient Education as Topic methods
- Abstract
Group-based education has the potential to substantially improve the outcomes of individuals with type 2 diabetes mellitus (T2DM) and reduce the enormous burden that chronic diseases place on healthcare systems worldwide. Despite this proven effectiveness, the utilisation of group services for the management of T2DM by Australian dietitians is surprisingly low. This study surveyed a sample of 263 Australian dietitians to explore the utilisation of group-based education for T2DM, as well as dietitians' preferences for practice and training. The results of this study indicate that Australian dietitians are currently under-utilising group-based education programs for the management of T2DM, with the primary reasons identified as a lack of training provided to dietitians in the area, limited access to facilities suitable for conducting group education, the perceived poor cost-effectiveness of these programs, and the lack of evidence-based practice guidelines for the group-based management of persons with T2DM. Additionally, the majority of preferences for further training were for either face-to-face or web-based formal training conducted over 3-6h. Clear, evidence-based practice guidelines and training resources for group education for the management of T2DM are needed in order to encourage better utilisation of group-based education by Australian dietitians.
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- 2017
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10. Effectiveness of group-based self-management education for individuals with Type 2 diabetes: a systematic review with meta-analyses and meta-regression.
- Author
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Odgers-Jewell K, Ball LE, Kelly JT, Isenring EA, Reidlinger DP, and Thomas R
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- Body Weight Maintenance, Combined Modality Therapy, Controlled Clinical Trials as Topic, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 complications, Glycated Hemoglobin analysis, Humans, Middle Aged, Overweight complications, Overweight prevention & control, Overweight therapy, Patient Care Team, Peer Group, Psychosocial Support Systems, Randomized Controlled Trials as Topic, Weight Loss, Diabetes Mellitus, Type 2 therapy, Evidence-Based Medicine, Group Structure, Healthy Lifestyle, Hyperglycemia prevention & control, Patient Education as Topic, Self-Management education
- Abstract
Aims: Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes., Methods: Six electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA
1c ) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c , and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self-efficacy., Results: Fifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group-based education compared with controls at 6-10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): -0.48, -0.15; P = 0.0002], 12-14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: -0.49, -0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: -1.26, -0.18; P = 0.009] and 36-48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: -1.52, -0.34; P = 0.002], but not at 24 months. Outcomes also favoured group-based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer-led interventions., Conclusions: Group-based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes., (© 2017 Diabetes UK.)- Published
- 2017
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11. Group participants' experiences of a patient-directed group-based education program for the management of type 2 diabetes mellitus.
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Odgers-Jewell K, Isenring EA, Thomas R, and Reidlinger DP
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- Aged, Disease Management, Female, Health Knowledge, Attitudes, Practice, Healthy Lifestyle, Humans, Male, Middle Aged, Motivation, Patient Education as Topic standards, Diabetes Mellitus, Type 2 therapy, Patient Education as Topic methods, Peer Group
- Abstract
Objective: The objective of this study was to explore the experiences of individuals who participated in a group-based education program, including their motivators in relation to their diabetes management, and the perceived impact of group interactions on participants' experiences and motivation for self-management. Understanding individuals diagnosed with diabetes experiences of group-based education for the management of type 2 diabetes mellitus may guide the development and facilitation of these programs., Methods: Semi-structured interviews were conducted with all individuals who participated in the intervention. Using thematic analysis underpinned by self-determination theory, we developed themes that explored participants' motivators in relation to diabetes management and the impact of group interactions on their experiences and motivation., Results: The key themes included knowledge, experience, group interactions and motivation. Participants perceived that the group interactions facilitated further learning and increased motivation, achieved through normalization, peer identification or by talking with, and learning from the experience of others., Conclusions: The results support the use of patient-centred programs that prioritize group interactions over the didactic presentation of content, which may address relevant psychological needs of people diagnosed with type 2 diabetes mellitus, and improve their motivation and health behaviours. Future group-based education programs may benefit from the use of self-determination theory as a framework for intervention design to enhance participant motivation.
- Published
- 2017
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12. Exercise improves quality of life in androgen deprivation therapy-treated prostate cancer: systematic review of randomised controlled trials.
