Search results for: renal diet

Authors: Maha Alhussain, Moira A Taylor, Ian A. Macdonald

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Background: It is well established that dietary composition has effects on metabolism and therefore impacts on health; however other aspects of diet, such as meal pattern, could also be important in both obesity management and promoting health. The present study investigated the effect of irregular meal frequency on anthropometric measurements and energy expenditure (EE) in healthy women. Design: 11 healthy weight women (18–40 years) were studied in a randomized crossover trial with two phases of 2 weeks each. In Phase 1, participants consumed either a regular meal pattern (6 meals/day) or an irregular meal pattern (varying from 3 to 9 meals/day). In Phase 2, participants followed the alternative meal pattern to that followed in Phase 1, after a 2-weeks washout period. In the two phases, identical foods were provided to a participant in amounts designed to keep body weight constant. Participants came to the laboratory after an overnight fast at the start and end of each phase. EE was measured in fasting state by indirect calorimetry. Postprandial EE was measured during the 3 h period after consumption of a milkshake, test drink. Results: There were no significant changes in body weight and anthropometric measurements after both meal pattern interventions. There was also no significant difference in mean daily energy intake between the regular and irregular meal pattern (2043 ±31 and 2099 ±33 respectively). EE in the fasting state showed no significant differences cross the experiment visits. There was a significant difference in Postprandial EE (measured for 3 h) by visit (P=0.04). Postprandial EE after the regular meal pattern was significantly higher than at baseline (P=0.002) or than after the irregular meal pattern (P= 0.04). Conclusion: Eating regularly for 14-day period significantly increases Postprandial EE which may contribute to weight loss and obesity management.

Keywords: energy expenditure, energy intake, meal pattern, weight loss

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Authors: Ali Christian Chinedu, Asogwa Vincent Chidindu, Ejiofor Toochukwu Eleazar, Okadi Ashagwu Ojang

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The increasing rate of Boko Haram insurgency, farmer-herder clashes, and kidnapping in Nigeria has resulted in food shortages and high cost of protein sources like beef and fish. This challenge could be curbed with the production of edible insects, which contain several nutritional benefits like calories, protein, fat, vitamins, and minerals, depending on their species, metamorphic stage, and diet. Unfortunately, the benefits and competencies in producing, preserving, and marketing edible insects are still unknown to the public, including prospective farmers in Nigeria. Hence, this study determined teachers’ perception of integrating edible insects into the Animal Husbandry Curriculum in Senior Secondary Schools in Nigeria to equip the future generation with the relevant competencies for alternative sustainable protein supply. The study was carried out in Enugu State, Nigeria. The participants for the study comprised 162 agricultural science teachers. A questionnaire titled: Edible Insects Integration in Animal Husbandry Curriculum Questionnaire (EIIAHCQ) was used to collect data using a descriptive survey research design. We conducted data collection with the help of six research assistants. The study identified 11 objectives, 11 contents, 10 teaching methods, and 9 evaluation methods that could be integrated into the existing curriculum of animal husbandry in Nigeria. Among others, the Ministry of Education should integrate the finding of this study into the curriculum of Animal Husbandry in Nigeria to enhance the protein supply and curb food insecurity now and in the future.

Keywords: animal husbandry curriculum, edible insects, entomophagy, integration, secondary school, Nigeria

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Authors: Abeer Mohammed, Nevein Mustafa Elashery, Mona Hassan Abdel Aal, Ereny Wilson Nagib

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The Aim of the current study is to investigate nutrition role in the management of psychiatric disorders. Research Design: A quasi- experimental research design was utilized for this study. Setting The study was conducted at outpatient clinic at Institute of Psychiatry affiliated to Ain Shams University hospitals, using a convenient sample of 50 psychiatric patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. Tools: data were collected through; first, an interview questionnaire covering socio-demographic characteristics, second, nutrition assessment tools Third, nutrition risk assessment. Fourth, nutrition management program Results showed that there were highly statistically significant improvements in modified nutritional supplements for patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders' patients after conducting the nutrition management program. Regarding psychiatric patients’ knowledge about healthy food, healthy nutritional habits, and patients’ awareness & readiness for change, there were highly statistically significant improvements. Concerning signs and symptoms of psychiatric disorders, there were highly statistically significant improvements for depression, schizophrenia, bipolar disorders, and obsessive-compulsive patients after conducting the management program. In conclusion, the nutrition management program was effective in improving symptoms associated with, depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. The study recommended that nurses should have more contribution in counseling psychiatric patients, and their families about healthy diet and healthy habits. Further research should recommend studying the effectiveness of herbs on enhancing mental health for psychiatric patients.

Keywords: nutrition, role, management, psychiatric disorders

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Authors: Hasan AL-Khshemawee, Manjree Agarwal, Xin Du, Yonglin Ren

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The possibility use of stable isotopes to study Medfly mating and life history were investigated in these experiments. 13C6 glucose was incorporated in the diet of the Mediterranean fruit fly Ceratitis capitata (Diptera: Tephidae). Treatments included labelling and unlabelled of either the media or adult sugar water. The measured started from egg hatching till the adults have died. After mating, the adults were analysed for 13C6 glucose ratio using Liquid chromatography-mass spectrometry LC-MS in two periods of time immediately and after three days of mating. Results showed that stable isotopes were used successfully for labelling Medfly in laboratory conditions, and there were significant differences between labelled and unlabelled treatment in eggs hatching, larval development, pupae emergence, survival of adults and mating behaviour. Labelling during larval development and combined labelling of larvae and adults resulted in detectable values. The label glucose in larvae stage did not effect on mating behaviour, however, the label glucose in adults’ stage was affected by mating behaviour. We recommended that it is possible to label adults of Mediterranean fruit fly C. capitata and detected the label after mating. This method offers good tools to study mating behaviour in Medfly and other types of insects and could be providing useful tools in genetic studies, sterile insect technique (SIT) or agricultural pest management. Also, we recommended using this technique in the field.

