Background and aimsSeveral neuromotor disorders share exclusive, although often overlooked, nutritional problems. The objective of this study is therefore to delineate the frequency of malnutrition, evaluate the effectiveness of nutritional care, and identify issues needing to be possibly strengthened when caring for these patients into a general pediatrics department.Patients and methodsThe study included 30 patients, 21 males and 9 females, aged between 2 and 15 years, affected by cerebral palsy, epileptic encephalopathy, and severe psychomotor developmental delay.Nutritional status was assessed by a dietary questionnaire administered to parents to investigate feeding difficulties; 3 days food diary to quantify daily calorie intake; anthropometrical (weight, height/length, body mass index percentiles, plicometry, specific body segments measurement) and blood (blood count, serum iron, albumin, transferrin, calcium, phosphorus) parameters.ResultsMore than 44% individuals of the study population was at risk of malnutrition, according to feeding difficulties, progressive depletion of weight, reduced daily calorie intake, reduced albumin and transferrin levels. This occurred despite a massive caregivers commitment, as documented by almost universal parental constant assistance during their long-duration meals.ConclusionsOur results individuate the nutritional aspect being still a problem in the care of children with severe neuromotor disability.
SUMMARYA theoretical model is proposed to describe the evolution of damage in brittle materials, such as concrete and masonry, subjected to increasing or sustained stresses of relatively high intensity. The model is based on the introduction of suitable damage variables in a rheological model. In this way, it is possible to describe the material behaviour under stresses either increasing or constant in time. The capabilities of the model in describing the mechanical response of material elements subjected to different stress histories are illustrated. Some correlations with experimental data from tests performed on masonry and concrete specimens are presented, to assess the reliability of the theoretical predictions. The results of some numerical applications to non-proportional stress paths are also illustrated. Finally, the limitations of the proposal are discussed and possible further improvements are envisaged.
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