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Teleni L, Chan RJ, Chan A, Isenring EA, Vela I, Inder WJ, and McCarthy AL
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- Androgen Antagonists therapeutic use, Antineoplastic Agents, Hormonal therapeutic use, Humans, Male, Prostatic Neoplasms drug therapy, Exercise psychology, Prostatic Neoplasms psychology, Quality of Life psychology
- Abstract
Men receiving androgen deprivation therapy (ADT) for prostate cancer (PCa) are likely to develop metabolic conditions such as diabetes, cardiovascular disease, abdominal obesity and osteoporosis. Other treatment-related side effects adversely influence quality of life (QoL) including vasomotor distress, depression, anxiety, mood swings, poor sleep quality and compromised sexual function. The objective of this study was to systematically review the nature and effects of dietary and exercise interventions on QoL, androgen deprivation symptoms and metabolic risk factors in men with PCa undergoing ADT. An electronic search of CINAHL, CENTRAL, Medline, PsychINFO and reference lists was performed to identify peer-reviewed articles published between January 2004 and December 2014 in English. Eligible study designs included randomised controlled trials (RCTs) with pre- and post-intervention data. Data extraction and assessment of methodological quality with the Cochrane approach was conducted by two independent reviewers. Seven exercise studies were identified. Exercise significantly improved QoL, but showed no effect on metabolic risk factors (weight, waist circumference, lean or fat mass, blood pressure and lipid profile). Two dietary studies were identified, both of which tested soy supplements. Soy supplementation did not improve any outcomes. No dietary counselling studies were identified. No studies evaluated androgen-deficiency symptoms (libido, erectile function, sleep quality, mood swings, depression, anxiety and bone mineral density). Evidence from RCTs indicates that exercise enhances health- and disease-specific QoL in men with PCa undergoing ADT. Further studies are required to evaluate the effect of exercise and dietary interventions on QoL, androgen deprivation symptoms and metabolic risk factors in this cohort., (© 2016 Society for Endocrinology.)
- Published
- 2016
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13. Body composition following stem cell transplant: comparison of bioimpedance and air-displacement plethysmography.
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Hung YC, Bauer JD, Horsely P, Ward LC, Bashford J, and Isenring EA
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- Absorptiometry, Photon, Adult, Aged, Air, Female, Hematopoietic Stem Cells, Humans, Male, Middle Aged, Neoplasms therapy, Young Adult, Adipose Tissue, Body Composition, Body Fluid Compartments, Body Mass Index, Electric Impedance, Plethysmography methods, Stem Cell Transplantation
- Abstract
Objective: The aim of this study was to assess the agreement between detected changes in body composition determined by bioimpedance spectroscopy (BIS) and air-displacement plethysmography (ADP) among patients with cancer undergoing peripheral blood stem cell transplantation (PBSCT); and to assess the agreement of absolute values of BIS with ADP and dual energy x-ray (DXA)., Methods: Forty-four adult hematologic cancer patients undergoing PBSCT completed both BIS and ADP assessment at preadmission and at 3 mo after transplantation. A subsample (n = 11) was assessed by DXA at 3 mo after transplantation. Results were examined for the BIS instrument's default setting and three alternative predictive equations from the literature. Agreement was assessed by the Bland-Altman limits of agreement analysis while correlation was examined using the Lin's concordance correlation., Results: Changes in body composition parameters assessed by BIS were comparable with those determined by ADP regardless of the predictive equations used. Bias of change in fat-free mass was clinically acceptable (all <1 kg), although limits of agreement were wide (more than ±6 kg). Overall, the BIS predictive equation accounting for body mass index performed the best. Absolute body composition parameters predicted by the alternative predictive equations agreed with DXA and ADP better than the BIS instrument's default setting., Conclusion: Changes predicted by BIS were similar to those determined by ADP on a group level; however, agreement of predicted changes at an individual level should be interpreted with caution due to wide limits of agreement., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
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14. Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial.
