<p><strong>Bakgrund</strong>: Verksamhetschefer, sjuksköterskor, utvecklingsledare och kostombud har påbörjat ett förbättringsarbete gällande kosten på ett särskilt boende för äldre i en mellansvensk kommun. <strong>Syftet</strong>: Att beskriva omvårdnadspersonalens uppfattning om förbättringar, försämringar samt inflytande gällande måltidsmiljön, efter att riktlinjer kring kosthållningen införts. <strong>Metod</strong>: Studien genomfördes med en kvalitativ ansats och en beskrivande design. Tjugofem omvårdnadspersonal intervjuades om sina uppfattningar. <strong>Resultat</strong>: Det framkom i studien att omvårdnadspersonalen till största del uppfattade att förbättringar skett kring kosthållningen efter införandet av de nya riktlinjerna. Omvårdnadspersonalen uppfattade att det hade påverkat de äldres vardag positivt genom: trevligare måltidsmiljö, hälsosammare och godare mat, kortare nattfasta samt ökat självbestämmande för de äldre. Det som uppfattades negativt var att det nya arbetssättet uppfattades som stressigt för viss personal på grund ökad disk och längre måltider. Flertalet av omvårdnadspersonalen uppfattade att de inte varit delaktiga i utformningen av riktlinjerna och det fanns svårigheter att få all personal till att arbeta enligt riktlinjerna. <strong>Slutsats:</strong> Författaren menar att denna studie har visat att det går att utföra förändringsarbete med gott resultat.</p> / <p><strong>Background</strong>: In one district of Sweden, improvements in the diets of the older people in a nursing home are being implemented by staff.  The staff included managers, nurses, dietary assistants and development workers. <strong>Aim</strong>: To explore nursing assistant perceptions of the advantages, disadvantages and influence around the meal environment after implementing new guidelines. <strong>Method</strong>: A descriptive design with a qualitative approach Twenty-five nursing assistants were interviewed about their perceptions. <strong>Results</strong>: It was found that the perceptions of the majority of the nursing assistants’ were some improvement in the wake of the new dietary guidelines. Furthermore, it was reported that the guidelines had appeared to affect the elderly in a positive fashion by improving the meal time environment, by providing healthier and better quality food, shortening the period between meals at night and increased their autonomy. The disadvantages of the new guidelines were that some staff found the new approach stressful owing to an increased amount of cleaning and longer meal times. In addition, the majority of staff felt that they were not included in the creation of the guidelines and there were also difficulties in implementing them across all staff members. <strong>Conclusion</strong>: According to the author this study shows that it is possible to work for change to the better in the care for older people.</p>

Bakgrund: Verksamhetschefer, sjuksköterskor, utvecklingsledare och kostombud har påbörjat ett förbättringsarbete gällande kosten på ett särskilt boende för äldre i en mellansvensk kommun. Syftet: Att beskriva omvårdnadspersonalens uppfattning om förbättringar, försämringar samt inflytande gällande måltidsmiljön, efter att riktlinjer kring kosthållningen införts. Metod: Studien genomfördes med en kvalitativ ansats och en beskrivande design. Tjugofem omvårdnadspersonal intervjuades om sina uppfattningar. Resultat: Det framkom i studien att omvårdnadspersonalen till största del uppfattade att förbättringar skett kring kosthållningen efter införandet av de nya riktlinjerna. Omvårdnadspersonalen uppfattade att det hade påverkat de äldres vardag positivt genom: trevligare måltidsmiljö, hälsosammare och godare mat, kortare nattfasta samt ökat självbestämmande för de äldre. Det som uppfattades negativt var att det nya arbetssättet uppfattades som stressigt för viss personal på grund ökad disk och längre måltider. Flertalet av omvårdnadspersonalen uppfattade att de inte varit delaktiga i utformningen av riktlinjerna och det fanns svårigheter att få all personal till att arbeta enligt riktlinjerna. Slutsats: Författaren menar att denna studie har visat att det går att utföra förändringsarbete med gott resultat. / Background: In one district of Sweden, improvements in the diets of the older people in a nursing home are being implemented by staff.  The staff included managers, nurses, dietary assistants and development workers. Aim: To explore nursing assistant perceptions of the advantages, disadvantages and influence around the meal environment after implementing new guidelines. Method: A descriptive design with a qualitative approach Twenty-five nursing assistants were interviewed about their perceptions. Results: It was found that the perceptions of the majority of the nursing assistants’ were some improvement in the wake of the new dietary guidelines. Furthermore, it was reported that the guidelines had appeared to affect the elderly in a positive fashion by improving the meal time environment, by providing healthier and better quality food, shortening the period between meals at night and increased their autonomy. The disadvantages of the new guidelines were that some staff found the new approach stressful owing to an increased amount of cleaning and longer meal times. In addition, the majority of staff felt that they were not included in the creation of the guidelines and there were also difficulties in implementing them across all staff members. Conclusion: According to the author this study shows that it is possible to work for change to the better in the care for older people.