Keywords: stable isotope, sterile insect technique (SIT), medfly, mating behaviour

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Authors: Sara D. Garduno-Diaz, Philippe Y. Garduno-Diaz

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To date, one of the few comprehensive indicators for the measurement of food security is the Global Food Security Index. This index is a dynamic quantitative and qualitative bench marking model, constructed from 28 unique indicators, that measures drivers of food security across both developing and developed countries. Whereas the Global Food Security Index has been calculated across a set of 109 countries, in this paper we aim to present and compare, for the Middle East and North Africa (MENA), 1) the Food Security Index scores achieved and 2) the data available on affordability, availability, and quality of food. The data for this work was taken from the latest (2014) report published by the creators of the GFSI, which in turn used information from national and international statistical sources. According to the 2014 Global Food Security Index, MENA countries rank from place 17/109 (Israel, although with resent political turmoil this is likely to have changed) to place 91/109 (Yemen) with household expenditure spent in food ranging from 15.5% (Israel) to 60% (Egypt). Lower spending on food as a share of household consumption in most countries and better food safety net programs in the MENA have contributed to a notable increase in food affordability. The region has also however experienced a decline in food availability, owing to more limited food supplies and higher volatility of agricultural production. In terms of food quality and safety the MENA has the top ranking country (Israel). The most frequent challenges faced by the countries of the MENA include public expenditure on agricultural research and development as well as volatility of agricultural production. Food security is a complex phenomenon that interacts with many other indicators of a country’s well-being; in the MENA it is slowly but markedly improving.

Keywords: diet, food insecurity, global food security index, nutrition, sustainability

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Authors: Giannis Arnaoutis, Dimitra Efthymiopoulou, Maria-Foivi Nikolopoulou, Yannis Manios

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AIM: Nitrate-containing supplements have been used extensively as ergogenic in many sports. However, extract fractions from plant-based nutritional sources high in nitrate and their effect on athletic performance, has not been systematically investigated. The purpose of the present study was to examine the possible effect of acute consumption of a “smart mixture” from beetroot and rocket on exercise capacity. MATERIAL & METHODS: 12 healthy, nonsmoking, recreationally active, males (age: 25±4 years, % fat: 15.5±5.7, Fat Free Mass: 65.8±5.6 kg, VO2 max: 45.46.1 mL . kg -1 . min -1) participated in a double-blind, placebo-controlled trial study, in a randomized and counterbalanced order. Eligibility criteria for participation in this study included normal physical examination, and absence of any metabolic, cardiovascular, or renal disease. All participants completed a time to exhaustion cycling test at 75% of their maximum power output, twice. The subjects consumed either capsules containing 360 mg of nitrate in total or placebo capsules, in the morning, under fasted state. After 3h of passive recovery the performance test followed. Blood samples were collected upon arrival of the participants and 3 hours after the consumption of the corresponding capsules. Time until exhaustion, pre- and post-test lactate concentrations, and rate of perceived exertion for the same time points were assessed. RESULTS: Paired-sample t-test analysis found a significant difference in time to exhaustion between the trial with the nitrate consumption versus placebo [16.1±3.0 Vs 13.5±2.6 min, p=0.04] respectively. No significant differences were observed for the concentrations of lactic acid as well as for the values in the Borg scale between the two trials (p>0.05). CONCLUSIONS: Based on the results of the present study, it appears that a nutritional supplement derived from vegetable extracts rich in nitrate, improves athletic performance in recreationally active young males. However, the precise mechanism is not clear and future studies are needed. Acknowledgment: This research has been co‐financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH – CREATE – INNOVATE (project code:T2EDK-00843).

Keywords: sports performance, ergogenic supplements, nitrate, extract fractions

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Authors: Pitchaon Maisuthisakul, Ladawan Changchub

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Rice (Oryza sativa L.) is a staple diet in Thailand. Rice cultivation is traditional occupation of Thailand which passed down through generations. The 1 Rai 1 san project is new agricultural theory according to sufficient economy using green technology without using chemical substances. This study was conducted to evaluate total phenolics using HPLC and colorimetric methods including total anthocyanin content of Thai rice extracting by simulated gastric and intestinal condition and to estimate antioxidant capacity using DPPH and thiocyanate methods. Color and visible spectrum of rice grains were also investigated. Rice grains were classified into three groups according to their color appearance. The light brown grain genotypes are Sin Lek, Jasmine 105, Lao Tek and Hawm Ubon. The red group is Sang Yod and Red Jasmine. Genotypes Kum, Hawm Kanya and Hawm Nil are black rice grains. Cyanidin-3-O-glucoside was found in only black rice genotypes, whereas chlorogenic acid was found in all rice grains. The black rice had higher phenolic content than red and light brown samples. Phenolic acids constitute a small portion of phenolic compounds after digestion in human and contribute to the antioxidant activity of Thai rice grains. Anthocyanin contents of all rice extracts ranged from 45.9 to 442.1 mg CGE/kg. All rice extracts showed the antioxidant efficiency lower than ferulic acid. Genotype Kum and Hawm nil exhibited the ability of antioxidant efficiency higher than α-tocopherol. Interestingly, the visible spectrum of only black rice genotypes showed the maximum peak at 530-540 nm. The results suggest that consumption of black rice gives more health benefits of grain to consumer.

