Background: This study aimed to assess malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria and Subjective Global Assessment (SGA) at baseline and determine the GLIM criteria that best predicted unplanned hospitalization in unintentional weight loss (UWL) outpatients.
Methods: A retrospective cohort study of 257 adult outpatients with UWL was performed. The GLIM criteria and SGA agreement were reported using Cohen’s kappa coefficient. Kaplan–Meier survival curves and adjusted Cox regression analyses were used for survival data. Logistic regression was used for the other correlation analysis.
Results: This study collected data from 257 patients for 2 years. Based on the GLIM criteria and SGA, malnutrition prevalence was 79.0% and 72.0%, respectively (k = 0.728, P < 0.001). Using SGA as a standard, GLIM had a sensitivity of 97.8%, a specificity of 69.4%, a positive predictive value of 89.2%, and a negative predictive value of 92.6%. Malnutrition was associated with higher rates of unplanned hospital admission independent of other prognostic factors (GLIM: hazard ratio (HR) 2.85, 95% confidence interval (CI): 1.22 to 6.68; SGA: HR 2.07, 95% CI: 1.13 to 3.79). Of the five GLIM criteria-related diagnostic combinations, disease burden or inflammation was the most important to predict unplanned hospital admission in multivariable analysis (HR 3.27, 95% CI: 2.03 to 5.28).
Conclusion: There was good agreement between the GLIM criteria and SGA. GLIM-defined malnutrition, as well as all five GLIM criteria-related diagnosis combinations, had the potential to predict unplanned hospital admissions in UWL outpatients within 2 years.
Keywords: Global Leadership Initiative on Malnutrition, Malnutrition Universal Screening Tool, Subjective Global Assessment, Body mass index, General practice

1. Patients with unintentional weight loss are very likely to progress to malnutrition
2. Unintentional weight loss is associated with adverse clinical outcomes, such as unplanned hospital admission
3. Unintentional weight loss caused by wasting disease was most likely to increase the incidence of unplanned hospitalization

Prior work conducted internationally has found that youth often are not involved and do not ask questions during medical visits. A pragmatic randomized controlled trial to test the effectiveness of an Attention-Deficit/Hyperactivity Disorder (ADHD) pre-visit video/question prompt list intervention to increase youth question-asking and provider education about ADHD during visits was conducted. Youth ages 11-17 years with ADHD were recruited from two pediatric clinics in rural U.S. counties and randomized. Intervention youth watched an 11-minute video that encouraged them to ask questions and completed a one-page ADHD question prompt list where they checked the questions that they wanted to ask their providers. One hundred and two youth participated; 32% were Black, 13% were Native American, 1% were Hispanic. Thirty-six percent were female. Youth in the intervention group were significantly more likely to ask their providers one or more questions about ADHD and its treatment than youth in the usual care group (40% compared to 12.5%, Pearson chi-square=9.8, p=0.002). Parents in the intervention group were not significantly more likely to ask questions about ADHD than parents in the usual care group (34.6% compared to 10.4%, Pearson chi-square=0.03, p=0.86). Providers were significantly more likely to educate youth in the intervention group about more non-medication treatments than youth in the usual care group (t-test=2.32, p=0.02). The intervention did not significantly increase visit length (14.7 minutes compared to 11.7 minutes, t-test=1.57, p=0.12). Providers were not significantly more likely to educate youth in the intervention group about school, relationships, or medications than youth in the usual care group. Youth are being followed for 6 months to examine how the intervention impacts school performance and ADHD symptoms. The intervention has the potential to improve ADHD management in rural practices as well as youth self-management. Further research should explore distal impacts on health, school success and relationships.

1. An ADHD question prompt list/video intervention increased youth question-asking during visits.
2. Providers were more likely to educate youth who received the intervention about non-medication treatments.
3. The parents of youth in the intervention group were not more likely to ask questions.

Background: Access to appropriate supports and services early in life has been shown to promote positive developmental outcomes for autistic children. However, significant challenges remain in the early identification of autism in general practice.

Objectives: As part of a cluster randomised control trial, this study examined and compared the perspectives and experiences of Australian general practitioners (GPs) in using a highly accurate developmental surveillance tool for autism from infancy to preschool (Social Attention and Communication Surveillance, SACS; JAMA Open 2022) via a digital program, with those using the usual care pathway.

Methods: A qualitative research methodology was utilised; all GPs from South-Western Sydney (NSW) and Melbourne (Victoria) who participated in the study were invited. Consenting GPs were interviewed over the phone/online or in person, which were audio-recorded, transcribed, and coded. An inductive interpretive approach was adopted, and data were analysed thematically.

