• 제목/요약/키워드: nutritional care and management

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Pediatric Acute Kidney Injury: Focusing on Diagnosis and Management

  • Cho, Myung Hyun
    • Childhood Kidney Diseases
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    • 제24권1호
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    • pp.19-26
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    • 2020
  • Acute kidney injury (AKI) is common in critically ill children, and is associated with increased mortality and long-term renal sequelae. The definition of pediatric AKI was standardized based on elevation in serum creatinine levels or decrease in urine output; accordingly, epidemiological studies have ensued. Although new biomarkers appear to detect AKI earlier and predict prognosis more accurately than traditional markers, they are not frequently used in clinical setting. There is no validated pharmacological intervention for AKI, so prevention and early detection are the mainstays of treatment. For high risk or early stage AKI patients, optimization of volume status and blood pressure, avoidance of nephrotoxins, and sufficient nutritional support are necessary, and have been demonstrated to be effective in preventing the occurrence of AKI and improving prognosis. Nevertheless, renal replacement therapy is needed when conservative care fails.

암성 악액질의 최신 지견 (Recent Advances in Cancer Cachexia)

  • 최상규
    • 종양간호연구
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    • 제11권1호
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    • pp.20-25
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    • 2011
  • Purpose: The study was aimed to review and understand the meaning of cancer cachexia. Methods: Using the keywords "cachexia" and "cancer cachexia" 30 oncology research published from 1974 to 2009 were selected for the review. Results: The mechanism of cancer cachexia has not been fully understood, but various pathogenesis appears to be involved in the development cachexia including altered metabolism of carbohydrate, lipid, and protein associated with cytokines and hormone. As a result, muscle strength, food intake and resting energy expenditure (REE) are reduced. Most medications for the treatment of cachexia show debating results except some drugs such as megace. Supportive care including nutritional education, nursing care, and social support are found another effective treatment options. Conclusion: The results of this study would help oncology nurses to understand the mechanism of cancer cachexia and its management.

농촌지역 독거노인의 식이패턴과 지역사회치주지수와의 관련성 (The Relationship Between Dietary Pattern and the Community Periodontal Index in Elderly People Living Alone in Rural Areas)

  • 박정순;박소영
    • 보건의료산업학회지
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    • 제11권4호
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    • pp.105-114
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    • 2017
  • Objectives : The purpose of this study was to investigate the relationship between dietary pattern and the Community Periodontal Index in elderly people who live alone in rural areas and to provide necessary data to strengthen nutrition education about the oral health of elderly people who live alone. Methods : Dental examinations and questionnaires were conducted with 380 elderly people who live alone in rural areas of Gyeonggi-do. Results : The Community Periodontal Index was higher when the elderly people who live alone had a low intake of vegetables and fruits, a high intake of sugars, a low number of breakfasts, a high frequency of overeating and a high frequency of instant ingestion. Conclusions : It is necessary to provide nutritional management services for the elderly people who live alone in rural areas and to provide preventive centered comprehensive oral care.

미국 Medicare 투석환자 치료의 질 지표 개발 : 4가지 주요 치료영역을 바탕으로 (Developing a Composite Quality Indicator to Assess The Quality of Care for US Medicare End-stage Renal Disease Patients)

  • 강혜영
    • 한국의료질향상학회지
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    • 제7권2호
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    • pp.204-216
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    • 2000
  • Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality indicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V) ${\geq}$ 1.2; (b) hematocrit level ${\geq}$ 30%; (c) serum albumin concentration ${\geq}$ 3.8g/dl ; and (d) blood pressure of <140 / <90mmHg. The 16 quality indicator were ranked according to their relative quality weights, which were estimated from its association with the relative risk of survival, adjusting for patient's baseline severity and dialysis facility characteristics. Results : Out of the entire sample of 2,179 patients, only 229 (10%) meet th recommended outcome levels for all 4 treatment areas. Overall, the study patients were distributed evenly over the 16 quality indicators, indicating a great variation in the quality of ESRD care. It appears that the rank of the 16 quality-indicators is driven by serum albumin concentration, suggesting that serum albumin concentration may be the most powerful predictor of ESRD patient survival among the 4 outcome measures. Conclusion : The developed quality indicator has the advantage of describin a range of care for dialysis patients and thus providing a more complete picture of care as compared to previous studies that have focused on only single or few components of the ESRD care.

