Analysis of palliative care needs and related factors of family caregivers of patients with advanced Alzheimer's disease / 重庆医学

Objective To explore the needs and influencing factors of palliative care among primary car-egivers in families of patients with advanced Alzheimer's disease(AD).Methods The main caregivers of 148 patients with advanced AD who were diagnosed at the Memory Clinic of this hospital from January 2021 to December 2022 were randomly selected as the research subjects.A self-designed questionnaire on palliative care needs was used for investigation and statistical analysis.Results The total score of the main caregivers for palliative medical needs was(91.88±15.19),with a score indicator of 66.57％.The highest score indicator was the demand for professional medical care guidance,and the lowest was the demand for social support.There were statistical differences in the scores of palliative medical care needs of caregivers with different a-ges,education level,relationship with patients,nursing experience,death of relatives and friends,annual family income,medical payment method and physical condition(P＜0.05).The results of linear regression analysis showed that education level,relationship with patients and nursing experience were the influencing factors of family caregivers'easing medical needs(P＜0.05).Conclusion The main caregivers of advanced AD patients have a high demand for palliative care,and there is an urgent need to strengthen palliative care services.

Study on operating room service requirements of patients undergoing foraminal endoscopic surgery based on Kano model / 中国实用护理杂志

Objective:To conduct a qualitative analysis of the operating room service demands of patients undergoing foraminal endoscopic surgery based on the Kano model, and the influence of satisfaction on each demand was calculated to provide a basis for the development of targeted improvement strategies.Methods:A cross-sectional study method was adopted to select 510 patients from the Affiliated Hospital of Qingdao University with foraminal endoscopic surgery from January 2022 to June 2023 by convenient sampling method. Kano two-factor questionnaire was compiled from five dimensions of surgical environment needs, information and knowledge needs, surgical safety needs, surgical nursing quality needs, emotional support needs and psychological needs for investigation, and the attribute classification of needs was determined. The service demand importance-satisfaction matrix of patients undergoing foraminoscopic surgery was drawn.Results:Finally, 472 patients were enrolled. with 217 males and 255 females, aged (57.78 ± 12.61) years old. Among the 42 operating room service needs of patients undergoing foraminal endoscopic surgery, 12 were attractive attributes (28.57%), 7 were expected attributes (16.67%), 17 were necessary attributes (40.48%), and 6 were indifferent attributes (14.29%). The importance-satisfaction matrix shows that there were 2 improvement needs for the first best, 2 improvement needs for the middle best and 15 improvement needs for the second best.Conclusions:Kano model can clearly define the demand attributes of patients undergoing local anesthesia foraminal endoscopic surgery and the influence on their satisfaction, effectively guide the priority improvement sequence of demands, and facilitate managers to scientifically and accurately improve surgical patient satisfaction.

Survey and analysis of long term care service needs for home disabled elderly people in Beiliu city / 现代医院

Objective To investigate the current situation of long-term care needs of the elderly with home-based disabil-ity in Beiliu City,and provide data support for the development of Internet plus care services in Beiliu City.Methods A ques-tionnaire survey method was used to design and distribute a survey questionnaire titled"Survey Questionnaire on Home Care Serv-ice Needs of Disabled Elderly People",to investigate the nursing service methods and home care needs of disabled elderly people in Beiliu City.Results Disabled elderly people mainly choose home-based nursing services,with a high demand for basic care,comfortable care,rehabilitation care,psychological care,and other aspects.Conclusion Home care is of great significance for improving the quality of life of disabled elderly people,and requires policy support such as medical insurance to promote the sup-ply of nursing services and meet the care needs of disabled elderly people.

Postoperative analgesic efficacy of nefopam after anorectal surgery: a retrospective observational study

Objective: To examine the effectiveness of nefopam on postoperative pain control after anorectal surgeries. Methods: We retrospectively reviewed the electronic medical records of patients who underwent anorectal surgeries from January 2019 to March 2022 at two medical centers. The data were divided into nefopam and conventional groups. The primary outcome was the number of patients who requested additional opioids in the 24-h postoperative period. The secondary outcomes were numeric rating pain scores (NRPS) within a 24-h postoperative period and analgesic drugs-related side effects. Results: Eighty-seven patients in the conventional group and 60 in the nefopam group were recruited. The nefopam group reported less additional opioid consumption than the conventional group in all dimensions of analysis, including overall, adjusted to anesthetic techniques and types of surgery. However, these did not reach statistical significance (P = 0.093). Only patients in the nefopam group who underwent hemorrhoidectomy under TIVA or spinal anesthesia significantly required fewer additional opioids (P = 0.016, 60% mean difference). Similarly, the 24-h postoperative morphine consumption was lower in the nefopam group (mean difference = -3.4, 95%CI: 0.72,6.08). Furthermore, significantly lower NRPS were reported in the nefopam group during the 12-18 h postoperative period (P = 0.009). On the other hand, analgesic drugs related side effects were similar in both groups. Conclusions: The administration of nefopam after major anorectal surgery is beneficially evident in reducing postoperative opioid requirements. (AU)

