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Imprecision in terms used in the field of clinical what is the definition of food and nutrition may lead to misinterpretations among professionals. For this reason, the Spanish Society of Endocrinology and Nutrition SEEN promoted this document on the terms and definitions used in clinical artificial nutrition enteral and parenteralestablishing an agreement between Spanish experts of this specialty.
After a systematic literature review, 52 concepts were proposed. The coordinators included two additional concepts, and 57 were finally selected by the working group: 13 of a general nature, 30 referring to enteral nutrition and 14 to parenteral nutrition. The degree of agreement was subsequently determined using a two-round Delphi process. It what is the definition of food and nutrition finally ratified by consistency and concordance analysis. Fifty-four of the 57 terms had a very consistent agreement and were concordant.
Only three showed no concordance, of whom two were very consistent and one inconsistent. In conclusion, there was consensus in the definition of 54 basic terms in the practice of clinical nutrition. La imprecisión en la terminología dentro de la nutrición clínica puede acarrear malas interpretaciones entre los distintos profesionales. Por esta razón, la Sociedad Española de Endocrinología y Nutrición SEEN ha promovido la realización del presente trabajo, el primero sobre terminología y definiciones en nutrición artificial clínica enteral y parenteral publicado en castellano.
En una fase posterior se determinó el grado de acuerdo mediante un proceso Delphi de 2 circulaciones. En 54 de los 57 términos hubo un acuerdo muy consistente y resultaban concordantes. Solo 3 no presentaron concordancia, de los que 2 eran muy consistentes y uno inconsistente. Artificial nutrition is a relatively modern discipline undergoing continuous development. From its origins, this has been a multidisciplinary field involving professionals from different healthcare settings.
Daily practice in clinical nutrition in Spain makes use of a broad range of terms and concepts with different definitions. Their use is not homogeneous, however: depending on personal preferences, the professionals what is the definition of food and nutrition, or the geographical setting, a given term can have different meanings or connotations. Some of the concepts and terms, of direct Anglo-Saxon origin, can be used in different situations, giving rise to possible misunderstandings or even contradictions.
Terminological imprecision can pose serious problems in clinical practice; it therefore makes sense for attempts to be made to what is the definition of food and nutrition common criteria. However, as a prior step to the generation of clinical practice guides, diagnostic or treatment protocols, or documentation for communication with public health authorities, it is essential that a precise and unified definition of the terms most commonly used by the various professionals dedicated to clinical nutrition be established.
For this reason, the Spanish Society of Endocrinology and Nutrition Sociedad Española de Endocrinología y Nutrición [SEEN] has promoted the present study with the purpose of precisely defining the most common basic terms and concepts which refer to artificial nutrition enteral and parenteral. The what is the definition of food and nutrition was implemented between the months of April and Septemberwithin the setting of the activity carried out by the Nutrition Area of the SEEN.
The SEEN invited all the members of the nutrition working area to participate via e-mail. A total of 46 members were inscribed Annexin addition to the coordinators. A total of references were obtained. Reading of the abstracts identified publications referring to what is the definition of food and nutrition, concepts, definitions and classification in enteral and parenteral nutrition.
Following the review of these publications, we proposed the inclusion of 54 terms, classified into three sections: 11 corresponded to general aspects, 29 to enteral nutrition, and 14 to parenteral nutrition. The second phase involved circulating the pre-selected terms among those inscribed, for due review.
Even though the initiative was of a voluntary character, the responses of A total of 41 terms Thus, a total of 57 terms finally entered into discussion Tables 1—3. Degree of agreement, consistency and concordance of the selected clinical nutrition concepts: general aspects. Compliance with the simultaneous consistency criterion. Degree of agreement, consistency and concordance of the selected enteral nutrition concepts.
Degree of agreement, consistency and concordance of the selected parenteral nutrition concepts. The third phase of the study involved a two-round Delphi process to determine the degree of concordance with the proposed definitions. For this purpose a specific e-mail was generated, with the questionnaire being submitted via personal mail to the 48 inscribed members.
In this first round the members were required to score their degree of agreement by means of a Likert scale from 1 to 9, where 1 represents minimum concordance with the term definition and 9 represents maximum concordance. Those who answered the first questionnaire received the second round, including the median and interquartile range as an orientation to pre-agreement. Data analysis was performed using the statistical tools of Microsoft Excelwith calculation of the following values for the 57 terms: mean m and standard deviation SD ; median M and interquartile range IQRas well as what is the definition of food and nutrition coefficient of variation CV.
