Understanding Anorexia and Eating Capability of Older Adults in Attempt to Prevent Malnutrition

Because of the rise of life expectancy, the older adults are now a big part of world’s population. In United States, prevalence of adults aged more than 65 years old increased from 36.6 million in 2005 to 47.8 million in 2015. In Indonesia, percentage of older adults increased two-fold from 1971 – 2019 as much as 9,6% or more than 25 million people. Along with this aging population, eating problems and malnutrition are getting more frequent. Aging causes several changes and degradation of body function which physiologically lead to anorexia and eating difficulty in older adults. Moreover, the other age-related factors such as social factor, economic factor, psychological factor, diseases and polypharmacy also have significant impact on food intake in older adults. Prevalence of inadequate energy intake and malnutrition in older adults are increasing, which lead them to become susceptible to acute and chronic diseases or worsening of their disease, increase hospitalization, and increase mortality rate. Even so, the signs of malnutrition of older adults are often late to be recognized, whereas the recovery of malnutrition in older adults is much more complicating than in younger adults. This review discusses about problems encountered by older adults that decrease their intake and cause malnutrition, to help clinicians recognize the cause of malnutrition in older adults earlier.

Space Retrieval Training for Memory Enhancement in Adults with Dementia

The final portfolio contains 8 research articles from national and international journals. Study designs include one systematic review, one randomized control trial with pretest-posttest design, three small-scale randomized control trials, one quasi-experimental study with no control, one time-series study, and one case study. All studies relate directly to components of the evidence-based practice question and will be used to draft new recommendations for implementation regarding spaced retrieval training for memory enhancement in adults with dementia. Seven out of the eight articles looked at the effects of SR techniques on functional tasks. Articles looked at eating difficulty (1), independent use of walkers (1), iADL function (3), use of technology (1), and ADL function (1). One out of eight articles looked at benefits of spaced retrieval techniques on episodic memory, which is not necessarily a functional task, but is needed to perform functional tasks.

Is wearing orthodontic appliances associated with eating difficulties and sugar intake among British adolescents? A cross-sectional study

Summary Aim To determine whether wearing orthodontic appliances was associated with eating difficulty and lower sugars intake among British adolescents. Methods This study analysed data from 4116 12- and 15-year-olds who participated in the 2013 Children’s Dental Health Survey in the UK. Information on eating difficulties in the past 3 months and usual intake of six sugary items was collected through self-administered questionnaires. The presence and type of orthodontic appliances (fixed or removable) were assessed during clinical examinations. Logistic regression was used to evaluate the association between wearing orthodontic appliances and eating difficulty whereas linear regression was used to evaluate the association between wearing orthodontic appliances and sugars intake. Regression models were adjusted for socio-demographic, behavioural, and clinical characteristics of adolescents. Results 12.9 per cent of the 4116 adolescents wore orthodontic appliances (10.1 per cent fixed and 2.8 per cent removable), 21.0 per cent reported eating difficulties and the mean daily intake of sugars was 5.3 times/day (SD: 3.7, range: 0–20). Adolescents with fixed appliances had 4.02 (95% CI: 3.03, 5.33) greater odds of reporting eating difficulty than those with no appliances, but no differences were found between adolescents wearing removable and no appliances. No association was found between wearing orthodontic appliances and daily sugars intake either [coefficients of 0.20 (95% CI: –0.27, 0.66) and –0.30 (95% CI: –0.96 to 0.36) for adolescents wearing fixed and removable appliances, respectively]. Conclusion Wearing fixed orthodontic appliances were associated with greater odds of reporting eating difficulty, but not with lower sugars intake among British adolescents.

COPING STRATEGIES AMONG MOTHERS OF CHILDREN WITH EATING DIFFICULTY

Background: The impact of eating difficulty in children can cause the intake of nutrients to be less, so the nutritional needs become unreachable. It is not easy for parents to face the fact that their children have eating difficulty. Coping becomes part of the adjustment. Coping is a special term used to indicate an individual's reaction when facing pressure or stress. Thus, the coping strategies of parents in dealing with children who have eating difficulty is requiredto deal with and control existing problems.Objective: The aim of this study was to explore the coping strategies of mothers who have children with eating difficulty.Methods: This research was a phenomenological qualitative research. Qualitative data collection techniques in this study was in-depth semi-structured interview techniques. Data analysis was performed by AtlasTi software. Content analysis was used to analyze raw data and identify overarching themes.Results: There four main themes and associated subthemes, were abstracted from the data, namely feeding problem manifestation (refusing to chew, throw out, prolonged mealtimes, inadequate food intake, food refusal, picky eating, closed mouth), stress full condition (angry/out of control, miserable, confused/puzzled, worried, impatient, frustrating), removed from the situation (positive thinking, ignored, acceptance, persevering, religious approaches),and action to modify situation (creative, seeking for help, looking for information, giving the nutrition supplement).Conclusion: This study may have implications for the implementation in overcoming child with eating difficulties. By understanding the mother's condition, then the treatment will be more focused and precise.

