LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 3239

Search options

  1. Article: Need for the Integrated Nutrition Pathway for Acute Care (INPAC): gaps in current nutrition care in five Canadian hospitals

    Keller, Heather

    BMC nutrition, 3:60

    2017  

    Abstract: BACKGROUND: Malnutrition is common in hospitalized patients and is associated with increased mortality, length of stay, and risk of re-admission. The consensus based Integrated Nutrition Pathway for Acute Care (INPAC) was developed and validated to ... ...

    Abstract BACKGROUND: Malnutrition is common in hospitalized patients and is associated with increased mortality, length of stay, and risk of re-admission. The consensus based Integrated Nutrition Pathway for Acute Care (INPAC) was developed and validated to enhance patients’ nutrition care and improve clinical outcomes. As part of the More-2-Eat project (M2E), five hospitals implemented INPAC activities (e.g. screening) in a single medical unit. The purpose of this paper is to demonstrate the care gaps with respect to INPAC activities on these five units prior to implementation. Results were used as part of a needs assessment on each unit, demonstrating where nutrition care could be improved and tailoring of implementation was required. METHODS: Cross-sectional data was collected by site research associates (RAs) using a standardized audit form once per week for 4 weeks. The audit contents were based on the INPAC algorithm. All medical charts of patients on the study unit on the day of the audit were reviewed to track routine nutrition care activities (e.g. screening). Data was descriptively displayed with REDCap™ and analyzed using R Studio software. RESULTS: Less than half of patients (249/700, 36%) were screened for malnutrition at admission. Of those screened, 36% (89/246) were at risk for malnutrition yet 36% (32/89) of these patients did not receive a dietitian assessment. Also, 21% (33/157) of patients who were not screened at risk were assessed. At least one barrier to food intake was noted in 85% of patient medical charts, with pain, constipation, nausea or vomiting being the most common. Many of these barriers were addressed through INPAC standard nutrition care strategies that removed the barrier (e.g. 41% were provided medication for nausea). Advanced nutrition care strategies to improve intake were less frequently recorded (39% of patients). CONCLUSION: These results highlight the current state of nutrition care and areas for improvement regarding INPAC activities, including nutrition screening, assessment, and standard and advanced nutrition care strategies to promote food intake. The results also provided baseline data to support buy-in for INPAC implementation in each M2E study unit. TRIAL REGISTRATION: Retrospectively registered ClinTrials.gov Identifier: NCT02800304, June 7, 2016.
    Keywords Assessment ; Audit ; Hospital ; Implementation ; Malnutrition ; Screening ; Strategies
    Language English
    Document type Article
    Database Repository for Life Sciences

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  2. Article: Nutritional quality of regular and pureed menus in Canadian long term care homes: an analysis of the Making the Most of Mealtimes (M3) project

    Keller, Heather

    BMC nutrition, 3:80

    2017  

    Abstract: BACKGROUND: Long term care (LTC) menus need to contain sufficient nutrients for health and pureed menus may have lower nutritional quality than regular texture menus due to processes (e.g., recipe alterations) required to modify textures. The aims of ... ...

