Search

Objectives: The objectives of this study were to examine the roles and needs of allied health professionals (AHPs) working in public healthcare settings in rural and regional Victoria, Australia in providing components of palliative care in their routine practice. Methods: A cross-sectional study was conducted between March and May 2023. Surveys were collected from AHPs working in public healthcare settings in the Loddon Mallee region of Victoria, Australia. Clinicians reported on the frequency of provision of care to patients with terminal illness, and their self-reported skill and confidence in providing interventions to patients with palliative care needs. Results: In total, 121 clinicians completed the survey. Almost every respondent reported they had provided care to patients with a terminal illness, with 41% of clinicians providing this care daily or weekly. The respondents were confident carrying out generalist interventions such as maintaining physical function but reported lower confidence in managing common symptoms of terminal illness such as loss of appetite, swallowing difficulties and changing communication needs. Two-thirds of respondents had not undertaken any training specific to palliative care, with many unaware of how to access palliative care-specific training. Conclusion: AHPs in rural and remote areas regularly provide care to patients with terminal illness. As the number of patients seen in non-specialist palliative care settings is likely to increase in rural and regional areas, the low self-reported confidence in providing common components of care, and the low uptake of palliative care-specific training must be addressed to ensure AHPs can provide high-quality care to people with terminal illness. What is known about the topic? Due to the increasing demand for palliative care services, this care is increasingly delivered by general non-specialist clinicians such as allied health professionals. What does this paper add? This study provides evidence for how often a surveyed population of allied health professionals in rural and regional Australia are providing care to people with a terminal illness, as well as their confidence, competence and learning needs. What are the implications for practitioners? High-quality care is needed at end-of-life, therefore rural and regional health services need to support allied health professionals to increase confidence and competence in providing palliative care. [ABSTRACT FROM AUTHOR]

Widowhood, in Indian society, is a dreaded condition of a woman after the death of her husband. It is an imposed performance that entails a set of ritualized practices and behavior to mark her transition to the state of a woman without. On many occasions, this state is ensured and maintained through multifarious rituals and practices, which range from restrictions on mobility, choices, and desires to injunctions on clothes, bodily demeanor, and food. This physio-social exercise of control and restraint alludes to a framework of religio-cultural discourse that renders widows as social and sexual non-beings. The present paper attempts to understand the state of widowhood through the analysis of two short stories in the collection, The Anger of Aubergines (1997) by Bulbul Sharma from the perspective of food. Food and eating, being the elementary aspects of everyday life, become important signifiers in studying the deprived state of widowhood. The paper intends to unpack the politics behind the imposition of a curriculum of gastronomic injunctions and food taboos on Hindu upper-caste widows. Further, the paper conceptualizes the appetite of widows as a subversive category not only in challenging the gender discourses behind their oppression but also in exonerating their status as desireless beings. [ABSTRACT FROM AUTHOR]

Background: Despite unclear evidence to support the long-term use of antipsychotics to treat challenging (problem) behaviours in people with autism in the absence of a psychiatric disorder, this practice is common. Methods: We conducted a systematic review and meta-analysis of all randomised controlled trials (RCTs) involving antipsychotics for people with autism of all ages, irrespective of the outcomes assessed. We searched seven databases and hand-searched ten relevant journals. Two authors independently screened titles, abstracts and full papers and extracted data using the Cochrane Handbook template. We conducted meta-analyses of outcomes and the rate of adverse events. Results: We included 39 papers based on 21 primary RCTs that recruited 1482 people with autism. No RCT assessed any psychiatric disorder outcome, such as psychoses or bipolar disorder. A meta-analysis of ten placebo-controlled RCTs showed a significantly improved Aberrant Behaviour Checklist-Irritability score in the antipsychotic group with an effect size of −6.45 [95% confidence interval (CI) −8.13 to −4.77] (low certainty). Pooled Clinical Global Impression data on 11 placebo-controlled RCTs showed an overall effect size of 0.84 (95% CI 0.48 to 1.21) (moderate certainty). There was a significantly higher risk of overall adverse effects (p = 0.003) and also weight gain (p < 0.00001), sedation (p < 0.00001) and increased appetite (p = 0.001) in the antipsychotic group. Conclusions: There is some evidence for risperidone and preliminary evidence for aripiprazole to significantly improve scores on some outcome measures among children with autism but not adults or for any other antipsychotics. There is a definite increased risk of antipsychotic-related different adverse effects. [ABSTRACT FROM AUTHOR]