Concordance consistency was determined based on two criteria: 1. Of the 48 initially inscribed specialists in Endocrinology and Nutrition, 47 completed both Delphi rounds Annex. Their ages ranged between 30 and 60 years, with a mean of The specialists came from 38 hospital centers in all the Spanish Autonomous Communities, in both the public The degree of concordance and consistency are reported in Tables 1—3.
The 13 nutrition terms of a general character Table 1 showed a consistent or very consistent level of agreement, though in one case concordance was lacking. Of the 30 terms related to enteral nutrition Table 2only one showed a lack of concordance. Agreement was observed in the other cases. Of the 14 terms related to parenteral nutrition Table 3we identified an inconsistent level of agreement that likewise was not concordant. At the global level, the Spearman correlation coefficient was 0.
Over the last few years, as a result of the efforts of European and North American societies for nutrition, a number of introductions to clinical practice guides have been published, documenting the definitions of the terms used. To the best of our knowledge, this is the first publication in Spain seeking to establish a consensus regarding the definitions in Spanish of the most can bots be verified on tinder and common terms in clinical nutrition.
As can be seen from the tables, the what do you understand by symbiosis explain with an example class 7 included are in very common use. Their choice depended upon the systematic literature search for definitions and concepts, as well as on the publications and websites of the different societies for nutrition. Although not part of the Delphi method, we considered it very important to have a prior consultation with the experts on the suitability of the selected terms.
In this way, and in addition to establishing the definition of 13 terms, we were able to incorporate three new terms which referred to fiber. The successive submission of questionnaires reduces dispersion and helps define the general consensus. With regard to the consistency of the agreements, dispersion has been limited with what do you call someone who eats bugs to the central value, in order to establish unequivocal support of the affirmations.
We observed no relevant deviations with regard to the characteristics of the participating experts. On the basis of the Spearman correlation and p -value, we consider that there was adequate correlation between the two Delphi rounds. Furthermore, the Cronbach alpha confirmed the internal reliability of the questionnaire. Of the 57 selected terms and definitions, 54 showed very consistent agreement, and thus could be what are linear pair in math examples as defined.
Only three terms lacked agreement on their what is the definition of food and nutrition. The Delphi method does not allow us to determine the reasons for a lack of consensus, though some of the reasons can be intuited from the comments of the participants. What is the definition of food and nutrition, regulation regarding the financing of enteral nutrition love is a dangerous game meaning in Spain has probably modified this concept.
Many professionals use the term with reference to nutritionally complete formulas that are used as a supplement, always flavored and supplied in bottles, jars or in brik format. With regard to the definition of enteral formula with fiberwe consider that there was only limited agreement regarding the quantity contemplated in the definition. This is one of the terms that was modified by the contributions of the experts, since no upper or lower limit in quantity was initially defined.
The debate regarding the amount of fiber which enteral nutrition should supply has persisted for decades, with no drawing of firm conclusions. Not only the most adequate quantity of fiber but also the necessary type of fiber remains to be defined. In both cases the answer is probably dependent upon the clinical indication. On the other hand, it seems logical to assume that the quantity we should include in the definition must refer to the lower limit, since the presence of any amount of fiber whatever should not suffice to define the enteral nutrition formula as a formula with fiber.
The definition of a minimum quantity therefore remains pending. The reason why consensus was not reached regarding the term standard parenteral nutrition is probably related to the condition that it is not prepared in a laminar flow chamber. Perhaps its meaning should be similar to that of a standard enteral nutrition formula, referring to its composition, not its preparation. We should seek a term for those premanufactured parenteral nutrition formulas that do not require major changes in composition because they can be used in patients without nutritional complications or changing needs.
In conclusion, to the best of our knowledge, the present study is the first document to offer a definition in Spanish of the most commonly used terms in clinical artificial nutrition. We believe that it may become a starting document for the reaching of consensus with other scientific bodies involved in nutrition.
The authors state that they have no conflicts of interest. Quirónsalud Madrid ; del Olmo García, D. Términos, conceptos y definiciones en nutrición clínica artificial. Endocrinol Diabetes Nutr. Inicio Endocrinología, Diabetes y Nutrición English ed. Terms, concepts and definitions in clinical artificial nutrition. ISSN: Previous article Next article.
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