bluuebunny/crossref_metadata_2025_split huggingface dataset:
What nutritional support literature do hospital nursing staff require?
Authors: Peake H. , Stockely M. , Frost G. 
Published: March 2003

BackgroundMany patients require nutritional intervention to help treat and/or prevent malnutrition. Nursing staff play a key role in identifying malnourished patients. To improve the management of artificial nutritional support, the Hammersmith Hospital NHS Trust has produced guidelines. This audit aimed to assess the need and adequacy of these guidelines and to examine any additional information required.MethodsThe dietetic department and nursing practice group developed a questionnaire. A total of 260 questionnaires were distributed by dietitians, 10 copies of the questionnaire to nurses on 26 wards. The completed forms were returned by internal post or collected the dietitian.ResultsThe response rate was 29%. All 77 nurses who responded felt there was a need for nutrition literature. Seventy‐three per cent of nurses were aware that the guidelines existed; however, referral to the resource was poor. Requests for additional information encompassed tube feeding and catering information. To provide this information, 84% requested a nutrition tutorial, 81% a preprinted care plan and 96% a ward manual specific to their speciality.ConclusionsAll nurses who were surveyed requested nutrition information. The current guidelines already reflect the requested information, but usage is poor. We aim to improve access and awareness by the hospital intranet, nutrition education and induction programme. The next update will cover gaps identified and additional requirements outside the guidelines remit will be discussed with the nursing practice group.
Probability of assertive behaviour, interpersonal anxiety and self‐efficacy of South African registered dietitians
Authors: Paterson M. , Green J. M. , Basson C. J. , Ross F. 
Published: March 2003

ObjectivesThere is little information on the probability of assertive behaviour, interpersonal anxiety and self‐efficacy in the literature regarding dietitians. The objective of this study was to establish baseline information of these attributes and the factors affecting them.MethodQuestionnaires collecting biographical information and self‐assessment psychometric scales measuring levels of probability of assertiveness, interpersonal anxiety and self‐efficacy were mailed to 350 subjects, who comprised a random sample of dietitians registered with the Health Professions Council of South Africa.ResultsForty‐one per cent (n=145) of the sample responded. Self‐assessment inventory results were compared to test levels of probability of assertive behaviour, interpersonal anxiety and self‐efficacy. The inventory results were compared with the biographical findings to establish statistical relationships between the variables. The hypotheses were formulated before data collection.ConclusionDietitians had acceptable levels of probability of assertive behaviour and interpersonal anxiety. The probability of assertive behaviour was significantly lower than the level noted in the literature and was negatively related to interpersonal anxiety and positively related to self‐efficacy.
An investigation into school children's knowledge and awareness of food and nutrition
Authors: Hart K. H. , Bishop J. A. , Truby H. 
Published: March 2003

With the diet and exercise behaviours of UK school children showing little improvement over recent years, the need for dietary change is clearly indicated. This study aimed to assess the nutritional knowledge and understanding of primary school children in order to identify the most effective format for future nutrition messages. A qualitative methodology was employed and 114 children, aged 7–11 years, took part in 23 focus groups separated by age, gender and socio‐economic status (SES). Issues discussed included parental food rules, children's perceptions of `good' and `bad' foods, diet–disease links and food groupings.Across the groups restrictive food rules were most frequently reported whilst between groups gender and SES differences were apparent in relation to parental control over food and children's nutritional knowledge. The limitations of the children's cognitive development could be seen in their conceptualization of food groups, where concrete grouping schemes were frequently used, and in the lack of understanding inherent in their food–health or food–nutrient associations. Taste and preference were confirmed as consistent influences in children's food classification.Primary school children may be receptive to food based dietary guidelines based on familiar, concrete food classifications. These should be cognitively appropriate and possibly need to be gender specific.
An audit of referrals of children with autistic spectrum disorder to the dietetic service
Authors: Bowers L. 
Published: March 2003