The aim of this experimental study was to investigate the hydraulic conditions at which air-entraining vortices would form in front of horizontal intakes and to determine the ways of eliminating the formation of these vortices by testing anti-vortex devices. For these reasons, a series of experiments were conducted in an experimental setup composed of a reservoir having the dimensions of 3.10 m x 3.10 m x 2.20 m and a pump connected to the intake pipe. Within the reservoir, between the concrete side walls adjustable plexiglass side walls were placed to provide the desired wall clearance for the intake pipes. Six pipes of different diameters / 5 cm, 10 cm, 14.4 cm, 19.4 cm, 25 cm and 30 cm were horizontally mounted on the front side of the reservoir one by one, and for each case, a wide range of discharges was provided from the reservoir by the pump. Under symmetrical approach flow conditions and zero bottom wall clearance, the experiments were repeated for each intake pipe and the &ldquo / critical submergence depths&rdquo / for the tested discharges were determined. At some of the discharges, the effect of horizontal plates located on the top of the pipe entrance as anti-vortex devices on the elimination of the vortices was investigated. The measured critical submergence depths were related in dimensionless form to the relevant dimensionless parameters and empirical equations were derived. These equations were compared with similar ones available in the literature and it was shown that the agreement between them was quite good.

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Objectives: The incidence of type 2 diabetes mellitus (DM2) is on the rise worldwide. The primary objective was to determine the prevalence of nutrient inadequacy and excessiveness in persons with DM2 with and without diabetic peripheral neuropathy (DPN). Study Design: A validated semi-quantitative food frequency questionnaire was used to determine the prevalence of inadequacy of nutrients with an estimated average requirement; the mean intake of nutrients with an adequate intake; and the proportion of persons not meeting the recommendations for the acceptable macronutrient distribution range (AMDR). Results: Differences were observed in the prevalence of inadequacy of vitamin A and the proportion of persons not meeting the AMDR for total fat, linoleic acid and carbohydrate. Conclusion: The aforementioned nutrients may have a significant role in the progression/development of DPN and should be studied in further detail. We recommend a balanced diet and use of a multi-vitamin for persons with DM2.

Objectives: The incidence of type 2 diabetes mellitus (DM2) is on the rise worldwide. The primary objective was to determine the prevalence of nutrient inadequacy and excessiveness in persons with DM2 with and without diabetic peripheral neuropathy (DPN). Study Design: A validated semi-quantitative food frequency questionnaire was used to determine the prevalence of inadequacy of nutrients with an estimated average requirement; the mean intake of nutrients with an adequate intake; and the proportion of persons not meeting the recommendations for the acceptable macronutrient distribution range (AMDR). Results: Differences were observed in the prevalence of inadequacy of vitamin A and the proportion of persons not meeting the AMDR for total fat, linoleic acid and carbohydrate. Conclusion: The aforementioned nutrients may have a significant role in the progression/development of DPN and should be studied in further detail. We recommend a balanced diet and use of a multi-vitamin for persons with DM2.