Keywords: rice, phenolic, antioxidant, anthocyanin

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Authors: A. Sadowska, R. Polaniak, P. Boczarski, E. Grochowska-Niedworok

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Working in a shopping center 12 hours a day as a shop assistant is a very demanding and stressful job, which is still underestimated. Proper eating habits, including recommended fruits, vegetables, products rich in fiber, omega-3 fatty acids, and proper hydration, can contribute to improvement in health and make shop assistants more resistant to stress. The aim of this study was to analyze the eating habits of shop assistants working in shopping centers 12 hours a day. Participant 101 sellers from Poland filled out authorial surveys. Nearly 50% of participants consumed the recommended number of 4 to 5 meals per day. There was a slight dependence between the number of meals consumed per day and the time that employers allowed for employee mealtimes. Respondents declared that they engaged in snacking, and they generally chose fruit, chocolates, and other sweets. Survey results indicated a low liquid intake, which was about 1,05 liters daily. Mineral water was chosen most often (63%) by participants. Participant fish consumption was very low in comparison with the norms, which can pose a risk of developing omega-3 fatty acids deficiency. Shop assistants stated that a change in their eating habits was necessary. Study findings suggest a moderate dependence between being on a diet and counting calories and macronutrients contained in meals. The number of meals eaten per day is correlated with the number of meals eaten at the worksite. The percentage of snacking by shop assistants was so high that it suggested a need for more nutrition education. The topic of eating habits among shop assistants should be examined using a larger group of participants. It is necessary to note a connection between nutrition and health problems.

Keywords: eating habits, work during 12 hours a day, shopping center, nutrition

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Authors: Madeleine Elder, Aye Htun

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Background: Myiasis is the parasitic infestation of body tissues by fly larvae. It predominantly occurs in poor socioeconomic regions of tropical and subtropical countries where it is associated with poor hygiene and sanitation. Cutaneous and wound myiasis are the most common presentations whereas urogenital myiasis is rare, with few reported cases. Case: a 26-year-old primiparous woman with a low-risk pregnancy presented to the emergency department at 37+3-weeks’ gestation after passing a 2cm black larva during micturition, with 2 weeks of mild vulvar pruritus and dysuria. She had travelled to India 9-months prior. Examination of the external genitalia showed small white larvae over the vulva and anus and a mildly inflamed introitus. Speculum examination showed infiltration into the vagina and heavy white discharge. High vaginal swab reported Candida albicans. Urine microscopy reported bacteriuria with Enterobacter cloacae. Urine parasite examination showed myiasis caused by Clogmia albipunctata species of fly larvae from the family Psychodidae. Renal tract ultrasound and inflammatory markers were normal. Infectious diseases, urology and paediatric teams were consulted. The woman received treatment for her urinary tract infection (which was likely precipitated by bladder irritation from local parasite infestation) and vaginal candidiasis. She underwent daily physical removal of parasites with cleaning, speculum examination and removal, and hydration to promote bladder emptying. Due to the risk of neonatal exposure, aspiration pneumonitis and facial infestation, the woman was steroid covered and proceeded to have an elective caesarean section at 38+3-weeks’ gestation, with delivery of a healthy infant. She then proceeded to have a rigid cystoscopy and washout, which was unremarkable. Placenta histopathology revealed focal eosinophilia in keeping with the history of maternal parasites. Conclusion: Urogenital myiasis is very rare, especially in the developed world where it is seen in returned travellers. Treatment may include systemic therapy with ivermectin and physical removal of parasites. During pregnancy, physical removal is considered the safest treatment option, and discussion around the timing and mode of delivery should consider the risk of harm to the foetus.

Keywords: urogenital myiasis, parasitic infection, infection in pregnancy, returned traveller

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Authors: Somayeh Khanjani, Samaneh Nabavi, Shirin Jalili

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Aluminum phosphide (ALP) is an inorganic phosphide used to control insects and is a highly effective insecticide and rodenticide used frequently to protect stored grain. Acute poisoning with this compound is common in some countries including India and Iran, and is a serious health problem. In Iran it was known as "rice tablet", for its use to preserve rice. Two kinds of rice tablets one being herbal while other containing 3g aluminum phosphide (AlP) are available for use in Iranian households to protect stored food grains from pests and rodents. The toxicity of Aluminum phosphide is attributed to the liberation of phosphine gas in contact with water or weak acid and is the major cause of poisoning and deaths. Rice tablet (Aluminum Phosphid) poisoning may be associated with serious and sometimes incurable complications. In 61.3% of patients were shown uniform ingestion. Vomiting was the most common symptoms reported by 96.4% patients. Agitation was reported in 36.9% and felling of thirsty in 27.9 %. Although many complications such as Hypotension, Adult Respiratory Distress Syndrome (ARDS), Acute Renal Failure (ARF) AND Multi Organ Failure (MOF) were the common complications observed in these patients, but the most lethal complication was Cardiac Arrhythmias occurred in 36.9% of cases. Abdominal pain in 31.4% of the patients, nausea in 79.4% of the patients and 41.1% of the patients showed metabolic acidosis. Suicidal intention was the most common cause of poisoning leading to deaths in 18.6% of the patients. Aluminum phosphide can cause either elevation, decrease or no change in electrolytes, bicarbonate and blood glucose level. The possible mechanism for changes in blood glucose levels are complex and depend on the balance of factors which increase its concentration and those which reduce it. AlP poisoning has been postulated to stimulate cortisol which leads to increasing blood level of cortisol, also it may cause stimulation of glucagon, and Adrenaline secretion; in addition, it can inhibit insulin synthesis which may lead to hyperglycemia. Another suggested mechanism of hyperglycemia is rennin activity in some cases, an increase in magnesium level of plasma and that of tissues, and high phosphate level. Although hyperglycemia is most frequent in this poisoning and also is known as a marker of poor prognostic, hypoglycemia in aluminum phosphide poisoning is a rare finding which may be so dangerous. Patients showed sever hypotension and sever acidosis in addition to sever hypoglycemia. The presenting features of AlP intoxication are rapid onset of shock, severe metabolic acidosis, cardiac dysrhythmias and adult respiratory distress syndrome (ARDS).