Autistic spectrum disorder (ASD) is a developing area for dietetic referrals. There is little published data on current dietetic practice. Some children with ASD are referred for gluten/casein free diet. The theory is that abnormal metabolites in the urine may be a result of incomplete breakdown of gluten and casein in the gut. There are some published open studies that support the efficiency of such a diet [Knivsberg et al. (1995) Scand. J. Educ. Res.39: 223; Lucarelli et al. (1995) Panminerva Med.37: 137; Whiteley et al. (1999) Int. J. Res. Practice3: 45] and also that there are many anecdotal reports that the diet helps some children.Aims and objectivesThis study aimed to audit the types of referral made to the dietetic service to identify key dietetic issues and to describe factors which may influence outcome/disease management.MethodsDietetic records were used to audit the referrals to the dietetic service over a 3‐month period. Seven‐day diet histories were assessed using computer food composition tables and topics of interest recorded against a draft protocol agreed within the profession.ResultsRequests for gluten‐free and casein‐free dietetic advice, and/or the management of food selectivity and dysfunctional feeding behaviour constituted the majority of referrals. In many cases, child's environment was rarely simple.ConclusionsDespite the limitations of this small study, the findings suggest that the management of these referrals is highly complex. A dietitian's input should ensure that the nutritional adequacy of the diet is maintained or restored.
Relationship between knowledge and claimed compliance with genuine and false nutrition messages
Authors: Main F. A. M. , Wise A. 
Published: March 2003

AbstractNutrition education messages about eight different foods, four of them genuine and four false, were set in a Latin square and eight questionnaires were produced and distributed to customers sitting in a cafe. For each message, subjects were asked to score the extent of their agreement and compliance. Scores were adjusted to remove effects of sex, age group and social class. Correlation coefficients between agreement and compliance scores were significant (P < 0.001) for each message. Subjects who had correct knowledge tended towards correct behaviour and those who agreed with misconceptions tended to have incorrect behaviour.
Defining and reporting diarrhoea during enteral tube feeding: do health professionals agree?
Authors: Whelan K. , Judd P. A. , Taylor M. A. 
Published: March 2003

AbstractIntroduction  The criteria used to define diarrhoea during enteral tube feeding (ETF) and the interrater reliability of nursing staff reporting it in clinical practice has not been investigated.Methods  A structured questionnaire was sent to a cohort of dietitians, specialist stroke nurses, intensive therapy unit (ITU) nurses and consultant gastroenterologists regarding their criteria for defining ETF diarrhoea. In a clinical study, nursing staff independently inspected faeces from patients receiving ETF and were asked whether they considered the patient to have diarrhoea.Results  Thirty‐five healthcare workers responded to the questionnaire. Faecal frequency, faecal consistency and faecal quantity were all considered important criteria in defining ETF diarrhoea. Faecal frequency was considered more important than consistency and quantity (P = 0.048), although not all professional groups agreed on the order of importance. In the clinical study, nursing staff agreed on the presence or absence of diarrhoea on 75% of occasions, with agreement being only fairly reliable (κ = 0.48).Conclusion  Healthcare workers use a range of criteria to define ETF diarrhoea, but may not agree on the importance of each criteria. In order to prevent confusion between professional groups, healthcare workers should be encouraged to describe faecal characteristics rather than rely on the term ‘diarrhoea’.
Distinctiveness and correlates of maladaptive behaviour in children and adolescents with Smith–Magenis syndrome
Authors: Bouras N. , Dykens E. M. , Smith A. C. M. 
Published: March 2003

AbstractThis two‐part study examines the distinctiveness and correlates of maladaptive behaviour in 35 children and adolescents with Smith–Magenis syndrome, a developmental disorder caused by an interstitial deletion of chromosome 17 (p11.2). Study I compares Child Behavior Checklist scores in 35 children with Smith–Magenis syndrome to age‐ and gender‐matched subjects with Prader–Willi syndrome and mixed intellectual disability. Subjects with Smith–Magenis syndrome had significantly higher levels of maladaptive behaviour than the other groups. Although some problems were shared across groups, 12 behaviours differentiated the three groups with 100% accuracy. Study 2 assessed the frequency and correlates of self‐injurious and stereotypical behaviours, including unusual features such as nail‐yanking, inserting objects into bodily orifices, self‐hugging and a ‘lick‐and flip’ behaviour. Nail‐yanking and bodily insertions were less common than other types of self‐injury, and self‐hugs and the ‘lick‐and flip’ stereotypies were seen in about half the sample. Although age and degree of delay were correlated with problem behaviours, sleep disturbance emerged as the strongest predictor of maladaptive behaviour. The implications are discussed for clinical diagnostic ambiguities between the Smith–Magenis and Prader–Willi syndromes, and for intervention.
Speech disorder in children with Down's syndrome
Authors: Dodd B. , Thompson L. 
Published: March 2003

