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Article ; Online: Accuracy of Water Delivery in Enteral Nutrition Pumps.

Bertagnolli, Erin J / Patterson, Mindy A / Utech, Anne / Walker, Renee N

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

2019 Volume 36, Issue 1, Page(s) 219–224

Abstract: Background: Adequate delivery of both enteral formula and water in patients receiving enteral nutrition (EN) is critical. Pump accuracy has been identified as a factor impeding enteral formula delivery; however, rarely is enteral water delivery ... ...

Abstract	Background: Adequate delivery of both enteral formula and water in patients receiving enteral nutrition (EN) is critical. Pump accuracy has been identified as a factor impeding enteral formula delivery; however, rarely is enteral water delivery investigated. The purpose of this study was to explore accuracy of delivering 1 L of water by EN pumps using different flush volumes and hang heights. Methods: Three EN pumps were used in vitro to flush 1 L of water at 50 mL every hour for 20 hours (50 mL, 20 times per day) and 500 mL every 4 hours for 8 hours (500 mL, 2 times per day) at 0 in. and 18 in. (or 45.72 cm) hang heights. Fifteen runs were conducted at each volume and hang height per pump. Actual delivered enteral water, remaining volume in enteral feeding bags, and volume reported per pump were recorded. Results: Hang height of 18 in. delivered a mean 3.91% (95% CI, 3.25-4.57) more water than bags hung at 0 in. (P < .0005). When delivering water in 500 mL increments, 1.57% (95% CI, 0.92-2.23) more water was delivered than when delivered in 50 mL increments (P < .005). Conclusion: Appropriate hang height recommendations improve enteral water delivery in patients receiving EN. The most accurate setting was 500 mL at 18 in., resulting in accurate water delivery in 97.8% of runs, whereas 50 mL at 0 in. delivered accurately 17.8% of the time. Appropriate bag hang height and water delivery volume is critical to maintain hydration status of patients receiving EN.
MeSH term(s)	Critical Illness ; Enteral Nutrition ; Humans ; Water
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2019-09-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	645074-x
ISSN	1941-2452 ; 0884-5336
ISSN (online)	1941-2452
ISSN	0884-5336
DOI	10.1002/ncp.10410
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Article ; Online: Educational programs for implementing ultrasound guided peripheral intravenous catheter insertion in emergency departments: A systematic integrative literature review.

Stone, Renee / Walker, Rachel M / Marsh, Nicole / Ullman, Amanda J

Australasian emergency care

2023 Volume 26, Issue 4, Page(s) 352–359

Abstract: Background: Ultrasound-guided peripheral intravenous catheter insertion has been identified as an effective method to improve the success rate of cannulation, thereby improving patient experience. However, learning this new skill is complex, and ... ...

Abstract	Background: Ultrasound-guided peripheral intravenous catheter insertion has been identified as an effective method to improve the success rate of cannulation, thereby improving patient experience. However, learning this new skill is complex, and involves training clinicians from a variety of backgrounds. The aim of this study was to appraise and compare literature on educational methods in the emergency setting used to support ultrasound guided peripheral intravenous catheter insertion by different clinicians, and how effective these current methods are. Review methods: A systematic integrative review was undertaken using Whittemore and Knafl's five stage approach. The Mixed Methods Appraisal Tool was used to assess the quality of the studies. Results: Forty-five studies met the inclusion criteria, with five themes identified. These were: the variety of educational methods and approaches; the effectiveness of the different educational methods; barriers and facilitators of education; clinician competency assessments and pathways; clinician confidence assessment and pathways. Conclusions: This review demonstrates that a variety of educational methods are being used in successfully training emergency department clinicians in using ultrasound guidance for peripheral intravenous catheter insertion. Furthermore, this training has resulted in safer and more effective vascular access. However, it is evident that there is a lack of consistency of formalised education programs available. A standardised formal education program and increased availability of ultrasound machines in the emergency department will ensure consistent practices are maintained, retained, therefore leading to safer practice as well as more satisfied patients.
MeSH term(s)	Humans ; Ultrasonography, Interventional/methods ; Ultrasonography ; Learning ; Emergency Service, Hospital ; Catheters
Language	English
Publishing date	2023-07-07
Publishing country	Australia
Document type	Systematic Review ; Journal Article ; Review
ISSN	2588-994X
ISSN (online)	2588-994X
DOI	10.1016/j.auec.2023.06.001
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Article ; Online: Lowering the impact of food insecurity in African American adults with type 2 diabetes mellitus (LIFT-DM) - Study protocol for a randomized controlled trial.