Requirements for the application of total quality in the university educational system in light of the information and technological revolution

A B S T R A C T Purpose: This study aims to identify the requirements for the application of total quality in the university educational system in light of the information and technological revolution. Methods: The qualitative analytical descriptive approach was used, the limitations of which are restricted to higher education institutions. Results: The study concluded the need for a feasible and effective educational system, centered on the student through his interaction and active participation, in which computer technologies and information and communication technology represented in local networks and the global Internet play a promising role based on the concept and philosophy oftotal quality in education. Conclusions: It is concluded that the nature of modern business requires educational and academic institutions to prepare students with a different set of skills other than those adopted by the old education system. The shape of educational institutions will be very different from what it is now, and the shape of the classroom will differ so that there will be a computer for each student, and departments in faculties will be able to communicate with different libraries to get what they want from references, scientific materials or educational software, and the shape of the course will differ from the usual It is likely that it will be replaced by a floppy or optical disk, and there will be a new type of teacher and students.

Objetivo: Identificar os requisitos para a aplicação da qualidade total no sistema educacional universitário à luz da revolução tecnológica e da informação. Métodos: Foi utilizada a abordagem descritiva analítica qualitativa, cujas limitações se restringem às instituições de ensino superior Resultados: O estudo concluiu a necessidade de um sistema educacional viável e eficaz, centrado no estudante através de sua interação e participação ativa, no qual as tecnologias de informática e de informação e comunicação representadas em redes locais e na Internet global desempenham um papel promissor baseado no conceito e na filosofia da qualidade total na educação. Conclusões: Conclui-se que a natureza das empresas modernas exige que as instituições educacionais e acadêmicas preparem os estudantes com um conjunto de habilidades diferentes daquelas adotadas pelo antigo sistema educacional. A forma das instituições educacionais será muito diferente do que é agora, e a forma da sala de aula será diferente de modo que haverá um computador para cada aluno, e os departamentos das faculdades poderão se comunicar com diferentes bibliotecas para obter o que desejam das referências, materiais científicos ou software educacional, e a forma do curso será diferente do habitual.

Objetivo: Identificar os requisitos para a aplicação da qualidade total no sistema educacional universitário à luz da revolução tecnológica e da informação. Métodos: Foi utilizada a abordagem descritiva analítica qualitativa, cujas limitações se restringem às instituições de ensino superior. Resultados: O estudo concluiu a necessidade de um sistema educacional viável e eficaz, centrado no estudante através de sua interação e participação ativa, no qual as tecnologias de informática e de informação e comunicação representadas em redes locais e na Internet global desempenham um papel promissor baseado no conceito e na filosofia da qualidade total na educação. Conclusões: Conclui-se que a natureza das empresas modernas exige que as instituições educacionais e acadêmicas preparem os estudantes com um conjunto de habilidades diferentes daquelas adotadas pelo antigo sistema educacional. A forma das instituições educacionais será muito diferente do que é agora, e a forma da sala de aula será diferente de modo que haverá um computador para cada aluno, e os departamentos das faculdades poderão se comunicar com diferentes bibliotecas para obter o que desejam das referências, materiais científicos ou software educacional, e a forma do curso será diferente do habitual.

Thought on Improving Medical Students’ Strain Capacity in the Application of Ethics in Clinical Teaching / 中国医学伦理学

Improveing students’ strain capacity in the application of medical ethics is an important part of clinical teaching. This paper revealed the basic connotation of strain capacity in the application of medical ethics, emphasized the necessity for medical students to possess this quality, and emphatically expounded that training students in clinical teaching according to the five basic practical requirements of ethical adaptability. For practical problems, students’ ethical discrimination ability, ethical difficult problem handling ability, and comprehensive application ability of ethics and law should be improved according to practical requirements.

