bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes Exercise Project
Authors: Murphy  , Simkins  , Helowicz  
Published: March 2003

Background: Exercise can play a major role in improving diabetic control and prevention of complications. In order to encourage overweight people with poorly controlled diabetes to take more exercise a group exercise programme was set up. Objectives: To evaluate the effectiveness of the diabetes exercise project 20 months after professional contact and funding had ceased. The project ran from October 1994 to March 1996 and the evaluation was carried out in November 1997. Method: Evaluation was carried out through a postal questionnaire, focus group discussions and clinical data collection on a sample of those referred on to the project.The project set out to find: (1) the number of the original group who took up the exercise programme and were still exercising on a regular basis; (2)the clinical outcomes in terms of changes in body mass index (BMI), glycosylated haemoglobin (HbA1) and diabetes medication from the start of the exercise project to the evaluation; (3) the self‐reported benefits to those with diabetes on the exercise programme, including any self‐reported effect regular exercise has had on their diabetes control at the time of the evaluation; (4) the factors associated with their ability to carry on exercising. Results: Clinical outcomes showed no significant changes in those who continued to exercise and those who stopped. However, there was a statistically significant increase (P = 0.01) in the proportion of those with non‐insulin dependent diabetes (NIDDM) who were treated with insulin, from 30% to 53%. Of the 42 who had replied to the questionnaire, 71% continued to exercise for more than 6 months and, of these, 52% continued to exercise for over 20 months. Self‐reported benefits of exercise included ‘increased energy levels’, a greater ability to concentrate and enjoy exercise, increased motivation and more positive mood and feelings. Improvement in diabetic control was reported by 25 (60%). Further benefits reported included a stabilizing of their diabetes, loss of weight and a more positive attitude towards their health. Conclusions: It is possible to motivate overweight, poorly controlled people with diabetes to exercise on a regular basis. To do so successfully, consideration needs to be given to having the right personnel involved in the exercise programmes, support from the health professionals and suitable facilities and instruction. Injury and lack of time were given as the main barriers to exercise.
Nutritional status of a brain‐injured population in a long‐stay rehabilitation unit: a pilot study
Authors: French A. M. , Merriman S. H. 
Published: March 2003

Summary Background: Studies elsewhere have shown a high incidence of malnutrition in brain‐injured people and in in‐patient populations. Objectives: To investigate the incidence of malnutrition in long‐term rehabilitation at the National Centre for Brain Injury Rehabilitation and to evaluate the usefulness of a range of measures of nutritional status. Methods: All (n=33) patients were invited to participate. Anthropometric, dietary, haematological and biochemical measurements were made. Result: The incidence of malnutrition was nil. The incidence of obesity was comparable to the ‘normal’ population. Subjects consumed a nutritionally adequate diet, except for NSP (fibre). Conclusion: The result was not only better than that of other therapeutic communities, it was better than the ‘normal’ population. Useful tools for assessment of nutritional status were found to be BMI, arm anthropometry, biochemistry, haematology and food diaries. Further study of the nutritional status of all admissions will identify the changes which can occur during long‐term rehabilitation.
Dietary habits of patients with renal stone disease in Greece
Authors: Hassapidou M. N. , Paraskevopoulos S. TH. , Karakoltsidis P. A. , Petridis D. , Fotiadou E. 
Published: March 2003

Summary Objective: To assess the dietary habits of 62 renal stone patients and to relate their diet to the likelihood of nephrolithiasis. Subjects and methods: All subjects completed a dietary questionnaire including questions regarding anthropometric characteristics, dietary habits and food consumption frequencies. Subjects were grouped according to sex. Results: Sixty per cent of the subjects were male and 40% female. Seventy‐nine per cent of the patients were obese (BMI > 25). The percentage of obese individuals was higher for men (84%) than for women (72%). Furthermore, BMI increased with age with a peak at the age of 50 years. All subjects had a high meat intake indicating a high animal protein consumption. Forty‐two per cent of the subjects consume meat 5–8 times per week and 24% consume meat 9–12 times per week. All subjects had a low milk and dairy products intake as well as low vegetable and fruit intake, indicating a strong possibility of low calcium and fibre intake. Conclusion: The results of the dietary survey recorded a diet which is associated with an increased risk of nephrolithiasis. The majority of the subjects were obese, had a high intake of animal protein from meat, a low intake of foods rich in calcium and a low number of meals per day.
A11. The influence of the media on eating disorders
Authors: Almond S. 
Published: March 2003

