- Email: [email protected]
Mini Nutrition Assessment Score as a Potential Predictor of Pressure Ulcers in Elderly Nursing Home Patients with Dementia
TUESDAY, OCTOBER 18
Poster Session: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy Measuring Vegetable Intake and Dietary Quality in Response to a Preschool-based Education Program
Mini Nutrition Assessment Score as a Potential Predictor of Pressure Ulcers in Elderly Nursing Home Patients with Dementia
Author(s): M. Sharafi1, H. Peracchio2, T. Dugdale3, S. Scarmo4, T. Huedo-Medina5, V. Duffy1; 1 University of Connecticut, 2University of Connecticut Department of Extension, 3 University of Connecticut Department of Allied Health Sciences, 4The Pew Charitable Trusts, 5Allied Health Sciences, Univ of CT
Author(s): A. O’Brien, J. Pope, K. Anguah, D. Erickson; Louisiana Tech University
Learning Outcome: After reading this poster and interacting with the presenters, the attendee should be able to describe: how to construct a dietary quality index; three uses and limitations of a liking survey as a dietary assessment instrument for preschoolers; and how this research could be applied to his/her practice setting. Feasible and sensitive tools are needed to assess dietary changes of preschoolers. We tested the sensitivity and utility of dietary quality indexes generated from parent reports against skin carotenoid status across a 16-wk intervention in preschoolers. Income-challenged preschoolers were assigned to control (n¼130) and intervention (n¼132) groups. Both received classroom and parent nutrition education; the intervention group received double the classroom minutes of nutrition education. Baseline and post-intervention dietary quality indexes were formed for preschoolers from parent-reported dietary liking (preschool-adapted liking survey) and intake (frequency screener). Teachers logged the preschoolers’ lunch vegetable intake 9-times across the intervention. Pre/post BMI percentiles and carotenoid status were assessed; 1 in 3 children were overweight/obese at baseline. The liking-based dietary quality index was most sensitive to the intervention effects. Intervention children had significant increases in liking-based dietary quality and, with improved lunch vegetable intake, the highest post-intervention dietary quality and carotenoid status. Children who achieved the highest dietary quality (liking and frequencybased) had greatest reduction in BMI% across the 16-wks. By path analysis, improved lunch vegetable intake significantly predicted dietary quality increases. The intervention led to greater increases in liking-based dietary quality, which in turn, to greater improvements in carotenoid status by post-intervention. Summary: With simple collection and processing, the liking survey was able to detect changes in dietary quality consistent with a carotenoid biomarker.
Funding Disclosure: This material is based upon work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, Hatch Formula Funds, project accession number 1001056.
Learning Outcome: Learner will recognize the relationship between nutrition assessment and pressure ulcer presence and severity in nursing home patients. Background: Tools to measure malnutrition as a predictor of pressure ulcers have not been established. This study was a retrospective case-control study done with data collected from past and present medical record information. The purpose was to determine whether there was a difference in the (1) presence and (2) severity of pressure ulcers in nursing home patients with dementia based on nutritional status as determined by Mini Nutrition Assessment (MNA) score. Methods: The convenience sample included 100 nursing home residents: 50 case subjects who had pressure ulcers and 50 matched control subjects who did not. Physical measurements and nutrition information was collected from medical records to determine an MNA score between 0 and 14. Pressure ulcer stage, 1-4, was determined according to National Pressure Ulcer Advisory Panel guidelines. Results: Upon data analysis, MNA scores for subjects with and without ulcers were significantly different (p¼.001) with means of 8.34+2.67 and 9.98+2.32 respectively. Scores of the ulcer groups did not follow a linear pattern, however, subjects with stage 4 ulcers had significantly lower MNA scores (6.33+2.55) than all of the other ulcer stage groups. Conclusions: These results show a relationship between low MNA scores and both increased presence and increased severity of pressure ulcers. Thus, MNA may potentially be used as criteria for implementing preventive measures and mitigating progression of existing ulcers in nursing homes. More research should be done to explore use of MNA in nursing homes as a means to both monitor nutritional status and implement pressure ulcer prevention methods. Funding Disclosure: None
