Proposed standard model and consistent terminology for monitoring and outcome evaluation in different dietetic care settings: Results from the EU-sponsored IMPECD project.

BACKGROUND & AIMS: Dietetic interventions contribute to certain health objectives and other outcomes, but are mostly part of a multimodal and multidisciplinary approach what makes evaluating the actual effects of dietitians' involvement rather complex. Although monitoring and outcome evaluation (M&OE) can provide routine data to prove the effectiveness of dietetic interventions, this has not been established yet in different dietetic settings. METHODS: A comprehensive framework for M&OE in dietetics was developed by dietetic experts from five European higher education institutes for dietetics in the course of the EU sponsored project "Improvement of Education and Competences in Dietetics (IMPECD)". RESULTS: Firstly, clear definitions on M&OE are proposed to facilitate the use of consistent terminology, with a specific emphasis on the term "impact" covering macro-level outcomes such as cost-effectiveness. Secondly, the Dietetic Care Process (DCP) was merged into a logic model to demonstrate the position of M&OE in relation to intervention planning and implementation, in both group and individual settings. Thirdly, selecting the appropriate indicators is indispensable to monitor and evaluate outcomes, and requires a high level of dietitians' critical reasoning. A categorized overview of indicators is provided to support this process. Lastly, the consortium developed a checklist to give dietitians a handle on what elements could be included in their M&OE plan and trigger them to perform M&OE in practice. CONCLUSIONS: Innovative M&OE models may help dietitians to demonstrate their effectiveness in improving clinical outcomes and justify their role in health care.

Functional relevance of human adh polymorphism.

This article represents the proceedings of a symposium at the 2000 ISBRA Meeting in Yokohama, Japan. The chairs were C. J. Peter Eriksson and Tatsushige Fukunaga. The presentations were (1) 4-Methylpyrazole as a tool in the investigation of the role of ADH in the actions of alcohol in humans, by Taisto Sarkola and C. J. Peter Eriksson; (2) ADH2 polymorphism and flushing in Asian populations, by Wei J. Chen, C. C. Chen, J. M. Ju, and Andrew T. A. Cheng; (3) Role of ADH3 genotypes in the acute effects of alcohol in a Finnish population, by Hidetaka Yamamoto, Kathrin Kohlenberg-Müller, and C. J. Peter Eriksson; (4) Clinical characteristics and disease course of alcoholics with different ADH2 genotypes, by Mitsuru Kimura, Masanobu Murayama, Sachio Matsushita, Haruo Kashima, and Susumu Higuchi; (5) ADH2 polymorphism, alcohol drinking, and birth defects, by Lucinda Carr, D. Viljoen, L. Brooke, T. Stewart, T. Foroud, J. Su, and Ting-Kai Li; and (6) ADH genotypes and alcohol use in Europeans, by John B. Whitfield.

[Comparative studies on the bioavailability of nicergoline from two different steady-state preparations]. / Vergleichende Untersuchungen zur Bioverfügbarkeit von Nicergolin aus zwei unterschiedlichen Darreichungsformen im Steady State.

Comparative Studies on the Bioavailability of Nicergoline from Two Different Preparations in Steady State The bioavailability of nicergoline (CAS 27848-84-6) in a new 30 mg tablet and a 10 mg dragee formulation (Sermion) was evaluated under steady state conditions in 18 healthy male volunteers between the age of 21 and 37 years. During the run-in phase, the volunteers received on 7 consecutive days 30 mg nicergoline either 1 x 30 mg/d tablet (test substance) or 3 x 10 mg dragees (reference). On day 8, after intake of 1 x 30 mg in a 24 h interval or 1 x 10 mg in a 8 h interval respectively, the plasma concentrations of the nicergoline metabolite 10-methoxy-6-methyl-ergoline-8 beta-methanol (MDL) were measured. The area under the plasma concentrations in the 24 h interval after administering the 30 mg tablet was not 3 times greater as to be expected; it was by a factor of 4 significantly greater than the area under the curve of the 10 mg dragee in the 8 h interval. Therefore, nicergoline has a higher availability in the 30 mg tablet than in the 10 mg dragee form. Both formulations were equally well tolerated.

[New methods of pharmacokinetic evaluation of alcohol and its metabolites in female and male probands]. / Neue Methoden zur pharmakokinetischen Beschreibung des Alkohols und seiner Metaboliten bei weiblichen und männlichen Versuchspersonen.

The Pharmacokinetics of ethanol and its metabolites were examined in 10 young healthy women and men after 1-hr intravenous ethanol application of 7.8 mmol/kg body weight. Therefore, a new pharmacokinetic model takes into account Michaelis-Menten-elimination kinetics of ethanol as well as kinetics of acetaldehyde and acetate, which are defined by first order processes. The metabolite-model adequately describes the ethanol and acetate concentration courses. In fact, the observed ethanol concentrations are so close to the model-predicted values, that the metabolite-model allows an evaluation of half-life-times of acetaldehyde and acetate. The analyses of ethanol infusion studies showed, that there are no sex differences in parameters of ethanol elimination: Maximal elimination velocity Vmax was 3.41 +/- 0.61 mmol/l.h in females and 3.98 +/- 0.69 mmol/l.h in males. Michaelis-Menten-constant kM was 1.49 +/- 0.44 mmol/l and 1.69 +/- 0.88 mmol/l, respectively. In the female group, the volume of distribution of ethanol V1 was with 38.4 +/- 5.01 significant smaller than in males with 50.5 +/- 3.51. In conclusion, the new metabolite-model can be used as a basis for the investigation of the entire alcohol metabolism.

[New methods for pharmacokinetic assessment of alcohol and its metabolites in male and female probands]. / Neue Methoden zur pharmakokinetischen Beschreibung des Alkohols und seiner Metaboliten bei weiblichen und männlichen Versuchspersonen.

The pharmacokinetics of ethanol and its metabolites were examined in 10 young healthy women and men after 1-hr intravenous ethanol application of 7.8 mmol/kg body weight. Therefore, a new pharmacokinetic model takes into account Michaelis-Menten-elimination kinetics of ethanol as well as kinetics of acetaldehyde and acetate, which are defined by first order processes. The metabolite-model adequately describes the ethanol and acetate concentration courses. In fact, the observed ethanol concentrations are so close to the model-predicted values, that the metabolite-model allows an evaluation of half-life-times of acetaldehyde and acetate. The analyses of ethanol infusion studies showed, that there are no sex differences in parameters of ethanol elimination: Maximal elimination velocity Vmax was 3.41 +/- 0.61 mmol/l.h in females and 3.98 +/- 0.69 mmol/l.h in males. Michaelis-Menten-constant kM was 1.49 +/- 0.44 mmol/l and 1.69 +/- 0.88 mmol/l, respectively. In the female group, the volume of distribution of ethanol V1 was with 38.4 +/- 5.0 l significant smaller than in males with 50.5 +/- 3.5 l. In conclusion, the new metabolite-model can be used as a basis for the investigation of the entire alcohol metabolism.