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Hung YC, Bauer JD, Horsely P, Coll J, Bashford J, and Isenring EA
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- Aged, Body Composition, Exercise, Female, Humans, Male, Middle Aged, Nutritional Status, Patient Discharge, Pilot Projects, Quality of Life, Queensland, Transplantation, Autologous, Counseling methods, Peripheral Blood Stem Cell Transplantation, Telephone
- Abstract
Adverse changes in nutrition-related outcomes including quality of life (QoL) occur after PBSC transplantation. This randomised controlled trial aims to evaluate the impact of nutrition and exercise counselling provided at hospital discharge on nutritional status, body composition and QoL post transplantation. Usual care (UC) (n=19) received no intervention after discharge; extended care (EC) (n=18) received fortnightly telephone counselling from a dietitian and exercise physiologist up to 100 days post transplantation. Nutritional status (patient-generated subjective global assessment, and diet history), QoL (EORTC QLQ-C30 version 3) and body composition (air displacement plethysmography) were assessed at pre-admission, discharge and 100 days post transplantation. Intervention groups were compared using two-sample t-tests of changes in the outcomes; results were adjusted using analysis of covariance. EC exhibited clinically important but not statistically significant increases in protein intake (14.7 g; confidence interval (CI) 95% -6.5, 35.9, P=0.165), cognitive functioning (7.2; CI 95% -7.9, 22.2, P=0.337) and social functioning (16.5; CI 95% -7.3, 40.3, P=0.165) compared with UC. Relative to pre-admission, EC experienced less weight loss than UC (-3.3 kg; CI 95% -6.7, 0.2, P=0.062). Physical activity was not significantly different between the groups. Ongoing nutrition and exercise counselling may prevent further weight loss and improve dietary intake and certain QoL components in autologous PBSC transplantation patients following hospitalisation.
- Published
- 2014
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15. The effect of nutrition intervention in lung cancer patients undergoing chemotherapy and/or radiotherapy: a systematic review.
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Kiss NK, Krishnasamy M, and Isenring EA
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- Body Weight, Energy Intake, Humans, Lung Neoplasms complications, Lung Neoplasms drug therapy, Lung Neoplasms radiotherapy, Malnutrition etiology, Malnutrition prevention & control, Nutritional Status, Quality of Life, Randomized Controlled Trials as Topic, Treatment Outcome, Feeding Behavior, Lung Neoplasms diet therapy, Malnutrition epidemiology
- Abstract
The prevalence of malnutrition in lung cancer patients across a variety of treatment modalities and disease stages ranges from 45% to 69%. Malnutrition is associated with poorer clinical outcomes in cancer patients. This systematic review examined whether dietary counseling or oral supplements during chemotherapy and/or radiotherapy in patients with lung cancer affect patient or clinical outcomes. Relevant nutrition intervention studies from 1980 to March 2012 were identified. Articles meeting predetermined inclusion/exclusion criteria were critically appraised and included in the review. The outcomes of interest included dietary intake, weight, nutritional status, quality of life, functional status, treatment response, and survival. Five eligible studies were identified including 3 randomized controlled trials, 1 historical cohort, and 1 case series. These studies suggest dietary counseling improves energy and protein intake during chemotherapy in patients with lung cancer but has no benefit to other outcomes during chemotherapy. There is insufficient evidence regarding the effect on patient or clinical outcomes during radiotherapy. Randomized trials examining dietary counseling in patients with lung cancer during radiotherapy are required.
- Published
- 2014
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16. Nutritional counseling and nutritional supplements: a cornerstone of multidisciplinary cancer care for cachectic patients.
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Isenring EA and Teleni L
- Subjects
- Cachexia etiology, Dietary Supplements, Humans, Neoplasms drug therapy, Neoplasms radiotherapy, Nutritional Status, Patient Care Team organization & administration, Treatment Outcome, Cachexia therapy, Counseling methods, Nutritional Support methods
- Abstract
Purpose of Review: The challenge with cancer cachexia is that it is not fully reversed by nutrition support. The purpose of this review is to provide an opinion on the nutritional management of cancer cachexia based on the most recent available evidence., Recent Findings: There continues to be a paucity of nutrition intervention studies in patients with cancer cachexia. In patients with cancer undergoing radiotherapy, there is strong evidence that nutrition counseling increases dietary intake, body weight, nutritional status and quality of life with some suggestion that dietary counseling may improve nutrition impact symptoms, treatment response and survival. In patients with cancer undergoing chemotherapy, the evidence is less clear. The use of n-3 polyunsaturated fatty acids may have some positive effects in patients with cancer; however, clinical judgment and care need to be taken in its application. Preliminary results of studies in the use of L-carnitine in improving fatigue are promising; however, the largest trial in 'healthy' cancer patients showed no benefit., Summary: Further research into the most appropriate methods for identifying and treating cancer cachexia is required. Regardless of whether patients are experiencing reduced dietary intake resulting in malnutrition or due to cachexia, nutrition remains a cornerstone of multimodal treatment.