Walker, Rebekah J / Knapp, Rebecca G / Dismuke-Greer, Clara E / Walker, Renee E / Ozieh, Mukoso N / Egede, Leonard E

Contemporary clinical trials

2020 Volume 99, Page(s) 106206

Abstract: Background: There is strong evidence that disparities in the burden of diabetes exist by both race and poverty. Food insecurity, or an inability to or limitation in accessing nutritionally adequate food, is an important modifiable social determinant of ... ...

Abstract	Background: There is strong evidence that disparities in the burden of diabetes exist by both race and poverty. Food insecurity, or an inability to or limitation in accessing nutritionally adequate food, is an important modifiable social determinant of health, particularly in adults with chronic disease. African Americans are more likely to be diagnosed with diabetes and more likely than whites to be food insecure. Methods: We describe a 4-year ongoing randomized controlled trial, which will test the separate and combined efficacy of monthly food vouchers and monthly food stock boxes layered upon diabetes education in improving glycemic control in low income, food insecure, African Americans with type 2 diabetes mellitus using a 2 × 2 factorial design. Three hundred African American adults with clinical diagnosis of diabetes and HbA1c ≥ 8% will be randomized into one of four groups: 1) diabetes education alone; 2) diabetes education plus food vouchers; 3) diabetes education plus stock boxes; and 4) diabetes education plus combined food vouchers and stock boxes. Our primary hypothesis is: among low-income, food insecure, African Americans with type 2 diabetes, those receiving diabetes education enhanced with food supplementation (food vouchers alone, stock boxes alone, or combination) will have significantly greater reduction in HbA1c at 12 months compared to those receiving diabetes education only. Discussion: Results from this study will yield valuable insight currently lacking on how best to design and deliver diabetes interventions to low-income, food insecure, African Americans with diabetes that takes into account both clinical and social determinants of health. Trial registration: This study was registered on November 29, 2019 with the United States National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT04181424).
MeSH term(s)	Adult ; Black or African American ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/therapy ; Food Insecurity ; Health Behavior ; Humans ; Poverty ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2020-11-07
Publishing country	United States
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2182176-8
ISSN	1559-2030 ; 1551-7144
ISSN (online)	1559-2030
ISSN	1551-7144
DOI	10.1016/j.cct.2020.106206
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Article ; Online: When is enteral nutrition indicated?

Bechtold, Matthew L / Brown, Patricia M / Escuro, Arlene / Grenda, Brandee / Johnston, Theresa / Kozeniecki, Michelle / Limketkai, Berkeley N / Nelson, Krystie K / Powers, Jan / Ronan, Andrea / Schober, Nathan / Strang, Brian J / Swartz, Cristina / Turner, Justine / Tweel, Lauren / Walker, Renee / Epp, Lisa / Malone, Ainsley

JPEN. Journal of parenteral and enteral nutrition

2022 Volume 46, Issue 7, Page(s) 1470–1496

Abstract: Enteral nutrition (EN) is a vital component of nutrition around the world. EN allows for delivery of nutrients to those who cannot maintain adequate nutrition by oral intake alone. Common questions regarding EN are when to initiate and in what scenarios ... ...

Abstract	Enteral nutrition (EN) is a vital component of nutrition around the world. EN allows for delivery of nutrients to those who cannot maintain adequate nutrition by oral intake alone. Common questions regarding EN are when to initiate and in what scenarios it is safe. The answers to these questions are often complex and require an evidence-based approach. The Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) established an Enteral Nutrition Committtee to address the important questions surrounding the indications for EN. Consensus recommendations were established based on eight extremely clinically relevant questions regarding EN indications as deemed by the Enteral Nutrition Committee. These consensus recommendations may act as a guide for clinicians and stakeholders on difficult questions pertaining to indications for EN. This paper was approved by the ASPEN Board of Directors.
MeSH term(s)	Consensus ; Enteral Nutrition ; Parenteral Nutrition
Language	English
Publishing date	2022-07-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	800861-9
ISSN	1941-2444 ; 0148-6071
ISSN (online)	1941-2444
ISSN	0148-6071
DOI	10.1002/jpen.2364
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Article: Predictive equations for energy needs for the critically ill.

