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The present study investigated whether vitamin E supplementation reduced oxidative stress in erythrocytes and improved vitamin E status in patients undergoing hemodialysis (HD). Plasma and erythrocyte α-tocopherol, plasma ascorbic acid, and iron status were determined in 11 regular HD patients prior to and post-dialysis, before and during oral supplementation of vitamin E, 400 IU daily for two months. HD patients were categorized into two groups according to their plasma ascorbic acid levels. We found that only the vitamin C sufficient group (>40 μM, Group I) had reliable measurements of erythrocyte α-tocopherol concentrations before vitamin E supplementation. In Group I prior to dialysis, erythrocyte α-tocopherol concentrations increased in response to vitamin E supplementation from 6.7 ± 0.7 μmol/L packed cells to 9.8 ± 0.6 (μmol/L packed cells (p<0.04). Moreover, there was a positive correlation (p<O.001) between plasma and erythrocyte α-tocopherol levels in Group I subjects. Additionally, vitamin E supplementation significantly increased hematocrits (39.9% ± 1.9% to 42.3% ±1.6%, p<0.004) post-dialysis only in Group I subjects. On the contrary, there was no change in hematocrits during vitamin E supplementation in the vitamin C deficient group (<40 μM, Group II). With respect to measures of iron status and recombinant human erythropoietin (rHuEPO) dose, no differences between before and during vitamin E supplementation were observed in two groups ofpatients. In summary, our data suggest that oral vitamin E supplementation protected erythrocytes from oxidative stress and improved vitamin E status in HD patients, but only in patients with adequate vitamin C status. / Graduation date: 2003

The purpose of this research study was to examine the nature and scope of nutrition counseling and/or education available to cardiac patients and the role of the Registered Dietitian (RD) in Cardiac Rehab Phase II Programs. One hundred and fifty programs were surveyed in regards to their program and the programs elements in regards to nutrition topics. To our knowledge, this is the first study to systematically examine the nature and scope of nutrition counseling and/or education and the role of the Registered Dietitian in Cardiac Rehab Phase II Programs.The results indicated that almost 75% of the programs surveyed offered nutrition counseling and/or education, regardless of the region examined. Also the majority of the programs were identified to have a Registered Dietitian on staff, but less than half reported a Registered Dietitian employment as full-time. There were also significant differences in regards to nutrition education topics among the regions. The results also uncovered a discrepancy between the perceived importance of having a Registered Dietitian on staff and their role as the primary provider of nutrition counseling and/or education. / Department of Family and Consumer Sciences

The medical records of 263 patients hospitalized between 14 and 28 days in a 405-bed, acute care, community hospital were reviewed before 100 records were obtained with complete data to determine percent recommended body weight (RBW), serum albumin, total lymphocyte count (TLC), and hematocrit on admission and near discharge. Serum albumin and hematocrit were the only indicators that changed significantly during hospitalization, with both decreasing from admission to discharge. Considering the four indicators together, changes in nutritional status of the patients during hospitalization were determined. Eighty three patients were found to be at least at moderate potential for nutritional risk on admission, and 95 were found to be at least at moderate potential for nutritional risk near discharge. No patients who were judged to be potentially at severe nutritional risk on admission improved their nutritional status during hospitalization. Paired comparisons of the four parameters indicated that hematocrit and serum albumin seemed to be measuring changes in potential nutritional status more similarly than any other pair of assessment indicators. Sixty-three of the patients did not receive what was judged to be adequate kilocalories and protein during hospitalization. Twelve of these patients were found to have an increase in potential nutritional risk status. Of the 163 medical records that were reviewed but did not have all indicators recorded, height was most often missing on admission, and weight and serum albumin were most often missing near discharge. / Master of Science

Bibliography: leaves 253-286 / vi, 299 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Faculty of Medicine, 1988

The actual fluid intake of forty (40) residents of a nursing home was determined by an analysis of detailed three-day food and fluid intake records obtained by direct observation. Intake was compared to an established standard to determine the adequacy of fluid intake for this population. Subjects were grouped in two groups according to age (<85 years and >85 years) to determine whether age influenced fluid intake. In addition, data such as number and frequency of medications and dependency factors, such as ability to feed self, ability to communicate, ability to move and ability to make decisions, were collected and correlated.There was no significant difference between actual fluid intake and required fluid intake for the population a whole and for the two age groups. However, there were individuals who had very low fluid intakes suggesting other factors which influence fluid intake. There were positive correlations between fluid obtained from non meal feedings and frequency of medication delivery and number of medications delivered during a 24 hour period. In addition, there were positive correlations among the dependency factors. There was no correlation among any of the dependency factors and fluid intake for the group as a whole or for the two age groups.It was concluded from this study that this population of elderly nursing home residents obtained adequate fluid. Medication frequency and number appeared to influence the amount of fluid that a resident might obtain during non meal feedings. However, as a subject became more dependent, this factor did not affect the fluid intake of this population. / Department of Home Economics