- Published
- 2013
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17. Clinical outcomes of vitamin D deficiency and supplementation in cancer patients.
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Teleni L, Baker J, Koczwara B, Kimlin MG, Walpole E, Tsai K, and Isenring EA
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- Calcifediol therapeutic use, Cholecalciferol blood, Cholecalciferol therapeutic use, Dietary Supplements, Dose-Response Relationship, Drug, Humans, Neoplasms blood, Neoplasms etiology, Treatment Outcome, Vitamin D blood, Vitamin D therapeutic use, Vitamin D Deficiency blood, Vitamin D Deficiency complications, Vitamin D Deficiency drug therapy, Calcifediol blood, Neoplasms epidemiology, Vitamin D Deficiency epidemiology
- Abstract
Results of recent studies suggest that circulating levels of vitamin D may play an important role in cancer-specific outcomes. The present systematic review was undertaken to determine the prevalence of vitamin D deficiency (<25 nmol/L) and insufficiency (25-50 nmol/L) in cancer patients and to evaluate the association between circulating calcidiol (the indicator of vitamin D status) and clinical outcomes. A systematic search of original, peer-reviewed studies on calcidiol at cancer diagnosis, and throughout treatment and survival, was conducted yielding 4,706 studies. A total of 37 studies met the inclusion criteria for this review. Reported mean blood calcidiol levels ranged from 24.7 to 87.4 nmol/L, with up to 31% of patients identified as deficient and 67% as insufficient. The efficacy of cholecalciferol supplementation for raising the concentration of circulating calcidiol is unclear; standard supplement regimens of <1,000 IU D₃ /day may not be sufficient to maintain adequate concentrations or prevent decreasing calcidiol. Dose-response studies linking vitamin D status to musculoskeletal and survival outcomes in cancer patients are lacking., (© 2013 International Life Sciences Institute.)
- Published
- 2013
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18. Malnutrition screening tools: comparison against two validated nutrition assessment methods in older medical inpatients.
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Young AM, Kidston S, Banks MD, Mudge AM, and Isenring EA
- Subjects
- Aged, Aged, 80 and over, Cohort Studies, Energy Intake, Evidence-Based Medicine, Female, Geriatric Assessment methods, Hospitalization, Humans, Male, Predictive Value of Tests, Prospective Studies, Risk Factors, Malnutrition diagnosis, Mass Screening methods, Nutrition Assessment
- Abstract
Objective: Although several validated nutritional screening tools have been developed to "triage" inpatients for malnutrition diagnosis and intervention, there continues to be debate in the literature as to which tool/tools clinicians should use in practice. This study compared the accuracy of seven validated screening tools in older medical inpatients against two validated nutritional assessment methods., Methods: This was a prospective cohort study of medical inpatients at least 65 y old. Malnutrition screening was conducted using seven tools recommended in evidence-based guidelines. Nutritional status was assessed by an accredited practicing dietitian using the Subjective Global Assessment (SGA) and the Mini-Nutritional Assessment (MNA). Energy intake was observed on a single day during first week of hospitalization., Results: In this sample of 134 participants (80 ± 8 y old, 50% women), there was fair agreement between the SGA and MNA (κ = 0.53), with MNA identifying more "at-risk" patients and the SGA better identifying existing malnutrition. Most tools were accurate in identifying patients with malnutrition as determined by the SGA, in particular the Malnutrition Screening Tool and the Nutritional Risk Screening 2002. The MNA Short Form was most accurate at identifying nutritional risk according to the MNA. No tool accurately predicted patients with inadequate energy intake in the hospital., Conclusion: Because all tools generally performed well, clinicians should consider choosing a screening tool that best aligns with their chosen nutritional assessment and is easiest to implement in practice. This study confirmed the importance of rescreening and monitoring food intake to allow the early identification and prevention of nutritional decline in patients with a poor intake during hospitalization., (Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
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19. Validity of the malnutrition screening tool for older adults at high risk of hospital readmission.