Background The cause of eating disorders is multifactorial. One of these is sociocultural factors which include family, peers and the media. It has been suggested that constant media pressures can lead to body dissatisfaction, which may result in distorted eating patterns.Aims To review the role of the media in relation to eating disordersResults There has been a shift in the media portrayal of the ’ideal’ body size for women, from the voluptuous curved figure of Marilyn Monroe in the 1950s to a thinner ’waif‐like’ look of Kate Moss in the 1980s.In the mass media shape and weight define perfection. Women perceive themselves as being bigger than they actually are. Their figure deviates from the ideal thus resulting in self body dissatisfaction.’All I see is these pretty models, I wish I could look like one of them.’ ( Wertheim et al. 1997
)The ’ideal’ body image is far from the physiologic norm. Supermodels are born with a specific body type and what the public doesn’t understand is that they cannot diet to achieve it.’Women don’t set out to be anorexic, they begin by thinking they’re too fat because everywhere they go the media is telling them that they are right’ ( Barrett, 1997)Products are often advertised displaying the ideal body shape in the hope that it will enhance the product and create body dissatisfaction. Purchasing the product is perceived as a positive step towards reaching the ’perfect’ body image. Concern surrounds the appearance of such advertisements in magazines aimed at adolescent girls, as at this age they are particularly vulnerable to the influences of the media.Stice and Shaw (1994) stated that exposure to the thin ’idea’ may have a negative effect on emotions leading to body dissatisfaction. Such emotions include depression, stress, guilt, shame, insecurity, unhappiness, and lower self‐confidence.A study by Schotte et al. (1990)
indicated that negative emotions can disrupt eating behaviour. Dieters watching a frightening film increased their food intake, whereas nondieters did not.Conclusion The media are not solely responsible for eating disorders but they do contribute by promoting the ’ideal’ physique. There is some resistance to media messages, as the majority of people do not develop distorted eating patterns.
A2. The carer’s perception of dietitians’ advice and its impact on the management of patients receiving haemodialysis
Authors: Rezaie M. A. 
Published: March 2003

Background Patients with end stage renal disease and their carers suffer many changes in their daily life style as a result of haemodialysis (HD) treatment. Information and education concerning the management of dietary requirements and restrictions for renal patients should be aimed at both patients and their carers.Aim This study investigated the impact of dietitians’ involvement and advice on the carers’ ability to manage patients’ dietary/fluid requirements.Method A total of 36 carers of renal patients receiving unit haemodialysis treatment were randomly recruited into this study from a hospital in Cardiff, Wales. All the carers completed the Haemodialysis carers questionnaire (HCQ), specifically designed for this study, delivered to them in the outpatient clinic by the dietitian.Results Of the 36 carers, 22 (61%) were female, six (16.7%) were male and eight (22%) did not report their gender. Thirteen (36%) of the carers were between the ages of 20–54 years and 23 (64%) were 55 years of age and older. Twenty‐six (72%) of the carers involved in this study were spouses and 34 (94.4%) of the carers lived with the patient. The mean duration of haemodialysis treatment for the patient was found to be 20 months. The results indicated that although the majority of the carers were informed about patients’ dietary and fluid restrictions, 45% had not received any dietary information. Dietitians’ one‐to–one interactions with the carer was the most effective way of providing information in enabling them to better manage the patient compared to other methods such as leaflet and information packs (P = 0.01). The majority of the carers knew how to contact the renal dietitian, however, many did not (P = 0.001). Almost all the carers considered receiving information about the purpose of HD, feed back on the patients’ condition, fluid/dietary restriction and details of available community resources as very important. Those carers who had the benefit of a dietitian’s involvement believed that their advice was very helpful and enabled them to cope better with the management and complications of patient fluid and dietary requirements (P < 0.02). Strong correlations were found (rs = 0.67; P < 0.01) between the amount of information received by the carers and the level of the carers satisfaction with this information. In contrast, there were no significant correlations between the amount of information received by the carers and different aspects of managing the patients’ diet, because 45% of the carers received none or little information.Conclusions Dietitians should involve the carers in the management of HD patient’s dietary/fluid requirements and restrictions in order to provide better quality of care and quality of life for both the patient and the carer.
A comparison of the amount of food served and consumed according to meal service system
Authors: Wilson A. , Evans S. , Frost G. 
Published: March 2003