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영양사 직무기술서 내용 타당성 검증을 위한 각 직무의 빈도 , 중요도 , 난이도 분석 (Analysis of the Frequency , Criticality and Difficulty of Each Job Task Elements for the Validity of the Dietitian's Job Description)

  • 문현경;이애랑;이영희;장영주
    • 대한영양사협회학술지
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    • 제7권1호
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    • pp.105-116
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    • 2001
  • This study was conducted a part of the project developing the standards of national board test for the dietitian's licence. The purpose of this study was to verify the dietitian's job description. To do this the survey was carried out for the frequency, criticality and difficulty of each job description with 4 point scales. The subjects was 521 dietitians, who have been working over 3 years at their position. The results are following ; 1. The each duty, task and task elements are verified with survey results. 2. Duties with high frequency and criticality were menu management, purchasing, storage and stock management, operational management for cooking, system management for distribution and sanitation management. 3. Duties with middle frequency and high criticality were managing equipment and facility, food service management, human resources management and self-development. 4. Duties with low frequency and high criticality were nutritional assessment for life cycles, nutrition therapy, nutrition education and disease management. 5. For difficulty, food service area show lower than of nutrition service area.

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여성 근로자의 영양섭취 및 건강상태 조사 : 사무직과 납 사업장 근로자의 비교 (Nutritional and Health Status of Women Workers by Working Fields)

  • 김민경;권세미;김희선
    • 대한지역사회영양학회지
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    • 제12권6호
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    • pp.773-781
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    • 2007
  • The objective of this study was to investigate the nutritional and health status of women industrial workers by working fields. One hundred forty eight (105 lead and 43 office) workers were recruited from March 2005 to October 2005. Information on age, education, smoking and drinking status were collected using questionnaire and nutrient intake and diet quality of workers were assessed by average of two-day 24 hr recall method. Biochemical indexes including blood lead level (PbB), indexes for iron status, serum calcium (Ca) and serum lipid profiles were analyzed from fasting venous blood or serum. Results showed that education level of lead workers was lower than that of office workers (p<0.05), but nutrient intake levels were not significantly different by working fields. Overall nutritional status of the subject were good except for calcium, vitamin $B_2$, C and folic acid intakes. PbB of lead workers were significantly higher than that of office workers while mean corpuscular hemoglobin concentration (MCHC) and serum Ca levels were significantly lower in lead workers. MCHC was positively correlated with zinc intake (r=0.166) and serum Ca was positively correlated with vitamin C intake (r=0.179). This study confirms that lead workers need extra care to keep their health and nutritional management especially for the nutrients known to interact with lead. Tailored nutrition education for workers at specific working fields needs to be more focused for the improvement of health status of industrial workers.

호스피스 스마트 환자 서비스 제공자를 위한 교육과정 개발 (Development of Educational Program for Hospice Smart Patient Service Provider)

  • 박재순;유양숙;박현정;최동원;최상옥;김성은;김효정
    • 종양간호연구
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    • 제9권1호
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    • pp.43-51
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    • 2009
  • Purpose: The purpose of the study was to develop an educational program reflecting the educational needs of Hospice Smart Patient service providers. Method: The description, goal, curriculum, method, and process evaluation of the educational program were constructed based on Modified Tyler-type Ends-Means Model followed by the analysis of current curriculum and needs of service providers. Results: The curriculum was constructed based on hospice volunteer program currently offered in Korea and the recommendations of hospice service volunteers and experts. A total of 90 hr was required to complete the curriculum that was composed of 'Introduction to cancer', 'Treatment and treatment complications of cancer', 'Post-treatment nutritional care', 'Helpful information', 'Introduction to hospice and palliative care', 'Comprehension of life and death', 'Holistic hospice and palliative care', 'How to communicate as a smart patient', 'Hospice and ethics', 'Pediatric hospice', 'Bereavement management', and 'Clinical practicum'. Conclusion: It is necessary to implement the developed educational program and evaluate its effectiveness, as well as making the service available to a greater number of cancer patients.