Made available in DSpace on 2015-03-26T13:54:53Z (GMT). No. of bitstreams: 1 texto completo.pdf: 443172 bytes, checksum: 25810212202085897d024a4831c5557d (MD5) Previous issue date: 2008-07-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present study involved two experiments that aimed to evaluate nutrient intake and total digestibility, pH and ruminal ammonia concentration (first experiment) as well as the productive performance of beef cattle (second experiment) that were fed with diets containing soybean (SS) 0; 25; 50; 75; 100%. The rate forage:concentrate was 60:40, based on the dry matter. In the first experiment, five HxZ crossbred animals fistulated in the rumen and abomasum that had an initial weight of about 390kg were used. The animals were distributed in a 5x5 Latin square. Chromc oxide was used to estimate the fecal excretion. The intakes of dry matter (DM), organic matter (OM), crude protein (CP), neutral detergent fiber (NDF), nonfiber carbohydrates (NFC), total carbohydrates (TC) and total digestible nutrients (TDN), expressed as kg.dia-1, showeda decreasing linear behavior while the intakes of EE and CP adjusted to the linear response plateau (LRP) model, thus estimating maximum values for the rates of 84 and 57% of corn silage in the forage, respectively. Diet effects were not detected (P>0.05) on the total apparent digestibility of DM, OG, CP, NDF and TC they revealed and average of 66.96; 69.49; 63.49; 57.60; 82.34 and 71.10%, respectively. On the other hand, EE aparent digestibility increased linearly following the corn silage rates. Quadratic effect of time collection for the ammonia concentration and the ruminal pH was observed where the maximum and minimal values 17.42 mg/dL and 6.23 mg/dL at 2,54and 4,27 hours were respectively estimated after feeding. In the second experiment, 35 anerolados and emasculated animals initially weighing 370 kg were used.The animals were distributed into a randomized block design with five treatments and seven repetitions. The experiment, which lasted 99 days long, was divided into a 15-day adaptation period and three 28-day periods. Five animals that were used as references were killed after the adaptation period in order to estimate the carcass gain. For estimating fecal excretion, ingestible neutral detergent fiber (iNDF) was used as an indicator, after the 240 hours "in situ" incubation. The intakes of NFC and CHO decreased linearly (P<0.05) according to the soybean silage rates in the diets, while the EE intake adjusted to a LRP model, with maximum value at the 89.55% rate of soybean silage in the forage. Lower intakes (P<0.05) of NCF and TC were observed for the diets that had higher rates of soybean silage than corn silage. Intakes for the other nutrients, expressed as kg/day, were not influenced by the diets. Weight and carcass gain, carcass yield and food conversion were not influenced by the diets either, they showed average values of 1.12 kg.day-1, 0.67 kg.day-1, 53.00% and 8.05, respectively. Soybean silage may be used as the single forage source in diets for anerolados cattle since it does not compromise the cattle productive performance or the ruminal fermentation patterns. However, its use may become and interesting alternative when associated to corn silage. / O presente estudo envolveu dois experimentos e foi realizado objetivando-se avaliar o consumo e a digestibilidade total dos nutrientes, o pH e a concentração de amônia ruminal (experimento1), bem como o desempenho produtivo de bovinos de corte (experimento 2) alimentados com dietas contendo 0; 25; 50; 75; 100% de silagens de soja (SS). A relação volumoso:concentrado foi de 60:40, com base na matéria seca. No primeiro experimento, foram utilizados cinco animais mestiços Holandês × Zebu, fistulados no rúmen e no abomaso, com peso inicial médio de 390 kg, distribuídos em um quadrado latino 5 × 5. Usou-se o óxido crômico para estimar a excreção fecal. Os consumos de matéria seca (MS), matéria orgânica (MO), proteína bruta (PB), fibra em detergente neutro (FDN), carboidratos nãofibrosos (CNF), carboidratos totais (CHOT) e nutrientes digestíveis totais (NDT), expressos em kg.dia-1, apresentaram comportamento linear decrescente, enquanto os consumos de EE e PB ajustaram-se ao modelo linear com resposta platô (LRP), estimando-se valores máximos para os níveis de 84 e 57% de silagem de soja no volumoso, respectivamente. Não foi detectado efeito (P>0,05) das dietas sobre as digestibilidades aparentes totais de MS, MO, PB, FDN, CNF, CHOT, cujas médias foram de 66,96; 69,49; 63,49; 57,60; 82,34; 71,10%, respectivamente. Por sua vez, a digestibilidade aparente do EE aumentou linearmente com os níveis de silagem de soja. O tempo decoleta teve efeito quadrático sobre a concentração de amônia e o pH ruminal, que apresentaram valores máximo e mínimo de 17,42 mg/dL e 6,23 mg/dL às 2,54 e 4,27 horas após a alimentação, respectivamente. No experimento 2, foram utilizados 35 animais anerolados, castrados, com peso inicial de 370 kg, distribuídos em delineamento de blocos casualizados, com cinco tratamentos e sete repetições. O experimento teve duração de 99 dias, divididos em três períodos de 28 dias, após 15 dias de adaptação. Cinco animais- referência foram abatidos após o período de adaptação, para estimativa do ganho de carcaça. A estimativa da excreção fecal foi feita utilizando-se a fibra em detergente neutro indigestível (FDNi) como indicador, após incubação in situ por 240 horas. Os consumos de CNF e carboidratos totais (CHOT) decresceram linearmente (P<0,05) com os níveis de silagem de soja nas dietas, enquanto o consumo de EE ajustou-se ao modelo LRP, com valor máximo para o nível de 89,55% de silagem de soja no volumoso. Os menores consumos de CNF e CHOT (P<0,05) foram observados nos animais mantidos com as dietas com maiores proporções de silagem de soja. Os consumos dos demais nutrientes, em kg/dia, não foram influenciados pelas dietas. O ganho de peso, ganho de carcaça, rendimento de carcaça e a conversão alimentar também não foram influenciados pelas dietas e apresentaram médias de 1,12 kg.dia-1, 0,67 kg.dia-1, 53,00% e 8,05, respectivamente. A silagem de soja pode ser utilizada como fonte única de volumoso em dietas para bovinos anelorados, uma vez que não compromete o desempenho produtivo e o padrão de fermentação ruminal desses animais. No entanto, proporciona melhores resultados se utilizada em associação à silagem de milho.

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