Laudo médico e a sua utilização em ações judiciais de fornecimento de medicamentos / The use of medical reports in lawsuits for the supply of medicines

O artigo discutiu os requisitos ínsitos do laudo médico e receituário decorrentes do julgamento do Recurso Especial n. 1.657.156/RJ, no qual o Superior Tribunal de Justiça fixou as bases de observância obrigatória por todos os juízes brasileiros para determinação de fornecimento de fármacos não constantes das listas oficiais do Sistema Único de Saúde. Foi feita pesquisa bibliográfica e documental, com abordagem qualitativa e exploratória, a partir do acórdão disponibilizado pelo portal do Superior Tribunal de Justiça; seguiu-se, então, para consultas às demais fontes bibliográficas, dentre as quais Google Scholar, Biblioteca Virtual em Saúde, Scientific Electronic Library Online e Biblioteca Digital Brasileira de Teses e Dissertações do Instituto Brasileiro de Informação em Ciência e Tecnologia. Por fim, passou-se à análise dos achados e, com embasamento teórico e empírico, buscou-se compreender e justificar as exigências relativas a laudo médico utilizado em ações judiciais, em uma tentativa de contribuir para a gestão da política sanitária e dos próprios processos judiciais, bem como para a popularização do precedente. Concluiu-se que o precedente do Superior Tribunal de Justiça levara à exigência de laudos médicos com mais informações, demandando nova atuação dos médicos, e à expectativa de priorização dos protocolos clínicos, das diretrizes terapêuticas e dos medicamentos constantes das listas oficiais do Sistema Único de Saúde.

The article discussed the requirements of medical reports and prescriptions resulting from the judgement of Special Appeal nº 1.657.156/RJ, in which the High Court of Justice established the compulsory adoption measures that all Brazilian judges must follow to decide on the supply of drugs that are not listed in the official Brazilian Unified Health System. This is a bibliographic and documentary research, with a qualitative and exploratory approach, based on the electronic document availability of the judgement trough the High Court of Justice portal. This research followed a critical approach, and entailed searches in various bibliographic sources, including: Google Scholar, Virtual Health Library, Scientific Electronic Library Online and the Brazilian Digital Library of Dissertations and Theses of the Brazilian Institute of Information in Science and Technology. Finally, we proceeded to the analysis of the findings, and, with a theoretical and empirical basis, we sought to understand and justify the requirements related to the medical report used in the lawsuits. This had the purpose of contributing to both the management of the health policy and the legal processes themselves, and the popularization of the requirements. It is concluded that these requirements will conduct to having medical reports with more information, doctors aware of important actions, and prioritization of clinical protocols, therapeutic guidelines and medications included in the official lists of Brazilian Unified Health System.

Ajuste del coeficiente basal de cultivo (Kcb) de frijol (Phaseolus vulgaris) mediante teledetección

Para realizar un manejo eficiente del agua en la agricultura es necesario conocer los requerimientos hídricos del cultivo, lo cual, se puede realizar de manera sencilla y rápida, con la ayuda de cámaras convencionales. En este estudio, se determinaron los requerimientos hídricos de un cultivo de frijol (variedad DIACOL CALIMA G4494), sembrado en CIAT, Palmira - Valle del Cauca, Colombia, mediante la estimación de la curva del coeficiente basal de cultivo (Kcb), derivada de la curva de fracción de cobertura vegetal (Fcv). Para determinar la curva de fracción de cobertura vegetal, se emplearon imágenes tomadas con una cámara digital en el espectro visible (RGB), a baja altura (menos de 3 m). Las necesidades hídricas del cultivo de frijol, se calcularon empleando los valores del coeficiente basal de cultivo derivados junto con la modelación FAO-56. Los resultados indican que la curva de Kcb ajustada por fotografía fue diferente a la curva estándar presentada en la publicación FAO-56 para frijol, mostrando, principalmente, diferencia en la duración de las etapas y los valores de Kcb, en estas etapas. En cuanto a las necesidades hídricas, al emplear la curva de Kcb ajustada por fotografías, se evidencia que el cultivo requiere más agua en las etapas media y final, para evitar estrés hídrico en las plantas.

To carry out efficient water management in agriculture, it is necessary to know the water requirements of the crop, which can be done easily and quickly with the help of conventional cameras. In this study, the water requirements of a bean crop (DIACOL CALIMA G4494 variety) planted in CIAT, Palmira - Valle del Cauca, Colombia, were determined by estimating the curve of the basal crop coefficient (Kcb) derived from the vegetation cover fraction curve (Fcv). To determine the vegetation cover fraction curve, images taken with a digital camera in the visible spectrum (RGB) at low height (less than 3m) were used. The water needs of the bean crop were calculated using the basal crop coefficient values derived together with the FAO-56 modelling. The results indicate that the Kcb curve adjusted by photography was different from the standard curve presented in the publication FAO-56 for beans, mainly showing a difference in the duration of the stages and the Kcb values in these stages. Regarding water needs, when using the Kcb curve adjusted by photographs, it is evident that the crop requires more water in the middle and final stages, to avoid water stress in the plants.