Keywords: aluminum phosphide (ALP), rice tablet, poisoning, phosphine gas

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Authors: S. Ahmad, M. Rizwan, B. Ayub, S. Mehmood, P. Akhtar

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This experiment was conducted to investigate the effect of supplementation of pure herbal blend on growth performance of boilers. One hundred and twenty birds were randomly distributed into 4 experimental units of 3 replicates (10 birds/replicate) as: negative control (basal diet), positive control (Lincomycin at the rate of 5g/bag), pure herbal blend at the rate of 150g/bag and pure herbal blend at the rate of 300g/bag. The data regarding weekly feed intake, body weight gain and feed conversion ratio were recorded, and fecal samples were collected at the end of starter and finisher phase for nutrient digestibility trial. The results of feed intake showed significant (P < 0.05) results in 1st (305g), 2nd (696.88g), 3rd (1046.9g) and 4th (1173.2g) week and feed conversion ratio indicated significant (P < 0.05) variations in 1st (2.54) and 4th (2.28) week of age. Also, both starter and finisher phase indicated significant (P < 0.05) differences among all treatment groups in feed intake (2023.4g) and (2302.6g) respectively. The statistical analysis indicated significant (P < 0.05) results in crop filling percentage (86.6%) after 2 hours of first feed supplementation. In case of nutrient digestibility trial, results showed significant (P < 0.05) values of crude protein and crude fat in starter phase as 69.65% and 56.62% respectively, and 69.57% and 48.55% respectively, in finisher phase. Based on overall results, it was concluded that the dietary inclusion of pure herbal blend containing neem tree leaves powder, garlic powder, ginger powder and turmeric powder increase the production performance of broilers.

Keywords: neem tree leave, garlic, ginger, herbal blend, broiler

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Authors: Hafiz Arbab Sakandar

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Time-restricted intermittent fasting (TRIF) impacts host’s physiology and health. Plenty of health benefits have been reported for TRIF in animal models. However, limited studies have been conducted on humans especially in underdeveloped economies. Here, we designed a study to investigate the impact of TRIF/Ramadan fasting (16:8) on the modulation of gut-microbiome structure, metabolic pathways, and predicted metabolites and explored the correlation among them at different time points (during and after the month of Ramadan) in Pakistani Expats living in China. We observed different trends of Shannon-Wiener index in different subjects; however, all subjects showed substantial change in bacterial diversity with the progression of TRIF. Moreover, the changes in gut microbial structure by the end of TRIF were higher vis-a-vis in the beginning, significant difference was observed among individuals. Additionally, metabolic pathways analysis revealed that amino acid, carbohydrate and energy metabolism, glycan biosynthesis metabolism of cofactors and vitamins were significantly affected by TRIF. Pyridoxamine, glutamate, citrulline, arachidonic acid, and short chain fatty acid showed substantial difference at different time points based on the predicted metabolism. In conclusion, these results contribute to further our understanding about the key relationship among, dietary intervention (TRIF), gut microbiome structure and function. The preliminary results from study demonstrate significant potential for elucidating the mechanisms underlying gut microbiome stability and enhancing the effectiveness of microbiome-tailored interventions among the Pakistani populace. Nonetheless, extensive, and rigorous large-scale research on the Pakistani population is necessary to expound on the association between diet, gut microbiome, and overall health.

Keywords: gut microbiome, health, fasting, functionality

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Authors: Ali Taheri Mirghaed, Sara Ahani, Ashkan Zargar, Seyyed Morteza Hoseini

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Diseases are the major challenges in intensive aquaculture that cause significant annual losses. Antibiotic-therapy is a common way to control bacterial disease in fish, and oxytetracycline (OTC) is the only oral antibiotic in aquaculture approved FDA. OTC has been found to have negative effects on fish, such as oxidative stress and immune-suppression, thus, it is necessary to mitigate such effects. Medicinal herbs have various benefits on fish, including antioxidant, immunostimulant, and anti-microbial effects. Therefore, we hypothesized if dietary ginger meal (GM) interacts with dietary OTC by monitoring plasma protein fractions in rainbow trout. The study was conducted as a 2 × 2 factorial design, including diets containing 0 and 1% GM and 0 and 1.66 % OTC (corresponding to 100 mg/kg fish biomass per day). After ten days treating the fish (60 g individual weight) with these feeds, blood samples were taken from al treatments (n =3). Plasma was separated by centrifugation, and protein fractions were determined by electrophoresis. The results showed that OTC and GM had interaction effects on total protein (P<0.001), albumin (P<0.001), alpha-1 fraction (P=0.010), alpha-2 fraction (P=0.001), beta-2 fraction (P=0.014), and gamma fraction (P<0.001). Beta-1 fraction was significantly (P=0.030) affected by dietary GM. GM decreased plasma total protein, albumin, and beta-2 but increased beta-1 fraction. OTC significantly decreased total protein (P<0.001), albumin (P=0.001), alpha-2 fraction (P<0.001), beta-2 fraction (P=0.004), and gamma fraction (P<0.001) but had no significant effects on alpha-1 and beta-1 fractions. Dietary GM inhibited/suppressed the effects of dietary OTC on the plasma total protein and protein fractions. In conclusion, adding 1% GM to diet can mitigate the negative effects of dietary OTC on plasma proteins. Thus, GM may boost health of rainbow trout during the period of medication with OTC.