Method of Meal Tray Delivery, Timing of Blood Glucose Testing and Insulin Administration. A Pilot Study
Mobile Multimedia Effects on Cognitive Engagement: Association between App Format, Learning and Cognitive Load
Author: A.T. Truong; Maine Medical Center
Author(s): K. DiFilippo1, K. Mathewson2, W. Huang1, J. Andrade1, K. ChapmanNovakofski1; 1University of Illinois at Urbana-Champaign, 2University of Alberta
Learning Outcome: The poster attendees will be able to describe how tray delivery methods are related to the timing of blood glucose testing and insulin administration for diabetic patients. Background: The prevalence of Type 1 & 2 diabetes is estimated to be present in about 25% of hospitalized patients. Timing between meal tray delivery (MTD), blood glucose testing (BGT) and insulin administration (IA) varied since the implementation of room service. Few studies offer tangible guidance how to best synchronize variable meal times with nursing staff activities. Methods: During the pre-trial, nutrition staff delivered trays to diabetic patients. Patients were reminded to notify their Registered Nurse (RN) and/or Certified Nursing Assistant (CNA) when their trays arrived. During the trial phase, nutrition staff delivered the trays to the nursing unit station and notified the unit secretary. The unit secretary then paged the appropriate RN/ CNA to deliver the trays to the patients’ rooms. Variables observed: the timing of diabetic trays delivered to the nursing unit station, timing of trays delivered to patients’ rooms, and patients’ first bites of meal. Timing of BGT and IA were retrieved from the electronic medical records. Data were collected from May to September of 2015 and analyzed with descriptive statistical methods. Results: Ninety-six events at various meals were directly observed. Blood glucose was checked within 30 minutes of the time the patients started eating 70% of the time for pre-trial and 85% for trial phases. Insulin was given within 15 minutes of the time the patient started eating 44% of the time for the pre-trial and 57% for the trial phases. Conclusion: The new method of tray delivery for diabetic patients showed improvement with the timing for blood glucose testing and insulin administration.
Learning Outcome: To increase understanding of the role of apps in learning nutrition knowledge. To Increase understanding of the role of app design in decreasing cognitive load to enhance learning. To describe the potential role of apps in reducing cognitive load for a more efficient learning process. Diet-related mobile applications (apps) are being used by clients and practitioners. In any form of mobile learning environment (MLE), there is limited evidence to support that multimedia improves learning efficiency. This lack of understanding could lead to MLE development that overloads learners’ cognitive and motivational processing capacities, compromising desired learning engagement. The objective of this study was to compare participants’ cognitive load from learning declarative knowledge on food concepts delivered via a multimedia-intensive gaming app or a passive app with the same content using electroencephalogram (EEG) measurements. Participants (n¼20) completed first one app, then the other a month later, counter-balanced in order, with knowledge tested one week after each session. Most participants had correct declarative knowledge measured during app use (median 97.7%, both apps) and at post-testing (median 100%, both apps). There were no significant knowledge differences between the gaming and passive app during use, post-testing, or from app use to post-test. For passive, 63% improved knowledge while in gaming 42% improved. At baseline, 6 scored 100% (range 81.4-100%) in passive compared to 7 in gaming (range 95.3-100%). 15 and 14 scored 100% at post-testing respectively. EEG spectra (the power of different oscillations in the brain) were recorded from participants while they used each app. More power in the 8 -10 Hz range (alpha waves) in the gaming app was found, associated with reduced cognitive load. The decreased cognitive load in the gaming app corroborate with the principle that MLEs support a more efficient, focused learning process.
Funding Disclosure: USDA National Institute of Food and Agriculture Hatch project through the Division of Nutritional Sciences, University of Illinois. This work was supported by the USDA National Institute of Food and Agriculture, Hatch Project #ILLU971-362.