AbstractThe speech of children with Down's syndrome (DS) is often unintelligible, unlike many other children who have an intellectual disability. However, the nature of their speech disorder is controversial. The speech error patterns of children with DS were compared to those of intellectually average chil‐dren with phonological disorder whose errors were characterized by inconsistency. The groups were matched for percentages of consonants produced in error. The data revealed no differences between the groups in terms of the number of words which were produced inconsistently on repeated productions in a picture‐naming task. However, further analyses revealed differences in the type of errors made by the groups in that the children with phonological disorder characterized by inconsistent errors made more changes to words on repeated production than the group with DS. The deficits underlying inconsistent pronunciation of words in the two groups of children under investigation would appear to differ. Intervention strategies should target the deficits identified.
Randomized trial of psychotropic medication information leaflets for people with intellectual disability
Authors: Strydom A. , Hall I. 
Published: March 2003

AbstractPeople with intellectual disability (ID), like other patient groups, are known to have a limited knowledge of medication. Leaflets are seen as an appropriate means of providing patient information. To test the hypothesis that medication information leaflets would improve the knowledge and care of the target group, the present authors designed a randomized trial and planned to do subgroup analyses where appropriate. The participants were individually randomized to two groups. A control group was given verbal medication information by their nurse or psychiatrist, and a study group was given specifically designed leaflets in addition to verbal information. The present authors recruited 54 people with mild to moderate ID and mental illness, aged 18 years and older, who were taking psychiatric medications. Questionnaires administered by a blind interviewer recorded outcomes such as medication knowledge and satisfaction at two time points. The participants with mild ID in the leaflet group had significantly reduced medication knowledge and understanding. There were no significant differences in satisfaction with clinicians and medication. Patient information leaflets may confuse people with mild ID in the short term. Other patient groups with cognitive deficits may have similar outcomes. Evaluation of outcomes of health education initiatives is important.
Depressive mood in students with mild intellectual disability: students’ reports and teachers’ evaluations*
Authors: Heiman T. 
Published: March 2003

AbstractThe present study examined 310 students with mild intellectual disability (ID) who attended special schools and self‐contained classes in mainstream schools with regard to their reports of depressive mood, and loneliness and social skills, and teachers’ perception of the students’ academic, social and behavioural competencies. A multivariate analysis of variance (MANOVA) revealed that: students in special schools reported higher levels of depression and felt lonelier than mainstream school students; girls exhibited a greater sense of depressive mood than boys; teachers assessed boys as having higher academic competencies than girls; and boys were considered more easily distracted and less independent. However, teachers considered girls to have more adequate social adjustment, and be more task‐oriented and more independent. For both groups, depressive mood can be predicted by distractibility and loneliness; by gender and lower academic competencies for special school students; or mainly by difficulties in social adjustment in the case of mainstream school students.
Neurological changes and emotional functioning in adults with Down Syndrome
Authors: Nelson Linda D. , Orme Denise , Osann Kathryn , Lott Ira T. 
Published: March 2003

AbstractThis study was designed to examine emotional changes in adults with Down Syndrome (DS) over time and whether changes in these psychological variables were associated with brain atrophy on MRI scan and the presence of pathological reflexes on the neurological examination. Participants were 26 adults with DS and their caregivers. Caregivers completed a measure of emotional functioning about individuals with DS at two different time points (1 year apart). Levels of cognitive functioning were measured and neurological and MRI examinations were performed on all subjects at initial testing. Significant group effect separated those with and without pathological findings on MRI and neurological exam across three different scales: depression, indifference, and pragmatic language functioning. Problems of poor pragmatic language functioning appeared later in the course of suspected Alzheimer's disease (AD), as demonstrated by a significant group effect at time 2, but not at initial testing. In these subjects, the primary emotional change was a decline in social discourse (e.g. conversational style, literal understanding, verbal expression in social contexts). These emotional levels were stable over time, regardless of degree of cognitive decline. Specific emotional changes occur during the course of AD which were associated with abnormal findings from MRI and from neurological examination. These results, along with abnormalities in brain imaging and the presence of pathological reflexes, suggested that frontal lobe dysfunction is likely to be an early manifestation of Alzheimer's Disease in Down Syndrome.
Mothers with learning difficulties and their support networks
Authors: Llewellyn G , McConnell D 
Published: March 2003