Walker, Renee N / Heuberger, Roschelle A

Respiratory care

2009 Volume 54, Issue 4, Page(s) 509–521

Abstract: Nutrition may affect clinical outcomes in critically ill patients, and providing either more or fewer calories than the patient needs can adversely affect outcomes. Calorie need fluctuates substantially over the course of critical illness, and nutrition ... ...

Abstract	Nutrition may affect clinical outcomes in critically ill patients, and providing either more or fewer calories than the patient needs can adversely affect outcomes. Calorie need fluctuates substantially over the course of critical illness, and nutrition delivery is often influenced by: the risk of refeeding syndrome; a hypocaloric feeding regimen; lack of feeding access; intolerance of feeding; and feeding-delay for procedures. Lean body mass is the strongest determinant of resting energy expenditure, but age, sex, medications, and metabolic stress also influence the calorie requirement. Indirect calorimetry is the accepted standard for determining calorie requirement, but is unavailable or unaffordable in many centers. Moreover, indirect calorimetry is not infallible and care must be taken when interpreting the results. In the absence of calorimetry, clinicians use equations and clinical judgment to estimate calorie need. We reviewed 7 equations (American College of Chest Physicians, Harris-Benedict, Ireton-Jones 1992 and 1997, Penn State 1998 and 2003, Swinamer 1990) and their prediction accuracy. Understanding an equation's reference population and using the equation with similar patients are essential for the equation to perform similarly. Prediction accuracy among equations is rarely within 10% of the measured energy expenditure; however, in the absence of indirect calorimetry, a prediction equation is the best alternative.
MeSH term(s)	Body Weight/physiology ; Calorimetry, Indirect ; Critical Illness/therapy ; Energy Intake/physiology ; Energy Metabolism/drug effects ; Energy Metabolism/physiology ; Humans ; Nutrition Assessment ; Nutritional Support ; Respiration, Artificial
Language	English
Publishing date	2009-04
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	603252-7
ISSN	0020-1324 ; 0098-9142
ISSN	0020-1324 ; 0098-9142
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Article ; Online: Return to Employment After Stroke in Young Adults: How Important Is the Speed and Energy Cost of Walking?

Jarvis, Hannah L / Brown, Steven J / Price, Michelle / Butterworth, Claire / Groenevelt, Renee / Jackson, Karl / Walker, Louisa / Rees, Nia / Clayton, Abigail / Reeves, Neil D

Stroke

2019 Volume 50, Issue 11, Page(s) 3198–3204

Abstract: ... parameters for return to employment poststroke. Methods- Forty-six individuals (18-40 years: n=6, 41-54 years ... n=21, 55-65 years: n=19) who have had a stroke and 15 healthy age-matched able-bodied controls were ...

Abstract	Background and Purpose- A quarter of individuals who experience a stroke are under the age of 65 years (defined as young adults), and up to 44% will be unable to return to work poststroke, predominantly because of walking difficulties. No research study has comprehensively analyzed walking performance in young adult's poststroke. The primary aim of this study is to investigate how a stroke in young adults affects walking performance (eg, walking speed and metabolic cost) compared with healthy age-matched controls. The secondary aim is to determine the predictive ability of walking performance parameters for return to employment poststroke. Methods- Forty-six individuals (18-40 years: n=6, 41-54 years: n=21, 55-65 years: n=19) who have had a stroke and 15 healthy age-matched able-bodied controls were recruited from 6 hospital sites in Wales, United Kingdom. Type, location, cause of stroke, and demographic factors (eg, employment status) were recorded. Temporal and spatial walking parameters were measured using 3-dimensional gait analysis. Metabolic energy expenditure and metabolic cost of walking were captured during 3 minutes of walking at self-selected speed from measurements of oxygen consumption. Results- Stroke participants walked slower (
MeSH term(s)	Adolescent ; Adult ; Aged ; Employment ; Energy Metabolism ; Female ; Gait ; Humans ; Male ; Middle Aged ; Oxygen Consumption ; Stroke/metabolism ; Stroke/physiopathology ; Stroke Rehabilitation ; United Kingdom ; Walking ; Walking Speed ; Young Adult
Language	English
Publishing date	2019-09-26
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/STROKEAHA.119.025614
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Article ; Online: Game-based learning to improve diagnostic accuracy: a pilot randomized-controlled trial.

