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"THOMAS, D. R"
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Validation of the Mini Nutritional Assessment short-form (MNA®-SF): A practical tool for identification of nutritional status
To validate a revision of the Mini Nutritional Assessment short-form (MNA®-SF) against the full MNA, a standard tool for nutritional evaluation.
A literature search identified studies that used the MNA for nutritional screening in geriatric patients. The contacted authors submitted original datasets that were merged into a single database. Various combinations of the questions on the current MNA-SF were tested using this database through combination analysis and ROC based derivation of classification thresholds.
Twenty-seven datasets (n=6257 participants) were initially processed from which twelve were used in the current analysis on a sample of 2032 study participants (mean age 82.3y) with complete information on all MNA items. The original MNA-SF was a combination of six questions from the full MNA. A revised MNA-SF included calf circumference (CC) substituted for BMI performed equally well. A revised three-category scoring classification for this revised MNA-SF, using BMI and/or CC, had good sensitivity compared to the full MNA.
The newly revised MNA-SF is a valid nutritional screening tool applicable to geriatric health care professionals with the option of using CC when BMI cannot be calculated. This revised MNA-SF increases the applicability of this rapid screening tool in clinical practice through the inclusion of a “malnourished” category.
Journal Article
Lyophilized (freeze-dried) human milk for preterm infants: a scoping review
Freeze-drying (FD), or lyophilization, is commonly used to preserve foods. FD offers potential to create a human milk-derived human milk fortifier, and an alternative to freeze-storing human milk. However, processing human milk is known to affect its components. This scoping review explores the effect of FD on the; macronutrient, micronutrient, vitamin, bioactive components, microbes and anti-microbial factors in human milk, and studies where lyophilized human milk has been given to newborn infants. 48 articles were identified after full text review. FD human milk reduces the fat globule size and as well as the quantity of enzymes, vitamin C and immunoglobulin. Common serum electrolyte disturbances have been reported when preterm infants’ are fed FD human milk however it appears a promising method to avoid exposure of preterm infants’ to cows’ milk. Due to limited data, further studies exploring the safety and efficacy of FD human milk in preterm infants are needed.
Journal Article
Fiat flux : the writings of Wilson R. Bachelor, nineteenth-century country doctor and philosopher
Wilson R. Bachelor was a Tennessee native who moved with his family to Franklin County, Arkansas, in 1870. A country doctor and natural philosopher, Bachelor was impelled to chronicle his life from 1870 to 1902, documenting the family's move to Arkansas, their settling a farm in Franklin County, and Bachelor's medical practice. Bachelor was an avid reader with wide-ranging interests in literature, science, nature, politics, and religion, and he became a self-professed freethinker in the 1870s. He was driven by a concept he called \"fiat flux,\" an awareness of the \"rapid flight of time\" that motivated him to treat the people around him and the world itself as precious and fleeting.
Book
Covariance mapping of two-photon double core hole states in C2H2 and C2H6 produced by an x-ray free electron laser
Few-photon ionization and relaxation processes in acetylene (C2H2) and ethane (C2H6) were investigated at the linac coherent light source x-ray free electron laser (FEL) at SLAC, Stanford using a highly efficient multi-particle correlation spectroscopy technique based on a magnetic bottle. The analysis method of covariance mapping has been applied and enhanced, allowing us to identify electron pairs associated with double core hole (DCH) production and competing multiple ionization processes including Auger decay sequences. The experimental technique and the analysis procedure are discussed in the light of earlier investigations of DCH studies carried out at the same FEL and at third generation synchrotron radiation sources. In particular, we demonstrate the capability of the covariance mapping technique to disentangle the formation of molecular DCH states which is barely feasible with conventional electron spectroscopy methods.
Journal Article
A self-completed nutrition screening tool for community-dwelling older adults with high reliability: A comparison study
Malnutrition is common in community-dwelling older adults and is associated with poor outcomes including hospitalization and mortality. Recently, a 6-question short form mini nutritional assessment (SF-MNA) was validated for rapid nutrition screening. Ideally, nutrition screening could be performed by individuals or their caregivers prior to or during an outpatient clinical visit, thus allowing for the ongoing monitoring of nutritional status among older adults.
We compared the SF-MNA administered by a healthcare professional (HCP) to a 6-item self-administered screening tool (Self-MNA) in 463 community dwelling older adults who gave informed consent. The population was 60% women with a mean age of 76.8+6.8 years. The HCP was blinded to the results of the Self-MNA questionnaire.
Using the SF-MNA, 27% of subjects were malnourished, 38% were at risk, and 35% had normal nutrition status. The agreement between the Self-MNA and the SF-MNA was 99% (Self-MNA sensitivity 99%, specificity 98%, false negative rate 1%, false positive rate 2%) for identifying Malnourished subjects and 83% (sensitivity 89%, specificity 77%, false negative rate 11%, false positive rate 23%) for identifying At Risk of Malnutrition compared to the MNA-SF administered by a HCP.
We found that the Self-MNA demonstrates sufficient inter-rater reliability for use in nutrition screening among community-dwelling older adults. Further validation studies and the possible impact of language translation should be pursued.
Journal Article
Policies for High Quality, Safe, and Sustainable Food Supply in the Greater Mekong Subregion
This book presents research into the production of safe, high-quality, and environmentally friendly agriculture products in the Greater Mekong Subregion. It also explores the actions and policy options that could be pursued. Three themes are examined: Improving Food Safety and Quality; Inclusive and Sustainable, Safe and Environment-Friendly Agriculture Products; and Value Chains for Safe and Environment-Friendly Agriculture Products. This aligns with the ASEAN Economic Community blueprint, which calls for the creation of a single market and production base for food, agriculture, forestry; and integration of the region into the global economy.
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