Funding Disclosure: None
A-86
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2016 Suppl 1—Abstracts Volume 116 Number 9
Poster Session: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy Measuring Vegetable Intake and Dietary Quality in Response to a Preschool-based Education Program
Mini Nutrition Assessment Score as a Potential Predictor of Pressure Ulcers in Elderly Nursing Home Patients with Dementia
Author(s): M. Sharafi1, H. Peracchio2, T. Dugdale3, S. Scarmo4, T. Huedo-Medina5, V. Duffy1; 1 University of Connecticut, 2University of Connecticut Department of Extension, 3 University of Connecticut Department of Allied Health Sciences, 4The Pew Charitable Trusts, 5Allied Health Sciences, Univ of CT
Author(s): A. O’Brien, J. Pope, K. Anguah, D. Erickson; Louisiana Tech University
Learning Outcome: After reading this poster and interacting with the presenters, the attendee should be able to describe: how to construct a dietary quality index; three uses and limitations of a liking survey as a dietary assessment instrument for preschoolers; and how this research could be applied to his/her practice setting. Feasible and sensitive tools are needed to assess dietary changes of preschoolers. We tested the sensitivity and utility of dietary quality indexes generated from parent reports against skin carotenoid status across a 16-wk intervention in preschoolers. Income-challenged preschoolers were assigned to control (n¼130) and intervention (n¼132) groups. Both received classroom and parent nutrition education; the intervention group received double the classroom minutes of nutrition education. Baseline and post-intervention dietary quality indexes were formed for preschoolers from parent-reported dietary liking (preschool-adapted liking survey) and intake (frequency screener). Teachers logged the preschoolers’ lunch vegetable intake 9-times across the intervention. Pre/post BMI percentiles and carotenoid status were assessed; 1 in 3 children were overweight/obese at baseline. The liking-based dietary quality index was most sensitive to the intervention effects. Intervention children had significant increases in liking-based dietary quality and, with improved lunch vegetable intake, the highest post-intervention dietary quality and carotenoid status. Children who achieved the highest dietary quality (liking and frequencybased) had greatest reduction in BMI% across the 16-wks. By path analysis, improved lunch vegetable intake significantly predicted dietary quality increases. The intervention led to greater increases in liking-based dietary quality, which in turn, to greater improvements in carotenoid status by post-intervention. Summary: With simple collection and processing, the liking survey was able to detect changes in dietary quality consistent with a carotenoid biomarker.
Funding Disclosure: This material is based upon work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, Hatch Formula Funds, project accession number 1001056.
Learning Outcome: Learner will recognize the relationship between nutrition assessment and pressure ulcer presence and severity in nursing home patients. Background: Tools to measure malnutrition as a predictor of pressure ulcers have not been established. This study was a retrospective case-control study done with data collected from past and present medical record information. The purpose was to determine whether there was a difference in the (1) presence and (2) severity of pressure ulcers in nursing home patients with dementia based on nutritional status as determined by Mini Nutrition Assessment (MNA) score. Methods: The convenience sample included 100 nursing home residents: 50 case subjects who had pressure ulcers and 50 matched control subjects who did not. Physical measurements and nutrition information was collected from medical records to determine an MNA score between 0 and 14. Pressure ulcer stage, 1-4, was determined according to National Pressure Ulcer Advisory Panel guidelines. Results: Upon data analysis, MNA scores for subjects with and without ulcers were significantly different (p¼.001) with means of 8.34+2.67 and 9.98+2.32 respectively. Scores of the ulcer groups did not follow a linear pattern, however, subjects with stage 4 ulcers had significantly lower MNA scores (6.33+2.55) than all of the other ulcer stage groups. Conclusions: These results show a relationship between low MNA scores and both increased presence and increased severity of pressure ulcers. Thus, MNA may potentially be used as criteria for implementing preventive measures and mitigating progression of existing ulcers in nursing homes. More research should be done to explore use of MNA in nursing homes as a means to both monitor nutritional status and implement pressure ulcer prevention methods. Funding Disclosure: None