Background Malnutrition affects between 25 and 40% of all hospitalized patients, the majority of whom receive their main nutritional intake from the food provided by the hospital catering system. There is currently very little published information concerning the nutritional impact on patients of different methods of catering service.Objective In the current study the effects of two catering service systems, plated and bulk service, on food and nutrient intake of hospital patients were compared.Methods One‐hundred and eight patient meals were surveyed, 51 on the plated meal and 57 on the bulk meal services. Patients were either on a general medical or an orthopaedic ward. Weighed food intake data were collected by weighing food served and comparing it to the weight of food left on the plate. Equal numbers of lunch and supper dishes were weighed. Also, a number of weekend surveys were carried out to take into account variation in service at weekends.Results Food wastage was greater with the plated system. Comparing the amount of energy and nutrients consumed by patients according to meal system: energy intakes were significantly lower with the plated system (414 ± 23 kcal vs. 319 ± 22 kcal, P < 0.004). Protein, fat and carbohydrate intakes were also significantly lower. The main reason for the observed differences was the higher total food intake of the main course of the bulk service meals. Energy intake from the main course was significantly higher among patients receiving bulk service meals (227 ± 10 kcal vs. 165 ± 14 kcal, P < 0.006).Conclusion Catering service systems can have a major impact on the nutritional intake of hospitalized patients.
Percutaneous endoscopic gastrostomy feeding in haemodialysis out‐patients
Authors: Sayce H. A. , Rowe P. A. , McGonigle R. J. S. 
Published: March 2003

Introduction Malnutrition is highly prevalent in haemodialysis (HD) patients and plays a major role in influencing outcome. Although use of home enteral feeding is expanding rapidly in the UK, it is a method of nutritional support which remains under‐utilized in HD out‐patients. We report our experience and outcomes in a series of eight cases.Methods Home gastrostomy feeding was initiated in eight malnourished HD out‐patients, administered either continuously overnight or as daily bolus feeds. Nutritional parameters were monitored weekly by the renal dietitian and included dry weight, upper‐arm anthropometry and serum albumin. The number and duration of hospitalizations during the period of feeding were recorded.Results After 3 months of feeding, median dry weight increased from 43.0 to 48.3 kg (P = 0.012), mid‐upper arm circumference increased from 20.2 to 24.8 cm (P = 0.018), triceps skinfold thickness increased from 7.3 to 11.3 mm (P = 0.046), mid‐upper arm muscle circumference increased from 17.7 to 19.8 cm (P = 0.027) and serum albumin increased from 29.5 to 36.5 g L−1 (P = 0.011). Few complications were encountered and hospital admission rates were low.Conclusion Home gastrostomy feeding, with appropriate monitoring and support, is an effective method of improving and maintaining nutritional status in this vulnerable group.
The validation of a nursing nutritional assessment tool for use on acute elderly wards
Authors: McCall R. , Cotton E. 
Published: March 2003