Keywords: ginger, plasma protein electrophoresis, dietary additive, rainbow trout

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Tais Basaco, Stefanie Pektor, Josue A. Moreno, Matthias Miederer, Andreas Türler

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Radiopharmaceuticals based in monoclonal anti-body (mAb) via chemical linkers have become a potential tool in nuclear medicine because of their specificity and the large variability and availability of therapeutic radiometals. It is important to identify the conjugation sites and number of attached chelator to mAb to obtain radioimmunoconjugates with required immunoreactivity and radiostability. Girentuximab antibody (G250) is a potential candidate for radioimmunotherapy of clear cell carcinomas (RCCs) because it is reactive with CAIX antigen, a transmembrane glycoprotein overexpressed on the cell surface of most ( > 90%) (RCCs). G250 was conjugated with the bifunctional chelating agent DOTA (1,4,7,10-Tetraazacyclododecane-N,N’,N’’,N’’’-tetraacetic acid) via a benzyl-thiocyano group as a linker (p-SCN-Bn-DOTA). DOTA-G250 conjugates were analyzed by size exclusion chromatography (SE-HPLC) and by electrophoresis (SDS-PAGE). The potential site-specific conjugation was identified by liquid chromatography–mass spectrometry (LC/MS-MS) and the number of linkers per molecule of mAb was calculated using the molecular weight (MW) measured by matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The average number obtained in the conjugates in non-reduced conditions was between 8-10 molecules of DOTA per molecule of mAb. The average number obtained in the conjugates in reduced conditions was between 1-2 and 3-4 molecules of DOTA per molecule of mAb in the light chain (LC) and heavy chain (HC) respectively. Potential DOTA modification sites of the chelator were identified in lysine residues. The biological activity of the conjugates was evaluated by flow cytometry (FACS) using CAIX negative (SKRC-18) and CAIX positive (SKRC-52). The DOTA-G250 conjugates were labelled with 177Lu with a radiochemical yield > 95% reaching specific activities of 12 MBq/µg. The stability in vitro of different types of radioconstructs was analyzed in human serum albumin (HSA). The radiostability of 177Lu-DOTA-G250 at high specific activity was increased by addition of sodium ascorbate after the labelling. The immunoreactivity was evaluated in vitro and in vivo. Binding to CAIX positive cells (SK-RC-52) at different specific activities was higher for conjugates with less DOTA content. Protein dose was optimized in mice with subcutaneously growing SK-RC-52 tumors using different amounts of 177Lu- DOTA-G250.

Keywords: mass spectrometry, monoclonal antibody, radiopharmaceuticals, radioimmunotheray, renal cancer

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Authors: Pil Kyoo Jo, Jee Young Kim, Yu Jin Oh, Sohyun Park, Young Ha Joo, Hye Suk Kim, Semi Kang

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When convenience drives daily food choices, the increased consumption of processed foods may be associated with the increased intakes of sodium and fat and further with the onset of chronic diseases. The purpose of this study was to investigate the levels of sodium, saturated fat, and calories intakes through processed foods and the dietary patterns among adult populations in South Korea. We used the nationally representative data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES, 2010-2012) and a cross-sectional survey on the eating behaviors among university students(N=893, 380 men, 513 women) aged from 20 to 24 years. Results showed that South Koreans consumed 43.5% of their total food consumption from processed foods. The 24-hour recalls data showed that 77% of sodium, 60% of fats, 59% of saturated fat, and 44% of calories were consumed from processed food. The intake of processed foods increased by 1.7% in average since 2008 annually. Only 33% of processed food that respondents consumed had nutrition labeling. The data from university students showed that students selected processed foods in convenience store when eating alone compared to eating with someone else. Given the convenience and lack of time, more people will consume processed foods and it may impact their overall dietary intake and further their health. In order to help people to make healthier food choices, regulations and policies to reduce the potentially unhealthy nutrients of processed foods should be strengthened. This research was supported by the National Research Foundation of Korea for 2011 Korea-Japan Basic Scientific Cooperation Program. This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2015S1A5B6037369).

Keywords: sodium, fat, processed foods, diet trends

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Authors: Mercy Chepkirui, Reuben Omondi, Paul Orina, Albert Getabu, Lewis Sitoki, Jonathan Munguti

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Globally, the decline in capture fisheries as a result of the growing population and increasing awareness of the nutritional benefits of white meat has led to the development of aquaculture. This is anticipated to meet the increasing call for more food for the human population, which is likely to increase further by 2050. Statistics showed that more than 50% of the global future fish diet will come from aquaculture. Aquaculture began commercializing some decades ago; this is accredited to technological advancement from traditional to modern cultural systems, including cage farming. Cage farming technology has been rapidly growing since its inception in Lake Victoria, Kenya. Currently, over 6,000 cages have been set up in Kenyan waters, and this offers an excellent opportunity for recognition of Kenya’s government tactic to eliminate food insecurity and malnutrition, create employment and promote a Blue Economy. However, being an open farming enterprise is likely to emit large bulk of waste hence altering the ecosystem integrity of the lake. This is through increased chlorophyll-a pigments, alteration of the plankton community, macroinvertebrates, fish genetic pollution, transmission of fish diseases and pathogens. Cage farming further increases the nutrient loads leading to the production of harmful algal blooms, thus negatively affecting aquatic and human life. Despite the ecological transformation, cage farming provides a platform for the achievement of the Sustainable Development Goals of 2030, especially the achievement of food security and nutrition. Therefore, there is a need for Integrated Multitrophic Aquaculture as part of Blue Transformation for ecosystem monitoring.