A well-balanced metabolism means a lower risk for metabolism-related neuropsychiatric disorders. Leptin is a secretory adipokine involved in the central control of appetite that appears to play a role in the etiology of feeding-related disorders. Additionally, the influence of exercise on feeding behaviors potentially modulates the circulation of metabolites that signal through the central nervous system. In this systematic review, we collected the recent clinical evidence on the effect of exercise on leptin concentrations in health individuals published from 2000 to 20 September 2022, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA 2020 statement). Six hundred and thirty-eight papers were retrieved and forty-eight papers were included in the qualitative synthesis. Data supports that exercise positively influences appetite via enhancing peripheral and central leptin signaling (reuptake), especially during weight loss. Exercise modulation of leptin signaling through leptin receptors helps to stabilize increases in food intake during periods of negative energy balance, prior to a decrease in the body fat tissue content. At a high intensity, exercise appears to counteract leptin resistance. [ABSTRACT FROM AUTHOR]

Individuals experiencing obesity or overweight conditions frequently encounter difficulties in managing their appetite. The sustained practice of resistance training over an extended duration presents a potential avenue for regulating appetite among this demographic. Despite the extensive examination of long-term resistance training in existing literature, a consensus on pertinent issues remains elusive, necessitating a comprehensive review. This paper aims to evaluate empirical studies examining alterations in energy intake and appetite among obese or overweight individuals engaging in prolonged resistance training regimens. Information was gathered from databases including EBSCOhost, Science Direct, PubMed, and Web of Science. Search queries were executed on Google Scholar and other sources, utilizing key terms pertinent to energy intake (or appetite), resistance training, and overweight (or obesity) for identifying relevant studies. A comprehensive evaluation of 38 full-text articles was conducted, resulting in the inclusion of eight articles in the review. The PEDro scale was utilized to assess bias and completeness risk, with no exclusion of any articles during this process. The impact of resistance training on energy intake in overweight or obese individuals was observed through sessions lasting 35-45 minutes conducted twice a week over a nine-month period. The exercise significantly influenced parameters such as energy intake, glucose levels, leptin concentrations, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Neuropeptide Y (NPY), and adiponectin. However, no significant effects were noted on perceived fullness and hunger, ghrelin PP, or PYY. Resistance training has the potential to impact energy intake and appetite regulation in overweight or obese individuals. Further research is warranted, particularly in exploring its effects on female and adolescent populations, implementing a sample size calculation strategy, conducting comparisons across three intensities, and undertaking a comprehensive analysis of relevant variables. [ABSTRACT FROM AUTHOR]

Older patients are prone to multimorbidity or related polypharmacy, which may cause various adverse drug reactions (ADRs) and a high incidence of drug‐related health problems. Although not often noted, ADRs include nutrition‐related adverse reactions. Aging, multiple illnesses, mental and psychological problems, declining physical function, and environmental factors can lead to decreased food intake and increased metabolic stress in older people, resulting in energy imbalances that cause malnutrition. ADRs can lead to appetite loss, followed by decreased food intake, which in turn causes malnutrition and deficiencies of various nutrients. However, these nutrition‐related ADRs have received less attention. This review article describes drug–nutrition interactions, with a particular focus on older patients. Geriatr Gerontol Int 2023; 23: 465–477. Pharmacotherapy is a very important means of disease prevention and treatment for older patients. However, adverse drug reactions can have a significant negative impact on the health of older people. In this paper, the impact of drug therapy on nutritional status, dietary intake, the absorption and excretion of nutrients, and metabolism, with a focus on older people, is reviewed. [ABSTRACT FROM AUTHOR]