    Abstract BACKGROUND: Long term care (LTC) menus need to contain sufficient nutrients for health and pureed menus may have lower nutritional quality than regular texture menus due to processes (e.g., recipe alterations) required to modify textures. The aims of this study were to: determine adequacy of planned menus when compared to the Dietary Reference Intake (DRI); compare the energy, macronutrients, micronutrients and fibre of pureed texture and regular texture menus across LTC homes to determine any texture, home or regional level differences; and identify home characteristics associated with energy and protein differences in pureed and regular menus. METHODS: Making the Most of Mealtimes (M3) is a cross-sectional multi-site study that collected data from 32 LTC homes in four Canadian provinces. This secondary analysis focused on nutrient analysis of pureed and regular texture menus for the first week of the menu cycle. A site survey captured characteristics and services of each facility, and key aspects of menu planning and food production. Bivariate analyses were used to compare menus, within a home and among and within provinces, as well as to determine if home characteristics were associated with energy and protein provision for both menus. Each menu was qualitatively compared to the DRI standards for individuals 70+ years to determine nutritional quality. RESULTS: There were significant provincial and menu texture interactions for energy, protein, carbohydrates, fibre, and 11 of 22 micronutrients analyzed (p < 0.01). Alberta and New Brunswick had lower nutrient contents for both menu textures as compared to Manitoba and Ontario. Within each province some homes had significantly lower nutrient content for pureed menus (p < 0.01), while others did not. Fibre and nine micronutrients were below DRI recommendations for both menu textures within all four provinces; variation in nutritional quality existed among homes within each province. Several home characteristics (e.g., for-profit status) were significantly associated with higher energy and protein content of menus (p < 0.01). CONCLUSIONS: There was variability in nutritional quality of menus from LTC homes in the M3 sample. Pureed menus tended to contain lower amounts of nutrients than regular texture menus and both menus did not meet DRI recommendations for select nutrients. This study demonstrates the need for improved menu planning protocols to ensure planned diets meet nutrient requirements regardless of texture. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02800291, retrospectively registered June 7, 2016.
    Keywords Dietary reference intake ; Older adults ; Long term care ; Menu quality ; Nutrients ; Pureed texture
    Language English
    Document type Article
    Database Repository for Life Sciences

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  3. Article: More-2-Eat: evaluation protocol of a multi-site implementation of the Integrated Nutrition Pathway for Acute Care

    Keller, Heather

    BMC nutrition, 3:13

    2017  

    Abstract: BACKGROUND: Nutrition care in hospitals is often haphazard, and malnourished patients are not always readily identified and do not receive the care they require. The Integrated Nutrition Pathway for Acute Care (INPAC) is an algorithm designed to improve ... ...

    Abstract BACKGROUND: Nutrition care in hospitals is often haphazard, and malnourished patients are not always readily identified and do not receive the care they require. The Integrated Nutrition Pathway for Acute Care (INPAC) is an algorithm designed to improve the prevention, detection and treatment of malnutrition in medical and surgical patients. More-2-Eat is an evaluation of the implementation of INPAC care activities (e.g. screening) in five diverse medical units from different hospitals in Canada. The primary purpose is to understand how tailored implementation affects INPAC uptake and factors that impact this implementation. The principal outcome is a toolkit that can provide guidance to others. METHODS: This participatory action research uses a before-after time series design to address several research questions focused on implementation and uptake of INPAC (e.g., Does the implementation of INPAC improve the detection of malnutrition? Do nutrition care related knowledge, attitudes and practices scores of unit staff change with the implementation of INPAC?). A six-month developmental phase where baseline data were collected is followed by a twelve-month implementation phase and a three-month sustainability phase. Qualitative and quantitative data are collected concurrently, and to address key research questions, these data are merged. Quantitative data are collected on-site by trained local dietitians and include chart audits of nutrition care practices and a more detailed assessment of recruited patients on quality of life, disability, frailty, food intake and barriers to food intake. Thirty-day post discharge follow up for these patients occurs by researchers via a telephone interview at three time points within baseline and implementation phases, to ascertain the same and other outcomes (e.g. readmission to hospital). Qualitative data include focus groups and key informant interviews completed by researchers, monthly teleconferences among the sites and site-completed forms that track implementation activities. Resource utilization of dietitian time for various care activities (e.g. assessment) and staff time to assist patients at mealtimes is also collected. DISCUSSION: More-2-Eat provides an example of how implementation can be tailored when a care algorithm is embedded into routine practice. The project also highlights important learning points with respect to data collection and techniques to support implementation. TRIAL REGISTRATION: Retrospectively registered ClinTrials.gov Identifier: NCT02800304 June 7, 2016.
    Keywords Hospitals ; Health plan implementation ; Malnutrition ; Nutrition assessment
    Language English
    Document type Article
    Database Repository for Life Sciences

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  4. Book ; Thesis: Der Aminoterminus der menschlichen RecQL4-Helikase