Evaluation of the Dietary Profile of Basketball Players in the Senior First Division Teams of Côte d’Ivoire

Introduction: Diet plays a fundamental role in the performance of athletes in general and basketball players in particular. For a better understanding of the nutrition of the athlete, this work aimed to evaluate the diet of Ivorian female basketball players in pre-competitive periods. Methodology: A retrospective frequency questionnaire survey was conducted from December 6, 2020 to the end of February 2021, on 86 female basketball players in the senior categories (17-35 years) playing in the first division. The collection of socio-demographic, anthropometric and dietary data before the competition was obtained for each team. Results: The study showed that 38.38% of the female basketball players had no side activities while 61.62% had a side activity. In general, 84.88% of the players had a normal Body Mass Index (BMI) compared to 06.98% overweight and 2.33% obese. The energy requirements of the women's teams were between 2427 and 2810 Kcal. The overall amount of energy consumed at breakfast in the pre-competitive period was below the required standards, while the amount of energy consumed at lunch and dinner was above the required standards for the players. Conclusion: In sum, the senior female basketball players of Côte d'Ivoire have a poor dietary profile. Nutritional interventions would be preferable for them in order to improve their nutritional knowledge on the one hand, and the distribution of caloric foods consumed during their different daily meals on the other hand, and to meet their energy needs.

Large-scale Staple Food Fortification as a Complementary Strategy to Address Vitamin and Mineral Vulnerabilities in India: A Critical Review

The slow improvement in micronutrient malnutrition globally and in India warrants a need for scaling?up scientifically proven, cost?effective public health interventions. The present review discusses the potential of staple food fortification as a complementary strategy to tackle micronutrient deficiencies, while addressing the current concerns raised regarding its implementation. The review indicates the below par status of current strategies like dietary diversity and supplementation to address multiple micronutrients deficiencies in India and the need for complementary strategies to tackle this problem. Based on systematic reviews and meta-analysis, global and national evidence has identified staple food fortification as a proven and recognized cost?effective solution to address micronutrient deficiencies. The Government of India has shown a strong leadership to promote this proven intervention. Further, the paper addresses the concern that large?scale staple food fortification (LSFF) may lead to excessive nutrient intakes when delivered together with other interventions, e.g., supplementation, dietary diversity, among the same populations. A key message that emerges from this review is that LSFF is safe with current dietary intake and deficiencies and low coverage of other interventions. Given the current situation of food and nutrition insecurity which the COVID-19 pandemic has further exacerbated, and the critical role that nutrition plays in building immunity, it is even more important that health and nutrition of the population, especially vulnerable age groups, is not only safeguarded but also strengthened. LSFF should be implemented without any further delay to reach the most vulnerable segments of the population to reduce the dietary nutrient gap and prevent micronutrient deficiencies. Effective monitoring and regular dietary surveys will help ensure these interventions are being deployed correctly.

Adecuación del aporte nutricional con la meta calórica en una unidad de cuidados intensivos pediátricos de referencia / Adequacy of nutritional intake with caloric goal in a reference pediatric intensive care unit

RESUMEN Objetivo. Describir el aporte nutricional en una unidad de cuidados intensivos pediátricos de referencia e identificar factores asociados al logro inadecuado de la meta calórica. Métodos. Estudio retrospectivo que revisa historias clínicas de menores de 14 años para identificar datos clínicos, valoración nutricional antropométrica y gasto energético según ecuación de Schofield. Resultados. Se incluyeron 65 pacientes, 54% de sexo masculino, edad de un mes a 13 años, 60% ingresó del servicio de urgencias, diagnósticos más frecuentes shock e insuficiencia respiratoria y 49,2% tenía estado nutricional normal. En el 28% de pacientes se alcanzó una adecuada meta calórica, 34% fue excesivo y 38% deficiente. El soporte nutricional se inició en las primeras 72 horas en 95% de pacientes, 84,6% por vía enteral y 80% tuvo interrupciones. El logro no adecuado de la meta fue más frecuente en menores de un año (51%, p=0,013) y en los que recibieron nutrición enteral (93%, p=0,019).