Variants of the melanocortin-4 receptor (MC4R) gene are the most common cause of monogenic obesity. It has been shown that, while obesity cannot be controlled with diet and exercise, glucagon-like-peptide-1 receptor agonists (GLP-1 RA) provide weight loss in the short term. In this paper, our experience with liraglutide treatment in an adolescent patient carrying a MC4R gene variant is presented. A female patient was admitted first at the age of 12.5 years with a complaint of progressive weight gain. She had marked excess of appetite since infancy. On physical examination of the pubertal female patient with a body mass index (BMI) of 36.1 kg/m2 (3.48 standard deviation score), there was no pathological finding except diffuse acanthosis nigricans. Laboratory examinations revealed only insulin resistance. Weight loss was not achieved with lifestyle changes, metformin and orlistat treatments. On genetic examination, a sporadic heterozygous c.206T>G(p.I69R) variant that had been reported previously, was found in MC4R gene. Treatment with the GLP-1 RA, liraglutide, was initiated and a 19.2% reduction was achieved in the body weight and BMI at the end of 32 weeks. However, the patient, whose treatment compliance was disrupted due to significant gastrointestinal complaints, returned to her former weight within a few months (13 weeks) after treatment was stopped. In this case with a known pathogenic variant in MC4R gene, decrease of appetite and weight loss were achieved with liraglutide treatment, but side-effects of this treatment led to discontinuation of therapy. In such cases, there is need for effective and tolerable treatment options. [ABSTRACT FROM AUTHOR]

Weight gain and metabolic disturbances are frequent in people treated with second generation antipsychotics (SGA). We aimed to investigate the effect of SGAs on eating behaviors, cognitions and emotions, as a possible contributor to this adverse effect. A systematic review and a meta-analysis were conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Original articles measuring outcomes relating to eating cognitions, behaviours and emotions, during treatment with SGAs were included in this review. A total of 92 papers with 11,274 participants were included from three scientific databases (PubMed, Web of Science and PsycInfo). Results were synthesized descriptively except for the continuous data where meta-analyses were performed and for the binary data where odds ratios were calculated. Hunger was increased in participants treated with SGAs with an odds ratio for appetite increase of 1.51 (95% CI [1.04, 1.97]; z = 6.40; p < 0.001). Compared to controls, our results showed that craving for fat and carbohydrates are the highest among other craving subscales. There was a small increase in dietary disinhibition (SMD = 0.40) and restrained eating (SMD = 0.43) in participants treated with SGAs compared to controls and substantial heterogeneity across studies reporting these eating traits. There were few studies examining other eating-related outcomes such as food addiction, satiety, fullness, caloric intake and dietary quality and habits. Understanding the mechanisms associated with appetite and eating-related psychopathology changes in patients treated with antipsychotics is needed to reliably inform the development of effective preventative strategies. [ABSTRACT FROM AUTHOR]

Melanocortin 3 receptor (MC3R) is a G-protein coupled receptor which has been defined mostly as a regulator of the appetite/hunger balance mechanisms to date. In addition to its function regarding the weight gain and appetite control mechanisms of MC3R, recent studies have shown that MC3R controls growth, puberty, and circadian rhythms as well. Despite the drastic effects of MC3R deficiency in humans and other mammals, its cellular mechanisms are still under investigation. In this review paper, we aimed to point out the importance of MC3R regulations in three main areas: 1) its impact on weight and appetite control, 2) its role in the control of growth, puberty, and the circadian rhythm, and, 3) its protein-protein interactions and cellular mechanisms. [ABSTRACT FROM AUTHOR]

Obesity is a global health problem. In the past decades, the prevalence rate of obesity has risen sharply in epidemiology. Obesity has become an increasingly severe epidemic burden linked with different kinds of diseases, consisting of cardiovascular disease, diabetes, metabolic associated fatty liver disease, and even in COVID-19. Beneficial flavonoids in foods, as functional ingredients, combat obesity and maintain energy balance through multiple mechanisms. This review provides a brief overview of biological targets, possible mechanisms and the current therapeutic interventions including suppressing appetite, increasing energy consumption, regulating gut microbiota, inhibiting adipogenesis, anti-inflammation. In vitro and in vivo experiments as well as available clinical evidence related to the anti-obesity effects of pure flavonoid and flavonoid-rich extracts are also summarized and depicted. Furthermore, the metabolism and bioavailability of flavonoids are also concluded and discussed. Beneficial flavonoids have become promising candidates for treating and avoiding obesity, but poor bioavailability and short elimination half-life affects the absorption and efficacy. This paper reviews the different types of flavonoids and their potential effect of preventing obesity, which provide the basis for further research. [ABSTRACT FROM AUTHOR]