- Author
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Wu ML, Courtney MD, Shortridge-Baggett LM, Finlayson K, and Isenring EA
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- Aged, Aged, 80 and over, Female, Humans, Male, Hospitalization, Malnutrition diagnosis, Nutritional Status, Patient Readmission
- Abstract
Malnutrition is a serious problem in older adults, particularly for those at risk of hospital readmission. The essential step in managing malnutrition is early identification using a valid nutrition screening tool. The purpose of this study was to validate the Malnutrition Screening Tool (MST) in older adults at high risk of hospital readmission. Two RNs administered the MST to identify malnutrition risk and compared it with the comprehensive Subjective Global Assessment (SGA) to assess nutritional status for patients 65 and older who had at least one risk factor for hospital readmission. The MST demonstrates substantial sensitivity, specificity, and agreement with the SGA. These findings indicate that nursing staff can use the MST as a valid tool for routine screening and rescreening to identify patients at risk of malnutrition. Use of the MST may prevent hospital-acquired malnutrition in acute hospitalized older adults at high risk of readmission., (Copyright 2012, SLACK Incorporated.)
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- 2012
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20. Beyond malnutrition screening: appropriate methods to guide nutrition care for aged care residents.
- Author
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Isenring EA, Banks M, Ferguson M, and Bauer JD
- Subjects
- Aged, Aged, 80 and over, Anthropometry, Cross-Sectional Studies, Female, Geriatric Assessment, Homes for the Aged, Humans, Long-Term Care, Male, Malnutrition epidemiology, Middle Aged, Prevalence, Queensland, Reproducibility of Results, Risk Factors, Sensitivity and Specificity, Malnutrition diagnosis, Mass Screening instrumentation, Nutrition Assessment
- Abstract
Background: Malnutrition is common in older adults and early and appropriate nutrition intervention can lead to positive quality of life and health outcomes., Objective: The purpose of our study was to determine the concurrent validity of several malnutrition screening tools and anthropometric parameters against validated nutrition assessment tools in the long-term-care setting., Study Design: This work was a cross-sectional, observational study., Participants/setting: Older adults (aged >55 years) from two long-term-care facilities were screened., Main Outcomes: Nutrition screening tools used included the Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment-Short Form (MNA-SF), and the Simplified Nutritional Assessment Questionnaire. Nutritional status was assessed by Subjective Global Assessment (SGA), Mini Nutritional Assessment (MNA), body mass index (BMI), corrected arm muscle area, and calf circumference. Residents were rated as either well nourished or malnourished according to each nutrition assessment tool., Statistical Analysis: A contingency table was used to determine the sensitivity and specificity of the nutrition screening tools and objective measures in detecting patients at risk of malnutrition compared with the SGA and MNA., Results: One hundred twenty-seven residents (31.5% men; mean age 82.7 ± 9 years, 57.5% high care) consented. According to SGA, 27.6% (n=31) of residents were malnourished and 13.4% were rated as malnourished by MNA. MST had the best sensitivity and specificity compared with the SGA (sensitivity 88.6%, specificity 93.5%, ?=0.806), followed by MNA-SF (85.7%, 62%, ?=0.377), MUST (68.6%, 96.7%, ?=0.703), and Simplified Nutritional Assessment Questionnaire (45.7%, 77.2%, ?=0.225). Compared with MNA, MNA-SF had the highest sensitivity of 100%, but specificity was 56.4% (?=0.257). MST compared with MNA had a sensitivity of 94.1%, specificity 80.9% (?=0.501). The anthropometric screens ranged from ?=0.193 to 0.468 when compared with SGA and MNA., Conclusions: MST, MUST, MNA-SF, and the anthropometric screens corrected arm muscle area and calf circumference have acceptable concurrent validity compared with validated nutrition assessment tools and can be used to triage nutrition care in the long-term-care setting., (Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)
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- 2012
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21. Helping understand nutritional gaps in the elderly (HUNGER): a prospective study of patient factors associated with inadequate nutritional intake in older medical inpatients.