Keywords: aquaculture, ecosystem, blue economy, food security

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Authors: Mohammed Jarrar, Shalini Behl, Nadia Shaheen, Abeer Fatima, Reem Nasab

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Skin aging is a slow multifactorial process influenced by both internal as well as external factors. Ultra-violet radiations (UV), diet, smoking and personal habits are the most common environmental factors that affect skin aging. Fat contents and fibrous proteins as collagen and elastin are core internal structural components. The direct influence of UV on elastin integrity and health is crucial on aging of skin by time. The deposition of abnormal elastic material is a major marker in a photo-aged skin. Searching for compounds that may protect against cutaneous photo-damage is highly valued. Retinoids and Alpha Hydroxy Acids protective and or repairing effects of UV have been endorsed by some researchers. For consolidating a better understanding of anti and protective effects of such anti-aging agents, we evaluated the combinatory effects of various dosages of lactic acid and retinol on the dermal fibroblasts elastin levels exposed to UV. The UV exposed cells showed significant reduction in the elastin levels. A combination of drugs with a higher concentration of lactic acid (30-35 mM) and a lower concentration of retinol (10-15mg/mL) showed to work better in enhancing elastin concentration in UV exposed cells. We assume this enhancement could be the result of increased tropo-elastin gene expression stimulated by retinol and lactic acid probably repaired the UV irradiated damage by enhancing the amount and integrity of the elastin fibers.

Keywords: alpha hydroxy acid, elastin, retinol, ultraviolet radiations

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Ram Sharan Mehta, Dina Khanal, Pushpa Parajuli, Gayanand Mandal, Bijaya Bartuala

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Background: Cardiovascular disease (CVD) is the leading cause of death worldwide. Adequate awareness of risk factors of CVD is the first step towards effective preventive strategies to combat the CVD burden in diabetes patients.This study aims to assess the awareness on risk factors of CVD among patients with diabetes mellitus attending diabetic clinic of BPKIHS and to find the association between awareness with their selected socio demographic variables. Methods and Material: A descriptive cross sectional study was conducted among 112 patients with diabetes in diabetic clinic of BPKIHS. Convenient sampling technique was used for data collection over duration of one month using interview schedule by HDFQ II tool. Data were analyzed by using descriptive and inferential statistics. (Chi square). Results: The mean age of respondents was 55.4±12.13 years. That mean HDFQ score was 14.31± 5.08. Only 33% of the respondents had adequate level of awareness whereas majority of the respondents (67%) had inadequate level of awareness. Majority of the respondent (83.9%) were aware about smoking, (78.6%) physical activity, (75%) increasing age, (75.9%) high blood pressure, (71.4%) overweight respectively. Whereas most of the respondents were not aware of high cholesterol, fatty diet, preventive strategies and association of diabetes with CVD. Awareness was statistically significant with (p=0.043) educational status, (p=0.025) monthly income, (p=0.05) residence, (p=0.006) CVD information received and (p=0.022) co morbid condition as a heart disease. Conclusion: The findings of this study concluded most of the respondents had an inadequate level of awareness on risk factors of CVD. So Effective education and appropriate preventive strategies of CVD are indeed important to reduce CVD burden in diabetes patients.

Keywords: cardiovascular disease, awareness, diabetes patients, risk

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Authors: Yara Mohamed Taha, Mohamed Ali El Desouky, Heba Kamal Abdel Hakim, Maha Hanafy Mahmoud

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Hepatotoxicity due to drugs and toxic chemicals constitutes a crucial health problem nowadays. Medicinal plants are widely used recently for protecting against many liver disorders and inflammatory conditions. This study aims to evaluate hepatoprotective impact of green tea extract (GTE), rosemary extract (RE) and rosmarinic acid (RA) against hepatotoxins; ferric nitrilotriacetate (Fe-NTA) and diethylnitrosamine (DEN) in rats. Five groups of male Wistar rats were included; one control negative, while the other groups were treated intraperitoneally with DEN as 160 mg.kg-1 b.w. on 15th day and Fe-NTA as 5 mg.kg-1 b.w. on 33rd day. One of them was control positive. The other three groups were pre-administered with daily protective oral doses of either 200 mg.kg-1 b.w. of RE or 1 g.kg- 1 b.w. of GTE or 50 mg.kg-1 b.w. of RA two weeks prior to DEN exposure and continued till the end of the experimental period. The obtained data revealed a highly significant increase of MDA, 8-OHdG, DNA damage percent, a significant depletion of GSH and elevated Gr-1 protein expression in hepatocytes with liver tissue histopathological changes of rats exposed to DEN+Fe-NTA. Pre-administration of protective doses of RE, GTE and RA to DEN+Fe-NTA treated rats could normalize the altered biochemical, histopathological and immunohistochemical parameters. In conclusion, RE, GTE and RA showed a hepatoprotective effect against liver toxicity induced by DEN+Fe-NTA, with the best antioxidant and anti-inflammatory impact were for RA and GTE. Therefore, the current study declared that rosemary, green tea and products enriched with rosmarinic acid should be involved daily in diet of people who are exposed to chemicals and environmental toxins to protect themselves from hepatotoxicity.