Morgan, Daniel J / Scherer, Laura / Pineles, Lisa / Baghdadi, Jon / Magder, Larry / Thom, Kerri / Koch, Christina / Wilkins, Nick / LeGrand, Mike / Stevens, Deborah / Walker, Renee / Shirrell, Beth / Harris, Anthony D / Korenstein, Deborah

Diagnosis (Berlin, Germany)

2024

Abstract: Objectives: Perform a pilot study of online game-based learning (GBL) using natural frequencies and feedback to teach diagnostic reasoning.: Methods: We conducted a multicenter randomized-controlled trial of computer-based training. We enrolled ... ...

Abstract	Objectives: Perform a pilot study of online game-based learning (GBL) using natural frequencies and feedback to teach diagnostic reasoning. Methods: We conducted a multicenter randomized-controlled trial of computer-based training. We enrolled medical students, residents, practicing physicians and nurse practitioners. The intervention was a 45 min online GBL training vs. control education with a primary outcome of score on a scale of diagnostic accuracy (composed of 10 realistic case vignettes, requesting estimates of probability of disease after a test result, 0-100 points total). Results: Of 90 participants there were 30 students, 30 residents and 30 practicing clinicians. Of these 62 % (56/90) were female and 52 % (47/90) were white. Sixty were randomized to GBL intervention and 30 to control. The primary outcome of diagnostic accuracy immediately after training was better in GBL (mean accuracy score 59.4) vs. control (37.6), p=0.0005. The GBL group was then split evenly (30, 30) into no further intervention or weekly emails with case studies. Both GBL groups performed better than control at one-month and some continued effect at three-month follow up. Scores at one-month GBL (59.2) GBL plus emails (54.2) vs. control (33.9), p=0.024; three-months GBL (56.2), GBL plus emails (42.9) vs. control (35.1), p=0.076. Most participants would recommend GBL to colleagues (73 %), believed it was enjoyable (92 %) and believed it improves test interpretation (95 %). Conclusions: In this pilot study, a single session with GBL nearly doubled score on a scale of diagnostic accuracy in medical trainees and practicing clinicians. The impact of GBL persisted after three months.
Language	English
Publishing date	2024-01-30
Publishing country	Germany
Document type	Journal Article
ISSN	2194-802X
ISSN (online)	2194-802X
DOI	10.1515/dx-2023-0133
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Book: Foragers of the terminal Pleistocene in North America

Driskell, Boyce N / Walker, Renee Beauchamp

2007

Author's details	edited by Renee B. Walker and Boyce N. Driskell
Keywords	Excavations (Archaeology) ; Hunting and gathering societies ; Paleo-Indians/Antiquities ; North America
Language	English
Size	xv, 328 p., ill., maps., 24 cm
Publisher	University of Nebraska Press
Publishing place	Lincoln u.a.
Document type	Book
Note	Includes bibliographical references (p. [239]-315) and index ; Introduction: New developments in Paleoindian subsistence studies / Renee B. Walker and Boyce N. Driskell -- Quacks in the ice : waterfowl, Paleoindians, and the discovery of America / Stuart J. Fiedel -- Faunal extinction, hunter-gatherer foraging strategies, and subsistence diversity among eastern Beringian Paleoindians / David R. Yesner -- Are Paleoindians of the Great Plains and Rockies subsistence specialists? / Marcel Kornfeld -- Discerning clovis subsistence from stone artifacts and site distributions on the southern Plains periphery / Michael B. Collins -- Late Paleoindian subsistence strategies in the western Great Lakes region : evidence for generalized foraging from northern Wisconsin / Steven R. Kuehn -- Hunting in the late Paleoindian period : faunal remains from Dust Cave, Alabama / Renee B. Walker -- Seed collecting and fishing at the Shawnee Minisink Paleoindian site : everyday life in the late Pleistocene / Richard J. Dent -- Gathering in the late Paleoindian period : archaeobotanical remains from Dust Cave, Alabama / Kandace D. Hollenbach -- Revising the paleoindian environmental picture in northeastern North America / Lucinda McWeeney -- Early Floridians and late megamammals : some technological and dietary evidence from four north Florida Paleoindian sites / James S. Dunbar and Pamela K. Vojnovski -- Ethnography, analogy, and the reconstruction of Paleoindian lifeways / Asa R. Randall and Kandace D. Hollenbach -- Making sense of Paleoindian subsistence strategies / Boyce N. Driskell and Renee B. Walker ; Some chapters originally presented at a Society for American Archaeology symposium in 2000
ISBN	0803248024 ; 9780803248021
Database	Former special subject collection: coastal and deep sea fishing

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Article ; Online: Erratum to: The Relationship Between Marijuana and Conventional Cigarette Smoking Behavior from Early Adolescence to Adulthood.