- Author
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Mudge AM, Ross LJ, Young AM, Isenring EA, and Banks MD
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- Activities of Daily Living, Age Factors, Aged, 80 and over, Appetite, Body Mass Index, Cohort Studies, Delirium complications, Diet, Disabled Persons, Female, Hospitals, Teaching, Humans, Male, Malnutrition complications, Malnutrition psychology, Prevalence, Prospective Studies, Queensland epidemiology, Risk Factors, Dietary Proteins administration & dosage, Energy Intake, Malnutrition epidemiology
- Abstract
Background & Aims: Malnutrition and poor intake during hospitalisation are common in older medical patients. Better understanding of patient-specific factors associated with poor intake may inform nutritional interventions. The aim of this study was to measure the proportion of older medical patients with inadequate nutritional intake, and identify patient-related factors associated with this outcome., Methods: Prospective cohort study enrolling consecutive consenting medical inpatients aged 65 years or older. Primary outcome was energy intake less than resting energy expenditure estimated using weight-based equations. Energy intake was calculated for a single day using direct observation of plate waste. Explanatory variables included age, gender, number of co-morbidities, number of medications, diagnosis, usual residence, nutritional status, functional and cognitive impairment, depressive symptoms, poor appetite, poor dentition, and dysphagia., Results: Of 134 participants (mean age 80 years, 51% female), only 41% met estimated resting energy requirements. Mean energy intake was 1220 kcal/day (SD 440), or 18.1 kcal/kg/day. Factors associated with inadequate energy intake in multivariate analysis were poor appetite, higher BMI, diagnosis of infection or cancer, delirium and need for assistance with feeding., Conclusions: Inadequate nutritional intake is common, and patient factors contributing to poor intake should be considered in designing nutritional interventions., (Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.)
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- 2011
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22. The Malnutrition Screening Tool is a useful tool for identifying malnutrition risk in residential aged care.
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Isenring EA, Bauer JD, Banks M, and Gaskill D
- Subjects
- Aged, Aged, 80 and over, Australia epidemiology, Female, Humans, Male, Malnutrition epidemiology, Prevalence, Reproducibility of Results, Residential Facilities, Risk, Sensitivity and Specificity, Geriatric Assessment methods, Malnutrition diagnosis, Mass Screening methods, Nutrition Assessment
- Abstract
Background: The Malnutrition Screening Tool (MST) is a valid nutrition screening tool in the acute hospital setting but has not been assessed in residential aged care facilities. The aim of this secondary analysis was to determine whether the MST could be a useful nutrition screening tool when compared with a full nutrition assessment by Subjective Global Assessment (SGA) in the residential aged care setting., Methods: Two hundred and eighty-five residents (29% male; mean age 84 +/- 9 years) from eight residential aged care facilities in Australia participated in the study. A secondary analysis of data collected during a nutrition intervention study was conducted. The MST consists of two questions related to recent weight loss and appetite. Although the MST was not specifically applied, weight loss and appetite information was available and an estimated MST score (0-5) was calculated. Nutritional status was assessed by a research assistant trained in using the SGA., Results: Malnutrition prevalence was 42.8% (122 malnourished out of 285 residents). Compared to the SGA, the MST was an effective predictor of nutritional risk (sensitivity = 83.6%, specificity = 65.6%, positive predictive value = 0.65, negative predictive value = 0.84)., Conclusions: The components of the MST have acceptable sensitivity and specificity, suggesting that it can play a valuable role in quickly identifying the risk of malnutrition in the residential aged care setting. Further prospective research using the MST tool against a broader array of objective and subjective nutritional parameters is required to confirm its validity as a screening tool in aged care settings.
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- 2009
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23. Maintaining nutrition in aged care residents with a train-the-trainer intervention and Nutrition Coordinator.