This study compared calorie needs, prescription and intake in enterally fed trauma and burn patients. Calorie needs of twenty-eight sequentially admitted patients were assessed by indirect calorimetry or by the Fick method. Caloric prescriptions were calculated from physicians orders. Following attainment of ordered goal rate, three day caloric intake was averaged. Caloric needs were not statistically different from caloric prescription. Caloric intake was significantly lower than caloric needs (p= 0.001). Intolerance and procedures were frequently cited reasons for withholding feedings. Results of this study suggest that trauma and burn patients may not receive the prescribed level of calories during the initial stage of enteral nutrition support. / Department of Family and Consumer Sciences

Thesis (MVoeding)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: Objectives: To assess whether actual nutrient intake of hospitalized patients with tuberculosis differed from that served by the hospital and from that required according to current recommendations. Design: Descriptive, cross-sectional study. Setting: Brooklyn Chest Hospital in Brooklyn, Cape Town, the Western Cape, South Africa. Subjects: Thirty patients, 23 male, seven female, with pulmonary tuberculosis, from Brooklyn Chest Hospital were enrolled in the study. Outcome measures: Assessment included dietary intake in order to calculate energy and nutrient intake and requirements, and height and weight at the beginning of the study in order to calculate BMI. Results: Patients were receiving and consuming sufficient macronutrients with the exception of protein in all patients, and micronutrients with the exceptions of calcium, iodine, folate and vitamin E in all patients, betacarotene, vitamin C and vitamin D in male patients, and selenium and pantothenate in female patients. Actual intake consumed in the hospital did not differ from that served by the hospital in the case of male patients, with the exception of iodine, however, due to significant plate wastage by female patients, consumed intake was less than that served by the hospital, with the exceptions of vitamin C and vitamin K. A total of 52% of the male patients, and 71% of the female patients, were normally nourished, according to their BMI. The remainder of the patients were mildly to severely malnourished on the basis of their BMI. Conclusions: According to current recommendations, the patients institutionalized at Brooklyn Chest Hospital for tuberculosis were receiving inadequate protein and selected micronutrients (calcium, iodine, folate and vitamin E in all patients, beta-carotene, vitamin C and vitamin D in male patients, and selenium and pantothenate in female patients). Therefore intervention programs, which serve as an adjunct to anti-tuberculosis therapy, should be introduced in order to rectify inadequate nutrient intake and to target malnourished patients. / AFRIKAANSE OPSOMMING: Doelstellings: Om te bepaal of die werklike voedingstofinname van gehospitaliseerde pasiënte met tuberkulose verskil van dit wat deur die hospitaal voorgeskryf word, en dit wat huidiglik aanbeveel word. Ontwerp: ‘n Beskrywende, dwarssnit studie. Milieu: Brooklyn Chest Hospitaal, te Brooklyn, Kaapstad, Westelike Provinsie, Suid Afrika. Studie groep: Dertig pasiënte met pulmonale tuberkulose van Brooklyn Chest Hospitaal (23 manlik, en sewe vroulik) is ingesluit in die studie. Toets parameters: Ondersoeke het ingesluit dieëtinname met die doel om energie en voedingstofinname en behoeftes te bereken, asook lengte en gewig meetings aan die begin van die studie om liggaamsmassaindex (LMI) te bereken. Resultate: Pasiënte het genoegsame hoeveelhede makro-voedingstowwe ontvang en ingeneem, met die uitsondering van proteïene by alle pasiënte, asook mikro-voedingstowwe, met die uitsondering van kalsium, jodium, folaat, en vitamine E by alle pasiënte, beta-karoteen, vitamine C en vitamine D by manlike pasiënte en selenium en pantoteensuur by vroulike pasiënte. Die werklike inname van voedsel in die hospitaal het nie verskil van dit wat deur die hospitaal voorgeskryf is in die geval van manlike pasiënte nie, met die uitsondering van jodium. As gevolg van beduidende voedselvermorsing deur vroulike pasiënte was werklike inname egter minder as wat deur die hospitaal voorgeskryf is, met die uitsondering van vitamine C en vitamine K. ‘n Totaal van 52% van die manlike pasiënte en 71% van die vroulike pasiënte het ‘n normale voedingstatus gehad volgens hulle LMI. Die oorblywende pasiënte was gering tot ernstig wangevoed op grond van hul LMI. Gevolgtrekkings: Volgens huidige aanbevelings het pasiënte, wat by Brooklyn Chest Hospitaal gehospitaliseer is vir tuberkulose, nie genoegsame hoeveelhede proteïene of geselekteerde mikro-voedingstowwe ontvang nie (kalsium, jodium, folaat, en vitamine E by alle pasiënte, betakaroteen, vitamine C en vitamine D by manlike pasiënte, en selenium en pantoteensuur by vroulike pasiënte). Daarom word intervensie programme voorgestel om te dien as ‘n toevoeging tot anti-tuberkulose behandeling, met die doel om onvoldoende voedingstof innames reg te stel en om ondervoede pasiënte te teiken.

