Objectives: Malnutrition is associated with a twofold higher risk of dying in patients with tuberculosis (TB) and considered an important potentially reversible risk factor for failure of TB treatment. The construct of malnutrition has three domains: intake or uptake of nutrition; body composition and physical and cognitive function. The objectives of this systematic review are to identify malnutrition assessment methods, and to quantify how malnutrition assessment methods capture the international consensus definition for malnutrition, in patients with TB.Design: Different assessment methods were identified. We determined the extent of capturing of the three domains of malnutrition, that is, intake or uptake of nutrition, body composition and physical and cognitive function.Results: Seventeen malnutrition assessment methods were identified in 69 included studies. In 53/69 (77%) of studies, body mass index was used as the only malnutrition assessment method. Three out of 69 studies (4%) used a method that captured all three domains of malnutrition.Conclusions: Our study focused on published articles. Implementation of new criteria takes time, which may take longer than the period covered by this review. Most patients with TB are assessed for only one aspect of the conceptual definition of malnutrition. The use of international consensus criteria is recommended to establish uniform diagnostics and treatment of malnutrition.
LINK
Background and aimsThe aim of this study was to gain insight in the effect of a preschool-based intervention for Early Childhood Education and Care (ECEC) teachers on promoting healthy eating and physical activity in toddlers.MethodsIn a cluster randomized controlled trial, 37 preschools of child care organization Impuls in Amsterdam Nieuw-West, the Netherlands, were randomly allocated to an intervention or control group. In total, 115 female ECEC teachers (mean age 42 ± 9 years) participated. The intervention for ECEC teachers consisted of two existing Dutch programs: ‘A Healthy Start’ and ‘PLAYgrounds’. The practices and knowledge of ECEC teachers concerning healthy eating and physical activity and the level of confidence in promoting healthy eating and physical activity in toddlers was assessed at baseline and 9 months of follow-up. To examine the effect of the intervention linear mixed models were used.ResultsPreliminary analyses of the practices indicated that Activity-related-Teaching/Autonomy-Support was increased in the intervention group (mean difference: 0.181), but not in the control group (mean difference: -0.048; p-value group*time: 0.025). Food-related-Pressure-to-Eat was decreased in the intervention group (mean difference: -0.580), but not in the control group (mean difference: -0.158; p-value group*time: 0.014). No effect of the intervention was found on knowledge (p-value group*time: 0.24) and the level of confidence (p-value group*time: 0.98) of ECEC teachers. ConclusionsThe preschool-based intervention seems to increase Activity-related-Teaching/Autonomy-Support and to decrease Food-related-Pressure-to-Eat. No effects were seen on knowledge and level of confidence of ECEC teachers in promoting healthy eating and physical activity in toddlers.
MULTIFILE