BackgroundElderly people are at great risk of poor nutritional status. Identifying those at nutritional risk is complex owing to its multifactorial nature and highlights the need for an easily administered nutritional screening tool.AimTo test the robustness of a tool used to identify those patients who require further dietetic assessment.MethodThe tool was tested on an ‘acute elderly’ ward to assess its statistical robustness, i.e. test–retest reliability, inter‐rater reliability, internal consistency and factor structure, concurrent and construct validity. The research was carried out by a dietitian and two nurses on an overall sample of 185 consecutive admissions.ResultsTest–retest results reflect that the tool is capable of yielding consistent assessments over time. Inter‐rater reliability results revealed that when comparisons of agreement between nurses and dietitians were examined there was consistent disagreement. Internal consistency was found to be low but the rotated factor analysis suggested a relationship between the items in the tool. Concurrent validity was exhibited with body mass index, albumin and American Nutrition Risk Index only. Construct validity was not sufficiently exhibited with any of the measures used.ConclusionThe tool has not demonstrated reliability as determined by the statistical measures and hence validity at this stage. Issues which need to be addressed to allow this tool to be used appropriately are discussed.
Dietary restraint in relation to nutrient intake, physical activity and iron status in adolescent females
Authors: Mulvihill C. B. , Davies G. J. , Rogers P. J. 
Published: March 2003

AimTo investigate the prevalence of dietary restraint in a female adolescent population, and to examine the nutritional consequences of dietary restraint and its implications for iron status.MethodsA total of 64 adolescent females, aged 14–15 years, were recruited from two all‐girl schools in central London. Nutrient intake, body weight, physical activity and iron status were measured. Findings were compared between three groups of subjects classified by dietary restraint.ResultsAdolescents with a higher BMI percentile were more likely to be highly restrained. Scores on the dietary restraint psychometric measures were comparable with other UK studies in this age group. Energy intake was inversely related to dietary restraint (mean energy intake (SE) for each restraint group were: low 8.99 MJ (0.48), medium 7.98 MJ (0.22) and high 7.35 MJ (0.39) P < 0.05); however, a corresponding relationship between dietary restraint and reduced micronutrient intakes was not found. Highly restrained eaters obtained more of their energy intake from bread, fruit and cheese and less from meat, meat products and confectionery. Levels of physical activity were not significantly different between the dietary restraint groups. There was a poor relationship between reported energy intake and estimated energy expenditure. Haematological parameters of iron status were similar across the restraint groups.ConclusionsDietary restraint was exercised by the consumption of a `healthy eating diet'. Dieting was not related to a lower iron status; however, the low dietary iron intake and poor iron status of the whole sample is of concern.
Estimation of total body water from bioelectrical impedance analysis in patients with pancreatic cancer – agreement between three methods of prediction
Authors: Bauer J. , Capra S. , Davies P. S. W. , Ash S. , Davidson W. 
Published: March 2003

AbstractIntroductionBioelectrical impedance analysis (BIA) is a useful field measure to estimate total body water (TBW). No prediction formulae have been developed or validated against a reference method in patients with pancreatic cancer. The aim of this study was to assess the agreement between three prediction equations for the estimation of TBW in cachectic patients with pancreatic cancer.MethodsResistance was measured at frequencies of 50 and 200 kHz in 18 outpatients (10 males and eight females, age 70.2 ± 11.8 years) with pancreatic cancer from two tertiary Australian hospitals. Three published prediction formulae were used to calculate TBW – TBWs developed in surgical patients, TBWca‐uw and TBWca‐nw developed in underweight and normal weight patients with end‐stage cancer.ResultsThere was no significant difference in the TBW estimated by the three prediction equations – TBWs 32.9 ± 8.3 L, TBWca‐nw 36.3 ± 7.4 L, TBWca‐uw 34.6 ± 7.6 L. At a population level, there is agreement between prediction of TBW in patients with pancreatic cancer estimated from the three equations. The best combination of low bias and narrow limits of agreement was observed when TBW was estimated from the equation developed in the underweight cancer patients relative to the normal weight cancer patients. When no established BIA prediction equation exists, practitioners should utilize an equation developed in a population with similar critical characteristics such as diagnosis, weight loss, body mass index and/or age.ConclusionsFurther research is required to determine the accuracy of the BIA prediction technique against a reference method in patients with pancreatic cancer.
Affective psychosis and Prader–Willi syndrome
Authors: Bouras N. , Beardsmore A. , Dorman T. , Cooper S.‐A. , Webb T. 
Published: March 2003