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Gaskill D, Isenring EA, Black LJ, Hassall S, and Bauer JD
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- Aged, Aged, 80 and over, Female, Frail Elderly statistics & numerical data, Geriatric Assessment, Humans, Male, Malnutrition diagnosis, Middle Aged, Nutrition Assessment, Nutritional Physiological Phenomena physiology, Nutritional Requirements, Prevalence, Prospective Studies, Queensland epidemiology, Homes for the Aged, Malnutrition epidemiology, Nursing Homes, Nutritional Sciences education, Nutritional Status
- Abstract
Objective: To investigate the impact of a train-the-trainer program on the nutritional status of older people in residential care., Design: Prospective, randomized controlled study., Setting: Eight nursing homes in Southeast Queensland, Australia., Participants: A total of 352 residents participated - 245 were female (69.6%). The mean age was 84.2 years and the majority (79.4%) were classified as high dependency., Intervention: Residents from four nursing homes were randomly selected for a nutrition education program coordinated by Nutrition Coordinators. Residents from the other four nursing homes (control) received usual care., Measurements: The Subjective Global Assessment was used to determine prevalence of malnutrition at baseline and six months post intervention. The Resident Classification Scale measured functional dependency. Prescribed diet, fluids, oral hygiene status and allied health referrals were obtained by chart audit., Results: Approximately half the residents were well nourished with 49.4% moderately or severely malnourished. Residents in the intervention group were more likely to maintain or improve their nutritional status compared with the control group who were more likely to experience a deterioration (P=0.027). The odds of the control group being malnourished post test was 1.6 times more likely compared with the intervention group but this did not reach statistical significance (P=0.1)., Conclusion: The results of the study encourage the implementation of a Nutrition Coordinator program to maintain nutritional status of aged care residents. Nevertheless, malnutrition rates continue to be unacceptably high. In a rapidly aging society, the aged care sector needs to confront malnutrition and provide better resources for staff to take measures against this problem.
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- 2009
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24. Malnutrition prevalence and nutrition issues in residential aged care facilities.
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Gaskill D, Black LJ, Isenring EA, Hassall S, Sanders F, and Bauer JD
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- Adult, Aged, Aged, 80 and over, Female, Geriatric Nursing, Humans, Male, Malnutrition nursing, Middle Aged, Multivariate Analysis, Prevalence, Queensland epidemiology, Frail Elderly statistics & numerical data, Malnutrition epidemiology, Nursing Homes statistics & numerical data, Nutrition Assessment, Residential Facilities statistics & numerical data
- Abstract
Objectives: To determine the prevalence of malnutrition and investigate nutritional issues in a sample of older people living in residential aged care facilities (RACFs)., Method: This study forms the descriptive component of a pretest post-test designed study conducted in eight RACFs. The Subject Global Assessment tool was used to determine the prevalence of malnutrition in 350 residents., Results: Nearly 70% of residents were women and 79.4% of all residents were classified as high care. Half the residents were well nourished (50.5%) with 43.1% moderately malnourished and 6.4% severely malnourished. Prevalence of malnutrition was significantly higher for residents receiving higher level care (odds ratio (OR) = 2.9 (95% confidence interval (CI): 1.7-5.2; P < 0.001)) and older than 90 years (OR = 3.0 (95% CI: 1.8-5.1; P < 0.001)). Of the residents considered to be malnourished, very few (17.8%) had been seen by a dietitian in the past 6 months or were receiving commercial supplements (29.2%)., Conclusions: There is a need for systematic, coordinated and multidisciplinary approaches to nutritional care for older people in residential care.
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- 2008
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25. Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice.