Keywords: hepatotoxicity, diethylnitrosamine and ferric nitrilotriacetate, rosemary extract (RE), green tea extract (GTE), rosmarinic acid (RA)

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Authors: N. Liu, N. Tuah, D. Ying

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This research aims to identify and test whether serious games can help children learn and pick up healthy eating habits. The practical component takes the form of digitalizing an already existing educational board game called “All you can eat” (AYCE), designed with the nutritious subject matter in mind. This time with the added features of online playability, which will widen its availability and accessibility to reach more players compared to the physical iteration. The game will be deployed alongside the conducting of theoretical research, which also involves teachers leading children to play said digital version. The research methodology utilizes two experiments, such as handing out surveys to gather feedback from both the partners and students. The research was carried out in several countries, namely Brunei, Malaysia, and Taiwan. The results are to be used for validating the concept of “serious games,” particularly when tied to the health aspect of the players, which in this case were children. As for the research outcomes, they can be applied to a variety of serious games that are related to health topics more broadly and not simply limited to healthy eating habits alone, adopting a balanced combination of practical and theoretical considerations. The study will also help other researchers in the correlated fields of serious game development and pediatrics to better comprehend the needs of children. On the theoretical side, these findings can enable further technological advancements to be made possible, a case in point being more serious games, to provide the appropriate social support precisely on the matter of health-related issues. Not just individuals but rather communities could benefit from improved health and well-being as a result of the project, which, when done right, will potentially improve their quality of life and have fun while doing it. AYCE will be demonstrated to support a wide range of health issues as a result of this research case.

Keywords: culture heritage, digital games, digitalization, traditional religious culture

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Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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Authors: Aghamolaei Teamur, Hosseini Zahra, Ghanbarnejad Amin

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Introduction: A diet rich in fruits and vegetables, especially for adolescents is of a great importance due to the need for nutrients and the rapid growth of this age group. The aim of this study was to investigate the relationship between decisional balance and self-efficacy with stages of change for fruit and vegetable consumption in high school students in Bandar Abbas, Iran. Methods: In this descriptive-analytical study, the data were collected from 345 students studying in 8 high schools of Bandar Abbas were selected through multistage sampling. To collect data, separate questionnaires were designed for evaluating each of the variables including the stages of change, perceived benefits, perceived barriers, and self-efficacy of fruit and vegetable consumption. Decisional balance was estimated by subtracting the perceived benefits and barriers. The data were analyzed using SPSS19 and one-way ANOVA. Results: The results of this study indicated that individuals’ progress along the stages of change from pre-contemplation to maintenance level was associated with a significant increase in their decisional balance and self-efficacy for fruit and vegetable consumption. (P < 0.001). The lowest level of decisional balance and self-efficacy regarding for fruit showed up in the pre-contemplation stage, and the highest level of decisional balance and self-efficacy was in the maintenance stage. The same trends were observed in the case of vegetable consumption. Conclusion: Decisional balance and self-efficacy should be considered in designing interventions to increase consumption of fruits and vegetables. There needs to be more emphasis in educational programs based on the Trans-theoretical Model (TTM) on the enhancement of perceived benefits and elimination of perceived barriers regarding consumption of fruits and vegetables.

Keywords: fruit, vegetable, decision balance, self-efficacy, trans-theoretical model

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Authors: Solange Adechian, Michèle Balage, Didier Remond, Carole Migné, Annie Quignard-Boulangé, Agnès Marset-Baglieri, Sylvie Rousset, Yves Boirie, Claire Gaudichon, Dominique Dardevet, Laurent Mosoni

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Studies have shown that timing of protein intake, leucine content, and speed of digestion significantly affect postprandial protein utilization. Our aim was to determine if one can spare lean body mass during energy restriction by varying the quality and the timing of protein intake. Obese volunteers followed a 6-wk restricted energy diet. Four groups were compared: casein pulse, casein spread, milk-soluble protein (MSP, = whey) pulse, and MSP spread (n = 10-11 per group). In casein groups, caseins were the only protein source; it was MSP in MSP groups. Proteins were distributed in four meals per day in the proportion 8:80:4:8% in the pulse groups; it was 25:25:25:25% in the spread groups. We measured weight, body composition, nitrogen balance, 3-methylhistidine excretion, perception of hunger, plasma parameters, adipose tissue metabolism, and whole body protein metabolism. Volunteers lost 7.5 ± 0.4 kg of weight, 5.1 ± 0.2 kg of fat, and 2.2 ± 0.2 kg of lean mass, with no difference between groups. In adipose tissue, cell size and mRNA expression of various genes were reduced with no difference between groups. Hunger perception was also never different between groups. In the last week, due to a higher inhibition of protein degradation and despite a lower stimulation of protein synthesis, postprandial balance between whole body protein synthesis and degradation was better with caseins than with MSP. It seems likely that the positive effect of caseins on protein balance occurred only at the end of the experiment.

Keywords: lean body mass, fat mass, casein, whey, protein metabolism

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Authors: Saida Haider, Syeda Madiha

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Parkinson’s disease (PD) is a common neurological disorder characterized by motor deficits and loss of dopaminergic neurons. Oxidative stress is said to play a pivotal role in the pathophysiology of the disease. In the present study, PD was induced by injection of rotenone (1.5 mg/kg/day, s.c.) for eight days. Pistachio (800 mg/kg/day, p.o.) was given for two weeks. At the end of treatment brains were dissected out and striatum was isolated for biochemical and neurochemical analysis. Morris water maze (MWM) test and novel object recognition (NOR) task was used to test the memory function while motor behavior was determined by open field test (OFT), Kondziela inverted screen test (KIST), pole test (PT), beam walking test (BWT), inclined plane test (IPT) and footprint (FP) test. Several dietary components have been evaluated as potential therapeutic compounds in many neurodegenerative diseases. Increasing evidence shows that nuts have protective effects against various diseases by improving the oxidative status and reducing lipid peroxidation. Pistachio is the only nut that contains anthocyanin, a potent antioxidant having neuroprotective properties. Results showed that pistachio supplementation significantly restored the rotenone-induced motor deficits and improved the memory performance. Moreover, rats treated with pistachio also exhibited enhanced oxidative status and increased dopamine (DA) and 5-hydroxytryptamine (5-HT) concentration in striatum. In conclusion, to our best knowledge, we have for the first time shown that pistachio nut possesses neuroprotective effects against rotenone-induced motor and cognitive deficits. These beneficial effects of pistachio may be attributed to its high content of natural antioxidant and phenolic compounds. Hence, consumption of pistachio regularly as part of a daily diet can be beneficial in the prevention and treatment of PD.

