key: cord-0732790-ckvdrk41
authors: Yeong, H.E.L.; Tan, S. Z.; Chow, P. Y.
title: Bridging the language barrier in nutrition education using digital solution during Covid-19 pandemic: a pilot survey
date: 2021-12-31
journal: Clinical Nutrition ESPEN
DOI: 10.1016/j.clnesp.2021.09.643
sha: c3cfdbeae983263175a027e60a482855d660553d
doc_id: 732790
cord_uid: ckvdrk41

nan

Rationale: Alongside dietetic input, high protein oral nutritional supplement (ONS) use demonstrates nutritional, clinical and functional benefits 1 . The purpose of this study was to investigate the acceptability and tolerance of a new high energy, high protein, low volume powdered ONS in community dwelling older adults. Methods: A prospective observational study of 17 community dwelling adults who had or were at risk of disease-related malnutrition (DRM) and commenced on a new powdered ONS (AYMES ActaSolve Protein Compact, 20g protein, 312-315kcal/130ml) for 30 days. Tolerance was assessed daily for the first 7 days by evaluating GI symptoms. Compliance was recorded for 30 days and measured by comparing ONS volume consumed against dietitian prescribed volume. Palatability was measured by a 5-point hedonic scale questionnaire (day 33). Results: 17 subjects were recruited (59% female, age 60-101y, BMI 14.5-25kg/m 2 ). 82.4% of study participants were already established on a different ONS prior to starting the study. No GI symptoms were reported in 64.5% (n¼11) of subjects, demonstrating GI tolerance of the new ONS. Of 6 subjects (35.3%) who did report symptoms, 5 (29%) had the same or similar symptoms at baseline, however total number of GI symptom episodes reduced and were not reported to be related to the new ONS. Mean compliance was excellent at 91% (65-100%) compared to baseline ONS compliance of 81% (31-100%) suggesting improved compliance with the new ONS. 71.4% of subjects preferred the study ONS to their existing ONS. Palatability was rated at 100% as overall acceptable. Carers/nurses (n¼12) rated the preparation instructions as 'easy' or 'very easy' to follow. Conclusion: Short-term compliance to a powdered high energy, high protein, low volume ONS is excellent and comparable to published ONS compliance data 2 . The new ONS is also easy to use, prepare, is convenient and highly palatable for the intended user. The new ONS is a clinically valuable option for the nutritional management of patients with or at risk of DRM. With limited resources and access to interpreter services, dietitians were challenged to maintain clear communication whilst providing timely nutrition therapy as an integral part of their chronic disease management. The purpose of this study was to determine the effectiveness of the use of translated nutrition education videos to cope with the large influx of non-English speakers in the healthcare setting during the pandemic. Methods: A pilot retrospective survey was administered to healthcare professionals who were directly involved in disseminating the translated nutrition education videos to affected patients. The survey included four questions relating to efficacy, accessibility, cost and time-saved as perceived by healthcare workers.

Results: A total of 20 healthcare professionals responded to the survey. Among them, 14 were nurses, four were dietitians and two were interpreters. The result of the survey reveals that 95% of the respondents deemed that the videos were effective nutrition education tools for non-English speaking patients. Most of them (85%) felt that the videos were easily accessible using mobile devices and did not encounter any network connectivity issues. Compared with conventional one-to-one nutrition counselling, 90% of them finds that the videos were more cost-saving and 95% of them believes that it saved more time for healthcare workers. Conclusion: The use of nutrition education videos as a means to reach out to more non-English speaking patients during the pandemic was perceived to be effective, low-cost and time-saving for patients and the healthcare system. Digital solutions not only benefit within the current crisis but it has also shined a light on the increasing importance of digital transformation in healthcare beyond the COVID-19 pandemic. Rationale: Children with cerebral palsy (CP) need nutritional support (NS) because of the high prevalence of nutritional disorders. The aim of the study was to evaluate the effectiveness of NS with hypercaloric (1.5 kcal/ ml) polymer formula with fibers in addition to standard dietary counseling in children with CP. Methods: The study included 15 children with CP aged 4-10 years, with the level of motor disorders GMFCS III-IV, whose z-score weight/age was lower than -1.5. All patients received a hypercaloric (1.5 kcal/ml) polymer formula with fibers in a volume of 200 ml per day for 3 months. The patients underwent three-time anthropometry (at the time of inclusion, after 6 weeks and after 12 weeks) with the measurement of body weight (BW), height (H), body mass index (BMI), shoulder circumference (SC) and shoulder muscles (SMC), the triceps skinfold thickness (TST) and subscapular skinfold thickness (SST).

Results: Over 12 weeks of monitoring the average BW gain was 1.15 kg [0.55-1.65 kg], H gain was 2.5 cm [1.25-3 cm] , and BMI -0.2 kg/cm 2 [-0.2-0.4 kg/cm 2 ]. There was a statistically significant increase in BW (p˂0,001) and H (p¼0.001) of patients after 12 weeks. BW gain was achieved in 14/15 patients (93%). An increase in H was observed in 12/15 patients (80%). There were changes in the z-score of BW (p¼0.03). During 12 weeks of monitoring, there were s increases of SC (p¼0.001), SMC (p¼0.01), and TST (p¼0.032). The cumulative analysis of these indicators showed an increase more in musculoskeletal mass, not fat mass. Conclusion: Despite the stagnation of anthropometric indicators, the appointment of NS had a positive effect on the indicators of H and BW, zscore of BW. Analysis of anthropometric indicators dynamics revealed that the period of prescribing nutritional support for children with CP should be more than 12 weeks, since it will be ineffective in the case of a shorter period

European Society for Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Neurological Impairment

Lal 1,3 . 1 Intestinal Failure Unit

Methods: Clinical records of adult HPN-dependent patients from 2001 to 2018 were reviewed. Data were collected on clinical characteristics, gastrointestinal (GI) anatomy and details of any surgery. Results: 458 cases (176 with intestinal fistula, 282 with SBS) were included, with a median HPN-dependency of 2.6 years

3% at 1 year, 24.2% at 2 years and 34.0% at 5 years. More patients undergoing surgery achieved autonomy (72.8% vs. 7.8%, p<0.001). SIL

3%) patients had been predicted to achieve autonomy based on their final GI anatomy (115cm SIL for Group 1, 60cm for Group 2 and 35cm Group 3 SBS-IF (1)) but only 159/290 (54.8%) of these did so

Conclusion: Reconstructive intestinal surgery significantly facilitates HPN weaning in patients with severe IF. While, final bowel anatomy is the most important predictor for achieving nutritional autonomy, this may be less likely in older people with greater co-morbidity. Of note, death as a competing factor impacts on the estimation of nutritional autonomy and we would recommend obtaining probabilities using the Aalen-Johansen estimator