ABSTRACT Objetive. Nutritional intake in a reference pediatric intensive care unit is described and factors associated with inadequate achievement of the caloric goal are identified. Methods. Retrospective study that reviews the medical records of children under 14 years of age to identify clinical data, anthropometric nutritional assessment and energy expenditure according to the Schofield equation. Results. 65 patients were included, 54% male, age range from one month to 13 years, 60% admitted to the emergency department, most frequent diagnoses were shock and respiratory failure and and 49.2% presented normal nutritional status. In 28% of patients an adequate caloric goal was reached, 34% was excessive and 38% deficient. Nutritional support was started in the first 72 hours in 95% of patients, 84.6% by enteral route, 80% had nutrition interruptions. The inadequate achievement of the goal was more frequent in children under one year of age (51%, p=0.013) and in those who received enteral nutrition (93%, p=0.019).

Alimentos incluidos en la canasta básica tributaria de Costa Rica y su capacidad para suplir los requerimientos nutricionales en el caso de la población con menos ingresos / Food included in the basic tax basket in Costa Rica and its capacity to meet the nutritional requirements of the population with lower incomes

Resumen En el campo nutricional se han desarrollado diversas normas enfocadas en proteger a los sectores más vulnerables económicamente. Una de estas es el Reglamento de Canasta Básica Tributaria de Costa Rica (CBT), el cual establece una reducción en la carga impositiva a los alimentos consumidos por tales grupos, según la Encuesta Nacional de Ingresos y Gastos de los Hogares (ENIGH) de 2013. El objetivo de esta investigación es comparar el valor nutricional de la CBT y los requerimientos nutricionales para el caso del primer quintil de la ENIGH. El enfoque del estudio es cuantitativo y de tipo correlacional. La muestra la conforma el primer quintil de la ENIGH, 2013, compuesto por adultos sanos entre 19 y 60 años. El análisis se realizó durante el primer cuatrimestre de 2020, mediante un instrumento formulado en Excel, en el cual se elaboró un plan de alimentación con los productos de la CBT, calculando el contenido de energía, macronutrientes, ácidos grasos saturados, fibra, calcio, zinc, magnesio, vitamina E y vitamina D. Se identificó que el 46 % de ellos son fuente o buena fuente de alguno de los nutrientes en estudio y que 6 de los 11 nutrientes se adecuan satisfactoriamente a los requerimientos. Se concluyó que, a partir de dichos comestibles, se puede formular una dieta acorde a las necesidades nutricionales de una población, por cuanto la mayoría de los excesos y las deficiencias encontradas no son perjudiciales para la salud.

Abstract On a national level, several regulations have been developed with the aim of protecting the economically most vulnerable sectors of the population. One of these regulations is the Costa Ricas Basic Tax Basket Regulations (CBT by the Spanish acronym for Canasta Básica Tributaria), which establishes a decrease in the tax burden on food consumed by the most vulnerable population of the 2013 National Household Income and Expense Survey (ENIGH by the Spanish acronym for Encuesta Nacional de Ingresos y Gastos de los Hogares). The objective of this research is to compare the nutritional value of the foods included in the CBT and the nutritional requirements of the first quintile members of the 2013 ENIGH. The research is quantitative and co-relational in type. The sample is the first income quantile of the ENIGH of 2013 and is composed of healthy adults with ages between 19 and 60. The analysis was made during the first four months of 2020, using an instrument formulated in Excel, in which meal plans are formulated only with the foods that are part of the CBT, to calculate the content of energy, macronutrients, saturated fatty acids, fiber, calcium, zinc, magnesium, vitamin E and vitamin D. The results determined that 46% of CBT foods are classified as source or good source of some of the studied nutrients. As well as 6 of the 11 studied nutrients are satisfactorily adapted to the requirements of the population. The results allow to conclude that with the foods included in the CBT, an adequately balanced meal plan can be formulated, because excess or deficiency of nutrients found in the meal plan are not considered harmful to the health.

