More-2-Eat implementation demonstrates that screening, assessment and treatment of malnourished patients can be spread and sustained in acute care; a multi-site, pretest post-test time series study.

Background: Malnutrition in medical and surgical inpatients is an on-going problem. More-2-Eat (M2E) Phase 1 demonstrated that improved detection and treatment of hospital malnutrition could be embedded into routine practice using an intensive researcher-facilitated implementation process. Yet, spreading and sustaining new practices in diverse hospital cultures with minimal researcher support is unknown.

Handgrip strength predicts length of stay and quality of life in and out of hospital.

Background: Handgrip strength (HGS) is a practical measure of strength and physical function that can be used to identify frailty among hospitalized patients, but its utility in this setting is unclear. To be considered useful, any functional measure needs to provide pertinent information on the patient and predict relevant outcomes such as health-care utilization (e.g.

An economic perspective on the causal explanations for the socioeconomic inequalities in health.

Socioeconomic inequality, or the socioeconomic status (SES) gradient, is arguably one of the most-studied phenomena in health. The gradient in health is apparent in objective and subjective measures, across virtually all countries, and is evident at individual and population levels. There is no longer much debate over the relationship between SES and health.

Improving the standard of nutrition care in hospital: Mealtime barriers reduced with implementation of the Integrated Nutrition Pathway for Acute Care.

Background: Poor food intake is common in hospital patients and is associated with adverse patient and healthcare outcomes; diverse mealtime barriers to intake often undermine clinical nutrition care.

Aim: This study determines whether implementation of locally adaptable nutrition care activities as part of uptake of the Integrated Nutrition Pathway for Acute Care (INPAC) reduced mealtime barriers and improved other patient outcomes (e.g.

Handgrip Strength, but Not 5-Meter Walk, Adds Value to a Clinical Nutrition Assessment.

Background: Decreased physical functioning is associated with malnutrition and common in acute care patients; determining loss of function is often considered part of a comprehensive nutrition assessment. Handgrip strength (HGS) and 5-meter timed walk (5m) are functional measures used in a variety of settings. This analysis sought to determine which functional measure could be added to a hospital nutrition assessment, based on its feasibility and capacity to discriminate patient subgroups.

Low food intake in hospital: patient, institutional, and clinical factors.

In-hospital malnutrition and inadequate food intake have been associated with negative outcomes (e.g., prolonged length of stay, readmission, mortality, and increased hospital costs).

Multi-site implementation of nutrition screening and diagnosis in medical care units: Success of the More-2-Eat project.

Background: Improving the detection and treatment of malnourished patients in hospital is needed to promote recovery.

Aim: To describe the change in rates of detection and triaging of care for malnourished patients in 5 hospitals that were implementing an evidence-based nutrition care algorithm. To demonstrate that following this algorithm leads to increased detection of malnutrition and increased treatment to mitigate this condition.

Nutrition Care after Discharge from Hospital: An Exploratory Analysis from the More-2-Eat Study.

Many patients leave hospital in poor nutritional states, yet little is known about the post-discharge nutrition care in which patients are engaged. This study describes the nutrition-care activities 30-days post-discharge reported by patients and what covariates are associated with these activities. Quasi-randomly selected patients recruited from 5 medical units across Canada ( = 513) consented to 30-days post-discharge data collection with 48.

Comparing Hospital Staff Nutrition Knowledge, Attitudes, and Practices Before and 1 Year After Improving Nutrition Care: Results From the More-2-Eat Implementation Project.

Background: Staff play key roles in the prevention, detection, and treatment of hospital malnutrition. Understanding staff knowledge, attitudes, and practices (KAP) is important for developing and evaluating change management strategies.

Methods: The More-2-Eat project improved nutrition care in 5 Canadian hospitals by implementing the Integrated Nutrition Pathway for Acute Care (INPAC).

Costs of hospital malnutrition.

Background & Aims: Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data.

The relationship between work hours and utilization of general practitioners in four Canadian provinces.

Objective: To assess whether long work hours act as a barrier to accessing general practitioner (GP) services.

Data Sources: Secondary data from the 1996/1997 National Population Health Survey (NPHS) and administrative health services utilization data from four Canadian provinces.

Study Design: This study was cross-sectional, however, employment variables and GP utilization were reflective of the 12-month period preceding the NPHS interview date.

Social assistance, lone parents and health: what do we know, where do we go?

Background: A mounting body of evidence indicates that lone mothers and their children are at higher risk of a variety of health problems. The dynamics of the relationship between social assistance, poverty and health are not well understood, and the study of this population presents substantial challenges. The purpose of this paper is to present an analysis of the state of research on lone parents, social assistance and health in an effort to make recommendations that will move the research forward.

Mutual influences on maternal depression and child adjustment problems.

Often undetected and poorly managed, maternal depression and child adjustment problems are common health problems and impose significant burden to society. Studies show evidence of mutual influences on maternal and child functioning, whereby depression in mothers increases risk of emotional and behavioral problems in children and vice versa. Biological mechanisms (genetics, in utero environment) mediate influences from mother to child, while psychosocial (attachment, child discipline, modeling, family functioning) and social capital (social resources, social support) mechanisms mediate transactional influences on maternal depression and child adjustment problems.

Temporal relations in daily-reported maternal mood and disruptive child behavior.

Examined temporal relations between maternal mood and disruptive child behaviour using daily assessments of 30 mother-child dyads carried out over 8 consecutive weeks (623 pooled observations). Pooled time-series analyses showed synchronous fluctuation in child behaviour and maternal distress. Time-lagged models showed temporal relations between maternal and child outcomes that changed according to the type of maternal mood and child behaviour being reported.

Social transfers and the health status of mothers in Norway and Canada.

The unconditional health status of lone mothers is worse than that of married mothers in Canada but not in Norway. Even controlling for demographic characteristics and health behaviours in Canada, the health status of lone mothers is worse. Only after we control for income does the differential in health status between married and lone mothers in Canada disappear.

Antecedent-consequence conditions in maternal mood and child adjustment: a four-year cross-lagged study.

Examined the mutual influence on maternal depressive symptoms and child adjustment problems and their antecedent-consequence conditions across 3 cycles of panel data collected over a 4-year period in the National Longitudinal Survey of Children and Youth (NLSCY). Results indicated stability in, and relations between, maternal and child outcomes. Cross-lagged panel correlations showed that maternal depressive symptoms tended to precede child aggression and hyperactivity but tended to follow child emotional problems.