To fully understand the causes and mechanisms involved in overeating and obesity, measures of both cognitive and physiological determinants of eating behavior need to be integrated. Effectively synchronizing behavioral measures such as meal micro-structure (e.g., eating speed), cognitive processing of sensory stimuli, and metabolic parameters, can be complex. However, this step is central to understanding the impact of food interventions on body weight. In this paper, we provide an overview of the existing gaps in eating behavior research and describe the development and validation of a new methodological platform to address some of these issues. As part of a controlled trial, 76 men and women self-served and consumed food from a buffet, using a portion-control plate with visual stimuli for appropriate amounts of main food groups, or a conventional plate, on two different days, in a random order. In both sessions participants completed behavioral and cognitive tests using a novel methodological platform that measured gaze movement (as a proxy for visual attention), eating rate and bite size, memory for portion sizes, subjective appetite and portion-size perceptions. In a sub-sample of women, hormonal secretion in response to the meal was also measured. The novel platform showed a significant improvement in meal micro-structure measures from published data (13 vs. 33% failure rate) and high comparability between an automated gaze mapping protocol vs. manual coding for eye-tracking studies involving an eating test (ICC between methods 0.85; 90% CI 0.74, 0.92). This trial was registered at Clinical Trials.gov with Identifier NCT03610776. [ABSTRACT FROM AUTHOR]

Background: Understanding how symptoms of mood disorders vary over time in relation to each other is potentially valuable for diagnosis and predicting episodes of illness. In this paper, we characterize the degree of similarity of time series of different mood disorder symptoms.Methods: We collected 32,215 mood disorder symptom questionnaires, administered twice-daily over 18 months to (n = 19) subjects with rapidly cycling bipolar disorder and (n = 20) healthy control subjects, using visual analog scales to rate 11 sets of symptom severity ratings plus a control item. We used Dynamic Time Warping to calculate similarity ratings between all within-subject pairs of severity ratings followed by Exploratory Factor Analysis (EFA) to identify latent factors of symptom time series across all subjects.Results: Two latent factors were identified: one with depression and anxiety; and a second, with concentration, energy, irritability, fatigue, appetite, euphoria/elation and overall mood. Restlessness, racing thoughts, and the control item (daily hours of daylight) did not cluster with any of the others.Limitations: Limited sample size dictated that we pool bipolar and healthy patients and use an iterative EFA procedure.Conclusion: This analysis suggests that, in a pooled sample of individuals with bipolar disorder and in healthy controls, severity ratings of overall depression and overall anxiety vary jointly as one dynamic factor, while some but not all other DSM mood symptoms vary jointly along with overall mood rating as a second dynamic factor. Further investigation may determine if these findings can simplify subjective symptom reporting in mood-monitoring studies. [ABSTRACT FROM AUTHOR]

COVID-19 symptoms range from severe respiratory failure to mild anorexia, cough and smell and taste alterations, adversely impacting nutritional intake. The aim of this paper was to establish malnutrition risk, Nutrition Impact Symptoms (NIS) and associations with reduced oral intake. A retrospective observational cohort of all people testing positive for COVID-19 was conducted. Malnutrition risk, nutritional status, weight, reduced oral intake and NIS on and during admission were collected. Dietetic consultation frequency and mode were captured. Some 80% (48/60) of participants reported at least one NIS, and 58% (25/60) reported two or more. Most frequent reported symptoms were cough (60%), sore throat (35%) and reduced appetite (28%). Significant associations existed between ≥2 NIS (p=0.006), reduced appetite (p=0.000) and reduced oral intake, with 20% requiring ongoing nutrition support and consultation. High NIS prevalence confirms systematised nutrition support pathways are indicated through incorporation into standard care across the healthcare continuum, including community care. [ABSTRACT FROM AUTHOR]