Perfil alimentar de transplantados cardíacos de um centro transplantador brasileiro - Atuação da enfermagem neste cenário / Perfil alimentario de los trasplantes de corazón en un centro de trasplante brasileño - Desempeño de la enfermería en este escenario / Food profile of heart transplants in a brazilian transplantation center - Nursing performance in this scenario

Objetivo- Descrever o perfil alimentar de pacientes pós transplante cardíaco (TC) tardio de um centro transplantador brasileiro. Método- Estudo observacional transversal com delineamento descritivo. O estudo ocorreu em uma instituição de ensino público de Minas Gerais. A coleta de dados ocorreu no período de 2017 a 2019. Resultados-. A amostra do estudo foi composta por 62 indivíduos transplantados entre os anos de 2006 a 2016. Aproximadamente 63% era do sexo masculino. A média de idade foi de 46,53 anos. O consumo de carboidratos e gorduras foi adequado em 46,77% e 59,68% da amostra, respectivamente. Já o consumo de proteínas foi acima do recomendado em 77,42% e o consumo de fibras abaixo do recomendado em 79,03%. Conclusão- Houve a predominância do sexo masculino. Os indivíduos apresentaram um consumo adequado somente de carboidratos e gorduras. Não houve na literatura estudos descrevendo a atuação do enfermeiro no processo de nutrição neste cenário(AU)

Objective- To describe the dietary profile of patients after late heart transplantation (HT) from a Brazilian transplant center. Method- Cross-sectional observational study with descriptive design. The study took place in a public education institution in Minas Gerais. Data collection took place from 2017 to 2019. Results-. The study sample consisted of 62 individuals transplanted between 2006 and 2016. Approximately 63% were male. The mean age was 46.53 years. The consumption of carbohydrates and fats was adequate in 46.77% and 59.68% of the sample, respectively. The consumption of proteins was above the recommended in 77.42% and the consumption of fibers below the recommended in 79.03%. Conclusion- There was a predominance of males. The individuals presented an adequate consumption of only carbohydrates and fats. There were no studies in the literature describing the role of nurses in the nutrition process in this scenario(AU)

Objetivo- Describir el perfil dietético de pacientes después de un trasplante cardíaco (TC) tardío de un centro de trasplante brasileño. Método- Estudio observacional transversal con diseño descriptivo. El estudio se llevó a cabo en una institución de educación pública en Minas Gerais. La recolección de datos se llevó a cabo de 2017 a 2019. Resultados-. La muestra del estudio estuvo compuesta por 62 individuos trasplantados entre 2006 y 2016. Aproximadamente el 63% eran hombres. La edad media fue de 46,53 años. El consumo de carbohidratos y grasas fue adecuado en el 46,77% y 59,68% de la muestra, respectivamente. El consumo de proteína estuvo por encima del nivel recomendado en un 77,42% y el consumo de fibra por debajo del nivel recomendado en un 79,03%. Conclusión- Hubo predominio del sexo masculino. Los individuos presentaron un consumo adecuado de solo carbohidratos y grasas. No hubo estudios en la literatura que describieran el papel del enfermero en el proceso de nutrición en este escenario.(AU)

Nutritional requirements for the elderly in India: A status paper

Advances in the medical field and healthcare sector during the last few decades have resulted in increased longevity. Increased lifespans have in turn led to a rapid global rise of the elderly population. However, ensuring the health and quality of life, especially in the context of chronic age-related ailments, among the growing geriatric population is a challenge. Ageing is associated with several changes in body composition including a decline in the lean body mass usually accompanied by an increase in body fat content which have a bearing on the nutrient requirements for the elderly. The nutrient requirements currently recommended for Indian adults are primarily computed using a factorial approach, that considers the cumulative loss of nutrients and is adjusted for optimal body weights and bioavailability. It is logical that physiological and metabolic changes associated with ageing influence several of these factors: body weight, lean mass, energy expenditure, nutrient retention and bioavailability and thus alter nutrient requirements compared to the adult population. Acknowledging these age-related changes, some international organizations have suggested nutrient requirements specific to the elderly. Given the contextual differences in physiology, caution needs to be exercised in adopting these guidelines for the Indian elderly. In addition, in the Indian context, there is sparse information on the diet and nutrient intakes vis-à-vis nutritional status and physiology of the elderly. This status paper highlights some of the pertinent issues related to nutritional requirements for the elderly that advocate a need for deriving nutritional requirements for the elderly in India

The use of linear programming to determine whether breastfed infants can achieve a nutritionally adequate complementary feeding diet: a case study of 6­11-month-old infants from KwaMashu, KwaZulu-Natal, South Africa