Results: 23 GPs (NSW: n = 11; Victoria: n = 12) agreed to be interviewed, with data saturation reached. Nine major themes emerged: common enablers included the role of GPs in early identification and support, enhanced communication between professionals and relationship-building with patients, and access to standardised screening tools. Specific facilitators to the feasibility and acceptability of the program included having access to autism specific screening tools (e.g., SACS) to increase confidence, and the importance of GP participation in further research and education. Several practical and socio-economic barriers were identified, including limited knowledge and uptake of screening tools, supporting GPs in developmental/paediatrics training, streamlined screening processes, and funding and resources.

Conclusions: The study highlighted the beneficial usage of digital screening tools such as the SACS for developmental surveillance of autism from infancy to preschool. The need for practice and policy changes, including further training of GPs, and sufficient time and public healthcare funding to complete developmental surveillance, was highlighted.

At the conclusion of my presentation attendees will take away:
1. That developmental surveillance (screening) for autism from infancy to preschool is accurate and effective
2. That developmental surveillance for autism in general practice is feasible and acceptable with appropriate supports and resources in place
3. That further research in general practice, and education of family doctors in the early identification of autism, is wanted and needed

Background: Liberia is among the 37 countries that account for the estimated 85% of the global burden of stunting according to the World Bank. The 2019-2020 Liberia Demographic and Health Survey reported that 30% of children under 5 are stunted with 10% of them severely stunted. Though 55% of infants 0-5 months were exclusively breastfed, only 3% of children 6-23 months were fed with a minimum acceptable diet.
Methods:An appraisal of the burden of malnutrition in Liberia through observations at the ELWA hospital, Monrovia and a detailed literature review of current works was done.
Results: Protein Energy Malnutrition was worsened by the Liberian civil war followed by the 2014-2016 Ebola outbreak in the country. This has led to the impoverishment of most citizens with the children worst hit. There is a resultant rise in teenage pregnancy rates, high school drop-out and high illiteracy levels. The attendant poverty has affected food security and social protection. Though some NGOs provide fortified diet for malnourished children in ELWA Hospital, it is not adequate and cannot be sustained. There is need for advocacy and training of local women on how to prepare fortified diet using local resources.
Conclusion: There is the urgent need for increase advocacy and mass education to reduce teenage pregnancy through increase contraceptive use and good sexual and reproductive health practices. Increase maternal literacy on exclusive breastfeeding, adequate nutrition including use of local alternatives, child spacing and women empowerment. Policy makers must make effort to put in place measures that will improve access to quality education, reduce gender inequality and provide social support. The international community can also help by providing support to the government and people of Liberia to help improve child nutrition and reduce stunting and its sequelae.
Key Words: malnutrition, stunting, gender inequality, maternal literacy, Liberia

from my presentation it is expected that attendees will take away
1. adverse effect of national insecurity on the health of the citizens
2. there is need to care for the vulnerable group in the society
3. the role of the government in caring for the citizens at the grassroot can never be overemphasized.

Aim: To assess the health screening of newly enrolled undergraduate students at a public sector University, Karachi, Pakistan.
Content:
A cross sectional study was conducted on newly entered undergraduate students at Family Medicine clinic of a Public University. Out of 1403 students, 397 were male and 1006 were female. Mean age of the students was 19 years. 667 (47.5%) students had normal BMI while 216 (15.4%) students were underweight (15.4%), 203 (14.5) were overweight and 228 (16.3%) were obese. 665 (47.4%) students had no protection against Hepatitis B, 355 (25.3%) needed a booster dose and 367 (26.2%) had protected antibodies against Hepatitis B.
Goal: The study identified key health issues in newly enrolled undergraduate students which were addressed at the time of visit. Those with unprotected antibodies against Hepatitis B were advised vaccination accordingly. Students with BMI in the range of overweight and obesity were counseled in detail and advised for weight reduction.

1. health issues identified in newly enrolled undergraduate students
2. Protection against Hepatitis B antibodies for undergraduate students
3. Counseling for weight reduction.