Kristman-Valente, Allison N / Hill, Karl G / Epstein, Marina / Kosterman, Rick / Bailey, Jennifer A / Steeger, Christine M / Jones, Tiffany M / Abbott, Robert D / Johnson, Renee M / Walker, Denise / David Hawkins, J

Prevention science : the official journal of the Society for Prevention Research

2017 Volume 18, Issue 4, Page(s) 439

Language	English
Publishing date	2017-05-02
Publishing country	United States
Document type	Journal Article ; Published Erratum
ZDB-ID	2251270-6
ISSN	1573-6695 ; 1389-4986
ISSN (online)	1573-6695
ISSN	1389-4986
DOI	10.1007/s11121-017-0789-x
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Article ; Online: ASPEN Consensus Recommendations for Refeeding Syndrome.

da Silva, Joshua S V / Seres, David S / Sabino, Kim / Adams, Stephen C / Berdahl, Gideon J / Citty, Sandra Wolfe / Cober, M Petrea / Evans, David C / Greaves, June R / Gura, Kathleen M / Michalski, Austin / Plogsted, Stephen / Sacks, Gordon S / Tucker, Anne M / Worthington, Patricia / Walker, Renee N / Ayers, Phil

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

2020 Volume 35, Issue 2, Page(s) 178–195

Abstract: Introduction: In the spring of 2017, the American Society for Parenteral and Enteral Nutrition (ASPEN) Parenteral Nutrition Safety Committee and the Clinical Practice Committee convened an interprofessional task force to develop consensus ... ...

Abstract	Introduction: In the spring of 2017, the American Society for Parenteral and Enteral Nutrition (ASPEN) Parenteral Nutrition Safety Committee and the Clinical Practice Committee convened an interprofessional task force to develop consensus recommendations for identifying patients with or at risk for refeeding syndrome (RS) and for avoiding and managing the condition. This report provides narrative review and consensus recommendations in hospitalized adult and pediatric populations. Methods: Because of the variation in definitions and methods reported in the literature, a consensus process was developed. Subgroups of authors investigated specific issues through literature review. Summaries were presented to the entire group for discussion via email and teleconferences. Each section was then compiled into a master document, several revisions of which were reviewed by the committee. Findings/recommendations: This group proposes a new clinical definition, and criteria for stratifying risk with treatment and screening strategies. The authors propose that RS diagnostic criteria be stratified as follows: a decrease in any 1, 2, or 3 of serum phosphorus, potassium, and/or magnesium levels by 10%-20% (mild), 20%-30% (moderate), or >30% and/or organ dysfunction resulting from a decrease in any of these and/or due to thiamin deficiency (severe), occurring within 5 days of reintroduction of calories. Conclusions: These consensus recommendations are intended to provide guidance regarding recognizing risk and identifying, stratifying, avoiding and managing RS. This consensus definition is additionally intended to be used as a basis for further research into the incidence, consequences, pathophysiology, avoidance, and treatment of RS.
MeSH term(s)	Adolescent ; Adult ; Aged ; Child ; Consensus ; Energy Intake ; Enteral Nutrition/methods ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Magnesium/blood ; Male ; Middle Aged ; Nutrition Assessment ; Parenteral Nutrition/methods ; Phosphorus/blood ; Potassium/blood ; Refeeding Syndrome/diagnosis ; Refeeding Syndrome/epidemiology ; Refeeding Syndrome/prevention & control ; Refeeding Syndrome/therapy ; Risk Factors ; Societies, Medical ; Young Adult
Chemical Substances	Phosphorus (27YLU75U4W) ; Magnesium (I38ZP9992A) ; Potassium (RWP5GA015D)
Language	English
Publishing date	2020-03-02
Publishing country	United States
Document type	Journal Article ; Practice Guideline ; Review
ZDB-ID	645074-x
ISSN	1941-2452 ; 0884-5336
ISSN (online)	1941-2452
ISSN	0884-5336
DOI	10.1002/ncp.10474
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