Objectives: The objectives of this study were to ascertain whether the nutrient requirements of 6­11-month-old infants can be met with a food-based approach, and to identify the nutrients of which it is difficult to achieve adequate intakes.Design, setting and subjects: A cross-sectional survey and interviews with mothers and caregivers from the KwaMashu Community Health Centre were conducted. One hundred and thirty-four interviews were completed. This information provided the food consumption input for the model using Optifood software. Results: The results revealed that with the current food pattern of infants from the study group in KwaMashu, iron, zinc and calcium are nutrients whose requirements are likely not to be met in the diet. The percentage RNI (recommended nutrient intake) for iron was 25.2%, zinc 51.3% and calcium 77%. Nutrient intakes for these nutrients of concern improved in the 'No pattern' diet but iron and zinc intakes remained below the RNI. According to the best diets modelled by Optifood, it appears that infants in KwaMashu would be able to achieve the recommended intakes of energy, protein, and 8 of the 11micronutrients, as long as breastfeeding on demand continues during the complementary feeding phase. Conclusions: This study calls into question the continued food-based focus to ensure nutrient adequacy in infants. In conjunction with efforts to improve household food security and continued support and promotion of breastfeeding for the first 2 years of life, targeted micronutrient supplementation may be needed to ensure the optimal growth and development of infants in South Africa.

Propuesta de requisitos generales para el sistema de gestión documental de la Universidad de La Habana / Proposal of general requirements for the document management system at the University of Havana

El objetivo de la presente investigación fue proponer una especificación de requisitos generales para el sistema de gestión documental de la Universidad de La Habana consecuente con un ejercicio de gobierno más responsable, abierto, transparente e inclusivo, con un enfoque orientado a la rendición de cuentas y a un mayor control social. La investigación presentó un diseño descriptivo y un enfoque mixto, con predominio cualitativo. Para contribuir al desarrollo de un sistema de información que creara capacidades sobre la base de información de calidad en esta institución, el estudio se basó en la triangulación de dos metodologías: una desde el dominio de la gestión documental y otra desde la ingeniería de requisitos. Como resultado, se presentaron 22 elementos y 201 requisitos, entre funcionales y no funcionales, con un carácter flexible y modular, que deben ser establecidos para el funcionamiento efectivo del sistema de gestión documental de esta Universidad(AU)

The purpose of the study was to propose a general requirements specification for the document management system at the University of Havana, in keeping with more responsible, open, transparent and inclusive governance, an accountability-oriented approach and greater social control. The research had a descriptive design, a mixed approach and qualitative predominance. To contribute to the development of an information system which would build capacities on the basis of quality information in this institution, the study was based on the triangulation of two methodologies: one from the document management domain and the other from requirements engineering. As a result, 22 items and 201 requirements were presented, both functional and non-functional, of a flexible and modular nature, which should be established for the effective operation of the document management system at this university(AU)

Metabolismo e importancia de los ácidos grasos poliinsaturados en la gestación y lactancia / Metabolism and importance of polyunsaturated fatty acids in pregnancy and lactation

Introducción: Los ácidos grasos polinsaturados de cadena larga son esenciales en la nutrición del feto y del recién nacido. Objetivo: Examinar la importancia de los ácidos grasos poliinsaturados durante el embarazo y la lactancia, para destacar los requerimientos, las recomendaciones y fuentes alimentarias. Métodos: Se realizó una revisión sistemática de la literatura internacional de los últimos 15 años en bases de datos, en español y en inglés. Se utilizaron las siguientes palabras clave: embarazo, lactancia, ácidos grasos poliinsaturados, omega 3/6, fuentes y requerimientos. Se identificaron los aspectos más relevantes y controversiales. Resultados: El ácido araquidónico y docosahexaenoico influyen sobre el perfil lipídico, la sensibilidad a la insulina, la proliferación y diferenciación de los preadipocitos. Sus concentraciones durante la gestación resultan uno de los principales factores responsables de la programación fetal, que son las adaptaciones metabólicas que condicionan la evolución de la salud futura. Concentraciones óptimas de ácidos grasos omega 3 y 6 son vitales para el desarrollo neurológico del feto y del recién nacido. La funcionalidad de la placenta puede afectar la adiposidad y los niveles fetales de nutrientes clave, como los ácidos grasos poliinsaturados de cadena larga. Conclusiones: La dieta es uno de los principales factores ambientales durante la gestación. La lactancia materna es la mejor alternativa nutricional durante el primer año de vida, por eso es fundamental promocionarla. Es importante ofrecer una asistencia adecuada y generar estrategias que estimulen el consumo de ácidos omega-3 como una herramienta de prevención a largo plazo(AU)