Keywords: rotenone, pistachio, oxidative stress, Parkinson’s disease

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Authors: Chanya Inprasit, Ching-Liang Hsieh, Yi-Wen Lin

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Obesity (OB) is a hazardous global health problem that has been increasing in prevalence, more severely in last decade. It is the mainly resultant from the imbalance between food consumption and energy expenditure, which is concordant with a modern lifestyle, implying an increase in calories with poorer quality of food intake accompanied by a decrease in physical activities. Obesity does not concern the appearance only but is also a major factor contributing to poor physiology, psychology, society and economic issues. Moreover, OB induces low-grade inflammation in the body through the regulatory effect it enacts on the adipocyte function. Various alternative treatments were investigated for body weight control, including Acupoint Catgut Embedding (ACE). ACE is the implantation of absorbable catgut sutures at specific acupoints, displaying durable and potent stimulation and thereby reducing the treatment frequency. Our study utilized a mouse model to exclude any psychological factors of OB and ACE treatment. High-fat diet and body weight were measured once a week before subjects in ACE and Sham group received the ACE treatment or placebo treatment. We hypothesized that ACE can control body weight through the interaction of the TRPV1 pathways, as TRPV1 accordingly responds to inflammatory factors. The results of body weight variation show a significant decrease in body weight in ACE group compared with the baseline of control and Sham group. Meanwhile, converse results were explored in TRPV1 knockout mice, where a significant maintenance of normal body weight throughout the experiment period was observed. There was no significant difference in food consumption of each group. These finding indicated that TRPV1 pathways and its associated pathways may be involved in the maintenance of body weight, which can be controlled by ACE treatment of genetic manipulation.

Keywords: acupoint catgut embedding, obesity, hypothalamus, TRPV1

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Authors: Marco Antonio Lara De la Calleja, María Catalina Ovando Chico, Eduardo Lopez Ruiz

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Community empowerment has been proved to be a key element in the solution of the food security problem. As a result of a conceptual analysis, it was found that agricultural production, economic development and governance, are the traditional basis of food security models. Although the literature points to social inclusion as an important factor for food security, no model has considered it as the basis of it. The aim of this research is to identify different dimensions that make an integral model for food security, with emphasis on community empowerment. A diagnosis was made in the study community (Tatoxcac, Zacapoaxtla, Puebla), to know the aspects that impact the level of food insecurity. With a statistical sample integrated by 200 families, the Latin American and Caribbean Food Security Scale (ELCSA) was applied, finding that: in households composed by adults and children, have moderated food insecurity, (ELCSA scale has three levels, low, moderated and high); that result is produced mainly by the economic income capacity and the diversity of the diet on its food. With that being said, a model was developed to promote food security through five dimensions: 1. Regional context of the community; 2. Structure and system of local food; 3. Health and nutrition; 4. Information and technology access; and 5. Self-awareness and empowerment. The specific actions on each axis of the model, allowed a systemic approach needed to attend food security in the community, through the empowerment of society. It is concluded that the self-awareness of local communities is an area of extreme importance, which must be taken into account for participatory schemes to improve food security. In the long term, the model requires the integrated participation of different actors, such as government, companies and universities, to solve something such vital as food security.

Keywords: community empowerment, food security, model, systemic approach

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Authors: Thavasimuthu Citarasu, Mariavincent Michaelbabu, Vikram Vakharia

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The rhizome of Java grass, Cyperus rotundus was extracted different organic polar and non-polar solvents and performed the in vitro antiviral and immunostimulant activities against White Spot Syndrome Virus (WSSV) and Vibrio harveyi respectively. Based on the initial screening the ethyl acetate extract of C. rotundus was strong activities and further it was purified through silica column chromatography and the fractions were screened again for antiviral and immunostimulant activity. Among the different fractions screened against the WSSV and V. harveyi, the fractions, F-III to FV had strong activities. In order to study the in vivo influence of C. rotundus, the fractions (F-III to FV) were pooled and delivered to the F. indicus through artificial feed for 30 days. After the feeding trail the experimental and control diet fed F. indicus were challenged with virulent WSSV and studied the survival, molecular diagnosis, biochemical, haematological and immunological parameters. Surprisingly, the pooled fractions (F-III to FV) incorporated diets helped to significantly (P < 0.01) suppressed viral multiplication, showed significant (P < 0.01) differences in protein and glucose levels, improved total haemocyte count (THC), coagulase activity, significantly increased (P < =0.001) prophenol oxidase and intracellular superoxide anion production compared to the control shrimps. Based on the results, C. rotundus extracts effectively suppressed WSSV multiplication and improve the immune system in F. indicus against WSSV infection and this knowledge will helps to develop novel drugs from C. rotundus against WSSV.

Keywords: antiviral drugs, cyperus rotundus, fenneropenaeus indicus, WSSV

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Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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