    Keller, Heidi

    von der biochemischen Charakterisierung zur biologischen Funktion

    2016  

    Author's details von Diplom-Biologin Heidi Keller
    Language German
    Size VII, 95 Seiten, Illustrationen, Diagramme
    Publishing place Jena
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Dissertation, Friedrich-Schiller-Universität Jena, 2016
    Note Zusammenfassung in deutscher und englischer Sprache
    HBZ-ID HT019364221
    Database Catalogue ZB MED Medicine, Health

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    2017 E 1020 order for loan Magazin

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Book ; Thesis: Gezielte Therapie rhabdoider Tumoren

    Keller, Hanna

    in vitro Wirksamkeit spezifischer molekularer Inhibitoren in Mono- und Kombinationstherapie

    2016  

    Institution Westfälische Wilhelms-Universität Münster
    Author's details vorgelegt von Keller, Hanna aus Münster
    Language German
    Size iii, 98 Blätter, Illustrationen, Diagramme
    Publishing place Münster
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Dissertation, Westfälische Wilhelms-Universität Münster, 2016
    HBZ-ID HT019135731
    Database Catalogue ZB MED Medicine, Health

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    2017 E 166 order for loan Magazin

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Book ; Thesis: Einfluss von Kommunikations- und Feedbacktraining auf die zahnmedizinische Kommunikations- und Interaktionskompetenz in der Selbst- und Fremdeinschätzung

    Keller, Helen

    2014  

    Author's details vorgelegt von Helen Keller
    Language German
    Size 163 Blätter, Diagramme
    Publishing place Heidelberg
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Dissertation, Ruprecht-Karls-Universität Heidelberg, 2015
    HBZ-ID HT018809534
    Database Catalogue ZB MED Medicine, Health

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    2015 E 1955 order for loan Magazin

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  7. Article ; Online: Nutrition Risk Is Associated with 3-Year Strength and Performance Indicators among Older Adults in the Canadian Longitudinal Study on Aging.

    Trinca, V / Keller, H

    The journal of nutrition, health & aging

    2023  Volume 27, Issue 10, Page(s) 868–877

    Abstract: Objectives: Determine if nutrition risk, as measured by SCREEN-8 is predictive of 3-year strength and performance indicators among community-living older adults after adjusting for key demographic and health variables. Sex-stratified analyses were also ... ...

    Abstract Objectives: Determine if nutrition risk, as measured by SCREEN-8 is predictive of 3-year strength and performance indicators among community-living older adults after adjusting for key demographic and health variables. Sex-stratified analyses were also determined.
    Design: Cohort study with baseline and 3-year follow-up data from the Canadian Longitudinal Study on Aging (CLSA).
    Participants: Participants 55 years and older at baseline were included (n = 22,502); those who reported nasogastric or abdominal tube feeding at either timepoint were excluded (n = 26). The final sample of participants available for analyses slightly varied depending on completion of the three outcome variables. List-wise deletion was used for nutrition risk and covariates to arrive at the sample available for analysis (n = 17,250).
    Measurements: The valid and reliable SCREEN-8 tool was used to measure nutrition risk. The minimum and maximum score of SCREEN-8 is 0 and 48, respectively, with lower scores indicating greater nutrition risk. Baseline SCREEN-8 score was used in analyses. Grip strength, chair rise test time and gait speed assessed at the 3-year follow-up were the strength and performance outcomes. Criteria outlined by the European Working Group on Sarcopenia in Older People 2 were used to determine low performance for grip strength (<27 kg for males and <16 kg for females), chair rise test time (>15 seconds) and gait speed (≤0.8 m/s).
    Results: Half of participants were female (49.4%) and mean age was 66.7 years (SD 7.9). Mean SCREEN-8 score was 39.2 (SD 6.0). Low grip strength, chair rise test performance and gait speed were found in 18.5%, 19.6% and 29.3% of participants, respectively. After adjusting for covariates (e.g., sex, age, education), SCREEN-8 score was significantly associated with grip strength (F = 11.21, p = .001; OR = 0.98, CI [0.97, 0.99]), chair rise time (F = 5.97, p = .015; OR = 0.99, CI [0.97, 0.997]), and gait speed (F = 9.99, p = .002; OR = 0.98, CI [0.97, 0.99]). Similar interpretation was seen in sex-stratified analyses, although chair rise time was not significant. Age, body mass index, Life Space Index Score and self-rated health were consistently associated with all outcome measures.
    Conclusion: Nutrition risk, as measured by SCREEN-8, significantly predicted 3-year strength and performance measures. Greater nutrition risk is associated with an increased odds of low performance on grip strength, chair rise test, and gait speed. Future research should implement nutrition risk screening in primary care settings with subsequent assessment and treatment for at risk clients to determine if nutrition interventions implemented post screening can delay age-related losses in strength and performance.
    MeSH term(s) Aged ; Female ; Humans ; Male ; Aging ; Canada ; Cohort Studies ; Hand Strength ; Longitudinal Studies ; Sarcopenia/diagnosis ; Middle Aged
    Language English
    Publishing date 2023-11-11
    Publishing country France
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2081921-3
    ISSN 1760-4788 ; 1279-7707
    ISSN (online) 1760-4788
    ISSN 1279-7707
    DOI 10.1007/s12603-023-1980-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Bonn / Germany