AbstractMothers with learning difficulties1are thought to be among the most socially isolated parents in the community. A great deal of attention has been directed to assessing their parenting abilities and teaching parenting skills, but less has been given to the support that mothers may (or may not) receive from family, friends and the service system. The present paper investigates mothers' views about the types of support which they receive and from whom they receive it. Data were derived from 70 mothers who participated in interviews using a support interview guide designed to accommodate the mothers' cognitive difficulties. The primary purpose of the interview was to explore the quantity and composition of the mothers' support networks, the frequency of contact and geographical proximity of support people, and the type of support provided. Key findings include: the central place that family members have in these mothers' lives; the importance of service providers as sources of information and advice; and the relative absence of friends and neighbours. Briefly, mothers living alone have service‐centred networks, mothers living with a partner have family‐centred networks with relatively dispersed family ties, and mothers living in a parent/parent‐figure household have local, family‐centred networks. The overall conclusion to be drawn from the present results is that these mothers do not live in a social vacuum, but many are socially isolated. The finding that so few mothers could identify supportive ties with friends and neighbours suggests that these mothers are isolated from their local communities and are potentially vulnerable if a breakdown occurs in the support provided by their families. The need for service providers to be more actively involved in linking mothers to their communities is discussed.
Health characteristics and health services utilization in older adults with intellectual disability living in community residences
Authors: Janicki M. P. , Davidson P. W. , Henderson C. M. , McCallion P. , Taets J. D. , Force L. T. , Sulkes S. B. , Frangenberg E. , Ladrigan P. M. 
Published: March 2003

AbstractBackground The health status and health needs of adults with intellectual disability (ID) change with advancing age, and are often accompanied by difficulties with vision, hearing, mobility, stamina and some mental processes.Aim The present study collected health status information on a large cohort of adults with ID aged ≥ 40 years living in small group, community‐based residences in two representative areas of New York State, USA.Method Adult group home residents with ID aged between 40 and 79 years (n = 1371) were surveyed to determine their health status and patterns of morbidity.Results Most subjects were characterized as being in good health. The frequency of cardiovascular, musculoskeletal and respiratory conditions, and sensory impairments increased with age, while neurological, endocrine and dermatological diseases did not. Psychiatric and behavioural disorders declined with increasing age, at least through 70 years of age. Although most conditions increased with age, their frequency varied by sex and level of ID. Frequencies of age‐related organ system morbidity were compared to data from the National Health and Nutrition Evaluation Survey III. It was found that adults with ID had a lower overall reported frequency of cardiovascular risk factors, including hypertension and hyperlipidaemia, and adult‐onset diabetes. Inconsistencies with mortality data among older adults with ID were observed (which showed equal if not greater prevalence of deaths as a result of cardiovascular disease and cancer).Conclusion These results suggest that either a cohort effect is operating (i.e. contemporary populations are healthier than previous populations), or that there may be under‐recognition of select risk factors and diseases.
Family environment and cognitive abilities in girls with fragile‐X syndrome
Authors: Kuo A. Y. , Reiss A. L. , Freund L. S. , Huffman L. C. 
Published: March 2003

AbstractBackground There remains some variance in cognitive ability that is unexplained in children with fragile‐X syndrome (FXS). Studies in typically developing children suggest that family environment might be one contributor to this unexplained variance. However, the effect of family environment in relation to cognition in atypical children with FXS has been relatively unexplored to date.Methods The present authors examined the putative genetic and environmental factors associated with cognition in a group of age‐matched children consisting of 26 females with FXS and 31 typically developing children. All subjects were administered the Wechsler Intelligence Scale for Children – Revised; and the subjects’ parents were administered the Wechsler Adult Intelligence Scale – Revised, and completed the Hollingshead Index of Social Status and the Moos & Moos Family Environment Scale.Results Using a multiple regression analytic strategy, the present authors found that family environment contributed significantly to cognitive abilities in typically developing girls, but did not have a unique contribution to cognitive abilities in girls with FXS. There was a suggestion that, for girls with FXS, socio‐economic status, a measure of sociocultural environment, was correlated with IQ.Conclusions The present study provides a basis for future research on the environmental contributions to cognitive abilities, particularly work related to verbal cognition.
Challenging behaviours should not be considered as depressive equivalents in individuals with intellectual disability
Authors: Tsiouris J. A. , Mann R. , Patti P. J. , Sturmey P. 
Published: March 2003

AbstractBackground  Depression is one of the most common forms of psychopathology in people with intellectual disability (ID). The present study evaluated the utility of an expanded assessment of psychiatric symptoms and challenging behaviours, as measured by the Clinical Behavior Checklist for Persons with Intellectual Disabilities (CBCPID).Methods  The CBCPID was administered to 92 people with ID, 35 of whom were diagnosed with a depressive disorder.Results  Item and factor analysis of the scale indicated that depression was best assessed using the core DSM‐IV symptoms of depressive disorder. Challenging behaviours such as self‐injury or aggression were not closely associated with depression. Short scales using the core DSM‐IV symptoms of depression were highly internally consistent. There was also evidence of the validity of these scales.Conclusions  This study found no evidence that challenging behaviours were depressive equivalents in this population. The present authors conclude that the assessment of depression in people with ID should focus on the core DSM‐IV symptoms of depression.