Dysphagia is a major problem in patients with neurologic disorders. Aspiration pneumonia and impaired nutritional status are consequences of dysphagia that result in high morbidity and mortality rates. Assessment and treatment of the dysphagic patient by a multidisciplinary team have been advocated but to date the effects of such an approach have not been demonstrated quantitatively. This prospective study was conducted to determine if a dysphagia program would improve patients' caloric intake and body weight, decrease the instances of aspiration pneumonia, or improve patients' feeding ability. Patients were referred from a 26 bed neurology/neurosurgery unit. A time series design was utilized. The control group consisted of 15 patients (mean age = 46.1 years), managed according to the existing ward routine. Subsequently, nursing staff attended a dysphagia training program. Following this, the treated group of 16 patients, (mean age = 49.3 years) was assessed by the dysphagia team, using bedside and videofluoroscopic examinations to determine the specific swallowing disorder. An individualized treatment program was designed for each patient. The groups were compared on the basis of deviation from their baseline weight, deviation from ideal energy intake, and the incidence of aspiration pneumonia. Statistical analysis revealed that the groups were comparable in age, number of days on the study, and Glasgow Coma Scale score; and that a significant weight gain and increase in caloric intake occurred in the treated group. No incidence of aspiration pneumonia was reported in either group. We speculate that this may have been influenced by the meticulousness of the care delivered in an acute unit as well as greater attention to prevention given in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

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Cirkulationsbegrebet markerer bl.a. et opgør med traditionelle videnskabshi- storiske positioner omkring videnshierarkier og -autoriteter, lineære sprednings- modeller og top-down-teorier, ligesom det åbner for analyser, der handler om meget andet end videnskabelig viden, og for analyser, der behandler viden som en alsidig og foranderlig størrelse. Det ser vi netop som styrken ved det videnshi- storiske felt. Svaret på spørgsmålet om cirkulationsbegrebet er et nyt nøglebegreb i historiefaget er ikke ligetil. Som beskrevet ovenfor, har cirkulationsbegrebet længe været en del af historiske undersøgelser inden for forskellige discipliner. Det som måske er nyt, er at begrebet er med til at styrke en tværfaglige indgang som i tilfældet med f.eks. boghistorie. Med temanummeret håber vi at vise, at et fokus på videnscirkulation kan føre til spændende analyser på tværs af mange forskellige perioder og emner. Rigtig god læselyst!

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