- Author
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Isenring EA, Bauer JD, and Capra S
- Subjects
- Analysis of Variance, Energy Intake radiation effects, Female, Gastrointestinal Neoplasms complications, Gastrointestinal Neoplasms radiotherapy, Head and Neck Neoplasms complications, Head and Neck Neoplasms radiotherapy, Humans, Male, Middle Aged, Nutritional Status, Outpatients, Prospective Studies, Protein-Energy Malnutrition prevention & control, Quality of Life, Time Factors, Treatment Outcome, Dietary Proteins administration & dosage, Energy Intake physiology, Nutrition Therapy, Protein-Energy Malnutrition etiology, Protein-Energy Malnutrition therapy, Radiotherapy adverse effects
- Abstract
Background: A randomized controlled trial previously conducted in radiation oncology patients demonstrated that nutrition intervention had a beneficial impact on body weight, nutritional status, and quality of life compared with standard practice, but it did not report on dietary intake data., Objective: To determine the impact of nutrition intervention compared with standard practice on dietary intake in outpatients receiving radiotherapy., Design: Prospective, randomized, controlled trial., Subjects: Sixty consecutive radiation oncology outpatients (51 men and nine women; age 61.9+/-14 years [mean+/-standard deviation])., Setting: Australian private radiotherapy facility., Intervention: Patients were randomly assigned to receive either nutrition intervention (n=29) (nutrition counseling following the American Dietetic Association [ADA] medical nutrition therapy [MNT] protocol for radiation oncology) or standard practice (n=31) (general nutrition talk and booklet)., Main Outcome Measure: Dietary intake (protein, energy, fiber) assessed at baseline and at 4, 8, and 12 weeks after starting radiotherapy., Statistical Analyses: Repeated-measures analysis of variance done on an intention to treat basis., Results: The nutrition intervention group had a higher mean total energy (P=0.029) and protein intake (P<0.001) compared with the standard practice group. Mean intake per kilogram of body weight for the nutrition intervention group ranged from 28 to 31 kcal/kg/day compared with 25 to 29 kcal/kg/day for the standard practice group (P=0.022). The nutrition intervention group had a higher mean protein intake (1.1 to 1.3 g/kg/day) compared with the standard practice group (1.0 to 1.1 g/kg/day) (P=0.001). Although the change in fiber intake between the groups was not significant, there was a trend in the anticipated direction (P=0.083)., Conclusions: Intensive nutrition intervention following the ADA MNT protocol results in improved dietary intake compared with standard practice and seems to beneficially impact nutrition-related outcomes previously observed in oncology outpatients receiving radiotherapy. The ADA MNT protocol for radiation oncology is a useful guide to the level of nutrition support required.
- Published
- 2007
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26. Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area.
- Author
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Isenring EA, Capra S, and Bauer JD
- Subjects
- Adult, Aged, Body Composition, Body Weight, Female, Humans, Male, Middle Aged, Nutritional Status, Outpatients, Prospective Studies, Quality of Life, Treatment Outcome, Gastrointestinal Neoplasms radiotherapy, Head and Neck Neoplasms radiotherapy, Malnutrition etiology, Malnutrition therapy, Nutritional Support, Radiotherapy adverse effects
- Abstract
Malnutrition occurs frequently in patients with cancer of the gastrointestinal (GI) or head and neck area and can lead to negative outcomes. The aim of this study is to determine the impact of early and intensive nutrition intervention (NI) on body weight, body composition, nutritional status, global quality of life (QoL) and physical function compared to usual practice in oncology outpatients receiving radiotherapy to the GI or head and neck area. Outpatients commencing at least 20 fractions of radiotherapy to the GI or head and neck area were randomised to receive intensive, individualised nutrition counselling by a dietitian using a standard protocol and oral supplements if required, or the usual practice of the centre (general advice and nutrition booklet). Outcome parameters were measured at baseline and 4, 8 and 12 weeks after commencing radiotherapy using valid and reliable tools. A total of 60 patients (51 M : 9 F; mean age 61.9+/-14.0 years) were randomised to receive either NI (n=29) or usual care (UC) (n=31). The NI group had statistically smaller deteriorations in weight (P<0.001), nutritional status (P=0.020) and global QoL (P=0.009) compared with those receiving UC. Clinically, but not statistically significant differences in fat-free mass were observed between the groups (P=0.195). Early and intensive NI appears beneficial in terms of minimising weight loss, deterioration in nutritional status, global QoL and physical function in oncology outpatients receiving radiotherapy to the GI or head and neck area. Weight maintenance in this population leads to beneficial outcomes and suggests that this, rather than weight gain, may be a more appropriate aim of NI.
- Published
- 2004
- Full Text
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