• Meal-related memory inhibits eating in humans. • Amnesia is associated with overeating and impaired interoception in humans. • Research in rodents and humans implicates the hippocampus in these effects. • Obesity disrupts memory and hippocampal functioning in rodents and humans. • These effects of obesity may create a vicious cycle that perpetuates obesity. This paper reviews evidence demonstrating a bidirectional relationship between memory and eating in humans and rodents. In humans, amnesia is associated with impaired processing of hunger and satiety cues, disrupted memory of recent meals, and overconsumption. In healthy participants, meal-related memory limits subsequent ingestive behavior and obesity is associated with impaired memory and disturbances in the hippocampus. Evidence from rodents suggests that dorsal hippocampal neural activity contributes to the ability of meal-related memory to control future intake, that endocrine and neuropeptide systems act in the ventral hippocampus to provide cues regarding energy status and regulate learned aspects of eating, and that consumption of hypercaloric diets and obesity disrupt these processes. Collectively, this evidence indicates that diet-induced obesity may be caused and/or maintained, at least in part, by a vicious cycle wherein excess intake disrupts hippocampal functioning, which further increases intake. This perspective may advance our understanding of how the brain controls eating, the neural mechanisms that contribute to eating-related disorders, and identify how to treat diet-induced obesity. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have reported that dietary fibers such as polydextrose and maltodextrin can reduce food intake; however, the studies on the differences of this effect are insufficient. The purpose of this paper is to compare the effects of dietary fibers maltodextrin and polydextrose on alterations of short-term satiety, energy intake and postprandial blood glucose in healthy females. Design/methodology/approach: This study was designed as a randomized, crossover and double blind research. For this purpose, 21 healthy females consumed a milkshake containing 0 g (control), 15 g polydextrose (PDX) and 15 g maltodextrin (MDX), and an ad libitum lunch meal was served 150 min later. Subjective appetite scores (hunger, satiety, prospective food consumption and desire to eat) were measured using a visual analog scale. Appetite scores and blood glucose were measured before preload and once per 15 min after milkshake consumption. Findings: Visual analog scale scores showed that PDX had an improved effect on satiety and hunger feelings. Compared to the control, dietary fiber increased the Area Under Curve (AUC) scores of satiety (p < 0.001) and decreased the AUC scores of hunger (p < 0.001), prospective food consumption (p < 0.001) and desire to eat (p < 0.001). Energy intake during ad libitum meal was significantly lower in PDX (Control: 862 (54.3) Kcal versus PDX: 679 (35.4) Kcal and MDX: 780 (49.3) Kcal. Moreover, the blood glucose levels were significantly lower in MDX. Originality/value: This study conducted with healthy females demonstrated that PDX was more effective in inducing satiety during subsequent food intake, and that postprandial blood glucose were within more healthy levels in MDX. [ABSTRACT FROM AUTHOR]

Background: Appetite control has attracted many scientists' attention recently since it contributes to weight management and the prevention of further metabolic disorders. Many studies have been done to assess the effect of flaxseed on satiety perception but the results are controversial. The aim of this study is to review these studies comprehensively (PROSPERO: CRD42021265751). Methods: Related articles were searched in PubMed/Medline, Web of Science, Scopus, and Cochrane databases on June 2021. No limitation was imposed in the search strategy. The keywords for appetite were visual analog scale, appetite, desire to eat, satiation, satiety, hunger, fullness and for Flaxseed they were flax, flax*, linseed*, lignin*, Linseed Oil, flaxseed, ground flaxseed, flaxseed oil, and Linum usitatissimum. Results: Thirteen papers were eligible to be included in this systematic review. These studies were inconsistent in results and some of them found no significant effect of flaxseed on appetite. However, three studies revealed a significant reduction in hunger perception as well as appetite, two studies found a decreasing effect on prospective consumption and three other studies observed a positive significant effect on fullness and satiety. Conclusion: Although there is a limited number of papers related to the effect of flaxseed on appetite perception or its equivalent terms, the available studies can suggest the potential role of flaxseed in decreasing appetite and hunger. More well-designed clinical randomized trials are necessary to prove this relationship more precisely. [ABSTRACT FROM AUTHOR]