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Examining the effect of intervention to nutritional problems of hospitalised elderly: a pilot project.

BACKGROUND: Up to 65% of elderly patients are protein-energy undernourished at admission or acquire nutritional deficits while hospitalised. OBJECTIVES: The aims of this project were: 1) to assess the quality of care concerning nutrition among geriatric units; 2) to assess the impact of implementive nutritional interventions on nutritional status and on the length of hospitalisation. DESIGN: Two hundred and six patients consecutively admitted in a geriatric unit of a general hospital were studied prospectively for 6 months (from January to June 2001). All patients underwent a comprehensive geriatric assessment. For the first 3 months the nutritional status of the patients on admission and at discharge were assessed without particular recommendations for nutritional intervention. A standardised nutritional intervention was proposed for the last 3 months. RESULTS: Median value of Mini-Nutritional Assessment was 19 points (ranged from 9 to 29), mean admission s prealbumin concentration (PAB) was 0.179 g/l, and C-reactive protein 5.9 2.8 mg/100ml. Hospitalisation stay was significantly lower during the interventional period than during the observational period. A higher mean PAB variation was observed during the interventional period as compared to the observational period. CONCLUSIONS: Nutritional assessment should be part of routine clinical practice in elderly hospitalized patients. A comprehensive screening tool for assessment of nutritional status is needed that is clinically relevant and cost-effective to perform. If malnutrition is suggested by such screening tests, implementations of nutritional intervention allow to ameliorate discharge nutritional status and to reduce hospitalization stay.

Journal Article↗

[Young patients with severe mental illness returning to school: results of a pilot project conducted in Montreal].

Schizophrenia generally appears at the beginning of adult life at a time when individuals have important academic choices to make for their professional future. Patients with schizophrenia suffer from cognitive deficits as well as positive and negative symptoms and experience disorganization. Schizophrenia is responsible for a high level of failure in obtaining a high school diploma, an important cause of social exclusion and low economic status. Twenty-seven students with severe mental health have been integrated in an educational program implemented in Montreal. Preliminary results indicate efficiency of the program with many students succeeding ministerial test. However, it is suggested that a ratio of 1/10 professor/students would be preferable in such special education class.

English Abstract↗