Method of Meal Tray Delivery, Timing of Blood Glucose Testing and Insulin Administration. A Pilot Study
Mobile Multimedia Effects on Cognitive Engagement: Association between App Format, Learning and Cognitive Load
Author: A.T. Truong; Maine Medical Center
Author(s): K. DiFilippo1, K. Mathewson2, W. Huang1, J. Andrade1, K. ChapmanNovakofski1; 1University of Illinois at Urbana-Champaign, 2University of Alberta
Learning Outcome: The poster attendees will be able to describe how tray delivery methods are related to the timing of blood glucose testing and insulin administration for diabetic patients. Background: The prevalence of Type 1 & 2 diabetes is estimated to be present in about 25% of hospitalized patients. Timing between meal tray delivery (MTD), blood glucose testing (BGT) and insulin administration (IA) varied since the implementation of room service. Few studies offer tangible guidance how to best synchronize variable meal times with nursing staff activities. Methods: During the pre-trial, nutrition staff delivered trays to diabetic patients. Patients were reminded to notify their Registered Nurse (RN) and/or Certified Nursing Assistant (CNA) when their trays arrived. During the trial phase, nutrition staff delivered the trays to the nursing unit station and notified the unit secretary. The unit secretary then paged the appropriate RN/ CNA to deliver the trays to the patients’ rooms. Variables observed: the timing of diabetic trays delivered to the nursing unit station, timing of trays delivered to patients’ rooms, and patients’ first bites of meal. Timing of BGT and IA were retrieved from the electronic medical records. Data were collected from May to September of 2015 and analyzed with descriptive statistical methods. Results: Ninety-six events at various meals were directly observed. Blood glucose was checked within 30 minutes of the time the patients started eating 70% of the time for pre-trial and 85% for trial phases. Insulin was given within 15 minutes of the time the patient started eating 44% of the time for the pre-trial and 57% for the trial phases. Conclusion: The new method of tray delivery for diabetic patients showed improvement with the timing for blood glucose testing and insulin administration.
Learning Outcome: To increase understanding of the role of apps in learning nutrition knowledge. To Increase understanding of the role of app design in decreasing cognitive load to enhance learning. To describe the potential role of apps in reducing cognitive load for a more efficient learning process. Diet-related mobile applications (apps) are being used by clients and practitioners. In any form of mobile learning environment (MLE), there is limited evidence to support that multimedia improves learning efficiency. This lack of understanding could lead to MLE development that overloads learners’ cognitive and motivational processing capacities, compromising desired learning engagement. The objective of this study was to compare participants’ cognitive load from learning declarative knowledge on food concepts delivered via a multimedia-intensive gaming app or a passive app with the same content using electroencephalogram (EEG) measurements. Participants (n¼20) completed first one app, then the other a month later, counter-balanced in order, with knowledge tested one week after each session. Most participants had correct declarative knowledge measured during app use (median 97.7%, both apps) and at post-testing (median 100%, both apps). There were no significant knowledge differences between the gaming and passive app during use, post-testing, or from app use to post-test. For passive, 63% improved knowledge while in gaming 42% improved. At baseline, 6 scored 100% (range 81.4-100%) in passive compared to 7 in gaming (range 95.3-100%). 15 and 14 scored 100% at post-testing respectively. EEG spectra (the power of different oscillations in the brain) were recorded from participants while they used each app. More power in the 8 -10 Hz range (alpha waves) in the gaming app was found, associated with reduced cognitive load. The decreased cognitive load in the gaming app corroborate with the principle that MLEs support a more efficient, focused learning process.
Funding Disclosure: USDA National Institute of Food and Agriculture Hatch project through the Division of Nutritional Sciences, University of Illinois. This work was supported by the USDA National Institute of Food and Agriculture, Hatch Project #ILLU971-362.
Funding Disclosure: None
A-86
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2016 Suppl 1—Abstracts Volume 116 Number 9