Biomedical subjects

C Compher

Publications and source records attributed to C Compher.

7 recordsLinked to original sources

PubMed2005

Comparison between Medgem and Deltatrac resting metabolic rate measurements.

OBJECTIVE: The primary aims of this trial were to evaluate the reproducibility of a portable handheld calorimeter (Medgem) in a clinical population, and to compare its measures with a calorimeter in typical use with these patients. DESIGN: Cross-sectional clinical validation study. SETTING: Outpatient Clinical Research Center. SUBJECTS: A total of 24 stable home nutrition support patients. INTERVENTIONS: In random order three measures of resting metabolic rate (RMR) were taken after a 4-h fast, 15 min rest and 2-h abstention from exercise. Two measures were taken with the same Medgem (MG) and one with the traditional calorimeter (Deltatrac). Reproducibility of MG measures and their comparability to a Deltatrac measure were assessed by Bland-Altman analysis, with >+/-250 kcal/day established a priori as a clinically unacceptable error. In addition, disagreement between the two types of measures was defined as greater than 10% difference. RESULTS: The mean difference between two MG measures was -6.8 kcal/day, with limits of agreement between 233 and -247 kcal/day and clinically acceptable. The mean difference between the Deltatrac and mean of two MG measures was -162 kcal/day, with limits of agreement between 577 and -253 kcal/day and clinically unacceptable. In all, 80% of the repeated MG RMR measures agreed within 10%, and the mean MG reading agreed with the Deltatrac in 60% of cases. CONCLUSIONS: RMR obtained using the MG calorimeter has an acceptable degree of reproducibility, and is acceptable to patients. The MG measures, however, are frequently lower than traditional measures and require further validation prior to application to practice in this vulnerable patient group.

Adolescent↗

PubMed1998

Nutritional requirements of an aging population with emphasis on subacute care patients.

Life expectancy in the United States has increased dramatically during the past century, creating a large population of people with potentially compromised nutritional status. Although requirements were previously believed to decline with aging, recent data suggest that requirements for protein and energy often do not decline and may actually increase during disease exacerbations. Optimal intake of vitamins and minerals is also under reevaluation, and significant segments of the population may have deficiencies based on limited intake or absorption. Social and psychological factors and difficulty chewing and swallowing may interfere with adequate intake. At the end of a hospital stay, many patients need continued skilled transitional care before discharge home. Many patients who have existing nutritional deficits, including weight loss, decreased serum proteins and pressure ulcers are admitted to subacute nursing facilities. Careful initial and periodic reassessment of nutritional status and aggressive nutritional management must be used to prepare patients for optimal independence after discharge. Improved clinical outcome can be achieved with prevention of malnutrition and timely correction of nutritional problems.

Aged↗

PubMed1993

Home nutrition support patient education materials.

The practice of providing specialized enteral and parenteral nutrition to patients in the home setting has expanded nationwide during the past decade. Accompanying this growth has been an increased need for education of patients, families, and care providers in techniques of administering intravenous and tube feedings safely after discharge from the hospital. To meet this demand for information, written home nutrition support (HNS) education materials have been developed by hospital nutrition support teams, patient education specialists, home care providers, and formula manufacturers. The time and financial costs of developing these materials may be prohibitive in certain institutions that need HNS education resources. A directory of the printed materials available has been compiled to facilitate communication and exchange of HNS education information among institutions. The directory is presented with this article, with important characteristics to consider in the development of HNS education materials.

Enteral Nutrition↗

PubMed1992

Staffing patterns in hospital clinical dietetics and nutrition support: a survey conducted by the Dietitians in Nutrition Support dietetic practice group.

The Dietitians in Nutrition Support dietetic practice group of The American Dietetic Association administered a questionnaire to evaluate changes in nutrition support services provided to hospitalized patients and home patients in 1989 and compared the results with results of a survey administered in 1986. The 1986 survey documented an increase in tube feeding to inpatients during 1984 to 1986 and greater dietitian staffing in tertiary care hospitals than in primary care hospitals and in larger hospitals in 1986. The 1989 questionnaire was mailed to clinical nutrition managers from a nationwide random sample of 1,000 hospitals from American Hospital Association members; 271 responses were received. Full-time equivalent (FTE) registered dietitians (RDs)--including clinical RDs, nutrition support service RDs, and clinical nutrition managers--decreased 11% from 1986 to 1989. FTE dietetic technicians decreased 22%. The number of FTE nutrition support service RDs and clinical nutrition managers decreased significantly (P less than .05). The mean number of FTE clinical dietitians per 100 beds decreased from 1.4 to 1.0 from 1986 to 1989. These decreases in dietetics staffing occurred despite an overall increase in total hospital FTE staff of 2.9%. Reported daily provision of nutrition support modalities to inpatients was 3.5% for parenteral nutrition, 4.9% for enteral tube feeding, and 9.6% for oral supplements. Decreased dietetics staffing was accompanied by other factors that negatively affect productivity (and therefore ability to provide adequate patient care), including inadequate delegation of technical tasks to dietetic technicians, limited availability of secretarial and computer support, and minimal provision of pocket pagers. These trends may be evidence of inadequacy of dietetics staffing to meet the needs of the US population for nutrition care.

Dietary Services↗

PubMed1991

Nutritional support in renal failure.

Adequate protein intake is necessary in renal failure to reduce morbidity. The desire to avoid dialysis should not be a justification to starve patients, particularly because fed patients have better survival rates in acute renal failure. The treatment techniques for renal failure may be used secondarily as a delivery route for nutrients.

Acute Kidney Injury↗

PubMed1990

Changes in billing for nutrition support services and dietetics staff resources between 1984 and 1986.

Changes in hospital funding resulting from the Prospective Payment System have been recognized as a major force in hospitals in the 1980s. The Dietitians in Nutrition Support (DNS) Practice Group examined these changes using a survey sent to 1,000 clinical nutrition managers at American Hospital Association (AHA) hospitals. The goals of the survey were (a) to evaluate changes in billing for nutrition services and (b) to evaluate changes in resources available to dietetics staff members. Although income from nutrition services to inpatients had increased only 18% since 1984, 45% of respondents reported an increase in payment for outpatient services. Prior to 1984, larger hospitals reported screening for malnutrition more often than smaller hospitals, and the responsibility for screening was handled more often by dietetic technicians than by RDs. Larger hospitals also reported establishment of a home nutrition support company more often than smaller hospitals. Computer and academic course costs were paid more frequently by nonprofit and tertiary hospitals. Although the number of hospitals billing for nutrition services to patients was small, most reported receiving payment. We conclude that charges for nutrition services by dietitians to outpatients have increased, and that most dietitians who bill for services receive payment. Academic and technological resources for RDs have increased in general, though smaller primary-care and for-profit hospitals report such supports less consistently than larger, tertiary-care, and not-for-profit hospitals.

Ambulatory Care↗

PubMedDate not supplied

Advanced dietetic training in nutrition support and metabolism: the University of Pennsylvania Medical Center experience.

The dietetic fellowship at the University of Pennsylvania Medical Center is highly rewarding for the nutrition support dietitians, and the dietetic fellows have identified an increased self-confidence as one of the major benefits. Advanced training of this nature is very labor intensive. In the current environment of cost containment and down-sizing of staff, it is unlikely that this type of program will flourish due to the high labor cost involved and limited funding available.

Academic Medical Centers↗