Hubungan Sulit Makan Pangan Hewani, Tingkat Asupan Energi, Asam Folat, dan Seng dengan Perkembangan Motorik Halus dan Motorik Kasar Anak Prasekolah di TK Kristen Setabelan Surakarta

Background: Motor development is the development of a child’s ability to control their movement and closely related to the development of the motor center in the brain. Difficulty eating animal based foods can cause nutritional deficiencies which negatively impact a child’s development, especially motor development. Objectives: This study aimed to analyze the correlation between eating difficulty animal based foods, energy, folic acid, and zinc intake with fine and gross motor development in preschoolers aged 4 in Setabelan Christian Kindergarten of Surakarta.Methods: This was observational study with cross sectional design. The population was all the preschoolers aged 4 years old. Sample was determined using simple random sampling technique with Slovin’s formula and 33 research subjects included in this study. The research variables were eating difficulty on animal based foods, energy, folic acid, and zinc intake as independent variables and motor development in preschoolers as dependent variable. Statistical analysis used was Chi Square and Spearman statistic in this research.Results: Based on Chi square statistic showed there was a correlation between eating difficulty on animal based foods with motor development of preschoolers with value of p < 0.05. Spearman test results showed there were relationships between energy, folic acid, and zinc intake with motor development of preschoolers with value of p < 0.05.Conclusions: There were relationships between eating difficulty on animal based foods, energy, folic acid, and zinc intake with fine motor development of preschoolers.ABSTRAK Latar Belakang: Perkembangan motorik adalah perkembangan unsur kematangan pengendalian gerak tubuh yang berkaitan dengan perkembangan pusat motorik di otak. Sulit makan pangan hewani merupakan salah satu alasan terjadinya defisiensi zat gizi yang dibutuhkan dalam perkembangan anak, khususnya perkembangan motoriknya.Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan sulit makan pangan hewani, tingkat asupan energi, asam folat, dan seng dengan perkembangan motorik halus dan motorik kasar pada anak prasekolah di TK Kristen Setabelan Surakarta usia 4 tahun. Metode: Penelitian dengan desain cross sectional dilaksanakan di TK Kristen Setabelan Surakarta. Populasinya seluruh murid TK Kristen Setabelan Surakarta berusia 4 tahun sebanyak 48 siswa. Pengambilan sampel menggunakan simple random sampling dengan rumus Slovin, didapatkan 33 subyek penelitian. Variabel penelitian yaitu sulit makan pangan hewani, tingkat asupan energi, asam folat, dan seng sebagai variabel bebas dan perkembangan motorik halus dan motorik kasar sebagai variabel terikat. Data primer dikumpulkan dengan wawancara dengan bantuan kuesioner. Analisis data menggunakan uji statistik Chi Square dan Spearman.Hasil: Analisa uji Chi Square menunjukkan ada kaitan antara sulit makan pangan hewani dengan perkembangan motorik halus dan motorik kasar anak prasekolah dengan nilai p < 0,05. Analisa uji Spearman menunjukkan ada kaitan antara tingkat asupan energi, asam folat, dan seng dengan perkembangan motorik halus dan motorik kasar anak prasekolah dengan nilai p < 0,05.Kesimpulan: Terdapat hubungan antara sulit makan pangan hewani, tingkat asupan energi, asam folat, dan seng dengan perkembangan motorik halus dan motorik kasar anak prasekolah.