Introduction: Long-chain polyunsaturated fatty acids are essential in the nutrition of the fetus and newborns. Objective: Examine the importance of polyunsaturated fatty acids during pregnancy and lactation to highlight food requirements, recommendations and sources. Methods: A systematic review of the international literature of the last 15 years was carried out in databases, in Spanish and English, using the following keywords: pregnancy, lactation, polyunsaturated fatty acids, omega 3/6, sources and requirements. The most relevant and controversial aspects were identified. Results: Arachydonic and docosahexaenoic acid influence lipid profile, insulin sensitivity, proliferation and differentiation of preadipocytes. Their levels during gestation are one of the main factors responsible for fetal programming that are metabolic adaptations conditioning the evolution of future health. Optimal levels of omega-3 and 6 fatty acids are vital for the neurological development of the fetus and newborn. Placenta´s functionality can affect adiposity and fetal levels of key nutrients, such as long-chain polyunsaturated fatty acids. Conclusions: Diet is one of the main environmental factors during gestation. Breastfeeding is the best nutritional alternative during the first year of life, which is why it is essential to promote it. It is important to provide adequate assistance and generate strategies that stimulate the consumption of omega-3 acids as a long-term prevention tool(AU)

Considerations on the chemistry, manufacture and control requirements for conditional marketing authorization drugs in China / 中国药科大学学报

@#Drug Administration Law revised in 2019 proposed for the first time conditional marketing authorization at the legal level, marking the formal implementation of the conditional marketing authorization in China. This paper compares the regulations and technical requirements of conditional marketing authorization drugs in China with those in Europe and the United States, in an attempt to learn from the experience of chemistry, manufacture and control review of these drugs in Europe and the United States, and to discuss the pharmaceutical technical requirements of conditional marketing authorization drugs in China.

Evaluation of functional status and assistive facilities requirements for the elderly with disabilities in rural areas of Liaoning Province / 中国实用护理杂志

Objective:To evaluate the functional status and assistive facilities requirements for the elderly with disabilities in rural areas of Liaoning Province, and to provide reference for the configuration of assistive facilities and the construction of further rehabilitation management mode for the elderly with disabilities.Methods:A total of 929 disabled rural elderly people in 15 deep poverty-stricken areas in Liaoning Province from 2019 to 2020 were selected to evaluate the functional status and needs of assistive devices by using general information questionnaire, disability status questionnaire and assistive device evaluation form for disabled elderly people.Results:There were 149 cases (16.0%) with grade 1 disability, 465 cases (50.1%) with grade 2 disability, 178 cases (19.2%) with grade 3 disability and 137 cases (14.7%) with grade 4 disability. The elderly with disabilities mainly had difficulties in long-distance walking, bathing, toilet use, defecation control, short distance walking, squatting, and transfer. The proportion of disabled elderly was 89.8% (834/929), 84.9% (789/929), 82.6% (767/929), 79.9% (742/929), 76.6% (712/929), 76.1% (707/929) and 60.5% (562/929), respectively. With the increase of disability severity, bathing, short walking, metastasis, shopping and preparing meals accounted for the greater proportion of the elderly with disabilities, and the differences were statistically significant ( P< 0.01). The elderly with disabilities had the greatest demand for wheelchairs, followed by mattresses for preventing stress injuries and four-legged walking sticks, with a demand rate of 56.3% (523/929),9.4% (87/929) and 7.0% (65/929), respectively. The elderly with different levels of disability had different needs on ordinary wheelchair, pressured-injury mattress, four-legged walking stick, stool chair, wheelchair with toilet seat and common walking stick, and the needs had statistically significant differences ( P<0.01). Conclusions:The elderly with disabilities in rural areas of Liaoning Province are mainly moderate to severe, mainly physical disabilities, and have great obstacles in self-care and daily living activities, with the highest demand for ordinary wheelchairs, anti-stress injury mattresses and four-legged canes. In the future, further intervention measures and rehabilitation management models should be developed according to the assessment results of the functions and assistive devices of the elderly with disabilities in rural areas, so as to meet the nursing and rehabilitation needs of the elderly with disabilities and improve their life quality.

Explanation of health requirements and surveillance specifications for radiation worker / 中华放射医学与防护杂志

Chinese National Standards GBZ 98-2020 Health Requirements and Surveillance Specifications for Radiation Worker was published and will replace the current standards GBZ 98-2017 Health Requirements for Radiation Workers and GBZ 235-2011 Specifications for Occupational Health Surveillance for Radiation Workers from May 1 in 2021. The significance of this new National Standards, the background, basic principles, basis of revision of important indicators and the matters needing attention in the application of the standard are described in detail, especially for the medical institutions carrying out occupational health examination requirements, the determination of occupational health examination items, examination method and examination reports, so as to avoid the possible misunderstandings and doubts in using the standards.