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / Background: Cancer patients have been documented to use complementary and alternative medicine (CAM) frequently, a subject that has been extensively researched. There is however a lack in the current literature of controlled studies that investigate the prevalence of CAM use among cancer patients compared to non-cancer controls. Aim: To assess and compare the prevalence of dietary related CAM use among adult cancer patients and non-cancer controls in the Norwich area, England. Methods: Self-administered questionnaires were used to survey cancer patients attending a comprehensive cancer centre in Norwich, and non-cancer controls attending three dental surgeries also in the Norwich area. Questions addressed patient demographics, information relating to cancer diagnosis (cancer cases only) and information on CAM use. CAM users were asked about types and duration of CAM use, reasons for use, information sources used, disclosure to health professionals, reported side effects and benefits and satisfaction with CAM therapies. Results: Questionnaires were distributed to 132 cancer cases and 126 controls, with 98 and 96 assessable replies received from the cases and controls respectively. Overall, 47% of the cancer cases used CAM, in comparison to 53% of the control group, with no significant difference (p=0.673) between the two groups. Large quantities of juice, multivitamins, fish oils and glucosamine were the most popular CAM therapies among the two groups. Usage was significantly associated with the cancer site (p=0.036) and duration of cancer diagnosis (p=0.050). Only 54% of the cancer cases and 44% of the controls informed a health professional about their CAM use. The main reasons for using CAM were to boost the immune system and to improve quality of life. Reported benefits included increased optimism and hope. Conclusions: Although CAM was commonly used by British cancer patients, there was no significant difference in comparison to the non-cancer controls. Therefore, increased awareness and knowledge of CAM use should not be limited only to those working with oncology patients, but be extended to health professionals in all patient groups.

Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2007. / OBJECTIVE: The objectives of this study were to determine the nutritional practices used in burns units in South Africa and to compare them with the latest available literature in order to make appropriate recommendations for possible implementation. METHODS: Validated questionnaires were sent out to surgeons, dietitians and professional nurses working in burns units that complied with the inclusion criteria. Information on the units was obtained from an advertisement placed via email through ADSA. Non-random sampling was done and all the burns units were included in the study. Descriptive cross-sectional statistics were used to analyze the data. RESULTS: Twelve burns units were identified. Ten of the burns units’ health professionals (surgeons, dietitians and professional nurses) participated in the study. All the health professionals had experience in burned patients’ management judging by the average number of year’s experience. The average number of adult burned patients treated was 188 (58-350) and the mortality per year was 16% [Standard Deviation (SD) 6.4%] About half of the professionals indicated they used a protocol for the implementation of nutrition support. A degree of miscommunication was noted between the health professionals working in the units. Very few units (n=2) were able to perform wound excisions within 72 hours post-burn. All the dietitians used predictive equations when estimating energy requirements and the most popular formula remained the Curreri formula. Various different predictive equations were used. Even though most institutions indicated that micronutrient supplementation was routine practice, no standard regimen existed and supplementation varied significantly between units. The oral route, enteral route or a combination were used to feed patients with different degrees of burns, and the majority (60%) of the health professionals stated that they waited until oral diets were tolerated before enteral nutrition was stopped. The nasogastric enteral route remained the most popular route. Very few units used other feeding routes, and they would rather opt for TPN if nasogastric feeding should fail. The estimated nutritional requirements were met in 90% of patients in whom the feeding tube was successfully placed. From the results it appeared that dietitians were less confident regarding the use of immunonutrition in burned patients, in spite of the available literature. Anabolic agents were not very commonly used in South Africa, probably due to the high cost. Patients were not followed-up regularly by dietitians. CONCLUSION The results of this study indicated that despite the use of correct recommendations in certain instances there remained a definite degree of variation and uncertainty amongst health professionals. There also appeared to be poor communication between health professionals. The burns units in South Africa should use set standards for nutritional managements, obtain and implement strict feeding protocols and improve communication amongst the health professionals.