Background
The first 1000 days of life – from conception to a child’s second birthday – is considered as most important to a child’s proper growth and development. Optimal nutrition is a major factor to achieving this. However, childhood malnutrition remains a huge challenge in sub-Saharan African countries like Nigeria where there is limited knowledge about malnutrition and its associated factors in children within this critical period of life. It is thus necessary to study and identify the factors linked to malnutrition among children within this period.
Objective
To describe the prevalence, pattern and factors associated with malnutrition in children below 2 years seen at the Sacred Heart Hospital, Abeokuta, , Nigeria.
Method
A cross-sectional study was conducted on on 214 children (aged 1 – 24 months) who attended the Pediatric Outpatient Department, selected by systematic random sampling method.. Data were collected using a pre-tested interviewer administered questionnaire and analyzed using SPSS version 22.
Results
The overall proportion of children with at least one form of malnutrition was 66.4%. The prevalence of stunting, wasting, underweight and overweight/obesity were 51.4%, 14.0%, 18.2% and 23.4% respectively. Malnutrition was significantly associated with child’s age, birth weight, gestational age at delivery (p < 0.05) and the father’s level of education. Furthermore, gestational age at delivery (preterm), child’s age group (1 – 6 months, 7 – 12 months and 13 – 18 months) and birth weight (less than 2.5 kg) were independent predictors of malnutrition in this study.
Conclusion
Routine use of simple anthropometric tools can help in early detection of different forms of malnutrition in young children, thus allowing for early intervention and prevention of negative consequences.

1. A lot of young African children are plagued with different forms of malnutrition.
2.There are many anthropometric tools to screen and make early diagnosis of these various forms of malnutrition.
3. There is a need to prioritize applicable interventions amongst the so many available in the literature.

Background. Timor Island is in East Nusa Tenggara Province, one of the poorest provinces in Indonesia. It has a high prevalence of stunting among children under-five. For most of the inhabitants, chewing beetle nuts is a need and becomes a habit to stimulate them to work. Roughly, it is not easy to find a good healthy tooth among those who chew it every day. On the other hand, healthy tooth plays a big contribution to the digestive system. It might be that among those who chew beetle-nut, This study aims to describe oral and dental health status.
Method. This is a cross-sectional study in a remote Timor Island among female high school students. They were measured for weight and height, followed by dental examinations. Weight and height were converted into body mass index and their z-scores as the standard of WHO.
Results. The students who participated in this study were 33 persons. Based on their height and weight, we found 51% of underweight and 81% were stunted, which indicated acute and chronic malnutrition, respectively. Among them, 12% had BMI less than the 5th percentile which means they were in acute on chronic conditions as a result of other diseases. We found 63% tooth decay, and 87% calculus, and half of them (54%) complained of a toothache. A high prevalence of undernutrition might have been an impact on dental health at the age when adult teeth should be strong. Tooth decay in the past might contribute to the nutritional status of the current situation.
Conclusion. We found a high prevalence of chronic malnutrition and tooth decay. They can be associated with each other. Nutrition intervention may have a good impact on dental health. On the other hand, good teeth are needed to digest nutrition, so it would be absorbed optimally.

1. Tooth decay and malnutrition were high prevalence and might associate with each other
2. Early case findings of tooth decay may contribute to preventing malnutrition.
3. Malnutrition might contribute to tooth decay and should be interfered with earlier.

Not only has the incidence of Eating Disorders (ED) increased over the course of the pandemic but assessment diagnosis and management has fallen increasingly to GPs who are busier and less supported than ever . The introduction of Australia’s medicare ED treatment items in Nov 2020 with GP assessment and referral key, showed courage and prescience. Consequently GPs have become increasingly involved in the space through both interest and necessity and creative responses are needed to support them. As whole person carers with expertise in mind and body GPs can be the gateway to and coordinators of the specialised multidisciplinary care that is necessary to intervene early and to manage longitudinally and provide the right care at the right time in the right place.
This GP case presentation aims to illustrate the complexity and supports available for managing an adolescent with a recent onset of anorexia nervosa in any setting. It will contain reference to a locally developed and validated screening tool for both online and face to face use as well as innovative digital resources designed for primary care. Through the voice of the treating GP and lived experience family/carer advocates, it will demonstrate best practice collaborative care and explore the supports available to translate this information to other transdiagnostic ED presentations.
The goal is to demonstrate that managing EDs is just like managing hypertension, diabetes or depression and must be core business for GPs everywhere. Instituting acceptable screening, informed assessment and careful evidence based treatment options in a collaborative multidisciplinary setting will bring treatment to consumers and carers at a disease stage where treatment is likely to be more successful and cost effective with better outcomes.

1. Primary care assessment of eating disorder presentation
2. Outline resources for supporting GP, patient and family
3. Demonstrate best practice team care approach