Relationship between Basic Feeding Rule Applied by Parents and Eating Difficulties of Children Under Five Years of Age in Kediri, East Java

ABSTRACT Background: Difficulty eating in children is a problem faced by parents. However, adequate nutritional intake is required for the growth and development of children. Basic feeding rules can be used as guidelines for parents to overcome the feeding problems in children. This study aimed to examine the relationship between basic feeding rule applied by parents and eating difficulties of children under five years of age in Kediri, East Java. Subjects and Method: A cross sectional study was conducted at Semampir, Kediri, East Java. A sample of 32 children under five years of age was selected by purposive sampling. The dependent variable was eating difficulty of children. The independent variable was basic feeding rule applied by parents. The data were collected by questionnaire. The data were analyzed by Spearman rho. Results: Basic feeding rule applied by parents showed positive correlation with eating difficulties in children under five years of age (r= 0.51, p= 0.003). Conclusion: Basic feeding rule applied by parents shows positive correlation with eating difficulties in children under five years of age. Keywords: basic feeding rule, difficulties, children under five years of age, Correspondence: Halimatus Saidah. Faculty of Health Sciences, Universitas Kadiri. Jln Selomangleng No 01, Kediri, East Java. Email: [email protected]. Mobile: +6281321784182. DOI: https://doi.org/10.26911/the7thicph.03.81

PREVALENCE OF UNDER NUTRITION AND ASSOCIATED FACTORS AMONG PEOPLE OF OLD AGE IN DEBRE MARKOS TOWN, NORTHWEST ETHIOPIA, 2015

Background: Malnutrition is defined as a disproportion of nutrients caused by either an excess intake of nutrients or a nutritional deficit. One of the most common nutritional problems in older people (aged 60 years and over) is under nutrition. Worldwide studies revealed that the prevalence of under nutrition in people of old age is high. Objective: To assess the prevalence of under nutrition and its associated factors among old people in Debre Markos town, Northwest Ethiopia, 2015. Methods and materials: A cross sectional study design was conducted among 423 study subjects of old age in Debre Markos town from August 4 to August 30, 2015. Primary data was collected using a pre tested Mini Nutritional Assessment Short-Form (MNA-SF) screening tool and structured questionnaires by trained data collectors. The data that was collected was entered and cleaned using EpiData version 3.1 statistical software then exported to the SPSS version 20 statistical package for further data analysis. Descriptive statistics of frequency, tables and graphs were used and summary measures were calculated to determine the prevalence of under nutrition. The data was also used to describe the distribution of the independent variables among study subjects. Bivariate and multivariate logistic regression models were utilized to calculate crude and adjusted odds ratios in order to identify factors associated with under nutrition of study participants at 0.05 level of significance. Result: The prevalence of under nutrition among study participants was found to be 22.7% (95%CI 18.7-26.7). A number of independent variables have a significant association with under nutrition, including gender (females (AOR 7.95 95% CI (2.86, 22.08)), age (Oldest Old and Middle Old, (AOR=3.45 95%CI (1.44, 8.26) and (AOR=5.25, 95%CI (2.48, 11.13) respectively), marital status (widowed elderly individuals (ARO 3.29 95 % CI (1.54, 7.06)), individuals with eating difficulty (AOR 10.73 95 % CI (4.49, 25.63), individuals with vision problems (AOR 5.67 95 % CI (2.80, 11.48) and meal frequency (ARO 6.71 95 % CI (3.31, 13.63). Conclusion and recommendation: Prevalence of under nutrition among study participants was 22.7%. Gender, age, marital status, eating difficulty, visual problems and meal frequency were found to be independent determinant factors of under nutrition among study subjects. The government, family members and other stakeholders should give more attention to older individuals especially older females.

Free Fibular Osteoseptocutaneus Flap for Reconstruction Giantameloblastoma

Ameloblastoma is a tumor originating from odontogenic epithelial cells. The tumor is located in the gray zone betweenbenign and malignant neoplasms. These tumors can occur at any age. Although traditionally divided as solid andcystic ameloblastoma, nearly all showed cystic changes. These tumors are invasive and have a very high recurrencerate. Ameloblastoma is an odontogenic tumor that is often found. These tumors are generally diagnosed in the fourthand fifth decade. Approximately 80% of these tumors occur in the jaw, with three-quarters are in the molar region andramus. Approximately 20% of them occurred in the premolar and incisivum. Operative therapy was elected a radicalresection of the affected parts of the jaw, followed by reconstruction. Bridging titanium plate can be used to replacepart of lost bone and serves as a means of reconstruction. Various methods of reconstruction of the mandible can bedone by using a bone graft from the calcaneus, fibula, ribs, scapula, iliac crest, or flap reconstruction. We report acase of male patients at entry RSHS Hospital May 11, 2010 18 years old with complaints arising the lump under thetongue ± 8 years ago, accompanied by difficulty eating, difficulty speaking, and shortness of breath. Patients in thediagnosis of ameloblastoma of the mandible on the basis of anatomic pathology examination. It was decided to do thereconstruction of segmental mandibulectomy and free fibular osteoseptocutaneous free flap with multiple osteotomy.Patients go home in improvement condition.