AbstractPrevious studies have demonstrated that maladaptive behaviours are common amongst adults with Prader–Willi syndrome (PWS). Case reports have also previously demonstrated that psychosis can occur amongst adults with PWS. The present study was undertaken in order to gain a better understanding of the psychopathology of the psychosis of PWS. Twentythree out of 25 adults identified with PWS living in Northamptonshire, UK, agreed to participate. Comprehensive psychiatric assessments (using the PPSLD), and measures of adaptive and maladaptive behaviours (using the AAMR‐ABS) were completed. Comparisons were made for the prevalence of psychiatric disorders against those from a previous epidemiological study of adults with intellectual disability of other aetiologies from a neighbouring county. The PWS group was found to have higher rates of affective disorders (a point prevalence of 17.4%), in which psychotic symptoms were common, but similar rates of schizophrenia/delusional disorders (4.3%) compared with the comparison group. Behaviour disorders were also common. Surprisingly, none of the PWS group was found to have generalized anxiety or phobic disorders. The diagnostic criteria for the episodes including psychotic symptoms are explored. The high rates of affective disorders is of clinical (i.e. treatment) importance as well as being of academic interest with regard to the genetics of psychiatric disorders.
Autism in Down’s syndrome: a family history study
Authors: Ghaziuddin M. 
Published: March 2003

AbstractSeveral recent reports have described the occurrence of autism in subjects with Down’s syndrome (DS). However, relatively little is known about the family history of these subjects, especially with reference to autism. In order to address this issue, the present author examined 11 subjects with DS and autism (DSM‐III‐R; nine males), and compared them with seven controls with DS but without autism (DSM‐III‐R; three males). Details about family psychiatric history were obtained from both groups with an emphasis on autism and related disorders. Subjects with both DS and autism had an excess of first‐degree relatives who met the description of the broader phenotype of autism. Seven (64%) of the subjects with autism had an affected parent as against one (14%) of the control group. Similarly, four out of 11 siblings (36%) in the DS with autism group showed features suggestive of the broader autistic phenotype compared to none in the control group. These findings suggest that, at least in some cases, autism‐specific genetic factors may be important even when autism occurs in the presence of known medical conditions. Further studies of the mechanism of comorbidity of autism with medical conditions may help clarify the aetiology of the disorder.
Self‐assessment of relationships with peers in children with intellectual disability
Authors: Zic A. , Igrić L. 
Published: March 2003

AbstractInteraction with peers is important for the development of children, but children with special needs may feel rejected by their peers. The present study examines self‐assessment of relationships with peers by children with intellectual disability (ID; n = 20) and children from the general population (n = 20). All participants attended a regular primary school and were aged between 7 and 10.5 years; both sexes were represented in the samples. The Behavior Rating Profile was applied. The results of the children with ID on the ‘Student Rating Scale: Peers’ did not show statistically significant differences from the results of children from general population, with both groups responding similarly to the self‐perception scale. However, the sociometric results obtained from their peers clearly show that children with ID are not accepted by their classmates. Peers frequently and more often refuse to study, sit together in class or socialize after classes with children with ID than is the case for children without ID. Despite the high frequency of rejection, it is concluded that children with ID of younger primary school age have average confidence in their own abilities and in the success of their relationships with their peers. Further education among the children who reject them could have a negative impact on their self‐esteem.