    Z 7466: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  8. Article: Kulturelle Perspektiven auf Beratung und Therapie.

    Keller, Heidi

    Praxis der Kinderpsychologie und Kinderpsychiatrie

    2022  Volume 71, Issue 3, Page(s) 206–219

    Abstract: This paper briefly characterizes two conceptions of child development, attachment theory and psychobiological approaches. Both share commonalities (e. g. focusing on infancy; relying on ethological approaches; studying parent - child regulations). They ... ...

    Title translation Cultural Perspectives on Counseling andTherapy.
    Abstract This paper briefly characterizes two conceptions of child development, attachment theory and psychobiological approaches. Both share commonalities (e. g. focusing on infancy; relying on ethological approaches; studying parent - child regulations). They also show marked differences, e. g. in methodology and moral evaluations. However, both approaches are based on the same implicit, taken for granted assumptions that are outlined with respect to cultural differences. Particularly caregiving networks and interaction strategies can be distinctly different in different cultural environments. Two socialization strategies with different values and practices of child development are introduced.Western middle-class families and traditional rural farmers in non-Western countries are selected because information is available in a research landscape where participants from non-Western middle class are rare.They can be regarded as embodying different cultural models with different emphases on autonomy and relatedness. Finally, implications for the clinical practice are discussed.
    MeSH term(s) Child ; Child Development ; Counseling ; Humans ; Socialization
    Language German
    Publishing date 2022-03-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 123711-1
    ISSN 0032-7034
    ISSN 0032-7034
    DOI 10.13109/prkk.2022.71.3.206
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.B 1131: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  9. Book ; Thesis: Untersuchung der Kohlenstoff- und Stickstoffallokation bei Hordeum vulgare L. im frühen Zeitraum nach der Anthese

    Keller, Harald

    von Harald Keller

    2012  

    Title variant Kohlenstoffallokation
    Language German
    Size 180 S., Ill., graph. Darst.
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Berlin, Humboldt-Univ., Diss., 2012
    Note Zsfassung in engl. Sprache
    HBZ-ID HT017356867
    Database Catalogue ZB MED Nutrition, Environment, Agriculture

    More links

    Kategorien

    In stock of ZB MED Bonn / Germany

    Shelf markLoan statusLocation
    124/701 available for loan (reading room) Freihandmagazin (U1)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  10. Book ; Thesis: Structural evolution of human alu ribonucleoprotein particles

    Keller, Heiko

    2011  

    Author's details vorgelegt von Heiko Keller
    Language English
    Size XII, 123 S., Ill., graph. Darst.
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Tübingen, Univ., Diss., 2011
    HBZ-ID HT017164634
    Database Catalogue ZB MED Medicine, Health

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    2012 D 212 order for loan Magazin

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top