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수정란이식에 있어서 수란우의 준비와 관리 (Preparation and Management of Recipients in Bovine Embryo Transfer)

  • 김창근
    • 한국수정란이식학회지
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    • 제1권1호
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    • pp.35-49
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    • 1986
  • Recipients are an integral part of embryo transfer and they are expensive to maintain as a good recipient. Recipient management is one of the most important components in a successful embryo transfer program. Management includes selection and subsequent care of the animals. A good recipient is basically on "open" cows or heffers whose reproductive tract is capable of receiving one or two embryos and incubating it to term. Potential recipients should be always be healthy and cycling normally ranging from 18 to 23 days. A thorough veterinary examination is recommended for candidate of recipients and cattle for questionable health should be eliminated from the recipient herd. Age and size of recipients are particularly important considerations when heifers are used, because of most embryos available for transfer are from large dams and sires. Body condition can influence a recipient's production, reproduction and health. Obese and underconditioned cattle should be avoided for use. Transfer of fresh embryos especially requires precise synchronization of donors and recipients. For estrus synchronization, PGF$_2$$\alpha$ is injected twice 10 to 12 days apart and short4erm progestagen treatment is applied to potential recipient cattle by coil into vagina (PRID) or ear implant (Synchro-Mate-B). The highest pregnancy results are achieved in recipients at exact synchrony with donors or 12 to 24 hr earlier than donors. Estrus detection is a major factor in breeding efficiency. High accuracy can be achieved by use of heat mount detection alds or by obserbing cattle for 30-minute peroids 3 times daily. Assay progesterone in milk can be used to discrIminate between pregnant and nonprenant recipients. Rectal palpation on day 35 to 70 after is an accurate and safe method of pregnancy diagnosis. Embryonic mortality in recipients may be associated with factors such as high environmental temperature and nutritional or lactational stress in early lactation period. Achievement of short calving interval requires concentrated management activity during the first 90 days following calving. Acceptable candidate for a recipient should be routinely vaccinated for infectious diseases. Proper nutritional programs according to NRC requirements and body condition scoring system for recipient cattles are vital to the ultimate success of an embryo transfer program.r program.

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미취학 아동 학부모의 식품 알레르기 인지도와 영양관리 (Food Allergy Awareness and Nutritional Management by the Parents of Preschool Children)

  • 김수빈;김정희
    • 대한지역사회영양학회지
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    • 제21권5호
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    • pp.426-439
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    • 2016
  • Objectives: This study was performed to measure the food allergy (FA) awareness and management by the parents of preschool children. Methods: A questionnaire survey was conducted with the parents of preschool children. The questionnaire was designed to identify the prevalence of food allergies, requirements of food allergy support and differences in food management according to the presence or absence allergic diseases, using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. After excluding incomplete responses, the data of 158 parents of preschool children (90.3%) was used for statistical analysis. Results: The rate of the preschool children who had experienced food allergy (FA, ever) was 38.6% while diagnosed for food allergy by doctor (Diagnosis of FA, ever) was 17.7%. Forty nine preschool children (80.3%) had food restriction, and twenty three of them (37.7%) had self-restriction without diagnosis. The consumption frequencies of allergenic foods in FA group, such as ramyeon, noodles, bread, eggs, yogurt and ice cream were significantly (p<0.001) lower than those of the other two groups. The major allergenic foods were eggs, milk, wheat and processed foods in FA group. The overall food allergy-related knowledge level of parents was insufficient. Only 26 parents (16.5%) had received training about food allergies. All parents wanted to receive food allergy-related supports. In addition, most of parents wanted information on substitute menu for children with food allergy. Conclusions: This study identified a lack of food allergy training for the parents of preschool children and the necessity for food allergy education. Food allergy-related supports, such as menus without allergenic ingredients, guidelines for managing food allergy & anaphylaxis emergency care plan etc, should be provided to the parents in order to avoid events related to food allergies.

Importance of relationship quality and communication on foodservice for the elderly

  • Seo, Sun-Hee;Back, Ki-Joon;Carol, W. Shanklin
    • Nutrition Research and Practice
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    • 제5권1호
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    • pp.73-79
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    • 2011
  • In order to promote foodservice for the elderly, foodservice managers in Continuing Care Retirement Communities (CCRCs) must identify the main factors to enhance the satisfaction and behavioral intentions with food service. The purpose of this study was to investigate the relationships between relationship quality (consisting of trust, commitment, and satisfaction) and communication in the formation of elderly's behavioral intentions with food services at CCRCs. A survey was administered to residents in two CCRCs and a total of 327 residents participated. A tested structural equation model exhibited good model fit and explanatory power of the study construct. Satisfaction directly influenced word-of-mouth and service quality has an influence on commitment. Commitment was a significant determinant of behavioral intentions to eat more often in the dining room. Also, communication showed positive association with trust. The results provided strong evidence for the importance of satisfaction and communication as a consequence of relationship marketing efforts. Suggestions for future research to better understand the elderly' behavioral intention judgments were given.